COVID-19 and the case for global development.

COVID-19 accentuates the case for a global, rather than an international, development paradigm. The novel disease is a prime example of a development challenge for all countries, through the failure of public health as a global public good. The COVID-19 pandemic has highlighted the falsity of any assumption that the global North has all the expertise and solutions to tackle global challenges, and has further highlighted the need for multi-directional learning and transformation in all countries towards a more sustainable and equitable world. We illustrate our argument for a global development paradigm by examining the implications of the COVID-19 pandemic across four themes or 'vignettes': global value chains, digitalisation, debt, and climate change. We conclude that development studies must adapt to a very different context from when the field emerged in the mid-20th century.

A qualitative study of trends in patient preferences for the management of the partially dentate state.

OBJECTIVE: To identify factors influencing attitudes of partially dentate adults towards dental treatment in Ireland. BACKGROUND: People are retaining more teeth later in life than ever before. Management of partially dentate older adults will be a major requirement for the future and it is important to determine factors which may influence patients' attitudes to care. SUBJECTS: A purposive sample of 22 partially dentate patients was recruited; 12 women and 12 men, ranging in age from 45 to 75 years. DATA COLLECTION: Semi-structured individual interviews. RESULTS: Dental patients have increasing expectations in relation to (i) a more sophisticated approach to the management of missing teeth and (ii) their right to actively participate in decision making regarding the management of their tooth loss. There is some evidence of a cohort effect with younger patients (45-64 years) having higher expectations. CONCLUSIONS: The evidence of a cohort effect within this study in relation to higher patient expectations indicates that both contemporary and future patients are likely to seek a service based on conservation and restoration of missing teeth by fixed prostheses.

Development and evaluation of a self-report measure for identifying type and use of removable partial dentures.

AIM: To develop and validate a self-complete questionnaire suitable for use in primary dental care settings. DESIGN: A questionnaire survey. PARTICIPANTS: The research was undertaken in primary dental care (general dental practices, Newcastle upon Tyne, UK) and two teaching hospitals (Newcastle Dental Hospital, UK; University Dental School and Hospital, Cork, Ireland). A self-assessment of numbers of teeth and removable partial dentures questionnaire was devised and distributed to 137 patients in the three settings. Following completion of the questionnaire, each patient's dentist then examined them and completed the same questionnaire. The two sets of information were then compared. In the second phase of the study, 37 subjects completed the questionnaire in their own home and their dentist completed the questionnaire at a subsequent clinical examination. RESULTS: There was excellent agreement regarding counting of teeth [80%, Kappa = 0.79, s.e. 0.04 for maxillary teeth and 77%, Kappa = 0.68, s.e. 0.03 for mandibular teeth]. There was also good agreement between dentists and patients in terms of positioning of spaces in the dental arch (79.6-92.6%). Subjects in the study were also able to accurately identify the type of denture they had (either acrylic or cobalt-chromium based). These findings were confirmed in the second phase of the study. CONCLUSIONS: Agreement between dentists and patients was very good. This self-report measure could be of use when gathering data for studies of partially dentate patients.

3D-Geomorphometrics tooth shape analysis in hypodontia.

Assessment of tooth morphology is an important part of the diagnosis and management of hypodontia patients. Several techniques have been used to analyze tooth form in hypodontia patients and these have shown smaller tooth dimensions and anomalous tooth shapes in patients with hypodontia when compared with controls. However, previous studies have mainly used 2D images and provided limited information. In the present study, 3D surface-imaging and statistical shape analysis were used to evaluate tooth form differences between hypodontia and control patients. Eighteen anatomical landmarks were recorded on the clinical crown of the lower left first permanent molar of 3D scanned study models of hypodontia and control subjects. The study sample group comprised of 120 hypodontia patients (40 mild, 40 moderate, and 40 severe hypodontia patients) and 40 age- and sex-matched controls. Procrustes coordinates were utilized to scale and superimpose the landmark coordinate data and then were subjected to principal component analysis (PCA). Subsequently, differences in shape as well as size were tested statistically using allometric analysis and MANOVA. Significant interaction was found between the two factor variables "group" and "sex" (p < 0.002). Overall expected accuracies were 66 and 56% for females and males, respectively, in the cross-validated discriminant-analysis using the first 20 PCs. Hypodontia groups showed significant shape differences compared with the control subjects (p < 0.0001). Significant differences in tooth crown shape were also found between sexes (p < 0.0001) within groups. Furthermore, the degree of variation in tooth form was proportional to the degree of the severity of the hypodontia. Thus, quantitative measurement of tooth shape in hypodontia patients may enhance the multidisciplinary management of those patients.

Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial.

PURPOSE: Removable partial dentures (RPD) used to restore the severely shortened mandible may adversely affect the remaining natural teeth and are associated with a low prevalence of use. This pilot study investigated patient satisfaction following restoration of mandibular shortened dental arches. MATERIALS AND METHODS: Sixty subjects with mandibular shortened dental arches entered a randomized controlled trial comparing two types of mandibular prostheses: bilateral free-end saddle RPDs and distal cantilever resin-bonded fixed partial dentures (FPD). Patient satisfaction was assessed using self-administered questionnaires before (baseline), 3 months after, and 1 year after provision of new prostheses. RESULTS: Improvements in levels of general satisfaction with teeth, appearance of teeth, and perceived masticatory ability were significant for the FPD group. Significant improvements in perceived masticatory ability were noted for both groups. There were also significant improvements in perceived levels of comfort of mandibular prostheses in both groups. Changes in summary satisfaction scores indicated improved satisfaction for both treatment groups but suggested a larger clinical effect for the FPD group. Significant differences between treatment groups were not established. CONCLUSION: Patient-based outcomes reported suggested that resin-bonded cantilever FPDs are an effective means of restoring the shortened mandibular dental arch in terms of patient comfort and acceptance.