Antimicrobial Efficacy of Silver Nanoparticles against Candida Albicans.

Current treatment protocols for patients diagnosed with denture stomatitis are under scrutiny, and alternative options are being explored by researchers. The aim of this systematic review was to determine if silver nanoparticles inhibit the growth of Candida albicans, and the research question addressed was: In adults, do silver nanoparticles inhibit the growth of Candida albicans in acrylic dentures and denture liners compared to normal treatment options. A systematic review was the chosen methodology, and criteria were formulated to include all types of studies, including clinical and laboratory designs where the aim was tested. Of the 18 included studies, only one was a clinical trial, and 17 were in vitro research. The inhibition of candidal growth was based on the % concentration of AgNPs included within the denture acrylic and denture liner. As the % AgNPs increased, candida growth was reduced. This was reported as a reduction of candidal colony forming units in the studies. The quality of the included studies was mostly acceptable, as seen from the structured and validated assessments completed.

Antimicrobial efficacy of silver nanoparticles against Candida albicans: A systematic review protocol.

INTRODUCTION: Denture-induced stomatitis is one form of candidiasis. It is characterised as inflammation and erythema of the oral mucosa underneath the denture-bearing areas and clinically classified into three types according to severity. Denture hygiene, appropriate mouth rinses and the use of antifungal therapy are commonly used to treat the condition, but new technologies are emerging that may assist in its treatment. AIM: The aim of this systematic review is to determine if silver nanoparticles inhibit the growth of Candida Albicans when included in acrylic dentures and in different denture liners. METHODOLOGY: A protocol was developed and published on PROSPERO (Registration No: CRD42019145542) and with the institutional ethics committee (Registration No: BM20/4/1). The protocol includes all aspects of a systematic review namely: selection criteria, search strategy, selection methods using predetermined eligibility criteria, data collection, data extraction, critical appraisal of included studies, and the intended statistical analyses such as calculating risk ratios (RR) for dichotomous outcomes and presented at 95% confidence intervals, a meta-analysis, if possible or a narrative report as needed. EXPECTED RESULTS: With rigorous inclusion criteria set and databases identified for searching, appropriate clinical and laboratory studies may be obtained but the results and its interpretation and translation into clinical practice may be a challenge as these depend on the quality of the research.

COVID-19 and its impact in the dental setting: A scoping review.

INTRODUCTION: The scoping review examined the evidence related to infection control and transmission measures of the SARS-CoV-2 virus in a dental setting during this pandemic. Dental practitioners are normally guided in practice by set ethical principles, thus the researchers wanted to determine how these rules are managed during this pandemic. METHODS: A protocol specific for the objectives of this study was developed according to the criteria for a scoping review. Relevant databases (Pubmed, Scopus, Elsevier, Science Direct, Wiley), including online access to health/ dental organizations (World Health Organization/ American Dental Association), were searched to identify evidence which was restricted to the English language for the period 2015-2020. Predetermined eligibility criteria were applied, evidence was assessed and data extracted for each included article. Relevant outcomes assessed were: infection control measures, transmission of the SARS-CoV-2 virus, such as modes and sources of transmission and the ethical principles related to the dental setting with a focus on the COVID-19 pandemic. RESULTS: Searches yielded a total of 402 articles: 387 from electronic databases and 15 from other sources. Of these, 231 were unrelated to the objectives of the current scoping review. The full text of 69 studies was assessed for eligibility, of which 26 were finalized for inclusion following the objectives and inclusion criteria set for the scoping review. Most of the included articles were reviews, recommendations and guidelines for dentists. A narrative explanation of the pre-specified outcomes is reported for the 3 areas covered for this review. There is no clinical evidence available that can support the recommendations by individuals, dental organizations or health authorities related to the objectives of this review, but these may be considered as the much needed guidelines during the unprecedented COVID-19 pandemic. A different ethical framework is required during a pandemic and these must be informed by evidence.

Translation of the shortened dental arch research into clinical practice: a stakeholder mapping approach.

AIM: To identify key participants that can ensure implementation of the SDA or PRDA as a prosthodontic management option using a stakeholder mapping approach. METHODS: A stakeholder mapping approach is employed which is a strategic method to identify, rate the importance of input and the influence, highlighting how clinical implementation can be ensured. A stakeholder map was used as the research tool. Stakeholders were classified according to their level of influence in either assisting with change or obstructing progress as well as the impact of their input within the dental organization and the broader South African environment. RESULTS: Several stakeholders were identified and were classified in two ways: Primary or secondary and according to their affiliation with the organization where change needs to occur. Initially, a lecture on the shortened dental arch was included in 4th year of undergraduate study, after consultation with the head of the department. This was abandoned as students misunderstood the use of the concept related to clinical requirements; thus, the location of where this concept must be taught, was reconsidered. The role of other key stakeholders that could effect change was also highlighted with this approach. CONCLUSION: This strategic analysis allowed identification of key stakeholders and their roles that can assist with implementation of the SDA or PRDA, some of whom should be addressed further to ensure alignment of practices to health policies. KEY POINTS: Knowledge translation consists of multiple stages from design to implementation which includes diffusion, dissemination (such as publishing) and implementation of evidence into clinical practice (application of concepts or procedures to improve patient care).Only quality research, as stipulated on the evidence pyramid, can be used to change curricula and clinical practices.The strategic approach with stakeholder mapping allows identification of key stakeholders in prosthodontics (knowledge brokers or communities of practice) that have the interest and influence to change curricula and clinical practice; including a combined approach with researchers which may enable easier application of quality care to patients.

An Overview of Systematic Reviews Related to Aspects of the Shortened Dental Arch and Its Variants in Adults.

PURPOSE: The aim of this study was to conduct an overview of systematic reviews (SRs) related to aspects of the shortened dental arch (SDA) and its variants and critically appraise the methodologic quality of included SRs using the AMSTAR checklist. MATERIALS AND METHODS: A comprehensive computerized search and a hand search of reference lists were conducted for SRs related to SDAs to identify publications from 2000 to 2016. All the present authors and a research assistant independently screened the results of the electronic searches using an eligibility form and extracted information using a specially designed prepiloted data extraction form. An 11-question AMSTAR checklist was completed for each included SR. Disputes were resolved by discussion between all researchers, and results were collated and interpreted. RESULTS: For the period of 2007 to 2016, the search yielded nine SRs incorporating 228 related articles. The research questions for each SR differed but were related to SDAs, thus, the included articles were similar across SRs. Characteristics such as aims/objectives, study outcomes, and conclusions of the nine included SRs were compared. The AMSTAR evaluation indicated that five out of nine studies were of a high quality (used a rigorous methodology) and the remaining four were of medium quality. All nine SRs provided designs and characteristics of included studies. None of the SRs assessed publication bias. CONCLUSION: Of the nine SRs, seven drew positive conclusions regarding the SDA concept, finding it functionally sound, although some suggested that more high-quality primary studies are still needed. The AMSTAR calculation indicated that most included SRs had an acceptable methodologic quality, emphasizing the reliability of their results.

From classroom teaching to clinical practice: experiences of senior dental students regarding the shortened dental arch concept.

This study explored the barriers to a meaningful translation of didactic classroom instruction to clinical practice, using the shortened dental arch (SDA) concept as a case study. A combination of survey and individual and group interviews (a mixed-methods approach) was used to collect data related to the SDA. The cohort consisted of senior dental students and their clinical teachers at the University of the Western Cape, South Africa. The response rates were 100 percent for the students (n=73) and 78 percent for the clinical teachers (n=16). Triangulation was employed to eliminate bias and strengthen the reliability of the research. In the quantitative analysis, most students (81 percent) reported having heard about the SDA concept at the university, but their responses revealed an absence of clinical implementation. The students agreed that patients can function adequately with an SDA and agreed with presenting it as a treatment option to patients. In the qualitative analysis, a "change in the clinical requirements," "being empowered by exposing them to SDA literature," and "change in health policies" were recommended measures to increase implementation of the SDA approach clinically. The students were positive about the SDA as a treatment option, but the lack of adequate knowledge and encouragement in clinical implementation was a hindrance to its use.