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Gao J, Yin W, Liu Y, Zhao X, Huangphattarakul V, Qu Y, Man Y. Cushioned grind-out technique transcrestal sinus floor elevation for simultaneous implantation in severe atrophic maxilla: A retrospective study with up to 7 years of follow-up. Clin Oral Implants Res 2023. [PMID: 37226843 DOI: 10.1111/clr.14099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effects of the cushioned grind-out technique transcrestal sinus floor elevation for simultaneous implant placement with ≤4 mm of residual bone height (RBH). MATERIALS AND METHODS This was a retrospective propensity score matching (PSM) study. Five PSM analyses included the confounding variables of Schneiderian membrane perforation, early and late implant failure, and peri-implant apical and marginal bone resorption. After PSM, we compared the difference in five aspects between the RBH ≤ 4 and >4 mm groups. RESULTS A total of 214 patients with 306 implants were included in this study. After PSM, the generalized linear mixed model (GLMM) indicated that RBH ≤ 4 mm had no significantly higher risk of Schneiderian membrane perforation and early and late implant failure (p = .897, p = .140, p = .991, respectively). The implant cumulative 7-year survival rate of the RBH ≤ 4 and >4 mm groups was 95.5% and 93.9%, respectively (log-rank test: p = .900). Within at least 40 cases per group after PSM, two multivariate GLMMs indicated that RBH ≤ 4 mm could not be identified as the promotive factor of bone resorption of either endo-sinus bone gain or crest bone level (RBH × time interaction p = .850, p = .698, respectively). CONCLUSIONS Within the limitations, 3 months to 7 years of post-prosthetic restoration review data indicated an acceptable mid-term survival and success rate of applying the cushioned grind-out technique in RBH ≤ 4 mm cases.
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Affiliation(s)
- Jiayu Gao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wumeng Yin
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yeyu Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiangqi Zhao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Vicha Huangphattarakul
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Crins LAMJ, Opdam NJM, Kreulen CM, Bronkhorst EM, Huysmans MCDNJM, Loomans BAC. Randomised controlled trial on testing an increased vertical dimension of occlusion prior to restorative treatment of tooth wear. J Oral Rehabil 2023; 50:267-275. [PMID: 36582043 DOI: 10.1111/joor.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Evaluation of a new vertical dimension of occlusion (VDO) in complex restorative treatments is considered a necessary step prior to placement of restorations. OBJECTIVES This randomised controlled trial (RCT) aimed to assess the effects of using an evaluation of a VDO increase before restorative treatment in patients with moderate-to-severe tooth wear, on OHRQoL, freeway space (FWS) and interventions to restorations. METHODS Forty-two patients with tooth wear were included and randomly allocated to either a test phase with a Removable Appliance (RA) or no test phase. Restorative treatment consisted of restoration of all teeth using composite restorations in an increased VDO. OHIP-score, freeway space (FWS) and clinical acceptability of restorations were assessed at baseline and at recall appointments (1 month and 1 year). Intervention to restoration was scored in case of material chipping or when the abutment tooth had increased sensitivity that could be linked to occlusal overloading. ANCOVA analyses, Univariate Cox regression, t-tests and descriptive analyses were performed (p < .05). RESULTS Clinical follow-up after 1 year was completed for 41 patients. No significant effect of testing the VDO with a RA could be found on the OHIP-score (p = .14). Reduction of FWS in the RA group, compared to the control group, was significantly lower at 1 year (p = .01, 95% CI -1.09 to -0.15). No effect on early interventions to restorations was found (p = .94). CONCLUSION This RCT showed that a removable appliance is not indicated to functionally test the increased VDO prior to restorative treatment in patients with tooth wear.
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Affiliation(s)
- Luuk A M J Crins
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Niek J M Opdam
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Cees M Kreulen
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Bas A C Loomans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Cebula M, Göstemeyer G, Krois J, Pitchika V, Paris S, Schwendicke F, Effenberger S. Resin Infiltration of Non-Cavitated Proximal Caries Lesions in Primary and Permanent Teeth: A Systematic Review and Scenario Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:jcm12020727. [PMID: 36675656 PMCID: PMC9864315 DOI: 10.3390/jcm12020727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
The present study aimed to meta-analyze and evaluate the certainty of evidence for resin infiltration of proximal carious lesions in primary and permanent teeth. While resin infiltration has been shown efficacious for caries management, the certainty of evidence remains unclear. The protocol was registered with PROSPERO (CRD42018080895), and PRISMA guidelines have been followed. The databases PubMed, Embase, and Cochrane CENTRAL were systematically screened, complemented by hand searches and cross-referencing. Eleven relevant articles were identified and included, i.e., randomized controlled trials (RCTs) comparing the progression of resin infiltrated proximal caries lesions (combined with non-invasive measures) in primary or permanent teeth with non-invasive measures. Random-effects meta-analyses and trial sequential analyses (TSA) were performed for per-protocol (PP), intention-to-treat (ITT), and best/worst case (BC/WC) scenarios. Six included trials assessed lesions in permanent teeth and five trails assessed lesions in primary teeth. The trials had a high or unclear risk of bias. Risk of caries progression was significantly reduced for infiltrated lesions in the PP, ITT, and BC scenarios in both permanent teeth and primary teeth, but not in the WC scenario. According to the TSA, firm evidence was reached for all of the scenarios except the WC. In conclusion, there is firm evidence for resin infiltration arresting proximal caries lesions in permanent and primary teeth.
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Affiliation(s)
- Marcus Cebula
- Clinical Research Department, DMG Dental Material Gesellschaft mbH, Elbgaustraße 248, 22547 Hamburg, Germany
| | - Gerd Göstemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Vinay Pitchika
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Sebastian Paris
- Department of Restorative, Preventive and Pediatric Dentistry, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Susanne Effenberger
- Clinical Research Department, DMG Dental Material Gesellschaft mbH, Elbgaustraße 248, 22547 Hamburg, Germany
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
- Correspondence:
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Schmitter M, Bömicke W, Behnisch R, Lorenzo Bermejo J, Waldecker M, Rammelsberg P, Ohlmann B. Ceramic Crowns and Sleep Bruxism: First Results from a Randomized Trial. J Clin Med 2022; 12:jcm12010273. [PMID: 36615073 PMCID: PMC9821737 DOI: 10.3390/jcm12010273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected.
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Affiliation(s)
- Marc Schmitter
- Department of Prosthodontics, University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-622-156-6052
| | - Rouven Behnisch
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Moritz Waldecker
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Pispero A, Marcon M, Ghezzi C, Massironi D, Varoni EM, Tubaro S, Lodi G. Posture Assessment in Dentistry for Different Visual Aids Using 2D Markers. Sensors (Basel) 2021; 21:s21227717. [PMID: 34833788 PMCID: PMC8619426 DOI: 10.3390/s21227717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/13/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022]
Abstract
Attention and awareness towards musculoskeletal disorders (MSDs) in the dental profession has increased considerably in the last few years. From recent literature reviews, it appears that the prevalence of MSDs in dentists concerns between 64 and 93%. In our clinical trial, we have assessed the dentist posture during the extraction of 90 third lower molars depending on whether the operator performs the intervention by the use of the operating microscope, surgical loupes, or with the naked eye. In particular, we analyzed the evolution of the body posture during different interventions evaluating the impact of visual aids with respect to naked eye interventions. The presented posture assessment approach is based on 3D acquisitions of the upper body, based on planar markers, which allows us to discriminate spatial displacements up to 2 mm in translation and 1 degree in rotation. We found a significant reduction of neck bending in interventions using visual aids, in particular for those performed with the microscope. We further investigated the impact of different postures on MSD risk using a widely adopted evaluation tool for ergonomic investigations of workplaces, named (RULA) Rapid Upper Limb Assessment. The analysis performed in this clinical trial is based on a 3D marker tracker that is able to follow a surgeon’s upper limbs during interventions. The method highlighted pros and cons of different approaches.
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Affiliation(s)
- Alberto Pispero
- Azienda Ospedaliera Santi Paolo e Carlo, Unità Operativa Complessa Odontostomatologia II, Università degli Studi di Milano, Via Beldiletto 1/3, 20142 Milan, Italy; (A.P.); (E.M.V.); (G.L.)
| | - Marco Marcon
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy;
- Correspondence:
| | - Carlo Ghezzi
- Private Practice, Via G. Verdi 4, 20019 Settimo Milanese, Italy;
| | | | - Elena Maria Varoni
- Azienda Ospedaliera Santi Paolo e Carlo, Unità Operativa Complessa Odontostomatologia II, Università degli Studi di Milano, Via Beldiletto 1/3, 20142 Milan, Italy; (A.P.); (E.M.V.); (G.L.)
| | - Stefano Tubaro
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy;
| | - Giovanni Lodi
- Azienda Ospedaliera Santi Paolo e Carlo, Unità Operativa Complessa Odontostomatologia II, Università degli Studi di Milano, Via Beldiletto 1/3, 20142 Milan, Italy; (A.P.); (E.M.V.); (G.L.)
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Abstract
Data are a key resource for modern societies and expected to improve quality, accessibility, affordability, safety, and equity of health care. Dental care and research are currently transforming into what we term data dentistry, with 3 main applications: 1) medical data analysis uses deep learning, allowing one to master unprecedented amounts of data (language, speech, imagery) and put them to productive use. 2) Data-enriched clinical care integrates data from individual (e.g., demographic, social, clinical and omics data, consumer data), setting (e.g., geospatial, environmental, provider-related data), and systems level (payer or regulatory data to characterize input, throughput, output, and outcomes of health care) to provide a comprehensive and continuous real-time assessment of biologic perturbations, individual behaviors, and context. Such care may contribute to a deeper understanding of health and disease and a more precise, personalized, predictive, and preventive care. 3) Data for research include open research data and data sharing, allowing one to appraise, benchmark, pool, replicate, and reuse data. Concerns and confidence into data-driven applications, stakeholders’ and system’s capabilities, and lack of data standardization and harmonization currently limit the development and implementation of data dentistry. Aspects of bias and data-user interaction require attention. Action items for the dental community circle around increasing data availability, refinement, and usage; demonstrating safety, value, and usefulness of applications; educating the dental workforce and consumers; providing performant and standardized infrastructure and processes; and incentivizing and adopting open data and data sharing.
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Affiliation(s)
- F Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Abstract
An increasing number of studies on artificial intelligence (AI) are published in the dental and oral sciences. The reporting, but also further aspects of these studies, suffer from a range of limitations. Standards towards reporting, like the recently published Consolidated Standards of Reporting Trials (CONSORT)-AI extension can help to improve studies in this emerging field, and the Journal of Dental Research (JDR) encourages authors, reviewers, and readers to adhere to these standards. Notably, though, a wide range of aspects beyond reporting, located along various steps of the AI lifecycle, should be considered when conceiving, conducting, reporting, or evaluating studies on AI in dentistry.
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Affiliation(s)
- F Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Grabliauskienė Ž, Zamaliauskienė R, Lodienė G. Pulp Vitality Testing with a Developed Universal Pulse Oximeter Probe Holder. ACTA ACUST UNITED AC 2021; 57:medicina57020101. [PMID: 33498652 PMCID: PMC7912332 DOI: 10.3390/medicina57020101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives An accurate determination of the pulp status is relevant for a proper endodontic diagnosis. Objectives: The aim was to develop a universal pulse oximeter probe holder for measuring the oxygen saturation and to evaluate the use of pulse oximetry as a test for pulp vitality, by comparing the levels of oxygen saturation in the index finger and in the healthy dental pulp. Materials and Methods The universal holder was designed with software and printed with a 3D printer. The study was carried out on 128 healthy teeth. They were divided into eight groups according to tooth type. Ten root canal treated teeth served as a negative control group. For each patient, a pulse oximeter was first applied on the tooth followed by the index finger. The significance level (α) was set at 0.05. Results: The developed and manufactured universal pulse oximeter probe holder was suitable to measure the pulp vitality of all types of teeth. The handle allowed for holding the pulse oximeter on the tooth in parallel, firmly and securely. Significantly higher oxygen saturation was observed in the index finger (97.22%) compared to the dental pulp (93.17%) (p < 0.001). No correlation was observed between the maxillary teeth and index finger oxygen saturation values (r = 0.05, p = 0.72), whereas, between the mandibular teeth and index finger, a positive correlation was detected (r = 0.29, p = 0.02). There were no significant differences in the pulp oxygen saturation values between different teeth groups. Conclusion: The newly developed universal pulse oximeter probe holder is an effective device for pulp vitality testing.
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Vetromilla BM, Opdam NJ, Leida FL, Sarkis-Onofre R, Demarco FF, van der Loo MPJ, Cenci MS, Pereira-Cenci T. Treatment options for large posterior restorations: a systematic review and network meta-analysis. J Am Dent Assoc 2020; 151:614-624.e18. [PMID: 32718491 DOI: 10.1016/j.adaj.2020.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The best treatment option for large caries in permanent posterior teeth is still a matter of uncertainty in dental literature. The authors conducted a network meta-analysis to address the challenges related to rehabilitation of these teeth. TYPES OF STUDIES REVIEWED The authors selected prospective and retrospective studies that compared at least 2 different treatment alternatives for permanent teeth with a minimum of 5 years of follow-up. The authors searched databases from MEDLINE, Scopus, Cochrane Library, and Web of Science in October 2019 without language or year of publication restrictions. RESULTS From 11,263 studies identified, 43 studies fulfilled the eligibility criteria and were included in the final review. Only 13 studies were randomized controlled trials and were classified as low risk of bias. Gold (annual failure rate of 0.29%) and metal ceramic (annual failure rate of 0.52%) crowns performed better for indirect restorations and direct resin composite performed better for direct restorations (annual failure rate of 2.19%). The most substantial comparisons were between feldspathic and glass ceramics, followed by direct resin composite and amalgam; there were no statistically significant differences between these interventions. Results of the pairwise meta-analysis showed mainly glass ionomer as significantly more prone to failure than amalgam and direct composite resin. CONCLUSIONS AND PRACTICAL IMPLICATIONS Reference standard direct and indirect materials except for glass ionomer can be used for restorations of large posterior caries.
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Knight A, Blewitt I, Al-Nuaimi N, Watson T, Herzog D, Festy F, Patel S, Foschi F, Koller G, Mannocci F. Rapid Chairside Microbial Detection Predicts Endodontic Treatment Outcome. J Clin Med 2020; 9:jcm9072086. [PMID: 32635158 PMCID: PMC7408726 DOI: 10.3390/jcm9072086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 01/03/2023] Open
Abstract
Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans. Results. Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%. Conclusion. A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163.
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Affiliation(s)
- Alan Knight
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Ian Blewitt
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Nassr Al-Nuaimi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Conservative Dentistry, College of Dentistry, University of Baghdad, Baghdad 10001, Iraq
| | - Tim Watson
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Dylan Herzog
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Frederic Festy
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Shanon Patel
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Specialist practice, London W1G 8SB, UK
| | - Federico Foschi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Garrit Koller
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Francesco Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Correspondence: ; Tel.: +44(0)-2071-881-573
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Abstract
Introduction: Dental anxiety is common and causes symptomatic use of oral health services. Objectives: The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. Methods: A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. Results: Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (β = −0.75, P < .001, for MDAS total score; β = −0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (β = −1.08, P < .001) and treatment-related dental anxiety (β = −0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (β = −0.217, P < .026) and women (β = −0.498, P < .001). Conclusion: Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). Knowledge Transfer Statement: Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.
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Affiliation(s)
- S. Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
- S. Lahti, Department of Community Dentistry, University of Turku, Turku, FI-20014, Finland.
| | - A. Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - R. Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
| | - T. Lähteenoja
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - G. Humphris
- Division of Populations and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
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12
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Pine CM, Adair PM, Burnside G, Brennan L, Sutton L, Edwards RT, Ezeofor V, Albadri S, Curnow MM, Deery C, Hosey MT, Willis-Lake J, Lynn J, Parry J, Wong FSL. Dental RECUR Randomized Trial to Prevent Caries Recurrence in Children. J Dent Res 2020; 99:168-174. [PMID: 31944893 DOI: 10.1177/0022034519886808] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to determine the efficacy of a dental nurse-delivered intervention-the Dental RECUR Brief Negotiated Interview for Oral Health (DR-BNI)-in reducing the recurrence of dental caries in children who have a primary tooth extracted. It was based on a 2-arm multicenter randomized controlled trial with blinded outcome assessment. Participants were 5- to 7-y-old children (n = 241) scheduled to have primary teeth extracted in 12 UK centers. Test intervention parents (n = 119) received DR-BNI led by trained dental nurses. DR-BNI is a 30-min structured conversation informed by motivational interviewing with a forward focus to prevent future caries. Preventive goals are agreed, and a review appointment is made with child's general dental practitioner, who is advised to treat the child as being at high caries risk. The control intervention (n = 122) was a parent-nurse conversation about child's future tooth eruption, with advice given to visit a general dental practitioner as usual. At baseline, the DR-BNI group's mean dmft was 6.8, and the control group's was 6.3. A median of 5 teeth were extracted, mainly under general anesthesia. Final dental assessments were conducted by a single examiner visiting 189 schools 2 y after intervention; 193 (80%) of 241 children were examined. In the control group, 62% developed new caries in teeth that were caries-free or unerupted at baseline, as compared with 44% in the test group, a significant reduction (P = 0.021). The odds of new caries experience occurring were reduced by 51% in the DR-BNI group as compared with control. There was a 29% decrease in the relative risk of new caries experience in the DR-BNI group as compared with control. This single low-cost, low-intensity intervention was successful in significantly reducing the risk of recurrence of dental caries in children. This trial has implications for changing pediatric dental practice internationally. Training in and implementation of a motivational interviewing-informed brief intervention provides opportunities for dental nurses to facilitate behavior change improving the oral health of children at high caries risk (ISRCTN 24958829).
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Affiliation(s)
- C M Pine
- Research and Innovation, Salford Royal NHS Foundation Trust, Northern Care Alliance NHS Group, Summerfield House, Salford, UK.,Barts and the London Schools of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - P M Adair
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University, Belfast, UK
| | - G Burnside
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - L Brennan
- Health Education North West, Regatta Place, Liverpool, UK
| | - L Sutton
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - R T Edwards
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - V Ezeofor
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - S Albadri
- Paediatric Dentistry, School of Dentistry, University of Liverpool, Liverpool, UK
| | - M M Curnow
- Public Dental Service, Broxden Dental Centre, NHS Tayside, Perth, UK
| | - C Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - M T Hosey
- Paediatric Dentistry, Centre of Oral, Clinical and Translational Science, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, London, UK
| | - J Willis-Lake
- Kent Community Health NHS Foundation Trust, Maidstone, UK
| | - J Lynn
- Community Dental Service, Arches Health and Care Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - J Parry
- Special Care Dental Service, Sussex Community NHS Foundation Trust, Brighton, UK.,Paediatric Dentistry, University College Cork, Cork, Ireland
| | - F S L Wong
- Barts and the London Schools of Medicine and Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
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13
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Arias MC, McNeil DW. Smartphone-based exposure treatment for dental phobia: a pilot randomized clinical trial. J Public Health Dent 2020; 80:23-30. [PMID: 31583708 PMCID: PMC7885165 DOI: 10.1111/jphd.12340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 06/23/2019] [Accepted: 08/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES High levels of dental care-related fear/anxiety, as well as phobia, result in delay or avoidance of dental care, which are associated with poorer oral and overall health. Both pharmacotherapeutic and psychosocial methods are available to treat those with high levels of dental fear/anxiety or phobia, but they are infrequently used and not easily accessed. Smartphones are a potential vehicle for delivering exposure therapy (e.g., a treatment involving systematic encounter with fear-evoking stimuli), but there is a need to test the acceptability of this approach in regard to treatment of high levels of dental anxiety/fear and phobia. METHODS There were 36 patients with high dental anxiety/fear/phobia randomly assigned to either a treatment or a waitlist condition. Participants completed a pre- and two-week post-multimodal assessment, including a dental behavioral avoidance task. The treatment condition included 2 weeks of self-directed exposure delivered via a personal smartphone in the patients' natural environment. RESULTS Participants in the treatment condition utilized the smartphone exposure an average of 1.6 times daily (SD = 0.85), and found the self-directed exposure highly acceptable. Moreover, they had lower self-reported anxiety and decreased cardiac reactivity at the postassessment compared with the preassessment; no change in anxiety was found for the control condition from pre- to postassessment. CONCLUSIONS Highly anxious, fearful, and dental phobic participants utilized smartphone-delivered exposure therapy, and found it to be an acceptable treatment method. Results support the utility and promise for further testing of the personal smartphone in delivering self-directed exposure therapy for high dental fear/anxiety and phobia.
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Affiliation(s)
- Matthew C. Arias
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Daniel W. McNeil
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- Department of Dental Practice & Rural Health, West Virginia University School of Dentistry, Morgantown, WV, USA
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14
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Feine JS. It's All About Improving Health. JDR Clin Trans Res 2019; 4:104-105. [PMID: 30931702 DOI: 10.1177/2380084419833667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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15
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Abstract
Dental caries remains a world-wide disease despite the global distribution of fluoride. It has become apparent that the introduction of significant levels of sugar (fermentable carbohydrate) into the diet has resulted in a change in the biofilm, encouraging acid formation. Further, there has been a shift in the microbiota in the biofilm to a flora that produces acid, and thrives and reproduces in an acidic environment. The management of caries activity under these conditions has focused on brushing to remove the biofilm with fluoride pastes, and high-dose fluoride treatments. Kleinberg, in the 1970s, identified an arginine-containing compound in saliva that several oral biofilm bacterial species metabolize to produce base. Multiple in situ and in vivo studies have been conducted, and have discussed the ability of multiple bacteria to increase the resting pH of the biofilm and even reduce the decrease in pH when the biofilm is challenged with glucose. This shift in resting pH can shift the level of caries formation by the biofilm. Here, we present 8 clinical studies, with different clinical designs, measuring different clinical outcomes, for a diverse, world-wide population. Each of these studies demonstrates reductions in caries formation beyond that seen with fluoride alone and several demonstrate the reversal of early caries lesions. Significant clinical research has been shown that 1.5% arginine combined with fluoride toothpaste has superior anti-caries efficacy to toothpaste containing fluoride alone.
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Affiliation(s)
- M S Wolff
- 1 Department of Cariology and Comprehensive Care, NYU College of Dentistry, New York, NY, USA
| | - A B Schenkel
- 1 Department of Cariology and Comprehensive Care, NYU College of Dentistry, New York, NY, USA
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16
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Abstract
Objective: The aim of this study is to assess the surface roughness of the implant-retained mandibular bar overdenture (BOD) and the implant-retained mandibular ball joint overdenture (BJOD) in jaw and its relation with the adhesion of molds and yeasts and mesophyll aerobe, in time 30 and 180 days in mouth. Materials and Methods: Five-systems titanium bar CARES® and synOcta® Straumann® Dental Implant System, Holding AG Inc., Basel, Switzerland (BOD), and five-systems joint ball Klockner® Implant System; Soadco Inc., Escaldes-Engordany; Andorra (BJOD), were used in two parallel groups of five participants, in an essay to simple blind person. To 30 and 180 days, the overdentures were withdrawn and evaluated the Ra: ųm. SJ-301® Mitutoyo Corporation Inc., Kanagawa, Japan, and the adhesion of microorganisms (colony-forming unit/ml). Results: The results were as follows: the Ra: Um (30th and 180th): BOD, 0.965–1.351; BJOD, 1.325–2.384. Adhesion: Molds and yeasts, BOD, 2.6 × 102 and 4.6 × 103; BJOD, 3.0 × 102 and 5.3 × 104. Adhesion: Mesophyll aerobe, BOD, 3.8 × 106 and 5.8 × 106; BJOD, 4.3 × 106 and 7.1 × 107. Conclusions: At 30 days (P = 0.489), there were no differences in BOD and BJOD for adhesion of molds and yeasts and mesophyll aerobe between both overdentures. At 180 days (P = 0.723), there were differences in the adhesion of mold and yeast and mesophyll aerobe, being greater in BJOD.
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Affiliation(s)
- Valenzuela Rocío
- University of Barcelone, Spain & Gastrovital, National Council Science Technology and Technological Innovation, Peru
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17
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Pulikkotil SJ, Nagendrababu V, Veettil SK, Jinatongthai P, Setzer FC. Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis - A systematic review and network meta-analysis of randomized controlled trials. Int Endod J 2018; 51:989-1004. [PMID: 29480930 DOI: 10.1111/iej.12912] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 02/20/2018] [Indexed: 11/29/2022]
Abstract
This systematic review (SR; PROSPERO database: CRD42017075160) and network meta-analysis (NMA) identified the most effective oral premedication for anaesthetic success of inferior alveolar nerve blocks (IANB) in cases of irreversible pulpitis. Medline and Ebscohost databases were searched up until 10/2017. Randomized controlled trials (RCT) studying the effect of oral premedication, alone or in combination, on the success of IANB for cases of irreversible pulpitis, compared to placebo or other oral premedications, were included. Quality of the included studies was appraised by the revised Cochrane risk of bias tool for randomized trials. Pairwise analysis, NMA and quality of evidence assessment using GRADE criteria were performed. Nineteen studies (n = 1654 participants) were included. NMA demonstrated that compared to placebo, dexamethasone was most effective in increasing anaesthetic success (RR, 2.92 [95% CI 1.74,4.91]; SUCRA = 0.96), followed by NSAIDs (RR, 1.92 [95% CI 1.63,2.27], SUCRA = 0.738) and Tramadol (RR, 2.03 [95% CI 1.18,3.49], SUCRA = 0.737). Premedication with acetaminophen added to NSAIDs demonstrated similar efficacy as NSAIDs alone (RR, 1.06 [95% CI 0.79,1.43]). Sensitivity analyses proved the superiority of dexamethasone or NSAIDs over any other premedications. Subgroup analyses of specific dosages in comparison with placebo demonstrated that dexamethasone 0.5 mg was most effective, followed by ketorolac 10 mg, piroxicam 20 mg, ibuprofen 400 mg + acetaminophen 500 mg and Tramadol 50 mg. Ibuprofen 400 mg, 600 mg and 800 mg had a significantly improved IANB success, while Ibuprofen 300 mg had no effect. Oral premedication with dexamethasone, NSAIDs or Tramadol significantly increased anaesthetic success. More trials are needed to evaluate the premedication effects of dexamethasone or Tramadol for improved anaesthetic success of IANB when treating irreversible pulpitis.
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Affiliation(s)
- S J Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - V Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - S K Veettil
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - P Jinatongthai
- Pharmacy Practice Division, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand.,School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | - F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA
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18
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Abstract
This 30-mo randomized clinical trial compared the effectiveness of 2 concentrations (12% or 38%) of silver diamine fluoride (SDF) and 2 periodicity of application (once or twice a year) in arresting cavitated dentin caries in primary teeth. Children aged 3 to 4 y who had at least 1 active cavitated caries lesion were enrolled and randomly allocated into 4 groups for intervention. Group 1 had 12% SDF applied annually (every 12 mo), group 2 had 12% SDF applied semiannually (every 6 mo), group 3 had 38% SDF applied annually, and group 4 had 38% SDF applied semiannually. Clinical examinations were performed semiannually in kindergarten by a single examiner to investigate whether the SDF-treated caries became arrested. A total of 888 children with 4,220 decayed tooth surfaces received SDF application at baseline, and 799 (90.0%) children with 3,790 surfaces (89.8%) were evaluated at the 30-mo examination. The caries arrest rates were 55.2%, 58.6%, 66.9%, and 75.7% for groups 1, 2, 3, and 4, respectively ( P < 0.001). Caries treated with 38% SDF had a higher chance of becoming arrested than those treated with 12% SDF (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.51-2.60, P < 0.001). The interaction between frequency of SDF application and visible plaque index (VPI) score was significant ( P = 0.017). Among those children who received annual SDF application, children with a higher VPI score had a lower chance to have their caries become arrested (OR, 0.59, 95% CI, 0.49-0.72). In conclusion, SDF at a concentration of 38% is more effective than that of 12% in arresting active caries in primary teeth. For children with poor oral hygiene, caries arrest rate of SDF treatment can be increased by increasing the frequency of application from annually to semiannually ( ClinicalTrials.gov NCT02385474).
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Affiliation(s)
- M.H.T. Fung
- Faculty of Dentistry, The University of
Hong Kong, Hong Kong
| | - D. Duangthip
- Faculty of Dentistry, The University of
Hong Kong, Hong Kong
| | - M.C.M. Wong
- Faculty of Dentistry, The University of
Hong Kong, Hong Kong
| | - E.C.M. Lo
- Faculty of Dentistry, The University of
Hong Kong, Hong Kong
| | - C.H. Chu
- Faculty of Dentistry, The University of
Hong Kong, Hong Kong
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19
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Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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20
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VanBuren J, Cavanaugh J, Marshall T, Warren J, Levy SM. AIC identifies optimal representation of longitudinal dietary variables. J Public Health Dent 2017; 77:360-371. [PMID: 28517028 DOI: 10.1111/jphd.12220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 04/06/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The Akaike Information Criterion (AIC) is a well-known tool for variable selection in multivariable modeling as well as a tool to help identify the optimal representation of explanatory variables. However, it has been discussed infrequently in the dental literature. The purpose of this paper is to demonstrate the use of AIC in determining the optimal representation of dietary variables in a longitudinal dental study. METHODS The Iowa Fluoride Study enrolled children at birth and dental examinations were conducted at ages 5, 9, 13, and 17. Decayed or filled surfaces (DFS) trend clusters were created based on age 13 DFS counts and age 13-17 DFS increments. Dietary intake data (water, milk, 100 percent-juice, and sugar sweetened beverages) were collected semiannually using a food frequency questionnaire. Multinomial logistic regression models were fit to predict DFS cluster membership (n=344). Multiple approaches could be used to represent the dietary data including averaging across all collected surveys or over different shorter time periods to capture age-specific trends or using the individual time points of dietary data. RESULTS AIC helped identify the optimal representation. Averaging data for all four dietary variables for the whole period from age 9.0 to 17.0 provided a better representation in the multivariable full model (AIC=745.0) compared to other methods assessed in full models (AICs=750.6 for age 9 and 9-13 increment dietary measurements and AIC=762.3 for age 9, 13, and 17 individual measurements). The results illustrate that AIC can help researchers identify the optimal way to summarize information for inclusion in a statistical model. CONCLUSIONS The method presented here can be used by researchers performing statistical modeling in dental research. This method provides an alternative approach for assessing the propriety of variable representation to significance-based procedures, which could potentially lead to improved research in the dental community.
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Affiliation(s)
- John VanBuren
- Pediatrics - Division of Critical Care, University of Utah, Salt Lake City, UT, USA
| | - Joseph Cavanaugh
- Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Teresa Marshall
- Preventative & Community Dentistry, University of Iowa, Iowa City, IA, USA
| | - John Warren
- Preventative & Community Dentistry, University of Iowa, Iowa City, IA, USA
| | - Steven M Levy
- Preventative & Community Dentistry, University of Iowa, Iowa City, IA, USA
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21
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Tickle M, O'Neill C, Donaldson M, Birch S, Noble S, Killough S, Murphy L, Greer M, Brodison J, Verghis R, Worthington HV. A Randomized Controlled Trial of Caries Prevention in Dental Practice. J Dent Res 2017; 96:741-746. [PMID: 28375708 DOI: 10.1177/0022034517702330] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a parallel group randomized controlled trial of children initially aged 2 to 3 y who were caries free, to prevent the children becoming caries active over the subsequent 36 mo. The setting was 22 dental practices in Northern Ireland, and children were randomly assigned by a clinical trials unit (CTU) (using computer-generated random numbers, with allocation concealed from the dental practice until each child was recruited) to the intervention (22,600-ppm fluoride varnish, toothbrush, 50-mL tube of 1,450 ppm fluoride toothpaste, and standardized, evidence-based prevention advice) or advice-only control at 6-monthly intervals. The primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were number of decayed, missing, or filled teeth (dmfs) in caries-active children, number of episodes of pain, and number of extracted teeth. Adverse reactions were recorded. Calibrated external examiners, blinded to the child's study group, assessed the status of the children at baseline and after 3 y. In total, 1,248 children (624 randomized to each group) were recruited, and 1,096 (549 intervention, 547 control) were included in the final analyses. Eighty-seven percent of intervention and 86% of control children attended every 6-mo visit ( P = 0.77). A total of 187 (34%) in the intervention group converted to caries active compared to 213 (39%) in the control group (odds ratio, 0.81; 95% confidence interval, 0.64-1.04; P = 0.11). Mean dmfs of those with caries in the intervention group was 7.2 compared to 9.6 in the control group ( P = 0.007). There was no significant difference in the number of episodes of pain between groups ( P = 0.81) or in the number of teeth extracted in caries-active children ( P = 0.95). Ten children in the intervention group had adverse reactions of a minor nature. This well-conducted trial failed to demonstrate that the intervention kept children caries free, but there was evidence that once children get caries, it slowed down its progression (EudraCT No: 2009-010725-39; ISRCTN: ISRCTN36180119).
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Affiliation(s)
- M Tickle
- 1 Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C O'Neill
- 2 Centre for Public Health, Queens' University Belfast, Belfast, Northern Ireland
| | - M Donaldson
- 3 Health & Social Care Board of Northern Ireland, Belfast, Northern Ireland
| | - S Birch
- 4 School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,5 Centre for Health Economics and Policy Analysis, McMaster University, Canada
| | - S Noble
- 6 Northern Health & Social Care Trust, Northern Ireland, Antrim, Northern Ireland
| | - S Killough
- 7 British Dental Association, Belfast, Northern Ireland
| | - L Murphy
- 8 Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, Northern Ireland
| | - M Greer
- 9 hVIVO, Queen Mary BioEnterprises Innovation Centre, London, UK
| | - J Brodison
- 10 DJ Maguire and Associates, Portadown, Northern Ireland
| | - R Verghis
- 8 Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, Northern Ireland
| | - H V Worthington
- 1 Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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22
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Belstrøm D, Holmstrup P, Fiehn NE, Kirkby N, Kokaras A, Paster BJ, Bardow A. Salivary microbiota in individuals with different levels of caries experience. J Oral Microbiol 2017; 9:1270614. [PMID: 28326153 PMCID: PMC5328370 DOI: 10.1080/20002297.2016.1270614] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/16/2016] [Accepted: 11/18/2016] [Indexed: 12/02/2022] Open
Abstract
This study compared salivary bacterial profiles in two groups having a 10-fold difference in levels of caries experience, as it was hypothesized that the composition of the salivary microbiota might associate with the levels of caries experience. Bacterial profiles in stimulated saliva samples from 85 individuals with low levels of caries experience (healthy group) and 79 individuals with high levels of caries experience (caries group) were analyzed by means of the Human Oral Microbiome Identification Next Generation Sequencing (HOMINGS) technique. Subsequently, saliva samples from caries-free individuals in the healthy group (n = 57) and the caries group (n = 31) were compared. A significantly higher α-diversity (p < 0.0001) and a twofold higher relative abundance of Neisseria, Haemophilus, and Fusobacterium were recorded in saliva samples from the healthy group compared with the caries group. Differences observed were more pronounced when limiting the analyses to caries-free individuals in each group. Data from this cross-sectional analysis suggest that low levels of caries experience might associate with a characteristic salivary bacterial composition different from that in individuals with high caries experience. Consequently, longitudinal studies are required to determine if the composition of the salivary microbiota might be a predictive factor of caries risk at the individual level.
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Affiliation(s)
- Daniel Belstrøm
- Section for Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Palle Holmstrup
- Section for Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Nils-Erik Fiehn
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Nikolai Kirkby
- Department of Medical Microbiology, Copenhagen University Hospital , Copenhagen , Denmark
| | - Alexis Kokaras
- Department of Microbiology, The Forsyth Institute , Cambridge , MA , USA
| | - Bruce J Paster
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Allan Bardow
- Section for Oral Medicine, Department of Odontology, Faculty of Health Sciences, University of Copenhagen , Copenhagen , Denmark
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23
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Kundzina R, Stangvaltaite L, Eriksen HM, Kerosuo E. Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. Int Endod J 2016; 50:924-932. [PMID: 27891629 DOI: 10.1111/iej.12719] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/02/2016] [Indexed: 11/27/2022]
Abstract
AIM The aim of this multicentre, parallel-group randomized clinical trial was to compare the effectiveness of mineral trioxide aggregate (MTA) and a conventional calcium hydroxide liner (CH) as direct pulp capping materials in adult molars with carious pulpal exposure. METHODOLOGY Seventy adults aged 18-55 years were randomly allocated to two parallel arms: MTA (White ProRoot, Dentsply, Tulsa Dental, Tulsa, OK, USA; n = 33) and CH (Dycal® , Dentsply DeTrey GmbH, Konstanz, Germany; n = 37). The teeth were temporized for 1 week with glass-ionomer (Fuji IX, GC Corp, Tokyo, Japan) and then permanently restored with a composite resin. The subjects were followed up after 1 week and at six, 12, 24 and 36 months. The primary outcome was the survival of the capped pulps, and the secondary outcome was postoperative pain after 1 week. Survival was defined as a nonsymptomatic tooth that responded to sensibility testing and did not exhibit periapical changes on radiograph. At each check-up, the pulp was tested for sensibility and a periapical radiograph was taken (excluding the radiographs taken at the 1-week follow-up). Kaplan-Meier survival analysis and log-rank test were used to assess the significant difference in the survival curves between groups. Chi-square test was used to assess the association between the materials and preoperative and postoperative pain. RESULTS At 36 months, the Kaplan-Meier survival analysis showed a cumulative estimate rate of 85% for the MTA group and 52% for the CH group (P = 0.006). There was no significant association between the capping material and postoperative pain. CONCLUSIONS Mineral trioxide aggregate performed more effectively than a conventional CH liner as a direct pulp capping material in molars with carious pulpal exposure in adult patients. This study has been registered at ClinicalTrials.gov, number NCT01224925.
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Affiliation(s)
- R Kundzina
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
| | - L Stangvaltaite
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
| | - H M Eriksen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
| | - E Kerosuo
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
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Abstract
PURPOSE The aim of this systematic review was to assess the gingival retraction methods in terms of the amount of gingival retraction achieved and changes observed in various clinical parameters: gingival index (GI), plaque index (PI), probing depth (PD), and attachment loss (AL). METHODS Data sources included three major databases, PubMed, CINAHL plus (Ebsco), and Cochrane, along with hand search. Search was made using the key terms in different permutations of gingival retraction* AND displacement method* OR technique* OR agents OR material* OR medicament*. RESULTS The initial search results yielded 145 articles which were narrowed down to 10 articles using a strict eligibility criteria of including clinical trials or experimental studies on gingival retraction methods with the amount of tooth structure gained and assessment of clinical parameters as the outcomes conducted on human permanent teeth only. Gingival retraction was measured in 6/10 studies whereas the clinical parameters were assessed in 5/10 studies. CONCLUSIONS The total number of teeth assessed in the 10 included studies was 400. The most common method used for gingival retraction was chemomechanical. The results were heterogeneous with regards to the outcome variables. No method seemed to be significantly superior to the other in terms of gingival retraction achieved. Clinical parameters were not significantly affected by the gingival retraction method.
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Affiliation(s)
| | - Samira Adnan
- Aga Khan University and Hospital, Karachi, Pakistan
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25
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Abstract
The aim of this study was to investigate the effect of a daily intake of probiotic lactobacilli on the prevalence and counts of oral Candida in frail elderly patients living in nursing homes. The study had a double-blind randomized placebo-controlled design with 2 parallel arms. The study group consisted of 215 older adults (range, 60 to 102 y) who were enrolled after informed consent. After baseline examination and randomization, the subjects were given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo twice daily (morning and evening). The intervention period was 12 wk, and saliva and plaque samples were collected at baseline and follow-up. The primary end point was prevalence of high Candida counts assessed from chairside tests. Secondary end points were levels of dental plaque and gingival inflammation. The groups were balanced at baseline. The attrition rate to follow-up was 19%. There was a statistically significant reduction in the prevalence of high Candida counts in the probiotic group but not in the placebo group, and the difference was statistically significant in both saliva and plaque (P < 0.05). No significant differences between the groups were noted concerning the levels of supragingival plaque or bleeding on probing. Thus, daily use of probiotic lozenges may reduce the prevalence of high oral Candida counts in frail elderly nursing homes residents (ClinicalTrials.gov NCT02391532).
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Affiliation(s)
- E Kraft-Bodi
- Public Dental Service, Ljungby Public Dental Clinic, Region Kronoberg, Ljungby, Sweden
| | - M R Jørgensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M K Keller
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C Kragelund
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Maxillofacial Unit, Halland Hospital, Halmstad, Sweden
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26
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Affiliation(s)
- T A DeRouen
- Center for Global Oral Health, School of Dentistry, University of Washington, Seattle, WA, USA
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27
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Santamaria RM, Innes NPT, Machiulskiene V, Evans DJP, Splieth CH. Caries management strategies for primary molars: 1-yr randomized control trial results. J Dent Res 2014; 93:1062-9. [PMID: 25216660 PMCID: PMC4293767 DOI: 10.1177/0022034514550717] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 08/15/2014] [Accepted: 08/19/2014] [Indexed: 11/17/2022] Open
Abstract
Minimal invasive approaches to managing caries, such as partial caries removal techniques, are showing increasing evidence of improved outcomes over the conventional complete caries removal. There is also increasing interest in techniques where no caries is removed. We present the 1-yr results of clinical efficacy for 3 caries management options for occlusoproximal cavitated lesions in primary molars: conventional restorations (CR; complete caries removal and compomer restoration), Hall technique (HT; no caries removal, sealing in with stainless steel crowns), and nonrestorative caries treatment (NRCT; no caries removal, opening up the cavity, teaching brushing and fluoride application). In sum, 169 children (3-8 yr old; mean, 5.56 ± 1.45 yr) were enrolled in this secondary care-based, 3-arm, parallel-group, randomized clinical trial. Treatments were carried out by specialist pediatric dentists or postgraduate trainees. One lesion per child received CR, HT, or NRCT. Outcome measures were clinical failure rates, grouped as minor failure (restoration loss/need for replacement, reversible pulpitis, caries progression, etc.) and major failure (irreversible pulpitis, abscess, etc.). There were 148 children (87.6%) with a minimum follow-up of 11 mo (mean, 12.23 ± 0.98 mo). Twenty teeth were recorded as having at least 1 minor failure: NRCT, n = 8 (5%); CR, n = 11 (7%); HT, n = 1 (1%) (p = .002, 95% CI = 0.001 to 0.003). Only the comparison between NRCT and CR showed no significant difference (p = .79, 95% CI = 0.78 to 0.80). Nine (6%) experienced at least 1 major failure: NRCT, n = 4 (2%); CR, n = 5 (3%); HT, n = 0 (0%) (p = .002, 95% CI = 0.001 to 0.003). Individual comparison of NRCT and CR showed no statistically significant difference in major failures (p = .75, 95% CI = 0.73 to 0.76). Success and failure rates were not significantly affected by pediatric dentists' level of experience (p = .13, 95% CI = 0.12 to 0.14). The HT was significantly more successful clinically than NRCT and CR after 1 yr, while pairwise analyses showed comparable results for treatment success between NRCT and CR (ClinicalTrials.gov NCT01797458).
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Affiliation(s)
- R M Santamaria
- Department of Preventive and Paediatric Dentistry, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
| | - N P T Innes
- The Division of Oral Health Science, School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - V Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D J P Evans
- The Division of Oral Health Science, School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - C H Splieth
- Department of Preventive and Paediatric Dentistry, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
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Law AS, Nixdorf DR, Aguirre AM, Reams GJ, Tortomasi AJ, Manne BD, Harris DR. Predicting severe pain after root canal therapy in the National Dental PBRN. J Dent Res 2014; 94:37S-43S. [PMID: 25355775 DOI: 10.1177/0022034514555144] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Some patients experience severe pain following root canal therapy (RCT) despite advancements in care. We sought to identify factors, which can be measured preoperatively, that predict this negative outcome so that future research may focus on preemptive steps to reduce postoperative pain intensity. Sixty-two practitioners (46 general dentists and 16 endodontists) who are members of the National Dental Practice-Based Research Network enrolled patients receiving RCT for this prospective observational study. Baseline data collected from patients and dentists were obtained before treatment. Severe postoperative pain was defined based on a rating of ≥7 on a scale from 0 (no pain) to 10 (pain as bad as can be) for the worst pain intensity experienced during the preceding week, and this was collected 1 wk after treatment. Multiple logistic regression analyses were used to develop and validate the model. A total of 708 patients were enrolled during a 6-m period. Pain intensity data were collected 1 wk postoperatively from 652 patients (92.1%), with 19.5% (n = 127) reporting severe pain. In multivariable modeling, baseline factors predicting severe postoperative pain included current pain intensity (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07 to 1.25; P = 0.0003), number of days in the past week that the subject was kept from their usual activities due to pain (OR, 1.32; 95% CI, 1.13 to 1.55; P = 0.0005), pain made worse by stress (OR, 2.55; 95% CI, 1.22 to 5.35; P = 0.0130), and a diagnosis of symptomatic apical periodontitis (OR, 1.63; 95% CI, 1.01 to 2.64; P = 0.0452). Among the factors that did not contribute to predicting severe postoperative pain were the dentist's specialty training, the patient's age and sex, the type of tooth, the presence of swelling, or other pulpal and apical endodontic diagnoses. Factors measured preoperatively were found to predict severe postoperative pain following RCT. Practitioners could use this information to better inform patients about RCT outcomes and possibly use different treatment strategies to manage their patients (Clinicaltrials.gov NCT01201681).
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Affiliation(s)
- A S Law
- Private Practice, The Dental Specialists, Lake Elmo, MN Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, MN
| | - D R Nixdorf
- Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN Department of Neurology, Medical School, University of Minnesota, Minneapolis, MN HealthPartners Institute for Education and Research, Bloomington, MN
| | - A M Aguirre
- Private Practice, Endodontic Associates, Coon Rapids, MN
| | - G J Reams
- PDA Permanente Dental Associates, Tigard, OR
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29
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Abstract
Large mandibular defects are difficult to reconstruct with good functional and aesthetic outcomes because of the complex geometry of craniofacial bone. While the current gold standard is free tissue flap transfer, this treatment is limited in fidelity by the shape of the harvested tissue and can result in significant donor site morbidity. To address these problems, in vivo bioreactors have been explored as an approach to generate autologous prefabricated tissue flaps. These bioreactors are implanted in an ectopic site in the body, where ossified tissue grows into the bioreactor in predefined geometries and local vessels are recruited to vascularize the developing construct. The prefabricated flap can then be harvested with vessels and transferred to a mandibular defect for optimal reconstruction. The objective of this review article is to introduce the concept of the in vivo bioreactor, describe important preclinical models in the field, summarize the human cases that have been reported through this strategy, and offer future directions for this exciting approach.
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Affiliation(s)
- A M Tatara
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - M E Wong
- Department of Oral and Maxillofacial Surgery, University of Texas Dental Branch at Houston, Houston, Texas, USA
| | - A G Mikos
- Department of Bioengineering, Rice University, Houston, Texas, USA
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30
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Opdam NJM, van de Sande FH, Bronkhorst E, Cenci MS, Bottenberg P, Pallesen U, Gaengler P, Lindberg A, Huysmans MCDNJM, van Dijken JW. Longevity of posterior composite restorations: a systematic review and meta-analysis. J Dent Res 2014; 93:943-9. [PMID: 25048250 DOI: 10.1177/0022034514544217] [Citation(s) in RCA: 405] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years' follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces.
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Affiliation(s)
- N J M Opdam
- Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands
| | - F H van de Sande
- Federal University of Pelotas, Graduate Program in Dentistry, Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
| | - E Bronkhorst
- Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands
| | - M S Cenci
- Federal University of Pelotas, Graduate Program in Dentistry, Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
| | - P Bottenberg
- Vrije Universiteit Brussels, Dept. of Oral Health Sciences, Laarbeeklaan 103, BE 1090 Brussels, Belgium
| | - U Pallesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Institute of Odontology, Nørre Allé 20, DK-2200, Copenhagen, Denmark
| | - P Gaengler
- Universität Witten/Herdecke, Abteilung für Zahnerhaltung und Präventive Zahnmedizin, Alfred-Herrhausen-Str. 44, D-58455 Witten, Germany
| | - A Lindberg
- Umeå University, Department of Odontology, SE-901 85 Umeå, Sweden
| | - M C D N J M Huysmans
- Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands
| | - J W van Dijken
- Umeå University, Department of Odontology, SE-901 85 Umeå, Sweden
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31
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Abstract
The objective of this randomized control trial was to compare the five-year clinical performance of direct and indirect resin composite restorations replacing cusps. In 157 patients, 176 restorations were made to restore maxillary premolars with Class II cavities and one missing cusp. Ninety-two direct and 84 indirect resin composite restorations were placed by two operators, following a strict protocol. Treatment technique and operator were assigned randomly. Follow-up period was at least 4.5 yrs. Survival rates were determined with time to reparable failure and complete failure as endpoints. Kaplan-Meier five-year survival rates were 86.6% (SE 0.27%) for reparable failure and 87.2% (SE 0.27%) for complete failure. Differences between survival rates of direct and indirect restorations [89.9% (SE 0.34%) vs. 83.2% (SE 0.42%) for reparable failure and 91.2% (SE 0.32%) vs. 83.2% (SE 0.42%) for complete failure] were not statistically significant (p = .23 for reparable failure; p = .15 for complete failure). Mode of failure was predominantly adhesive. The results suggest that direct and indirect techniques provide comparable results over the long term (trial registration number: ISRCTN29200848).
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Affiliation(s)
- W M Fennis
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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32
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Worthington HV, Glenny AM, Clarkson JE. Twenty years of the Cochrane Collaboration. J Dent Res 2013; 92:680-1. [PMID: 23686241 DOI: 10.1177/0022034513491116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Cochrane Collaboration is 20 years old this year. Established in 1993, the Collaboration has sought to provide an up-to-date, critical evidence base for all those involved in health care decision-making at a variety of levels. This article illustrates the work of the Cochrane Oral Health Group, based at the University of Manchester, UK.
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Affiliation(s)
- H V Worthington
- The University of Manchester, School of Dentistry, Oxford Road, Manchester, M13 9PL, UK.
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