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Javed MQ, Khan M, Khan KI, Almutairi N. Endodontic infection control practices among Pakistani general dental practitioners: A national cross-sectional questionnaire survey. J Taibah Univ Med Sci 2023; 18:1342-1349. [PMID: 37305026 PMCID: PMC10248868 DOI: 10.1016/j.jtumed.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
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.
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Affiliation(s)
- Muhammad Q. Javed
- Deparment of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, 52571, Qassim, Saudi Arabia
| | - Mansoor Khan
- Department of Operative Dentistry, Foundation University College of Dentistry, Foundation University, Rawalpindi, Pakistan
| | - Kiran I. Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad, KPK, Pakistan
| | - Nawaf Almutairi
- Deparment of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, 52571, Qassim, Saudi Arabia
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Patel S, Puri T, Mannocci F, Bakhsh AA. The outcome of endodontic treatment using an enhanced infection protocol in specialist practice. Br Dent J 2022; 232:805-811. [PMID: 35689064 DOI: 10.1038/s41415-022-4339-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/05/2021] [Indexed: 11/09/2022]
Abstract
Objectives This study aims to determine the outcome of primary root canal treatment with specific enhanced infection control protocol. The secondary aim was to compare percentages of successful outcomes in this study with a previous study undertaken by the same operator using both periapical radiograph (PR) and cone beam computed tomography (CBCT).Materials and methods Root canal treatment of 110 teeth in 95 patients carried out by a single operator using an enhanced infection control procedure (disinfection of gutta percha before obturation, changing of gloves after each intraoperative radiograph and also before the start of the root canal obturation). PR and CBCT scans of 94 teeth in 87 patients were assessed 12 months after completion of primary root canal treatment and compared with their respective pre-treatment (diagnostic) PR and CBCT scans. Healing was assessed by a consensus panel consisting of two calibrated examiners. Comparison of the PR and CBCT images for 'healed' and/or 'healing' outcomes was performed using McNemar's test.Results The 'healed' rate (absence of periapical radiolucency) was 89.4% using PR and 78.7% for CBCT (p <0.046). This rate increased to 95.7% for PR and 92.6% for CBCT when the 'healing' group (reduced size of periapical radiolucency) was included (p <0.046).Conclusion The frequent changing of gloves during the course of endodontic treatment and disinfection of gutta percha points before obturation, together with the use of contemporary rotary files, resulted in a high success rate of primary root canal treatment compared to similar clinical studies conducted previously.
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Affiliation(s)
- Shanon Patel
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK; Specialist Practice, London, UK.
| | - Taranpreet Puri
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
| | - Francesco Mannocci
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
| | - Abdulaziz A Bakhsh
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK; Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Assessing the Iatrogenic Contribution to Contamination During Root Canal Treatment. J Endod 2022; 48:479-486. [DOI: 10.1016/j.joen.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/22/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022]
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Abusrewil S, Alshanta OA, Albashaireh K, Alqahtani S, Nile CJ, Scott JA, McLean W. Detection, treatment and prevention of endodontic biofilm infections: what's new in 2020? Crit Rev Microbiol 2020; 46:194-212. [PMID: 32233822 DOI: 10.1080/1040841x.2020.1739622] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as it is commonly known is founded on the ability to eradicate microbial biofilm infection and prevent re-infection of the highly complex root canal space. Despite many "advances" in clinical endodontics we have seen little improvement in outcomes. The aim of this critical review paper is to provide a contemporary view of endodontic microbiology and biofilm polymicrobiality, provide an understanding of the host response, and how together these impact upon clinical treatment. Ultimately, it is intended to provide insight into novel opportunities and strategies for the future diagnostics, treatment, and prevention of endodontic disease.
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Affiliation(s)
- Sumaya Abusrewil
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Om Alkhir Alshanta
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Khawlah Albashaireh
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Saeed Alqahtani
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Christopher J Nile
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James Alun Scott
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - William McLean
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Malmberg L, Hägg E, Björkner AE. Endodontic infection control routines among general dental practitioners in Sweden and Norway: a questionnaire survey. Acta Odontol Scand 2019; 77:434-438. [PMID: 30835605 DOI: 10.1080/00016357.2019.1584330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The purpose of this study was to investigate endodontic infection prevention and control routines among general dental practitioners in Sweden and Norway. Materials and methods: A questionnaire was sent by email to 1384 general dental practitioners employed in Sweden and Norway. The participants were asked questions concerning different aspects of infection prevention and control during endodontic treatment; use of rubber dam, sealing of rubber dam, antibacterial solutions, and use of hand disinfectant and gloves. Results: The response rate was 61.4% (n: 819). 96.9% reported routinely using rubber dam during endodontic treatment. 88.3% reported always, or sometimes, sealing the area between rubber dam and tooth. Most disinfected the endodontic operative field, but the antibacterial solutions used varied. 11.9% did not use gloves at all during treatment, and 10.5% did not use hand disinfectant during treatment. Conclusions: Most of the general dental practitioners took measures to establish and maintain aseptics during endodontic treatment, which infers an awareness of the importance of endodontic infection prevention and control. But the results were self-reported and there may be a gap between claimed and actual behaviour. Further studies using observation methodologies are needed to assess how infection control routines are performed in everyday clinical practice.
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Affiliation(s)
- Leona Malmberg
- Faculty of Odontology, Department of Endodontics, Malmö University, Malmö, Sweden
| | - Ellen Hägg
- Faculty of Odontology, Department of Endodontics, Malmö University, Malmö, Sweden
- The Specialist Clinic of Endodontics, the Public Dental Service of Skåne, Malmö, Sweden
| | - Annika Elisabeth Björkner
- Faculty of Odontology, Department of Endodontics, Malmö University, Malmö, Sweden
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Niazi SA, Vincer L, Mannocci F. Glove Contamination during Endodontic Treatment Is One of the Sources of Nosocomial Endodontic Propionibacterium acnes Infections. J Endod 2016; 42:1202-11. [DOI: 10.1016/j.joen.2016.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 01/28/2023]
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Heal C, Sriharan S, Buttner PG, Kimber D. Comparing non‐sterile to sterile gloves for minor surgery: a prospective randomised controlled non‐inferiority trial. Med J Aust 2015; 202:27-31. [DOI: 10.5694/mja14.00314] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/15/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Clare Heal
- College of Medicine and Dentistry, James Cook University, Mackay, QLD
| | - Shampavi Sriharan
- College of Medicine and Dentistry, James Cook University, Mackay, QLD
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Amos JR, Moy AS, Gomez A. Design of a new non-sterile glove-dispensing unit to reduce touch-based contamination. Australas Med J 2014; 7:171-4. [PMID: 24719654 DOI: 10.4066/amj.2014.2043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Despite best efforts by healthcare providers to sterilise their hands through hand washing prior to touching medical equipment and patients, bacteria are still present and can be spread through physical contact. We aimed to reduce the spread of touch-induced and airborne bacteria and virus spreading by using a touch-free glove-dispensing system that minimally exposes gloves in the box to air. METHOD The team met multiple times to undertake early prototyping and present ideas for the design. We experimented with folding gloves in varying patterns, similar to facial tissuedispensing boxes, and tried several methods of opening/closing the glove box to determine the most effective way to access gloves with the least amount of physical contact. We considered the user experience and obtained user feedback after each design iteration. RESULTS Ultimately, we decided on a vertically oriented box with optional holes for dispensing a glove on the side of the box or on the bottom by means of the pull-down drawer mechanism. This system will dispense a single glove at a time to the user with the option of using a pull-down drawer trigger to decrease the likelihood of physical contact with unused gloves. Both methods dispense a single glove. CONCLUSION By reducing physical contact between the healthcare practitioner and the gloves, we are potentially reducing the spread of bacteria. This glove box design ensures that gloves are not exposed to the air in the clinic or hospital setting, thereby further reducing spread of airborne germs. This could assist in decreasing the risk of nosocomial infections in healthcare settings.
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Affiliation(s)
| | | | - Audrey Gomez
- Department of Bioengineering, University of Illinois at Urbana-Champaign
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Hughes KA, Cornwall J, Theis JC, Brooks HJL. Bacterial contamination of unused, disposable non-sterile gloves on a hospital orthopaedic ward. Australas Med J 2013; 6:331-8. [PMID: 23837081 DOI: 10.4066/amj.2013.1675] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Non-sterile disposable gloves are used on large hospital wards, however their potential role as a vehicle for pathogen transmission has not been explored in this setting. AIMS This study investigates glove use on a hospital orthopaedic ward to examine whether pathogen contamination occurs prior to contact with patients. METHOD Glove samples were aseptically removed from boxes on a hospital orthopaedic ward on opening and days 3, 6 and 9 thereafter. Following elution of bacteria and viable counts, glove isolates were identified by standard techniques and 16s rDNA sequencing. Methicillin resistance of staphylococci was determined by disc diffusion, Epsilon tests and PCR. Gloves were inoculated to determine two isolate survival rates. RESULTS Total bacterial counts ranged from 0 to 9.6 x 10(3) cfu/glove. Environmental bacteria, particularly Bacillus species, were present on 31/38 (81.6%) of samples. Half (19/38) the samples were contaminated with skin commensals; coagulase negative staphylococci were predominant. Enterococcus faecalis , Klebsiella pneumoniae , Pseudomonas sp. or methicillin susceptible Staphylococcus aureus were recovered from 5/38 (13.2%) of samples. Significantly more skin commensals and pathogens were recovered from samples from days 3, 6, 9 than box-opening samples. Staphylococcus epidermidis and Klebsiella pneumoniae inoculated onto gloves remained viable for several days but counts decreased. CONCLUSION Health care workers introduced skin commensals and pathogenic bacteria into glove boxes indicating that unused, non-sterile gloves are potential pathogen transmission vehicles in hospitals. Findings highlight adherence to handwashing guidelines, common glove retrieval practice, and glove-box design as targets for decreasing bacteria transmission via gloves on hospital wards.
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Affiliation(s)
- Kim A Hughes
- Department of Microbiology and Immunology, Otago School of Medical Sciences, University of Otago
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Ferreira AM, Andrade DD, Haas VJ. Microbial contamination of procedure gloves after opening the container and during exposure in the environment. Rev Esc Enferm USP 2011; 45:745-50. [PMID: 21710084 DOI: 10.1590/s0080-62342011000300028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 10/04/2010] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to quantify the colony forming units (cfu) on latex procedure gloves in the beginning, middle, and end of the containers in real (professional) and controlled (researcher) gloving situations; evaluate the microbial load of the gloves, considering the time of exposure in the environment. This comparative prospective study was conducted at an intensive care unit of a teaching hospital. The microbiological data was collected from the gloves using digital-pressure. Microbiological evaluations were performed on 186 pairs of gloves: 93 in the control group and 93 in real gloving situations. In the control group, the average cfu was 4.7 against 6.2 in the real gloving situation. Hence, no statistically significant difference was found (p=.601). In addition, the cfu values of gloves in the beginning, middle and end of the containers also did not show any significant differences (p>.05). The most common strain was Staphylococcus spp. The time of exposure in the environment did not increase the cfu value of the latex gloves.
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Affiliation(s)
- Adriano Menis Ferreira
- Departamento de Enfermagem, Universidade Federal de Mato Grosso do Sul, Três Lagoas, MS, Brasil
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ELEAZER PAULD. Armamentarium and Sterilization. COHEN'S PATHWAYS OF THE PULP 2011. [PMCID: PMC7315343 DOI: 10.1016/b978-0-323-06489-7.00006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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