6-month Recall Research Articles

One-year clinical evaluation of bulk-fill composite resin restorations plasticized by preheating and ultrasonics: A randomized clinical trial.

Introduction:Bulk-fill composite restorations displayed substantial annual failure related to imperfect marginal adaptation. Although preheated composites improved, marginal adaptation demonstrated early loss of plasticity. A new technique of ultrasonics plasticization was used for fabricating restorations.Aim:The aim of this study was to assess the clinical behavior of bulk-fill composite resin restorations plasticized by preheating and ultrasonics.Methodology:Randomized split-mouth double-blinded clinical trial was designed. Bulk-fill composite resin (Tetric N-Ceram Bulk Fill Ivoclar Vivadent products, Delhi) was used to fill 56 cavities. In 28 restorations, composite resin was plasticized by preheating in composite warmer (Delta Co., India) and remaining were plasticized with modified ultrasonic–retreatment tip-RT No 2 (Cricdental, India). Clinical follow-up assessments were done at 6 and 12 months using Ryge's criteria. Mann–Whitney U-test was used for statistical analysis with P < 0.05 and effect size of 0.61.Results:Hundred percent clinical success with ultrasonic plasticized group and 95.2% success with preheated composite resin group were observed without statistical significance.Conclusion:The ultrasonics plasticization of composite resin demonstrated comparable results with that of preheated composite resin after 6- and 12-month recall. Use of vibration energy utilizing the thixotropic effect might have resulted in better clinical performance.

Translation, Reliability, and Validity Test of Odia Version of Menopause-Specific Quality of Life Questionnaire Among Postmenopausal Women for Menopausal Symptoms.

Introduction:The Menopause-specific Quality of Life (MENQOL) questionnaire was developed in 1996 to assess the health-related quality of life (QOL) in the menopausal transition and it addresses the degree to which menopausal symptoms had bothered women. The objective of this study was to translate the MENQOL questionnaire in the Odia- regional language of India and validate it for usage in the Odia-speaking menopausal women.Methods:The original English questionnaire MENQOL with 1-month recall period was translated by the researchers. According to instructions by Mapi Research Trust, the questionnaire was forward and backward translated, followed by participant testing and proofreading. Validity and reliability were evaluated by the following tests: internal consistency (reliability), stability (test-retest reliability) with Cronbach's alpha correlations, Pearson's correlation coefficients, and content validity index.Results:A total of 80 postmenopausal women participated in the study. The ICC score and Cronbach's alpha value of all the four domains such as vasomotor, psychosocial, physical, and sexual of both MENQOL English and Odia (MENQOL-E and MENQOL-O) versions recommended excellent homogeneity. The internal consistency using the Cronbach's alpha showed high reliability (0.993) between the MENQOL-E and MENQOL-O questionnaires.Conclusion:The MENQOL-O questionnaire will be used at the individual to community health-care settings to measure QOL and those identified with lower menopause-related QOL, they may get support and care.

Patient Centered Outcomes among a Cohort Receiving Regenerative Endodontic Procedures or Apexification Treatments

IntroductionThis multicentered cohort study evaluated factors associated with patient-centered outcomes of immature permanent teeth that received regenerative endodontic procedures (REPs) or apexification treatment (APEX). MethodsA record review identified teeth treated with REPs or APEX between September 2005 and December 2014. Data regarding treatment and patient-centered outcomes were extracted from records with a 3-month minimum recall. When possible, participants presented for an in-person prospective research visit. Patient-centered success was defined as an asymptomatic, functional tooth not requiring further endodontic or surgical intervention after completion of the original treatment during the study observation. Risk ratios and adjusted and unadjusted Cox proportional hazard ratios were calculated. ResultsThe analytic cohort of 187 individuals included 211 teeth (93 REPs and 118 APEX) with an average follow-up of 32 months. Most cases were successful (81% REPs and 92% APEX) and survived the observation period (96% REPs and 97% APEX). The success rate of REPs was lower than APEX and decreased more rapidly over time. Cox regression analysis demonstrated that when controlling for other variables, the association between treatment type and outcome is not significant. Preoperative infection, teeth with more immature roots, and REP treatment are potentially important predictors. Among teeth receiving REPs, a lower failure rate was observed for teeth that received multiantibiotic paste (3/43) compared with calcium hydroxide (11/45). ConclusionsTeeth receiving REPs required clinical intervention earlier than teeth that received APEX treatment, although a preoperative abscess and more immature root also affected this outcome. Using multiantibiotic paste versus calcium hydroxide in REPs may improve success.

Bronchial Thermoplasty Global Registry (BTGR): 2-year results

ObjectivesBronchial thermoplasty (BT) is a device-based treatment for subjects ≥18 years with severe asthma not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Bronchial Thermoplasty Global Registry (BTGR) collected...

Impact of APOE Genotype on Neurocognitive Outcomes in Hippocampal Avoidance Whole Brain Radiotherapy for Brain Metastases: A Secondary Analysis of Phase II Blinded Randomized Trial

Apolipoprotein E (APOE) polymorphism is a well-known risk associated with Alzheimer's disease. Its role in neurocognition decline after whole brain radiotherapy (WBRT) for brain metastases is not well-investigated. The present secondary analysis of a prospective blinded randomized controlled phase II trial aimed to evaluate the impact of APOE genotypes upon neurocognitive outcomes after WBRT with or without hippocampal avoidance.Adult patients with brain metastases were stratified by prior radiosurgery and randomized to hippocampal avoidant conformal WBRT versus conformal WBRT without hippocampal avoidance to 30 Gy in 10 fractions from March 2015 to November 2018. Memantine was not used during or after WBRT. Standardized neurocognitive test battery (Hopkins Verbal Learning Test-Revised [HVLT-R], Trail Making Test), was performed at baseline, 1, 2, 4, 6, and every 3 months up to two years by trained independent health professionals. Both clinical trial participants and examiners were blinded to the treatment group assignment. APOE alleles were determined by the genome-wide genotyping. The association between APOE genotypes and neurocognitive outcomes was analyzed by general linear model. The role of APOE genotypes on the effect of hippocampal avoidance during WBRT was also evaluated. Factorial ANOVA was used to assess the independent factors associated with neurocognitive outcomes.Among 65 analyzable patients, APOE genotyping was available for 64.6% (n = 42) of patients. The most frequent APOE allele was ε3 homozygote (ε3/ε3, n = 24), followed by ε2 carrier (ε2/ε3, n = 11) and ε4 carrier (ε4/ε3, n = 7). No differences in baseline characteristics and cognitions between patients of different APOE genotypes. At 6-month, patients carrying APOE ε2 and ε4 allele had the best and worst preservation in HVLT-R total recall (mean difference, ε2: +3.18 versus ε4: -3.20, P = 0.008), and delayed recall (mean difference, ε2 carrier: +0.46 versus ε4 carrier: -2.40, P = 0.03), respectively. The effect of preservation in 6-month memory score is the strongest in the APOE ε2 carriers followed by the APOE ε3 homozygotes, and the least in the APEO ε4 carriers in order (P = 0.028). Only patients of APOE ε3 homozygotes showed improved preservation in late memory score by hippocampal avoidant WBRT at 6-month (mean difference, hippocampal avoidant: +3.67 versus conformal: -3.18, P = 0.037) and beyond. APOE genotyping was independent of age and hippocampal avoidance to be associated with the preservation of 6-month HVLT-R total recall (P = 0.042), and HVLT-R delayed recall (P = 0.032).The APOE genotype is associated with the risk of memory decline after WBRT. Specifically, APOE ε2 carriers exhibited better while ε4 carriers showed worse perpetuation in verbal memory function after WBRT. APOE ε3 homozygotes but not APOE ε2 or ε4 carriers benefit late memory preservation by hippocampal avoidant WBRT for brain metastases.

The Difference of Marginal Bone Preservation between Dental Implants with Non-Threaded or Micro-Threaded Collar Designs

This study analyzes the marginal bone loss (MBL) among dental implants characterized with non-threaded collar design (NT) when compared to the more classic micro-threaded collar design (MC) as such might reflect the future dentogengival esthetics, implant metal show, and mucositis. A total of 112 patients who received 311 implants have been included in the study and analyzed for their postoperative MBL using sequential periapical radiographs. The prevalence of postoperative peri-implant mucositis was recorded as well. The periapical radiographic comparison was performed between the immediate postoperative record and at the 24-month recall visit. Among the 311 implants, 124 (39.9%) had NT implants, and 187 (60.1%) had MC implants. Out of the 112 patients, 37 (44.6%) were females, and 10 (34.5%) were males included in the NT group. In contrast, 46 (55.4%) females and 19 (65.5%) males were in the MC group. The mean age among the two groups was 41.43 ± 15.900 and 46.68 ± 16.070, respectively. In contrast, the mean MBL among the groups were 0.544 ± 0.7129 and 0.061 ± 0.2648, respectively. The change in MBL was not positively correlated with gender (p-value = 0.154) or age (p-value = 0.115) in both groups. However, there was a significant difference (p-value = 0.001, X2 = 62.796, Df = 4) of MBL between the two implant systems themselves. The MBL was higher in people implanted with the NT system when compared to MC. Therefore, the MC implant system can be a better choice for marginal bone preservation, especially in restoring esthetically demanding areas in the mouth.

Rehearsal’s effect on long-term recall and comprehension of orthodontic informed consent

The purpose of this study was to determine if written rehearsal of informed consent improved 6-month recall and comprehension compared with the current best practices. A consultation was provided and subjects read the modified informed consent document. They were randomized to group A (received the core and up to 4 custom elements of treatment, wrote what each image displayed) or group B (presentation of the 18 elements with core elements chunked at the end followed by up to 4 custom elements). Interviews recording knowledge recall/comprehension occurred immediately and after months later. Overall, no significant differences in baseline or 6-month follow-up scores were found between groups. Initially, group A outperformed group B in some core domains. There were no significant differences between groups in the change of scores from initial to follow-up. Follow-up scores were significantly lower than baseline scores (P<0.05). Higher initial scores were associated with larger drops at follow-up. A decrease in knowledge>20% was common. Overall the methods are comparable at baseline and 6-months. Initial content retention was roughly 60+%, with 6%-9% deterioration. For areas of treatment methods, risk, discomfort, and resorption at 6-months, the current processes failed the patient and left the practitioner vulnerable to risk management issues. Results support the rehearsal method with immediate feedback for misunderstandings as the preferred method for informed consent.

Comparison of Marginal Bone Levels Around Tissue-Level Implants with Platform-Matched and Bone-Level Implants with Platform-Switching Connections: 1-Year Results of a Prospective Cohort Study with a Split-Mouth Design.

This clinical study was conducted to compare the influence of a platform-switched bone-level implant and a platform-matched tissue-level implant on marginal bone loss during the first year after loading. Edentulous subjects who applied for two-implant-retained mandibular overdentures and showing sufficient bone volume for implants with 4.3-mm diameter and 12-mm length were enrolled. For standardization reasons, all subjects received a platform-matched tissue-level implant and a platform-switched bone-level implant in the anterior mandible. Since implants from the same manufacturer were used, both implants had identical implant thread designs and surface properties. All subjects received two-implant-retained mandibular overdentures with opposing maxillary complete dentures, and the implants were loaded after 6 weeks. Marginal bone loss was monitored via panoramic radiographs obtained immediately after loading and at the 6- and 12-month recalls after implant loading, and periodontal parameters, such as pocket probing depths, Plaque Index scores, and bleeding on probing, were also measured and recorded. Twenty-six patients received 26 bone-level and 26 tissue-level implants. No statistically significant differences were detected between the bone loss of the two groups for all the measurements (P > .05). Additionally, no significant difference was detected between the measured periodontal parameters of the two groups (P > .05). Within the limitations of this prospective clinical study with a follow-up time of 12 months, it can be concluded that the platform-switching bone-level design and the platform-matching tissue-level design show similar bone loss in the anterior edentulous mandible.

Clinical and Radiographic Assessments of Potassium Nitrate in Polycarboxylate Versus Mineral Trioxide Aggregate as Pulpotomy Biomaterials in Immature Mandibular First Permanent Molars: A Randomized Clinical Trial

IntroductionThe purpose of this study was to compare clinically and radiographically the effects of potassium nitrate in polycarboxylate cement and mineral trioxide aggregate (MTA) as pulpotomy agents in vital immature mandibular first molars. MethodsThe trial design was a parallel randomized, 1:1 allocation ratio, with both the participants and the data assessor blinded. A total of 50 molars of 48 eligible children aged 6–9 years were studied. The children had mandibular immature first molars with extensive caries that revealed pulp exposure during caries excavation. Patients were randomly allocated equally into 2 groups in which potassium nitrate in polycarboxylate cement (the intervention group) and MTA (the control group) were used as pulpotomy biomaterials. The treated teeth were restored permanently. The primary outcome was clinical/radiographic assessment after 1 week, 6 months, and 12 months. The secondary outcomes were radiometric analysis at 6 and 12 months to determine dimensional changes during maturogenesis. The digital radiographs were imported to image processing software to perform radiometric measurements. Data were tabulated and statistically analyzed with significance set at P ≤ .05. ResultsOnly a single tooth failed at the 6-month recall, and another one was lost during recall in each group. Thus, the overall success rate for cases/group who finally attended the 12-month follow-up time point was 92% (23/25) with no statistically significant difference between the 2 groups. At the 12-month recall, successful cases showed root development with an increase in root length and a decrease in apical foramen width. Complete apical closure was observed in 65.2% of the roots in the intervention group and 52.1% in the control group. ConclusionsThe clinical and radiographic success reported in the present study reveals that potassium nitrate in polycarboxylate cement could be used as a biological and economic alternative to MTA as a pulpotomy agent in vital immature mandibular first molars. Further follow-up for longer periods is recommended.

A Clinical and Radiographic Assessment of Sodium Hypochlorite Versus Formocresol Pulpotomy in Primary Molar Teeth: 12-month Follow-up.

Objective: The aim of this study was to compare the clinical and radiographic success rates of pulpotomy in primary molars using formocresol versus sodium hypochlorite.Methods: Twenty-three children aged 4-9 years with at least two primary molars requiring pulpotomy were randomly allocated into two groups. All teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCl or formocresol. Clinical and radiographic signs/symptoms were recorded at six and 12 months. Outcomes were statistically analyzed using Fisher’s exact test and Chi-squaretest.Results: Clinical success rates at 6 and 12-month follow-up in both groups was 100%. At 6-month follow-up, radiographic success rate for NaOCl and formocresol groups was 100%. At 12-month recalls, in NaOCl group, 20 teeth (87%) and in formocresol group, 21 teeth (91.3%) had radiographic success. No significant difference was found in the radiographic success rates at 12 months (P=1.00). Internal root resorption was the most common radiographic pathologic finding in both groups.Conclusion:Clinical and radiographic success rates in NaOCl group was comparable with formocresol group, so NaOCL can be suggested as an alternative for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed.

One-year results of a novel self-adhesive bulk-fill restorative and a conventional bulk-fill composite in class II cavities\u2014a randomized clinical split-mouth study

ObjectivesIn the context of the phase-down of amalgam, development of easily applicable, permanent restorative materials is of high clinical interest. Aim of this study was to evaluate the clinical performance of a novel, tooth-colored, self-adhesive bulk-fill restorative (SABF, 3M Oral Care) and a conventional bulk-fill composite (Filtek One, 3M Oral Care; FOBF) for restoring class II cavities. The null-hypothesis tested was that both materials perform similar regarding clinical performance.Materials and methodsIn this randomized split-mouth study, 30 patients received one SABF and one FOBF restoration each. Scotchbond Universal (3M Oral Care) was used as adhesive for FOBF (self-etch mode), while SABF was applied directly without adhesive. Restorations were evaluated by two blinded examiners at baseline, 6 months and 12 months employing FDI criteria. Non-parametric statistical analyses and χ2-tests (α = 0.05) were applied.ResultsThirty patients (60 restorations) were available for the 6- and 12-month recalls exhibiting 100% restoration survival. All restorations revealed clinically acceptable FDI scores at all time points and for all criteria. Only regarding esthetic properties, FOBF performed significantly better than SABF regarding surface lustre (A1) and color match and translucency (A3) at all time points and marginal staining (A2b) at 12 months.ConclusionsThe null-hypothesis could not be rejected. Both materials performed similarly regarding clinical performance within the first year of clinical service. SABF exhibited slightly inferior, but clinically fully acceptable esthetic properties as compared to FOBF.Clinical relevanceWithin the limitations of this study, the self-adhesive bulk-fill restorative showed promising results and may be recommended for clinical use.

The Physiologic and Emotional Effects of 360-Degree Video Simulation on Head-Mounted Display Versus In-Person Simulation: A Noninferiority, Randomized Controlled Trial.

A key simulation component is its capability to elicit physiological changes, improving recall. The primary aim was to determine whether parasympathetic responses to head-mounted display simulations (HMDs) were noninferior to in-person simulations. The secondary aims explored sympathetic and affective responses and learning effectiveness. The authors conducted a noninferiority trial. Hospital providers who did not use chronotropic medications, have motion sickness, or have seizures were included. The authors randomized participants to in-person or HMD simulation. Biometric sensors collected respiratory sinus arrhythmia and skin conductance levels to measure parasympathetic and sympathetic states at baseline, during, and after the simulation. Affect was measured using a schedule. The authors measured 3-month recall of learning points and used split-plot analysis of variance and Mann-Whitney U tests to analyze. One hundred fifteen participants qualified, and the authors analyzed 56 in each group. Both groups experienced a significant change in mean respiratory sinus arrhythmia from baseline to during and from during to afterward. The difference of change between the groups from baseline to during was 0.134 (95% confidence interval = 0.142 to 0.410, P = 0.339). The difference of change from during the simulation to after was -0.060 (95% confidence interval = -0.337 to 0.217, P = 0.670). Noninferiority was not established for either period. Sympathetic arousal did not occur in either group. Noninferiority was not established for the changes in affect that were demonstrated. The mean scores of teaching effectiveness and achievement scores were not different. Although a parasympathetic and affective response to the video simulation on an HMD did occur, it was not discernibly noninferior to in-person in this study.

Successful Pulp-Preserving Treatment for Peri-invagination Periodontitis of Double Dens Invaginatus With Oehlers Type IIIA and IIIB: A Case Report

Dens invaginatus (DI), which often occurs in the maxillary lateral incisor, is an important issue in endodontics because the treatment complexity increases depending on the degree of invagination and the vitality or nonvitality of the pulp. An 11-year-old female patient with a sinus tract in the gingiva of the maxillary lateral incisors showed peri-invagination periodontitis and double DI on radiography. Cone-beam computed tomographic imaging was used to examine the structure in the root canal in detail, and Oehlers type IIIA and IIIB DI was found. It was also shown that the patient’s bone defect was caused by type IIIA. Because a healthy reaction was observed in the pulp test, the final diagnosis was peri-invagination periodontitis associated with type IIIA of the double DI with vital pulp. We expected the lesion to heal by treating only the type IIIA invaginated pseudo–root canal while preserving the healthy pulp. The invaginated root canal was cleaned under a microscope using ultrasonic instruments and nickel-titanium files to minimize irritation to the pulp. Because the lesion shrinkage was confirmed by cone-beam computed tomographic imaging taken 3 months after the start of treatment, vertical compaction of the warm gutta-percha technique was performed. At the 6-month postoperative recall, the pulp was normal, and the lesions were further improved. Treatment of the main root canal of double DI is complicated. However, proper diagnosis and careful cleaning of the invaginated root canal are essential for healing while preserving the pulp.

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

Comparative Evaluation of Marginal Bone Loss and Implant Failure Rate in Smokers and Nonsmokers.

Background:Smoking impose various ill-effects on the alveolar bone concerning dental implants including reduced bone height, delayed healing of bone, poor peri-implant bone formation, increased bone loss, and peri-implantitis.Aims:The present clinical trial was aimed to analyze the smoking effect on dental implant survival rate as well as marginal bone loss in dental implants.Materials and Methods:Out of 86 patients, Group I had 43 patients who were smokers and Group II had nonsmokers. Following the implant placement, marginal bone loss radiographically and mobility were assessed clinically at 3, 6, and 12 months after implant loading.Results:The mean marginal loss seen in smokers at 3 months was 2.13 ± 0.21, 2.46 ± 0.09, 2.60 ± 0.0.92, and 2.74 ± 0.11 for maxillary anterior, maxillary posterior, mandibular anterior, and mandibular posterior regions, respectively. The 12-month recall visit showed a higher proportion of smokers having implant mobility. In smokers, 13.95% (n = 6) of the study participants had implant mobility, whereas 6.97% (n = 3) of the nonsmokers had mobility.Conclusion:Smoking is associated with long-term implant failure which is directly proportional to the duration ad frequency of smoking. Furthermore, smoking has a detrimental effect on dental implants and its surrounding bone.

Prevalence of low back pain among intensive care nurses: A meta-analysis.

Low back pain (LBP) is a ubiquitous health problem affecting most of healthcare staff. However, there have been not effort to derive robust prevalence estimates of LBP among intensive care unit (ICU) nurses. To determine the prevalence of LBP among ICU nurses. A systematic review and meta-analysis was conducted. Five databases were searched: Web of Science, PubMed, MEDLINE (Ovid), Embase, and CINHAL databases. Original research that reported the prevalence of LBP among ICU nurses using a 12-month recall period were included. In order to assess methodological quality, we used a quality rating system which is specifically developed for LBP studies. Cochran's Q and the I2 test were applied to assess heterogeneity. Subgroup analysis was applied to identify factors that may contribute to heterogeneity. Presence of potential publication bias was assessed by using Egger's test and visual inspection of the symmetry in funnel plots. Twenty-seven studies reporting data from 2004 to 2020 on the prevalence of LBP in a defined ICU nurses were included (participants:6258; range: 3-1345). Twenty-one (77.8%) studies were of "high" quality. Among the included studies, the lowest and the highest prevalence were found to be 34.5% and 100.0%, respectively. Meta-analysis of included studies yielded a pooled prevalence of 12-month LBP at 76.0% (95% CI, 69.0%-81.8%). (I2 = 96.0%, Chi-squared=722, P-value < .01). LBP is prevalent among ICU nurses. Greater attention is urgently needed to address this burdensome health problem among ICU nurses, particularly with an emphasis to develop preventive strategies. The results of our meta-analysis have important consequences for ICU nurse managers. Our finding of high prevalence rate of LBP among ICU nurses suggests that more attention should be devoted to develop and apply prevention programs for ICU nurses to manage this global issue.

Cracked teeth: Distribution and survival at 6 months, 1 year and 2 years after treatment

The unpredictable condition of cracked teeth warrants further investigation and clinical experiences. The purpose of this study was to collect and record data on demographics, clinical characteristics, different treatment modalities and survival of cracked teeth at 6-month, 1-year and 2-year recalls. 77 cracked teeth from 65 patients were included. Data on demographics, clinical parameters, treatment modalities and recall were collected. Binomial, multinomial and chi square tests were used for statistical analysis. Most cracked teeth occurred in patients greater than 40 years old (p<0.01). Cracked teeth themselves were most often molars (79.22%; p<0.01), a non-terminal tooth in the arch (62.34%; p<0.05) and nonendodontically-treated teeth (94.81%; p<0.01). Cracked teeth exhibited pain to percussion (63.64%, p<0.05) or biting (74.03%; p<0.01), and no or only positive mobility (76.62%; p<0.01). Cracks were most often oriented in the mesiodistal direction (68.83%; p<0.01). Higher survival rates were noted in cracked teeth lacking pre-operative pain to palpation or spontaneous pain, and with no or only positive mobility at 6-month and 1-year recalls. In vital cracked teeth, higher survival rates were noted in teethlacking pre-operative pain to palpation and with no or only positive mobility at 2-year recalls. The absence of pre-operative palpation discomfort, spontaneous pain and minimal mobility, as well as the presence of pulp vitality were associated with higher survival rates of cracked teeth at all recall times. Results are useful for diagnosis and outcomes-based treatment planning of cracked teeth.

Treatment Outcomes of Pulpectomy in Primary Maxillary Incisors Filled with ZOE and Metapex: A Two-year Retrospective Study.

To address a literature gap by evaluating, in a larger set of samples, the clinical and radiographic outcomes of pulpectomy in primary maxillary incisors using ZOE and calcium hydroxide/iodoform paste. To also identify the predisposing factors for treatment outcomes. Medical charts of 124 patients (aged 16 to 60 months) and radiographs of their incisors (309 incisors) were reviewed (128 with ZOE and 181 with Metapex). All incisors were restored with composite resin crowns. The radiographic success rates for ZOE and Metapex were: 85.9% and 82.9% at the 12-month recall, and 69.2% and 64% at the 24-month recall, with no statistically significant difference between the two groups. Clinical failures occurred more frequently in the Metapex group (P = 0.006), as clinical signs of pain and soft tissue pathosis were found in 6.2% of the Metapex cases at 24 months but none in the ZOE group. Significant predisposing factors for radiographic success were type of tooth, degree of obturation at recalls, and preoperative root resorption. The radiographic success rates are comparable between the ZOE and Metapex groups. Clinical pathological manifestations such as pain and soft tissue pathosis are seen in the Metapex group at recalls, but none in the ZOE group. Predisposing factors such as type of incisor, preoperative root resorption, and extent of filling at recalls are associated with the radiographic success rate.

Humanistic and Economic Burden of Blindness Associated with Retinal Disorders in a Brazilian Sample: A Cross-Sectional Study.

Vision impairment and blindness have been significantly associated with high medical care expenditures, decrease in health utility, and loss or reduction of productivity. The objective of this study was to assess the humanistic and economic burden of blindness in a Brazilian sample from a societal perspective. Cross-sectional, observational, and multicenter study enrolling individuals with blindness (defined as the best corrected visual acuity less than 6/60 in the better-seeing eye) caused by retinal disorders. Data collection was performed between December 2012 and December 2014 through face-to-face interview using a structured questionnaire and three standardized patient-reported outcomes instruments. Direct costs were estimated by multiplying the amount of resources used (12-month recall period) by the corresponding unit cost. Productivity losses were measured using the human capital method. All data were collected in Brazilian real (BRL) and converted to United States dollar (USD), using the exchange rate of 1USD = 3.0415BRL (May7, 2015). A total of 146 subjects from 17 research sites were included with a mean age of 68 (SD = 14.8) years and equal gender distribution. Blindness negatively affected both general and vision-specific health-related quality of life. One-half of patients presented some level of anxiety and depression; of these, about 50% with moderate or severe symptoms. Around one-third of subjects (34.2%) reported at least one fall in the previous 12months due to vision impairment; of these subjects, 14% reported fractures. Emergency room visits and hospitalization were reported by around 25% and 5% of subjects, respectively. The short-term costs (annual costs) of severe vision impairment or blindness for the studied subjects was USD128,389.09 (USD879.37 per person). Total medical direct costs summed USD116,182.00 (USD795.77 per person), 61.7% of which was due to outpatient visits (with physicians and other healthcare professionals). The long-term costs (lifetime productivity loss) totalized USD1,962,599.50 (USD13,442.47 per person). This study demonstrated that blindness imposes both humanistic and economic burden for individuals and for Brazilian society. It also pointed out that there is room to improve blindness management, especially for the poorest people, including health education for individuals, availability of services, and reduction of barriers to patients' access to healthcare assistance. This was a good starting point; however, further research is needed.

Tooth loss in complying and non-complying periodontitis patients with different periodontal risk levels during supportive periodontal care

ObjectivesTo evaluate yearly tooth loss rate (TLR) in periodontitis patients with different periodontal risk levels who had complied or not complied with supportive periodontal care (SPC).Materials and methodsData from 168 periodontitis patients enrolled in a SPC program based on a 3-month suggested recall interval for at least 3.5 years were analyzed. For patients with a mean recall interval within 2–4 months (“compliers”) or > 4 months (“non-compliers”) with different PerioRisk levels (Trombelli et al. 2009), TLR (irrespective of the cause for tooth loss) was calculated. TLR values were considered in relation to meaningful TLR benchmarks from the literature for periodontitis patients either under SPC (0.15 teeth/year; positive benchmark) or irregularly complying with SPC (0.36 teeth/year; negative benchmark).ResultsIn both compliers and non-compliers, TLR was significantly below or similar to the positive benchmark in PerioRisk level 3 (0.08 and 0.03 teeth/year, respectively) and PerioRisk level 4 (0.12 and 0.18 teeth/year, respectively). Although marked and clinically relevant in non-compliers, the difference between TLR of compliers (0.32 teeth/year) and non-compliers (0.52 teeth/year) with PerioRisk level 5 and the negative benchmark was not significant.ConclusionA SPC protocol based on a 3- to 6-month recall interval may effectively limit long-term tooth loss in periodontitis patients with PerioRisk levels 3 and 4. A fully complied 3-month SPC protocol seems ineffective when applied to PerioRisk level 5 patients.Clinical relevancePerioRisk seems to represent a valid tool to inform the SPC recall interval as well as the intensity of active treatment prior to SPC enrollment.