Post Length Research Articles

Comparison of outcome of Simple Excision vs Limberg Flap of pilonidal sinus in terms of post operative pain, operative time, wound infection and hospital stay.

Objective: To compare post operative pain, wound infection, intraoperative time and length of hospital stay in both groups of simple excision and Limberg flap. Study Design: Comparative Prospective study. Setting: CMA Teaching and Research Hospital/Azra Naheed Medical and Dental College, Lahore, Pakistan. Period: 1st September 2021 to 1st September 2023. Methods: After approval from the Institutional review board of Azra Naheed Medical & Dental College/CMA Hospital, the sample was 120 patients was raised using non-convenience probability sampling divided into 2 groups. Group A patients underwent simple excision while Group B patients underwent Limberg flap Inclusion criteria include all the patients with age more than 13 years and diagnosed as case of pilonidal sinus. All the data was entered and processed by using SPSS 26. Comparison of two groups was done by apply independent sample t-test. A p-value of ≤ 0.05 was considered significant. Results: The average age of the patients was 45.88 ± 9.78 years with minimum and maximum ages were 15 & 59 year respectively. Mean post operative pain was 2.6 ± 1.9 in group A while 3.9 ± 2.7 in group B (p value = <0.05). Similarly wound infection, duration of surgery and length of hospital stay were also less in group A patients as compared to group B patients. Conclusion: Simple excision of pilonidal sinus is better from Limberg flap in terms of post operative pain, wound infection, duration of surgery and length of hospital stay.

Optimizing pediatric tonsillectomy outcomes with an opioid sparing anesthesia protocol: Learning and continuously improving with real-world data.

This quality improvement initiative is a continued pursuit to optimize outcomes by iteratively improving our opioid sparing anesthesia protocol for tonsillectomy with or without adenoidectomy at our pediatric ambulatory surgical center through data driven Plan-Do-Study-Act cycles. From 1/2015 through 12/2023, our standardized tonsillectomy protocol underwent nine procedure-specific perioperative Plan-Do-Study-Act cycles, three procedure-specific postoperative prescription Plan-Do-Study-Act cycles, and four general ambulatory surgical center enhanced recovery Plan-Do-Study-Act cycles. We analyzed data from the medical record using statistical process control charts. The primary outcome measure was the percent of patients requiring intravenous opioid in the post anesthesia care unit. Secondary outcomes included maximum post anesthesia care unit pain score, the percent of patients requiring treatment for nausea and/or vomiting in the post anesthesia care unit, and the number of postoperative opioid prescription dosages. Balancing measures were average post anesthesia care unit length of stay, percent of patients with prolonged Post Anesthesia Care Unit length of stay (>120 min), and 30-day reoperation rate. A total of 5654 tonsillectomy with or without adenoidectomy cases were performed at our ambulatory surgical center from 2015 to 2023. The incidence of intravenous opioid administered in the post anesthesia care unit initially rose with opioid free anesthesia launch, but subsequently decreased below the target of 10%. Maximum post anesthesia care unit pain scores rose from mean 3.6 to 4.5, but subsequently returned to the baseline of 3.5, while the incidence of postoperative nausea and/or vomiting improved. The average post anesthesia care unit length of stay increased by 10 min with opioid free anesthesia; however, prolonged post anesthesia care unit stay and 30-day reoperation rates were unchanged. The continued refinement of our opioid sparing anesthesia protocol has led to reduced perioperative and home opioid use, stable maximum post anesthesia care unit pain scores, and improved postoperative nausea and vomiting rates, with only a slight increase in mean post anesthesia care unit length of stay.

Exploring emotional dynamics: Word count effects in Facebook posts by sports shoe brands

This study examines the impact of word count in Facebook posts on user engagement and emotional responses, focusing on sports shoe brands. It addresses a research gap concerning the effects of post length on various emotional aspects and engagement metrics within social media marketing. Data were collected from January 1, 2024, to January 30, 2024, covering posts from January 2013 to December 2023 on official Facebook pages of several sports shoe brands. After cleaning an initial 723 posts, 636 were analyzed using statistical methods and Python libraries. Eight emotional aspects—fear, anger, sadness, trust, anticipation, joy, disgust, and surprise—were examined in relation to post length. Mean reaction values and emotional aspects were compared before and during the COVID-19 period. A structured equation model (SEM) in AMOS assessed these relationships. The analysis revealed that longer posts positively influenced trust (β = 0.208, ρ < 0.001), anticipation (β = 0.095, ρ < 0.05), joy (β = 0.259, ρ < 0.001), and surprise (β = 0.072, ρ < 0.05), but did not significantly affect fear (β = 0.065, ρ = 0.089), sadness (β = 0.054, ρ = 0.155), or disgust (β = 0.072, ρ = 0.116). During COVID-19, increased trust and anticipation were noted, while sadness and anger decreased. This study highlights that longer Facebook posts can enhance engagement through increased trust, anticipation, joy, and surprise, offering valuable insights for optimizing social media content strategies.

Drivers of Knowledge Sharing in Virtual Brand Communities: Self-Determination Perspective

ABSTRACT The prevalence of virtual brand communities and the knowledge sharing occurring throughout these populations has become a staple of both business and consumer online realities. Expanding work on personal motivations, and guided by self-determination theory, this research explores autonomous and relatedness motivations that drive individual knowledge sharing within online communities. The authors argue that such knowledge sharing can be fostered by many drivers, including self-presentation factors, brand community engagement elements, user attitude toward the brand, user reputation, size of community network, and reciprocity from other community members. Analysis was conducted using data collected longitudinally from 2866 club members of Xiaomi’s online MI User Interface community in China. Results reveal that personal signature, post length, online time, login frequency, brand attitude, reputation, online social network, and reciprocity all positively affect individual knowledge sharing within the virtual brand community, while the use of picture posts may have adverse effects and impact knowledge sharing negatively.

EP291 - Drinking, Eating, Mobilising after elective colorectal surgery- ‘DrEaMing’, a CQUIN project

Abstract Introduction DrEAMing- Early drinking, eating and mobilising after elective surgery, is a simplified and key part of enhanced recovery programmes. It helps decrease post operative complications and length of hospital stay. It also helps reduce the backlog of patients waiting for surgery. Objectives As per commissioning for quality and innovation (CQUIN) 2023/2024 guidelines, our aim was to ensure that at least 80 percent of patients are supported to DrEaM- Drink, Eat, Mobilise, within 24 hours of surgery. Our audit includes only colorectal surgeries. Methods 21 patients underwent elective colorectal surgery from July-September,2023. Patient’s notes, post operative notes and nursing notes were analysed to identify the inadequacies in each of the three limbs of DrEaMing. Results Free fluids were ordered for 21/21 (100%) and administered to 17/21 (81%) patients. Food was ordered for 16/21 (76%) and given to 12/21(57%) patients. Lastly, 16/21 patients had orders for mobilisation and 10/21 (48%) were supported for the same. The results were discussed at clinical governance meeting and interventions were advised for better implementation and compliance to guidelines. Conclusion There is a deficiency in effective implementation of DrEaMing project and this can be improved by better communication between surgeons and nurses. Surgeons should clearly document patients who aren’t suitable for enhanced recovery programme. We also requested changes to the built operative notes about post operative orders so that the instructions are not missed. We intend to adopt these measures and repeat the cycle of this QIP.

The influence of zirconia and fiber posts with different lengths on the fracture strength of maxillary central incisors restored with zirconia crowns: an in vitro study.

Endodontically treated teeth are more susceptible to fractures than vital teeth because of significant coronal and radicular dentin loss during endodontic therapeutic procedures. The objective of the present in vitro study was to estimate and compare the influence of the post length and type on the fracture strength of endodontically treated maxillary central incisors. Sixty extracted human maxillary central incisors were decoronated 2 mm above the cementoenamel junction. The teeth were selected and subjected to standard endodontic treatment, resulting in three groups with different preparation lengths: 5, 7.5, and 10 mm. Each group was randomly divided into two subgroups according to the post type: zirconia or fiber. After appropriate surface treatment, they were cemented with adhesive resin cement and restored with zirconia crowns. Thermocycling (5°C to 55°C, 60 s, 1500 cycles) was performed after cementing the zirconia crowns onto each tooth. Prepared samples were subjected to a compressive static load of 0.5 mm/min, at an angle of 130 degrees to the long axis of the roots, using a universal testing machine (Matest) at a crosshead speed of 0.5 mm/min, until fracture. The significance of the results was assessed using two-way analysis of variance (ANOVA) and the Tukey-Kramer test (α = 0.05). The ANOVA analysis indicated significant differences (P < 0.05) between the groups. The Tukey-Kramer test revealed no significant differences among the zirconia posts with lengths of 5 mm (26.5 N ± 13.4), 7.5 mm (25.2 N ± 13.9), and 10 mm (17.1 N ± 5.2). Also, in the fiber post group, there was no significant difference when the posts with lengths of 7.5 mm (13.4 N ± 11.0) were compared with those of 5 mm (6.9 N ± 4.6) and 10 mm (31.7 N ± 13.1). The 10-mm-long post displayed superior fracture strength, and the 5-mm-long post showed significantly lower mean values (P < 0.001). The fracture strength of zirconia posts (with lengths of 5 and 7.5 mm) was found to be significantly higher than that of fiber posts (with lengths of 5 and 7.5 mm). The 10-mm-long fiber post group demonstrated significantly higher fracture strength values, and the 5-mm-long fiber post group showed the lowest values for the force resulting in root fracture; these groups were significantly different from each other (P < 0.001). The fracture strength analysis with a universal testing machine is the only method that enables the estimation of the differences between zirconia and fiber posts with different lengths in endodontically treated teeth.

Less is More: Stress Detection through Condensed Social Media Contents

In the digital age, social media has been a go-to platform for stress-related discussions, yielding valuable data to advance the understanding and detection of stress. Swift identification of stress indicators in these online conversations is essential in enabling immediate support and helping to avert subsequent severe mental and physical health issues, especially during global crises such as pandemics and conflicts. Detecting stress in social media posts automatically poses a formidable challenge. While techniques such as supervised Pretrained Language Models (PLMs) and zero-shot Large Language Models (LLMs) based classifiers have demonstrated significant performance, they exhibit limitations, especially on platforms like Reddit. For example, on Reddit, users tend to write lengthy, expressive posts, which causes these methods to often fail to consider the entire context, leading to incomplete or inaccurate assessments of a user's mental health or stress status. To overcome these limitations, we present a new approach to identifying and classifying stress-related discourse on social media. Our approach involves analyzing condensed versions of user posts, such as user-provided summaries or the "Too Long Didn’t Read" (TLDR) portion of the original post. We question whether these abridged texts can yield a more accurate classification of stress. In this paper, we make the following contributions. First, we investigate the relationship between the performance of the model's perceived textual context and the length of social media posts. Second, we present a novel approach to use the summarized texts for stress detection. We experiment with different classifiers to evaluate their performance on stress detection accuracy using summarized versus full-length posts. Furthermore, by examining the emotional and linguistic features of the original posts and their summaries, we suggest improvements to current state-of-the-art LLM-based stress classifier prompts, thereby enhancing stress detection capabilities. Finally, when user summaries are absent, we synthetically generate meaningful user post summaries by incorporating the power of LLMs. Our results show that the stress detection performance deteriorates for longer posts, and utilizing the TLDR and summaries improves classification outcomes. We also provide augmented datasets containing human and AI-generated summaries for future research in stress detection on social media.

Evaluation of the Fracture Resistance of Different Designs of All-Resin Post and Core Systems: An In Vitro Study.

Introduction There is a growing demand for post and core systems that offer both ease of use and efficiency. Recently introduced dual-cure build-up and post cement materials exhibit properties similar to dentin. The objective of this laboratory experiment is to compare the fracture resistance among three distinct post and core systems and identify the locations of failures within each group. Material and methods This in vitro experimental study involved 30 epoxy resin-based blocks (Endo Training Bloc J, Dentsply Sirona, Ballaigues, Switzerland) divided into three groups: The first group was a post space preparation and restoration with a fiber post (RelyX™ Fiber Post, 3M ESPE, Saint Paul, Minnesota, United States) 1.6 mm in diameter and 10 mm in length (Group A) where core build-up and cementation were performed using a dual-cure build-up and cement for endodontic post resin material (Core X Flow, Dentsply DeTrey, Konstanz, Germany). The second group was a post space preparation and restoration using a dual-cure build-up and cement for endodontic post resin material, 10 mm in length filled with resin but without fiber post placement (Group B). The third group was where post space and core were filled and restored with a dual-cure build-up and cement for endodontic post resin material, 5 mm in length and without fiber post placement (Group C). Subsequently, samples were mounted and tested using a universal testing machine (Instron, Canton, Massachusetts, United States), and the fracture site was located. Results Significant differences were identified among the three groups, indicating the impact of both post length and type on fracture resistance (p-value <0.05). Group B exhibited the highest mean compressive strength resistance and maximum load at 899.3330 (N), followed by Group C at 848.9690 (N) and Group A at 751.9620 (N). The predominant failures in the samples were core fractures or debonding of the core material. Conclusion All-resin posts demonstrated high fracture resistance, unlike fiber posts which displayed inferior fracture resistance.

(263) Evaluating Changes in Social Media Discussions Regarding Vasectomies Before and After The Dobbs V. Jackson Supreme Court Decision

Abstract Introduction In June 2022, the U.S. Supreme Court overruled Roe v. Wade, the 1973 case establishing a federally protected right to abortion, through the case Dobbs v. Jackson. Subsequent research has demonstrated an increase in the number of men seeking vasectomy consultations as men take more ownership of family planning. We hypothesized that there might be a similar, paralleled change in online discussions about vasectomy following the court’s decision. Objective We sought to characterize themes and tones in social media discussions regarding vasectomies before and after the Dobbs decision. Methods We analyzed vasectomy-related discussions on Reddit, a large social media platform, using qualitative analysis and natural language processing-based sentiment analysis. Using the Reddit API, 1000 posts from 1 year before Dobbs and 1 year after were extracted from the subreddit group r/vasectomy. The group has 13,400 active members. Qualitative analysis was performed to determine overall themes within discussion posts. Poster age and comments about male sexual dysfunction were noted. Sentiment analysis was performed using the validated software VADER, which is specifically tuned expressions on social media platforms and assigns posts scores that can be interpreted as having positive, neutral, or negative sentiments. Results 213 total posts (107 pre-Dobbs and 106 post-Dobbs) were randomly selected for thematic and sentiment analysis. Posters in the post-Dobbs period were significantly younger than posters in the pre-Dobbs period (25.5 years vs. 31.7 years, p = 0.05). Posters in the post-Dobbs period were also more likely to mention their sexual dysfunction or raise questions regarding their sexual function post-operatively (p = 0.03). Notable discussion themes pre-Dobbs focused on post-operative concerns (n = 31), actionable advice (n = 38), or second opinions (n = 50). Patients also sought to reflect upon their experiences with their vasectomy (n = 30). While similar themes were noted post-Dobbs, more posts focused on describing pre-operative anxieties (n = 36), raising second thoughts regarding a scheduled vasectomy (n = 36), and acknowledging in some way the importance or value of having an online community such as r/vasectomy (n = 60). There was no significant difference in the length of posts (p = 0.44) or the number of positive, neutral, or negative sentiment posts (p = 0.98) between time periods. Conclusions Online discussion forums may provide insight into patients’ experiences with vasectomies during a contentious sociopolitical time when contraceptive options are changing. After the Dobbs decision, patients seemed to express increased pre-operative anxiety and doubt regarding their decisions to get vasectomies, but also expressed greater appreciation for the online community in r/vasectomy. This overall mix of feelings may explain any lack of difference in positive and negative sentiment in posts between the time periods. Disclosure No.

How long must a post be? A retrospective survival analysis on a large cohort with long follow-ups

ObjectivesPost and core (PC) is frequently used, but clinical evidence concerning how long a post must be is scarce. Recommendations in dental literature range from half of the root which should be incorporated, to post space preparations conducted as deep as possible increasing the risk for root perforation thus tooth loss. Therefore, the aim of this retrospective survival analysis is to evaluate the post length as well as the post-clinical crown ratio on a large patient cohort with long follow-ups. Materials and methodsOverall 1026 PC in 731 patients could be included in this study (2004–2023). The files were analysed due to the parameters post length and post-clinical crown ratio on X-Ray. Furthermore, the influence of the type of covering prosthetic restoration, location, type of tooth, luting material, PC material, bone attachment and therapist was evaluated. The statistical analysis was assessed using Kaplan-Meier (univariate influences) and Cox regression (multifactorial influences). ResultsSurvival until extraction as well as decementation was significantly influenced by bone attachment and covering prosthetic restoration. Posts reaching the middle third of the root showed highly significant (p < 0.001) better survival probabilities than those reaching the coronal or apical third. Regarding the post-clinical crown ratio, no significant difference was found for post = crown/post > crown, whereas post<crown showed highly significant lower survival probabilities (p < 0.001). ConclusionsThe post space preparation should not be extended over the middle third of the root, but has to be deep enough to ensure that the post is at least as long as the clinical crown. Clinical significanceAgainst the background of the large sample size and the long follow-ups, the results of this retrospective survival analysis are suitable to give general recommendations regarding how long a post has to be in order to ensure the best survival probability for PC treatment.

The utility and impact of outpatient telemetry monitoring in post-transcatheter aortic valve replacement patients

BackgroundConduction disturbances are a common complication of transcatheter aortic valve replacement (TAVR). Mobile Cardiac Telemetry (MCT) allows for continuous monitoring with near “real time” alerts and has allowed for timely detection of conduction abnormalities and pacemaker placement in small trials. A standardized, systematic approach utilizing MCT devices post TAVR has not been widely implemented, leading to variation in use across hospital systems. ObjectivesOur aim was to evaluate the utility of a standardized, systematic approach utilizing routine MCT to facilitate safe and earlier discharge by identifying conduction disturbances requiring permanent pacemaker (PPM) placement. We also sought to assess the occurrence of actionable arrhythmias in post-TAVR patients. MethodsUsing guidance from the JACC Scientific Expert Panel, a protocol was implemented starting in December 2019 to guide PPM placement post-TAVR across our health system. All patients who underwent TAVR from December 2019 to June 2021 across four hospitals within Northwell Health, who did not receive or have a pre-existing PPM received an MCT device at discharge and were monitored for 30 days. Clinical and follow-up data were collected and compared to pre initiative patients. ResultsDuring the initiative 693 patients were monitored with MCT upon discharge, 21 of whom required PPM placement. Eight of these patients had no conduction abnormality on initial or discharge ECG. 59 (8.6 %) patients were found to have new atrial fibrillation or flutter via MCT monitoring. There were no adverse events in the initiative group. Prior to the initiative, 1281 patients underwent TAVR over a one-year period. The initiative group had significantly shorter length of stay than pre-initiative patients (2.5 ± 4.5 vs 3.0 ± 3.8 days, p < 0.001) and lower overall PPM placement rate within 30 days post-TAVR (16 % vs 20.5 %, P = 0.0125). ConclusionsIn our study, implementation of a standardized, systematic approach utilizing MCT in post-TAVR patients was safe and allowed for timely detection of conduction abnormalities requiring pacemaker placement. This strategy also detected new atrial fibrillation and flutter. Reduction in post TAVR pacemaker rate and length of stay were also noted although this effect is multifactorial.

Radiographic Assessment of 121 Glass Fiber Post Procedures in 32 Patients Aged 21-60 Years Performed by 6th-Year Dental Students During the 2022-2023 Academic Year at the College of Dentistry, Jazan University, Saudi Arabia.

BACKGROUND The restoration of endodontically treated teeth (ETT) and severely damaged teeth has been a concern of clinicians. Glass Fiber Post (GFPs) combine the strength of carbon fiber posts with the esthetic appearance of glass to resemble natural dentin during dental restoration procedures. This radiographical study assessed the GFP carried out by students enrolled in the Clinical Comprehensive Course at the College of Dentistry, Jazan University. MATERIAL AND METHODS A total of 32 patients treated by 18 6th-year dental students with 121 GFPs were assessed in this cross-sectional radiographic study. The assessment covered tooth type, arch, post-to-root width, length of post in relation to the crown and root lengths, amount of remaining gutta percha (GP), and gap between GP and post. Data were analyzed using SPSS, and associations between variables were determined using the chi-square test. RESULTS Maxillary teeth were the most frequently restored with posts (88.4%) with most being (58.7%) anterior teeth, and 50.4% of posts had widths that were one-third that of the root. The percentage of posts was twice (71.1%) or equal to (26.4%) the crown length, whereas two-thirds of the tested GFPs were >5 mm of the remaining GP. Significant differences were observed in location and position of teeth with post width, post length in relation to crown or root length, and amount of remaining GP, with P values of 0.018, 0.000, and 0.001, respectively. CONCLUSIONS The assessed radiographs revealed that the performance of sixth year students in accomplishment GFP radiographically was satisfactory and within the values recommended in the literature.

In Vitro Effect of the Length of Relocated Cervical Margin with Casting Post and Core, Prefabricated Fiber Post, and Polyethylene Fiber with a Composite Core on Fracture Resistance and Marginal Integrity.

This study aimed to assess the effect of length of the relocated cervical margin with casting post and core (CP), prefabricated fiber post and composite core (PFP), and polyethylene fiber-reinforced composite (PEFRC) on fracture resistance and marginal integrity. In this in vitro study, 70 sound human maxillary premolars were divided into seven groups according to the type of post and core system and length of the relocated cervical margin (n = 10): control (no preparation), PFP-3, PEFRC-3, CP-3 with 3 mm of cervical margin relocation (CMR), PFP-6, PEFRC-6, and CP-6 (with 6 mm of CMR). The samples were restored with zirconia crowns (except the control group). Epoxy resin replicas were fabricated before and after thermomechanical loading. Marginal integrity was assessed at the luting cement-core, core-tooth, and luting cement-enamel interfaces under a scanning electron microscope (SEM) (×200). Fracture resistance and failure mode were subsequently assessed. Data were analyzed by independent t-test, paired t-test, ANOVA, Tukey-Games Howell, Mann-Whitney, Kruskal-Wallis, Wilcoxon, Mann-Whitney with Bonferroni correction, and Fisher-Freeman-Halton tests (α = 0.05). The marginal integrity of the groups with 3 mm of CMR followed the following order: PEFRC > PFP > CP at all interfaces (P < 0.05). In 6-mm CMR groups, this order was CP < PFP = PEFRC at the luting cement-core and (CP < PEFRC) = PFP at the core-tooth interface. No significant difference was found in fracture resistance when comparing the 3-mm CMR groups with each other (P > 0.05). PFP-6 showed higher FR than CP-6 (P < 0.001). PEFRC-6 had no significant difference with PFP-6 and CP-6 (P > 0.05). In each post and core system, 3-mm CMR groups showed higher marginal integrity and fracture resistance (P < 0.05). Increasing the length of the relocated cervical margin decreased the marginal integrity and fracture resistance of all three systems of CP, PFP, and PEFRC.

Influence of Post Length, Post Material, and Substance Loss on the Fracture Resistance of Endodontically Treated Teeth: A Laboratory Study

To evaluate the effects of post length, post material, and substance loss on the fracture resistance of endodontically treated mandibular premolars. A total of 96 extracted human mandibular first premolars were endodontically treated and divided into 12 test groups (n = 8 each) based on the number of residual walls (one/two), post material (glass-fiber/titanium), and post length (5 mm, 7.5 mm, and 10 mm). After luting the posts, specimens received a composite resin core and a crown preparation with a 1.5-mm ferrule. Cast cobalt-chromium crowns were cemented using glass-ionomer cement. After 1,200,000 chewing cycles with a load of 49 N and simultaneous thermocycling (5°C to 55°C), specimens were quasi-statically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed using three-way, two-way, and one-way ANOVA (α = .05). Fracture modes were examined under a stereomicroscope (×25 magnification) and recorded. The mean ± SD fracture loads ranged from 642 ± 190 N (one wall, glass fiber, 5 mm) to 1,170 ± 130 N (two walls, titanium, 7.5 mm). The mean fracture load of titanium posts was significantly higher than that of glass-fiber posts (P < .001), and the 7.5-mm post length exhibited significantly higher fracture loads than groups with 5-mm and 10-mm post length (P = .008). Teeth restored with titanium posts revealed considerably higher fracture resistance than teeth restored with glass-fiber posts, especially if 7.5-mm-length posts were used.

Fracture resistance of endodontically treated teeth, restored with two post-core systems in different post space diameters (in vitro study)

BackgroundFracture resistance of post-core restoration depends on the design of the post, post diameter, post length, the type of adhesive cement used along with material of the core. Despite the different studies concerning the effect of post space diameter on the fracture resistance of endodontically treated teeth, more information regarding fracture resistance and the effect of different post space systems/materials and diameters is required.Aim of the studyThis study aimed to evaluate fracture resistance of endodontically treated teeth, restored with two post-core systems in different post space diameters.Materials and methodsTwenty freshly extracted maxillary central incisors were collected for this study. They were randomly divided into four groups according to intracanal post and its diameter. Group GN (glass-fiber post of 10-mm length and 1.3-mm diameter with composite core), group GW (glass-fiber post of 10-mm length and 1.75-mm diameter with composite core), group ZN (custom-made zirconia one-piece post-core of 10-mm length and 1.3-mm diameter) and group ZW(custom-made zirconia one-piece post-core of 10-mm length and 1.75-mm diameter).Fracture resistance for all samples was evaluated using the universal testing machine under a static load. The data was collected and statistically analyzed using One-Way ANOVA test. Modes of failure were assessed using stereomicroscope for each group.ResultsThe highest mean fracture resistance was recorded in group GW (638.7 ± 285.1 N), followed by group ZW (598.5 ± 127.6 N), then GN group (442.8 ± 65.38 N). The lowest mean fracture resistance was recorded in group ZN (435.3 ± 117.3 N). One-Way ANOVA test revealed that there was no statistically significant difference in fracture resistance values among the groups.ConclusionPost space diameter had an impact over the fracture resistance of endodontically treated teeth. Modulus of elasticity of post material had a major effect on the fracture resistance and mode of failure along with the restorability of the restored tooth. However, there was no statistically significant difference among the tested groups.

Survey regarding the use of endodontic posts among dentists of twin cities, Rawalpindi and Islamabad, Pakistan

The purpose of the study was to assess the knowledge, attitude, and practices of dentists of twin cities regarding the use of endodontic posts in root canal treated tooth. A questionnaire was created and distributed among dentists of Rawalpindi and Islamabad via social media platforms regarding the use of posts. The results revealed that majority (60%) of the participants used endodontic posts for teeth with adequate ferrule, and believed that the function of endodontic posts is to retain the core material (50.5%). Glass fibre posts were preferred for anterior teeth (87%), whereas metal posts were favoured in posterior teeth (63%). It was concluded that the main function of the endodontic post is to retain the core material. The commonest indication is when there is at least 2mm of ferrule present and the optimal post length is 2/3rd of the root canal. Keywords: Post-Core Technic, Endodontically-treated tooth, Dental dowel.

HPB P18 Continuous drain irrigation as a risk mitigation strategy for postoperative pancreatic fistula; a meta-analysis

Abstract Background Postoperative Pancreatic Fistula (POPF) formation serves as the principle cause for the significant morbidity and mortality rates observed following pancreatectomy. Several different POPF mitigation strategies have been previously trialled, with variable success. Continuous drain irrigation as a treatment strategy for infected pancreatic necrosis has previously been described as an effective treatment strategy, however its role following pancreatectomy has yet to be determined. Methods A meta-analysis of the pre-existing literature was performed. The primary endpoint was determining whether continuous drain irrigation reduced POPF rates following pancreatectomy. Secondary endpoint evaluated its impact on post operative morbidity, mortality and length of stay. Analysis of dichotomous variables (complication rates) was calculated utilising the odds ratio (OR) with 95% confidence interval (CI) with the Mantel–Haenszel method with a random effects model. Continuous data (length of stay) was assessed using mean difference (MD) and 95% CI with the inverse variance random effects model. Data was tabulated and visualised through the creation of forest plots. Results Nine articles involving 782 patients was included in this meta-analysis. Continuous drain irrigation use was associated with a statistically significant reduction in POPF rates (OR (95% CI) 0.40 (0.19-0.82), p=0.01). Upon subgroup analysis, a significant reduction in clinically relevant POPF was also noted (OR 0.37 (0.20-0.66), p = 0.0008). A reduction in post operative complications was also observed: delayed gastric emptying (0.45 (0.24-0.84), p = 0.01) and the need for re-operation (0.33 (0.11-0.96), p = 0.04). This reduction in post operative complications rates also translated into a reduced post operative length of stay (MD -2.62 (-4.97 - -0.26), p =0.03). Conclusions Continuous drain irrigation following pancreatectomy serves as an effective risk mitigation strategy against POPF.

Evaluation of the accuracy of direct intraoral scanner impressions for digital post and core in various post lengths: An in-vitro study.

Despite the growing utilization of direct intraoral scanners (IOSs) in dentistry, there is a scarcity of research investigating their accuracy, specifically in post and core. Few studies have conducted comprehensive three-dimensional assessments and comparisons of IOSs with the conventional impression technique, particularly in different post space lengths. The purpose of this in vitro study was to digitally assess the accuracy of direct intraoral scanner (IOS) impressions for different post space lengths, specifically 6, 8, and 10 mm. A total of 45 typodont teeth (maxillary central incisors) were selected for this study. The teeth underwent endodontic treatment and were divided into three subgroups, each with 15 teeth, based on the desired post space lengths: 6, 8, and 10 mm. Intraoral scans of all specimens were acquired directly using the CEREC Primescan intraoral scanners by two trained examiners. The obtained scan data were compared with conventional impressions obtained using light and heavy bodies of polyvinyl siloxane (PVS). As a control, the conventional impressions were subsequently scanned using an inEos X5a lab scanner. The accuracy of the digital scans was evaluated in the coronal, middle, and apical thirds using the Geomagic Control X software. Statistical analysis was performed using Bonferroni Post-hoc and One-way ANOVA tests to analyze the data. The overall mean root mean square (RMS) deviations for the different post lengths across the three thirds groups were 58, 81, and 101 μm for the 6, 8, and 10 mm subgroups, respectively. There were no statistically significant differences in the accuracy of the coronal and middle thirds among all subgroups (p > 0.5). However, in the apical third, the 10 mm subgroup exhibited a significantly lower accuracy (163 μm) compared to the 6 mm (96 μm) and 8 mm (131 μm) subgroups (p < 0.05). These results suggest that while the accuracy of intraoral scans using direct IOS impressions was consistent in the coronal and middle thirds regardless of the post length, there was a noticeable decrease in accuracy in the apical third, particularly with longer post lengths. Considering the limitations of this in vitro study, chairside direct IOS impressions offer a viable and clinically acceptable alternative to the conventional impression technique for post space lengths of 6 and 8 mm. However, as the post space length preparation increases, the accuracy of IOS decreases. The Chairside direct IOS enables expedited and efficient digital impression capture within the root canal, ensuring acceptable accuracy for intracanal post length preparation of up to 8 mm.

Current Insights on Fiber Posts: A Narrative Review of Laboratory and Clinical Studies.

The aim of this study was to review the literature related to the clinical performance and laboratory findings regarding fiber posts, as well as the cementation technique employed with their use. A literature search was performed using an electronic database, PubMed/Medline, between 2010 and 2023. The terms used were "intra coronal post, fiber post, post cementation, and post length". Titles and abstracts were initially screened, and a full-text assessment was conducted for those that fulfilled the inclusion criteria. The reference list of the collected papers was also screened for further relevant citations. In this work, 135 potentially eligible studies were analyzed. Titles and abstracts of 90 studies followed the inclusion criteria and were selected for a full-text assessment, resulting in 50 studies selected. Moreover, additional studies from relevant citations were included, totaling 57 studies. According to the laboratory and clinical studies revised, the survival rate between fiber and prefabricated and cast metal posts was similar, and failures were mainly related to the loss of retention. The intra-canal post length of less than two-thirds of the root length presented successful results when ferrule was present. Furthermore, the ferrule increased the longevity of teeth restored with fiber posts. Additionally, the use of a surface treatment protocol for fiber posts and the adhesive cementation technique both contributed to the clinical success and longevity of the intra-canal post.

Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth.

Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.