Australian dental journal最新文献

Endodontic treatment can be challenging for a number of reasons, including the microscopic nature of the clinical environment, reliance on tactile sensation and lack of direct visualization of the work being performed. Commonly, endodontic patients present with pain and distress, which can exacerbate an already difficult clinical situation. Complications may might arise prior to, or during treatment, despite practising with the utmost care and skill. Preventing and managing these complications can take considerable time and energy, and oftentimes assistance from or referral to more experienced colleagues is required. The aim of this review is to discuss medico-legal considerations in endodontics, with clinical correlations and a focus on the Australian legal landscape. [Correction added on 18 October 2023, after first online publication: The abstract was amended from a structured to an unstructured abstract.]

Objective

To evaluate the effectiveness of the Empower model of care (EMC) on reducing the addition of teeth to removable partial dentures (RPD).

Methods

Data reports were generated through the Titanium electronic database to retrieve all clients at Monash Dental Services (MHDS) who participated in the EMC or received an RPD prior to the implementation of EMC was assessed over a two-year period to determine if they had additional teeth added to their partial dentures (PD). A logistic regression was performed testing whether a combination of socio-demographic and clinical variables, provided a multivariate explanation of the EMC outcome.

Results

Prior to EMC, 2034 patients attended MHDS requiring RPDs with 363 returning to have teeth added. From 2018 to 2020, 38 of 584 participants in EMC returned to have teeth added to their PDs. Those in the ‘High’ risk group were two times more likely to return requiring additional teeth (OR = 1.99; 95%CI:1.31–3.02); each additional year of age increased the odds of requiring additional teeth (OR = 1.03; 95%CI:1.02–1.04). Participants of the EMC were more than two times less likely to require additional teeth (OR = 0.42; 95%CI:0.29–0.59). The variance in requiring additional teeth accounted for using the full model was 9.1% (η² = 0.091).

Conclusions

This analysis confirms the effectiveness of the EMC. This approach assists denture wearers to maintain good oral health and provides an effective way of managing public health funds by reducing denture repairs and additions. © 2023 Australian Dental Association.

Background

Dental graduates need to demonstrate clinical competency. This mixed-methods study explored the perceptions of clinicians who employ or work with new graduates from the University of Otago, New Zealand, and identified themes reflecting graduates’ preparedness for independent practice.

Methods

An online survey using a semantic differential scale and open-ended questions collected opinions and experiences from the workforce. Quantitative data were analysed using SPSS software, and qualitative data were analysed thematically.

Results

A representative sample of the workforce was obtained with a response rate of 35% (N = 83). Most clinicians engage new graduates to support the profession and/or rural communities. They perceived that graduates were well prepared in most areas, could translate theory to clinical practice and demonstrate professionalism. Graduates were reportedly stronger in basic dentistry, communication, ethics, and record keeping however were less strong in complex treatment planning, molar endodontics, fixed prosthodontics and exodontia. Clinical exposure during dental training was perceived as more limited, and mentoring and guidance in the transition to practice were deemed to be important.

Conclusions

New Zealand dental graduates appear prepared for independent practice; however, maximising clinical opportunities during training, mentoring and early professional development in advanced areas of practice is essential to enhance competency and confidence.

Background

The purpose of this study was to evaluate the local reactions and new bone formation of rat subcutaneous and bone tissue to different calcium silicate cements.

Methods

In this study, 80 rats were divided into five groups as control, BIOfactor MTA (BIO), NeoMTA Plus (NEO), MTA Repair Hp (REP), Biodentine (DENT) and then into two subgroups according to sacrification times (7, 30 days; n = 8). Polyethylene tubes filled with appropriate materials (test groups); empty tubes (control group) were implanted into the dorsum of each rat subcutaneously. For intraosseous implantation, materials were placed in the cavities created in tibia of rats. Subcutaneous tissue and tibia samples were stained with haematoxylin-eosin and subjected to histopathological analysis. A score (0–3) was used to grade inflammatory reaction and new bone formation. Data were analysed by Kruskal–Wallis and Mann–Whitney U tests (P < 0.05).

Results

Inflammatory reaction observed in subcutaneous and intraosseous tissues for 7 days decreased significantly in all groups over time (P < 0.05). It was determined that there was significant increase in new bone formation in REP, BIO, DENT groups over time (P < 0.05).

Conclusion

Four contemporary bioceramic materials induced local inflammation and tissues changes shortly after subcutaneous implantation, which were reduced over time. In ıntraosseous implantation, all materials induced new bone formation over time.

Registration number

ADJ-03-23-0134. © 2023 Australian Dental Association.

Background

Although well accepted by clinicians and patients, teledentistry is not currently a widely used model of care within Australian public oral health services. This qualitative study aimed to review and evaluate dental clinicians' perceptions, by determining the acceptability and appropriateness of teledentistry as a model of care.

Methods

A purposive sample of 12 public dental practitioners employed by a Local Health District in Sydney, and who had participated in teledentistry consultations, were recruited to participate in focus groups. Focus group discussions were transcribed verbatim and subjected to thematic analysis.

Results

Teledentistry was a novel concept for most participants and was well accepted. Participants valued the use of a standardized consultation template as well as effective communication with other dental clinicians to support the practice of teledentistry. However, many found attempting contact with patients over the telephone difficult as well as the perceived patient frustration with the administration process and technological difficulties experienced.

Conclusion

Teledentistry has the potential for growth and expansion in the public health system. From the opinions in this study, the authors propose further research is needed into the efficacy of teledentistry to assist with the development of a model of care that would be beneficial for dental clinicians and their patients. © 2023 Australian Dental Association.

Background

Oral health care improves diabetes management; however, medical and other health practitioners do not commonly refer their patients with diabetes for oral health care. This study aimed to understand barriers to and enablers of dental referrals for patients with diabetes.

Methods

Quantitative data were collected from a cross-sectional survey of health care providers attending a virtual Grand Rounds on the relationship between oral health and diabetes. Attendees were invited to complete and share a Forms survey. Barriers to and enablers of dental referrals were compared for 18 health professionals working in inpatient/ward settings to 23 working in community/primary care settings using the chi-square test.

Results

Across both work settings, only 12% of respondents often or always discussed the importance of oral health and only 8% often or always referred their patients with diabetes for dental care. Time barriers, awareness and knowledge of how/where to send dental referrals were significant barriers, while online referral pathways, more education and availability of brochures for the patient to take home were identified as key enablers for dental referrals.

Conclusions

Online referral pathways, targeted oral health education and resources for medical and health professionals caring for patients with diabetes may increase the number of patients being referred for dental care as part of their diabetes managements. © 2023 Australian Dental Association.

Background

The aim of this study was to evaluate the shear bond strength of three different calcium silicate-based cements (CBCs) with two different bulk-fill composite resins (CRs).

Methods

Plexiglas moulds with a diameter of 4 mm and a thickness of 2 mm were prepared (n = 60). The Biodentine, NeoPutty and MTA Cem LC samples were randomly divided into two subgroups containing 10 samples each. Surfaces of samples were air dried and Single Bond universal adhesive was applied. Cylindrical plastic capsules of 4 mm height and 2 mm inner diameter belonging to Filtek Bulk-fill and EverX Posterior CRs were centred on coating material and polymerized for 20 s. After shear bond strength (SBS) testing, all samples were examined by scanning electron microscopy (SEM) to identify failure patterns. Three samples, one from each group, were prepared to evaluate chemical composition of CBCs and examined with an energy dispersive X-ray spectroscopy for surface elemental analysis.

Results

The values obtained from the tests were evaluated as statistically significant (P < 0.05). After SBS testing, the difference between all CBCs was statistically significant in both CRs.

Conclusion

According to the findings in this study, it was concluded that MTA Cem LC had highest SBS values in both CRs. © 2023 Australian Dental Association.

Background

Oral health promotion initiatives must be evidence-based and consistent with broader health messaging. The Oral Health Messages for the Australian Public were first produced in 2009 and sought to enable a focused, and strategic approach to oral health promotion in Australia. As the evidence base and needs of the Australian population have since changed, this consensus statement was updated in 2022–2023.

Methods

The process of updating the messages consisted of 3 phases (preparatory phase, the Delphi technique, final revision phase). The preparatory phase included public and expert consultation, an umbrella review of published scientific literature and review of available recommendations, policies and guidelines. The Delphi technique used in this study was guided by Guidance on Conducting and REporting DElphi Studies (CREDES) and included 2 voting rounds. There were 70 experts in round 1 and 60 experts in round 2. Delphi participants comprised of experts from a variety of fields to ensure diversity and inclusion, balance expertise and maximize stakeholder representation. Consensus was defined as 75% agreement.

Results

A total of 11 messages were included in the 2022 update of Oral Health Messages for Australia.

Conclusion

The updated oral health messages will support oral health promotion policy and activity at both individual and population level to improve the oral health of Australians.