Associations of occupational physical activity and active transport with depressive symptoms in a middle-income country.

OBJECTIVE: This study investigated the associations of occupational physical activity and active transport with depressive symptoms, stratified by income range, among Brazilian working adults. STUDY DESIGN: This cross-sectional study drew on data from the 2019 Brazilian National Health Survey. METHODS: We used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms in working adults aged 18-65 years, with physical activities (occupational physical activity and active transport) self-reported through a specially developed questionnaire. Crude and adjusted logistic regression models were fitted. RESULTS: Individuals at the highest level of occupational physical activity (odds ratio [OR] 1.35; 95% confidence interval [95% CI] 1.19-1.53) and at the moderate level of active transport to work (OR 1.66; 95% CI 1.24-2.22) returned increased odds of depressive symptoms as compared with those who were inactive in these domains. Stratified by income group, light active transport to work (OR 0.57; 95% CI 0.34-0.95) in the lower income group (Range 1) was associated with lower odds of depressive symptoms. On the other hand, individuals at the highest level of active transport to work returned higher odds of depressive symptoms in the low- and intermediate-income groups, Ranges 3 and 4 (OR 1.92; 95% CI 1.22-3.00 and OR 2.91; 95% CI 1.71-4.95, respectively). CONCLUSION: Our results suggest that occupational physical activity and active transport may be a risk factor for depressive symptoms. They also point to differences in this relationship by income range. Further studies are needed to pursue the analysis of how specific domains of physical activity contribute to depressive symptoms.

PRIASE 2021 guidelines for reporting animal studies in Endodontology: explanation and elaboration.

Laws and ethics require that before conducting human clinical trials, a new material, device or drug may have to undergo testing in animals in order to minimize health risks to humans, unless suitable supporting grandfather data already exist. The Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) 2021 guidelines were developed exclusively for the specialty of Endodontology by integrating and adapting the ARRIVE (Animals in Research: Reporting In Vivo Experiments) guidelines and the Clinical and Laboratory Images in Publications (CLIP) principles using a validated consensus-based methodology. Implementation of the PRIASE 2021 guidelines will reduce potential sources of bias and thus improve the quality, accuracy, reproducibility, completeness and transparency of reports describing animal studies in Endodontology. The PRIASE 2021 guidelines consist of a checklist with 11 domains and 43 individual items and a flowchart. The aim of the current document is to provide an explanation for each item in the PRIASE 2021 checklist and flowchart and is supplemented with examples from the literature in order for readers to understand their significance and to provide usage guidance. A link to the PRIASE 2021 explanation and elaboration document and PRIASE 2021 checklist and flowchart is available on the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org/priase/).

PRIASE 2021 guidelines for reporting animal studies in Endodontology: a consensus-based development.

Animal testing is crucial in situations when research on humans is not allowed because of unknown health risks and ethical concerns. The current project aims to develop reporting guidelines exclusively for animal studies in Endodontology, using an established consensus-based methodology. The guidelines have been named: Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) 2021. Nine individuals (PD, VN, AK, PM, MN, JF, EP, JJ and SJ), including the project leaders (PD, VN) formed a steering committee. The steering committee developed a novel checklist by adapting and integrating their animal testing and peer review experience with the Animals in Research: Reporting In Vivo Experiments (ARRIVE) guidelines and also the Clinical and Laboratory Images in Publications (CLIP) principles. A PRIASE Delphi Group (PDG) and PRIASE Online Meeting Group (POMG) were also formed. Thirty-one PDG members participated in the online Delphi process and achieved consensus on the checklist items and flowchart that were used to formulate the PRIASE guidelines. The novel PRIASE 2021 guidelines were discussed with the POMG on 9 September 2020 via a Zoom online video call attended by 21 individuals from across the globe and seven steering committee members. Following the discussions, the guidelines were modified and then piloted by several authors whilst writing a manuscript involving research on animals. The PRIASE 2021 guidelines are a checklist consisting of 11 domains and 43 individual items together with a flowchart. The PRIASE 2021 guidelines are focused on improving the methodological principles, reproducibility and quality of animal studies in order to enhance their reliability as well as repeatability to estimate the effects of endodontic treatments and usefulness for guiding future clinical studies on humans.

Preferred Reporting Items for Animal Studies in Endodontology: a development protocol.

The regulated use of animals in endodontic research is often necessary to investigate the biological mechanisms of endodontic diseases and to measure the preclinical efficacy, biocompatibility, toxicology and safety of new treatments, biomaterials, sealers, drugs, disinfectants, irrigants, devices and instruments. Animal testing is most crucial in situations when research on humans is not ethical, practical or has unknown health risks. Currently, there is a wide variability in the quality of manuscripts that report the results of animal studies. Towards the goal of improving the quality of publications, guidelines for preventing disability, pain, and suffering to animals, and enhanced reporting requirements for animal research have been developed. These guidelines are referred to as Animals in Research: Reporting In Vivo Experiments (ARRIVE). Henceforth, causing any form of animal suffering for research purposes is not acceptable and cannot be justified under any circumstances. The present report describes a protocol for the development of welfare and reporting guidelines for animal studies conducted in the specialty of Endodontology: the Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) guidelines. The PRIASE guidelines will be developed by adapting and modifying the ARRIVE guidelines and the Clinical and Laboratory Images in Publication (CLIP) principles. The development of the new PRIASE guidelines will include a five-step consensus process. An initial draft of the PRIASE guidelines will be developed by a steering committee. Each item in the draft guidelines will then be evaluated by members of a PRIASE Delphi Group (PDG) for its clarity using a dichotomous scale (yes or no) and suitability for its inclusion using a 9-point Likert scale. The online surveys will continue until each item achieves this standard, and a set of items are agreed for further analysis by a PRIASE Face-to-face Consensus Meeting Group (PFCMG). Following the consensus meeting, the steering committee will finalize and confirm the PRIASE guidelines taking into account the responses and comments of the PFCMG. The PRIASE guidelines will be published and disseminated internationally and updated periodically based on feedback from stakeholders.

Methods for measurement of root canal curvature: a systematic and critical review.

The assessment of root canal curvature is essential for clinical and research purposes. This systematic review presents an overview of the published techniques for the measurement of root canal curvature features using imaging and to provide a critique of their clinical application. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify measurement methods for root canal curvatures. The search strategy retrieved 10594 records in total, and 31 records fulfilled the inclusion criteria. From 2D image acquisitions, eleven studies measured exclusively the angle of curvature, an additional thirteen measured other curvature features (level, height, radius, length and shape). Seven reports described methods from 3D imaging (CBCT, µCT). Root canal curvatures should be measured, for clinical proposes, to facilitate endodontic treatment planning, and in research, to reduce the risk of selection bias. This review has revealed that there are many methods described in the literature; however, no consensus exists on which method should be used. Some of the methodologies have potential clinical translation, whereas others are suitable for research purpose only, as they require a specific software or radiographic exposure in the mesiodistal direction.

Association of manual or engine-driven glide path preparation with canal centring and apical transportation: a systematic review.

The role and effect of glide path preparation in root canal treatment remain controversial. This systematic review aims to compare apical transportation and canal centring of different glide path preparation techniques, with or without subsequent engine-driven root canal preparation. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify the effect of glide path preparation (or its absence) on apical transportation and canal centring. An assessment for the risk of bias in included studies was carried out. Amongst 2146 studies, 18 satisfied the inclusion criteria. Nine studies assessed glide path preparation per se, comparing apical transportation and canal centring of rotary systems and/or manual files; eleven further investigations examined the efficacy of the glide path prior to final canal preparation with different engine-driven systems. Risk of bias and other study design features with potential influence on study outcomes and clinical implications were assessed. Based on the available evidence, and within the limitation of the studies included, preparation of a glide path using rotary sequences performs similarly (in most of the component studies) or significantly better than manual preparation when assessing apical transportation or canal centring. When compared to the absence of a glide path, canal shaping following glide path preparation was of similar, or significantly better quality, in regard to apical transportation or canal centring.

Interaction between chlorhexidine-impregnated gutta-percha points and several chlorine-containing endodontic irrigating solutions.

AIM: To evaluate if the immersion of chlorhexidine-impregnated gutta-percha points in chlorine-containing endodontic irrigants causes colour changes and precipitate formation. METHODOLOGY: Eighty-one size 25 chlorhexidine medicated (Activ Points, Roeko, Langenau, Germany) and 27 size 25 standard gutta-percha points (Roeko) were immersed in microtubes, containing the following solutions: 0.5 and 5.25% NaOCl or Aquatine (Optident, Ilkley, UK). The samples were visually assessed, by two independent observers, at regular intervals over 3 weeks, to detect colour changes and precipitate formation. A score system was used to grade the precipitate intensity. To compare the number of days required for a precipitate to form mean and standard differences were calculated; the means between the groups were compared using a one-way analysis of variance test. Mean intensity scores were calculated and compared between groups using Kruskal-Wallis procedure followed by the Mann-Whitney test. RESULTS: The groups containing 5.25% NaOCl started to produce a visible precipitate after fourteen days (16.48 ± 0.98) for the Activ points; this process was first noticed with the standard gutta-percha group on day 17 (18.33 ± 1.22 days), with a statistically significant difference (P = 0.002). When looking at the intensity scores from day 17 onwards, these two groups differed statistically, with a greater amount for the AP group (P < 0.001). No other test group presented with changes. CONCLUSION: The placement of impregnated gutta-percha points, in 5.25% NaOCl for a 2-week period, caused the formation of a precipitate in the experimental conditions of this study.

The effect of surface tension reduction on the clinical performance of sodium hypochlorite in endodontics.

Sodium hypochlorite (NaOCl) is recommended as an endodontic irrigant in view of its broad antimicrobial and tissue dissolution capacities. To enhance its penetration into inaccessible areas of root canals and to improve its overall effect, the addition of surface-active agents has been suggested. The aim of this investigation was to review the effect of the reduction of the surface tension on the performance of NaOCl in endodontics. A search was performed in the Medline electronic database (articles published up to 28 July 2012, in English) with the search terms and combinations as follows: 'sodium hypochlorite AND surface tension or interfacial force or interfacial tension or surface-active agent or amphiphilic agent or surface active agent or surfactant or tenside or detergent'. The purpose of this search was to identify publications that compared NaOCl alone and NaOCl modified with the addition of a surface-active agent in endodontics. A hand search of articles published online ('in-press' and 'early view'), and appearing in the reference list of the articles included, was further performed, using the same search criteria as the electronic search. The search identified 302 publications, of which 11 fulfilled the inclusion/exclusion criteria of the review. The evidence available suggests that surface-active agents improve the penetration of NaOCl in the main canal and have no effect on its pulp tissue dissolution ability. There are, however, insufficient data to enable a sound conclusion to be drawn regarding the effect of modifying NaOCl's surface tension on lubrication, antimicrobial and smear layer or debris removal abilities.

Influence of pH changes on chlorine-containing endodontic irrigating solutions.

Chlorine-containing solutions are used for broad disinfection purposes. Water disinfection literature suggests that their disinfectant action depends on pH values as this will influence the available free chlorine forms. Hypochlorous acid (HOCl) has been suggested to have an antimicrobial effect around 80-100 times stronger than the hypochlorite ion. The aim of this paper was to review the influence of pH changes on the efficacy of chlorine-containing endodontic irrigating solutions. An electronic and hand search (articles published through to 2010, including 'in press' articles; English language; search terms 'root canal irrigants AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'antimicrobial action AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'tissue dissolution AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'smear layer AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution') was performed to identify publications that compared chlorine water solutions with different pH. Of 1304 publications identified, 20 were considered for inclusion in the review. The search resulted in the retrieval of articles studying sodium hypochlorite (NaOCl), superoxidized waters (SOW) and sodium dichloroisocyanurate (NaDCC). Regarding antimicrobial efficacy, the literature suggested that reducing the pH value of NaOCl to between 6 and 7.5 would lead to improved action; SOW was described as having a lower antimicrobial effect. The tissue dissolution activity NaOCl decreased when the pH reached values between 6 and 7.5; NaDCC and SOW had no clinically relevant tissue dissolution capability. Chlorine solutions of different characteristics appeared to have some cleaning efficacy although they should to be used in conjunction with chelating and/or detergent agents.

Some factors influencing the stability of Sterilox(®), a super-oxidised water.

Super-oxidised waters, particularly Sterilox(®), have been suggested for the disinfection of dental unit water lines and dental impression materials owing to their antimicrobial efficacy. One of the previously suggested characteristics is their short shelf life. The purpose of this investigation was to understand the effect of storage conditions on Sterilox(®)'s stability. Eight bottles (four completely full, four half-full) of freshly prepared solution were divided into four groups and subsequently stored by being either exposed to or protected from sunlight. The chlorine concentration was monitored using chlorine test strips until the concentration reached zero, or until the thirteenth week. Statistically significant differences between the groups exposed to sunlight and the non-exposed groups (p <0.001) were found. The mean loss of chlorine per day for the non-exposed samples was 1.01 mg/L, whilst the mean for the exposed samples was 2.42 mg/L. The presence of air did not affect the chlorine decomposition in the bottles. The results of this investigation indicate that when the solution is exposed to sunlight, the decrease of chlorine starts at day 4, whilst for the groups sheltered from sunlight, the process started after day 14. Therefore, Sterilox(®) solutions appear to be more stable than previously surmised.

Type 2 dens invaginatus in a maxillary lateral incisor: a case report of a conventional endodontic treatment.

Dens invaginatus is a rare malformation of the teeth resulting from the invagination of the tooth crown before biological mineralization occurs. In most cases, the thin or incomplete enamel lining of the invagination cannot prevent the entry of bacteria into the pulp, which leads to pulp necrosis with an eventual periapical inflammatory response. The treatment options include preventive sealing or filling of the invagination, root canal treatment, endodontic apical surgery and extraction. The root canal treatment of such teeth is often complicated because of their anatomical complexity. This case describes a successful non-surgical endodontic treatment of a maxillary lateral incisor with type 2 dens invaginatus with a large periradicular lesion. At follow-up examinations after 6 and 12-months, the tooth was asymptomatic and the healed lesion was evident radiographically

Diagnostic ability of computed tomography to evaluate external root resorption in vitro.

OBJECTIVES: The aim of this study was to evaluate the diagnostic ability of CT to detect simulated external root resorption defects. METHODS: External root resorption defects of different sizes and in different locations were simulated in 59 human mandibular incisors. Cavities simulating root resorption defects of 0.6 mm, 1.2 mm, or 1.8 mm in diameter and 0.3 mm, 0.6 mm, or 0.9 mm in depth (small, medium and large defects) were drilled in the cervical, middle and apical thirds of buccal surfaces. Axial CT was used to obtain cross-sectional images of the teeth, and 177 root thirds were assessed by a blinded observer. RESULTS: Of the 131 cavities, 117 were detected (89%). 32 of the 44 (72.72%) cavities located in the apical third were identified. A statistically significant difference (P<0.01) was found between the sizes of defects examined in the apical third. CONCLUSIONS: The evaluation of CT diagnostic ability revealed high sensitivity and excellent specificity. However, small cavities located in the apical third were more difficult to detect than all other cavities.