Background
Dental professionals are the primary care providers for traumatic dental injuries (TDI). The dental traumatology literature has a number of studies evaluating the knowledge of dental professionals from different parts of the world but its global status is unknown. Hence, the aim of this systematic review was to assess the global status of knowledge for the prevention and emergency management of TDI in dental professionals and to provide recommendations for future research.
Materials and Methods
The protocol was designed as per the PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad‐based search using text words and MeSH terms was performed in established databases as per a pre‐defined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta‐analysis was performed.
Results
Sixteen studies, which had been published between 2008 and 2020, were included for qualitative synthesis. Most of them were cross‐sectional, used convenience sampling and evaluated knowledge for avulsion. Previous dental trauma training was undertaken by <50% of the participants of five studies, <50% knew about the correct approach in management of complicated crown fractures in three studies and ≤60% in four studies knew the critical time for replantation. There was insufficient level of knowledge in >50% of the included studies. High risk of bias was found in three studies.
Conclusion
The knowledge level in several areas of the world was unknown. The studies lacked uniformity in methods and well‐designed questionnaires and they revealed insufficient levels of knowledge among dental professionals.
Background
Pulpotomy is an effective, vital pulp therapy procedure for caries‐affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable.
Aim
The aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison.
Design
This review followed the principles of evidence‐based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self‐designed pilot‐tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews‐2 (AMSTAR‐2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta‐analyses.
Results
The scrutiny of 62 full‐text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta‐analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full‐strength/1:5 diluted and full‐strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data.
Conclusions
The pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries‐affected primary teeth and elucidates the domains that require primary studies in the future.
Idiopathic gingival enlargement is a rare non-hemorrhagic, slowly proliferative fibrous lesion of the gingival tissue in which no causative agent can be identified. These type of enlargement causes esthetic and functional problems. This case report highlights the diagnosis and treatment of the idiopathic gingival enlargement of a 14 years old female patient who presented with a generalized diffuse type of gingival enlargement in both the maxillary and mandibular arches which covers maximum portion of the crowns. Based on family history and clinical examination, diagnosis was made following which segment wise gingivectomy was carried out. Histopathologic evaluation was also done. Post operative enlargement was noticed on first week which gradually decreased to some extent in the third week post operatively.
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