Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective To explore the clinical application of manipulations in treating cervical vertigo and the status of research on its therapeutic mechanism with bibliometric methods.Methods Using"cervical vertigo","cervicogenic dizziness","manipulations"and"tuina"as the key words,the literatures on clinical application of manipulations in treating cervical vertigo and its therapeutic mechanism were retrieved from the databases of China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP)and Wanfang Data Knowledge Service Platform,and the retrieval time was set from the establishment of each database to December 31,2023.The relevant literature obtained from the databases was screened,classified and summarized,and then statistical analysis was performed in terms of the chronological distribution,literature types and research types,therapies,and characteristics of the basic researches of the included literature.Results A total of 1 412 articles about manipulations in treating cervical vertigo and with postive outcomes have been issued in China in the recent 30 years.The quantity of literature showed an overall increasing trend before 2013,and then gradually decreased after 2013.Of the 1412 articles,1 231(87.18％)were issued by the journals,1 202(85.13％)articles were about clinical research,while only 48(3.40％)articles were about basic research.Of the 1 202 articles about clinical research,only 357 articles mentioned the name of manipulations in details definitely,which accounted for 155 types in a variety of types or names.Of the 1 202 articles about clinical research,34.44％of them were about therapy of manipulations alone for the treatment cervical vertigo,and the other clinical research were all about combined therapies,the combined therapy of manipulations plus acupuncture-moxibustion/electro-acupuncture being the most common(25.37％).Of the 48 articles about basic research,research on biomechanics was most commonly seen(38 articles,79.17％).Conclusion Manipulation therapy has been widely used for the treatment of cervical vertigo in the recent 30 years.At present,the quality of clinical research on the treatment of cervical vertigo by manipulation therapy is not high,the manipulation techniques were in a wide variety,and the research lacks of objective criterions.The research direction for basic studies is single,and breakthroughs are needed in the quality and quantity of basic research.In the future research,the naming of manipulations for cervical vertigo should be considered,and the explicit naming principles and criterions should be established;the quality level of clinical studies should be improved and the basic research should be emphasized,so as to provide more reliable theoretical and experimental evidences for manipulations in treating cervical vertigo,and promote its clinical application.

BACKGROUND:Cervical rotatory manipulation is widely used in the treatment of neck-related diseases with a clear curative effect,but it also has some risks in clinical practice.The previous study of our group found that cervical rotatory manipulation can reduce the tensile mechanical properties of the atherosclerotic carotid artery,but it is not clear about the effects of different cervical rotatory manipulations(positioning/non-positioning)and different degrees(mild/moderate/severe)of atherosclerosis on the tensile mechanical properties of the carotid artery. OBJECTIVE:To explore the effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery. METHODS:The 120 male New Zealand rabbits were randomly divided into eight experimental groups with different degrees of atherosclerosis and different cervical rotatory manipulations:severe atherosclerosis + positioning/non-positioning cervical rotatory manipulation,moderate atherosclerosis + positioning/non-positioning cervical rotatory manipulation,mild atherosclerosis + positioning/non-positioning cervical rotatory manipulation,and normal rabbit + positioning/non-positioning cervical rotatory manipulation,as well as three model control groups:mild/moderate/severe atherosclerosis + non-cervical rotatory manipulation,and the blank control group.Two-factor analysis of variance was used to explore the main effects and interactive effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery.One-way analysis of variance was applied to explore the influence of different cervical rotatory manipulations on the tensile mechanical properties of the internal carotid artery under the same degree of atherosclerosis. RESULTS AND CONCLUSION:(1)Both different cervical rotatory manipulations and different degrees of atherosclerosis were the main effect factors affecting the tensile mechanical properties of the internal carotid artery.(2)For both mild and severe atherosclerosis,both positioning and non-positioning cervical rotatory manipulations reduced the maximum stress of the internal carotid artery(P<0.05)and also increased the physiological elastic modulus of the internal carotid artery(P<0.05).(3)For moderate atherosclerosis,positioning and non-positioning cervical rotatory manipulations also increased the physiological elastic modulus of the internal carotid artery(P<0.05).Non-positioning cervical rotatory manipulation reduced the maximum strain of the internal carotid artery(P<0.05),and its maximum strain was also less than the internal carotid artery of the positioning cervical rotatory manipulations(P<0.05).(4)For the normal internal carotid artery,in addition to the maximum strain,both positioning and non-positioning cervical rotatory manipulations had no statistically significant effects on other tensile mechanical indicators of the internal carotid artery(P>0.05).(5)The results suggest that both positioning and non-positioning cervical rotatory manipulations may increase the stiffness of the atherosclerotic internal carotid artery,reducing its elasticity and brittleness.Therefore,both positioning and non-positioning cervical rotatory manipulations may increase the risk of cardiovascular events in mild/moderate/severe atherosclerotic internal carotid artery,and the more severe the atherosclerosis is,the greater the risk of positioning/non-positioning cervical rotatory manipulation treatment,but the risk of positioning cervical rotatory manipulation is not lower than that of non-positioning cervical rotatory manipulation.

Objective In order to discuss the evaluation of generalized sterization for dental handpieces. Methods The generalized sterization for dental handpieces were used inclued collection dental handpieces, automatically cleaned, dried and distilled with oil, packed with paper or plastics and sterized with pulse-vuccum. Results All the indexes were fitted to the standard after the generalized sterization among the dental handpieces. The valid rate was 100%. Conclusions Generalized sterization for dental handpieces are effective measures to guarantee the clinical sterization quality.