DENTAL TRAUMATOLOGY, Issue 2 2004
Jay D. Shulman
Abstract,,, To explore the association between incisal trauma and occlusal characteristics using oral examination and health interview data from the Third National Health and Nutrition Examination Survey 1988,1994 (NHANES III). Incisal trauma examinations were performed on 15 364 individuals 6,50 years of age using an ordinal scale developed by the National Institute of Dental and Craniofacial Research. Occlusal examinations were performed on 13 057 individuals 8,50 years of age. We fitted separate multivariate logistic regression models for maxillary and mandibular incisor trauma adjusting for socio-demographic variables (age, gender, race-ethnicity) and occlusal characteristics (overbite, overjet, open bite). 23.45% of all individuals evidenced trauma on at least one incisor, with trauma more than four times more prevalent on maxillary (22.59%) than on mandibular incisors (4.78%). Males (OR = 1.67) had greater odds of trauma than females; Whites (OR = 1.37) and non-Hispanic Blacks (OR = 1.37) had greater odds of trauma than Mexican,Americans. The odds of trauma increased with age, peaked from age 21 to 30 (OR = 2.92), and declined. As overjet increased, so did the odds of trauma. Compared to individuals with ,0-mm overjet, odds of trauma increased from 1,3 mm (OR = 1.42) to 4,6 mm (OR = 2.42) to 7,8 mm (OR = 3.24) to >8 mm (OR = 12.47). Trauma to incisors is prevalent but mostly limited to enamel. Trauma to maxillary incisors is associated with overjet, gender, race-ethnicity, and age, while trauma to mandibular incisors is associated with gender, age, and overbite. [source]

Oral hygiene and the need for treatment of the dependent institutionalised elderly

GERODONTOLOGY, Issue 2 2006
Sylvie Montal
Objective:, To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. Background:, For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. Materials and methods:, From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. Results:, The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. Conclusion:, The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly. [source]

The effect of pH on surface hardness and microstructure of mineral trioxide aggregate

INTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2008
M. S. Namazikhah
Abstract Aim, To evaluate the surface microhardness of mineral trioxide aggregate (MTA) specimens following exposure of their surface to a range of acidic environments during hydration. In addition, the morphological microstructure features of samples were studied by scanning electron microscopy (SEM). Methodology, White ProRoot MTA (Dentsply Tulsa Dental, Johnson City, TN, USA) was mixed and packed into cylindrical polycarbonate tubes. Four groups, each of 10 specimens, were formed using a pressure of 3.22 MPa and exposed to pH 4.4, 5.4, 6.4 and 7.4, respectively, for 4 days. Vickers microhardness of the surface of each specimen was measured after exposure. Four groups of two specimens were prepared and treated in the same way prior to qualitative examination by SEM. Data were subjected to one-way anova and post hoc Tukey's test. Result, The greatest mean surface hardness values (53.19 ± 4.124) were observed following exposure to pH 7.4 with the values decreasing to 14.34 ± 6.477 following exposure to pH 4.4. The difference between these values at the 95% CI (33.39,44.30) was statistically significant (P < 0.0001). There were no distinct morphological differences between groups in terms of the internal microstructure. However, a trend was observed that the more acidic the solution, the more extensive the porosity of the specimens. Conclusion, Under the conditions of this study, surface hardness of MTA was impaired in an acidic environment. [source]

Sensitivity and Tooth Whitening Agents

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 2 2002
RANDALL M. POHJOLA DDS
ABSTRACT Purpose: Three commercially available dentist-prescribed home-applied bleaching systems were evaluated to identify the incidence of sensitivity and to compare the efficacy of whitening the maxillary anterior teeth of 18 patients. Methods: Nite White Excel 2Z (Discus Dental), fx (Challenge Products), and Rembrandt Xtra-Comfort (DenMat Corp.) were randomly assigned to six patients each. The fx product was used as a control since it was not advertised as a zero sensitivity product. The manufacturers' instructions for tray fabrication and use were followed while the patients bleached for 2 weeks. The patients kept a diary and were recalled at 1 week, 2 weeks, and 4 weeks. The shade change and the presence or absence of any sensitivity were evaluated at each recall. Results: Nite White Excel 2Z was used for 83 days of treatment with the following percentage of positive sensitivity reported: 0% hot and cold, 2.4% throat sensitivity, 2.4% tongue sensitivity, and 25.3% gingival sensitivity. Rembrandt Xtra-Comfort was used for 84 days with 0% hot and cold, 0% throat, 11.9% tongue, and 27.4% gingival sensitivity reported. The fx product was used for 83 days and resulted in 14.5% hot and cold, 3.6% throat, 1.2% tongue, and 16.9% gingival sensitivity. All products lightened the teeth an average of eight shade tabs on the Vita guide. There was a statistically significant difference between the groups when comparing the presence of sensitivity (chi-squared test, p < .001) but not when comparing the shade tab change. [source]

Type 2 diabetes and periodontal indicators: epidemiology in France 2002,2003

JOURNAL OF PERIODONTAL RESEARCH, Issue 4 2006
C. Mattout
Background and Objective:, ,Diabetes and periodontal disease have been associated in the literature. In the present study, the periodontal heath of noninsulin-dependent diabetic adults was compared with that of a general population of nondiabetic patients. Material and Methods:, In France, 2144 adults (age: 35,65 years) were examined for life habits (tobacco, alcohol), biological diagnosis (type II diabetes, arterial hypertension), biometry (weight, size) and biochemistry. Dental and periodontal data included plaque index, gingival index, probing depth, and clinical attachment loss. Results:, Descriptive and multifactorial analysis evidenced a more severe periodontal disease in diabetic patients. Moreover, when the plaque index was held constant, the gingival index was more elevated in diabetics. In nondiabetics, age, gender, glycemia, alcohol, and tobacco smoking were identified as significant risk factors for periodontal disease. In contrast, in diabetic subjects, only tobacco smoking was a significant risk factor. Conclusion:, In type II diabetics, the diabetes factor is probably more significant than periodontal risk factors, age, and gender. [source]

An Assessment of the Dental Public Health Infrastructure in the United States

JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2006
Scott L. Tomar DMD
Abstract Objectives: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the US dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. Methods: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. Results: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of $1 million or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 US members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. Conclusions: Findings suggest the US dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the US dental public health infrastructure will require substantial collaboration among many diverse partners. [source]

Clinical Outcome of Overdenture Treatment on Two Nonsubmerged and Nonsplinted Astra Tech MicrothreadÔ Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2009
Hugo De Bruyn DDS
ABSTRACT Background: The use of two implants for mandibular overdenture stabilization improves the patients' comfort and well-being. This treatment could be more cost-effective if surgery and prosthetic treatment could be performed by one clinician in the normal setting of a dental clinic. Purpose: The aim of this retrospective clinical study was to describe implant success, restorative outcome, and the patients' opinion of mandibular overdenture treatment on two early-loaded, nonsplinted Astra Tech TiOblast MicrothreadÔ (Astra Tech Dental, Mölndal, Sweden) implants. Materials and Methods: Thirty-seven consecutive patients treated with implant-supported mandibular overdentures were invited for a clinical examination. Implant survival, marginal bone level, quality of implant and prosthetic treatment, and the patients' opinion by means of questionnaires were scored. Results: Thirty-four patients attended the examination. Two implants were lost in one patient and the failure rate for the total group of patients was 3%. As 8 of the 33 remaining patients were still in the provisional loading stage, they were not included in the final clinical and radiographic examination. Based on 25 patients and 50 implants with a mean follow-up of 18.8 months (range 4,33), implant positioning and occlusion/articulation scored perfect in 74 to 80% of the cases. Retention of the dentures was rated perfect in 80%, but 20% needed minor activation of the attachments, 20% showed signs of abrasion, and 20% had already been repaired. The average marginal bone level was 0.8 mm below the reference point. The mean pocket depth was 2.1 mm, and 54% of the peri-implant tissues were free of bleeding. The patients were appreciative of the work carried out by their dentist and they indicated a significant improvement in their well-being and quality of life. Conclusions: It can be concluded that the Astra Tech implant system was successfully used by the general dentist both surgically and prosthetically with minimal implant failures and prosthetic complications and that this led to high levels of patient appreciation and overall satisfaction. [source]

Effect of implant design on survival and success rates of titanium oral implants: a 10-year prospective cohort study of the ITI® Dental Implant System

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004
Ioannis K. Karoussis
Abstract Aim: The aim of this 10-year study (observation time 8,12 years, mean: 10 years) was to compare the survival rates, success rates and incidences of biological complications using three different implant designs of the ITI® Dental Implant System. Material and methods: In 89 dental patients treated comprehensively, a total of 112 hollow screw (HS), 49 hollow cylinder (HC) and 18 angulated hollow cylinder (AHC) implants were installed depending on the available bone volume and according to prosthetic needs. One and 10 years after surgical placement, clinical and radiographic parameters were assessed. The incidences of peri-implantitis according to various thresholds were registered over 10 years of maintenance. Results: Success criteria at 10 years were set at: pocket probing depth (PPD)5 mm, bleeding on probing (BoP),, bone loss < 0.2 mm annually. The survival rate for HS was 95.4%, for HC 85.7% and for AHC 91.7%. Ninety percent of all the HS, 71% of the HC and 88% of the AHC did not present with an incidence of peri-implantitis over the 10 years, HC having significantly higher incidence of peri-implantitis than HS (P< 0.004). With the success criteria set above, a success rate for HS of 74%, for HC of 63% and for AHC of 61% was identified at 10 years. However, including a definition of PPD6 mm, BoP , and bone loss < 0.2 mm annually for success, the rates for HS were 78%, for HC 65% and for AHC 67%, respectively. Basing success criteria purely on clinical parameters (without radiographic analysis), such as: PPD5 mm and BoP,, the success rates increased to 90%, 76% and 89%, respectively. With PPD6 mm and BoP , as success criteria chosen, the respective rates were 94%, 82% and 94% for HS, HC and AHC implants, respectively. Conclusions: A significantly higher survival rate as well as a significantly lower incidence of peri-implantitis was identified for hollow screw design ITI® Dental Implants after 10 years of service when compared to hollow cylinder design ITI® Dental Implants (95.4% vs. 85.7%; 10% vs. 29%). Depending on the setting of the threshold criteria for success, success rates are highly variable and hence, reporting of success rates with elaboration on the criteria set appears crucial for comparison of different studies. Résumé Le but de ce suivi d'une décennie a été de comparer les taux de survie, les taux de succès et les incidences des complications biologiques de l'utilisation de trois modèles implantaires différents du système ITI® Dental Implant. Chez 89 patients, 112 vis creuses (HS), 49 cylindres creux (HC) et 18 cylindres creux angulés (AHC) ont été placés suivant le volume osseux disponible et les nécessités prothétiques. Une et dix années après leur placement, des paramètres cliniques et radiographiques ont été définis. Les incidences de paroïmplantite relatives aux différents seuils ont été enregistrées durant ces dix années de maintenance. Les succès des critères à dix ans étaient placés à : PPD5 mm, BoP-, perte osseuse <0,2 mm/an. Le taux de survie pour HS était de 95,4%, pour HC de 86% et pour AHC de 92%. Nonante pour cent de tous les HS, 71% des HC et 88% des AHC ne présentaient pas d'incidences de paroïmplantite durant ces dix années, HC ayant une plus importante incidence de paroïmplantite que HS (p<0,004). Grace aux critères de succès indiqués, un taux de succès de 74% pour HS, de 63% pour HC et de 61% pour AHC a été identifié après dix ans. Cependant, en définissant le succès avec PPD6mm, BoP- et perte osseuse <0,2mm/an, les taux étaient de 78% pour HS, de 65% pour HC et de 67% pour AHC. En basant les taux de succès uniquement sur les paramètres cliniques (sans l'analyse radiographique) tels que PPD5 mm et BoP-, les taux de succès augmentaient respectivement à 90, 76 et 89%. Avec PPD6mm et BoP- comme critères de succès, les taux s'élevaient respectivement à 94, 82 et 94%. Un taux de survie significativement plus important ainsi qu'une incidence significativement plus faible de paroïmplantite étaient constatés au niveau des implants vis creuses après dix ans de mise en fonction comparés aux cylindres creux. Suivant l'établissement du seuil pour les critères du succès, les taux de ce succès sont extrêmement variables et rapporter les taux de succès suivant l'élaboration des critères est donc crucial pour comparer différentes études. Zusammenfassung Ziel: Das Ziel dieser 10-Jahresstudie (Beobachtungszeit 8,12 Jahre, Mittelwert: 10 Jahre) war es, bei ITI® -Implantaten mit drei verschiedenen Designs, die Erfolgs- und Überlebensrate zu vergleichen, und das Auftreten von biologischen Zwischenfällen zu untersuchen. Material und Methode: Bei 89 synoptisch behandelten Patienten implantierte man in Abhängigkeit des vorhandenen Knochenvolumens und der prothetischen Anforderungen insgesamt 112 Hohlschraubenimplantate (HS), 49 Hohlzylinderimplantate (HC) und 18 abgewinkelte Hohlzylinderimplantate (AHC). Ein und zehn Jahre nach der Implantation nahm man die klinischen und radiologischen Parameter auf. Eine Periimplantitis registrierte während der 10-jährigen Erhaltungsphase anhand verschiedener Grenzwerte. Resultate: Die Kriterien für einen Erfolg nach 10 Jahren legte man bei den folgenden Werten fest: PPD <5mm, BOP-, jährlicher Knochenverlust <0.2mm. Die Überlebensrate für ein HS lag bei 95.4%, für ein HC bei 85.7% und für ein AHC bei 91.7%. 90% aller HS, 71% aller HC und 88% aller AHC zeigte während den 10 Jahren nie Anzeichen einer Periimplantitis, wobei die HC signifikant häufiger Periimplantitis hatten, als die HS (p<0.004). Mit den oben festgelegten Erfolgskriterien ergab sich nach 10 Jahren für die HS eine Erfolgsrate von 74%, für die HC eine von 63% und für die AHC eine von 61%. Veränderte man die Definition auf "PPD<6mm, BOP -, jährlicher Kochenverlust <0.2mm", so betrugen die Erfolgsraten für die HS 78%, für die HC 65% und für die AHC 67%. Basierten die Erfolgskriterien rein auf klinischen Parametern (PPD <5mm, BOP-, keine röntgenologische Anlyse), so stiegen die Erfolgsraten auf 90%, 76% und 89% an. Wählte man die Erfolgskriterien "PPD <6mm und BOP -", so betrugen die Erfolgsraten für die HS 94%, für die HC 82% und für die AHC 94%. Zusammenfassung: Verglich man nach 10-jähriger Funktion die Hohlschrauben des ITI® -Implantat-Systems mit den Hohlzylindern desselben Systems, so ergab sich für die HS sowohl eine signifikant höher Überlebensrate, wie auch ein selteneres Auftreten von Periimplantitis (95.4% vs. 85.7%; 10% vs. 29%). Die Erfolgsraten variieren in Abhängigkeit der in der Definition eines Erfolges festgelegten Grenzwerten enorm stark. Dies erweist sich im Vergleich von verschiedenen Studien als hinderlich, weil die Definition der Erfolgsraten meist auf verschiedenen Kriterien beruhen. Resumen Intención: La intención de este estudio de 10 años (tiempo de observación 8,12, media: 10 años) fue comparar los índices de supervivencia, índices de éxito e índices de complicaciones biológicas usando tres diferentes diseños de implantes del Sistema de Implantes Dentales ITI®. Material y Métodos: Se instalaron en 89 pacientes dentales tratados completamente un total de 112 tornillos huecos (HS), 49 cilindros huecos (HC) y 18 cilindros huecos angulados (AHC) dependiendo de la disponibilidad de volumen óseo y de acuerdo con las necesidades protésicas. Se valoraron parámetros clínicos y radiográficos uno y diez años tras la colocación quirúrgica. Se registraron las incidencias de periimplantitis de acuerdo con varios umbrales a lo largo de 10 años de mantenimiento. Resultados: Los criterios de éxito a los 10 años se situaron en PPD5mm, BoP-, pérdida ósea < 0.2mm por año. El índice de supervivencia para los HS fue del 95.4%, para los HC del 85.7% y para los AHC del 91.7%. El 90% de los HS, el 71% de los HC y el 88% de los AHC no presentaron ninguna incidencia de periimplantitis a lo largo de los 10 años, HC tuvo una significativamente mayor incidencia de periimplantitis que HS (p< 0.004). Con los criterios de éxito antes mencionados, se identificó un índice de éxito para HS del 74%, para HC del 63% y para AHC del 61% a los 10 años. De todos modos, incluyendo una definición de PPD6mm, BoP, y pérdida ósea <0.2mm al año para tener éxito, los índices para HS fueron del 78%, para HC 65% y para AHC 67%, respectivamente. Basando los criterios de éxito puramente en parámetros clínicos (sin análisis radiográficos), tales como: PPD5mm y BoP-, los índices de éxito subieron hasta el 90%, 76% y 89%, respectivamente. Con el PPD6mm y BoP , como criterios de éxito elegidos, los índices respectivos fueron del 94%,82% y 94% para implantes HS, HC y AHC, respectivamente. Conclusiones: Se identificó un significativamente mayor índice de supervivencia al igual que una menor incidencia de periimplantitis para el diseño de tornillo hueco Implante Dental ITI®. (95.4% vs. 85.7; 10% vs. 29%). Dependiendo de la definición del criterio del umbral de éxito, los índices de éxito son altamente variables y por tanto, los informes de los índices de éxito con elaboración de la definición de criterios parece ser crucial para la comparación de los diferentes estudios. [source]

Baseline characteristics of participants in the oral health component of the Women's Interagency HIV Study

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 2 2004
Roseann Mulligan
Abstract ,,, Objectives:, This study described baseline sociodemographic and oral health characteristics of a subset of HIV sero-positive and sero-negative women who participated in the oral health component of the Women's Interagency HIV Study (WIHS). Methods: In 1995,96, 584 HIV sero-positive and 151 sero-negative women from five WIHS core sites were enrolled in the oral study. Data on oral mucosa, salivary glands, dentition and periodontium, along with demographics, socioeconomics, and behavioral characteristics, were used to characterize this population. Results:, Mean (SD) age was 37 (8) years for HIV sero-positive and 36 (8) years for sero-negative women; 27% of sero-positive women had CD4 counts ,200 and 34% had viral loads >50 000 copies/ml. Sero-positive and sero-negative women were similar demographically, as well as on plaque index, gingival bleeding, linear gingival banding, and numbers of DMF teeth and surfaces, but sero-positive women had more abnormal gingival papilla (P = 0.004) and fewer teeth (P = 0.01). Among sero-positive women, those with <200 CD4 counts had more DMF teeth (P = 0.007), and the number of DMF surfaces increased with decreasing CD4 counts (P = 0.04). Sero-positive women who fit the Center for Disease Control (CDC) AIDS criteria were also more likely to have more DMF teeth (P = 0.004), DMF surfaces (P = 0.003), and decayed and/or filled (DF) root surfaces (P = 0.0002) compared to sero-positive women without AIDS. Conclusions:, Dental and periodontal variables showed little difference between HIV sero-positive and sero-negative women. Among sero-positive women, there were significant differences in coronal and root caries by AIDS diagnostic criteria, but no periodontal indicators by either AIDS diagnostic criteria or CD4 status, were observed. [source]

Hypersensitivity reactions associated with endovascular devices

CONTACT DERMATITIS, Issue 1 2008
Golara Honari
Allergic reactions to endoprostheses are uncommon and reported in association with orthopaedic, dental, endovascular and other implanted devices. Hypersensitivity reactions to the biomaterials used in endovascular prostheses are among the infrequent reactions that may lead to local or systemic complications following cardiovascular therapeutic interventions. This article reviews potential immunotoxic effects of commonly used biomaterials. Reports of putative hypersensitivity reactions to endovascular devices, including coronary stents, perforated foramen occluders, pacemakers and implantable cardioverter defibrillators are also reviewed. [source]

Dental squash injuries , a survey among players and coaches in Switzerland, Germany and France

DENTAL TRAUMATOLOGY, Issue 5 2006
Robert Persic
Abstract,,, Squash belongs to sporting activities with medium risk of causing dental trauma. Because of high velocity, close body contact and the use of rackets the injury potential in squash has increased. The aim of this work was to conduct a comparative study between Switzerland, Germany and France on a number of issues: the frequency of dental and facial injuries in squash, athletes' habits of wearing mouthguards, as well as the general level of information about emergency measures after a dental trauma and the resulting consequences. Using a standardized questionnaire a total of 653 individuals, 600 squash players and their 53 coaches, were interviewed. In each of the three countries 200 players belonging to four different divisions (juniors, amateurs, semi-professionals and professionals) were surveyed. Of these 653 interviewees 133 (20.4%) have already observed a dental injury; 27 (4.5%) have experienced a dental trauma themselves. Less than half of all interviewed players and coaches (47.6%) were aware of the possibility of replanting avulsed teeth. Just 5.1% were familiar with the tooth rescue kit. Only one individual wore a mouthguard. The results show that the area of squash requires more information about prevention through sports associations, coaches and dentists. [source]

Oral trauma, mouthguard awareness, and use in two contact sports in Turkey

DENTAL TRAUMATOLOGY, Issue 5 2006
Ibrahim Tulunoglu
Abstract,,, The purpose of the present study was to evaluate the occurrence of dental hard and soft tissue injuries during participation in contact sports, and the awareness and use of mouthguards in a young adult sample of semi-professional or amateur boxers and tae kwon do participants in Turkey. The samples consisted of 274 young adults [174 male (63.5%) and 100 female (36.5%)] aged between 17 and 27 years of which 185 (67.5%) were tae kwon do practitioners, and 89 (32.5%) were boxers. The participants answered a standard questionnaire. All answers were evaluated and then statistical analyses were performed. Of the total sample, 61 of the subjects (22.3%) suffered dental trauma. Of these sufferers, 32 (17.3%) were boxers and 29 (32.6%) were tae kwon do practitioners. It was found that 19 (6.9%) athletes lost their teeth post-trauma. Of the 54 subjects (19.7%) suffering soft tissue injuries, 44 were female (81.5%), while only 10 were male (18.5%), of which 40 (74.1%) were tae kwon do practitioners and 14 (25.9%) were boxers. Of the total sample of 274 subjects, 228 (83.2%) were well informed about mouthguard usage. Of the total sample, 153 (55.8%) of the subjects used mouthguards, all of which were boil-and-bite type. The results of our study indicate that dentists and sports authorities in Turkey should promote the use of mouthguards in contact sports such as tae kwon do and boxing, which have a serious risk for dental and oral soft tissue trauma and tooth loss. [source]

Incidence of dental trauma associated with facial trauma in Brazil: a 1-year evaluation

DENTAL TRAUMATOLOGY, Issue 1 2004
Alessandro Costa Da Silva
Abstract,,, Dental trauma occurs frequently in young people, and mostly occurs in conjunction with facial trauma. In the literature, there are still few reports relating dental trauma, facial trauma, and soft-tissue injuries. This research aimed to evaluate: (i) the overall incidence of dental trauma in 340 patients who presented with facial trauma over a 1-year-period, (ii) the epidemiology of these related diseases, and (iii) the most common dental trauma when a facial trauma was present. Of all facial trauma, 15.29% presented dental trauma, of which luxations and avulsions were the most frequent injuries (40.30% each), occurring mainly on weekends (38.46%) and in October (15.38%), followed by March and June (13.46% each). The sex ratio presented the proportion of 3.3:1 (M:F). Trauma occurred mainly in the second decade (44.23%). These results highlight the high incidence of dental and facial trauma, and suggest the importance of the adoption of appropriate prevention protocols and effective therapeutic methods. [source]

Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumption

DENTAL TRAUMATOLOGY, Issue 1 2001
U. Perheentupa
Abstract , The purpose of the study was to assess the lifetime prevalence of dental injuries and risk factors involved in a general population-based birth cohort. The study population consisted of 5737 subjects who had participated in a health survey at the age of 31 years. Altogether 52% of the participants were women. This partly computer-based health survey included two questionnaires on previous dental and non-dental injuries, general health, occupational status and lifestyle. The current study was based on these questionnaires. The lifetime prevalence of dental fractures was 43% and the lifetime prevalence of dental luxations and exarticulations 14%. Men more commonly had dental injuries than women. Particularly mental distress and a history of previous injuries were shown to increase the risk for dental injuries. Furthermore, overweight and high alcohol consumption were positively associated with a high lifetime prevalence of tooth trauma. Regular physical activity decreased trauma occurrence. Socioeconomic status further affected the lifetime prevalence of dental injuries. The conclusion of the study was that personal, social and physical factors played a role in the occurrence of dental trauma. [source]

Direct and indirect time spent on care of dental trauma: a 2-year prospective study of children and adolescents

DENTAL TRAUMATOLOGY, Issue 1 2000
U. Glendor
Abstract , The aim was to account for the total time spent by professional care-givers (direct time) and by patients and companions engaged as support and help (indirect time) to treat and otherwise attend to children and adolescents with dental trauma to primary and permanent teeth. The study was based on a random sample of 192 children and adolescents with dental traumas reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years after the trauma episode. On average, direct time represented 16% of total time for all visits for dental trauma to permanent teeth and 11% for trauma to primary teeth. The most extensive type of indirect time was transport time, which took up 30% of the total time spent on injuries to permanent teeth and 36% for injuries to primary teeth. Multiple regression analysis of the impact of dental and demographic injury variables on the time variables showed that complicated trauma was associated with extended time, direct as well as indirect, for permanent and primary teeth injuries. Our estimate of the average relative increase in total time spent by patients and companions in cases of complicated injury to permanent teeth was 117% (95% confidence interval [CI], 52,211) for patients and 112% (95% CI, 42,217) for companions. For transport time a strong predictor was access to a dental clinic near the place of residence. Lack of access could extend the average transport time by 180% (95% CI, 80,335) for patients and 163% (95% CI, 67,317) for their companions in cases of injuries to primary teeth. [source]

Patients' help-seeking behaviours for health problems associated with methadone and buprenorphine treatment

DRUG AND ALCOHOL REVIEW, Issue 4 2008
ADAM R. WINSTOCK
Abstract Introduction and Aims. Clients in opioid substitution therapy often have considerable unmet health-care needs. The current study aimed to explore health problems related to opioid substitution therapy among clients on methadone and buprenorphine treatment. Design and Methods. A self-complete, cross-sectional survey conducted among 508 patients receiving methadone and buprenorphine treatment at community pharmacies in New South Wales (NSW), Australia. Results. The most common problems for which participants had ever sought help were dental (29.9%), constipation (25.0%) and headache (24.0%). The most common problems for which participants would currently like help were dental (41.1%), sweating (26.4%) and reduced sexual enjoyment (24.2%). There were no significant differences between those currently on methadone and those currently on buprenorphine for any of the health problems explored, nor differences for gender or treatment duration. Participants on methadone doses 100 mg or above were significantly more likely to want help currently for sedation. Discussion and Conclusions. The considerable unmet health care needs among participants in this study suggest that treatment providers should consider improving the detection and response to common health problems related to opioid substitution therapy. [source]

Ultrastructural study of the jaw structures in two species of Ampharetidae (Annelida: Polychaeta)

ACTA ZOOLOGICA, Issue 3 2004
Alexander B. Tzetlin
Abstract Two species of jaw bearing Ampharetidae (Adercodon pleijeli (Mackie 1994) and Ampharete sp. B) were investigated in order to describe the microanatomy of the mouth parts and especially jaws of these enigmatic polychaetes. The animals of both studied species have 14,18 mouth tentacles that are about 30 µm in diameter each. In both species, the ventral pharyngeal organ is well developed and situated on the ventral side of the buccal cavity. It is composed of a ventral muscle bulb and investing muscles. The bulb consists of posterior and anterior parts separated by a deep median transversal groove. In both species, the triangular teeth or denticles are arranged in a single transversal row on the surface of the posterior part of the ventral bulb just in front of its posterior edge. There are 36 denticles in Adercodon pleijeli and 50 in Ampharete sp. B. The height of the denticles (6,12 µm) is similar in both species. Each tooth is composed of two main layers. The outer one (dental) is the electron-dense sclerotized layer that covers the tooth. The inner one consists of long microvilli with a collagen matrix between them. The thickness of the dental layer ranges from 0.95 to 0.6 µm. The jaws of the studied worms may play a certain role in scraping off microfouling. The fine structure of the jaws in Ampharetidae is very similar to that of the mandibles of Dorvilleidae, the mandibles and the maxillae of Lumbrineridae, Eunicidae and Onuphidae, and the jaws of other Aciculata. This type of jaw is characterized by unlimited growth and the absence of replacement. The occurrence of jaws in a few smaller Ampharetidae is considered as an apomorphic state. [source]

,Schools without walls?' Developments and challenges in dental outreach teaching , report of a recent symposium

EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2006
K. A. Eaton
Abstract, During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of ,care teams' in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental ,school without walls'. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed. [source]

Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history-taking skills

EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2004
M. Schittek Janda
Simulations are important educational tools in the development of health care competence. This study describes a virtual learning environment (VLE) for diagnosis and treatment planning in oral health care. The VLE is a web-based, database application where the learner uses free text communication on the screen to interact with patient data. The VLE contains forms for history taking, clinical images, clinical data and X-rays. After reviewing the patient information, the student proposes therapy and makes prognostic evaluations of the case in free text. A usability test of the application was performed with seven dental students. The usability test showed that the software responded with correct answers to the majority of the free text questions. The application is generic in its basic functions and can be adapted to other dental or medical subject areas. A randomised controlled trial was carried out with 39 students who attended instruction in history taking with problem-based learning cases, lectures and seminars. In addition, 16 of the 39 students were randomly chosen to practise history taking using the virtual patient prior to their first patient encounter. The performance of each student was recorded on video during the patient sessions. The type and order of the questions asked by the student and the degree of empathy displayed towards the patient were analysed systematically on the videos. The data indicate that students who also undertook history taking with a virtual patient asked more relevant questions, spent more time on patient issues, and performed a more complete history interview compared with students who had only undergone standard teaching. The students who had worked with the virtual patient also seemed to have more empathy for the patients than the students who had not. The practising of history taking with a virtual patient appears to improve the capability of dental students to take a relevant oral health history. [source]

Helicobacter pylori in human oral cavity and stomach

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2008
Ralf Bürgers
The oral cavity has been suspected as an extra-gastroduodenal reservoir for Helicobacter pylori infection and transmission, but conflicting evidence exists regarding the occurrence of H. pylori in the mouth, independently of stomach colonization. Ninety-four gastric biopsy patients were analysed for the concurrent presence of H. pylori in the mouth and stomach. Samples were collected from different areas within the mouth and H. pylori DNA was amplified by the polymerase chain reaction (PCR) and verified by sequencing. Helicobacter pylori -specific serology was performed, and stomach colonization was determined by culture. In addition, relevant dental and periodontal parameters, as well as general health parameters, were recorded. Helicobacter pylori was found in the stomach of 29 patients and in the oral cavity of 16 patients. In only six patients was the bacterium detected simultaneously in the stomach and mouth. Notably, the 10 patients in whom the bacterium was found solely in the mouth did not have serum antibodies to H. pylori. The occurrence of H. pylori in the mouth was found to be correlated neither to any general or oral health parameters, nor to any particular site of collection. This study shows that H. pylori can occur in the oral cavity independently of stomach colonization. [source]

Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2006
Ad De Jongh
This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent. [source]

Nearly half of dental randomized controlled trials published in German are not included in Medline

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2002
Jens C. Türp
Randomized controlled trials (RCTs) are considered the most reliable type of clinical intervention studies. However, not all reports of RCTs are accessible in Medline. This can impede the validity of the results of systematic reviews. Ten German-language dental journals were manually searched to locate reports of controlled clinical trials published between 1970 and 2000. The publication type was determined and compared with Medline. Of the 15 777 articles, 210 reports of RCTs and 410 articles of non-randomized controlled clinical trials (CCTs) were identified. Only 56% of the RCTs and 75% of the CCTs are available in Medline. Of the 118 reports of RCTs registered in Medline, 15 are indexed with the correct Publication Type term. Our data suggest that (a) hand-searching plays a valuable role in identifying reports of clinical dental trials, and (b) a literature search in Medline is likely to yield incomplete results. [source]

Oral status of 35 subjects with eating disorders , A 1-year study

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2000
Rolf Öhrn
The aim was to record changes over time in the oral status of subjects with diagnosed eating disorders. The outpatient psychiatrist had referred to the hospital dental clinic 35 women (19,47 yr, median 27 yr) with eating disorders, diagnosed according to DSM III-R criteria. At the baseline examination, dental, medical and dietary histories were taken, and intra-oral clinical and radiographic examinations were supplemented by intra-oral photographs, study casts and salivary analysis. The subjects were re-examined 1 yr later. Together, the investigators assessed progression of tooth wear blindly by comparing coded study casts from the baseline and 12-month examinations. Progression of erosive tooth wear was recorded in almost half of the subjects. Several subjects had low unstimulated salivary flow rates (<0.1 ml/min) and very high counts of mutans streptococci and lactobacilli, both at baseline and 1 yr later. The flow rates for paraffin-stimulated saliva at baseline were significantly lower for subjects with progression of erosive tooth wear than for those without. Because of the increased susceptibility to both caries and erosion, patients with eating disorders should be encouraged to have regular dental check-ups. Test of salivary flow may serve as an indicator of patients' risk of progression of erosive tooth wear. [source]

Rudabánya: A late miocene subtropical swamp deposit with evidence of the origin of the African apes and humans

EVOLUTIONARY ANTHROPOLOGY, Issue 2 2002
László Kordos
Abstract Rudabánya, a rich late Miocene fossil site in northern central Hungary, has yielded an abundant record of fossil primates, including the primitive catarrhine Anapithecus and the early great ape Dryopithecus. While the affinities of Anapithecus are not clear, Dryopithecus is clearly a great ape sharing numerous characteristics of its dental, cranial and postcranial anatomy with living great apes. Like all Miocene hominids (great apes and humans), Dryopithecus is more primitive in a number of ways than any living hominid, which is probably related to the passage of time since the divergence of the various lineages of living hominids, allowing for similar refinements in morphology and adaptation to take place independently. On the other hand, Dryopithecus (and Ouranopithecus) share derived characters with hominines (African apes and humans), and Sivapithecus (and Ankarapithecus) share derived characters with orangutans, thus dating the split between pongines and hominines to a time before the evolution of these fossil great apes. Pongines and hominines follow similar fates in the late Miocene, the pongines moving south into Southeast Asia from southern or eastern Asia and the hominines moving south into East Africa from the Mediterranean region, between 6 to 9 Ma. [source]

Original article: Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, Iran

GERODONTOLOGY, Issue 3 2010
Maryam Rabiei
doi:10.1111/j.1741-2358.2009.00313.x Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, Iran Objective:, The aim of this study was to determine the prevalence of dental and oral mucosal lesions in institutionalised elderly people in Rasht. Background:, Oral health in the elderly people is important to tailor the health programmes for this increasing age group within the population. Methods:, A total of 216 elderly people residing in a geriatric nursing home were included in the study. Subjects were interviewed and examined clinically and registered in a data collection form and analysed using spss version 11 program (SPSS Inc, Chicago, Illinois, USA). Results:, The prevalence of dental and oral disorders was 44.9% and 86.1% respectively. The most frequent oral disorders were dry mouth (42.1%), fissure tongue (25.9%), atrophic of tongue (25%), sublingual varicosity (22.7%), burning sensation (16.7%) and varix (15.3%). The prevalence of edentulousness was 56% (95%CI: 49,63%). The mean level of retained teeth was 3.22. The odds of an oral mucosal disorder in females were significantly more than in males (OR = 2.79, 95%CI: 1.25,6.23). Discussion:, The findings revealed a high prevalence of dental and oral disorders in institutionalised elderly people in Rasht in comparison to similar studies. The mean of retained teeth was also much lower than in other reports. Therefore, the necessity for regular oral examination of these rapidly expanding age groups of people is essential. [source]

Responses of jawbone to pressure,

GERODONTOLOGY, Issue 2 2004
Gunnar E. Carlsson
Objective:, To provide a literature review of bone resorption of edentulous jaws focusing on responses to pressure. Background:, After the extraction of all teeth in a jaw there is a continuous reduction of the residual ridge. The individual variation of bone resorption is great, and the aetiology is complex and not yet well understood. Materials and methods:, A search of the literature published up to May 2003 on bone resorption and pressure was performed using PubMed/Medline. Results:, Animal studies have demonstrated that excessive and constant pressure induces bone resorption. Recent experimental research has indicated that bone resorption is a pressure-regulated phenomenon with a lower threshold for continuous than for intermittent pressure. Clinical studies have suggested that residual ridge resorption is due more to the effects of denture wearing than to disuse atrophy. However, the results of leaving out dentures at night are not conclusive. Nor does the literature offer any strong evidence for the so-called combination syndrome, which has been described as a result of unfavourable loading. Clinical studies using multivariate analyses indicate that female gender and systemic factors may be of greater importance than oral and denture factors. Implant-supported prostheses have a bone preserving effect rather than the continuing resorption under complete dentures. Conclusions:, The best way to reduce bone resorption is to avoid total extraction, preserve a few teeth and fabricate overdentures. In edentulous jaws, placement of implant-supported prostheses will lead to less bone loss and may even promote bone growth. To increase our knowledge of residual ridge resorption extended experimental, clinical and statistical methods will be needed, preferably including collaboration between dental and medical researchers. [source]

Periodontal status and IOTN interventions among young hemophiliacs

HAEMOPHILIA, Issue 4 2006
S. AZHAR
Summary., ,Fifty-two young individuals suffering from severe haemophilia A and B volunteered to be compared with school- and college-going students for oral health status description and subsequent management. A total of 244 students (84.42% boys and 15.58% girls) with the age group of 13,23 years were divided into two groups, A and B (controls). The purpose of this study was to increase awareness about evidence-based dental practices by oral examinations followed by comparisons of periodontal health and prevalence of malocclusions among medically compromised students and healthy controls. Results described the oral health in severe haemophilic population to be compromised with combined simplified health index score of 0.50 and Decayed/Modified/Filled Teeth (DMFT) index score of 2.07 when compared with 0.42 and 0.95, respectively, among group B. Although prevalence of malocclusion and orthodontic treatment needs among group A were higher, yet it was not confirmed as a reason for degraded dental and periodontal status. However, spontaneous and/or toothbrush (trauma)-induced gingival bleeding episodes among group A could be explained as factors discouraging oral hygiene maintenance, particularly self-administered measures. Four haemophiliacs presented with symptoms of Temporomandibular Joint Dysfunction Syndrome (TMPDS). Evidence-based oral medicine and clinical practices need to be encouraged and applied to enhance the quality of life among haemophiliacs, particularly in developing world. Dental treatment needs of haemophilic population appear to be greater and maybe incorporated in routine dental practices, at institutional and individual levels. [source]

A systematic review of musculoskeletal disorders among dental professionals

INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2009
MJ Hayes
Abstract:, Musculoskeletal problems have become a significant issue for the profession of dentistry and dental hygiene. This review provides a detailed examination and discussion regarding the prevalence of musculoskeletal disorders (MSD) in dental personnel and possible causative factors. All research studies or literature reviews, which have reported on the prevalence of musculoskeletal symptoms and/or potential risk factors for this problem in dentists, dental hygienists and dental students, were selected for inclusion. Our literature suggests that the prevalence of general musculoskeletal pain ranges between 64% and 93%. The most prevalent regions for pain in dentists have been shown to be the back (36.3,60.1%) and neck (19.8,85%), while the hand and wrist regions were the most prevalent regions for dental hygienists (60,69.5%). Interestingly, we found that studies on MSDs among dental and dental hygiene students are quite limited. Many risk factors have been identified, including static and awkward posture and work practices. Overall, the review suggests that musculoskeletal problems represent a significant burden for the dental profession. More research in the form of larger studies is urgently required, to help more clearly elucidate the development of this important issue for dental hygienists and dental hygiene students. [source]

Oral self-care habits of dental and healthcare providers

INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2008
Y Zadik
Abstract:, Objective:, To evaluate the self-care level of dental and healthcare providers regarding prevention of oral diseases Methods:, Healthcare providers (dental assistants and surgeons, laboratory personnel, biologists, medics, paramedics, corpsmen, nurses, pharmacists, physicians, physiotherapists, psychologists, social workers, speech therapists, X-ray technicians) and non-health care providing adults (the general population) were asked to respond to a questionnaire regarding their routine measures for maintaining oral health Results:, Three hundred and twenty-six healthcare providers and 95 non-healthcare providers participated in the study. Regarding toothbrushing, flossing, undergoing periodic dental examinations and professional scaling/polishing, dental practitioners have better, but not perfect, maintenance habits than other healthcare providers. Non-dental healthcare providers have better dental habits than the general population, and nurses and medical practitioners have better dental habits than medics, paramedics, corpsmen and para-medical professionals. Among non-dental healthcare providers, nurses have a relatively high frequency of toothbrushing and flossing but a low frequency of periodic examinations and scaling/polishing. Generally, females reported significantly higher frequencies of toothbrushing and flossing than males did. The toothpaste selection of the participants was primarily influenced by dentists' recommendations, the flavour of the toothpaste, and its anti-malodour effect were the most dominant factors. Conclusion:, The compliance of health professionals, especially dental practitioners, with appropriate oral health measures is relatively high. However, the dental team cannot always assume that the dental patient, who also happens to be a healthcare provider, has meticulous oral habits. The dental hygienist and surgeon have to educate and motivate their patients, especially healthcare providers because of the influence of the latter on their own patients. [source]

Relationships between features associated with vomiting in purging-type eating disorders

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2005
Lauren Reba BA
Abstract Objective Vomiting is a pernicious symptom of eating disorders. We explored the relation between the symptom of vomiting and features of eating disorder course and severity, personality traits, and Axis I and II comorbidity in individuals with purging-type eating disorders. Method The sample included participants from the multisite, international Price Foundation Genetic Studies, who had an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified) and had data available for the frequency of purging behaviors (n = 1,048). Axis I disorders, personality disorders, trait anxiety, perfectionism, and temperament and character dimensions were included as possible correlates. Results The presence of vomiting was associated with less regular laxative use, lower self-directedness, organization, personal standards, and higher novelty seeking. Conclusion Vomiting remains a prevalent and potentially destructive symptom of eating disorders, with significant dental and medical morbidity. Our findings suggest that certain clinical and personality variables distinguish individuals with purging-type eating disorders who vomit from those who do not, although there were no marked differences in Axis I or II comorbidity. Specifically targeting treatment to decrease duration of exposure to this dangerous symptom continues to be an important clinical objective. © 2005 by Wiley Periodicals, Inc. [source]