Post and Core Treatment to Refit Telescopic Crown-Retained Dentures after Abutment Tooth Fracture: An Evaluation of Therapy by Retrospective Survival Analysis.

Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra axial forces, abutment tooth fracture is a common cause of failure for TCDs; thus, PC treatment is often needed to refit the existing telescopic crown (TC). However, there are no clinical survival data on whether the PC treatment was used to refit the TC after abutment tooth fracture (PC2) or the PC was already fitted at the time of TCD treatment (PC1). A total of 246 patients with 399 PC treatments were retrospectively evaluated for follow-ups up to 17.33 years. The files were analysed for PC1 and PC2. Furthermore, the influence of the jaw, type of tooth, luting material, PC material, bone attachment, therapist and cause of failure was recorded. For statistical analysis, Kaplan-Meier and Cox regression analyses were conducted. PC2 showed highly significant lower survival probabilities than PC1 (p < 0.001). Moreover, the bone attachment and the age of the patient at the time of fitting the PC crown had an influence on the survival (p < 0.001). Therefore, PC2 should be carefully discussed with the patient and PC1 should be favoured in endodontically treated abutment teeth for TCDs.

Survival of Double-Crown-Retained Implant-and-Tooth- Supported Removable Partial Dentures: A ≥ 5-Year Clinical Follow-up Study.

PURPOSE: To assess the survival of double-crown-retained implant-and-tooth-supported removable partial dentures (DCR-ITSRPDs), evaluate abutment survival, and identify first aftercare measures. MATERIALS AND METHODS: The influence of various factors on the survival of the DCR-ITSRPDs and the abutments were observed in this retrospective and clinical follow-up study using the Kaplan-Meier estimate. In addition, the first-required aftercare measure for each prosthesis was evaluated. RESULTS: In total, 47 DCR-ITSRPDs were investigated (mean observation: 4.3 ± 3.8 years; max: 14.3 years), 3 of which (6.4%) had to be replaced. The survival probability for DCR-ITSRPDs was 100% at 5 years and 75% at 10 years. A total of 297 abutments (120 natural teeth and 177 dental implants) were observed, 22 of which (7.4%; 6 teeth and 16 implants) failed. The survival probability for teeth was 90.2% at the 5- and 10-year mark; for dental implants, it was 90.4% at 5 years and 76.3% at 10 years. CONCLUSIONS: DCR-ITSRPDs are a successful and durable treatment option for patients with substantially reduced residual dentitions. Both prostheses and abutments show good survival times after 5 and 10 years in function. The patient-associated factors tested showed no influence on the survival of DCR-ITSRPDs and abutments. Peri-implant infection was the decisive factor for abutment loss; therefore, regular dental prophylaxis and examinations are of major importance.

How long must a post be? A retrospective survival analysis on a large cohort with long follow-ups.

OBJECTIVES: Post and core (PC) is frequently used, but clinical evidence concerning how long a post must be is scarce. Recommendations in dental literature range from half of the root which should be incorporated, to post space preparations conducted as deep as possible increasing the risk for root perforation thus tooth loss. Therefore, the aim of this retrospective survival analysis is to evaluate the post length as well as the post-clinical crown ratio on a large patient cohort with long follow-ups. MATERIALS AND METHODS: Overall 1026 PC in 731 patients could be included in this study (2004-2023). The files were analysed due to the parameters post length and post-clinical crown ratio on X-Ray. Furthermore, the influence of the type of covering prosthetic restoration, location, type of tooth, luting material, PC material, bone attachment and therapist was evaluated. The statistical analysis was assessed using Kaplan-Meier (univariate influences) and Cox regression (multifactorial influences). RESULTS: Survival until extraction as well as decementation was significantly influenced by bone attachment and covering prosthetic restoration. Posts reaching the middle third of the root showed highly significant (p < 0.001) better survival probabilities than those reaching the coronal or apical third. Regarding the post-clinical crown ratio, no significant difference was found for post = crown/post > crown, whereas post

An avian Modified Glasgow Coma Scale as a prognostic indicator in raptors with head trauma.

OBJECTIVE: To develop a Modified Glasgow Coma Scale (MGCS) for use in raptors presenting with head trauma and assess the agreement of the MGCS scores between examiners with varying backgrounds, and to assess the prognostic value of the avian MGCS in raptors with head trauma. ANIMALS: 156 native raptorial species. METHODS: All raptors received an MGCS assessment within 8 hours of their presentation, between January 1, 2018, and December 31, 2019. For the first objective, the assessment was performed by a veterinary student, a wildlife veterinarian, and a board-certified or resident veterinary neurologist. Each animal received a score in 3 categories (motor activity, level of consciousness, and brain stem reflexes) and an overall score. For the second objective, the MGCS scoring was performed by the intaking clinical team member and survival after 48 hours was documented. RESULTS: Agreement between the 3 individual scores was assessed via Cronbach α and intraclass correlation. There was excellent-good agreement in all 3 assessment categories as well as the overall score. Univariate associations between survival and demographic factors were determined using the χ2 test. Overall, raptors with a total MGCS of < 10 were less likely to survive than those with a score > 12. CLINICAL RELEVANCE: An avian-specific MGCS demonstrated good-excellent agreement among raters of various backgrounds in assessing raptors with head trauma. Additionally, this study showed that an avian-specific MGCS may be correlated with the probability of survival within the first 48 hours after presentation to rehabilitation facilities in raptors with head trauma.

Evaluation of the Agreement Between 2 Point-Of-Care Glucometers and a Laboratory Automated Analyzer in North American Raptors.

Blood glucose abnormalities are commonly observed in veterinary medicine. Point-of-care (POC) glucometers provide rapid results, are inexpensive, and require very small sample volumes to measure blood glucose concentrations. Although POC glucometers are used frequently in dogs and cats, there have been few studies evaluating POC glucometers in avian species, none of which include raptors. This study evaluated the agreement between a veterinary POC glucometer, a human POC glucometer, and a benchtop laboratory automated analyzer (auto analyzer) using both plasma and whole blood samples from 50 free-ranging raptors admitted to the University of Illinois Wildlife Medical Clinic (Urbana, IL, USA). The veterinary POC glucometer, when used with plasma and whole blood, and the human POC glucometer, when used with whole blood, were in poor agreement with the laboratory auto analyzer. The human POC glucometer, when used with plasma, was in greatest agreement with the laboratory auto analyzer, meeting the US Food and Drug Administration's accuracy guidelines for "over-the-counter" POC glucometers for use in humans. Based on these results, the use of the Contour Next EZ with plasma samples is the only POC recommended for use in raptors. Further research should focus on assessing the clinical utility of blood glucose measurements when treating various disease processes in raptors and the prognostic value of blood glucose measurements when assessing critically ill raptors.

PROGNOSTIC INDICATORS FOR SURVIVAL OF ORPHANED EASTERN GRAY SQUIRRELS (SCIURUS CAROLINENSIS).

The eastern grey squirrel (EGS), Sciurus carolinensis, is a tree squirrel native to the eastern United States. This species commonly presents to wildlife medical clinics for a variety of human-related injuries including confrontations with road traffic and pet predation. The purpose of this study was to assess initial examination findings as prognostic indicators for survival in EGS. The medical record database of the University of Illinois Wildlife Medical Clinic was searched from January 2012 through December 2018 for records of EGS weighing <300 g. The squirrels were identified as survivors (individuals surviving, released, or transferred to a rehabilitator within 72 hr of intake) or nonsurvivors (individuals euthanized or dying within 72 hr of intake after receiving medical care). Presenting weight, health status, method of feeding, and singleton versus group presentation were categorically recorded for each case. The data were modeled using a series of candidate logistic regression models fitted using the generalized linear model. An information theoretical approach determined the best fit model. A total of 955 EGS were included in this study. Factors that predicted a nonsurvivor status included EGSs that presented with any health system abnormality (odds ratio [OR], 4.81; 95% confidence interval [CI], 3.34-6.72), EGSs that presented between December and May (OR, 1.60; 95% CI, 1.12-2.27) rather than between June and November, and individuals with neurologic signs (OR, 2.61; 95% CI, 1.51-4.51) compared with EGSs without neurologic signs. Despite not being included in the final model, the presence of respiratory signs (OR, 3.43; 95% CI, 2.41-4.89) and diarrhea (OR, 4.01; 95% CI, 1.59-10.09) were significantly associated with a higher likelihood of nonsurvival status. Wildlife medical clinics and rehabilitation centers may use this information by initiating more aggressive therapies or instituting distinct euthanasia protocols for EGS that present with body system abnormalities, particularly neurologic clinical signs, and those that present in the winter months.

PROGNOSTIC INDICATORS FOR SURVIVAL OF ORPHANED NEONATAL AND JUVENILE EASTERN COTTONTAIL RABBITS (SYLVILAGUS FLORIDANUS): 1,256 CASES (2012-17).

Orphaned eastern cottontail rabbits (ECRs; Sylvilagus floridanus) often present to wildlife clinics within their geographic range and require considerable dedication of time and resources. The objective of this analytical cross-sectional study was to assess initial examination findings to be used as prognostic indicators for orphaned neonatal and juvenile ECRs. The medical records of the University of Illinois Wildlife Medical Clinic were searched for ECRs presenting between 2012 and 2018. This criterion identified 1,256 ECRs that were then classified as survivors (survived and released) or as nonsurvivors (euthanized or natural death) within 72 h of admission. Presenting weight, body system abnormalities, hydration status, intervention prior to presentation, and singleton versus group presentation were categorically recorded for each individual ECR. The data were modeled using a series of logistic regression models fitted using the general linear model. Individuals were significantly more likely to be nonsurvivors if they presented as singletons (P<0.0001), presented with moderate/severe (P<0.001) or mild integumentary signs (P=0.0261), presented with multi-organ disease (P<0.001), presented with neurologic signs (P<0.0003), or had treatment provided prior to presentation (P=0.031). Factors that did not predict survival status in ECRs included body weight (P=0.210), presence of respiratory signs (P=0.674), and presence of dehydration (P=0.356). These findings may be used at wildlife medical clinics to make triage criteria for euthanasia as well as dedicate limited funds and labor to cases with the best prognosis for survival.

Community Healthcare and Technology to Enhance Communication in Pediatric Obesity Care.

Childhood obesity continues to be a critical healthcare issue and a paradigm of a pervasive chronic disease affecting even our youngest children. When considered within the context of the socioecological model, the factors that influence weight status, including the social determinants of health, limit the impact of multidisciplinary care that occurs solely within the medical setting. Coordinated care that incorporates communication between the healthcare and community sectors is necessary to more effectively prevent and treat obesity. In this article, the Expert Exchange authors, with input from providers convened at an international pediatric meeting, provide recommendations to address this critical issue. These recommendations draw upon examples from the management of other chronic conditions that might be applied to the treatment of obesity, such as the use of care plans and health assessment forms to allow weight management specialists and community personnel (e.g., school counselors) to communicate about treatment recommendations and responses. To facilitate communication across the healthcare and community sectors, practical considerations regarding the development and/or evaluation of communication tools are presented. In addition, the use of technology to enhance healthcare-community communication is explored as a means to decrease the barriers to collaboration and to create a web of connection between the community and healthcare providers that promote wellness and a healthy weight status.