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The goal of this article is to describe an integrated parallel process for the co-development of written and computable clinical practice guidelines (CPGs) to accelerate adoption and increase the impact of guideline recommendations in clinical practice. From February 2018 through December 2021, interdisciplinary work groups were formed after an initial Kaizen event and using expert consensus and available literature, produced a 12-phase integrated process (IP). The IP includes activities, resources, and iterative feedback loops for developing, implementing, disseminating, communicating, and evaluating CPGs. The IP incorporates guideline standards and informatics practices and clarifies how informaticians, implementers, health communicators, evaluators, and clinicians can help guideline developers throughout the development and implementation cycle to effectively co-develop written and computable guidelines. More efficient processes are essential to create actionable CPGs, disseminate and communicate recommendations to clinical end users, and evaluate CPG performance. Pilot testing is underway to determine how this IP expedites the implementation of CPGs into clinical practice and improves guideline uptake and health outcomes., (Copyright © The Authors 2023.)

This study assessed adults' perceptions toward preparedness to better inform emergency planning efforts for households and communities. The 2016 Styles , an Internet panel survey, was used to assess emergency preparedness competencies. Descriptive analyses were performed to describe the sociodemographic factors by preparedness status. Multivariable logistic regressions were used to examine the association between perceived preparedness and characteristics associated with preparedness attitudes, motivators, and barriers. Approximately 40% of adults surveyed reported that they were prepared for emergencies. The main motivator for those prepared was awareness of local disasters (38.9%), and a leading barrier was confusion about how to plan for the unknown (23.7%). Those prepared were more likely to have the right supplies (adjusted odds ratio [AOR] = 1.25, 95% confidence interval [CI] = [1.05, 1.50]), discuss emergency plans (AOR = 1.21, 95% CI = [1.02-1.42]), and act before an emergency occurred (AOR = 1.35, 95% CI = [1.15, 1.59]), compared with adults who did not report being prepared. Results from this research indicate that identifying motivation to prepare for emergencies can contribute to public health disaster planning. Preparation is a critical step that allows the community and its citizens to be more equipped to function during and after a disaster.

Global health security involves developing the infrastructure and capacity to protect the health of people and societies worldwide. The acceleration of global travel and trade poses greater opportunities for infectious diseases to emerge and spread. The International Health Regulations (IHR) were adopted in 2005 with the intent of proactively developing public health systems that could react to the spread of infectious disease and provide better containment. Various challenges delayed adherence to the IHR. The Global Health Security Agenda came about as an international collaborative effort, working multilaterally among governments and across sectors, seeking to implement the IHR and develop the capacities to prevent, detect, and respond to public health emergencies of international concern. When examining the recent West African Ebola epidemic as a case study for global health security, both strengths and weaknesses in the public health response are evident. The central role of public health surveillance is a lesson reiterated by Ebola. Through further implementation of the Global Health Security Agenda, identified gaps in surveillance can be filled and global health security strengthened.

The purpose of this study was to investigate the potential for temperature increase along the external root surface during ultrasonic post removal in a simulated clinical environment. Thirty-seven extracted teeth were decoronated, instrumented, and then obturated with gutta-percha and sealer. Post spaces were prepared, followed by cementation of stainless steel posts. A simulated clinical environment was created by using a polymethylmethacrylate sheet with holes custom fitted for the extracted teeth and then suspended over a heated water bath. Two thermocouples were attached at 6 and 12 mm from the top of the post along the external root surface. Teeth were divided into 3 test groups, no coolant, air-cooled, and water-cooled. Temperature changes were recorded by using a Vishay 5000 Strain Smart system. Results demonstrated that a significant difference existed in the average heat rates between the upper and lower thermocouples for no coolant and water-cooled groups at the medium setting and the air-cooled group at the high setting. The average heat rates were significantly different between the 2 thermocouples for all 3 groups when comparing the 2 ultrasonic power settings. Results indicated that the average heat rate was less for the water-cooled group when using a medium power setting.

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device. [ABSTRACT FROM AUTHOR]

Providing safe drinking water for the entire world's population is essential for ensuring sustainable development. The presence of harmful compounds in aquifers, majorly toxic elements, is a serious environmental concern around the globe. This research aimed to quantify for the initial period the amounts of toxic elements in freshwater in the Dehradun Industrial Region of Uttrakhand, India, as well as the associated health risks. The PTEs (potentially toxic elements) Fe, Cd, Mn, Cu, Cr and Pb, Zn, Ni is measured by AAS and compared to BIS and WHO requirements for drinking safety. The order of mean trace element values in all groundwater samples were determined as Fe > Zn > Cu > Ni > Co > Cd > Pb. HPI was discovered to be higher than high class during the research period (HPI > 30), but under the severe contamination criterion of 100. Iron's MI and PI values were consistently over the threshold limit during the research period, and certain toxic elements were discovered exceptionally near the threshold limit, indicating a severe future influence on groundwater quality. According to PCA (principal component analysis), CM (correlation matrix), and potential health hazard, maximum levels of toxic elements in groundwater in the Dehradun region are attributed to land use patterns, anthropogenic activity, industrial activity, fertilizer and pesticide leaching, and residential waste into the aquifer system. The findings of this study could aid local planners and policymakers in preventing health risks from contaminated aquifers through the deployment of suitable monitoring and mitigation measures. [ABSTRACT FROM AUTHOR]

Aim: An accurate working length (WL) estimation is fundamental to a successful endodontic therapy. The objective of this comparative in vitro research was to investigate the performance of iPex II and the Root ZX Mini electronic apex locators (EALs) in measuring root canal WL with different irrigant solutions and their relation to the electrical conductivity of irrigation solutions. Materials and Methods: Seventy sound permanent lower premolar teeth, each with a single root and developed apices, were used. Under an X15 stereomicroscope, the real working length was determined with the aid of a #10 file. After that, teeth were placed into an alginate model, and the iPex II and Root ZX Mini were used for the detection of electronic working length with various irrigants. Seventy teeth were randomly distributed into seven groups, 10 per each group (group I: dry canal; group II: distilled water; group III: ozonated water; group IV: 5% sodium hypochlorite (NaOCl); group V: 2% chlorhexidine, group VI: 17% ethylenediaminetetraacetic acid (EDTA) solution, and group VII: 17% EDTA gel). The difference in WL was calculated by deducting real working length from its electronic working length. The study also evaluates the electrical conductivity of the seven endodontic irrigant solutions. The two-way analysis of variance (ANOVA) test was used for statistical analysis. Results: Statistically, neither both types of EALs (P = 0.088) nor various irrigating solutions with varying electrical conductivities (P = 0.099) significantly affect the accuracy of EL estimation. Conclusions: There were no significant differences between the accuracy of the Root ZX Mini and the iPex II. The accuracy of both apex locators is unaffected in the presence of various irrigation solutions with varying electrical conductivities in this research. [ABSTRACT FROM AUTHOR]

The increasing frequency of zoonotic spillover events and viral mutations in low and middle-income countries presents a critical global health challenge. Contributing factors encompass cultural practices like bushmeat consumption, wildlife trade for traditional medicine, habitat disruption, and the encroachment of impoverished settlements onto natural habitats. The existing "vaccine gap" in many developing countries exacerbates the situation by allowing unchecked viral replication and the emergence of novel mutant viruses. Despite global health policies addressing the root causes of zoonotic disease emergence, there is a significant absence of concrete prevention-oriented initiatives, posing a potential risk to vulnerable populations. This article is targeted at policymakers, public health professionals, researchers, and global health stakeholders, particularly those engaged in zoonotic disease prevention and control in low and middle-income countries. The article underscores the importance of assessing potential zoonotic diseases at the animal-human interface and comprehending historical factors contributing to spillover events. To bridge policy gaps, comprehensive strategies are proposed that include education, collaborations, specialized task forces, environmental sampling, and the establishment of integrated diagnostic laboratories. These strategies advocate simplicity and unity, breaking down barriers, and placing humanity at the forefront of addressing global health challenges. Such a strategic and mental shift is crucial for constructing a more resilient and equitable world in the face of emerging zoonotic threats. [ABSTRACT FROM AUTHOR]

Access through porcelain restorations is a technically delicate and stressful procedure. Although this is a common dilemma in endodontics, little research has explored alternatives in cutting through porcelain. The purpose of this study was to compare the use of a carbide bur plus water, diamond bur plus water, and air abrasion to access through porcelain. All-ceramic samples were accessed using the different techniques. Samples were evaluated using two transillumination methods, white light, and fluorescent liquid penetrant described by the American Society for Testing and Materials. Edge chipping, microcracking, and catastrophic fracture of porcelain caused by the techniques were statistically compared. Fluorescent liquid penetrant was a more sensitive method for microcrack detection. There were significant differences between the preparation techniques. Air abrasion was significantly less destructive, and caused no catastrophic fractures, edge chipping or microcracks. Preparation by air abrasion took longer to complete.

Benzhydrolpiperidine (BZP) insecticides represent a novel class of chemistry. Their specificity and efficacy as well as their low mammalian toxicity give them excellent potential for commercialization. Several N-arylalkylbenzhydrolpiperidines were tested for activity against a variety of insects in the laboratory and greenhouse. These tests were used to select compounds for field trials and determine rates of application for field tests. The BZP compounds have good activity against Lepidoptera, with modest Coleoptera activity. They are toxic by oral administration and have about 100-fold lower activity by topical exposure. A methyl carbamate BZP, F4265, was the most active compound, with LC50 values of 6 mg litre(-1) or less for most Lepidopteran species tested. F4265 was active in a variety of field trials at 112-224gAI ha(-1). Whole-plant testing methods conducted in the greenhouse were effective in determining field test rates.

This study was conducted on 10 anterior and premolar teeth that were scheduled for endodontic treatment. After length of tooth determination, a series of test K-file handles were locked at lengths varying from 3 mm short to 0.5 mm long of the foramen. Samples of impedance were taken at each length with a digital signal processor at six different frequencies and for each of seven different irrigants or canal conditions. A total of five different root canal irrigants were used in each tooth (RC Prep, 70% isopropyl alcohol, 14.45% EDTA sodium solution, normal saline, and 5.25% NaOCl), along with two variations of a dry canal. The greatest impedance changes occurred +/- 0.25 mm from the foramen. No significant difference was noted in prediction error at different frequencies (p > 0.05); however, prediction error was significant with respect to different irrigants (p < 0.02). Conductive irrigants demonstrated less change of electrical characteristics with length than nonconductive irrigants, thus allowing a greater prediction of file position in relation to the foramen using electrically nonconductive irrigants.

The ability of two instrumentation techniques to negotiate and enlarge small curved canals was com-compared radiographically. Fifty canals in extracted human molar teeth were instrumented by the progressive enlargement (PE) technique, a form of step-back preparation using standard K files, or by the balanced force (BF) technique using K files whose tips had been specially modified. By using drawings and projected radiographic images of the files, the position of the largest file used in the apical preparation, #30 or #35 for the PE technique and #45 for the BF technique, was compared with the position of a small file placed in the canal before instrumentation. The PE and BF techniques were equally capable of instrumenting small curved canals to their respective largest apical preparation sizes. However, at sizes equivalent to the largest apical preparation sizes used in the PE technique, the BF technique produced significantly less deviation from the center of the original canal.

Nurses' household preparedness is critical if they are to avoid role conflict and report for duty during an emergency. To date, the alignment between nurses' perceived and actual household preparedness remains under examined. Investigating one of these variables in isolation fails to consider that perceived and actual household preparedness must be high and aligned. If misaligned, vulnerabilities could surface during emergencies, like concerns about family safety, potentially impacting a nurse's commitment to duty during a crisis, or nurses may lack the actual preparedness to continue working long hours during an emergency. An online questionnaire was distributed to registered nurses in Ireland. The questionnaire was informed by a review of the literature and captured nurses' perceived and actual household preparedness, attitudes towards and exposure to a range of emergencies, and pertinent demographic characteristics. The results showed a relationship between how nurses view their household preparedness and their actual preparedness. Regression analyses indicate that while there is an overlap, the factors associated with how prepared nurses think they are and how prepared they are can differ. This means that strategies to boost actual preparedness may differ from those needed to boost perceived preparedness. This finding underscores the importance of psychosocial preparedness. Feeling prepared is crucial as it can influence how one responds in an emergency. Considering both the perceived and actual aspects of household preparedness can lead to a more effective response during emergencies. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate the knowledge, attitude, and practice (KAP) of endodontists in India for working length measurements using Apex locators. Methods: This study is an online questionnaire-based survey consisting of 24 questions in total, divided into five parts. The first part consisted of questions related to demographic details, the second part inquires about the tools and technology used for working length determination, and the remaining questions evaluate the KAP regarding the use of apex locators to determine working length (five questions each). Participants in the study were either pursuing or completed postgraduation in endodontics. A total of 257 responses were recorded; however, six participants were excluded due to incomplete submission. Thus, 251 responses were analyzed as descriptive analyses. Correlation analysis and Chi-square tests were performed to find any association between demographic variables and years of experience in practice with KAP of using apex locators by endodontists. Results: In this study, it was observed that the knowledge of the majority of endodontic practitioners was fair, with a positive attitude and practice of using apex locators. Knowledge of the study participants was significantly (P ≤ 0.05) associated with the good attitude and practice of the study participants. Furthermore, years of experience in practice have a positive association with the KAP of endodontists. Conclusion: It can be concluded that endodontists have better clinical acceptance, as they show positive attitudes and practices for using apex locators for working length determination. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of traditional and conservative endodontic access hole preparation on fracture resistance of chairside computer‐aided design and computer‐aided manufacturing (CAD‐CAM) lithium disilicate maxillary right central incisor crowns. Materials and methods: Fifty‐seven milled lithium disilicate maxillary right central incisor crowns were designed and fabricated with a chairside CAD‐CAM system (Planmeca Romexis, Planmeca). The abutment preparation had a 1.0 mm incisal reduction and 1.0 mm chamfer finish. The restorations were bonded with resin cement to printed resin dies (n = 19 per group) and were treated and divided into three groups, (1) no endodontic access, (2) traditional triangular endodontic access, and (3) conservative ovoidal endodontic access. The endodontic access of the crowns was sealed with flowable resin composite. Restorations were subjected to 10,000 cycles of thermal cycling between 5° and 55°C. Then, restorations were loaded and exposed to compressive loading force, and the crack initiation (CI) and complete fracture (CF) were recorded. SEM micrographs of broken specimens on the printed dies were captured. ANOVA test and Bonferroni's correction were used for statistical comparison. Results: The fracture resistance among the three groups varied. Crowns with no endodontic access displayed significantly (p < 0.001) higher resistance [CI: 1025 (121) N; CF 1134 (127) N], followed by crowns with conservative ovoidal endodontic access [CI: 924 (60) N; CF: 1000 (72) N. Crowns with traditional triangular endodontic access showed the significantly (p < 0.001) lowest fracture resistance [CI: 635 (82) N; CF: 709 (75) N]. Conclusion: The fracture resistance of chairside CAD‐CAM lithium disilicate maxillary anterior crowns is influenced by the type of endodontic access provided. Conservative ovoidal endodontic access provides crowns with higher fracture resistance than traditional triangular endodontic access. Crowns with no endodontic access provided the highest resistance than other types of endodontic access. [ABSTRACT FROM AUTHOR]

Aim: To estimate the working length of teeth using conventional tactile technique, radiovisiography technique, Apex locator, and confirmation of working length by cone beam computed tomography technique. Materials and Methods: Forty patients with the age group between 20 and 50 years with irreversible pulpitis were included in this study. After taking a preoperative radiograph, the procedure was started. The cavity wall buildup was done using composite in the cases needed and then rubber dam application was done. The working length of mesiobuccal and mesiolingual canal was taken using cone beam computed tomography and this was considered as the standard value. Then using tactile method, length of the canal was measured using radiovisiographic software followed by apexlocator. Result: The Apex locator has showed best result as compared to tactile and radiovisiography. Conclusion: Apex locator values were closest to cone beam computed tomography working length measurement values and electronic apexlocator can be used efficiently as an alternative method for working length determination. The quality of various techniques according to ranks of working length determination was found to be Cone beam computed tomography (CBCT) > Apexloc > Radiovisiography (RVG) > Tactile. Thus, Apex locator can be used as an alternative to cone beam computed tomography for working length determination. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Surgery & Clinical Research is the property of Master Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Various taper file systems are available and it is considered that by reduction in taper of the preparation might reduce the chances of fracture. Therefore, this study is performed. Objective: To assess the influence of different taper of root canal preparation on the fracture resistance of endodontically treated mandibular premolars. Material And Methods: Twenty extracted mandibular premolars with single canals were selected and randomly divided into two groups (n = 20). In group 1 (n = 10) canals were prepared with 4 % taper. In group 2 (n = 10) canals were prepared with 6 % taper, with apical diameter 25 using Hyflex CM file system. Irrigation was done with 5.25% NaOCl, EDTA and saline. Obturation was done with Gutta-percha using single cone obturation technique followed by restoration of access cavity with resin composite. Teeth were mounted in acrylic resin and fracture resistance was checked using UTM, data examined statistically. Result: Significant difference was registered between 4% taper (269.6 N) and 6% taper (249.3 N) of root canal preparation regarding the fracture resistance of premolars tested (p =0.005). Conclusion: It can be concluded that, minimizing the taper of the preparation, fracture resistance increases by preserving the amount of tooth structure loss during root canal treatment. [ABSTRACT FROM AUTHOR]

Vertical root fracture presents a diagnostic problem, and treatment is not usually successful. This case report demonstrates use of calcium hydroxide paste to induce healing of fractured roots. Glass-ionomer cement was used as a root canal sealer and then condensed into the root canals to bind the segments together. [ABSTRACT FROM AUTHOR]

Copyright of Revista Estomatología is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study is to comparatively evaluate the fracture resistance of root canals obturated with 3 different obturating systems in endodontically treated teeth to find the effect of cold lateral condensation, Thermafil obturation and Downpack backfill obturation technique on the fracture resistance of endodontically treated teeth.60 freshly extracted single-rooted lower central incisor were divided based on type of obturation done into control groups (n = 12) where Group I (n = 12): Negative control group; teeth were neither instrumented nor obturated. Group II (n = 12): Positive group; only instrumentation, no obturation was performed and experimental groups (n = 12) where Group III (n = 12): Obturation using cold lateral compaction technique, Group IV (n = 12): Obturation using Thermafil obturation technique and Group V (n = 12): Obturation using Downpack backfill obturation technique. One way ANOVA and tukey's multiple comparisons were applied to test for evaluation of fracture resistance among all the groups. The results showed that group I had the highest fracture resistance among all the groups followed by group IV, group V, group III and lowest was seen in group II. In conclusion, Group I had the highest fracture resistance among all the groups. [ABSTRACT FROM AUTHOR]

Objective: To explore the long-term effects on discolouration by demeclocycline HCl (Ledermix, LED) or doxycycline hyclate (Doxymix, DOX) pastes placed in extracted human teeth over a 27-month period under different storage conditions. Methods: The canals in 38 teeth were prepared carefully, to minimize exposure to contamination from irrigants, then either LED (Lederle Pharmaceuticals, Germany) or DOX (Ozdent, Australia) were placed. Samples were stored in the dark for 3 months followed by daylight for 24 months. The storage conditions varied as follows: Group 1: Open access, dry storage (OD); Group 2: Closed access, dry storage (CD); Group 3: Open access, wet storage (OW); Group 4: Closed access, wet storage (n=4 for each material). Additional teeth were used as controls: Polyethylene glycol only in a closed canal; and saline only irrigation with LED paste in a closed canal. Standardised digital photographs were taken over 27 months and evaluated for changes in luminosity. Results: Darkening of tooth structure occurred in all LED groups and in the two DOX groups that were stored wet, during exposure to light, with a faster rate with LED. The most rapid staining occurred with LED in moist conditions with an open access cavity. The least staining occurred with DOX in samples stored dry. With prolonged exposure to light, a reversal in staining occurred with DOX at 3 months and LED at 9 months. Conclusion: Staining of tooth structure is influenced by the choice of medicament, and by exposure to moisture and air. Light has a bimodal effect, first driving staining, but later reversing it. This can be explained by different wavelengths of light causing photodegradation and photo-oxidation of tetracyclines and their complexes with tooth mineral. [ABSTRACT FROM AUTHOR]

The continuing demand for agrochemical insecticides that can meet increasing grower, environmental, consumer and regulatory requirements creates the need for the development of new solutions for managing crop pest insects. The development of resistance to the currently available insecticidal products adds another critical driver for new insecticidal active ingredients (AIs). One avenue to meeting these challenges is the creation of new classes of insecticidal molecules to act as starting points and prototypes stimulating further spectrum, efficacy and environmental impact refinements. A new class of insecticides is foreshadowed by the first molecule exemplifying that class (first‐in‐class, FIC) and offers one measure of innovation within the agrochemical industry. Most insecticides owe their discovery to competitor‐inspired (i.e. competitor patents/products) or next‐generation (follow‐on to a company's pre‐existing product) strategies. In contrast, FIC insecticides primarily emerge from a bioactive hypothesis approach, with the largest segment resulting from the exploration of new areas of chemistry/heterocycles and underexploited motifs. Natural products also play an important role in the discovery of FIC insecticides. Understanding the origins of these FIC compounds and the approaches used in their discovery can provide insights into successful strategies for future FIC insecticides. This review analyses information on historic and recently introduced FIC insecticides. Its main objective has been to identify the most successful discovery strategies for identifying new agrochemical solutions to meet the challenge of minimizing crop losses resulting from insects. © 2022 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Objective: To undertake a joint analysis of the influence of fracture width, dental thickness and distance of the fracture from the cortical bone on the radiographic diagnosis of vertical root fractures. Methods: Thirty-six uniradicular bovine teeth were endodontically treated and distributed into three groups according to the remaining root dentine thickness: 1.2 mm, 1.5 mm and 1.8 mm. Each group comprised 12 teeth, six with vertical root fracture and six without. Scanning electron microscopy (SEM) images of the fractured tooth groups were obtained and the fracture lines were measured. All specimens were inserted into bone defects created in bovine ribs, at different distances from the external cortical bone. Digital periapical radiographs were randomly evaluated by three blinded examiners (presence or absence of fractures). Results: The specificity for periapical radiography was found to be 89% and the accuracy rate was 57.4%. The mixed-model regression using the generalised estimating equation (GEE) model showed that the width of the fracture line and the thickness of the dental remnant play an important role in radiographic detection of vertical root fractures. There is a lower chance of correct diagnosis with fracture line widths < 0.2 mm (odds ratio [OR] 0.294, 95% confidence interval [CI] 0.103 to 0.836; P = 0.022) and tooth thicknesses < 1.2 mm (OR 0.342, 95% CI 0.157 to 0.747; P = 0.007). Conclusion: Fracture line widths < 0.2 mm and smaller root thicknesses lead to a less accurate diagnosis of vertical root fractures on periapical radiographs. [ABSTRACT FROM AUTHOR]

Copyright of Revista ADM is the property of Asociacion Dental Mexicana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vertical root fractures (VRF) are longitudinally orientated, complete or incomplete cracks that can occur on the tooth root at any level and usually initiate from the internal root canal wall. VRFs commonly occur in root canal-filled teeth and may result in the loss of the affected tooth. A PubMed search to April 2017 was completed using the key words "vertical root fractures", "endodontic treatment" and "root-filled teeth". Abstracts were read to identify relevant articles before retrieval. A search of reference lists identified further studies and 62 articles were selected. Diagnosis of VRFs can often be challenging. The combined use of history taking, periodontal probing and periapical radiographs is essential. The aetiology is multifaceted and includes predisposing factors such as tooth type, root canal morphology, and iatrogenic factors involving materials and devices used in root canal treatment and for post space preparation. Emerging risk factors such as implant-associated VRF have recently been identified. Prevention of VRF includes conservation of dentine during root canal instrumentation, appropriate choices of materials for preparation, irrigation and disinfection and avoiding excessive forces during lateral and vertical condensation of gutta-percha (GP). Cracks formed during root-end preparations in apical surgery may also lead to VRF, and teeth with the "butterfly effect" seem to be more at risk. Traditionally, treatment of VRFs has been tooth extraction. Alternative treatments such as bonding of separated root fragments followed by intentional replantation have gained some momentum. [ABSTRACT FROM AUTHOR]

Purpose: To present four different cases with a diagnosed cemental tear. The differences in aetiology, clinical diagnosis and treatment of cemental tears are described and discussed in order to provide guidance for clinical practice. Cases: Four patients of different ages presented with gingival swelling and other different complaints. Clinically, localised deep periodontal pockets and inflammation were noted on affected aspects in four cases. Radiographic examination revealed a prickly or flakey structure and bone loss on the affected side of the involved tooth. Different treatments, such as extraction, traditional periodontal initial therapy, periodontal flap surgery, or no clinical intervention were given based on different extents of tooth mobility and bone loss. In the first two cases, teeth with cemental tear were extracted due to poor prognosis. In case 3, deep pockets recovered to a normal condition, while cemental tears on the distal aspect of tooth 21 had no abnormal sensation or clinical symptoms. In case 4, a periapical radiograph showed distal bone loss was interrupted, and the tooth also recovered normal mobility. Histopathological evaluation of the specimens with H&E staining all resulted in a definitive diagnosis of cemental/cementodentinal tears. Conclusions: Cementodentinal or cemental tears are unique, localized, tooth-related factors associated with attachment loss. Aging, trauma and occlusal overload are the main aetiological factors. Early diagnosis and appropriate treatment will avoid unnecessary tooth extraction and result in a better prognosis. Detailed clinical and radiographic examinations as well as explorative surgery may help to make a diagnosis of cemental tears, but histopathological analysis is the only method for a definitive diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare the volume of removed dentin, transportation, and centering ability of TRUShape (TRS; Dentsply Tulsa Dental Specialties) system with ProTaper Next (PTN; Dentsply Maillefer) by using micro-computed tomography (μCT). Method and Materials: Twenty extracted human mandibular first molars with two separate mesial canals with curvatures of 25 to 35 degrees were divided into two experimental groups (n = 20) according to the rotary nickel-titanium file system used in canal instrumentation as follows: group TRS and group PTN. Canals were scanned before and after instrumentation using μCT to evaluate root canal transportation, centering ratio, and volumetric changes. Data of canal transportation and centering ratio values were analyzed using independent t test. Volume changes data were statistically analyzed using Mann-Whitney test. Statistical significance level was set at P < .05. Results: The PTN group had a significantly lower mean volume of removed dentin (2.09 ± 0.41 mm3) than the TRS group (2.77 ± 0.72 mm3) (P < .05). At the coronal level, there was no significant difference in canal transportation (P = .170) and centering ratio (P = .111) between TRS and PTN groups. However, at the apical and middle levels, the PTN group had a significantly lower mean transportation value and higher centering ratio than the TRS group (P < .05). Conclusion: Root canal preparation with the PTN system revealed better performance with fewer canal aberrations than the TRS system in curved root canals. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic has affected every country in many ways. Its substantial economic impacts are causing businesses to fade, pushing many nations into an economic downturn. This exposes organizations worldwide to unique risks which cannot be foreseen with conventional methods of risk analysis. This research is part of a broader action design research project conducted in collaboration with industry partner to answer an important research question: How to extend PESTLE risk analysis model to assess pandemic preparedness? In this context, the health factor is added to extend the traditional PESTLE risk analysis model. Furthermore, the interdependence between PESTLE factors has also been investigated, which has not been discussed before. The contribution of this research is the novel PESTLE+ risk analysis model that will help individuals and businesses to improve their understanding of the health crisis, such as the COVID‐19, adjust accordingly and eventually endure the ongoing crisis, which is driving most businesses into liquidation. [ABSTRACT FROM AUTHOR]

Minimally invasive endodontics (MIE) aims to preserve the maximum of tooth structure during root canal therapy. In the last 15 years there has been rapid progress and development in endodontics, making treatment procedures safer, more accurate, and more efficient. Meanwhile, reproducible results can be achieved even in difficult root canal morphologies with severe or double curvatures. In addition to various material improvements, the implementation of the surgical microscope (SM) in endodontics is an important innovation, making it possible to optimize each step in the treatment protocol in terms of substance preservation. [ABSTRACT FROM AUTHOR]

Antimicrobial photodynamic therapy (aPDT) is a complementary therapeutic modality for periodontal and endodontic diseases, in which Gram-negative bacteria are directly involved. Currently, there are few evidences regarding the effects of aPDT on bacterial components such as lipopolysaccharide (LPS) and it would represent a major step forward in the clinical use of this therapy. In this context, this study aimed to evaluate the efficacy of different photosensitizers (PSs) used in aPDT in LPS inhibition. Four PSs were used in this study: methylene blue (MB), toluidine blue (TBO), new methylene blue (NMB), and curcumin (CUR). Different approaches to evaluate LPS interaction with PSs were used, such as spectrophotometry, Limulus amebocyte lysate (LAL) test, functional assays using mouse macrophages, and an in vivo model of LPS injection. Spectrophotometry showed that LPS decreased the absorbance of all PSs used, indicating interactions between the two species. LAL assay revealed significant differences in LPS concentrations upon pre-incubation with the different PSs. Interestingly, the inflammatory potential of LPS decreased after previous treatment with the four PSs, resulting in decreased secretion of inflammatory cytokines by macrophages. In vivo, pre-incubating curcumin with LPS prevented animals from undergoing septic shock within the established time. Using relevant models to study the inflammatory activity of LPS, we found that all PSs used in this work decreased LPS-induced inflammation, with a more striking effect observed for NMB and curcumin. These data advance the understanding of the mechanisms of LPS inhibition by PSs. [ABSTRACT FROM AUTHOR]

Background: Electronic reporting of integrated disease surveillance and response (eIDSR) was implemented in Adamawa and Yobe states, Northeastern Nigeria, as an innovative strategy to improve disease reporting. Its objectives were to improve the timeliness and completeness of IDSR reporting by health facilities, prompt identification of public health events, timely information sharing, and public health action. We evaluated the project to determine whether it met its set objectives.Method: We conducted a cross-sectional study to assess and document the lessons learned from the project. We reviewed the performance of the local government areas (LGAs) on timeliness and completeness of reporting, rumors identification, and reporting on the eIDSR and the traditional paper-based system using a checklist. Respondents were interviewed online on the relevance, efficiency, sustainability, project progress and effectiveness, the effectiveness of management, and potential impact and scalability of the strategy using structured questionnaires. Data were cleaned, analyzed, and presented as proportions using an MS Excel spreadsheet. Responses were also presented as direct quotes.Results: The number of health facilities reporting IDSR increased from 103 to 228 (117%) before and after implementation of the eIDSR respectively. The timeliness of reporting was 43% in the LGA compared to 73% in health facilities implementing eIDSR. The completeness of IDSR reports in the last 6 months before the evaluation was ≥85%. Of the 201 rumors identified and verified, 161 (80%) were from the eIDSR pilot sites. The majority of the stakeholders interviewed believed that eIDSR met its predetermined objectives for public health surveillance. The benefits of eIDSR included timely reporting and response to alerts and disease outbreaks, improved timeliness, and completeness of reporting, and supportive supervision to the operational levels. The strategy helped stakeholders to appreciate their roles in public health surveillance.Conclusion: The eIDSR has increased the number of health facilities reporting IDSR, enabled early identification, reporting, and verification of alerts, improved timeliness and completeness of reports, and supportive supervision of staff at the operational levels. It was well accepted by the stakeholder as a system that made reporting easy with the potential to improve the public health surveillance system in Nigeria. [ABSTRACT FROM AUTHOR]

Rapid detection and response to infectious disease outbreaks requires a robust surveillance system with a sufficient number of trained public health workforce personnel. The Frontline Field Epidemiology Training Program (Frontline) is a focused 3-month program targeting local ministries of health to strengthen local disease surveillance and reporting capacities. Limited literature exists on the impact of Frontline graduates on disease surveillance completeness and timeliness reporting. Using routinely collected Ministry of Health data, we mapped the distribution of graduates between 2014 and 2017 across 47 Kenyan counties. Completeness was defined as the proportion of complete reports received from health facilities in a county compared with the total number of health facilities in that county. Timeliness was defined as the proportion of health facilities submitting surveillance reports on time to the county. Using a panel analysis and controlling for county-fixed effects, we evaluated the relationship between the number of Frontline graduates and priority disease reporting of measles. We found that Frontline training was correlated with improved completeness and timeliness of weekly reporting for priority diseases. The number of Frontline graduates increased by 700%, from 57 graduates in 2014 to 456 graduates in 2017. The annual average rates of reporting completeness increased from 0.8% in 2014 to 55.1% in 2017. The annual average timeliness reporting rates increased from 0.1% in 2014 to 40.5% in 2017. These findings demonstrate how global health security implementation progress in workforce development may influence surveillance and disease reporting. [ABSTRACT FROM AUTHOR]

The ongoing advancement of materials and methods for root canal instrumentation is resulting in improved techniques with minimal variations to the canal morphology. One standard for assessment of the shaping quality of curved root canals is preparation-induced straightening of the canal. The aim of the study: To compare the effects of 2 Nickel-Titanium rotary systems, 2Shape (Micro-Mega, Besançon, France) and ProTaper Next (Dentsply, Sirona, Ballaigues, Switzerland), on maintaining the distobuccal canals curvature of extracted human maxillary molar teeth using periapical radiographs. Materials and methods: In this study a total of 26 distobuccal roots of upper maxillary molars were used and divided into 2 groups: Group 1 (n=13) root canals prepared with 2Shape system (TS1, TS2) (Micro-Mega, Besançon, France) and Group 2 (n=13) root canals prepared with ProTaper Next (X1, X2) (Dentsply, Sirona, Ballaigues, Switzerland). A buccolingual radiograph was taken for every sample before and after instrumentation in the same position, and the postoperative angle of curvature was measured with the Image J Software and the same principle of the method of Schneider. The post instrumentation curvature degree was subtracted from the pre instrumentation curvature degree and these results represented the degree of straightening. Result: P< 0.05 was significant for ProTaper Next and 2Shape. 2Shape respected better the curvature angulations than ProTaper Next. Conclusion: Selection of the instruments has an important influence on the respect of the root canal curvature angulations. [ABSTRACT FROM AUTHOR]

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Background: To compare the effect of ProTaper Next and One Shape rotary files on canal transportation and centering abilities in resin block with simulated curved canal. Methods: An in-vitro experimental study was carried out in Dental clinics. Sixty resin blocks (30 per group) having simulated curved canals prepared with ProTaper Next and One Shape and then filled with red and blue Indian ink, respectively. Photographs of resin blocks obtained using standardized manner were then transferred to the Adobe Photoshop 7.0. Centering abilities and amount of transportation were then calculated at coronal, middle and apical portion of canal for both the groups. Independent sample t-test was used to compare the transportation and centering ability of both file systems. Level of significance was kept at p-value ≤0.01. Results: One Shape file resulted in more canal transportation at all the levels (apical, middle and coronal part) as compared to ProTaper Next file, however, difference was not statistically significant (p-value >0.01). Statistically significant difference was noted at the apical third between these two rotary files with One Shape file showing more centered preparation as opposed to ProTaper Next file (p-value <0.01). Conclusion: One Shape file system had more centered canal preparations specifically at the apical region as compared to ProTaper Next. One Shape also lead to more canal transportation in comparison to ProTaper Next, however the difference was not statistically significant. [ABSTRACT FROM AUTHOR]