Expert consensus on endodontic therapy for patients withsystemic conditions

The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. Asystemic consideration of the patient’s overall health along with oral conditions holds the utmost importance in determining thenecessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is acollaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontictherapy in patients with compromised overall health.

Expert consensus on difficulty assessment of endodontic therapy

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Expert consensus on irrigation and intracanal medication in root canal therapy

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.

Expert consensus on digital guided therapy for endodontic diseases

Digital guided therapy(DGT)has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades.The concept of DGT for endodontic diseases is categorized into static guided endodontics(SGE),necessitating a meticulously designed template,and dynamic guided endodontics(DGE),which utilizes an optical triangulation tracking system.Based on cone-beam computed tomography(CBCT)images superimposed with or without oral scan(OS)data,a virtual template is crafted through software and subsequently translated into a 3-dimensional(3D)printing for SGE,while the system guides the drilling path with a real-time navigation in DGE.DGT was reported to resolve a series of challenging endodontic cases,including teeth with pulp obliteration,teeth with anatomical abnormalities,teeth requiring retreatment,posterior teeth needing endodontic microsurgery,and tooth autotransplantation.Case reports and basic researches all demonstrate that DGT stand as a precise,time-saving,and minimally invasive approach in contrast to conventional freehand method.This expert consensus mainly introduces the case selection,general workflow,evaluation,and impact factor of DGT,which could provide an alternative working strategy in endodontic treatment.

Experts consensus on the procedure of dental operative microscope in endodontics and operative dentistry

The dental operative microscope has been widely employed in the field of dentistry,particularly in endodontics and operative dentistry,resulting in significant advancements in the effectiveness of root canal therapy,endodontic surgery,and dental restoration.However,the improper use of this microscope continues to be common in clinical settings,primarily due to operators’insufficient understanding and proficiency in both the features and established operating procedures of this equipment.In October 2019,Professor Jingping Liang,Vice Chairman of the Society of Cariology and Endodontology,Chinese Stomatological Association,organized a consensus meeting with Chinese experts in endodontics and operative dentistry.The objective of this meeting was to establish a standard operation procedure for the dental operative microscope.Subsequently,a consensus was reached and officially issued.Over the span of about four years,the content of this consensus has been further developed and improved through practical experience.

Pre- and Post-Surgical Health-Related Quality of Life Evaluation of Esophageal Carcinoma Patients

For patients with esophageal carcinoma (ESCA), health-related quality of life (HRQoL) has now become an essential feature. To examine the quality of life of preoperative and postoperative ESCA patients, we used the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ C-30) and the Quality of Life Questionnaire Oesophageal 18 (QLQ-OES18). Using the EORTC QLQ-C30 and the QLQ-OES18 questionnaire, the analysis of the quality of life scores of 246 patients with oesophageal cancer who were operated on at the Sun Yat-sen University Cancer Centre during the period 2013 to 2015 was carried out. Differences between pre- and post-surgical EORTC QLQ C-30 and QLQ-OES18 scores were examined using the Student’s t-test. Patients’ global health status (QoL) decreased significantly one month after the operation but gradually recovered within a year. In terms of the role function, the emotional function, the cognitive function, and the perception and function variants, EORTC QLQ-C30 and QLQ-OES18 scores increased statistically significantly, as did clinical signs variables such as exhaustion, nausea, vomiting, pain, sleeplessness, decreased appetite, stomach pain, and economic hardship. After surgery, there was an improvement in functional and symptom domains in esophageal carcinoma patients. EORTC QLQ-C30 and QLQ-OES18 can be used to assess the HRQoL before and after surgical procedures.

Expert consensus on regenerative endodontic procedures

Regenerative endodontic procedures(REPs)is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis.The ultimate objective of REPs is to regenerate the pulp-dentin complex,extend the tooth longevity and restore the normal function.Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports,case series,cohort studies,and randomized controlled studies.However,variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics.The heterogeneity in protocols may cause confusion among dental practitioners,thus guidelines and considerations of REPs should be explicated.This expert consensus mainly discusses the biological foundation,the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis,as well as the main complications of this treatment,aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies,suggesting REPs may become a more consistently evidence-based option in dental treatment.

Effects of Video Combined with the Teach-Back Method on the Respiratory Function Exercise of Patients Undergoing Thoracotomy

Objective: To explore the effect of video combined with the teach-back method on respiratory function exercise in patients undergoing tumor thoracotomy. Methods: Eligible patients undergoing thoracotomy for tumor were selected from the thoracic surgery at a level-A tertiary hospital between August 2021 and December 2021 and included in the control group and the observation group (40 patients in each group). To prevent two groups of patients from interacting with each other, the thoracic surgery ward I was distinguished as the control group, which was adopted by the routine instruction. Based on routine instruction, the thoracic surgery ward II conducted respiratory function exercise instruction by video combined with the teach-back method to compare the two groups’ compliance with respiratory function exercise, complication rates, and patient satisfaction. Results: The patient compliance with respiratory function exercise in the observation group was significantly higher (P < 0.05) and the rate of pulmonary complications in the observation group was lower (P < 0.05) than that in the control group, while the observation group had a high level of satisfaction (P Conclusion: Taking video combined with the teach-back method, an effective health education method, can improve the compliance of the respiratory function exercise of patients undergoing thoracotomy for tumor and promote the recovery of pulmonary function to reduce the incidence of postoperative pulmonary complications so as to improve patient satisfaction.

Regenerative Therapeutic Applications of Mechanized Lipoaspirate Derivatives

Autologous adipose tissue is one of the most commonly used fillers.Plastic surgeons are increasingly using it in aesthetic or reconstructive surgery owing to its abundant source,easy availability,and minimal invasiveness.Increasing amount of evidence has shown its reparative ability rather than just filling utility due to the presence of adipose-derived stem cells(ADSCs)that exhibit multipotential differentiation and paracrine characteristics.However,traditional enzymatic isolation of ADSCs is often difficult in clinical settings,limiting its application.Recently,with the development of mechanical techniques for preparation of lipoaspirates,bioactive adipose tissue can be successfully identified and isolated.Such components with therapeutic potential might also be helpful in tissue repair and regeneration.In this article,we introduced several types of mechanized lipoaspirates derivatives(such as emulsified fat,adipose extracellular matrix(ECM),and cell-free extraction)and their applications from bench to bedside.

Biodegradation of nicosulfuron by a novel Alcaligenes faecalis strain ZWS11

A bacterial strain ZWS11 was isolated from sulfonylurea herbicide-contaminated farmland soil and identified as a potential nicosulfuron-degrading bacterium. Based on morphological and physicochemical characterization of the bacterium and phylogenetic analysis of the 16 S r RNA sequence, strain ZWS11 was identified as Alcaligenes faecalis. The effects of the initial concentration of nicosulfuron, inoculation volume, and medium p H on degradation of nicosulfuron were investigated. Strain ZWS11 could degrade 80.56% of the initial nicosulfuron supplemented at 500.0 mg/L under the conditions of p H 7.0, 180 r/min and30°C after incubation for 6 days. Strain ZWS11 was also capable of degrading rimsulfuron,tribenuron-methyl and thifensulfuron-methyl. Four metabolites from biodegradation of nicosulfuron were identified, which were 2-aminosulfonyl-N, N-dimethylnicotinamide（M1）, 4, 6-dihydroxypyrimidine（M2）, 2-amino-4, 6-dimethoxypyrimidine（M3） and2-（1-（4,6-dimethoxy-pyrimidin-2-yl）-ureido）-N,N-dimethyl-nicotinamide（M4）. Among the metabolites detected, M2 was reported for the first time. Possible biodegradation pathways of nicosulfuron by strain ZWS11 were proposed. The degradation proceeded mainly via cleavage of the sulfonylurea bridge, O-dealkylation, and contraction of the sulfonylurea bridge by elimination of a sulfur dioxide group. The results provide valuable information for degradation of nicosulfuron in contaminated environments.

Engine-Map-Based Predictive Fuel-Efficient Control Strategies for a Group of Connected Vehicles

An engine-map-based predictive fuel-efficient control strategy for a group of connected vehicles is presented. A decentralizedmodel predictive control framework is formulated to predict the optimal velocity profile that compromises fuel economy andmobility while guaranteeing the safety of each vehicle. In the model predictive control framework, an engine-map-based fuelconsumption model is established by implementing a backward conventional vehicle model in the cost function. Moreover,the cost function is normalized by dividing each term by its reference value. An extra cost is added to the safety term when thedistance between adjacent vehicles drops to a critical value to guarantee vehicle safety, while another extra cost is consideredfor the velocity tracking term to prevent the violation of traffic rules. The results of simulation show the effectiveness of theproposed control method.