COVID-19 Reflections on Restorative Treatments of Permanent First Molars.

BACKGROUND AND AIM: It is important to provide appropriate dental care for newly erupted permanent first molars (PFMs) since they are susceptible to caries. As the coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in the way dental services are provided to patients, the purpose of this study is to examine the procedure records assigned to PFMs of 6-15 year-olds during the pandemic and analyze the restorative material preferences of the residents of public dental hospitals. MATERIALS AND METHODS: Procedure records of patients aged between 6-15 years were extracted from the Public Oral and Dental Health Center, Bursa, Türkiye. All teeth groups except PFMs were excluded, while extracted, survived (restorative/endodontic/prosthetic procedures), and prevented (fissure sealant application) PFMs were analyzed retrospectively. Furthermore, restorative material preferences were analyzed by arch location, cavity surfaces, and dentition types. RESULTS: Strong positive correlation was seen between age and PFM extraction (r=0.973; p<0.001) and age and PFM restorative treatments (r= 0.966; p<0.001); a negative correlation was detected between age and fissure sealants (r= -0.984; p<0,001) performed on PFMs of 8-15-year-olds. Amalgam was most often preferred as the restorative material (p<0.05). CONCLUSION: The distribution of treatments and dental restorations can vary based on many factors, and the pandemic conditions may have changed treatment preferences to favor preventive dentistry. The excess of multi-surface restorations may be related to the delay of treatment applications during COVID-19.

Flipped Classroom in Restorative Dentistry: A First Test Influenced by the Covid-19 Pandemic.

PURPOSE: This study compared the success of dental students with flipped classroom and traditional classroom learning in the restorative dentistry course for the first time at the Faculty of Dentistry of Reims during the 2019- 2020 academic year, influenced by the Covid-19 pandemic, and analysed the correlation with students' feelings. The use of an active learning method can improve success during final exams and increase the motivation of students. MATERIALS AND METHODS: The same teacher taught half of the restorative dentistry course in the flipped classroom approach and the other half as traditional classroom. For the flipped classroom, students were required to complete their homework online before the face-to-face sessions. An exam at the beginning and the end of the semester was conducted with questions about concepts learned with each learning method. Statistical analysis was performed using a t-test at the 0.05 significance level. A questionnaire on satisfaction was conducted to determine the students' opinion on this new learning method in the flipped classroom compared to the traditional classroom. RESULTS: The flipped classroom learning method enabled students to achieve better results on the final exam, with a statistically significant difference compared to traditional classroom learning. Student responses to the satisfaction questionnaire showed an increase in motivation and interest in the lessons and correspond to the increase in exam success. CONCLUSION: The use of the flipped classroom for lower cognitive-level activities is more appreciated by students and yields better results than knowledge acquisition in the traditional classroom.

Coronavirus disease (COVID-19) transmission through aerosols in restorative and endodontic practice: Strategies for prevention.

Rapid spread of coronavirus disease 2019 (COVID-19) in several countries of the world has created a state of public health emergency. COVID-19 is principally a respiratory disease, and the virus is present in respiratory secretions. Oral health-care professionals are susceptible to being infected with the disease since they work in close proximity to patient's face and oral cavity for long period of time. Restorative dentists and endodontists play a significant role in delivering "urgent" or "emergency" dental care to patients. Occupational Safety and Health Administration has categorized dentists performing aerosol-generating treatment procedures at "very high exposure risk" whereas the dentists not performing aerosol-generating procedures at "high exposure risk." Most of the restorative and endodontic treatment procedures involve generation of aerosols. Owing to the possibility of transmission of virus through aerosols, these procedures may transmit the disease to clinician or other patients. A comprehensive search of literature was conducted with the help of PubMed/MEDLINE and Scopus databases using a combination of terms, "COVID-19," "severe acute respiratory syndrome coronavirus 2," "aerosols," "restorative dentistry," and "endodontics." Along with universal precautions, some additional precautions need to be taken to prevent such transmission and cross-infection. This article reviews the research evidence about the role of aerosols in the transmission of COVID-19 and various measures which should be implemented during restorative and endodontic practice for the prevention of such transmission.

Résumé La propagation rapide de la maladie à coronavirus 2019 (COVID-19) dans plusieurs pays du monde a créé un état d'urgence de santé publique. Le COVID-19 est principalement une maladie respiratoire et le virus est présent dans les sécrétions respiratoires. Les professionnels de la santé bucco-dentaire sont susceptibles d'être infectés par la maladie, car ils travaillent à proximité du visage et de la cavité buccale du patient pendant une longue période. Les dentistes restaurateurs et les endodontistes jouent un rôle important dans la prestation de soins dentaires "urgents" ou "d'urgence" aux patients. L'Occupational Safety and Health Administration (OSHA) a classé les dentistes effectuant des procédures de traitement générant des aérosols à "Risque très élevé", tandis que les dentistes n'effectuant pas de procédures générant des aérosols à "Risque élevé d'exposition". La plupart des procédures de traitement de restauration et d'endodontie impliquent la génération d'aérosols. En raison de la possibilité de transmission du virus par les aérosols, ces procédures peuvent transmettre la maladie au clinicien ou à d'autres patients. Une recherche complète de la littérature a été menée à l'aide des bases de données PubMed/MEDLINE et Scopus en utilisant une combinaison de termes, "COVID-19", "SARS-CoV-2", "aérosols", "dentisterie restauratrice" et "endodontie". Outre les précautions universelles, certaines précautions supplémentaires doivent être prises pour prévenir une telle transmission et une infection croisée. Cet article passe en revue les preuves de la recherche sur le rôle des aérosols dans la transmission de COVID-19 et diverses mesures qui devraient être mises en œuvre lors de la pratique réparatrice et endodontique pour la prévention d'une telle transmission. Mots-clés: COVID-19, aérosols, dentisterie restauratrice, endodontie, évacuation à haut volume.

Challenges of oral radiography prescriptions during the COVID-19 outbreak in Shiraz, Iran

Background: Considering the severity of the COVID-19 outbreak and its rapid person-to-person transmission and the challenges it has brought about in dentistry, especially in intraoral radiography, following the established guidelines in prescribing radiographs is of great prominence. Objectives: We aimed to evaluate the necessity of prescribed intraoral radiographs and to estimate the number of unnecessary prescriptions during the COVID-19 pandemic. Methods: This cross-sectional study was conducted among 143 patients with a mean age of 29.36 ± 14.11 years who visited the Radiology Department of Shiraz Dental School during the peak of the COVID-19 outbreak. Information, including gender, age, systemic diseases, referring department, and type and urgency of radiography, was collected using a checklist. Chi-squared test and Fisher’s exact test were run to assess the relationships between variables. Results: Among all the patients referred to the Radiology Department, the endodontics and oral medicine departments accounted for the highest percentage of referrals. The relationship between the necessity of radiography prescriptions and dental departments was significant (P < 0.05). The lowest rate of unnecessary referrals was reported in the Department of Endodontics (13.3%), whereas the highest rate of unnecessary referrals was attributed to the aesthetic and restorative dentistry departments (73.3%). There was a significant association between dental department and the type of prescribed radiographs (extraoral/intraoral). The Orthodontics Department was the only department with more extraoral radiograph prescriptions than intraoral radiographs. One-third of the prescribed intraoral radiographs and half of the extraoral radiographs were unnecessary, with a significant difference during the pandemic (P = 0.019). Conclusions: Although there has been some success in the development of COVID-19 vaccines, this pandemic will not be easily eradicated. Therefore, it is crucial to follow the established guidelines and postpone unnecessary dental procedures to improve the safety of our community and the world in general. © 2021, Author(s).

Remote clinical consultations in restorative dentistry-A survey.

OBJECTIVES: To assess the patient experience of Remote Clinical Consultations (RCCs) for head and neck cancer and cleft lip and palate patients undergoing specialist restorative dentistry treatment in the context of a secondary care service. METHODS: An online survey was designed; all ninety three patients were invited to participate in its completion following a video or telephone remote clinical consultation with one restorative consultant in Addenbrooke's Hospital between August 2020 and April 2021. The video consultations were carried out via NHS England's Attend Anywhere platform. RESULTS: Sixty three responses were received. Over 70% of patients valued a video or telephone remote clinical consultation rather than an in-person attendance. Patients reported a good experience and would recommend a remote clinical consultation instead of an in-person attendance if no treatment would likely be required. Those who were less likely to recommend a remote clinical consultation were those who had difficulties logging-in to the remote platform or had technical issues. CONCLUSION: While a number of patients still would have preferred a face-to-face attendance, both telephone and video remote consultations were highly valued by patients, and the overall patient experience was that of acceptance. Benefits of remote consultations perceived by patients included having set time to discuss concerns and queries, becoming familiar with a clinician prior to any treatment, saving time, minimising travel and reducing expenses. Barriers to a positive experience included technical difficulties. This survey contributes to the evidence supporting remote clinical consultations as a practical way of delivering specialist consultations in restorative dentistry, it highlights this virtual process largely relates to the practicalities of service provision and highlights the use of remote consultations for specific appointments. CLINICAL SIGNIFICANCE: This study demonstrates patient feedback to a strategy implemented due to adaptations in working methods required as result of the Covid-19 pandemic. Patients were found to have a positive, accepting experience of both telephone and video remote clinical consultations. the study identifies a high patient acceptability and ability to overcome some of the disadvantages of an in-person attendance including saving time, travel and associated expenses while also contributing to a reduction in CO2 emissions and potentially improving clinical efficiency and capacity. These findings add to existing evidence and are indicative that remote consultations provide a practical way of delivering specialist communication in restorative dentistry as part of a unique patient pathway.

Stainless-steel crowns in children: Norwegian and Finnish dentists' knowledge, practice and challenges.

BACKGROUND: Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists. METHODS: The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists' perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents' background and their answers were evaluated. RESULTS: Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type. CONCLUSION: Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.

Traumatic Dental Injuries During the COVID-19 Pandemic.

This paper details the characteristics of traumatic dental injuries (TDIs) during the Coronavirus 2019 (COVID-19) pandemic in 2020 at an Urgent Dental Care hub at King's College Hospital Dental Institute, London, UK. For comparisons to be made, the characteristics of TDIs from a similar period in 2019 was also collected. Data was collected retrospectively from clinical records of patients suffering from dental trauma during both periods. An analysis was completed and conclusions drawn. The results suggest that the COVID-19 pandemic influenced the frequency, aetiology and type of TDIs. In order to suitably manage the provision of dental services, consideration must be given to the influence of pandemics on the characteristics of dental emergencies.