Aim: To compare the levels, causes and the impact of stress from cohort of fifthyear dental students in the Faculties of Dental Medicine in Plovdiv, Bulgaria and Montpellier, France. Materials and methods: The questionnaire we used comprised the modified version of the 56-item Dental Environment Stress (DES) questionnaire. It was completed by fifth-year undergraduate dental students in both faculties in 2011 and 2016, totaling 335 dental students. A five-point Likert scale was used to record the responses from the subjects. Statistical analysis was performed with STATA version 14.1 (StataCorp, College Station, USA) specialized software. Results: The mean age of studied population was not significantly different between 2011 and 2016 (p=0.08). The common stress value per student was 1.74 (CI: 1.64; 1.84, range: 0.12; 4.50). It was higher in Plovdiv (1.79±0.81) than in Montpellier (1.63±0.66); it was statistically higher for girls (1.94±0.70) than for boys (1.49±0.77), and decreased between 2011 and 2016. A significant overall effect of the common mean stress was influenced by the town (p=0.008), year of study (p=0.003), gender (p=0.0001) and accommodation (p=0.01) of the student. Conclusion: Academicals and clinical factors of stress are prevailing stressors during education. The challenge is now to decrease the influence of both, without altering the quality of dental education. Regular discussions and debriefs about the clinical cases before and after clinical activity. Alternative methods of education and examination, such as interactive methods, could be considered in order to reduce the stress of theoretical exams.

Introduction: The term “stress” refers to the effect of certain external factors (physical or mental) on the individual’s physical and psychological health. Stress is very high in dental medicine. It may well be generated by the process of training in dentistry. During their training dental students express high levels of stress and considerable stress-related symptoms such as physical problems, depression, obsessive-compulsive and personality disorders. The perceived stress can be dependent on socio-cultural factors. The type of personality, gender, emotional intelligence and other individual characteristics may also influence the stress effects. Aim: To determine the main sources of stress in students during their dental training and compare the level of stress fifth-year dental students experience in the Faculty of Dental Medicine, Plovdiv, Bulgaria and the Faculty of Dentistry in Montpellier, France. Methods: We recruited in the study fifth-year students from the Faculty of Dental Medicine in Plovdiv, Bulgaria and the Faculty of Dentistry in Montpellier, France. The modified Dental Environment Stress (DES) questionnaire was used to assess the effect of the various stressors. The questionnaire survey was conducted between February and March 2008. Results: The living arrangements domain indicates higher levels of stress in Bulgarian students compared to their French counterparts with significant statistical difference for all factors. In personal factors the highest levels of stress were found with respect to the reduced holidays during school year and financial problems. Exams were the highest stressor in academic work domain and for the survey as a whole. In educational environment factors the stressors with the highest significance were the interactions with patients, academic environment (for French students) and risk of cross transmitted infections (for Bulgarian students). The high stress during clinical work is related to completing the assigned clinical workload quota and the shortage of time for clinical work. Conclusions: The students from both faculties report the highest mean levels of stress are related to examinations and clinical factors. Bulgarian students experienced higher mean levels of stress compared to their French colleges. The differences in mean stress levels are associated with socio-cultural factors and variations in educational curriculums at both dental faculties.

In 2009 a new type of endodontic sealers was introduced to the market. The so called “bioceramic” sealers are a promising alternative to the present golden standard of root canal fillings. Now a decade later, still very little is known about the ability to remove these sealers in cases of non-surgical endodontic retreatment (NSER). There are only a limited number of articles that provide such information. The commonly used hand files are not efficient in removing thoroughly the sealer from the main canal walls. Machine driven files are much easier and faster alternative to the hand ones, but are still not able to ensure complete removal. Although ultrasonics can be applied only in the straight portion of the main canal, they raise the efficacy of sealer removal. Photon-initiated photoacoustic streaming (PIPS) is another way to enhance the removal of bioceramics. Solvents like chloroform and orange oil are effective in softening gutta-percha, but not the bioceramics. This article reviews the available scientific data concerning removal of bioceramic materials in the context of a NSER. 

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