Use of Rubber Dams During Root Canal Treatment in Taiwan

Background/PurposeIsolation of teeth with rubber dams is an important procedure for infection control in dentistry, especially in endodontic treatment. This study surveyed the prevalence of rubber dam usage in nonsurgical root canal treatment (RCT) by dentists under the National Health Insurance system in Taiwan.MethodsA total of 1,332 completed RCT cases were randomly selected from a large database from the Bureau of National Health Insurance in Taiwan in 2004. The radiographs and dental charts of the selected cases were evaluated for the prevalence of rubber dam usage in RCT. The frequencies of rubber dam usage for RCT by dentists were compared between hospitals and private dental clinics and among six different regions in Taiwan.ResultsThe overall prevalence of rubber dam usage for RCT by dentists under the National Health Insurance system in Taiwan was 16.5%. The frequency of rubber dam usage for RCT by dentists in hospitals (32.8%) was significantly higher than that (10.3%) in private dental clinics (p < 0.0001). However, there was no significant difference in the frequency of rubber dam usage for RCT by dentists among six different geographic regions in Taiwan.ConclusionThe prevalence of rubber dam usage for RCT by dentists in Taiwan is relatively low. Because rubber dam isolation of an endodontically-treated tooth can provide better infection control, increase patient protection, and improve treatment efficiency, there is an urgent need to advise dentists in Taiwan to use rubber dams for every RCT case

From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy

From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy

A cone-beam computed tomography study of C-shaped root canal systems in mandibular second premolars in a Taiwan Chinese subpopulation

Background/Purpose: The purpose of this study is to investigate the prevalence and the morphologic characteristics of the radicular groove and root canal system in human mandibular second premolars with C-shaped root in a Taiwan Chinese subpopulation using cone-beam computed tomographic (CBCT) imaging. Methods: CBCT images of 580 mandibular second premolars were collected from 317 patients. All of the mandibular second premolars were examined in serial axial sections to identify the presence of any C-shaped root and C-shaped canal systems. The morphologic characteristics of mandibular second premolars with C-shaped roots were studied by performing measurements of serial axial sections. Results: The prevalence rate of mandibular second premolars with a C-shaped root was 3.45% (20/580 teeth) and the rate of those with a C-shaped canal system was 2.24% (13/580 teeth). It was found that 69% of the radicular grooves were located on the lingual half of the root (9/13 teeth) in mandibular second premolars with a C-shaped canal system. In those teeth with a lingual radicular groove, the main canal was toward the buccal side. Frequently, the first C-shaped canal image was found at the mid-root level. The deepest part of the radicular groove was located at about 2.5 mm apical to the first C-shaped canal image. Conclusion: There was a 2–3% morphologic variation of the mandibular second premolar with a C-shaped root canal system among the Taiwan Chinese subpopulation investigated in this study. Detailed knowledge of the morphological characteristics of teeth may be valuable when choosing clinical treatments. Keywords: Cone-beam CT, Mandibular second premolar, C-shaped canal system, Reversed C-shaped canal system, Radicular groov