The outbreak of COVID-19 pandemic in 2020 has dramatically changed teaching approach in dental schools due to the switch to distance learning and the lack of practice training in direct contact with patients with possible impact on clinical skills of students. The aim of the study was to assess the level of the 2020 final year dental students’ self-confidence in performing different dental procedures through specially designed questionnaire and compare it to self-confidence of the 2019 final year students. An anonymous questionnaire consisting of 40 questions regarding self-confidence level in performing 40 different dental procedures and based on five points Likert-like scale was distributed during November 2020 to final year dental students whose studies were disrupted by the COVID-19 pandemic lockdown in one semester. The study group comprised their answers. The comparison was done with the control group that consisted of students’ answers on the same questionnaire from previous 2019 year conducted as a part of regular internal educational evaluation. Response rate was 74.2% in study group and 89.3% in control group. Mean level of self-confidence reported by 115 students in study group was significantly lower than that reported by 100 students in control group (3.28±1.08 vs. 3.58±0.88, respectively) and the distribution of self-confidence scores were different in observed groups. Graduates from study group felt less confident than those from control in 8 clinical skills. Abrupt changes in teaching modalities caused by COVID-19 pandemic had significant impact on final year dental students’ self-confidence indicating additional educational needs in postgraduate period.

Background/Objectives: Inexperienced dentists and dental students are especially prone to misdiagnosis, and this represents a huge problem regarding antimicrobial stewardship. We aimed to develop a mobile app for rational antibiotic prescribing in dentistry based on local–systemic symptoms and patient factors, rather than solely on diagnosis, to tackle misdiagnosis. Methods: The study involved 64 participants, 50 of which were third-year dental students attending a pharmacology course focusing on antimicrobials, comprising lectures and practical sessions without (noAPP group, n = 22) or with (APP group n = 28) the assistance of a mobile application. The other 14 participants were practicing dentists who decided to register and use the application. All registered users of the application were asked to take a feedback survey, while learning outcomes were evaluated via a pharmacology quiz. Results: A decision tree was used for application development. In total, 76 impressions were collected on the application. The majority of the impressions were related to odontogenic–endodontic infections. Multiple linear regression analysis did not reveal differences in survey responses between practicing dentists and undergraduate students in the feedback survey responses. There was a significant difference in the mean pharmacology test scores between the noAPP and APP groups (5.50 ± 1.80 vs. 7.21 ± 1.03, p = 0.0001). Conclusions: The dentalantibiotic.com application was developed to support rational antibiotic prescribing, in view of tackling misdiagnosis, among inexperienced dentists, as well as to assist in undergraduates’ pharmacology learning, and the current study shows its large impact as an educational tool. The majority of participants considered it easy to use, efficient in facilitating the right antibiotic choice, and useful for everyday decision-making.

High elution and diffusion of 2-hydroxylethyl methacrylate (HEMA) and camphorquinone (CQ) through dentinal tubules may induce pulp injury and postoperative sensitivity. We aimed to investigate the melatonin protective effect in HEMA- and CQ-treated human dental pulp cells (hDPCs) as well as its relevance in a mechanism for postoperative sensitivity in diabetic patients. hDPCs were exposed to HEMA (5 mM) and/or CQ (1 mM) in the absence and presence of melatonin (MEL) (0.1 mM and 1 mM). Heme oxygenase-1 (HMOX1), NADPH oxidase-4 (NOX4), BCL-2-associated X-protein (BAX), B-cell lymphoma-2 (BCL-2) and caspase-3 (CASP3) gene expression levels, and superoxide dismutase (SOD) activity were measured in hDPCs while inducible nitric oxide synthase (iNOS) and melatonin protein expression were measured in human dental pulp as well, by RT-PCR, by ELISA, and spectrophotometrically. Bioinformatic analyses were performed by using the ShinyGO (v.0.75) application. Type 2 diabetic patients showed a higher incidence of postoperative sensitivity and lower melatonin and higher iNOS content in dental pulp tissue compared with non-diabetic patients. Melatonin, when co-added in hDPC culture, reverses HEMA and CQ cytotoxic effects via anti-apoptotic and anti-inflammatory/antioxidant iNOS-related effects. Enrichment analyses showed that genes/proteins, altered by HEMA and CQ and normalized by melatonin, are the most prominently overrepresented in type 2 diabetes mellitus pathways and that they share subcellular localization in different oligomeric protein complexes consisting of anti- and pro-apoptotic regulators. This is the first evidence of the ability of melatonin to counteract iNOS-mediated inflammatory and stress effects in HEMA- and CQ-treated hDPCs, which could be of significance for the modulation of presently observed immediate postoperative sensitivity after composite restoration in type 2 diabetic patients.

To evaluate knowledge regarding the management of deep carious lesions and exposed pulps among undergraduate and postgraduate endodontic students from ten dental institutions across ten countries, and the impact of operator (material, antibiotic prescription) and patient-related (age, symptoms) factors on their treatment protocols. An online questionnaire was distributed to evaluate student knowledge of the management of deep caries and exposed pulp related to four clinical scenarios. Simple descriptive statistics were used to describe the data and McNemar tests were employed to identify significant differences between the scenarios. The P-value was set at 5%. A total of 435 undergraduates and 139 postgraduates from ten dental schools participated in this survey. The final survey included 401 responses from undergraduates and 127 from postgraduates for statistical analysis. When symptoms were present, the majority of undergraduate and postgraduate students preferred non-selective (complete) caries removal over selective (partial) caries removal in young patients. The majority of postgraduates preferred partial pulpotomy in younger patients and pulpectomy and root canal treatment (RCT) in older patients. The majority of undergraduates preferred pulpectomy and RCT in both young/old patients when symptoms were present. The majority of undergraduates and postgraduates opted for mineral trioxide aggregate and Biodentine, respectively, when treating the exposed pulp. Systemic antibiotics were not recommended by both undergraduates and postgraduates, regardless of the patient's age and symptoms. Among the scenarios surveyed, the majority of undergraduates and postgraduates preferred: a) pulpectomy and RCT for older patients in the presence or absence of symptoms; b) hydraulic calcium silicate cements as pulp capping material; and c) did not recommend systemic antibiotics. The majority of students choose non-selective (complete) caries removal in all cases and if the pulp is exposed, the use of hydraulic calcium silicate cements iwas the preferred material. Systemic antibiotics are considered unnecessary, irrespective of the patient's age and symptoms.

The adhesion of endodontic sealers to dentin may be influenced both by the chemical composition of the sealer and the final irrigation protocol. The aim of this study was to examine the push-out bond strength of three differently formulated bioceramic sealers to root canal dentin, after different irrigation protocols. Four cavities were prepared in dentine discs obtained from middle thirds of third molars with fused roots. Discs were randomly divided into three groups (n = 8). Group 1: specimens were immersed in 2.5% NaOCl; group 2: in 2.5% NaOCl followed by 17% EDTA; and group 3: in a solution of 2.5% NaOCl with 9% etidronic acid (HEDP). The cavities on each disk were filled with four tested sealers: AH Plus Bioceramic, Bio C Angelus, BioRoot RCS, and AH Plus (n = 8 per sealer). The push-out bond strength test was performed after 7 days. The data were statistically analyzed using two-way analysis of variance with the Bonferroni post hoc test (α = 0.05). Irrigation with NaOCl resulted in significantly lower bond strength values of the sealers in comparison to NaOCl/EDTA and NaOCl/HEDP groups. In the NaOCl and NaOCl/HEDP groups, BioRoot RCS showed similar push-out bond strength compared to AH Plus and significantly higher compared to Bio-C and AH Plus Bioceramic. In the NaOCl/EDTA group, bioceramic sealers achieved a significantly weaker bond strength compared to AH Plus. The bond strength of BioRoot RCS was significantly higher compared to Bio-C and AH Plus Bioceramic. The irrigation protocols and the chemical composition of the sealers significantly influenced their bond strength to dentin. Epoxy resin-based sealer achieved the strongest bond strength, while within bioceramic sealers, the highest values were obtained for BioRoot RCS and the lowest for AH Plus Bioceramic.