Sodium hypochlorite (NaOCl), an effective endodontic irrigant against Enterococcus faecalis (EF), is harmful to periapical tissues. Natural pineapple-orange eco-enzymes (M-EE) and papaya eco-enzyme (P-EE) could be potential alternatives. This study aimed to assess the antimicrobial efficacy of M-EE and P-EE at different concentrations and fermentation periods against EF, compared to 2.5% NaOCl. Fermented M-EE and P-EE (3 and 6 months) at various concentrations were mixed with EF in a 96-well plate incubated for 24 h anaerobically. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of M-EE and P-EE were determined via EF growth observation. EF inhibition was quantitatively measured and compared between different irrigants using the one-way analysis of variance (ANOVA), and different fermentation periods using the independent-samples T-test. M-EE and P-EE showed MIC at 50% and MBC at 100% concentrations. There was no significant difference in antimicrobial effect when comparing M-EE and P-EE at 50% and 100% to 2.5% NaOCl. P-EE at 6 months fermentation exhibited higher EF inhibition compared to 3 months at concentrations of 25% (p = 0.017) and 0.78% (p = 0.009). The antimicrobial properties of M-EE and P-EE, at both 100% and 50% concentrations, are comparable to 2.5% NaOCl. They could therefore be potential alternative endodontic irrigants, but further studies are required.

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BACKGROUND: There is an increasing concern about musculoskeletal disorders (MSD), resulting from occupational health hazards among dentists. Dentists who are susceptible to occupational health hazards could develop cumulative trauma disorders, lead to absenteeism from work, loss of productivity and performance or even long-term disability. OBJECTIVE: This study aims to determine the prevalence of musculoskeletal disorders among dentists, explore the risk factors and identify the ergonomics preventive measures for dental professionals. METHODS: Articles published between 2008–2020 were searched in scientific databases (MEDLINE, PubMed, Scopus and Cochrane Library). The Critical Appraisal Skills Programme Systematic Review checklist was used to assess the quality of the studies. RESULTS: Eighteen studies were found to be suitable in the final review. Relevant data was extracted and summarized from the included studies. The annual prevalence of musculoskeletal disorders in any body site ranged between 68% and 100% . The most predominant regions for musculoskeletal disorders among dental professionals were identified to be the lower back (29% to 94.6% ), shoulder (25% to 92.7% ), and neck (26% to 92% ). The most frequently reported risk factors of MSDs were the individual characteristic female gender (57.1% ), followed by awkward working postures (50% ), long working experience (50% ) and being dental specialists (42.9% ). Several preventive measures were identified as the most effective ways in preventing MSDs, the use of magnification (40% ) and regular physical activity (40% ). CONCLUSIONS: This review reported high prevalence of musculoskeletal disorders (MSD) among dentists. It critically updates and adds the latest evidence on occupational ergonomics among dentists.

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Rehabilitation of posterior erosive tooth wear can be especially challenging in the presence of substantial tooth structure loss and limited inter-occlusal space. This article describes two case reports illustrating a conservative approach using the one-step Dahl approach in the management of localized posterior erosive tooth wear. The occlusal surfaces of worn teeth in both cases were successfully restored using direct composite resin and gold onlay, respectively. The material was placed in supra-occlusion during the initial stage. This technique enables intrusion of affected worn teeth and the opposing counterpart. Eruption of the remaining dentition will occur after two to three months to re-establish a complete occlusal relationship. With proper treatment planning, the one-step Dahl approach offers a simpler and predictable positive outcome in restoring structurally compromised posterior worn teeth.