Nonheme FeIV═O Complexes Supported by Four Pentadentate Ligands: Reactivity toward H- and O- Atom Transfer Processes.

Four new pentadentate N5-donor ligands, [N-(1-methyl-2-imidazolyl)methyl-N-(2-pyridyl)-methyl-N-(bis-2-pyridylmethyl)-amine] (L1), [N-bis(1-methyl-2-imidazolyl)methyl-N-(bis-2-pyridylmethyl)amine] (L2), (N-(isoquinolin-3-ylmethyl)-1,1-di(pyridin-2-yl)-N-(pyridin-2-ylmethyl)methanamine (L3), and N,N-bis(isoquinolin-3-ylmethyl)-1,1-di(pyridin-2-yl)methanamine (L4), have been synthesized based on the N4Py ligand framework, where one or two pyridyl arms of the N4Py parent are replaced by (N-methyl)imidazolyl or N-(isoquinolin-3-ylmethyl) moieties. Using these four pentadentate ligands, the mononuclear complexes [FeII(CH3CN)(L1)]2+ (1a), [FeII(CH3CN)(L2)]2+ (2a), [FeII(CH3CN)(L3)]2+ (3a), and [FeII(CH3CN)(L4)]2+ (4a) have been synthesized and characterized. The half-wave potentials (E1/2) of the complexes become more positive in the order: 2a < 1a < 4a ≤ 3a ≤ [Fe(N4Py)(CH3CN)]2+. The order of redox potentials correlates well with the Fe-Namine distances observed by crystallography, which are 2a > 1a ≥ 4a > 3a ≥ [Fe(N4Py)(CH3CN)]2+. The corresponding ferryl complexes [FeIV(O)(L1)]2+ (1b), [FeIV(O)(L2)]2+ (2b), [FeIV(O)(L3)]2+ (3b), and [FeIV(O)(L4)]2+ (4b) were prepared by the reaction of the ferrous complexes with isopropyl 2-iodoxybenzoate (IBX ester) in acetonitrile. The greenish complexes 3b and 4b were also isolated in the solid state by the reaction of the ferrous complexes in CH3CN with ceric ammonium nitrate in water. Mössbauer spectroscopy and magnetic measurements (using superconducting quantum interference device) show that the four complexes 1b, 2b, 3b, and 4b are low-spin (S = 1) FeIV═O complexes. UV/vis spectra of the four FeIV═O complexes in acetonitrile show typical long-wavelength absorptions of around 700 nm, which are expected for FeIV═O complexes with N4Py-type ligands. The wavelengths of these absorptions decrease in the following order: 721 nm (2b) > 706 nm (1b) > 696 nm (4b) > 695 nm (3b) = 695 nm ([FeIV(O) (N4Py)]2+), indicating that the replacement of the pyridyl arms with (N-methyl) imidazolyl moieties makes L1 and L2 exert weaker ligand fields than the parent N4Py ligand, while the ligand field strengths of L3 and L4 are similar to the N4Py parent despite the replacement of the pyridyl arms with N-(isoquinolin-3-ylmethyl) moieties. Consequently, complexes 1b and 2b tend to be less stable than the parent [FeIV(O)(N4Py)]2+ complex: the half-life sequence at room temperature is 1.67 h (2b) < 16 h (1b) < 45 h (4b) < 63 h (3b) ≈ 60 h ([FeIV(O)(N4Py)]2+). Compared to the parent complex, 1b and 2b exhibit enhanced reactivity in both the oxidation of thioanisole in the oxygen atom transfer (OAT) reaction and the oxygenation of C-H bonds of aromatic and aliphatic substrates, presumed to occur via an oxygen rebound process. Furthermore, the second-order rate constants for hydrogen atom transfer (HAT) reactions affected by the ferryl complexes can be directly related to the C-H bond dissociation energies of a range of substrates that have been studied. Using either IBX ester or H2O2 as an oxidant, all four new FeII complexes display good performance in catalytic reactions involving both HAT and OAT reactions.

The somatic care of patients with comorbid mental disorders: protocol of a mixed-methods study aiming to identify barriers to and enablers of utilization of somatic healthcare (SoKo).

BACKGROUND: Healthcare for people with somatic and comorbid mental diseases can pose a challenge to the healthcare system. The aim of the SoKo study (the Somatic care of patients with mental Comorbidity) is to assess the current state of care and the facilitators and barriers of somatic care of people with somatic disorders and comorbidity of a mental disorder. METHODS: The study is conducted as a mixed-methods approach and will include (a) descriptive and inferential analysis of secondary claims data of persons insured by a German statutory health insurance company in North Rhine-Westphalia (Techniker Krankenkasse, TK-NRW), (b) qualitative individual interviews and group discussions, and (c) based on (a) and (b), quantitative surveys of both patients and physicians. We intend to analyse a sample of claims data of about 2.6 million persons insured by TK-NRW (group comparisons between TK-NRW insured persons with a diagnosis of a prevalent somatic disease [ICD-10-GM E01-E07, E11, E66, I10-I15, I20-I25, I60-I64] with and without comorbidity of a mental disorder [F00-F99]), in order to assess the uptake of somatic care by people with mental and somatic comorbidity. In addition, primary data from patients with the aforementioned somatic illnesses and a mental comorbidity as well as primary data from physicians (general practitioners and medical specialists) will be collected. The focus here will be on support factors and barriers in the somatic care of people with mental comorbidity. DISCUSSION: Up to now, there have been no published results of a systematic collection of both secondary and primary data on the utilisation of different care services of somatically ill patients with mental comorbidity for Germany. The present mixed-methods study aims to address this gap. TRIAL REGISTRATION: The trial is registered with the German Clinical Trials Register DRKS: DRKS00030513. The trial was registered on 3rd February 2023.

[Oncologic Care of Breast Cancer Patients with Preexisting Disabilities: Results of a Qualitative Study on Perceived Barriers, Communication Difficulties, and Needs]. / Die onkologische Versorgung von Brustkrebspatientinnen mit vorbestehender Behinderung ­ Ergebnisse einer qualitativen Studie über wahrgenommene Barrieren, kommunikative Schwierigkeiten und Bedarfe.

Up to now, people with disabilities have received little consideration in health care with regard to their individual needs. This study gathers information on the internal perspective of breast cancer patients with a pre-existing disability with regard to needs and barriers in oncological care. For this purpose, qualitative, guideline-based interviews were conducted and analysed using qualitative content analysis. Twenty-three patients with physical disabilities, chronic physical illnesses, sensory disabilities, mental illnesses and/or intellectual disabilities were included. Depending on the type of disability, patients faced different barriers. In order to reduce the barriers experienced by people with disabilities in care, it is necessary to promote cooperation between care providers from different care sectors and to train care providers in dealing with people with disabilities.

Synthesis and characterisation of a very low-coordinate diferrous [2Fe-2S]0 unit.

Here we present the synthesis of a unique diferrous [2Fe-2S]0 complex with only three-coordinate iron ions via reduction of a four-coordinate diferric [2Fe-2S]2+ complex with concomitant ligand loss. The obtained compounds were thoroughly examined for their properties (e.g. by 57Fe Mössbauer spectroscopy and magnetic susceptibility measurements). Facile cleavage of the [2Fe-2S] rhombus, commonly seen as rather stable, by CS2 is also shown.

Development of the health behaviour scale for cancer patients (HBSCP), analysis of its factorial structure and evaluation of its psychometric properties.

OBJECTIVE: The development and validation of a health behaviour scale for cancer patients (HBSCP). METHODS: An 11-item scale was developed based on existing literature on health behaviour and cancer prevention and care. Identified dimensions include the following: nutrition and weight, physical activity, nicotine and alcohol use, stress, and adherence to medical health services. Experts rated the items in regard to content and wording. The scale was tested in two cross-sectional datasets of n = 4626 and n = 4558 newly diagnosed breast cancer patients in North Rhine-Westphalia, Germany. Psychometric properties were assessed (internal consistency, item discrimination, exploratory and confirmatory factor analysis). Correlations with physical functioning (EORTC QLQ-C30) and personality traits (Big Five Inventory) were computed (full assessment of construct validity was not possible). RESULTS: A two-factor structure (1. adherence to medical health services; 2. Individual protective health behaviour) with nine items (item reduction due to findings in the factor analyses) with good item properties and reliability was identified. The scale showed significant associations with physical functioning and the personality traits of conscientiousness. CONCLUSION: The HBSCP is an instrument with good psychometric properties that measures cancer patients' health behaviour. Healthcare providers and researchers can use the HBSCP in the context of health promotion and prevention.

Reduction of green off-flavor compounds: Comparison of key odorants during fermentation of soy drink with Lycoperdon pyriforme.

The consumption of soy drink in Western countries is limited due to its green off-flavor. Hence, fermentation of soy drink with Lycoperdon pyriforme to tailor the aroma has been investigated. After 28 h the green off-flavor was not perceived by 60% of the sensory panel (n = 23). Molecular sensory changes of soy drink during fermentation were decoded by means of direct immersion-stir bar sorptive extraction coupled with gas chromatography-mass spectrometry-olfactometry and aroma dilution analysis. The semi-quantification of key odorants revealed a significant decrease of the representative green odorants (i.e., hexanal, (E)-2-nonenal, (E,E)-2,4-decadienal) of soy drink, among of which hexanal even turned below its odor threshold. The quantitative reduction of these odorants correlated with the organoleptic difference. Besides that, nutritionally relevant parameters of soy drink including protein, fat, and polyphenol content kept consistent during the short fermentation process.

[Self-Perception and External Perception of Peer Support Workers in Clinical Psychiatric Practice]. / Selbst- und Fremdwahrnehmung von Genesungsbegleitenden im klinisch-psychiatrischen Alltag.

OBJECTIVE: Since 2016, peer support workers (PSW) have been working in a clinical group with nine psychiatric clinics. The aim of this study was to collect expectations and experiences with peer support work. METHOD: Twelve PSW and 32 clinicians (key informants, KI) from all clinics participated in an anonymous, written survey. RESULTS: Both PSW and KI evaluated the overall importance of peer support, the cooperation between PSW and the clinical staff and the support from supervisors positively. KI rated the importance of peer support higher than the PSW themselves. PSW expressed the wish to act more independently. Compared to the self-perception of PSW, KI experienced them more insecure and burdened. CONCLUSION: Our findings speak in favor of a high level of satisfaction with peer support work, but they also point to critical differences between external and self-perceptions of PSW. Qualitative and more extensive quantitative surveys are required.

Are There Disparities in Surgical Treatment for Breast Cancer Patients with Prior Physical Disability A Path Analysis.

INTRODUCTION: Cancer care for patients with prior physical disability has hardly been researched in clinical research, health services research, or special education. This article aims to compare the severity of disease and the surgical treatment of diagnosed breast cancer patients with and without prior physical disability. METHODS: A total of 4,194 patients with primary breast cancer who underwent surgery in a breast cancer center in North Rhine-Westphalia, Germany, participated in an annual postoperative postal survey, which was complemented by clinical data. Latent class analysis and logit path models were applied to study (1) differences in terms of UICC staging and local cancer treatment between patients with and without prior physical disability and (2) respective differences by disability severity. RESULTS: Patients with physical disability (n = 780; 18.7%) had a higher chance of receiving mastectomy compared to breast-conserving therapy, even after controlling for socioeconomic status and UICC staging. Disability severity is directly and indirectly associated with receiving a mastectomy. CONCLUSION: In light of the research gap on disability and cancer, this work indicates disparities in care for breast cancer patients with prior physical disability. Inequalities might be attributable to (1) unequal access to care, (2) individual preferences and difficulties, or (3) medical difficulties.

Does basic information concerning nutrition improve the information needs of breast cancer patients? An evaluation.

PURPOSE: International and national studies have shown unmet information needs regarding nutrition in breast cancer patients. An intervention study has examined the question of the extent to which a fact sheet on the topic of nutrition is suitable to cover the need for information of breast cancer patients. METHOD: The fact sheet with basic information on nutrition was distributed in 21 intervention breast care centres in 2017. The use of the fact sheets was evaluated in a quasi-experimental design as part of the annual breast cancer patients' survey of the University of Cologne. The breast cancer patients considered were being treated with primary breast carcinoma in a hospital in North Rhine-Westphalia. A multilevel analysis was carried out in order to quantify the effect of the intervention. RESULTS: Unmet information needs are experienced more by younger and non-native German-speaking patients. With regard to education, patients without a graduation and a high grade of education express more unmet information needs. The multilevel analysis showed that patients who were treated at an intervention site and therefore possibly received the fact sheet have a significantly higher chance of their information needs being met (OR = 1.45; p ≤ 0.05). CONCLUSION: The intervention study showed that a fact sheet with basic information on nutrition is a possible instrument to satisfy the information needs of breast cancer patients and therefore reduce unmet information needs regarding nutrition. This intervention study is a pragmatic example on how to reduce unmet information needs among breast cancer patients in Germany.

Health disparities among breast cancer patients with/without disabilities in Germany.

BACKGROUND: Prevalence and incidence of cancer are increasing in people with disability. Nevertheless, little is known about cancer care for people with disabilities. OBJECTIVE: The goal of this study was to examine the quality of care of breast cancer patients with pre-existing disabilities regarding diagnosis and type of breast surgery in Germany. METHODS: Within the framework of quality assurance of breast cancer centers, a patient survey was conducted by the University of Cologne. Survey data from 4626 newly-diagnosed breast cancer patients treated in 86 hospitals were analyzed using multilevel modeling. Data about socio-demographics, disability specific data as well as data about diagnosis and type of surgery were collected. RESULTS: About 13% (n = 568) of the patients indicated they had a pre-existing disability prior to their breast cancer. The majority of patients with disabilities have physical impairments (PI n = 385; 68.0%) or sensory impairments (SI n = 131; 23.1%). 16.7% of the patients indicated they have a mental illness (MI n = 95; 16.7%) and 8 patients indicated to have an intellectual disability (ID n = 8; 1.4%). Patients with PI and SI are less often diagnosed for cancer through a mammography screening (OR PI = 0.70; p < 0.05; OR SI = 0.58; p < 0.05). Patients with PI are less likely to receive breast conserving treatment (OR = 0.58; p < 0.00) and more likely to have a mastectomy without reconstruction (OR = 1.96; p < 0.00) compared to patients without disabilities. CONCLUSION: Our data show that there are differences in the frequency of cancer diagnosis through mammography screening and in surgery applied between breast cancer patients with and without disabilities.

[Influence of Sociodemographic Factors on Type of and Stage at Diagnosis in Breast Cancer]. / Zum Einfluss soziodemografischer Faktoren auf die Art der Verdachtsdiagnosestellung und das Tumorstadium bei Erstdiagnose von Brustkrebs.

This study examines the influence of sociodemographic factors on the type of and stage at diagnosis in breast cancer in Germany. METHOD: As part of the certification of the breast cancer centers by the German Cancer Society (DGK), the Institute of Medical Sociology, Health Services and Rehabilitation Science (IMVR) conducted nationwide post-stationary postal patient surveys (n=852). The influence of sociodemographic factors on the type of diagnosis and on the stage at diagnosis were each analyzed using a multinomial logistic regression. RESULTS: 45.5% palpated the tumor by themselves, 33.4% were diagnosed by mammography screening and 16.6% by gynecological check-up. Being diagnosed by screening was associated with an early stage cancer. Furthermore, breast cancer patients without private health insurance or with a low educational level were less likely to be diagnosed by a gynecological check-up. Patients within screening age (50-69) had higher odds for an early stage breast cancer. Patients with a low educational level had lower odds for an early stage breast cancer. CONCLUSION: Fifty percent of the breast cancer patients were not diagnosed by screening. Mammography screening appears to be more sensitive in detecting early stage cancer, since we found an association between diagnosis by screening and an early stage cancer. Age outside of the screening range and a low educational level might be risk factors for an advanced stage breast cancer. High screening rates, especially for these risk groups, seem to be important for early detection of breast cancer.

[Is There An Association Between Audit Results and Patient Experiences at Breast Centres in North Rhine-Westphalia?] / Gibt es einen Zusammenhang zwischen den Auditergebnissen und den Patientinnenerfahrungen in Brustzentren in Nordrhein-Westfalen?

AIM OF THE STUDY: To ensure and improve the quality of care, patients with breast cancer in North Rhine-Westphalia are supposed to be treated in certified breast centres only. To obtain this certification, every 3 years all centres must undergo an auditing process. They also have to participate in an annual patient survey. While some studies have evaluated the benefit of certified centres regarding the quality of care offered, here we evaluate the relationship between the audit results and the experiences of patients. METHODS: The quantitative results of the audit reports of 2014-2016 of breast centres in North Rhine-Westphalia were linked by multilevel analyses with different scales of the annual, post-operative, postal survey of primary breast cancer patients. RESULTS: Audit reports and survey data on 3016 patients from 33 breast centres were examined and after adjusting for multiple testing, no statistically significant interrelation was found. CONCLUSION: There are no associations between the results of a centre in the audit and the experiences of the patients. It appears that patients have a distinctive, subjective perception that cannot be represented by the audits alone, even though patient orientation is explicitly requested in the certification catalogue. This result underlines the benefit of the obligatory annual patient survey because it can provide information that apparently cannot be obtained from other sources, such as certification audits. CONCLUSION: As a whole, an association between the audit results of a centre and the experiences of the patients treated there are weak. The audit results do correlate with the perceived process organization. However, other dimensions of patient experience are distinctive and subjective. Even though patient orientation is explicitly requested in the certification requirements, patient experience is not be represented by the audits alone. This finding underlines the benefit of obligatory annual patient surveys because they can provide additional information.

Waiting time, communication quality, and patient satisfaction: An analysis of moderating influences on the relationship between perceived waiting time and the satisfaction of breast cancer patients during their inpatient stay.

OBJECTIVE: Waiting time has been consistently found to be a significant predictor of patient dissatisfaction. The aim of this study is to examine whether positive communication experiences with health care providers could moderate the negative relationship between waiting time and patient satisfaction. METHODS: Data from a sample of 4626 breast cancer patients in Germany during their inpatient stay were analyzed. Multilevel logistic regression models were estimated in order to examine whether health literacy-sensitive communication (HL-COM) moderates the negative effects of perceived long waiting times on satisfaction. The models were adjusted for sociodemographic and clinical information and personality. RESULTS: Patients who perceived long waiting times were significantly less likely to be satisfied with treatment and with their hospital. Among patients who experienced high HL-COM, the negative relationship between perceived waiting time and satisfaction disappeared, with minimal differences in satisfaction between those who perceived waiting long and those who did not. CONCLUSION: While waiting time persists as a significant predictor of satisfaction, this study finds that positive communication experiences with health care providers could potentially alleviate negative effects of long waiting time. PRACTICE IMPLICATIONS: Along with the ongoing efforts to reduce waiting time, the improvement of health literacy-sensitive communication could be instrumental in patients' overall inpatient assessment.

Differences in Perceived Waiting Time by Health Insurance Type in the Inpatient Sector: An Analysis of Patients With Breast Cancer in Germany.

Although the relationship between health insurance and waiting time has been established in the ambulatory sector in Germany, research in the inpatient sector is limited. This study aims to contribute to previous work through analyzing differences in perceived waiting time by health insurance type during the inpatient stays of patients with breast cancer in Germany. This study utilizes cross-sectional data from 2017 of patients with breast cancer (N = 4626) who underwent primary breast cancer surgery in a certified breast care center in Germany. Results from multilevel logistic regression models indicate a significant effect of health insurance status on perceived waiting time, net of other relevant factors (patient's sociodemographic background, Union for International Cancer Control stage, grading, self-reported and classified health, type of surgery, and chemotherapy). Patients with statutory insurance were significantly more likely than privately insured patients to report long waiting times for examinations/procedures, discharge, and to speak with the physician. There were no significant differences in waiting time for nursing staff between private and statutory insurance holders. Results align with previous findings in the ambulatory sector and suggest a private health insurance advantage, with private patients receiving priority to some health care services. Disparities in health care accessibility and quality need to continue to be addressed and discussed, as well as the impact of health insurance type on other indicators of health.

Short length of stay and the discharge process: Preparing breast cancer patients appropriately.

OBJECTIVE: Breast cancer is the most common cancer among women worldwide, increasing the relevance of an efficient and successful care process. As length of stay (LOS) in the hospital decreases, patients' satisfaction with the LOS varies. We hypothesize that successful discharge planning can improve this evaluation. METHODS: Data of 4,390 female breast cancer patients from a cross-sectional survey was analyzed. The data was collected in 2017 in 86 German hospitals. Logistic regressions were used to test hypotheses. RESULTS: The majority of included patients rated their LOS as appropriate. However, patients who felt better prepared for discharge were less likely to rate their stay as too short. A longer stay in the hospital further decreased this likelihood. The effect of LOS was moderated by patient experiences with preparation for discharge. CONCLUSION: As hospital LOS decreases, one challenge in allowing patients to feel sufficiently informed and ready to go home is the reduced time for face-to-face consultations. Our results indicate, however, that a strong and thorough discharge planning makes the actual number of days for LOS irrelevant for patient's rating of LOS. PRACTICE IMPLICATIONS: The study results underscore the importance of ensuring the quality and thoroughness of the discharge process.

Decision criteria influencing the therapeutic approach to invasive cervical resorption: a case series.

Invasive cervical resorption (ICR) is a dental lesion starting in the cervical region and involving the loss of dental hard tissue as a result of odontoclastic action. Due to its localization and invasive pattern, this process represents a challenging clinical situation. When feasible, the major aim of an ICR treatment is to completely remove the pathologic tissue (specifically at the entry point of the lesion) and to seal the resulting defect, without compromising tooth rehabilitation. In this context, choosing how to access the resorptive lacuna is essential. Two main options have been described in the literature: an external approach, requiring the surgical exposure of the resorptive lacuna, and an internal approach, taking advantage of the endodontic access cavity. However, there are no guidelines that indicate which approach to choose for the treatment of an ICR. This article is based on four clinical cases. It aims to provide specific clinical and radiologic features that should be considered in order to take the most appropriate decision, when choosing between the internal and the external approaches. It is proposed to base the therapeutic strategy on the accessibility and the size of the portal of entry of the lesion. When the entry point is wide, its extension along the root must also be taken into account. Other important parameters are the circumferential and vertical extents of the lesion in the radicular dentin. Although it is not a determining factor, the pulpal involvement of the lesion can also be considered.

How do breast cancer patients experience multidisciplinary tumor conferences? - A description from the patient perspective.

OBJECTIVES: Aim of this study was to investigate the experiences of breast cancer patients who participated in multidisciplinary tumor conferences (MTCs). STUDY DESIGN: Data from two consecutive years of an annual postal survey of patients with primary breast cancer were combined. Data was collected between February and July 2015 (response rate 72%) and 2016 (response rate 73%) from N = 8893 patients (ICD-10 C50) after hospital discharge from 86 breast cancer center hospitals in North Rhine-Westphalia, Germany. The study used a mixed-methods design. Standardized quantitative survey questions were analyzed descriptively and an open-ended question was analyzed using qualitative content analysis. RESULTS: Around 9% of the patients were invited to participate in a multidisciplinary tumor conference (MTC) and 49% of the invited patients reported actual participation in a MTC. Approximately 87% of those patients did not regret their participation in the MTC. The qualitative analysis from the open-ended question indicated that MTC participation was perceived by patients as being both supportive and informative (n = 109 expressions). However, some patients reported difficult experiences and emotional reactions during and after participation (n = 37 expressions). Altogether, the patients' perception was divided into positive and negative, cognitive and emotional experiences following participation in a MTC. CONCLUSION: The perception of the MTCs varies between the participating patients. Further research on advantages and disadvantages for patients and particularly on the feasibility from the provider's perspective is necessary.

Why do newly diagnosed breast cancer patients seek a second opinion? - Second opinion seeking and its association with the physician-patient relationship.

OBJECTIVE: To examine breast cancer patients' reasons to seek a second opinion (SO) and the underlying variables. To find out more about the outcome of the SO, the perceived helpfulness and the effect on the physician-patient relationship. METHODS: In 2017, 4626 newly diagnosed breast cancer patients from 86 hospitals in Germany completed a postoperative mail survey (response rate = 89.04%). Data from 419 SO-seeking patients was obtained and analyzed by conducting logistic regression and non-parametric group comparisons. RESULTS: Reasons to seek an SO were mostly unrelated to the physician-patient relationship. Reasons related to the physician-patient-relationship were associated with a lower education level. The SO mostly (72.2%) equaled the first opinion. A different treatment plan recommendation (25%) reportedly affected the patients' relationship with their primary physician. Patients who received a different diagnosis reported more fear of progression. Most patients found the SO helpful. CONCLUSION: The reasons to seek an SO are primarily unrelated to the physician-patient relationship. However, less educated patients seem to have different reasons to seek an SO. These reasons were reportedly associated with the physician-patient relationship. PRACTICE IMPLICATIONS: Physicians may need to explicitly ascertain the patient's needs within the physician-patient communication to avoid inequalities based on patient education.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents.

OBJECTIVES: The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. SUBJECTS AND METHODS: Sixty subjects (mean age 12.2 years; SD 1.9; range 8-17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. RESULTS: Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26-756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. CONCLUSIONS: Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.