Comparison of iRoot BP Plus and Calcium Hydroxide as Pulpotomy Materials in Permanent Incisors with Complicated Crown Fractures: A Retrospective Study.

INTRODUCTION: Calcium hydroxide has been used as a traditional pulpotomy agent for a long time but has some disadvantages. iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) is a newly developed, ready-to-use calcium silicate-based bioactive ceramic with excellent bioactivity and sealing ability. However, whether iRoot BP Plus shows superiority over calcium hydroxide as a pulpotomy material on permanent incisors with complicated crown fractures remains unknown. METHODS: This research included 205 permanent incisors with complicated crown fractures. These teeth were treated with pulpotomy and divided into 2 groups according to the pulpotomy material (105 treated with iRoot BP Plus and 100 with calcium hydroxide). Clinical and radiographic information was collected during the 12- to 24-month follow-up period. The formation of reparative dentin bridges and pulp canal obliteration were analyzed using radiographs in both groups. RESULTS: The success rates for recall in the average follow-up period of 17.5 ± 4.4 months (12-24 months) after pulpotomy treatment were significantly different between the 2 groups, with 99% for the iRoot BP Plus group and 93% for the calcium hydroxide group. Reparative dentin bridges were observed in 92.4% of the iRoot BP Plus group and 90% of the calcium hydroxide group, but the difference was not significant. Pulp canal obliteration was observed in 2 teeth (2%) in each group. CONCLUSIONS: The success rates obtained in our study indicate that iRoot BP Plus as a pulpotomy agent can be a suitable alternative to calcium hydroxide to manage complicated crown fractures.

Medical professionalism in China and the United States: a transcultural interpretation.

As in other societies, medical professionalism in the Peoples' Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, "Medical Professionalism in the New Millennium: A Physician Charter," by the Chinese Medical Doctor Association (hereafter, the Charter)(1). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians' attitudes toward the fundamental principles and core commitments put forward in the Charter. Based on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients' autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically-recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism-a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine cross-cultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary.

Chinese physicians' attitudes toward and understanding of medical professionalism: results of a national survey.

BACKGROUND: Medical professionalism has been developing in the Peoples' Republic of China as one way to better address perennial and new challenges in healthcare in an ever-changing society. Among many recent developments in this area is promotion by the national Chinese Medical Doctor Association of the principles and values contained in the international document, "Medical Professionalism in the New Millennium: A Physician Charter." OBJECTIVE: To discover Chinese physicians' attitudes toward and understanding of medical professionalism. METHODOLOGY: The authors distributed a self-reporting questionnaire that included 34 statements and four case scenarios concerning the general principles of medical professionalism: the primacy of patients' welfare, respect for patients' autonomy, promotion of social justice, and professional self-regulation. The questionnaire included controversial issues such as the role of the family in decision making and reporting medical errors. A total of 2,966 practicing physicians, randomly selected from the Chinese Medical Association database, were surveyed, and 1,198 valid questionnaires were returned. Our sample covered 23 provinces and 51 cities throughout the Peoples' Republic of China. RESULTS: More than 80 percent of the physicians who responded agreed that the physician-patient relationship should be a relationship of trust founded on professional altruism, and that informed consent is necessary. More than 95 percent agreed that physicians should promote professional self-regulation as well as social justice. More than half agreed with the principle of the primacy of patients' welfare (62.8 percent), and that physicians have a responsibility to report medical errors and incompetent colleagues (51.0 percent). In certain cases, a great majority of Chinese physicians favored familism and paternalism. LIMITATIONS: The study does not include data on how Chinese physicians practice medical professionalism, or the perspectives of physicians working in smaller cities and in rural areas. CONCLUSIONS: Based on responses to the survey, Chinese physicians strongly support the majority of the fundamental principles and responsibilities of medical professionalism, including dedication, altruism, social justice, self-regulation, and informed consent. However, their support for the primacy of patients' welfare as a general principle, and the physician's responsibility to report medical errors and incompetent colleagues, is relatively low. To help advance medical professionalism in the People's Republic of China, professional development programs and medical ethics education should not only emphasize the general principles involved, but also formulate guidelines on how these principles can be carried out in practice.