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1.
N Engl J Med ; 389(9): 795-807, 2023 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-37646677

RESUMEN

BACKGROUND: Among infants with isolated cleft palate, whether primary surgery at 6 months of age is more beneficial than surgery at 12 months of age with respect to speech outcomes, hearing outcomes, dentofacial development, and safety is unknown. METHODS: We randomly assigned infants with nonsyndromic isolated cleft palate, in a 1:1 ratio, to undergo standardized primary surgery at 6 months of age (6-month group) or at 12 months of age (12-month group) for closure of the cleft. Standardized assessments of quality-checked video and audio recordings at 1, 3, and 5 years of age were performed independently by speech and language therapists who were unaware of the trial-group assignments. The primary outcome was velopharyngeal insufficiency at 5 years of age, defined as a velopharyngeal composite summary score of at least 4 (scores range from 0 to 6, with higher scores indicating greater severity). Secondary outcomes included speech development, postoperative complications, hearing sensitivity, dentofacial development, and growth. RESULTS: We randomly assigned 558 infants at 23 centers across Europe and South America to undergo surgery at 6 months of age (281 infants) or at 12 months of age (277 infants). Speech recordings from 235 infants (83.6%) in the 6-month group and 226 (81.6%) in the 12-month group were analyzable. Insufficient velopharyngeal function at 5 years of age was observed in 21 of 235 infants (8.9%) in the 6-month group as compared with 34 of 226 (15.0%) in the 12-month group (risk ratio, 0.59; 95% confidence interval, 0.36 to 0.99; P = 0.04). Postoperative complications were infrequent and similar in the 6-month and 12-month groups. Four serious adverse events were reported (three in the 6-month group and one in the 12-month group) and had resolved at follow-up. CONCLUSIONS: Medically fit infants who underwent primary surgery for isolated cleft palate in adequately resourced settings at 6 months of age were less likely to have velopharyngeal insufficiency at the age of 5 years than those who had surgery at 12 months of age. (Funded by the National Institute of Dental and Craniofacial Research; TOPS ClinicalTrials.gov number, NCT00993551.).


Asunto(s)
Fisura del Paladar , Insuficiencia Velofaríngea , Preescolar , Humanos , Lactante , Técnicos Medios en Salud , Fisura del Paladar/complicaciones , Fisura del Paladar/cirugía , Europa (Continente) , Complicaciones Posoperatorias/epidemiología , Insuficiencia Velofaríngea/diagnóstico , Insuficiencia Velofaríngea/etiología , América del Sur , Técnicas de Diagnóstico Quirúrgico
2.
BMC Oral Health ; 25(1): 173, 2025 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-39893407

RESUMEN

OBJECTIVES: This study evaluates and compares the performance of ChatGPT-3.5, ChatGPT-4 Omni (4o), Google Bard, and Microsoft Copilot in responding to text-based multiple-choice questions related to oral radiology, as featured in the Dental Specialty Admission Exam conducted in Türkiye. MATERIALS AND METHODS: A collection of text-based multiple-choice questions was sourced from the open-access question bank of the Turkish Dental Specialty Admission Exam, covering the years 2012 to 2021. The study included 123 questions, each with five options and one correct answer. The accuracy levels of ChatGPT-3.5, ChatGPT-4o, Google Bard, and Microsoft Copilot were compared using descriptive statistics, the Kruskal-Wallis test, Dunn's post hoc test, and Cochran's Q test. RESULTS AND DISCUSSION: The accuracy of the responses generated by the four chatbots exhibited statistically significant differences (p = 0.000). ChatGPT-4o achieved the highest accuracy at 86.1%, followed by Google Bard at 61.8%. ChatGPT-3.5 demonstrated an accuracy rate of 43.9%, while Microsoft Copilot recorded a rate of 41.5%. CONCLUSION: ChatGPT-4o showcases superior accuracy and advanced reasoning capabilities, positioning it as a promising educational tool. With regular updates, it has the potential to serve as a reliable source of information for both healthcare professionals and the general public. CLINICAL TRIAL NUMBER: Not applicable.


Asunto(s)
Educación en Odontología , Humanos , Encuestas y Cuestionarios , Turquía , Educación en Odontología/métodos , Radiografía Dental , Evaluación Educacional/métodos , Radiología/educación
3.
Support Care Cancer ; 32(5): 295, 2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38635051

RESUMEN

OBJECTIVE: The aim of this in vitro study was to evaluate the effect of radiotherapy on the surface microhardness and roughness of different bioactive restorative materials. MATERIALS AND METHODS: A total of 60-disc specimens (5 mm × 2 mm) were performed in four groups (n = 15 each) from Equia Forte HT, Cention N, Activa Bioactive Restorative, and Beautifil II. Following the polishing procedure (600, 1000, 1200 grit silicon carbide papers), all specimens were irradiated at 2 Gy per fraction, five times a week for a total dose of 70 Gy in 30 fractions over 7 weeks. Before and after the irradiation, the specimens were analyzed regarding the surface roughness and microhardness. Surface morphology was also analyzed by scanning electron microscopy. Kruskal-Wallis test, Wilcoxon test, and paired sample t-test were used for statistical analysis. RESULTS: Significant differences were found after radiation with increased mean roughness of both Cention N (p = 0.001) and Beautifil II (p < 0.001) groups. In terms of microhardness, only the Beautifil II group showed significant differences with decreased values after radiation. There were statistically significant differences among the groups' roughness and microhardness data before and after radiotherapy (p < 0.05). CONCLUSION: The effect of radiotherapy might differ according to the type of the restorative material. Although results may differ for other tested materials, giomer tends to exhibit worse behaviour in terms of both surface roughness and microhardness. CLINICAL RELEVANCE: In patients undergoing head and neck radiotherapy, it should be taken into consideration that the treatment process may also have negative effects on the surface properties of anti-caries restorative materials.


Asunto(s)
Caries Dental , Oncología por Radiación , Humanos , Cariostáticos , Cuello , Proyectos de Investigación
4.
Support Care Cancer ; 32(2): 92, 2024 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-38193941

RESUMEN

PURPOSE: Despite the availability of various prevention methods, dental caries continue to be diagnosed in patients receiving head and neck radiotherapy (RT). Since conventional approaches do not evaluate posttreatment alterations in dietary behaviors, we aimed to assess the influence of radiation-induced xerostomia on post-RT cariogenic dietary habits in patients. METHODS: Fifty-seven patients completed the Xerostomia Questionnaire (XQ) and answered questions regarding daily cariogenic food and beverage (CFB) intake, daily tooth brushing, fluoride application, and subjective total taste acuity (STTA). They also underwent evaluations to determine the Simplified Oral Hygiene Index (OHI-S) score, Saxon test score, number of decayed-missing-filled teeth (DMFT), and proportion of DMFT to the test teeth (DMFT rate). Clinical records were searched for information regarding RT modalities, including the median of the mean dose to the parotid glands, days after the completion of RT, submandibular gland resection, whole-neck irradiation, and the DMFT value and rate before RT. The patients were divided into low and high XQ score groups based on the median XQ score of 47.5 for the two sample tests. Univariable and multivariable regression analyses were used to identify independent factors for frequent CFB intake. RESULTS: Higher XQ scores were associated with a significantly greater frequency of CFB intake (p = 0.028*). Regression analysis also identified a higher XQ score (p = 0.017*) as an independent risk factor for frequent CFB intake. CONCLUSION: Radiation-induced xerostomia increased the frequency of CFB intake.


Asunto(s)
Caries Dental , Úlceras Bucales , Oncología por Radiación , Xerostomía , Humanos , Caries Dental/epidemiología , Caries Dental/etiología , Xerostomía/epidemiología , Xerostomía/etiología , Xerostomía/prevención & control , Conducta Alimentaria
5.
Clin Radiol ; 79(4): 312-318, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38302376

RESUMEN

AIM: To survey current UK radiology trainee experiences and opinions regarding the quality of paediatric radiology training encountered in their core years, and assess their career ambitions with regards to paediatric radiology. MATERIALS AND METHODS: A 22-question online survey, approved by the BSPR committee, was promoted over 12 months (1 February 2022 to 31 January 2023) across current radiology trainees and fellows via regional radiology training programme directors (TPDs), Junior Radiology Forum (JRF) trainee representatives, at BSPR Junior Forum webinar teaching sessions, and via social media/word of mouth. RESULTS: Eighty-three UK survey responses were received from 17/19 (89%) training schemes. Sixty of the 83 (72%) had taken or were due to take a 2-4 month core paediatric radiology placement partly at tertiary centres (66/83, 80%), with 67/83 (81%) receiving dedicated didactic teaching. Only 26/83 (31%) reported fulfilling core curriculum competencies and 32/83 (39%) reported not receiving enough paediatric radiology training. Almost a quarter (18/83, 22%) reported <2 months of paediatric radiology rotation during core training and 12% (10/83) across six training schemes, reported no dedicated paediatric teaching sessions. Respondents who left negative comments around their experience were more likely to reject paediatric radiology as a future career option (p<0.05). CONCLUSIONS: Only 31% of UK radiology trainees reported having enough paediatric radiology training to achieve core competencies. Standardised training, teaching, and increased on-call support could improve confidence in dealing with emergency cases and encourage interest in paediatric radiology beyond junior years.


Asunto(s)
Radiología , Humanos , Niño , Radiología/educación , Radiólogos , Encuestas y Cuestionarios , Curriculum , Reino Unido
6.
BMC Health Serv Res ; 24(1): 1407, 2024 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-39543688

RESUMEN

BACKGROUND: Investing in allied health, dentistry, medical, and nursing undergraduate and postgraduate qualifying education is critical to meet a growing demand on global health care systems. Clinical placements are an integral component of qualifying training and are conventionally unpaid. Widespread economic challenges, attributed to a post-COVID-19 pandemic recovery era and global unrest, have led to growing economic hardship for populations, even in high-income countries like Australia. Allied health, dentistry, medical, and nursing undergraduate and postgraduate students undertaking unpaid clinical placements are not immune from these stressors, which has implications for education providers, ageing populations, the future health care system, and policy-makers. The purpose of this review was to better understand these stressors by scoping the financial implications of unpaid clinical placements for allied health, dentistry, medical, and nursing students in Australian research. METHODS: The Joanna Briggs Institute's scoping review methodology was used. This involved a search of academic databases and an extensive search of grey literature sources. Literature published from 1 January 2014 was included. Citations were independently screened by two reviewers. RESULTS: Thirty-three research studies were included. Most studies focused on allied health students (n = 12), followed by nursing (n = 11), and medical students (n = 5), with an additional five studies focused on multiple disciplines, including dentistry. One study had an interventional component. Findings were grouped around four concepts: reliance on self-reported measures of financial implications, costs of unpaid clinical placements for students, implications of costs for students, and an urgent need for targeted strategies to redress. CONCLUSIONS: The financial implications of unpaid clinical placements for allied health, dentistry, medical, and nursing students in Australia are well-established in research. Impacts are significant for the future of Australia's health workforce and health system. Research findings have been consistent over the past decade in advocating for greater financial support for students undertaking unpaid clinical placements and flexibility of placement models to mitigate the indirect costs of placements. Collaboration between state and federal government, universities, peak professional bodies, and placement host organisations is imperative to implement a suite of strategies to redress the financial burden experienced by students and secure the future of Australia's health workforce.


Asunto(s)
COVID-19 , Estudiantes de Enfermería , Humanos , Australia , Estudiantes de Enfermería/estadística & datos numéricos , SARS-CoV-2 , Estudiantes de Medicina/estadística & datos numéricos , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/economía
7.
Pediatr Radiol ; 54(1): 20-26, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37962606

RESUMEN

The global temperature has been increasing resulting in climate change. This negatively impacts planetary health that disproportionately affects the most vulnerable among us, especially children. Extreme weather events, such as hurricanes, tornadoes, wildfires, flooding, and heatwaves, are becoming more frequent and severe, posing a significant threat to our patients' health, safety, and security. Concurrently, shifts in environmental exposures, including air pollution, allergens, pathogenic vectors, and microplastics, further exacerbate the risks faced by children. In this paper, we provide an overview of pediatric illnesses that are becoming more prevalent and severe because of extreme weather events, global temperature increases, and shifts in environmental exposures. As members of pediatric health care teams, it is crucial for pediatric radiologists to be knowledgeable about the impacts of climate change on our patients, and continue to advocate for safe, healthier environments for our patients.


Asunto(s)
Biodiversidad , Radiología , Humanos , Niño , Plásticos , Temperatura , Cambio Climático
8.
J Med Internet Res ; 26: e60684, 2024 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-39714078

RESUMEN

BACKGROUND: Structured and standardized documentation is critical for accurately recording diagnostic findings, treatment plans, and patient progress in health care. Manual documentation can be labor-intensive and error-prone, especially under time constraints, prompting interest in the potential of artificial intelligence (AI) to automate and optimize these processes, particularly in medical documentation. OBJECTIVE: This study aimed to assess the effectiveness of ChatGPT (OpenAI) in generating radiology reports from dental panoramic radiographs, comparing the performance of AI-generated reports with those manually created by dental students. METHODS: A total of 100 dental students were tasked with analyzing panoramic radiographs and generating radiology reports manually or assisted by ChatGPT using a standardized prompt derived from a diagnostic checklist. RESULTS: Reports generated by ChatGPT showed a high degree of textual similarity to reference reports; however, they often lacked critical diagnostic information typically included in reports authored by students. Despite this, the AI-generated reports were consistent in being error-free and matched the readability of student-generated reports. CONCLUSIONS: The findings from this study suggest that ChatGPT has considerable potential for generating radiology reports, although it currently faces challenges in accuracy and reliability. This underscores the need for further refinement in the AI's prompt design and the development of robust validation mechanisms to enhance its use in clinical settings.


Asunto(s)
Inteligencia Artificial , Radiología , Humanos , Radiología/normas , Radiología/métodos , Radiografía Panorámica/métodos
9.
Emerg Radiol ; 31(6): 807-814, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39412593

RESUMEN

RATIONALE AND OBJECTIVES: Interpreting CT studies of facial trauma is challenging, and there are often substantial differences in the characterization of complex facial trauma between radiologists and surgeons. We designed a collaborative multidisciplinary project to reconcile differences in facial fracture interpretation through an educational intervention. The effectiveness of this intervention was evaluated through surgeon feedback on radiology reports. MATERIALS AND METHODS: Radiology residents, neuroradiology fellows, and neuroradiology attendings were recruited as participants at a single tertiary care academic center. Otolaryngology residents were recruited as evaluators. Participants completed surveys and provided preliminary reports for example cases of facial trauma before and after attending an educational session. Evaluators performed a blinded review of these preliminary reports based on ideal reports developed by surgical and neuroradiology attendings. RESULTS: 26 participants (20 residents, 1 neuroradiology fellow, 5 neuroradiology attendings) completed the study. Six otolaryngology residents participated as evaluators. To assess interrater reliability, three evaluators graded a shared set of 15 reports and demonstrated substantial agreement with a Kendall's W of 0.71. Participants demonstrated significant improvement in overall report accuracy, clarity, and organization. In subunit analysis, there were significant improvements in reporting Le Fort, nasoseptal, and nasoorbitoethmoid fractures. No significant improvements occurred in the reporting of upper face, zygomaticomaxillary complex, or mandibular fractures. In contrast, survey analysis demonstrated significantly improved confidence in interpreting trauma involving all facial subunits. CONCLUSION: Compared with survey results, surgeon assessment of radiology reports better demonstrated areas of improvement after an educational intervention. A multidisciplinary approach to assessing educational efforts may better evaluate the practical effectiveness of educational interventions.


Asunto(s)
Competencia Clínica , Traumatismos Faciales , Internado y Residencia , Radiología , Tomografía Computarizada por Rayos X , Humanos , Radiología/educación , Traumatismos Faciales/diagnóstico por imagen , Benchmarking , Retroalimentación , Educación de Postgrado en Medicina , Encuestas y Cuestionarios , Cirujanos/educación , Otolaringología/educación
10.
Dentomaxillofac Radiol ; 53(6): 390-395, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-38848473

RESUMEN

OBJECTIVES: This study evaluated the performance of four large language model (LLM)-based chatbots by comparing their test results with those of dental students on an oral and maxillofacial radiology examination. METHODS: ChatGPT, ChatGPT Plus, Bard, and Bing Chat were tested on 52 questions from regular dental college examinations. These questions were categorized into three educational content areas: basic knowledge, imaging and equipment, and image interpretation. They were also classified as multiple-choice questions (MCQs) and short-answer questions (SAQs). The accuracy rates of the chatbots were compared with the performance of students, and further analysis was conducted based on the educational content and question type. RESULTS: The students' overall accuracy rate was 81.2%, while that of the chatbots varied: 50.0% for ChatGPT, 65.4% for ChatGPT Plus, 50.0% for Bard, and 63.5% for Bing Chat. ChatGPT Plus achieved a higher accuracy rate for basic knowledge than the students (93.8% vs. 78.7%). However, all chatbots performed poorly in image interpretation, with accuracy rates below 35.0%. All chatbots scored less than 60.0% on MCQs, but performed better on SAQs. CONCLUSIONS: The performance of chatbots in oral and maxillofacial radiology was unsatisfactory. Further training using specific, relevant data derived solely from reliable sources is required. Additionally, the validity of these chatbots' responses must be meticulously verified.


Asunto(s)
Educación en Odontología , Evaluación Educacional , Radiología , Humanos , Radiología/educación , Evaluación Educacional/métodos , Educación en Odontología/métodos , Lenguaje , Radiografía Dental/métodos
11.
Dentomaxillofac Radiol ; 53(7): 501-508, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39018170

RESUMEN

OBJECTIVES: This study aimed to evaluate the impact of 3D-printed mannequins on the training of predoctoral students. METHODS: Two 3D-printed training models were developed: a traditional model that simulates a sound adult patient and a customized model with pathological and physiological changes (impacted third molar and edentulous region). Students accomplished their pre-clinical training divided into a control group (CG, n = 23), which had access to the traditional model, and a test group (TG, n = 20), which had access to both models. Afterward, they performed a full mouth series on patients and filled out a perception questionnaire. Radiographs were evaluated for technical parameters. Descriptive statistics and the Mann-Whitney test were used to compare the groups. RESULTS: Students provided positive feedback regarding the use of 3D printing. The TG reported a more realistic training experience than the CG (P = .037). Both groups demonstrated good clinical performance (CG = 7.41; TG = 7.52), and no significant differences were observed between them. CONCLUSIONS: 3D printing is an option for producing simulators for pre-clinical training in Oral Radiology, reducing student stress and increasing confidence during clinical care.


Asunto(s)
Educación en Odontología , Maniquíes , Impresión Tridimensional , Humanos , Educación en Odontología/métodos , Radiología/educación , Competencia Clínica , Masculino , Femenino , Estudiantes de Odontología/psicología , Encuestas y Cuestionarios , Adulto
12.
J Radiol Prot ; 44(3)2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39197468

RESUMEN

Since 2013, the adoption of Directive 2013/59/EURATOM in the European Union has mandated emergency plans for facilities housing radiology equipment, including radiology and dental clinics, and required periodical testing of these plans. However, the testing procedures have sparked widespread confusion regarding the definition of radiological emergencies in clinical settings. A potential solution lies in broadening the scope to include 'radiological events', covering accidents, incidents or other type of unjustified exposures. Utilizing realistic scenarios can enhance the radiological protection system within institutions, specifically addressing situations that might lead to unwanted patient exposure.


Asunto(s)
Protección Radiológica , Radiografía Dental , Humanos , Unión Europea , Radiología
13.
Eur J Dent Educ ; 28(1): 236-250, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37579026

RESUMEN

INTRODUCTION: Blended learning seems to be an effective teaching concept in oral radiology. During the COVID-19 pandemic, blended learning shifted towards online-only learning. The aim of the present study was to compare the effectiveness of pandemic online-only and pre-pandemic blended learning in three consecutive oral radiology courses (C1, C2 and C3) and to examine whether additional video-based e-learning modules (VBLMs) had a positive impact on undergraduate students' performance during pandemic semesters. MATERIALS AND METHODS: Data from 205 undergraduate dental students participating either in a blended learning or an online-only learning concept were analysed. Pre-pandemic blended learning comprised face-to-face seminars and access to an oral radiology platform (ORP). Pandemic online-only learning comprised online seminars, access to the ORP and additional VBLMs (two VBLMs for C1, four VBLMs for C2 and six VBLMs for C3). Through standardised e-exams at the beginning and end of each semester, performance in final exams and knowledge gain were compared between the two groups. RESULTS: No significant differences in scores in final exams (p = .11) and knowledge gain (p = .18) were found when comparing the pre-pandemic and pandemic groups. On course level, however, students receiving a lower number of VBLMs performed significantly worse in final exams (C1: p < .01, C2: p = .02) and showed inferior knowledge gain (C2: p < .01) during the pandemic. CONCLUSIONS: Within the limitations of the study, the present investigation confirmed that pandemic online-only learning involving VBLMs might be as effective as pre-pandemic blended learning.


Asunto(s)
Instrucción por Computador , Radiología , Humanos , Estudios Longitudinales , Pandemias , Educación en Odontología , Estudiantes , Radiología/educación
14.
Eur J Dent Educ ; 28(2): 377-387, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37885281

RESUMEN

INTRODUCTION: The aim of this study was to investigate how students perceive the benefit of participating in a teacher-organised session providing feedback on exams, termed post-exam feedback, in two dental hygienist programmes. METHODS: The study was based on interviews with 22 participants, including 18 students and 4 faculty teachers. The data were approached on the basis of thematic analysis, allowing us to generate insights on how the participants reflected on their participation in the post-exam feedback sessions and how they perceived this arrangement as learners. RESULTS: The findings from the study suggest that motivated students consider post-exam feedback to be beneficial in clearing up uncertainties and deepening their understanding of issues not fully understood during the exam, as well as supporting their further learning. Less motivated students mainly consider post-exam feedback to be relevant for students who do not pass the exams. CONCLUSIONS: Organised in a student-centred way and with attentiveness to student learning preferences, the results suggest that post-exam feedback can be valuable for enhancing assessment and supporting student learning related to exams.


Asunto(s)
Evaluación Educacional , Radiología , Humanos , Retroalimentación , Evaluación Educacional/métodos , Higienistas Dentales , Educación en Odontología , Estudiantes
15.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(1): 138-143, 2024 Feb 18.
Artículo en Zh | MEDLINE | ID: mdl-38318908

RESUMEN

OBJECTIVE: To observe the clinical efficacy of pulpotomy in patients of different ages and to explore the occurrence and characteristics of pulpal calcification. METHODS: A total of 77 patients who underwent pulpotomy for mature permanent premolars and molars with caries-derived pulp exposure in the Department of General Dentistry, Peking University School and Hospital of Stomatology from October 2019 to August 2022 were selected. Pulpotomies were performed in a single visit using iRoot BP Plus bioceramic material as pulp capping agent. The patients were divided into three groups according to age: 25 cases in the adolescent group (11-20 years old) with a mean age of (15.88±2.19) years; 27 cases in the middle-aged group (21-50 years old) with a mean age of (34.59±8.67) years; and 25 cases in the elder-aged group (51-83 years old) with a mean age of (63.84±7.40) years. The patients were reviewed 1 year after the operation to evaluate the clinical efficacy and to record the formation of calcified bridge, thickness of calcified bridge, and pulp calcification index (PCI). RESULTS: There was no statistically significant difference between the three groups in terms of gender, dentition, and tooth position (P > 0.05). The 1-year postoperative follow-up rate was 85.71% (66/77), including 88.00% (22/25) in the adolescent group, 85.19% (23/27) in the middle-aged group, and 84.00% (21/25) in the elder-aged group. The 1-year follow-up clinical success rates of the three groups were 95.45% (21/22), 91.30% (21/23), and 95.24% (20/21), respectively, with no statistically significant difference (P>0.05). Among the clinical success cases, calcified bridges appeared in 12 cases (57.14%, 12/21) in the adolescent group, 8 cases (38.10%, 8/21) in the middle-aged group, and 3 cases (15.00%, 3/20) in the elder-aged group, with statistically significant differences (χ2= 7.810, P = 0.020 < 0.05). The difference was statistically significant (F = 4.434, P = 0.020 < 0.05) when comparing the thickness of calcified bridges among the three groups. Calcified bridge thickness was negatively correlated with age (r = -0.516, P < 0.05). The changes in pulpal calcification index ΔPCI were 0.67 ± 0.58, 0.43 ± 0.51, and 0.25 ± 0.52, respectively, with statistically significant differences among the three groups (F = 3.404, P = 0.040 < 0.05). CONCLUSION: Pulpotomy for caries-derived pulp exposure in elderly patients could also achieve a high success rate. The incidence of calcified bri-dges after pulpotomy and the acceleration of pulpal calcification were age-related. The adolescent group was more likely to form calcified bridges and also showed more pronounced accelerated root canal calcification.


Asunto(s)
Pulpotomía , Radiología , Persona de Mediana Edad , Anciano , Adolescente , Humanos , Adulto , Niño , Adulto Joven , Anciano de 80 o más Años , Silicatos , Dentición Permanente , Tratamiento del Conducto Radicular , Resultado del Tratamiento , Óxidos , Compuestos de Calcio , Combinación de Medicamentos
16.
Radiology ; 307(1): e221263, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36511806

RESUMEN

The U.S. National Council on Radiation Protection and Measurements (NCRP) conducted a retrospective assessment of the U.S. data, and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) performed a similar worldwide assessment for 2009-2018 (with most data from 2014 to 2017). Using the data from those reports, the frequency of radiologic and nuclear medicine studies, annual collective, and per capita effective dose in the United States for 2016 were compared with worldwide estimates from 2009 to 2018. There were an estimated 691 million radiologic, CT, dental, and nuclear medicine studies performed in the United States in 2016, which represented 16.5% of the 4.2 billion performed worldwide. The United States also accounted for 74 million CT procedures (18% of the world's estimated total), 275 million conventional radiology procedures (11% of the world's total), 8.1 million interventional radiologic procedures (34% of the world's total), 320 million dental radiography procedures (29% of the world's total), and 13.5 million nuclear medicine procedures (34% of the world's total). The U.S. collective effective dose was 717 000 person-sieverts (17.6% of the world's total). The average annual individual effective dose in the United States was 2.2 mSv compared with 0.56 mSv worldwide. The United States accounts for a large and disproportionate share of global medical radiation procedures and collective effective dose, but use of CT has increased more in other countries compared with the United States.


Asunto(s)
Medicina Nuclear , Traumatismos por Radiación , Humanos , Estados Unidos , Dosis de Radiación , Estudios Retrospectivos , Radiografía
17.
Support Care Cancer ; 31(12): 644, 2023 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-37851095

RESUMEN

INTRODUCTION: Radiotherapy-induced xerostomia (RIX) is one of the most common adverse effects of radiotherapy (RT) in head and neck cancer patients (HNC) and a major determinant of survivors' quality of life. The primary objective was to evaluate the reduction of patients' xerostomia symptoms after the utilisation of a sodium-hyaluronate mouthwash compared to a placebo solution. The secondary objectives were to evaluate the improvement of quality of life and to evaluate the patients' satisfaction. METHODS: The protocol was approved by the ethical committee (Ref. 50,053/19) and registered at ClinicalTrials.gov (ID: NCT05103124). The study was a double-blind randomised clinical trial (RCT) with a crossover design and was conducted at the Fondazione Policlinico Universitario A. Gemelli, Rome. RESULTS: Thirty-two patients completed the study protocol. Lower values of the modified Xerostomia Questionnaire (XQ) were retrieved when comparing the baseline scores to the ones after the treatment, when compared with placebo (Mann-Whitney U test = 0.01); higher values of patients' satisfaction (Likert scale) and modified XQ were retrieved for the sodium-hyaluronate mouthwash (Mann-Whitney U test = 0.001). CONCLUSIONS: This RCT highlights the advantages of treating RIX with the sodium-hyaluronate mouthwash since it seems to be clinically effective in reducing its symptoms, without any reported adverse events. CLINICALTRIALS: gov: NCT05103124 in 17/10/2021.


Asunto(s)
Neoplasias de Cabeza y Cuello , Oncología por Radiación , Xerostomía , Humanos , Antisépticos Bucales/uso terapéutico , Ácido Hialurónico/uso terapéutico , Xerostomía/tratamiento farmacológico , Xerostomía/etiología , Xerostomía/prevención & control , Sodio/uso terapéutico , Neoplasias de Cabeza y Cuello/radioterapia , Calidad de Vida
18.
Support Care Cancer ; 32(1): 38, 2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38110572

RESUMEN

AIM: Radiation-induced oral mucositis (RIOM) is the most frequent side effect in head and neck cancer (HNC) patients treated with curative radiotherapy (RT). A standardized strategy for preventing and treating RIOM has not been defined. Aim of this study was to perform a real-life survey on RIOM management among Italian RT centers. METHODS: A 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy. RESULTS: A total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity. CONCLUSION: Great variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients' compliance and overall treatment time of the radiation course is still unclear and needs further investigation.


Asunto(s)
Neoplasias de Cabeza y Cuello , Mucositis , Traumatismos por Radiación , Oncología por Radiación , Estomatitis , Humanos , Mucositis/tratamiento farmacológico , Antisépticos Bucales/uso terapéutico , Bicarbonato de Sodio/uso terapéutico , Ácido Hialurónico/uso terapéutico , Estomatitis/etiología , Estomatitis/prevención & control , Traumatismos por Radiación/etiología , Traumatismos por Radiación/prevención & control , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Esteroides
19.
BMC Med Educ ; 23(1): 855, 2023 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-37953275

RESUMEN

BACKGROUND: Acquiring adequate theoretical knowledge in the field of dental radiography (DR) is essential for establishing a good foundation at the prepractical stage. Currently, nonface-to-face DR education predominantly relies on two-dimensional (2D) videos, highlighting the need for developing educational resources that address the inherent limitations of this method. We developed a virtual reality (VR) learning medium using 360° video with a prefabricated head-mounted display (pHMD) for nonface-to-face DR learning and compared it with a 2D video medium. METHODS: Forty-four participants were randomly assigned to a control group (n = 23; 2D video) and an experimental group (n = 21; 360° VR). DR was re-enacted by the operator and recorded using 360° video. A survey was performed to assess learning satisfaction and self-efficacy. The nonparametric statistical tests comparing the groups were conducted using SPSS statistical analysis software. RESULTS: Learners in the experimental group could experience VR for DR by attaching their smartphones to the pHMD. The 360° VR video with pHMD provided a step-by-step guide for DR learning from the point of view of an operator as VR. Learning satisfaction and self-efficacy were statistically significantly higher in the experimental group than the control group (p < 0.001). CONCLUSIONS: The 360° VR videos were associated with greater learning satisfaction and self-efficacy than conventional 2D videos. However, these findings do not necessarily substantiate the educational effects of this medium, but instead suggest that it may be considered a suitable alternative for DR education in a nonface-to-face environment. However, further examination of the extent of DR knowledge gained in a nonface-to-face setting is warranted. Future research should aim to develop simulation tools based on 3D objects and also explore additional uses of 360° VR videos as prepractical learning mediums.


Asunto(s)
Radiología , Realidad Virtual , Humanos , Autoeficacia , Programas Informáticos , Satisfacción Personal
20.
J Radiol Prot ; 43(1)2023 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-36927616

RESUMEN

A high volume of dental imaging is carried out each year. In the UK, guidance on the use of patient contact shielding for these investigations is published by the British Institute of Radiology (BIR) and in a document jointly produced by the Faculty of General Dental Practice and Public Health England (FGDP/PHE). Both these sources of guidance have been updated recently and patient contact shielding is no longer recommended for most imaging settings in dental radiology. It is unclear whether radiology departments at dental teaching hospitals in the UK are aware of these sources of guidance, and how this relates to clinical practice within these departments. A survey was carried out exploring the awareness of current guidelines and clinical practice at dental teaching hospitals in the UK. The survey was sent to a representative at 17 different dental teaching hospital radiology departments. Responses were received from 11 departments. The range of intra-oral and extra-oral imaging carried out at these departments was comparable. Ten departments were aware of the existence of national guidelines for patient contact shielding, however only four were specifically aware of the recent BIR guidelines and only four were specifically aware of the FGDP/PHE guidelines. No department was aware of both sets of guidelines. No departments used thyroid protection for bitewing, periapical, lower 45 degree occlusal, panoramic or lateral cephalometric radiographs. Six departments sometimes or always used thyroid protection for upper standard occlusal imaging. Two departments used thyroid protection for cone beam CT imaging. No departments routinely used lead aprons on patients for dental imaging. In conclusion, radiology departments at dental teaching hospitals in the UK do not use patient contact shielding for most imaging situations in dental radiology. There is mixed awareness of current national guidelines, but the reported clinical practice aligns well with the current guidelines.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Radiología , Humanos , Encuestas y Cuestionarios , Inglaterra , Hospitales de Enseñanza
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