Successful endodontic treatment needs accurate determination of working length (WL). Electronic apex locators (EALs) were presented as an alternative to radiographic methods; and since then, they ...have evolved and gained popularity in the determination of WL. However, there is insufficient evidence on the post-operative pain, adequacy, and accuracy of EALs in determining WL.
The systematic review and meta-analysis aims to gather evidence regarding the effectiveness of EALs for WL determination when compared to different imaging techniques along with postoperative pain associated with WL determination, the number of radiographs taken during the procedure, the time taken, and the adverse effects.
For the review, clinical studies with cross-over and parallel-arm randomized controlled trials (RCTs) were searched in seven electronic databases, followed by cross-referencing of the selected studies and related research synthesis. Risk of bias (RoB) assessment was carried out with Cochrane's RoB tool and a random-effects model was used. The meta-analysis was performed with the RevMan software 5.4.1.
Eleven eligible RCTs were incorporated into the review and eight RCTs into the meta-analysis, of which five had high RoB and the remaining six had unclear RoB. Following meta-analysis, no significant difference in postoperative pain was found among the EAL and radiograph groups (SMD 0.00, CI .29 to .28, 354 participants; P value = 0.98). Radiograph group showed better WL accuracy (SMD 0.55, CI .11 to .99, 254 participants; P value = 0.02), while the EAL group had 10% better WL adequacy (RR 1.10, CI 1.03-1.18, 573 participants; P value = 0.006).
We found very low-certainty evidence to support the efficacy of different types of EAL compared to radiography for the outcomes tested. We were unable to reach any conclusions about the superiority of any type of EAL. Well-planned RCTs need to be conducted by standardizing the outcomes and outcome measurement methods.
...a detailed radiological examination was carried out using cone beam CT (CBCT) in order evaluate the short-rooted tooth,1 2 sectional image obtained from the CBCT showed that total length of the ...tooth was 14.57 mm, crown length from incisal tip to cementoenamel junction (CEJ) was 10.18 mm and root length from CEJ to the tip of the root was 4.40 mm, (figure 1A–C). ...light intermittent forces were employed to bring about tooth movement and to prevent deleterious effects on tooth 11.16–18 Prior to treatment onset, the patient was informed about the condition she presented with and the limitations, risks and objectives of treatment. During the course of treatment, constant monitoring of root and bone tissue in relation to the tooth 11 with SRA was ensured.19 20 Orthodontic treatment was satisfactorily completed with sufficient overjet, overbite, incisor angulation and stable posterior occlusion. Learning points Pretreatment orthodontic radiographs are extremely helpful in careful evaluation of the crown–root ratio of individual teeth in order to rule out iatrogenic root resorption.
Background: Fixed orthodontic retainers must be well retained on the tooth surfaces, allow physiologic movement of teeth and exert minimal forces on the teeth to be retained. Previous studies ...analyzed the bond strength and amount of deflection caused due to the debonding force but not the magnitude of force needed for unit deformation. Aims: This study aims to evaluate and compare the bond strength and load deflection rate (LDR) of three different fixed retainer wires. Materials and Methods: The wires were divided into three Groups: A - three-stranded twisted ligature wire, B - Bond-A-Braid (Reliance Orthodontics), and C - three-stranded twisted lingual retainer wire (3M Unitek). Twenty models were prepared for each group with a passive 15 mm long lingual retainer wire bonded to two lower incisors. An occlusogingival force was applied to the wire until it debonded. For LDR, three-point bending test was done at 0.5 mm deflection. These forces were measured using a Universal Instron Testing Machine. Statistical Analysis: Mean bond strength/LDR and pairwise comparisons were analyzed with one-way ANOVA and Tukey's honest significant difference post hoc test, respectively. Results: Group C exhibited the highest mean bond strength and LDR of 101.17N and 1.84N, respectively. The intergroup comparisons were all statistically significant. Conclusion: Compared to the other two wire types, Group C might be better retained on the teeth due to its higher bond strength. With its relatively higher LDR value, it may resist deformation from occlusal forces, thereby reducing inadvertent tooth movement and yet remain flexible enough to allow physiologic tooth movements.
Evidence suggests a role for excessive inflammation in COVID-19 complications. Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis, and coronary disease. We aimed to ...investigate the effect of colchicine on the composite of COVID-19-related death or hospital admission.
The present study is a phase 3, randomised, double-blind, adaptive, placebo-controlled, multicentre trial. The study was done in Brazil, Canada, Greece, South Africa, Spain, and the USA, and was led by the Montreal Heart Institute. Patients with COVID-19 diagnosed by PCR testing or clinical criteria who were not being treated in hospital were eligible if they were at least 40 years old and had at least one high-risk characteristic. The randomisation list was computer-generated by an unmasked biostatistician, and masked randomisation was centralised and done electronically through an automated interactive web-response system. The allocation sequence was unstratified and used a 1:1 ratio with a blocking schema and block sizes of six. Patients were randomly assigned to receive orally administered colchicine (0·5 mg twice per day for 3 days and then once per day for 27 days thereafter) or matching placebo. The primary efficacy endpoint was the composite of death or hospital admission for COVID-19. Vital status at the end of the study was available for 97·9% of patients. The analyses were done according to the intention-to-treat principle. The COLCORONA trial is registered with ClinicalTrials.gov (NCT04322682) and is now closed to new participants.
Trial enrolment began in March 23, 2020, and was completed in Dec 22, 2020. A total of 4488 patients (53·9% women; median age 54·0 years, IQR 47·0–61·0) were enrolled and 2235 patients were randomly assigned to colchicine and 2253 to placebo. The primary endpoint occurred in 104 (4·7%) of 2235 patients in the colchicine group and 131 (5·8%) of 2253 patients in the placebo group (odds ratio OR 0·79, 95·1% CI 0·61–1·03; p=0·081). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 96 (4·6%) of 2075 patients in the colchicine group and 126 (6·0%) of 2084 patients in the placebo group (OR 0·75, 0·57–0·99; p=0·042). Serious adverse events were reported in 108 (4·9%) of 2195 patients in the colchicine group and 139 (6·3%) of 2217 patients in the placebo group (p=0·051); pneumonia occurred in 63 (2·9%) of 2195 patients in the colchicine group and 92 (4·1%) of 2217 patients in the placebo group (p=0·021). Diarrhoea was reported in 300 (13·7%) of 2195 patients in the colchicine group and 161 (7·3%) of 2217 patients in the placebo group (p<0·0001).
In community-treated patients including those without a mandatory diagnostic test, the effect of colchicine on COVID-19-related clinical events was not statistically significant. Among patients with PCR-confirmed COVID-19, colchicine led to a lower rate of the composite of death or hospital admission than placebo. Given the absence of orally administered therapies to prevent COVID-19 complications in community-treated patients and the benefit of colchicine in patients with PCR-proven COVID-19, this safe and inexpensive anti-inflammatory agent could be considered for use in those at risk of complications. Notwithstanding these considerations, replication in other studies of PCR-positive community-treated patients is recommended.
The Government of Quebec, the Bill & Melinda Gates Foundation, the National Heart, Lung, and Blood Institute of the US National Institutes of Health, the Montreal Heart Institute Foundation, the NYU Grossman School of Medicine, the Rudin Family Foundation, and philanthropist Sophie Desmarais.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows:
To assess the effects of herbs/herbal extracts to prevent or minimise tooth decay in children and adults.
PDF
