Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial

PURPOSE

The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP).

METHODS

A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates.

RESULTS

The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05).

CONCLUSION

In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP.

TRIAL REGISTRATION NUMBER

Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.

Determining optimal risk assessment model in construction projects (Case study: steel plant construction project

Introduction: Identifying occupational hazards and managing occupational safety and health risks has been the most important mission and responsibility of the health and safety management system in organizations and adopting coded plans to achieve this is the key to continuously improving this system and promoting it. The aim of the present study was to determine the optimal risk assessment methodology in development projects. Materials and Methods: This was a descriptive-analytic research In this research, using previous research studies and collecting expert opinions, the most important criteria for selecting a specific risk assessment methodology, and then using one of the three most-used techniques is an important activity in the steel making industry and risk assessment. Then, the decision matrix is based on the strengths and weaknesses of the models. The prioritization of these three methods is done using the hierarchical analysis decision method. Results: In this paper, five key factors, the degree of application in identifying hazards, usability in different stages of risk assessment, reliability, ease of use, and training needs and costs, are identified as the most important criteria for choosing a risk assessment technique and the FMEA method was considered as the best  Risk Assessment Method. Conclusion: FMEA methodhas been introduced with regard to its capabilities as an optimal risk assessment method for contruction projects.

Optimum dose of ketamine for prevention of postanesthetic shivering; a randomized double-blind placebo-controlled clinical trial

Our objective was to investigate the efficacy and the optimum dosage of ketamine for post anesthetic shivering prevention. One-hundred and twenty patients (ASA I-II) scheduled for elective orthopedic surgery were randomly allocated to receive ketamine in 3 groups ; groups A (0.125 mg/Kg), groups B (0.25 mg/Kg) and C (0.5 mg/Kg) along with those receiving 0.9% normal saline as the placebo group. Tympanic temperature was measured immediately after induction of anesthesia, 30 min after induction, before administration of the study drug and by the end of the surgery. The four groups did not differ significantly in their hemodynamic parameters and tympanic temperature. The frequency of shivering was significantly less in groups B (0.25 mg/Kg) and C (0.5 mg/Kg) than in groups A (0.125 mg/Kg) and D (placebo). In addition recovery, extubation time and hallucination was observed to be less in group B compared to group A. Prophylactic 0.25 and 0.5 mg/kg ketamine was found to be effective in preventing postanesthetic shivering with a better response observed with 0.25 mg/kg dosage.