Hand Instruments Research Articles

Clinical Comparison of Guided Biofilm Therapy and Scaling and Root Planing in the Active Phase of Periodontitis Management.

The aim of this randomized, controlled, split-mouth study was to compare full-mouth air polishing followed by ultrasonic debridement (known as Guided Biofilm Therapy [GBT]) versus traditional Scaling and Root Planing (SRP), in terms of pocket closure in patients with stages III and IV periodontitis. The patients underwent periodontal therapy in two sessions. At the beginning of the first session, quadrants I and IV and II and III were randomly assigned to GBT or SRP treatment. Periodontal parameters were collected at baseline, 6 weeks (T1), and 3 months (T2) after therapy. The primary outcome was the number of experimental sites (pocket probing depth [PPD] >4 and <10 mm) becoming closed pockets (PPD ≤ 4 mm bleeding on probing [BOP] negative) at T1 and T2. Secondary outcomes were PPD, recession, clinical attachment level, BOP, and plaque index variations at the experimental sites and treatment time. A 10% difference in the primary outcome between the two protocols was set as the threshold to define inferiority/noninferiority of the test treatment. The primary outcome was modeled using a generalized estimating equation model to account for intrapatient measurement correlation. The estimates are reported as differences between groups' percentages (treatments or time points) and corresponding 95% confidence interval (95% CI). All analyses assumed a significance level of 5%. A total of 32 patients were selected. Mean PPD (mm) reduced from 6.23 (6.06-6.40) to 3.33 (3.06-3.61) at T2 for GBT, and from 6.21 (6.04-6.38) to 3.32 (3.11-3.53) at T2 for SRP. Both treatments reached a comparable percentage of closed pockets at T1 (77.9% for GBT vs. 80.1% for SRP, p = 0.235) and T2 (84.1% for GBT vs. 84.4% for SRP, p = 0.878), with no statistically or clinically significant difference. GBT and traditional SRP with ultrasonic and hand instruments reach satisfactory clinical results in the active treatment of patients with stages III and IV periodontitis, with comparable rates of closed pockets and treatment time. GBT is a suitable option in the active phase of periodontitis management in patients with stages III and IV periodontitis.

Effectiveness of hand and rotary instrumentations during biomechanical preparation in primary teeth: an umbrella review with evidence stratification.

Biomechanical preparation (BMP) of primary teeth often involves using hand and rotary instruments. This study aimed to assess the effectiveness of hand and rotary instruments during BMP in primary teeth. A thorough search for relevant systematic reviews and meta-analyses (SRMAs) was conducted in four databases, including MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. The primary outcome assessed was the instrumentation time (IT) for BMP, and the identified SRMAs were qualitatively analysed using the ROBIS tool. Furthermore, quantitative analysis, evidence stratification, and GRADE analysis of eligible SRMAs were performed using the browser-based R package metaumbrella software. Six SRMAs addressing the research question were included, with five being evaluated as having a high risk of bias (ROB). The findings indicated that the IT required for BMP in primary teeth was 3.2 min less (95% CI = 1.52 to 4.93; I2 = 96%; P = < 0.001) using rotary instruments compared to hand instruments, with a 'class IV' evidence stratification and 'very low' class of evidence. Based on the existing evidence, it can be inferred that there is insufficient quality data to recommend the use of rotary instruments over hand instruments in primary teeth.

A multi-national survey-based evaluation of undergraduate/predoctoral endodontic education.

To evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide. The current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data. Amongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training. According to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.

A Survey of Dental Hygiene Pre-Clinic Instrumentation Selection and Sequence.

The purpose of this study was to assess the selection and sequence of dental hygiene instruments taught during dental hygiene pre-clinical education in the United States. Exempt status was received from the University of New Mexico's IRB (ID 21-336). A survey was developed with questions to be answered involving decisions for clinical teaching and sequencing on various assessment and implementation instruments during pre-clinic education. The instrument was 11 questions with multiple choice, ranking and short answer. A survey link was included through email invitation and successfully sent to 301 accredited dental hygiene programme directors in the United States. Results were collected and analysed through descriptive statistics. Forty-three of the invited participants completed the survey, a 14% response rate. Almost half (n = 24) of the participants chose to teach the periodontal probe first and 19 chose the explorer. Twenty-five participants selected they teach the sickle scalers first, 14 teach the universal curette scalers first and 4 teach the Gracey curette scalers first. All participants teach electronically powered scalers with 33 teaching after hand instrumentation and 8 before. Results from this study emphasise that educators teach clinical instrumentation from professional opinion, but no attestation specifically suggests the use of evidence-based pedagogical standards for clinical teaching. Dental hygiene programmes could benefit from further research on pre-clinic instrument selection and sequencing as a way of standardised clinical teaching. These clinical implications could advance the science for standardised teaching of clinical instrumentation and sequencing in dental hygiene education.

Volumetric analysis of Hand and Rotary instrumentation and Evaluation of Obturating material in Primary teeth using CBCT – A Clinical trial

Aims &amp; Background: The biomechanical preparation is considered a critical step in the Pulpectomy procedure. The goal is to remove the microbiological contents in the canal and protect tooth function. In-vitro studies demonstrate that the shape of the root canal is more conical, favouring higher obturation quality and thereby increasing success rate using rotary files. So, this clinical trial aims to compare the volume of root canals before and after root canal instrumentation using hand and rotary files and to evaluate the flow of obturating material using CBCT in primary molars. Materials and Methods: This trial was conducted in 20 primary molars which were assigned to Group 1 (Hand files) and Group 2 (Rotary files). A CBCT was taken at 3 different intervals i.e., Prior to the procedure, After BMP, After the procedure. The difference between the Pre-instrumentation and Post-instrumentation CBCT images reveals the 3D volume change measured using hand and rotary files. Post-instrumentation and Post-obturation CBCT scans display the flow of root canal filling material in primary molars. Results: There were statistically significant differences noticed within Group 1 (p value = 0.000); and pre-instrumentation and post-instrumentation, pre-instrumentation and post-obturation in Group 2 (p value = 0.000). No statistically significant difference seen between post-instrumentation and post-obturation values (p value = 0.076). Significant differences were found in post-instrumentation and post-obturation volumes between groups. Conclusion: This trial concluded that rotary files led to a more productive funnel-shaped canal preparation that resulted in better obturation quality with minimal voids than hand files. Clinical significance: Rotary files using 3D imaging allowed more conservative and efficient root canal preparation while maintaining anatomy, resulting in superior three-dimensional obturation than hand files.

Does achieving apical patency increase postoperative pain during endodontics?

PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature up to May 2023. Twelve studies were included for meta-analysis. Two authors screened databases to identify suitable studies, with a third investigator resolving disagreements. Inclusion criteria were randomized controlled trials (RCTs) involving individuals without systemic diseases, who underwent root canal treatment in a permanent tooth with or without apical patency. Outcomes included pain, number of patients with pain and analgesic use. Exclusion criteria included patients who had undergone tooth extraction, incomplete data reports and studies which were not RCTs. There were no limits on publication language. A search of PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from Google Scholar, ProQuest, OpenAire, and BASE identified 92 articles until May 2023. After removing 42 duplicates, 50 article full texts were assessed. Ultimately, 12 studies were included, seven of which were new relative to previous systematic reviews. Data were analysed using RevMan 5.4 software. Dichotomous categorical data were analysed through the Cochran-Mantel-Haenszel test, with the inverse variance method used for continuous data. Following assessment of heterogeneity with the χ2 test, fixed- or random- effects modeling was used. Pain scores were reported within one week by ten studies, but three were excluded from meta-analysis due to methodological issues. Studies involving participants aged 14-65 years, with pulp necrosis, apical periodontitis, or pulpitis, were included for analysis. Irrigation solutions varied from saline to sodium hypochlorite (2.25-5.25%), EDTA, citric acid, or chlorhexidine. Types of teeth treated included molars and anterior teeth. All studies used a 10# K-file for apical patency and various hand and nickel-titanium instruments for canal preparation. Generally, there was slightly reduced post-operative pain reported through the maintenance of patency. This was evident in the initial post-operative period of 24 h (OR = 1.69, P = 0.002), 1-day (MD = -1.69, P = 0.03) and 2-days (MD = -0.85, P = 0.04), but became non-significant over the remainder of the 7-day monitoring period. There was no significant difference in analgesic use between groups (OR = 0.82, P = 0.42). Studies were classified into three groups based on quality: four high quality with low risk of bias; three moderate quality with some concerns; and five low quality with high risk of bias. Evidence quality varied; pain scores on days 1 and 2 were of low quality, with very low quality for 12 h and days 3-6. High heterogeneity and imprecision were noted, especially in pain measurements and analgesic use. The meta-analysis indicates that during the initial post-operative period, apical patency significantly reduces postoperative pain. However, the findings should be interpreted cautiously due to high heterogeneity and variable evidence quality. Given that apical patency is seen as desirable for achieving the biological aims of endodontic treatment, the fact that it also appears to reduce post-operative pain helps to align patient reported outcome measures with traditional measures indicating success.

A-356 A hand-held microfluidic platform for rapid and sensitive identification of respiratory viruses from nasal swab samples

Abstract Background Identifying the infected individual with a fast and accurate test is essential to constrain the spread of viruses and provide the proper treatment. Antigen rapid test (ART) provides quick screening of infection for patients; however, it shows less promising in the detection of early infection and patent’s full recovery as its inferior sensitivity to the nucleic acid detection method. On the other hand, bulky and costly instrument, tedious and prolonged procedures in traditional nucleic acid testing is also unfavorable for the screening. Delta is developing a fully automated hand-held POC using molecular technology to simultaneously detect 4 targets in 20 mins. The POC can be stand-alone or linked to mobile or PC app for different application scenarios. The proprietary recipe of the lysis buffer could neutralize the inhibition in the sample with effective pathogen lysis in seconds. The microfluidic cartridge containing lyophilized reagent can be stored at room temperature. The amplification signal is detected via the optical system from the colorimetric LAMP. This study is to evaluate the performance of the POC system in detecting SARS-CoV2 (SC2), FluA and B viruses in nasal swab. In addition, the assay performance was further compared with other commercial products available. Methods The attenuated SC2 virus, FluA and B viruses were diluted with 1xTE into different concentrations. The diluted viruses were spiked into the lysis buffer in 5% v/v ratio. Nasal samples collected from donors were soaked and swirled inside the cartridges containing lysis buffer according to the manufacturers’ instructions. For commercial products without lysis buffer, direct swabs were used. The cartridges were then put into the respective devices for further testing. Results The lyophilized SC2 assay consistently detected the viruses at 1000 copies/ml (20 out of 20) in real nasal samples in the presence of Delta Lysis Buffer (containing lyophilized neutralizer). However, without Lysis buffer, there was no signal detected even in the presence of 240x LoD viruses. The whole workflow sensitivity was tested with SC2 positive samples at 1x, 4x, 10x LoD and negative samples in the nasal sample matrix on Delta hand-held system. The results were processed via embedded algorithm and displayed on device as well as on PC and mobile app respectively. Out of 79 positive samples tested, the detection rate was 100%. There was no false positive detection for 31 negative samples tested. Positive internal control indicated the valid runs. 5 major SC2 subtypes (99.8% in silico analysis of 366,707 strains), 10 FluA and 9 FluB subtypes were successfully detected. Further, Delta hand-held platform outperformed in the LoD of SC2 with 500 copies/swab comparing to the ≥50,000 copies/swab of the benchmarked commercial platforms. Conclusions The performance of the hand-held molecular detection system we developed demonstrated a rapid, sensitive, and competitive analytical performance in the respiratory panel detection. The capability of device linking to apps and clouds for data management and the extendable docking system for multiple devices to run samples simultaneously and independently, make it applicable for the infectious diseases screening in both clinical settings and for home-use.

To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy.

The introduction of the rotary file system for children was a revolution in the field of pediatric endodontics. These files are cost-effective and help in consistent obturations with shorter instrumentation time. The present randomized controlled trial (RCT) was planned for a comparative evaluation of rotary and manual techniques in biomechanical preparation of primary molars to determine their effect in terms of cleaning and shaping efficacy, working time, quality of obturation, and postoperative pain. A randomized clinical trial study was conducted in 75 children aged 5-9 years requiring pulpectomy. Each tooth was randomly assigned to one of the three treatment groups: Kedo-S files, rotary K-Flex files, and hand instruments group. It was observed that Kedo-S files and rotary K-Flex files were more effective in cleaning and shaping of root canals compared to hand H/K files. The postbacterial count for hand files was higher compared to rotary files. Shorter working time was seen with rotary files (3.88-5.04 minutes) compared to hand files (15.68 minutes). Rotary files showed a reduced number of voids, with Kedo-S files in 92% of cases and rotary K-Flex files in 80% of cases. Apical seal and extent of fill were maximum with rotary files, having a grade C rating in 92% of cases. Kedo-S files and rotary K-Flex files showed a significant reduction in postoperative pain compared to hand files. The present study showed a significant reduction in bacterial count, working time, quality of obturation, and postoperative pain with rotary files. Moudgalya MS, Tyagi P, Tiwari S, et al. To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy. Int J Clin Pediatr Dent 2024;17(8):864-870.

Fingertip Reconstruction in Hand Injuries

Fingertip amputations are a significant issue in the United States, with approximately 45,000 performed annually, with a 7.5 per 100,000 incidence rate. The primary cause of finger injuries is metal objects and bladed hand instruments, which can lead to cuts, loss of limbs, or damage to nerves and blood vessels. Therapy aims to restore sensation, long-lastingness, and bone support for nail development. Inadequate management can result in cosmetic issues, cold sensitivity, skin soreness, and persistent impairment in functionality. Nail bed injuries, such as lacerations, avulsions, and crush injuries, can result in post-traumatic fingertip amputation. Physical examinations are necessary to evaluate the functional and sensory capabilities of the damaged finger. Surgical intervention is necessary for severe cases, with primary closure or revision amputation being the preferred procedure. Full-thickness skin grafting is also used for fingertip amputations, preserving the structure of the recipient's fingers and addressing areas with insufficient skin. Flap repair is a method for managing fingertip amputations, using skin from another area or distant region. Local flaps are best for small covering areas, while regional flaps are used for extensive incisions. These flaps prevent prolonged immobilization and allow for a return of feeling in the fingertip. Post-amputation complications include delayed wound healing, nail abnormalities, heightened sensitivity, pain, intolerance to cold, scar retraction, limited finger movement, persistent ulcers, infection, and loss of tissue flaps. Inadequate management of fingertip amputations can lead to cosmetic flaws, reduced tolerance to cold, and increased skin sensitivity.

Chemo mechanical caries removal CMCR: Efficacy of Carisolv gel in primary molar teeth.

To evaluate the efficacy of CariSolv gel with respect to chemo-mechanical caries removal in primary molar teeth. The cross-sectional study was conducted at the Department of Paediatric Dentistry, Bakhtawar Amin Dental College and Hospital, Multan, Pakistan, from July to December 2022, and comprised patients of either gender aged 6-12 years having vital, primary molar teeth with clinical and radiographic evidence of carious lesion. Freshly prepared CariSolv gel 0.2 ml to 1.0ml was applied to carious dentine for a minimum of 30 seconds, using chemo-mechanical caries removal hand instruments. The cavity preparation was rinsed and dried. Image caries detector dye was applied by micro brush for 10 seconds. After the cavity preparation was washed and dried, any red-stained dentine indicated residual infected dentine. A maximum of 3 chemo-mechanical caries removal cycles were allowed. Data was analysed using SPSS 26.0. Of the 134 patients, 74(55.2%) were boys and 60(44.8%) were girls. The overall mean age was 8.55±1.58 years. The procedure was successful in 115(85.8%) cases. Age and gender were not significantly associated with the outcome (p>0.05). Chemo-mechanical caries removal method using CariSolv gel was found to be a viable alternative to traditional drilling techniques for caries removal in primary molar teeth.

Effect of a Novel Adaptive Handle Design on the Ergonomic Performance of Periodontal Curettes in Dental Hygienists with and without Musculoskeletal Disorders: A Pilot Clinical Study.

(1) Background: Musculoskeletal disorders (MSDs), discomfort, fatigue, pain, and other acute and chronic work-related injuries are common among dental clinicians. Hand instruments constitute a primary risk factor for these conditions. The overall goal of this study was to compare in dental hygienists with healthy hands, and in those with MSDs, the effect of three different handle designs on instrumentation-related muscle work, comfort, fatigue, and quality of tactile feedback. (2) Methods: Clinicians tested three periodontal curettes: one with a novel adaptive silicone handle, another with a rigid resin handle, and the third with a rigid silicone handle. Ten hygienists-five with MSDs and five without-each scaled three typodonts using the three different curettes. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey's post hoc test, and a significance level of p < 0.05 was implemented. (3) Results: On average, mean comfort and fatigue across all instruments were significantly worse in testers with MSDs, who also expended significantly more work to complete the same task. In all testers, a novel adaptive handle design was associated with significantly reduced total muscle work and post-instrumentation fatigue, as well as better comfort than conventional rigid handle designs. (4) Conclusions: An adaptive curette handle design demonstrated significantly better ergonomic outcomes than conventional rigid curette handle designs. Hygienists with MSDs expend significantly more muscle work during dental instrumentation.

Periodontal host-modulation therapy with avocado/soybean unsaponifiables in rats with arthritis.

The aim of this study was to evaluate the effect of the avocado/soybean unsaponifiables (ASU) in the treatment of induced periodontitis in rats with experimental arthritis. Sixty rats were randomly assigned to 4 groups according to the type of treatment and the systemic condition of the animals: CTR-S: healthy animals in which saline solution (SS) was administered; ASU-S: healthy animals in which ASU (0.6 mg/kg) was administered; AR/ASU-S: animals with induced arthritis in which ASU was administered; AR-S: animals with induced arthritis in which SS was administered. Periodontitis was induced by ligatures, maintained for 15 days. Subsequently, the treatment was performed by scaling with hand instruments. The SS and ASU were administered daily by gavage until euthanasia of the animals that occurred at 7, 15 or 30 days after the scaling procedure (N.=5 animals/group). Bone resorption, inflammatory infiltrate composition, and osteoclastogenesis were assessed. The AR-S group had greater bone loss, smaller amounts of fibroblasts and larger amounts of inflammatory cells than all other groups. In addition, the AR-S group had greater osteoclastogenesis in relation to the healthy animal groups. The use of ASU improved the healing pattern after treatment for experimental periodontitis in animals with arthritis reducing the periodontal bone loss.

Common practices of dental implant maintenance among dental hygienists working in the Netherlands - A survey.

Dental implant maintenance is crucial to obtain and maintain a healthy peri-implant situation. Although it is part of a dental hygienists (DH) scope of practice, the knowledge and common practices among DHs in the Netherlands are unclear. A web-based survey was distributed by the Dutch Association of DHs, by spreading survey QR codes and snowballing. The role of the different DH curricula 2- or 3-year diploma and a 4-year bachelor's degree is evaluated. In total, 165 (diploma: 73, bachelor: 92) DHs responded. Peri-implant diseases were well known (98%), indices and clinical symptoms were used to assess peri-implant tissues. A periodontal probe (97%) was used and bone loss was evaluated on radiographs (89%). Treatment was performed supra- and subgingivally (69%), mostly by titanium (45%) or plastic hand instruments (42%). Ultrasonic (52%) and air-abrasive (52%) devices were often used. The recall interval for maintenance was based on a risk-adjusted protocol (70%). DHs with a bachelor's received significantly more training compared to DHs with a diploma during primary education (p < 0.001). Diploma DHs mainly obtained their knowledge from continuing education (p = 0.04). In general, there was no significant difference in knowledge or common practices. The primary education of DHs with a 2- or 3-year diploma and a 4-year bachelor's varies. Due to the continuing education of diploma DHs, knowledge and common practices generally do not differ. Most DHs in the Netherlands perform implant maintenance. A periodontal probe and radiographs are used for examination. Instrumentation is performed supra- and subgingivally, usually with titanium or plastic hand instruments. The recall interval is based on a patient's risk assessment.

Cryptanalysis of the cryptosystems based on the generalized hidden discrete logarithm problem

In this paper, we will solve an important form of hidden discrete logarithm problem (HDLP) and a generalized form of HDLP (GHDLP) over non-commutative associative algebras (FNAAs). We will reduce them to discrete logarithm problem (DLP) in a finite field through analyzing the eigenvalues of the representation matrix. Through the analysis of computational complexity, we will show that HDLP and GHDLP are not good improvements of DLP. With all the instruments in hand, we will break a series of corresponding schemes. Thus, we can conclude that all ideas of constructing cryptographic schemes based on the two solved problems are of no practical significance.

In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis.

This study aimed to assess the efficacy of root canal debris removal in primary teeth through irrigation using the Endo-Irrigator Plus (CWAIS). A total of 25 primary mandibular first molars were divided into five groups, with five teeth in each group. After determining the working length and performing biomechanical preparation, groups I and II were subjected to hand and rotary instrumentation (ProTaper, Dentsply, United States of America) with conventional syringe irrigation with positive pressure, while groups III and IV were instrumented using hand and rotary instrumentation with positive and negative pressure irrigation employing the Endo-Irrigator Plus (CWAIS) system. Sodium hypochlorite (5.25%) and ethylenediaminetetraacetic acid (EDTA) (17%) were used as irrigants. Group V served as the control group, undergoing only root canal access opening. The removal of the smear layer was analyzed at the cervical, middle, and apical thirds of the canal using environmental scanning electron microscopy (SEM). Statistical significance was set at p < 0.05. Statistically significant differences were observed among all groups at the cervical, middle, and apical levels (p < 0.05). Groups III and IV exhibited significantly lower smear scores at all levels, particularly in the apical third, as observed through SEM examination. The use of the Endo-Irrigator Plus (CWAIS) system demonstrated superior debridement of intracanal debris in primary teeth compared to the positive pressure irrigation method. Badnaware SD, Kakade A, Takate V, et al. In Vitro Efficacy of Apical Negative Pressure Irrigation in Primary Teeth: A Smear Layer Analysis. Int J Clin Pediatr Dent 2024;17(6):653-657.

Insights Into Laparoscopic Port Site Complications: A Comprehensive Review.

Laparoscopic surgery has become a widely accepted standard of care for numerous procedures in the modern world. Nearly every major surgical procedure previously only possible by employing open techniques may now be completed laparoscopically, attributable to the quick advancement of technology and surgeons' abilities. There are several complications associated with the laparoscopic port site, either infective, non-infective, or neoplastic. This study aims to explore the morbidity associated with the port site following laparoscopic surgery and discuss the risk factors for complications. The umbilical port was most frequently associated with port-site hernia (PSH), followed by the epigastrium and the left and right hypochondrium. Prolonged port manipulation and reinsertion, longer surgical times, failure to effectively close the fascial defect, and wound infection are responsible for the development of PSH. Port-site infection (PSI) is one avoidable adverse effect of laparoscopic surgery. Patients who have a history of diabetes, malnourishment, prolonged preoperative hospital stays, preoperative Staphylococcus aureus colonization of the nares, perioperative blood transfusions, and tobacco or steroid use are more likely to have PSI. Port-site hydatid cyst (PSHC) and port-site tuberculosis (PST) are rare but possible. While uncommon, a doctor should rule out endometriosis if a painful mass in the surgical scar, such as the trocar site, is discovered in a reproductive-age woman who has had pelvic or obstetric surgery in the past. Port-site metastasis (PSM) is the term for tumor-cell implantation at the trocar insertion site after a malignant tumor is removed laparoscopically. PSM has been reported in 1-2% of laparoscopic gynecologic surgical procedures. A few potential mechanisms for cell implantation at the port site include embolization of exfoliated cells during tumor dissection or hematogenous spread, air turbulence during long laparoscopic operations, and direct implantation onto the wound during forced, unprotected organ/tissue retrieval or from contaminated surgical instruments during tumor dissection. Nonetheless, the triggering mechanism is likely essentially multifaceted.Prevention is better than cure. Port-site hernia can be prevented using smaller trocars and meticulous rectus sheath defect closure at the end of surgery. The rest of the port site complications can be prevented by employing autoclavable laparoscopic hand instruments, utilizing autoclaved water to clean the instruments following disassembly, adhering to the recommended concentration, contact duration, and usage cycles when sterilizing instruments with liquid sterilizers, preventing bile or gut content from spilling into the operating room or the port site, using non-porous specimen retrieval bags for recovering the specimen, and thoroughly cleaning and irrigating the port site before closing the wound.

Application of Modern Technology in Minimal Invasive Dentistry - A Narrative Review

Preserving human anatomy and physiology is the ultimate goal of all health-related endeavours.The conservation of healthy tooth structure is the goal of minimal-intervention dentistry. The concept of "minimum/minimal intervention dental care" first appeared in the early 1980s. From its origins in general medicine, the minimum intervention philosophy in dentistry was created, focusing patient-oriented oral and dental care to prevent and treat oral disorders and maintaining over all oral health. A more conservative approach to tooth preparation and restoration in operative dentistry is called minimally invasive restorative dentistry. This terminology is relatively new. It comprises prompt identification prior to the onset of cavitation, sealing fissures and pits in uninfected areas, fluoride administration, minimum surgical repair of carious lesions, caries risk evaluation, and patient education regarding self-care. A wide range of methods are used, from initial identification of any demineralized tooth structure to evaluation and therapy, including air abrasion, laser cavity preparation, chemo-mechanical caries removal, and hand instrumentation. Adopting the current advanced method requires sufficient knowledge. The trio that comprises tissue histology, dental biomaterials science and professional patient care and management of materials are considered by the "golden triangle" of minimally invasive treatment options for dental caries in order to enable the successful application of minimally invasive dentistry in all patients. The term "minimal intervention dentistry" (MID) was first used in the early 2000s in a policy statement. Maintaining the greatest amount of healthy tooth structure and keeping teeth functional for life are the goals of MID. This approach is endorsed by the World Dental Federation (FDI) as the modern approach to dental caries management

The first experiences of preclinical dentistry students with rotary instruments: A pilot study

Abstract Introduction: Rotary instrumentation has been included in the undergraduate endodontic curriculum to improve the quality of endodontic treatment. The aim of this study was to compare the technical quality of root canal fillings performed by preclinical dentistry students trained with hand instrumentation (THI) or not during their initial trial with rotary instruments. Materials and Methods: Twenty-four 3rd-year students were distributed into two groups: 12 students THI group and 12 students not trained with hand instrumentation (NTHI group). Both the groups received a 50-min theoretical lecture and a demonstration about the ProTaper Universal® system before being asked to complete endodontic treatments on one extracted maxillary central incisor, premolar, and molar using rotary instrumentation and obturation with the single-cone technique. The endodontic treatment technical quality was determined by periapical radiographs. Data were statistically analyzed, and P &lt; 0.05 was considered statistically significant. Results: A total of 144 root canals were performed by preclinical students. Although the difference in the technical quality of the canals was nonsignificant among the groups (P &gt; 0.05), the THI group had more adequately filled root canals (45.8%) than the NTHI group (29.2%). Only maxillary central incisors had underfilled canals, whereas teeth with multirooted canals were subjected to various procedural errors in both the groups (P &gt; 0.05). Conclusions: Intensive hand instrumentation (HI) preclinical training did not significantly improve the technical quality of root canals performed by preclinical dentistry students during their initial trial with rotary instruments. The student’s familiarity with HI did not decrease the incidence of procedural errors when performing root canal treatment with rotary instruments.

Comparative Evaluation of GC Gold Label IX with GC Gold Label IX Extra and GC Gold Label Hybrid in Cavitated Lesions Prepared by Hand Instrumentation Technique in Primary Molars: An In Vivo Study.

The purpose of the present study was to compare the clinical efficacy of GC Gold Label IX, GC Gold Label IX Extra, and GC Gold Label Hybrid in occlusal surface cavities in primary molars prepared by hand instrumentation technique. Ninety primary molars were selected from the children according to the inclusion and exclusion criteria. The selected teeth were randomly allocated into the following three groups, with 30 teeth in each group, according to the restorative material used: group I: GC Gold Label IX, group II: GC Gold Label IX Extra, and group III: GC Gold Label Hybrid. Occlusal cavities were prepared using hand instruments. Caries removal efficacy was verified using caries detector dye. The restorative materials were mixed and condensed into the prepared cavities. The restorations were assessed using modified United States Public Health Service (USPHS) evaluation criteria at 1, 3, and 6 months. The results were tabulated and statistically analyzed using the Chi-squared test. No significant difference was found in terms of color match, marginal discoloration, marginal integrity, surface roughness, and secondary caries, but a significant difference was observed in terms of retention and anatomic form between group I and group III. GC Gold Label Hybrid exhibited better clinical performance with respect to GC Gold Label IX and comparable clinical performance with respect to GC Gold Label IX Extra. GC Gold Label Hybrid is a newly developed glass ionomer cement (GIC), and its clinical performance needs to be studied. Mittal M, Bajaj N, Bhola M, et al. Comparative Evaluation of GC Gold Label IX with GC Gold Label IX Extra and GC Gold Label Hybrid in Cavitated Lesions Prepared by Hand Instrumentation Technique in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(5):570-575.

Does Full-Mouth Disinfection Influence the Size of the Periodontal Inflammatory Burden and the Level of hsCRP?

To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in C-reactive protein (CRP) levels. The study included 20 systemically healthy subjects (11 women and 9 men) 30 to 68 years old with localised or generalised periodontitis (stage III, grade C). The sizes of the periodontal wound and periodontal inflammatory burden were measured with the web application "Periodontalwound", which is based on measurements of average tooth cervices, as well as probing depths and bleeding on probing assessed at six sites around each tooth present in the oral cavity. The levels of hsCRP (high-sensitivity CRP) were measured with an immunochemical method. All three parameters were measured before initial treatment and 3 months after therapy. Full-mouth disinfection included removal of plaque and calculus with ultrasonic and hand instruments in one session. The results showed a statistically significant decrease in the size of the periodontal wound (p < 0.001), a statistically significant decrease in the size of periodontal inflammatory burden (p < 0.001), and a decrease in hsCRP levels 3 months after therapy. Full-mouth disinfection leads to a decrease in the periodontal wound and periodontal inflammatory burden size, as well as a decrease in the levels of hsCRP in patients with localised or generalised periodontitis (stage III, grade C).