Work-related musculoskeletal disorders among dentists and their prevention through ergonomic interventions - A systematic review

Introduction: Occupational or work-related musculoskeletal disorders (WMSDs) vastly prevail among dental professionals. This review aims to summarize the prevalence of WMSDs and ergonomic interventions for the prevention of WMSDs among dental professionals. Methods: Thorough literature search was done using scientific databases. The terms musculoskeletal disorders among dentists/dental professionals/ hygienists in dentistry, occupational or work-related MSDs, ergonomics, ergonomic interventions, and several combinations were used as keywords. Articles published in the English language only were included. Abstracts, thesis work, and other languages were excluded. Results: Our findings revealed several studies showing the prevalence of WMSD among dental professionals and ergonomic interventions to prevent MSDs among dental professionals. Conclusion: Dental practice is highly challenging both in terms of physical and mental status there is a need for continuing efforts to discover innovative preventive strategies, to reduce the prevalence of WMSDs. This article guides dental professionals to incorporate the proper ergonomic methods in their early stages of day-to-day work, for long-term and healthy dental practice.

Esthetic Intraradicular Rehabilitation Of Grossly Decayed Anterior Teeth With Fibre Reinforced Composite Post - A Case Report

Traumatized or badly broken down teeth due to caries require quick functional and esthetic repair. As there is a loss of structural integrity, loss of moisture and loss of dentin toughness in endodontically treated teeth, it necessitates special care during treatment and also it has been said that these teeth have a reduced level of proprioception which could impair normal protective reflexes. Restoration of endodontically treated teeth should aim at replacing the missing tooth structure, maintain function, esthetics and protect against fracture and infection. One of the modern methods of restoring badly broken down endodontically treated teeth is metal-free fibre reinforced composite posts (FRC). This clinical case report describes the restoration of infected anterior teeth with esthetic FRC post system.   Keywords: Esthetic rehabilitation, fibre reinforced composite posts (FRC), Composite resin, Ceramic crowns.   &nbsp

Stress distribution among periodontally compromised abutments: A comparative study using three-dimensional finite element analysis

Aims: The aim of the study was to evaluate the stress distribution patterns in teeth and supporting structures of fixed prosthesis and design modifications in a fixed prosthesis with either normal or reduced bone support of an additional abutment. Study was also undertaken to disprove Ante′s law. Materials and Methods: Main models and variations of main models (modification 1, 2, 3, 4, 5, 6, 7, 8) were subjected to 200 N at angulations of 90° and 15° on functional cusps. Results for each loading were obtained as stress distribution color images and numerical values were recorded. A three-dimensional finite element analysis study of variations of normal models was performed using two finite element softwares, namely PRO-Engineer wildfire version 1.0 manufacturer: Parametric technology corporation, Needham, MA 02494 U.S.A. Results: When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Eventhough the pericemental area of compromised abutments with an additional abutment (canine) was more than the combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante′s law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments. Conclusions: When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Even though the pericemental area of compromised abutments with an additional abutment (canine) was more than combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante′s law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments

Assessment of survival rate of dental implants in patients with bruxism: A 5-year retrospective study

Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The present study was conducted to assess complications in dental implants in bruxism patients. Materials and Methods: This 5-year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2016. Among these patients, 124 had bruxism habit. Dental radiographs or patients' recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw-type and 130 cemented-type fixations had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented-type fixation and fracture of ceramic (85) in screw-type fixation. The difference was statistically significant (P = 0.01). Forty-two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among genders was statistically nonsignificant (P = 0.21). Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications

Assessment of knowledge, practices, and work place condition related to ergonomics among dental students of Bhopal city - A questionnaire study

Background: Dental profession is susceptible to various postural and nonpostural occupational risks. Aim : To determine knowledge, practice, and condition of work place regarding ergonomic posture among dental students from Bhopal city, Central India. Also to observe any correlation among knowledge, practice, and condition of work place scores. Materials and Methods : A self-administered questionnaire study was conducted among 231 dental students. The questionnaire consisted of three parts: Knowledge, practice, and condition of work place. Analysis of variance was used to compare mean of knowledge, practice of clinical posture, and condition of work place. Pearson′s correlation coefficient has been applied to compute correlation among knowledge, practice, and condition of work place scores. A P value < 0.05 was considered significant for all statistical analyses. Results : We found that 70% of dental students perform torsion of the body and cervical flexion to improve vision and prefer direct vision when working. Only 59% reported that they are working with ergonomically designed dental unit and instruments. Most of them reported that the work stool is not comfortable. Mean knowledge, practice, and condition of work place scores were 3.93 (1.26), 5.01 (1.58), and 2.60 (1.14), respectively. Significant differences between the groups were noted for means of practice scores (P ≤ 0.01). Significant linear correlation was seen between knowledge-practice scores (r = 0.20) (P ≤ 0.01), practice-condition of work place scores (r = 0.14) (P ≤ 0.05), and knowledge-condition of work place scores (r = 0.14) (P ≤ 0.05). Conclusion : The knowledge of ergonomic postural requirements and their clinical application among the dental students surveyed were not satisfactory. A multifactorial approach that includes preventive education, postural and positioning strategies, proper selection, and use of ergonomic equipment should be employed