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Aims: Necroptosis is one of programmed death that may aggravate spinal cord injury (SCI). We aimed to investigate the effect and mechanism of exendin‐4 (EX‐4) on the recovery of motor function and necroptosis after SCI. Methods: The SD rats with left hemisection in the T10 spinal cord as SCI model were used. The behavior tests were measured within 4 weeks. The effects of EX‐4 on necroptosis‐associated proteins and autophagy flux were explored. In addition, the SHSY5Y cell model was introduced to explore the direct effect of EX‐4 on neurons. The effect of lysosome was explored using mTOR activator and AO staining. Results: EX‐4 could improve motor function and limb strength, promote the recovery of autophagy flux, and accelerate the degradation of necroptosis‐related protein at 3 d after injury in rats. EX‐4 reduced lysosome membrane permeability, promoted the recovery of lysosome function and autophagy flux, and accelerated the degradation of necroptosis‐related proteins by inhibiting the phosphorylation level of mTOR in the SHSY5Y cell model. Conclusion: Our results demonstrated that EX‐4 may improve motor function after SCI via inhibiting mTOR phosphorylation level and accelerating the degradation of necroptosis‐related proteins in neurons. Our findings may provide new therapeutic targets for clinical treatment after SCI. [ABSTRACT FROM AUTHOR]

The aim was to compare the effect of different endodontic surgical treatments on the stress distributions in dentin of a simulated first mandibular molar tooth using the finite element analysis method. Three surgical endodontic procedures (apical resection, root amputation, and hemisection) were simulated in a first mandibular molar. Biodentine or mineral-trioxide-aggregate was used to repair the surgery site in apical resection and root amputation models; the remaining root canal spaces were filled with gutta-percha. Access cavities were restored using resin composite. In hemisection model, root canal was filled with gutta-percha, and coronal restoration was finished with a monolithic zirconia crown. A sound tooth model was created as a control model. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Maximum von Mises stresses were evaluated in dentin near the surgery regions and the entire tooth. Apical resection/Biodentine and apical resection/mineral-trioxide-aggregate models generated maximum von Mises stresses of 39.001 MPa and 39.106 MPa, respectively. The recorded maximum von Mises stresses in root amputation models were 66.491 MPa for root amputation/Biodentine and 73.063 MPa for root amputation/mineral-trioxide-aggregate models. The highest maximum von Mises stress value among all models was observed in the hemisection model, measuring 138.87 MPa. Hemisection induced the highest von Mises stresses in dentin, followed by root amputation and apical resection. In apical resection, Biodentine and mineral-trioxide-aggregate did not show a significant difference in stress distribution. Biodentine in root amputation may lead to lower stresses compared to mineral-trioxide-aggregate. [ABSTRACT FROM AUTHOR]

This report presents the therapeutic approach and results of a case of impacted undeveloped double teeth using 3D simulation in a school-age child. A 10-year-old girl was referred to hospital for the evaluation and treatment of fully impacted premolar double teeth in the left maxillary area. After evaluation, the double teeth were surgically removed, hemisected, and replanted after modification. For accurate surgery, replicas were made of the double teeth using CBCT and a 3D printer, and several mock surgeries were performed. Although remarkable signs for clinical and radiologic pathology were not found at the 5-month follow-up, short root with infraocclusion was found at the 30-month follow-up. This treatment widened the treatment spectrum with modern diagnostic approaches and preparation in large double teeth in children. [ABSTRACT FROM AUTHOR]

Abstract Background Double teeth are dental anomalies that can lead to aesthetic and orthodontic problems. Case presentation This report discusses two cases involving the multidisciplinary management of permanent maxillary left lateral incisors fused with a supernumerary tooth in two girls aged 9 and 10. Following intraoral and radiographic examinations, one was diagnosed with fusion, and the other was diagnosed with concrescence. The crown of the fused incisor was separated using a burs and extracted intraorally. The concrescent incisor was separated along its length using a laser and intentionally replanted extraorally. After a 6-year follow-up, no pathological signs were observed in the fused incisor. However, after an 11-year follow-up, external resorption was observed in the concrescent incisor. Conclusions Both incisors remained asymptomatic throughout the observation period. This case report highlights two different and effective methods employed to preserve the natural function, form, and aesthetics of double incisors.

Background: Double teeth are dental anomalies that can lead to aesthetic and orthodontic problems. Case presentation: This report discusses two cases involving the multidisciplinary management of permanent maxillary left lateral incisors fused with a supernumerary tooth in two girls aged 9 and 10. Following intraoral and radiographic examinations, one was diagnosed with fusion, and the other was diagnosed with concrescence. The crown of the fused incisor was separated using a burs and extracted intraorally. The concrescent incisor was separated along its length using a laser and intentionally replanted extraorally. After a 6-year follow-up, no pathological signs were observed in the fused incisor. However, after an 11-year follow-up, external resorption was observed in the concrescent incisor. Conclusions: Both incisors remained asymptomatic throughout the observation period. This case report highlights two different and effective methods employed to preserve the natural function, form, and aesthetics of double incisors. [ABSTRACT FROM AUTHOR]

Large animal models of spinal cord injury may be useful tools in facilitating the development of translational therapies for spinal cord injury (SCI). Porcine models of SCI are of particular interest due to significant anatomic and physiologic similarities to humans. The similar size and functional organization of the porcine spinal cord, for instance, may facilitate more accurate evaluation of axonal regeneration across long distances that more closely resemble the realities of clinical SCI. Furthermore, the porcine cardiovascular system closely resembles that of humans, including at the level of the spinal cord vascular supply. These anatomic and physiologic similarities to humans not only enable more representative SCI models with the ability to accurately evaluate the translational potential of novel therapies, especially biologics, they also facilitate the collection of physiologic data to assess response to therapy in a setting similar to those used in the clinical management of SCI. This review summarizes the current landscape of porcine spinal cord injury research, including the available models, outcome measures, and the strengths, limitations, and alternatives to porcine models. As the number of investigational SCI therapies grow, porcine SCI models provide an attractive platform for the evaluation of promising treatments prior to clinical translation. [ABSTRACT FROM AUTHOR]

One of dentistry's primary objectives is the long-term maintenance of teeth. Hemisection may be the best line of action when only one root is decayed and the other one is intact. This case report outlines and depicts a situation in which the deteriorated terminal abutment was part of a cantilevered fixed prosthesis. Hemisection and prosthesis rehabilitation had successful outcomes. [ABSTRACT FROM AUTHOR]

Root resection procedures are indicated in the treatment of periodontal furcation involvement and root fractures in one of the roots of multirooted teeth. Their long-term prognosis is comparable to that of implants. The present article is a case report of root separation and removal of the mesial root along with crown in mandibular first molar which was successfully employed as a part of the oral rehabilitation procedure. [ABSTRACT FROM AUTHOR]

The first teeth to erupt in the oral cavity are the mandibular molars which are more prone to endodontic and periodontal involvement. This may lead to significant issues like an increase in pocket depth, furcation involvement, loss of clinical attachment and mobility of teeth ultimately resulting in tooth loss. Thus, it necessitates cautious oral hygiene measures. Advances in dentistry have led to treatment modalities for preserving teeth which were earlier indicated for extraction. Hence, periodontally compromised tooth with severe furcation involvement, which may not be amenable for regeneration, may be retained by bicuspidisation. Bicuspidisation is a surgical technique which involves separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually, followed by rehabilitation with fixed prosthesis of the individual segments. This not only eliminates furcation involvement but also facilitates effective oral hygiene maintenance. In the present case report, a 50-year-old male patient reported with the chief complaint of pain, sensitivity and food lodgement in left mandibular first molar. Clinical and radiographic examination revealed grade III furcation involvement, significant pocket depths, delayed electric pulp test response and bone loss in furcation area. Bicuspidisation was opted as the suitable treatment modality. Root canal treatment was done, followed by bicuspidisation and subsequent rehabilitation with novel prosthetic technique. The bicuspids were restored using combination of deep margin elevation, and non splinted Lithium Disilicate table-top restorations. Six month follow-up showed good healing of hard and soft tissues around the bicuspidized sections, which was indicative of a successful treatment outcome, and can be attributed to a careful case selection, choice of restorative materials and techniques as well as good oral hygiene compliance.

Procedural errors like separation of instrument, canal transportation have been the stumbling blocks for effective and perennial endodontic therapy. There are some distinct circumstances where tooth may be indicated for extraction after an endodontic treatment. In such conditions hemisection and root amputation are the modalities which can be exercised for saving the tooth. This case report presents the rehabilitation of a endodontically treated mandibular first molar in a 28 year old female patient who underwent hemisection procedure. A separated instrument in the root canal of mesial root was addressed during the procedure. After the hemisection the mesial portion of tooth was rehabilitated with specifically designed porcelain fused to metal fixed partial denture. This conservative treatment procedure aimed at preserving maximal original tooth structure and an alternative to extraction of the natural tooth. [ABSTRACT FROM AUTHOR]

Locomotion is controlled by spinal circuits that interact with supraspinal drives and sensory feedback from the limbs. These sensorimotor interactions are disrupted following spinal cord injury. The thoracic lateral hemisection represents an experimental model of an incomplete spinal cord injury, where connections between the brain and spinal cord are abolished on one side of the cord. To investigate the effects of such an injury on the operation of the spinal locomotor network, we used our computational model of cat locomotion recently published in eLife (Rybak et al., 2024) to investigate and predict changes in cycle and phase durations following a thoracic lateral hemisection during treadmill locomotion in tied-belt (equal left-right speeds) and split-belt (unequal left-right speeds) conditions. In our simulations, the "hemisection" was always applied to the right side. Based on our model, we hypothesized that following hemisection, the contralesional ("intact", left) side of the spinal network is mostly controlled by supraspinal drives, whereas the ipsilesional ("hemisected", right) side is mostly controlled by somatosensory feedback. We then compared the simulated results with those obtained during experiments in adult cats before and after a mid-thoracic lateral hemisection on the right side in the same locomotor conditions. Our experimental results confirmed many effects of hemisection on cat locomotion predicted by our simulations. We show that having the ipsilesional hindlimb step on the slow belt, but not the fast belt, during split-belt locomotion substantially reduces the effects of lateral hemisection. The model provides explanations for changes in temporal characteristics of hindlimb locomotion following hemisection based on altered interactions between spinal circuits, supraspinal drives, and somatosensory feedback., Competing Interests: Competing interests: The authors declare no competing interests.

The initial mechanical damage of a spinal cord injury (SCI) triggers a progressive secondary injury cascade, which is a complicated process integrating multiple systems and cells. It is crucial to explore the molecular and biological process alterations that occur after SCI for therapy development. The differences between the rostral and caudal regions around an SCI lesion have received little attention. Here, we analyzed the differentially expressed genes between rostral and caudal sites after injury to determine the biological processes in these two segments after SCI. We identified a set of differentially expressed genes, including Col3a1, Col1a1, Dcn, Fn1, Kcnk3, and Nrg1, between rostral and caudal regions at different time points following SCI. Functional enrichment analysis indicated that these genes were involved in response to mechanical stimulus, blood vessel development, and brain development. We then chose Col3a1, Col1a1, Dcn, Fn1, Kcnk3, and Nrg1 for quantitative real-time PCR and Fn1 for immunostaining validation. Our results indicate alterations in different biological events enriched in the rostral and caudal lesion areas, providing new insights into the pathology of SCI.

Large animal models of spinal cord injury may be useful tools in facilitating the development of translational therapies for spinal cord injury (SCI). Porcine models of SCI are of particular interest due to significant anatomic and physiologic similarities to humans. The similar size and functional organization of the porcine spinal cord, for instance, may facilitate more accurate evaluation of axonal regeneration across long distances that more closely resemble the realities of clinical SCI. Furthermore, the porcine cardiovascular system closely resembles that of humans, including at the level of the spinal cord vascular supply. These anatomic and physiologic similarities to humans not only enable more representative SCI models with the ability to accurately evaluate the translational potential of novel therapies, especially biologics, they also facilitate the collection of physiologic data to assess response to therapy in a setting similar to those used in the clinical management of SCI. This review summarizes the current landscape of porcine spinal cord injury research, including the available models, outcome measures, and the strengths, limitations, and alternatives to porcine models. As the number of investigational SCI therapies grow, porcine SCI models provide an attractive platform for the evaluation of promising treatments prior to clinical translation.

Primary teeth play a crucial role in functional, aesthetic and speech tasks. They are also responsible for maintaining the jaw space for successor permanent teeth. Thus, dentists should understand that extraction might be the easiest decision but not always the correct one, especially, in the case of multiple loss of primary molars. On the other hand, endodontic treatments should be accurately diagnosed - necrotic and irreversibly inflamed teeth - and performed with suitable dental tools and materials. Then it is important to provide a good sealing with a suitable final restoration. This case report discusses an approach for preserving a mandibular primary second molar which had a radiographic lesion in the mesial root and the furcation area with multiple loss of primary molars (before eruption of first permanent molar). This treatment was done by performing a root canal treatment (pulpectomy) just for the distal root and a hemisection procedure by extracting the mesial root, followed by applying SSC crown and space maintainer (band and loop). To conclude, this type of treatment should be temporary until the eruption of the first permanent molar and then changed to be a lingual arch appliance. Moreover, hemisection was a suitable alternative approach to extraction over 36 months of following up.

Hemisection denotes a procedure which saves the multi-rooted teeth by endodontic approach of the restorable half and deliberate excision of the compromised tooth structure, as opposed to extraction, that sacrifices the whole tooth. In the present case report, conventional root canal therapy of the root, to be saved, was performed, followed by hemisection of the affected root with the vertical cut method. When complete healing at the surgical site was observed, clinically and radiographically, fixed dental prosthesis was given. Radiographic success observed at recall visit indicated bone formation at the extraction site and the tooth was found to serve normal function. It was a conservative approach aiming to retain as much original tooth structure as possible against the option of extraction of the natural tooth.

Hemisection of a molar denotes the removal or separation of a root along with its accompanying part of crown. It is a suitable treatment option when caries or periodontal damage is restricted to one root while the other root is relatively healthy. Hemisection of the affected tooth helps to retain the tooth structure, surrounding alveolar bone, and may also facilitate the placement of a fixed prosthesis. This report describes the hemisection as a successful treatment option to save grossly carious mandibular first molars with or without periodontal involvement. With careful treatment planning and precise surgical management hemisection and prosthetic rehabilitation can yield promising results. Undesirable consequences of tooth loss were prevented in this way. [ABSTRACT FROM AUTHOR]

Hemisection is a procedure involving the removal of an untreatable root with an accompanied crown portion while saving the other healthy root with adequate bone support. This case report represents the treatment of 2nd mandibular molar with irretrievable and unable to bypass separated instruments in the mesiobuccal canal of the mesial root. After sectioning the tooth, mesial root with the crown portion was extracted, and the remaining part of the tooth was restored as a premolar. Restorative rehabilitation was done by cementing a three-unit metal ceramic bridge. The good outcomes of endodontic treatment and patient demand towards the conservation of tooth encouraged the procedure of hemisection. For the preservation of terminal mandibular molars with irretrievable and unable to bypass separated instruments, hemisection can be considered as an alternative treatment option our objective is to conserve terminal mandibular molar with adequate bone support as a replacement in this area is complex, time consuming, and costly.

The first teeth to erupt in the oral cavity are the mandibular molars which are more prone to endodontic and periodontal involvement. This may lead to significant issues like an increase in pocket depth, furcation involvement, loss of clinical attachment and mobility of teeth ultimately resulting in tooth loss. Thus, it necessitates cautious oral hygiene measures. Advances in dentistry have led to treatment modalities for preserving teeth which were earlier indicated for extraction. Hence, periodontally compromised tooth with severe furcation involvement, which may not be amenable for regeneration, may be retained by bicuspidisation. Bicuspidisation is a surgical technique which involves separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually, followed by rehabilitation with fixed prosthesis of the individual segments. This not only eliminates furcation involvement but also facilitates effective oral hygiene maintenance. In the present case report, a 50-yearold male patient reported with the chief complaint of pain, sensitivity and food lodgement in left mandibular first molar. Clinical and radiographic examination revealed grade III furcation involvement, significant pocket depths, delayed electric pulp test response and bone loss in furcation area. Bicuspidisation was opted as the suitable treatment modality. Root canal treatment was done, followed by bicuspidisation and subsequent rehabilitation with novel prosthetic technique. The bicuspids were restored using combination of deep margin elevation, and non splinted Lithium Disilicate table-top restorations. Six month follow-up showed good healing of hard and soft tissues around the bicuspidized sections, which was indicative of a successful treatment outcome, and can be attributed to a careful case selection, choice of restorative materials and techniques as well as good oral hygiene compliance. [ABSTRACT FROM AUTHOR]

With advances in dentistry as well as the increased patients' desire to retain their natural teeth, there is a paradigm shift from extraction to the preservation of teeth. Mandibular first molars are the primary occlusal load-bearing teeth, commonly extracted teeth due to dental caries and periodontal disease. Hemisection is a conservative alternative to retain a hopeless tooth. Following endodontic treatment and selective root removal, the remaining portion of the tooth is splinted to the adjacent teeth with a fixed partial denture prosthesis. The resorption of the alveolar ridge surrounding the extraction socket may complicate the subsequent prosthetic procedure. Hence, socket preservation technique evolved, which prevents such untoward changes in the extraction socket. This case report shows hemisection procedure in a grossly carious first mandibular right molar with furcation involvement of a healthy 40-year-old female patient followed by autologous platelet-rich fibrin placement in the extraction socket. One year follow-up showed little alveolar resorptive changes with better healing and function clinically.

Biomaterial bridging provides physical substrates to guide axonal growth across the lesion. To achieve efficient directional guidance, combinatory strategies using permissive matrix, cells and trophic factors are necessary. In the present study, we evaluated permissive effect of poly (acrylonitrile-co-vinyl chloride) guidance channels filled by different densities of laminin-precoated unidirectional polypropylene filaments combined with Schwann cells, and glial cell line-derived neurotrophic factor for axonal regeneration through a T10 hemisected spinal cord gap in adult rats. We found that channels with filaments significantly reduced the lesion cavity, astrocytic gliosis, and inflammatory responses at the graft-host boundaries. The laminin coated low density filament provided the most favorable directional guidance for axonal regeneration which was enhanced by co-grafting of Schwann cells and glial cell line-derived neurotrophic factor. These results demonstrate that the combinatorial strategy of filament-filled guiding scaffold, adhesive molecular laminin, Schwann cells, and glial cell line-derived neurotrophic factor, provides optimal topographical cues in stimulating directional axonal regeneration following spinal cord injury. This study was approved by Indiana University Institutional Animal Care and Use Committees (IACUC #:11011) on October 29, 2015.

The high incidence of persistent periapical infection in the lateral group of teeth is one of the problems of modern dentistry. The purpose of our study was to determine the reasons for preserving the periapical focus of infection after conservative treatment and to identify ways of solving this problem. The analysis of domestic and foreign literature on this subject is carried out. An original questionnaire for dentists was developed, according to which 127 doctors were interviewed. Also explored 187 intraoral radiographs of first and second molars of the mandible and presented three clinical observations. Due to the high frequencies in the region of one of the root mandibular molars localization of the pathological process, conservative and surgical therapy is method of elimination chronic periapical infection. The effectiveness of treatment depends not only on the qualifications of the doctor, but also on the patient’s responsible attitude to the recommendations, in particular to comply with their terms of prosthetics.

Background: Hemisection Is a procedure for amputation of roots and resection of teeth performed due to periodontal abnormalities involving bifurcation, abnormalities in one root, very deep gingival margin due to caries or fracture. Tooth extraction is a process of alveolar dental expenditure, where the teeth are no longer able to do the treatment again. After the extraction of one of the roots the tooth socket heals slowly. Some factors such as lack of blood supply, dehydration, exudate excess, or foreign bodies hamper socket healing. Silver Ion Water is liquid embedded with silver ion which is known to promote wound healing. This study utilizes silver ion water of 15 ppm concentrate. Purpose: To understand the process of wound healing after 1 root tooth extraction the water supply of silver ions Method: Marmot teeth removed, then the wound was given H2O2 for 3 days to make chronic inflammation. Samples were divided into 3 groups. Wounds of the control group were not given water silver ions, group 1 was given a silver ions water for 3 days, group 2 was given a silver ion water for 5 days. On day 8, the socket is cut and fabricated plate HPA. Results: The number of fibroblasts, chronic inflammatory cells, blood vessels of the control group was 64, 97, 22, group 1 was 84, 78, 31, group 2 was 119, 40, 45. Conclusion: Silver Ion Water shown to accelerate wound healing after one root extraction. [ABSTRACT FROM AUTHOR]

Hemisection denotes removal or separation of root with its accompanying crown portion of mandibular molars. It is one of the treatment options for preserving the remaining part of the molar having sound periodontium. Careful case selection is necessary for long-term success. The present case report demonstrates the successful management of hemisection of 36 with a fixed partial denture. [ABSTRACT FROM AUTHOR]

Successful propagation throughout the step cycle is contingent on adequate regulation of whole-limb stiffness by proprioceptive feedback. Following spinal cord injury (SCI), there are changes in the strength and organization of proprioceptive feedback that can result in altered joint stiffness. In this study, we measured changes in autogenic feedback of five hindlimb extensor muscles following chronic low thoracic lateral hemisection (LSH) in decerebrate cats. We present three features of the autogenic stretch reflex obtained using a mechanographic method. Stiffness was a measure of the resistance to stretch during the length change. The dynamic index documented the extent of adaptation or increase of the force response during the hold phase, and the impulse measured the integral of the response from initiation of a stretch to the return to the initial length. The changes took the form of variable and transient increases in the stiffness of vastus (VASTI) group, soleus (SOL), and flexor hallucis longus (FHL), and either increased (VASTI) or decreased adaptation (GAS and PLANT). The stiffness of the gastrocnemius group (GAS) was also variable over time but remained elevated at the final time point. An unexpected finding was that these effects were observed bilaterally. Potential reasons for this finding and possible sources of increased excitability to this muscle group are discussed. [ABSTRACT FROM AUTHOR]

The perio-endo lesions confront the clinician as far as diagnosis and prognosis of the affected teeth is concerned. Hemisection is the treatment choice for perio-endo lesions to preserve the remaining part of the molar having sound periodontium. It is a resection of periodontally involved root along with the associated crown portion. Prognosis and treatment of perio-endo lesions depend on the severity of bone loss, root trunk length, degree of root separation, curvature of root, ability to eradicate the osseous defect, and restorative and oral hygiene procedures. In this case report, root canal treatment and hemisection were successfully performed to treat advanced perio-endo lesions. By this way, natural tooth and surrounding structures were preserved and thereby cost was lesser than the other treatment alternatives.

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Hemisection is a procedure involving the removal of an untreatable root with an accompanied crown portion while saving the other healthy root with adequate bone support. This case report represents the treatment of 2nd mandibular molar with irretrievable and unable to bypass separated instruments in the mesiobuccal canal of the mesial root. After sectioning the tooth, mesial root with the crown portion was extracted, and the remaining part of the tooth was restored as a premolar. Restorative rehabilitation was done by cementing a three-unit metal ceramic bridge. The good outcomes of endodontic treatment and patient demand towards the conservation of tooth encouraged the procedure of hemisection. For the preservation of terminal mandibular molars with irretrievable and unable to bypass separated instruments, hemisection can be considered as an alternative treatment option our objective is to conserve terminal mandibular molar with adequate bone support as a replacement in this area is complex, time consuming, and costly. [ABSTRACT FROM AUTHOR]

Incomplete spinal cord injury is challenging to diagnose and treat. This overview of Brown-Séquard syndrome outlines key assessment and nursing considerations important to enhancing recovery outcomes. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D)-printed guides have been used in endodontics to prepare a conservative access, locate calcified or missing canals, and perform precisive osteotomy in apicoectomy. Here, we present the treatment of a fusion tooth by combining 3D printing technology and endodontic intervention in a 10-year-old patient. The bifid crown of a maxillary right lateral incisor #7 had caused esthetic concerns and malocclusion. Clinical and radiographic examinations showed that #7 is fused with a supernumerary tooth with 2 independent root canals. The fusion involved the entire crown and the coronal and middle roots. Because of financial constraints, a multidisciplinary approach involving endodontic, orthodontic, and prosthodontic treatment was excluded. We hemisectioned the tooth intraorally with a 3D-printed guide, extracted the supernumerary tooth, and transplanted tooth #7 to a position with improved esthetics and occlusion. A 3D-printed tooth replica was used to prepare the recipient site for autotransplantation. At the 6-month follow-up, tooth #7 was diagnosed with pulp necrosis and asymptomatic apical periodontitis. Root canal treatment of tooth #7 was completed, and osseous healing was observed 8 months later. The patient had no clinical symptoms and was satisfied with the outcome 14 months after hemisection and transplantation. The open space between teeth #7 and #8 was closed without orthodontic treatment. We present an alternative option to treat a fusion tooth in young patients who do not opt for other treatment options because of their stage of development or for socio-economic reasons. Techniques in modern endodontics, such as cone-beam computed tomographic imaging and 3D printing, should be adapted when it is beneficial to patients. [ABSTRACT FROM AUTHOR]

Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Manik et al.)

If left untreated, an inflammatory periodontal disease eventually leads to attachment loss. This may have an impact on a multi-rooted tooth's bifurcation or trifurcation. The division of a tooth with two roots into two distinct parts is known as hemisection.  Hemisection  is the term used to describe the removal or separation of a two-rooted tooth's root and crown, most likely a mandibular molar. Compared to other treatment options, hemi-sectioning the affected tooth can help preserve the tooth's structure and alveolar bone. Careful selection of cases is essential for the long-term success of the procedure. In this case report, in contrast to the more common option of extracting the natural tooth, a treatment option is discussed for molars with extensive decay that threatens tooth loss. Therefore, this option should be discussed with patients when deciding on a course of treatment, and it may be a good substitute for extraction and implant therapy, particularly in cases of advanced endo-perio lesions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khetan et al.)

Diagnosis and management of endo-perio lesions differ from those lesions of single causative factor. These present signs and symptoms, which cannot be easily attributed or accounted for, require more detailed examination and definitive treatment plan. The outcomes are not readily predictable as of lesions of single origin. Distinguishing the primary etiological factor and overlapping secondary clinical features require thorough knowledge and understanding of the pathology, anatomy, and microbiology with respect to the teeth involved. The primary and secondary etiological factors can have numerous variations and hence makes arriving at a definitive treatment plan complex. However systematic examination combined with relevant investigations always provides a correct direction toward optimum treatment plan. This article presents four cases of endo-perio lesions and their successful management by different treatment modalities.

With advances in dentistry as well as the increased patients' desire to retain their natural teeth, there is a paradigm shift from extraction to the preservation of teeth. Mandibular first molars are the primary occlusal load-bearing teeth, commonly extracted teeth due to dental caries and periodontal disease. Hemisection is a conservative alternative to retain a hopeless tooth. Following endodontic treatment and selective root removal, the remaining portion of the tooth is splinted to the adjacent teeth with a fixed partial denture prosthesis. The resorption of the alveolar ridge surrounding the extraction socket may complicate the subsequent prosthetic procedure. Hence, socket preservation technique evolved, which prevents such untoward changes in the extraction socket. This case report shows hemisection procedure in a grossly carious first mandibular right molar with furcation involvement of a healthy 40-year-old female patient followed by autologous platelet-rich fibrin placement in the extraction socket. One year follow-up showed little alveolar resorptive changes with better healing and function clinically. [ABSTRACT FROM AUTHOR]

The disciplines of endodontics and periodontics fuse when molars that have bifurcation or trifurcation involvements are treated with hemisection and radosection. Attempts to save parts of teeth go back 100 years or more, but it is the increased predictability of success of endodontic therapy and the increased sophistication of periodontal treatment that have given us the means to save molars with furcation problems that, otherwise, would be lost. When restorative dentistry has already been finished, and the retention of part of the tooth will extend the life of a crown or fixed partial denture, the patient certainly deserves the option of hemisection or root amputation rather than extraction. The aim of the study is to evaluate the knowledge, attitude and practice of hemisection and radisection among dentists. This survey is conducted among dental students and dental practitioners. A self administered questionnaire was made and circulated among the participants. The sample size was 132 and the questionnaire was circulated through online means. The data was obtained and the results were tabulated using excel and statistical analysis was done using SPSS software. From the survey, all dental practitioners (58) and interns (72) knew that there are procedures to save the tooth when furcation is involved; however interns (2) didn't know about such procedures, however Pearson's Chi square test was not significant (p>0.05). Dental practitioners (56) and interns (67) knew that mandibular molars commonly undergo hemisection, however the Pearson's Chi square test was not significant (p>0.05). From this study it can be concluded that both dental practitioners and interns had sufficient knowledge about hemisection and radisection. However only dental practitioners who are having experience and confidence have responded that they will be able to perform hemisection and radisection in their regular practice. It is always better to save and preserve natural tooth as much as possible and it is important to train the upcoming dental graduates in performing hemisection and radisection. [ABSTRACT FROM AUTHOR]

Incomplete spinal cord injury is challenging to diagnose and treat. This overview of Brown-Séquard syndrome outlines key assessment and nursing considerations important to enhancing recovery outcomes. [ABSTRACT FROM AUTHOR]

The perio-endo lesions confront the clinician as far as diagnosis and prognosis of the affected teeth is concerned. Hemisection is the treatment choice for perio-endo lesions to preserve the remaining part of the molar having sound periodontium. It is a resection of periodontally involved root along with the associated crown portion. Prognosis and treatment of perio-endo lesions depend on the severity of bone loss, root trunk length, degree of root separation, curvature of root, ability to eradicate the osseous defect, and restorative and oral hygiene procedures. In this case report, root canal treatment and hemisection were successfully performed to treat advanced perio-endo lesions. By this way, natural tooth and surrounding structures were preserved and thereby cost was lesser than the other treatment alternatives. [ABSTRACT FROM AUTHOR]

Transfer of information across a spinal lesion is required for many aspects of recovery across diverse motor systems. Our understanding of axonal plasticity and which subpopulations of neurons may contribute to bridging substrates following injury, however, remains relatively incomplete. Most recently, attention has been directed to propriospinal neurons (PSNs), with research suggesting that they are capable of bridging a spinal lesion in rodents. In the current study, subpopulations of both long (C5) and short (T6, T8) PSNs—as well as a supraspinal system, the rubrospinal tract (RST)—were assessed following low thoracic (T9) hemisection in the cat using the retrograde tracer Fluoro-Gold. Acutely, within 2 weeks post-hemisection, the numbers of short and long PSNs, as well as contralateral RST neurons, with axons crossing the lesion were significantly decreased relative to uninjured controls. This decrease persisted bilaterally and was permanent in the long PSNs and the contralateral red nucleus (RN). However, by 16 weeks post-hemisection, the numbers of ipsilesional and contralesional short PSNs bridging the lesion were significantly increased. Further, the number of contralesional contributing short PSNs was significantly greater in injured animals than in uninjured animals. A significant increase over uninjured numbers also was seen in the ipsilateral (non-axotomized) RN. These findings suggest that a novel substrate of undamaged axons, which normally terminates rostral to the lesion, grows past a thoracic lesion after injury. This rostral population represents a major component of the bridging substrate seen and may represent an important anatomical target for evolving rehabilitation approaches as a substrate capable of contributing to functional recovery. [ABSTRACT FROM AUTHOR]

Mandibular molar tooth function is important for cats, however, current veterinary dental practice is to extract teeth affected by even very small resorptive lesions. The aim of this article was to describe an attempt at salvaging mandibular molar teeth where the mesial root and associated crown remained unaffected by resorption. Three cats presented with localised resorption of the distal root of a mandibular molar tooth were treated by hemisection, extraction of the distal root and endodontic treatment of the mesial root. The oral function was maintained in all three cats with no clinical evidence of pain or further resorption at follow-up 10 months post treatment. One cat was also examined at 27 months post treatment, at which stage there was still no oral discomfort and the tooth appeared fine but there were radiographic signs suggestive of early apical resorption. Whilst longer term follow-up is required, it appears that hemisection may be an acceptable treatment for these localised resorptive lesions, at least for the short to medium term. [ABSTRACT FROM AUTHOR]

Hemisection surgery involves the premeditated amputation of one or more roots and its overlying coronal structure to facilitate partial tooth retention. This can be carried out in cases where a multi-rooted tooth may have its furcation area, or one or more of its roots severely affected by periodontal disease, caries or a periodontal-endodontic lesion. With appropriate case selection and pre-operative planning it is possible to attain good aesthetics, a friendly environment for the periodontium and a good long-term prognosis. This report outlines a technique whereby a hemisected tooth may be restored without compromising its positional relationship to its abutments and by minimising occlusal loading. [ABSTRACT FROM AUTHOR]

Mandibular first molars are the major standpoint for occlusion, and also have a wide peri-cemental area. Under specific conditions, hemisection of the tooth is indicated after an endodontic treatment. The following case report presents the hemisection of grossly carious, endodontically treated mandibular first molar, in a 23 year old female, followed by replacement of the mesial root with a single piece immediate loaded BCS (Bi-Cortical Screw) implant and a single unit porcelain fused to metal crown for the prosthetic rehabilitation of the remaining tooth structure, with the BCS implant providing strength and support to the weakened tooth structure. This procedure is an innovation in prosthetic rehabilitation of tooth structure left after hemisection and enhances the predictability of success rate of hemisection.

Hemisection is the separation of the whole tooth from the mesial to distal in the upper molars and premolars and from the buccal to lingual in the lower molars, and removal of the pathological root together with the crown. Hemisection is an appropriate treatment option when caries, resorption, iatrogenic complication or periodontal damage is limited to one root and the other root is relatively healthy. Hemisection of the affected tooth helps to preserve alveolar bone which surrounding the tooth structure and supports fixed dentures. Therefore, when a molar tooth should be extracted only because of damage at one root, hemisection or root amputation treatment alternatives should be kept in mind. This case series describes hemisection as a successful treatment method to recover teeth with iatrogenic complications and irretrievable root caries were limited to single root. [ABSTRACT FROM AUTHOR]

Background: Periodontal health is a prerequisite of successful comprehensive dentistry. To achieve the long-term therapeutic targets of comfort, good function, treatment predictability, longevity, and ease of restorative and maintenance care, active periodontal infection must be treated and controlled before the initiation of restorative dentistry. Periodontal treatment is undertaken to ensure the establishment of stable gingival margins before tooth preparation. Non-inflamed, healthy tissues are less likely to change as a result of subgingival restorative treatment or post-restoration periodontal care. Hence, certain measures should be taken for periodontally compromised abutments in fixed partial denture (FPD). Aim: The aim of the study was to create awareness on the management of periodontally compromised abutments in FPD. Materials and Methods: A self-administered questionnaire with 15 questions will be prepared and circulated among 100 undergraduates, postgraduates and practitioners from Saveetha Dental College and Hospitals. Level of confidence and awareness was rated according to the interns and practitioners knowledge and the capacity. Data collection and analysis will be done based on frequencies and percentage values using SPSS software. Results: Nearly 32% of participants say that prognosis of FPD in periodontally compromised abutments is compromised, 26% of participants say fair, 25% of participants say poor, and 16% of participants say good prognosis. 42% of participants answered that bone grafting can be done in periodontally compromised abutments, 13% of them does not practice bone grafting and 41% of them were not sure about it. Conclusion: In the present study, the awareness rate on the management of periodontally compromised abutments in FPD among 100 undergraduates, postgraduates, and practitioners was moderate, hence to improve more knowledge and awareness certain awareness programs, dental education programs should be undertaken. [ABSTRACT FROM AUTHOR]

Separation and removal of a root alongwith the overlying part of a multi-rooted tooth is called tooth hemisection. This procedure is mainly performed to conserve natural dentition as well as the teeth which would act as a key prosthetic abutment. After endodontic treatment, extracting the defective part, whether mesial or distal roots, and leaving the remaining sound roots is the main aim of hemisection. Though hemisection is well-recognized and described in several publications, restoration of the resected molar is still subject to discussion and investigation. Restoration should allow patients to maintain the extracted site, as well as the forces to be directed along the remaining roots. In this case report, advanced periodontal lesion extending to the apical part of the distal root was observed at the right mandibular first molar. Firstly, endodontic treatment was carried out, followed by periodontal treatment - including hemisection. The hemisected tooth was restored by fixed partial denture with premolars as abutments. Hemisection can be successful if a proper case selection is done. Success of hemisection depends on the quality and quantity of the bone around the remaining roots, on a proper prosthetic plan for orienting the forces along the remaining roots, as well as on an adequate maintenance. [ABSTRACT FROM AUTHOR]

A promising treatment strategy for spinal cord injury (SCI) is to reduce inhibition from chondroitin sulfate proteoglycans (CSPGs). For example, administering intracellular σ peptide (ISP) can improve the ability of axons to cross inhibitory CSPGs and improve function in rodent models of SCI. To translate such treatments into the clinic, we need robust and sensitive methods for studying rodent models. In this study, we applied a newly developed suite of quantitative gait analysis tools: gait analysis instrumentation and technology optimized for rodents (GAITOR), which consists of an arena and open-source software (AGATHA: automated gait analysis through hues and areas). We showed that GAITOR can be used to detect subtle functional improvements (measured by hindlimb duty factor imbalance) in rats following ISP administration in a T10 hemisection injury model. We demonstrated that SCI-specific parameters (right paw placement accuracy and phase dispersion) can be easily added to GAITOR to track recovery. We confirmed the gait observations via retrograde tracer uptake. We concluded that GAITOR is a powerful tool for measuring recovery after moderate/mild SCI, and could be used to replace expensive/inflexible commercially-available gait analysis techniques. [ABSTRACT FROM AUTHOR]