Nurses' educational needs in the oral health of inpatients at Yazd Province in Iran: a Delphi study.

BACKGROUND: Oral hygiene is an integral part of general health of a person. Nurses qualified about oral care can play an important role in improving the quality of oral health in hospitalized patients. This study investigated the educational needs of nurses in the field of oral health of hospitalized patients. METHODS: The study used the modified Delphi method in three rounds. Fifty faculty members of the School of Dentistry and Nursing were selected via purposive sampling. The data collection tool was a demographic form and an open-ended questionnaire in the first round and a structured questionnaire in the next rounds. The analysis was performed using both content and descriptive analysis techniques. RESULTS: The top ten oral health education priorities for nurses were greater than 75% with a consensus level: oral anatomy and physiology, learning the signs and symptoms of common oral diseases, learning of oral medications and administration, learning the drugs that cause damage to the mouth and teeth, training in managing dental emergencies, patient education for tooth brushing and taking care of the mouth, especially in the elderly patient, providing oral and dental care, training for unconscious and fasting patients, undergoing chemotherapy and radiotherapy, and hospitalization in intensive care unit. CONCLUSION: The findings of the study emphasized the need for interdisciplinary cooperation between nursing and dental professionals for the development of an oral health curriculum for nurses to promote and improve oral health and prevent dental diseases in hospitalized patients and the community.

Comparison of Microleakage of CEM Cement Apical Plug in Different Powder/ Liquid Ratio in Immature Teeth Using Fluid Filtration Technique.

STATEMENT OF THE PROBLEM: Sealing ability is one of the most important factors for successful endodontic treatment. Some studies have shown that the powder to liquid ratio can influence the properties of dental materials. Subsequently, this may happen for those used for sealing in endodontics. PURPOSE: The purpose of this research was to assess the microleakage of calcium-enriched mixture (CEM) cement apical plug in different powder to liquid ratio. MATERIALS AND METHOD: Ninety-six extracted human single root and single canal teeth were decoronated. Working length was determined using ≠15 k-file. Canal preparation was performed using step back method. Samples were divided into 3 groups randomly. CEM cement was placed into the canal with 1.13, 2.27 and 3.40 powder to liquid ratio in the group 1, 2 and 3, respectively. After complete setting of CEM cement, the micro leakage value was evaluated using fluid filtration method. Data were analyzed using ANOVA and Scheffe tests. RESULTS: The bubble movement in three groups showed a statistically significant difference (p< 0.001). Minimum and maximum bubble movements were observed in the group with powder to liquid ratios of 3.40 and 1.13 respectively. CONCLUSION: Increased CEM Cement powder to liquid ratio will increase the sealing ability of this material as apical plug. Considering the conditions of this study, the powder to liquid ratio of 3:40 provided the best sealing ability.

Diagnostic Value of Cone-Beam Computed Tomography and Digital Periapical Radiography in Detection of Separated Instruments.

Introduction: File Fracture is one of the most common problems during root canal treatment which can affect treatment procedure and prognosis, so it is important to diagnose and prevent it. The aim of this study was to evaluate and compare the diagnostic value of cone-beam computed tomography (CBCT) and digital periapical radiography for detection of separated instrument retained inside the canal. Methods and Materials: Ninety single-rooted extracted human teeth were selected and randomly divided into 3 groups (n=30). Group 1, separated file #10 at the 2-mm apical third of the root canal; group 2, separated file #35 at the 2-mm apical third of the root canal; and group 3, without a broken file (control group). The teeth were instrumented to size #30 and were shaped to size #55 and then the canals were obturated up to separated instrument, or the working length for the teeth without a separated instrument, with lateral condensation technique. After that all teeth were placed in dry skull, digital radiography and CBCT was taken. After data collection, data was analyzed using SPSS software by means of sensitivity, specificity, positive and negative predictive values, and frequency tables. Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fractured file #10 in the canal was 96.7% and 63.3%, 76.7%, 73.1%, 67.6%, 70%, for CBCT, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography in detection of a fracture file #35 in the canal was 93.3%, 96.7%, 96.6%, 93.5% and 95%, and 36.7%, 76.7%, 61.1%, 54.8%, 56.66%, for CBCT, respectively. Conclusion: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of digital periapical radiography was better than the CBCT technique in both sizes of broken files.

Evaluating the Accuracy of Two Microleakage Assessment Methods for Mineral Trioxide Aggregate and Calcium-enriched Mixture Cement.

INTRODUCTION: Multiple methods for evaluating microleakage have been introduced over the years, but there has been no agreement as to which technique will give more accurate results. The aim of this study was to compare the accuracy and results of fluid filtration and marginal adaptation methods for mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement apical plugs. METHODS AND MATERIALS: A total of 250 single-rooted human teeth were collected. The teeth were decoronated, the root canals were prepared and open apex condition was stimulated by passing #1 to 4 Peeso Reamer drills from apical foramen. Five teeth were selected as the positive and negative controls and the rest of the samples were randomly allocated to two groups of MTA and CEM cement plugs. In each group, apical plug was placed into the canal. After the apical plugs were completely set, microleakage and marginal adaptation of the samples were evaluated using fluid filtration method and scanning electron microscopy (SEM), respectively. The obtained results were analyzed by independent-samples t test. RESULTS: Gap between plug and dentin walls and air bubbles displacement was higher in MTA group compared to the CEM cement group, though this difference between MTA group and CEM cement group was not statistically significant. Conclusion: According to the obtained results, it seems that there is a direct relationship between the two methods of microleakage assessment.

Comparison of Marginal Adaptation of MTA and CEM Cement Apical Plugs in Three Different Media.

INTRODUCTION: The aim of this study was to compare the marginal adaptation of mineral trioxide aggregate (MTA) and calcium-enriched mixture(CEM) cement apical plugs in open apex teeth in dry, blood- and saliva-contaminated canals. METHODS AND MATERIALS: A total of 120 human extracted single-rooted teeth were used. The teeth were decoronated and canals were cleaned and shaped up to #80 K-Files. After simulating open apex condition, samples were randomly divided into two groups (Group 1: MTA plug and group 2 CEM cement plug) and each group was then further divided into 3 subgroups (dry canal, blood- and saliva-contaminated canals). MTA and CEM cement apical plugs were placed into the canal. After full setting of apical plug, immediate marginal adaptation of the samples was assessed by electronic microscope. The data were analyzed using the two-way analysis of variance. RESULTS: There was no statistically difference between the average marginal gap in MTA and CEM cement groups in three different conditions. The average gap in dry canal was significantly lower than canal contaminated with blood and saliva. CONCLUSION: It seems that marginal adaptations of MTA and CEM apical plug was not significantly different in various conditions and the two materials can be used successfully in this method.

Comparison of Microleakage of MTA and CEM Cement Apical Plugs in Three Different Media.

INTRODUCTION: Microleakage is of the causes of endodontic treatment failure. The aim of this in vitro study, was to compare the microleakage of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement apical plugs in three environments. METHODS AND MATERIALS: A total of 130 human extracted single rooted teeth were collected. After decoronation, preparation of the root canal space and simulation of open apices, 5 teeth were selected as positive and negative control groups and the rest of the samples were randomly divided into two groups (MTA plug and CEM cement plug) and each group was divided into 3 subgroups (dry, contaminated with saliva and contaminated with blood). In each group apical plug was placed into the canal. After full setting of the apical plug, microleakage of the samples were evaluated using fluid filtration method and the data were analyzed using two-way analysis of variance. RESULTS: In dry and saliva contaminated environments, the leakage of MTA samples were 40.906±2.081 and 39.608±2.081, respectively which was significantly more than that of CEM cement samples (26.977±2.081 and 27.000±2.081, respectively). However, in blood-contaminated environments, the amount of leakage in MTA group (21.640±2.081) was significantly lower than CEM cement group (44.358±2.081). CONCLUSION: According to the results of this study, in dry and saliva-contaminated conditions CEM cement provides significantly better seal in comparison to MTA.

Antimicrobial Activity of Calcium Hydroxide and Betamethasone on Enterococcus faecalis; An in vitro Assessment.

INTRODUCTION: Calcium hydroxide (CH) is one of the most common intracanal medications. Corticosteroids (CS) are used in endodontics because of their anti-inflammatory activity. This study aimed to evaluate the antimicrobial effect of CH+betamethasone and CH+saline against Enterococcus faecalis (E. faecalis) using agar diffusion test and measuring the microbial zone of inhibition (ZOI). METHODS AND MATERIALS: Four plates containing Mueller-Hinton broth and E. faecalis culture media, were prepared. In each plate, 5 holes (5×3 mm) were created and a creamy mixture of CH+betamethasone was inserted into the holes (10 holes for each material). Two holes with ampicillin disks and two empty holes were used as negative and positive controls, respectively. Plates were incubated for 24 h and then the diameter of microbial ZOI was measured. The pH of each mixture was measured by pH meter. Data were analyzed using the Mann-Whitney U test. RESULTS: The mean diameter of ZOI for CH+betamethasone and CH+saline was 3.4 and 3 mm, respectively. The difference was not significant (P=0.143). The pH was 12.5 for CH+saline and 12.3 CH+betamethasone, respectively. CONCLUSION: The mixture of CH+betamethasone had good antimicrobial effects against E. faecalis. Further studies are needed to confirm the value of this mixture in clinical settings.

Sealing ability of mineral trioxide aggregate and calcium-enriched mixture cement as apical barriers with different obturation techniques.

INTRODUCTION: Endodontic treatment in pulpless immature teeth is challenging due to the lack of an apical stop. Insertion of an apical plug is an alternative to conventional long-term apexification with calcium hydroxide. The aim of this study was to compare the apical microleakage of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as apical plugs with three different obturation techniques. METHODS AND MATERIALS: This experimental study was conducted on 130 single rooted human teeth with one canal. Samples were randomly divided into 2 experimental groups (n=60) and two negative and positive control groups containing 5 samples each. After cleaning and shaping, an open apex configuration was prepared in all samples. MTA or CEM cement apical plugs with 5 mm thicknesses were placed. Then, each group was divided to 4 subgroups and the remaining space of root canals were filled with either lateral compaction or thermoplasticized injectable gutta-percha or was obturated by filling the entire canal with apical plug material. In one remaining subgroup the canal space was left unfilled. Microleakage was measured by the fluid filtration method and results were analyzed by means of the two-way ANOVA test. RESULTS: There were no significant differences between microleakage of MTA and CEM cement apical plugs (P=0.92). The difference between three obturation methods was not significant, either (P=0.39). CONCLUSION: MTA and CEM cement have similar sealing ability as apical plugs and no significant difference was found in microleakage of the three groups.

Computer and Internet use among Undergraduate Medical Students in Iran.

OBJECTIVE: Although computer technologies are now widely used in medicine, little is known about its use among medical students in Iran. The aim of this study was to determine the competence and access to computer and internet among the medical students. METHODS: In this descriptive study, medical students of Shahid Sadoughi University of Medical Science, Yazd, Iran from the fifth years were asked to answer a questionnaire during a time-tabled lecture slot. The chi-square test was used to compare the frequency of computer and internet use between the two genders, and the level of statistical significance for all test was set at 0.05. RESULTS: All the students have a personal computer and internet access. There were no statistically significant differences between men and women for the computer and internet access, use wireless device to access internet, having laptop and e-mail address and the difficulties encountered using internet. The main reason for less utilization of internet was slow speed of data transfer. CONCLUSIONS: Because of the wide range of computer skills and internet information among medical students in our institution, a single computer and internet course for all students would not be useful nor would it be accepted.

The position of lingula as an index for inferior alveolar nerve block injection in 7-11-year-old children.

BACKGROUND AND AIMS: Inferior alveolar nerve block injection is one of the common intra oral anesthetic techniques, with a failure rate of 15-20%. The aim of this study was to evaluate the position of the lingula as an index for this injection. MATERIALS AND METHODS: Thirty eight panoramic radiographs of 7-11 year old patients were analyzed and the distance between the lingula index and occlusal plane was measured. Then, lower alveolar nerve block injection was performed on 88 children. Finally, a visual analogue scale was used to measure the rate of pain in the patients. RESULTS: This distance increased with age and in children younger than nine years is -0.45 mm on the right side and -0.95 mm on the left side. This distance in children older than 9 years is -0.23 mm on the right side and 0.47 mm on the left side. The success rates of inferior alveolar nerve block injection based on lingual index were 49% on the right side and 53.8% on the left side. CONCLUSION: As the lingual index has various positions and its distance from the occlusal plane increases with age, it is not an appropriate landmark for inferior alveolar nerve block injection.

Comparing the Disinfecting Efficacies of Micro 10, Deconex, Alprocid and Microzid AF on the Microorganisms on Radiographic Equipments.

BACKGROUND AND AIMS: The exposure and processing of dental radiographs are not routinely associated with the spatter of blood or saliva; however, infection control is still an issue resulting from contaminated equipment, supplies, film packets or cassettes. This study aimed at comparing the efficacy of four commercially available disinfectants on microorganisms present on the equipment of radiology department. MATERIALS AND METHODS: Samples from twelve sites of the radiology department were collected using a sterile swab smeared with normal saline, which was then dipped in a test tube. Experimental surfaces were then disinfected by the spray-wipe-spray method using one of Micro 10, Deconex, Alprocid or Microzid AF disinfectants, followed by resampling. The samples were subsequently cultured on blood agar and EMB plates and the colonies were counted. Isolates were identified by biochemical tests. For statistical analysis, Wilcoxon signed ranks test, Kruskal-Wallis, Chi-square and Fisher exact tests were used. RESULTS: Staphylococcus aureus and coagulase-negative staphylococci had the highest and Lactobacillus spp. had the lowest prevalence before disinfection. There were significant differences between the cfu/mL of bacteria before and after disinfection with any of the four disinfectant solutions. There was a significant difference between efficacy of Deconex and Alprocid (P = 0.014), Deconex and Microzid AF (P = 0.001), and Deconex and Micro 10 (P = 0.001). CONCLUSION: According to the results, Deconex has the highest disinfectant efficacy compared to other solutions.