Knowledge, attitude and practice on use of magnification in dentistry among dental students

Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 253 ISSN 1989 – 9572 DOI: 10.47750/je .2022.13.06.023 Knowledge, a i ude and p ac ice on use o magni ica ion in den is y among den al s uden s Ranje h Rajan KV1 D .Akshay Khandelwal2* Jou nal o Educa o s,Teache s and T aine s, Vol. 13 (6) h ps://je .labos o .com/ Da e o ecep ion: 15 Oc 2022 Da e o e ision: 18 No 2022 Da e o accep ance: 24 Dec 2022 Ranje h Rajan KV, D .Akshay Khandelwal (2022). Knowledge, a i ude and p ac ice on use o magni ica ion in den is y among den al s uden s Jou nal o Educa o s, Teache s and T aine s,Vol. 13(6). 253-262. 1Sa ee ha Den al College and Hospi al, Sa ee ha Ins i u e o medical and echnical sciences, Sa ee ha Uni e si y, Chennai- 600077 Tamil Nadu, India 2Senio Lec u e , Depa men o conse a i e den is y and endodon ics , Sa ee ha Den al College and Hospi als,Sa ee ha Ins i u e o medical and echnical sciences, Sa ee ha Uni e si y Chennai- 600077 Tamil Nadu, India Jou nal o Educa o s, Teache s and T aine s, Vol. 13 (6) ISSN 1989 – 9572 h ps://je .labos o .com/ Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 254 Knowledge, a i ude and p ac ice on use o magni ica ion in den is y among den al s uden s Ranje h Rajan KV1, D .Akshay Khandelwal2* 1Sa ee ha Den al College and Hospi al, Sa ee ha Ins i u e o medical and echnical sciences, Sa ee ha Uni e si y, Chennai- 600077 Tamil Nadu, India 2Senio Lec u e , Depa men o conse a i e den is y and endodon ics , Sa ee ha Den al College and Hospi als,Sa ee ha Ins i u e o medical and echnical sciences, Sa ee ha Uni e si y Chennai- 600077 Tamil Nadu, India *Co esponding Au ho Email: 151901069.sdc@sa ee ha.com1, akshayk.sdc@sa ee ha.com2 ABSTRACT In oduc ion : Magni ica ion in gene al is conside ed one o he impo an e olu ions in science, and speci ically in den is y. This Re olu ion allowed scien is s o unde ake main s udies in he na u al wo ld and accele a e p og ess in he ields. Magni ica ion also helps in he main enance o e gonomic wo k pos u e in den is y. The aim o his s udy was o assess he awa eness, a i ude, knowledge and p ac ice o den al s uden s owa ds use o magni ica ion in den is y. Ma e ials and Me hod : The S udy se ing used he e is an online se ing. The popula ion aken o his s udy is 100 den al s uden s om Tamil Nadu . The su ey is conduc ed using a s anda dised ques ionnai e. Da a was collec ed and abula ed. The da a collec ion so wa e used is SPSS so wa e.The esul s o his s udy in e ms o indi idual beha io and awa eness o den al s uden s owa ds use o magni ica ion in den is y a e compa able wi h simila s udies conduc ed in o he coun ies. The MCQ ype ques ions a e p epa ed wi h choices wi h he help o google o ms,and all he ques ions we e sha ed. Fo his esea ch 10 sel s uc u ed ques ionnai es we e c ea ed. Resul s: In he cu en s udy he ques ionnai e was ci cula ed on he basis o knowledge, a i ude and p ac ice. The da a was collec ed and s a is ically analysed. 52% o he pa icipan s we e emale and 48% o he pa icipan s we e male (Figu e1). Majo i y o pa icipan s (70%) ag eed ha use o magni ica ion de ices in den is y enhances isualiza ion and imp o es e gonomics. (Figu e 2).14% o he pa icipan s ag eed ha Den al p ocedu es ha e become complica ed and hence he use o magni ica ion in den is y has a ained a signi ican posi ion. The analysis showed ha he le el o awa eness among males and emales was simila . Chi squa e alue= 1.432; P alue= 0.430 ( p>0.05, hence s a is ically signi ican ). Conclusion: The s uden s pa icipa ing in he s udy had adequa e knowledge bu he a i ude and p ac ice sco e we e compa a i ely less. The ecen de elopmen s in magni ica ion wo k en i onmen s a e a posi i e s ep owa ds ope a o com o , bu new e gonomic equipmen has limi ed alue wi hou he c i ical analysis o cu en p ac ice pa e ns. Keywo ds: A i ude; Awa eness; Den al s uden ; E gonomic wo k; Knowledge; Magni ica ion loupes; P ac ice INTRODUCTION Magni ica ion is gene ally conside ed as one o he mos impo an e olu ions in science, and speci ically in den is y. This Re olu ion mainly allows scien is s o ocus mainly on s udies in he na u al wo ld and accele a e p og ess in he ields(1). The di e en idea o enhanced magni ica ion was in oduced o den is y in he o m o an ope a ing mic oscope in 1978. The Den al Ope a ing Mic oscope helps in di e en kinds o den al p ocedu es(2). Regula use o a DOM in a ious den al special ies was ad oca ed o ca ies diagnosis and exca a ion, c own ma gins and pos placemen ,and u ca ion and pe o -a ion epai s(3). Despi e he expensi e cos and ela i ely long du a ion lea ning cu e when s a ing using magni ica ion ools in he di e en den al special ies, i is gene ally belie ed ha hei use should be ad oca ed(4). They a e becoming an impo an in eg al pa o he e a o mode n mic osu ge y in a ious ields o den is y o hese yea s. Th ee p ima y ad an ages we e iden i ied in ela ion o he usage o magni ica ion de ices in endodon ics, like enhanced isualiza ion, imp o ed wo king pos u e, and inc eased e e al(5). Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 255 The clea ad an age o using a DOM (Den al Ope a ing Mic oscope) in den is y, esul ed in he Commission on Den al Acc edi a ion e-qui ing aining(6). The Ame ican Associa ion o Endodon ics (AAE) s a ed ha endodon ics could ha e use o a DOM in he ollowing p ocedu es like de ec ing hidden canals, mainly he MB2 canal in maxilla y mola s, hen e ea men cases whe e emo ing ma e ials like ob u a ion ma e ials and pos s in necessa y, and also emo ing b oken ins u-men s, achie ing p ope conse a i e access h ough supe io isualiza ion o he pulp chambe and canal o i- ices, pe o a ion epai s, and all s eps o endodon ic su ge y(7). S uden s using magni ica ion loupes wo ked as e , comple ed mo e ee h p epa a ions, and also used compu e -assis ed e alua ion less equen ly, and demon-s a ed be e o e all pe o mances. Endodon ics is con ined o a na ow ope a ing space as i deals wi h miniscule ana omy(8). As a esul , p ac i ione s who manage in ica e cases appea o ha e highe isual acui y. O e he yea s, many magni ica ion de ices ha e been in oduced as b idging ools be ween he naked eyes and he mic oscope(9). In ac , ools, like an endoscope, magni ying glass, and e en in ao al came a, ha e la gely been supe seded by con empo a y de ices ha seem o be mo e p ac ical and as well as con enien o applica ion, like loupes and den al ope a ing mic oscopes. This e iew gi es se e al common ypes o magni ica ion de ices applied in he discipline o endodon ics, he ac o s ha in luence hei adop ion, he ad an ages, and sho comings, as well as he impo ance o using magni ica ion de ices o endodon ics(10). Magni ica ion mainly helps in he main enance o e gonomic wo k pos u e in den is y, once hese magni ica ion lenses b ing he ope a i e ield close o p o essional(11). Loupes gi e a ype o magni ica ion and hei use can p omo e highe quali y on den al ea men (12). Among di e en ac o s ha can encou age p ac i ione s o use magni ica ion de ices a e exposu e o magni ica ion de ices by bo h demons a ions and den al con e ences, and also by inc easing awa eness on he bene i s o using such echnology and heal h- ela ed issues such as isual de e io a ion and musculoskele al pain(13). Besides hose ad an ages magni ica ion can be good o musculoskele al heal h main enance o den al p ac i ione s(14). Ve y ew s udies ha e been published on he opic o den al magni ica ion among den al p ac i ione s (15). Simila ly, a ecen ly conduc ed s udy on den al in e ns and inal yea unde g adua e s uden s, showed s a is ically signi ican imp o emen in he ou come o class II ca i y p epa a- ions o hose using magni ica ion loupes(16).Ou eam has ex ensi e knowledge and esea ch expe ience ha has ansla e in o high quali y publica ions(17–26),(27– 30),(31–35)(36). The aim o his s udy was o assess he a i ude, knowledge and p ac ice o den al s uden s owa ds use o magni ica ion in den is y. MATERIALS AND METHOD The S udy se ing used he e is an online se ing. The popula ion aken o his s udy is 100 pa icipan s om Tamil Nadu . The su ey is conduc ed using a s anda dised ques ionnai e. Da a was collec ed and abula ed. The da a collec ion so wa e used is SPSS so wa e.The esul s o his s udy in e ms o indi idual beha io and awa eness o den al s uden s owa ds use o magni ica ion in den is y a e compa able wi h simila s udies conduc ed in o he coun ies. The MCQ ype ques ions a e p epa ed wi h choices wi h he help o google o ms,and all he ques ions we e sha ed. Fo his esea ch 10 sel s uc u ed ques ionnai es we e c ea ed. Ou pu a iables can be isk ac o s, ood habi s, aged people. The sampling me hod used he e is a con enien sampling me hod. Me hod o ep esen a ion o da a is Pie cha , Ba Diag am. S a is ical es s used a e Desc ip i e s a is ics. Independen a iables can be Age, Weigh , Gende , Risk ac o s, c own ma gins and pos placemen , Neu onal Ne wo k and Deep Lea ning. dependen a iables can be awa eness, in e ac ion, knowledge, a i ude, p ac ice. This s udy is app o ed by he Ins i u ional Re iew Boa d, Sa ee ha Den al College, Chennai. S a is ical es s used a e Desc ip i e s a is ics. Independen a iables can be Age, Gende , Risk ac o s, ea men echniques, ad anced sha p ins umen s. Dependen a iables can be awa eness, in e ac ion, knowledge, a i ude, pe cep ions. RESULTS In he cu en s udy he ques ionnai e was ci cula ed on he basis o knowledge, a i ude and p ac ice. The da a is collec ed and s a is ically analysed. 52% o he pa icipan s we e emale and 48% o he pa icipan s we e male. Majo i y o pa icipan s (70%) ag eed ha use o magni ica ion de ices in den is y enhances isualiza ion and imp o es e gonomics. 14% o he pa icipan s ag eed ha Den al p ocedu es ha e become complica ed and hence he use o magni ica ion in den is y has a ained a signi ican posi ion. 70% ag eed ha applica ion o magni ica ion in endodon ics has ye o be in oduced in o mains eam p ac ice due o a ious in luences in beha io al pa e ns (Figu e 1). 18% o pa icipan s el ha su gical mic oscopes p o ide much g ea e magni ica ion, highe op ical pe o mance when ma ched wi h no mal den al loupes (Figu e 2). 30% o pa icipan s a e awa e ha applica ion o magni ica ion de ices in endodon ics is mainly mean o isual enhancemen and imp o ed e gonomics (Figu e 3). 60% o pa icipan s we e awa e ha Mic oscope p o ides 400 imes mo e isual accu acy han he naked eye and 100 imes he isual in o ma ion han adi ional den al loupes (Figu e 4). 34% o pa icipan s expe ienced ha Den al loupes aid den is s, hygienis s, and den al he apis s o de ise accu a e diagnoses o o al condi ions (Figu e 5). 45% o pa icipan s ag eed ha use o Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 256 magni ica ion in den is y appea s o be o inc easing in e es . Majo i y o emales (25%) and males (23%) knew ha he applica ion o magni ica ion de ices in endodon ics is mainly mean o isual enhancemen and imp o ed e gonomics (Figu e 6). Majo i y o males (33%) and emales (17%) knew ha su gical mic oscopes p o ide much g ea e magni ica ion, highe op ical pe o mance when ma ched wi h no mal den al loupes (Figu e 7). Figu e 1: Pie cha showing pe cen age dis ibu ion o esponses o s a emen applica ion o magni ica ion in endodon ics has ye o be in oduced in o mains eam p ac ice due o a ious in luences in beha io al pa e ns. 52%- Disag ee (blue); 48% - Ag ee (g een). Majo i y o pa icipan s (52%) ag eed ha he s a emen 's applica ion o magni ica ion in endodon ics has ye o be in oduced in o mains eam p ac ice due o a ious in luences in beha io al pa e ns. Figu e 2: Pie cha showing pe cen age dis ibu ion o esponses o he s a emen su gical mic oscopes p o ide much g ea e magni ica ion. 51%- Disag ee (blue); 49% - Ag ee (g een). Majo i y o pa icipan s (51%) disag eed wi h he s a emen ha su gical mic oscopes p o ide much g ea e magni ica ion. Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 257 Figu e 3: Pie cha showing pe cen age dis ibu ion o esponses o in ol emen o knowledge abou he use o magni ica ion de ices in den is y enhances isualiza ion and imp o es e gonomics. 42%- Disag ee (blue); 58% - Ag ee (g een). Majo i y o pa icipan s (58%) ag eed wi h use o magni ica ion de ices in den is y enhances isualiza ion and imp o es e gonomics. Figu e 4: Pie cha showing pe cen age dis ibu ion o esponses o in ol emen o knowledge ha mic oscope p o ides 400 imes mo e isual accu acy han he naked eye and 100 imes he isual in o ma ion han adi ional den al loupes. 48%- Disag ee (blue); 52% - Ag ee (g een). Majo i y o pa icipan s (52%) ag eed ha he mic oscope p o ides 400 imes mo e isual accu acy han he naked eye and 100 imes he isual in o ma ion han adi ional den al loupes. Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 258 Figu e 5: Pie cha showing pe cen age dis ibu ion o esponses o den al loupes aid den is s, hygienis s, and den al he apis s o de ise accu a e diagnoses o o al condi ions. 37%- Disag ee (blue); 63% - Ag ee (g een). Majo i y o pa icipan s (63%) ag eed ha den al loupes aid den is s, hygienis s, and den al he apis s o de ise accu a e diagnoses o o al condi ions. Figu e 6: Ba g aph showing he associa ion o esponses based on di e en gende o he awa eness on applica ion o magni ica ion, whe e blue deno es ag ee and g een deno es disag ee. X axis ep esen s gende and Y axis ep esen s pe cen age. Ou o 100 pa icipan s, 25% o emales epo ed ha applica ion o magni ica ion de ices in endodon ics is mainly mean o isual enhancemen and imp o ed e gonomics , whe eas only 23% o male epo ed ha applica ion o magni ica ion de ices in endodon ics is mainly mean o isual enhancemen and imp o ed e gonomics. Majo i y o emales (25%) and males (23%) knew ha he applica ion o magni ica ion de ices in endodon ics is mainly mean o isual enhancemen and imp o ed e gonomics. The analysis showed ha he le el o awa eness among males and emales was simila . Chi squa e alue= 1.543; P alue= 0.840 ( p>0.05, hence s a is ically signi ican ). Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 259 Figu e 7: Ba g aph showing he associa ion o esponses based on di e en gende o he awa eness o su gical mic oscopes p o iding g ea e magni ica ion, whe e blue deno es ag ee and g een deno es disag ee. X axis ep esen s gende and Y axis ep esen s pe cen age. Ou o 100 pa icipan s, 17% o emales epo ed ha su gical mic oscopes p o ide much g ea e magni ica ion, highe op ical pe o mance when ma ched wi h no mal den al loupes , whe eas only 33% o male epo ed ha su gical mic oscopes p o ide much g ea e magni ica ion, highe op ical pe o mance when ma ched wi h no mal den al loupes. Majo i y o males (33%) and emales (17%) knew ha su gical mic oscopes p o ide much g ea e magni ica ion, highe op ical pe o mance when ma ched wi h no mal den al loupes. The analysis showed ha he le el o awa eness among males and emales was simila . Chi squa e alue= 1.432; P alue= 0.430 ( p>0.05, hence s a is ically signi ican ). DISCUSSION The use o la es equipmen is e lec i e o clinicians as being mo e p o essional and also skill ul. As pa ien s belie e and con idence a e es ablished, mo e wo d-o -mou h e e als will ensue(37). A came a can be ixed o he mic oscope o enable he clinician o ake high esolu ion pho os o gi e a lec u e on he case p ognosis(2). This may help in as e unde s anding among pa ien s owa ds he p ope ea men plan(4). Many epo ed disad an ages a e he acclima iza ion pe iod o he la es wo king en i onmen , he high cos o he magni ica ion de ice and i s ela ed accesso ies, addi ional s eps o in ec ion con ol, as well as a po en ial sha p inju y a he wo kplace(38). P e ious s udies by Mamoun JS e al , a gue ha high-powe ed magni ica ion (4x-6x o mo e) p o ides subs an ially mo e isual in o ma ion o diagnosing and gi es ea men o den al pa hology when compa ed o he use o basic le el is 2.5x magni ica ion. In all phases o gene al den is y, he inc eased isual de ail p o ided by high magni ica ion educes ambigui y in bo h diagnosis and ea men decision-making(39). The cos s o bo h loupe and mic oscope a e conside ed imp ac ical, pa icula ly in de eloping na ions(40). The sepa a e ligh ing sys em ha needs o be a ached wi h he loupe and small size su gical ins umen s may also incu an added cos (5). The use o high olume sui able wo king dis ance is impe a i e o minimize con amina ion. P o ec i e ou e co e placed on he loupe which p e en s he lenses om sc a ching. Su ace deb is on he lenses can be emo ed wi h gen le blowing and blo ing(8). Sha p inju ies can occu due o he ca eless use o loupes du ing den al p ocedu e. Passing skills mus be well-coo dina ed be ween he clinician and he assis an o a oid inju ies(41). Ve y li le numbe s o s udies ha e been published on he opic o den al magni ica ion among den al p ac i ione s(42). Simila ly, a ecen ly conduc ed s udy on den al in e ns and inal yea unde g adua e s uden s, showed s a is ically signi ican imp o emen in he ou come o class II ca i y p epa a- ions o hose using magni ica ion loupes(43). Jou nal o Educa o s, Teache s and T aine s JETT, Vol. 13 (6); ISSN: 1989-9572 260 Fu he mo e, when endodon ic mic osu ge y is pe o med unde magni ica ion wi h mode n mic osu gical me hods, he success a e is 94%, as opposed o 59%, when pe o med wi h nei he magni ica ion no cu ing- edge ins umen s(44). Teleconsul a ion may also u n in o a eali y by li e communica ion whene e he e is a use o hese magni ica ion de ices gains high accep ance by den al p ac i ione s. CONCLUSION The ecen de elopmen s in magni ica ion wo k en i onmen s a e a posi i e s ep owa ds ope a o com o , bu new e gonomic equipmen has limi ed alue wi hou he c i ical analysis o cu en p ac ice pa e ns. F om his su ey, we can conclude ha mos den al s uden s a e awa e o he impo ance o magni ica ion. Thei a i ude and p ac ice sco es a e hough lesse compa ed o he knowledge sco es. ACKNOWLEDGEMENT I would like o acknowledge he depa men o conse a i e den is y ,and he managemen o he cons an suppo in his s udy. The au ho s ex end hei since e g a i ude o he Sa ee ha Den al College o hei cons an suppo o ca y ou his esea ch. Financial Suppo New Hi- Tech O ganisa ion, Chennai, India Con lic ing In e es Au ho s ha e decla ed ha no compe ing in e es s exis . Funding Sou ce The p esen s udy was suppo ed by he ollowing agencies ● Sa ee ha Den al College ● SIMATS, Sa ee ha Uni e si y ● New Hi- Tech O ganisa ion, Chennai, India REFERENCE 1. Wajnga en D, Ga cia P. 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