OBJECTIVES: To investigate the prevalence of different primary reasons for endodontic referrals and the clinical symptoms of the referred cases. MATERIALS AND METHODS: Clinical data of total endodontic treatment cases (1,014 teeth) including endodontic referral cases (224 teeth) between January 1, 2010 and December 31, 2012, at Kangdong Sacred Heart Hospital, were investigated retrospectively. The one major reason for referral, the clinical symptoms, and the resulting treatment procedures of referral cases were recorded. The percentages of clinical symptoms of the endodontic referral cases and the total endodontic treatment cases were compared by chi2 test for each symptom. RESULTS: Persistent pain was the most frequent reason for endodontic referral (29.5%), followed by presence of gingival swelling and sinus tract (24.1%), and apical radiolucency (12.9%). Referrals in cases involving endodontic difficulties such as canal calcification, broken instruments, post, perforation, and resorption were less than 5.0%, respectively. The percentages of four major clinical symptoms of pain, apical radiolucency, previous endodontic treatment, and gingival swelling and sinus tract were significantly higher in the endodontic referral cases than those in the total endodontic cases (p = 0.001). Among the included referral cases, 72.8% were treated with nonsurgical endodontic treatment only. Teeth other than the referred teeth were diagnosed as the origin of the problem in 5.8% of the referrals. CONCLUSIONS: The high prevalence of pain, apical radiolucency, previous treatment, and gingival swelling and sinus tract in endodontic referral cases suggest that these symptoms may be what general practitioners consider to be difficult and refer to endodontists.
General Practitioners ; Heart ; Humans ; Prevalence* ; Referral and Consultation* ; Retrospective Studies ; Tooth

OBJECTIVES: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. MATERIALS AND METHODS: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. RESULTS: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and < or = 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. CONCLUSIONS: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.
Bites and Stings ; Cohort Studies ; Dental Pulp Cavity ; Gingiva ; Logistic Models ; Prospective Studies ; Retreatment ; Tooth

Apoptosis ; Biological Availability ; Blotting, Western ; Caspase 3 ; Caspase 9 ; Cell Death ; Cell Survival ; Cytochromes c ; Ellagic Acid ; Hydrolyzable Tannins ; Insurance Benefits ; Neurodegenerative Diseases ; Neurons ; Neuroprotective Agents ; Oxidative Stress ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Protein Kinases ; Reactive Oxygen Species ; Sincalide

PURPOSE: Many studies have suggested that neuronal cells protect against oxidative stress-induced apoptotic cell death by polyphenolic compounds. We investigated the neuroprotective effects and the mechanism of action of Momordica charantia ethanol extract (MCE) against H₂O₂-induced cell death of human neuroblastoma SK-N-MC cells. METHODS: The antioxidant activity of MCE was measured by the quantity of total phenolic acid compounds (TPC), quantity of total flavonoid compounds (TFC), and 2,2-Diphenyl-1-pycrylhydrazyl (DPPH) radical scavenging activity. Cytotoxicity and cell viability were determined by CCK-8 assay. The formation of reactive oxygen species (ROS) was measured using 2,7-dichlorofluorescein diacetate (DCF-DA) assay. Antioxidant enzyme (SOD-1,2 and GPx-1) expression was determined by real-time PCR. Mitogen-activated protein kinases (MAPK) pathway and apoptosis signal expression was measured by Western blotting. RESULTS: The TPC and TFC quantities of MCE were 28.51 mg gallic acid equivalents/extract g and 3.95 mg catechin equivalents/extract g, respectively. The IC₅₀ value for DPPH radical scavenging activity was 506.95 µg/ml for MCE. Pre-treatment with MCE showed protective effects against H₂O₂-induced cell death and inhibited ROS generation by oxidative stress. SOD-1,2 and GPx-1 mRNA expression was recovered by pre-treatment with MCE compared with the presence of H₂O₂. Pre-treatment with MCE inhibited phosphorylation of p38 and the JNK pathway and down-regulated cleaved caspase-3 and cleaved PARP by H₂O₂. CONCLUSION: The neuroprotective effects of MCE in terms of recovery of antioxidant enzyme gene expression, down-regulation of MAPK pathways, and inhibition apoptosis is associated with reduced oxidative stress in SK-N-MC cells.
Apoptosis ; Blotting, Western ; Caspase 3 ; Catechin ; Cell Death ; Cell Survival ; Down-Regulation ; Ethanol ; Gallic Acid ; Gene Expression ; Humans* ; Hydrogen* ; MAP Kinase Signaling System ; Mitogen-Activated Protein Kinases ; Momordica charantia* ; Momordica* ; Neuroblastoma* ; Neurons ; Neuroprotective Agents* ; Oxidative Stress ; Phenol ; Phosphorylation ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Sincalide

The aim of this study was to evaluate the effect of mouthrinse products containing deep sea water. We used original deep sea water (DSW) and processed deep sea water desalinated by reverse osmosis at one time (DDW-1), by reverse osmosis at two times (DDW-2) and concentrated by reverse osmosis (CDW). We made 2 kinds of mouthrinse products containing CDW and other agents for smell and taste and one product without deep sea water. The negative control was distilled water. In vivo study, the dental plaque index scores and the gingival index scores were reduced after 4 weeks mouthrinsing three times daily with 4 kinds of deep sea water and 3 kinds of mouthrinse products(p<0.05). The pH of dental plaque in 1 minute after mouthrinsing was not higher than 5.5 in all solutions, but the pH in 20 minutes after mouthrinsing was higher than 5.7 in DSW, CDW and 3 kinds of products which had higher mineral contents. In vitro study, the mouthrinse solutions containing the higher mineral contents were also the more effective in reduction of methyl mercaptan which is one of the causes of halitosis. The 2 kinds of products containing deep sea water killed Streptococcus mutans (ATCC 25175) in culture plates in one minute. These results indicate the usability of deep sea water in mouthrinses for oral hygiene management.
Dental Plaque ; Dental Plaque Index ; Halitosis ; Hydrogen-Ion Concentration ; Oral Hygiene ; Osmosis ; Periodontal Index ; Seawater* ; Smell ; Streptococcus mutans ; Water

Objectives: This study explored the current status of nursing informatics education in South Korea and developed a standardized curriculum for it. Methods: Data were collected in two stages: first, an online survey conducted from December 2020 to February 2021 among 60 nursing schools to analyze the current status of nursing informatics education; and second, a two-round Delphi survey with 15 experts from March to April 2021 to determine the mean and standard deviation of the demand for each learning objective in nursing informatics education. A standardized curriculum proposal was developed based on the results of the two-round Delphi survey. Results: Nursing informatics was most commonly taught in the fourth year (34%), with two credits. The proportion of elective major subjects was high in undergraduate and graduate programs (77.4% and 78.6%, respectively), while the proportion of nursing informatics majors was low (21.4%). The curriculum developed included topics such as nursing information system-related concepts, definitions and components of healthcare information systems, electronic medical records, clinical decision support systems, mobile technology and health management, medical information standards, personal information protection and ethics, understanding of big data, use of information technology in evidence-based practice, use of information in community nursing, genome information usage, artificial intelligence clinical information systems, administrative management systems, and information technology nursing education. Conclusions Nursing informatics professors should receive ongoing training to obtain recent medical information. Further review and modification of the nursing informatics curriculum should be performed to ensure that it remains up-to-date with recent developments.