Alani A, Bishop K. Dens invaginatus. Part 1: classification, prevalence and aetiology. International Endodontic Journal, 41, 1123-1136, 2008 Aim To review and discuss the aetiology, prevalence and classification of this dental anomaly together with the morphology of an invagination and the most appropriate nomenclature. Summary This review considers the different possible nomenclatures and concludes that dens invaginatus is the most appropriate description. The paper highlights the different reported prevalence figures and concludes that the problem is probably one of the most common of the dental developmental abnormalities with maxillary lateral incisors most commonly affected. The paper suggests that the classification system described by Oehlers (1957a) is probably the most clinically relevant and that the morphological features associated with this problem may increase the risk of pulpal pathology developing and complicate any possible endodontic treatment. Key learning points • The aetiology of dens invaginatus is still unknown, although there is some evidence that it may be genetic in origin.• The problem is probably more prevalent than most clinicians are aware of and this is because of the diagnostic difficulties associated with the anomaly.• The nature of the problem may increase the risk of pulp disease and complicate any root canal treatment.
* Thorough clinical and radiographic examination is required to diagnose and successfully treat minor to severe invaginations. * Modern clinical techniques may facilitate the management of invaginations once considered untreatable.
Background
In South Africa, COVID-19 control measures to prevent SARS-CoV-2 spread were initiated on 16 March 2020. Such measures may also impact the spread of other pathogens, including influenza virus and respiratory syncytial virus (RSV) with implications for future annual epidemics and expectations for the subsequent northern hemisphere winter.
Methods
We assessed the detection of influenza and RSV through facility-based syndromic surveillance of adults and children with mild or severe respiratory illness in South Africa from January to October 2020, and compared this with surveillance data from 2013 to 2019.
Results
Facility-based surveillance revealed a decline in influenza virus detection during the regular season compared with previous years. This was observed throughout the implementation of COVID-19 control measures. RSV detection decreased soon after the most stringent COVID-19 control measures commenced; however, an increase in RSV detection was observed after the typical season, following the re-opening of schools and the easing of measures.
Conclusion
COVID-19 non-pharmaceutical interventions led to reduced circulation of influenza and RSV in South Africa. This has limited the country’s ability to provide influenza virus strains for the selection of the annual influenza vaccine. Delayed increases in RSV case numbers may reflect the easing of COVID-19 control measures. An increase in influenza virus detection was not observed, suggesting that the measures may have impacted the two pathogens differently. The impact that lowered and/or delayed influenza and RSV circulation in 2020 will have on the intensity and severity of subsequent annual epidemics is unknown and warrants close monitoring.
Resin-bonded restorations have many advantages over conventional alternatives. Advances in adhesive technology together with a better understanding of the clinical function of such restorations have allowed resin-bonded bridges to play an important role in everyday clinical practice. This paper highlights the role and importance of the single abutment, single pontic cantilever resin-bonded bridge. Clinical experience might suggest that the cantilever design offers a viable alternative to other designs. Furthermore, the paper suggests that when cantilever resin-bonded bridges fail initially, re-bond often leads to predictable long-term success. Factors such as patient selection, abutment preparation, retainer design and the aesthetic limitations of resin-bonded bridges are also discussed. The authors can claim that further clinical studies are necessary to identify exactly what factors influence the success of cantilever and other resin-bonded designs.
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