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Huysmans MC, Fontana M, Lussi A, Jablonski-Momeni A, Banerjee A, Ricketts D, Schwendicke F, Mendes FM, Douglas G, Schmalz G, Campus G, Aps J, Horner K, Neuhaus KW, van der Veen MH, Opdam N, Doméjean S, Martignon S, Kühnisch J, Splieth C. ORCA-EFCD consensus report on clinical recommendations for caries diagnosis. Paper III: caries diagnosis at the individual level. Caries Res 2024:000539427. [PMID: 38776884 DOI: 10.1159/000539427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of the present consensus paper was to provide recommendations for clinical practice on the individual etiological and modifying factors to be assessed in the individual diagnosis of caries, and the methods for their assessment, supporting personalized treatment decisions. The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups which were asked to provide recommendations on 1) caries detection and diagnostic methods, 2) caries activity assessment and 3) forming individualised caries diagnoses. The experts responsible for "individualised caries diagnosis" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous eDelphi survey. The threshold for approval of recommendations was determined at 70% agreement. Ten recommendations were approved and agreed by the whole expert panel, covering medical history, caries experience, plaque, diet, fluoride and saliva. While the level of evidence was low, the level of agreement was typically very high, except for one recommendation on salivary flow measurement, where 70% agreed. It is recommended that all aspects of caries lesion progression and activity, recent caries experience, medical conditions and medications, plaque, diet, fluoride and saliva should be synthesized to arrive at an individual diagnosis. The expert panel merged evidence from existing guidelines and scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
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Abdin M, Ahmed E, Hamad R, Splieth C, Schmoeckel J. Success rates and failures of fixed and removable space maintainers after the premature loss of primary molars. Quintessence Int 2024; 55:304-312. [PMID: 38362703 DOI: 10.3290/j.qi.b4984249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The evidence base for the use of space maintainers is relatively sparce despite being used for decades after the premature loss of primary molars. This study aims to increase the dental evidence base via investigating retrospectively the success rates of prefabricated fixed and removable space maintainers inserted from 2019 to 2021 and followed up until February 2023 at a specialized university clinic and to identify reasons for any reported minor and major failure. The authors hypothesized that there is no significant difference in failure rates between fixed and removable space maintainers inserted after the premature loss of a single primary molar per quadrant. METHOD AND MATERIALS Patients' digital records were searched yielding 645 space maintainers. After the application of inclusion criteria, 157 (67%) fixed prefabricated space maintainers in 112 children and 77 (33%) removable space maintainers in 61 children were analyzed for an average of 18.4 ± 9.5 months. RESULTS Kaplan-Meier survival analysis with Mantel-Cox statistics showed an overall cumulative survival time of 31.6 months (SE = 1.15, 95% CI = 29.4 to 33.9). Major failure occurred significantly more in removable maintainers (n = 40/67, 59.7%), mostly due to loss of the appliance, compared to fixed space maintainers (n = 27/67, 40.3%; P < .001). The present study indicates that space maintainers were mainly placed in young children with high caries experience, where treatment was mostly possible using advanced behavior management. CONCLUSIONS Fixed space maintainers had a significantly lower failure rate than their removable counterpart. However, both require continual repairs, preservation, or even replacement till the eruption of the permanent tooth.
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Fisher J, Splieth C, Matanhire-Zihanzu C, Glick M. Advancing the concept of global oral health to strengthen actions for planetary health and One Health. Int J Equity Health 2024; 23:71. [PMID: 38622718 PMCID: PMC11017574 DOI: 10.1186/s12939-024-02176-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
Advancing the concept of global oral health can help tackle the triple planetary crises of climate change, nature and biodiversity loss, and pollution and waste. A model for oral and planetary health places more explicit focus on understanding the state of the Earth's systems, changing environment in relation to planetary health boundaries and their impact on human well-being. This can facilitate a planet-centric critical thinking for equity in global oral health that contributes to UN 2030 Agenda for Sustainable Development.
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Affiliation(s)
- Julian Fisher
- Center for Integrative Global Oral Health, University of Pennsylvania, School of Dental Medicine, 240 S. 40th Street, 3rd Floor East, Philadelphia, USA.
| | - Christian Splieth
- Präventive Zahnmedizin und Kinderzahnheilkunde, University of Greifswald, Fleischmannstr. 42, Greifswald, 17487, Germany
| | - Cleopatra Matanhire-Zihanzu
- Department of Oral Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, MP167 Mt Pleasant, Harare, Zimbabwe
| | - Michael Glick
- Center for Integrative Global Oral Health, University of Pennsylvania, School of Dental Medicine, 240 S. 40th Street, 3rd Floor East, Philadelphia, USA
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Kühnisch J, Aps JK, Splieth C, Lussi A, Jablonski-Momeni A, Mendes FM, Schmalz G, Fontana M, Banerjee A, Ricketts D, Schwendicke F, Douglas G, Campus G, van der Veen M, Opdam N, Doméjean S, Martignon S, Neuhaus KW, Horner K, Huysmans MCD. ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment. Clin Oral Investig 2024; 28:227. [PMID: 38514502 PMCID: PMC10957694 DOI: 10.1007/s00784-024-05597-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. MATERIALS AND METHODS The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey. RESULTS Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel. CONCLUSION Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations. CLINICAL RELEVANCE The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
| | | | - Christian Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Adrian Lussi
- University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - David Ricketts
- Unit of Restorative Dentistry, University of Dundee, Dundee, UK
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany
| | - Gail Douglas
- Department of Dental Public Health, University of Leeds Dental School, Leeds, UK
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Monique van der Veen
- Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
- Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Klaus W Neuhaus
- Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Shedeed O, Al Masri A, Splieth C, Pink C, Santamaria R. Are pediatric preformed zirconia crowns comparable to preformed metal crowns? A real-life retrospective study. Quintessence Int 2023; 54:630-639. [PMID: 37313578 DOI: 10.3290/j.qi.b4157323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Although minimally and noninvasive caries management are advocated in pediatric dentistry, extensive caries progression often requires endodontic treatment followed by crowning of the tooth. Thus, the aim of this study was to evaluate the success of esthetic preformed zirconia crowns (PZCs) compared to the standard preformed metal crowns (PMCs) after pulpotomy in primary molars retrospectively. METHOD AND MATERIALS Patients' digital records in a specialized pediatric clinic in Germany were analyzed to include 2- to 9-year-olds, who had received one or more PMCs or PZCs after a pulpotomy between 2016 and 2020. The main outcomes were success, minor failure (restoration loss, wear, or fracture), or major failure (need for extraction or pulpectomy). RESULTS In total, 151 patients with 249 teeth (PMC, n = 149; PZC, n = 100) were included. The mean follow-up time was (19.9 months), with 90.4% of the crowns followed for at least 18 months. The majority of the crowns were considered successful (94.4%). The differences in the success rates between PMCs (96%) and PZCs (92%) did not reach the level of statistical significance (P = .182). All minor failures (1.6%) were in the PZC group and located in the maxilla. Independent of crown type, especially first primary molars were prone to failure (7.9%; second primary molars, 3.3%). CONCLUSION PMCs and PZCs both show high clinical success rates as restorations of primary teeth after a pulpotomy. However, there was a tendency of greater minor or major failure in the PZC group.
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Faheem M, Moheb D, Bahgat S, Splieth C, Bekes K. Changes in Oral-Health-Related Quality of Life of Egyptian Children Treated under Dental General Anesthesia: A Prospective Study. J Clin Med 2023; 12:5792. [PMID: 37762733 PMCID: PMC10532267 DOI: 10.3390/jcm12185792] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Treatment of young children under dental general anesthesia (DGA) is sometimes necessary due to lack of cooperation and the complexity of dental treatment. The aim of this study was to assess the changes in oral-health-related quality of life (OHRQoL) in children following treatment under DGA. METHODS A consecutive sample of 88 children aged 5 and younger who were referred to the department of pediatric dentistry, Cairo university, Egypt, for treatment under DGA was included. Parents were asked to complete the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) questionnaire before and 4 weeks after treatment. The Wilcoxon signed-rank test was used to compare baseline and follow up scores. Effect sizes (ES) were also calculated. RESULTS The overall ECOHIS scores decreased significantly from 16.72 (±7.07) to 0.9 (±3.08); (p < 0.001, Wilcoxon signed-rank test) after treatment under DGA, demonstrating a large effect size of 2.2. The scores of the two subscales of the ECOHIS, the child impact scale (CIS) and the family impact scale (FIS), also decreased significantly (p < 0.001). CONCLUSIONS Treatment under DGA not only improved the OHRQoL of the Egyptian children in our sample significantly, but also had a positive effect on their families' quality of life.
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Affiliation(s)
- Mahmoud Faheem
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17489 Greifswald, Germany; (M.F.); (C.S.)
| | - Dalia Moheb
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt; (D.M.)
- School of Dentistry, Newgiza University, Giza 12577, Egypt
| | - Sherif Bahgat
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo 12613, Egypt; (D.M.)
| | - Christian Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17489 Greifswald, Germany; (M.F.); (C.S.)
| | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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Kramer A, Splieth C. Health promotion through structured oral hygiene and good tooth alignment. GMS Hyg Infect Control 2022; 17:Doc08. [PMID: 35707231 PMCID: PMC9174873 DOI: 10.3205/dgkh000411] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aim Periodontal diseases and caries are two of the most common forms of chronic degenerative diseases, with consequences not only for the oral cavity manifesting as tooth loss, orofacial pain and xerostomia, but also with effects on the cardiovascular system and, in the elderly, on the pneumonia rate. This can be prevented or controlled by structured oral hygiene. Method Based on a systematic literature search in PubMed, the possibilities for ensuring structured oral hygiene are analyzed. Results and conclusion Limiting the consumption of sugary meals and beverages, regular removal of food debris - supplemented by sugar-free chewing gum if desired - and preventing plaque formation by brushing with fluoridated toothpastes, using dental floss and interdental brushes after meals, serve to prevent or control gingivitis, periodontitis and caries. In the long term, the development of periodontitis-associated cardiovascular diseases and, in the elderly, the risk of pneumonia can probably be reduced. Antiseptic rinsing of the oral cavity is an important supplement to prevent periodontitis, especially in cases of limited ability to perform mechanical biofilm removal, but also for the prevention of respiratory infections. Proper functional tooth alignment is important for optimal mechanical cleaning to prevent plaque accumulation. If correction of misaligned teeth is possible with the use of removable aligners instead of fixed orthodontic appliances, these are to be preferred because of the better accessibility for mechanical hygiene measures.
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Affiliation(s)
- Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald,Germany,*To whom correspondence should be addressed: Axel Kramer, Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 49 a, 17489 Greifswald, Deutschland, Phone: +49 3834 515542, E-mail:
| | - Christian Splieth
- Preventive & Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Alkilzy M, Schmoeckel J, Schwahn C, Basner R, Al-Ani A, Takriti M, Splieth C. Multicenter RCT on Intensive Caries Prevention for Children Undergoing Dental General Anaesthesia: Intensive caries prevention for children undergoing dental general anaesthesia. J Dent 2022; 118:104057. [PMID: 35121137 DOI: 10.1016/j.jdent.2022.104057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Early childhood caries is a persistent problem often leading to dental treatment under general anaesthesia (GA). Thus, this study investigated the effect of two additional individual caries prevention appointments before and after GA. MATERIALS AND METHODS In this multi-center, 2-arm randomized, controlled clinical trial, 408 children (age 2-5 years, mean 4.2±1.04) intended for GA were recruited and randomly assigned to the intervention and control groups with or without two additional intensive oral hygiene appointments before and after the GA. At baseline and at 6-/12-months follow-ups, approximal plaque index (API), gingival sulcus bleeding index (SBI), caries experience (dmft/s) and initial caries were recorded. RESULTS Participants in test group and control group (ITT; n=161 vs. n=147) as well as drop-outs in test and control groups (n=40 vs. n=58) showed no statistical significant difference in baseline characteristics. Test and control groups showed equivalent baseline oral health parameters (API: 78 and 77%, SBI: 22.6 and 23.5%, dmft: 8.5 and 8.2, respectively), which continuously improved during the study. The test group exhibited statistically significant greater improvement (API: 42%, SBI: 7%) than the control (API: 54%, OR: 0.48; P=0.003; SBI: 12%, OR=0.44; P=0.005). Due to the robust rehabilitation with predominantly stainless steel crowns and extractions, caries incidence was minimal and, therefore, without statistical significance (mean increase dt, test: 0.5, control: 0.6; P=0.68), which was also true for new initial carious lesions (mean increase test: 0.8 vs. control: 0.9; P=0.55). CONCLUSIONS Additional preventive sessions for children undergoing treatment under GA improved their oral hygiene parameters signifiqantly. CLINICAL SIGNIFICANCE Intensive caries prevention appointments for children receiving dental treatment under GA improved their oral hygiene and might reduce their caries risk.
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Affiliation(s)
- Mohammad Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany.
| | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthetics, University of Greifswald, Greifswald, Germany
| | - Roger Basner
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Ali Al-Ani
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Moutaz Takriti
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Christian Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
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Elhennawy K, Anang M, Splieth C, Bekes K, Manton DJ, Hedar Z, Krois J, Jost-Brinkmann PG, Schwendicke F. Knowledge, attitudes, and beliefs regarding molar incisor hypomineralization (MIH) amongst German dental students. Int J Paediatr Dent 2021; 31:486-495. [PMID: 32813919 DOI: 10.1111/ipd.12715] [Citation(s) in RCA: 9] [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: 04/30/2020] [Revised: 06/30/2020] [Accepted: 07/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists. AIM To assess final-year German dental students' knowledge, attitudes, and beliefs regarding MIH. MATERIALS AND METHODS A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected. RESULTS Twenty-two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH; however, only 42% knew how to implement them. One-third were able to identify MIH and 16% reported diagnostic confidence when doing so; 90% assumed the MIH prevalence to be <10%. Two-thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training. CONCLUSION German students were familiar with MIH; however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up-to-date curricula should be implemented to educate future dentists in Germany.
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Affiliation(s)
- Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, corporate memberof Freie Universität Berlin, Humboldt-Universität, and BerlinInstitute of Health, Aßmannshauser Str. 4-6, Berlin, 14197, Germany
| | - Mostafa Anang
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Christian Splieth
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Katrin Bekes
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - David John Manton
- Paediatric Dentistry and Cariology, Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, A. Deusinglaan 1, Groningen, 9700 AD, The Netherlands
| | - Zen Hedar
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, corporate memberof Freie Universität Berlin, Humboldt-Universität, and BerlinInstitute of Health, Aßmannshauser Str. 4-6, Berlin, 14197, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, corporate memberof Freie Universität Berlin, Humboldt-Universität, and BerlinInstitute of Health, Aßmannshauser Str. 4-6, Berlin, 14197, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, corporate memberof Freie Universität Berlin, Humboldt-Universität, and BerlinInstitute of Health, Aßmannshauser Str. 4-6, Berlin, 14197, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, corporate memberof Freie Universität Berlin, Humboldt-Universität, and BerlinInstitute of Health, Aßmannshauser Str. 4-6, Berlin, 14197, Germany
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Berg B, Cremer M, Flothkötter M, Koletzko B, Krämer N, Krawinkel M, Lawrenz B, Przyrembel H, Schiffner U, Splieth C, Vetter K, Weißenborn A. Kariesprävention im Säuglings- und frühen Kindesalter. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01167-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Youssef BR, Söhnel A, Welk A, Abudrya MH, Baider M, Alkilzy M, Splieth C. RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment. Clin Oral Investig 2021; 25:4825-4832. [PMID: 33527192 PMCID: PMC8342397 DOI: 10.1007/s00784-021-03787-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351 Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-03787-x.
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Affiliation(s)
- Bahaa R Youssef
- Departments of Preventive Dentistry and Pediatric Dentistry, University Medicine of Greifswald, Fleischmannstr. 42, 17487, Greifswald, Germany
| | - Andreas Söhnel
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine of Greifswald, Greifswald, Germany
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology and Endodotontology, University Medicine of Greifswald, Greifswald, Germany
| | - Mohamed H Abudrya
- Departments of Preventive Dentistry and Pediatric Dentistry, University Medicine of Greifswald, Fleischmannstr. 42, 17487, Greifswald, Germany
| | - Mohamed Baider
- Departments of Preventive Dentistry and Pediatric Dentistry, University Medicine of Greifswald, Fleischmannstr. 42, 17487, Greifswald, Germany
| | - Mohammad Alkilzy
- Departments of Preventive Dentistry and Pediatric Dentistry, University Medicine of Greifswald, Fleischmannstr. 42, 17487, Greifswald, Germany
| | - Christian Splieth
- Departments of Preventive Dentistry and Pediatric Dentistry, University Medicine of Greifswald, Fleischmannstr. 42, 17487, Greifswald, Germany.
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Martignon S, Bartlett D, Manton DJ, Martinez-Mier EA, Splieth C, Avila V. Epidemiology of Erosive Tooth Wear, Dental Fluorosis and Molar Incisor Hypomineralization in the American Continent. Caries Res 2021; 55:1-11. [PMID: 33440378 DOI: 10.1159/000512483] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/18/2020] [Indexed: 11/19/2022] Open
Abstract
Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.
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Affiliation(s)
- Stefania Martignon
- UNICA - Caries Unit Research, Research Department, Universidad El Bosque, Bogotá, Colombia,
| | - David Bartlett
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - David J Manton
- Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands.,Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - E Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Christian Splieth
- Section of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Viviana Avila
- UNICA - Caries Unit Research, Research Department, Universidad El Bosque, Bogotá, Colombia
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Bernhardt O, Krey KF, Daboul A, Völzke H, Splieth C, Kocher T, Schwahn C. Association between coronal caries and malocclusion in an adult population. J Orofac Orthop 2020; 82:295-312. [PMID: 33337523 PMCID: PMC8384790 DOI: 10.1007/s00056-020-00271-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/10/2020] [Accepted: 10/22/2020] [Indexed: 01/18/2023]
Abstract
Purpose Only a few but conflicting results have been reported on the association between malocclusions and caries. We investigated this association using data from the population-based cross-sectional Study of Health in Pomerania (SHIP). Methods Sagittal, vertical and transversal intermaxillary relationship, space conditions and sociodemographic parameters of 1210 dentate subjects (median age 30 years, interquartile range 25–35 years) were collected. Caries was assessed with the Decayed-Missing-Filled Surfaces index but analyzed as ordered outcome (four levels: sound, enamel caries, caries, tooth loss) in ordinal multilevel models, taking into account subject, jaw, and tooth level simultaneously. Results Anterior open bite ≤3 mm (odds ratio [OR] = 2.08, 95% confidence interval [CI]: 1.19–3.61), increased sagittal overjet of 4–6 mm (OR = 1.31, CI: 1.05–1.64), distal occlusion of ½ premolar width (OR = 1.27, CI: 1.05–1.53) and distal 1 premolar width (OR = 1.31, CI: 1.06–1.63) were associated with adjusted increased odds for a higher outcome level (caries). Anterior spacing (OR = 0.24, CI: 0.17–0.33), posterior spacing, (OR = 0.69, CI: 0.5–0.95), posterior crowding (OR = 0.57, CI: 0.49–0.66) and buccal nonocclusion (OR = 0.54, CI: 0.33–0.87) were associated with a lower outcome level (caries). Conclusion The results from this population-based study suggest that a connection between caries and malocclusion exists to a limited extent in young adults. The associations with caries are contradictory for several malocclusion variables. Distal occlusion (OR = 1.31, CI: 1.06–1.63) and related skeletal anomalies displayed positive associations with caries whereas crowding did not. Orthodontic treatment of anterior crowding would probably not interfere with caries experience. These aspects should be considered for patient information and in treatment decisions.
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Affiliation(s)
- Olaf Bernhardt
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany.
| | - Karl-Friedrich Krey
- Department of Orthodontics, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Amro Daboul
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany
| | - Christian Splieth
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Walther-Rathenau-Str. 42a, 17475, Greifswald, Germany
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Ahmad SH, Petrou MA, Alhumrani A, Hashim R, Splieth C. Prevalence of Molar-Incisor Hypomineralisation in an Emerging Community, and a Possible Correlation with Caries, Fluorosis and Socioeconomic Status. Oral Health Prev Dent 2019; 17:323-327. [PMID: 31225537 DOI: 10.3290/j.ohpd.a42725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To determine the prevalence of molar-incisor hypomineralisation (MIH) in 7- to 9-year-old (±1 year) schoolchildren living in Dubai, United Arab Emirates, and to find a possible association with caries, fluorosis and socioeconomic status. MATERIALS AND METHODS In this cross-sectional study, a representative sample of 779 children with an age of 7 to 9 years ±1 year in primary schools in Dubai were randomly selected and examined by one investigator who had previously been trained and calibrated with the diagnostic criteria of European Academy of Paediatric Dentistry (EAPD) for MIH, caries diagnostic criteria of the World Health Organization (WHO) and Dean's criteria for fluorosis. RESULTS The prevalence of MIH in Dubai was 7.57% and was almost identical for both genders (female 7.57% and male 7.58%). The caries index was high (2.41±1.7). Children with MIH in Dubai exhibited statistically significantly higher DMFT values than did children without MIH (mean 3.5 ± 1.7 vs 2.3 ± 1.7; p < 0.001). The prevalence of fluorosis was 10.9% with no statistically significant age or gender differences. CONCLUSION The prevalence of MIH in Dubai is low. However, the caries and fluorosis values are much higher, which calls for strengthening caries-preventive efforts.
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Schwendicke F, Splieth C, Breschi L, Banerjee A, Fontana M, Paris S, Burrow MF, Crombie F, Page LF, Gatón-Hernández P, Giacaman R, Gugnani N, Hickel R, Jordan RA, Leal S, Lo E, Tassery H, Thomson WM, Manton DJ. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 2019; 23:3691-3703. [PMID: 31444695 DOI: 10.1007/s00784-019-03058-w] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [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: 12/05/2018] [Accepted: 08/08/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. METHODS Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. RESULTS Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. CONCLUSIONS Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. CLINICAL RELEVANCE Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Christian Splieth
- Preventive & Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna-Alma Mater Studiorum, Bologna, Italy
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's Health Partners, King's College London, London, UK
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Michael F Burrow
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Felicity Crombie
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Lyndie Foster Page
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Patricia Gatón-Hernández
- Department of Dentistry, University of Barcelona, Barcelona, Spain
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca, Chile
| | - Neeraj Gugnani
- Department of Pediatric and Preventive Dentistry, DAV (C) Dental College, Yamunanagar, Haryana, India
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | | | - Soraya Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Edward Lo
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Hervé Tassery
- Faculty of Dentistry, AMU University, Marseille, France
| | - William Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - David J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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Alkilzy M, Midani R, Höfer M, Splieth C. Improving Toothbrushing with a Smartphone App: Results of a Randomized Controlled Trial. Caries Res 2019; 53:628-635. [DOI: 10.1159/000499868] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/22/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives: Performing proper toothbrushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of a smartphone app for improving manual toothbrushing via a gravitation sensor. Methods: In this prospective, controlled, single-blinded, randomized clinical trial, 49 children (mean age 5.1 ± 0.6 years, 27 female) were randomly assigned to test (n = 26) and control (n = 23) groups. All children were provided with manual toothbrushes with an integrated gravitation sensor and they received oral health instructions. Only the children of the test group got an additional smartphone app to visualize and reward proper brushing in form and time. At baseline and recalls after 6 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded for analysis between the two groups. Results: At baseline, there were no significant differences between the test and control group regarding plaque and gingival indices (QHI: 2.36 ± 0.7 and 2.42 ± 0.8; p = 0.94; PBI: 0.42 ± 0.2 and 0.47 ± 0.3; p = 0.59). At the 6- and 12-week recalls, the test group showed statistically significantly better oral health indices than the controls (6-week recall, QHI: 0.8 ±0.5 and 1.88 ± 0.9; p < 0.001; PBI: 0.08 ± 0.1 and 0.26 ± 0.2; p < 0.001; 12-week recall, QHI: 0.44 ± 0.5 and 1.49 ± 0.7; p < 0.001; PBI: 0.05 ± 0.18 and 0.21 ± 0.1; p < 0.001). Conclusion: The results highlight the enormous possibilities of a toothbrushing application via the smartphone, at least for medium-term oral hygiene improvement in preschool children and even after excluding the app. The long-term effect should also be investigated to exclude the expected novelty effect.
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Abstract
Clinical and patient-reported outcomes were reported for carious primary molars treated with the Hall technique (HT) as compared with conventional carious tissue removal and restorations (i.e., conventional restoration [CR]) in a 5-y randomized controlled practice-based trial in Scotland. We interrogated this data set further to investigate the cost-effectiveness of HT versus CR. A total of 132 children who had 2 matched occlusal/occlusal-proximal carious lesions in primary molars ( n = 264 teeth) were randomly allocated to HT or CR, provided by 17 general dental practitioners. Molars were followed up for a mean 5 y. A societal perspective was taken for the economic analysis. Direct dental treatment costs were estimated from a Scottish NHS perspective (an NHS England perspective was taken for a sensitivity analysis). Initial, maintenance, and retreatment costs, including rerestorations, endodontic treatments, and extractions, were estimated with fee items. Indirect/opportunity costs were estimated with time and travel costs from a UK perspective. The primary outcome was tooth survival. Secondary outcomes included 1) not having pain or needing endodontic treatments/extractions and 2) not needing rerestorations. Cost-effectiveness and acceptability were estimated from bootstrapped samples. Significantly more molars in HT survived (99%, 95% CI: 98% to 100%) than in CR (92%; 87% to 97%). Also, the proportion of molars retained without pain or requiring endodontic treatment/extraction was significantly higher in HT than CR. In the base case analysis (NHS Scotland perspective), cumulative direct dental treatment costs (Great British pound [GBP]) of HT were 24 GBP (95% CI: 23 to 25); costs for CR were 29 (17 to 46). From an NHS England perspective, the cost advantage of HT (29 GBP; 95% CI: 25 to 34) over CR (107; 86 to 127) was more pronounced. Indirect/opportunity costs were significantly lower for HT (8 GBP; 95% CI: 7 to 9) than CR (19; 16 to 23). Total cumulative costs were significantly lower for HT (32 GBP; 95% CI: 31 to 34) than CR (49; 34 to 69). Based on a long-term practice-based trial, HT was more cost-effective than CR with HT retained for longer and experiencing less complications at lower costs.
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Affiliation(s)
- F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Krois
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Robertson
- 2 Child Dental Health, School of Dentistry, University of Dundee, Dundee, Scotland
| | - C Splieth
- 3 Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - R Santamaria
- 3 Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - N Innes
- 2 Child Dental Health, School of Dentistry, University of Dundee, Dundee, Scotland
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Qadri G, Alkilzy M, Franze M, Hoffmann W, Splieth C. School-based oral health education increases caries inequalities. Community Dent Health 2018; 35:153-159. [PMID: 30106523 DOI: 10.1922/cdh_4145qadri07] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the effect of one and half years of an oral health promotion program in primary schools. DESIGN A cluster-randomized controlled trial. PARTICIPANTS 740 students aged 9-12 years (48% female) recruited from the fifth grade of 18 different primary schools in West Pomerania, Germany. METHODS General and oral health education was provided to the teachers in the intervention schools, which they conveyed to their students. No additional measures were conducted in the control schools. Medical and dental school examinations, as well as questionnaires for the students and their parents were conducted at baseline and follow-up. Data were analysed using Poisson regression models. RESULTS A significant incident rate ratio between caries increment was found, with a 35% higher risk in the control group. However, parents' socioeconomic characteristics modified the effect of the program on their children, as high socio-economic status in the intervention group was associated with 94% reduction in the incidence risk ratio (p ⟨ 0.001). CONCLUSIONS The program was effective in improving dental health among students with higher socio-economic status. No preventive effect could be found in low socio-economic status groups.
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Affiliation(s)
- G Qadri
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Germany
| | - M Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Germany
| | - M Franze
- Department of Community Medicine, University of Greifswald, Germany
| | - W Hoffmann
- Department of Community Medicine, University of Greifswald, Germany
| | - C Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Germany
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Splieth C, Al-Ani A, Schmoeckel J, Alkilzy M, Takriti M. Einzelbeitrag: Nationale Mundgesundheitsuntersuchung bei Flüchtlingen in Deutschland 2016/2017. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C Splieth
- Universität Greifswald, Präventive Zahnmedizin & Kinderzahnheilkunde, Greifswald, Deutschland
| | - A Al-Ani
- Universität Greifswald, Präventive Zahnmedizin & Kinderzahnheilkunde, Greifswald, Deutschland
| | - J Schmoeckel
- Universität Greifswald, Präventive Zahnmedizin & Kinderzahnheilkunde, Greifswald, Deutschland
| | - M Alkilzy
- Universität Greifswald, Präventive Zahnmedizin & Kinderzahnheilkunde, Greifswald, Deutschland
| | - M Takriti
- Universität Greifswald, Präventive Zahnmedizin & Kinderzahnheilkunde, Greifswald, Deutschland
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Innes NPT, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Doméjean S, Fontana M, Leal S, Lo E, Machiulskiene V, Schulte A, Splieth C, Zandona A, Schwendicke F. Managing Carious Lesions: Consensus Recommendations on Terminology. Adv Dent Res 2017; 28:49-57. [PMID: 27099357 DOI: 10.1177/0022034516639276] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.
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Affiliation(s)
- N P T Innes
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - J E Frencken
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L Bjørndal
- Department of Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Maltz
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - D J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - D Ricketts
- Operative Dentistry, Fixed Prosthodontics and Endodontology, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - K Van Landuyt
- KULeuven BIOMAT, Department of Oral Health Sciences, University of Leuven and Dentistry University Hospitals Leuven, Leuven, Belgium
| | - A Banerjee
- Conservative and MI Dentistry, King's College London Dental Institute, London, UK
| | - G Campus
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy; WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - S Doméjean
- CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, Clermont-Ferrand, France; Univ Clermont1, UFR d'Odontologie, Clermont-Ferrand, France; Centre de Recherche en Odontologie Clinique EA 4847, Clermont-Ferrand, France
| | - M Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan; Ann Arbor, MI, USA
| | - S Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - E Lo
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - V Machiulskiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Schulte
- Department of Special Care Dentistry, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - C Splieth
- Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - A Zandona
- Department of Operative Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - F Schwendicke
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Schwendicke F, Frencken J, Bjørndal L, Maltz M, Manton D, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Doméjean S, Fontana M, Leal S, Lo E, Machiulskiene V, Schulte A, Splieth C, Zandona A, Innes N. Managing Carious Lesions. Adv Dent Res 2016; 28:58-67. [DOI: 10.1177/0022034516639271] [Citation(s) in RCA: 372] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.
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Affiliation(s)
- F. Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - J.E. Frencken
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L. Bjørndal
- Department of Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M. Maltz
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - D.J. Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - D. Ricketts
- Section of Operative Dentistry, Fixed Prosthodontics and Endodontology, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - K. Van Landuyt
- KULeuven BIOMAT, Department of Oral Health Sciences, University of Leuven and Dentistry University Hospitals Leuven, Leuven, Belgium
| | - A. Banerjee
- Conservative and MI Dentistry, King’s College London Dental Institute, London, UK
| | - G. Campus
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Italy; WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - S. Doméjean
- CHU Clermont-Ferrand, Service d’Odontologie, Hôtel-Dieu, Clermont-Ferrand, France; Univ Clermont1, UFR d’Odontologie, Clermont-Ferrand, France; Centre de Recherche en Odontologie Clinique EA 4847, F-63000 Clermont-Ferrand, France
| | - M. Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - S. Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - E. Lo
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - V. Machiulskiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A. Schulte
- Department of Special Care Dentistry, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - C. Splieth
- Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - A.F. Zandona
- Department of Operative Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - N.P.T. Innes
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
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Innes N, Santamaria R, Duggal M, Splieth C. Letter to the Editor. Pediatr Dent 2016; 38:278-279. [PMID: 27557915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
OBJECTIVES The aim of this study was to determine the relationship between iso-body mass index (iso-BMI) and both dental caries status and caries increment among German school children. METHODS Six hundred and ninety-four students (age range 9-12 years, mean 10.34 ± 0.56, 48% females) were recruited from the fifth grade of 18 primary schools. Weight, height, and oral health data number of decayed, missing and filled teeth (DMFT) as well as parent/legal guardian questionnaire (measuring SES) were collected during school dental examination at baseline and after one and a half-year follow-up. The body mass index (BMI) was calculated using the international classification system for childhood overweight and obesity (iso-BMI). Statistical analyses were performed using Poisson regression models. RESULTS Iso-BMI was significantly associated with dental caries prevalence and severity in the permanent dentition (P = 0.039). Low-normal weight children had a lower mean DMFT (0.56) than did overweight/obese children (0.70). In addition, a border-line significant association was found between overweight/obese children and caries increment (P = 0.055). CONCLUSION Although iso-BMI was associated with dental caries prevalence and severity, the association between caries increment and iso-BMI did not reach a statistical significance. Overweight/obese children however acquired more additional carious lesions during the follow-up period than children with low-normal weight.
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Affiliation(s)
- Ghalib Qadri
- Preventive and Pediatric Dentistry Department, University of Greifswald, Greifswald, Germany; Al-Hada Military Hospital, Taif, Saudi Arabia
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Abstract
OBJECTIVES The caries patterns of child populations in Germany have changed during the last 20 years. This affects the referrals and provision of specialist dental care for children. This study has two aims: first, to investigate referrals received by a specialized pediatric dental institution in 1995 and 2008, and second, to assess the treatments performed during full oral rehabilitations under general anesthesia in this institution from 2007 to 2008. METHODS All data of referred patients were evaluated for 1995 and 2008 separately. Comparisons were carried out for different socio-demographic, medical, and dental parameters. All patients treated under general anesthesia (GA) between March/2007 and December/2008 were examined retrospectively and their data were analyzed. RESULTS In 1995 (n = 191), significantly older children were referred to specialized pediatric dental care compared to 2008 (n = 179). In addition, a shift of surgical referrals to very young children with high caries levels was clearly noticed, resulting in considerably more oral rehabilitation performed under GA in 2008 (n = 73). Thus, the mean values of 6.4 fillings and 2.7 extractions per child were quite high. CONCLUSIONS Preventive treatment approaches for primary dentition in Germany need further improvement by focusing on high caries-risk groups, as specialized pediatric dentistry bears the great burden of providing oral rehabilitations under GA in young children.
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Affiliation(s)
- Mohammad Alkilzy
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany; Department of Paediatric Dentistry, University of Aleppo, Aleppo, Syria
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Wyne A, Hammad N, Splieth C. Oral health knowledge of health care workers in special children's center. Pak J Med Sci 2015; 31:164-8. [PMID: 25878636 PMCID: PMC4386179 DOI: 10.12669/pjms.311.6477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/25/2014] [Accepted: 11/27/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the oral health knowledge of health care workers in special children's center. METHODS A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. RESULTS All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to "wait till there is some pain in case of a dental cavity" before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of "gum disease". Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers' response in relation to their specific job. CONCLUSION The special health care workers in the disabled children's center generally had satisfactory oral health knowledge and practices.
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Affiliation(s)
- Amjad Wyne
- Amjad Wyne, MDS. Professor, Department of Pediatric Dentistry and Orthodontics, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Nouf Hammad
- Nouf Hammad, MSc. Associate Professor, Department of Pediatric Dentistry and Orthodontics, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Christian Splieth
- Christian Splieth, PhD. Professor, Preventive and Pediatric Dentistry, University of Greifswald, Rotgerberstr, Germany
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Splieth C. Kariöse Initialläsionen: Fluoridierung, Versiegelung oder Infiltration? Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1546865] [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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Splieth C, Franze M, Plachta-Danielzik S, Thyrian J, Schmidt C, John U, Kohlmann T, Müller M, Hoffmann W. GeKoKidS – Gesundheitskompetenz bei Kindern in der Schule. Gesundheitswesen 2014; 77 Suppl 1:S78-9. [DOI: 10.1055/s-0032-1331250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- C. Splieth
- Abteilung für Präventive Zahnmedizin und Kinderzahnheilkunde, Universitätsmedizin Greifswald
| | - M. Franze
- Abteilung Versorgungsepidemiologie und Community Health, Institut für Community Medicine, Universitätsmedizin Greifswald (ICM-VC)
| | - S. Plachta-Danielzik
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel
| | - J. Thyrian
- Abteilung Versorgungsepidemiologie und Community Health, Institut für Community Medicine, Universitätsmedizin Greifswald (ICM-VC)
| | - C. Schmidt
- Abteilung Methoden der Community Medicine, Institut für Community Medicine, Universitätsmedizin Greifswald
| | - U. John
- Institut für Epidemiologie und Sozialmedizin, Universitätsmedizin Greifswald
| | - T. Kohlmann
- Abteilung Methoden der Community Medicine, Institut für Community Medicine, Universitätsmedizin Greifswald
| | - M. Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel
| | - W. Hoffmann
- Abteilung Versorgungsepidemiologie und Community Health, Institut für Community Medicine, Universitätsmedizin Greifswald (ICM-VC)
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Altarabulsi MB, Alkilzy M, Petrou MA, Splieth C. Clinical safety, quality and effect of resin infiltration for proximal caries. Eur J Paediatr Dent 2014; 15:39-44. [PMID: 24745591] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Resin infiltration of proximal lesions is a new approach to stop caries progression. The aim of this clinical trial was to assess its safety and quality, as well as the therapeutic effect. MATERIALS AND METHODS In 47 children, adolescents and young adults, ten dentists applied the infiltration material ICON (DMG, Germany) on initial proximal lesions according to the manufacturer's instruction. One lesion with radiographic extension into enamel or the outer third of dentin per participant was allocated for the treatment. The clinical safety and quality of resin infiltration were assessed 1 week, 6 months and 12 months after the treatment and the evaluation of the therapeutic effect was analysed by pair-wise radiographs. RESULTS The clinical safety and quality of the infiltration were assessed in 45 individuals after 12 months. The test surfaces showed no relevant changes in clinical status, plaque accumulation or gingival status (p > 0.05). A high quality of infiltration was found for the marginal adaptation. In contrast to the improvement of colour at the one-week recall (p = 0.005), the infiltrated surfaces showed a statistically significant increase in the discoloration within the following year (p = 0.014). Out of the 43 lesions which could be assessed radiographically, only two lesions showed progression to a different score (4.7%). CONCLUSION Resin infiltration can be considered a safe and effective treatment to reduce progression of initial proximal caries.
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Affiliation(s)
- M B Altarabulsi
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - M Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - M A Petrou
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - C Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
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Meller C, Santamaria R, Connert T, Splieth C. Predicting Caries by Measuring Its Activity Using Quantitative Light-Induced Fluorescence in vivo: A 2-Year Caries Increment Analysis. Caries Res 2012; 46:361-7. [DOI: 10.1159/000338379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 03/13/2012] [Indexed: 11/19/2022] Open
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Schulte AG, Pitts NB, Huysmans MCDNJM, Splieth C, Buchalla W. European Core Curriculum in Cariology for undergraduate dental students. Eur J Dent Educ 2011; 15 Suppl 1:9-17. [PMID: 22023541 DOI: 10.1111/j.1600-0579.2011.00694.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
As dental caries prevalence is still high in many populations and groups of both children and adults worldwide, and as caries continues to be responsible for significant health, social and economic impacts, there is an urgent need for dental students to receive a systematic education in cariology based upon current best evidence. Although European curriculum guidelines for undergraduate students have been prepared in other dental fields over the last decade, none exist for cariology. Thus the European Organisation for Caries Research (ORCA) formed a task force to work with the Association of Dental Education in Europe (ADEE) on a European Core Curriculum in Cariology. In 2010, a workshop to develop such a curriculum was organised in Berlin, Germany, with 75 participants from 24 European and 3 North/South American countries. The Curriculum was debated by five pre-identified working groups: I The Knowledge Base; II Risk Assessment, Diagnosis and Synthesis; III Decision-Making and Preventive Non-surgical Therapy; IV Decision-making and Surgical Therapy; and V Evidence-based Cariology in Clinical and Public Health Practice and then finalised jointly by the group chairs. According to this Curriculum, on graduation, a dentist must be competent at applying knowledge and understanding of the biological, medical, basic and applied clinical sciences in order to recognise caries and make decisions about its prevention and management in individuals and populations. This document, which presents several major and numerous supporting competences, does not confine itself to dental caries alone, but refers also to dental erosion/non-erosive wear and other dental hard tissue disorders.
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Affiliation(s)
- A G Schulte
- Department of Conservative Dentistry, University of Heidelberg, Heidelberg, Germany. - heidelberg.de
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Schulte AG, Pitts NB, Huysmans MCDNJM, Splieth C, Buchalla W. European core curriculum in cariology for undergraduate dental students. Caries Res 2011; 45:336-45. [PMID: 21757903 DOI: 10.1159/000330006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2011] [Indexed: 11/19/2022] Open
Abstract
As dental caries prevalence is still high in many populations and groups of both children and adults worldwide, and as caries continues to be responsible for significant health, social and economic impacts, there is an urgent need for dental students to receive a systematic education in cariology based upon current best evidence. Although European curriculum guidelines for undergraduate students have been prepared in other dental fields over the last decade, none exist for cariology. Thus the European Organisation for Caries Research (ORCA) formed a task force to work with the Association of Dental Education in Europe (ADEE) on a European Core Curriculum in Cariology. In 2010, a workshop to develop such a curriculum was organised in Berlin, Germany, with 75 participants from 24 European and 3 North-South American countries. The Curriculum was debated by five pre-identified working groups: I The Knowledge Base; II Risk Assessment, Diagnosis and Synthesis; III Decision-making and Preventive Non-surgical Therapy; IV Decision-making and Surgical Therapy; and V Evidence-based Cariology in Clinical and Public Health Practice and then finalised jointly by the group chairs. According to this Curriculum, on graduation, a dentist must be competent at applying knowledge and understanding of the biological, medical, basic and applied clinical sciences in order to recognise caries and make decisions about its prevention and management in individuals and populations. This document, which presents several major and numerous supporting competences, does not confine itself to dental caries alone, but refers also to dental erosion/non-erosive wear and other dental hard tissue disorders.
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Affiliation(s)
- A G Schulte
- University of Heidelberg, Heidelberg, Germany.
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Splieth C, Alsoliman S, Franze M, Hoffmann W. Orales Gesundheitsbewusstsein, -verhalten, -wissen und Einstellung bei Schulkindern. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266209] [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: 10/19/2022]
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Fahland R, Schmidt C, Franze M, Splieth C, Thyrian J, Plachta-Danielzik S, Hoffmann W, Kohlmann T. Die Erfassung von gesundheitsbezogenem Verhalten, Wissen, Einstellung und Kommunikation bei Kindern in Mecklenburg-Vorpommern. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266544] [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: 10/19/2022]
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Hoffmann W, Fendrich K, Splieth C, Franze M. Gesundheitsbezogene Lebensqualität (HRQoL) bei von Schmerzen betroffenen 5.-Klässlern – Ergebnisse des bevölkerungsbezogenen Projekts „Gesundheitskompetenz bei Kindern in der Schule (GeKoKidS)“ und Vergleich mit dem KiGGS. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266565] [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: 10/19/2022]
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Schmidt CO, Fahland RA, Franze M, Splieth C, Thyrian JR, Plachta-Danielzik S, Hoffmann W, Kohlmann T. Health-related behaviour, knowledge, attitudes, communication and social status in school children in Eastern Germany. Health Educ Res 2010; 25:542-551. [PMID: 20228152 DOI: 10.1093/her/cyq011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Enhancing health literacy is a keystone in health promotion. Yet, most studies on health literacy are limited to functional literacy levels. Furthermore, little evidence is available from children. Based on Nutbeam's outcome model for health promotion, this study aims (i) to elaborate a set of short scales to measure important health literacy domains in children and (ii) to analyse their associations among each other, with health behaviour as an intermediate health outcome, subjective health, social status and gender. The sample comprised 852 school children in fifth grade, aged 9-13 years, in Western Pomerania, Germany. Items were taken from the child's questionnaire to form short scales for health-related knowledge, attitudes, communication and behaviour. The internal consistencies of the communication and attitude scales were 0.73 and 0.57, respectively. Unidimensional scalability of the knowledge and behaviour scales was supported by item response models. Associations between health scales were modest. In regression analyses, social status and gender predicted only health knowledge and communication but not health behaviours, attitudes and self-efficacy. Health knowledge was not associated with any other scale. Our results suggest that targeting one specific component of health literacy in children is likely to exert only small effects on health status and health behaviour.
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Affiliation(s)
- Carsten Oliver Schmidt
- Methods of Community Medicine, Institute of Community Medicine, University of Greifswald, Walther Rathenau Strasse 48, 17487 Greifswald, Germany.
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Franze M, Fendrich K, Schmidt C, Splieth C, Hoffmann W. Schmerzen und Schmerzmanagement bei Kindern in Greifswald und Ostvorpommern: Vergleich mit den Ergebnissen des Kinder- und Jugendgesundheitssurveys (KiGGS). Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1249357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Franze
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Ernst-Moritz-Arndt-Universität Greifswald
| | - K. Fendrich
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Ernst-Moritz-Arndt-Universität Greifswald
| | - C. Schmidt
- Institut für Community Medicine, Abteilung Methoden der Community Medicine, Ernst-Moritz-Arndt-Universität Greifswald
| | - C. Splieth
- Abteilung für Präventive Zahnmedizin und Kinderzahnheilkunde, Ernst-Moritz-Arndt-Universität Greifswald
| | - W. Hoffmann
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Ernst-Moritz-Arndt-Universität Greifswald
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Franze M, Fendrich K, Schmidt C, Splieth C, Hoffmann W. Schmerzen und Schmerzmanagement bei Kindern in Greifswald und Ostvorpommern: Vergleich mit den Ergebnissen des Kinder- und Jugendgesundheitssurveys (KiGGS). Gesundheitswesen 2010; 72:e45-50. [DOI: 10.1055/s-0029-1242785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alkilzy M, Berndt C, Meller C, Schidlowski M, Splieth C. Sealing of proximal surfaces with polyurethane tape: a two-year clinical and radiographic feasibility study. J Adhes Dent 2009; 11:91-94. [PMID: 19492709] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Proximal carious lesions comprise a constant clinical problem. The aim of this investigation was to test the safety and clinical effect of a new treatment for proximal caries. MATERIALS AND METHODS In 50 patients with two proximal initial lesions (D1-3 without cavitation, bitewing radiograph), orthodontic rubber rings were applied to gain access to the interproximal space. One of the lesions was sealed with a thin polyurethane-dimethacrylate foil using a bonding agent; the other lesion received oral home care with dental floss and fluoridated toothpaste, and was left as control. RESULTS In clinical follow-ups after 6 and 12 months and radiographic evaluation after two years, clinical retention of proximal tape and the underlying sealant, marginal adaptation, discoloration, tooth vitality, proximal plaque, and gingivitis were checked. In addition, carious lesions were assessed clinically and radiographically. The sealants showed good retention, marginal adaptation, and color. After two years, vitality of all teeth was still positive and no relevant differences in plaque accumulation or gingival status were found between sealed and control teeth. Nine sealed lesions showed caries regression and 2 progression. In contrast, only 4 control lesions regressed and also 2 showed progression. The loss of tape had no significant influence on the lesion progression, indicating the effect of the underlying bond. All other sealants and control lesions were stable, indicating an arrest of the lesion. CONCLUSION Sealing initial proximal lesions showed no clinical problems and mostly arrest of initial carious lesions on bitewing radiographs.
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Affiliation(s)
- Mohammad Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Germany.
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Meller C, Söhnel A, Splieth C. A new in vivo method for measuring caries activity with a colorimeter. Clin Oral Investig 2006; 10:140-4. [PMID: 16498525 DOI: 10.1007/s00784-006-0036-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Accepted: 01/10/2006] [Indexed: 11/30/2022]
Abstract
The aim of this in vivo study was to assess the association between caries prevalence and changes in mineralization measured with a colorimeter (Color Compare CC 400, JENOPTIK, Jena, Germany). After a clinical examination (defs/DMFS, initial caries lesions), an area of a deciduous tooth was etched in each of the 35 children (psi = 8.11+/-2.41 years) with 37% phosphoric acid gel for 1 min. Immediately after, this demineralization was stained with 2% aqueous methylene blue and the red/green/blue spectrum measured with a colorimeter. Twenty-four hours later, the remineralization of this area was measured following the same staining procedure. Color measurements were clearly reduced after 24 h, indicating remineralization, and they correlated highly with the age of the children (Spearman correlation coefficient r = -0.48, p = 0.004). Correlations between the number of initial caries lesions in the deciduous and permanent dentition and color measurements after demineralization were statistically significant (r = 0.41 and 0.37, p = 0.02 and 0.045, respectively). The difference between the first and second measurements correlated significantly with the number of initial caries lesions in the permanent dentition (r = 0.42, p = 0.02). The values after artificial demineralization correlated with the number of initial lesions for the permanent (r = 0.368, p = 0.045) and deciduous (r = 0.408, p = 0.015) dentition. This resistance to artificial demineralization had stronger correlation coefficients with the caries incidence than the caries experience and initial lesions, which are considered to be the most valid caries predictors. In conclusion, these data suggest that the degree of demineralization after etching and its changes with time could be associated with caries parameters. Its use in prospective clinical trials on caries activity could be a successful approach.
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Affiliation(s)
- C Meller
- Centre of Oral Health, Department of Restorative Dentistry, Periodontology and Endodontology, Ernst Moritz Arndt University, Rotgerberstrasse 8, 17487 Greifswald, Germany.
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Meller C, Heyduck C, Tranaeus S, Splieth C. A New in vivo Method for Measuring Caries Activity Using Quantitative Light-Induced Fluorescence. Caries Res 2006; 40:90-6. [PMID: 16508264 DOI: 10.1159/000091053] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2004] [Accepted: 05/16/2005] [Indexed: 11/19/2022] Open
Abstract
The aim of this in vivo study was to assess the association between caries prevalence and activity parameters and the properties of etched sites measured with quantitative light-induced fluorescence (QLF). In a clinical method, two areas of a deciduous tooth were etched in each of 44 children (mean age 8.23 years+/-1.45) with 36% phosphoric acid gel for 1 min and 4 min, respectively. DeltaQ of the etched site was measured immediately after the etching (DeltaQ1) and 24 h later (DeltaQ2) with QLF. In addition, deft/DMFT, approximal plaque (API), bleeding on probing (mod. PBI), active carious lesions and currently used fluorides were recorded. In a regression analysis for the deft, the use of fluoridated salt (standardized coefficient SC=-0.25) and fluoride gel (SC=-0.37) showed the greatest effect, as did the fluoride gel (SC=-0.26) and gingival bleeding (SC=0.50) for the number of active carious lesions. The deft and the number of active carious lesions correlated significantly (r=0.70, p<0.001). DeltaQ1 and DeltaQ2 showed a significant statistical correlation with the age-adjusted deft (0.39<r<0.52, p<0.01) and with the number of active lesions (0.42<r<0.59, p<0.01). Correlations between DeltaQ and the API, PBI and the fluoride scores were slightly weaker but also statistically significant. In a principal-component analysis, these parameters were approximately identical, indicating a strong relationship between the different variables and DeltaQ. This relationship was especially strong for the deft and the active carious lesion scores. In conclusion, these data suggest that the degree of demineralization by etching and its changes with time are associated with caries activity and that this method might be used for the early assessment of caries activity.
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Affiliation(s)
- C Meller
- Center of Oral Health, University of Greifswald, Greifswald, Germany.
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Welk A, Rosin M, Seyer D, Splieth C, Siemer M, Meyer G. German dental faculty attitudes towards computer-assisted learning and their correlation with personal and professional profiles. Eur J Dent Educ 2005; 9:123-30. [PMID: 15982382 DOI: 10.1111/j.1600-0579.2005.00370.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Compared with its potential, computer technology use is still lacking in medical/dental education. OBJECTIVES To investigate the primary advantages of computer-assisted learning (CAL) systems in German dental education, as well as the reasons for their relatively low degree of use correlated with personal and professional profiles of respondents. METHOD A questionnaire was mailed to heads in the departments of conservative dentistry and prosthetic dentistry in all dental schools in Germany. Besides investigating the advantages and barriers to the use of computer technology, the questionnaire also contained questions regarding each respondent's gender, age, academic rank, experience in academia and computer skills. RESULTS The response rate to the questionnaire was 90% (112 of 125). The results indicated a distinct discrepancy between the desire for and actual occurrence of lectures, seminars, etc. to instruct students in ways to search for and acquire knowledge, especially using computer technology. The highest-ranked advantages of CAL systems in order, as seen by respondents, were the possibilities for individual learning, increased motivation, and both objective theoretical tests and practical tests. The highest-ranked reasons for the low degree of usage of CAL systems in order were the inability to finance, followed equally by a lack of studies of CAL and poor cost-advantage ratio, and too much effort required to integrate CAL into the curriculum. Moreover, the higher the computer skills of the respondents, the more they noted insufficient quality of CAL systems (r = 0.200, P = 0.035) and content differences from their own dental faculty's expert opinions (r = 0.228, P = 0.016) as reasons for low use. CONCLUSION The correlations of the attitudes towards CAL with the personal and professional profiles showed not only statistical significant reinforcements of, but also interesting deviations from, the average responses.
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Affiliation(s)
- A Welk
- Department of Restorative Dentistry, Periodontology, and Paediatric Dentistry, University of Greifswald, Greifswald, Germany.
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Abstract
Endodontic treatment of a maxillary lateral incisor with dens invaginatus in association with sinus tract and lateroradicular lesion is reported. Invaginated teeth present technical difficulties with respect to their management because of complicated canal morphology. This case was treated by conventional root canal treatment. At follow up examination after one year the tooth was asymptomatic and radiographically showed repair of the lesion.
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Affiliation(s)
- Heike Steffen
- Department of Operative Dentistry, Periodontology and Pediatric Dentistry, Ernst-Moritz-Arndt-University: School of Dentistry, Greifswald, Germany.
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Mack F, Mojon P, Budtz-Jørgensen E, Kocher T, Splieth C, Schwahn C, Bernhardt O, Gesch D, Kordass B, John U, Biffar R. Caries and periodontal disease of the elderly in Pomerania, Germany: results of the Study of Health in Pomerania. Gerodontology 2004; 21:27-36. [PMID: 15074537 DOI: 10.1046/j.1741-2358.2003.00001.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to describe the oral health status of older adults living in northeastern Germany. MATERIALS AND METHODS Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross-sectional, population-based study. Data on 1446 subjects aged 60-79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. RESULTS The prevalence of edentulousness varied from 16% in the 60-65-year-old group to 30% in the 75-79-year-old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60-65 years) to one in the oldest (75-79 years). Among subjects aged 60-69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70-79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70-79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60-69 years: 85% vs. 71% in 70-79-year-old men; women aged 60-69 years: 71% vs. 62% in 70-79-year-olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. CONCLUSIONS It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.
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Affiliation(s)
- Florian Mack
- Centre of Oral Health, Department of Prosthetic Dentistry and Dental Materials, University of Greifswald, Greifswald, Germany.
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Bernhardt O, Gesch D, Splieth C, Schwahn C, Mack F, Kocher T, Meyer G, John U, Kordass B. Risk factors for high occlusal wear scores in a population-based sample: results of the Study of Health in Pomerania (SHIP). INT J PROSTHODONT 2004; 17:333-9. [PMID: 15237882] [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: 04/30/2023]
Abstract
PURPOSE Using a population-based sample of the cross-sectional epidemiologic "Study of Health in Pomerania" (SHIP), this study evaluated whether certain occlusal and sociodemographic factors besides age and gender are risk factors for high dental wear. MATERIALS AND METHODS Medical history and dental and sociodemographic parameters of 2,529 dentate subjects selected representatively and according to age distribution were checked for correlations with the occurrence of high occlusal wear symptoms using a multivariate logistic regression model. Occlusal wear was recorded using the attrition index by Ekfeldt et al and was age adjusted by determining high occlusal wear for every 10-year age group as index values > or = 90th percentile. RESULTS The following independent variables were found to be correlated with high occlusal wear: male gender, odds ratio 2.2; frequent bruxism, odds ratio 2.5; loss of molar occlusal contact (Eichner classification), odds ratio from 1.5 to 3.1; edge-to-edge relation of incisors, odds ratio 1.7; unilateral buccolingual cusp-to-cusp relation, odds ratio 1.8; and unemployment, odds ratio 1.6. In contrast, anterior cross-bite, unilateral posterior cross-bite, and anterior crowding were protective for high occlusal wear levels, as shown by significantly reduced odds ratios. Gender-separated analysis showed that self-reported bruxism was a risk factor only for men. CONCLUSION In addition to some occlusal factors, the main factors associated with occlusal wear were bruxism and gender.
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Affiliation(s)
- Olaf Bernhardt
- Department of Operative Dentistry, Dental School, University of Greifswald, Germany.
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Welk A, Splieth C, Rosin M, Kordass B, Meyer G. DentSim - a future teaching option for dentists. Int J Comput Dent 2004; 7:123-30. [PMID: 15516090] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Apart from a requirement to acquire more and more academic knowledge, during their training, dental students need to acquire a full range of highly precise manual and technical skills, including excellent hand/eye coordination, to enable them to visualize and understand how to prepare cavities, prior to placing restorations. Furthermore, unlike medical students, dental students are in the position of administering treatment to patients very early in their training. The increasing academic workload means that these skills have to be mastered in a short space of time. This you will gain in the future only through the use of effective methods of the educations - for example by the use of the computer-assisted dental simulators (DentSim/DenX), which serves the visual-, audio- and practical learning channel simultaneously. Unlike the conventional phantom heads, the DentSim-unit has the following advantages - the acquisition of knowledge takes place in a multimedia learning environment with a high audio-visual content and degree of interaction and complexity, - problem-oriented learning takes place through clinically relevant work, - individual students can work to personalized programs through the digital tutor function, - two-dimensional knowledge is transferred into three-dimensional spatial work, - three-dimensional preparations can be easily analysed by two-dimensional error analysis, - all preparation exercises are recorded for error and effectiveness analysis. Apart from student training, the computer-assisted simulators can also be used for the evaluation of the effectiveness or the quality control of various teaching methods in the context of Evidence Based Dental Education.
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Affiliation(s)
- A Welk
- Department of Restorative Dentistry, Periodontology and Paediatric Dentistry, University of Greifswald, Germany.
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Pine CM, Adair PM, Nicoll AD, Burnside G, Petersen PE, Beighton D, Gillett A, Anderson R, Anwar S, Brailsford S, Broukal Z, Chestnutt IG, Declerck D, Ping FX, Ferro R, Freeman R, Gugushe T, Harris R, Lin B, Lo ECM, Maupomé G, Moola MH, Naidoo S, Ramos-Gomez F, Samaranayake LP, Shahid S, Skeie MS, Splieth C, Sutton BK, Soo TC, Whelton H. International comparisons of health inequalities in childhood dental caries. Community Dent Health 2004; 21:121-30. [PMID: 15072481] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To undertake formative studies investigating how the experience of dental caries in young children living in diverse settings relates to familial and cultural perceptions and beliefs, oral health-related behaviour and oral microflora. PARTICIPANTS The scientific consortium came from 27 sites in 17 countries, each site followed a common protocol. Each aimed to recruit 100 families with children aged 3 or 4 years, half from deprived backgrounds, and within deprived and non-deprived groups, half to be "caries-free" and half to have at least 3 decayed teeth. OUTCOME MEASURES Parents completed a questionnaire, developed using psychological models, on their beliefs, attitudes and behaviours related to their child's oral health. 10% of children had plaque sampled. RESULTS 2,822 children and families were recruited. In multivariate analyses, reported toothbrushing behaviours that doubled the odds of being caries-free were a combination of brushing before age 1, brushing twice a day and adult involvement in brushing. Analyses combining beliefs, attitudes and behaviours found that parents' perceived ability to implement regular toothbrushing into their child's daily routine was the most important predictor of whether children had caries and this factor persisted in children from disadvantaged communities. 90% of children with lactobacillus had caries. CONCLUSIONS Parental beliefs and attitudes play a key role in moderating oral health related behaviour in young children and in determining whether they develop caries. Further research is indicated to determine whether supporting the development of parenting skills would reduce dental caries in children from disadvantaged communities independent of ethnic origin.
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Affiliation(s)
- Cynthia M Pine
- WHO Collaborating Centre on Oral Health in Deprived Communities, University of Liverpool Dental School, England, UK.
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Pine CM, Adair PM, Burnside G, Nicoll AD, Gillett A, Borges-Yáñez SA, Broukal Z, Brown J, Declerck D, Ping FX, Gugushe T, Hunsrisakhun J, Lo ECM, Naidoo S, Nyandindi U, Poulsen VJ, Razanamihaja N, Splieth C, Sutton BK, Soo TC, Whelton H. Barriers to the treatment of childhood caries perceived by dentists working in different countries. Community Dent Health 2004; 21:112-20. [PMID: 15072480] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To explore whether dentists' beliefs and attitudes to providing preventive and restorative dental care for young children can form a barrier to the provision of care. BASIC RESEARCH DESIGN The Barriers to Childhood Caries Treatment (BaCCT) Questionnaire, a standardised international measure was developed and applied. PARTICIPANTS Through a research consortium, each site was asked to recruit 100 dentists. The sample participating was not intended to be nationally representative. Dentists were mainly randomly selected and contacted by mail with one or more mailings depending on site. RESULTS 2,333 dentists in 14 countries and 17 sites participated. Factor analysis identified four factors as potential barriers. Two factors were found to be barriers in many sites. First, in most countries, dentists agreed that young children's coping skills limit their ability to accept dental care. Secondly, dentists with negative personal feelings, for example, that providing care can be stressful and troublesome and that they feel time constrained. Differences in dentists' beliefs can be partly explained by their work profile, with those treating children often, and those working under systems where they feel they can provide quality care being least likely to identify barriers to providing care for children. CONCLUSIONS The BaCCT Questionnaire was determined to be a valid psychometric measure. Separately, it was found that health systems do impact on dentists' ability to deliver preventive and restorative care for children but that these effects vary across countries and further work is needed to determine how best these should be examined.
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Affiliation(s)
- Cynthia M Pine
- WHO Collaborating Centre on Oral Health in Deprived Communities, University of Liverpool Dental School, England, UK
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Adair PM, Pine CM, Burnside G, Nicoll AD, Gillett A, Anwar S, Broukal Z, Chestnutt IG, Declerck D, Ping FX, Ferro R, Freeman R, Grant-Mills D, Gugushe T, Hunsrisakhun J, Irigoyen-Camacho M, Lo ECM, Moola MH, Naidoo S, Nyandindi U, Poulsen VJ, Ramos-Gomez F, Razanamihaja N, Shahid S, Skeie MS, Skur OP, Splieth C, Soo TC, Whelton H, Young DW. Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups. Community Dent Health 2004; 21:102-11. [PMID: 15072479] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
UNLABELLED OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. CLINICAL SETTING Nurseries, health centres and dental clinics in 17 countries. PARTICIPANTS 2822 children aged 3 to 4 years and their parents. MAIN OUTCOME MEASURES Dental examination of children and questionnaire to parents. RESULTS Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. CONCLUSIONS This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.
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Affiliation(s)
- Pauline M Adair
- Department of Clinical Psychology, The Royal Hospitals, Belfast, Northern Ireland
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Splieth C, Bernhardt O, Heinrich A, Bernhardt H, Meyer G. Anaerobic microflora under Class I and Class II composite and amalgam restorations. Quintessence Int 2003; 34:497-503. [PMID: 12946067] [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] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The microflora around and beneath restorations is an important factor of restoration failure. The aim of this pilot study was to determine and compare the microbial spectrum under composite and amalgam restorations with special attention to the anaerobic flora. METHOD AND MATERIALS Ten composite and five amalgam restorations scheduled for replacement were clinically evaluated for marginal gaps, fractures, and secondary caries. After their removal and caries diagnosis, a dentin sample just below the restoration was taken under sterile conditions, stored in a prereduced transport medium for anaerobic bacteria, and immediately transferred to a laboratory for microbial diagnosis. RESULTS The clinical parameters showing mostly moderate marginal imperfections and the ratios of aerobic to anaerobic flora were comparable for composite and amalgam restorations (11.4%:88.6% and 15.4%:84.5%, respectively). The microbial variety under composite restorations was much greater compared to amalgam, and it was similar to that of infected root canals including anaerobic gram-negative rods, such as Fusobacterium species or Porphyromonas species. Beneath amalgam, the microbial flora was similar to the one found in carious dentin and plaque, with anaerobic and facultatively anaerobic gram-positive rods dominating. Quantitatively, there were up to eight times more microorganisms under composite restorations. The number of bacterial strains correlated with the caries activity and the filling material, the number of anaerobic rods correlated highly with caries activity and localization. In a linear regression, caries activity and the filling material had statistically significant influence on the bacterial load. CONCLUSION Although caries activity and location had the greatest influence on the microbial flora under the restorations, the kind of restoration material seemed to have an additional effect on the composition of the microflora. This pilot study indicates that inadequate composite restorations may promote the growth of cariogenic, as well as obligate anaerobic and potentially pulpopathogenic bacteria, which should be confirmed by further studies.
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Affiliation(s)
- Christian Splieth
- Department of Restorative Dentistry, Periodontology, and Pediatric Dentistry, University of Greifswald, Greifswald, Germany.
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Hensel E, Gesch D, Biffar R, Bernhardt O, Kocher T, Splieth C, Born G, John U. Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section. Quintessence Int 2003; 34:370-8. [PMID: 12795357] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4,310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.
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Affiliation(s)
- Elke Hensel
- Department of Orthodontics, Dental School, University of Greifswald, Greifswald, Germany
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