Clinical audit training improves undergraduates' performance in root canal therapy

AIM

To evaluate the effectiveness of clinical audit-feedback cycle as an educational tool in improving the technical quality of root canal therapy (RCT) and compliance with record keeping performed by dental undergraduates.

METHODS

Clinical audit learning was introduced in Year 3 of a 5-year curriculum for dental undergraduates. During classroom activities, students were briefed on clinical audit, selected their audit topics in groups of 5 or 6 students, and prepared and presented their audit protocols. One chosen topic was RCT, in which 3 different cohorts of Year 3 students conducted retrospective audits of patients' records in 2012, 2014 and 2015 for their compliance with recommended record keeping criteria and their performance in RCT. Students were trained by and calibrated against an endodontist (κ ≥ 0.8). After each audit, the findings were reported in class, and recommendations were made for improvement in performance of RCT and record keeping. Students' compliance with published guidelines was presented and their RCT performances in each year were compared using the chi-square test.

RESULTS

Overall compliance with of record keeping guidelines was 44.1% in 2012, 79.6% in 2014 and 94.6% in 2015 (P = .001). In the 2012 audit, acceptable extension, condensation and the absence of mishap were observed in 72.4, 75.7% and 91.5%; in the 2014 audit, 95.1%, 64.8% and 51.4%; and in 2015 audit, 96.4%, 82.1% and 92.8% of cases, respectively. In 2015, 76.8% of root canal fillings met all 3 technical quality criteria when compared to 48.6% in 2014 and 44.7% in 2012 (P = .001).

CONCLUSION

Clinical audit-feedback cycle is an effective educational tool for improving dental undergraduates' compliance with record keeping and performance in the technical quality of RCT.

A comparative effect of mouthwashes with different alcohol concentrations on surface hardness, sorption and solubility of composite resins

The longevity and durability of composite resins are influenced by the actions of water, saliva, drinks, food and features of the oral environment.

OBJECTIVE

The aim of this study was to evaluate the effect of mouthwashes containing alcohol on the surface hardness, sorption and solubility of composite resins.

METHODS

Disc-shaped specimens were prepared with two composite resins Z250 (Z2) and Z350XT (Z3). Measurements of Vickers hardness were performed before and after immersion in Plax, PerioGard, Listerine, ethanol and distilled water for 12 h at 37°C, followed by a further 12 h at 37°C in artificial saliva. Sorption and solubility were performed according to ISO 4049. Data were analysed using one-way ANOVA and Tukey tests (α=0.05).

RESULTS

None of the mouthwashes significantly reduced the hardness of the resin Z2 (p>0.05). The greatest change in resin Z3 hardness was produced by PerioGard (p<0.01). Plax produced the lowest changes in the sorption and solubility of resins Z2 and Z3 (p<0.01), followed by Listerine and PerioGard.

CONCLUSIONS

The sorption and solubility properties of the composite resins were more altered by mouthwashes than the surface hardness.

Asthma and oral health: a review

Asthma is a chronic inflammatory condition that causes the airways to constrict and produce excess mucus, making breathing difficult. It is characterized by the obstruction of airflow which is variable over a short period of time. This condition is reversible, either spontaneously or can be controlled with the help of drugs. Asthma medication comprises bronchodilators, corticosteroids and anticholinergic drugs. Most of these drugs are inhaled using various forms of inhalers or nebulizers. The effect of these drugs on oral health is the subject of debate among dental practitioners. Patients taking asthma medication may be at risk of dental caries, dental erosion, periodontal diseases and oral candidiasis. Hence, patients with bronchial asthma on medication should receive special prophylactic attention. This article reviews the correlation between asthma and oral health, and suggests various measures to counter possible oral health problems related to asthma.

A comparative histological analysis of human pulp following direct pulp capping with Propolis, mineral trioxide aggregate and Dycal

BACKGROUND

Permanent teeth pulp exposures have traditionally been treated with calcium hydroxide pulp capping. The aim of this study was to investigate the response of human pulp tissue which were mechanically exposed to a new material, Propolis and compare it with two existing and commonly used pulp capping agents (mineral trioxide aggregate and Dycal).

METHODS

Thirty-six intact human premolars were mechanically exposed. Teeth were divided into six groups of 6 teeth each and were capped with Propolis, mineral trioxide aggregate and Dycal. Final restoration was done with posterior composite resin using light cured glass ionomer cement as a liner. The teeth were then extracted on the 15th or the 45th day and processed for histological evaluation.

RESULTS

Differences in inflammatory response and dentine bridge formation of the exposed pulp to the three different materials were statistically calculated using chi-square test and were found to be non-significant. There was more pulp inflammation in teeth treated with Dycal than with Propolis and MTA on the 15th as well as on the 45th day. Propolis and MTA showed bridge formation in more teeth, and the bridges were in closer proximity to pulp capping material than teeth treated with Dycal on the 45th day.

CONCLUSIONS

The response of pulps to Propolis as a pulp capping agent was comparable to MTA and Dycal.

Asthma and dental erosion

Asthma is a chronic inflammatory condition of the airway, characterised by the presence of airflow obstruction which is variable over short periods of time, or is reversible with treatment. Medication comprises of bronchodilators, corticosteroids and anticholinergic drugs. Most asthma drugs are inhaled using various forms of inhalers or nebulizers. Inhaled drugs must be used regularly. The effects of these drugs on the dentition such as tooth decay and erosion have been a subject of debate among dental practitioners. Asthmatic medications can place the patient at risk of dental erosion by reducing salivary protection against extrinsic or intrinsic acids. Asthmatic individuals are one of the higher risk groups suffering from dental erosion. Therefore patients with bronchial asthma should receive special prophylactic attention. This article presents a case of an asthmatic with dental manifestations and reviews the possible causes and management of the same.

Bilateral maxillary paramolars and endodontic therapy: a rare case report

Supernumerary paramolars are a rare anomaly of the maxillofacial complex. They are more common in the maxilla than the mandible. This article reports a rare case of bilateral maxillary paramolars, their complications and management.

A conservative method to reproduce lost gingival tissue--an innovative approach

One of the greatest assets a person can have is a smile that shows beautiful, natural teeth. The restoration of a smile is one of the most appreciated and gratifying services a dentist can render. The positive psychologic effects of improving a patient's smile often contribute to an improved self image and enhanced self esteem. Periodontal attachment loss in the maxillary anterior region can often lead to esthetic and functional clinical problems. Lifelong motivation is essential to the supportive therapy for these patients, and the maintenance of good esthetics, combined with conducive to maintaining long term dental and professional health. This paper aims to demonstrate an innovative treatment option for dealing with aesthetic challenges posed by a patient.

Delayed replantation: can it be a success?

This case report describes delayed replantation of an avulsed maxillary central incisor in a 17-year-old male patient following an injury on fall one day earlier. Avulsed maxillary right permanent central incisor was replanted back into the socket after extra-oral root canal treatment. One year follow up showed validity of treatment, with no evidence of resorption in the replanted tooth.

Management of foreign body aspiration or ingestion in dentistry

Foreign body aspiration or ingestion can be a potential complication during routine dental treatment. The handling of dental objects requires particular care, especially where the patient is supine or semi-recumbent. Dentist must be able to manage emergency situations in which patients accidentally swallow dental instruments or materials during treatment and procedures. This article reviews the complications, management and prevention of aspiration or ingestion of foreign bodies.

Asthma: A Risk Factor for Dental Caries?

This report points out a correlation between asthma and dental caries. It also gives certain guidelines on the measures to be taken in an asthmatic to negate the risk of dental caries.Key words: Asthma, Caries risk, Caries prevention, Dental cariesDOI: 10.3126/jnps.v30i3.3929J Nep Paedtr Soc 2010;30(3):175-176