-
Journal of Pharmacy & Bioallied Sciences Jun 2021The purpose of our study was to analyze the knowledge and attitude of conservative as well as endodontic practice among dental professionals during coronavirus pandemic...
AIM
The purpose of our study was to analyze the knowledge and attitude of conservative as well as endodontic practice among dental professionals during coronavirus pandemic situation.
METHODOLOGY
A cross-sectional study was conducted over a period of 3 months among 1256 dental surgeons, which included 400 MDS and 856 BDS dentists. Questionnaire assessed knowledge of the participants about COVID-19, risk assessment about the pandemic, preparedness of the participants, as well as specific precautions in cases which require conservative and endodontic treatment strategies against COVID-19.
RESULTS
It was observed that around 83% of the study participants felt that rubber dams are a useful tool to prevent cross-infections, even COVID-19. However, COVID-19 prevention techniques such as use of low-speed handpiece and chemicomechanical techniques were preferred by a smaller number of participants: 25% of participants by former, only 12% for the latter. To prevent aerosol splatter, use of high-volume suction was preferred by 49% of dental surgeons.
CONCLUSION
In our study, we concluded that dental surgeons, who come under high risk category; had good basic knowledge about COVID-19 disease process as well as transmission. However, it is imperative that these clinicians need to be extra cautious in handling cases during this pandemic time and limit the disease spread as well.
PubMed: 34447108
DOI: 10.4103/jpbs.JPBS_740_20 -
Journal of International Society of... 2024The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of...
AIM
The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices.
MATERIALS AND METHODS
The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests.
RESULTS
Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal.
CONCLUSION
The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.
PubMed: 38827352
DOI: 10.4103/jispcd.jispcd_157_23 -
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 -
Scientific Reports Feb 2020Rubber dams are widely used for landscaping in urban rivers and they retain large amounts of sediments. The sediments are rich in phosphorus (P) which can cause river...
Rubber dams are widely used for landscaping in urban rivers and they retain large amounts of sediments. The sediments are rich in phosphorus (P) which can cause river eutrophication. Little is known about P release in rubber dams. We investigated the potential of sediment P release by isotherm experiment in an urban river with 30 rubber dams of northern China. We found that the potential of sediment P release (percentage saturation of zero equilibrium P concentration, EPC) was 76% at natural river part above dams, and then decreased to 67% at the 4 dam because of high deposition of fine sediments within the upper 4 dams. Between the 5 and the 30 dams, EPC increased to 90% because of the decrease of fine sediments and water soluble reactive P. EPC was also significantly higher (p < 0.05) in April and August than in November. The results suggest that the potential of sediment P release in this dammed river was mainly controlled by sediment grain size and biological effects. Therefore, management strategies for dammed rivers should focus on reducing P inputs and improving the hydraulic conditions.
PubMed: 32066760
DOI: 10.1038/s41598-020-59493-3 -
The Cochrane Database of Systematic... Oct 2020Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro-organisms and may pose a risk for the spread of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro-organisms and may pose a risk for the spread of infections between dentist and patient. The COVID-19 pandemic has led to greater concern about this risk.
OBJECTIVES
To assess the effectiveness of methods used during dental treatment procedures to minimize aerosol production and reduce or neutralize contamination in aerosols.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases on 17 September 2020: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (in the Cochrane Library, 2020, Issue 8), MEDLINE Ovid (from 1946); Embase Ovid (from 1980); the WHO COVID-19 Global literature on coronavirus disease; the US National Institutes of Health Trials Registry (ClinicalTrials.gov); and the Cochrane COVID-19 Study Register. We placed no restrictions on the language or date of publication.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on aerosol-generating procedures (AGPs) performed by dental healthcare providers that evaluated methods to reduce contaminated aerosols in dental clinics (excluding preprocedural mouthrinses). The primary outcomes were incidence of infection in dental staff or patients, and reduction in volume and level of contaminated aerosols in the operative environment. The secondary outcomes were cost, accessibility and feasibility.
DATA COLLECTION AND ANALYSIS
Two review authors screened search results, extracted data from the included studies, assessed the risk of bias in the studies, and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data. We assessed heterogeneity.
MAIN RESULTS
We included 16 studies with 425 participants aged 5 to 69 years. Eight studies had high risk of bias; eight had unclear risk of bias. No studies measured infection. All studies measured bacterial contamination using the surrogate outcome of colony-forming units (CFU). Two studies measured contamination per volume of air sampled at different distances from the patient's mouth, and 14 studies sampled particles on agar plates at specific distances from the patient's mouth. The results presented below should be interpreted with caution as the evidence is very low certainty due to heterogeneity, risk of bias, small sample sizes and wide confidence intervals. Moreover, we do not know the 'minimal clinically important difference' in CFU. High-volume evacuator Use of a high-volume evacuator (HVE) may reduce bacterial contamination in aerosols less than one foot (~ 30 cm) from a patient's mouth (MD -47.41, 95% CI -92.76 to -2.06; 3 RCTs, 122 participants (two studies had split-mouth design); very high heterogeneity I² = 95%), but not at longer distances (MD -1.00, -2.56 to 0.56; 1 RCT, 80 participants). One split-mouth RCT (six participants) found that HVE may not be more effective than conventional dental suction (saliva ejector or low-volume evacuator) at 40 cm (MD CFU -2.30, 95% CI -5.32 to 0.72) or 150 cm (MD -2.20, 95% CI -14.01 to 9.61). Dental isolation combination system One RCT (50 participants) found that there may be no difference in CFU between a combination system (Isolite) and a saliva ejector (low-volume evacuator) during AGPs (MD -0.31, 95% CI -0.82 to 0.20) or after AGPs (MD -0.35, -0.99 to 0.29). However, an 'n of 1' design study showed that the combination system may reduce CFU compared with rubber dam plus HVE (MD -125.20, 95% CI -174.02 to -76.38) or HVE (MD -109.30, 95% CI -153.01 to -65.59). Rubber dam One split-mouth RCT (10 participants) receiving dental treatment, found that there may be a reduction in CFU with rubber dam at one-metre (MD -16.20, 95% CI -19.36 to -13.04) and two-metre distance (MD -11.70, 95% CI -15.82 to -7.58). One RCT of 47 dental students found use of rubber dam may make no difference in CFU at the forehead (MD 0.98, 95% CI -0.73 to 2.70) and occipital region of the operator (MD 0.77, 95% CI -0.46 to 2.00). One split-mouth RCT (21 participants) found that rubber dam plus HVE may reduce CFU more than cotton roll plus HVE on the patient's chest (MD -251.00, 95% CI -267.95 to -234.05) and dental unit light (MD -12.70, 95% CI -12.85 to -12.55). Air cleaning systems One split-mouth CCT (two participants) used a local stand-alone air cleaning system (ACS), which may reduce aerosol contamination during cavity preparation (MD -66.70 CFU, 95% CI -120.15 to -13.25 per cubic metre) or ultrasonic scaling (MD -32.40, 95% CI - 51.55 to -13.25). Another CCT (50 participants) found that laminar flow in the dental clinic combined with a HEPA filter may reduce contamination approximately 76 cm from the floor (MD -483.56 CFU, 95% CI -550.02 to -417.10 per cubic feet per minute per patient) and 20 cm to 30 cm from the patient's mouth (MD -319.14 CFU, 95% CI - 385.60 to -252.68). Disinfectants ‒ antimicrobial coolants Two RCTs evaluated use of antimicrobial coolants during ultrasonic scaling. Compared with distilled water, coolant containing chlorhexidine (CHX), cinnamon extract coolant or povidone iodine may reduce CFU: CHX (MD -124.00, 95% CI -135.78 to -112.22; 20 participants), povidone iodine (MD -656.45, 95% CI -672.74 to -640.16; 40 participants), cinnamon (MD -644.55, 95% CI -668.70 to -620.40; 40 participants). CHX coolant may reduce CFU more than povidone iodine (MD -59.30, 95% CI -64.16 to -54.44; 20 participants), but not more than cinnamon extract (MD -11.90, 95% CI -35.88 to 12.08; 40 participants).
AUTHORS' CONCLUSIONS
We found no studies that evaluated disease transmission via aerosols in a dental setting; and no evidence about viral contamination in aerosols. All of the included studies measured bacterial contamination using colony-forming units. There appeared to be some benefit from the interventions evaluated but the available evidence is very low certainty so we are unable to draw reliable conclusions. We did not find any studies on methods such as ventilation, ionization, ozonisation, UV light and fogging. Studies are needed that measure contamination in aerosols, size distribution of aerosols and infection transmission risk for respiratory diseases such as COVID-19 in dental patients and staff.
Topics: Adolescent; Adult; Aerosols; Aged; Air Filters; Air Microbiology; Bacterial Infections; Child; Child, Preschool; Colony Count, Microbial; Dentistry; Disinfectants; Humans; Infection Control, Dental; Middle Aged; Occupational Diseases; Randomized Controlled Trials as Topic; Rubber Dams; Suction; Virus Diseases; Young Adult
PubMed: 33047816
DOI: 10.1002/14651858.CD013686.pub2 -
Brazilian Oral Research 2024This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC)... (Randomized Controlled Trial)
Randomized Controlled Trial
This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.
Topics: Child; Humans; Child, Preschool; Rubber Dams; Dental Care; Dental Caries; Molar; Acrylic Resins; Silicon Dioxide
PubMed: 38198308
DOI: 10.1590/1807-3107bor-2024.vol38.0009 -
Journal of Oral Science Sep 2020The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital...
The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital tooth bleaching with a mixture of sodium perborate and 30% hydrogen peroxide rolled in Japanese paper for a traumatically injured tooth, and in-office vital-tooth bleaching for the upper front six teeth and first premolars, were performed. Five-year follow-up showed satisfactory stability in the bleaching effects and did not show any problems in the traumatically injured tooth. The use of Japanese paper for non-vital tooth bleaching may minimize damage to discolored non-vital teeth.
Topics: Bicuspid; Humans; Hydrogen Peroxide; Japan; Tooth Bleaching; Tooth Discoloration; Tooth, Nonvital
PubMed: 32863316
DOI: 10.2334/josnusd.19-0416 -
Swiss Dental Journal Jul 2020Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these...
Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.
Topics: Endodontics; Female; Humans; Male; Practice Patterns, Dentists'; Root Canal Therapy; Rubber Dams; Students; Surveys and Questionnaires
PubMed: 32674530
DOI: 10.61872/sdj-2020-07-08-02 -
BMJ Case Reports Aug 2021Avulsion injuries are usually seen in the anterior maxillary teeth as a result of trauma. Avulsion as an endodontic mishap is extremely rare. This report highlights an...
Avulsion injuries are usually seen in the anterior maxillary teeth as a result of trauma. Avulsion as an endodontic mishap is extremely rare. This report highlights an unusual instance of exarticulation of a recently traumatised maxillary central incisor tooth when the rubber dam was applied during a routine non-surgical endodontic procedure. The tooth was immediately repositioned and stabilised with wire composite splint. Endodontic treatment was initiated after rubber dam isolation with a modified technique. Calcium hydroxide was used as intracanal medicament dressing, and obturation was done after 2 weeks. The treatment was successful with uneventful periodontal healing at 24-month follow-up. The presence of well-demarcated periodontal ligament space and absence of any resorptive area on the radiograph could be defined as a successful outcome for the present case.
Topics: Humans; Incisor; Male; Rubber Dams; Tooth Avulsion; Young Adult
PubMed: 34404646
DOI: 10.1136/bcr-2021-241872 -
Brazilian Dental Journal 2020
Topics: COVID-19; Endodontics; Humans; Pandemics; Rubber Dams
PubMed: 33237226
DOI: 10.1590/0103-6440202003760