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31.
Objective: Evaluate the incidence of mental disorders using pegylated interferon plus ribavirin retreatment in nonresponder hepatitis C virus‐infected patients. Method: The Mini‐International Neuropsychiatric Interview (MINI) was used to evaluate 30 hepatitis C virus‐infected interferon‐nonresponder patients at baseline and following 4, 12 and 24 weeks of pegylated interferon retreatment. Results: During the pegylated interferon/ribavirin retreatment, 5(16.6%) patients developed psychiatric side effects: 3(10%) were diagnosed with major depressive disorder, 1(3.3%) had a brief psychotic disorder and 1(3.3%) presented with panic attacks. Conclusion: This is the first prospective study evaluating the incidence of neuropsychiatric side effects during interferon retreatment of hepatitis C virus‐infected patients, suggesting that the risk of acquiring serious psychiatric symptoms during retreatment with interferon‐α (IFN‐α) may not be higher than during the first antiviral therapy. This finding challenges the hypothesis that during a second treatment with IFN‐α, patients with hepatitis C may be at greater risk for neuropsychiatric side effects than naïve patients.  相似文献   
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Introduction

This microsurgical clinical study evaluated if teeth that have undergone endodontic retreatment are associated with more dentinal defects than primary root canal–treated teeth.

Methods

One hundred fifty-five patients who underwent periapical microsurgery treatment in a private practice setting were evaluated. The root ends were resected, and the roots were inspected for the presence of dentinal defects through the surgical operating microscope with the help of a 0.8-mm-diameter light-emitting diode probe light and methylene blue dye. The root canal treatment history (primary vs retreatment) of the teeth was documented and related to the presence or absence of dentinal defects. Bivariate analysis was performed using the chi-square test, and a multivariate analysis was performed using logistic regression to evaluate possible confounding effects of patient age, sex, and tooth location on the association between treatment and the presence of dentinal defects.

Results

Of the 155 treated teeth, 33 were excluded (3 fractured and 30 missing treatment history). Of the remaining 122 included teeth, 73 (59.8%) had undergone primary root canal treatment and 49 (40.2%) retreatment. Sixteen teeth (22.5%) of the primary root canal group versus 33 (64.7%) of the retreatment group had dentinal defects. The proportion of retreated teeth with dentinal defects compared with primary treatment was statistically significant (P < .001) with a higher proportion of retreated teeth having dentinal defects. In the multivariate analysis, only the type of treatment was statistically significant (P < .001).

Conclusions

This clinical study showed that root canal–retreated teeth are associated with more dentinal defects than primary root canal–treated teeth.  相似文献   
35.

Aim

To assess the influence of the crown height, root length, crown-to-root ratio, and tooth type on the survival of teeth subjected to surgical endodontic retreatment and classified as periapically healed.

Methodology

A single operator performed endodontic microsurgery interventions between 2008 and 2018 on teeth with refractory apical periodontitis. The present analysis selected the teeth classified as “complete periapical healing” according to the scale suggested by Molven. The postoperative periapical radiographs and those taken at the last recall visit were analysed by two independent calibrated examiners, who measured crown height and root length in a blind manner. The crown-to-root ratio was calculated as the ratio of the two variables. The level of inter- and intra-operator agreement was tested with Bland–Altman plots with 95% limits of agreement. An independent statistician conducted a survival analysis using Kaplan–Meier plots and a log-rank test (α = 0.05) to assess the significance of the differences among the subgroups defined by the following criteria: (a) crown height <median vs. >median; (b) root length <median vs. >median; (c) crown-to-root ratio <1 vs. >1; (d) crown-to-root ratio <median vs. >median; (e) single-rooted teeth vs. multi-rooted teeth.

Results

At the end of the analysis, 42 patients were evaluated, each one contributing to the study with a single tooth. The mean follow-up period was 4.2 ± 2.4 years. Survival estimates were significantly improved for the teeth with roots longer than 8 mm, in comparison with that with shorter roots (p < 0.05). There were no statistically significant differences among the remaining considered subgroups.

Conclusions

Under the conditions of this retrospective study, teeth with longer residual roots after apical surgery exhibited better chances of survival when compared to teeth with roots shorter than 8 mm. The other considered variables did not seem to affect the survival of apically resected teeth.  相似文献   
36.

Introduction

Nonsurgical retreatment procedure involves the complete removal of the previous filling material to allow thorough instrumentation, disinfection, and refilling of root canal system. We aimed to determine the residuals of the root-filling material by using 3 different retreatment techniques with the aid of micro–computed tomography.

Methods

Thirty extracted human maxillary molar teeth were included. All root canals were also obturated with F2 ProTaper single cones and AH Plus sealer. The following retreatment techniques were performed: group 1, ProTaper retreatment files; group 2, Mtwo retreatment files; and group 3, ProFile files. For the assessment of residual filling material, preoperative and postoperative micro–computed tomography scans were compared with each other, and the working time was recorded. One-way analysis of variance was used to analyze the differences between the groups. The significance level was set at P < .05.

Results

None of the retreatment techniques were capable of removing the whole filling material. The percentages of the residual filling materials for groups 1, 2, and 3 were 34.45, 45.43, and 23.63, respectively. There was a statistically significant difference between groups 2 and 3 (P < .05). ProTaper and ProFile instruments required less time for the removal of filling materials when compared with Mtwo instrument.

Conclusions

ProFile files revealed the best results for endodontic retreatment in terms of both removing capacity and time requirement.  相似文献   
37.

Introduction

The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth.

Methods

A total of 1000 teeth treated with nonsurgical root canal therapy were analyzed, and the following information was recorded for each patient: reasons for failure and extraction, type of tooth, presence and type of coronal restoration, smoking status, age, gender, and level of education. One main reason was recorded for each failed tooth. The associations between reasons for failure, patient, and tooth were tested by using χ2 analysis.

Results

Of the 1000 endodontically failed teeth analyzed in this study, 28.1% (n?=?281) were extracted, 66% (n?=?660) were re-treated, and 5.9% (n?=?59) were treated with apical surgery. Among the reasons for failure, restorative and endodontic reasons were seen most frequently (43.9%, n?=?439), whereas orthodontic reasons were seldom seen (0.1%, n?=?1). The most common reason for extraction was for prosthetic reasons (40.8%), and perforation/stripping was the least common (2.9%). The mandibular first molars were the most frequently extracted teeth (27.4%, n?=?77).

Conclusions

The most common reason for the extraction of endodontically treated teeth was for prosthetic reasons. Among the reasons for failure, restorative and endodontic reasons were the most frequently seen, and orthodontic reasons were the most seldom. The teeth that failed most frequently were mandibular first molars, and the teeth that failed least frequently were maxillary third molars. The most common reason for the extraction of failed endodontically treated teeth was for prosthetic reasons.  相似文献   
38.
BACKGROUND: High-dose peginterferon-alpha (PegIFN-alpha) induction and prolongation of therapy may be an option to improve sustained virological response (SVR) rates among hepatitis C virus (HCV) non-responders, although a higher and a longer dosing of PegIFN-alpha may intensify side effects. METHODS: We randomized 53 patients, who previously failed with standard IFN-alpha+/-ribavirin, to a high-dose induction and an extended regimen with PegIFN-alpha-2b [3.0 microg/kg once weekly (q.w.) 12 weeks-->2.0 microg/kg q.w. 12 weeks-->1.5 microg/kg q.w. 48 weeks] or a standard regimen (1.5 microg/kg q.w. 48 weeks). All patients received daily weight-based ribavirin (800-1200 mg/day). The short-form 36 health survey was used to evaluate health-related quality of life (HRQL). RESULTS: Intention-to-treat analysis showed no significant difference in SVR rate (44% vs. 37%, P=0.62) and relapse rate (9% vs. 31%, P=0.17) between experimental and standard treatment. Overall, 80% of the [positive predictive value (PPV)] patients with rapid virological response (RVR, HCV-RNA negativity at week 4) achieved SVR. No significant dose-related differences in HRQL were seen between both groups. At baseline, genotype 2 or 3 [odds ratio (OR): 7.4, 95% confidence interval (CI): 1.4-33.3, P=0.01] and gamma-glutamyltransferase (GGT) levels <2 x ULN (upper limit of normal) (OR: 6.76, 95% CI: 1.5-31.3, P=0.009) were significantly associated with SVR. Multivariate logistic regression at week 4 showed that only baseline GGT <2 x ULN (OR: 7.3, 95% CI: 1.4-38.5, P=0.01) and RVR (OR: 15.6, 95% CI: 3.2-76.9, P<0.001) were independently predictive for SVR. CONCLUSION: Retreatment with PegIFN-alpha-2b and ribavirin for a minimum of 48 weeks should be considered in all patients unresponsive to previous IFN-based therapies. Baseline GGT values and RVR are highly predictive for retreatment outcome.  相似文献   
39.
The purpose of the present study was to assess the effect of solvents on root canal transportation in endodontic retreatment. Sixty extracted human permanent mandibular first molars with curved root canals were selected. All of the root canals were prepared using Twisted File Adaptive instruments (SybronEndo, Orange, CA, USA) and filled with gutta‐percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) using the cold lateral compaction technique. The teeth were assigned to four retreatment groups as follows (n = 15): eucalyptol, chloroform, orange oil and control. The canals were scanned using cone‐beam computed tomography scanning before and after instrumentation. The chloroform group showed a significantly higher mean transportation value than the orange oil and control groups at the 3 and 5 mm levels (P = 0.011 and P = 0.003, respectively). There was no significant difference among the orange oil, eucalyptol and control groups in terms of canal transportation (P > 0.61). The chloroform led to more canal transportation than the eucalyptol and orange oil during endodontic retreatment.  相似文献   
40.
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