Knowledge, behavior and attitudes of dental practitioners towards photodynamic therapy use in dental practice.

BACKGROUND: The aim of the present study was to assess knowledge, behavior and attitudes of dental practitioners (DPs) towards photodynamic therapy (PDT) in dental clinical practice. METHODS: A cross-sectional study was performed and a 13-item survey questionnaire was given to DPs practicing in 13 different teaching hospitals in Karachi, Pakistan. Questions were aimed at exploring the knowledge of DPs regarding PDT and their attitude towards PDT and perceptions that may influence clinical practices. Chi-square and spearman coefficient were conducted to compare subgroups and correlate factors with the knowledge score of DPs. RESULTS: A total of 509 questionnaires were completed (response rate=82%). Median age of participants was 34 years and 70% were females. Most DPs demonstrated good knowledge related to PDT, and nearly 77%, 69% and 62% were aware of the mechanism of action and the role of photosensitizers in PDT respectively. It was reported that 74% of the respondents expressed that they are comfortable to know about PDT in detail for their clinical practice. A cumulative 54% disagreed that discussing the option for PDT with their patients was peripheral to their role as clinicians. A striking 82% would like to attend seminars and workshops on PDT. Significant difference was found among senior lecturers and assistant professors for the knowledge items (p <0.05). No statistical correlation was found between the knowledge items score of DPs and their behavior (r=0.18; p=0.762), attitude (r=0.04; p=0.594) and self-rated knowledge (r=0.42; p=0.854). CONCLUSION: Dental practitioners showed adequate knowledge regarding PDT and its use in dentistry. However, expertise with regards to handling and training is warranted so that DPs could use PDT in their dental practice.

MTA monoblock obturation technique in endodontic retreatment.

A 48-year-old male patient presented to the Department of Endodontics for evaluation of right first permanent molar, which had received non-surgical root canal treatment two years ago and was restored with core material. The presenting symptoms included swelling in the buccal vestibule and pain overnight. Clinical examination demonstrated that the mandibular right first molar was sensitive to percussion and also showed fluctuant swelling in the vestibule proximal to the molar and mild mobility. Radiographic examination revealed a poor quality obturation of the mesial and distal root, distal root resorption, extensive periapical and furcation radiolucency and bone loss. A diagnosis of acute periapical abscess of the mandibular right first molar was made. Tooth was treated non-surgically by the manual application of MTA in the root canal. Follow-up evaluation was performed at one year after the treatment. Clinically, treatment was considered successful due to the absence of clinical signs, symptoms and radiographic appearance with substantial reduction (more than 50%) in the diameter of the periapical radiolucency. Mineral trioxide aggregate monoblock obturation technique appears to be a valid technique to obtain periradicular healing in re-treatment of previously root canal treated teeth with periapical lesion.

Monoblock obturation technique for non-vital immature permanent maxillary incisors using mineral trioxide aggregate: results from case series.

Ten patients presented with non-vital immature teeth for root canal treatment. In all these cases the pre-operative clinical examination revealed apical periodontitis with a buccal sinus tract of endodontic origin. These cases were treated by a mineral trioxide aggregate (MTA) monoblock obturation technique. Follow-up evaluations were performed at 1 - 2 years after treatment. Eight out of 10 cases were associated with periradicular healing at follow-up evaluation. Mineral trioxide aggregate Monoblock obturation technique appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps.