Tooth survival following root canal treatment by general dental practitioners in a Swedish county - a 10-year follow-up study of a historical cohort.

AIM: To evaluate the 10-year survival rate of root filled teeth treated by general dental practitioners (GDPs), and to identify possible prognostic factors. METHODOLOGY: In 2006, 3676 individuals had at least one tooth root filled by a GDP within the Norrbotten Public Dental Service, Sweden. Over the next 10 years, 331 individuals died and were excluded. A random sample of 302 of the remaining individuals was included in the study, of whom 280 (n = 280 teeth) were included in the analysis. Dental records were reviewed retrospectively by a calibrated researcher to collect predetermined data regarding individual, pre-operative, intra-operative and post-operative factors. The outcome measure was tooth extraction over time, and cases with no events were censored, regardless of apical status or symptoms, until last known date of tooth survival. In case of missing data, individuals were recalled for a control visit. Kaplan-Meier survival tables and Cox regression models were used for analysis. P < 0.05 was considered statistically significant. RESULTS: The cumulative 10-year survival was 81.7% (standard error: 2.6%), and the mean incidence of tooth extraction during the 10 years was 1.8% per year. The univariate analysis identified three possible prognostic factors (P < 0.05) that were associated with extraction: molars, two or more emergency inter-appointment visits during the treatment, and root canal treatments consisting of five or more separate sessions. A multivariate regression analysis revealed no significant relationships for the variables gender, tooth type, number of contacts, any emergency visits during endodontic treatment, number of sessions to complete endodontic treatment, pulp diagnosis, or type of permanent restoration and extraction. CONCLUSIONS: The mean incidence of tooth loss over the first 10 years after completion of root canal treatment performed by a GDP was approximately 2% per year. No prognostic factors could be identified.

'Seeing is believing': a qualitative approach to studying the use of cone beam computed tomography in endodontics in Sweden.

AIM: To gain insight into the decision processes of dentists when requesting a cone beam computed tomography (CBCT) examination in endodontic settings. METHODOLOGY: Fourteen dentists (eight female) 33-58 years of age (mean = 44) practising in Sweden were interviewed. Ten of the dentists were specialists in Endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists comprised a strategically selected diverse sample in terms of gender, age, work experience, educational background, location of practice, service affiliation and accessibility to CBCT. Data were obtained through semistructured interviews exposing the context of their last three self-reported referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer's open-ended questions. The interviews were audio-recorded and transcribed verbatim. The text was analysed by qualitative content analysis. RESULTS: The manifest content was organized into three categories that were defined as visualization as a desire, facilitating tough decisions and allocating responsibility. CONCLUSION: An overall theme (covering the latent content) was identified: A balance between clinical common sense and a 'better safe than sorry' attitude guides the use of CBCT in endodontic settings. Informants had high clinical standards, knowledge concerning radiation risks and good sense, which could compensate for their lack of knowledge of guidelines. The national radiation regulatory system was perceived to work as a slightly porous gatekeeper for over-usage.

The impact of cone beam computed tomography on the choice of endodontic diagnosis.

AIM: To determine whether the outcome of cone beam computed tomography (CBCT) examinations performed in accordance with the European Commission guidelines in a clinical setting has an impact on choosing diagnoses in endodontics. METHODOLOGY: A prospective observational study was conducted. Fifty-three consecutive patients (81 teeth) from two different endodontic specialist clinics in Sweden were followed. After performing a thorough clinical examination (based on the history, clinical findings, and diagnostic tests such as intra-oral radiography), the examiner wrote down a preliminary diagnosis before CBCT examination. After the CBCT examination, a new diagnosis was made by the same examiner. Both the pre- and the post-CBCT examination diagnoses were plotted according to patients and teeth. The CBCT examinations were performed using similar equipment and protocols that were standardized amongst the clinics. RESULTS: The diagnoses were changed for at least one tooth in 22 patients (41%); overall, the diagnoses were changed for 28 teeth (35%). CONCLUSION: CBCT has a substantial impact on diagnostic thinking in endodontics when used in accordance with the European Commission guidelines.

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics.

OBJECTIVES: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. METHODS: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. RESULTS: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). CONCLUSIONS: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

Encapsulation of trans-dehydrocrotonin in liposomes: an enhancement of the antitumor activity.

The aim of this study was the encapsulation of trans-dehydrocrotonin (t-DCTN) and its inclusion complexes with hydropropyl-beta-cyclodextrin (HP-beta-CD) in liposomes to improve t-DCTN antitumor activity. The in vitro kinetic profiles of t-DCTN-loaded liposomes (LD) and t-DCTN:HP-beta-CD-loaded liposomes (LC) were evaluated using the dialysis technique. The antitumor activity of LD and LC were investigated against Sarcoma 180 in Swiss mice. Histopathological and hematological analyses were carried out. The amounts of t-DCTN and t-DCTN:HP-beta-CD inclusion complex encapsulated in liposomes were equivalent to 1 mg of t-DCTN. The encapsulation efficiencies of LD and LC were 95.0 +/- 3.8% and 91.1 +/- 5.6%, respectively. In relation to kinetics, the drug release profiles of t-DCTN are in substantial agreement with the Fickian model. The treatment of animals with LD and LC produced tumor inhibitions of 79.4 +/- 9.6% and 63.5 +/- 5.5%, respectively. The liposomal encapsulation of t-DCTN by entrapment in the phospholipid bilayer increased at twice the antitumor activity. Moreover, the liposomal formulations reduced the hepatotoxicity effect of the drug and no significant hematological toxicity was observed in the treated animals. However, the counting of platelets was slightly decreased. Thus, the results show that the development of liposomal formulations containing t-DCTN or t-DCTN:HP-beta-CD is an important advance for enabling this drug to be use in therapy.

Hemorrhagic syndrome and acute renal failure in a pregnant woman after contact with Lonomia caterpillars: a case report.

A case of a 37-week pregnant woman who developed a hemorrhagic syndrome and acute renal failure after contact with Lonomia caterpillars is reported. The accident also initiated labour and the patient gave birth to an alive child. Some pathophysiological aspects of the genital bleeding and of the acute renal failure are discussed.

[Computerized precordial mapping--the Mapcard system]. / Mapa precordial computarizado--o sistema Mapcard.

A computerized Data Acquisition System conceived and built by LNETI/DEE in cooperation with Department of Cardiology of Hospital Santa Cruz, and its application to processing and representation of cardiac precordial maps (MAPCARD SYSTEM), was described. A description was made about the evolution on cardiac maps, their main areas of interest, pointing to future ways. With this economic and easy to use system, important perspectives of hospital utilization are opened, in the fields of non invasive diagnostic and clinical research technics.

Quasi-elastic light scattering of carnauba wax in the liquid phase: dynamics 2.

Quasi-elastic light scattering of carnauba wax in the liquid phase is obtained in a heterodyne setup, and dynamic processes are analyzed through electrophoresis. Nonspherical polar clusters are found, containing a net electrical charge. An applied square-wave electric field induces drift and rotation of these clusters.These effects are dependent on strength and frequency of the applied electric field. At 373 K and in the low frequency limit the local electric field strength is approximately 70 times the strength of the applied one. This enhancement is believed to be caused by collective orientation of the clusters. The electrophoretic mobility is 1.1 X 10(-12) m2/V sec in the high frequency limit and 7.4 X 10(-11) m2/V sec in the low frequency limit. The electric dipole moment is 6.3 X 10(-16) N(-1/2) m(-1/2) where N is the cluster density/cubic meter and the net charge is about one or two elementary charges.