Search Results (18)

Background/Objectives: This study evaluates the penetration of a calcium silicate-based sealer (BC Universal) into dentinal tubules after different final irrigation protocols. Methods: Eighty-four single-rooted extracted teeth were instrumented with ProTaper Gold to size F4 and assigned to four groups (n = 21) according to the final irrigation protocol as follows: conventional needle irrigation (CNI), sonic agitation with EndoActivator (EA), ultrasonic activation (UA), and XP-Endo Finisher (XPF). A total of 20 canals from each group were filled with BC Universal sealer mixed with fluorescein and the single-cone obturation technique. The remaining specimen in each group served as a negative control to assess potential imaging bias. Specimens were sectioned 3 mm from the apex and analyzed under confocal laser scanning microscopy. Sealer penetration was assessed by penetration area (PA), maximum depth (MaxD), mean depth (MeanD), and percentage of canal perimeter infiltrated (P). Data were analyzed using Kruskal–Wallis or ANOVA tests (α = 0.05). Results: All activation/agitation techniques showed significantly higher penetration than CNI across all variables (p < 0.001). No significant differences were found among EA, PUI, and XPF for PA, MaxD, and MeanD. However, XPF exhibited the highest perimeter infiltration, which was significantly greater than EA and UA (p < 0.001). Conclusions: Irrigant activation significantly enhanced dentinal tubule penetration of BC Universal sealer compared to CNI. XPF provided superior P, suggesting superior circumferential distribution. These findings suggest a more effective cleaning of the root canal in the apical third achieved by the tested irrigant activation/agitation techniques, which may improve the sealing potential of BC Universal sealer. Full article

Reducing fertilizer and pesticide use is a crucial path for the green transformation of agricultural production, which has garnered sustained attention in research on sustainable agricultural development. Based on the theoretical analysis, this article analyzes the spatiotemporal evolution characteristics of fertilizer and pesticide usage intensity (FUI and PUI) in the Yangtze River Delta (YRD) over the past 20 years and uses a Two-Way Fixed Effects Model to test their impacts and mechanisms. Findings show that agricultural development in the YRD shows a pattern of specialization and intensification with a significant north–south divide, with zero growth and reduction in fertilizer and pesticide use across the region from 2010 to 2015, but the current FUI and PUI are still nearly three and five times higher than the global average. Over the past 20 years, the FUI is high in the north and low in the south, high in the plains and low in mountainous-hilly areas, and high in suburban areas and low in remote counties. Adversely, the PUI is high in the south and low in the north, high in mountainous-hilly areas and low in plains, and high in suburban areas and low in remote counties. The FUI and PUI of characteristic agricultural areas of fruit, tea, and forestry in southern Anhui and southwestern Zhejiang, as well as the agroecological and facility agriculture clusters in southern Jiangsu and the suburbs of Shanghai, have approached the peak and successfully moved into the new green development stage earlier compared to other areas. In contrast, the grain and oil production plains areas along the Yangtze River, the coast, in northern Anhui, and in northern Jiangsu are relatively lagging behind. The combination of soil, water, light, and heat resource conditions and modes of agriculture production shape the absolute figures of FUI and PUI, and factors such as the level of local economic development and public fiscal expenditure significantly influence the trajectories of spatiotemporal differentiation in the progress of reducing fertilizer and pesticide in the YRD. Full article

In deep-space exploration, Pickup Ion Analyzers (PUIAs) operate under varying thermal environments in orbit, where thermally induced stress–deformation coupling may severely degrade their performance and long-term stability. To address temperature field analysis for in-orbit PUIAs, in this study, we propose a coupled simulation framework integrating external heat flux, parallel temperature field calculation, and thermoelastic deformation analysis, establishing a systematic link from thermal inputs to performance analysis. Based on external heat flux results, a parallel LU decomposition algorithm reduced the computational time from 11.8 h to 2.9 h for rapid temperature field solutions. At 38 astronomical units (AUs), the instrument’s temperature distribution ranged from −45 °C to 51.13 °C, with simulation errors compared to COMSOL simulations meeting engineering accuracy requirements. Maximum thermoelastic deformation induced by thermal gradients reached 0.110 mm. Performance degradation due to deformation in key metrics—including ion energy resolution, angular resolution, detection field-of-view, geometric factor, and mass resolution—was below 7.2%. This research improves the computational efficiency of the temperature field and systematically quantifies temperature effects on PUIA performance in deep-space environments, and the proposed methodology could provide technical support for optimizing on-orbit thermal management strategies. Full article

Objectives: This study aimed to evaluate the efficacy of cleaning in minimally shaped mesial and oval distal canals of 3D models of mandibular molars, focusing on positive pressure irrigation, wireless and conventional passive ultrasonic irrigation (PUI), and diode laser (DL) at 980 nm. Methods: Forty-four 3D-printed resin models, based on eleven natural mandibular molars (each with mesial and distal canals), were divided into four groups (n = 11 per group) to evaluate different irrigation methods. A total of 22 mesial canals (size 20/.04) and 11 oval distal canals (size 25/.04) were analyzed per group. Each root canal was uniformly filled with an artificial hydrogel to simulate a biofilm mixture. Following this preparation, the specified irrigation techniques were applied to the respective groups. Quantitative evaluations of pre- and post-irrigation images were performed to assess the efficiency of tissue removal along the entire length of the canal and in the apical, middle, and coronal thirds. Results: The findings revealed no significant differences in the initial amount of tissue between the samples, indicating uniform filling. In the apical region of mesial canals, conventional PUI showed the highest cleaning efficiency (14.1% residual tissue), significantly outperforming the other methods (p < 0.05). Cordless PUI and DL also surpassed positive pressure irrigation, leaving 30.4% and 29.3% residual tissue, respectively, compared to 42.2% with positive pressure. In the middle third, all methods tested performed better than needle irrigation (p < 0.05), but there were no significant differences in the coronal third or over the full canal length. Distal oval canals showed no significant differences in cleaning effectiveness among methods. Conclusions: Although no single method was superior regarding the full canal length, supplementary techniques such as PUI and DL offer potential benefits over conventional irrigation methods, particularly in the apical third of the canal. Complementary approaches such as conventional PUI and diode laser at 980 nm showed superior cleaning efficiency, particularly in the apical third. These results suggest their integration could improve the effectiveness of cleaning in minimally instrumented mesial canals. Full article

Background: In reverse shoulder arthroplasty (RSA), the neck–shaft angle (NSA) has trended downward from 155° to 135° to reduce scapular notching, but concerns about instability persist. To assess superior–lateral stability, we developed the intraoperative two-hand lever test (2HLT). The primary objective was to evaluate the effectiveness of the 2HLT, analyze the learning curve in this first study reporting on the new Perform stem, and compare the liner characteristics of 155° and 135° systems. Methods: In a single-surgeon learning curve study, 81 RSA procedures with the new Perform stem (Stryker) were included. The outcomes included the 2HLT test applied in 65 cases, early dislocations, stem alignment, stem length, liner type/thickness, and complications. The early dislocation rate was compared to 167 prior Ascend Flex RSA procedures (Stryker). The liner characteristics of three 135° systems (Perform/Stryker, Univers/Arthrex, and Altivate/Enovis) were compared to traditional 155° Grammont systems (Delta Xtend/DePuy, Affinis Metal/Mathys, SMR 150/Lima, and Aequalis Reversed/Stryker), focusing on jump height (JH) and the liner stability ratio (LSR). Results: In 63% (31/49) of the cases, the 2HLT detected superior–lateral instability, necessitating a retentive 135° liner. The early dislocation rate in the Perform cohort was 4.9% (0% for retentive liners, 8% for standard liners) versus 0% in the Ascend Flex cohort. The mean effective NSA was 133° (127–144°) for short Perform stems and 135° (129–143°) for long stems. Long Perform stems significantly reduced varus outlier density below 132° and 130° (p = 0.006, 0.002). The 36 mm Perform 135° standard liner has a JH of 8.1 mm and an LSR of 152%, markedly lower than the Altivate (10.0 mm/202%) and Univers (9.7 mm/193%) and similar to traditional 155° Grammont liners (8.1–8.9 mm/147–152%). Perform retentive liners have LSR values of 185–219%, comparable to the established 135° design standard liners (195–202%). In the Perform cohort, early complications included four superior–lateral dislocations (all standard liners, LSR 147–152%) requiring four revisions. Conclusions: Perform standard liners have a lower LSR than the established 135° designs. Retentive Perform liners (LSR > 184%) are comparable to standard liners of established 135° designs and effectively mitigate instability. We recommend discontinuing non-retentive Perform standard liners (NSA 135°, LSR < 158%) due to the 63% superior–lateral instability rate detected with the novel 2HLT, necessitating retentive liners, the documented LSR-NSA implant mismatch, and an early clinical dislocation rate of up to 8%. Full article

The rapid development of urbanization necessitates effective analytical methods to address its complexities. Peri-urbanization, the expansion of settlement boundaries and urban spread, is a critical aspect of this phenomenon. This study introduces a quantitative method to analyze peri-urbanization, providing a peri-urban index (PUI) for medium-sized cities based on peri-urban dynamics. Utilizing the analytical hierarchy process (AHP), the weight values of influencing dynamics are calculated, establishing a peri-urban scale (PUS) ranging from one to five based on rural and urban characteristics. Applied to a medium-sized case study city, the method assesses the peri-urbanization from 2007 to 2022. Four main dynamics—socio-demographics, economic-employment, land use-accessibility, and building-texture patterns—and fourteen sub-dynamics were identified and weighted using AHP. The city’s PUI values over different years reveal a 41.6% increase, indicating significant peri-urbanization. This quantitative approach, which innovatively integrates multiple numerical analysis methods, not only highlights the peri-urbanization trends of the city but also provides a comparative analysis framework for other cities. The method’s ability to track changes over time and compare different urban areas supports the development of sustainable urbanization strategies, ensuring balanced growth and resource allocation. This method offers urban planners, policymakers, and architects a powerful tool to manage and guide future urban expansion effectively through interdisciplinary collaboration. Full article

This study aimed to evaluate the safety and efficacy of a novel Poly-Ether-Ether-Ketone (PEEK) expandable vertebral body replacement (VBR) for anterior cervico-thoracic vertebral column reconstruction in patients with metastatic, traumatic, or degenerative diseases. Radiographic and clinical outcomes, as well as complication rates, were analyzed in a retrospective analysis of 28 patients (61 ± 13 years; 64% female) who underwent an anterior cervical corpectomy and fusion (ACCF) with the Expandable Corpectomy Device (ECD) from DePuy/Synthes (2011–2020). Correction of the bisegmental kyphotic angle (BKA) was chosen as the primary outcome. Bony fusion, loss of device height, and implant subsidence were evaluated additionally. Clinical outcome was assessed using Odom’s criteria, the numerical pain rating scale (NRS), the American Spinal Injury Association Impairment Scale (AIS), and the Karnofsky Performance Status Scale (KPSS). Our study found a significant improvement in the BKA (12.3° ± 9.6°; p = 0.0002) at the last follow-up with no statistically relevant loss of device height (p = 0.96) or implant subsidence (p = 0.99). Successful bony fusion was observed in all patients. The KPSS significantly improved in patients with a tumorous disease at the time of discharge (p = 0.0009), and the sensation of pain showed significant improvement at six months post-operatively and at the final follow-up (p = 0.004; p = 0.021). However, four patients needed further secondary posterior stabilization, and one ECD was explanted due to a severe surgical site infection after an accidental esophageal lesion. In conclusion, the ECD proofed the radiographic stability for the anterior column reconstruction of the cervico-thoracic spine with significantly improved clinical outcome. Full article

This study aimed to assess the penetration of AH-Plus (AHP) and AH-Plus Bioceramic (AHPB) sealers into dentinal tubules subsequent to different irrigation activation protocols. One hundred fifty teeth were divided into five groups according to the final irrigation protocol: conventional syringe irrigation (CSI), EndoActivator (EA), passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser, and SWEEPS. Then, the teeth were divided into two subgroups (n = 15) according to the canal sealer type. The maximum penetration depth (MPD) point and percentage of the sealer were evaluated using confocal laser scanning microscopy. Then, the data were statistically analyzed. The highest MPD values were observed in the SWEEPS groups, while the lowest value was in the CSI groups. Considering the effect of the sealer type and irrigation protocol interaction, there was a significant difference between the Er,Cr:YSGG laser, and EA groups for the AHPB sealer (p < 0.05), while it was insignificant for the AHP sealer (p > 0.05). The AHP and AHPB sealers statistically presented similar penetration properties. Laser-activated irrigation presented a higher sealer penetration compared to the other techniques. Full article

The purpose of this study was to analyze the influence of Chitosan 0.2% in various final cleaning methods on the bond strength of fiberglass post (FP) to intrarradicular dentin. Ninety bovine incisors were sectioned to obtain root remnants measuring 18 mm in length. The roots were divided: G1: EDTA 17%; G2: EDTA 17% + PUI; G3: EDTA 17% + EA; G4: EDTA 17% + XPF; G5: Chitosan 2%; G6: Chitosan 2% + PUI; G7: Chitosan 2% + EA; G8: Chitosan 2% +XPF. After carrying out the cleaning methods, the posts were installed, and the root was cleaved to generate two disks from each root third. Bond strength values (MPa) obtained from the micro push-out test data were assessed by using Kruskal–Wallis and Dwass–Steel–Critchlow–Fligner tests for multiple comparisons (α = 5%). Differences were observed in the cervical third between G1 and G8 (p = 0.038), G4 and G8 (p = 0.003), G6 and G8 (p = 0.049), and Control and G8 (p = 0.019). The final cleaning method influenced the adhesion strength of cemented FP to intrarradicular dentin. Chitosan 0.2% + XPF positively influenced adhesion strength, with the highest values in the cervical third. Full article

Background: Early postoperative mobilization is essential for orthogeriatric patients. The prognostic nutritional index (PNI) is widely used to evaluate nutritional status. This study sought to investigate the predictive value of PNI for early postoperative mobility in patients with pertrochanteric femur fractures. Materials and methods: This study included 156 geriatric patients with pertrochanteric femur fractures treated with TFN-Advance™ (DePuy Synthes, Raynham, MA, USA). Mobility was evaluated on the third postoperative day and by discharge. Stepwise logistic regression analyses were performed to evaluate the association significance of PNI with postoperative mobility together with comorbidities. The optimal PNI cut-off value for mobility was analyzed using the receiver operating characteristic (ROC) curve. Results: Three days postoperatively, PNI was an independent predictor of mobility (OR: 1.14, 95% CI: 1.07–1.23, p < 0.01). By discharge, it was found that PNI (OR: 1.18, 95% CI: 1.08–1.30, p < 0.01) and dementia (OR: 0.17, 95% CI: 0.07–0.40, p < 0.001) were significant predictors. PNI correlated weakly with age (r = −0.27, p < 0.001). The PNI cut-off value for mobility on the third postoperative day was 38.1 (specificity = 78.5%, sensitivity = 63.6%). Conclusions: Our findings indicate that PNI is an independent predictor of early postoperative mobility in geriatric patients with pertrochanteric femur fractures treated with TFNA™. Full article

This study aimed to evaluate the effectiveness of different Passive Ultrasonic Irrigation (PUI) protocols on debris removal and exposure of dentinal tubules in simulated complex root canal cavities. Twenty single-rooted human mandibular premolars with simulated root canal cavities were filled with the debris and randomly divided into ten groups based on the final irrigation protocol: 1—positive control; 2—negative control; 3—conventional irrigation (CI) with 2.5% sodium hypochlorite (NaOCl); 4—CI with 17% ethylenediaminetetraacetic acid (EDTA) followed by NaOCl; 5—three cycles of PUI for 20 s (NaOCl-NaOCl-NaOCl); 6—three cycles of PUI for 20 s (NaOCl-EDTA-NaOCl); 7—one 60 s PUI cycle (NaOCl); 8—one PUI 180 s cycle (NaOCl); 9—two cycles of PUI for 60 s (EDTA-NaOCl); and 10—two cycles of PUI for 60 s (NaOCl-EDTA). The groups were analyzed by SEM. The Kruskal-Wallis test was used at a 5% level. PUI showed a higher reduction of debris, similar to the positive control group (p > 0.05) and higher than the CI and negative control groups (p < 0.05). Regarding the exposure tubules, the CI groups were similar to the negative control group in all cavities (p > 0.05). The PUI groups were similar to the positive control group (p > 0.05). However, only groups 6, 7, and 10 were statistically different from the CI and negative control (p < 0.05). The protocols using PUI, comprising groups with three cycles of 20 s (NaOCl-EDTA-NaOCl), two cycles of 60 s (EDTA-NaOCl), or one cycle of 60 s (NaOCl), were more effective at removing debris and increasing the exposure of dentinal tubules. Full article

This article presents an experimental approach to the geometrical planning of the medial opening wedge high tibial osteotomy surgery which, as it is known, is an efficient surgical strategy quite widely used in treating knee osteoarthritis. While most of the published papers focus on analyzing this surgery from a medical point of view, we suggest a postoperative experimental evaluation of the intervention from a biomechanical point of view. The geometrical planning and, more specifically, the determination of the point of intersection between the corrected mechanical axis and the medial-lateral articular line of the knee, is a problem quite often debated in literature. This paper aims to experimentally investigate the behavior of the tibia with an open wedge osteotomy fixed with a locking plate, TomoFix (DE Puy Synthes), taking into account two positions of the mechanical axis of the leg on the width of the tibial plateau, measured from medial to lateral at 50% and 62.5% (Fujisawa point), respectively. The variations of the force relative to the deformation, strains, and displacements resulting from the progressive loading of the tibial plateau are studied. The research results reveal that using the Fujisawa point is better for conducting the correction not only for medical reasons, but also from a mechanical point of view. Full article

Background and Objectives: The purpose of the present study was to investigate the anti-bacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). Materials and Methods: Eighty-six extracted single- and double-rooted human teeth were used in the experiment. The following four experimental groups were evaluated, as well as a control group: group 1: single root + PUI (n = 20); group 2: single root + laser application (n = 20); group 3: double roots + PUI (n = 20); group 4: double roots + laser application (n =20); control group (n = 6): 3 single roots, 3 double roots. The qPCR assay was performed in three stages to evaluate the efficacy of the adjunctive method against Enterococcus faecalis. SEM analysis was also used to examine the microstructure of root canal surfaces. The data were statistically analyzed using the Friedman test and the Kruskal–Wallis test with Bonferroni adjustment. Results: The decrease in the DNA levels from S1 (before preparation) to S2 (just after preparation) was highly significant in all groups, and decreases in DNA levels from S2 to S3 (after incubation for 1 week) were found in all experimental groups except group 1. An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05). However, in double roots, experimental groups did not show significantly lower DNA levels than the control group (p > 0.05). SEM images showed that cleaning of the root canal surface and reduction of dentin debris were achieved only in single-rooted teeth when using PUI application. Conclusions: Two adjunctive methods were effective in reducing E. faecalis in single rooted tooth. Full article

Objectives: This study aims to evaluate the efficacy of the rotary instrument XP-endo Finisher for the removal of Ca(OH)₂ aided by different irrigation regimens. Methods: Sixteen double-rooted upper premolar human teeth were selected for the study. Thirty-two canals were prepared using a ProTaper Next rotary system up to X3. Then, the canals were filled with Ca(OH)₂. The volume of Ca(OH)₂ inside the canals was measured by microcomputed tomography (micro-CT). After that, the teeth were randomly allocated into two experimental groups, i.e., A and B (n = 16 canals). In group A, Ca(OH)₂ was removed using the master apical file (X3). In group B, Ca(OH)₂ was removed using a XP-endo finisher. In half of both groups (n = 8), syringe irrigation (SI) was used, while passive ultrasonic irrigation (PUI) was used for the other half. After removal, the remaining volume of Ca(OH)₂ was measured. All data were statistically analyzed using two-way ANOVA with Tukey’s post hoc test. Results: The percentages of remaining Ca(OH)₂ in the apical thirds of all canals were significantly higher as compared with the middle and coronal thirds in all groups (p < 0.05). There was no significant difference between different files and techniques (p > 0.05). Clinical Significance: This study presents a new method for the removal of Ca(OH)₂ from root canals. Full article

Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction. Full article