Royal Dental Hospital of Melbourne

Orifice barriers (OBs) are commonly placed as sub-seals following root canal treatment, to resist microbial leakage if the primary coronal seal fails. However, despite numerous in vitro studies, clinical evidence supporting their efficacy is limited. This is the first systematic review of the in vivo endodontic literature evaluating OB effectiveness in root filled teeth (RFT), addressing a critical research gap. MEDLINE, Embase, CENTRAL, Web of Science and Scopus were systematically searched from inception through 16th May 2025. Articles were screened using Covidence by two independent reviewers. Risk of bias and certainty of evidence assessments were undertaken to assess methodological rigour of included studies. Seven studies met the inclusion criteria. OBs improved outcomes for teeth with radicular cracks in two small single-arm cohort studies (90.6 % success & 96.6 % survival at 2-4years; 100 % at 1-3years). OBs were associated with lower apical periodontitis (AP) in one cross-sectional study (p < 0.005), while in a second, positioning the root filling/coronal restoration interface apical to marginal bone level was associated with lower AP (p < 0.005). Two remaining cohort studies showed no significant benefit for OBs in RFT. One randomised controlled trial showed no benefit of OBs, but follow-up was only one year. Heterogeneity among studies precluded meta-analysis. Very low certainty in vivo evidence supports OBs in cracked RFT, but there is little evidence for OBs elsewhere. The limitations identified underscore the need for well-designed prospective in vivo studies to validate the evidence base for OBs. OB placement apical to radicular cracks may improve success and survival for cracked RFT, with specialist referral for treatment under microscopy recommended in such cases. OBs may play a role in creating a well-sealed coronal restoration following RCT, but further clinical research is required to determine their efficacy.

Dental professionals experience challenges that impact on their willingness to treat patients with disabilities and additional health care needs, resulting in poorer access to dental care and unmet treatment needs. Fifty-eight public-sector oral health professionals responded to an online survey. They responded to questions about the barriers they encountered when treating patients with disabilities and additional healthcare needs and their preferences for support. Clinicians reported environment-related factors to have the greatest impact on treatment of patients with intellectual and physical disabilities (94.8%). Clinician-related barriers were the least reported (67.2%). Participants felt that having greater flexibility in appointments and support from more experienced clinicians would be most likely to encourage clinicians to treat these patients. Most (83.0%) were interested in developing their skills and knowledge. There is significant opportunity for additional supports for clinicians to improve access to dental care for people with special healthcare needs.

ABSTRACTLateral medullary syndrome (LMS) is commonly associated with vertebral artery strokes, characterized by varied neurological manifestations depending on the site of the lesion. We report the positive effects of interdisciplinary rehabilitation interventions in helping achieve improved functional, psychosocial, and quality of life outcomes in a patient with LMS and complex neurological disabilities.

BackgroundPractical classes and skills labs, where students learn, practice, and demonstrate key professional and technical skills, are essential in health professional education. As such, attendance at practical classes has historically been mandated and, in some cases, an “attendance hurdle” (i.e., mandatory minimum attendance requirement that students must meet to pass the course) is applied to subjects where practical classes are a core part of the curriculum. We aimed to explore students’ attitudes, beliefs and experiences of attendance hurdles for practical classes.MethodsWe surveyed students from entry-to-practice programs in Medicine, Dentistry, Oral Health, Optometry, Physiotherapy, Social Work, Nursing, and Speech Pathology who were currently or previously enrolled in a subject/s with attendance hurdles for practical classes. In a single online survey, students answered multiple-choice, ranking, and Likert questions about their attitudes, beliefs, and experiences of attendance hurdles for practical classes. Data were analysed descriptively and with Pearson chi-squared test of association.ResultsSixty-three percent (n=362) of 575 students who completed the survey wanted to maintain attendance hurdles. In contrast, almost 80% of students stated they would attend 80% or more of classes without attendance hurdles. Many students believed that attendance hurdles could adversely affect some individuals (e.g., due to personal circumstances and sociodemographics), and half believed as adult learners, they should decide whether to attend practical classes. Students valued the in-class tutor feedback and application to clinical practice that practical classes offered. Students suggested that greater flexibility in the timing of practical classes would be more likely than hurdles to improve attendance.ConclusionsThe advantages of participating in practical classes to develop essential clinical skills are evident to students, and likely motivate them to attend most scheduled classes. Numerous factors can lead to student absences, and mandating attendance may disadvantage some students. Alternatives to attendance policies could include offering scheduling flexibility and student sign-up, accommodating students' personal and health needs, and aligning classes to student values.

The authors declare no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

BackgroundWhile drugs have a limited role in the management of dental presentations, Australian dentists have high rates of inappropriate prescribing of antibiotics. There is also a lack of relevant drug resources for dentists in Australia. Our team developed Drugs4dent®, a medicines decision support tool, that provides dentists with relevant drug knowledge, assists with appropriate prescribing and provides safety checks to reduce prescribing errors. The aim of this pilot study was to improve Drugs4dent® with focus groups of dentists, and assess the acceptability, usability, and user experience, of Drugs4dent®.MethodsFocus groups of ten dentists were established to inform the improvement of Drugs4dent®. Acceptability and usability testing of Drugs4dent® was then undertaken with a further ten dentists using interviews and a survey. The survey was based on the Framework for Acceptability and System Usability Scale. Inductive thematic analysis was undertaken using Nvivo for the focus groups and interviews, and descriptive statistics for analysis of survey results.ResultsDentists from the focus group and interviews found the content of Drugs4dent® acceptable and useful for dentistry, recognising that similar drug information is currently not available. The majority agreed that Drugs4dent® would improve their ability to prescribe according to guidance. Participants reported Drugs4dent® was intuitive, and information was easy to locate. Most dentists preferred Drugs4dent® integrated with their dental practice software. In the absence of this functionality, they preferred Drugs4dent® as a standalone resource, without needing to input patient data. Drugs4dent® was subsequently commercialised with MIMS Australia, to create the decision support tool: MIMS Drugs4dent®.ConclusionsDrugs4dent® is the first dental medicines decision tool in Australia. The high acceptability and usability of the tool, and subsequent commercialisation indicates that MIMS Drugs4dent® has substantial promise for the future, and can transform access to relevant drug information for Australian dentists.