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Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge to achieving SDM, both for the clinician and the patient. The treatments are often perceived as more challenging to complete by the clinician, and the assessment of risk and likely outcome requires a deep understanding of the (limited) evidence base. see more For the patient, decisions can be required at a time of acute symptoms and prolonged treatments. There are health literacy demands in comparison to some less complex dental treatments. Treatment decisions may be based more on inherent biases and prior experiences than objective probabilities. This article discusses options and supports effective shared decision making in endodontic treatment.Traumatised permanent anterior teeth can require endodontic treatment which may be immediate as part of acute trauma management, or delayed due to the development of sequelae. This paper will enable clinical decision making by exploring a range of situations in which endodontic treatment may be indicated, and also offer practical advice regarding effective endodontic treatment for paediatric dental trauma patients.Endodontic treatment of traumatised permanent teeth in paediatric patients is often challenging. However, with timely decision making and appropriate treatment, these teeth can often last throughout childhood and adolescence thus ensuring that a young patient does not have the social burden of a missing tooth and needing a prosthesis, and has the maximum restorative options available to them as they enter adulthood.
This systematic review aims to identify and synthesise available evidence to determine the clinical and radiographic outcomes of REP involving any disinfection irrigant together with a non-antibiotic intracanal medicament.

Experimental and observational studies evaluating the outcomes of REP in immature non-vital permanent teeth in 6-16 year olds, where the protocol used any type of disinfectant irrigant together with a non-antibiotic intracanal medicament (non-setting calcium hydroxide) were included. Data was narratively synthesised and presented in respect to the primary outcome (elimination of symptoms and infection) and secondary outcomes (increase in root length/width; positive response to vitality testing; patient-reported outcomes; adverse effects).

1628 studies were identified, of which five met the eligibility criteria for inclusion in the review. Studies included one randomised control trial and four observational studies. All five studies showed an absence of clinical signs and symptoms for all teeth postoperatively with radiographic resolution or absence of pathology following the disinfection stages of the REP used. Choice of secondary outcomes were inconsistent but included further root development, coronal discolouration and root canal calcifications postoperatively. There was a high risk of bias in all five studies and subsequently the quality of the evidence base was judged to be low.

REP using a non-antibiotic disinfectant approach appears capable of providing satisfactory outcomes for a non-vital immature permanent tooth. Further high-quality research is required before solid recommendations towards clinical practice guidelines for the disinfection portion of REP can be implemented.
REP using a non-antibiotic disinfectant approach appears capable of providing satisfactory outcomes for a non-vital immature permanent tooth. Further high-quality research is required before solid recommendations towards clinical practice guidelines for the disinfection portion of REP can be implemented.This article provides a contemporary synopsis of effective cleaning of the root canal system, an essential stage of root canal treatment. It provides a clinical update on the current state of knowledge on cleaning of the root canal system, and presents an outline of essential theory and practical tips for achieving effective and safe cleaning of the root canal system.Casing wear is a serious problem in highly-deviated wells because serious wear will lead to casing deformation, drilling tool sticking and failure of subsequent operations. The purpose of this paper is to predict casing wear depth and evaluate its effect on casing strength degradation in highly-deviated well drilling operation. Special attention has been given to the algorithm to achieve the prediction and evaluation. The effect of tool joint on contact force distribution is considered in contact force model. Then a wear depth prediction model and its solution method are proposed based on crescent-shaped wear morphology and wear-efficiency model. Besides, strength degradation of worn casing is analyzed in bipolar coordinate system and the model is verified by finite element method. Therefore, the technology of casing wear prediction and residual strength evaluation is completed systematically. Then, to apply casing wear prediction and residual strength evaluation technologies to an actual highly-deviated well, casing wear experiment and friction coefficient experiment are carried out to obtain wear coefficient and friction coefficient. Finally, based on the established models as well as experimental results, the distribution of casing wear is predicted and residual strength is evaluated. The method presented in this paper will contribute greatly to casing wear prediction and evaluation in highly-deviated wells.Paraoxonase-1 (PON-1) activity is a new inflammatory and oxidative marker. Technical effects and biological factors could affect the accuracy of PON-1 activity measurement. We investigated the effects of storage at different temperatures, repeated freeze-thaw cycles, interferences from hemolytic, lipemic, and icteric samples, and seasonal effects on PON-1 activity in horses. We evaluated 2 substrates with an automated spectrophotometer. Ten equine serum samples were stored under different conditions. Although storage at room (21°C) or refrigeration (4°C) temperature induced a statistically significant decrease (p less then 0.05) in PON-1 activity, this is not diagnostically relevant. PON-1 activity in frozen samples (-20°C) was stable for short-term storage; diagnostically significant (p less then 0.01) fluctuations were observed after 1 mo. Four repeated freeze-thaw cycles were assessed, and all cycles affected PON-1 activity (p less then 0.01); however, this was diagnostically significant only after the 4th cycle.
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