Knowledge, Attitudes, and Practices of Dental Students from Romania Regarding Self-Perceived Risk and Prevention of Infectious Diseases.

University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed a cross-sectional questionnaire-based study among dentistry students from Romania to assess self-perceived risk of infectious diseases and their KAP on topics related to infectious disease prevention. The surveyed students presented good knowledge regarding personal protective equipment (PPE), and their PPE practices significantly correlated with the perceived usefulness of PPE. Only 45.1% correctly recognized all vaccine-preventable diseases (VPDs), but knowledge regarding VPDs significantly improved with increasing year of study (τb = 0.298, p = 0.001), confirming a positive education effect. Awareness regarding the need for screening for bloodborne viruses is poor; the majority of students had never performed a test for hepatitis C virus infection (HCV) (59.4%) or for human immunodeficiency virus (HIV) infection (60.4%). Furthermore, most respondents incorrectly considered themselves at high or very high risk of acquiring BBV, and perceived risk was inversely correlated with willingness to treat patients with hepatitis B virus (HBV) infection (τb = -0.214, p = 0.018), HCV infection (τb = -0.234, p = 0.013), or HIV infection (τb = -0.242, p = 0.006). This led to 3.0% of respondents stating that they would hypothetically deny dental treatment to a patient with HBV infection, 5.0% for HCV infection, and 10.9% for HIV infection, the proportion being significantly higher for HIV (z = -2.2, p = 0.026). In conclusion, better knowledge is needed among dental students regarding their own vaccination history, screening for bloodborne viruses, accurate estimates for their risk of acquiring bloodborne viruses during routine dental practice, and the existence of post-exposure measures following occupational exposure. Improving student knowledge and awareness could translate into a higher willingness to treat patients with chronic viral infections and into a safer and more inclusive dental practice. We propose an adaptation to the university curriculum to cover these key areas for targeted focus to empower future dental practitioners and to facilitate the improvement of across-discipline metacompetences for infection prevention and control.

The Limitations of Periapical X-ray Assessment in Endodontic Diagnosis-A Systematic Review.

Diagnosis is a key aspect in endodontic treatment, in a decade where invasive interventions are misapprehended as social tendency instead of medical necessity. All diagnostic facets should be considered before intending the operative phase. Intraoral endodontic radiology-based diagnosis has been shown to be limited. Periapical X-ray is the most used endodontic imaging, yet it does not provide high accuracy. Traditionally, dentists have been trained to diagnose a cyst by certain aspects (size, shape and appearance); hence, an assumption that teeth are affected by "periapical cyst" were subjected to unnecessary extraction or apicoectomy. The aim of this systematic review is to critically appraise the publications that relate the histological diagnosis of a periapical lesion (considered the gold standard) to intraoral X-ray investigation. Ovid Medline, PubMed, ScienceDirect, Mendeley and Scopus were searched for English-language studies comparing periapical diagnosis obtained by using two techniques (histopathology and X-ray). Sixteen articles were included for the final analysis (qualitative and quantitative evaluation) out of which only two supported the statement that periapical diagnosis can be coherently assessed through periapical imaging. Although there is not enough evidence to deliver a definitive conclusion, there are many publications that refute the diagnosis of a cyst via periapical X-ray.

An application of microscopic investigation on extracted premolar with dyschromia, related to the components of endodontic sealer.

The aim of this study was an assessment of the overall optical characteristics changes in volume of the dentin, after the diffusion of the chemical components included in the sealer throughout the endodontic space, in order to demonstrate the discoloration effect of the endodontic sealer on tooth crown of a recently extracted maxillary premolar. Thin sections were studied using the polarized transmitted light microscopy and under a stereomicroscope, operating in transmitted light and reflected light. There were performed serial images of magnitude 40×. Each image was covered by a grid aimed for microscopic sections volumetric measurements. Therefore, all the serial images were merged and resulted a global image of the entire section surface. Thus, we have analyzed a total of three sections of the same tooth. Based on these sets of images, there were made estimations of the areas affected by colorations, determinations that can be extrapolated to total tooth areas, in terms of volumetric color change of dentin. The proportion of low coloristic infiltrated dentin was very close to the deeply impregnated dentin and the overall impregnated dentin covered half of the total dentin analyzed area.

An optical investigation of dentinal discoloration due to commonly endodontic sealers, using the transmitted light polarizing microscopy and spectrophotometry.

The aim of this study was to establish the degree of tooth crown staining by commonly used endodontic sealers. Crown discolorations by tooth canal sealers [AH Plus (Dentsply DeTrey Gmbh, Konstanz, Germany); Endofill (Produits Dentaires SA, Vevey, Switzerland); Apexit (Dentsply DeTrey Gmbh, Konstanz, Germany); and MTA Fillapex (Angelus, Londrina, Brazil)] were tested on extracted human premolars. The samples were divided into five groups of five samples each, after root canal sealing. Five teeth were used as control groups. The spectrophotometric method was performed in order to quantify in terms of color change of the coronal part (it was also recorded a track on how the color changes over time). For the microscopic study of the extracted dental specimens subjected to this study, polarized transmitted light microscopy was used. This method involves the development of special microscopic preparations, called "thin sections". In our case, the thin section was performed on 20 prepared and obturated recently extracted teeth. The degree of discoloration was determined after one week and three months using spectrophotometry and polarized light microscopy. All sealers usually cause some degree of discoloration on the cervical aspect of the crowns that increases in time. AH Plus and Endofill caused the greatest discoloration, followed by Apexit and MTA Fillapex.