ObjectivesEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.MethodsA structured questionnaire prepared after consultation with experts in the field and guided by the “Report of the SAGE working group on vaccine hesitancy” was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine.ResultsAlthough 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines.ConclusionsCOVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

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Objective: The objective of this study is to evaluate the fracture resistance and failure mode of endodontically treated teeth restored with lithium disilicate endocrowns of different crown thicknesses. Materials and Methods:A total of 30 endodontically treated permanent mandibular first molars were sectioned horizontally 2 mm above the highest point of the cemento-enamel junction. The specimens were divided into three groups, and each group was restored with lithium disilicate (IPS e-max press) endocrowns of different crown thicknesses (3, 4.5, and 6 mm, respectively). After cementation, specimens were stored in room temperature for 72 hours, followed by subjecting them to compressive strength testing until failure. The fracture loads and the failure mode were recorded. Statistically analysis was performed using one-way analysis of variance.Results: A statistically significant difference was found in the fracture resistance between the three groups with the highest fracture resistance in the 3 mm group, followed by the 4.5 mm group, and the least in the 6 mm group (P < .05). Most of the failures were accompanied with tooth fracture (90% in 3 mm group, 100% in 4.5 mm group, and 80% in 6 mm group). Conclusions:Increasing the crown thickness of the endocrowns reduced the fracture resistance of restored teeth. Minimum fracture loads for all teeth restored with endocrowns were significantly higher than the maximum occlusal forces reported in the literature.Clinical Significance: Fracture resistance and mode of failure of lithium disilicate (IPS e-max press) endocrowns varies widely between crown thicknesses. Clinicians should be cautious with crown thickness for endocrown restorations. K E Y W O R D S endocrowns, endodontically treated teeth, failure mode, fracture resistance, lithium disilicate

The use of an occlusal template for the placement of multiple PMC under general anaesthesia reduces the time taken for their placement and reduces the incidence of immediate post-operative discomfort.