OBJECTIVE: To investigate the effect of the hand file size on the accuracy of Root ZX (J. Morita Co., Kyoto, Japan) and iPex (NSK, Tochigi, Japan).
METHODS: Seventy-five single-rooted teeth were decoronated, and canals were coronally flared with Gates Glidden burs sizes 4, 3, and 2. Actual canal length was determined by averaging two readings obtained by inserting K-file size 8 until its tip was apparent at the most coronal border of the apical foramen. The reference length was actual length-0.5 mm. The blinded operator utilized Root ZX and iPex following the manufacturer\'s recommendations. Teeth were placed in sponge blocks soaked with Ringer\'s solution. Canals were irrigated with 5% sodium hypochlorite. K-file size 8 was attached to the lip clip and introduced until the APEX/0.0 mark, then withdrawn to the 0.5 mark. A stable meter gauge for five seconds indicated an acceptable reading. Readings with sizes 10 and 15 were obtained afterward. All measurements were done twice, then averaged. Data analysis was done using ANOVA and a posthoc Bonferroni test with the significance level set at P<0.05.
RESULTS: For Root ZX, the mean length with size 8 was not significantly different from the mean reference length (P=0.205). The same was found for its mean length at size 10 (P=0.093). However, the mean Root ZX length with size 15 was significantly shorter than the mean reference length (P=0.019). Mean iPex lengths with sizes 8, 10, and 15 were all significantly shorter than the mean reference length (P=0.038, 0.006, and 0.02, respectively).
CONCLUSIONS: The size of the hand file affected the precision of Root ZX and iPex.

Immunodysregulation polyendocrinopathy enteropathy x-linked (IPEX) syndrome is a monogenic autoimmune disease caused by FOXP3 mutations. Because it is a rare disease, the natural history and response to treatments, including allogeneic hematopoietic stem cell transplantation (HSCT) and immunosuppression (IS), have not been thoroughly examined.
This analysis sought to evaluate disease onset, progression, and long-term outcome of the 2 main treatments in long-term IPEX survivors.
Clinical histories of 96 patients with a genetically proven IPEX syndrome were collected from 38 institutions worldwide and retrospectively analyzed. To investigate possible factors suitable to predict the outcome, an organ involvement (OI) scoring system was developed.
We confirm neonatal onset with enteropathy, type 1 diabetes, and eczema. In addition, we found less common manifestations in delayed onset patients or during disease evolution. There is no correlation between the site of mutation and the disease course or outcome, and the same genotype can present with variable phenotypes. HSCT patients (n = 58) had a median follow-up of 2.7 years (range, 1 week-15 years). Patients receiving chronic IS (n = 34) had a median follow-up of 4 years (range, 2 months-25 years). The overall survival after HSCT was 73.2% (95% CI, 59.4-83.0) and after IS was 65.1% (95% CI, 62.8-95.8). The pretreatment OI score was the only significant predictor of overall survival after transplant (P = .035) but not under IS.
Patients receiving chronic IS were hampered by disease recurrence or complications, impacting long-term disease-free survival. When performed in patients with a low OI score, HSCT resulted in disease resolution with better quality of life, independent of age, donor source, or conditioning regimen.