Evaluation of Knowledge and Practice of Dentists and Assistants in Dental Clinics and Incidence of Sharp Instrument Injuries in Rafsanjan

Background: Injuries caused by sharp instruments are the most important problems that expose dentists and healthcare workers to dangerous blood-borne diseases (AIDS and hepatitis). The aim of this study was to evaluate the incidence of needle stick injuries; and the knowledge and practice of dentists and their assistants about prevention and encountering the injuries caused by sharp instruments in Rafsanjan in 2013. Methods: In this cross-sectional descriptive-analytical study, a researcher-made questionnaire (demographic information, knowledge and practice about reducing exposure and post-exposure practice) were completed by 100 dentists and 115 dental assistants. Data were analyzed using two-sample t-test and linear regression by SPSS 18. Results: During one year, 25% of dentists and 31.1% of assistants were injured by sharp instruments. The mean score of practice and knowledge in dentists was 3.31±0.70 and 3.91±1.49 from the maximum score of 10 and 11. The mean score of practice in assistants was 1.98±0.63 from the maximum score of 9. There was no significant relationship between knowledge and practice score, and gender, age, length of professional experience, and training university. Professional dentists compared to the general dentists showed better practice and knowledge (P=0.03, P=0.01). There was no significant relationship between dentists knowledge and assistants practice (P=0.063) and also between dentists practice and assistants practice (P=0.071). Conclusion: The knowledge and practice level of dentists about sharp instrument injuries and also their assistants’ practice was undesirable and implementing re-education programs seems to be necessary

Effect of chlorhexidine on the durability of a new universal adhesive system

The effect of chlorhexidine on bond durability of universal adhesives is not clear. The aim of this study was to evaluate the effect of chlorhexidine on 6-month water storage bond strength of adhesive systems. 72 freshly sound human extracted molars were selected. In each tooth both buccal and lingual sides were prepared by bur to reach superficial dentin and randomly divided into 6 groups and 12 sub-groups and bonded with Scotchbond Universal (SBU) or Scotchbond Multi-purpose (SBMP) with/without chlorhexidine (CHX) usage. Group 1: SBU, group2: SBU+CHX, group3: Etch+SBU, group4: Etch+CHX+SBU, group5: Etch+SBMP, group6: Etch+CHX+SBMP. After composite curing, water storage and thermocycling was done. Each group was divided into two subgroups. One was tested immediately, and the other was thermocycled for 5000 cycles (5-55 °C) (it was equivalent to 6 months of storage in distilled water). Shear bond strength test was done and failure modes were determined by Stereomicroscope. The data were analyzed by one-way ANOVA, Tukey post-hoc test and Paired Two test with P<0.050 as the level of significance. Shear bond strength in late SBU (Self etch) was significantly lower than late SBU [Etch and rinse (ER)], P value= 0.0001, also shear bond strength in late SBU [self-etch (SE)] was significantly lower than immediate SBU (SE), P value= 0.01. There were no significant differences between other sub-groups and conditions. The most failure mode was adhesive in all the groups. Long term bonding durability of SBU(ER) was better than SBU (SE). CHX usage had prevented bond strength decrease in SBU and SBMP in long term. CHX usage did not have any effect on immediate shear bond strength of SBU and SBMP. Immediate and late shear bond strength of SBMP with/without CHX usage was similar to SBU(SE, ER)

Educational Quality and Facilities Assessment in the Department of Restorative Dentistry from the Viewpoint of Dentistry Students of Kerman University of Medical Sciences, Iran, in 2014

Background & Objective: Restorative dentistry is a fundamental field in dentistry and students’ opinions about its education can be helpful in finding its deficiencies and solving them. The aim of this study was to evaluate dentistry students’ attitudes toward restorative dentistry education, and its facilities and physical environment. Methods: This descriptive, cross-sectional study was performed on fourth, fifth, and sixth year students of the School of Dentistry of Kerman University of Medical Sciences, Iran. The data collection tool was a two-part questionnaire consisting of demographic characteristics form and 38 questions about environment, facilities, and educational and exam methods, and 1 open question scored based on a Likert scale (very appropriate to inappropriate). Data were analyzes using t-test, ANOVA, and linear regression in SPSS software. The significant level was considered as 0.05 in all tests. Results: Among the 110 participates, 61.8% were women and 38.2% were men. The average attitude score (from 26 to 130) was 84.86 ± 11.30. Overall attitude score was not significantly different between genders, academic years, and different restorative scores. However, in the education field, the fifth and sixth year students had significantly higher attitude scores than the fourth year students. Conclusion: Satisfaction with the clinical and theoretical education of restorative dentistry in the School of Dentistry of Kerman University of Medical Sciences is acceptable, but its physical environment and facilities must be improved. Key Words: Restorative dentistry, Education, Students, Attitude, Kerman (Iran

Shear bond strength of different adhesive systems to normal and caries-affected dentin

BACKGROUND AND AIM: According to the effect of the adhesive and substrate type on the bond strength, examination of the adhesive is required in all aspects. The aim of this study was to evaluate the shear bond strength of different adhesive systems to normal dentin (ND) and caries affected dentin (CAD) in permanent teeth. METHODS: Thirty extracted molars with small occlusal caries were selected. After preparation and determination of ND and CAD by caries detector, teeth were divided into three groups and treated with one of the two tested adhesives: Single Bond 2 (SB2), Scotchbond Universal with etch (SBU-ER), and Scotchbond Universal without etch (SBU-SE). Then composite (Filtek Z-250 XT) were attached to the surfaces and cured. After water storage (24 hours) and thermocycling (500 cycles 5-55 °C), bond strength was calculated and failure modes were determined by stereomicroscope. The data were analyzed by one-way ANOVA and post-hoc test [Tukey HSD (honest significant difference)] and with P ˂ 0.050 as the level of significance. RESULTS: Only SBU-ER had significantly higher shear bond strength than SBU-SE in ND (P = 0.027) and CAD (P = 0.046). Bond strength in SBU-ER the highest and in SBU-SE had the lowest amounts in CAD and ND. There was no significant difference in each group between ND and CAD. CONCLUSION: The 2-step etch-and-rinse adhesive (SBU-ER) had higher bond strength to ND and CAD than the self-etch adhesive (SBU-SE). KEYWORDS: Dentin Bonding Agent Normal, Caries-Affected Dentin, Shear Bond Strength Tes

Sealing of adhesive systems in ferric sulfate-contaminated dentinal margins in class V composite resin restorations

Background. Hemostatic agents are applied to prepare an isolated bleeding-free condition during dental treatments and can influence adhesive restorations. This study evaluated the effect of a hemostatic agent (ViscoStat) on microleakage of contaminated dentinal margin of class V composite resin restorations with three adhesives. Methods. Sixty freshly extracted human molars were selected and class V cavities (3×3×1.5 mm) were prepared on buccal and lingual surfaces. Gingival margins of the cavities were placed below the cementoenamel junction. The teeth were divided into six groups randomly. The adhesives were Excite, AdheSE and AdheSE One. In three groups, the gingival walls of the cavities were contaminated with ViscoStat and then rinsed. The cavities were restored with composite resin and light-cured. After storage in distilled water (37°C) for 24 hours and polishing, the samples were thermocycled and sealed with nail varnish. Then they were stored in 1% basic fuchsin for 24 hours, rinsed and mounted in self-cured acryl resin, followed by sectioning buccolingually. Dye penetration was observed under a stereomicroscope and scored. Data were statistically analyzed with Kruskal-Wallis and Mann-Whitney U tests. P<0.05 was set as the level of significance. Results. Only in the Excite group, contamination did not have adverse effects on dentin microleakage (P > 0.05). In the contaminated groups, Excite had significantly less microleakage than the others (P = 0.003). AdheSE and AdheSE One did not exhibit significant difference in microleakage (P > 0.05). Conclusion. ViscoStat hemostatic agent increased dentinal microleakage in AdheSE and AdheSE One adhesives with no effect on Excite

Needlestick injuries in dentists and their assistants in Kerman, Iran: Prevalence, knowledge, and practice

BACKGROUND AND AIM: Needlestick (NS) injuries are one of the most important subjects in the dental field which can cause so many dangerous blood-borne diseases. The aim of this study was to evaluate the prevalence, knowledge, and practice of dentists and their assistants about exposure to sharp contaminated instruments in Kerman, Iran, in 2012. METHODS: In this cross-sectional study, self-administered questionnaires were distributed among 190 dentists and 250 assistants. Data were analyzed by chi-square and 2-sample tests. RESULTS: 32% of dentists and 30.7% of assistants had experienced NS injury. The mean scores of knowledge and practice in dentists were 4.88 ± 1.69 and 3.37 ± 0.70 from the maximum scores of 10 and 4. There was only a significant correlation between knowledge score and gender (P = 0.02), and a near significant correlation between practice and gender (P = 0.06) (male > female). However, they had no correlation with age, length of professional experience, and educational degree. In assistants, the mean score of practice was 2.84 ± 0.67 from the maximum score of 5. Furthermore, 96.6% of dentists and 76.3% of assistants had been vaccinated against hepatitis B. CONCLUSIONS: The obtained results show that the practice level of dentist in NS injury prevention and management is good but their knowledge and also their assistants’ practice is undesirable. The level of knowledge and practice was the same for general and specialist dentists. It seems that specialist dentists cooperate better in vaccination and measuring of anti-HBs antibody titre

Needlestick injuries in dentists and their assistants in Kerman, Iran: Prevalence, knowledge, and practice

BACKGROUND AND AIM: Needlestick (NS) injuries are one of the most important subjects in the dental field which can cause so many dangerous blood-borne diseases. The aim of this study was to evaluate the prevalence, knowledge, and practice of dentists and their assistants about exposure to sharp contaminated instruments in Kerman, Iran, in 2012. METHODS: In this cross-sectional study, self-administered questionnaires were distributed among 190 dentists and 250 assistants. Data were analyzed by chi-square and 2-sample tests. RESULTS: 32% of dentists and 30.7% of assistants had experienced NS injury. The mean scores of knowledge and practice in dentists were 4.88 ± 1.69 and 3.37 ± 0.70 from the maximum scores of 10 and 4. There was only a significant correlation between knowledge score and gender (P = 0.02), and a near significant correlation between practice and gender (P = 0.06) (male > female). However, they had no correlation with age, length of professional experience, and educational degree. In assistants, the mean score of practice was 2.84 ± 0.67 from the maximum score of 5. Furthermore, 96.6% of dentists and 76.3% of assistants had been vaccinated against hepatitis B. CONCLUSIONS: The obtained results show that the practice level of dentist in NS injury prevention and management is good but their knowledge and also their assistants’ practice is undesirable. The level of knowledge and practice was the same for general and specialist dentists. It seems that specialist dentists cooperate better in vaccination and measuring of anti-HBs antibody titre. KEYWORDS: Needlestick, Dentist, Knowledge, Practice, Hepatitis, Infection Control, Assistants, Prevalenc

Peripheral Giant Cell Granuloma: A Review of 123 Cases

Background: Peripheral giant cell granuloma is one of the reactive hyperplastic lesions of the oral cavity, which originates from the periosteum or periodontal membrane following local irritation or chronic trauma. The purpose of this study was to present the clinical characteristics of peripheral gi-ant cell granuloma in a group of Iranian population. Methods: A series of 123 consecutive confirmed cases of peripheral giant cell granuloma after biopsy were evaluated. Age, sex, anatomic location, consistency, etiologic factor, pain and bleeding history, color, surface texture, and pedicle situation were recorded and were analyzed by chi-square test and values were considered to be significant if P < 0.05. Results: Age ranged from 6 to 75 years (mean 33 years). Women affected more than men (M/F 1:1.1). Peripheral giant cell granuloma was seen in the mandible more than in the maxilla and in the anterior region more than in the posterior region. In most cases, lesions were pink, pedunculated and had non-ulcerated surface. In less than half of the cases, there was no history of bleeding and also pain was rarely reported. Calculus was the most common etiologic factor. Conclusion: The results confirmed that the clinical features of peripheral giant cell granuloma in a group of Iranian population are almost similar to those reported by other investigators

Shear bond strength of three adhesive systems to enamel and dentin of permanent teeth

Background and Aims: The purpose of this experimental study was to investigate the shear bond strength of three new adhesive systems to enamel and dentin of permanent human teeth using three new etch and rinse and self-etch adhesive systems.Materials and Methods: Sixty intact caries-free third molars were selected and randomly divided into 6 groups. Flat buccal and lingual enamel and dentin surfaces were prepared and mounted in the acrylic resin perpendicular to the plan of the horizon. Adhesives used in this study were Tetric N-Bond, AdheSE and AdheSE-One F (Ivoclar/Vivadent, Schaan, Liechtenstein). The adhesives were applied on the surfaces and cured with quartz tungsten halogen curing unit (600 mW/cm2 intensity) for 20 s. After attaching composite to the surfaces and thermocycling (500 cycles, 5-55ºC), shear bond strength was measured using a universal testing machine at a crosshead speed of 0.5 mm/min. The failure modes were examined under a stereomicroscope. The data were statistically analyzed using T-test, one-way ANOVA, Tukey and Fisher's exact tests.Results: In enamel, Tetric N-Bond (28.57±4.58 MPa) and AdheSE (21.97±7.6 MPa) had significantly higher bond strength than AdheSE-One F (7.16±2.09 MPa) (P<0.0001). Tetric N-Bond had higher bond strength than AdheSE but there was not any significant difference between them (P=0.093). In dentin, there were significantly differences among all adhesives (P<0.001). Tetric N-Bond (20.62±3.03 MPa) showed the highest and AdheSE-One F (6.54±1.13 MPa) had the lowest value. The bond strength in enamel was higher than that observed in dentin and the difference was significant in Tetric N-Bond (P=0.044) and AdheSE (P=0.000) groups. There were no significant differences in the mode of failures among groups (P>0.05).Conclusion: Shear bond strength to dentin in Tetric N-Bond (etch and rinse system( was higher than self-etch adhesives (AdheSE and AdheSE-One F). The bond strength to enamel and dentin in two-step self-etch (AdheSE) was higher than one-step self-etch (AdheSE-One F)