A simple technical innovation to prevent needle stick injuries among dental professionals.

OBJECTIVE: Dental healthcare personnel face the potential danger of being exposed to infectious patients while administering local anesthesia injections during dental operations. This could lead to unintentional transfer of infectious diseases from patients to physicians. Although safety measures such as the One-hand-scoop technique and the use of safety syringes, plastic needle cap holders, and needles with safety caps are in place, there have been instances of needle stick injuries reported in clinics. This might be due to the lack of adherence to conventional safety measures or the impracticality of safety techniques and safety syringes. This article aims to demonstrate the utilization of dental tweezers, specifically London College tweezers or dental forceps, for the secure recapping of needles, eliminating the requirement for extra equipment or devices. SUBJECTS AND METHODS: After obtaining ethical approval (Approval No.: 024-01-2024) from the College of Dentistry, Dar Al Uloom University, 67 dental professionals, with consent for participation in the study, were included. They were requested to use dental tweezers/London College tweezers and dental extraction forceps such as maxillary anterior, mandibular anterior, and maxillary bayonet root forceps individually to recap the local anesthetic needles. The efficacy of these techniques was evaluated against the one-hand scoop technique for its ease, convenience, and reliability in preventing needle stick injuries. RESULTS: The evaluation of dental professionals regarding the ease of using dental tweezers to recap needles, compared to the one-hand scoop technique (p=0.592), maxillary bayonet root forceps (p=0.746), mandibular anterior forceps (p=0.380), and maxillary anterior forceps (p=0.808), did not yield statistically significant results. The assessment of the procedural simplicity of the one-hand scoop technique showed a satisfaction rate of over 40%, whereas the application of dental tweezers resulted in a satisfaction rate of 30%. However, the use of dental tweezers for needle recapping resulted in a satisfaction rate of over 50%, compared to a satisfaction rate of 30% for the one-handed scoop technique. CONCLUSIONS: There is no statistically significant difference in the assessment of the efficacy of dental tweezers and the one-hand scoop technique, bayonet root forceps, mandibular anterior forceps, maxillary anterior forceps, and dental tweezers for the needle capping technique. Therefore, dental forceps can be used instead of the one-handed scoop approach. The needle recapping procedure outlined in our study, aimed at preventing needle stick injuries, is simple to implement, and all dental specialties have convenient access to the required instruments.

Use of photosensitizers activated by photodynamic therapy on the canal disinfection of radicular dentin bonded to Dimethacrylate-based glass fiber post: an assessment of pushout bond strength.

OBJECTIVE: The present lab-based investigation aimed at evaluating the canal disinfectants using photodynamic therapy (PDT) using different photosensitizers, conventional NaOCl, a mixture of doxycycline, citric acid, and a detergent (MTAD) and their impact on the bond strength of glass fiber post to radicular dentin. MATERIALS AND METHODS: Forty extracted human premolars were gathered and disinfected. The decoration was performed up to the cementoenamel junction. Using the crown down technique cleaning of the canal was done following rinse with distilled water. All canals were dried with paper points and obturated with gutta-percha. Post space was prepared using peso reamers and samples were randomly allocated into four groups following different disinfection regimes: Group 1 - Methylene blue photosensitizer (MBP) + MTAD; Group 2 - RBP (Rose Bengal photosensitizer) + MTAD; Group 3 - CP (curcumin photosensitizer) + MTAD and Group 4 - 2.25% NaOCl + MTAD (control). Following disinfection, the canals were dried and the post was placed and cemented within the canal. Samples were dissected at coronal, middle, and apical third and placed in a universal testing machine for push-out bond strength (PBS). Debonded surfaces were evaluated for failure modes. PBS was examined using a one-way analysis of variance (ANOVA). The means of PBS were compared using Tukey multiple comparison tests with a significance threshold of (p<0.05). RESULTS: Group 3 canals disinfected with CP and MTAD had the highest PBS at two levels: cervical (9.57±1.21 MPa), middle (6.37±0.79 MPa), and group 2 canal space disinfected by RBP and MTAD had the maximum PBS in apical portion (5.35±0.42 MPa). No significant difference at all root levels between group 2 (RBP + MTAD) and group 3 (p>0.05). Canal irrigation with group 1 (MBP + MTAD) and group 4 control (2.25% NaOCl + MTAD) exhibited comparable PBS at all three levels of the root. CONCLUSIONS: CP, MTAD, RBP and MTAD for canal disinfection and bonding of glass fiber post to radicular dentin demonstrated comparable bond values at all three root levels and can be recommended in clinical settings after further investigations.

Biomechanical planning for minimally invasive indirect restorations.

This paper explores the planning and execution of indirect partial-coverage restorations and will outline practical recommendations for maximising the outcomes for minimally invasive (MI) approaches to indirect restorations, with a special focus on vital teeth, endodontically-treated teeth and worn dentitions. Throughout the paper, the supporting evidence for each rationale for partial-coverage restorations will be considered, as well as the risks and benefits of adopting an MI approach to indirect restorations.

Antibacterial Efficacy of Muringa Seed Extract and Potato Peel Extract Against Enterococcus faecalis.

BACKGROUND: Elimination of infection and prevention of reinfection should be the main goal in the treatment of apical periodontitis. The most challenging part of endodontics is the complete disinfection of root canal system. Herbal alternatives have emerged as the more biofriendly approach in root canal irrigation and disinfection. AIM AND OBJECTIVE: The aim of this study was to evaluate the antimicrobial efficacy of natural extracts like muringa seed and potato peel extract against Enterococcus faecalis. MATERIALS AND METHODS: The antimicrobial activity was determined using agar diffusion test. The solutions were divided into three groups: Group I- Muringa seed extract, Group II- potato peel extract, and Group III-5.25% sodium hypochlorite. The zones of inhibition of growth were recorded. The strain used for this study was Enterococcus faecalis ATCC 29212. RESULTS AND CONCLUSION: Muringa seed extract (Group I) demonstrated the best result among the tested solutions. Although there was no significant difference between potato peel extract (Group II) and 5.25% sodium hypochlorite (Group III). Within the limitations of this study, herbal extracts tested has shown significant antimicrobial action against Enterococcus faecalis.

Antimicrobial Efficacy of Different Natural Extracts Against Persistent Root Canal Pathogens: An In vitro Study.

INTRODUCTION: The spread of drug-resistant pathogens is one of the most serious threats to successful treatment of microbial diseases. Extracts of plants such as flowers, buds, seeds, leaves, twigs, bark, herbs, wood, fruits, and roots have evoked interest as sources of natural products. Irrigation with a broad-spectrum antiseptic substance and inter-appointment intracanal medication has become a standard regimen in root canal therapy. AIM: The aim of this study is to compare the antimicrobial efficacy of different natural extracts such as guava leaf extract, Aloe vera extract, papaya leaf extract, and cashew apple extract against Enterococcus faecalis and Candida albicans. MATERIALS AND METHODS: The antimicrobial activity was determined using agar diffusion test. The solutions were divided into four groups: Group I - guava leaf extract, Group II - A. vera extract, and Group III - papaya leaf extract, and Group IV - cashew apple extract. The zones of inhibition of growth were recorded. The strains used for this study were E. faecalis ATCC 29212 and C. albicans ATCC 90028. RESULTS AND CONCLUSION: Sodium hypochlorite had demonstrated the best results among the tested solutions. Among the herbal extracts, cashew apple extract and guava leaf extract had shown statistically significant activity against E. faecalis and C. albicans.

Apical Extrusion of Intracanal Bacteria following use of Two Engine-driven Instrumentation Techniques: An in vitro Study.

AIM: The aim of the present study was to compare in vitro the amount of debris extruded apically from extracted teeth, using Twisted files and ProTaper rotary during two different instrumentation systems. MATERIALS AND METHODS: Forty-five human single-rooted mandibular premolar teeth were randomly divided into three groups and contaminated with Enterococcus faecalis. The teeth in experimental groups were instrumented until reaching the working length with ProTaper rotary instruments and Twisted files with XSmart and XSmart Dual groups. Debris extruded from the apical foramen was collected into glass vials and the amount of bacteria was calculated. The data obtained were analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests, with p = 0.05 as the level for statistical significance. RESULTS: The XSmart Dual group extruded comparatively lesser bacteria compared to the XSmart group. Lesser amount of bacterial extrusion was seen when Twisted files were used compared to the ProTaper files (p < 0.05). CONCLUSION: Under the circumstances of this in vitro study, it can be concluded that all instrumentation techniques produced measurable apical extrusion of debris. So, it is upon the practitioner to decide which system best fits their individual needs and their level of skill and experience that will provide the best possible endodontic care for our patients. CLINICAL SIGNIFICANCE: The newer instrument designs, including noncutting tips, different cross sections, radial lands, and variable tapers, are better for the clinicians to improve working safety, to reduce the working time, and to create a greater flare within the preparations.

Oral manifestation in mentally challenged children.

BACKGROUND: In general, mentally challenged children have higher rates poor oral hygiene, gingivitis and periodontitis than the general population. An investigation was undertaken to assess the oral manifestations of mentally challenged children in Chennai, India. MATERIALS AND METHODS: The study group consisted of 150 children (70 Down syndrome patients and 80 cerebral palsy patients). Of which, 93 patients were males and 57 were females. RESULTS: Speech difficulty hindered the communication between the patient and the dentist. Mastication and swallowing difficulties were also present in few children. Profuse salivation was a cause for drooling of saliva down the cheeks, which was a constant finding in cerebral palsy children. The oral hygiene statuses of the patient were significantly poor. The prevalence of periodontitis was 35.7% in Down syndrome and 55.0% in cerebral palsy patients. Whereas, the prevalence of gingivitis was found to be 92.9% and 61.3% respectively. The prevalence of fractured maxillary anterior teeth was found to be more evident in cerebral palsy patients (62.9%) when compared to Down syndrome patients (0.0%). An increase in age shows an increase in the decayed-missing-filled teeth which is statistically significant. CONCLUSION: The prominent findings like flat nasal bridge (94.3%), hypertelorism (92.9%), high arched palate (78.6%) and fissured tongue (78.6%) in our study, suggest that they could be used as a reliable clinical markers to diagnose Down syndrome condition.