Scielo RSS <![CDATA[South African Dental Journal ]]> http://www.scielo.org.za/rss.php?pid=0011-851620220003&lang=en vol. 77 num. 3 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Resisting the urge to prescribe antibiotics. Antibiotic resistance and dentistry</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300001&lng=en&nrm=iso&tlng=en <![CDATA[<b>Significance of April month in Dentistry</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300002&lng=en&nrm=iso&tlng=en <![CDATA[<b>An evidence-based guide to occlusion and articulation. <i>Part 3: A guide to functional occlusion: teeth vs joint.</i></b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300003&lng=en&nrm=iso&tlng=en <![CDATA[<b>Prevalence of Sharps Injuries at a Tertiary Teaching Oral Health Centre, Gauteng, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300004&lng=en&nrm=iso&tlng=en INTRODUCTION: Needle-stick and sharps injuries are an occupational hazard in dental training institutions. The study aimed to quantify and describe the nature of Needle-stick and sharp injuries (NSI) at a Tertiary Teaching Oral Health Centre (TTOHC) in South Africa METHODS: An analytic, cross-sectional study was conducted among students engaged in clinical service and oral health staff supervising them at the Oral Health Centre, Gauteng, South Africa. An adapted 18-item self-administered questionnaire was provided to all students and staff. Standard ethical guidelines were followed according to institutional ethics committee approval (M171131 RESULTS: A response rate of 88% (n=73) was obtained from students, with the majority of participants being female(67%), dentistry students (88 %), aged between 18-25 years, in their fourth year of study (45%) while only 3.7% were final year oral hygiene students. The staff participants were dentists (80.6%) while most staff participants (88.3%) were employed for 3 years or less. The NSI prevalence at the TTOHC was 41.3% (n=45). The number of staff reporting the injury for both staff and students was recorded to be 80% (n = 36 of 45 injuries), with 77.3% of injured individuals receiving post-exposure prophylaxis (PEP) against possible HIV-infection, however, more than a third (39%) reported not to have completed the PEP. The department in which the most NSIs occurred was Maxillofacial and Oral Surgery. Sharp injuries were mostly due to needle sticks. Most NSIs occurred among senior students with more clinical experiences and particularly during the early and late periods in a year CONCLUSION: The prevalence of needle and sharp injuries was high and of concern. The sharps injury reporting rate was good, however, less than half of injured individuals completed the PEP treatment. The findings highlighted which students were most at risk to encounter NSI, including the period during their training when it was most likely to occur, thus enabling directed re-emphasis and training in Infection Control and Prevention <![CDATA[<b>The Induction of Bone Formation by the recombinant human transforming growth Factor-ß<sub>3</sub>: From preclinical studies in <i>Papio ursinus </i>to translational research in <i>Homo sapiens</i></b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300005&lng=en&nrm=iso&tlng=en AIM AND OBJECTIVES: Skeletal bone defects of the axial or the craniomaxillofacial skeletons still present formidable challenges to skeletal reconstructionists, tissue biologists and modern medicine. In systematic research experiments in the Chacma baboon Papio ursinus our laboratories have shown the previously unreported osteoinductive activity of the three mammalian transforming growth factor-ß (TGF-β) isoforms. This review discusses the induction of bone formation by the mammalian TGF-ßs with particular reference to the substantial and rapid induction of bone by the recombinant hTGF-ß3 from the laboratory benches, to pre-clinical studies in heterotopic and orthotopic mandibular sites of Papio ursinus to clinical translation in human patients. DESIGN AND METHODS: A series of systematic research experiments in Papio ursinus using the hTGF-ß3 together with earlier experiments using the -ß1 and ß2 isoforms are reviewed and re-analyzed molecularly and morphologically to provide the basic research data for the reported clinical translation in human patients. RESULTS: The three mammalian hTGF-ß isoforms and notably hTGF-ß3 induce rapid and substantial induction of heterotopic bone in intramuscular sites of Papio ursinus. Relatively low doses of hTGF-ß1 or hTGF-ß3 in binary application with hBMP-7 synergize to induce massive corticalized ossicles in the rectus abdominis muscle. In orthotopic mandibular sites, 125 and 250 doses of hTGF-ß3 induce bone formation across large mandibular defects in Papio ursinus with corticalized buccal and lingual plates by day 30, with modeling and maintenance of corticalized bone by 9 to 12 months after implantation of the 250 dose in 3 cm mandibular defects Papio ursinus DISCUSSION: hTGF-ß3 significantly up-regulates RUNX-2 and Osteocalcin expression on day 15 controlling the differentiation of progenitor stem cells into the osteoblastic lineage. The induction of bone by the hTGF-ß3 is via the bone morphogenetic proteins pathway; hTGF-ß3 controls the induction of bone by regulating the expression of BMPs gene and gene products via Noggin expression, eliciting bone induction by up-regulating exogenous BMPs <![CDATA[<b>Factors Enabling and Constraining CPD compliance amongst South African Dental Technicians practising in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300006&lng=en&nrm=iso&tlng=en INTRODUCTION: Health professions' regulatory bodies are experiencing numerous challenges with compliance to Continuing Professional Development (CPD) requirements. The South African Dental Technicians Council (SADTC) stipulates that dental technicians be CPD compliant and accrue an annual minimum of 30 Continuing Educational Units (CEUs). The SADTC acknowledged that there is a lack of compliance with CPD by dental technicians. AIM: The study aimed to elicit dental technicians' opinions on, and experiences of, continuing professional development. DESIGN: The study utilized a descriptive cross-sectional research design within a quantitative framework. A purposeful sampling technique was used to select and invite registered dental technicians (n=103) from KwaZulu-Natal (KZN). METHODS: Dental technicians (n =103) in KZN were invited to participate in the study by completing an online questionnaire, which elicited their experiences with regards to meeting their CPD requirements RESULTS: Dental technicians preferred formal, employer-funded CPD activities that are conducted during working hours as compared to online CPD activities. Dental technicians acknowledged that mandatory CPD is a costly requirement. They further recognised that they were unaware of non-attendance based CPD activities as methods of accruing CEUs CONCLUSION: The study revealed that dental technicians in KZN experience challenges in being CPD compliant. <![CDATA[<b>Exploring the feasibility of a framework to align a competency framework in a dental curriculum: a Delphi study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300007&lng=en&nrm=iso&tlng=en AIM: The aim of this study was to test the feasibility of an implementation framework for an undergraduate competency framework by means of a Delphi study. METHODS: A modified Delphi research design consisting of two rounds was conducted and aimed to seek consensus defined as agreement of 70% or more from a group of experts. Twenty-two (22) dental experts were purposefully selected from the four dental schools in South Africa. An online survey consisting mainly of closed-ended questions was used and analysed quantitatively. In addition, the second part of each question included a comment section to allow participants to elaborate on their answer. Comments were considered as adapted statements for the second round of the Delphi. RESULTS: Thirteen (13) participants completed the first round, and 10 participants completed the second round of the Delphi study. Following the first round of the Delphi, consensus (70%) was reached for five of the seven statements. These statements focus on the impact of internal and external stakeholders on the dental schools, leadership support for faculty development, teaching and learning changes, and curriculum mapping. Statements that needed further consideration in round 1 included impact of institutional framework and diversity of academics. Consensus was reached for both the diversity of academics statements in round 2. CONCLUSION: The results suggest that the proposed framework to align and implement the AfriMEDS core competency framework was feasible. However, from the comments of the dental experts there seems to be no common understanding of implementation and alignment of the institutional frameworks and the AfriMEDS core competency framework. <![CDATA[<b>Evolution of Sialendoscopy in clinical practice: Survey of attending practitioners</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300008&lng=en&nrm=iso&tlng=en INTRODUCTION: Sialendoscopy is a relatively new technique that is safe, minimally invasive and effective as a diagnostic as well as a therapeutic tool for the management of deep seated, proximal, salivary ductal obstruction. However, more than 20 years since its inception it is still not in mainstream use worldwide. OBJECTIVES: Our aim of this study was to ascertain the awareness of sialendoscopy amongst the medical fraternity in South Africa. More specifically, to determine whether it was frequently used amongst practitioners and the type of cases managed using sialendoscopy METHODS: An exploratory survey design involving 100 practitioners was used to collect data, using an online survey involving 10 closed-ended multiple choice questions. RESULTS: The results of the study revealed that while practitioners saw patients who could benefit from sialendoscopy, most practitioners did not feel comfortable performing the procedure independently, and as such, most patients were referred on to other professionals for management. CONCLUSION: The majority of attending practitioners believed that they would benefit from further practical and theoretical training in the field of sialendoscopy, illustrating the need for continued professional development in this area. <![CDATA[<b>Maxillofacial Radiology 198</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300009&lng=en&nrm=iso&tlng=en INTRODUCTION: Sialendoscopy is a relatively new technique that is safe, minimally invasive and effective as a diagnostic as well as a therapeutic tool for the management of deep seated, proximal, salivary ductal obstruction. However, more than 20 years since its inception it is still not in mainstream use worldwide. OBJECTIVES: Our aim of this study was to ascertain the awareness of sialendoscopy amongst the medical fraternity in South Africa. More specifically, to determine whether it was frequently used amongst practitioners and the type of cases managed using sialendoscopy METHODS: An exploratory survey design involving 100 practitioners was used to collect data, using an online survey involving 10 closed-ended multiple choice questions. RESULTS: The results of the study revealed that while practitioners saw patients who could benefit from sialendoscopy, most practitioners did not feel comfortable performing the procedure independently, and as such, most patients were referred on to other professionals for management. CONCLUSION: The majority of attending practitioners believed that they would benefit from further practical and theoretical training in the field of sialendoscopy, illustrating the need for continued professional development in this area. <![CDATA[<b>Special-IST versus Special inter-IST</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300010&lng=en&nrm=iso&tlng=en Dentists who wish to specialize in a specific discipline have to undergo and complete a rigorous, structured and extensive postgraduate academic and practical training programme, and pass all the requisite exams. Only then can they be registered with a regulating professional body and be recognized as such in that field. Thereafter their scope of practice becomes limited to that specialty alone. This differs from general dentists, who are not restricted in their scope of practice, but may have limitations to the extent of their capabilities. They may choose to upskill themselves through attendance at short courses, hands-on training workshops, informal study groups, dental company workshops or even YouTube videos. Unlike the trainee in a formal institution, this is unstructured and outcomes are unspecified, yet some of these practitioners then market themselves as specialists in these fields. While the Health Professions Council of South Africa (HPCSA) has set out a list of core ethical values and standards for good practice, there are no regulations enforcing the need for these practitioners to undergo and pass HPCSA recognized examinations to assess their capabilities, knowledge and skill in these modalities. This opens the profession up to risks of practitioners contravening a number of core values and standards expected of trusted professionals and can mislead and put the general public at risk. This paper aims to explore if regulation of this type of practice is required, who should be allowed to offer additional training to dentists, and who should be regulating the trainers. <![CDATA[<b>What's new for the clinician- summaries of recently published papers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162022000300011&lng=en&nrm=iso&tlng=en Dentists who wish to specialize in a specific discipline have to undergo and complete a rigorous, structured and extensive postgraduate academic and practical training programme, and pass all the requisite exams. Only then can they be registered with a regulating professional body and be recognized as such in that field. Thereafter their scope of practice becomes limited to that specialty alone. This differs from general dentists, who are not restricted in their scope of practice, but may have limitations to the extent of their capabilities. They may choose to upskill themselves through attendance at short courses, hands-on training workshops, informal study groups, dental company workshops or even YouTube videos. Unlike the trainee in a formal institution, this is unstructured and outcomes are unspecified, yet some of these practitioners then market themselves as specialists in these fields. While the Health Professions Council of South Africa (HPCSA) has set out a list of core ethical values and standards for good practice, there are no regulations enforcing the need for these practitioners to undergo and pass HPCSA recognized examinations to assess their capabilities, knowledge and skill in these modalities. This opens the profession up to risks of practitioners contravening a number of core values and standards expected of trusted professionals and can mislead and put the general public at risk. This paper aims to explore if regulation of this type of practice is required, who should be allowed to offer additional training to dentists, and who should be regulating the trainers.