Implementation of minimal invasive gynaecological surgery certification will challenge gynaecologists with new legal and ethical issues.

The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient's safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence. The influence of such an educational and credentialing path could improve safety and offer financial benefits to the hospitals, physicians and healthcare authorities. Moreover the medicolegal consequences can be important when a significant amount of surgeons possess the different diplomas. As the programs are becoming universally accessible, recognised as the best scientific standard, included in the continuous medical education (CME) and continuous professional development (CPD), it is expected that a significant number of surgeons will soon accomplish the diploma path. The co-existence and practice of both non-certified and certified surgeons with different degrees of experience is unavoidable. However, it is expected that national health systems (NHS), hospitals and insurance companies will demand and hire doctors with high and specific proficiency to endoscopic surgery. When medico-legal cases are under investigation, the experts should be aware of the limitations that individual experience provides. The court first of all examines and then judges if there is negligence and decides accordingly. However, lack of certification may be considered as negligence by a surgeon operating a case that eventual faces litigation problems. Patients' safety and objective preoperative counselling are mandatory, directly connected to MIS certification while eliminating any dispute of surgeons' credibility.

Color changes of denture base materials after disinfection and sterilization immersion.

This study evaluated the effects of chemical disinfectants on the color of denture base materials. Materials tested included Paladon 65 (Kulzer, Friedrichdorf, Germany), Triad VLC (Dentsply Int, York, PA), and ProBase Cold (Ivoclar, Schaan, Liechtenstein). The disinfectants were Klinex (Lever Hellas, Athens, Greece), Cidex-7 (Johnson & Johnson, East Windsor, NJ), Hibitane (Imperial Chemical, Macclesfield, UK), and Cabadol (Detax Karl Huber, Ettlingen, Germany). Denture material samples were placed in the various disinfectants and evaluated for color changes (delta E*) at intervals of 10 minutes, 10 hours, and 7 days. Changes in color were measured using a tristimulus colorimeter on 10 samples for each denture material and disinfectant combination. It was concluded that if the recommended disinfecting times are followed, no observable color changes should be anticipated for the denture materials tested. Even the long-term (7-day) immersion caused observable color changes only with Cabadol, a phenol-based disinfectant, and ProBase and Triad denture materials.

Repairs with visible light-curing denture base materials.

Visible light-curing interpenetrating networks are newly developed materials suitable for several dental applications. These materials have several advantages, including versatility and good physicomechanical properties, but also present some weaknesses, such as increased water sorption and poor adhesion to plastic teeth. The suitability of a visible light-curing resin as a repair material, ie, its bending strength, was examined. Results were compared to those obtained with a self-curing acrylic resin. The visible light-curing resin led to repairs with lower strength.

Dimensional stability of dentures processed in boilable acrylic resins: a comparative study.

An investigation was conducted to evaluate and compare the dimensional stability of three fast boilable denture resins with a conventional and a high-impact denture resin processed with a long-curing cycle. Although the boilable denture resins have been introduced to the dental profession and offer merits such as faster processing, saving time for the dentist, patient, and technician, reduction of energy costs, and dramatic increase in denture laboratory production without adding personnel or purchasing new equipment, the relevant dental literature is sparse. The results of this investigation indicate that all five denture resins produced dentures that shrink. Also measurements between certain teeth showed shrinkages. Linear shrinkages of denture bases and teeth distances were less than 1%. Flange-to-flange and molar-to-molar changes were less than 0.5 mm and 0.2 mm respectively. Maxillary complete dentures processed in boilable resins presented less distortion in the midpalatal area across the posterior section than dentures processed in the conventional heat-cured resin. Although linear changes reported in this investigation were thought to be clinically insignificant, clinical studies should be conducted to establish correlation with laboratory findings.

Dimensional accuracy of duplicate dentures prepared by different methods.

The production of a duplicate denture demands a high degree of perfection to maintain dimensional accuracy of the duplicate denture. Duplicate dentures were made by four methods in order to investigate the dimensional accuracy in relation to a master denture. Replicas made from modeling wax (all-wax replica or acrylic resin base-wax teeth replica) demonstrated better dimensional accuracy compared with the all-acrylic resin replicas. It is well known that modeling wax used alone as a temporary denture base is an unsatisfactory material. The inherent shortcomings of the material may be overcome if dentists and patients make their assessment of the duplicate as quickly as possible in the mouth. The other alternative may be the production of a duplicate denture with an acrylic resin base and modeling wax teeth.