ABSTRACT This study evaluated the cytotoxicity of four bioceramic root canal sealers (bioceramic sealers): GuttaFlow Bioseal (GB), MTA Fillapex, CeraSeal Bioceramic root canal sealer (CS), and iRoot SP root canal sealer (iRSP). The viability of human gingival fibroblast (HGF) cells was used to evaluate the cytotoxicity of these bioceramic sealers. HGF cells were cultured and exposed to bioceramic sealer extracts for 24 hours, 48 hours and 72 hours at 37°C in an incubator humidified with 5% CO2. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide or MTT assay was conducted to determine cell viability at each incubation period and compared among all bioceramic sealers. The Kruskal-Wallis test revealed statistically significant differences between the positive control group and MTA Fillapex, MTA Fillapex and GB, and between GB and iRSP with p < 0.05. However, no statistical differences were found in cell viability for each material across all the incubation periods. GB was the least cytotoxic bioceramic sealer with cell viability exceeding 90% throughout the 72-hour incubation followed by CS, iRSP, and MTA Fillapex with non-cytotoxicity after 72-hour incubation, mild cytotoxicity after 72-hour incubation, and mild cytotoxicity after 72-hour incubation, respectively. However, iRSP showed moderate cytotoxicity, and MTA Fillapex was severely cytotoxic (< 30% cell viability) after 24-hour incubation.
Root Cause Analysis ; Dental Pulp Test

Birth Weight ; China ; Humans ; Infant, Newborn ; Root Cause Analysis

Medication safety is a significant issue in hospitals everywhere. Although the number of errors caused by high risk medication is less common, the impact on the patient is more critical due to their potentially fatal outcome. Great improvements are needed to reduce errors and increase this aspect of patient safety. Several health quality organizations have reported a list of high-risk medications and useful clinical guidelines, including improving communication, standardizing medication order protocols, providing decision-support tools, and continually monitoring for errors. It is evident that systemic redesign would be more effective in quality improvement; however, given that the medication process is not the same in each institute, root cause analysis based on each error report should be carried out to improve medication safety. Moreover, it is worth noting that leadership should play an important role in the creation of a culture that supports and promotes a strong health and safety performance of an organization.
Fatal Outcome ; Humans ; Leadership ; Medication Errors ; Patient Safety* ; Quality Improvement ; Root Cause Analysis

Medication safety is a significant issue in hospitals everywhere. Although the number of errors caused by high risk medication is less common, the impact on the patient is more critical due to their potentially fatal outcome. Great improvements are needed to reduce errors and increase this aspect of patient safety. Several health quality organizations have reported a list of high-risk medications and useful clinical guidelines, including improving communication, standardizing medication order protocols, providing decision-support tools, and continually monitoring for errors. It is evident that systemic redesign would be more effective in quality improvement; however, given that the medication process is not the same in each institute, root cause analysis based on each error report should be carried out to improve medication safety. Moreover, it is worth noting that leadership should play an important role in the creation of a culture that supports and promotes a strong health and safety performance of an organization.
Fatal Outcome ; Humans ; Leadership ; Medication Errors ; Patient Safety* ; Quality Improvement ; Root Cause Analysis

OBJECTIVETo investigate the surgical outcome and its influencing factors in patients of congenital basilar invagination (BI) with atlanto-axial dislocation (AAD).

METHODSFrom May 2004 to August 2010, 120 patients who had BI with AAD were surgically treated with direct posterior intraoperative distraction-reduction and fixation technique, 93 patients were successfully followed up by means of questionnaire survey, telephone and clinical evaluation. Pre- and postoperative dynamic cervical X-rays, computed tomographic scans, 3-dimentional reconstruction views and magnetic resonance imaging were performed. Pre- and postoperative Japanese Orthopaedic Association (JOA) score, distance between odontoid tip and Chamberlain's line and atlantodental interval were measured to evaluate the surgical result. Statistical analysis was performed by means of paired t test and Pearson Correlation analysis.

RESULTSThere were 93 cases were followed up for 24-99 months with an average of 46.5 months. Until the final follow-up, clinical symptoms were improved in 79 patients (84.9%), and were stable in 7 patients (7.5%) and deteriorated in 4 patients (4.3%). Three patients died postoperatively (3.2%). Patients without intramedullary signal intensity change (ISIC) had better surgical outcome. Patients with compression from anterior odontoid tip and posterior bone margin of occipital foramen had the worst surgical outcome (F = 3.987, P < 0.01). Overall, good decompression and bone fusion were shown on postoperative image in 87 patients (93.5%). There were 3 deaths in this series because of basilar artery thrombosis, posterior fossa hematoma and unknown reasons each.

CONCLUSIONSThe direct posterior intraoperative distraction-reduction and fixation technique is an effective simple and safe method for the treatment of BI with AAD. Anterior compression from odontoid tip and posterior compression from bone margin of occipital foramen-atlantal posterior arch play important roles in its developing mechanism. ISIC on MRI is a predictive factor for the worse surgical outcome.

Adolescent ; Adult ; Atlanto-Axial Joint ; surgery ; Bone Screws ; Child ; Decompression, Surgical ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Platybasia ; complications ; surgery ; Root Cause Analysis ; Spinal Fusion ; methods ; Young Adult