Tag: nevin manimala

J Contemp Dent Pract. 2022 Sep 1;23(9):883-888. doi: 10.5005/jp-journals-10024-3389.

ABSTRACT

AIM: To study the impact of three different surface treatments namely sandblasting, silane-coupling agent, and laser on the retention of zirconia prosthesis and bond strength of zirconia to a resin-luting agent.

MATERIALS AND METHODS: Sixty zirconia crowns were fabricated and were divided into four groups of 15 samples each on the basis of surface treatments. A control group with no surface treatment (group A), laser-treated (group B), treatment with silane-coupling agent (group C), and sandblasting with aluminium oxide (Al₂O₃) particles (group D). Testing was then carried out using a universal testing machine (0.5 mm/min crosshead speed). At a point where the crown got separated from the tooth, the reading in kilogram force (kgF) was recorded. The data were collected and analyzed statistically.

RESULTS: Group D produced the highest mean bond strength (17.5233 kgF) followed by group B (10.0067 kgF), group C (8.6907 kgF), and group A (3.3773 kgF). One-way ANOVA test showed a p-value more than 0.05, concluding no significant difference among the groups. Tukey’s HSD post hoc test gave the p-value corresponding to the F-statistic of one-way ANOVA lower than 0.01 when intergroup comparison was done confirming a significant difference among the groups.

CONCLUSION: The bond strength significantly increased in the samples treated by sandblasting compared with those treated with laser and silane-coupling agents.

CLINICAL SIGNIFICANCE: The success of a zirconia prosthesis lies on its bonding with the tooth structure. Bond failure leads to loss of function and hence ends up in failure. Selection of the proper surface treatment will not only improve the bond strength but also amplify the retention of zirconia-based prosthesis, thereby reducing the failure of the final prosthesis. It also improves the longevity of the prosthesis and restores the lost function which is the basic clinical aim of a prosthodontic treatment.

PMID:37282994 | DOI:10.5005/jp-journals-10024-3389

J Contemp Dent Pract. 2022 Sep 1;23(9):877-882. doi: 10.5005/jp-journals-10024-3397.

ABSTRACT

AIM: To evaluate the perspectives of parents and children on the impact of early childhood caries (ECC) on the oral health-related quality of life (OHQoF).

MATERIALS AND METHODS: About 400 children aged 3-5 years were recruited for the study. About 200 children who were caries-free were the controls for the study. The remaining 200 consisted of children who were diagnosed with ECC and required dental rehabilitation under general anesthesia. Oral health-related quality of life was recorded at baseline and 6 months after intervention using the Michigan oral health-related quality of life scale. Data were analyzed and evaluated using Statistical Package for Social Sciences (SPSS) Version 25.0.

RESULTS: Children with ECC were found to have a significantly lower oral health-related quality of life compared with caries-free children, and a statistically significant difference was seen between both groups. The main concern for both parents and children at baseline was pain at the first visit when the evaluation was done. After the intervention, a significant improvement in the oral health-related quality of life was seen.

CONCLUSION: Early childhood caries was found to have detrimental effects on the oral health-related quality of life. Full-mouth rehabilitation under general anesthesia was found to bring a significant improvement in the oral health-related quality of life. The perspectives of both parents and children were found to be similar.

CLINICAL SIGNIFICANCE: Early childhood caries has an impact on the lives of children and their parents. Oral health-related quality of life was low with children suffering from ECC. Full-mouth rehabilitation under general anesthesia can significantly improve the OHRQoL of children. Continuous monitoring of the children with regular follow-ups and parental education should be enforced to prevent the relapse of ECC.

PMID:37282993 | DOI:10.5005/jp-journals-10024-3397

J Contemp Dent Pract. 2022 Sep 1;23(9):872-876. doi: 10.5005/jp-journals-10024-3408.

ABSTRACT

AIM: To assess the microleakage of mineral trioxide aggregate (MTA) repair high plasticity (HP), EndoSequence root repair material (ESRRM) putty, and Biodentine, when used as an apical plug in immature permanent teeth.

MATERIALS AND METHODS: In an in vitro model, 55 extracted maxillary incisors were decoronated and resected 3 mm apically to obtain standardized 15-mm root blocks, which were then cleaned and shaped. All samples had a 1.1-mm standardized, prepared artificial open apex. The teeth were arbitrarily designated into three experimental groups (n = 15) and two control (positive/negative) groups (n = 5). In the experimental groups, orthograde 4-mm thick apical plugs of Biodentine (group I), ESRRM putty (group II), and MTA repair HP (group III) were placed. Positive control samples were left vacant while negative control samples were filled with Biodentine. The bacterial leakage method was used to appraise the sealing efficiency of the cements.

RESULTS: Statistical package for the social sciences (SPSS) software, version 21.0, was used for data analysis. Post hoc Tukey’s test, one-way analysis of variance (ANOVA), and repeated measures of ANOVA were used for intergroup and intragroup comparisons. On day 1, there was a significant difference between the groups, with group II showing the least and group 1 showing the maximum microleakage. No significant difference among the groups was seen at other observational periods. There was a tendency for leakage to increase significantly from day 1 to 7, then decrease till the end of the experimental period.

CONCLUSION: It was concluded that the three materials evaluated, with time, exhibited comparable apical microleakage when treating teeth with open apices.

CLINICAL SIGNIFICANCE: MTA repair HP can be used as an apical plug material in open apices with similar success as ESRRM putty and marginally better outcome than Biodentine.

PMID:37282992 | DOI:10.5005/jp-journals-10024-3408

J Dent Hyg. 2023 Jun;97(3):21-27.

ABSTRACT

This case report describes the implementation approach and evaluation of a medical-dental integration (MDI) project in Colorado that embedded dental hygienists (DHs) into 10 medical practice settings. Through the MDI Learning Collaborative, DHs were integrated into primary care medical care practices to provide full-scope dental hygiene care to patients. Dental hygienists were trained to collect quality-improvement metrics on all encounters, including untreated tooth decay, and referred patients with restorative needs to partnering dentists. Cross-sectional, aggregated clinic-level oral health metrics were submitted monthly from 2019-2022. Descriptive statistics were used to describe the population receiving MDI care and interviews were conducted with MDI staff to describe their perspectives on this approach to comprehensive care. A logistic regression model, adjusted for time and practice, compared untreated dental caries in established vs new MDI patient-visits. From 2019-2021, integrated DHs completed 13,458 visits to low-income patients, Medicaid (70%, n=9,421), uninsured (24%, n=3,230), SCHIP (3%, n=404), private (3%, n=404), of various ages: 0-5 (29%, n=3,838), 6-18 (17%, n=2,266), 18-64 (51%, n=6,825), >65 (4%, n=529). A total of 912 visits were provided to pregnant patients. Services included caries risk assessment (n=9,329), fluoride varnish (n=6,722), dental sealants (n=1,391), silver diamine fluoride (n=382), x-rays (n=5,465) and scaling/root-planing (n=2,882). Improvement was found in untreated decay of established vs. new patient-visits in four of the practices. Dental hygienists integrated into medical teams provided full-scope dental hygiene care to patients and expanded access to dental services. Medical-dental integration (MDI) care was variably associated with reduction in untreated decay. Integrating dental hygienists into primary care medical practices has potential to improve oral health-related outcomes, however access to restorative dental care remains a challenge.

PMID:37280106

J Dent Hyg. 2023 Jun;97(3):28-40.

ABSTRACT

Purpose Patient and person-centered care are often used interchangeably. The abbreviation PCC is used in this paper in instances where patient/person centered care reflects the definition of person-centeredness. The purpose of this study was to assess how PCC is taught and evaluated in entry-level dental hygiene education programs to prepare graduates for future collaborations with oher health care pprofessionals in a wide range of practice settings.Methods A cross-sectional study was conducted using a 10-item survey emailed to directors of 325 accredited, entry-level dental hygiene education programs in the United States in December 2021. Descriptive statistics were calculated for all variables. Associations with curriculum settings, teaching, and evaluation methods for PCC, according to program degrees granted, were tested with Chi-square and Fisher’s Exact tests.Results The response rate was 23% (n=75). Seventy percent offered an associate degree (AS) and 29% offered a baccalareate degree (BS); 42% reported more than half of their curriculum is allocated to teaching PCC. Didactic lectures (100%), case presentations (97%), and clinical instruction (97%) were the most common methods used for teaching PCC. Baccalaureate programs used external rotations more than associate programs for teaching and evaluation of PCC (84.2% vs. 45.5%; p<0.01). The most common PCC terms used in Quality Assurance Plans included providing individualized care (99%) and delivering evidence-based care (91%). Ninety-three percent strongly agree-agree that teaching PCC prepares graduates for working in different settings (e.g., schools, nursing homes, etc.), and 82% strongly agree-agree that PCC prepares graduates to work with a variety of providers.Conclusion The allocation of curricula time for PCC varied widely across respondents. Conversely, the majority felt their graduates were well-prepared to work in different settings where both PCC and IPP are likely to be practiced. This study serves as a baseline for further analysis of how dental hygiene education is preparing graduates for future practice settings.

PMID:37280102

J Natl Cancer Inst. 2023 Jun 6:djad107. doi: 10.1093/jnci/djad107. Online ahead of print.

ABSTRACT

BACKGROUND: The patterns and determinants of long-term income among adolescent and young adult (AYA) cancer survivors, and the differences compared to peers, have not yet been fully explored. This study investigated the long-term effects of cancer on the income of AYA cancer survivors.

METHODS: The Netherlands Cancer Registry identified all AYA cancer patients (18-39 years) diagnosed in 2013 and alive 5 years post diagnosis. Clinical data of the selected AYA patients were linked to individual, administrative real-world labor market data of Statistics Netherlands. The control group consisted of a random sample of individuals of the same age, sex and migration background without cancer. Data on 2,434 AYA cancer patients and 9,736 controls were collected annually from 2011 until 2019. Changes in income level were measured and compared with the control group using difference-in-difference regression models.

RESULTS: AYA cancer survivors experience, on average, an 8.5% decrease in annual earnings, relative to the control population. The effects are statistically significant and permanent; (p < 0.01). Younger AYAs (those aged 18-25 years 15.5% income reduction), married cancer survivors (12.3%), females (11.6%), those diagnosed with stage IV disease (38.1%) and central nervous system (CNS; 15.7%) cancer patients experienced the largest decline in income, on average, relative to controls, all else constant.

CONCLUSION: Although dependent on the sociodemographic and clinical characteristics, a cancer diagnosis at AYA age has significant implications on the income of cancer patients. Awareness of vulnerable groups and the development of policies to mitigate the financial impact of cancer are critical.

PMID:37280086 | DOI:10.1093/jnci/djad107

Respir Care. 2023 Jun 6:respcare.10534. doi: 10.4187/respcare.10534. Online ahead of print.

ABSTRACT

BACKGROUND: Inhaled corticosteroids (ICSs) are a fundamental pillar of most regimens for long-term control of persistent asthma. Poor adherence to ICS medication is a common problem in the asthma population that can lead to poor asthma control. We hypothesized that conducting a follow-up telephone call after general pediatric clinic visits for asthma would improve refill persistence.

METHODS: We conducted a prospective cohort analysis of pediatric and young adult subjects followed in our pediatric primary care clinic for asthma on ICS medication found to have poor ICS refill persistence. This cohort received a follow-up telephone outreach call 5-8 weeks after the clinic visit. The primary outcome measure was refill persistence with regard to ICS therapy.

RESULTS: There were 289 subjects who met the inclusion criteria and did not meet any exclusion criteria for the study (n = 131 in the primary cohort, n = 158 in the post-COVID cohort). The mean ICS refill persistence increased significantly for subjects in the primary cohort (39.4 ± 30.8% post intervention vs 32.4 ± 19.7% pre intervention) (P = .02) but not in the post-COVID cohort (36.4 ± 25.6% post intervention vs 38.9 ± 21.0% pre intervention) (P = .26). There was not a statistically significant change in hospitalizations after the intervention in either the primary or the post-COVID cohorts (P = .08 and .07, respectively). Systemic corticosteroid courses and emergency department visits decreased significantly post intervention (P = .01 and P = .004, respectively) in the primary group but not in the post-COVID group (P = .75 and P = .16, respectively).

CONCLUSIONS: These results suggest that telephone outreach after out-patient clinic visits for asthma may have short-term benefit in ICS refill persistence; however, the effect size was small.

PMID:37280076 | DOI:10.4187/respcare.10534

Eur J Cardiothorac Surg. 2023 Jun 6:ezad220. doi: 10.1093/ejcts/ezad220. Online ahead of print.

ABSTRACT

OBJECTIVES: (i) To monitor cerebral blood flow velocity (CBFv) throughout aortic arch repair surgery and during recovery period in paediatric intensive care. (ii) To examine the relationship between near infrared spectroscopy (NIRS) and transcranial doppler ultrasound (TCD) during cardiac surgery. (iii) Examine CBFv in patients cooled to 20 °C and 25 °C.

METHODS: During aortic arch repair and after surgery, TCD was monitored in 24 neonates, alongside NIRS, blood pH, pO2, pCO2, HCO3, lactate, Hb, Htc (%) and temperature (core and rectal). General linear models were used to examine differences over time and cooling temperature. Repeated measured correlation (rmcor) were used to determine relationship between NIRS and TCD.

RESULTS: CBFv changed during arch repair procedure (main effect of time: p = 0.001). During cooling phase, CBFv increased by 10.0 cm/s (5.97 cm/s, 17.7 cm/s) compared to normothermic (p = 0.019). Once recovering in PICU, CBFv had increased from the preoperative measurement by 6.2 cm/s (0.21, 13.4; p = 0.045). CBFv changes were similar between patients cooled to 20 °C and 25 °C (main effect of temperature: p = 0.22). Repeated measures correlation identified a statistically significant but weak positive correlation between CBFv and NIRS (r = 0.25, p = <0.001).

CONCLUSIONS: Our data suggested that CBFv changed throughout aortic arch repair and was higher during cooling period. A weak relationship was found between NIRS and TCD. Overall, these findings could provide clinicians with information on how to optimise long-term cerebrovascular health.

PMID:37280071 | DOI:10.1093/ejcts/ezad220

J Clin Pathol. 2023 Jun 6:jcp-2023-208759. doi: 10.1136/jcp-2023-208759. Online ahead of print.

ABSTRACT

Aims To assess if ambient temperature-related effects on serum potassium levels impact clinical decision-making. Methods This study is an ecological time series consisiting of 1 218 453 adult patients with at least one ACE inhibitor (ACEI) prescription who participate in a large UK primary care dataset.Descriptive statistics and a quasi-Poisson regression model using time series data at regular time intervals (monthly) were undertaken to examine the association between potassium measurements and ACEI/potassium supplement prescriptions. RESULTS: It is noted that correlating with lower ambient temperature, serum potassium values follow a seasonal pattern; peaks in winter months and troughs in summer. During summer months, there are clear annual spikes in the number of potassium prescriptions suggesting a change in prescribing practice during periods of potentially spurious hyperkalaemia. The converse pattern is seen in the ACEI prescription proportion which spikes annually during the winter period with lower average ambient temperatures. Our time series modelling demonstrated that each one unit increase in potassium is associated with a 33% increased rate of ACEI prescriptions (risk ratio, RR 1.33; 95% CI 1.12 to 1.59) and 63% decreased rate of potassium supplements (RR 0.37; 95% CI 0.32 to 0.43). CONCLUSIONS: Our findings highlight the seasonal pattern in serum potassium and we observe a corresponding alteration in prescribing practice for potassium sensitive medications. These findings demonstrate the importance of educating clinicians on the presence of seasonal potassium variability in addition to standard measurement error, and its potential impact on their prescribing activity.

PMID:37280056 | DOI:10.1136/jcp-2023-208759

BMJ Open. 2023 Jun 6;13(6):e066744. doi: 10.1136/bmjopen-2022-066744.

ABSTRACT

OBJECTIVE: This study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran.

DESIGN: This was a cross-sectional study.

METHODS: Totally 430 EMTs who had been engaged in their respective units for more than 6 months from all emergency facilities in Lorestan province were selected using single stage cluster sampling method. Data were collected from April to July 2019 using two standard questionnaires: job stress (Health and Safety Executive (HSE)) and WRQoL. The OR with 95% CI was used to declare the statistical association (p≤0.05).

RESULTS: All participants were exclusively males, with a mean age of 32±6.87 years. The overall average score of job stress using the HSE scale was 2.69±0.43; while the overall quality of working life score was 2.48±1.01. The type of working shift was found to have a significant impact on the HSE-average score (F(3,417)=5.26, p=0.01); and on the WRQoL-average score (F(3,417)=6.89, p<0.01).

CONCLUSION: Two-thirds of EMTs working in governmental hospitals had job stress and a low quality of work-related life. Additionally, work shift was statistically significant associated with EMTs’ job stress and WRQoL.

PMID:37280030 | DOI:10.1136/bmjopen-2022-066744