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Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas

Ahmed HM, Cohen S, Lévy G, Steier L, Bukiet F

Aust Dent J, 2014 Dec;59(4):457-63.
PMID: 25091028 DOI: 10.1111/adj.12210

Proper isolation is an essential prerequisite for successful endodontic treatment. This article aims to provide an update on the prevalence of rubber dam (RD) use, and the role of education along with attitudes of general dental practitioners (GDPs) and patients towards the application of RD in endodontics. Critical ethical issues are also highlighted. Using certain keywords, an electronic search was conducted spanning the period from January 1983 to April 2013 to identify the available related investigations, and the pooled data were then analysed. The results show that although RD is the Standard of Care in endodontic practice, there is a clear discrepancy in what GDPs are taught in dental school and what they practice after graduation. There is little scientific evidence to support the application of RD; however, patient safety and clinical practice guidelines indicate that it is unnecessary and unethical to consider a cohort study to prove what is already universally agreed upon. A few clinical situations may require special management which should be highlighted in the current guidelines. This would pave the way for clear and straightforward universal guidelines.
Exploratory evidence maps for the WHO Classification of Tumours 5th edition for lung and thymus tumors

Giesen C, Del Águila Mejía J, Armon S, Cierco Jimenez R, Myles N, Goldman-Lévy G, et al.

Virchows Arch, 2024 Nov;485(5):869-878.
PMID: 39448408 DOI: 10.1007/s00428-024-03886-6

The WHO Classification of Tumours (WCT) guides cancer diagnosis, treatment, and research. However, research evidence in pathology continuously changes, and new evidence emerges. Correct assessment of evidence in the WCT 5th edition (WCT-5) and identification of high level of evidence (LOE) studies based on study design are needed to improve future editions. We aimed at producing exploratory evidence maps for WCT-5 Thoracic Tumours, specifically lung and thymus tumors. We extracted citations from WCT-5, and imported and coded them in EPPI-Reviewer. The maps were plotted using EPPI-Mapper. Maps displayed tumor types (columns), descriptors (rows), and LOE (bubbles using a four-color code). We included 1434 studies addressing 51 lung, and 677 studies addressing 25 thymus tumor types from WCT-5 thoracic tumours volume. Overall, 87.7% (n = 1257) and 80.8% (n = 547) references were low, and 4.1% (n = 59) and 2.2% (n = 15) high LOE for lung and thymus tumors, respectively. Invasive non-mucinous adenocarcinoma of the lung (n = 215; 15.0%) and squamous cell carcinoma of the thymus (n = 93; 13.7%) presented the highest number of references. High LOE was observed for colloid adenocarcinoma of the lung (n = 11; 18.2%) and type AB thymoma (n = 4; 1.4%). Tumor descriptors with the highest number of citations were prognosis and prediction (n = 273; 19.0%) for lung, and epidemiology (n = 186; 28.0%) for thymus tumors. LOE was generally low for lung and thymus tumors. This study represents an initial step in the WCT Evidence Gap Map (WCT-EVI-MAP) project for mapping references in WCT-5 for all tumor types to inform future WCT editions.
The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University--Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries

Komabayashi T, Kawamura M, Kim KJ, Wright FA, Declerck D, Goiâs Mdo C, et al.

Int Dent J, 2006 Oct;56(5):310-6.
PMID: 17069075

OBJECTIVE: To explore and describe international oral health attitudes/ behaviours among final year dental students.
METHODS: Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings.
RESULTS: The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums."
CONCLUSION: Grouping the countries into international clusters yielded useful information for dentistry and dental education.
An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students

Kawamura M, Wright FA, Declerck D, Freire MC, Hu DY, Honkala E, et al.

Int Dent J, 2005 Aug;55(4):205-11.
PMID: 16167608

To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students.