Outcome of root canal retreatment filled with gutta-percha techniques: A systematic review and meta-analysis.

OBJECTIVE: The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to retreatment success. DATA: The PRISMA guidelines were followed for the present review. The study protocol was registered in the International Prospective Database of Systematic Reviews (PROSPERO CRD42021283134). Risk assessment was performed using the Newcastle-Ottawa scale. Funnel plots were used to detect publication bias and asymmetry was assessed using Egger's tests. SOURCES: PubMed, Scopus, ScienceDirect, Cochrane, and additional sources were searched. STUDY SELECTION: Studies published until 10 December 2022. Clinical studies evaluating the success of root canal retreatment filled with gutta-percha with at least a 1-year follow-up were selected. RESULTS: Ten studies and one unpublished study fulfilled the inclusion criteria for quantitative analysis. The success rate of non-surgical root canal retreatment was 71% (95% CI: 66%-76%) with strict criteria and 87% (79% - 93%) with loose criteria for 1-3 years of follow-up, and 77% (66% - 86%) with strict criteria for a 4-5 years of follow-up. Endodontically retreated teeth with periapical lesions had a lower success rate under strict criteria. The tooth type, dental arch, initial periapical index (PAI) score, and the number of visits also affected the treatment success rate under strict criteria. For the loose criteria, teeth with larger periapical lesions and higher initial PAI scores had a lower success rate. CONCLUSIONS: According to the present systematic review and meta-analysis, non-surgical root canal retreatment results in favourable outcomes. The presence of a periapical radiolucency, periapical lesions >5mm, a higher initial PAI score, multiple-visit retreatments, and mandibular and molar teeth resulted in a lower success rate. CLINICAL SIGNIFICANCE: Non-surgical root canal retreatment filled with gutta-percha techniques is a relatively predictable procedure with a high success rate. Several variables can affect retreatment success, mainly the presence and size of a periapical lesion and the type of tooth.

Outcome of Nonsurgical Root Canal Retreatment Procedures Obturated with Warm Gutta-percha Techniques: A Longitudinal Clinical Study.

INTRODUCTION: To evaluate the success rate of nonsurgical root canal retreatment at the 2-3-year follow-up and identify the possible prognostic factors. METHODS: Patients who underwent root canal retreatment at a university dental clinic were contacted for clinical and radiographic follow-up. The retreatment outcomes in these cases were based on clinical signs, symptoms, and radiographic criteria. Inter- and intraexaminer concordances were calculated using Cohen's kappa coefficient. The retreatment outcome was dichotomized into success or failure according to strict and loose criteria. The radiographic success criteria consisted of complete resolution or absence of a periapical lesion (strict criteria) or a reduction in the size of an existing periapical lesion at recall (loose criteria). χ2 tests were used to evaluate possible variables associated with retreatment outcomes (age, sex, tooth type, location, contact points, periapical status, quality of previous and final root canal filling, previous and final restoration, number of visits, and complications). RESULTS: Overall, 129 teeth (113 patients) were included in the final evaluation. The success rate was 80.6% under strict criteria and 93% under loose criteria. Molars, teeth with an initially higher periapical index score, and teeth with >5 mm periapical radiolucency had a lower success rate according to the strict criteria model (P < .05). When the loose success criteria were used, teeth with larger (>5 mm) periapical lesions and those that had been perforated during retreatment showed a lower success rate (P < .05). CONCLUSIONS: The present study demonstrated that nonsurgical root canal retreatment is a highly successful procedure after an observation period of 2-3 years. Treatment success is primarily affected by the presence of large periapical lesions.

Prevalence of SARS-CoV-2 antibodies and risk factors in the pandemic epicentre of Catalonia.

To define the seroprevalence of antibodies against SARS-CoV-2 in the municipality of Vilanova del Camí (in the region of Conca d'Ódena, Barcelona, Spain) and to know the risk factors associated with positive seroprevalence. Cross-sectional descriptive study. The population of Vilanova del Camí had the opportunity to voluntarily attend two screenings (October and December 2020) for antibodies against the nucleocapsid protein of SARS-CoV-2 using a Rapid Diagnostic Test (RDT) (Salocor (Salofa Oy). Participants in the screening signed an informed consent form. From the 3,610 attendees at the screening, 2,170 patients were randomly selected. The relationship between antibody test results and other demographic (sex, age, morbidity index) and clinical (diagnoses, smoking and drugs) variables was analysed. The prevalence of antibodies against SARS-CoV-2 was 9.6% (95% CI of 8.4% to 10.9%) and was similar for men and women but increased with age. Among complex chronic patients, 14.3% had antibodies against SARS-CoV-2, and among patients with advanced chronic disease, 25% had antibodies against SARS-CoV-2. Age, AMG (Adjusted Morbidity Groups) index, COVID-19 diagnosis and contact with a COVID-19 case were risk factors for positive seroprevalence. A higher seroprevalence was detected in the October screening (12.16%) than in the December screening (8.38%). In the December screening, obesity was a risk factor for positive seroprevalence. This study demonstrates the high seroprevalence of antibodies against SARS-CoV-2 in the pandemic epicentre of Catalonia.

Association between the reduction of face-to-face appointments and the control of patients with type 2 diabetes mellitus during the Covid-19 pandemic in Catalonia.

AIM: To analyse the relation between face-to-face appointments and management of patients with type 2 diabetes mellitus (T2DM) visited in primary care practices (PCP). METHODS: Retrospective study in 287 primary care practices (PCPs) attending>300,000 patients with T2DM. We analysed the results of 9 diabetes-related indicators of the Healthcare quality standard, comprising foot and retinopathy screening, blood pressure (BP) and glycemic control; and the incidence of T2DM. We calculated each indicator's percentage of change in 2020 with respect to the results of 2019. RESULTS: Indicators' results were reduced in 2020 compared to 2019, highlighting the indicators of foot and retinopathy screening (-51.6% and -25.7%, respectively); the glycemic control indicator (-21.2%); the BP control indicator (-33.7%) and the incidence of T2DM (-25.6%). Conversely, the percentage of type 2 diabetes patients with HbA1c > 10% increased by 34%. PCPs with<11 weekly face-to-face appointments offered per professional had greater reductions than those PCPs with more than 40. For instance, a reduction of -60.7% vs -38.2% (p-value < 0.001) in the foot screening's indicator; -27.5% vs -12.5% (p-value < 0.001) in glycemic control and -40.2 vs -24.3% (p-value < 0.001) in BP control. CONCLUSIONS: Reducing face-to-face visits offered may impact T2DM patients' follow-up and thus worsen their control.

Association of screen time and sleep duration among Spanish 1-14 years old children.

BACKGROUND: Due to the change in screen time usage in the last decade, there is needed to add more evidence about the relationship of screen time and sleep duration. OBJECTIVE: To assess the association between screen time and sleep duration among Spanish children between 1 and 14 years old. METHODS: We used data from the 2017 Spanish National Health survey, conducted on a representative sample of the Spanish population. We categorised daily leisure screen time as 0-59, 60-119, 120-179, and ≥180 minutes. We classified sleep duration, depending on the age, as proper sleep duration and short sleep duration. We calculated unadjusted, and adjusted prevalence ratio (PR) and 95% confidence interval (CI) of short sleep duration according to daily leisure screen time after adjusting for potential confounders. PR's were derived from fitting generalised linear models with Poisson distribution and robust variance. RESULTS: Of the 5517 Spanish children aged 1-14 years, 44.3% spent 120 minutes or more of daily leisure screen time and 23.6% had short sleep duration. 24.5% and 28.2% of children spending between 120 and 179 minutes and exceeding 180 minutes of daily leisure screen time suffered short sleep duration, respectively. In the adjusted model, higher patterns of daily leisure screen time were associated with short sleep duration: adjusted PR120-179  = 1.34 (95% CI 1.18, 1.54) and adjusted PR≥180  = 1.48 (95% CI 1.27, 1.73). CONCLUSIONS: Around one out of four Spanish children between 1 and 14 years old, exceeding 120 minutes of daily leisure screen time, had short sleep duration. More scientific research is needed for institutions to work on providing novel healthcare programmes that consider these new determinants of child health.

General Anxiety in Dental Staff and Hemodynamic Changes over Endodontists' Workday during the Coronavirus Disease 2019 Pandemic: A Prospective Longitudinal Study.

INTRODUCTION: The aim of this study was to assess general anxiety levels in endodontists and dental assistants related to different conditions during the pandemic and lockdown and to evaluate hemodynamic changes in endodontists' heart rate (HR), blood pressure, and blood oxygenation during their workday. METHODS: Anxiety levels in endodontists and dental assistants were recorded weekly during the state of alarm declared because of the coronavirus disease 2019 pandemic. Hemodynamic parameters were monitored using a sphygmomanometer for HR and blood pressure and a pulse oximeter for oxygen saturation. Measurements were taken before and after each root canal treatment as well as on arrival at the clinic and at the end of the working day. Rest data, recorded every Saturday, served as a control. Data analysis was performed using chi-square, paired t, Mann-Whitney, and analysis of variance tests (P < .05). RESULTS: General anxiety decreased over the weeks, with significant differences between weeks 1 and 4 (P < .05). Endodontists perceived higher anxiety levels of anxiety during anesthesia inoculation and dental assistants during the dental unit's disinfection and equipment material (P < .05). There was a significant increase in the cardiovascular response in all endodontists in the clinic registrations compared with rest data (P < .05). Values were higher in the strict confinement period and significant for HR when arriving at the clinic (P < .05). CONCLUSIONS: Levels of general anxiety were higher during the first weeks. The chief perceived factors related to anxiety in endodontists and dental assistants were the risk of contagion and protection measures. Higher HR and blood pressure levels were registered during the workday, especially when arriving at the clinic.

Dental Anxiety, Fear, and Root Canal Treatment Monitoring of Heart Rate and Oxygen Saturation in Patients Treated during the Coronavirus Disease 2019 Pandemic: An Observational Clinical Study.

INTRODUCTION: The present study aimed to evaluate anxiety in patients and to monitor their heart rate (HR) and blood oxygenation (SpO2) before, during, and after a root canal treatment (RCT) during the state of alarm in 2 different periods of strict and partial confinement. METHODS: The patients who required a primary RCT were selected. Demographic, preoperative, and postoperative variables were registered, including perceived dental anxiety, fear, HR, and SpO2. Spearman correlation, chi-square, Mann-Whitney, and Kruskal-Wallis tests were used for frequency distribution and variable interaction, and Wilcoxon and Mann-Whitney tests were used to compare HR and SpO2 between groups and different treatment points. RESULTS: Ninety-six patients were included. The median Modified Dental Anxiety Scale scores were 8 (interquartile range [IQR], 6-9.25) and 6 (IQR, 5.5-8) in patients treated during the strict and partial confinement periods. The median fear scores were 2 (IQR, 0-5) and 3 (IQR, 1-5), respectively. Having a previous dental bad experience resulted in higher dental anxiety and fear (P < .05). HR was increased in patients with higher MDAS and fear scores and in those treated during the strict confinement (P < .05). In treatment time points T6 (x-ray taking), and T7 (post-treatment), HR decreased compared with the other evaluated treatment time points (P < .05). No clinical differences were found regarding SpO2. CONCLUSIONS: Self-perception on dental anxiety and fear was similar to other studies in a nonpandemic context. Patients with higher levels of dental anxiety and those treated in the strict confinement period presented an elevated HR. However, it can be stated that RCT performed by endodontists does not result in a significant alteration in patients.

Outcome and Survival of Endodontically Treated Cracked Posterior Permanent Teeth: A Systematic Review and Meta-analysis.

INTRODUCTION: The aim of the present systematic review and meta-analysis was to evaluate the success and survival rate of endodontically treated cracked posterior teeth and to assess the preoperative factors that affect teeth survival. METHODS: The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42019119091). Electronic search was performed for studies up to November 30, 2018 in the following databases: PubMed, Scopus, and Cochrane. All searches were done following the PRISMA guidelines. Clinical studies evaluating the success and/or the survival rate of cracked teeth that were endodontically treated with at least 1-year follow-up were selected. The Newcastle-Ottawa scale was used to evaluate risk assessment. Publication bias was evaluated with funnel plots, and the Egger's test was performed to test asymmetry. RESULTS: From the 410 studies identified through the initial search, 7 studies qualified for the final analysis, all of which were longitudinal cohort studies. The results of the meta-analysis indicated a survival rate of 88% (confidence interval, 0.81-0.94) and a success rate of 82% (confidence interval, 0.78-0.86) after 1 year of follow-up. The presence of a periodontal pocket associated to a crack (relative risk, 1.11) resulted in a higher risk of tooth loss. Patient sex, tooth type, position, the number of cracks present, and preoperative pulp status did not affect treatment survival rate (P > .05). Most of the included studies did not have an accurate record of many variables that could affect the tooth survival. Plus, studies did not present extended follow-up periods or an adequate dropout rate to properly assess treatment outcome and survival. CONCLUSIONS: According to the results of the present systematic review and meta-analysis, root canal treatment in cracked posterior teeth can be considered a suitable treatment option. The presence of an associated periodontal pocket results in a lower survival rate.

Relation between tobacco control policies and population at high risk of lung cancer in the European Union.

INTRODUCTION: Lung cancer accounts for nearly 2 million deaths per year worldwide, the majority of cases due to smoking as the main risk factor associated. The aim of this study was to assess the relation between the level of implementation of tobacco control policies and the population at high risk of lung cancer in the European Union (EU). METHODS: The Special Eurobarometer 458 "Attitudes of Europeans towards tobacco and electronic cigarettes", conducted in 2017, and the Tobacco Control Scale (TCS) 2010, 2013, and 2016 were the sources of our data. High risk of lung cancer was defined by the inclusion criteria in the National Lung Screening Trial (NLST) and the Dutch-Belgian Lung Cancer Screening Trial (NELSON), the largest lung cancer screening trials carried out in the US and the EU. We calculated Spearman's rank correlation coefficients (rsp) and fitted multilevel generalized linear mixed models using the quasi-Poisson family to assess the correlation at the national level and analyze the association at the individual level, respectively, between the scores in the TCS (higher scores means better implementation of tobacco control policies) and the proportion of individuals at high risk of lung cancer in member states of the EU. RESULTS: The scores in the TCS 2010 were statistically negatively correlated with the current proportion of ever and former smokers at high risk according to NELSON criteria (-0.41; 95%CI -0.68, -0.04 and -0.49; 95%CI -0.73, -0.13, respectively). We observed statistically significant inverse associations between the scores in the TCS 2010 for the highest quartiles and the proportion of individuals at high risk of lung cancer according to both criteria. Non-statistically significant negative correlations and inverse associations were observed with other TCS. CONCLUSION: There is a lag between the implementation of tobacco control policies and the reduction of the rates of high risk of lung cancer. Member states should reinforce comprehensive tobacco control policies to reduce the population at high risk of lung cancer in the EU.

Outcome of Partial Pulpotomy in Cariously Exposed Posterior Permanent Teeth: A Systematic Review and Meta-analysis.

INTRODUCTION: The current systematic review and meta-analysis aimed to evaluate the success rate of partial pulpotomy in treating permanent posterior teeth with carious vital pulp exposure. A secondary aim was to assess the prognostic factors using a meta-regression. METHODS: An electronic search was performed for studies from January 1950 to November 2018 in the following databases: PubMed, ScienceDirect, and Cochrane. All searches were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies evaluating the success rate of cariously exposed vital human permanent posterior teeth treated with a partial pulpotomy were selected. Only randomized clinical trials and prospective clinical studies were included for evaluation. The Newcastle-Ottawa Scale and the Cochrane Collaboration's tool were used to evaluate risk assessment. RESULTS: From the 218 studies identified through the initial search, 11 studies qualified for the final analysis (5 randomized clinical trials and 6 prospective studies). The results of the meta-analysis indicate a success rate of 98% (confidence interval [CI]: 0.94-1), 96% (CI: 0.92-0.99), and 92% (CI: 0.83-0.97) after 6 months and 1 and 2 years of follow-up. Examining the probable prognostic factors using meta-regression analysis, only preoperative pulp status (P = .001) was identified as a significant factor, with studies including teeth with the presumptive diagnosis of irreversible pulpitis displaying significantly lower results. The final solution, pulp capping material, apex closure, and the age of the patient did not affect the treatment success rate (P > .05). CONCLUSIONS: The available data suggest that a partial pulpotomy results in high success rates in treating cariously exposed permanent posterior teeth up to 2 years. Six months of monitoring can be considered an appropriate period when evaluating the success of a partial pulpotomy although more clinical and radiographic controls are essential to ensuring success.

Cáncer cutáneo distinto de melanoma: tendencia de la incidencia poblacional en Girona, 1994-2007 / Non-melanoma skin cancer: incidence time trends analysis in Girona, Spain, 1994-2007

Fundamento y objetivo: Describir la tendencia de la incidencia del cáncer cutáneo no melanoma (CCNM): carcinoma escamoso cutáneo (CEC) y carcinoma basocelular (CB) en Girona.Pacientes y método: Los casos incluidos en el estudio fueron los 9.247 pacientes con diagnóstico de CCNM reportados en el Registro de Cáncer Poblacional de Girona durante el período comprendido entre enero de 1994 y diciembre de 2007. Para el análisis de la tendencia de la incidencia poblacional se utilizó la tasa ajustada a la población mundial y se estandarizó por el método directo; para la tendencia por grupo de edad se utilizó la tasa específica por estos grupos (45-64, > 64 años). Se excluyó el grupo de menores de 45 años. Se utilizaron los métodos de regresión joinpoint para estimar las tendencias temporales mediante el cálculo del porcentaje del cambio anual según el grupo histológico y los grupos de edad seleccionados. Resultados: La tasa ajustada a la población mundial fue de 55,74 casos por 105 personas-año, siendo superior en varones (67,13) que en mujeres (46,9); la del CB fue superior a la del CEC (44,56 y 11,18 respectivamente). La tasa del CCNM en ambos sexos se incrementó desde 48,53 (1994-95) hasta 60,54 (2006-07) con un porcentaje de cambio anual del 2,30%, siendo más importante este incremento para la mujer (2,65%) que para el varón (1,99%). Conclusiones: En nuestra población se detecta un importante incremento en la incidencia del CCNM, siendo más importante para el CEC que para el CB, en los mayores de 64 años y en las mujeres (AU)

Background and objective: We aimed to assess the population-based incidence trends of non-melanoma skin cancer (NMSC): squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Patients and method: From January 1994 to December 2007, 9,247 patients diagnosed with NMSC were recruited in the population-based Cancer Registry of Girona. Incidence rates were calculated with age-adjusted according to the Word standard population (WASR) by a direct method and reported as number of new cases per 100,000 person-year. To evaluate incidence trends by age group we used specific rates for these groups (45-64, > 64 years). We excluded patients younger than 45 years. Joinpoint method was used to estimate the average annual percentage change (AAPC) for the whole study period according to histologic and age groups. Results: Age-adjusted incidence was 55.74 per 105 person-year; it was higher in males (67.13) than in females (46.9). Age-adjusted incidence for BCC was higher compared with the incidence for SCC (44.56 and 11.18 respectively). Age-adjusted incidence rate for NMSC for both sexes increased from 48.53 (1994-95) to 60.54 (2004-05) with an AAPC of 2.30%, which was higher in females (2.65%) than in males (1.99%). Conclusions: There has been a significant increase in the incidence of NMSC in our area, particularly evident for SCC, and it is more important in patients older than 64 years and in females (AU)

[Non-melanoma skin cancer: incidence time trends analysis in Girona, Spain, 1994-2007]. / Cáncer cutáneo distinto de melanoma: tendencia de la incidencia poblacional en Girona, 1994-2007.

BACKGROUND AND OBJECTIVE: We aimed to assess the population-based incidence trends of non-melanoma skin cancer (NMSC): squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). PATIENTS AND METHOD: From January 1994 to December 2007, 9,247 patients diagnosed with NMSC were recruited in the population-based Cancer Registry of Girona. Incidence rates were calculated with age-adjusted according to the Word standard population (WASR) by a direct method and reported as number of new cases per 100,000 person-year. To evaluate incidence trends by age group we used specific rates for these groups (45-64, > 64 years). We excluded patients younger than 45 years. Joinpoint method was used to estimate the average annual percentage change (AAPC) for the whole study period according to histologic and age groups. RESULTS: Age-adjusted incidence was 55.74 per 10(5) person-year; it was higher in males (67.13) than in females (46.9). Age-adjusted incidence for BCC was higher compared with the incidence for SCC (44.56 and 11.18 respectively). Age-adjusted incidence rate for NMSC for both sexes increased from 48.53 (1994-95) to 60.54 (2004-05) with an AAPC of 2.30%, which was higher in females (2.65%) than in males (1.99%). CONCLUSIONS: There has been a significant increase in the incidence of NMSC in our area, particularly evident for SCC, and it is more important in patients older than 64 years and in females.

Sodium tungstate decreases sucrase and Na+/D-glucose cotransporter in the jejunum of diabetic rats.

Sodium tungstate reduces glycemia and reverts the diabetic phenotype in several induced and genetic animal models of diabetes. Oral administration of this compound has recently emerged as an effective treatment for diabetes. Here we examined the effects of 30 days of oral administration of tungstate on disaccharidase and Na+/D-glucose cotransporter (SGLT1) activity in the jejunum of control and streptozotocin-induced diabetic rats. Diabetes increased sucrase-specific activity in the jejunal mucosa but did not affect the activity of lactase, maltase, or trehalase. The abundance and the maximal rate of transport of SGLT1 in isolated brush-border membrane vesicles also increased. Tungstate decreased sucrase activity and normalized SGLT1 expression and activity in the jejunum of diabetic rats. Furthermore, tungstate did not change the affinity of SGLT1 for d-glucose and had no effect on the diffusional component. In control animals, tungstate had no effect on disaccharidases or SGLT1 expression. Northern blot analysis showed that the amount of specific SGLT1 mRNA was the same in the jejunum from all experimental groups, thereby indicating that changes in SGLT1 abundance are due to posttranscriptional mechanisms. We conclude that the antidiabetic effect of tungstate is partly due to normalization of the activity of sucrase and SGLT1 in the brush-border membrane of enterocytes.

[Paratesticular rhabdomyosarcoma]. / Rabdomiosarcoma paratesticular.

Contribution of one case of paratesticular rhabdomyosarcoma in a 10-years old male patient. Following radical orchiectomy it was classified as Group Ia (Intergroup Rhabdomyosarcoma Study). Treatment was completed with 9 polychemotherapy courses of Ifosfamide, Vincristine and Actinomicine D. The patient was disease-free 6 months after the treatment.

Rabdomiosarcoma paratesticular / Paratesticular rhabdomyosarcoma

Presentamos un caso de rabdomiosarcoma paratesticular en un niño de 10 años. Tras practicar orquiectomía inguinal radical fue clasificado como estadio Ia según el IRS (Intergroup Rhabdomyosarcoma Study). El tratamiento se completó con quimioterapia adyuvante (9 ciclos de Ifosfamida, Vincristina y Actinomicina D) y el paciente permanece libre de enfermedad 6 meses después del tratamiento (AU)

Contribution of one case of paratesticular rhabdomyosarcoma in a 10-years old male patient. Following radical orchiectomy it was classified as Group Ia (Intergroup Rhabdomyosarcoma Study). Treatment was completed with 9 polychemotherapy courses of Ifosfamide, Vincristine and Actynomicine D. The patient was disease-free 6 months after the treatment (AU)