The association of endodontic prognostic factors with the presence of periapical lesion, its volume, and bone characteristics in endodontically treated molars: a cross-sectional study.

BACKGROUND: This study intended to evaluate the association between several endodontic prognostic factors with the presence of periapical lesions (PLs), their volume, and bone characteristics including cortical bone destruction (CBD) and buccal plate bone height (BPBH) in root-filled molar teeth using cone-beam computed tomography. METHODS: A collection of 143 scans of endodontically treated maxillary/mandibular first or second molars recorded over 8 years, were obtained from a specialized radiology center. Data on prognostic factors including tooth number, gender, jaw type, the status and number of missed canals, obturation length, restoration type, presence of a separated instrument, presence of a post or screw in the canals, and presence of perforation were collected. The assessed outcomes included PL presence, PL volume, CBD, and BPBH. The association between prognostic factors and outcomes was evaluated using multiple logistic regression models with adjusted covariates and multifactorial ANOVA at a significance level of 0.05. RESULTS: A total of 282 molars from 82 women and 50 men with a mean age of 40.6 ± 12.27 were included. Among those, 139 teeth presented PL with a mean volume of 18.68 mm3. CBD was prevalent in 137 teeth and the mean BPBH appeared to be 9.45 mm. The presence of a missed canal (OR = 10.022, P < .05), underfilled canal (OR = 3.725, P < .05), overfilled canal (OR = 15.859, P = .018), and perforation (OR = 15.261, P = .013) was significantly associated with PLs. None of the prognostic factors could considerably contribute to the CBD (P > .05). The presence of a missed canal was positively associated with the PL volume (P < .05). Similarly, missed canals (P < .05), perforation (P < .05), and separated instruments (P = .004) were associated with a significantly reduced BPBH. CONCLUSIONS: Overfillings, perforations, missed canals, and underfillings were identified as remarkable predictors of PL, arranged in descending order of their respective impact. The only factor capable of significantly increasing the PL volume was the missed canal. In brief, obturation length errors, perforations, missed canals, and separated instruments were robustly correlated with endodontic failure, which highlights the importance of mitigating the potential for errors by following the fundamentals of endodontics.

Reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents: a systematic review and meta-analysis of effectiveness.

BACKGROUND: The application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of pain and discomfort, especially in younger patients. The purpose of the present systematic review is to evaluate the efficacy of the methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. MATERIALS AND METHODS: English-language literature from inception until September 6th, 2022 was searched in MEDLINE (via PubMed), SCOPUS, Web of Science, Cochrane, EMBASE, and ProQuest Dissertations & Theses Database Global for articles. Randomized controlled trials (RCTs) comparing methods of reducing the pain and/or discomfort associated with rubber dam clamp placement in children and adolescents were retrieved. Risk of bias assessment was performed using a Cochrane risk of bias-2 (RoB-2) risk assessment tool and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profile. Studies were summarized and pooled estimates of pain intensity scores and incidence of pain were calculated. The meta-analysis was conducted in the following groups according to type of interventions (LA, audiovisual (AV) distraction, behavior management (BM), electronic dental anesthesia (EDA), mandibular infiltration, inferior alveolar nerve block (IANB), TA), outcome (intensity or incidence of pain), and assessment tool (face - legs - activity - cry - consolability (FLACC), color scale, sounds - motor - ocular changes, and faces pain scale (FPS)): (a) pain intensity using (LA + AV) vs (LA + BM), (b) pain intensity using EDA vs LA (c) presence or absence of pain using EDA vs LA (d) presence or absence of pain using mandibular infiltration vs IANB (e) Comparing pain intensity using TA vs placebo (f) Presence or absence of pain using TA vs placebo. Meta-analysis was conducted using StataMP software, version 17.0 (StataCorp, College Station, Texas). Restricted maximum-likelihood random effect model (REML), Mean difference (MD) with 95% confidence interval, and log odds ratio (OR) with 95% CI were calculated were calculated. RESULTS: Initially, 1452 articles were retrieved. Sixteen RCTs were finally included for reviewing and summarizing. Nine articles with a total of 867 patients were included for quantitative meta-analysis. The differences in pain intensity scores were not significant in any comparison groups (group a: [MD = -0.04 (95% CI = - 0.56, 0.47), P = 0.87, I2 = 0.00%], group b: [MD = 0.25 (95% CI = -0.08, 0.58), P = 0.14, I2 = 0.00%], group c [MD = -0.48 (95% CI = -1.41, 0.45), P = 0.31, I 2 = 0.00%], group d: [MD = -0.67 (95% CI = -3.17, 1.83), P = 0.60, I 2 = 0.00%], group e: [MD = -0.46 (95% CI = -l.08, 0.15), P = 0.14, I 2 = 90.67%], and group f: [MD = 0.61 (95% CI = -0.01, 1.23), P = 0.06, I 2 = 41.20%]. Eight studies were judged as having some concern for risk of bias and the remaining studies were considered as low risk for bias. The certainty of evidence was considered medium for all comparison groups. DISCUSSION: In the present meta-analysis, a considerable difference was obtained between the included studies regarding intervention methods and pain assessment tools and the analysis was performed in groups with small numbers of the studies. Owing to the mentioned variabilities and the small number of studies, the results of the analysis should be interpreted with caution. The indistinguishability of the manifestations of pain/discomfort from fear/anxiety, particularly in children, should also be considered while using the results of the present study. Within the limitations of the current study, no significant differences were found between the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. A larger number of more homogenous studies regarding intervention methods and pain assessment tools need to be conducted in order to draw stronger conclusions. TRIAL REGISTRATION: This study was registered in PROSPERO (ID number: CRD42021274835) and research deputy of Mashhad University of Medical Sciences with ID number 4000838 ( https://research.mums.ac.ir/ ).

Facial Asymmetry in Unilateral Congenital Superior Oblique Muscle Palsy.

SIGNIFICANCE: This study was conducted to evaluate facial asymmetry in unilateral congenital superior oblique muscle palsy (SOP). The results showed that all facial asymmetry parameters had a higher frequency in SOP patients compared with orthotropic individuals. PURPOSE: This study aimed to evaluate the characteristics of facial asymmetry in unilateral congenital SOP and compare with orthotropic individuals. METHODS: This cross-sectional comparative case series was conducted in 58 patients with ocular torticollis caused by SOP (mean ± standard deviation age, 18 ± 12 years) and 58 orthotropic individuals (mean ± standard deviation age, 19 ± 13 years). The exact form of torticollis was determined by direct observation from yaw, roll, and pitch axes. Four photographs were taken from patients: (1) with torticollis to calculate the amount of head tilt; (2) with the head in the straight position to calculate the facial angle and relative facial size (RFS); and (3 and 4) with the head positioned downward (to compare the cheek size) and upward (to assess columella deviation and nostril asymmetry). RESULTS: Twenty-nine patients (50%) had a head tilt, 23 (39.66%) had combined head tilt and a face turn, and 6 (10.44%) had a pure face turn. The mean ± standard deviation of head tilt, facial angle, and RFS was 10.11 ± 6.31°, 1.11 ± 1.67°, and 1.003 ± 0.126 in SOP patients, respectively, and the mean RFS and facial angle were significantly higher in SOP patients compared with orthotropic individuals (both P < .001). Facial hemihypoplasia, unilateral cheek compression, nostril asymmetry, and columella deviation were observed in 43 (74.1%), 31 (53.4%), 39 (67.2%), and 38 patients (65.5%), respectively, which were all significantly more common compared orthotropic individuals (P < .001). Facial asymmetry was seen in 52 patients (91.2%) and 17 orthotropic subjects (29.3%), respectively (P < .001). CONCLUSIONS: All quantitative and qualitative facial asymmetry parameters had a higher frequency in SOP patients compared with orthotropic subjects.

Comparison of the effects of instrument assisted soft tissue mobilization and dry needling on active myofascial trigger points of upper trapezius muscle.

Background: Myofascial pain syndrome is one of the most common complaints in patients referring to orthopedic treatment centers. The present study aimed to examine the effects of instrument-assisted soft tissue mobilization (IASTM) and dry needling (DN) on active myofascial trigger points (AMTrP) of the upper trapezius muscle (UTM). Methods: The current study was designed as a randomized clinical trial and a total of 81 patients, aged 18-40 years, with active myofascial trigger points in the upper trapezius muscle were randomly divided into 3 groups: group 1 (n = 30) received DN treatment, group 2 (n = 26) received IASTM treatment, and group 3 (n = 25) was considered as the control group (no intervention). The numeric pain scale (NPS), pain pressure threshold (PPT), active cervical contra-lateral flexion (ACLF), neck disability index (NDI), and muscle thickness (MT), according to rehabilitative ultrasonic imaging (RUSI), were measured at baseline, immediately after the last session (session 4 in week 2), and 1 month after the last session. The statistical analysis was conducted at a 95% confidence level. The P values less than.05 were considered as statistically significant. Results: Both techniques were effective in treating active trigger point of the upper trapezius (p<0.05), but there was no significant difference between the treatment groups in terms of any of the above variables except for ACLF (p>0.05) Conclusion: Both IASTM and DN were determined to improve NPS, PPT, ROM, and NDI in participants with active trigger points in the upper trapezius, although IASTM was more effective in increasing ACLF in these patients.

Pulmonary rehabilitation and exercise therapy in a patient with COVID-19: A Case report.

Dyspnea, shortness of breath, and inability to perform activities of daily living are the main complaints in patients with COVID-19 and physiotherapy has a vital role in managing such symptoms. We present a case treated with pulmonary and neurological physiotherapy, which improved symptoms and quality of life. In this case report, the importance and potential effect of concise physiotherapy on patients with COVID-19 is presented.

Facial Asymmetry in Unilateral Duane Retraction Syndrome.

SIGNIFICANCE: The overall objective of this study was to evaluate facial asymmetry in patients with unilateral Duane retraction syndrome (DRS). The results showed a high frequency of facial asymmetry parameters of the opposite side of head turn in unilateral DRS patients. PURPOSE: The purposes of this study were to evaluate the characteristics of facial asymmetry in unilateral exotropic and esotropic DRS and to compare the findings with orthotropic subjects. METHODS: This cross-sectional comparative case series study was performed in 44 consecutive patients with head turn caused by DRS and 44 orthotropic subjects from 2016 to 2019. Four pictures were taken from the patients' faces. The first and second pictures were taken when patients had head turn and when the head was completely straight for calculating the facial angle and relative facial size, respectively. The third and fourth pictures were taken when the head was positioned downward (to compare the size of the cheek) and upward (to evaluate nose asymmetry). RESULTS: The mean ± SD age of DRS patients and orthotropic subjects was 16.23 ± 9.92 and 20.68 ± 11.82 years, respectively. The frequency of facial asymmetry and all facial parameters (cheek compression, nasal tip and columella deviation, and compression of one of the nostrils) was significantly higher in DRS patients compared with orthotropic subjects (P < .001). In DRS patients with facial asymmetry, columella and nasal tip deviation (P = .006) and cheek and face compression (P = .03) were significantly more prevalent in the opposite direction of head turn. In the DRS group, the mean ± SD age of the patients with and without facial asymmetry was 17.37 ± 9.76 and 7.40 ± 6.54 years, respectively (P = .02). CONCLUSIONS: The frequency of facial asymmetry and all facial parameters was significantly higher in DRS patients compared with orthotropic subjects. In unilateral DRS patients, the face was more commonly affected on the opposite side of head turn.

Back Muscle Function in Older Women With Age-Related Hyperkyphosis: A Comparative Study.

OBJECTIVE: The purpose of this study was to compare static maximal back extensor muscle force, endurance, and characteristics of flexion relaxation phenomenon (FRP) in older women with and without age-related hyperkyphosis. METHODS: Maximum back extensor force and endurance measured in a sitting position with a designed load cell setup; appearance, onset, and offset angles of FRP; and extension relaxation ratio (ERR) during a dynamic flexion-extension task were compared between 24 older women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 65 ± 4.4 years, and 24 older women without hyperkyphosis (thoracic kyphosis angle ≪50°), mean age 63 ± 4.3 years. Variables of force, endurance, angles of FRP, and ERR were analyzed using an independent sample t test. A χ2 test was used to identify differences between groups in FRP appearance. RESULTS: Static back extensor force and endurance were significantly lower among those with versus those without hyperkyphosis (P ≪ .001). Although the 2 groups did not differ in FRP appearance and ERR in the superficial erector spinal muscles (P ≫ .05), FRP in the hyperkyphosis group started sooner and ended later than in the group without hyperkyphosis (P ≪ .05). CONCLUSION: Our study indicates that women with age-related hyperkyphosis had decreased static maximal force and endurance of the back extensor muscles and prolonged myoelectrical silence of the superficial erector spinal muscles. Reduced endurance of the superficial erector spinal muscles may trigger early onset of FRP and prolonged relaxation of these muscles.

The Effect of Functional Stretching Exercises on Neural and Mechanical Properties of the Spastic Medial Gastrocnemius Muscle in Patients with Chronic Stroke: A Randomized Controlled Trial.

BACKGROUND: Following spasticity, neural and mechanical changes of the paretic muscle often occur, which affect the muscle function. The aim of this study was to investigate the effect of functional stretching exercises on neural and mechanical properties of the spastic muscle in patients with stroke. MATERIALS AND METHODS: This study was a single-blinded, randomized control trial. Forty five patients with stroke (experimental group: n = 30; control group: n = 15) participated in this study. Subjects in the experimental group participated in a functional stretching program 3 times a week for 4 weeks. Subjects in both groups were evaluated before the training, at the end of training, and then during a 2-month follow-up. Neural properties, including H-reflex latency and Hmax/Mmax ratio, were acquired. Mechanical properties, including fascicle length, pennation angle, and muscle thickness in the spastic medial gastrocnemius muscle, were evaluated. Repeated measure analysis of variance was used in the analysis. RESULTS: Time by group interaction in the pennation angle (P = .006), and in muscle thickness (P = .030) was significant. The results indicated that the H-reflex latency (P = .006), pennation angle (P < .001), and muscle thickness (P = .001) were altered after stretching training program and these changes were at significant level after 2-month follow-up. CONCLUSION: The results indicated that the use of functional stretching exercises can cause significant differences in neural and mechanical properties of spastic medial gastrocnemius muscle in patients with chronic stroke.

Bayesian Zero- Inflated Poisson model for prognosis of demographic factors associated with using crystal meth in Tehran population.

Background: Use of methamphetamine (MA) and other stimulants has increased steadily over the past 10 years. Risk factor evaluation to reduce the problem in the community is one solution to protect people from addiction. This study aimed at using Bayesian zeroinflated Poisson (ZIP) model to investigate the relationship between the number of using crystal meth and some demographic factors in Tehran population. Methods: A cross-sectional study was conducted to investigate crystal meth abuse in Tehran, the capital of Iran, in 2012. Stratified sampling method was used to select samples from 22 urban areas of Tehran. Trained researchers referred to the public places, such as streets, parks, squares, and libraries, to perform face-to-face interviews with the randomly selected samples. Bayesian ZIP model was used to perform the analysis, and SAS 9.3 program was used for data analysis. Results: A total of 993 individuals were studied. According to Bayesian ZIP model, sex (mean= -0.27, 95%CI (-0.485, -0.061)), age (mean= 0.03, 95%CI (0.018, 0.043)), high school level education (mean= 1.276, 95%CI (0.699, 01.9)), diploma level education (mean= 10.4, 95%CI (0.511, 1.69)), and university level education (mean= 0.69, 95%CI (0.142, 1.33)) were all found to have significant associations with crystal meth usage, being the dependent variable. Conclusion: Males, those with higher education levels, and older people in Tehran population are more likely to use crystal meth. This demographic information may be useful in designing preventive programs. Moreover, it is better to analyze count data with excessive zeroes using Bayesian zero- inflated model instead of the usual count models.

Combined Analysis of Vascular Endothelial Growth Factor Expression with Cyclooxygenase-2 and Mast Cell Density in Oral Squamous Cell Carcinoma.

BACKGROUND: Overexpression of vascular endothelial growth factor (VEGF) and cyclooxygenase-2 (COX-2) and increasing mast cell density (MCD) in premalignant and malignant oral lesions have been documented. However, their correlation with clinicopathologic parameters and survival rate in oral squamous cell carcinoma (OSCC) is not completely clear. This study aimed to assess these subjects. METHODS: VEGF, COX-2, and mast cell tryptase expression were examined immunohistochemically in 57 cases of OSCC. The relationships between the markers' expression and clinicopathologic data were assessed using bivariate and multivariate analysis. RESULTS: Spearman's rank correlation coefficient showed a significant correlation between VEGF and COX-2 expression (r = 0.462, p < 0.001), as well as between VEGF expression and MCD (r = 0.306, p < 0.001). Multivariate analysis showed no significant correlation between the markers' immunoexpression and overall survival (OS), but a significant correlation between mode of invasion and OS [hazard ratio 0.362 (95% CI: 0.138- 0.974); p = 0.038] was observed. An association between MCD and gender (p = 0.042) was also found, as MCD was higher in males. CONCLUSION: The significant correlation of VEGF expression with COX-2 expression and MCD may represent the roles of COX-2 and MCD in tumor angiogenesis by modulating VEGF production. However, VEGF, COX-2, and MCD are not useful indicators to predict prognosis in OSCC. Nevertheless, the mode of invasion can be considered as an independent prognostic factor in OSCC patients.

The Reliability of Standing Sagittal Measurements of Spinal Curvature and Range of Motion in Older Women With and Without Hyperkyphosis Using a Skin-Surface Device.

OBJECTIVE: The purpose of this study was to investigate the intrarater reliability of a skin-surface instrument (Spinal Mouse, Idiag, Voletswil, Switzerland) in measuring standing sagittal curvature and global mobility of the spine in older women with and without hyperkyphosis. METHODS: Measurements were made in 19 women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 67 ± 5 years, and 14 women without hyperkyphosis (thoracic kyphosis angle <50°), mean age 63 ± 6 years. Sagittal thoracic and lumbar curvature and mobility of the spine were assessed with the Spinal Mouse during neutral standing, full spinal flexion, and full spinal extension. Tests were performed by the same examiner on 2 days with a 72-hour interval. The intrarater reliability of the measurements was analyzed using the intraclass correlation coefficient, standard error of measurement and minimal detectable change. RESULTS: Intraclass correlation coefficients ranged from 0.89 to 0.99 in both groups. The standard errors of measurement ranged from 1.02° to 2.06° in the hyperkyphosis group and from 1.15° to 2.22° in the normal group. The minimal detectable change ranged from 2.85° to 5.73° in the hyperkyphosis group and from 3.20° to 6.17° in the normal group. CONCLUSIONS: Our results indicated that the Spinal Mouse has excellent intrarater reliability for the measurement of sagittal thoracic and lumbar curvature and mobility of the spine in older women.

Objective vs subjective analyses of arch form and preformed archwire selection.

INTRODUCTION: Maintaining a patient's original arch form increases treatment stability. In this study, we assessed the agreement between subjective analyses of arch form and archwire selection by orthodontists and an objective method with Cast Analyzer Iranian X software (Khallaghane Mehr, Tehran, Iran). METHODS: Thirty-six casts with normal occlusion were scanned with a laser. The software generated the best-fit curve using a fourth-degree polynomial equation to the clinical bracket points on the casts; then it selected the best preformed nickel-titanium archwire based on the root mean square calculation either objectively or semiobjectively. Three orthodontists selected the best-fit curve and archwire subjectively using the casts. To assess intraexaminer reliability, the same orthodontists reevaluated 10 casts after 2 weeks. To assess interexaminer reliability, the 3 orthodontists performed the analyses with the software and on the casts. Agreements were evaluated with the intraclass correlation coefficient and Dahlberg's formula. RESULTS: The semiobjective method (visual selection of wire by orthodontists using the software) yielded the best results. The differences were clinically negligible between the objective (fully automated) and semiobjective methods (1.30 vs 1.36 mm). CONCLUSIONS: The objective method improved wire adaptation to the clinical bracket points. Agreement among orthodontists regarding wire selection will improve significantly when they are trained to use the software.

Application of hurdle model with random effects for evaluating the balance improvement in stroke patients.

BACKGROUND: Stroke is a prevalent cause of disability in adults. The fall is the most common balance and motor impairments, which affects the quality of life in stroke patients. This study aims to employ random effects hurdle model for evaluating the balance improvement in stroke patients under the occupational therapy. METHODS: In this longitudinal study with repeated measurement during one year between 2013 and 2014, the data was collected using non-random sampling method from three occupational therapy clinics. For a total of 38 stroke patients, the number of falls was recorded every two weeks. The random effects hurdle model and random effects zero inflated Poisson (ZIP) model were fitted to the data and were compared together. Data analysis was carried out using SAS Software version 9.2. RESULTS: The results of random effects ZIP model showed that the covariates of sex and age and affected side of stroke and follow up duration had statistically significant effect on balance improvement (p< 0.05). The occupational therapy has been effective on balance improvement more than 40% during one year. CONCLUSION: The ZIP model with random effects can capture zero inflation and correlation structure in longitudinal count data simultaneously. Older patients, women and patients with left-side impairments were more at risk of fall and balance impairment, so they need more care and therapy.

Effect of aging on saccular function.

BACKGROUND: Aging can cause loss of balance, which may lead to physical and psychological problems. As the role of the otolith organs in maintaining postural stability has been emphasized in recent years, the present study investigated the effect of aging on saccular function using cervical vestibular evoked myogenic potentials (cVEMP). METHODS: The participants were assigned into two groups; group one included 31 young adults with a mean age of 22.15 (range: 19-26 yr) and group two consisted of 31 old adults with a mean age of 69.76 years (range: 61-79 yr). All participants hearing sensitivity was normal with no history of balance problems. VEMP was recorded for all subjects using tone burst 500 Hz stimuli at the threshold level and 95 dB nHL intensity level through air-conduction stimulation via an insert receiver. RESULTS: There was a significant difference in the cVEMP response threshold (p< 0.001), P1 wave latency (p<0.001), P1/N1 amplitude (p< 0.001), and asymmetry ratio of P1/N1 amplitude (p< 0.05) between the two groups. No significant difference was found between the left and right ears or in N1 wave latency between the two groups. CONCLUSION: VEMP abnormalities observed in healthy older adults showed the sensitivity of this test in identifying early signs of vestibular dysfunction. VEMP is an easy-to-use test that requires a short time to be performed. Therefore, it can be used as a selective objective screening test to detect vestibular disorders.

Comparison of a 30-year trend of incidence, prevalence, and DALY due to low back pain in Iran with Low- and High-SDI countries; Based on GBD study 2019 Data.

Introduction: Low back pain (LBP) represents the leading cause of disability worldwide and is a major economic and welfare problem. This study aimed to report incidence, prevalence, and disability-adjusted life years (DALY) rates of LBP in Iran by gender and different sociodemographic index (SDI) countries from 1990 to 2019. Methods: The age-standardized LBP and incidence, prevalence, and DALY were extracted based on the Global Burden of Disease (GBD) 2019 in Iran for males and females, and low- and high-SDI countries during 1990- 2019. Results: GBD 2019 data for LBP in Iran indicate a significant downward trend of incidence and prevalence from 1993 to 2019 in males, females, and both, except during the 1999-2002 period for females. A sharp reduction is seen in LBP incidence and prevalence from 1996 to 1999. Gender is not a determining factor in the LBP prevalence in Iran. Regarding the SDI categories, Iran had the highest incidence rate compared to countries with low- and high SDIs. High-SDI countries had the highest prevalence and DALY compared with Iran and low-SDI countries. Conclusion: The age-standardized incidence and prevalence of LBP in Iran showed a downward trend, from 1993 to 2019, especially from 1996 to 1999. Comparing Iran with low- and high-SDI countries, a heavier incidence of LBP was observed in Iran and heavier prevalence and DALY were seen in high-SDI countries. Therefore, more therapeutic healthcare interventions are required to reduce the LBP burden more effectively.

Managing failed vital pulp therapies in mature permanent teeth in a retrospective cohort study, with success and survival rates of managing protocols.

Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011-2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan-Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.

The Effect of Physiotherapy on Erectile Dysfunction Secondary to Prostatic Adenectomy: A Randomized Control Trial Study.

PURPOSE: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA). MATERIALS AND METHODS: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound. RESULTS: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P<0.001, η2P=0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P<0.001, η2P=0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased. CONCLUSION: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

An Analysis of Scientific Research Trends in Oral Implantology Between 2016 and 2022.

The present study aims to evaluate the trends of oral implant-related research in design and topics between the range of 2016 to the end of 2022. The electronic search was conducted in MEDLINE via Pubmed. Papers published in Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, and International Journal of Oral Implantology as well as previously European Journal of Oral Implantology, International Journal of Oral and Maxillofacial Implants, and Journal of Oral Implantology between January 1, 2016, and December 30, 2022, were retrieved. Articles were classified according to their study design and major subjects. The Joinpoint regression model was used to determine changes in the trends of study designs and topics. Statistical significance was defined as a p-value <.05. A total of 3382 articles were analyzed in this study. In the specified period, in vivo, prospective cohort, retrospective case control, randomized clinical studies in the design and prosthetic complications, peri-implant hard tissue studies in the topic experienced a significant decreasing pattern in the number of published articles as well as the total number of articles. Case reports and series, retrospective cohort, nonrandomized clinical studies in the design and outcomes of implant-related treatment plans, immediate implant placement, and peri-implantitis in the topic experienced a significant decreasing pattern followed by a significant increasing pattern with a turning point between 2017 and 2020. Considering the limitations of this scientific topical trend analysis, it can be concluded that the recent pandemic affected the research path in oral implantology in many ways.

Outcomes and predictive factors of vital pulp therapy in a large-scale retrospective cohort study over 10 years.

This cohort study evaluated the long-term success/survival of vital pulp therapies (VPTs) after carious pulp exposure in adult teeth. Additionally, factors influencing long-term success were identified. Teeth treated during 2011-2022 in a private clinic were studied with clinical/radiographic follow-ups. Data included patient demographics, tooth specifics, and treatment details. Outcomes were classified as success/failure based on clinical/radiographic findings, with tooth functionality determining the survival rate. Encompassing 1149 patients and 1257 VPT-treated teeth, the average monitoring period was 42.2 months. Overall VPTs' survival and success rates were 99.1% and 91.6%, respectively. Success rates for 768 direct pulp cappings, 217 miniature pulpotomies, and 272 full pulpotomies were 91.9%, 92.6%, and 90.1%, respectively (P > 0.05). Influencing factors included symptomatic irreversible pulpitis (SIP; HR 1.974, 95% CI 1.242-3.137; P = 0.004), radiographic signs of apical periodontitis (AP; HR 2.983, 95% CI 1.961-4.540; P < 0.001), restoration type (HR 2.263, 95%CI 1.423-3.600; P = 0.001), and restoration surfaces (HR 1.401, 95%CI 1.034-1.899; P = 0.030). This study concludes that VPT techniques consistently exhibit high long-term success/survival rates in treating carious pulp exposures. Critical predictors include initial clinical signs of SIP/AP, caries extent, and use of composite restorations.