COVID-19 outbreak: Should dental and medical practices consider uv-c technology to enhance disinfection on surfaces? - A systematic review.

AIMS: During the COVID-19 pandemic the search for complementary methods to enhance manual disinfection in dental and medical practices raised relevance. We sought evidence for the addition of ultraviolet-C (UV-C) disinfection to manual cleaning protocols -and whether it improves the logarithmic (log) reduction of surface pathogen colonies. METHODS: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD420200193961. Six electronic sources were consulted looking for clinical trials performed in healthcare environments in which pathogens were quantified by colony-forming unit (CFU)-enumeration before and after interventions, all databases were last consulted on May 2021. We assessed the risk of bias using an adapted Revised Cochrane Risk of Bias Tool (RoB 2). The certainty of the evidence was qualified according to the Classification of Recommendations, Evaluation, Development, and Evaluation (GRADE) approach. RESULTS: We identified 1012 records and 12 studies fulfilled the inclusion criteria. All included studies reported enhanced disinfection in the UV-C arm; most of them reported 1-log to 2-log reduction in approximately 10 to 25 min. Only three studies reached a 5-log and 6-log reduction. When manual cleaning was performed alone, only two studies reported a 1-log reduction using a chlorine-based disinfectant. We detected a high risk of bias in 1 study. Certainty of evidence was classified as moderate and low. CONCLUSIONS: The evidence points out the effectiveness of UV-C technology in reducing manual cleaning failures, enhancing the logarithmic reduction of surface pathogen colonies. However, the safety and success of these devices will depend on several physical and biological factors. A judicious project must precede their use in clinical and medical offices under the supervision of a physicist or other trained professional.

Thirty-six-month clinical evaluation of posterior high-viscosity bulk-fill resin composite restorations in a high caries incidence population: interim results of a randomized clinical trial.

OBJECTIVES: This study compared the clinical performance of two bulk-fill (BF) and one conventional resin composite in a population with a high caries incidence. MATERIALS AND METHODS: A total of 138 class I and II restorations were performed and randomly divided into three groups (n = 46) with equal allocation: Filtek BF (FBF; 3M ESPE), Tetric EvoCeram BF (TBF; Ivoclar Vivadent), and control Filtek Z250 (Z250; 3M ESPE). The evaluations were performed using the USPHS and FDI criteria at baseline and after 12 and 36 months by a previously calibrated evaluator. The Friedman and Wilcoxon tests for paired data were used for statistical analysis (α = 0.05). RESULTS: The DMFT index at baseline was 9.44, with 87% from the decayed component. After 36 months, 108 restorations (n = 36) were evaluated. Two failures were observed for TBF at marginal adaptation and recurrence of caries, resulting in a survival rate of 94.44% and an annual failure rate (AFR) of 1.26%. No equivalence was observed between the criteria for surface roughness, marginal adaptation, and discoloration. CONCLUSIONS: The 36-month clinical performance of high-viscosity BF resin composites was comparable to conventional incremental-filled resin composites. The FDI criteria better presented the restorations' clinical success. However, in the case of failure, both criteria provided the same result. CLINICAL RELEVANCE: High-viscosity bulk-fill resin composites showed excellent performance after 36 months in a high caries incidence population. It can be considered a simplified alternative restoration method that reduces operating time and minimizes possible operator errors.

Do Helmet Use and Type Influence Facial Trauma Occurrence and Severity in Motorcyclists? A Systematic Review and Meta-analysis.

PURPOSE: This article consists of a systematic review of the literature, which verified whether the use and types of helmets reduce the occurrence and severity of facial fractures in hospitalized motorcyclists after traffic accidents. MATERIALS AND METHODS: Prevalence studies and cohort studies, published in Latin American languages with no restrictions on publication dates, were considered. Two authors independently screened reference lists for eligible articles, assessed them for inclusion criteria, and extracted the data using a specific form. Twenty-six articles were selected, all prevalence studies. RESULTS: The patients who used a helmet had a lower prevalence and severity of facial fractures, compared to patients who did not wear a helmet. There were no differences in the occurrence of lower third fractures between patients who used or did not wear a helmet at the time of the trauma; as well as in meta-analysis of occurrence and severity of facial trauma between helmet types (open or closed). CONCLUSIONS: It can be concluded that the use of helmet leads to a lower number of fractures and severity of trauma when compared to nonuse. Regarding the type of helmet, there was no difference in the occurrence and severity of facial fracture in individuals who used closed or opened helmets.

Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis.

OBJECTIVES: The purpose of this systematic review was to compare the clinical performance of bulk-fill resin composites with conventional resin composites used for direct restorations of posterior teeth. METHODS: This review followed the PRISMA statement. This review was registered at PROSPERO (registration number CRD42016053436). A search of the scientific literature was performed by two independent reviewers using the PubMed/MEDLINE, Embase, The Cochrane Library, and Web of Science databases from commencement until January 2018. The research question was "Do bulk-fill resin composites have a clinical performance comparable to conventional resin composites in posterior restorations?" Only studies evaluating class I and II direct restorations in permanent teeth with a follow-up period of at least 1 year were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (restoration failure or success). RESULTS: Ten articles were selected, comprising 941 analyzed restorations. The mean follow-up period was 33.6 months (12-72 months). No statistically significant differences in the failure rate were observed between conventional and base/flowable bulk-fill resin composites (p = 0.31; RR 1.49; 95% CI 0.69-3.25) or full-body/sculptable bulk-fill resin composites (p = 0.12; RR 1.89; 95% CI 0.84-4.24). CONCLUSIONS: The present systematic review and meta-analysis indicate similar clinical performances of bulk-fill and conventional resin composites over a follow-up period of 12 to 72 months. CLINICAL SIGNIFICANCE: Based on the results of this study, the bulk-fill resin composites could be an alternative for direct restorations in posterior teeth. However, clinical trials of longer duration are required.

Endodontic Treatment of Complex Dens Invaginatus Teeth with Long Term Follow-Up Periods.

Dens invaginatus is characterized by invagination of enamel and dentin in the dental papilla prior to tissue calcification. This malformation commonly occurs in the maxillary lateral incisors. The present study reports two complex endodontic treatments in Oehlers' type II and III dens invaginatus, with periapical lesion and presence of bone resorption. In the reported cases, conventional endodontic therapy was successful and sufficient enough to eliminate the infectious process, allowing periapical bone neoformation and absence of symptomatology. Dens invaginatus is a relatively easy-to-diagnose dental malformation. However, it is necessary to know its radiographic aspects. The treatment results demonstrated that, although the cases of dens invaginatus of high complexity are challenging, an accurate diagnosis accompanied with proper endodontic treatment can avoid unnecessary surgical intervention and allow great chances of favorable prognosis in long term.