The fit of tapered posts in root canals luted with zinc phosphate cement:A histological study

Objectives. Stress transmission to the root through passive fitting dental posts is partly influenced by the thickness of the cement layer between the post and the prepared root canal surface as well as the fit of the post in the root canal. The objective of this study was to compare the cement gap between the post surfaces and the root canals using five prefabricated, tapered, unthreaded titanium posts of different manufacturers, without and with cement. Methods. Following the endodontic treatment with hand instruments of 100 intact anterior teeth, post spaces were prepared using opening drills of the corresponding size of post. Fifty posts were cemented with zinc phosphate cement into the roots for each system while another 50 posts were inserted into the canal without using the cement. After histological sectioning, the cement gap was measured at six sites for three times at the coronal, middle and apical regions between the root canal wall and the post surface under a light microscope before and after cementation. Results. Before cementation, the highest overall cement gap was observed with the Dr Mooser post system (R) (46 mu m) and the lowest with the Velva post system (R) and Cylindro-Conical system (R) (30 mu m). Significantly less (P <0.05) mean cement gap was observed with respect to the Erlangen post system (R) (41 mu m), the Dr Mooser post system (R) (48 mu m), the MP Pirec post system (R) (34 mu m) and Velva post system (R) (33 pm) when compared with the Cylindro-Conical system (R) (62 tm). The Cylindro-Conical system (R) (79, 61 gm) and MP Pirec post system (R) (25, 24 tm) demonstrated no significant difference (P > 0.001) compared with Velva-Post (R) (38, 20 mu m) at the coronal and middle part, respectively (Mann-Whitney U-test, Boneferroni correction). Significant differences (P <0.001) were observed between the cement gap at the coronal and apical part for the Cylindro-Conical system (R) (79, 46 mu m), Dr Mooser post system (R) (45, 56 mu m) and MP Pirec post system (R) (25, 52 mu m). After cementation, the highest cement gap at the coronal part was obtained with the Cylindro-Conical system (R) (79 +/- 21 mu m) and the lowest with the MP Pirec post system (R) (25 +/- 9 mu m). However, at the apical end, the MP Pirec post system (R) (52 +/- 89 gm) and Dr Mooser post system (R) (56 +/- 16 gm) revealed the highest gap. Significance. Form-congruence between the preparation drill and the post systems exhibited differences. The most consistent cement gap either at the coronal, middle or apical parts of the root canals was obtained with the Erlangen post system (R). (c) 2005 Academy of Dental Materials. Published by Elsevier Ltd. All. rights reserve

Clinical care of pregnant and postpartum women with COVID-19: Living recommendations from the National COVID-19 Clinical Evidence Taskforce

To date, 18 living recommendations for the clinical care of pregnant and postpartum women with COVID-19 have been issued by the National COVID-19 Clinical Evidence Taskforce. This includes recommendations on mode of birth, delayed umbilical cord clamping, skin-to-skin contact, breastfeeding, rooming-in, antenatal corticosteroids, angiotensin-converting enzyme inhibitors, disease-modifying treatments (including dexamethasone, remdesivir and hydroxychloroquine), venous thromboembolism prophylaxis and advanced respiratory support interventions (prone positioning and extracorporeal membrane oxygenation). Through continuous evidence surveillance, these living recommendations are updated in near real-time to ensure clinicians in Australia have reliable, evidence-based guidelines for clinical decision-making. Please visit https://covid19evidence.net.au/ for the latest recommendation updates

Heterozygous Variants in KMT2E Cause a Spectrum of Neurodevelopmental Disorders and Epilepsy

We delineate a KMT2E-related neurodevelopmental disorder on the basis of 38 individuals in 36 families. This study includes 31 distinct heterozygous variants in KMT2E (28 ascertained from Matchmaker Exchange and three previously reported), and four individuals with chromosome 7q22.2-22.23 microdeletions encompassing KMT2E (one previously reported). Almost all variants occurred de novo, and most were truncating. Most affected individuals with protein-truncating variants presented with mild intellectual disability. One-quarter of individuals met criteria for autism. Additional common features include macrocephaly, hypotonia, functional gastrointestinal abnormalities, and a subtle facial gestalt. Epilepsy was present in about one-fifth of individuals with truncating variants and was responsive to treatment with anti-epileptic medications in almost all. More than 70% of the individuals were male, and expressivity was variable by sex; epilepsy was more common in females and autism more common in males. The four individuals with microdeletions encompassing KMT2E generally presented similarly to those with truncating variants, but the degree of developmental delay was greater. The group of four individuals with missense variants in KMT2E presented with the most severe developmental delays. Epilepsy was present in all individuals with missense variants, often manifesting as treatment-resistant infantile epileptic encephalopathy. Microcephaly was also common in this group. Haploinsufficiency versus gain-of-function or dominant-negative effects specific to these missense variants in KMT2E might explain this divergence in phenotype, but requires independent validation. Disruptive variants in KMT2E are an under-recognized cause of neurodevelopmental abnormalities