1
|
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.
Collapse
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
| |
Collapse
|
2
|
Malmberg L, Benavente Hansson C, Grönqvist J, Brundin M, Björkner AE. Endodontic operative field asepsis: a comparison between general dentists and specialists. Acta Odontol Scand 2023; 81:603-608. [PMID: 37417780 DOI: 10.1080/00016357.2023.2232855] [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: 04/28/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The aim was to evaluate the establishment of an aseptic endodontic operative field in general dentistry by assessing general dentists' ability to reduce the amount of contamination to a non-cultivable level, and to compare the operative field asepsis at a general dentistry clinic with that at an endodontic specialist clinic. MATERIALS AND METHODS A total of 353 teeth were included in the study (153 in general dentistry, 200 at the specialist clinic). After isolation, control samples were taken, the operative fields disinfected with 30% hydrogen peroxide (1 min) followed by 5% iodine tincture or .5% chlorhexidine solution. Samples were collected from the access cavity area and buccal area, placed in a fluid thioglycolate medium, incubated (37°, 7 d), evaluated for growth/non-growth. RESULTS Significantly more contamination was observed at the general dentistry clinic (31.6%, 95/301), than at the endodontic specialist clinic (7.0%, 27/386) (p <.001). In general dentistry, significantly more positive samples were collected in the buccal area than in the occlusal area. Significantly more positive samples were collected when the chlorhexidine protocol had been used, both in general dentistry (p <.001) and at the specialist clinic (p =.028). CONCLUSIONS The result from this study shows insufficient endodontic aseptic control in general dentistry. At the specialist clinic, both disinfection protocols were able to reduce the amount of microorganisms to a non-cultivable level. The observed difference between the protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as confounding factors may have contributed to the result.
Collapse
Affiliation(s)
- Leona Malmberg
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Johan Grönqvist
- The Endodontic Specialist Clinic, The Public Dental Health Service of Västerbotten County, Umeå, Sweden
| | - Malin Brundin
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Annika Elisabeth Björkner
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
3
|
Cheung MC, Parashos P. Current endodontic practice and use of newer technologies in Australia and New Zealand. Aust Dent J 2023; 68:186-196. [PMID: 37382301 DOI: 10.1111/adj.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. METHODS Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. RESULTS Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone-beam computed tomography (CBCT; 98.6%) and calcium silicate-based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine-driven nickel-titanium (NiTi) instruments (91.4%); Group E had more experience with engine-driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands-on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). CONCLUSION Dental dam, EAL and engine-driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association.
Collapse
Affiliation(s)
- M C Cheung
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - P Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
4
|
Christensen HQ, Linde BR, Bårdsen A, Vilhjalmsson VH, Haug SR. Influence of dental education on adoption and integration of technological aids in the delivery of endodontic care by dental practitioners: a survey. Acta Odontol Scand 2022; 80:611-618. [PMID: 35531869 DOI: 10.1080/00016357.2022.2071986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To investigate adoption and integration of technological aids during endodontic treatment and where dental practitioners (DPs) learnt to use this technology. MATERIALS AND METHODS An electronic questionnaire was distributed to all 459 dentists who graduated from University of Bergen between 2008 and 2018. The respondents were divided into two cohorts, older graduates (2008-2013) and newer graduates(2014-2018). RESULTS A total of 314(68.4%) DPs answered the questionnaire. Magnification in the form of dental operating microscopes (DOM) and dental loupes was used by 180 (59.6%), electronic apex locators (EAL) by 271(89.7%) and motor-driven files by 281 (93.4%) DPs. The most frequent response, as to where they learnt to use them was: during undergraduate dental (UG) education. Significantly more newer graduates (90.7%) performed instrumentation based on what they learnt during UG education (p < .001). Older graduates based their instrumentation method equally on what they learnt during UG education (51.9%) and continuing dental education(42.6%). Rubber dam was used during all treatment procedures by 93% of the DPs. CONCLUSIONS UG education is a communication channel with long-lasting importance for adoption and integration of technology by DPs. Exposure to innovations (awareness) during UG education is adequate for integration of technology. Continuing dental education is as valuable as UG education for adoption of technology for older graduates.
Collapse
Affiliation(s)
- Hanne Q. Christensen
- Department of Clinical Dentistry, Section for Endodontics, Faculty of Medicine, University of Bergen, Norway
| | - Brita R. Linde
- Department of Clinical Dentistry, Section for Endodontics, Faculty of Medicine, University of Bergen, Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, Section for Endodontics, Faculty of Medicine, University of Bergen, Norway
| | - Vilhjalmur H. Vilhjalmsson
- Department of Clinical Dentistry, Section for Endodontics, Faculty of Medicine, University of Bergen, Norway
| | - Sivakami R. Haug
- Department of Clinical Dentistry, Section for Endodontics, Faculty of Medicine, University of Bergen, Norway
| |
Collapse
|
5
|
Wikström A, Brundin M, Romani Vestman N, Rakhimova O, Tsilingaridis G. Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long-term outcomes - a longitudinal cohort study. Int Endod J 2022; 55:630-645. [PMID: 35332566 PMCID: PMC9325385 DOI: 10.1111/iej.13735] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
Aim This prospective cohort study evaluates clinical and radiographical outcomes of endodontic pulp revitalization (PR) of traumatized necrotic incisors. Methodology Pulp revitalization was performed in 75 traumatized necrotic immature incisors from 71 patients. The radiographic outcome measures were continued root formation (width and length), root resorption, apex closure, periapical index, and root development stage. The clinical outcome measures were percussion pain, palpation pain, pathological tooth mobility, swelling, sinus tract, ankylosis, crown discolouration, response to pulp sensitivity test, and subjective pain. Treatment outcomes were categorized as a success based on the absence of clinical symptoms and when radiographic evidence was present for apical healing and continued root development. The performed statistical tests were repeated measures anova, pairwise comparisons of interactions (t‐test), McNemar's test, and linear regression model. Results In 45 of 75 teeth (60%), PR was successful with the resolution of clinical and radiographic signs and continued root development. PR failed due to the absence of bleeding (n = 19) and persistent infection (n = 11). PR showed statistically significant increases in root length (11%), and dentinal wall thickness (30%), root maturation (pre‐operative 3.38 [CI 1.88; 4.88]; post‐operative 4.04, [CI 2.56; 5.52]) apical closure (71.4%), healing of pre‐operative apical periodontitis (100%), and healing of pre‐operative inflammatory root resorptions (100%). Three predictive variables for continued root maturation were identified – root development stage at entry (p = .0001, β 0.649), [CI 0.431; 0.867], trauma to the soft tissues (p = .026, β −0.012), [CI −0.0225; −0.015], and pre‐operative dentinal wall thickness (p = .009, β −0.001); [CI −0.001; 0.0001]. Conclusions Our findings indicate that PR provides satisfactory clinical and radiographical outcomes in traumatized necrotic incisors. The failed cases were related to lack of bleeding and persistent infections, indicating that new techniques are needed to improve the predictability of PR.
Collapse
Affiliation(s)
- Alina Wikström
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allé 8, Box 4064, SE-141 04, Huddinge, Sweden.,Department of Endodontics, Public Dental Health Services. Eastmaninstitutet, Dalagatan 11, Box 6031, 102 31, Stockholm, Sweden.,Centre of Paediatric Oral Health, Alfred Nobels allé 8, Box 4064, SE-141 04, Huddinge, Sweden
| | - Malin Brundin
- Department of Endodontics, Umeå University, Umeå, Sweden
| | - Nelly Romani Vestman
- Department of Endodontics, County Council of Västerbotten, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | - Georgios Tsilingaridis
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allé 8, Box 4064, SE-141 04, Huddinge, Sweden.,Centre of Paediatric Oral Health, Alfred Nobels allé 8, Box 4064, SE-141 04, Huddinge, Sweden
| |
Collapse
|
6
|
Leinonen S, Vehkalahti MM. Compliance with Key Practices of Root Canal Treatment Varies by the Reward System Applied in Public Dental Services. J Endod 2021; 47:1592-1597. [PMID: 34343591 DOI: 10.1016/j.joen.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To assess clinical practices in root canal treatments (RCTs) performed by general dental practitioners under 2 different reward schemes applied in public dental services. METHODS This study used a retrospective design with tooth as the observation unit. The data included all teeth (n = 547) with nonsurgical primary RCT completed in 2016. Electronic documents included treatment details and radiographs. RCT assessment covered 4 key items: taking pre- and postoperative radiographs, using a rubber dam, measuring working length. Assessed dichotomies indicated whether practices were adequate. Dentists' reward schemes were "salaried" and "fee-for-service." Chi squared tests analyzed frequency differences. RESULTS RCTs formed 2 groups by the reward scheme: 305 RCTs were performed by salaried dentists and 242 by fee-for-service dentists. Preoperative radiographs were diagnosable for 76.1% and postoperative radiographs, for 95.1% of all RCTs. Rubber dam use was documented for 28.9% of the RCTs, more frequently when performed by salaried than by fee-for-service dentists (43.9% vs 9.9%, P < .001). Working length measurement was documented for 72.9% of the RCTs, more frequently for RCTs performed by salaried than by fee-for-service dentists (85.2% vs 57.4%, P < .001). All 4 key items were assessed as adequate in 19.0% of all RCTs, more frequently when performed by salaried than by fee-for-service dentists (29.5% vs 5.8%, P < .001). CONCLUSIONS Deficiencies in RCTs, particularly underuse of rubber dams call for further research to understand the reasons for noncompliance with good clinical practice guidelines.
Collapse
Affiliation(s)
- Sini Leinonen
- Department of Social Services and Healthcare, The City of Porvoo, Porvoo, Finland
| | - Miira M Vehkalahti
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
| |
Collapse
|
7
|
Elagib MFA, Baldo SMH, Tawfig A, Alqarni MA, Ghandour IA, Idris AM. Knowledge, attitude, and practice regarding infection control measures among dental students during COVID-19 pandemic. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:455-467. [PMID: 34047677 DOI: 10.1080/19338244.2021.1931796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Among health care professionals, dentists are more prone to infection due to their direct contact with blood and saliva. This study highlights the level of compliance with infection control measures among dental students; and linked this to their knowledge and attitudes regarding infection control measures and proper vaccinations. The study is a multi-centre analytical cross-sectional survey. The sample size was 969 clinical years' students from governmental and private dental colleges in Sudan and Saudi Arabia. A pre-coded, pre-tested, and anonymous questionnaire consisted of seven categories of knowledge, attitude, awareness, and practices, including 40 questions, was answered. The study has linked knowledge, attitude, and practice in dental clinics with possible COVID-19 transmission in dental clinics. The results showed that the use of some Personal Protective Equipment was low in Sudan and moderate in Saudi Arabia (statistically significant, p < 0.001). Moderate percentage of Hepatitis B vaccination status, with low percentage of Post HBV serology, was reported (p < 0.001). The percentages of major causes of percutaneous and/or eye exposure/injury, for examples, were as follows: anesthesia (33.3-62.7%, p 0.006) and suture needle (17.5-39.4%, p 0.037). In conclusion, dental students in the present study had good knowledge and positive attitudes regarding infection control in general, but showed moderate compliance with the recommended infection control guidelines.
Collapse
Affiliation(s)
- Mohamed F A Elagib
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
- Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Sara M H Baldo
- Sudan Medical Specialization Board (SMSB), Khartoum, Sudan
| | - Ahmed Tawfig
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - I A Ghandour
- Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
- Sudan Medical Specialization Board (SMSB), Khartoum, Sudan
| | - Abubakr M Idris
- Department of Chemistry, College of Science, King Khalid University, Abha, Saudi Arabia
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
8
|
Malmberg L, Sturestam A, Fagring A, Björkner AE. Endodontic follow-up practices, sources of knowledge, and self-assessed treatment outcome among general dental practitioners in Sweden and Norway. Acta Odontol Scand 2020; 78:547-552. [PMID: 32401091 DOI: 10.1080/00016357.2020.1763455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To reduce the gap between what can be achieved in endodontic treatments and the observed treatment outcome among general dental practitioners, the present study set out to assess the status of the endodontic practices as regards to knowledge and self-assessed skills among general dental practitioners in Sweden and Norway.Material and method: The questionnaire was sent to 1384 general dental practitioners. It contained questions regarding access to continuing education in endodontics, sources of knowledge for clinical management of patients, post-operative follow-ups, self-assessed success-rate, and the initial diagnosis impact on the outcome of endodontic treatments.Results: The response rate was 61.4%. Almost half estimated their endodontic success-rate to be 90%. About two-thirds of the respondents did not know, or did not believe, that the initial diagnosis could affect the outcome of their endodontic treatments. Respondents who did not believe the diagnosis could impact the outcome were more likely to estimate their success rate as the highest (p<.001). Less than half performed post-operative follow-ups a year after treatment. A third of the respondents had not attended any continuing endodontic education.Conclusion: Dentists who do not receive regular feedback on their treatments may lack insight into their own shortcomings. If this is combined with insufficient knowledge and understanding it may result in sub-par endodontic treatments being performed. It is important to have reliable ways to communicate current endodontic knowledge and to establish robust methods that may help dentists accurately assess their own performance in endodontics.
Collapse
Affiliation(s)
- Leona Malmberg
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Anna Sturestam
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Annika Fagring
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Annika Elisabeth Björkner
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|