Educational approaches for assessing knowledge about and actions of educators in response to dental avulsion.

BACKGROUND: Dental trauma affects especially schoolchildren and adolescents. Educators, the responsible for the first appointment, have a fundamental role in the prognosis of dental avulsion that occurred in this environment. AIM: To evaluate the educational approaches for assessing knowledge and actions in response to dental avulsion among educators. SETTINGS AND DESIGN: This cross-sectional and quanti-qualitative study included 197 teachers and 24 pedagogical coordinators (PCs), from the public schools of Pato Branco, Paraná, Brazil. METHODS: A questionnaire was initially administered regarding the knowledge about avulsion to all participants. Teachers just read a manual and answered the questionnaire after 30 days. PCs were divided into (n = 12): G1 - manual + fictitious scenario of avulsion and G2 - active methodology + fictitious scenario. The questionnaire was re-administered to all. STATISTICAL ANALYSIS: Quantitative data were analyzed statistically. For the qualitative stage, two questions were proposed and the Bardin's analysis was performed. RESULTS: For teachers, knowledge about avulsion increased after the intervention (P < 0.001), except as related to cleaning the tooth (P = 0.21). Activities involving G1 and G2 also led to an increase in knowledge, but no difference occurred in this increase between the approaches (P = 0.14). Qualitative analysis highlighted the need for calm and for performing actions that could favor a good prognosis in cases of avulsion. CONCLUSIONS: The level of knowledge increased after interventions, but no significant differences between the educational approaches were found.

Effect of Root Canal Preparation on Propagation of Dentinal Microcracks.

Introduction: This study evaluated the propagation of dentinal microcracks and the root canal volume increase after being prepared with two endodontic instruments: ProTaper Next (PTN) and WaveOne Gold (WOG) by micro-computed tomography analysis. Methods and Materials: We selected 48 maxillary molars randomly distributed in two groups: PTN and WOG. The samples were scanned before and after instrumentation, and then the image analysis was performed to detect the propagation of pre-existing dentinal micro-cracks and calculate the pre- and post-instrumentation volume. The statistical analysis was performed using Student's t-test, Fisher's exact test, and ANCOVA (P<0.05). Results: Dentinal microcracks were observed in 95.8% of the samples, both PTN and WOG instruments propagated microcracks after instrumentation, but there was no significant difference between the instruments (P=0.538). In relation to the root canal volume there was no statistic difference between PTN and WOG systems for the mesiobuccal (P=0.426) and distobuccal root canals (P=0.523). Conclusion: We can conclude that both ProTaper Next and WOG systems propagate dentinal microcracks after root canal preparation in this in vitro study, without statistical significance. The root canal volume prepared also showed no statistically significant difference between the two groups. This in vitro study requires further studies for more concrete conclusions.

Cone-Beam Computed Tomography Detection of Separated Endodontic Instruments.

INTRODUCTION: This study compared the accuracy, sensitivity, and specificity of different imaging diagnostic protocols, cone-beam computed tomography (CBCT) and digital periapical radiography (DPR), in identifying separated endodontic instruments in filled root canals. METHODS: One hundred eight root canals from 36 mandibular molars were prepared and obturated. Of these, 84 were filled without separated instruments, and 24 were filled with the presence of a separated instrument (stainless steel hand file or reciprocating instrument). Subsequently, different CBCT imaging protocols were acquired: i-CAT Classic (ICC) (0.25-mm isotropic voxel), i-CAT Next Generation (ICN) (0.125-mm isotropic voxel), and PreXion 3D (PXD) (0.09-mm isotropic voxel). Moreover, a DPR exam was obtained (08 mA, 70 kVp, and exposure time of 0.2 seconds). Two calibrated endodontists evaluated each image for the presence or absence of fractured files on a 5-point scale, ranging from definitely absent to definitely present. The accuracy, sensitivity, and specificity measures for each method were estimated. The data were evaluated by Fisher exact test and binomial test. RESULTS: Nine instruments were identified in DPR (37.5%) and none in the CBCT protocols (P > .05). The type of instrument (stainless steel hand file or reciprocating instrument) did not influence the identification of the separated instrument (P > .05). This study showed that DPR is the most accurate and sensitive imaging technique, with 83.3% and 37.5%, respectively. CONCLUSIONS: DPR is the better imaging diagnostic exam to evaluate the presence of separated endodontic instruments inside a root canal in comparison with the ICC, ICN, and PXD tomographic protocols. However, most of the separated instruments were not identified.