Periapical Microsurgery: Assessment of Different Types of Light-emitting Diode Transilluminators in Detection of Dentinal Defects.

INTRODUCTION: This study evaluated 4 different light-emitting diode (LED) transilluminators and the impact of operator experience in the detection of dentinal defects through an ex vivo TRUEJAW surgical model (Dental Engineering Laboratories, Santa Barbara, CA). METHODS: Forty-four extracted and endodontically treated mandibular premolar teeth were evaluated. Teeth were mounted in the models followed by surgical flaps and osteotomies to expose the apical third of the roots. After apical resection, the root-end surfaces were randomly inspected for the presence or absence of dentinal defects using a dental operating microscope (DOM) at ×19.4 magnification by experienced and novice LED evaluators. The assessment was made with the DOM light and 4 masked LED transilluminators of different diameters and luminous flux. The teeth were examined outside the models to establish the ground truth. The sensitivity, specificity, and kappa and McNemar test values of each light source by examiner were calculated. RESULTS: The use of LED transilluminators improved the diagnostic sensitivity of dentinal defects when compared with the DOM light alone for both examiners. For the LED-experienced evaluator, the medium-low transilluminator had statistically significant higher sensitivity than the DOM light and the small-low and small-high transilluminators (P < .05). For the novice LED evaluator, the medium-high transilluminator had the highest sensitivity. There was a statistically significant difference between the sensitivities of the medium-low transilluminator between the examiners (P < .05). CONCLUSIONS: Within the limitations of this ex vivo surgical study, dentinal defects were more often detected with the LED transilluminators with a larger diameter and increased lumens. The operator's LED transilluminator experience was found to have a positive effect on the detection of dentinal defects using transillumination.

An Assessment of the Bacterial Diversity found in Dental Unit Waterlines using the Illumina MiSeq.

Water from the waterlines of dental units is often contaminated with bacteria but there have been few studies accurately assessing the diversity of these bacterial populations. The aim of our study was to assess the bacterial diversity present in water collected from dental unit waterlines using the Illumina MiSeq. Water was collected from two separate dental units located in a dental hospital and two units found in two separate private clinics in Gangneung-si, Korea. From the four water samples that were analyzed, a total of 233 bacterial genera were identified. The most abundant genera were Sphingomonas (25%), Halomonas (20%), Reyranella (8%), and Novosphingobium (6%). Halomonas was more prevalent in the two dental units located at the dental hospital, while Reyranella and Sphingomonas were more commonly found in the private dental clinics. Only 19 of the 233 identified genera were common between water samples from all dental units. Opportunistic pathogens were shown to account for 7.7% of the total bacterial genera identified. Our results have demonstrated that there is a wide assortment of bacterial genera present in dental unit waterlines.

Clínica Dental: norma técnica No. 016-2019 ­DRACES / Dental Clinic: technical standard No. 016-2019 ­DRACES

DRACES [Departamento de Regulación, Acreditación y Control de Establecimientos de Salud] Este documento tiene como objeto: "la Regulación, Autorización y Control de las Clínicas Dentales, en concordancia con el Reglamento para la Regulación, Autorización, Acreditación y Control de Establecimientos de Atención para la Salud, Acuerdo Gubernativo 376-2007." Es de carácter obligatorio, por lo que se aplica tanto al sector público, privado, social o subsector de la seguridad social, en todo el territorio nacional. Contiene además, las definiciones de los conceptos relacionados al tema principal, además de la infraestructura que deberá tener cada clínica, incluidos el equipo y recurso humano y técnico.

Laboratorio mecánico dental: norma técnica No. 24-2019 / Dental mechanical laboratory: technical standard No. 24-2019

Este documento tiene como objeto: "la regulación, autorización y control de los laboratorios mecánicos dentales, en concordancia con el Reglamento para la Regulación, Autorización, Acreditación y Control de Establecimientos de Atención para la Salud, Acuerdo Gubernativo 376-2007." Es de carácter obligatorio, por lo que se aplica tanto al sector público, privado, social o subsector de la seguridad social, en todo el territorio nacional. Contiene además, las definiciones de los conceptos relacionados al tema principal, además de la infraestructura que deberá tener cada clínica, incluidos el equipo y recurso humano y técnico.

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry. METHODS: This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Meta-analysis was performed to estimate the effect of seat type on the ergonomic risk score in dentistry. The heterogeneity among studies was assessed using I2 statistics. RESULTS: The search resulted in 3147 records, from which two were considered eligible for this review. Both studies were conducted with a total of 150 second-year dental students who were starting their laboratory activities using phantom heads. Saddle seats were associated with a significantly lower ergonomic risk than conventional seats [right side (mean difference = -3.18; 95% CI = -4.96, -1.40; p < 0.001) and left side (mean difference = -3.12; 95% CI = -4.56, -1.68; p < 0.001)], indicating posture improvement. CONCLUSION: The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students.

Risk assessment for the spread of Candida sp. in dental chair unit waterlines using molecular techniques.

AIMS: The aim of this study was to evaluate the presence of yeasts in dental chair unit waterlines (DCUWLs) and to test their ability to form biofilms. MATERIALS AND METHODS: Eighteen dental waterlines were analysed by culture in liquid Sabouraud in order to allow the quantification and the purification of isolated yeasts from their internal surfaces. All isolates were identified by standard laboratory procedures, including CHROMagar Candida medium for orientation, commercial yeast identification system Api Candida, MALDI-TOF MS and DNA sequencing. To evaluate their kinetics of antifungal susceptibility during different phases of biofilm formation, these yeasts were subjected to three antifungal agents. RESULTS: From the 18 DCUWLs studied, 10 were altered (55.56%). Eleven strains of Candida sp. [Candida albicans (2), Candida guilliermondii (5) and Candida glabrata (4)] and two species of non-Candida; Rhodotorula spp. (1) and Trichosporon spp. (2) were identified. The majority of yeasts in planktonic form were susceptible to amphotericin B, caspofungin and voriconazole, except C. albicans was resistant to voriconazole. In the biofilm form, caspofungin was the most effective antifungal agent for all isolated strains. For the other antifungal agents, sessile cells were resistant. CONCLUSION: Several types of yeasts were identified; the most frequently isolated genus was Candida. The majority of these yeasts had the ability to form biofilms and resisted antifungal agents used in this study.

[Importance of cleaning and disinfection of critical surfaces in dental health services. Impact of an intervention program]. / Importancia del proceso de limpieza y desinfección de superficies críticas en un servicio dental. Impacto de un programa de intervención.

Introduction Dental care has become a challenge for healthcare associated infection prevention programs, since the environment, within other factors, plays an important role in the transmission chain. Materials and Methods An intervention program was designed for the Dental Unit of Hospital Militar de Santiago, between years 2014 and 2015. The program contemplated 3 stages: diagnostic, intervention and evaluation stage. Objective To improve the safety of critical surfaces involved in dental healthcare. Results During the diagnostic stage, the cleaning and disinfection process was found to be deficient. The most contaminated critical surface was the instrument holder unit, then the clean area and lamp handle. The surfaces that significantly reduced their contamination, after the intervention, were the clean area and the instrument carrier unit. Conclusion Training in the processes of cleaning and disinfecting surfaces and dental equipment is one of the cost-effective strategies in preventing healthcare-associated infections (HCAI), with simple and easy-to-apply methods.

Importancia del proceso de limpieza y desinfección de superficies críticas en un servicio dental: impacto de un programa de intervención / Importance of cleaning and disinfection of critical surfaces in dental health services: impact of an intervention program

Resumen Introducción La atención odontológica se ha transformado en un desafío para los programas de prevención y control de infecciones asociadas a la atención de salud (IAAS), dado que el ambiente, entre otros factores, juega un rol importante en la cadena de transmisión. Método Se realizó un programa de intervención en el Servicio de Dental del Hospital Militar de Santiago, entre los años 2014-2015, que contempló tres etapas: etapa diagnóstica, de intervención y de evaluación. Objetivo Mejorar la seguridad de las superficies críticas involucradas en la atención dental. Resultados Durante la etapa diagnóstica se constató que el proceso de limpieza y desinfección era deficiente. La superficie crítica más contaminada fue la unidad porta-instrumental, luego el área limpia y la manilla de la lámpara. Las superficies que redujeron significativamente su contaminación, posterior a la intervención, fueron el área limpia y la unidad porta-instrumental. Conclusiones La capacitación en relación a los procesos de limpieza y desinfección de superficies y del equipamiento dental es una de las estrategias costo-eficientes en la prevención de las IAAS, sencilla y fácil de aplicar.

Introduction Dental care has become a challenge for healthcare associated infection prevention programs, since the environment, within other factors, plays an important role in the transmission chain. Materials and Methods An intervention program was designed for the Dental Unit of Hospital Militar de Santiago, between years 2014 and 2015. The program contemplated 3 stages: diagnostic, intervention and evaluation stage. Objective To improve the safety of critical surfaces involved in dental healthcare. Results During the diagnostic stage, the cleaning and disinfection process was found to be deficient. The most contaminated critical surface was the instrument holder unit, then the clean area and lamp handle. The surfaces that significantly reduced their contamination, after the intervention, were the clean area and the instrument carrier unit. Conclusion Training in the processes of cleaning and disinfecting surfaces and dental equipment is one of the cost-effective strategies in preventing healthcare-associated infections (HCAI), with simple and easy-to-apply methods.

Microbial assessment of dental unit waterlines in an institutional setup in Karnataka, South India.

BACKGROUND AND AIM: Biofilms in dental unit waterlines (DUWLs), suction hoses, and fittings are a potentially significant source of cross-contamination posing significant health risk as these may come into contact with patients during treatment. The purpose of this in vitro study was to identify the spectrum of bacterial flora colonizing the DUWLs and to detect pathogenic microorganisms present in such an environmental niche. MATERIALS AND METHODS: Thirty DUWL samples were collected from in use dental units selected randomly from various clinical departments. Samples were collected from the following devices; 3-in-1 syringe waterline, section of waterline tubing supplying the 3-in-1 syringe, and the air rotor water. The samples were subjected to bacteriological analysis, and all bacterial isolates were tested for their ability to form biofilms. RESULTS: A descriptive analysis of the results obtained was carried out, and it was observed that 7 out of 30 (23.3%) samples collected from DUWL were supplying water of unsatisfactory quality with species of low-pathogenicity bacteria isolated present in significant numbers; four of ten (40%) water supply lines contained bacterial biofilms; and the species with greatest capability to form biofilms were Enterobacter species (spp.). In addition, the results were also subjected to Chi-square test which revealed no statistical difference between the species and the location of collection of samples. CONCLUSION: Within the limitations of this study, it is concluded that DUWLs are not totally free of contamination. Microbial biofilms are a significant source of cross-contamination and cross-infection in the dental clinic environment.

Light-emitting Diode Assessment of Dentinal Defects after Root Canal Preparation with Profile, TRUShape, and WaveOne Gold Systems.

INTRODUCTION: The objective of this study was to use light-emitting diode (LED) transillumination to assess the presence of dentinal defects in roots instrumented with 3 different root canal preparation systems: ProFile (Dentsply Tulsa Dental Specialties, Tulsa, OK), TRUShape (Dentsply Tulsa Dental Specialties), and WaveOne Gold (Dentsply Tulsa Dental Specialties). METHODS: Eighty mesial roots of mandibular molars presenting 2 canals were randomly divided into 4 different groups (n = 20) as follows: the control group, no root canal preparation was performed; the ProFile group, root canals were prepared with nickel-titanium ProFile sizes 20.06 and 25.06; the TRUShape group, root canals were prepared with nickel-titanium rotary TRUShape instrument sizes 20.06 and 25.06; and the WaveOne Gold group, root canals were prepared with the reciprocating WaveOne Gold instrument #25.07. The specimens were sliced at 3, 6, and 9 mm from the apex with a low-speed saw under water cooling. Microscopic pictures of the specimens were taken with the aid of LED; the root canal space was masked, and 2 independent evaluators assessed the images for the assessment of dentinal defects. The number of dentinal defects was recorded, and the chi-square test was used for statistical analysis (P < .05). RESULTS: The number of specimens presenting dentinal defects was as follows: the control group = 10, the ProFile group = 10, the TRUShape group = 13, and the WaveOne Gold group = 10. CONCLUSIONS: Using the novel LED method, no difference in the visualization of dentinal defects was found among the ProFile, TRUShape, and WaveOne systems and the control group. Previous studies using the traditional sectioning method lack proper control and should be evaluated with caution.

Assessment of interns and postgraduate dental student's knowledge regarding equipment ergonomics.

CONTEXT: The substantial knowledge concerning ergonomics and its practical application is vital for forestalling musculoskeletal disorders. The role of equipment ergonomics (EE) in preventing these work-related ailments is significantly noteworthy. AIM: The aim of the study was to assess the prevailing perception of postgraduates (PGs) and interns regarding EE and preparing the Indian dental workforce for the challenges of India's growing economy and population. SETTINGS AND DESIGN: Authors conducted a cross-sectional survey between December 2013 and February 2014 amidst the interns and PG dental students of Davangere city, Karnataka, India. SUBJECTS AND METHODS: The data were collected using 21-item custom designed proforma, comprising of questions evaluating student's basic knowledge about EE. STATISTICAL ANALYSIS USED: Statistical analysis was done using Chi-square test in each group (PGs and interns) and Mann-Whitney test was implemented for comparison between both groups. RESULTS: Of 358 subjects surveyed, 48% PGs and 52% interns affirmed that they came across EE only through this survey. In addition, 91.18% of PGs and 90.59% interns believed that the accentuation on EE is less in the current dental curriculum. CONCLUSIONS: Comprehensive understanding and practical application of EE among the participants was found to be lacking. The importance of microbreaks and chair side exercises should be emphasized and training should be initiated at an early stage before improper postural habits develop.

Cultural and Molecular Evidence of Legionella spp. Colonization in Dental Unit Waterlines: Which Is the Best Method for Risk Assessment?

Legionella spp. are ubiquitous in aquatic habitats and water distribution systems, including dental unit waterlines (DUWLs). The aim of the present study was to determine the prevalence of Legionella in DUWLs and tap water samples using PMA-qPCR and standard culture methods. The total viable counts (TVCs) of aerobic heterotrophic bacteria in the samples were also determined. Legionella spp. were detected and quantified using the modified ISO 11731 culture method. Extracted genomic DNA was analysed using the iQ-Check Quanti Legionella spp. kit, and the TVCs were determined according to the ISO protocol 6222. Legionella spp. were detected in 100% of the samples using the PMA-qPCR method, whereas these bacteria were detected in only 7% of the samples using the culture method. The number of colony forming units (CFUs) of the TVCs in the DUWL and tap water samples differed, with the bacterial load being significantly lower in the tap water samples (p-value = 0). The counts obtained were within the Italian standard range established for potable water in only 5% of the DUWL water samples and in 77% of the tap water samples. Our results show that the level of Legionella spp. contamination determined using the culture method does not reflect the true scale of the problem, and consequently we recommend testing for the presence of aerobic heterotrophic bacteria based on the assumption that Legionella spp. are components of biofilms.

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

BACKGROUND: Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. METHODS: A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. RESULTS: Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. CONCLUSIONS: Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.