COVID-19 outbreak in North Macedonia: an overview of its impact on dentistry.

Since the pandemic of the novel coronavirus - SARS-CoV-2 - has been declared and strict social measures have been introduced in the middle of March, including curfew, the dentistry had to adjust and find ways to better adapt itself to the new situation. This article provides a brief overview of the situation with COVID-19 in our country since the beginning of the pandemic, gives a reminder of what COVID-19 is, and which its modes of transmission are, and considers the ways of protection in dental offices considering that dentistry is one of the riskiest activities given the patient-dentist proximity and the use of specific high-speed handpieces. This review also provides an overview of the dental preventive measures taken worldwide, including in the field of Pediatric Dentistry, as well as an overview of dental patients' management, and gives possible best ways to care for healthy, sick or patients suspected for COVID-19. Finally, an extensive presentation of the way of work at the University Dental Clinical Center and the Faculty of Dental Medicine in Skopje, North Macedonia, over the last year is given, including protocols for admission of patients.

Effects of Addition of Quaternary Ammonium Antimicrobial Compounds into Root Canal Sealers.

OBJECTIVE: The aim of this study is to determine the effect of the addition of benzalkonium chloride and cetylpyridinium chloride in three commercial root canal sealers. MATERIALS AND METHODS: Three different root canal sealers were used: EndoRez, N2, and Apexit Plus. The samples were prepared by mixing the components according to the manufacturers' guidelines and adding 2% in weight of the antimicrobials to the newly mixed cement. The paste was placed in molds and stored in an incubator (37°C, 24 h). The samples were then stored in 5-mL distilled water. Samples without antimicrobials served as a control. All samples were tested at 3 time intervals: 1 day, 1 week, and 1 month following their storage in distilled water. The impact of the antimicrobials on the solubility of the sealers, the release of chloride ions (Cl-), and the pH value were examined. STATISTICAL ANALYSIS: Analysis was done using one-way analysis of variance and the post hoc Tukey's honestly significant difference test. RESULTS: Chloride ions are present in storage media with EndoRez, N2, and Apexit Plus samples (without antimicrobials) following all tested storage intervals. The addition of the antimicrobials increased the release of chloride ions. Endodontic cements without addition of antimicrobials show an increase in weight after 1 month. The highest pH value is measured in Apexit Plus samples. The solutions in which N2 samples (with and without addition of antimicrobials) were stored did not have a significant change in their pH, while in the EndoRez solutions, a significant decrease in the pH value after the first week was measured. CONCLUSIONS: The addition of antimicrobials might lead to improved characteristics of the root canal sealers.

The effect of antimicrobial additives on the properties of dental glass-ionomer cements: a review.

Aim: The aim of this article is to review the literature on the use of antimicrobial additives in glass-ionomer dental cements. Method: An electronic search between 1987 and the end of 2017 was performed using PubMed, Web of Science and Google search engines with the terms glass-ionomer, glass polyalkenoate, antibacterial and antimicrobial as the key words. The search was refined by excluding the majority of references concerned with cement antimicrobial properties only. Extra papers already known to the authors were added to those considered. Results: A total of 92 relevant articles have been cited in the review of which 55 are specifically concerned with the enhancement of antibacterial properties of glass-ionomers, both conventional and resin-modified, with additives. In addition, information is included on the uses of glass-ionomers and the biological properties of the antibacterial additives employed. There are several reports that show that additives are typically released by diffusion, and that a high proportion is usually left behind, trapped in the cement. Additives generally increase setting times of cements, and reduce mechanical properties. However, smaller amounts of additive have only slight effects and the longer-term durability of cements appears unaffected. Conclusion: Modified glass-ionomer cements seem to be acceptable for clinical use, especially in the Atraumatic Restorative Treatment (ART) technique.

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents.

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent.