The aim of the study was to analyze the chemical–physical properties and bioactivity (apatite-forming ability) of three recently introduced premixed bioceramic root canal sealers containing varied amounts of different calcium silicates (CaSi): a dicalcium and tricalcium silicate (1–10% and 20–30%)-containing sealer with zirconium dioxide and tricalcium aluminate (CERASEAL); a tricalcium silicate (5–15%)-containing sealer with zirconium dioxide, dimethyl sulfoxide and lithium carbonate (AH PLUS BIOCERAMIC) and a dicalcium and tricalcium silicate (10% and 25%)-containing sealer with calcium aluminate, tricalcium aluminate and tantalite (NEOSEALER FLO). An epoxy resin-based sealer (AH PLUS) was used as control. The initial and final setting times, radiopacity, flowability, film thickness, open pore volume, water absorption, solubility, calcium release and alkalizing activity were tested. The nucleation of calcium phosphates and/or apatite after 28 days aging in Hanks balanced salt solution (HBSS) was evaluated by ESEM-EDX, vibrational IR and micro-Raman spectroscopy. The analyses showed for NeoSealer Flo and AH Plus the longest final setting times (1344 ± 60 and 1300 ± 60 min, respectively), while shorter times for AH Plus Bioceramic and Ceraseal (660 ± 60 and 720 ± 60 min, respectively). Radiopacity, flowability and film thickness complied with ISO 6876/12 for all tested materials. A significantly higher open pore volume was observed for NeoSealer Flo, AH Plus Bioceramic and Ceraseal when compared to AH Plus (p < 0.05), significantly higher values were observed for NeoSealer Flo and AH Plus Bioceramic (p < 0.05). Ceraseal and AH Plus revealed the lowest solubility. All CaSi-containing sealers released calcium and alkalized the soaking water. After 28 days immersion in HBSS, ESEM-EDX analyses revealed the formation of a mineral layer that covered the surface of all bioceramic sealers, with a lower detection of radiopacifiers (Zirconium for Ceraseal and AH Plus Bioceramic, Tantalum for NeoSealer Flo) and an increase in calcium, phosphorous and carbon. The calcium phosphate (CaP) layer was more evident on NeoSealer Flo and AH Plus Bioceramic. IR and micro-Raman revealed the formation of calcium carbonate on the surface of all set materials. A thin layer of a CaP phase was detected only on AH Plus Bioceramic and NeoSealer Flo. Ceraseal did not show CaP deposit despite its highest calcium release among all the tested CaSi-containing sealers. In conclusion, CaSi-containing sealers met the required chemical and physical standards and released biologically relevant ions. Slight/limited apatite nucleation was observed in relation to the high carbonation processes.

Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p < 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working >5 h/day and >30 h/week. In addition, a high prevalence was found in operators working for 2–5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators.

Background: Recently several calcium silicate flowable sealers have been introduced as endodontic materials for the root canal. This clinical study tested the use of a new premixed calcium silicate bioceramic sealer in association with the Thermafil warm carrier-based technique (TF). Epoxy-resin-based sealer with the warm carrier-based technique was the control group. Methodology: Healthy consecutive patients (n = 85) requiring 94 root canal treatments were enrolled in this study and assigned to one filling group (Ceraseal-TF n = 47, AH Plus-TF n = 47) in accordance with operator training and best clinical practice. Periapical X-rays were taken preoperatively, after root canal filling and after 6, 12 and 24 months. Two evaluators blindly assessed the periapical index (PAI) and sealer extrusion in the groups (k = 0.90). Healing rate and survival rate were also evaluated. Chi-square tests was used to analyze significant differences between the groups. Multilevel analysis was performed to evaluate the factors associated with healing status. Results: A total of 89 root canal treatments in 82 patients were analyzed at the end-line (24 months). The total drop-out was 3.6% (3 patients; 5 teeth). A total of 91.1% of healed teeth (PAI 1-2) was observed in Ceraseal-TF, with 88.6% in AH Plus-TF. No significant difference was observed on healing outcome and survival among the two filling groups (p > 0.05). Apical extrusion of the sealers occurred in 17 cases (19.0%). Of these, 6 occurred in Ceraseal-TF (13.3%) and 11 in AH Plus-TF (25.0%). Three Ceraseal extrusions were radiographically undetectable after 24 months. All the AH Plus extrusions did not change during the evaluation time. Conclusions: The combined use of the carrier-based technique and premixed CaSi-based bioceramic sealer showed clinical results comparable with carrier-based technique and epoxy-resin-based sealer. The radiographical disappearance of apically extruded Ceraseal is a possible event in the first 24 months.

Dental-care workers operate very close to the patient’s mouth and are at high risk of contamination by SARS-CoV-2. Droplets may be contaminated by patient’s saliva and exhaled breath particles. All asymptomatic patients should be considered as Coronavirus positive. All dental procedures must be revised after positive identification of SARS-Cov-2. Novel recommendations as the use of novel suction cannula designed for fast spray/saliva aspiration, use of Tyvek suits and innovative sprayhoods designed for dental-care worker protections are proposed to prevent virus transmission. New tailored operative and clinical procedures are being currently developed by university dental clinics and hospitals in attempt to reduce risk for dental workers and patients.

Extensive literature reports an increase in physical disorders (pain, pathologies, dysfunctions) and mental malaise/uneasiness (stress, burnout) affecting dental professionals in relation to fast and pressing rhythms of work, long working hours, increasingly demanding patients, ever-evolving technologies, etc. This project has been conceived to bring the science of yoga around the world to dental professionals as a preventive (occupational) medicine and to provide knowledge and means for self-care. Yoga is a concentrative self-discipline of the mind, senses, and physical body, that requires regular daily exercise (or meditation), attention, intention, and disciplined action. M&M: The study aimed to design a Yoga protocol specifically devised for dental professionals (dentists, dental hygienists, and dental assistants) including positions (āsana) to be practiced/used in the dental office. The protocol is targeted for the upper body, namely neck, upper back, chest, shoulder girdle, and wrists, being areas greatly affected by work-related musculoskeletal disorders. This paper represents a yoga-based guideline for the self-cure of musculoskeletal disorders among dental professionals. Results: The protocol includes both sitting (Upavistha position) and standing (Utthana or Sama position) āsana, with twisting (Parivrtta), side bending (Parsva), flexion and forward bending (Pashima), and extension and arching (Purva) āsana to mobilize and decompress, and to provide nourishment and oxygen to the musculo-articular system. The paper delivers different concepts and theories developed and deepened by the authors and introduces and spreads yoga as a medical science among dental professionals for the prevention and treatment of work-related musculoskeletal disorders. We articulate notions ranging from stretching out using the vinyāsa method (breath-driven movement) and inward-focused attention to contemplative/concentrative science, interoceptive attention, self-awareness, the mind–body connection, and receptive attitude. The theory of “muscles are bone ties” is coined and delivered with regard to tensegrity musculoskeletal fascial structures connecting, pulling together, and nearing the bone segments where they are anchored. The paper describes over 60 āsana envisaged to be performed on dental stools or using the walls of a dental office or a dental unit chair. A detailed guideline on the work-related disorders that can find relief with the protocol is provided, including the description of breath control for the practice of āsana in vinyāsa. The foundations of the technique reside in the Iyengar Yoga method and Parināma Yoga method. Conclusions: This paper represents a guideline for self-cure in the prevention or treatment of musculoskeletal disorders affecting dental professionals. Yoga is a powerful concentrative self-discipline able to provide physical and mental well-being, representing great help and support in daily life and business for dental professionals. Yógāsana restores retracted and stiff muscles, giving relief to the strained and tired limbs of dental professionals. Yoga is not intended for flexible or physically performing persons but for people who decide to take care of themselves. The practice of specific āsana represents a powerful tool for the prevention or treatment of MSDs related to poor posture, forward head, chronic neck tension (and related headache), depressed chest, compressive disorders on wrists and shoulders as carpal tunnel, impingement syndromes, outlet syndrome, subacromial pain syndrome and spinal disc pathologies. Yoga, as an integrative science in medicine and public health, represents a powerful tool for the prevention and treatment of occupational musculoskeletal disorders and an extraordinary path for the self-care of dental professionals, sitting job workers, and healthcare providers suffering from occupational biomechanical stresses and awkward postures.