Introduction Treatment decisions for a heavily restored endodontically treated tooth vary amongst clinicians owing to multitude of factors. This phenomenon not only often poses dilemmas to clinicians of different clinical backgrounds, but also exerts a degree of treatment difficulty to the treating clinician. Previous studies indicated that specialty training and clinical experience significantly impacted clinical decision‐making process. Materials and methods Master of Science postgraduate students in endodontics, prosthodontics, periodontics, oral surgery and implantology participated in a questionnaire‐based cross‐sectional study. The dental specialties were further categorised into restorative and surgical dentistry. A multiple‐choice questionnaire with three clinical cases was distributed to the students. Data were analysed for trends using descriptive statistics. Results There was a 44% response rate; the majority of respondents were from restorative dentistry specialties. Cases 1 and 2 were rated as moderate to high difficulty, and Case 3 was predominantly rated as high difficulty with procedure predictability being the main factor affecting their clinical decision‐making in three cases. Endodontic retreatment was selected as the preferred treatment in Cases 1 and 2 and periradicular surgery in Case 3. The students were fairly confident in managing Cases 1 and 2, but not in Case 3. Referral patterns were consistent in Cases 1 and 2 with endodontists being the first choice of referral except for Case 3 where 48% preferred to refer to oral surgeons and 35% choosing endodontists. Some indication of differences between specialties were noted throughout. Years in practice appeared to be related to the importance of predictability in Case 3 only. Conclusion Considerable inter‐clinician variability was noted whereby specialty postgraduate training impacted on clinical decision‐making. Overall, procedural predictability, technical difficulty, risk of damage to the tooth and patient preference were the most highly ranked factors affecting clinical decision‐making. Evidence‐based treatment guidelines and dental curricula should be reviewed to enhance inter‐clinician agreement in clinical decision‐making, ultimately improving patient care.

No abstract

Results: The websites were scored and the three highest rated are as follows: in third place The Royal College of General Practitioners, in joint second were the Royal College of Physicians (London) and Royal College of Surgeons in Ireland and in first place with the highest rating, the Royal College of Surgeons of England. Conclusion: These websites are key in the way the colleges interact with both medical professionals and the public. Our subjective opinion that the websites varied in their effectiveness as a resource, correlated with variability in the scoring. We found that many of the college websites have the potential to deliver more for their users.

No abstract

Minor oral surgery can give rise to bleeding intra- and post-operatively. This can be minimal in most patients; however, it can be more problematic in patients with impaired clotting disorders, liver disease, or taking any form of anticoagulation therapy. Haemostatic agents are available to overcome such bleeding risks. The topical application of 1:1000 adrenaline used in medicine can be considered for use in dentistry. Adrenaline is widely used within medicine, surgery and dentistry. Examples include its use in local anaesthetic agents, in the management of anaphylaxis and as part of the cardiopulmonary resuscitation algorithm. 1:1000 adrenaline used topically for ear, nose and throat surgeries has shown improved visual fields during surgery with better surgical outcomes. It is relatively safe, but in patients with cardiovascular comorbidities, it should be practised with caution. This has precipitated the idea for its use within oral surgical procedures, including canine exposures, third molar surgery, root displacement into the antrum and periapical surgery. The haemostatic effect of 1:1000 adrenaline as an alternative should be considered in operative dentistry and oral surgery to aid in haemostasis and improve intra-operative visualisation, reducing the risk of iatrogenic damage and bleeding, thereby improving treatment outcomes.