What ultimately matters in root canal treatment success and tooth preservation: a 25‐year cohort study

alexandrossfakianakis shared this article with you from Inoreader What ultimately matters in root canal treatment success and tooth preservation: a 25‐year cohort study via International Endodontic Journal Abstract Aim There are currently no prospective studies evaluating the long-term outcomes of non-surgical root canal treatments beyond 5 years, both in terms of treatment success and tooth preservation, and identifying factors predictive of treatment outcome. The aim of the present work was therefore to fill this gap by assessing these outcomes over time and identifying predictive variables based on a systematic data collection over a 25-year period. Methodology Data concerning the treatments (N=2500) were systematically collected since 1990. Information was recorded among clinical, technical, radiographic, patient-related characteristics, i.e. approximately 150 variables for each treatment. The data were analysed regarding both treatment success and tooth preservation by multivariable Cox proportional hazards model and survival curves were generated. Statistical significance level was set at 0.0125. Results 56.4% of the treatments could be followed over time (0−25y, mean=6.5y, median=5y). Survival probability decreased almost linearly for treatment success, with about 85% after 5 years and 60% after 20 years, and for tooth preservation, with about 90% at 5 years and 50% at 20 years. The variables significantly associated with treatment failure were: pre-operative pain (Hazard Ratio – HR=1.56 (95%CI 1.23−1.97), persistent pain (HR=2.63 (95%CI 1.44−4.80), good operator rating of treatment prognosis (HR=0.46 (95%CI 0.36−0.58), size of periapical bone radiolucency (HR=1.88 (95%CI 1.67−2.11), and tooth type (p=0.0006). For tooth extraction, they were: combined endodontic-periodontal lesion (HR=3.37 (95%CI 1.88−6.05), pre-existing complication before treatment (HR=1.67 (95%CI 1.26−2.21), good operator rating of treatment prognosis (HR=0.45 (95%CI 0.33−0.60), clinical failure of root canal treatment (HR=2.78 (95%CI 1.98−3.89) and tooth type (p=0.0012). Conclusion Root canal treatment success and tooth preservation on the arch are not static outcomes, but evolve with time. Among a substantial set of potential predictors, only a small proportion was significantly predictive of treatment success and tooth preservation, most of them being disease and patient characteristics, and not technical aspects, except pre-existing complications. These observations challenge the importance frequently given to byzantine considerations related to the numerous technical details of endodontic procedures, as opposed to general concepts of good clinical practice. View on Web

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Characteristics of Nasal Foreign Bodies and Equipment on Complications During Removal Procedures

alexandrossfakianakis shared this article with you from Inoreader Characteristics of Nasal Foreign Bodies and Equipment on Complications During Removal Procedures via The Laryngoscope This study aimed to clarify the equipment for the safe removal of nasal foreign bodies. Suction, paper clips, and cotton swabs were considered beneficial equipment for the safe removal of nasal foreign bodies because of minimizing complications and their high versatility. Objective The treatment of nasal foreign bodies involves safe and reliable removal. Few reports have investigated the relationship between equipment and the incidence of complications. Methods This retrospective study included 300 patients with nasal foreign bodies (average: 3.28 years, interquartile range: 2–4 years). Patients' background, characteristics of nasal foreign body, equipment to remove the nasal foreign body, and complications were obtained from medical records. Statistical analysis was performed using Pearson's chi-square test for associated factors and the incidence of epistaxis among the complications. Results Nasal foreign bodies were found and removed in 256 patients. Forceps, hooks, suction, modified paper clips, and cotton swabs were mainly used to remove the nasal foreign bodies. Epistaxis due to the removal procedure was observed in 26 patients. The occurrence of epistaxis differed depending on the equipment (p = 0.077) and was less frequent in suction and paper clips than in forceps (p < 0.05 and p = 0.077). Epistaxis was not observed when a cotton swab was used. Aspiration and septal perforation were not observed. A statistical relationship was not detected between the hardness of foreign bodies and the occurrence of epistaxis (p = 0.251). The incidence of epistaxis was higher in cases nasal foreign bodies remained for 1 day and over than in cases foreign bodies were removed within 1 day (p < 0.05). Conclusions This study revealed that suction, modified paper clips, and cotton swabs could be beneficial options for minimizing complications in the removal of nasal foreign bodies. Level of Evidence Level 4 Laryngoscope, 2023 View on Web

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Peri‐implantitis: A bibliometric network analysis of top 100 most‐cited research articles

alexandrossfakianakis shared this article with you from Inoreader Peri‐implantitis: A bibliometric network analysis of top 100 most‐cited research articles via Clinical Implant Dentistry and Related Research Abstract Background Over the past decades, there has been an increase in research publications focusing on peri-implantitis. When facing limited healthcare resources, bibliometric analyses can guide researchers and funding parties toward areas where reallocation or more focus on research activity is warranted. The main objective of this study was to identify the trends of the top 100 cited articles on peri-implantitis research as the first study of its kind. Methods A Web of Science search, using the keywords "peri-implantitis or periimplantitis" was built to create a database of the most-cited articles. Articles were ranked by citation count and screened by two independent reviewers. The bibliometric characteristics of the studies were gathered and analyzed using several bibliometric software. Author collaborations, author clusters, and keyword co-occurrence network analyses were also performed. The correlation between the citation count and the age of each article was tested. Results The top 100 cited papers were published from 1994 to 2018 and the total citation counts ranged from 119 to 972 with 244.5 citations/paper on average. There was no correlation between the age of the articles and the citation count (p-value = 0.67). 21% of the studies consisted of prospective clinical studies. 35% of the papers focused on treatment and prevention of peri-implantitis while 65% concerned epidemiology. The top three most prolific countries were Sweden (n = 31), Germany (n = 15), and Switzerland (n = 13). We found 12 authors who had greater than five publications on the list. Also, the most published journal was Clinical Oral Implants Research. Conclusion This study provides insight into the characteristics and quality of the most highly cited peri-implantitis literature. This revealed a deficiency in terms of the number of studies on treatment strategies as well as a higher level of evidence studies among the most- impactful papers on peri-implantitis at the moment. View on Web

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The potential of biophysiology for understanding motivation, engagement and learning experiences

alexandrossfakianakis shared this article with you from Inoreader The potential of biophysiology for understanding motivation, engagement and learning experiences via British Journal of Educational Psychology Abstract Background and Aims Integrative models applied to human learning and performance emphasize the joint operation of biological, psychological, social, and educational processes to fully understand human functioning. Educational psychology researchers have typically emphasized psycho-educational and psycho-social factors in motivation, engagement and learning, but do not often consider the biophysiological factors. Results This Editorial and Special Issue advances current understanding on the role of biophysiological factors and processes in students' and teachers' motivation, engagement, and learning experiences, by showcasing recent educational research that included biophysiological measures and methods. Conclusions As we discuss, conducting integrative biophysiological and psycho-educational research has potential to derive vital substantive, methodological, and applied insights that provide a rigorous basis for more effective educational theory, research, and practice. View on Web

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How accurate is computer-assisted mandible gunshot wound management by patient-specific distraction device? Preoperative planning versus postoperative outcomes

alexandrossfakianakis shared this article with you from Inoreader How accurate is computer-assisted mandible gunshot wound management by patient-specific distraction device? Preoperative planning versus postoperative outcomes via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Gunshot wounds of the lower face are a challenge for the surgeon. Customized distraction osteogenesis (DO) is a well-established procedure for managing facial gunshot wounds. However, differences between the preoperative planning and postoperative outcomes are often noted. This multi-centre, retrospective study was performed to analyse the differences between the planning and outcomes for the lower third of the face, in patients undergoing the computer-assisted repair of mandible gunshot wounds using patient-specific distraction devices. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Perspectives on Adherence from the ACTG 5360 MINMON Trial: A Minimum Monitoring Approach with 12 Weeks of Sofosbuvir/Velpatasvir in Chronic Hepatitis C Treatment

alexandrossfakianakis shared this article with you from Inoreader Perspectives on Adherence from the ACTG 5360 MINMON Trial: A Minimum Monitoring Approach with 12 Weeks of Sofosbuvir/Velpatasvir in Chronic Hepatitis C Treatment via Clinical Infectious Diseases Advance Access Abstract Background With the advent of efficacious oral Direct-acting antivirals (DAAs) for hepatitis C virus(HCV), identification of characteristics associated with adherence is critical to treatment success. We examined correlates of sub-optimal adherence to HCV therapy in a single-arm, multinational, clinical trial. Methods ACTG A5360 enrolled HCV treatment-naïve persons without decompensated cirrhosis from 5 countries. All participants received a 12-weeks course of sofosbuvir/velpatasvir at entry. In-person visits occurred at initiation and week 24, sustained virologic response (SVR) assessment. Adherence at week 4 was collected remotely and was dichotomized optimal (100%, no missed doses) versus sub-optimal (<100%). Correlates of sub-optimal adherence were explored using logistic regression. Results 400 participants enrolled; 399 initiated treatment; 395/397 (99%) reported completing at week 24.. Median age was 47 year s with 35% female. Among the 368 reporting optimal adherence at week 4 SVR was 96.5% (95% CI [94.1%, 97.9%]) vs. 77.8% (95% CI [59.2%, 89.4%]) p-value < 0.001. In the multivariate model age < 30 years and being a US participant were independently associated with early sub-optimal adherence. Participants < 30 years were 7.1 times more likely to have early sub-optimal adherence compared to their older counterparts. Conclusion Self-reported optimal adherence at week 4 was associated with SVR. Early self-reported adherence could be used to identify those at higher risk of treatment failure and may benefit from additional support. Younger individuals < 30 years may also be prioritized for additional adherence support. View on Web

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Merkelzellkarzinom

alexandrossfakianakis shared this article with you from Inoreader Merkelzellkarzinom via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1949-3751 Das Merkelzellkarzinom ist ein aggressiver neuroendokriner Tumor, welcher durch schnelles Wachstum und frühzeitige Metastasierung charakterisiert ist. Das mediane Erkrankungsalter liegt zwischen 75–80 Jahren. Mit Zunahme des durchschnittlichen Bevölkerungsalters tritt der einstmals seltene Tumor immer häufiger auf. Neben den klassischen Therapiesäulen Chirurgie, Strahlentherapie und Chemotherapie spielt die Immunonkologie au ch beim Merkelzellkarzinom eine zunehmend wichtige Rolle. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

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