The exceptional optoelectronic properties of metal halide perovskites (MHPs) are presumed to arise, at least in part, from the peculiar interplay between the inorganic metal-halide sublattice and the ...atomic or molecular cations enclosed in the cage voids. The latter can exhibit a roto-translative dynamics, which is shown here to be at the origin of the structural behavior of MHPs as a function of temperature, pressure and composition. The application of high hydrostatic pressure allows for unraveling the nature of the interaction between both sublattices, characterized by the simultaneous action of hydrogen bonding and steric hindrance. In particular, we find that under the conditions of unleashed cation dynamics, the key factor that determines the structural stability of MHPs is the repulsive steric interaction rather than hydrogen bonding. Taking as example the results from pressure and temperature-dependent photoluminescence and Raman experiments on MAPbBrFormula: see text but also considering the pertinent MHP literature, we provide a general picture about the relationship between the crystal structure and the presence or absence of cationic dynamic disorder. The reason for the structural sequences observed in MHPs with increasing temperature, pressure, A-site cation size or decreasing halide ionic radius is found principally in the strengthening of the dynamic steric interaction with the increase of the dynamic disorder. In this way, we have deepened our fundamental understanding of MHPs; knowledge that could be coined to improve performance in future optoelectronic devices based on this promising class of semiconductors.
The impact of minimally invasive endodontic procedures on root canal disinfection has not been determined. This ex vivo study compared root canal disinfection and shaping in teeth with contracted or ...conventional endodontic cavities.
Mandibular incisors with oval-shaped canals were selected and anatomically matched based on micro–computed tomographic (micro-CT) analysis and distributed into 2 groups. Conservative and conventional access cavities were prepared, and the canals were contaminated with a pure culture of Enterococcus faecalis for 30 days. Root canal preparation in both groups was performed using the XP-endo Shaper instrument (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and 2.5% sodium hypochlorite irrigation. Intracanal bacteriologic samples were taken before and after preparation, and DNA was extracted and subjected to quantitative polymerase chain reaction. Micro-CT scans taken before and after preparation were used for shaping evaluation. Bacteriologic data were analyzed by the Poisson regression model and the chi-square test with Yates correction. Micro-CT data were analyzed by the Wilcoxon, Mann-Whitney, and Student t tests with the significance level set at 5%.
All initial samples were positive for E. faecalis. After preparation, the number of bacteria-positive samples was significantly higher in the contracted cavity group (25/29, 86%) than in the conventional cavity group (14/28, 50%) (P < .01). Intergroup quantitative comparison showed that the reduction in bacterial counts was also significantly higher in the group of conventional cavities (P < .01). Micro-CT data revealed no significant difference in the amount of unprepared areas between groups.
Our findings showed that although shaping using an adjustable instrument was similar between groups, disinfection was significantly compromised after root canal preparation of teeth with contracted endodontic cavities.
Abstract Introduction This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-titanium instruments, followed by 2 distinct adjunctive procedures in the root ...canals of extracted mandibular molars by means of a correlative analytical approach. Methods Twenty-two extracted mandibular molars were selected and anatomically matched between groups on the basis of micro–computed tomographic analysis. In the first phase of the experiment, root canals were contaminated with Enterococcus faecalis and subjected to chemomechanical preparation with BT RaCe instruments and 2.5% NaOCl irrigation. Then either XP-Endo Finisher instrument or passive ultrasonic irrigation was used to supplement disinfection. Micro–computed tomography was used to show whether the percentage of unprepared areas correlated to bacterial counts. In the second phase, the same teeth were contaminated once again, and the adjunctive procedures were used. Samples from the isthmus area of mesial roots and the apical 5-mm fragment of distal roots were obtained by cryopulverization. Samples taken before and after treatment steps in both phases were evaluated by quantitative polymerase chain reaction and statistically analyzed. Results In phase 1, preparation in both groups resulted in substantial decrease of bacterial counts ( P < .001). The adjunctive approaches led to a further small bacterial reduction, which was significant for XP-Endo Finisher ( P < .05). No significant differences were observed between groups for persisting bacterial counts. Correlative analysis revealed no statistically significant relationship between bacterial reduction and the percentage of unprepared areas ( P > .05). In phase 2, both methods had significant antibacterial effects in the main canal, but none of them could predictably disinfect the isthmus/recess areas. Conclusions Both XP-Endo Finisher and passive ultrasonic irrigation exhibited antibacterial effectiveness, but only the former caused a significant reduction in the bacterial counts after chemomechanical preparation. None of them were effective in predictably disinfecting the isthmus/recess areas.
This study evaluated the microbiological conditions of the apical root canal system of teeth with posttreatment apical periodontitis and correlated them with observations from cone-beam computed ...tomographic (CBCT) imaging, micro–computed tomographic (micro-CT) imaging, and histopathology.
Root apices were obtained from 36 root canal–treated teeth subjected to periradicular surgery. CBCT examination was available before surgery. The apical root specimens were scanned in a micro-CT device and then cryopulverized. The powder was subjected to DNA extraction for real-time polymerase chain reaction quantification of total bacteria, Streptococcus species, members of the phylum Actinobacteria, and Enterococcus faecalis. Microbiological findings were evaluated for associations with CBCT, micro-CT, and histopathologic data. An association between lesion size and the proportion of unfilled apical canal system volume was also assessed.
All cryopulverized specimens were positive for total bacteria. Actinobacteria and streptococci occurred in 35 and 33 specimens, respectively, and were usually dominant in the community. Actinobacteria counts were 2.23 times higher in granulomas than in cysts. Streptococci were significantly more present in small lesion cases. E. faecalis was detected in only 7 samples, always as a dominant community member. The association of total bacteria, streptococci, and Actinobacteria counts with the unfilled canal volume was significant in the univariate analyses but not confirmed in the adjusted analyses. Large lesions were significantly associated with a higher volume of unfilled apical canals.
Bacterial infection occurred in all root apices, with high prevalence and dominance of Actinobacteria and streptococci. The volume of the unfilled apical canal system was significantly associated with the lesion size and possibly with bacterial counts. Findings illustrate the need to thoroughly disinfect and fill the apical root canal of infected teeth during endodontic therapy.
Dens invaginatus or dens in dente is a developmental dental anomaly resulting from an invagination of the enamel organ into the dental papilla during odontogenesis. Radiographically, it is usually ...seen as a radiolucent invagination surrounded by a radiopaque area (enamel) limited to the tooth crown or extending into the root. Because the invagination is opened to the oral cavity, it can retain saliva, food remnants, and bacteria. In conditions where the enamel lining of the invagination is naturally absent or lost because of caries, bacterial cells and products can diffuse from the invagination through the dentin tubules to reach the pulp and cause disease. Management of teeth with dens invaginatus includes preventive sealing or filling of the invagination, or if the pulp is affected, therapeutic options include vital pulp therapy, nonsurgical root canal treatment, apexification or regenerative endodontic procedures, periradicular surgery, intentional replantation, or extraction. It is recommended that the invagination be always approached, regardless of the type of dens invaginatus. The root canal should be treated whenever the pulp is irreversibly inflamed or necrotic. Endodontic management of teeth with dens invaginatus is often tricky because of its anatomic complexity, and special and customized strategies should be devised. This review discusses the endodontic implications of this anomaly and the current treatment recommendations based on anatomic, pathological, and technologic considerations.
This study assessed the cleaning, shaping, and disinfection abilities of 2 instrumentation systems in molar root canals using a novel correlative analytical approach.
The root canals from extracted ...mandibular and maxillary molars with apical periodontitis were pair matched according to anatomic similarities as determined by micro–computed tomographic analysis and prepared with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (n = 16) or Reciproc Blue (VDW, Munich, Germany) (n = 16) instruments and 2.5% sodium hypochlorite irrigation. Pre- and postpreparation micro–computed tomographic scans were used to identify and calculate the unprepared surface areas (shaping), which were histobacteriologically evaluated for the presence of residual bacteria (disinfection) and pulp tissue remnants (cleaning) in each canal third.
Unprepared canal surface areas for XP-endo Shaper and Reciproc Blue in the full canal length were approximately 26% and 19% (P < .05), respectively (30% and 23% in the apical part of the canal, P > .05). Preparation with Reciproc Blue resulted in 37.5% canals free of bacteria in all sections examined and 56% in the apical sections only. XP-endo Shaper resulted in 44% canals free of bacteria in all sections, and 56% in the apical part of the canal only. Pulp tissue remnants were not observed in 31% (all canal sections) and 50% (apical canal sections) of specimens from both instrument systems. No significant differences were observed between instruments when comparing the amount of pulp tissue remnants and the number of cases negative for bacteria and tissue remnants (P > .05).
Although the Reciproc Blue instrument had superior shaping ability in comparison with XP-endo Shaper, both systems performed similarly in cleaning and disinfecting root canals. Irregular canals and difficult-to-reach areas were not thoroughly cleaned and disinfected by any of the tested systems.
This ex vivo study evaluated the intracanal bacterial reduction promoted by chemomechanical preparation using a single-file technique varying the volume, concentration, and retention time of sodium ...hypochlorite (NaOCl) irrigation in comparison with a multifile system.
Palatal roots from extracted maxillary first molars were selected and anatomically matched based on microcomputed tomographic analysis for group distribution. The canals were contaminated with a fresh mixed bacterial culture grown in anaerobiosis and recently obtained from a tooth with apical periodontitis. Specimens were divided into 4 groups of 24 each according to the following preparation protocols: REC-6LOW (Reciproc R50 instrument VDW, Munich, Germany, 6% NaOCl, low irrigant volume), REC-2.5LOW (R50, 2.5% NaOCl, low irrigant volume), REC-2.5HI (R50, 2.5% NaOCl, high irrigant volume), and BR-2.5HI (BioRaCe FKG Dentaire, LaChaux-de-Fonds, Switzerland, 2.5% NaOCl, high irrigant volume). The total time of preparation was recorded. Intracanal bacteriologic samples were taken before and after preparation; DNA was extracted and subjected to quantitative polymerase chain reaction.
Bacteria were detected in 22 initial samples from the REC-2.5LOW group and in 23 from the other groups. Intragroup analysis showed that all tested preparation protocols were highly effective in significantly reducing the intracanal bacterial counts (P < .001). Intergroup comparison of bacterial reduction levels revealed a statistically significant difference between BR-2.5HI and REC-2.5LOW (P < .05). Counts of bacteria were 2.5 times significantly higher in REC-2.5LOW compared with BR-2.5HI. No other significant differences were found in quantitative findings (P > .05).
The concerted effects of multiple instruments, the high volume of irrigation, and the long retention time of NaOCl irrigant had a positive influence on intracanal disinfection during chemomechanical preparation.
•Bacterial reduction was compared between a single-file and a multifile system.•All protocols produced a highly significant intracanal bacterial reduction.•Counts of bacteria were 2.5 times significantly higher in the REC-2.5LOW group when compared with the BR-2.5HI group.•Disinfection was better with multiple instruments, high volume, and longer sodium hypochlorite exposure.
The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval canals of extracted vital teeth using a correlative analytic approach.
Oval distal canals from 33 ...freshly extracted mandibular molars with pulp vitality were scanned by micro–computed tomographic (micro-CT) imaging for sample selection. Specimens matched by anatomic similarities were distributed into 3 experimental groups according to the instrument system to be evaluated: the Self-Adjusting File (SAF; ReDentNOVA, Ra'anana, Israel), TRUShape (Dentsply Sirona, Tulsa, OK), and XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The irrigant was 5.25% sodium hypochlorite heated at 37°C. After rescanning with micro-CT imaging, the unprepared surface areas were identified, measured, and then histologically evaluated for the amount of pulp remnants in each root third.
When the apical 4-mm canal segment was evaluated, the SAF exhibited significantly less unprepared areas than the XP-endo Shaper (P < .05), and there were no significant differences for the other comparisons (P > .05). Analysis of the full canal length showed no statistically significant differences between the 3 tested systems (P > .05). Likewise, the tested systems did not differ significantly in cleaning the unprepared walls (P > .05).
There was no significant difference in the amount of unprepared surface areas between the 3 instrument systems, except for the comparison between the SAF and XP-endo Shaper in the apical 4-mm segment. None of them prepared 100% of the root canal walls. The cleaning ability of the 3 systems was similar.
•The mean unprepared apical areas ranged from 10% (SAF) to 18% (XP-endo Shaper).•SAF exhibited less unprepared areas than XP-endo Shaper in the apical canal.•In the full canal length, the amount of prepared walls was similar for the 3 systems.•The 3 instrument systems displayed similar behavior in terms of cleaning.
As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed. Using a validated antibody assay against SARS-CoV-2 spike protein, we determined a high ...seroconversion rate (94%) in 200 patients with cancer in New York City that had received full dosing with one of the FDA-approved COVID-19 vaccines. On comparison with solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematologic malignancies (85%), particularly recipients following highly immunosuppressive therapies such as anti-CD20 therapies (70%) and stem cell transplantation (73%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post vaccination. Relatively lower IgG titers were observed following vaccination with the adenoviral than with mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify immunosuppressed cohorts that need novel vaccination or passive immunization strategies.
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•COVID-19 vaccines lead to high rates of seroconversion among patients with cancer•Patients with hematologic malignancies show lower immunogenicity post vaccination•Prior immunosuppressive therapies lead to lower responsiveness to COVID-19 vaccines•Prior COVID infection leads to more robust antibody responses to COVID-19 vaccines
Evaluating the IgG levels against SARS-CoV-2 spike protein, Thakkar et al. demonstrate high rates of seroconversion in a diverse cohort of patients with cancer, while identifying lower immunogenicity in patients with hematologic malignancies and in patients having received immunosuppressive therapies.
This ex vivo study aimed to evaluate the shaping abilities and preservation of dentin with traditional and modern instruments after using sizes 25 and 40 in oval canals of mandibular incisors with ...conservative access.
Thirty mandibular incisors with single straight oval canals were selected and assigned into 2 groups (n = 15) according to the instrument system used during preparation, Slim Shaper (SS) plus Apical Shaper (AS) and Protaper Gold (PG). The samples were subjected to micro-computed tomography before and after preparation with sizes 25 and 40. The shaping parameters evaluated included canal volume and surface area, amount of unprepared root canal walls, and reduction in pericervical dentin.
Canal volume and surface area were significantly increased after enlargement with each instrument size (P < .01). The percentage of unprepared areas showed a significant intragroup decrease after using PG F2 and F4 or SS 3 and AS (P < .05). Intergroup comparison showed no significant differences. Pericervical dentin was reduced in all groups. The intragroup comparison only revealed a significant reduction (P < .01) between PG F2 and F4. In addition, a significant decrease in pericervical dentin (P < .05) was observed between PG F4 40/.06 and AS 40/.03. No significant differences were observed between PG F2 25/.08 and SS 3 25/.04.
Increasing the instrumentation size from 25 to 40 significantly reduces the percentage of unprepared areas regardless of the system used. In addition, using a modern system with a regressive taper allows the maintenance of pericervical dentin without compromising shaping efficacy in the apical third of the mandibular incisors with oval canals and conservative access.