Evaluating the efficacy of OralDETECT training: Face-to-face versus online delivery in dental education.

OBJECTIVE: This study evaluated the effectiveness of face-to-face (F2F) and online OralDETECT training programme in enhancing early detection skills for oral cancer. METHODS: A total of 328 final-year dental students were trained across six cohorts. Three cohorts (175 students) received F2F training from the academic years 2016/2017 to 2018/2019, and the remaining three (153 students) underwent online training during the Covid-19 pandemic from 2019/2020 to 2021/2022. Participant scores were analysed using the Wilcoxon signed rank test, the Mann-Whitney test, Cohen's d effect size, and multiple linear regression. RESULTS: Both F2F and online training showed increases in mean scores from pre-test to post-test 3: from 67.66 ± 11.81 to 92.06 ± 5.27 and 75.89 ± 11.03 to 90.95 ± 5.22, respectively. Comparison between F2F and online methods revealed significant differences in mean scores with large effect sizes at the pre-test stage (p < 0.001), while significant differences with small effect sizes were noted for post-test 1 (p = 0.002) and post-test 3 (p = 0.041). Regression analysis indicated that the delivery method is associated with the participants' final scores. CONCLUSION: F2F and online versions of the OralDETECT training programme significantly enhance participants' knowledge and skills in oral cancer detection. Although F2F appeared to be more effective, the difference was not substantial enough to be considered educationally meaningful.

Effectiveness of "OralDETECT": a Repetitive Test-enhanced, Corrective Feedback Method Competency Assessment Tool for Early Detection of Oral Cancer.

Early diagnosis of oral cancer results in less aggressive treatment and improves the quality of life and overall 5-year survival rate. Well-trained dental professionals can play a crucial role in the early detection of oral cancers. The present study aims to determine the effectiveness of the training program "OralDETECT", a spaced repetitive, test-enhanced learning tool with a corrective feedback mechanism for early detection of oral cancer. Thirty-two dentists and 259 dental students from three Malaysian dental schools were involved in this study. All participants were trained and calibrated to recognize oral potentially malignant disorders (OPMD) and oral cancer using "OralDETECT", which is comprised of a series of pre-test, lecture, post-tests and review sessions. The percentage of correct answers (scores) for each test given by the participants was calculated and analysed using a paired t test. It was found that the overall percentage of diagnostic accuracy for both dental professionals and student groups increased to above 80% from the pre-tests to the final post-tests. There was a significant improvement in overall scores between the pre-tests and all three post-tests for the dental professional groups and the student groups. The diagnostic accuracy for individual OPMD and lesions suspicious of oral cancer also increased to above 80% for both groups. The results of our study demonstrate that the "OralDETECT" is an efficient and effective competency tool which can be used to train dental professionals and students for the early detection of OPMD and oral cancer.

Incidence rates of tuberculosis in chronic hepatitis C infected patients with or without interferon based therapy: a population-based cohort study in Taiwan.

BACKGROUND: It is debated whether interferon-based therapy (IBT) would affect the incidence of active tuberculosis (TB) among hepatitis C virus (HCV) infected patients. Although some case reports have demonstrated a possible association, the results are currently inconclusive. Therefore, we conducted a nation-wide population study to investigate the incidence of active TB in HCV infected patients receiving IBT in Taiwan. METHODS: This 9-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 ( >23.7 million). This insurance program covers all citizens in Taiwan. We conducted a retrospective cohort study that identified subjects with HCV infection. IBTs were defined as regimens that included interferon α, peginterferon α2a and peginterferon α2b for at least 2 months. Among them, 621 subjects received IBT, and 2,460 age- and gender-matched subjects were enrolled for analysis. The Cox proportional hazards models were used to estimate the hazard ratio (HR) for active TB, and associated confidence intervals (CIs), comparing IBT cohort and untreated cohort. The endpoint in this study was whether an enrolled subject had a new diagnosis of active TB. RESULTS: During the 9-year enrollment period, the treated and untreated cohorts were followed for a mean (± SD) duration of 6.97 ± 0.02 years and 8.21 ± 0.01 years, respectively. The cumulative incidence rate of active TB during this study period was 0.150 and 0.151 per 100 person-years in the IBT treated and untreated cohorts, respectively. There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61-12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28-3.78). The Cox proportional hazards model demonstrated that IBT was not a risk factor for active TB . The only risk factor for active TB was the occurrence of hepatic encephalopathy. CONCLUSION: Our results showed that IBT is associated with increased hazard of active TB in HCV infected patients in 1-year follow-up; however, the effect sizes were not statistically significant.

Morphometric analysis of the cranial base in Asians.

This study tested the hypothesis that developmental heterogeneity in cranial base morphology increases the prevalence of Class III malocclusion and mandibular prognathism in Asians. Thin-plate spline (TPS) graphical analysis of lateral cephalometric radiographs of the cranial base and the upper midface configuration were compared between a European-American group (24 females and 31 males) and four Asian ethnic groups (100 Chinese, 100 Japanese, 100 Korean and 100 Taiwanese; 50 females and 50 males per group) of young adults with clinically acceptable occlusion and facial profiles. Procrustes analysis was performed to identify statistically significant differences in each configuration of landmarks (P < 0.001). The TPS graphical analysis revealed that the greatest differences of Asians were the horizontal compression and vertical expansion in the anterior portion of the cranial base and upper midface region. The most posterior cranial base region also showed horizontal compression between the basion and Bolton point, with forward displacement of the articulare. Facial flatness and anterior displacement of the temporomandibular joint, resulting from a relative retrusion of the nasomaxillary complex and a relative forward position of the mandible were also noted. These features that tend to cause a prognathic mandible and/or retruded midface indicate a morphologic predisposition of Asian populations for Class III malocclusion.

Evaluating the performance of fibronectin 1 (FN1), integrin α4ß1 (ITGA4), syndecan-2 (SDC2), and glycoprotein CD44 as the potential biomarkers of oral squamous cell carcinoma (OSCC).

OBJECTIVES: Some extracellular matrix genes as prognostic biomarkers for oral squamous cell carcinoma (OSCC) were evaluated. METHODS: We investigated gene expression of fibronectin 1 (FN1), integrin α4ß1 (ITGA4), syndecan-2 (SDC2), and glycoprotein CD44 in matched OSCC/margin tissues. RESULTS: Areas under receiver-operating characteristic curves (AUCs) of relative mRNA expression of FN1, ITGA4, SDC2, and CD44 were 0.700, 0.677, 0.513, and 0.549, respectively. For tongue/mouth floor and edentulous ridge, AUC for FN1 and ITGA4 were 0.827 and 0.725 and sensitivities/specificities were 80%/84% and 88%/52%, respectively. CONCLUSION: FN1 and ITGA4 are potential OSCC biomarkers for tongue/mouth floor and edentulous ridge.

The association of responsiveness in oral and general health-related quality of life with patients' satisfaction of new complete dentures.

PURPOSE: The objective was to determine the responsiveness properties of the Oral Health Impact Profile (OHIP) short-forms and 36-item Short-Form (SF-36) in complete denture treatment, and further to evaluate the association between patients' satisfaction and improvements in oral and general health-related quality of life (OHRQoL and HRQoL) after fitting of new, complete dentures. METHODS: Study data were obtained from the 'Dentures for the Elders through Public Funding' study conducted in Kaohsiung County. A total of 224 subjects received denture treatments with 6-month follow-up and pre-/post-treatment interviews by questionnaire. The OHIP and SF-36 were used to measure OHRQoL and HRQoL. In addition, specific questions investigating seven aspects of patients' satisfaction were used to measure the patients' perceptions of complete denture success. The responsiveness of all outcome measures and their dimensions were assessed by effect size (ES). Multivariable analysis was used to examine the association between patients' satisfaction and OHIP/SF-36 while adjusting for demographic characteristics. RESULTS: There were improvements with regard to the 'physical pain' (ES = 0.19) and 'psychological discomfort' (ES = 0.42) dimensions of the Taiwanese short-form OHIP (OHIP-14T) after new complete denture treatment, but only improvement in the 'general health' (ES = 0.17) dimension in the SF-36 measure. Patients satisfied with 'comfort' and 'ease of cleaning' of their new dentures were significantly associated with the improvement of the OHIP-49 and OHIP-14T. CONCLUSIONS: This study suggests that denture treatments are associated with improvements of OHRQoL, but not in HRQoL. Furthermore, patients' satisfaction was significantly associated with responsiveness of OHRQoL but less significantly associated with responsiveness of HRQoL.

Exploring the quality of life after denture-wearing within elders in Kaohsiung.

OBJECTIVE: The objective of the research is to investigate whether the elderly people's quality of life get improved after denture wearing. MATERIAL AND METHODS: About 1600 elderly persons, over 65 years old, were sampled as the research target. The overall response rate was 71.62%. The tool of research is a structural questionnaire Oral Health Impact Profile (OHIP) that was used to measure the oral health-related quality of life. Individual's satisfaction of denture wearing divides into three groups: edentulous individuals who are satisfied with denture wearing, edentulous individuals who are not satisfied with denture wearing and dentulous individuals. RESULTS: The result shows the eight variables, which are oral health condition, frequency of snacks-eating, age, frequency in participation in social activities, instrumental activities of daily living (IADL), vision, satisfaction with life and physical functions, have significant influence on total OHIP score. CONCLUSIONS: Although being edentulous, if the elderly are satisfied with their denture, the quality of life can be maintained and not affected by oral health problems. It is suggested that the further researches can include more relevant factors when in a discussion on the oral health-related quality of life, especially, the subjective perception of individual's feeling.

Effects of denture maintenance on satisfaction levels of Taiwanese elderly using removable partial dentures: a pilot study.

OBJECTIVE: The aim of this study was to evaluate the correlation between patient satisfaction with removable partial dentures and denture maintenance by patients, including regular application of denture adhesives and cleansers. BACKGROUND: The success of removable partial dentures depends on patient satisfaction with dentures and their regular denture maintenance. MATERIALS AND METHODS: Demographic information, the Oral Impacts on Daily Performance (OIDP) indicator and details of denture maintenance (including the use of denture cleansers and adhesives) were collected from 193 (41.5% men and 58.5% women) participants by using questionnaires. A dentist performed oral examinations to evaluate denture function according to the OIDP items photographically and recorded the number of remaining teeth and Kennedy's classification. RESULTS: Most participants were satisfied with their removable partial dentures and tended to have higher satisfaction levels than the dentist's estimation. Further, those using denture adhesives and cleansers had higher satisfaction levels than those not using such denture maintenance. CONCLUSIONS: Appropriate education regarding denture use is important because regular denture maintenance by patients affects their degree of satisfaction with dentures, as well as the dentist's skill and the patient's oral condition. Dentists could use this information to predict the potential success of dentures.

MMP-8 -799 C>T genetic polymorphism is associated with the susceptibility to chronic and aggressive periodontitis in Taiwanese.

AIM: Matrix metalloproteinase (MMP)-8 is a protease that degrades numerous extracellular molecules and has been implicated in the pathogenesis of periodontitis. Polymorphism in the MMP-8 could affect the susceptibility to disease. Our aim was to evaluate the association between periodontitis and MMP-8 -799 C>T polymorphism. MATERIAL AND METHODS: Genomic DNA was obtained from 361 chronic periodontitis patients (CP), 96 aggressive periodontitis patients (AgP), and 106 periodontally healthy controls (HC). MMP-8 -799 C>T polymorphism was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The frequencies of genotypes in diseased groups were similar but were significantly different from those in the HC. Multivariate logistic regression analysis with adjustment for age, gender and smoking indicated that increased risks of AgP and CP were associated with the -799 T allele (in AgP, adjusted OR = 1.99, p = 0.04; in CP, adjusted OR = 1.87, p = 0.007). To avoid the confounded effect of smoking on MMP-8 polymorphism to periodontitis, the analysis was conducted on non-smokers and the associations were significant. CONCLUSIONS: These results suggested that non-smoking Taiwanese with the MMP-8 -799 T allele were associated with the risks of both CP and AgP. Further studies in other ethnic populations are necessary.

Application of the Oral Health Impact Profile (OHIP) among Taiwanese elderly.

PURPOSE: To validate the Chinese (Taiwan) version of the Oral Health Impact Profile (OHIP-49T) and develop a short form of the OHIP (OHIP-14T) for the elderly. METHODS: A total of 1402 subjects, aged 65 and above, received a personal interview and oral examination. Internal consistency, measured by Cronbach's alpha, and test-retest reliability were assessed by intra-class correlation coefficient (ICC) during a 2-week interval. The criterion-related validity of OHIP-49T was evaluated through associations between the OHIP-49 score with prosthetic need and prosthetic status. A subset (OHIP-14T) questionnaire, derived through a controlled regression procedure, was compared with the original OHIP-14 by Slade (OHIP-14S). RESULTS: The Cronbach's alpha and ICC values were 0.97 and 0.98 for OHIP-49T and 0.90 and 0.93 for OHIP-14T. Mean scores of the OHIP-49T were significantly associated with prosthetic status (P = 0.0013) and prosthetic need (P = 0.0004), which were examined by dentists. The OHIP-14T score had stronger discriminatory ability than OHIP-14S. CONCLUSIONS: The OHIP-49T showed satisfactory reliability and validity for this Taiwanese elderly population. The OHIP-14T is more effective to measure OHRQoL than OHIP-14S.

Treatment of adult Class III malocclusions with orthodontic therapy or orthognathic surgery: receiver operating characteristic analysis.

INTRODUCTION: The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. METHODS: We used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness. RESULTS: For a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤-4.73 mm; Wits appraisal, ≤-11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤-0.18 mm; and gonial angle, ≥120.8°. CONCLUSIONS: We selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions.

The association of Fcgamma receptor IIIb genetic polymorphism and susceptibility to periodontitis in Taiwanese individuals.

AIM: The allelic polymorphism of FcgammaRIIIb, the neutrophil-specific receptor involved in the phagocytosis of immunoglobulin G-opsonized bacteria, has functionally distinct capacities that are important in host defence mediated by neutrophils. The aim of this study was to identify whether the polymorphism of FcgammaRIIIb is associated with periodontitis in Taiwanese individuals. MATERIALS AND METHODS: This case-control study included of 93 aggressive periodontitis (AgP) patients, 372 chronic periodontitis (CP) patients and 158 healthy controls (HC). The FcgammaRIIIb genotypes were determined by PCR using allele-specific primers. The risk for periodontitis associated with genotypes was calculated as the odds ratio (OR). RESULTS: A significant difference was observed in the distribution of the FcgammaRIIIb genotype between either AgP and HC, or AgP and CP, but not between CP and HC. The OR for carriage of the NA2 allele (NA1NA2+NA2NA2 versus NA1NA1) in AgP was 3.27 [95% confidence interval (CI)=1.57-7.51, p=0.0027] and 2.94 (95% CI=1.49-6.48, p=0.0037), as compared with HC and CP. After adjusting for possible confounding factors, the association was still significant. CONCLUSIONS: The results of the present study suggest that subjects carrying at least one copy of the FcgammaRIIIb-NA2 allele might be associated with susceptibility to AgP. However, the clinical implications of the FcgammaRIIIb allelic polymorphism should be determined by further studies.

Prediction of Frailty and Dementia Using Oral Health Impact Profile from a Population-Based Survey.

Oral health and dentition have been associated with cognitive ability and frailty, but an applicable screening tool has not yet been developed. This study aimed to establish risk prediction models for dementia and frailty. A sample of 2905 community-dwelling older adults aged ≥58 years using the Taiwan Longitudinal Study on Aging (TLSA) survey was adapted and analyzed for this study. Risk scores were estimated by stepwise logistic regression. In models adjusted for covariates, increased age, female sex, no dental prosthesis (adjusted Odds ratio [adjOR], 1.61; 95% confidence interval [CI], 1.11-2.35), diabetes mellitus, chronic kidney disease, and an increased Oral Health Impact Profile (OHIP)-7T Q3 score (adjOR, 1.33; 95% CI, 1.19-1.49) were all significantly associated with frailty. In addition to these factors, an inability to self-report height or weight (adjOR, 4.52; 95% CI, 3.52-5.81) and an increased OHIP-7T Q7 score (adjOR, 1.21; 95% CI, 1.06-1.37) were significantly associated with dementia. The cut-off points of the risk scores for frailty and dementia were 80 (sensitivity, 80.0%; specificity, 81.2%) and 77 (sensitivity, 83.4%; specificity, 71.5%), respectively. The findings highlighted a number of composite risk factors of frailty and dementia. Importantly, the developed prediction models were easily applicable to screen for frailty and dementia in communities or dental clinics.

Rapid virological response and treatment duration for chronic hepatitis C genotype 1 patients: a randomized trial.

UNLABELLED: Recommended treatment for hepatitis C virus genotype 1 (HCV-1) patients is peginterferon plus ribavirin for 48 weeks. We assessed whether treatment duration of 24 weeks is as effective as standard treatment in HCV-1 patients with a rapid virological response (RVR; seronegative for hepatitis C virus [HCV] RNA at 4 weeks). Two hundred HCV-1 patients were randomized (1:1) to either 24 or 48 weeks of peginterferon-alpha-2a (180 microg/week) and ribavirin (1000-1200 mg/day) with a 24-week follow-up. The primary endpoint was a sustained virological response (SVR; seronegative for HCV RNA at 24-week follow-up). Overall, the 48-week arm had a significantly higher SVR rate (79%) than the 24-week arm (59%, P = 0.002). For 87 (43.5%) patients with an RVR, the 24-week arm had a lower SVR rate [88.9%; 95% confidence interval (CI): 80%-98%] than the 48-week arm (100%, P = 0.056). For 52 patients with low baseline viremia (<400,000 IU/mL) and an RVR, the 24-week arm had rates (CI) of relapse and SVR of 3.6% (-3%-11%) and 96.4% (89%-103%), respectively, which were comparable to those of the 48-week arm (0% and 100%) with difference (CI) of 3.6% (-7.2%-6.6%) and -3.6% (-14.3% to -0.6%), respectively. Multivariate analysis in all patients showed that RVR was the strongest independent factor associated with an SVR, followed by treatment duration, mean weight-based exposure of ribavirin, and baseline viral load. CONCLUSION: HCV-1 patients derive a significantly better SVR from 48 weeks versus 24 weeks of peginterferon/ribavirin even if they attain an RVR. Both 24 and 48 weeks of therapy can achieve high SVR rates (>96%) in HCV-1 patients with low viral loads and an RVR.

Cyclooxygenase-2 Gene-765 single nucleotide polymorphism as a protective factor against periodontitis in Taiwanese.

AIM: Prostaglandin E(2) (PGE(2)) is considered to be an important mediator of tissue destruction in periodontitis. The cyclooxygenase (COX) catalyses the production of PGs. COX-2, which is induced in an inflammatory response, is responsible for PGs synthesis at sites of inflammation. A single nucleotide polymorphism of COX-2(-765) has been shown to alter the expression of the COX-2 gene. The purpose of the present study was to evaluate the association of the COX-2(-765) polymorphism and susceptibility to periodontitis in Taiwanese. MATERIAL AND METHODS: Eighty-five cases of aggressive periodontitis (AgP), 343 cases of chronic periodontitis (CP) and 153 cases of healthy controls (HC) were recruited for the study. Genotypes of COX-2(-765) were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The distribution of genotypes among groups was compared by logistic regression analyses. The risk for periodontitis associated with genotypes was calculated as the odds ratio (OR). RESULTS: The prevalence of the GC and CC genotypes was significantly lower in AgP (5%) and in CP (29%) compared with the HC (42%). The ORs for carriage of the -765C allele (GC+CC versus GG) in AgP and CP were 0.068 (95% CI=0.020-0.173, p<0.0001) and 0.571 (95% CI=0.385-0.849, p=0.006), respectively. After adjustment for age, gender and smoking status, the OR was 0.071 (95% CI=0.017-0.219) and 0.552 (95% CI=0.367-0.829) for AgP and CP, respectively. CONCLUSIONS: The results of the study suggest that the -765G to C polymorphism of the COX-2 gene is associated with a decreased risk for periodontitis in Taiwanese, especially in AgP. However, the biological meaning needs further investigation.

Evaluation on the movement of endosseous titanium implants under continuous orthodontic forces: an experimental study in the dog.

OBJECTIVES: The purpose of this study was to evaluate the movement of pure titanium implants under different continuous forces in the edentulous alveolar ridge. MATERIAL AND METHODS: Four pairs of titanium implants were inserted into the right maxillary and mandibular post-extraction edentulous ridge of the experimental dog. Three different levels of continuous force (100, 200, and 500 g) were loaded onto three pairs of adjacent implant abutments using a memory Ni-Ti coil spring for up to 6 months and the remaining two implant abutments as the control group received no force. The positions of implant abutments were observed and the distances between the implants abutment at the top, middle and base levels were measured at the 0th, 2nd, 3rd, 6th and 8th month of the follow-up period. RESULTS: There was no significant change in the distances between adjacent abutments loaded with 100 or 200 g continuous forces throughout the entire study period. However, significantly more movement of implant abutments was noted in the 500 g pair after the 3rd month of loading when compared with the 200 or the 100 g pair (both P < 0.001). This change further increased at the 6th month (P < 0.001, 0.01, respectively). Moreover, the difference in the measurements at the top, middle and base level indicated that the two adjacent implants moved in a tipping manner in the 500 g pair after 3 and 6 months of loading. CONCLUSION: The osseointegrated implants remained stable and rigid with a pulling force of 100 and 200 g after 6 months of loading. However, when the force reached 500 g, the implants moved in an inward-tipping pattern. The results suggested that endosseous titanium implants might not necessarily be rigid anchorages under all circumstances.

Smoking characteristics and saliva cotinine levels in Taiwanese smokers: gender differences.

AIMS: The present study examined the smoking characteristics and a biomarker of a community-based sample of Taiwanese individuals, seeking to determine the correlates of nicotine dependence for each gender. BACKGROUND: Nicotine dependence is a key barrier to smoking cessation. Additionally, nicotine metabolism may influence smoking behaviour and dependence. Correlates of nicotine dependence and biochemical markers of smoking for the Taiwanese population have not yet been studied. METHODS: Participants were 402 men and 110 women smokers, who had recently smoked at least one cigarette every day over a recent year. All participants completed a questionnaire which included demographic data, smoking background, self-reported quantity of cigarettes per day and the Fagerstrom Test for Nicotine Dependence. The participants also provided saliva samples. RESULTS: Female smokers were younger, more likely to be unmarried and were on average higher educated than males. A higher percentage of females reported that family members smoked and tended to be younger at initiation and were also more likely to have attempted to quit on previous occasions. Males reported smoking significantly more cigarettes than females, however, there was no significant difference in the Fagerstrom Test for Nicotine Dependence scores between the two groups. The average saliva cotinine level was significantly higher for males than females (228.8 ng/ml vs. 94.6 ng/ml, p < 0.0001). Family and friends smoking were risk factors of nicotine dependence among both men and women smokers, but there was a stronger association of both factors on dependence levels for women. Being married is a risk factor for dependence for women but not for men. CONCLUSION: These findings support the evidence that smoking characteristics and a biochemical marker differ between the males and females. RELEVANCE TO CLINICAL PRACTICE: The results of the study are useful for health policymakers, assisting them in planning tobacco control activities in light of gender differences.

Assessing a conceptual model with both oral health and health related quality of life in community-dwelling elders.

PURPOSE: The objective of this study was to test a hypothesized conceptual model for both the clinical and non-clinical status of oral health and health related quality of life (OHRQoL & HRQoL) among community-dwelling elders. MATERIALS AND METHODS: Study participants (n = 517), who were recruited as part of a Taiwanese elderly community survey, were collected via dental examinations and questionnaires. We collected measures of clinical variables, self-reported symptom status, OHRQoL, nutritional status and HRQoL. The 517 participants were randomly assigned to one of two samples, to provide one training sample for estimation and one testing sample for validation. The path analysis with all observed variables was conducted based on the proposed theoretical model delineating pathways. RESULTS: All of the direct pathways hypothesized by the model were significant. Functional status (OHRQoL measured by OHIP-14T) mediated clinical occlusion, and symptom status mediated nutritional status (MNA) and HRQoL (WHOQOL-BREF). The model accounted for 29% of the variance in HRQoL and demonstrated a good fit with the data. CONCLUSIONS: This conceptual model suggests that OHRQoL, as an important mediator, links clinical conditions, symptom status, nutritional status, and overall HRQoL. Therefore, when therapeutic efforts are made to improve the outcomes for patients with oral diseases, not only can the OHRQoL be enhanced, but also the HRQoL can be improved as a result.

Resonance frequency analysis of miniscrew implant stability.

This study used resonance frequency (RF) analysis to assess miniscrew implant (MSI) stability during wound healing in a sample of 68 patients (41 women, 27 men; mean age, 27.7 years). The 104 MSIs included 66 placements in the buccal shelf (BS; 2.0 × 12 mm) and 38 placements in interradicular (IR; 1.5 × 8 mm) sites. Thirteen (12.5%) of the MSIs failed. A new RF detection device was used to measure RF at baseline (T0) and at 3 (T1), 6 (T2), 9 (T3), 12 (T4), and 15 (T5) weeks after placement. A linear mixed-effects model was fitted to change in RF values. As compared with the BS group, the IR group had significantly lower RF values on the right side from T0 through T4 and on the left side from T0 through T2. Insertion site and time of visit were significantly associated with RF value. The effects of time of visit significantly differed between the BS and IR sites. Starting from T0, the MSIs placed at both sites had significantly lower RF values at all intervals, except for T0-T1. Future studies should examine how the present clinical protocols can optimize timing of MSI loading to maximize the success rate.

Prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan.

BACKGROUND: In Taiwan, a distinct ethnic group variation in incidence and mortality rates has been suggested for most carcinomas. Our aim is to identify the role of prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan. METHODS: Taiwan Cancer Registry records of 9039 subjects diagnosed with oral and pharyngeal carcinoma were analyzed. The population was divided into three ethnic groups by residence, which were Taiwanese aborigines, Hakka and Hokkien communities. Five-year survival rates were estimated by Kaplan-Meier methods. Ethnic curves differed significantly by log-rank test; therefore separate models for Taiwanese aborigines, Hakka and Hokkien were carried out. The Cox multivariate proportional hazards model was used to examine the role of prognostic factors on ethnic survival. RESULTS: The five-year survival rates of oral and pharyngeal carcinoma were significantly poorer for Hokkien community (53.9%) and Taiwanese aborigines community (58.1%) compared with Hakka community (60.5%). The adjusted hazard ratio of Taiwanese aborigines versus Hakka was 1.07 (95%CI, 0.86-1.33) for oral and pharyngeal carcinoma mortality, and 1.16 (95%CI, 1.01-1.33) for Hokkien versus Hakka. Males had significantly poor prognosis than females. Subjects with tongue and/or mouth carcinoma presented the worst prognosis, whereas lip carcinoma had the best prognosis. Subjects with verrucous carcinoma had better survival than squamous cell carcinoma. Prognosis was the worst in elderly subjects, and subjects who underwent surgery had the highest survival rate. CONCLUSION: Our study presented that predictive variables in oral and pharyngeal carcinoma survival have been: ethnic groups, period of diagnosis, gender, diagnostic age, anatomic site, morphologic type, and therapy.