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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.
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http://dx.doi.org/10.1038/s41368-025-00372-w | DOI Listing |
Biosens Bioelectron
September 2025
Materials Artificial Intelligence Center, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China. Electronic address:
Screening for high-risk human papillomavirus (hrHPV) infection is essential for cervical cancer prevention. However, developing a simple, portable, and low-cost hrHPV genotyping method remains challenging, particularly in resource-limited settings. Herein, we present an innovative amplification-free, point-of-care hrHPV genotyping platform integrating CRISPR/Cas12a with alkaline phosphatase (ALP)-mediated surface plasmon effect.
View Article and Find Full Text PDFAdv Mater
September 2025
Department of Chemical Engineering, McGill University, 3610 University Street, Montréal, QC, H3A 0C5, Canada.
Naturally conductive protein nanowires have inspired efforts to engineer electrical conductivity into synthetic fibrous proteins for the development of bioelectronic materials and devices. A comprehensive analysis of charge transport in these systems requires a combination of various measurement methods, instruments and electrode designs. Measurements under direct current (DC) typically focus on charge transport without distinguishing between charged species, requiring alternating current (AC) and electrochemical methods to probe additional phenomena.
View Article and Find Full Text PDFOphthalmic Physiol Opt
September 2025
VOLANTIS, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Purpose: To gain a better understanding of corneal Stress-Strain Index (SSI) maps in healthy eyes and to determine their changes with age.
Method: The eyes of 72 participants (age 43.1 ± 20.
PLoS One
September 2025
College of Information and Control Engineering, Institute of Disaster Prevention, Sanhe, Hebei, China.
Seismic noise separation and suppression is an important topic in seismic signal processing to improve the quality of seismic data recorded at monitoring stations. We propose a novel seismic random noise suppression method based on enhanced variational mode decomposition (VMD) with grey wolf optimization (GWO) algorithm, which applies the envelope entropy to evaluate the wolf individual fitness, determine the grey wolf hierarchy, and obtain the optimized key elements K and α in VMD. Then, the decomposed effective intrinsic mode functions (IMFs) are extracted to separate and suppress random noises.
View Article and Find Full Text PDFOrthopadie (Heidelb)
September 2025
Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Konarskiego 13, 05-400, Otwock, Poland.
Purpose: Performing a one-stage periarticular osteotomy in conjunction with total knee arthroplasty (TKA) constitutes a technically complex procedure. In such demanding cases, a personalized approach utilizing patient-specific instrumentation (PSI) may serve as an advantageous option to achieve optimal precision in bone cuts, thereby enhancing both clinical and radiological postoperative outcomes.
Methods: We present a case report of a 22-year-old man with multiple epiphyseal dysplasia (MED) resulting in knee osteoarthritis with complex femoral deformity and restricted (passive at 30-120° and active at 80-120°) range of movement (ROM).