Retrospective Follow-up Assessment of Risk Variables Influencing the Outcome of Autologous Tooth Transplantation.

INTRODUCTION: This retrospective study aimed to identify which patient-, donor tooth-, recipient site-, and surgical procedure-related variables may influence the outcome of tooth autotransplantation. METHODS: The sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models. RESULTS: After a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05). CONCLUSION: Based on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient's bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.

Defective Assistive Device Involvement in Older Adult Emergency Department Visits.

Background and Objectives: Many older adults adopt equipment to address physical limitations and reduce dependence on others to complete basic activities of daily living. Although a few prior studies have considered injuries associated with assistive devices for older adults, those studies focused on older adults' health and functional risks for injury. There is limited analysis of older adult injuries involving defective or malfunctioning assistive devices. Research Design and Methods: Data from this study are from the National Electronic Surveillance System All Injury Program which collected data on consumer product-related injuries from a probability sample of 66 hospital Emergency Departments across the United States. Data from 30 776 older adult Emergency Department (ED) injury narratives from 2016 to 2020 were coded according to the assistive device involved and whether malfunctioning led to the injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned. Results: A total of 10 974 older adult ED cases were treated for 12 488 injuries involving a defective device. Injuries included 4 212 head and neck injuries (eg, concussion), 4 317 trunk injuries (eg, hip fractures), and 3 959 arm or leg injuries (eg, leg fracture). Of these patients, 4 586 were admitted to a hospital ward for further evaluation and treatment. Seventy percent of these patients were injured while using a walker; in contrast, wheelchairs were implicated in only 4% of the above cases. Design flaws were identified in 8 158 cases and part breakage/decoupling incidents in 2 816 cases. Discussion and Implications: Our findings provide evidence that assistive devices are actively involved in older adult injuries. Further research is needed to reduce injuries associated with assistive devices by educating patients and their careproviders about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.

Dynamically guided transantral piezoelectric endodontic microsurgery: A case report with technical considerations.

AIM: Endodontic microsurgery (EMS) of maxillary molars may represent a complex challenge to the clinician due to the location of the roots and the proximity of the maxillary sinus floor. This report aimed to describe the simultaneous use of a computer-assisted dynamic navigation (C-ADN) system and piezoelectric bony-window osteotomy for the transantral microsurgical approach of a maxillary left first molar with adequate root canal filling and symptomatic apical periodontitis. SUMMARY: This case report highlights the importance of C-ADN to carry out a minimally invasive buccal surgical access to palatal roots affected by apical periodontitis and provides a practical example to help clinicians make treatment decisions based on the available evidence. Clinical and tomographic evaluations were performed before the surgical procedure and at 24-month follow-up. This case was treated using a C-ADN system fitted to a piezotome for the buccal approach of the buccal roots, maxillary sinus membrane lifting, and for transantral location, root-end resection, cavity preparation, and filling of the palatal root. The navigation system allowed to achieve an accurate apical canal terminus location and root-end filling of the three roots with a minimally invasive piezoelectric crypt approach. At the 24-month follow-up examination, the patient remains asymptomatic, with normal periapical structures, and regeneration of maxillary sinus walls. It was concluded that the combination of dynamic navigation with piezoelectric bony-window osteotomy offers enhanced accuracy, tissue preservation, diminished risk of iatrogenic complications, and could maximize success and survival rates in transantral EMS.

Efectividad de la Six-Item Carpal Tunnel Symptoms Scale para el diagnóstico del síndrome del túnel carpiano / Effectiveness of the Six-Item Carpal Tunnel Symptoms Scale (CTS-6) questionnaire for the diagnosis of carpal tunnel syndrome

Introducción: A partir del Boston Carpal Tunnel Questionnaire, se desarrolló una escala corta de 6 ítems llamada Six-Item Car-pal Tunnel Symptoms Scale (CTS-6). Objetivo: Evaluar la CTS-6 para detectar pacientes con neuropatía periférica del nervio mediano con criterio quirúrgico. materiales y métodos: Se realizó un estudio descriptivo prospectivo observacional en un grupo de pacientes con diagnóstico clínico de síndrome del túnel carpiano. Se utilizó la CTS-6, y se corroboró el diagnóstico mediante electromiografía. Posteriormente, los pacientes fueron operados. Se analizaron las diferencias en el puntaje de la CTS-6 entre los distintos niveles de gravedad determinados por electromiografía. Resultados: Se analizaron 106 pacientes. El 20,75% tenía síndrome del túnel carpiano bilateral. Se evaluaron 126 manos. La mediana del puntaje de la CTS-6 fue de 21 (mín. 16,5; máx. 26). Según los resultados de la electromiografía, el 24,22% de los casos de síndrome del túnel carpiano eran graves. Al comparar el puntaje de la CTS-6 según la gravedad del síndrome del túnel carpiano evaluada por electromiografía, la mediana del puntaje de la CTS-6 fue de 16,5 en los casos leves, de 21 en los casos moderados y de 26 en los casos graves. Conclusiones: El puntaje de la CTS-6 fue mayor en los pacientes con síndrome del túnel carpiano grave según la electromiografía. Esto plantea la hipótesis de que podría ser útil como herramienta diagnóstica no invasiva en el síndrome del túnel carpiano para definir pacientes que se beneficien con el tratamiento quirúrgico. Nivel de Evidencia: IV

Introduction: The Six-Item Carpal Tunnel Symptoms Scale (CTS-6) is a a short 6-item scale based on the Boston Carpal Tunnel Questionnaire (BCTQ). Objective: To evaluate the CTS-6 to identify patients with peripheral neuropathy of the median nerve us-ing surgical criteria. materials and methods: A prospective descriptive observational study was conducted on a group of patients diagnosed with carpal tunnel syndrome. The CTS-6 was employed, and the diagnosis was confirmed with electromyography. The patients then underwent surgery. The differences in the CTS-6 score between the various severity levels measured by electro-myography were examined. Results: 106 patients were analyzed and a total of 126 hands were evaluated. 20.75% had bilateral carpal tunnel syndrome. The median CTS-6 score was 21 (min. 16.5; max. 26). According to electromyography results, 24.22% of CTS cases were severe. When comparing the CTS-6 score according to the severity of carpal tunnel syndrome assessed by electromyography, the median CTS-6 score was 16.5 in mild cases, 21 in moderate cases, and 26 in severe cases. Conclusions: Electromyography revealed a higher CTS-6 score in patients with severe carpal tunnel syndrome. This raises the possibility that it could be used as a noninvasive diagnostic tool in carpal tunnel syndrome to determine which patients would benefit from surgical therapy. Level of Evidence: IV

Safety Concerns in Mobility-Assistive Products for Older Adults: Content Analysis of Online Reviews.

BACKGROUND: Older adults who have difficulty moving around are commonly advised to adopt mobility-assistive devices to prevent injuries. However, limited evidence exists on the safety of these devices. Existing data sources such as the National Electronic Injury Surveillance System tend to focus on injury description rather than the underlying context, thus providing little to no actionable information regarding the safety of these devices. Although online reviews are often used by consumers to assess the safety of products, prior studies have not explored consumer-reported injuries and safety concerns within online reviews of mobility-assistive devices. OBJECTIVE: This study aimed to investigate injury types and contexts stemming from the use of mobility-assistive devices, as reported by older adults or their caregivers in online reviews. It not only identified injury severities and mobility-assistive device failure pathways but also shed light on the development of safety information and protocols for these products. METHODS: Reviews concerning assistive devices were extracted from the "assistive aid" categories, which are typically intended for older adult use, on Amazon's US website. The extracted reviews were filtered so that only those pertaining to mobility-assistive devices (canes, gait or transfer belts, ramps, walkers or rollators, and wheelchairs or transport chairs) were retained. We conducted large-scale content analysis of these 48,886 retained reviews by coding them according to injury type (no injury, potential future injury, minor injury, and major injury) and injury pathway (device critical component breakage or decoupling; unintended movement; instability; poor, uneven surface handling; and trip hazards). Coding efforts were carried out across 2 separate phases in which the team manually verified all instances coded as minor injury, major injury, or potential future injury and established interrater reliability to validate coding efforts. RESULTS: The content analysis provided a better understanding of the contexts and conditions leading to user injury, as well as the severity of injuries associated with these mobility-assistive devices. Injury pathways-device critical component failures; unintended device movement; poor, uneven surface handling; instability; and trip hazards-were identified for 5 product types (canes, gait and transfer belts, ramps, walkers and rollators, and wheelchairs and transport chairs). Outcomes were normalized per 10,000 posting counts (online reviews) mentioning minor injury, major injury, or potential future injury by product category. Overall, per 10,000 reviews, 240 (2.4%) described mobility-assistive equipment-related user injuries, whereas 2318 (23.18%) revealed potential future injuries. CONCLUSIONS: This study highlights mobility-assistive device injury contexts and severities, suggesting that consumers who posted online reviews attribute most serious injuries to a defective item, rather than user misuse. It implies that many mobility-assistive device injuries may be preventable through patient and caregiver education on how to evaluate new and existing equipment for risk of potential future injury.

Many ways, one microorganism: Several approaches to study Malassezia in interactions with model hosts.

Malassezia, a lipophilic and lipid-dependent yeast, is a microorganism of current interest to mycobiologists because of its role as a commensal or pathogen in health conditions such as dermatological diseases, fungemia, and, as discovered recently, cancer and certain neurological disorders. Various novel approaches in the study of Malassezia have led to increased knowledge of the cellular and molecular mechanisms of this yeast. However, additional efforts are needed for more comprehensive understanding of the behavior of Malassezia in interactions with the host. This article reviews advances useful in the experimental field for Malassezia.

Formal definition of the MARS method for quantifying the unique target class discoveries of selected machine classifiers.

Conventional binary classification performance metrics evaluate either general measures (accuracy, F score) or specific aspects (precision, recall) of a model's classifying ability. As such, these metrics, derived from the model's confusion matrix, provide crucial insight regarding classifier-data interactions. However, modern- day computational capabilities have allowed for the creation of increasingly complex models that share nearly identical classification performance. While traditional performance metrics remain as essential indicators of a classifier's individual capabilities, their ability to differentiate between models is limited. In this paper, we present the methodology for MARS (Method for Assessing Relative Sensitivity/ Specificity) ShineThrough and MARS Occlusion scores, two novel binary classification performance metrics, designed to quantify the distinctiveness of a classifier's predictive successes and failures, relative to alternative classifiers. Being able to quantitatively express classifier uniqueness adds a novel classifier-classifier layer to the process of model evaluation and could improve ensemble model-selection decision making. By calculating both conventional performance measures, and proposed MARS metrics for a simple classifier prediction dataset, we demonstrate that the proposed metrics' informational strengths synergize well with those of traditional metrics, delivering insight complementary to that of conventional metrics.

Injury prevention for older adults: A dataset of safety concern narratives from online reviews of mobility-related products.

Older adults are among the fastest-growing demographic groups in the United States, increasing by over a third this past decade. Consequently, the older adult consumer product market has quickly become a multi-billion-dollar industry in which millions of products are sold every year. However, the rapidly growing market raises the potential for an increasing number of product safety concerns and consumer product-related injuries among older adults. Recent manufacturer and consumer injury prevention efforts have begun to turn towards online reviews, as these provide valuable information from which actionable, timely intelligence can be derived and used to detect safety concerns and prevent injury. The presented dataset contains 1966 curated online product reviews from consumers, equally distributed between safety concerns and non-concerns, pertaining to product categories typically intended for older adults. Identified safety concerns were manually sub-coded across thirteen dimensions designed to capture relevant aspects of the consumer's experience with the purchased product, facilitate the safety concern identification and sub-classification process, and serve as a gold-standard, balanced dataset for text classifier learning.

Seroprevalence against Diphtheria in Pregnant Women and Newborns in Colombia: New Arguments to Promote Maternal Immunization.

The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended during pregnancy for neonatal protection against pertussis, although little is known of the protection it provides against diphtheria. The work used a cross-sectional design to estimate seroprevalence against diphtheria in 805 pregnant women with ≥37 gestation weeks and their newborns whose deliveries were attended in eight hospitals randomly chosen from a subregion of Antioquia, Colombia and to explore factors related with maternal protection. Levels of IgG antibodies were determined by using a commercial enzyme-linked immunosorbent assay test. Placental transfer of antibodies and crude and adjusted prevalence ratio (aPR) were analyzed to describe factors related with maternal protection against diphtheria. Protection against diphtheria was observed in 91.7% (95% CI 90.3-93.0) of the pregnant women and 93.1% (95% CI 91.7-94.4) of newborns, whose antibody levels were positively correlated (Spearman's r = 0.769; p = 0.000). Maternal protection could be influenced by having been vaccinated during the current pregnancy (aPR 0.85, 95% CI: 0.82-0.93). The protective effect of vaccination during pregnancy and the efficiency of maternal antibody transfers were detected. Public health efforts should focus on increasing Tdap vaccination during each pregnancy to protect mothers and newborns against diphtheria.

Demystifying Dens Invaginatus: Suggested Modification of the Classification based on a Comprehensive Case Series.

Dens invaginatus (DI) is one of the most common developmental anomalies observed in maxillary lateral incisors. An early diagnosis requires thorough clinical knowledge, advanced radiographic evaluation as well as the use of cone beam computed tomography (CBCT) and dental operating microscope (DOM), dictates the successful endodontic management of such teeth. A total of 7 cases with (DI) in maxillary lateral incisors were collected from dental practitioners worldwide, analysed and reported in the present case series. Our aim was to analyse and understand the various morphological patterns of DI in maxillary lateral incisors with their varied treatment protocols employed worldwide. This article illustrates the aberrant morphological patterns and the diverse treatment protocols followed by the clinicians worldwide. The use of biomaterials enhances post-operative healing. Further, a modification in the existing classification has been proposed in this report which would enable the clinicians to easily diagnose, categorise and effectively manage DI. The different treatment protocols employed for the management of DI has been discussed and the use of CBCT and DOM in identifying and managing the anatomical variation of DI were emphasised.

Application of computer-assisted dynamic navigation in complex root canal treatments: Report of two cases of calcified canals.

Root canal treatment and non-vital bleaching of teeth with pulp canal obliteration may represent a complex challenge to the clinician. This report describes the usefulness of the computer-assisted dynamic navigation system for the root canal treatment of two cases of teeth with a history of traumatic injury, extensively obliterated root canals and crown discoloration. Clinical and cone-beam computed tomographic evaluations were completed prior to procedures and 12 months after treatment. Both cases were treated using a computer-assisted dynamic navigation system coupled to a high-speed handpiece in order to establish the location and orientation of the partially obliterated canal and endodontic access route planning. The system allowed an accurate localisation of the root canal with a conservative access cavity. At the 12-month recall examination, the patients continue to be symptom-free, with a normal appearance of the mucogingival complex, adequate restoration of the tooth colour and intact periapical structures.

Successful seroconversion against diphtheria and tetanus induced through maternal vaccination in a region of Colombia.

PURPOSE: This study aims to compare protection against diphtheria and tetanus conferred on the mother and the neonate before and after maternal vaccination against tetanus, diphtheria, and acellular pertussis (Tdap), transfer of antibodies, and the variables that could impact on the protection. MATERIALS AND METHODS: The study followed a cohort of 200 pregnant women from a region in Colombia, contacted during prenatal control before vaccination and upon delivery. The work determined immunoglobulin G antibodies against diphtheria and tetanus of pregnant women and umbilical cord. The proportion of protection, the geometric mean of the concentration, and the transfer of maternal antibodies were calculated. The protection profile of the pregnant women was explored by using multiple correspondence analysis. RESULTS: The concentration of antibodies against diphtheria was significant before and after vaccination of the pregnant women (p=0.000) with proportions of 85.0% and 97.5%, respectively, and of 98.6% in the umbilical cord, with significant antibody correlation (Spearman's coefficient=0.668, p=0.01). Sero-protection against tetanus before vaccination was at 71.0%, after at 92.6%, and in the umbilical cord at 95.9%, with significant antibody concentration before and after vaccination (p=0.000) and antibody correlation (Spearman's coefficient=0.936, p=0.01). Sero-protection was higher when the pregnant women were vaccine 8 to 11 weeks before delivery. Unprotected pregnant women were those not vaccinated during pregnancy. CONCLUSION: The high proportion of protection against diphtheria and tetanus and the placental transfer support the need to promote maternal immunization with Tdap.

Vertical root fractures: A time-dependent clinical condition. A case-control study in two colombian populations.

BACKGROUND: This nested case-control study can be viewed as an efficient way to sample subjects from a large cohort study case-control study aimed to analyze the effect of different clinical factors on the appearance of vertical root fractures in endodontically-treated teeth (ETT) over time. MATERIAL AND METHODS: By matching 90 cases and 270 controls nested in a cohort of 450 patients. Incident "cases" included those ETT in which a confirmed VRF. The "controls" were ETT with clinical and radiographic evidence of normality. When an "incident case" was detected, three random "controls" according to the evaluation time registered in years were selected. Time interval corresponded to the exposure time from the end of the endodontic treatment until the tooth was included in the study. Demographic and clinical parameters included: age, gender, type, and location of the tooth, type of endodontic treatment, number of appointments necessary to complete the endodontic treatment, use of intra-canal medication, the apical extension of the filling, type of coronal restoration, the role of the tooth in the rehabilitation treatment, presence of intra-radicular posts, and presence of an adjacent implant, were analyzed over time. Statistical analysis: univariate descriptive analysis, Pearson's χ2 test, and a logistic regression model adjusted for the most significant variables with a 95% confidence interval. RESULTS: The prevalence of vertical root fractures was 16.42%. The multivariate analysis confirmed that re-treatment (OR:12.19; OR:4.28;P<0.05) lasting five to ten years and intra-canal medication (OR:6.16;P=0.004) for more than eleven years significantly more associated with the risk of vertical root fracture. For teeth with intra-canal post or direct coronal restorations, the risk of vertical root fracture was three times lower. CONCLUSIONS: Endodontic re-treatment and the use of intracanal medication such as calcium hydroxide should be considered primary and secondary risk factors, respectively, according to the appearance of VRF over time. Key words:Apical surgery, endodontic re-treatment, endodontically-treated teeth, risk factors, vertical root fracture.

Detección por citometría de flujo de la enfermedad mínima residual en las leucemias agudas / Detection of the minimal residual disease by flow cytometry in patients with acute leukemia

Introducción: La enfermedad mínima residual es la permanencia de células leucémicas residuales en niveles subclínicos luego de la remisión de la enfermedad. Esta condición incrementa el riesgo de recaída y mortalidad. Objetivo: Caracterizar factores clínicos y moleculares de pacientes con leucemias agudas y enfermedad mínima residual detectada por citometría de flujo en una institución de alta complejidad de la ciudad de Medellín, Colombia durante los años 2015 - 2017. Metodología: Este es un estudio descriptivo retrospectivo, que incluyó pacientes con leucemia diagnosticada por citometría de flujo. Se realizó un muestreo no probabilístico de casos consecutivos. La información recolectada fue digitada en una base de datos en Excel, y el análisis se realizó a través del programa IBM SPSS Versión 24, empleando según la naturaleza de cada variable frecuencias absolutas y relativas, promedio y desviación estándar o mediana y rangos intercuartílicos según su distribución. Resultados: Se incluyó un total de 60 pacientes con predominio del sexo masculino 63,3 por ciento (38). El diagnóstico más frecuente fue la leucemia linfoide 78,3 por ciento (47). Del total de pacientes incluidos, 36,6 por ciento (22) fue positivo para enfermedad mínima residual; 28,3 por ciento recibió trasplante de médula ósea y el 10 por ciento (6) presentó compromiso de líquido cefalorraquídeo. En la segunda citometría en pacientes con enfermedad mínima residual, 90,9 por ciento (20) expresaba CD45+. El 31,8 por ciento (7) de los pacientes con enfermedad mínima residual presentó recaída. Conclusión: La enfermedad mínima residual es una condición frecuente en pacientes con leucemias agudas que requiere seguimiento y constituye un factor pronóstico relevante(AU)

Introduction: The minimal residual disease is the permanence of residual leukemic cells at subclinical levels after remission of the disease. This condition increases the risk of relapse and mortality. Objective: To characterize the clinical and molecular factors of patients with acute leukemias and minimal residual disease detected by flow cytometry in a highly complex institution in the city of Medellín, Colombia during the years 2015 - 2017. Methodology: This is a retrospective descriptive observational study, which included patients with leukemia diagnosed by flow cytometry. A non-probabilistic sampling of consecutive cases was carried out. The information collected was entered into a database in Excel, and the analysis was carried out through the IBM SPSS Version 24 program, using absolute and relative frequencies, average and standard deviation or median and interquartile ranges, according to the nature of each variable and its distribution. Results: 60 patients were included in which male sex predominated with 63.3 percent (38). The most frequent diagnosis was lymphoid leukemia with 78.3 percent (47). Of the total patients included, 36.6 percent (22) were positive for minimal residual disease; 28.3 percent received a bone marrow transplant and 10 percent (6) had a cerebrospinal fluid compromise. In the second cytometry of the patients with minimal residual disease, 90.9 percent (20) expressed CD45 +. 31.8 percent (7) of the patients with minimal residual disease relapsed. Conclusion: Minimal residual disease is a frequent pathology in patients with acute leukemias that requires follow-up and constitutes a relevant prognostic factor(AU)

Microstructural, microchemical, and mechanical changes associated with the clinical reuse of two nickel-titanium endodontic instruments.

BACKGROUND: Nickel-titanium (NiTi) instruments have represented a great technological development that enabled endodontists conforming irregular-shaped root canals. Notwithstanding, the repeated use of these instruments may lead to the fracture without any prior visible warning signs. This study aimed to evaluate how multiple clinical instrumentation/sterilization cycles of two NiTi mechanized instruments can affect their microstructural, microchemical, and mechanical characteristics. MATERIALS AND METHODS: In this observational descriptive study, a total of 140 NiTi instruments, 70 ProTaper Gold® (PTG) and 70 WaveOne Gold® (WOG) were analyzed. For each brand system, instruments were evaluated in the as-received condition (n = 10) and after one (n = 20), two (n = 20), and three (n = 20) instrumentation/sterilization cycles. Intraoperative instrumentation parameters were recorded for all used instruments. Afterward, the files were examined using scanning electron microscopy and energy-dispersive X-ray microanalysis. All of the instruments were tensile-fatigue tested until rupture in order to calculate the mechanical tensile strength and the maximum elongation percentage for the samples. Statistical analysis was completed using Chi-square, Kruskal-Wallis H-, or Mann-Whitney U-tests with a statistical significance set at P < 0.05. RESULTS: Significant increasing changes in surface topography (P < 0.05, Chi-square test) and chemical composition (P < 0.05, Kruskal-Wallis H-test) in both brand systems through instrumentation/sterilization cycles were detected. In addition, values of mechanical tensile strength and maximum elongation percentage increased significantly through instrumentation/sterilization cycles in the PTG group, whereas only the median values of mechanical tensile strength increased significantly in the WOG group (all P < 0.01, Kruskal-Wallis H-test). CONCLUSION: Although multiple instrumentation/sterilization cycles may render NiTi instruments more flexible and fatigue resistant, the significant changes detected in their surface topography and chemical composition should preclude their repeated clinical use in the routine endodontic practice as prevention for breakage.

The perception of tooth whitening practices during and after orthodontic treatment: A survey of orthodontists.

BACKGROUND: At present, there are limited studies on how tooth whitening procedures are applied in orthodontic patients. Therefore, the objective of this study was to assess the perception of tooth whitening practices during and after orthodontic treatment. MATERIAL AND METHODS: A survey of orthodontists in Medellín (Colombia) between January and October 2020 was carried out. The survey instrument was developed to obtain information regarding the perception and practices of tooth whitening during and after orthodontic treatment. RESULTS: 133 orthodontists with a mean age of 41,6 years old participated in the survey. Over 60% of participants reported >6 years of experience as orthodontist. The majority (99,2%) reported that their patients request tooth whitening. Of these, 71,2% refer the patient to another dental professional for the procedure while 28,8% administers it. More than half of orthodontists reported that their patients request dental whitening during orthodontic treatment. The majority (>90%) of orthodontists do not recommend tooth whitening during orthodontic treatment. Furthermore, >80% consider that tooth whitening is best recommended after brackets have been removed. CONCLUSIONS: Requests for tooth whitening from orthodontic patients is very frequent and most orthodontists favor the referral to another dental professional for the procedure. The majority do not recommend tooth whitening during orthodontic treatment and prefer waiting 1 to 3 months after brackets removal for the procedure. Key words:Tooth whitening, orthodontic treatment, brackets.

In vivo detection of vertical root fractures in endodontically treated teeth: Accuracy of cone-beam computed tomography and assessment of potential predictor variables.

BACKGROUND: This study aimed: (a) to determine the diagnostic performance of cone-beam computed tomography (CBCT) for detection of vertical root fractures (VRFs); (b) to evaluate the predictive value of diagnostic criteria regarding the definition of VRFs; and (c) to examine the robustness of the association of patient-, tooth-, and treatment-related variables with VRFs. MATERIAL AND METHODS: 130 root-filled teeth with signs/symptoms of VRFs underwent clinical and CBCT assessments. Definite diagnosis of VRF was confirmed by endodontic microsurgical (EMS) exploration. Determination of diagnostic performance of CBCT was based on standard algorithms derived from two-way contingency table analysis. Predictive value of diagnostic criteria and the association between predictor variables with VRFs were analyzed using logistic regression models. RESULTS: VRFs were detected during EMS in 50% of the teeth. Based on the finding of fracture lines on CBCT scans, sensitivity, specificity, and accuracy were 86.2%, 13.8%, and 50%, respectively. Teeth having more than three diagnostic criteria present had significant higher odds for VRF diagnosis. After logistic regression analysis, parafunctional habits, one-canal roots, excessive root canal enlargement, and absence of intra-radicular posts remained as robust predictor variables of VRFs. CONCLUSIONS: Although the sensitivity of CBCT for VRFs detection is high, the risk of false-positive results related to its low specificity makes that all suspected cases must be confirmed by surgical exploration. VRFs cannot be reliably diagnosed by isolated clinical signs/symptoms; instead those teeth possessing more than three diagnostic criteria might be considered practically pathognomonic. The parafunctional habits, one-canal roots, excessive root canal enlargement, and the absence of intra-radicular posts may act strongly/independently for the occurrence of VRFs in endodontically treated teeth. Key words:Cone-beam computed tomography, diagnostic accuracy, diagnostic surgery, predictor variables, root canal treatment, vertical root fracture.

Seroprevalence of Varicella in Pregnant Women and Newborns in a Region of Colombia.

We estimate the seroprevalence of IgG antibodies to varicella zoster virus (VZV) based on the first serological study in a cohort of pregnant women and newborns from the Aburrá Valley (Antioquia-Colombia) who attended delivery in eight randomly chosen hospitals. An indirect enzyme immunoassay was used to determine anti-VZV IgG antibodies. Generalized linear models were constructed to identify variables that modify seropositivity. In pregnant women, seropositivity was 85.8% (95% CI: 83.4-85.9), seronegativity was 12.6% (95% CI: 10.8-14.6), and concordance with umbilical cord titers was 90.0% (95% CI: 89-91). The seropositivity of pregnant women was lower in those who lived in rural areas (IRR: 0.4, 95% CI: 0.2-0.7), belonged to the high socioeconomic status (IRR: 0.4, 95% CI: 0.2-0.7), and had studied 11 years or more (IRR: 0.6, 95% CI: 0.4-0.8). Among newborns, seropositivity was lower in those who weighed less than 3000 g (IRR: 0.8, 95% CI: 0.6-1.0). The high seropositivity and seronegativity pattern indicates the urgent need to design preconception consultation and vaccination reinforcement for women of childbearing age according to their sociodemographic conditions, to prevent infection and complications in the mother and newborn.

Cone-beam Computed Tomographic and Micro-computed Tomographic Evaluations of the Root Apexes of Teeth with Posttreatment Apical Periodontitis.

INTRODUCTION: This study evaluated the association of different variables that may influence the outcome of root canal treatment through cone-beam computed tomographic (CBCT) and micro-computed tomography (micro-CT) assessments of root apexes obtained by endodontic microsurgery of teeth with posttreatment apical periodontitis (AP), the agreement between CBCT and micro-CT findings, and the association of these variables with symptoms or lesion size. METHODS: Clinical and CBCT records and root apexes obtained by endodontic microsurgery from 11 cases of symptomatic AP and 22 cases of asymptomatic AP were available. Apical root specimens were further scanned using micro-CT imaging. CBCT parameters included periapical radiolucency size, apical extent/density of root canal filling, and occurrence of procedural errors. Micro-CT images evaluated the same parameters plus the presence of filling material in lateral canals and ramifications, the volume of the filled/nonfilled apical root canal, and the percentage of the nonfilled canal space. The agreement between CBCT/micro-CT observations was evaluated. RESULTS: Mandibular teeth, a lesion size <5 mm, a nonfilled volume <0.04 mm3, and the decreased percentage of the nonfilled canal volume were significantly associated with symptomatic AP. Maxillary teeth and inadequate apical filling density were significantly associated with larger lesions. Agreement between CBCT/micro-CT scores varied from fair (procedural errors) to satisfactory (extent/density of filling). CONCLUSIONS: Tooth location, lesion size, the nonfilled apical canal volume, and the percentage of the nonfilled apical canal volume were associated with symptomatic AP. In addition, lesion size was significantly associated with tooth location and apical root canal filling density. CBCT imaging may not provide a reliable evaluation of procedural errors associated with posttreatment disease.

Adherence to Antidepressant Therapies in Patients with Depressive Disorders Attending an Outpatient Clinic in a Public Mental Health Hospital, Antioquia, Colombia in 2017.

To evaluate the level of adherence to antidepressant therapies and associated factors in patients with depressive disorders. a cross-sectional analytical study was conducted in patients diagnosed with depressive disorders. The sample was for convenience, and a survey including sociodemographic, clinical, and therapeutic variables was designed. The Morisky-Green test, Beliefs about Medicines Questionnaire, and Simplified Medication Adherence Questionnaire were also used, all of which have been validated for assessing adherence in patients with depression. The qualitative variables were evaluated with absolute and relative frequencies, and a bivariate analysis was performed. This study included 54 patients with an average age of 49.5 ± 13.7 years, and 83.3% were women. All patients were diagnosed with major depression, and 9.25% also had an anxiety disorder. According to the Morisky-Green test, only 37% of patients were compliant with the drug therapy, although this was not statistically significant. Women were less compliant than men (33.3% versus 55.6%; p = 0.21). The beliefs that patients have regarding medication do not have a great impact on adherence to antidepressant therapy. However, it was evidenced that adherent patients had less doubts about the medication administered in comparison to non-adherent patients.