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Bailey O, Shand B, Ellis I. Class II composite restoration technique teaching: A randomised controlled crossover laboratory-based trial involving a novel ringless sectional matrix technique. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:963-973. [PMID: 36539980 DOI: 10.1111/eje.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Objectives were to assess how different techniques (including a novel ringless sectional matrix approach) affect students' restorative outcomes, and their preferences for and preparedness to clinically implement new techniques with the aim of introducing appropriate techniques to the undergraduate curriculum. MATERIALS AND METHODS Students performed two class II composite restorations in plastic teeth using two sectional matrix techniques (separating ring vs. without [ringless]), and two composite restorative techniques (incremental vs. injection-moulded bulk-fill). Restorations were assessed on multiple parameters which were combined to rate them as "good" or not. Online surveys assessed students' preferences for and preparedness to clinically implement new techniques. RESULTS Contact area concavity (OR = 106, p < .001) and cervical marginal overhang (OR = 7.4, p < .001) were much more likely with the separating ring compared to the ringless sectional matrix technique. "Good" restorations were 29.5 times more likely when using ringless compared to separating ring techniques and 3.3 times more likely when using the injection-moulding bulk-fill compared to layered composite technique. A majority of students preferred the ringless to separating ring sectional matrix technique and the injection-moulding bulk-fill to layered composite technique. Large majorities felt prepared to implement the new techniques clinically with no or minimal guidance. CONCLUSIONS A classic sectional matrix technique with separating ring resulted in a much greater occurrence of contact area concavity and cervical marginal overhang than a novel ringless approach. When allied with student preferences and clinical preparedness, inclusion of the novel ringless approach in the undergraduate curriculum can be supported alongside bulk-fill injection-moulding techniques.
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Affiliation(s)
- Oliver Bailey
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bonnie Shand
- Dental Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Ellis
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Kanzow P, Lechte C, Wiegand A, Wilson NHF, Lynch CD, Blum IR. Teaching of posterior composites for the restoration of permanent teeth in undergraduate dental training programmes: Systematic review and meta-analysis. J Dent 2023; 135:104589. [PMID: 37336355 DOI: 10.1016/j.jdent.2023.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. STUDY SELECTION Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI). SOURCES Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023. DATA Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (padj.≤0.003). CONCLUSIONS The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques. CLINICAL SIGNIFICANCE Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
| | - Clemens Lechte
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | | | - Christopher D Lynch
- University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, United Kingdom
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Alreshaid L, El-Badrawy W, Kulkarni G, Santos MJ, Prakki A. Resin Composite Versus Amalgam Restorations Placed in United States Dental Schools. Oper Dent 2023; 48:21-32. [PMID: 36472481 DOI: 10.2341/22-007-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the latest teaching policies for posterior resin composite placement versus amalgam and to determine the actual numbers of posterior resin composites versus amalgam restorations placed in American dental schools from 2008 to 2018. METHODS Emails were sent to the deans of all 66 dental schools in the United States to collect data in the forms of: 1) Questionnaire on current teaching policies of posterior composite and amalgam restorations; and 2) Data entry form to collect the actual numbers of posterior composite and amalgam restorations placed in their clinics. Descriptive statistics were used to summarize ratios of posterior restorations. Inferential analysis (chi-square test and z-test) was employed to compare posterior restoration proportions over time and within each year. Level of significance was set at 0.05. RESULTS For the teaching questionnaire, the response rate was 52% (n=34). Seventy-six per cent of the responding schools reported that they assign 50% or more of their preclinical restorative teaching time towards posterior resin composite placement, while 50% of the responding schools devoted 25% or less towards amalgam teaching. Data entry response rate was 26% (n=17). In 2008, amalgam and resin composite restorations were placed almost equally. However, resin composite restorations were placed significantly more frequently from 2009 onwards in all responding schools. The results revealed a significant ongoing increasing trend in placing posterior resin composites in all responding schools over time (p<0.05). CONCLUSIONS Data analysis revealed a clear trend towards an increase in posterior resin composite restoration placement and a decrease in the number of amalgam restorations. However, the time assigned for posterior resin composite teaching is not aligned with quantity of restorations placed. Review and adjustment of the time allocated for teaching and training of each material are suggested.
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Affiliation(s)
- L Alreshaid
- Lulwah Alreshaid, BDS, PhD candidate, Department of Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto M5G 1G6 ON, Canada; Department of Restorative Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - W El-Badrawy
- Wafa El-Badrawy, BDS, MSc, Department of Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - G Kulkarni
- Gajanan Kulkarni, BDS, LLB, MSc, DDS, Dip Paed, PhD, FRCD (C), Department of Pediatric Dentistry, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - M J Santos
- Maria Jacinta Santos, DDS, MSc, PhD, Department of Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - A Prakki
- *Anuradha Prakki, DDS, MSc, PhD, associate professor, Department of Clinical Sciences, University of Toronto, Faculty of Dentistry, Toronto, ON, Canada
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Pietrokovski Y, Zeituni D, Schwartz A, Beyth N. Comparison of Different Finishing and Polishing Systems on Surface Roughness and Bacterial Adhesion of Resin Composite. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7415. [PMID: 36363005 PMCID: PMC9657816 DOI: 10.3390/ma15217415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Insufficient dental restoration finishing and polishing may lead to plaque accumulation, gingival inflammation, staining, caries, and esthetic impairment. Here, the effect of two finishing and polishing systems on surface roughness and bacterial adhesion were evaluated. Two finishing and polishing kits were evaluated: diamond burs (Shine 1-2, Strauss & Co, Raanana, Israel) and paper discs (Sof-Lex 3M ESPE, Seefeld, Germany) (n = 30 each). For each group surface roughness was evaluated using an optical profilometer (Contour GT-K1, Bruker, Billerica, MA, USA) (n = 10). Surface bacteria were evaluated for biofilm biomass using crystal violet (CV) staining (absorbance measured at 538 nm) and viable counts (CFU/mL) (n = 20). The control group included polymerized discs against a Mylar strip (n = 30). Student’s t test and one-way ANOVA were used for statistical evaluation. Diamond burs, paper discs, and control average surface RA were 169.4 ± 45.2 µ, 364 ± 77.7 µ, and 121.2 ± 18.1 µ, respectively. There was a significant difference found between all groups (p < 0.00001). Bacterial biomass on diamond burs, paper discs, and control samples were 0.458 ± 0.161, 0.507 ± 0.139, and 0.446 ± 0.142, respectively (p = 0.257). Viable bacterial counts (CFU/mL) on diamond burs, paper discs, and control samples were 2.25 × 104, 2.95 × 104, and 2.75 × 104, respectively (p = 0.856). A comparison between two finishing and polishing kits showed that the shine 1−2 diamond bur kit produced a smoother surface than the polishing disc kit. No differences were found in the biofilm biomass quantification and bacterial viable count between the groups.
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Awad MM, Alradan M, Alshalan N, Alqahtani A, Alhalabi F, Salem MA, Rabah A, Alrahlah A. Placement of Posterior Composite Restorations: A Cross-Sectional Study of Dental Practitioners in Al-Kharj, Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312408. [PMID: 34886134 PMCID: PMC8656557 DOI: 10.3390/ijerph182312408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Dental practitioner-related factors can affect the quality of composite restorations. This study aimed to investigate the clinical techniques used by dental practitioners (DPs) while placing direct posterior composite restorations. Methods: A questionnaire survey that sought information related to the placement of posterior composite restorations was delivered to 161 DPs working in the Al-Kharj area, Saudi Arabia. The collected data were statistically analyzed using Pearson’s Chi-square test and Fisher’s exact test considering the DP’s working sector and the answered questions. Results: A total of 123 DPs completed the survey (76.4% response rate). There was a statistically significant difference between DPs working in the private sector and those working in the governmental sector in 7 out of 17 questionnaire items namely: preparing a minimum depth of 2 mm, (p = 0.001); mechanical means of retention, (p = 0.003); operative field isolation, (p = 0.004); adhesive strategy, (p < 0.001); light-curing unit used, (p = 0.013); the use of radiometer, (p = 0.023), and dental matrix selection, (p < 0.001). Conclusion: The clinical techniques applied by DPs working in the private sector in Al-Kharj, Saudi Arabia when placing posterior composite restorations, including the specifications of cavity preparation, operative field isolation, and selection of the dental matrix system, may be substandard compared to those applied by DPs working in the governmental sector.
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Affiliation(s)
- Mohamed M. Awad
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
- Correspondence: or (M.M.A.); (A.A.)
| | - Mansour Alradan
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Nawaf Alshalan
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Ali Alqahtani
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (M.A.); (N.A.); (A.A.)
| | - Feras Alhalabi
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
| | - Mohammed Ali Salem
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; (F.A.); (M.A.S.)
| | - Ahmed Rabah
- Department of Prosthetic Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia;
| | - Ali Alrahlah
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
- Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence: or (M.M.A.); (A.A.)
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Liu J, Zhang H, Sun H, Liu Y, Liu W, Su B, Li S. The Development of Filler Morphology in Dental Resin Composites: A Review. MATERIALS (BASEL, SWITZERLAND) 2021; 14:5612. [PMID: 34640020 PMCID: PMC8509641 DOI: 10.3390/ma14195612] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022]
Abstract
Dental resin composites (DRCs) with diverse fillers added are widely-used restorative materials to repair tooth defects. The addition of fillers brings an improvement in the mechanical properties of DRCs. In the past decade, diverse fillers have emerged. However, the change of emerging fillers mainly focuses on the chemical composition, while the morphologic characteristics changes are often ignored. The fillers with new morphologies not only have the advantages of traditional fillers (particles, fibrous filler, etc.), but also endow some additional functional characteristics (stronger bonding ability to resin matrix, polymerization resistance, and wear resistance, drug release control ability, etc.). Moreover, some new morphologies are closely related to the improvement of traditional fillers, porous filler vs. glass particles, core-sheath fibrous vs. fibrous, etc. Some other new morphology fillers are combinations of traditional fillers, UHA vs. HA particles and fibrous, tetrapod-like whisker vs. whisker and fibrous filler, mesoporous silica vs. porous and silica particles. In this review, we give an overall description and a preliminary summary of the fillers, as well as our perspectives on the future direction of the development of novel fillers for next-generation DRCs.
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Affiliation(s)
- Jiani Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China; (J.L.); (H.Z.); (Y.L.); (W.L.)
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310006, China
| | - Hao Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China; (J.L.); (H.Z.); (Y.L.); (W.L.)
| | - Huijun Sun
- Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, UK; (H.S.); (B.S.)
| | - Yanru Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China; (J.L.); (H.Z.); (Y.L.); (W.L.)
| | - Wenlin Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China; (J.L.); (H.Z.); (Y.L.); (W.L.)
| | - Bo Su
- Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, UK; (H.S.); (B.S.)
| | - Shibao Li
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Dental Materials, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China; (J.L.); (H.Z.); (Y.L.); (W.L.)
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Wang Y, Zhu M, Zhu XX. Functional fillers for dental resin composites. Acta Biomater 2021; 122:50-65. [PMID: 33290913 DOI: 10.1016/j.actbio.2020.12.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022]
Abstract
Dental resin composites (DRCs) are popular materials to repair caries. Although various types of DRCs with different characteristics have been developed, restoration failures still exist. Bulk fracture and secondary caries have been considered as main causes for the failure of composites restoration. To address these problems, various fillers with specific functions have been introduced and studied. Some fillers with specific morphologies such as whisker, fiber, and nanotube, have been used to increase the mechanical properties of DRCs, and other fillers releasing ions such as Ag+, Ca2+, and F-, have been used to inhibit the secondary caries. These functional fillers are helpful to improve the performances and lifespan of DRCs. In this article, we firstly introduce the composition and development of DRCs, then review and discuss the functional fillers classified according to their roles in the DRCs, finally give a summary on the current research and predict the trend of future development.
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Affiliation(s)
- Yazi Wang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China; Département de Chimie, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada
| | - Meifang Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China.
| | - X X Zhu
- Département de Chimie, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada.
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Reher V, Reher P, Peres KG, Peres MA. Fall of amalgam restoration: a 10-year analysis of an Australian university dental clinic. Aust Dent J 2020; 66:61-66. [PMID: 33197295 DOI: 10.1111/adj.12807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The use of amalgam in Dentistry has decreased since the 1980s. This study aimed to (i) assess the time trend in the usage of amalgam and composite in posterior teeth at Griffith University Dental Clinic from 2010 to 2019; (ii) to test whether this trend varied according to the dental health provider. METHODS We analysed clinic records from 2010 to 2019. Prais-Winsten analyses were performed, and the average annual percentages change (AAPC) for amalgam and composite was estimated. RESULTS There were 397,013 procedures, including 80,995 direct posterior restorations. Amalgam use decreased from 12.9% in 2010 to 0.5% in 2019 among students, while composite use increased from 87.1% to 99.5% of posterior restorations. The annual increase of the composite was 1.4% per year for students, while amalgam decreased by 30.2% per year on average. A similar trend was noted among the dentists. CONCLUSIONS A significant decrease in the use of amalgam was observed over time for both students and professionals. This trend raises questions about curriculum reviews, focusing on the repair, maintenance and safe removal of amalgam while reinforcing the learning on Minimally Invasive Dentistry and composite restorations based on the patient's caries risk.
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Affiliation(s)
- V Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - P Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - K G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - M A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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Kanzow P, Büttcher AF, Wilson NH, Lynch CD, Blum IR. Contemporary teaching of posterior composites at dental schools in Austria, Germany, and Switzerland. J Dent 2020; 96:103321. [DOI: 10.1016/j.jdent.2020.103321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/27/2022] Open
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Fiorillo L, Cervino G, De Stefano R, Iannello G, Cicciù M. Socioeconomic behaviors on dental professions: a Google Trends investigation in Italy. ACTA ACUST UNITED AC 2020; 69:317-323. [PMID: 32278342 DOI: 10.23736/s0026-4970.20.04352-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Dental profession has expanded, and the knowledge that oral health affects systemic health is of greater concern to patients. The purpose of this study is to understand the demand for dental treatments in Italy, knowing if there is any correlation between socioeconomic condition and oral rehabilitation typology. Moreover, focusing on the requested rehabilitations type and on finding alternatives, unconventional solutions. EVIDENCE ACQUISITION The research was conducted using an important research database defined Google Trends, with search terms such as "dolore denti" (toothache). A statistical analysis has been conducted in this study evaluation Pearson Correlation Coefficient. EVIDENCE SYNTHESIS The results divided region by region provide data that reflect the socio-economic conditions of the population concerned. Other results have been obtained from government source, to learn about the economic situations of the individual regions, for this reason the GDP was examined. Furthermore, there are important results regarding the parasanitary professions to which patients, for economic reasons, tend to refer. CONCLUSIONS This study will surely be an excellent starting point to investigate professional abuse and above all to assess the needs of the different regions.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Imaging, School of Dentistry, G. Martino Polyclinic, University of Messina, Messina, Italy -
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Imaging, School of Dentistry, G. Martino Polyclinic, University of Messina, Messina, Italy
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences, Morphological and Functional Imaging, School of Dentistry, G. Martino Polyclinic, University of Messina, Messina, Italy
| | - Gaetano Iannello
- Department of Biomedical and Dental Sciences, Morphological and Functional Imaging, School of Dentistry, G. Martino Polyclinic, University of Messina, Messina, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Imaging, School of Dentistry, G. Martino Polyclinic, University of Messina, Messina, Italy
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