A Comparative Evaluation of fibrin density with Chitosan, Papain and 17% EDTA-Normal saline combination as irrigants in teeth with open apices: An ex vivo SEM study.

Context: In regenerative endodontic techniques, a blood clot acts as a natural scaffold for revitalizing dental pulp tissue. Although 17% ethylene diamine tetra acetic acid (EDTA) releases growth factors from the dentin matrix and induces odontoblast differentiation, it has anticoagulant property. Aims: The aim of the study is to evaluate the ability of alternatives (0.2% chitosan and papain) in fibrin formation when used as root canal irrigants during regenerative endodontic procedures in teeth with open apices. Also investigated whether 0.2% chitosan and papain solutions can be used as alternatives to 17% EDTA-normal saline solution (EDTA-NSS) combination, as root canal irrigants during regenerative endodontic procedures in teeth with open apices. Subjects and Methods: Twenty-five human freshly extracted single-rooted mandibular premolars were taken. They were then divided into five groups and irrigated accordingly. Human donor blood samples were collected and placed in the specimens and fibrin density was evaluated using scanning electron microscopy. Comparison of fibers per 10 µm among 5 experimental groups at each level was performed using one-way analysis of variance test. Results: Results revealed that the specimens irrigated with EDTA-NSS followed by papain had an increased fibrin density when compared with chitosan. Conclusions: All the root canal irrigants that were used in this study as part of treatment protocol for open apex exhibited positive results.

Understanding client engagement in digital mental health interventions: An investigation of the eTherapy Attitudes and Process Questionnaire.

AIMS: Digital mental health services may increase the accessibility and affordability of mental health treatments. However, client dropout a low use is often reported. The purpose of the current study was to investigate the structural validity of the e-Therapy Attitudes and Process (eTAP) questionnaire, as a theoretically based (theory of planned behavior) tool for understanding ongoing client engagement intentions with digital mental health treatments. The possible role of eHealth literacy in predicting behavioral intentions to use digital mental health treatments was also examined. METHODS: Participants were 244 Australian-based adults aged between 18 and 56 years, who were currently using a digital mental health tool. Data were collected via online survey. RESULTS: Confirmatory Factor Analysis was conducted, with good model fit obtained following two theoretically supported modifications. Moderated hierarchical regression supported the utility of the theory of planned behavior in predicting behavioral intentions, with attitudes emerging as a strong and consistent individual predictor. No support was found for the moderating role or individual significance of eHealth literacy. CONCLUSIONS: These findings support the clinical and research use of the eTAP as a theory-based measure to understand client engagement in digital mental health interventions. The study also highlights the need for interventions to target attitudes to improve clients' ongoing engagement in digital mental health.

A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders

Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality. (AU)

Cada vez más la investigación demuestra las ventajas terapéuticas de las intervenciones mediante realidad virtual en distintos estados de salud mental, aunque esta investigación raramente se traslada a la aplicación en el contexto clínico. Esta revisión sistemática pretende analizar la eficacia de las intervenciones actuales de realidad virtual en trastornos emocionales, centrándose en las características clínicas y tecnológicas que afectan a la transferencia de los tratamientos desde la investigación hasta la práctica clínica. Se llevó a cabo una amplia búsqueda bibliográfica sistemática de acuerdo con las directrices PRISMA para estudios que abarcan la aplicación de la intervención mediante realidad virtual a población clínica adulta con trastornos emocionales. Se consideraron elegibles 37 estudios, que fueron valorados y revisados para descartar sesgos. Los efectos de los tratamientos eran normalmente grandes, siendo considerada la realidad virtual como una modalidad de tratamiento eficaz para diversos trastornos de ansiedad y el de estrés postraumático. Las intervenciones de realidad virtual normalmente se han utilizado para la exposición en los enfoques de terapia cognitivo-conductual. Se observó una considerable variabilidad en coste, especificaciones tecnológicas, grado de implicación del terapeuta, formato de presentación, dosificación, duración y frecuencia del tratamiento. En algunos estudios se observó que el rigor metodológico estaba por debajo de los niveles óptimos. (AU)

A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders.

Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality.

Cada vez más la investigación demuestra las ventajas terapéuticas de las intervenciones mediante realidad virtual en distintos estados de salud mental, aunque esta investigación raramente se traslada a la aplicación en el contexto clínico. Esta revisión sistemática pretende analizar la eficacia de las intervenciones actuales de realidad virtual en trastornos emocionales, centrándose en las características clínicas y tecnológicas que afectan a la transferencia de los tratamientos desde la investigación hasta la práctica clínica. Se llevó a cabo una amplia búsqueda bibliográfica sistemática de acuerdo con las directrices PRISMA para estudios que abarcan la aplicación de la intervención mediante realidad virtual a población clínica adulta con trastornos emocionales. Se consideraron elegibles 37 estudios, que fueron valorados y revisados para descartar sesgos. Los efectos de los tratamientos eran normalmente grandes, siendo considerada la realidad virtual como una modalidad de tratamiento eficaz para diversos trastornos de ansiedad y el de estrés postraumático. Las intervenciones de realidad virtual normalmente se han utilizado para la exposición en los enfoques de terapia cognitivo-conductual. Se observó una considerable variabilidad en coste, especificaciones tecnológicas, grado de implicación del terapeuta, formato de presentación, dosificación, duración y frecuencia del tratamiento. En algunos estudios se observó que el rigor metodológico estaba por debajo de los niveles óptimos. La utilización remota de realidad virtual no era frecuente a pesar de las posibilidades que ofrece para usarse en casa. Las intervenciones de realidad virtual tienen el potencial de superar barreras en los cuidados y cubrir mejor las necesidades de los consumidores. La investigación futura debería analizar la eficacia de la realidad virtual para tratar los trastornos depresivos y el desorden obsesivo compulsivo. Mejorar los informes metodológicos y el desarrollo de las intervenciones mediante realidad virtual transdiagnósticas y practicadas a distancia podría facilitar la transferencia de esta modalidad de tratamiento.

Organizational and Policy Barriers to the Use of Digital Mental Health by Mental Health Professionals.

Background: Digital mental health (DMH) provides effective methods of overcoming issues of time constraints, accessibility, and availability of mental health care. They can provide a valuable means to deliver mental health care in the present pandemic. However, adoption of these methods has been slow. Mental health professional (MHP) concerns at the organizational and policy level that influence this slow adoption need to be examined. Materials and Methods: A narrative review was conducted to identify the barriers. Searches using the databases Scopus, Embase, and PubMed were conducted to identify research focused on barriers reported by MHPs to use DMH. Results: The search resulted in 356 unique citations, and 21 papers met the inclusion and exclusion criteria. Forward and backward sampling resulted in identifying an additional 19 relevant papers. Discussion: Unmet needs for information, training, and infrastructure, challenges to the workflow and excessive workloads, and ambiguous policies serve as barriers to DMH use. This article recommends strategies for researchers, organizations, DMH designers, and governmental institutions to ensure efficient utilization of DMH. Conclusions: Concerted efforts at individual, organizational, and governmental levels are essential to ensure efficient utilization of DMH.

Evaluation of Frictional Forces Generated between Three Different Ligation Methods with Four Different Sizes of Orthodontic Archwires: An In vitro Study.

AIM: This in vitro study was done to evaluate and compare the frictional forces produced by a passive self-ligating bracket (SLB) and two types of elastomeric ligatures (unconventional elastomeric ligatures [UELs] and conventional elastomeric ligatures [CELs]) on a conventional bracket used with four types of wires. MATERIALS: In this in vitro study, 8 numbers of conventional preadjusted edgewise appliance stainless steel brackets and 4 numbers of passive SLBs were tested. Four types of archwires and two types of ligatures were tested. Brackets were divided into three groups - Group I, Group II, and Group III. All the three groups were further divided into four subgroups based on different archwires. METHODS: Custom-made mounting jig was specially constructed for this study - upper member and lower member. After the samples were mounted, traction test was conducted using universal testing machine and readings were tabulated for all specimens. The variables in each group were subjected to one-way analysis of variance. RESULTS: All the three groups were tested for its total friction, static friction, and kinetic friction. SLBs showed a static mean little lower and had kinetic mean little greater than conventional bracket with unconventional module. CONCLUSION: UELs on conventional brackets and SLBs are able to produce lower frictional force when compared with CELs on conventional brackets.

Musculoskeletal Disorders and Mental Health-related Issues as Occupational Hazards among Dental Practitioners in Salem City: A Cross-sectional Study.

BACKGROUND: Like in any other profession, dental surgeons are also afflicted by many occupational health hazards such as Musculoskeletal disorders (MSD) and mental health related issues. AIMS: To assess the distribution of MSD and mental health related issues amidst dentists in Salem City according to age, sex and number of working hours per week. OBJECTIVES: A survey was organized to check the rate of occurrence of these occupational health hazards among dental practitioners in Salem city. MATERIALS AND METHODS: The study was conducted among one hundred and fifty dentists practicing in Salem City in the form of questionnaire. Dentists were asked about any occupational disease that they suffered related to a musculo-skeletal pain and its location whether in the back, upper limbs or lower limbs. In addition to this, dentists were asked about mental stress that they had experienced. RESULTS: MSD showed higher rate of prevalence compared to mental health related issues. CONCLUSION: The application of preventive measures is necessary, in view of the high rate of these disorders in the society of dental practitioners.

Erosion Infiltration Technique': A Novel Alternative for Masking Enamel White Spot Lesion.

Enamel White spot lesions are early signs of demineralization under the intact enamel, which may or may not lead to the development of caries. An inactive white spot lesion might act as an arrested dental caries and impair the esthetic appearance by displaying a milky white color from its interior opacity. The first choice of treatment is remineralization with various remineralizing agents such as fluoride and ACP-CCP. Caries infiltration is a less invasive and effective method for arresting the white spot lesions. It also improves the esthetics by masking the chalky white appearance by the process of optical adaptation to the adjacent healthy enamel. This is achieved by the hydrophobic resin, which has a similar refractive index to that of the healthy enamel.