Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth: A systematic review and meta-analysis.

OBJECTIVES Different materials have been used for capping the pulp after exposure during caries removal in permanent teeth. The purpose of this study was to collate and analyze all pertinent evidence from randomized controlled trials (RCTs) on different materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth. MATERIALS AND METHODS Trials comparing two or more capping agents used for direct pulp capping (DPC) or pulpotomy were considered eligible. An electronic search of four databases and two clinical trial registries was carried out up to February 28, 2021 using a search strategy properly adapted to the PICO framework. Screening, data extraction, and risk of bias (RoB) assessment of primary studies were performed in duplicate and independently. The primary outcome was clinical and radiological success; secondary outcomes included continued root formation, tooth discoloration, and dentin bridge formation. RESULTS 21 RCTs were included in the study. The RoB assessment indicated a moderate risk among the studies. Due to significant clinical and statistical heterogeneity among the studies, performing network meta-analysis (NMA) was not possible. An ad hoc subgroup analysis revealed strong evidence of a higher success of DPC with Mineral Trioxide Aggregate (MTA) compared to calcium hydroxide (CH) (odds ratio [OR] = 3.10, 95% confidence interval [CI]: 1.66-5.79). MTA performed better than CH in pulp capping (both DPC and pulpotomy) of mature compared to immature teeth (OR = 3.34, 95% CI: 1.81-6.17). The GRADE assessment revealed moderate strength of evidence for DPC and mature teeth, and low to very low strength of evidence for the remaining subgroups. CONCLUSIONS Considerable clinical and statistical heterogeneity among the trials did not allow NMA. The ad hoc subgroup analysis indicated that the clinical and radiographic success of MTA was higher than that of CH but only in mature teeth and DPC cases where the strength of evidence was moderate. PROSPERO Registration: number CRD42020127239

Implementation of electrochemical, optical and denuder-based sensors and sampling techniques on UAV for volcanic gas measurements : examples from Masaya, Turrialba and Stromboli volcanoes

Volcanoes are a natural source of several reactive gases (e.g., sulfur and halogen containing species) and nonreactive gases (e.g., carbon dioxide) to the atmosphere. The relative abundance of carbon and sulfur in volcanic gas as well as the total sulfur dioxide emission rate from a volcanic vent are established parameters in current volcanomonitoring strategies, and they oftentimes allow insights into subsurface processes. However, chemical reactions involving halogens are thought to have local to regional impact on the atmospheric chemistry around passively degassing volcanoes. In this study we demonstrate the successful deployment of a multirotor UAV (quadcopter) system with custom-made lightweight payloads for the compositional analysis and gas flux estimation of volcanic plumes. The various applications and their potential are presented and discussed in example studies at three volcanoes encompassing flight heights of 450 to 3300m and various states of volcanic activity. Field applications were performed at Stromboli volcano (Italy), Turrialba volcano (Costa Rica) and Masaya volcano (Nicaragua). Two in situ gas-measuring systems adapted for autonomous airborne measurements, based on electrochemical and optical detection principles, as well as an airborne sampling unit, are introduced. We show volcanic gas composition results including abundances of CO2, SO2 and halogen species. The new instrumental setups were compared with established instruments during ground-based measurements at Masaya volcano, which resulted in CO2 = SO2 ratios of 3.6 0.4. For total SO2 flux estimations a small differential optical absorption spectroscopy (DOAS) system measured SO2 column amounts on transversal flights below the plume at Turrialba volcano, giving 1776 1108 T d1 and 1616 1007 T d1 of SO2 during two traverses. At Stromboli volcano, elevated CO2 = SO2 ratios were observed at spatial and temporal proximity to explosions by airborne in situ measurements. Reactive bromine to sulfur ratios of 0.19 104 to 9.8 104 were measured in situ in the plume of Stromboli volcano, down wind of the vent.Published2441-24574V. Processi pre-eruttiviJCR Journa

Sulfur degassing at Erta Ale (Ethiopia) and Masaya (Nicaragua) volcanoes: Implications for degassing processes and oxygen fugacities of basaltic systems

We investigate the relationship between sulfur and oxygen fugacity at Erta Ale and Masaya volcanoes. Oxygen fugacity was assessed utilizing Fe 3+/ΣFe and major element compositions measured in olivine-hosted melt inclusions and matrix glasses. Erta Ale

The crater lake of Ilamatepec (Santa Ana) volcano, El Salvador: insights into lake gas composition and implications for monitoring

We here present the first chemical characterization of the volcanic gas plume issuing from the Santa Ana crater lake, a hyper-acidic crater lake (pH of -0.2 to 2.5) in north-western El Salvador. Our results, obtained during regular surveys in 2017 and 2018 using a Multi-GAS instrument, demonstrate an hydrous gas composition (H2O/SO2 ratios from 32 to 205), and SO2 as the main sulphur species (H2S/SO2 = 0.03-0.1). We also find that gas composition evolved during our investigated period, with the CO2/SO2 decreasing by one order of magnitude from March 2017 (37.2 ± 9.7) to 2018 (<3). This compositional evolution toward more magmatic (SO2-rich) compositions is interpreted in the context of the long-term evolution of the volcano following its 2005 and 2007 eruptions. We find that, in spite of reduced (background-level) seismicity, the magmatic gas supply into the lake was one order of magnitude higher in March 2017 (Total Volatile Flux: 20,200-30,200 t/day; the total volatile flux is the sum of H2O+CO2+SO2+H2 fluxes in our specific case) than in the following periods (Total Volatile Flux: 615-4112 t/day). We propose that the elevated magmatic/hydrothermal transport in March 2017, combined with a 15% reduction in precipitation, caused the volume of the lake to decrease, ultimately reducing its sulfur absorbing and scrubbing capacity, and hence causing the gas plume CO2/SO2 ratio to decrease. The recently observed increases in temperature, acidity and salinity of the lake are consistent with this hypothesis. The small volume of Santa Ana lake, compared to other crater lakes such as the pre-2017 Poás (Costa Rica), Yugama (Japan), Ruapehu (New Zealand) and Kawah Ijen (Indonesia), makes it sensitive to variations in the underlying magmatic-hydrothermal system. We conclude that the installation of a continuous, fully-automated Multi-GAS is highly desirable to monitor any future change in lake plume chemistry, and hence state of volcanic activity.Publishedid 664V. Processi pre-eruttiviJCR Journa

Insights into the mechanisms of phreatic eruptions from continuous high frequency volcanic gas monitoring: Rinc\uf3n de la Vieja Volcano, Costa Rica

Understanding the trigger mechanisms of phreatic eruptions is key to mitigating the effects of these hazardous but poorly forecastable volcanic events. It has recently been established that high-rate volcanic gas observations are potentially very suitable to identifying the source processes driving phreatic eruptions, and to eventually detecting precursory changes prior to individual phreatic blasts. In February-May 2017, we deployed a Multi-GAS instrument to continuously monitor gas concentrations in the crater lake plume of Rincon de la Vieja, a remote and poorly monitored active volcano in Costa Rica, site of frequent phreatic/phreatomagmatic eruptions. Forty-two phreatic/phreatomagmatic eruptions were seismically recorded during our investigated period, 9 of which were also recorded for gas by the Multi-GAS. To the best of our knowledge, these represent the first instrumentally measured gas compositions during individual phreatic/phreatomagmatic explosions at an active volcano. Our results show that during background quiescent degassing the Rincon de la Vieja crater lake plume was characterized by high CO2/SO2 ratios of 64 +/- 59 and H2S/SO2 ratios of 0.57 +/- 0.20. This composition is interpreted as reflecting hydrothermal (re) processing of magma-sourced gas in the sub-limnic environment. Phreatic blasts were recorded by the Multi-GAS as brief (1-2min long) pulses of elevated gas mixing ratios (up to similar to 52 ppmv SO2 and &gt; 3,000 ppmv CO2), or more than an order of magnitude higher than during background degassing (similar to 1 ppmv SO2 and similar to 450 ppmv CO2). During the phreatic eruption(s), the H2S/SO2 ratio was systematically lower (&lt; 0.18) than during background degassing, but the CO2/SO2 ratio remained high (and variable), ranging from 37 to 390. These S-poor compositions for the eruptive gas imply extensive processing of the source magmatic gas during pre-eruptive hydrothermal storage, likely by deposition of native S and/or sulfate. Our gas results are thus overall consistent with a mechanismof phreatic eruptions triggered by accumulation of magmatic-hydrothermal gases beneath a hydrothermal seal. We claim that real-time Multi-GAS monitoring is urgently needed at other crater lake-hosting volcanoes (e.g., Ruapehu, Aso), where phreatic eruptions may similarly be preceded by phases of reduced S degassing at the surface

The helium and carbon isotope characteristics of the Andean Convergent Margin

© The Author(s), 2022. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Barry, P. H., De Moor, J. M., Chiodi, A., Aguilera, F., Hudak, M. R., Bekaert, D. V., Turner, S. J., Curtice, J., Seltzer, A. M., Jessen, G. L., Osses, E., Blamey, J. M., Amenabar, M. J., Selci, M., Cascone, M., Bastianoni, A., Nakagawa, M., Filipovich, R., Bustos, E., Schrenk, M. O. , Buongiorno, J., Ramírez, C. J., Rogers, T. J., Lloyd, K. G. & Giovannelli, D. The helium and carbon isotope characteristics of the Andean Convergent Margin. Frontiers in Earth Science, 10, (2022): 897267, https://doi.org/10.3389/feart.2022.897267.Subduction zones represent the interface between Earth’s interior (crust and mantle) and exterior (atmosphere and oceans), where carbon and other volatile elements are actively cycled between Earth reservoirs by plate tectonics. Helium is a sensitive tracer of volatile sources and can be used to deconvolute mantle and crustal sources in arcs; however it is not thought to be recycled into the mantle by subduction processes. In contrast, carbon is readily recycled, mostly in the form of carbon-rich sediments, and can thus be used to understand volatile delivery via subduction. Further, carbon is chemically-reactive and isotope fractionation can be used to determine the main processes controlling volatile movements within arc systems. Here, we report helium isotope and abundance data for 42 deeply-sourced fluid and gas samples from the Central Volcanic Zone (CVZ) and Southern Volcanic Zone (SVZ) of the Andean Convergent Margin (ACM). Data are used to assess the influence of subduction parameters (e.g., crustal thickness, subduction inputs, and convergence rate) on the composition of volatiles in surface volcanic fluid and gas emissions. He isotopes from the CVZ backarc range from 0.1 to 2.6 RA (n = 23), with the highest values in the Puna and the lowest in the Sub-Andean foreland fold-and-thrust belt. Atmosphere-corrected He isotopes from the SVZ range from 0.7 to 5.0 RA (n = 19). Taken together, these data reveal a clear southeastward increase in 3He/4He, with the highest values (in the SVZ) falling below the nominal range associated with pure upper mantle helium (8 ± 1 RA), approaching the mean He isotope value for arc gases of (5.4 ± 1.9 RA). Notably, the lowest values are found in the CVZ, suggesting more significant crustal inputs (i.e., assimilation of 4He) to the helium budget. The crustal thickness in the CVZ (up to 70 km) is significantly larger than in the SVZ, where it is just ∼40 km. We suggest that crustal thickness exerts a primary control on the extent of fluid-crust interaction, as helium and other volatiles rise through the upper plate in the ACM. We also report carbon isotopes from (n = 11) sites in the CVZ, where δ13C varies between −15.3‰ and −1.2‰ [vs. Vienna Pee Dee Belemnite (VPDB)] and CO2/3He values that vary by over two orders of magnitude (6.9 × 108–1.7 × 1011). In the SVZ, carbon isotope ratios are also reported from (n = 13) sites and vary between −17.2‰ and −4.1‰. CO2/3He values vary by over four orders of magnitude (4.7 × 107–1.7 × 1012). Low δ13C and CO2/3He values are consistent with CO2 removal (e.g., calcite precipitation and gas dissolution) in shallow hydrothermal systems. Carbon isotope fractionation modeling suggests that calcite precipitation occurs at temperatures coincident with the upper temperature limit for life (122°C), suggesting that biology may play a role in C-He systematics of arc-related volcanic fluid and gas emissions.This work was principally supported by the NSF-FRES award 2121637 to PB, KL, and JM. Field work was also supported by award G-2016-7206 from the Alfred P. Sloan Foundation and the Deep Carbon Observatory to PB, KL, DG, and JM. Additional support came from The National Fund for Scientific and Technological Development of Chile (FONDECYT) Grant 11191138 (The National Research and Development Agency of Chile, ANID Chile), and COPAS COASTAL ANID FB210021 to GJ. DG was partially supported by funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program Grant Agreement No. 948972—COEVOLVE—ERC-2020-STG

Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline.

BackgroundThe ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease.AimTo develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss.MethodsThis S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders.ResultsThe S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed.ConclusionThe first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available

Understanding and forecasting phreatic eruptions driven by magmatic degassing

Abstract This paper examines phreatic eruptions which are driven by inputs of magma and magmatic gas. We synthesize data from several significant phreatic systems, including two in Costa Rica (Turrialba and Poás) which are currently highly active and hazardous. We define two endmember types of phreatic eruptions, the first (type 1) in which a deeper hydrothermal system fed by magmatic gases is sealed and produces overpressure sufficient to drive explosive eruptions, and the second (type 2) where magmatic gases are supplied via open-vent degassing to a near-surface hydrothermal system, vaporizing liquid water which drives the phreatic eruptions. The surficial source of type 2 eruptions is characteristic, while the source depth of type 1 eruptions is commonly greater. Hence, type 1 eruptions tend to be more energetic than type 2 eruptions. The first type of eruption we term “phreato-vulcanian”, and the second we term “phreato-surtseyan”. Some systems (e.g., Ruapehu, Poás) can produce both type 1 and type 2 eruptions, and all systems can undergo sealing at various timescales. We examine a number of precursory signals which appear to be important in understanding and forecasting phreatic eruptions; these include very long period events, banded tremor, and gas ratios, in particular H2S/SO2 and CO2/SO2. We propose that if these datasets are carefully integrated during a monitoring program, it may be possible to accurately forecast phreatic eruptions