Background Cytocompatibility should always be considered, especially if the surface of treated carious lesions is close to soft tissue or is accidentally exposed to the oral soft tissue by the clinician. Methods The aim of the present study was to compare the cytocompatibility of two fluoride-containing liquids and two resin-containing restorative materials with buccal mucosa fibroblasts. The fluoride-containing materials were silver diamine fluoride and water-based silver fluoride. Results The statistical analysis was completed by comparing the positive control growth of the buccal mucosa fibroblasts to the growth of cells exposed to various materials. The one-way ANOVA with Tukey’s HSD result was completed. All the assessed materials compared to the control wells for both the 24 and 48 h time intervals indicated a significant cytocompatibility result, except for the test wells with Stela (SDI) at the 24 h time interval. There was no significant difference between the step 2 liquids and the two dental materials in cytocompatibility at the 24 h interval. All four materials indicated no significant differences between the cytocompatibility of any dental materials for 48 h. Conclusion The cytocompatibility assessment for Riva Star and Riva Star Aqua with the direct method in a full dispensing drop is not viable for step 1 of the fluoride-containing liquids. The use of Stela Light Cure is a suitable material that will be in contact with buccal mucosa as it showed potential for increased cytocompatibility compared to Riva Light Cure. Riva Star Aqua is more cytocompatible than Riva Star.
The reach of Coronavirus Disease - 2019 (COVID-19) has even reached the ethical guidelines for good practice from the Health Professions Council of South Africa (HPCSA).The health care worker should carefully consider the guidance outlined in several of the booklets as patient treatment has multiple dimensions where COVID-19 had impacted on clinical practice. Due to the nature of dentistry and aerosol generation, special care must be taken when treating healthy patients and patients that are carriers but do not realise that they are COVID-19 positive.COVID-19 transmission and aerosol dissemination may expose the practice team to hazards of infection. The risk is elevated when implementing aerosol generating procedures without any protective equipment. The oral health care worker (OHCW) and staff thus require the appropriate personal protective equipment (PPE) as suggested by country-specific guidelines, for example, The South African Dental Association (SADA).To this extent, practicing dentistry in the 21st century is complex and amidst the current COVID-19 pandemic the OHCW is presented with more pitfalls. As the pandemic is showing no sign of abating in SA, this has presented the OHCW with a range of additional ethical considerations.These dilemmas may be resolved in a variety of ways following an understanding of the basic knowledge of core ethical values and standards for good practice outlined by the HPCSA guidelines.
Abstract Background Children continue to suffer from the impact of the human immunodeficiency virus‐acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In Cape Town, these children receive medical care including antiretroviral therapy from facilities like Tygerberg Hospital's Paediatric Infectious Diseases Clinic. HIV‐infected children may experience an increased caries experience when compared with their healthy peers. Aim The aim of this study was to determine the oral health status of HIV‐infected children younger than 12 years receiving antiviral drugs at the Paediatric Infectious Diseases Clinic. Design A cross‐sectional survey was conducted among children aged between 2 and 12 years presenting at this clinic. Caregivers were interviewed to obtain information regarding health seeking behaviour, oral hygiene practices and dietary habits. A single clinician undertook a standardized clinical intraoral examination according to the World Health Organization guidelines, with modifications. Results Sixty‐six children were recruited. A high prevalence of dental caries (78.8%) and an unmet treatment need of 90.4% were recorded among the participants. Most children had never visited the dentist, and those who did had mainly received emergency dental care. Conclusion The high prevalence of severe dental caries in this population highlights the need for oral health awareness and the inclusion of oral health care in the comprehensive care of children with HIV. Why this paper is important to paediatric dentists The study highlights the importance of collaborating with health professions outside of dentistry. Doctors and nurses are often the first health professionals to come into contact with children with special needs. They should therefore be made aware of the early signs of decay so that these patients can be referred for dental treatment timeously. Holistic management of children with special healthcare needs is essential to improve their overall well‐being.
Fissure sealants are recommended to be applied soon after the tooth eruption, mainly at the level of the first permanent molars.The additional benefits of the application of bioactive fissure sealant materials lies in the build-in functionality of these materials to chemical attack in oral cavity as well as additional antibacterial action.
Aerosol generation and a wide range of pathogens originating from the oral cavity of the patient contaminate various surfaces of the dental clinic. The aim was to determine the efficacy of vaporized hydrogen peroxide fogging on pathogens related to the dental environment and its possible application in dentistry. PICOS statement (Population, Intervention, Comparison/Control, Outcome and Study design statement) was used in the review. Six electronic databases were searched for articles published from 2010 to 2020. Articles written in English reporting vaporized hydrogen peroxide on pathogens deemed to be relevant to the dental environment were assessed. The quality of the studies was assessed using the risk-of-bias assessment tool designed for the investigation of vaporized hydrogen peroxide application in dentistry. A total of 17 studies were included in the qualitative synthesis. The most commonly reported single bacterial pathogen was Methicillin-resistant Staphylococcus aureus in five studies, and the viruses Feline calicivirus, Human norovirus, and Murine norovirus were featured in three studies. The results of the studies reporting the log kill were sufficient for all authors to conclude that vaporized hydrogen peroxide generation was effective for the assessed pathogens. The studies that assessed aerosolized hydrogen peroxide found a greater log kill with the use of vaporized hydrogen peroxide generators. The overarching conclusion was that hydrogen peroxide delivered as vaporized hydrogen peroxide was an effective method to achieve large levels of log kill on the assessed pathogens. The hydrogen peroxide vapor generators can play a role in dental bio-decontamination. The parameters must be standardized and the efficacy assessed to perform bio-decontamination for the whole clinic. For vaporized hydrogen peroxide generators to be included in the dental bio-decontamination regimen, certain criteria should be met. These include the standardization and efficacy assessment of the vaporized hydrogen peroxide generators in dental clinics.
Background Acquiring psychomotor and clinical skills are an essential part of dental students training. This particular aspect posed a unique challenge for an undergraduate Prosthetic final year module in a South African dental school during the Corona virus disease-19 (COVID-19) pandemic. Teaching of clinical skills was completely interrupted during the country’s initial response to the pandemic. With the easing of country lockdown restrictions, the final year dental students were allowed to return to campus to continue with clinical practice training. This therefore called for innovative and novel strategies to determine and address inadequacies in their learning and clinical practices. Objective The purpose of the OSCE was to assess the impact of the interruption of clinical practice and clinical competence. Methods An OSCE station was created for each student where all the questions were placed which was planned to be included by the department. The student therefore did not have to move from station-to-station, thus, he/she was the only one touching the different materials or instruments at that station. It was also based in an enclosed clinic, which was prepared using the advocated COVID protocols, and all clinics were equipped with the required instruments and equipment required for each question. To ensure social distancing, groups of students were scheduled individually, thus, the OSCE was conducted over 4 days with not more than 22 students per day. Results Performance of students in the OSCE provided feedback of clinical competence, preparedness to return to clinical practice and it also identified gaps in the teachings. Conclusion This assessment after such a long period of absence from clinics, including the assessment plan, structured feedback sessions involving the department gave the student’s confidence on their return to manage their patients.
Objective: To investigate the presence of voids in bulk fill flowable composites.Methods: This study investigated two well-known bulk-fill flowable composites, Smart Dentin Replacement (SDR) (Dentsply/Caulk, Milford, Germany) and Filtek bulk fill flowable (FBF) (3M ESPE, Minnesota, USA).Three ampules of each material were randomly selected.The ampules were subjected to 3D Micro-CT (General Electric Phoenix V|Tome|X L240) reconstruction in order to assess the presence of any voids within the ampules.results: Voids were present in all the ampules.The total void percentage for each group of three ampules was found to be SDR : 1.147 % and FBF : 0.0424 %.There was a significant difference between the volume of voids for SDR and FBF, p-value=0.003924.conclusion: Voids were found in the randomly selected samples of bulk-fill flowable composites.This is undesirable and manufacturers should be urged to ensure that no voids are present, or at least are minimized in the ampules of material.
Background: Patients seeking treatment from general medical practitioners (GP) may be unaware or ill-informed that dentists are the more appropriate professionals to manage their orofacial symptoms, being able to diagnose and treat, or, if deemed necessary, appropriately refer.Aims: To: (1) determine from a group of patients (n = 37) their initial preference of health care provider, when seeking treatment for orofacial symptoms (2) establish their awareness of the appropriate proficiency of the dentist, and, (3) determine the referral pathway before patients attended the Tygerberg Oral Medicine Clinic. Methods:A cross sectional study design; quantitative data was collected by a modified previously published Bell-questionnaire with closed-ended questions.Results: 53.8% of patients preferred a dentist to attend to a mouth or jaw problem and 46.1%, a GP.When clinical scenarios were posed, all directly related to the scope of practice of the dental practitioner, it was of concern that 47.3% chose the GP and 52.67% chose the dentist. Conclusion:Patients initially chose the GP for many orofacial diseases, although they indicated at the Oral Medicine clinic that the dentist had the most relevant knowledge.Participants did not associate some of the orofacial symptoms with the training of dentists.
Background: To determine the total volumetric change and the relative speed of shrinkage of bulk fill flowable composites during polymerization.Materials and methods: A specially designed electronic mercury dilatometer was used to determine the volumetric change.The light intensity was 500mW/cm 2 .The mercury dilatometer measured the volumetric change every 0.5 seconds during the 35 second irradiation exposure time.The materials tested were Z250 as standard and control.Four bulk fill flowable composites were tested.Results: The sequence of total volumetric change was found to be: Z250 < Filtek bulk fill < Xtra-Base bulk fill < SDR < Venus bulk fill.The speed of shrinkage of the bulk fill flowables was faster than that of Z250, while the 2 flowables with the highest shrinkage speed (SDR and Venus) also had the highest total volumetric change.Of the different materials tested the volumetric change of Z250 (1.13%) was the lowest and significantly less (p<0.05)than that of SDR (1.55%) and Venus (1.72%).The material with the highest filler content (Z250) also showed the lowest shrinkage (1.13%) but this effect could not be seen in the flowables.In general, it was found that a 35 second irradiation period (with a light intensity of 500mW/cm 2 ) was satisfactory for complete polymerization of the resins. Conclusions:The volumetric changes and speed of shrinkage were higher for all 4 bulk fill flowable composites than for Z250.SDR and Venus flowables had the fastest and highest volumetric shrinkage.Clinical significance: The manufacturers of bulk fill flowable composites advocate filling layers of 4mm.However, because of the high shrinkage values found in this study it should be suggested that the standard 2mm layer increments still be used.
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