Publications by authors named "S B McClanahan"

85 Publications

Cemental tear: An overlooked finding associated with rapid periodontal destruction. A case series.

Aust Dent J 2021 Apr 17. Epub 2021 Apr 17.

Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.

Cemental tear is defined as cementum fragment completely or partially detached from the root surface, and it has been associated with localized rapid periodontal breakdown. Although history of trauma and/or attrition may be risk factors, the etiopathology of cemental tear remains unknown. This case series aims to discuss the clinical, radiographic and histopathologic features of cemental tears to aid clinicians in making differential diagnosis. Three teeth from three patients presenting a periradicular lesion underwent an exploratory surgery to determine the cause and provide treatment. Soft and hard tissue biopsies were obtained from each lesion and forwarded for histopathologic evaluation. Two patients received a guided tissue regeneration (GTR) procedure, which allowed the tooth to be retained. One patient received an extraction with simultaneous guided bone regeneration (GBR) due to a hopeless prognosis of the tooth. The results after histopathologic evaluation yielded a final diagnosis of cemental tear for all three patients. Cemental tears may be overlooked, and therefore, they should be included in the differential diagnosis of periapical periodontitis, endodontic-periodontal lesion and vertical root fracture (VRF).
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http://dx.doi.org/10.1111/adj.12844DOI Listing
April 2021

Motivation to recover for adolescent and adult eating disorder patients in residential treatment.

Eur Eat Disord Rev 2021 Jul 13;29(4):622-633. Epub 2021 Apr 13.

Eating Recovery Center and Pathlight Behavioural Health Centers, Denver, Colorado, USA.

Objective: This study aimed to assess how baseline motivation to recover impacts eating disorder (ED) and comorbid symptoms at end-of-treatment (EOT) for adolescents and adults in inpatient/residential treatment.

Method: Two hundred and three adolescent (M = 15.90) and 395 adult (M = 25.45) patients with a Diagnostic Statistical Manual, 5th edition ED diagnosis completed the Decisional Balance Scale (DBS) at baseline, and psychosocial measures (ED symptoms, anxiety, depression, obsessive-compulsive disorder symptoms), and %body mass index (kg/m ; BMI) or median %BMI (for adolescents) at baseline and EOT.

Results: The DBS Avoidance Coping and Burdens subscales at baseline were significantly lower for adolescents than adults (p < 0.001), whereas the DBS Benefits subscale at baseline did not significantly differ between subsamples (p = 0.06). Motivation to recover via DBS subscales was a more reliable predictor of EOT outcomes for both ED and comorbid psychopathology in adults (significant predictor in 19 of 54 total analyses, and 4 significant associations post-Bonferroni correction) than adolescents (significant predictor in 5 of 54 total analyses, and 1 significant association post-Bonferroni correction).

Conclusions: Baseline motivation to recover may be an important predictor of outcome for adult patients in inpatient/residential treatment but does not appear associated with outcomes for adolescent patients.
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http://dx.doi.org/10.1002/erv.2828DOI Listing
July 2021

Posttraumatic stress disorder symptoms and trauma-informed care in higher levels of care for eating disorders.

Int J Eat Disord 2021 Apr 31;54(4):627-632. Epub 2020 Dec 31.

Eating Recovery Center and Pathlight Mood and Anxiety Centers, Denver, Colorado, USA.

Objective: The purpose of the current study was to examine the prevalence and trajectory of posttraumatic stress disorder (PTSD) symptoms among patients with eating disorders (EDs) in higher level of ED care with trauma-informed components, but without a formal evidence-based trauma intervention.

Method: Participants were 613 adults diagnosed with EDs receiving treatment at inpatient, residential, or partial hospitalization levels of care. Participants completed the PTSD Checklist-5 (PCL-5) at admission and discharge.

Results: Over half of patients scored above the cutoff of 33 on the PCL-5 at admission, suggestive of PTSD symptoms characteristic of a formal PTSD diagnosis. The average PCL-5 score significantly decreased for every ED diagnostic category, and there was a significant reduction in the proportion of patients above the PCL-5 cutoff score at discharge. PCL-5 subscales measuring PTSD criteria B (intrusions) and C (avoidance) improved with modest effect sizes, whereas PCL-5 subscales D (negative alterations in cognitions and mood) and E (alterations in arousal and reactivity) improved with larger effect sizes.

Discussion: PTSD symptoms are prevalent among patients with EDs seeking higher levels of care. Despite not offering evidence-based trauma-specific interventions, PTSD symptoms decreased over the course of treatment. However, improvements cannot definitely be attributed to trauma-informed care.
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http://dx.doi.org/10.1002/eat.23455DOI Listing
April 2021

Pilot assessment of a virtual intensive outpatient program for adults with eating disorders.

Eur Eat Disord Rev 2020 11 26;28(6):789-795. Epub 2020 Aug 26.

Eating Recover Center and Insight Behavioral Health Centers, Denver, Colorado, USA.

Access to evidence-based treatment for eating disorders is severely limited by patient barriers and available clinician training. While clinical parameters often point to the need for a high level of care, patients may resist pursuing higher levels of care due to these barriers. One option that might mitigate such obstacles is the provision of a higher level of care via internet-based treatment for eating disorders. We sought to determine the feasibility, acceptability, and preliminary clinical outcomes associated with treatment of eating disorders through virtual intensive outpatient programming (VIOP). Fifty-seven patients meeting DSM-5 criteria for an eating disorder participated in VIOP. Of the 57 patients in VIOP treatment, 3 did not complete voluntary measures at admission or discharge, and 9 additional patients did not complete voluntary measures at discharge. Overall, 45 VIOP patients completed admission and discharge assessments, including a net promoter score (NPS) question assessing patient acceptability. Recruitment, treatment adherence, and completion of assessments in VIOP were feasible and acceptable. VIOP patients showed significant and clinically meaningful improvements in all outcomes measured, including self-reported eating disorder symptoms, depression, self-esteem, quality of life, and overall satisfaction. VIOP appears feasible, acceptable, and evidences clinically meaningful changes in eating and mood disorder symptoms.
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http://dx.doi.org/10.1002/erv.2785DOI Listing
November 2020

In Vitro Comparison of Porcelain Fused to Metal Crown Retention after Endodontic Access and Subsequent Restoration: Composite, Amalgam, Amalgam with Composite Veneer, and Fiber Post with Composite.

J Endod 2020 Aug 17. Epub 2020 Aug 17.

Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota. Electronic address:

Introduction: The aim of this study was to evaluate the effect of different access opening restorative materials on crown retention.

Methods: Thirty-eight extracted molars were mounted in resin and prepared for porcelain fused to metal (PFM) crowns. The crowns were fabricated and cemented with zinc phosphate, and the force to displace it was measured with a tensile-testing machine before and after endodontic access preparations. The endodontic access area, crown preparation axial wall, and preparation surface area were measured for comparison. The crowns were then recemented, and access openings were restored with either amalgam or composite before displacement force was remeasured. The restorative material was removed from each access opening; access area was measured and restored again (amalgam with composite or fiber post with composite) for displacement force to be remeasured. Paired t test was used to compare the means of displacement between groups. One-way analysis of variance was used to compare the mean outcome measure within the groups.

Results: Statistical analyses showed retention after unfilled access was significantly lower than intact crowns. Amalgam, composite, amalgam + composite, and fiber post + composite increased retention beyond the original value. There was no statistical difference among the different restorative protocols. Qualitative results indicate that the restorative material remains in the crown after displacement regardless of the material used to restore the access.

Conclusions: The results from this study suggest that an endodontic access cavity decreases retention of a PFM crown. However, subsequent restoration with amalgam, composite, amalgam + composite, or post + composite may increase the original retention of the crown.
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http://dx.doi.org/10.1016/j.joen.2020.08.009DOI Listing
August 2020