Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial.

PURPOSE: The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP). METHODS: A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates. RESULTS: The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05). CONCLUSION: In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP. TRIAL REGISTRATION NUMBER: Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.

The occurrence of flexion-relaxation phenomenon in elite cyclists during trunk forward bending.

Flexion-relaxation phenomenon (FRP) is a well-known phenomenon in spinal extensor muscles. According to the literature, prolonged flexed posture leads to creep phenomenon and affects the active and passive neuromuscular control of the spinal column. The purpose of this study was to investigate FRP occurrence in elite cyclists that prolonged flexion posture is an integral part of their professional life. Their muscles' contraction pattern during forward bending was also compared. Electromyography (EMG) was recorded during flexion and extension from standing position in thoracic erector spinae (TES), lumbar erector spinae (LES) and gluteus maximus (Gluteus max) in 15 healthy male elite cyclists. In addition, the kinematic data related to the trunk angles were simultaneously recorded by a motion analysis system. Two-way ANOVA was used to assess the effects of muscle group and direction of movement on maximum amplitude of EMG activity. Among 15 cyclists, FRP was detectable in 60%, 87% and 73% of the participants in TES, LES and Gluteus max, respectively, and happened between 74% and 82% of the trunk flexion. There was no statistically significant difference in onset and offset of muscles FRP. Despite prolong hyper kyphotic posture, FRP was identifiable in TES, LES and Gluteus max muscles of elite cyclists.

A comparison of scapulothoracic muscle electromyographic activity in subjects with and without subacromial impingement syndrome during a functional task.

Shoulder impingement syndrome (SIS) is the common cause of shoulder pain and disability and the individuals suffering from it are usually in different levels of physical activity covering an extensive age range. In spite of limited scientific evidence for an altered motor pattern in the shoulder muscles of patients with SIS, they are frequently referred to physiotherapists in an attempt to optimize coordination and strength of the affected muscles. The aim of this study was to compare scapular muscle activity in a general population of subjects with and without SIS during an arm elevation task executed at different speeds in two load conditions. The study is that of a comparative observational using a simple convenience sampling method, comprising 8 females (31.63 ± 9.39) with SIS and 10 females (29.10 ± 6.57) without SIS, matched in terms of age, body mass index (BMI) and levels of physical activity. The surface EMG (SEMG) of all the trapezius muscles, i.e., -upper fibers (UT), middle fibers (MT), and lower fibers (LT) serratus anterior (SA), and middle deltoid were recorded during shoulder elevation in a scapular plane at three speeds (slow, moderate, and fast) and two load conditions (with and without load). Data were analyzed using independent t-tests and three-factor repeated measures analysis of variance and Bonferroni method for paired comparisons. The EMG tests results in muscle activities revealed no significant differences between the two groups at three speeds, and with and without load. The findings do not support the claim that SIS necessarily accompanies changes in scapula thoracic and glenohumeral muscle activity.

The influence of Positional Release Therapy on the myofascial trigger points of the upper trapezius muscle in computer users.

OBJECTIVE: The purpose of the present study was to investigate the effect of Positional Release Therapy (PRT) in computer users via latent trigger points (LTrPs) of the upper trapezius muscle. MATERIALS AND METHODS: Twenty-eight women with the upper trapezius MTrPs participated in this study. Subjects were randomly classified into two groups (14 in each group): the subjects in the Group 1 received PRT in shortened position while those in the group 2 received sham control in the neutral position of the upper trapezius muscle. They received three therapy sessions every other day for one week. The local pain intensity and Pressure pain threshold (PPT) were measured via Visual Analogue Scale (VAS) and algometry, respectively, before interventions and repeated 5 min after the first and third treatment sessions in each group. RESULTS: One-way ANOVA was used for data analysis. After treatment, between groups comparison revealed that for PPT and VAS, there were significant differences between the two groups (VAS and PPT; P < 0.05). CONCLUSION: Both groups (PRT and sham control) showed alleviation of pain and increase in PPT during three sessions of therapy although PRT showed to be more effective in these patients.

Effect of bonding application time on the microleakage of Class V sandwich restorations.

BACKGROUND: The aim of this study was to assess the effect of bonding application time on the microleakage of Class V sandwich restorations. METHODS: Eighty non-carious third molars were randomly divided into 16 groups. Two Class V cavities were prepared on the buccal and lingual surfaces of teeth. Three groups were restored with Fuji II GIC and treated with a total-etch bonding system (Stea/SDI) immediately after insertion, at 7 minutes and 15 minutes after mixing the glass ionomer cements (GICs). Another three groups were restored with Riva Self Cure GIC and treated with the total-etch system identically. The other six groups were subjected to self-etching bonding (Frog/SDI) after GIC placement in an identical procedure. The remaining groups were made using light cure GICs (Fuji II or Riva Light Cure) in conjunction with the total-etch or self-etching systems. Cavities were then restored with composite (Valux plus, 3M/ESPE). Samples were subsequently immersed in 2% methylene blue solution for 48 hours and observed under a stereomicroscope after sectioning. Four-scale grading was used to assess microleakage in occlusal and gingival walls. Data were analysed using Kruskal-Wallis and Mann-Whitney tests. RESULTS: The self-etching bonding system exhibited more microleakage in occlusal margins regardless of time. Over time, microleakage significantly decreased in gingival margins in all self-cure groups except for Riva Self Cure treated with the total-etch system (p < 0.05). CONCLUSIONS: Bonding application time had no effect on the microleakage of occlusal margins. However, maturation of GICs induced a decreased microleakage in gingival margins.

Passive transfer of streptococcus-induced antibodies reproduces behavioral disturbances in a mouse model of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection.

Streptococcal infections can induce obsessive-compulsive and tic disorders. In children, this syndrome, frequently associated with disturbances in attention, learning and mood, has been designated pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Autoantibodies recognizing central nervous system (CNS) epitopes are found in sera of most PANDAS subjects, but may not be unique to this neuropsychiatric subset. In support of a humoral immune mechanism, clinical improvement often follows plasmapheresis or intravenous immunoglobulin. We recently described a PANDAS mouse model wherein repetitive behaviors correlate with peripheral anti-CNS antibodies and immune deposits in brain following streptococcal immunization. These antibodies are directed against group A beta-hemolytic streptococcus matrix (M) protein and cross-react with molecular targets complement C4 protein and alpha-2-macroglobulin in brain. Here we show additional deficits in motor coordination, learning/memory and social interaction in PANDAS mice, replicating more complex aspects of human disease. Furthermore, we demonstrate for the first time that humoral immunity is necessary and sufficient to induce the syndrome through experiments wherein naive mice are transfused with immunoglobulin G (IgG) from PANDAS mice. Depletion of IgG from donor sera abrogates behavior changes. These functional disturbances link to the autoimmunity-related IgG1 subclass but are not attributable to differences in cytokine profiles. The mode of disrupting blood-brain barrier integrity differentially affects the ultimate CNS distribution of these antibodies and is shown to be an additional important determinant of neuropsychiatric outcomes. This work provides insights into PANDAS pathogenesis and may lead to new strategies for identification and treatment of children at risk for autoimmune brain disorders.