kamyar khosravi

Endodontic therapy has been regarded as a safe treatment option with highly promising results in preserving natural teeth. Numerous factors may influence the longevity of endodontically treated teeth (ETT), thus altering their success/survival rate. Thisstudy aimed to determine the survival and success rates of endodontically treated premolars and molars with different complex restorative/prosthodontic treatments.

A total of 190 patients with an ETT were included, who had received final coronal restoration up to 14 days after the temporary one and at least one year prior to the enrollment. The investigator evaluated the quality of endodontic filling, coronal restoration, mobility, and proximal contacts. Data were analyzed with multiple binary logistic regression and the Chi-Square test.

The average duration of follow-up was 28.6±11.9 months. Overall, 89.4% (170/190) of the teeth survived. The overall success rate for the investigated teeth was 70.5% (134/190). Success rates of 100% for crown, 95.7% for post and core crown (PCC), and 94.7% for amalgam build-up with post were achieved. However, the success rates were 75%, 52.5%, and 50% for amalgam build-up, composite build-up, and PCC with crown lengthening, respectively. The Chi-square test revealed that there was a significant difference between the different restorations in terms of success (P<0.001). Multiple binary logistic regression models revealed that coronal leakage (P=0.048), obturation void (P=0.037), obturation length (P=0.020), mobility (P=0.002), type of the restoration (P<0.001), and proximal contact (P<0.001) were significant predictors for success. However, apicallucency, root length, marginal caries, tooth type, and post did not appear to be significant indicators of success (P>0.05).

ETT with minimal mobility, exhibiting underfilled obturations without visible voids, and having received crown/PCC/amalgam build-up with a post, along with the presence of both proximal contacts, tend to exhibit a significantly high success rate.

This study aimed to evaluate the efficacy of the orifice-level passive ultrasonic activation (OL-PUA) technique in removing debris from the mesial root canals of mandibular molars, besides comparing it with other approaches, including manual dynamic agitation (MDA), EndoActivator, and laser-activated irrigation (LAI).

Ninety mesial roots of mandibular molars were prepared up to 25.06 using the Race rotary system, filled with 3% sodium hypochlorite (NaOCl), and then they were randomly assigned to 5 groups (n = 15) based on the activation protocol: MDA, EndoActivator, OL-PUA, LAI (using a diode laser), and needle irrigation (no activation). Moreover, one group served as the negative control using normal saline as the final irrigant. The roots were decalcified and sectioned into coronal, middle, and apical cross-sections. After histological staining, the remaining debris was assessed with an optical microscope and measured in the canals and isthmuses using histomorphometric analysis. Statistical analyses were performed by using one-way ANOVA and Tukey’s HSD post hoc test (P = 0.05).

Although less residual debris was observed after OL-PUA/LAI than using the EndoActivator/MDA methods, no significant difference was found between the four activation techniques at any root third (P > 0.05). The OL-PUA/LAI group harbored significantly less remaining debris than the needle-irrigated samples at all root thirds (P < 0.05). Debris accumulation increased from the coronal to the apical root thirds.

No statistical difference was detected between the four activation techniques in terms of debris-removal performance, and none of them resulted in completely debris-free canals. Orifice-level PUA proved to be a promising approach with significant efficacy in removing debris compared to control groups.

Bedside teaching is a concentrated form of small-group teaching that takes place in the presence of the patient. Improvement in communication skills in a sympathetic manner with the patient and the ability to provide a purposeful history description and earning skills in clinical examinations is a goal that can only be achieved at the patient’s bedside. Bedside teaching has declined in recent years despite all its benefits; however, there are strong recommendations to continue this teaching modality for its valued benefits. In this context, we aimed to deal with the importance of bedside teaching and the challenges ahead in the covid epidemic as well as its alternatives for teaching medical students. 

Evidence acquisition: 

This study was conducted through a literature search on articles in English with the relevant keywords (((((((“students, medical”[Mesh]) AND (“COVID-19”[Mesh])) AND (“education”[Mesh])) AND (“patient-centered care”[Mesh])) AND (“patient care team”[Mesh])) OR (“teaching rounds”[Mesh])) OR (“education, distance”[Mesh])) AND (“Physical examination”[Mesh]) using PubMed, Scopus, Web of Sciences, Cochrane, and Embase databases from 2001 to 2022.

In our search, 22 related articles were found, 3 of which were clinical trials) and 4 were review articles. This study summarized the following important issues related to bedside teaching: 1- We discussed the definition, importance, benefits, and difficulties of bedside teaching on the way to education; 2- We deliberated the causes of reluctance to carry out education at the bedside and the ways to deal with the reduction of its implementation; 3-we also noticed alternative methods for medical education in periods of special contact restrictions with patients such as the COVID-19 epidemic in this review.

Bedside teaching has a fundamental role in medical education. In particular circumstances, such as covid 19 epidemy, in which the bedside teaching courses were suspended, it is necessary to allocate other educational arrangements and design a distance learning curriculum, including virtual teaching, uploading videos to view clinical procedures on social media platforms, interview with a virtual patient, and simulation.

The coronavirus disease 2019 (Covid-19) has become a public health emergency of worldwide concern. In addition to the serious impacts of this disease, it has caused numerous problems for dental treatments. Here, the findings on the first phase of the cohort study on reopening the School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran and its subordinate clinics during the COVID-19 pandemic were reported. Data were collected via a 100-item self-administered online questionnaire from June 2 to June 20, 2020. A total of 1,110 members from the academics, students, and personnel of the school participated in the study. The questionnaire included demographic data, socio-personal patterns, systemic conditions, COVID-19 infection information, and personal protective equipment (PPE). Since the outbreak of the pandemic, 87.4% of the professors, 49.0% of the students, and 29.0% of the personnel of the school used personal vehicles other than public transportation. In addition, over 50.0% of the students and about 70.0% of the other two groups had not attended any gatherings. Moreover, 83.0% of the academics, 93.0% of the students, and 84.0% of the personnel had no systemic conditions. Furthermore, about 16.0% of the professors, 14.0% of the students, and 22.0% of the personnel had tested for the COVID-19 infection, of whom only about 1.0% reported positive results. Fatigue, dry coughs, and shortness of breath were the most common symptoms reported by the respondents. Dental offices are high-risk environments for the transmission of air-borne diseases. Considering the low percentage of the participants with positive test, it may be concluded that the safety protocols could effectively limit the spread of the COVID-19 infection.

The use of evidence-based dentistry (EBD) as the integration of investigations and clinical decisions has been a focus of attention in recent years.

The present study aimed to evaluate the knowledge, attitude, and practice of EBD among Iranian dentists in 2019.

A total of 140 self-administered questionnaires with 57 items were distributed among dentists in the 2019 exhibition of Iranian dentists. Moreover, 60 self-administered questionnaires were sent to five different dentistry schools in Iran. The analyses were carried out using the Chi-square test, independent samples t-test, and Pearson correlation.

A total of 119 fully-responded self-administered questionnaires were analyzed in this study. The dentists attending EBD workshops obtained significantly higher scores of knowledge. The Cochrane Library, manufacturer’s brochures, and evidence-based guidelines were used the least for clinical decisions. Consultation with colleagues, use of textbooks, and personal judgment were mostly utilized for clinical decisions. In addition, 93.3% of the participants stated sensible uncertainties in their clinical decisions. The most important barriersto EBD were the need for long discussions with patients, lack of skills in the critical appraisal of articles, and lack of motivation in dentists with the incidence rates of 62.2%, 62.2%, and 39.5%, respectively.

Due to the low levels of EBD knowledge among Iranian dentists, it is recommended to give further close attention to increasing the knowledge in this regard. However, their high enthusiasm for participation in EBD workshops and enhancement ofEBD skills is promising.