Retrospective analysis of factors associated with the success of stepwise excavation procedure in deep carious lesions.

BACKGROUND: Recent scientific evidence regarding the stepwise excavation procedure (SWP) has not addressed the consideration of patient factors when selecting SWP as treatment for deep carious lesions (DCLs). This study assessed patient factors predicting a successful SWP defined as a tooth restored with SWP and did not result in root canal treatment or a dental extraction. METHODS: SWPs completed in 626 patients without symptomatic irreversible pulpitis at the University of Iowa College of Dentistry from January 2004 through December 2012 were evaluated. Patient demographic and tooth-specific characteristics were assessed in their relationship with the main outcome. RESULTS: SWPs had a 75% success rate when evaluated within 36 months of the initial treatment. Findings showed that patients who had successful SWP treatment of DCLs were somewhat younger than patients whose SWP treatment was not successful (mean age, 37.4 years and 40.5 years, respectively; odds ratio, 0.981; 95% confidence interval, 0.967 to 0.994; P = .0058). Patients who returned to their second appointment within 5 to 9 months were more likely to have a successful SWP treatment than those returning sooner than 5 months (odds ratio, 0.338; 95% confidence interval, 0.210 to 0.545; p < .0001). CONCLUSION: Treatment of deep carious lesions with SWP is effective for pulp preservation and patient age may influence the outcome. PRACTICAL IMPLICATIONS: Although a somewhat younger mean patient age was associated with successful treatment of DCLs, SWP can be successful regardless of patient age and clinicians should consider SWP in treating DCLs.

Comparison of Mechanical and Indirect Ultrasonic Placement Technique on Mineral Trioxide Aggregate Retrofill Density in Simulated Root-end Surgery.

INTRODUCTION: The objective of this study was to evaluate the density of mineral trioxide aggregate (MTA) root-end filling placed by either manual condensation or manual condensation with indirect ultrasonic activation under simulated root-end surgery conditions in vitro. METHODS: Extracted human molar teeth were obtained and sectioned to provide single-rooted samples (n = 50). Roots were instrumented to a size of 40 with a .04 taper and obturated with a warm vertical technique. The coronal end of each root was embedded in resin. A root-end resection and root-end preparation were completed on each root. Samples were randomly assigned to receive root-end fillings with ProRoot MTA (Dentsply, Tulsa, OK) by 1 of 2 techniques: manual condensation alone (group M, n = 25) or manual condensation with indirect ultrasonic activation (group U, n = 25). MTA was placed incrementally to the level of the root end using the enumerated technique. Samples were weighed immediately before and after filling placement. MTA was removed from all samples so as not to change the root-end preparation, rinsed, and dried. Each sample then underwent MTA placement by the opposite technique, and weight was again measured immediately before and after MTA placement. MTA filling weights for each technique were analyzed statistically using a technique for repeated measures analysis. Statistical analysis was conducted to account for any carryover or order effects. RESULTS: After adjustment for carryover effects, it was found that regardless of the order of placement, the mean fill weight of MTA produced by the indirect ultrasonic method was on average 4.42 mg heavier than that produced by manual condensation alone. This result was statistically significant (P < .0003). CONCLUSIONS: Under simulated root-end surgery conditions, indirect ultrasonic condensation of MTA root-end fillings was shown to produce a filling that was significantly denser than MTA placed by manual condensation alone.

The CSB Incident Screening Database: description, summary statistics and uses.

This paper briefly describes the Chemical Incident Screening Database currently used by the CSB to identify and evaluate chemical incidents for possible investigations, and summarizes descriptive statistics from this database that can potentially help to estimate the number, character, and consequences of chemical incidents in the US. The report compares some of the information in the CSB database to roughly similar information available from databases operated by EPA and the Agency for Toxic Substances and Disease Registry (ATSDR), and explores the possible implications of these comparisons with regard to the dimension of the chemical incident problem. Finally, the report explores in a preliminary way whether a system modeled after the existing CSB screening database could be developed to serve as a national surveillance tool for chemical incidents.

CIM y sensibilidad a los antibioticos de 96 cepas de E. coli EPI aisladas de diarreas infatiles / Minimum inhibitor concentration (CIM) and the sensibility to antibiotics of 96 stocks of escherichia coli intestinal enteropathogenic (IEP) isolated from infantile diarrhoeses

Determinamos la sensibilidad por difusión y la concentración inhibitoria mínima (CMI) a cepas de E. coli EPI aisladas de materia fecal provenientes de diarreas infatiles. La sisomicina, amicacina, gentamicina y ácido oxolínico resultan efectivos sobre 70 por ciento de los tres serogrupos de E. coli EPI. La sensibilidad mayor se observa en el poligrupo C a gentamicina, ácido oxolinico y fosfomicina; y la resistencia mayor está en el poligrupo A para el cloranfenicol, ampicilina y trimetoprima sulfametaxazol. La CIM para Cefotaxime y Mezlocilina se correlacionan con lo obtenido por difusión, resultando la Cefotaxime útil en la aplicación de enteritis y gastroenteritis por E. coli EPI de poligrupos B y C. Aconsejamos la tipificación de los agentes etiólogicos de las diarreas infatiles para aplicar correctamente el antibiotico específico determinado por antibiograma previo, siempre y cuando el cuadro clínico que presente el niño afectado evidencie gravedad y/o complicación para su salud (AU)

CIM y sensibilidad a los antibioticos de 96 cepas de E. coli EPI aisladas de diarreas infatiles / Minimum inhibitor concentration (CIM) and the sensibility to antibiotics of 96 stocks of escherichia coli intestinal enteropathogenic (IEP) isolated from infantile diarrhoeses

Determinamos la sensibilidad por difusión y la concentración inhibitoria mínima (CMI) a cepas de E. coli EPI aisladas de materia fecal provenientes de diarreas infatiles. La sisomicina, amicacina, gentamicina y ácido oxolínico resultan efectivos sobre 70 por ciento de los tres serogrupos de E. coli EPI. La sensibilidad mayor se observa en el poligrupo C a gentamicina, ácido oxolinico y fosfomicina; y la resistencia mayor está en el poligrupo A para el cloranfenicol, ampicilina y trimetoprima sulfametaxazol. La CIM para Cefotaxime y Mezlocilina se correlacionan con lo obtenido por difusión, resultando la Cefotaxime útil en la aplicación de enteritis y gastroenteritis por E. coli EPI de poligrupos B y C. Aconsejamos la tipificación de los agentes etiólogicos de las diarreas infatiles para aplicar correctamente el antibiotico específico determinado por antibiograma previo, siempre y cuando el cuadro clínico que presente el niño afectado evidencie gravedad y/o complicación para su salud