Dental radiographic procedures during COVID-19 outbreak and normalization period: recommendations on infection control

Impacts of the COVID-19 pandemic on the routine of Brazilian oral radiologists

OBJECTIVE

To analyze the challenges and impacts of COVID-19 on the routine of Brazilian oral radiologists regarding changes in biosafety protocols, number of patients and staff, the flow of acquisition, and availability of images.

METHODS

Structured digital questionnaires with questions related to the impacts of the COVID-19 pandemic on Oral Radiology were applied and analyzed. Descriptive statistical analysis was used to describe the items included in the survey, and means and standard deviations were calculated to describe continuous variables and frequency percentages to describe categorical data.

RESULTS

A high number of Brazilian oral radiologists continued to work in the pandemic period, with little or no change in their working hours. Digital flow and teleradiology are in most of their workplaces and the changes imposed by the pandemic will be incorporated and permanent, according to most of the participants in this study.

CONCLUSIONS

The COVID-19 pandemic brought important impacts on radiology clinics, with changes in the flow of patients, in the service and in the type of exam performed. In addition, adaptation to biosafety standards became necessary, with a significant increase in spending on personal protective equipment.

Content Analysis of YouTube Videos That Demonstrate Panoramic Radiography

In this digital era, dental students often search for online resources for self-directed learning. YouTube is one of the most commonly sought online platforms for educational or instructional videos. No prior study has examined the validity of panoramic radiography videos available on YouTube. This study provides a content analysis of these YouTube videos. A search for relevant YouTube videos was conducted in April 2022. The search string was: (panoramic OR pan OR OPG) AND (dental OR dentistry OR X-ray). The first 100 videos that resulted from the search and their related videos were screened. Exclusion criteria included irrelevance (e.g., no demonstration of panoramic radiography procedures) and non-English videos. For each included video, the following parameters were recorded: image receptor type, patient age, patient type (real patient, animation, or phantom head), patient preparation procedures, machine preparation, patient positioning, and operator safety. The number of views, comments, likes, and channel subscribers were recorded, as well as the video duration and the age of the video. Forty videos were included and analyzed. Most of the videos demonstrated digital panoramic radiography with an adult patient. Procedures on the patient and machine preparations as well as patient positioning were generally explained well. However, most videos did not well-demonstrate operator safety details concerning the use of adequate personal protective equipment. View count, comment count, and channel subscriber count positively correlated with the like count. Clinicians and students should carefully critique the content of such instructional videos and refer to the contents from other sources such as user manuals and latest recommendations from local authorities.

Sailing through the COVID-19 Pandemic and Beyond: An Evidence-Based Analysis for Dental Healthcare and Practice

This integrative review aims to provide a consolidated evidence-based appraisal of the most up-to-date guidelines and recommendations of international public and professional health regulatory bodies in relation to preparedness framework for restructuring safe delivery of dental services amid and beyond the coronavirus disease-2019 (COVID-19) pandemic. Most recent updated guidelines for dental professionals from major international health regulatory bodies were reviewed. PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, WHO COVID-19 and LILACS databases, along with relevant preprints were searched, and citations were checked up to January 23, 2021. The search was performed by one author. Shortlisted articles were read and brought to consensus to be included in the study by at least two co-authors. In case of any disagreement between the judgements, an independent co-author's decision was taken as final. Of 849 records searched, 61 articles were included in the study. Following content analysis of the global guidelines and the collected prevailing evidence, the common themes and recommendations of different guidance documents were collated and summarized into seven domains. Most guidelines have a consensus regarding implementation of rigorous administrative, engineering and environmental infection control strategies. However, variations do exist with regard to the use of respirators in non-aerosol-generating procedure (non-AGP) settings, employment of airborne precautions during non-AGPs, use of supplemental air-handling systems, and preoperative use of mouthwashes. This evidence-based analysis can serve as a useful reopening resource tool and facilitate effective restructuring for delivery of optimal, equitable and safe dental practices globally, during and while emerging from the pandemic.

Effect of enveloping and disinfection methods on artefact formation on enveloped PSP plate images

Objectives

To investigate the artefacts caused by different disinfection and protection methods that can be used for infection control of photostimulable phosphor (PSP) plates.

Methods

The plates that were enveloped with single or double envelopes were sprayed with an alcohol-containing solution or wiped with an alcohol-containing tissue. Four PSP groups with two plates in each group were formed (A = wiping single envelope, B = wiping double envelopes, C = spraying onto single envelope, and D = spraying onto double envelopes). Any artefacts (1 = no artefact, 2 = presence of artefact less than 0.5 cm wide, and 3 = presence of artefact larger than 0.5 cm wide) on the 12 acquired images were evaluated.

Results

Artefacts (score-3) occurred on the images of Group C-2 PSP plate after the 3rd exposure. According to the Kruskal–Wallis test the difference between the artefact score of the four methods was found significant. Post-hoc comparisons showed the Group C artefact scores were higher than the others and the difference was significant. The total time of enveloping and disinfection processes for groups was; A = 6.30 min, B = 7.58 min, C = 5.48 min, and D = 7.14 min.

Conclusions

Regardless of the number of envelopes, wiping with a tissue was less likely to cause artefacts, while spraying was reliable only when double envelopes were used. However, using a tissue and double envelopes, which are less risky in terms of artefact, causes time loss, difficulty in manipulation, environmental pollution and high cost.

Confinement by COVID-19 and Degree of Mental Health of a Sample of Students of Health Sciences

BACKGROUND

In response to the global COVID-19 pandemic, most countries have taken important measures to control the spread of the virus, such as population confinement and the closure of universities.

OBJECTIVE

The main objective of this study is to evaluate how the situation resulting from COVID-19 has affected the mental health of a group of health sciences students.

MATERIAL AND METHODS

This is a cross-sectional, descriptive, observational study with a sample of 160 people, conducted through an online survey of final-year students of dentistry, nursing and medicine at the Faculty of Medicine and Health Sciences of the University of Barcelona.

RESULTS

A total of 82.4% of students reported having suffered stress, anxiety and distress due to the pandemic situation, and 83.10% of participants are worried about not knowing when the academic year will restart.

CONCLUSIONS

Confinement has negatively affected the mental health of students.

Knowledge and Attitude of Polish Dental Healthcare Professionals during the COVID-19 Pandemic

Objectives: This study analyzed Polish dentists’ knowledge of the SARS-CoV-2 virus and the main problems in their work during the early phase of the pandemic. Methods: Dentists responded to an online anonymous survey consisting of 57 questions relating to socio-demographics, knowledge about COVID-19, and office procedures. The obtained data were analyzed using basic descriptive statistics, significance of dependencies and Chi square and Mann–Whitney tests; p < 0.05. Results: Ultimately, responses from 730 dentists were included. The mean age was 43.62 ± 11.57. Almost 3/4 of the respondents followed the information on COVID-19. A total of 95.5% had knowledge about COVID-19. Genetic testing was the basic test according to 69.2%. Further, 56.0% were concerned about the pandemic, and 23.6% were significantly anxious. In addition, 42.1% considered a risk of infection with the SARS-CoV-2 in the workplace as very high. A total of 84.0% admitted patients performing a triage and using personal protective equipment (PPE). Further, 44.5% planned to become vaccinated. Continuing the work during the pandemic was strongly correlated with age, sector, and location and duration of work. Conclusions: Most Polish dentists follow the information on the COVID-19 protocol and have sufficient knowledge about COVID-19. Dentists are concerned and anxious about the situation. The vast majority admitted patients during the pandemic and use PPE. Only almost half plan to be vaccinated.

The Impact of COVID-19 on Dentistry in Yichang, China, and Protective Suggestions for Normalisation of Epidemic Prevention

Background

Coronavirus disease 2019 (COVID-19) has been identified as a pandemic by the World Health Organization in March 2020, and it affects all aspects of life, including dental care.

Objectives

The purpose of this article is to explore the impact of COVID-19 on the daily operations of the stomatology department and provide some guidance for dental health care personnel around the world in continuing to provide exemplary care while limiting the spread of COVID-19.

Materials and methods

Retrospective analyses were performed on dental patients’ medical records from the stomatology department of the First People's Hospital of Yichang, China, which were collected in the pre-epidemic, epidemic, and post-epidemic periods. Hospital-wide triage and stomatology department–specific protocols were established in the hospital to prevent cross-infection during the COVID-19 pandemic.

Results

The number of patients decreased and proportion of emergency cases increased during the epidemic period. With prevention protocols in place, the number of dental patients returned to the normal range with a slight elevation during the post-epidemic period. Thus far, there has not been a single documented case of COVID-19 related to dental treatment in the hospital.

Conclusions

COVID-19 has a major impact on daily life, including dental care services. Effective prevention and control measures including 3 levels of protection—zoning, instrumentation, and environmental disinfection—are needed for dental settings to provide care.

Ultrasonography-guided invasive procedures of the temporomandibular joint

Temporomandibular joint (TMJ) complex is one of the most complex joints, which connects the mandible to the skull. This kind of joint system has the ability to perform complex and bilateral movements. Due to complex anatomy, there is a need for a thorough investigation to find the correct etiology of TMJ disorders. For a thorough investigation, starting from clinical examination to imaging strategies should be performed meticulously. Radiographic imaging is an important element in the correct diagnosis. Because of the anatomic complexity of the temporomandibular joint and its proximity to the temporal bone, mastoid air cells, and auditory structures, imaging of the joint structures should also be investigated. Therefore, careful clinical and radiological examinations are essential in the evaluation of TMJ. The manuscript examines the potential use and technique of ultrasonography (USG) in fine-needle aspiration biopsy and intra-articular sodium hyaluronate/steroid injection.

Recommendations, Practices and Infrastructural Model for the Dental Radiology Set-up in Clinical and Academic Institutions in the COVID-19 Era

The pandemic of Coronavirus disease (COVID-19) has emerged as a global catastrophe that is plaguing mankind. In the past eight months since the world discovered about COVID-19, we learned a lot about server acute respiratory syndrome coronavirus 2 (SARS CoV-2) and perhaps there is much more to discover and understand about the virus. With the current understanding of the disease, we assume it will remain in an active state of transmission and progression among the community for a long time. Thus, it is advisable to adopt the disease's prevention protocol in our daily and work routine. During this pandemic patient requiring dental treatment cannot be neglected and the role of dental imaging is crucial in delivering treatment. Hence, this article attempts to provide an evidence-based compilation about the mode of transmission and clinical features of COVID-19. It also throws light on the potential source of disease transmission in the dental radiology setting. In addition, it suggests preventive measures to curb the infection and infrastructural model of the clinical setting that will assist in achieving control over the disease transmission. This article intends to project a strategy about protocols, infrastructure, and daily activities in a dental radiology office that institutions can adopt with modifications according to their local scenario.

Comprehensive review of guidelines to practice prosthodontic and implant procedures during COVID-19 pandemic

OBJECTIVES

To present a comprehensive review of current literature available on Corona virus disease and dentistry, modifications required in dental and laboratory settings; and recommended disinfection protocols in current scenario. Special emphasis has been given to discuss guidelines for handling different prosthodontic procedures and implications of this pandemic on prosthodontic practice, education and research.

MATERIALS AND METHODS

Relevant literature pertaining to COVID-19 and dentistry was scrutinized on electronic search engines including PubMed, EMBASE and Cochrane. Guidelines given by various organizations, institutions, national and international regulatory bodies and Indian Prosthodontic Society were also consulted to gather information pertaining to the objectives of our review.

RESULTS

and observations: A total of 160 articles including cross-sectional studies, in vitro study, narrative reviews, letters to the editor and opinions were found to be relevant in accordance with our search strategy. Documented literature revealed that Covid-19 pandemic has culminated in serious clinical, financial and psychological implications in the field of dentistry. Certain steps such as adoption of teledentistry, judicious use of protective equipment, use of rubber dams, pre-procedural rinses have been suggested unanimously. However, there is a dearth of evidence-based recommendations in literature. Data regarding consequences of delaying prosthodontic procedures and patients' perspectives is also sparse.

CONCLUSION

The COVID-19 necessitates the need to adopt a balanced approach while treating patients and safeguarding the dental professionals at the same time. Risk-benefit ratio has to be assessed along with stringent following of guidelines and disinfection protocols to combat this unprecedented situation.