Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application.
Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates.
Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.
METHODS: A cross-sectional study was conducted at rugby tournaments in 2009 and 2010 on players aged 16 and over. Convenient sampling was performed. A total of 456 self-administered questionnaires were returned. Data collected were analysed using SPSS 21. Descriptive analysis was undertaken for the demographic data. The subjects were classified according to their experience of sustaining each type of injury. Cross-tabulation and chi-square tests were carried out to compare the responses. When the expected cell count was less than five, Fisher's exact test was used. The level of significance was set at P < 0.05.
RESULTS: The prevalence of self-reported dental injuries was as follows: tooth fracture (19.3%), luxation (6.6%) and avulsion (1.1%). Significant differences were found, whereby 52.2% of those who had no history of tooth fracture were more likely to seek immediate treatment (P < 0.001), whereas 42% of those who previously experienced tooth fracture claimed that they would only visit a dentist if they experienced pain (P = 0.001). Management of luxation and avulsion did not differ significantly between the groups. However, about half of those who did not have a history of tooth avulsion admitted to not knowing the correct answer, while three of five casualties would keep the tooth iced.
CONCLUSIONS: Knowledge of the management of tooth fracture and storage medium differs between previous casualties and non-casualties. Overall, knowledge of dental trauma management was insufficient, suggesting the need to educate and train the players.
METHODOLOGY: A cohort (n = 206) of fourth-year undergraduate dental students were recruited from four different Dental Schools and divided randomly into two groups (Group A and B). The participants assessed six test endodontic cases using anonymized versions of the American Association of Endodontists (AAE) case difficulty assessment form (AAE Endodontic Case Difficulty Assessment Form and Guidelines, 2006) and EndoApp, a web-based CDA tool. Group A (n = 107) used the AAE form for assessment of the first three cases, followed by EndoApp for the latter. Group B (n = 99) used EndoApp for the initial three cases and switched to the AAE form for the remainder. Data were collected online and analysed to assess participants' knowledge reinforcement and agreement with the recommendation generated. Statistical analysis was performed using the two-way mixed model anova, Cohen's Kappa (κ) and independent t-tests, with the levels of significance set at P
METHODS AND MATERIALS: Two videos of access cavity preparation were filmed, one showing the occlusal view (OV) and one showing the sectional view (SV). Third-year dental students (n=57) who consented to participate in the study were divided into two groups to watch one of the videos. The perception and performance of both groups were compared using the Mann-Whitney U test and Fisher's exact test.
RESULTS: At baseline, group OV (n=29) and group SV (n=28) were not significantly different in terms of operative scores (P=0.330). After watching the videos, the basic understanding of the theories was similar in both groups. However, the SV group responded more positively towards the helpfulness of the video in visualizing the inner anatomy of the tooth and in implementing the procedures (P<0.05). The SV group also completed the exercise within a shorter time (P<0.001). Nevertheless, the quality of the prepared access cavities was not significantly different between groups.
CONCLUSION: Within the limitations of this study, the additional step in sectioning a tooth before demonstration of access cavity preparation seems well worth the effort, offering the novice students advantages in visualizing certain anatomical landmarks and implementing access cavity preparation procedure within a shorter timeframe. Nevertheless, it did not improve the final quality of the preparations.
METHODS: A cross-sectional study was conducted using consecutive sampling. Each participant went through screening using the PUFA index, orthopantomography assessment using PAI, and comprehensive clinical examination to derive pulpal and apical diagnoses. The outcomes were dichotomized. Reliability was estimated using the Cohen kappa coefficient. Sensitivity, specificity, and predictive values were calculated. The area under the receiver operating characteristic curve was compared using the chi-square test.
RESULTS: A total of 165 participants were examined, 98.2% of whom had a decayed, missing, or filled tooth index >0. Of 4115 teeth assessed, 16.2% (n = 666) were diagnosed with pulpal disease and 7.9% (n = 325) with periapical disease. Interexaminer reliability for the PUFA index and PAI was 0.87 and 0.80, respectively. Intraexaminer reliability was 0.83 and 0.76 for the PUFA index and 0.75 and 0.72 for PAI. For pulpal diagnosis, the sensitivity of the PUFA index and PAI was 67.6% and 41.7%, respectively; the specificity of the PUFA index and PAI was 99.8% and 99.2%, respectively. For apical diagnosis, the sensitivity of the PUFA index and PAI was 87.7% and 75.4%, respectively; the specificity of the PUFA index and PAI was 95.4% and 98.4%, respectively. The PUFA index is statistically more accurate than PAI for pulpal diagnosis and apical diagnosis (P < .05).
CONCLUSIONS: The PUFA index can be used in screening for pulpal and periapical diseases with some limitations.
METHODS: A random sample of digital panoramic radiographs from the database of a dental hospital was evaluated. Two calibrated examiners (κ ≥ 0.89) assessed the technical quality of the root fillings and the radiographic periapical health status by using the periapical index. Descriptive statistical analysis was carried out, followed by multilevel modeling by using tooth-level and patient-level predictors. Model fit information was obtained, and the findings of the best-fit model were reported.
RESULTS: A total of 6409 teeth were included in the analysis. The predicted probability of a tooth having AP was 0.42%. There was a statistically significant variability between patients (P
MATERIALS AND METHODS: A questionnaire consisting of eight domains with 43 questions was sent to all the Universiti Kebangsaan Malaysia's (UKM) dental graduates of 2019 and 2020 cohorts. The domains were as follows: (A) gathering information at chairside, (B) diagnosis, (C) treatment planning, (D) treatment and prevention, (E) community-based, (F) management and administrative, (G) communication and (H) personal management and professional development. Three additional questions were included to assess satisfaction on clinical teaching and supervision, requirements and assessment and cross-infection control.
RESULTS: A total of 54 (91.5%) and 45 (100%) questionnaires were returned by the 2019 and 2020 cohorts, respectively. The 2019 cohort consistently perceived their competencies to be high across all the eight domains, and these responses were significantly higher than the 2020 cohort for seven out of the eight domains (p
METHODS: A random convenient sampling methodology was employed for sample selection. A pre-tested 11-item questionnaire was validated on the dental officers. The survey was distributed to 182 GDPs attending the annual Malaysian Dental Association conference in January 2010. The data obtained was statistically analyzed using descriptive analysis and logistic regression was employed to predict the probability of achieving high scores.
RESULTS: A total of 182 general dental practitioners participated in the study, with the majority being female (n=153, 75%). The place of practice significantly affected the knowledge score. In the group that scored more than 80 points (n=84, 46%), 76% of them worked with government hospitals. Age, work duration and number of traumatised teeth previously treated had no significant effect. The odds ratio for place of practice indicates that respondents who work in government hospitals are 3.6 times more likely to score more than 80 points compared to those who worked in private clinics (OR=3.615, P=0.001).
CONCLUSION: The knowledge level on the management of avulsed tooth among general dental practitioners in Malaysia needs to be improved. Strategies in improvement of the Malaysian dental educational system, continuous dental educational activities and utilisation of guidelines on trauma management should be recommended to increase the knowledge level of avulsed tooth management to ensure good treatment outcomes.
CLINICAL IMPLICATION: Trauma prevention and further education regarding the management of avulsed tooth is an essential requirement to improve general dental practitioners knowledge and clinical skills.