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Tse KL, Savoldi F, Li KY, McGrath CP, Yang Y, Gu M. Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study. Prog Orthod 2023; 24:31. [PMID: 37691059 PMCID: PMC10493207 DOI: 10.1186/s40510-023-00481-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/17/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general population, and multiple criteria can be used for assessing AH on lateral cephalometric radiograph (LCR). The present analysis represents the first report performed according to these requirements in a large cross-sectional sample of children. METHODS LCRs of 517 12-year-old children (286 males, 231 females) randomly selected from the general population were retrospectively retrieved. AH was defined using three criteria (At/Nd, Ad-Ba/PNS-Ba, 1-Npaa/Npa), and twelve craniofacial variables were measured (SNA, SNB, ANB, Wits, Cd-Gn, MnP^SN, MxP^MnP, TPFH/TAFH, OPT^SN, C2ps-C4pi^SN, H-CV, H-FH). Skeletal characteristics were compared between children with and without AH using Mann-Whitney U test. Binary logistic regression (adjusted for sex and skeletal growth) was used to independently quantify the association between craniofacial factors and AH. RESULTS The prevalence of children with AH was 17.6% (according to At/Nd), 19.0% (according to Ad-Ba/PNS-Ba), and 13.9% (according to 1-Npaa/Npa). Children with AH presented greater antero-posterior jaw discrepancy (larger ANB, smaller SNB), greater mandibular divergence (larger MnP^SN), forward head posture (larger OPT^SN and C2ps-C4pi^SN), and anteriorly positioned hyoid bone (larger H-CV). Larger SNA (OR = 1.39-1.48), while smaller SNB (OR = 0.77-0.88) and Wits (OR = 0.85-0.87), were associated with greater likelihood of having AH, independently from the assessment method used. CONCLUSIONS The prevalence of children with AH ranged from 13.9 to 19.0% based on LCR. Greater antero-posterior maxillo-mandibular discrepancy and mandibular retrusion were independently associated with higher likelihood of having AH.
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Affiliation(s)
- Kwan Lok Tse
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China
| | - Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China
| | - Kar Yan Li
- Clinical Research Centre, Faculty of Dentistry, The University of Hong Kong, 5/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China
| | - Colman P McGrath
- Dental Public Health, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 1/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China
| | - Yanqi Yang
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, People's Republic of China.
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Sardana D, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Caries-preventive effectiveness of two different fluoride varnishes: A randomised clinical trial in patients with multi-bracketed fixed orthodontic appliances. Int J Paediatr Dent 2023; 33:50-62. [PMID: 35737872 DOI: 10.1111/ipd.13013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/28/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with multi-bracketed fixed orthodontic appliances are at a higher risk of developing enamel demineralisation. AIM To compare the efficacy of the quarterly application of two varnishes in preventing white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. DESIGN Ninety-nine patients were randomly allocated into three intervention groups: Group A-standard oral hygiene instructions (OHI); Group B-5% sodium fluoride (NaF) varnish with standard OHI; and Group C-NaF plus tricalcium phosphate varnish with standard OHI. The outcome was assessed at 6-monthly intervals using a quantitative laser fluorescence device, clinical evaluation and photographic evaluation on six maxillary anterior teeth. A logistic regression model using generalised estimating equations with the intervention group, time and their interaction was used to compare the occurrence of WSLs, whereas the independent-samples Kruskal-Wallis test was used to compare the means of fluorescent values among different groups at p = .05. RESULTS Generalised estimating equations (with intervention and time as predictors) showed that only the effect of time was found to be significant (p < .001), whereas there was no significant difference among the three intervention groups (p = .305) using clinical assessment or photographic assessment (p = .599). At the 18-month follow-up, sodium fluoride (NaF) varnish with standard OHI was shown to reduce the odds of WSLs by 55% (p = .200), and NaF plus tricalcium phosphate varnish with standard OHI by 42% (p = .327). CONCLUSION The study failed to demonstrate that the quarterly application of both the study varnishes with OHI provided additional benefits compared with standard OHI alone in preventing WSLs, taking the effect of time of follow-up into consideration. There were higher odds of developing WSLs with an increased duration of orthodontic treatment.
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Affiliation(s)
- Divesh Sardana
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.,Division of Pediatric Dentistry, The University of Oklahoma College of Dentistry, Oklahoma city, USA
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Lau CCM, Savoldi F, Yang Y, Hägg U, McGrath CP, Gu M. Minimally important differences in oral health-related quality of life after fixed orthodontic treatment: a prospective cohort study. Eur J Orthod 2022; 45:281-286. [DOI: 10.1093/ejo/cjac063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Summary
Background
The minimally important difference (MID, the smallest difference that patients perceive as beneficial) has been proposed to assess whether study results are clinically meaningful, reducing the shortcoming of P-values-based approaches in the assessment of clinical outcomes. The post-treatment changes and the MID in Oral Health-Related Quality of Life (OHRQoL) among adults undergoing fixed orthodontic treatment were investigated.
Methods
Ninety-two patients (29.1 ± 6.3 years old, 18 males and 74 females) were prospectively included. Oral Health Impact Profile (OHIP-14) and United Kingdom Oral Health-related Quality of Life (OHQoL-UK) were used to assess OHRQoL at baseline and post-treatment (50.8 ± 15.7 months). Global Transition Rating (GTR) was used to assess oral health/well-being, Peer Assessment Review (PAR), and Index of Complexity, Outcome and Need (ICON) were used to assess occlusion. Wilcoxon signed-rank test was used to assess changes in OHRQoL and occlusion, Kruskal–Wallis one-way ANOVA and Mann–Whitney U-test were used to assess associations between OHRQoL and oral health/well-being or occlusion. MID for OHIP-14 and OHQoL-UK was estimated via anchor-based (PAR, ICON, GTR) and distribution-based approach (effect size, standardized response mean, standard error of measurement).
Results
The median OHIP-14 and OHQoL-UK post-treatment scores were significantly changed, indicating improved OHRQoL. Based on the agreement between different methods, the MID of OHIP-14 and OHQoL-UK were at least 15 and 6 scale points, corresponding to a large effect size (1.5–1.7).
Conclusions
Orthodontic treatment had a positive long-term impact on OHRQoL. MID for the OHIP-14 and OHQoL-UK provide guidance to interpreting the impact of orthodontic treatment on the OHRQoL of patients.
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Affiliation(s)
- Clement C M Lau
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
| | - Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
| | - Yanqi Yang
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
| | - Urban Hägg
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
| | - Colman P McGrath
- Dental Public Health, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital , Sai Ying Pun , Hong Kong S.A.R
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Sardana D, Manchanda S, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Prevention of demineralization during multi-bracketed fixed orthodontic treatment: An overview of systematic reviews. Int J Paediatr Dent 2022; 32:473-502. [PMID: 34562331 DOI: 10.1111/ipd.12927] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Demineralization during multi-bracketed fixed orthodontic treatment is a well-known problem. AIM To systematically evaluate the evidence for the prevention of enamel demineralization during multi-bracketed fixed orthodontic treatment. DESIGN Systematic reviews (with or without meta-analysis) that have appraised the primary studies on the prevention of demineralization during multi-bracketed fixed orthodontic treatment were searched systematically and included as per pre-defined eligibility criteria. The risk of bias of the included reviews was assessed by two authors using the ROBIS tool and AMSTAR-2 tool. RESULTS Twenty-nine reviews conducted on 128 exclusive primary studies were included for the present overview; 23 of these reviews were assessed to be of a high risk of overall bias, 5 were of low risk, and 1 review was of unclear risk of bias. CONCLUSIONS Predominantly, the published reviews have focused on fluorides, whereas some reviews have also studied the role of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), reminder therapy, lasers, and sealants. Professional fluorides, sealants, reminder therapy, and lasers might be valuable interventions to prevent demineralization during orthodontic treatment based on the conclusions of reviews with high quality; however, further studies are required to elucidate the role of CPP-ACP, chlorhexidine varnish, and powered toothbrushes.
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Affiliation(s)
- Divesh Sardana
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China.,T.H. Chan School of Public Health, Harvard University, Massachusetts, USA
| | - Sheetal Manchanda
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
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Sardana D, Li KY, Ekambaram M, Yang Y, McGrath CP, Yiu CK. Validation of clinical photography and a laser fluorescence device for assessment of enamel demineralization during multi-bracketed fixed orthodontic treatment. Photodiagnosis Photodyn Ther 2022; 38:102828. [PMID: 35339722 DOI: 10.1016/j.pdpdt.2022.102828] [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: 12/23/2021] [Revised: 02/19/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
AIM To compare the validity of DIAGNOdent pen™ 2190 and clinical photographs in the diagnosis (presence or absence) and assessment of white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. METHODS A total of 1607 readings from 99 patients were obtained using DIAGNOdent pen™ 2190, clinical photographs, and visual assessment criteria to assess WSLs at 6 -, 12- and 18 months after bonding of brackets. Receiver operating characteristic curves were constructed, and areas under the curve (AUC) were calculated to assess the presence or absence of WSLs and distinguish the severity of WSLs as slight or severe. Sensitivities, specificities, and AUC were calculated for outcomes at an alpha of 0.05 and 95% confidence intervals (CIs). RESULTS The values of sensitivity and specificity of DIAGNOdent pen™ 2190 were found to be 0.78 and 0.83, respectively, to distinguish presence/absence of WSLs with good accuracy (AUC= 0.855; 95% CI: 0.820-0.889) and for digital photographs, accuracy was excellent (AUC= 0.973, 95% CI: 0.956-0.991) with sensitivity and specificity of 0.96 and 0.99, respectively. However, the accuracy of DIAGNOdent pen™ 2190 was poor (AUC= 0.543, 95% CI: 0.418-0.668) in delineating slight and severe WSLs with a sensitivity of 0.31 and specificity of 0.83; while the values of sensitivity and specificity for distinguishing slight or severe lesions for clinical photographs were 0.96 and 0.99, respectively with excellent accuracy (AUC=0.978, 95% CI: 0.936-1.000). CONCLUSIONS Clinical photographs had better validity than DIAGNOdent pen™ 2190 in diagnosis and assessment of severity of demineralized lesions during multi-bracketed fixed orthodontic treatment.
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Affiliation(s)
- Divesh Sardana
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R; T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kar Yan Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | | | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Colman P McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Cynthia Ky Yiu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R.
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Sun L, Wong HM, McGrath CP. Sociodemographic and Clinical Factors That Influence Oral Health-Related Quality of Life in Adolescents: a Cohort Study. Community Dent Health 2022; 39:8-13. [PMID: 34862861 DOI: 10.1922/cdh_00190sun06] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine the sociodemographic and clinical factors that may influence oral health-related quality of life (OHRQoL) at ages 12 to 15. BASIC RESEARCH DESIGN Cohort study. PARTICIPANTS Cluster-randomized sample of Hong Kong 12-year-olds. MAIN OUTCOME MEASURES The Child Perceptions Questionnaire (CPQ11-14) was used to measure OHRQoL as the response variable. Periodontal status and caries were examined according to WHO criteria. Malocclusion was assessed using Dental Aesthetic Index. Potential predictors of OHRQoL (age, gender, father's education, mother's education, household income, periodontal status, caries, and malocclusion) were analyzed by structural equation modelling. RESULTS At age 12, 589 participants (305 females, 284 males) were included. At age 15, 331 (172 females and 159 males) were followed up. For direct effects, age 15 was associated with higher oral symptoms (OS) scores (β=0.124, 95%CI=0.049 to 0.2) but lower emotional well-being (EWB) scores (β=-0.105, 95%CI=-0.184 to -0.03). Males had higher OS scores than females (β=0.126, 95%CI=0.059 to 0.208). Mother's education had positive effects on children's EWB (β=-0.096, 95%CI=-0.159 to -0.018). Malocclusion had negative effects on functional limitations (FL) (β=0.083, 95%CI=0.013 to 0.186). For indirect effect, mother's education showed a link via EWB to OHRQoL (β=-0.077, 95%CI=-0.123 to -0.018). Malocclusion showed a link via FL to OHRQoL (β=0.037, 95%CI=0.006 to 0.087). CONCLUSIONS Age, gender, mother's education and malocclusion predicted OHRQoL at ages 12 and 15.
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Affiliation(s)
- L Sun
- Department of Orthodontics, Stomatological Hospital of Guilin Medical University, China
| | - H M Wong
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - C P McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Li DTS, Wong NSM, Li SKY, McGrath CP, Leung YY. Timing of arthrocentesis in the management of temporomandibular disorders: an integrative review and meta-analysis. Int J Oral Maxillofac Surg 2021; 50:1078-1088. [PMID: 33602649 DOI: 10.1016/j.ijom.2021.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/04/2020] [Revised: 11/18/2020] [Accepted: 01/20/2021] [Indexed: 01/23/2023]
Abstract
The aim of this study was to assess the best timing to perform arthrocentesis in the management of temporomandibular disorders with regard to conservative treatment. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, reference list search, and manual search was performed. Relevant articles were selected after three search rounds for final review based on six predefined inclusion criteria, followed by a round of critical appraisal. Eleven publications, including eight randomized controlled trials and three prospective clinical studies, were included in the review. The studies were divided into three groups based on the timing of arthrocentesis: (1) arthrocentesis as the initial treatment; (2) early arthrocentesis; and (3) late arthrocentesis. Meta-analysis was carried out to compare the efficacy of improvement in mouth opening and pain reduction in the three groups. All three groups showed improvement in mouth opening and pain reduction, with forest plots suggesting that arthrocentesis performed within 3 months of conservative treatment might produce beneficial results. We conclude that there is a knowledge gap in the current literature regarding the preferable timing to perform arthrocentesis in the management of temporomandibular disorders, and more high-quality randomized controlled trials are required to shed light on this subject.
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Affiliation(s)
- D T S Li
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - N S M Wong
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - S K Y Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - C P McGrath
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Y Y Leung
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Sardana D, Manchanda S, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Effectiveness of self-applied topical fluorides against enamel white spot lesions from multi-bracketed fixed orthodontic treatment: a systematic review. Eur J Orthod 2020; 41:661-668. [PMID: 31112229 DOI: 10.1093/ejo/cjz015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The regular use of fluoride dentifrices is quite practical, widespread and linked to global decline of dental caries. However, the role of self-applied topical fluorides in prevention and reversal of Enamel White Spot Lesions (EWSLs) during multi-bracketed fixed orthodontic treatment is not yet explored. OBJECTIVE To systematically appraise the current literature on the effectiveness of self-applied topical fluorides in the prevention and reversal of EWSLs occurring during multi-bracketed fixed orthodontic treatment. SEARCH METHODS Four electronic databases (Cochrane Library, Embase via Ovid, Medline via Ovid, and Scopus) and gray literature were searched using the broad MeSH terms and keywords. SELECTION CRITERIA Only randomized/quasi-randomized controlled clinical trials evaluating the effectiveness of self-applied fluorides in the prevention of EWSLs during multi-bracketed fixed orthodontic treatment or reversal of post-orthodontic EWSLs were included. DATA COLLECTION AND ANALYSIS Two reviewers independently screened for studies, extracted data and assessed the risk of bias using the Cochrane risk of bias tool 2.0. Due to substantial variations in the interventions, control groups, and the measurement of outcome among studies, quantitative synthesis could not be performed as planned. RESULTS Only three studies could be included in the present review; two of them assessing prevention of EWSLs and one addressing reversal of post-orthodontic EWSLs. One of the studies was judged to be of low risk of overall bias, whereas 2 studies were adjudged to be of high risk of overall bias because of deviations from intended interventions. The certainty of evidence about the role of self-applied fluorides in prevention and reversal of EWSLs was found to be of low quality; hence, our confidence in the effect estimate is limited, and future well-conducted trials might alter the effect estimates. LIMITATIONS The inclusion of only English literature and inability to perform quantitative synthesis due to a limited number of studies. CONCLUSIONS AND IMPLICATIONS Although the review did not confirm the effectiveness of self-applied fluorides in the reversal of EWSLs, it did partially substantiate the positive role of self-applied fluorides in the prevention of EWSLs occurring during multi-bracketed fixed orthodontic treatment. The review recommends the need for well-designed randomized controlled trials evaluating the effectiveness of self-applied fluorides on the prevention and reversal of EWSLs during multi-bracketed fixed orthodontic treatment. REGISTRATION PROSPERO database (Registration number: CRD42018108590) and is freely available at: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018108590. FUNDING This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Divesh Sardana
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Sheetal Manchanda
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
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Firmino RT, Granville-Garcia AF, McGrath CP, Bendo CB, Ferreira FM, Paiva SM. Validation for Brazilian Portuguese language of the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Int J Paediatr Dent 2020; 30:234-243. [PMID: 31628878 DOI: 10.1111/ipd.12585] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/19/2019] [Accepted: 10/15/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral health literacy (OHL) is associated with oral health outcomes. AIM To validate the Brazilian Portuguese version of the Hong Kong OHL Assessment Task for Paediatric Dentistry (HKOHLAT-P). DESIGN We performed cross-cultural adaptation of the HKOHLAT-P. A sample of 200 pre-schoolers and caregivers from Campina Grande, Brazil completed the Brazilian HKOHLAT-P (BOHLAT-P), sociodemographic questionnaire, the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Child dental caries was assessed. Instrument reliability was measured by internal consistency (Cronbach's alpha) and test-retest (ICC). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) evaluated dimensionality. Regression models tested associations between BOHLAT-P and exploratory variables (P < .05). RESULTS BOHLAT-P demonstrated excellent reliability (Cronbach's alpha = 0.92; ICC = 0.95). BOHLAT-P and BREALD-30 scores (r = .71), number of schooling years (r = .60), and reading hours (r = .34) were positively correlated. BOHLAT-P and B-ECOHIS scores (r = -.22), and BOHLAT-P scores and number of cavitated teeth (r = -.15) were negatively correlated. After controlling for confounding variables, BOHLAT-P scores were not associated with caries or number of teeth with cavitated caries. CONCLUSION BOHLAT-P is a valid and reliable instrument to assess the OHL of Brazilian parents.
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Affiliation(s)
- Ramon Targino Firmino
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Colman P McGrath
- Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cristiane Baccin Bendo
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda Morais Ferreira
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Yeung PM, Wong VCN, McGrath CP, Yiu CKY, Lee GHM. Oral health status of children with epilepsy in Hong Kong. ACTA ACUST UNITED AC 2019; 10:e12479. [PMID: 31755666 DOI: 10.1111/jicd.12479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/22/2019] [Revised: 10/06/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
AIM This study assessed and compared the oral health status, dental trauma experience and oral health habits of children with and without epilepsy. METHODS Thirty-five children with epilepsy aged 3-18 years old were recruited from the pediatric neurology clinics of 2 university-affiliated district hospitals. A sample of 35 age- and gender-matched healthy children was recruited as controls. Clinical data on caries, gingival health, oral hygiene level and dental trauma were collected and compared between the groups. Information about children's oral health habits and reported dental trauma experience were obtained by structured questionnaire. RESULTS Children with epilepsy had significantly poorer gingival health than healthy controls. No significant differences in dental caries experience, oral hygiene level, dental trauma experience, oral health habits and dental care service utilization were observed between the children with and without epilepsy. Among the children with epilepsy, those taking more than 1 antiepileptic drug had a greater prevalence of dental caries when compared with those receiving mono-antiepileptic drug therapy. The presence of gingival hyperplasia indicated poorer gingival health in epileptic children. CONCLUSION The study shows that children with epilepsy had poorer oral health status in terms of gingival health than those without epilepsy.
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Affiliation(s)
- Patricia M Yeung
- Pediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Virginia C N Wong
- Department of Pediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Cynthia K Y Yiu
- Pediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Gillian H M Lee
- Pediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Sardana D, Manchanda S, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Corrigendum to: Effectiveness of self-applied topical fluorides against enamel white spot lesions from multi-bracketed fixed orthodontic treatment: a systematic review. Eur J Orthod 2019; 41:669. [DOI: 10.1093/ejo/cjz033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Sardana D, Manchanda S, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Prevention of Demineralization Around Orthodontic Brackets Using Sealants: A Systematic Review and Meta-Analysis. Pediatr Dent 2019; 41:430-531. [PMID: 31882028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: To evaluate the role of sealants in the prevention of enamel white spot lesions (EWSLs) around bonded orthodontic brackets. Methods: Eight databases and grey literature were searched for randomized or quasirandomized controlled clinical trials that assessed the placement of sealants around bonded brackets for the prevention of demineralization during fixed orthodontic treatment. Two reviewers independently selected studies, extracted data, assessed the risk of bias using Cochrane Risk of bias tool 2.0, and evaluated the certainty of evidence using the GRADE approach. Results: Eight clinical trials were included for qualitative synthesis; five of which assessed the outcome at debonding and hence were included for quantitative synthesis. Odds ratios (ORs) were calculated using the corrected Becker-Balagtas method. The OR of EWSLs in the sealants group versus the control group was found to be 0.69 (95 percent confidence interval [95% CI] equals 0.53, 0.89; P=.005) in the five included studies; however, after performing sensitivity analysis by excluding two studies with high risk of bias, the value was 0.68 (95% CI equals 0.41, 1.13; P=0.138). Conclusions: The certainty of evidence regarding the effectiveness of sealants in the prevention of the EWSLs was found to be moderate (downgraded because of the study limitations).
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Affiliation(s)
- Divesh Sardana
- Sardana is a research postgraduate student, Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, People's Republic of China
| | - Sheetal Manchanda
- Manchanda is a research postgraduate student, Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, People's Republic of China
| | - Manikandan Ekambaram
- Dr. Ekambaram is a senior lecturer, Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Dr. Yang is a clinical associate professor, Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, People's Republic of China
| | - Colman P McGrath
- Dr. McGrath is a clinical professor, Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, People's Republic of China
| | - Cynthia K Y Yiu
- Dr. Yiu is a clinical professor, Paediatric Dentistry and Orthodontics, Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, People's Republic of China;,
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Savoldi F, Xinyue G, McGrath CP, Yang Y, Chow SC, Tsoi JKH, Gu M. Reliability of lateral cephalometric radiographs in the assessment of the upper airway in children: A retrospective study. Angle Orthod 2019; 90:47-55. [PMID: 31403838 DOI: 10.2319/022119-131.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To test the reliability of Lateral cephalometric radiographs (LCRs) for use in the assessment of the upper airway, hyoid bone, soft palate, and tongue. MATERIALS AND METHODS The records of 57 healthy Chinese children from a nonhospital population (mean age = 12.6 years, SD = 0.5, 28 males and 29 females) who received two consecutive LCRs in the natural head posture were retrospectively analyzed. Fifteen linear, angular, and area measurements were used to describe the airway, hyoid bone, soft palate, and tongue. The reliability between the two LCRs was assessed with the intraclass correlation coefficient (ICC) and F-test. Errors were estimated with the Dahlberg and Bland-Altman method, and intra- and inter-assessor agreements were determined. RESULTS Measurements of upper airway and hyoid bone had excellent method reliability, intra-assessor reliability, and inter-assessor reliability (ICC > 0.8). However, the method reliability and the inter-assessor reliability for soft palate and tongue was less favorable (ICC from 0.60 to 0.96). Soft palate area and thickness were the most critical parameters. Intra-assessor reliability was greater than both method reliability and inter-assessor reliability (which were similar). CONCLUSIONS The measurement of upper airway morphology, defined as the intramural space, and of the hyoid bone position were highly reliable on LCRs of children. However, the limited reliability in the assessment of tongue and soft palate area may compromise the diagnostic application of LCRs to these structures.
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Wen YF, Wong HM, McGrath CP. Developmental shape changes in facial morphology: Geometric morphometric analyses based on a prospective, population-based, Chinese cohort in Hong Kong. PLoS One 2019; 14:e0218542. [PMID: 31252428 PMCID: PMC6599092 DOI: 10.1371/journal.pone.0218542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/04/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Thorough understanding of developmental changes of human facial shape is lacking. The present study aimed to evaluate developmental shape changes of facial morphology based on a prospective, population-representative, Chinese cohort in Hong Kong. METHODS A population-representative sample of Chinese in Hong Kong was followed. Serial facial images of over 260 participants were obtained at age 12, 15, and 18 years. Facial landmarks were digitized and the corresponding coordinates were submitted for Generalized Procrustes Analysis. The resultant Procrustes shape coordinates, which captured shape information encoded by the facial landmarks, were then used for statistical shape analyses. RESULTS Small but significant developmental changes in mean facial shape were observed (p < 0.0001 for all pairwise comparisons). Significant age-related changes in the magnitude of variance of facial shape were also observed (p < 0.05). Phenotypic growth trajectories representing developmental shape changes were similar in size (p > 0.05) between sexes but differed in direction (p < 0.05) in shape space and trajectory shape (p < 0.05). The magnitude of shape differences between sexes remained constant from 12 to 18 years. Results of frontal facial shape analyses after removing the effect of allometry were similar to results obtained before removal of allometry. For lateral facial configurations, allometric trajectories among the age-by-sex groups were similar in slope (p > 0.05) but varied in directions in the multidimensional shape space. CONCLUSIONS Our findings suggested significant age-related changes in facial shape and provided a dynamic view of developmental changes in sexual dimorphism of facial shape. Allometry contributed minimally to developmental changes in frontal facial shape. In addition, the allometric trajectories for lateral facial configurations were similar in rate of shape change but differed in their directions in shape space.
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Affiliation(s)
- Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- * E-mail:
| | - Colman P. McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Sardana D, Zhang J, Ekambaram M, Yang Y, McGrath CP, Yiu CK. Effectiveness of professional fluorides against enamel white spot lesions during fixed orthodontic treatment: A systematic review and meta-analysis. J Dent 2019; 82:1-10. [DOI: 10.1016/j.jdent.2018.12.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/28/2018] [Accepted: 12/16/2018] [Indexed: 11/29/2022] Open
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Park JS, Anthonappa RP, King NM, McGrath CP. The family impact of dental general anaesthesia in children: A meta-analysis. Int J Paediatr Dent 2018; 29:149-161. [PMID: 30468690 DOI: 10.1111/ipd.12452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/10/2018] [Accepted: 11/05/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND The health and well-being of children are intimately linked to their parents' physical, emotional, and social health and social circumstances. AIM To conduct a meta-analysis of studies that have used the Early Childhood Oral Health Impact Scale (ECOHIS) and Child Oral Health-Related Quality of Life (COHRQoL) instruments, to evaluate the family impact scale (FIS) changes following their children's dental treatment under general anaesthesia (DGA). METHODOLOGY A systematic search was undertaken using the PRISMA guidelines. The inclusion criteria consisted of patients below 16 years of age, DGA, pre- and post-operative assessments, and the use of ECOHIS and COHRQoL. FIS changes were the primary outcome measure, where the mean difference (MD) was calculated. RESULTS After initial search of 105 studies in the database, twenty-one articles were included in the analysis. A positive outcome in the FIS changes was identified in all studies. The combined MD for FIS using ECOHIS and COHRQoL was 1.52 [95% CI: 1.15-1.89; P < 0.00001; I2 =87%] and 1.10 [95% CI: 0.68-1.52; P < 0.00001; I2 =79%], respectively. CONCLUSIONS Dental treatment with general anaesthesia for children had a significant positive impact on parental emotions, activity, and conflict. Following DGA, there was significant improvement in the FIS, with large MD.
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Affiliation(s)
- Joon Soo Park
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Robert P Anthonappa
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Nigel M King
- Paediatric Oral Health Research Group, School of Dentistry, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Colman P McGrath
- Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
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Li LW, Wong HM, McGrath CP. Longitudinal association between obesity and periodontal diseases among secondary school students in Hong Kong: a prospective cohort study. BMC Oral Health 2018; 18:189. [PMID: 30458748 PMCID: PMC6247631 DOI: 10.1186/s12903-018-0659-3] [Citation(s) in RCA: 5] [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: 09/04/2018] [Accepted: 11/08/2018] [Indexed: 01/21/2023] Open
Abstract
Background There is no consensus opinion regarding the association between obesity and periodontal diseases among children and adolescents in the literature. Methods A prospective observational cohort study was conducted in a Hong Kong cohort at age 12, 15 and 18. CPI and various obesity indices including BMI, WC, WHR, WHtR, and TRSKF were recorded during each wave of data collection. Information on socioeconomic status and oral health behaviors were collected through self-completed questionnaires. Results Two hundred and eighty-two (male: 122 and female: 160) participants completed all three rounds of data collection. Prevalence of overweight/obesity was 27.0, 19.1, and 14.2% at 12, 15, and 18 years, respectively. 19.9% participants had healthy periodontal conditions at age 12. While the percentage dropped to 10.3% at 15 years and 5.7% at 18 years. The proportion of 15-year-old adolescents who brushed teeth more than twice a day was significantly higher among participants belonging to the lower BMI, WC, WHR, and WHtR category (P < 0.05). The fully adjusted model revealed that participants with lower BMI at age 15 had higher probability of having more than 50% index teeth free from periodontal diseases at age 18 (OR: 2.78; 95% CI: 1.16, 6.64; P = 0.022). Conclusions Although higher BMI at 15 years was associated with more extensive periodontal inflammation at age 18, this was believed to be an indirect association confounded by the poor oral health care among overweight/obese individuals. Oral health promotions should be directed to improve periodontal conditions of overweight/obese secondary school students.
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Affiliation(s)
- Ling-Wei Li
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China
| | - Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
| | - Colman P McGrath
- Periodontology & Public health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China
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Sun L, Wong HM, McGrath CP. Relationship Between the Severity of Malocclusion and Oral Health Related Quality of Life: A Systematic Review and Meta-analysis. Oral Health Prev Dent 2018; 15:503-517. [PMID: 28944350 DOI: 10.3290/j.ohpd.a38994] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the impact of untreated malocclusion on different aspects of oral health-related quality of life (OHRQoL). MATERIALS AND METHODS All relevant literature published up to February 18, 2016 was collected from nine electronic databases. To make studies comparable, studies that used the dental aesthetic index (DAI), index of orthodontic treatment need (IOTN), or index of complexity, outcome and need (ICON) to measure malocclusion and oral health impact profile (OHIP) to measure OHRQoL were selected for systematic review. Meta-analysis, two independent-samples t-test and binary logistic regression were used to test whether different malocclusion severity groups had different OHIP scores. RESULTS A total of 564 non-duplicate publications were identified first. Of these, 13 studies were included in this review. All studies had a cross-sectional design and most of them used convenience samples. Eleven studies presented a significant result about the association of malocclusion and OHIP scores. Statistical analyses showed that malocclusion had an impact on all subscales scores, and more severe malocclusion indicated higher OHIP scores on the subscales of physical disability, physical pain, psychological discomfort, psychological disability, and social disability. CONCLUSION Untreated malocclusion was significantly associated with OHRQoL. The more severe the malocclusion, the worse was the impact on some physical domains and all psychosocial domains of OHRQoL. There was a lack of longitudinal population-based studies to confirm this result.
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Du RY, Yiu CKY, Wong VCN, McGrath CP. Erratum to: Autism Developmental Profiles and Cooperation with Oral Health Screening. J Autism Dev Disord 2016; 46:1131. [DOI: 10.1007/s10803-015-2604-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Li LW, Wong HM, Sun L, Wen YF, McGrath CP. Anthropometric measurements and periodontal diseases in children and adolescents: a systematic review and meta-analysis. Adv Nutr 2015; 6:828-41. [PMID: 26567204 PMCID: PMC4642430 DOI: 10.3945/an.115.010017] [Citation(s) in RCA: 26] [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: 11/14/2022] Open
Abstract
The aim of this systematic review was to identify and summarize evidence of the association between anthropometric measurements and periodontal status in children and adolescents. We searched PubMed, Institute for Scientific Information Web of Knowledge, Cochrane Library, and 7 additional databases, following the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, up to December 2014. Observational studies reporting data on the association between anthropometric measurements and periodontal diseases in 2-18-y-old participants were included. An initial search identified 4191 papers; 278 potentially effective studies (k = 0.82) and 16 effective studies (k = 0.83) were included after screening. The mean quality of evidence among the studies was 20.3, according to the Strengthening the Reporting of Observational studies in Epidemiology checklist (k = 0.79). Meta-analyses showed that obesity (measured by body mass index) was significantly associated with visible plaque index (OR: 4.75; 95% CI: 2.42, 9.34), bleeding on probing (OR: 5.41; 95% CI: 2.75, 10.63), subgingival calculus (OR: 3.07; 95% CI: 1.10, 8.62), probing depth (OR: 14.15; 95% CI: 5.10, 39.25) and flow rate of salivary secretion (standardized mean difference: -0.89; 95% CI: -1.18, -0.61). However, various results were reported in the effective studies that were not included in meta-analyses. In conclusion, obesity is associated with some signs of periodontal disease in children and adolescents. Further studies with a comprehensive prospective cohort design and more potential variables are recommended.
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Affiliation(s)
| | | | - Ling Sun
- Paediatric Dentistry and Orthodontics and
| | | | - Colman P McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Abstract
Background Even though oral cavity cancer (OCC; ICD 10 codes C01, C02, C03, C04, C05, and C06) ranks eleventh among the world’s most common cancers, accounting for approximately 2 % of all cancers, a trend analysis of OCC in Hong Kong is lacking. Hong Kong has experienced rapid economic growth with socio-cultural and environmental change after the Second World War. This together with the collected data in the cancer registry provides interesting ground for an epidemiological study on the influence of socio-cultural and environmental factors on OCC etiology. Methods A multidirectional statistical analysis of the OCC trends over the past 25 years was performed using the databases of the Hong Kong Cancer Registry. The age, period, and cohort (APC) modeling was applied to determine age, period, and cohort effects on OCC development. Joinpoint regression analysis was used to find secular trend changes of both age-standardized and age-specific incidence rates. Results The APC model detected that OCC development in men was mainly dominated by the age effect, whereas in women an increasing linear period effect together with an age effect became evident. The joinpoint regression analysis showed a general downward trend of age-standardized incidence rates of OCC for men during the entire investigated period, whereas women demonstrated a significant upward trend from 2001 onwards. Conclusions The results suggest that OCC incidence in Hong Kong appears to be associated with cumulative risk behaviors of the population, despite considerable socio-cultural and environmental changes after the Second World War.
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Affiliation(s)
- Keisuke Ushida
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, PR-China.
| | - Colman P McGrath
- Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, PR-China.
| | - Edward C M Lo
- Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, PR-China.
| | - Roger A Zwahlen
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, PR-China.
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Abstract
This paper reviews six key communication models and frameworks in healthcare contexts. Comparison suggests key inter-relationships between the different stages of the clinical consultations. Implications are identified for future study in healthcare provider-patient communication. Clinical Relevance: To understand the healthcare provider-patient interaction through communication models.
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Abstract
There is growing interest in the association between anthropometric measurements and dental caries in childhood over time (life-course studies). The aim of this review was to identify and systematically review the evidence of the association between anthropometric measurements and dental caries in childhood over time. PubMed, Institute for Scientific Information (ISI) Web of Knowledge, the Cochrane Library, and 6 other databases were searched to identify effective articles. A systematic approach involving critical appraisal was conducted to examine the relation between anthropometric measurements and dental caries in preschool- and school-aged populations from longitudinal studies. An initial search identified 1338 studies, with 59 potentially effective studies (κ = 0.82) and 17 effective studies (κ = 0.88). The quality of reporting among the studies ranged from 19.5 to 30.0 according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) criteria. Among the effective studies, 2 studies in which caries was used to predict anthropometric measurements consistently found an inverse association and 15 studies in which anthropometric measurements were used to predict caries were inconsistent, with results appearing to be influenced by nonuniformity of assessments, setting, and procedure of measurements; age and ethnicity of participants; and confounders of dental caries. In conclusion, among >1000 studies identified, 17 informed this systematic review. The quality of reporting of these studies varied considerably. Evidence of the association between anthropometric measurements and dental caries is conflicting and remains inconclusive.
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Affiliation(s)
| | | | | | - Colman P McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Bridges SM, Parthasarathy DS, Au TKF, Wong HM, Yiu CKY, McGrath CP. Development of functional oral health literacy assessment instruments: application of literacy and cognitive theories. J Public Health Dent 2013; 74:110-9. [PMID: 24015770 DOI: 10.1111/jphd.12033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 05/09/2013] [Accepted: 07/16/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured. METHODS Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy. RESULTS The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed. CONCLUSIONS Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity.
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Affiliation(s)
- Susan M Bridges
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Du RY, McGrath CP, Yiu CK, King NM. Oral health behaviors of preschool children with cerebral palsy: a case-control community-based study. Spec Care Dentist 2012; 34:298-302. [DOI: 10.1111/j.1754-4505.2012.00295.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rennan Y. Du
- PhD student, Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Colman P. McGrath
- Clinical Professor in Dental Public Health, Periodontology and Public Health, Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Cynthia K.Y. Yiu
- Clinical Professor in Paediatric Dentistry, Paediatric Dentistry and Orthodontics, Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Nigel M. King
- Winthrop Professor in Paediatric Dentistry, School of Dentistry, Faculty of Medicine, Dentistry and Health Sciences; The University of Western Australia; Perth Australia
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To TNF, Rabie ABM, Wong RWK, McGrath CP. The adjunct effectiveness of diode laser gingivectomy in maintaining periodontal health during orthodontic treatment. Angle Orthod 2012; 83:43-7. [PMID: 22591260 DOI: 10.2319/012612-66.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of diode laser gingivectomy as an adjunct to nonsurgical periodontal treatment in the management of periodontal health among patients receiving fixed orthodontic appliance therapy (FOAT). MATERIALS AND METHODS Thirty patients undergoing FOAT with gingival enlargement were block randomized into two treatment groups. The test group received diode laser gingivectomy (940-nm diode laser, ezlase, Biolase Technology Inc) as an adjunct to nonsurgical periodontal treatment. The control group received nonsurgical periodontal treatment only. For both groups, five periodontal parameters were assessed at baseline, 1 month, 3 months, and 6 months: Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, and Gingival Overgrowth Index. Intra- and intergroup variations in the periodontal parameters were determined over time. RESULTS Both groups showed statistically significant improvements in periodontal health over the study period (P < .05). However, significant improvements in periodontal health were evident earlier among the test group subjects (P < .05). The magnitude of improvement in periodontal health compared to baseline was greater in the test group than in the control group for Gingival Overgrowth Index at 1 month (P < .001) and 3 months (P < .05), Gingival Index at 3 months (P < .05) and 6 months (P < .05), and probing pocket depth at 1 month (P < .05). CONCLUSIONS Nonsurgical periodontal management with or without the adjunct use of lasers can be effective in the management of gingival health problems among patients receiving FOAT. The adjunctive use of lasers can produce an earlier and greater improvement in gingival health.
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Affiliation(s)
- Tony N F To
- The University of Hong Kong, Hong Kong, China
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Bridges SM, Yiu CKY, McGrath CP. Multilingual interactions in clinical dental education: a focus on mediated interpreting. Commun Med 2011; 8:197-210. [PMID: 23264983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In clinical dental consultations in multilingual contexts, medical interpreting is often performed by the supporting staff as part of routine triadic formulations. As academic dentistry becomes increasingly internationalized, issues of language and culture add to the interactional complexity of clinical communication and education. A multivariate approach was adopted to investigate one case of multilingualism in dentistry in Asia. Collection of both survey (n = 86) and interactional data provided empirical evidence regarding language use and language demands across integrated Polyclinics. Descriptive statistics of Dental Surgery Assistant (DSA) perception data and conversation analysis (CA) of mediated interpretation indicate that, as members of the oral healthcare team, DSAs in Hong Kong are an essential resource in their role of intercultural mediators between patients and clinicians, both staff and students. Discussion of sociolinguistic notions of place-as-location and place-as-meaning supports a wider conceptualization of the role of support staff as interpreters in clinical settings. Implications are drawn for policy, curriculum and staff development.
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Affiliation(s)
- Susan M Bridges
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China.
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