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 investigate the differences in indwelling duration, clinical scenarios, and complications between the modified midline catheter (MMC) and the central venous catheter (CVC) in the treatment of patients in the medical intensive care unit (ICU) and the risk factors for complications based on real-world data. METHODS: A retrospective cohort study was conducted. The adult patients admitted to the medical ICU of the Third Xiangya Hospital of Central South University and had undergone placement of either a MMC or a CVC between January 1, 2023, and July 31, 2024, were consecutively enrolled by querying the hospital's electronic medical record system. Based on the type of catheter inserted, the patients were divided into the MMC group and the CVC group. The two groups were compared regarding the selection of catheters in the context of different underlying diseases, the actual clinical application after catheterization, catheter-related complications, the international normalized ratio (INR) and platelet count (PLT) during puncture and catheterization, the length of ICU stay, total length of hospital stay, catheter indwelling duration, and mortality during hospitalization. Multivariate Logistic regression analysis was employed to identify independent risk factors for catheter removal. RESULTS: Among the 274 patients, 52 received a MMC and 222 received a CVC. The utilization rate of MMC was significantly higher than that of CVC in patients with acute respiratory distress syndrome (ARDS), cardiovascular disease, and cancer [ARDS: 92.3% (48/52) vs. 70.3% (156/222), cardiovascular disease: 84.6% (44/52) vs. 54.5% (121/222), cancer: 30.8% (16/52) vs. 17.1% (38/222), all P < 0.05]. However, the use of MMC was significantly lower than CVC when vasoactive drug infusion was required [57.7% (30/52) vs. 79.7% (177/222), P < 0.05]. A significantly higher proportion of patients in the MMC group had a catheter indwelling time ≥ 12 days as compared with the CVC group [32.7% (17/52) vs. 13.5% (30/222), P < 0.05]. There were no statistically significant differences in other underlying diseases, venous access usage, INR and PLT during puncture and catheterization, length of ICU stay, total length of hospital stay, and in-hospital mortality of patients between the two groups. Regarding catheter-related complications, although the incidence of partial or complete catheter removal in the MMC group was significantly higher than that in the CVC group [36.5% (19/52) vs. 5.4% (12/222), P < 0.05], the incidence of puncture site fluid leakage, puncture site skin allergy, and deep vein thrombosis were significantly lower than those in the CVC group [puncture site fluid leakage: 1.9% (1/52) vs. 22.1% (49/222), puncture site skin allergy: 0% (0/52) vs. 20.7% (46/222), deep vein thrombosis: 3.8% (2/52) vs. 16.7% (37/222), all P < 0.05]. Furthermore, the proportion of patients experiencing three or more types of complications in the MMC group was significantly lower than that in the CVC group [5.8% (3/52) vs. 17.6% (39/222), P < 0.05]. Multivariate Logistic regression analysis of risk factors for catheter removal identified the use of a MMC [odds ratio (OR) = 8.518, 95% confidence interval (95%CI) was 3.710-19.560, P < 0.001] and a catheter indwelling time ≥ 12 days (OR = 3.133, 95%CI was 1.297-7.567, P = 0.011) as independent risk factors. CONCLUSIONS MMC was more frequently used in patients with ARDS, cardiovascular disease, and cancer, whereas CVC was primarily employed for vasoactive drug infusion. The use of MMC and a longer indwelling time were identified as independent risk factors for catheter removal. Despite a higher removal rate, the overall incidence of complications was significantly lower with MMC than with CVC. These findings suggest that MMC could serve as a routine alternative to CVC in most of clinical scenarios, provided that measures are implemented to prevent removal.
Humans ; Retrospective Studies ; Intensive Care Units ; Catheterization, Central Venous/methods* ; Central Venous Catheters ; Risk Factors ; Length of Stay ; Male ; Female ; Middle Aged ; Adult ; Catheters, Indwelling ; Aged

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.

Objective To evaluate the quality of prediction model on healthcare-associated infections in China,so as to standardize research process and reporting methods.Methods It performed a literature search for healthcare-associated infections prediction model studies published using the following databases by the end of 2022.After independently screening the literature and cross-checking the extracted data according to the inclusion and exclusion criteria,the research team applied the prediction model risk of bias assessment tool(PROBAST)to evaluate the methodological quality,and the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)statement to evaluate the quality of study reporting.Results A total of 81 healthcare-associated infections prediction studies were identified.Their median PROBAST overall adherence were 58.11%±13.88%,median TRIPOD adherence were 56.11%±16.35%.The main methodological flaws involved participants defined,ignored complexities in data,and omitted missing data.The reporting flaws lay in the items of risk groups,sample size,and supplementary information.Conclusion There are methodological deficiencies and incomplete reporting of domestic hospital infection prediction modelling studies,which limit the reliability and applicability of the results and leave much room for improvement.