Accuracy and Consistency of Gemini Responses Regarding the Management of Traumatized Permanent Teeth.

BACKGROUND: The aim of this cross-sectional observational analytical study was to assess the accuracy and consistency of responses provided by Google Gemini (GG), a free-access high-performance multimodal large language model, to questions related to the European Society of Endodontology position statement on the management of traumatized permanent teeth (MTPT). MATERIALS AND METHODS: Three academic endodontists developed a set of 99 yes/no questions covering all areas of the MTPT. Nine general dentists and 22 endodontic specialists evaluated these questions for clarity and comprehension through an iterative process. Two academic dental trauma experts categorized the knowledge required to answer each question into three levels. The three academic endodontists submitted the 99 questions to the GG, resulting in 297 responses, which were then assessed for accuracy and consistency. Accuracy was evaluated using the Wald binomial method, while the consistency of GG responses was assessed using the kappa-Fleiss coefficient with a confidence interval of 95%. A 5% significance level chi-squared test was used to evaluate the influence of question level of knowledge on accuracy and consistency. RESULTS: The responses generated by Gemini showed an overall moderate accuracy of 80.81%, with no significant differences found between the responses of the academic endodontists. Overall, high consistency (95.96%) was demonstrated, with no significant differences between GG responses across the three accounts. The analysis also revealed no correlation between question level of knowledge and accuracy or consistency, with no significant differences. CONCLUSIONS: The results of this study could significantly impact the potential use of Gemini as a free-access source of information for clinicians in the MTPT.

Clinical and radiographic features of external cervical resorption - An observational study.

AIM: To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR). METHODOLOGY: This study involved 215 ECR lesions in 194 patients referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK). The clinical and radiographic findings (periapical [PA] and cone beam computed tomography [CBCT]) were readily accessible for evaluation. A checklist was used for data collection. Inferential analysis was carried out to determine if there was any potential association between type and location of tooth in the jaw as well as sex, age of the patient and ECR presentation and radiographic feature. RESULTS: Eighty-eight patients (94 teeth) were female and 106 patients were male (121 teeth), the mean age (±SD) was 41.5 (±17.7) years. Fifteen patients (7.7%) had more than one ECR lesion. The most affected teeth were maxillary central incisors (21.4% [46 teeth]) and mandibular first molars (10.2% [22 teeth]). ECR was most commonly detected as an incidental radiographic finding in 58.1% [125 teeth] of the cases. ECR presented with symptoms of pulpal/periapical disease in 23.3% [n = 50] and clinical signs (e.g. pink spot, cavitation) in 16.7% [36 teeth] of the cases. Clinical signs such as cavitation (14%), pink spot (5.1%) and discolouration (2.8%) were uncommon, but their incidence increased up to 24.7% when combined with other clinical findings. ECR was detected in the resorptive and reparative phases in 70.2% and 29.8% of the cases respectively. CONCLUSION: ECR appears to be quiescent in nature, the majority being asymptomatic and diagnosed incidentally from PA or CBCT. When assessed with the Patel classification, most lesions were minimal to moderate in relation to their height (1 or 2) and circumferential spread (A or B). However, the majority of ECRs were in (close) proximity to the pulp. Symptoms and clinical signs were associated with (probable) pulp involvement rather than the height and circumferential spread of the lesion. Clinical signs were more frequently associated when ECR affected multiple surfaces.

A Machine-Learning Model for Lung Age Forecasting by Analyzing Exhalations.

Spirometers are important devices for following up patients with respiratory diseases. These are mainly located only at hospitals, with all the disadvantages that this can entail. This limits their use and consequently, the supervision of patients. Research efforts focus on providing digital alternatives to spirometers. Although less accurate, the authors claim they are cheaper and usable by many more people worldwide at any given time and place. In order to further popularize the use of spirometers even more, we are interested in also providing user-friendly lung-capacity metrics instead of the traditional-spirometry ones. The main objective, which is also the main contribution of this research, is to obtain a person's lung age by analyzing the properties of their exhalation by means of a machine-learning method. To perform this study, 188 samples of blowing sounds were used. These were taken from 91 males (48.4%) and 97 females (51.6%) aged between 17 and 67. A total of 42 spirometer and frequency-like features, including gender, were used. Traditional machine-learning algorithms used in voice recognition applied to the most significant features were used. We found that the best classification algorithm was the Quadratic Linear Discriminant algorithm when no distinction was made between gender. By splitting the corpus into age groups of 5 consecutive years, accuracy, sensitivity and specificity of, respectively, 94.69%, 94.45% and 99.45% were found. Features in the audio of users' expiration that allowed them to be classified by their corresponding lung age group of 5 years were successfully detected. Our methodology can become a reliable tool for use with mobile devices to detect lung abnormalities or diseases.

Magnetic extrusion technique for restoring severely compromised teeth: A case report.

An orthodontic magnetic extrusion technique is described for the management of an extensively damaged maxillary premolar. A cylindrical neodymium-iron-boron (Nd2Fe14B) magnet was attached to the remaining tooth structure, and a second magnet was placed on a resin-bonded partial denture. A 4.5-mm extrusion was obtained after 3 adjustments, and the tooth was prepared with a 3-mm buccal and 2-mm lingual ferrule by following a biologically oriented preparation technique and restored with a monolithic zirconia crown. Eighteen months after completing the treatment, no evidence of soft tissue dehiscence, abnormal tooth mobility, endodontic failure, or root resorption was found.

Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial.

The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.

A multicentre randomized trial of combined individual and telephone counselling for smoking cessation.

OBJECTIVE: The present study assessed the effectiveness of smoking cessation programs combining individual and telephone counselling, compared to individual or telephone counselling alone. METHOD: A randomized, multicentre, open-label trial was performed between January 2009 and July 2011 at six smoking cessation clinics in Spain. Of 772 smokers assessed for eligibility, 600 (77%) met inclusion criteria and were randomized. Smokers were randomized to receive individual counselling, combined telephone and individual counselling, or telephone counselling. The primary outcome was biochemically validated continuous abstinence at 52 weeks. RESULTS: The 52-week abstinence rate was significantly lower in the telephone group compared to the combined group (20.1% vs. 29.0%; OR, 1.32; 95% CI, 1.1-2.7) and to the individual counselling group (20.1% vs. 27.9%; OR, 1.37; 95% CI, 1.0-2.8). The 52-week abstinence rates were not significantly higher in the combined group than the individual group (OR, 0.97; 95% CI, 0.7-1.4). CONCLUSION: Individual counselling and combined individual and telephone counselling were associated with higher 52-week abstinence rates than telephone counselling alone. A combined approach may be highly useful in the clinical treatment of smokers, as it involves less clinic visits than individual counselling alone, thus reducing the program cost, and it increases patient compliance compared to telephone counselling alone.

Influence of Cone-beam Computed Tomography in Clinical Decision-making among Different Specialists in External Cervical Resorption Lesions: A Before-After Study.

INTRODUCTION: Inadequate management of external cervical resorption (ECR) lesions may impact the treatment outcome. This study aimed to ascertain the influence of cone-beam computed tomography (CBCT) in clinical decision-making choices in cases of ECR among dentistry specialists (endodontics, prosthodontics, oral surgery, periodontics orthodontics, and general dentistry). A secondary objective was to evaluate the self-reported level of difficulty in choosing a treatment plan before and after viewing the CBCT images. METHODS: Sixty examiners from different specialties were chosen to evaluate 12 cases of ECR lesions. Each case included clinical photographs, digital periapical radiographs, and a small-volume CBCT scan. In the first assessment, the examiners were given all the relevant information of each case, except the CBCT scan. Each examiner was asked to select 1 of the proposed treatment options and assess the difficulty of decision-making. Four weeks later, the examiners randomly reviewed the same 12 cases with additional information from the CBCT data. RESULTS: After the CBCT evaluation, the clinicians changed their treatment plan in 72.2% of the cases (P < .05). The self-reported level of difficulty in choosing a treatment changed in all groups after evaluating the CBCT scans (P < .05). After viewing the CBCT scan, the extraction option increased significantly in all groups (P < .05). CONCLUSIONS: CBCT scan had a significant impact on clinical decision-making in cases of ECR evaluated by different specialists.

Root Membrane Replantation as an Alternative Technique for the Socket Preservation.

Background and Overview. Socket shield is a technique that allows the maintenance of tissue volumes. In the reported clinical case, the replantation of the buccal root fragment mistakenly extracted during a socket shield surgery is performed. We present a follow-up to 5 years with an unexpected healing.Case Description. An 88-year-old patient underwent an immediate loading implant placement associated with the replantation of the mistakenly extracted root fragment. The shaping of the fragment was performed extraorally, and the replantation was done so that the fragment protruded above the crest margin.Conclusions and Practical Implications. The 5-year follow-up shows an uneventful healing of the implant. At 48 months, postoperative CBCT exam reports images compatible with the regeneration of the bone over the portion of root that protruded over the margin. The outcome suggests clinical implications, as the opportunity to easily shape the fragment extraorally and replant sound portion of the root (not necessary the buccal) in buccal socket with bone defect.

A Free App for Diagnosing Burnout (BurnOut App): Development Study.

BACKGROUND: Health specialists take care of us, but who takes care of them? These professionals are the most vulnerable to the increasingly common syndrome known as burnout. Burnout is a syndrome conceptualized as a result of chronic workplace stress that has not been successfully managed. OBJECTIVE: This study aims to develop a useful app providing burnout self-diagnosis and tracking of burnout through a simple, intuitive, and user-friendly interface. METHODS: We present the BurnOut app, an Android app developed using the Xamarin and MVVMCross platforms, which allows users to detect critical cases of psychological discomfort by implementing the Goldberg and Copenhagen Burnout Inventory tests. RESULTS: The BurnOut app is robust, user-friendly, and efficient. The good performance of the app was demonstrated by comparing its features with those of similar apps in the literature. CONCLUSIONS: The BurnOut app is very useful for health specialists or users, in general, to detect burnout early and track its evolution.

Magnetic extrusion for restoring teeth with a negative ferrule effect: a 2-year follow-up case report.

The restoration of severely damaged teeth with no coronal structure requires an adequate supracrestal tissue attachment (STA) and a distance of at least 3 mm between the crown margin and the alveolar crest. Management of a tooth with no walls and only subgingival tooth structure implies that the tooth has no ferrule. Ferrule preparation from 1.5 to 2.0 mm with a circumference greater than 75% is crucial for a good medium- and long-term prognosis (especially at the anterior segments) and increases survival probability by 5%. Three main options may be considered to create space for a ferrule: crown lengthening, orthodontic extrusion or surgical extrusion. Although extrusion is widely performed with fixed orthodontic appliances using arch wires or elastics attached to the tooth, the same outcome can also be achieved with magnets. This article reports on a 56-year-old male with a severely damaged tooth 23 with no ferrule, which was an abutment of an In-Ceram alumina fixed partial denture (FPD). The treatment plan consisted of a magnetic extrusion of tooth 23 using a provisional tooth-implant FPD made of polymethyl methacrylate (PMMA). The treatment lasted approximately 10 months, with the last clinical and radiographic control carried out 2 years post-extrusion. The present case report aims to demonstrate that magnetic extrusion with an FPD provides a friction-free system in which the direction and amount of force can be manipulated. This technique offers an excellent alternative for the restoration of teeth with insufficient ferrule, or even with no ferrule. Further prospective studies and randomized controlled trials are needed to demonstrate the feasibility of this treatment option.

Autotransplantation of impacted maxillary canines into surgically modified sockets and orthodontic treatment: a 4-year follow-up case report.

The permanent maxillary canine is the second most frequently impacted or displaced tooth. The standard treatment for an impacted canine includes, among other things, surgical exposure and orthodontic alignment. Surgical techniques for this procedure vary depending on whether the tooth is labially or palatally impacted, while orthodontic techniques vary according to clinical judgment and experience. Autotransplantation is a treatment alternative for impacted canines with complete root formation. The success of tooth transplantation depends on the vitality of the periodontal ligament (PDL) attached to the donor tooth, and its viability decreases when it is exposed extraorally. This article reports on maxillary canine autotransplantations combined with connective tissue grafts (CTGs) and orthodontics. The recipient mesiodistal space was created orthodontically and the recipient socket was prepared using dental implant drills. Following transplantation, bone defects were grafted using guided bone regeneration (GBR). At 4 years post-transplantation, the soft tissue level was stable and periapical radiographs showed a practically normal contour of the alveolar crest around teeth 13 and 23. The two permanent canines presented no root resorption and ankylosis, and no signs of inflammation or bleeding were observed. The procedure used in this case report demonstrates that canine transplantation combined with GBR, plastic surgery procedures, and orthodontic treatment may yield acceptable and predictable esthetic results.

Cone-beam Computed Tomographic Analysis to Detect the Association between Primary and Secondary Endodontic Infections and Mucosal Thickness of Maxillary Sinus.

INTRODUCTION: This retrospective study used cone-beam computed tomographic (CBCT) imaging to evaluate the differences in the mucosal thickness of the Schneiderian membrane in primary and secondary endodontic lesions. METHODS: A total of 121 CBCT scans were analyzed. Clinical features such as sex, age, size and volume of the periapical lesion, dimension of the bone, morphology, and relationship between the roots and the mucosal thickness were recorded and analyzed in primary and secondary endodontic lesions in CBCT sagittal and coronal planes. Data were analyzed using the chi-square test, the Mann-Whitney U test, and multiple logistic regression (P < .05). RESULTS: Statistical analysis revealed no significant differences in membrane thickness between the primary and secondary lesions in the sagittal and coronal planes (P = .08 and .06). Differences between age groups were statistically significant in both groups (P < .05). The volume of the periapical lesions of the secondary endodontic lesions were statistically greater than that of the primary lesions (P < .05). Mucosal thickness prevalence increased when the volume of the lesion was greater, and the bone dimension was narrower in maxillary second premolars and first and second molars. Teeth with 2 or more affected roots were directly related to increased sinus mucosa thickening. CONCLUSIONS: CBCT images showed no differences in mucosal thickening between primary and secondary endodontic lesions.

Outcome of Autotransplantation of Mature Third Molars Using 3-dimensional-printed Guiding Templates and Donor Tooth Replicas.

Autotransplantation exhibits a number of advantages compared with other treatment options (ie, dental implants or fixed partial prostheses), such as greater resistance to occlusal loading, maintenance of the periodontal ligament and surrounding bone, and the potential for better esthetics. The aim of this study was to determine clinical outcomes for autotransplanted teeth with complete root formation using 3-dimensional-printed guiding templates and tooth replicas. Twenty-seven third molars with completely formed roots were autotransplanted. Each donor tooth and recipient site were examined clinically and radiographically (periapical radiographs). A selective cone-beam computed tomographic scan was taken of each donor tooth and recipient site. The images of the selected donor teeth were segmented and saved as stereolithography files. Similar to virtual planning of dental implants, correct angulation, rotation, and accurate positioning of the donor teeth were predefined using the stereolithography files. According to the virtually defined positions and dimensions of the donor teeth, 3-dimensional guiding templates and donor tooth replicas were printed. All autotransplantations were performed according to 1 treatment protocol and surgical technique. In 22 of the 24 transplanted teeth, no inflammation occurred during the healing period. At 2 years, no pathologic radiolucency or tooth resorption was observed in the 22 donor teeth. The autotransplanted teeth fulfilled the success criteria in 22 cases for a 91.7% success rate. Digital planning could potentially provide an accurate alternative to current autotransplantation techniques.

Invasive Cervical Resorption: Clinical Management in the Anterior Zone.

According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.

Influence of academic training in endodontics and implantology on decision-making in undergraduate students.

PURPOSE: To evaluate the effect of academic training on decision-making in a group of undergraduates who have undergone training in endodontics and implantology. BASIC PROCEDURES: A single group of undergraduate dentistry students (n = 65) was given a survey consisting of 15 endodontic cases. Each case included periapical radiographs and clinical photographs. Students were asked to select one of the eight proposed treatments. In their 4th year, the students first responded to the survey after completing endodontics. One year later, after completing their studies in implantology, the same students completed the same survey again. MAIN FINDINGS: Under the conditions of this study, differences in undergraduate training significantly affected treatment decisions. PRINCIPAL CONCLUSIONS: Undergraduate decision-making was affected by academic training.

Autotransplantation of Mandibular Third Molar with Buccal Cortical Plate to Replace Vertically Fractured Mandibular Second Molar: A Novel Technique.

Tooth replacement often leads to inadequate vertical volume in the recipient site bone when a tooth has been extracted because of a vertical root fracture (VRF). This case report presents the autotransplantation of a mandibular third molar (tooth #32) with the attached buccal cortical plate to replace a mandibular second molar (tooth #31) diagnosed with a VRF. After extraction of tooth #31, the recipient socket was prepared based on the size measured in advance with cone-beam computed tomographic imaging. The precise and calculated osteotomy of the cortical bone of tooth #32 allowed for the exact placement of the donor tooth in the position of tooth #31. The total extraoral time was only 25 minutes. The block was fixed to the recipient socket with an osteosynthesis screw and splinted with a double resin wire for 8 weeks. At the 6-month follow-up, the screw was removed, and the stability of the tooth and the regeneration obtained throughout the vestibular area were confirmed. At the 2-year follow-up, the transplanted tooth was asymptomatic and maintained a normal bone level. Advantages of autotransplantation over dental implants include maintenance of proprioception, possible orthodontic movements, and a relatively low cost. This case report demonstrates that an autotransplantation of a third molar attached to its buccal cortical plate is a viable option to replace teeth with a VRF.

Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists.

INTRODUCTION: Treatment options for endodontic failure include nonsurgical or surgical endodontic retreatment, intentional replantation, and extraction with or without replacement of the tooth. The aim of the present study was to determine the impact of cone-beam computed tomographic (CBCT) imaging on clinical decision making among general dental practitioners and endodontists after failed root canal treatment. A second objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. METHODS: Eight patients with endodontically treated teeth diagnosed as symptomatic apical periodontitis, acute apical abscess, or chronic apical abscess were selected. In the first session, the examiners were given the details of each case, including any relevant radiographs, and were asked to choose 1 of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 8 cases with the additional information from the CBCT data. RESULTS: The examiners altered their treatment plan after viewing the CBCT scan in 49.8% of the cases. A significant difference in the treatment plan between the 2 imaging modalities was recorded for endodontists and general practitioners (P < .05). After CBCT evaluation, neither group altered their self-reported level of difficulty when choosing a treatment plan (P = .0524). The extraction option rose significantly to 20% after viewing the CBCT scan (P < .05). CONCLUSIONS: CBCT imaging directly influences endodontic retreatment strategies among general dental practitioners and endodontists.

Influence of Cone-beam Computed Tomography in Clinical Decision Making among Specialists.

INTRODUCTION: Clinical information and diagnostic imaging are essential components of preoperative diagnosis. The aim of this study was to determine the influence of cone-beam computed tomographic (CBCT) imaging on clinical decision-making choices among different specialists (prosthodontists, endodontists, oral surgeons, and periodontists) in endodontic treatment planning. A secondary objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. METHODS: In accordance with the endodontic case difficulty guidelines of the American Association of Endodontists, 30 endodontic cases with varying degrees of complexity were selected. Each case included clinical photographs, digital periapical radiographs, and a small-volume CBCT scan. In the first evaluation, examiners were given all the information of each case, except the CBCT scan. Examiners were asked to select one of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 30 cases with the additional information from the CBCT data. RESULTS: The CBCT scans only had a significant influence on the treatment plan when the endodontic case was classified as high difficulty (P < .05). The level of difficulty in choosing a treatment choice was significantly more difficult after viewing a preoperative CBCT scan (P < .05), with the exception of the endodontists (P = .033). After viewing the CBCT scan, the extraction option increased significantly (P < .05). CONCLUSIONS: CBCT imaging has a substantial impact on endodontic decision making among specialists, particularly in high difficulty cases.

Continuous Apical Negative-Pressure Ultrasonic Irrigation (CANUI): A new concept for activating irrigants.

BACKGROUND: Irrigation of the root canal system is an essential step in the endodontic treatment. The aim of this article is to introduce continuous apical negative-pressure ultrasonic irrigation (CANUI), a new irrigation concept, and compare the characteristics of this new technique with current devices for activating the irrigant. MATERIAL AND METHODS: CANUI is designed for cleaning and disinfecting the root canal system. The device consists of a tube inside another tube that allows the continuous ultrasonic exchange of fresh irrigant, as the irrigant is simultaneously aspirated apically. The coronal and apical tubes are 0.75 and 0.3 mm in diameter, respectively. It is composed of a nickel-titanium microcannula suitable for the working length of curved canals. RESULTS: The CANUI technique has the advantages of apical negative pressure (to avoid apical extrusion of the irrigant) and continuous ultrasonic irrigation (continuous refreshment of the irrigant and forced introduction into the canal ramifications). CONCLUSIONS: The CANUI technique could improve the irrigation technique of dentists to reach more disinfection in endodontic treatments. Key words:Apical negative pressure, continuous ultrasonic irrigation, irrigation in curved canals, irrigation systems.

TControl: A mobile app to follow up tobacco-quitting patients.

BACKGROUND AND OBJECTIVE: Tobacco smoking is a major risk factor for a wide range of respiratory and circulatory diseases in active and passive smokers. Well-designed campaigns are raising awareness to the problem and an increasing number of smokers seeks medical assistance to quit their habit. In this context, there is the need to develop mHealth Apps that assist and manage large smoke quitting programs in efficient and economic ways. OBJECTIVES: Our main objective is to develop an efficient and free mHealth app that facilitates the management of, and assistance to, people who want to quit smoking. As secondary objectives, our research also aims at estimating the economic effect of deploying that App in the public health system. METHODS: Using JAVA and XML we develop and deploy a new free mHealth App for Android, called TControl (Tobacco-quitting Control). We deploy the App at the Tobacco Unit of the Santa Maria Hospital in Lleida and determine its stability by following the crashes of the App. We also use a survey to test usability of the app and differences in aptitude for using the App in a sample of 31 patients. Finally, we use mathematical models to estimate the economic effect of deploying TControl in the Catalan public health system. RESULTS: TControl keeps track of the smoke-quitting users, tracking their status, interpreting it, and offering advice and psychological support messages. The App also provides a bidirectional communication channel between patients and clinicians via mobile text messages. Additionally, registered patients have the option to interchange experiences with each other by chat. The App was found to be stable and to have high performances during startup and message sending. Our results suggest that age and gender have no statistically significant effect on patient aptitude for using TControl. Finally, we estimate that TControl could reduce costs for the Catalan public health system (CPHS) by up to € 400M in 10 years. CONCLUSIONS: TControl is a stable and well behaved App, typically operating near optimal performance. It can be used independent of age and gender, and its wide implementation could decrease costs for the public health system.