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BMC Oral Health Jun 2023The application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The application of rubber dams is a widely accepted method of tooth isolation in dental practice. Placement of the rubber dam clamp might be associated with levels of pain and discomfort, especially in younger patients. The purpose of the present systematic review is to evaluate the efficacy of the methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents.
MATERIALS AND METHODS
English-language literature from inception until September 6, 2022 was searched in MEDLINE (via PubMed), SCOPUS, Web of Science, Cochrane, EMBASE, and ProQuest Dissertations & Theses Database Global for articles. Randomized controlled trials (RCTs) comparing methods of reducing the pain and/or discomfort associated with rubber dam clamp placement in children and adolescents were retrieved. Risk of bias assessment was performed using a Cochrane risk of bias-2 (RoB-2) risk assessment tool and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profile. Studies were summarized and pooled estimates of pain intensity scores and incidence of pain were calculated. The meta-analysis was conducted in the following groups according to type of interventions (LA, audiovisual (AV) distraction, behavior management (BM), electronic dental anesthesia (EDA), mandibular infiltration, inferior alveolar nerve block (IANB), TA), outcome (intensity or incidence of pain), and assessment tool (face - legs - activity - cry - consolability (FLACC), color scale, sounds - motor - ocular changes, and faces pain scale (FPS)): (a) pain intensity using (LA + AV) vs (LA + BM), (b) pain intensity using EDA vs LA (c) presence or absence of pain using EDA vs LA (d) presence or absence of pain using mandibular infiltration vs IANB (e) Comparing pain intensity using TA vs placebo (f) Presence or absence of pain using TA vs placebo. Meta-analysis was conducted using StataMP software, version 17.0 (StataCorp, College Station, Texas). Restricted maximum-likelihood random effect model (REML), Mean difference (MD) with 95% confidence interval, and log odds ratio (OR) with 95% CI were calculated were calculated.
RESULTS
Initially, 1452 articles were retrieved. Sixteen RCTs were finally included for reviewing and summarizing. Nine articles with a total of 867 patients were included for quantitative meta-analysis. The differences in pain intensity scores were not significant in any comparison groups (group a: [MD = -0.04 (95% CI = - 0.56, 0.47), P = 0.87, I = 0.00%], group b: [MD = 0.25 (95% CI = -0.08, 0.58), P = 0.14, I = 0.00%], group c [MD = -0.48 (95% CI = -1.41, 0.45), P = 0.31, I 2 = 0.00%], group d: [MD = -0.67 (95% CI = -3.17, 1.83), P = 0.60, I 2 = 0.00%], group e: [MD = -0.46 (95% CI = -l.08, 0.15), P = 0.14, I 2 = 90.67%], and group f: [MD = 0.61 (95% CI = -0.01, 1.23), P = 0.06, I 2 = 41.20%]. Eight studies were judged as having some concern for risk of bias and the remaining studies were considered as low risk for bias. The certainty of evidence was considered medium for all comparison groups.
DISCUSSION
In the present meta-analysis, a considerable difference was obtained between the included studies regarding intervention methods and pain assessment tools and the analysis was performed in groups with small numbers of the studies. Owing to the mentioned variabilities and the small number of studies, the results of the analysis should be interpreted with caution. The indistinguishability of the manifestations of pain/discomfort from fear/anxiety, particularly in children, should also be considered while using the results of the present study. Within the limitations of the current study, no significant differences were found between the proposed methods for reducing pain and discomfort associated with rubber dam clamp placement in children and adolescents. A larger number of more homogenous studies regarding intervention methods and pain assessment tools need to be conducted in order to draw stronger conclusions.
TRIAL REGISTRATION
This study was registered in PROSPERO (ID number: CRD42021274835) and research deputy of Mashhad University of Medical Sciences with ID number 4000838 ( https://research.mums.ac.ir/ ).
Topics: Child; Humans; Adolescent; Rubber Dams; Pain; Dental Instruments; Randomized Controlled Trials as Topic
PubMed: 37328861
DOI: 10.1186/s12903-023-03115-7 -
Journal of Pharmacy & Bioallied Sciences Jul 2023The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an...
INTRODUCTION
The success of restoration processes depends on the efficient control of moisture and microorganisms. Dental restorative procedures frequently use rubber dams as an isolation technique. There is still room for evidence-based discussion over how rubber dam use affects the durability and caliber of dental restorations. In this review, the effects of rubber dam isolation vs alternative isolation techniques for dental restorative procedures are compared.
MATERIALS AND PROCEDURES
An extensive online search in the various databanks of the EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "isolation, oral surgery, dental surgery, retractors, rubber dam, and methods of isolation." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of bias, meta-analysis was carried out. The outcome was measured as the successful restoration at the end of follow-up period representing the thorough isolation.
RESULTS
A total of 1342 people were involved in six studies from across the world that were carried out between 2010 and 2015. High bias risk existed in all the studies. Five investigations compared the rubber dam vs cotton rolls. Due to discrepancies in the data supplied, one study was omitted from the analysis. Three of the four trials that were still running showed restored survival rates with all having a follow-up of at least six months. The survival of the restored composite teeth for six months in rubber dam isolation with odds ratio of 2.29, 1.38, and 1.00 at the end of six months, one year and one and half year respectively. However, the evidence was very low and speculative. The isolation was seen effective in the primary teeth specifically for the proximal lesions. None of the included studies discussed side effects or provided information on the treatment's upfront costs.
CONCLUSION
The application of rubber dams in dental techniques may result in successful outcome compared to cotton rolls, according to some low-certainty evidence revealed in this research. Other times, the evidence is really ambiguous. It is necessary to conduct additional, high-quality studies investigating how rubber dam use affects various restorative procedures.
PubMed: 37654409
DOI: 10.4103/jpbs.jpbs_518_22 -
Preventive Medicine Reports Oct 2023Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This... (Review)
Review
Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This study aimed to assess the effectiveness of various aerosol mitigation interventions during clinical dental procedures in real-world environments. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase for English studies up to March 2023 according to the PRISMA guidelines. Only peer-reviewed controlled clinical trials (CCT) or randomized controlled trials (RCT) studies involving human subjects were included. The risk of bias of selected researches were evaluated by two independent authors using the Cochrane Collaboration tool. The literature search yielded 3491 articles, of which 42 studies met the inclusion criteria and were included in this study. Most studies evaluated bacterial contamination in bio-aerosols, while the viral and fungal contamination was assessed in only three studies. Overall, various approaches have been applied in reducing aerosol contamination in clinical scenarios, including high-volume evacuators (HVE), mouse rinses and rubber dams, air cleaning systems, and high-efficiency particulate air (HEPA) filters. The available evidence suggests that various aerosol mitigation strategies could be implemented to decrease the risk of cross-infection during clinical dental procedures in real-world environments. However, further clinical trials are necessary to establish statistical validity in measuring aerosol contamination and mitigation, as well as to evaluate the risk of infection transmission for viral and fungal contamination.
PubMed: 37680854
DOI: 10.1016/j.pmedr.2023.102383 -
The Journal of Clinical Pediatric... Jul 2023This review aims to summarize and analyze previous studies that evaluated the clinical efficiency, patient satisfaction, and future preference of Isolite System... (Review)
Review
This review aims to summarize and analyze previous studies that evaluated the clinical efficiency, patient satisfaction, and future preference of Isolite System Isolation (ISI) and DryShield System Isolation (DSI) and compare them to other forms of isolation during dental treatment in children. Both authors independently searched engines using the keywords "Isolite", "Vacuum", "DryShield" and their combinations in March 2022. The inclusion criteria included peer-reviewed articles written in English and clinical trials that assessed the clinical efficiency, patient satisfaction, and future preference of ISI or DSI during dental treatment on healthy unaffected children and compared it to other isolation systems such as rubber dam and cotton roll. A total of five articles were included, and data were extracted by both authors independently and compiled into one single table.Five clinical trials were identified. The use of both ISI and DSI systems is associated with more noise, requires less chair time, is more comfortable, and is preferred by more children than rubber dam or cotton ball isolation.The review reports promising results in clinical efficiency, patient satisfaction, and future preference for both Isolite and DryShield isolation systems. Both systems require less chair time and were preferred by pediatric patients for future dental treatment when compared to both rubber dam and cotton roll isolation systems. Less fluid leaking and gagging reflex were reported when compared to cotton roll isolation. When compared to rubber dam isolation, they were associated with less discomfort.
Topics: Humans; Child; Patient Satisfaction; Rubber Dams; Pit and Fissure Sealants; Composite Resins
PubMed: 37408340
DOI: 10.22514/jocpd.2023.029 -
Cureus Apr 2024There are unfavorable opinions connected with rubber dam isolation amongst dental students during adhesive restorative treatments. The aim of this study was to...
PURPOSE
There are unfavorable opinions connected with rubber dam isolation amongst dental students during adhesive restorative treatments. The aim of this study was to investigate the various barriers to practicing rubber dam isolation during dental procedures and provide necessary insight towards implementation of rubber dam among undergraduate dental students in Jazan.
MATERIALS AND METHODS
A pre-validated questionnaire in English entitled Rubber Dam Isolation Survey (E-RDIS) based on the Capability Opportunity Motivation-Behaviour (COM-B) model of behavioral change wheel was responded by 226 university dental students.
RESULTS
The satisfaction of training was highest among sixth year students (Mean=3.57, p<0.001). Fourth year dental students scored higher in the capability (Mean=3.18) and were more highly motivated to use rubber dams (Mean=4.21). Third year students were more likely to use rubber dams in anterior teeth (Mean=3.52) whereas fourth year students use rubber dam in posterior teeth (Mean=3.74). Lack of motivation was found to be the significant barrier influencing rubber dam usage (odds ratio (OR)=12.1; 3.74, p<0.05).
CONCLUSION
The satisfaction with training differed among the students of different years. The rubber dam technique might be used more frequently if it were made clear to students that mastering it would be necessary for them to receive good grades.
PubMed: 38752044
DOI: 10.7759/cureus.58329 -
Journal of Taibah University Medical... Dec 2023This study was aimed at evaluating the self-reported endodontic infection control practices of general dental practitioners in Pakistan.
OBJECTIVE
This study was aimed at evaluating the self-reported endodontic infection control practices of general dental practitioners in Pakistan.
METHODS
An e-questionnaire was sent to 619 general dental practitioners in several WhatsApp groups. Sixteen questions associated with various infection control measures recommended by the ESE were asked, including the use of various isolation methods/rubber dams, the selection of canal irrigants and anti-bacterial solutions, and practices regarding hand hygiene and use of examination gloves. The e-questionnaire also included questions associated with demographics. Data analysis was conducted in SPSS-24. Descriptive statistics were documented as percentages and frequencies.
RESULTS
Of 619 GDPs, 350 responded (56.5% response rate), of whom 43.7% worked in private dental practices. The majority were women (64%), had graduated after 2010 (81.1%), and were 24-34 years of age (78.9%). A total of 72.3% of GDPs used cotton rolls, and 17.4% routinely used rubber dams for endodontic isolation; 89% did not disinfect the operative field; 80% reported using different concentrations of NaOCl during root canal instrumentation; and 0.9% reported not using any irrigant during endodontic procedures. A total of 61.7% reported always using intra-canal medication during multi visit endodontic treatment, among whom 82.5% reported using Ca(OH)2. Finally, 100% of respondents reported using gloves during endodontic treatment.
CONCLUSION
The results indicated that the GDPs tended to follow some of the endodontics quality standards recommended by the ESE, but the overall implementation of all guidelines requires improvement.
PubMed: 37305026
DOI: 10.1016/j.jtumed.2023.05.014 -
Restorative Dentistry & Endodontics Nov 2023Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the...
Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide non-surgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.
PubMed: 38053779
DOI: 10.5395/rde.2023.48.e32 -
Cureus Apr 2024Introduction Anxiety is an emotion representing apprehension towards an unknown stimulus or situation. Rubber dam application during dental procedures in children makes...
Introduction Anxiety is an emotion representing apprehension towards an unknown stimulus or situation. Rubber dam application during dental procedures in children makes the treatment more comfortable and acceptable as it gives them a psychological feeling that treatment is being carried out outside the oral cavity. The prime objective of this study was to evaluate and compare physiological parameters, which include pulse rate, arterial oxygen saturation level, blood pressure, and respiratory rate before and after rubber dam isolation. Material and methods The study consisted of 30 children patients of 7-10 years, comprised of 14 females and 16 males with a mean age of 8.15 ± 0.93 years. The study was a 'split mouth' clinical design study, where 60 sites in 30 patients (two sites in each patient) were used. The selected sites were divided into two groups by a convenience sampling method and were categorized as Group-I (control group - 30 sites were treated with pit and fissure sealants under cotton roll and saliva ejectors on mandibular right permanent first molar) and Group-II (study group - 30 sites were treated with pit and fissure sealants underrubber dam isolation on mandibular left permanent first molar). Results Rubber dam application reduced different physiological parameters of stress such as pulse rate, systolic and diastolic blood pressure, and respiratory rate at different intervals from the baseline values. Rubber dam and cotton roll applications have no significant effects on oxygen saturation levels at different intervals in healthy individuals. From statistical analysis, it was evident that a statistically significant difference was evident between the control and experimental groups (P value < 0.005). Conclusion It is confirmed in this study that rubber dam reduces different physiologic parameters of stress. After the application of the rubber dam, children's pulse rate, systolic and diastolic blood pressure, and respiratory rate were reduced. Clinical significance The study highlights the imperative role of rubber dam isolation in improving dental and medical effectiveness. In addendum to this, our research promotes the clinical use of rubber dams in pediatric dentistry.
PubMed: 38770463
DOI: 10.7759/cureus.58615 -
Journal of Oral Science Jan 2024This study investigated the efficacy of various antiseptics for disinfection of rubber dams used during endodontic treatment, the duration of disinfection effectiveness,...
PURPOSE
This study investigated the efficacy of various antiseptics for disinfection of rubber dams used during endodontic treatment, the duration of disinfection effectiveness, and the disinfection protocol employed by dental schools in Thailand.
METHODS
The efficacy of 10% povidone-iodine, 1.5% tincture iodine and 70% ethyl alcohol in eliminating Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) on the rubber dam was investigated. Time duration of disinfection was evaluated at 0, 30, 60, and 120 min. The two-step disinfection method adopted at Thai dental school was examined. Independent t-test or Kruskal-Wallis followed by a Dunnett's test was used for statistical analysis.
RESULTS
Among the three antiseptics, 10% povidone and 1.5% tincture iodine eradicated the microorganisms completely, whereas 70% ethyl alcohol did not achieve a statistically significant decrease. The duration of sterilization effectiveness was 120 min for 10% povidone-iodine, but bacteria were eliminated only at 0 min by 1.5% tincture iodine. The results also indicated that the two-step protocol scarcely eliminated the microorganisms.
CONCLUSION
The best antiseptic for rubber dam disinfection is 10% povidone-iodine, which remains effective for 120 min. The two-step protocol typically practiced in Thai dental schools needs to be updated. The use of 10% povidone-iodine alone is adequate for complete eradication of E. faecalis and C. albicans.
Topics: Anti-Infective Agents, Local; Povidone-Iodine; Rubber Dams; Disinfection; Ethanol; Iodine
PubMed: 37853618
DOI: 10.2334/josnusd.23-0136 -
BioMed Research International 2024[This retracts the article DOI: 10.1155/2020/5397838.].
[This retracts the article DOI: 10.1155/2020/5397838.].
PubMed: 38549973
DOI: 10.1155/2024/9848395