Comparation of the effectiveness of conventional needle irrigation and photon-induced photoacoustic streaming with sodium hypochorite in the treatment of teeth with apical periodontitis: a randomized clinical trial.

Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5'-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.

Can performance status mediate the relationship between therapy-related symptoms and health-related quality of life in children with cancer? A mediation model.

PURPOSE: Understanding the interplay among health-related quality of life (HRQoL), therapy-related symptoms, and performance status can offer insights into potential strategies to enhance HRQoL for pediatric cancer patients. This study aimed to examine the mediating effect of performance status on the relationship between symptom burden and HRQoL in children and adolescents with cancer. METHOD: A cross-sectional study was conducted. Participants were recruited from two tertiary hospitals located in Guangzhou, China. HRQoL, therapy-related symptoms, and performance status were assessed using the DISAKIDS Chronic Generic Measure (DCGM-37), Therapy-Related Symptom Checklist for Children (TRSC-C), and Lansky Play Performance Scale (LPPS), respectively. RESULTS: A total of 287 children with cancer (aged 11.08 ± 2.34 years) were included. The DCGM-37 scores were 59.70 ± 9.64. Emotion (56.45 ± 14.56) and physical limitations (58.59 ± 15.38) were the most affected domains. The number of symptoms experienced was 12.49 ± 5.95. The DCGM-37 demonstrated strong negative correlations with the TRSC-C (r = -0.60, P < 0.001) and number of symptoms (r = -0.62, P < 0.001), but mild-to-moderate negative correlations (r -0.16∼ -0.42, P < 0.05) with individual symptoms. The TRSC-C demonstrated an indirect effect on the DCGM-37 via the LPPS (Bootstrap-corrected standardized ß = -0.05, 95 % CI -0.10∼ -0.01; SE = 0.02). Additional analysis showed that tripping/falling (OR = 4.02, 95 % CI 2.02-7.98; P < 0.001) and sore mouth (OR = 2.38, 95 % CI 1.56-3.64; P < 0.001) were associated factors for presenting poor performance status in children undergoing acute chemotherapy. CONCLUSIONS: The accumulated symptom burden, rather than individual symptoms, weighs heavily on the HRQoL. Performance status partially mediated the relationship between symptom burdens and HRQoL among these patients.

A minimally invasive method for titanium mesh fixation with resorbable sutures in guided bone regeneration: A retrospective study.

OBJECTIVES: Titanium mesh has become a mainstream choice for guided bone regeneration (GBR) owing to its excellent space maintenance. However, the traditional fixation method using titanium screws impacts surgery efficiency and increases patient trauma. We report a novel method of fixing a titanium mesh using resorbable sutures. We assessed the feasibility of resorbable sutures for fixing a titanium mesh and whether it can serve as a stable, universal, and minimally invasive fixation method for a broader application of titanium meshes. METHODS: Patients undergoing GBR with a digital titanium mesh fixed using titanium screws (TS group) and resorbable sutures (RS group) were observed at different time points. The stability of the fixation methods was evaluated on parameters such as titanium mesh spatial displacement, bone augmentation, and bone resorption. RESULTS: A total of 36 patients were included in this study. The exposure rate of the titanium mesh in the TS group was 16.67%, while no exposure was noted in the RS group. There was no significant difference in the parameters of titanium mesh spatial displacement, bone augmentation, and bone resorption between the two groups (p > 0.05). CONCLUSION: The use of resorbable sutures for fixing a titanium mesh can achieve similar results to traditional fixation using titanium screws. Although this new fixation method can improve the efficiency of the surgery and reduce the risk of complications, the long-term clinical effects require further follow-up investigation.

Exploring polymerisation of methylglyoxal with NH3 or alanine to analyse the formation of typical polymers in melanoidins.

To investigate the formation of typical melanoidin polymers, methylglyoxal (MGO) with NH3 or alanine (Ala) was used to form coloured compounds, with glyoxal or acetone used as controls. The products were characterised using chromatography, mass spectrometry, and spectroscopy. Spectroscopic results showed that the coloured compounds formed were similar to melanoidins in food. GC-MS results showed that the MGO-based reaction generated similar volatile compounds using the Maillard reaction. Mass spectrometry showed that the molecular weights of structural units in the polymers were mainly 162, 169, and 176 Da, and these could be reassembled using the basic units derived from MGO alone or in combination with nitrogen. Hence, polymers recombined using basic structural units should be considered while determining melanoidin biomarkers. The preparation of coloured compounds using MGO with NH3 can be used as a novel method to produce the control compounds for melanoidin after process optimization.