1,720,993 research outputs found
Implant-associated Vertical Root Fracture in Adjacent Endodontically Treated Teeth : a Case Series and Systematic Review
No full textIntroduction This study aimed to report a possible effect of the presence of an adjacent implant on the development of a vertical root fracture (VRF) in endodontically treated teeth. Methods A series of 8 cases in 7 patients with teeth diagnosed with VRF after the placement of implants in the adjacent area is described and analyzed. In addition, a comprehensive literature search with strict inclusion and exclusion criteria was undertaken to identify additional clinical studies that assessed this clinical scenario. Results The case series analysis revealed that the time from implant placement to the diagnosis of VRF was between 5 and 28 months (average = 11 months). The majority of cases occurred in female patients who received 2 or more implants. Six of the 7 patients were older than 40 years, with an average age of 54 years. The majority of teeth with VRF were premolar or mandibular molar teeth (6/8 teeth). All fractured teeth had been restored with a crown and had a post present, and the quality of the root canal filling was determined to be adequate. The systematic review revealed that implant-associated VRF has not been investigated or reported in the literature yet. Conclusions Based on a systematic review of the literature, this case series, although limited in its extent, is the first clinical report of a possible serious adverse event of implant-associated VRF in adjacent endodontically treated teeth. Additional clinical studies are indicated to shed light on this potential phenomenon
Evolving New Strategies for Periodontal, Endodontic, and Alveolar Bone Regeneration
No full textThis chapter describes evolving experimental approaches that are geared toward periodontal/bone regeneration. Currently, the pinnacle of regenerative periodontal treatment is the use of bone substitutes combined with barrier membranes, which already demonstrates how far we have progressed from the old resective approaches that dominated the field. Thus, the focus of the clinical repertoire shifted from a purely surgical to biologically oriented treatment of the detrimental effects of periodontal disease and bone defects that may prevent future implant placement. The continuous presence of bacteria at the tooth-epithelium or implant-epithelium junction results in a progressive inflammatory process, which leads to the destruction of the gingival connective tissue and subsequently of the alveolar bone, periodontal ligament (PDL), and cementum on the root surface. This process, when left undisturbed, will lead eventually to the loss of the involved tooth or implant. Not only is this loss of periodontal support detrimental to the stability and function of the tooth or implant, it also hampers the restoration of the diseased area with implants following the removal of the ailing tooth/implant. Therefore, the clinical art of periodontology has been paying a tremendous amount of attention to periodontal regeneration
Radiographic Identification of Separated Instruments Retained in the Apical Third of Root Canal-filled Teeth
No full textIntroduction: The aim of the study was to compare the diagnostic ability to radiographically detect separated stainless steel (SS) versus nickel-titanium (NiTi) instruments located at the apical third of filled root canals with either AH 26 (Dentsply DeTrey GmbH, Konstanz, Germany) or Roth sealer (Roth International Ltd, Chicago, IL). Methods: Sixty single-rooted extracted human teeth with 1 straight root canal were instrumented to a size 25 apical diameter. In 40 teeth, apical 2-mm segments of SS (n = 20) or NiTi (n = 20) files were intentionally fractured in the apical part of the root canal. The remaining 20 teeth without fractured files served as a control group. Subsequently, the root canals were filled using laterally condensed gutta-percha and either AH 26 sealer (AH) or Roth sealer (Roth). All teeth were radiographed using conventional Kodak film (Eastman Kodak Co, Rochester, NY) and a charge-coupled device digital sensor. The evaluation of the images for the presence of a fractured instrument was performed independently by 2 blinded observers. The data were statistically analyzed using McNemar and Fisher exact tests. Results: The kappa values were 0.76 and 0.615 for the first and second observers, respectively, and 0.584 between the observers. There were no significant differences in the diagnostic ability between digital and conventional radiography or the different root canal sealers (AH vs Roth, P > .05). The sensitivity to detect fractured SS was significantly higher than NiTi (P < .05). Conclusions: It may be difficult to radiographically detect a retained separated instrument. It is easier to radiographically detect fractured SS than NiTi instruments retained at the apical third of the root canal. © 2014 American Association of Endodontists
The Diagnostic Efficacy of Cone-beam Computed Tomography in Endodontics : A Systematic Review and Analysis by a Hierarchical Model of Efficacy
No full textIntroduction The aim of this study was to evaluate the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in endodontics based on a systematic search and analysis of the literature using an efficacy model. Methods A systematic search of the literature was performed to identify studies evaluating the use of CBCT imaging in endodontics. The identified studies were subjected to strict inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for appraisal of the literature on the levels of efficacy of a diagnostic imaging modality. Results Initially, 485 possible relevant articles were identified. After title and abstract screening and a full-text evaluation, 58 articles (12%) that met the inclusion criteria were analyzed and allocated to levels of efficacy. Most eligible articles (n = 52, 90%) evaluated technical characteristics or the accuracy of CBCT imaging, which was defined in this model as low levels of efficacy. Only 6 articles (10%) proclaimed to evaluate the efficacy of CBCT imaging to support the practitioner's decision making; treatment planning; and, ultimately, the treatment outcome, which was defined as higher levels of efficacy. Conclusions The expected ultimate benefit of CBCT imaging to the endodontic patient as evaluated by its level of diagnostic efficacy is unclear and is mainly limited to its technical and diagnostic accuracy efficacies. Even for these low levels of efficacy, current knowledge is limited. Therefore, a cautious and rational approach is advised when considering CBCT imaging for endodontic purposes
Immediate implant placement in endodontically infected sites : an alternative treatment for compromised teeth
No full textIn certain clinical conditions when endodontic treatment is either impractical or unlikely to improve the previous results, tooth extraction and replacement with a dental implant becomes a viable alternative. Although the presence of active infection has long been considered a major contraindication to the insertion of implants immediately following tooth extraction, several articles assessing this treatment modality reported excellent and promising results. The aim of this literature review is to evaluate and discuss the clinical outcome of implants placed immediately following extraction in endodontically infected sockets. A Medline and EMBASE search was performed to identify articles published from 1966 to 2010 using the keywords "dental implants", "immediate implant", "extraction socket", "infected teeth", "infected site", "infected socket". No restrictions were placed regarding the study design. Only clinical articles with at least 6 months of follow-up were included. The available relevant literature concerning this topic was limited, and based on relatively low level of evidence study designs with limited follow-up periods. However, the data analysis of the selected articles showed that an immediate implant insertion in endodontically infected sites following tooth extraction and careful debridement of the socket, could be a predictable viable technique. Additional large scaled, well-designed studies are required in order to further assess the clinical applications of this treatment alternative
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Principles of Evidence-Based Decision-Making
No full textEvidence-based medicine is defined as “the conscientious, explicit and judicious use of current best evidence about the care of individual patients integrated with clinical expertise and patient values to optimize outcomes and quality of life”.
In the hierarchy of study designs used in clinical research, randomized controlled trials (RCTs), prospective controlled trials (CTs) and meta-analyses or systematic reviews (SRs) of RCTs are considered to provide the highest level of evidence. Conversely, uncontrolled studies like case series and case reports, as well as retrospective studies, due to the features of the study design and many methodological aspects that may somehow affect the outcomes, are considered to have a higher level of bias as compared to RCTs. The latter are specifically designed to minimize the experimental bias in any steps of the study procedures, so as to provide the most reliable possible outcomes.
Since the volume of published information is steadily increasing, it is extremely important to assess the level of evidence of the publications, in order to discern which information should be relied upon to formulate an evidence-based treatment plan and provide the patients with the most accurate, up-to-date and trustworthy information.
The purpose of this chapter is to provide the basis of the evidence-based dentistry in order to facilitate clinicians in their daily decision-making process
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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