Complete debridement and disinfection of the root canal system are fundamental requirements for successful endodontic treatment. Despite the morphological challenges of the internal root anatomy, root canal irrigants play an important role in the optimization of the root canal preparation, which is essentially a chemo-mechanical procedure. Enterococcus faecalis is one of the most resistant microorganisms that dominants the microbial ecosystem of persistent periradicular lesions in retreatment cases. For that reason, many in vitro and in vivo studies evaluated and compared the antibacterial activity of sodium hypochlorite and chlorhexidine at varying concentrations using different experimental models against this microorganism. However, many controversies with regard to the ideal irrigant and concentration do in fact exist. Hence, this review aims to discuss the antibacterial activity of these two main root canal irrigants against Enterococcus faecalis using the agar diffusion and direct contact methods and the possible modulating factors responsible for inconsistent findings among different studies. In addition, the disinfection potential of both chemical agents on gutta percha and Resilon cones are also discussed. The source of this review was conducted through an electronic literature search using PubMed database from December 1997 until December 2011, which analyze the related laboratory investigations of both irrigants, published in major endodontic journals.
Objective
The aim of this review was to provide an insight about the factors affecting the properties of glass ionomer cements and provides a review regarding studies that are related to modification of glass ionomer cements to improve their properties, particularly on physical‐mechanical and antimicrobial activity.
Methods
PubMed and Science Direct were searched for papers published between the years 1974 and 2018. The search was restricted to articles written in English related to modification of glass ionomer cements. Only articles published in peer‐reviewed journals were included. The search included literature reviews, in vitro, and in vivo studies. Articles written in other languages, without available abstracts and those related to other field were excluded. About 198 peer‐review articles in the English language were reviewed.
Conclusion
Based on the finding, most of the modification has improved physical‐mechanical properties of glass ionomer cements. Recently, researchers have attempted to improve their antimicrobial properties. However, the attempts were reported to compromise the physical‐mechanical properties of modified glass ionomer cements.
Clinical significance
As the modification of glass ionomer cement with different material improved the physical‐mechanical and antimicrobial properties, it could be used as restorative material for wider application in dentistry.
ObjectivesEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.MethodsA structured questionnaire prepared after consultation with experts in the field and guided by the “Report of the SAGE working group on vaccine hesitancy” was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine.ResultsAlthough 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines.ConclusionsCOVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.
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