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Fenske F, Kujat B, Krause L, Meyer S, Sander AK, Repmann J, Neuhaus M, Haak R, Roth A, Lethaus B, Ziebolz D, Schmalz G. Preoperative dental screening can reduce periprosthetic infections of hip and knee endoprostheses in the first month after surgery: results of a cohort study. Infection 2024; 52:535-543. [PMID: 38060067 PMCID: PMC10954939 DOI: 10.1007/s15010-023-02128-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE The oral cavity and, in particular, potential oral foci might pose a risk of periprosthetic joint infection (PJI). The aim of this cohort study was to determine whether practical preoperative dental screening would reduce the prevalence of early PJI in the first month after surgery. METHODS Patients attending a specialized endoprosthesis implantation clinic between 2018 and 2022 were recruited. Two groups were examined. The test group consisted of patients attending the clinic between 2020 and 2022 and who were referred to their family dentist using a standardized form. The comparison group consisted of patients who were treated in the clinic between 2018 and 2020. They were not referred to their family dentist. The two groups were compared for the prevalence of PJI. Univariate analysis followed by multiple logistic regression was performed to confirm risk factors for PJI in this cohort. RESULTS 2560 individuals (test group: 1227, comparison group: 1333) were included. The prevalence of PJI was significantly lower in the test group (0.8% vs. 1.8%, p = 0.04). Multiple logistic regression with PJI as the dependent variable showed that a dental referral was a strong predictor of a lower prevalence of PJI (OR: 0.43, CI95 0.205-0.917, p = 0.03). Male gender was also strongly associated with a higher frequency of PJI (OR: 2.68, CI95 1.32-5.42, p = 0.01). Age (OR: 1.06, CI95 1.01-1.10, p = 0.01) and BMI (OR: 1.11, CI95 1.05-1.17, p < 0.01) had little effect on the risk of PJI. CONCLUSION Dental referral using a standardized form can reduce the prevalence of early PJI. Accordingly, orthopedists and dentists should collaborate in this practical way.
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Affiliation(s)
- Fabian Fenske
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Benjamin Kujat
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Leah Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Stephan Meyer
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Anna-Katharina Sander
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Jaqueline Repmann
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Michael Neuhaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Andreas Roth
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
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Sukotjo C, Bertucci DE, Patel JY, Yuan JCC, Santoso M. Evaluating augmented reality e-typodont to improve a patient's dental implant health literacy. J Prosthet Dent 2023:S0022-3913(23)00539-5. [PMID: 37714746 DOI: 10.1016/j.prosdent.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/17/2023]
Abstract
STATEMENT OF PROBLEM Information regarding dental implants can be difficult to understand for participants. Improving patients' dental implant health literacy remains a challenging process. PURPOSE The purpose of this clinical study was to develop and evaluate patients' understanding of the implant treatment procedure, components, and sequences using traditional typodont and augmented reality (AR) applications (e-typodont), with the goal of improving their oral health literacy. MATERIAL AND METHODS Participants who had sought dental implant treatment at the group practice and implant clinic at the University of Illinois Chicago (UIC) College of Dentistry were invited to enroll in this study. Participants were asked to fill out the first questionnaire (Q1) assessing their understanding of implant treatment procedures, components, and sequences. The participants were randomly exposed to 1 of the 2 modes of delivering education, typodont or AR e-typodont. The participants were asked to complete the additional 2 questionnaires (Q2 and Q3), and the posttest questionnaire (Q1) to re-evaluate their understanding of the implant treatment procedure, components, and sequences. All data were entered and coded into a spreadsheet. Descriptive (mean) and statistical (Wilcoxon Signed Ranks and Mann-Whitney U test) analyses were used (α=.05). RESULTS Both interventions significantly increased participants' understanding of implant treatments (typodont: P=.004; e-typodont: P<.001), implant components (typodont: P=.003; e-typodont: P<.001), and implant treatment sequences (typodont: P=.001; e-typodont: P<.001). The e-typodont group significantly improved participants' understanding of implant treatments (P=.006), implant components (P=.023), and implant treatment sequences (P=.008) compared with the typodont group. Participants perceived the e-typodont mode of delivery to be significantly more interesting (P=.002), interactive (P=.008), educational (P=.002), user-friendly (P=.016), and "Wow" (P=.002) compared with the traditional typodont mode of delivery. CONCLUSIONS Both interventions improved participants' understanding of implant treatment procedures, components, and sequences. The e-typodont showed better improvement in participants' understanding of dental implants compared with the traditional typodont.
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Affiliation(s)
- Cortino Sukotjo
- Professor and Director, Predoctoral Implant Program, Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, Ill.
| | - Dominique Erica Bertucci
- Resident, Pediatric Dentistry, Children's Hospital Colorado Anschutz Medical Campus, Aurora, Colo
| | | | - Judy Chia-Chun Yuan
- Associate Professor and Interim Assistant Dean for Clinical Affairs, Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Markus Santoso
- Assistant Professor, Digital Worlds Institute, University of Florida, Gainesville, Fla
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Schmalz G, Lenzen C, Reuschel F, Fenske F, Haak R, Goralski S, Roth A, Ziebolz D. Lack of oral health awareness and interdisciplinary dental care: a survey in patients prior to endoprosthesis and orthopaedic centres in Germany. BMC Oral Health 2023; 23:92. [PMID: 36782181 PMCID: PMC9926854 DOI: 10.1186/s12903-023-02793-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVES This cross-sectional survey aimed to evaluate the oral health behaviour of patients prior to endoprosthesis (EP), as well as the handling of oral health topics by German orthopaedic surgeons. MATERIALS AND METHODS Consecutive patients prior to EP answered a questionnaire regarding oral health behaviour, oral hygiene, oral complaints and information on the relationship between EP and oral health. Another questionnaire was digitally mailed to orthopaedic centres throughout Germany. This questionnaire included the importance of oral health for EP and issues on dental referrals/consultations prior to EP. RESULTS A total of 172 patients were included in the study, of whom 35.5% of patients reported that they were informed about oral health and EP. Half of the individuals reported regular professional tooth cleaning, and less than one-third (29.1%) reported of the performance of interdental cleaning. Information on oral health and EP was associated with regular professional tooth cleaning (yes: 59.8% vs. no: 35.6%, p = 0.01). A total of 221 orthopaedic clinics were included in the study, of which only a few had dental contact (14%), although the majority (92.8%) of the clinics were familiar with causal relationships between oral health and EP infections. Less than half of the centres reported of either verbal (48%) or written (43.9%) referrals for their patients to the dentist. University Medical Centres reported of more frequent dental contacts (p < 0.01). CONCLUSION Prior to EP, patients exhibited deficits in oral health behaviour, and orthopaedic clinics exhibited a lack of dental collaboration. Improvements in interdisciplinary care, especially regarding practical concepts for patient referral and education on oral health, appear to be necessary.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103, Leipzig, Germany.
| | - Carina Lenzen
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Florentine Reuschel
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Fabian Fenske
- grid.9647.c0000 0004 7669 9786Department of Craniomaxillofacial Surgery, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Szymon Goralski
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Roth
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- grid.9647.c0000 0004 7669 9786Department of Cariology, Endodontology and Periodontology, University Medical Center Leipzig, University of Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
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Schmalz G, Fenske F, Reuschel F, Bartl M, Schmidt L, Goralski S, Roth A, Ziebolz D. Association between oral health and oral health-related quality of life in patients before hip and knee endoprosthesis surgery: a cross-sectional study. BMC Oral Health 2022; 22:604. [PMCID: PMC9749641 DOI: 10.1186/s12903-022-02650-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Objectives
Aim of this cross-sectional study was the assessment of oral health-related quality of life (OHRQoL) health-related quality of life (HRQoL), oral health behaviour and oral health status in patients before hip and knee endoprosthesis (EP) surgery. Moreover, associations between OHRQoL, HRQoL and oral health should be examined.
Methods
Consecutive patients before hip and/or knee EP implantation were recruited and referred to the dental clinic for oral examination including: number of remaining teeth, dental findings (DMF-T-Index), periodontal condition (periodontal treatment need, Staging/Grading) and temporomandibular joint screening. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14), HRQoL by short-form 36 survey.
Results
Hundred and sixty two patients with a mean age of 66.80 ± 11.10 years were included, which had on average 18.22 ± 8.57 remaining teeth and a periodontal treatment need of 84.5%. The OHIP G14 sum score revealed a median of 1 (mean: 2.7 ± 4.4, 25–75th percentile: 0–4) and its dimension oral function of 0 (mean: 0.8 ± 1.8, 25–75th percentile: 0–1), what was also found for psychosocial impact (median: 0, mean: 1.4 ± 2.6, 25–75th percentile: 0–2). The OHIP G14 sum score and both dimensions were significantly associated with mental component summary (p < 0.01). A higher number of remaining teeth as well as remaining molars/premolars were associated with lower OHIP G14 sum score (p = 0.02). This was also found for the dimension oral function (p < 0.01).
Conclusion
Patients prior to hip and knee EP had an unaffected OHRQoL, although they had an insufficient oral health. Individuals before EP implantation need increased attention in dental care, fostering information, sensibilization and motivation of the patients.
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