Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists: A multinational survey from 13 countries

Background: Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp-dentine complex to its normal physiological state.Aim: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET.Design: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period.Results: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period.Conclusion: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes

Nucleus size and DNA accessibility are linked to the regulation of paraspeckle formation in cellular differentiation

Background Many long noncoding RNAs (lncRNAs) have been implicated in general and cell type-specific molecular regulation. Here, we asked what underlies the fundamental basis for the seemingly random appearance of nuclear lncRNA condensates in cells, and we sought compounds that can promote the disintegration of lncRNA condensates in vivo. Results As a basis for comparing lncRNAs and cellular properties among different cell types, we screened lncRNAs in human pluripotent stem cells (hPSCs) that were differentiated to an atlas of cell lineages. We found that paraspeckles, which form by aggregation of the lncRNA NEAT1, are scaled by the size of the nucleus, and that small DNA-binding molecules promote the disintegration of paraspeckles and other lncRNA condensates. Furthermore, we found that paraspeckles regulate the differentiation of hPSCs. Conclusions Positive correlation between the size of the nucleus and the number of paraspeckles exist in numerous types of human cells. The tethering and structure of paraspeckles, as well as other lncRNAs, to the genome can be disrupted by small molecules that intercalate in DNA. The structure-function relationship of lncRNAs that regulates stem cell differentiation is likely to be determined by the dynamics of nucleus size and binding site accessibility.FWN – Publicaties zonder aanstelling Universiteit Leide

Clinical decision-making of repair vs. Replacement of defective direct dental restorations: a multinational cross-sectional study with meta-analysis

Objectives: This web-based survey, conducted across multiple countries, sought to explore the factors that impact the decision-making of clinicians when it comes to managing defective direct restorations. Methods: A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations. Results: Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p = 0.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p < 0.001) and open/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p < 0.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision-making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries. Conclusion: This study underscores the complexity of the decision-making process and the need for evidence-based guidelines to inform clinicians' decisions regarding restoration management. Patient-level factors predominantly influence decision-making, emphasizing the need for individualized approaches. Clinical Significance: The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth-level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence-based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care

Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries : a multinational cross-sectional study with meta-analysis

AIM : The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. METHODS : CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/ no) was identified and recorded. RESULTS : Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P , .05). The prevalence of DLC ranged from 3% to 50%, and the overall prevalence was 22% (95% CI: 15%–29%). RE prevalence ranged from 0% to 12%, and the overall prevalence was 3% (95% CI: 2%–5%). There were no significant differences between left and right M1Ms or between genders for either DLC or RE (P ..05). CONCLUSION : The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications.https://www.sciencedirect.com/journal/journal-of-endodonticsam2024OdontologySDG-03:Good heatlh and well-bein

Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries: a multinational cross-sectional study with meta-analysis

Aim: The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. Methods: CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/no) was identified and recorded. Results: Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P .05). Conclusion: The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications

Struktura i właściwości stopów żelaza o różnym składzie chemicznym po borowaniu dyfuzyjnym

The purpose of the paper was to test how the content of carbon and alloying elements in steels influence the structure and properties of boronized layers. The following grades of steels were used during the tests: C45, C99U, 41Cr4, 42CrMo4, 45SG, 50HS, 60G, and 102Cr6. In the process of boronizing, the two-phase layer of borides of FeB and Fe2B were obtained on the tested steels with a hardness from 1900 HV0.1 for boride FeB to 1600 HV0.1 for Fe2B, irrespective of the chemical composition of the core/substrate. As the content of carbon and alloying elements in steels increase, the structure of borides becomes more compact, and the needles are thicker. The richer in alloying elements the core and the more carbon in steel, the thinner is the boride layer. After boronizing, the layer of FeB and Fe2B with a thickness of approx. 110 μm for C45 steel to approx. 90 μm for 102Cr6 steel was obtained. The test results indicate that the brittleness of borides increases in steels with the addition of Cr, and it decreases in steels containing Si and Mn. The highest wear resistance was obtained in steel 102Cr6.Zbadano wpływ zawartości węgla i dodatków stopowych w stali na strukturę i właściwości warstw borowanych. Do badań zastosowano stale: C45, C99U, 41Cr4, 42CrMo4, 45SG, 50HS, 60G i 102Cr6. W procesie borowania na badanych stalach uzyskano dwufazową warstwę borków żelaza FeB i Fe2B o twardości ok. 1900 HV0.1 dla borku FeB i 1600 HV0.1 dla Fe2B, niezależnie od składu chemicznego podłoża. Wraz ze wzrostem zawartości węgla w stali oraz dodatków stopowych struktura borków jest bardziej zwarta, igły są grubsze. Im bogatsze jest podłoże w dodatki stopowe i im więcej węgla w stali, tym warstwa jest cieńsza. Po borowaniu otrzymano warstwę borków żelaza FeB-Fe2B o grubości od ok. 110 μm dla stali C45 do ok. 90 μm dla stali 102Cr6. Z przeprowadzonych badań wynika, że kruchość warstw borków rośnie dla stali z dodatkiem Cr, a maleje dla stali zawierających Si oraz Mn. Najwyższą odporność na zużycie uzyskano w stali 102Cr6

Przeciwzużyciowe warstwy borków żelaza na stali konstrukcyjnej C45 modyfikowane chromem i laserem

The paper presents the influence of diffusional boronizing, borochromizing processes, and laser modification on microstructure, microhardness, and frictional wear resistance of C45 constructional steel. The borochromizing process consists of two stages: first the boronizing was applied, and then chromizing was carried out as a second step. The boronizing was performed at 900°C for 4h, and then chromizing at 1020°C for 7h using the gas-contact method in powder containing amorphous boron and ferrochrome. Then, the boronized and borochromized layer was modified by remelting it using a TRUMPH CO2 2600W-power laser. The microstructure after diffusional boronizing and borochromizing consists of needle-like iron borides with a thickness of 80 μm and 100 μm and with a microhardness of 1400 HV0.1–1850 HV0.1. Three zones are formed after laser modification: the remelted zone MZ (eutectic mixture of borides and martensite) with a thickness of 100–120 μm, a martensitic heat affected zone (HAZ), and the core. The microhardness in the remelted zone is approx. 1200 HV0.1, as a result of which there appears a milder hardness gradient between the surface and the core. It was found that the frictional wear resistance of the boride layers modified by chromium and laser is higher than that of the layers after diffusional boronizing.W pracy przedstawiono wpływ procesu borowania i borochromowania dyfuzyjnego oraz laserowej modyfikacji na mikrostrukturę, mikrotwardość i odporność na zużycie przez tarcie stali konstrukcyjnej C45. Proces borochromowania składa się z dwóch etapów: borowania, a następnie chromowania. Borowanie przeprowadzono w temperaturze i czasie wynoszącym 900°C i 4 h, a chromowanie w 1020°C i 7 h w mieszaninie proszkowej zawierającej bor amorficzny i żelazo-chrom. Warstwy borowane i borochromowane następnie poddano modyfikacji przez przetopienie laserem CO2 firmy TRUMPH o mocy 2600 W. Mikrostruktura warstw borowanych i borochromowanych dyfuzyjnie zawiera iglaste borki żelaza o grubości ok. 80 μm i 100 μm oraz mikrotwardości 1400–1850 HV0.1. Po laserowej modyfikacji otrzymuje się trzy strefy: przetopioną MZ o grubości 100–120 μm (mieszanina eutektyczna borków i martenzytu), martenzytyczną strefę wpływu ciepła HAZ, a następnie rdzeń. Mikrotwardość w strefie przetopionej wynosi ok. 1200 HV0.1, stąd wynika łagodniejszy gradient twardości między powierzchnią a rdzeniem. Stwierdzono, że warstwy borków modyfikowane chromem i laserem wykazują wyższą odporność na zużycie przez tarcie od borowanych dyfuzyjnie

Wybrane właściwości warstwy borowanej dyfuzyjnie modyfikowanej miedzią

The paper presents the results of studies on microstructure, microhardness, fracture toughness, cohesion and wear resistance of copper modified boronized layers. Borocopperizing process consisted in simultaneous introduction of metallic copper and amorphous boron by diffusion. Borocopperized layers, similarly to boronized layers have a single-zone structure. It was observed that diffusion borocopperizing had a positive effect on microhardness, brittleness, cohesion and wear resistance.W pracy przedstawiono wyniki mikrostruktury, mikrotwardości, odporności na kruche pękanie, kohezji i odporności na zużycie przez tarcie warstw borowanych modyfikowanych miedzią. Proces boromiedziowania polegał na dyfuzyjnym wprowadzeniu miedzi metalicznej i boru amorficznego. Otrzymane warstwy miały podobnie jak warstwy borowane budowę jednostrefową. Stwierdzono korzystny wpływ boromiedziowania dyfuzyjnego na mikrotwardość, kruchość, kohezję oraz odporność na zużycie przez tarcie

Influence of boronizing on microstructure and selected properties of constructional steel

W artykule przedstawiono porównawcze badania wpływu borowania dyfuzyjnego na właściwości stali C45 i 41Cr4. Zbadano mikrostrukturę, skład fazowy, mikrotwardość, odporność na kruche pękanie i odporność na zużycie przez tarcie tych stali.The article presents a comparative research of influence of boronizing on the properties of C45 and 41Cr4 steels. Microstructure, phase composition, microhardness, fracture toughness and wear resistance of the steels were examined