[Show abstract][Hide abstract] ABSTRACT: The transmission of blood-borne viruses in dental offices is a potential hazard to patients and dental staff. The aim of the study was to clarify the current situation regarding hepatitis B virus vaccination, percutaneous injuries among members of the Lithuanian dental community.
A confidential, self administered questionnaire was send to all 2235 Lithuanian general dental practitioners. The questionnaire collected data on sociodemographic characteristics, practice time, working place and environment, hepatitis B virus (HBV) vaccination, history of hepatitis B infection, and needlestick and sharp instruments injury (NSII).
Overall response rate was 64.7% (87.4% of them were women; 64.1% were working in five major cities of Lithuania and 60.8% in private clinics. Mean age of respondents was 44.8 (range 23 - 74 years). As much as 95.3% dentists expressed concern about the risk of cross-infection from patients to themselves and their dental assistants. Respondents reported: complete immunization against HBV (35.9%); previous hepatitis infection (4.3%); needlestick and sharp instruments injury (78.5%); collecting medical history about HBV from patients (30.9%).
Despite a high risk of needlestick and sharp instruments injury in the dental practice as well as high risk of HBV infection and the existence of strong rules and recommendations for routine HBV vaccination, vaccine coverage among Lithuanian dentists cannot be assumed to be adequate. Further continuing education programs and stronger control measures might be suggested.
Full-text · Article · Jan 2011 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: To analyze clinical data of patients treated for mouth floor cellulitis during 2003-2006 years at the Department of Maxillofacial Surgery, Vilnius University Hospital Zalgiris Clinic and to compare the results with existing data.
Patient's gender, age, social insurance, demographic profile, preference of first visit, previous treatment, origin of inflammation, symptoms of disease, treatment protocol and outcomes were evaluated from 240 clinical records.
The male-female ratio was 1.3:1. The mean age of patients was 43.18+/-7.56 years. 65% of patients were from urban. 47% of patients were employed, 15% retirees, 22% unemployed, 10% children, 2% students and 4% handicapped people. In 65% of cases primary diagnosis was incorrect. Majority of patients appealed to doctor on the first five days from the beginning of the disease. 93.7% of mouth floor cellulites were odontogenic origin. In 32.9% of the patients at the time of first examination the extension of inflammation into parapharyngeal, pterygomandibular spaces or neck together with mouth floor cellulitis was diagnosed. In 1.7% (in 4 out of 240) of cases infection extended into the neck and parapharyngeal spaces despite treatment. In 2% (in 5 out of 240) of cases infection extended to mediastinum.
Despite the aggressive treatment serious complications still are possible. Delayed treatment procedures might determine poor prognosis.
Full-text · Article · Jan 2010 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to gather information about the various aspects, technical and biological, of endodontic treatment as performed by Lithuanian general dental practitioners and to compare their choices with established endodontic treatment standards of undergraduate education.
Questionnaires were sent to all 2,850 Lithuanian dental practitioners. The structured questionnaire included inquiries about gender, duration of professional activity, working environment, details about instruments and materials.
From total 1532 (53.8%) questionnaires were returned. Only responses from general dental practitioners (1431) were included. Of the respondents 66% never used a rubber dam. Most practitioners relied on conventional stainless steel instruments. The NiTi hand files were often and routinely used by 32.2% of the respondents. Sodium hypochlorite was the most popular choice as a root canal irrigant. Calcium hydroxide paste was used as an inter-appointment medicament. Cold-lateral condensation root filling method was used by 72.8% of the respondents while 15.6% used a paste for the root filling.
The results of this study indicate that the recently graduated dental practitioners were following the recommended standard of endodontic treatment better than those with a longer time from the graduation. It is important to improve the quality of existing courses of continuous education in endodontology in order to ensure the necessary competency in clinical practice. The low use of a rubber dam and low adoption of new technologies in Lithuania is not acceptable and needs to be changed.
Full-text · Article · Jan 2010 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: Research data regarding attitudes of general dental practitioners towards endodontic therapy is rare. The present review summarizes existing literature and analyzes human factors that could potentially influence the outcome of endodontic treatment in general dental practice. Root canal treatment usually fails when treatment falls short of acceptable standards. The results of questionnaire surveys from several countries indicate that differences between daily general practice and academic teaching exist. The results of studies indicated that majority of general practitioners disregard the most basic principles of endodontic treatment. The most striking finding is the generally negative attitude amongst general dental practitioners towards performing endodontic treatment and adoption of new technologies in a daily endodontic practice. The results confirm that root canal treatment is technically demanding and in general practice is carried out under less than optimal conditions. This review shows the importance of continuous dental education for practitioners in order to update their knowledge.
Preview · Article · Feb 2009 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: To gather information about the radiographic facilities and techniques used by Lithuanian general dentists.
Questionnaires were sent to all 2879 Lithuanian dental practitioners registered on the Lithuanian Dental Chamber licence registry data list. The questionnaire was made with multiple-choice answers. Respondents were invited to choose the only one category of answer that best fitted their clinical attitude. Questions included in the present survey concerned general and specific information regarding peculiarities of radiographic imaging. Only answers of respondents who are licensed as general dentists were included in this study.
From the 2850 questionnaires mailed 1532 were returned. The response rate was 53.8%. Of the total responses 1431 questionnaires were received from licensed general dentists. Of total 956 dentists practiced in urban and 576 dentists in rural areas. 61.6% of respondents had access to an intra-oral radiographic unit in their practice and 91.5% of them used dental radiography always or often as the diagnostic tool. To support the film packet in the patient's mouth alternatively film holder or patient's finger was used by 48% of respondents, while film holder was used only by 19.3% of dentists.
Recently graduated dental practitioners more common used diagnostic radiography in endodontic pathology than dentists with a longer time from graduation. Film holder was not a popular device among general dental practitioners to perform periapical radioraphs. It is important to improve the existing dental curriculum to ensure the necessary competency when using dental radiography and film holders routinely in clinical practice.
Preview · Article · Jan 2009 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the technical quality of root fillings in root filled teeth, their association with periapical status and prevalence of apical periodontitis.
The sample consisted of 83 subjects, presenting consecutively as new patients seeking dental care (prosthetic, endodontic and cariologic treatment) in the years 2005/2006. Clinical and radiographic examination on each patient was performed using the scoring system (Periapical index (PAI)) proposed by Ørstavik et al. From the periapical radiographs status of endodontically treated teeth was recorded. For each tooth the following items were surveyed: the presence of a root filling, its quality (lateral seal and length in the root canal) and the periapical status.
Of the 2186 functional teeth, 283 had undergone root canal treatment (13%). Amongst 283 root filled teeth, 122 teeth (43.1%) had radiological signs of a periapical lesion (PAI>2). Only 28.6% of the root filled teeth fulfilled the criteria of an acceptable root canal filling. Inadeguate lateral seal of root filling was observed in 165 (58.3%) of 283 endodontically treated teeth. Inadequate length of endodontic treatment was discovered in 183 (64.7%) out of 283 teeth. Root filled teeth without voids had apical periodontitis in 25 (21.0%) out of 118 of cases, whereas if voids were detected, disease was present in 97 (58.8%) out of 165 teeth (p<0.001). Apical periodontitis was found in 23 (23.0%) out of 100 teeth with adequate length of root filling, whereas if the filling was too short or long, periapical lesions were present in 99 (54.0%) out of 183 teeth (p<0.001).
Apical periodontitis was present in 43,1% of root filled teeth. Only 28.6% of the root filled teeth fulfilled the criteria of an acceptable root canal filling. The results of this study indicate that inadequate root fillings were more often associated with an increased prevalence of apical periodontitis. On the contrary, adequate root fillings significantly reduced the prevalence of disease. Many root canal treatments were technically unsatisfactory and substantial efforts must be made to improve the standard of endodontic treatment.
Preview · Article · Jan 2006 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: Root canal retreatment in teeth restored with intraradicular posts has attracted interest due to the difficulties of their removal without weakening, perforating or fracturing the remaining root structure. The use of ultrasonic devices has been suggested by some authors to facilitate post removal, reducing the possibility of fractures or root perforations. The purpose of this study was to determine the efficacy of cast posts removal by ultrasonic device regarding post length, adaptation of post to root canal walls and cement type.
Seventy-seven single rooted endodontically treated teeth restored with cast posts were included to this study. Post removal was processed with ultrasonic and time for this was recorded. The length and width of the post, quality of post adaptation, type of cement were evaluated according to radiographic findings and clinical records.
Mean value of time needed for post removal was 14.15 (SD +/- 8.57) minutes. A strong correlation was observed between the time of post removal and post length (r=0.620, p=0.000). The mean time required for the removal of posts cemented with zinc phosphate was 11.36 min (SD +/- 5.84) and for the posts cemented with resin modified glass-ionomer was 15.37 min (SD +/- 3.83). Statistically significant difference in the time needed for the posts cemented with different cements was observed (p = 0.002). The mean time needed for the post removal with the inappropriate adaptation was 10.1 min (SD +/- 6.0) and the time for the post with appropriate adaptation was 15.7 min (SD +/- 8.9). Statistically significant difference between these two groups was observed for the time of posts removal (p = 0.003). According to the results of linear regression model test, 50% of variation in time needed to remove posts was explained by following variables: post length, post adaptation and the cement type. The total regression model was highly significant (p = 0.000).
The time taken for post removal depended on post length, its adaptation in the root canal and on the type of luting cement. Root fractures are unlikely to occur with good case selection.
Full-text · Article · Feb 2005 · Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]
[Show abstract][Hide abstract] ABSTRACT: SUMMARY Vertical root fracture of endodontically treated tooth is a frustrating complication that leads tooth to extraction. The aim of this study was to evaluate clinical and radiographical findings in endodontically treated and restored teeth with the vertical root fractures. During a three year period the authors examined 50 patients with 53 root-canal-treated teeth with vertical fracture. During study the existence of vertical root fracture, the type of root canal therapy, the type of coronal restoration, the type, length of the post and the height of the tooth coronal part were evaluated. In 60.4 % of all studied cases with vertically fracture were premolars, 22.6 % constituted incisors followed by molars 13.2%. Thirty seven vertically fractured teeth out of 53 (70%) served as bridge abutment, 16 (30%) vertically fractured teeth were restored with single restoration. Cast posts, screw posts, amalgam or composite cores were observed in 43 teeth out of 53 (81 %). In 38 cases out of 43 (88,4%) filling material or post was ending at the coronal third of the root canal. The mean of the length of the post was 4.1mm (SD±1.5), while the mean of the height of coronal restorations was 7.6 mm (SD±1.1). The correlation between the length of the post from the root canal orifice and the height of the coronal restoration was observed (p=0.025). A V-shaped pattern osseous defect (dehiscence) was typical and was found in 96 % of cases. Periodontal pocket was detected in 46 out of 53 cases with mean depth 4.63mm (SD±1.1). This study confirm the findings of other studies where was stated that vertical root fractures are caused by poorly designed dowels (too short, too wide or both), inappropriate selection of the tooth as a bridge abutment or as a consequence of overzealous endodontic forces by a restoration that exerted lateral pressure on the axial walls of the preparation.