Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

Objective: Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods: A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results: Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115). Conclusions: According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of this study with the clinical outcomes

Oral rehabilitation with dental implants in oligodontia patients

Purpose: The aim of this retrospective report was to evaluate the treatment outcome of oral rehabilitation with dental implants in oligodontia patients. Materials and Methods: Thirteen oligodontia patients treated with dental implants were examined clinically and radiographically (follow-up 3 +/- 2 years, range 1 to 8 years). In addition, patient-mediated concerns of satisfaction, treatment experience, and level of impairment of oral functions were assessed with questionnaires. Results: In general, all patients were satisfied with the implant treatment and experienced the treatment as nonaggravating. There was significant functional improvement, with an implant survival rate of 86% and 96% for the maxilla and mandible, respectively. Conclusion: Dental implants can play an important role in the oral rehabilitation of patients with oligodontia. Patients were generally satisfied with the overall treatment experience and reported significant functional improvement. Implant survival rate was comparable with previous reports

Developing Resilience in the Aged and Dementia Care Workforce

Developing resilience in the aged and dementia care workforce is animportant element of support given their high demand environment. Jn this chapter,we outline the key known factors relevant for resiliency of aged and dementia careworkforces, focusi ng on direct care workers who provide health care and physical,emotional , and social support to older adults and people with dementia as part oftheir job roles. We describe workforce characteristics, job demands, and resources,as well as personal and emotional responses lo work with international comparisonsmade where in formation is available. Several theoretical constructs in social andorganizational psychology are overviewed and applied to the investigation ofresilience in care work contexts. Organisational psychology can help the aged caresector prepare for the increased need to attract and retain a resilient workforce.Occupational communion is one of the several new theoretical constructs thatprovide potential for ·trategies for interventional support and training. Our worksuggests chat measurement models should be developed that consider positivecoping speci fic to the social nature of caring and the ncurodegcnerativc conditionssuch as dementia, as well ac; the characteristics of the workforce