Influence of high-irradiance light curing on the marginal integrity of composite restorations in primary teeth.

BACKGROUND: Reducing the necessary time to restore primary teeth improves the cooperation of paediatric patients. This study aimed to investigate the marginal integrity of restorations prepared with a bulk-fill resin-based composite (RBC) containing additional fragmentation chain transfer (AFCT) compared to a conventional RBC when light cured with a rapid high-irradiance (3 s) and a regular (10 s) curing mode. METHODS: Forty class-II cavities were prepared in 40 primary molars. The molars were randomly divided into four groups based on the applied light-curing modes (regular: 10 s @ 1200 mW/cm2 or high-irradiance: 3 s @ 3000 mW/cm2) and the used restorative material (AFCT-containing bulk-fill RBC "Power Fill" or AFCT-free conventional RBC "Prime"). After thermo-mechanical loading, the marginal integrity was analysed using scanning electron microscopy. A beta regression model and pairwise comparisons were used to statistically analyse the data. RESULTS: The mean marginal integrity (% ± SD) of the restorations for each group was as follows: Power Fill (10 s: 79.7 ± 15.6) (3 s: 77.6 ± 11.3), Prime (10 s: 69.7 ± 11.1) (3 s: 75.0 ± 9.7). The difference between the RBCs for the same light-curing mode was statistically significant (p ≤ 0.05). The difference between the light-curing modes for the same RBC was not statistically significant (p ˃ 0.5). CONCLUSIONS: AFCT-containing bulk-fill RBC "Power Fill" achieves similar marginal integrity when light-cured with either high-irradiance or regular light-curing modes. "Power Fill" achieves better marginal integrity than the conventional RBC "Prime" regardless of the applied light-curing mode.

[Compression or expansion of morbidity in outpatient healthcare? : Generation 65plus in 2007 and 2014]. / Kompression oder Expansion der Morbidität in der ambulanten Versorgung? : Die Generation 65plus in 2007 und 2014.

BACKGROUND: The ageing population raises the question whether there is a compression or expansion of morbidity. OBJECTIVE: This study examined the development of morbidity and the associated outpatient volume of services in outpatient healthcare. MATERIAL AND METHODS: With a nationwide sample of statutory health insurance patients, the development of the documented morbidity and outpatient volume of services of the generation 65plus was empirically examined by a retrospective, cohort-specific study based on outpatient claims data covering the years 2007 and 2014. RESULTS: In 2014 the proportion of multimorbid patients was increased compared to chronically ill patients, other users and non-users. A subgroup analysis showed declining incidences for nearly all age and gender groups. In total, the average outpatient volume of services per patient increased, which is primarily attributable to increasing care of multimorbid and deceased patients. CONCLUSION: High life expectancy leads to a susceptibility for chronic diseases and multimorbidity, which indicates an expansion of morbidity in outpatient care. The resulting increased need for outpatient care should be covered with specific healthcare concepts for chronically ill and multimorbid patients. Declining incidences are a positive indication to reinforce health-promoting measures for the generation 65plus. To develop specific healthcare offers for a heterogeneous generation 65plus, a differentiated analysis for example by socioeconomic status and disease patterns is needed.

Comparing nationwide prevalences of hypertension and depression based on claims data and survey data: An example from Germany.

INTRODUCTION: Coded diagnoses in claims data offer a comprehensive basis for health sciences and health policy decisions. For example, morbidity-based risk adjustment schemes use coded diagnoses to allocate resources. Therefore a routinely performed validation is important. Data reconciliation with medical records would be first best, but is not possible here. This paper validates population-based prevalences of hypertension and depression based on claims data by comparing them with prevalences stem from two different epidemiological survey data. METHOD: Data sources accessible are a nationwide sample based on outpatient claims data (GSPR), a nationwide health interview and examination survey (DEGS1) and a nationwide telephone interview survey (GEDA). The analysis includes SHI-insured aged 18-79 who live in 2010 in Germany. RESULTS: There was high agreement for hypertension prevalences between GSPR (28.98% [28.95-29.02]) and DEGS1 (28.0% [26.5-29.5]) but not with GEDA (22.9% [22.1-23.7]). The agreement for depression prevalences was high between the two surveys (DEGS1: 7.6% [6.7-8.5] and GEDA: 6.7% [6.3-7.2]) and moderate compared to GSPR (12.23% [12.21-12.26]). CONCLUSION: For an objectifiable disease, such as hypertension, diagnostic coding with claims data seems to be valid to be used for risk adjustment in German outpatient health care. Even though depression prevalences differ between claims data and survey data, more effort is required to understand the magnitude of a reference systems impact on prevalence estimates.