Legal liability facing COVID-19 in dentistry: Between malpractice and preventive recommendations.

The dental profession is considered at high potential risk of exposure and transmission of SARS-Cov-2. Thus, dentists should implement special safety measures in order to prevent any possible contamination during dental sessions and should be aware of the legal implications of their act in order to avoid malpractice leading them to be a causative agent of transmission of this virus. This paper aimed to provide a global review on COVID-19 preventive recommendations at dental clinics and discussed the legal values of such procedures, the dentist criminal and civil liability arising from transmitting this virus to a patient, the obligation of care under COVID-19 and the possible solution to this dilemma. The review concluded that dentists should follow all modern scientific procedures which are in their interest and in the interest of patients to maintain their safety and advised dentists to document all steps taken during the period of COVID-19 outbreak, because any undocumented action is considered not to have taken place, and they shall be bound by the burden of proof.

Choice of Endodontic Fiber Posts and its Influence on Dental Malpractice: An in vitro Evaluation.

AIMS AND OBJECTIVES: The fiber post type used in restoring endodontically treated teeth may affect the dental expert decision in the case of dental malpractice. The aim of this study was to evaluate the low-cost commercial fiber post in comparison with a higher cost or well-known documented fiber post system. MATERIALS AND METHODS: A total of 20 premolars were selected for the study; following endodontic treatment, specimens were randomly divided into two groups of 10 specimens each according to the type of fiber post used: (1) Low-cost commercial fiber post (OYAPost, Taper Lucent, OYARICOM) and (2) higher cost well-known fiber post (Rely X Fiber post, 3M ESPE). Both fiber posts were cemented using self-adhesive cement (Rely X Unicem). Samples were subjected to push-out bond strength and to failure analysis. One-way analysis of variance was used (p < 0.005). RESULTS: There was no significant difference between the bond strength of the two tested groups (p > 0.05), while statistically significant difference (p < 0.05) was noted between the different post space regions (cervical, middle, and apical). CONCLUSION: Based on the evidence from the study, it can be concluded that the type of fiber post should not affect the dental expert decision in the case of dental malpractice/lawsuit. CLINICAL SIGNIFICANCE: All types of low-cost fiber posts may behave similarly to other higher cost or well-documented fiber posts.

The outcomes of the elderly in acute care general surgery.

INTRODUCTION: Elderly patients form a growing subset of the acute care surgery (ACS) population. Older age may be associated with poorer outcomes for some elective procedures, but there are few studies focusing on outcomes for the elderly ACS population. Our objective is to characterize differences in mortality and morbidity for acute care surgery patients >80 years old. METHODS: A retrospective review of all ACS admissions at a large teaching hospital over 1 year was conducted. Patients were classified into non-elderly (<80 years old) and elderly (≥80 years old). In addition to demographic differences, outcomes including care efficiency, mortality, postoperative complications, and length of stay were studied. Data analysis was completed with the Student's t test for continuous variables and Fisher's exact test for categorical variables using STATA 12 (College Station, TX, USA). RESULTS: We identified 467 non-elderly and 60 elderly patients with a mean age-adjusted Charlson score of 3.2 and 7.2, respectively (p < 0.001) and a mortality risk of 1.9 and 11.7 %, respectively (p < 0.001). The elderly were at risk of longer duration (>4 days) hospital stay (p = 0.05), increased postoperative complications (p = 0.002), admission to the ICU (p = 0.002), and were more likely to receive a non-operative procedure (p = 0.003). No difference was found (p = NS) for patient flow factors such as time to consult general surgery, time to see consult by general surgery, and time to operative management and disposition. CONCLUSIONS: Compared to younger patients admitted to an acute care surgery service, patients over 80 years old have a higher risk of complications, are more likely to require ICU admission, and stay longer in the hospital.

Oral and craniofacial clinical signs associated to genetic conditions in human identification part I: a review.

BACKGROUND: Forensic dentistry is one of the most reliable methods used in human identification when other technique as fingerprint, DNA, visual identification cannot be used. Genetic disorders have several manifestations that can target the intra-oral cavity, the cranio-facial area or any location in the human body. MATERIALS AND METHODS: A literature search of the scientific database (Medline and Science Direct) for the years 1990 to 2014 was carried out to find out all the available papers that indicate oral, cranio-facial signs, genetic and human identification. RESULTS: A table with 10 genetic conditions was described with oral and cranio-facial signs that can help forensic specialist in human identification. CONCLUSION: This review showed a correlation between genetics, facial and intra-oral signs that would help forensic ondontologist in the identification procedures.

Long-term effect of a single dose of sulfur mustard on nerve conduction velocity and electromyography pattern in rat hindlimb.

OBJECTIVE: Biological effects of sulfur mustard (SM) on various systems have been investigated in both humans and animals. However, few studies are available on the effect of SM on the peripheral nervous system. In the present study, long-term effects of a single dose of SM on nerve conduction velocity and electromyography (EMG) pattern is evaluated in hindlimb of adult male rats. METHODS: SM poisoning was induced by two means: subcutaneous injection of 1 and 3.5 mg/kg SM in two experimental groups (1 and 2) and cutaneous application of 8 and 13 mg/kg SM in groups 3 and 4. Sham and control groups received SM vehicle, isopropyl alcohol, and nothing, respectively. Electrophysiological assessments were performed after 26 weeks as follows: sciatic nerve conduction study that included measuring, amplitude, duration, and latency of M-wave, F-wave latency, and EMG study in resting and minimal contraction states. RESULTS: Results indicate that sciatic nerve conduction velocity did not significantly change in any experimental groups. However, resting EMG records showed some abnormalities very similar to positive sharp waves and fasciculation reported in humans. These abnormalities were observed in 6 of 36 intoxicated rats. CONCLUSIONS: Although the present data are in favor of axonal degeneration, to rule out the possibility of other types of degeneration, additional thorough studies at ultrastructural level are suggested.