Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

The correct working posture of dentists is not only the premise of clinical diagnosis, treatment quality and safety but also an important guarantee for the occupational health of dentists. Presently, research on the working posture of dental professionals and related influencing factors is relatively mature internationally. Still, the dental curriculums in our country have not systematically introduced theoretical knowledge and standards related to working posture. This review analyzes and summarizes previous literature on the importance of dental working posture, criteria, assessment methods, and influencing factors, in hopes of providing references and theoretical supports for future guidelines and standards.

Oral static biofilm model is an important tool for in vitro simulation of oral microecological environment, which has become an important method for studying the pathogenesis of various oral diseases and testing the efficacy of various drugs, oral care products and foods due to its low cost, high throughput, good reliability and easy operation. The establishment of oral static biofilm models allows the selection of different devices, inoculum sources, media, substrates and culture conditions according to the purpose of the study, and the evaluation of biofilm growth by various methods such as measuring biomass, metabolic activity, community structure and performing visualization analysis. This paper summarizes the methodological elements reported in recent years for the establishment and evaluation of oral static biofilm models, and analyzes and discusses the applicability of various methods in the hope of contributing to the research and production practice in related fields.
Biofilms ; Reproducibility of Results

Objective To determine the utility of musculoskeletal ultrasound imaging to support physical findings in different stages of recovery and in recommending treatment regimens.Methods Forty-three hemiplegic stroke survivors with shoulder pain were enrolled.Physical examinations were performed 3 and 6 months after the stroke using a visual analogue scale (VAS),a modified Ashworth scale,measurements of passive range of motion and Brunnstrom staging.This was coupled with sonography of the long head of the biceps,the subscapularis tendon,the supraspinatus tendon,the infraspinatus tendon,the acromioclavicular joint and the subacromial-subdeltoid bursa.Results Three months after the stroke the average VAS score correlated negatively with the average Brunnstrom stage of the shoulders (r=-0.39,P≤0.01),with the range of passive abduction (r=-0.56,P≤ 0.01),the range of passive external rotation (r=-0.36,P≤ 0.02),and the range of passive flexion (r=-0.37,P≤ 0.02).It was positively correlated with abnormal sonographic findings of the long head tendon of the biceps (r=0.32,P≤ 0.04),the subscapularis tendons (r=0.31,P≤0.04) and the supraspinatus tendons (r=0.53,P≤0.01).However,3 months later the VAS results were negatively correlated with Brunnstrom stage (r=-0.45,P ≤ 0.01),range of passive shoulder abduction (r=-0.60,P≤0.01),range of passive external rotation (r=-0.41,P≤0.01),and passive range of flexion (r=-0.52,P≤ 0.01),but positively correlated with spasticity (r=0.34,P≤ 0.03),biceps tendinopathy (r=0.45,P≤0.01),subscapularis tendinopathy (r=0.33,P≤ 0.03) and supraspinatus tendinopathy (r=0.56,P≤ 0.01).Rotator cuff injury was significantly more severe 6 months after stroke than at 3 months.The incidence of pain in the hemiplegic shoulder and abnormal sonographic findings of the biceps tendon and subscapularis tendon were significantly higher at 6 months than at 3 months after the stroke.Supraspinatus tendon problems were notable both at 3 and 6 months.Conclusions Pain in a hemiplegic shoulder is positively correlated with abnormal sonographic findings but negatively correlated with Brunnstrom stages and passive range of motion 3 and 6 months after stroke.Six months after stroke,pain is positively correlated with muscle tone.The tendon at the long head of the biceps and the rotator cuff are vulnerable to injury,especially at 6 months after stroke.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Objective Conducting reading therapy to enrich the content of health education, to meet the knowledge needs of the patients during hospitalization and to enhance the patients'confidence with diseases, thus to improve patients' the quality of life and satisfaction. Methods Patients with breast cancer who had surgery were selected between January 2014 to December 2014. They were randomly divided into the control group ( traditional health education ) and the intervention group according to the random number method. Patients in the intervention group read the related information provided by the research team, coached, information platform and salon during perioperative and rehabilitation period. They selected the method of"read-centric and interactive reading therapy" which is combined with each as intervention. Results No statistic difference was found between the scores of SAS and SDS on admission (P>0. 05). After the reading therapy, scores of SAS and SDS were (44. 02 ± 4. 81), (45. 66 ± 3. 78) and were all lower than those in the control group (64.52 ±6.89) and (63.67 ±4.92) (t=17.25, 18.25;P<0.05). The satisfactions of the patients and their families in the intervention group were (97. 6 ± 2. 1), which were higher than that in the control group (91.4 ± 1. 2). The difference was statistically significant (t = -18. 13,P <0. 05). Conclusions Using reading therapy in breast cancer patients during perioperative period can be in line with modern "biology-psychology-social medicine" model, provide effective measures for health education and psychological care, enrich the forms and content of health education, significantly improve patients' and their families' satisfaction and mental state during perioperative and rehabilitation period. And it makes psychological care of cancer patients more feasible.

Objective To explore the effect of surgery observation process for surgical excutive nurse to improve comprehensive quality of nurses , patients′satisfaction and nursing quality .Methods There were 370 selective operation patients , in whom 185 had been chosen as control group from October to November 2013;while another 185 patients would have selective operation during December 2013 to January 2014 as experimental group.The patients in the control group received routine perioperative nursing while nurses in the experimental group provided seamless nursing after information collection before operation , surgery observation during operation and formulating corresponding nursing after operation . The quality of perioperative nursing and patients′satisfaction for nursing job compared between two groups .Results After surgery operation carrying out, the quality of postoperative nursing enhanced from (95.01 ±2.13) to (98.46 ±1.54) scores (t =-18.742,P<0.05), and patients satisfaction increased from (91.30 ±0.20) to (98.60 ±1.10) scores (t=-5.410,P<0.05).Conclusions The process of nurses′perioperative observation offered a seamless nursing for perioperative patients and benefits nurses′comprehensive quality , nursing quality and satisfaction .