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2.
J Contemp Dent Pract ; 20(10): 1126-1131, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31883244

RESUMEN

AIM: Modern clinical caries management involves early stage caries diagnosis and should fit with dental health policy. The objective of this study was to achieve early caries detection in enamel and dentine with a laser-based system (DIAGNOdent™ pen) first and secondary with a new fluorescence intra-oral camera (Soprolife®). A visual inspection with a loupe was used as control. MATERIALS AND METHODS: Following the consolidated standards of reporting trials recommendations, 628 occlusal fissures were included for analysis. RESULTS: The sensitivity and specificity of both devices varied depending on the cutoff threshold of the caries score, and the ROC curve showed higher values for the Soprolife® than for DIAGNOdent™ pen. The values of the area under the curve decreased from 0.81 (Soprolife® in daylight) to 0.79 (Soprolife® in fluorescent mode) and 0.67 for DIAGNOdent™ pen. DIAGNOdent™ pen reproducibility (intra and inter-investigator) showed a wide dispersion, with many values scattered beyond the confidence limits (±2 SD), and the weighted kappa coefficient, which was quite low (0.58), confirmed this tendency. CONCLUSION: Caries prevalence in terms of public health policy is of interest and caries detection increased significantly when using an fluorescence-based intra-oral camera. CLINICAL SIGNIFICANCE: The clinical significance of these findings is that fluorescence could help improve caries diagnosis, reduce clinical misinterpretations, and finally benefit the patients. How to cite this article: Terrer E, Slimani A, Giraudeau N, et al. Performance of Fluorescence-based Systems in Early Caries Detection: A Public Health Issue. J Contemp Dent Pract 2019;20(10):1126-1132.


Asunto(s)
Caries Dental , Salud Pública , Esmalte Dental , Dentina , Fluorescencia , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
3.
Contemp Clin Trials Commun ; 16: 100444, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31709310

RESUMEN

Dental caries is a major oral disease resulting from a complex interaction between the commensal microbiota, host susceptibility (heredity, immunity, diseases, etc.) and environmental factors (diet, dental hygiene, etc.). To predict the patient's risk of new carious lesions or progression of existing lesions, the Caries Risk Assessment (CRA) takes account of clinical, biological and behavioural factors. Thus, the CRA can predict whether the patient is at high or low risk of developing caries. The practitioner can thus set up a follow-up adapted to the risk of the patient. However, although bacteria are the main etiological factor of carious lesions, the CRA does not consider bacterial quantification or just focus on the level of S. mutans in the saliva. As the majority of cavities are interproximal in adolescence, the aim of this trial is to identify and quantify the interdental microbiota of adolescents aged from 15 to 17 years with low or high carious risk. So, the quantification of new biomarkers associated with carious lesion could be added to the CRA to improve it.

4.
Microorganisms ; 7(9)2019 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-31491909

RESUMEN

Adolescence is closely associated with a high risk of caries. The identification of specific bacteria in an oral microniche, the interdental space of the molars, according to carious risk can facilitate the prediction of future caries and the anticipation of the progression or stabilization of caries in adolescents. A cross-sectional clinical study according to the bacteriological criteria of interdental healthy adolescents and carious risk factors-low and high-using a real-time polymerase chain reaction technique was conducted. The presence of 26 oral pathogens from the interdental microbiota of 50 adolescents aged 15 to 17 years were qualitatively and quantitatively analyzed. Bacteria known to be cariogenic (Bifidobacterium dentium, Lactobacillus spp., Rothia dentocariosa, Streptococcus cristatus, Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus wiggsiae) did not present differences in abundance according to carious risk. Periodontal bacteria from the red complex are positively correlated with carious risk. However, only 3 bacteria-S. sobrinus, E corrodens and T. forsythia-presented a significant increase in the highest group. Estimating the risk of caries associated with bacterial factors in interdental sites of molars in adolescents contributes to the better definition of carious risk status, periodicity and intensity of diagnostic, prevention and restorative services.

5.
Eur J Dent ; 13(1): 53-57, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31242508

RESUMEN

OBJECTIVE: A large number of digital tools supporting students have emerged over recent years which are encouraged in tutoring. A study conducted at the University of Montpellier (France) among 3rd, 4th, and 5th year dentistry students aimed primarily to identify the type of pedagogical support the students preferred according to their discipline. The secondary aim was to evaluate the student satisfaction after establishing a new pedagogical support. MATERIALS AND METHODS: A total of 165 questionnaires were completed. The main questions concerned pedagogical use of information technology and multimedia tools, choice of dentistry disciplines most justifying their use, and pedagogical gaps in these disciplines. Next, a program of pedagogical videos was developed for the most corresponding discipline. A satisfaction survey was finally conducted. RESULTS: Nearly 95.7% of students found online classes and E-learning via the virtual learning environment useful, with the most requested type being video. Demand was stronger in conservative dentistry and endodontics (27%), prosthetics (19%), and periodontology (18%). The most apprehended disciplines were endodontics in the 3rd year, endodontics and prosthetics in the 4th year, and prosthetics in the 5th year. Regarding satisfaction, 100% of students appreciated these videos and 99.4% considered they fulfilled expectations. CONCLUSION: All students requested videos, especially for clinical subjects such as endodontics. With digital technology, our world is experiencing a technological revolution resulting in many daily life changes. With students evolving in a digitally saturated society, our ways of learning and teaching need rethinking. Digital technology can help improve learning effectiveness and develop pedagogical practices more adapted to today's students.

6.
J Int Soc Prev Community Dent ; 7(Suppl 2): S92-S98, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29184835

RESUMEN

Objectives: The purpose of this study was to identify the major sources of perceived stress and their relation to a student satisfaction questionnaire about the curriculum and the pedagogy among French dental students. Materials and Methods: All dental students (n = 178) from years 4 to 6 at the University of Montpellier (France) participated in this exploratory survey. In spring 2016, a 3-part questionnaire was distributed during clinical sessions: the first part asked about sociodemographic and living conditions, the second part aimed to assess the students' perceived stress (Dental Environmental Stress questionnaire), and the third part was a satisfaction questionnaire exploring the clinical organization and the teaching methodologies (Student Course Experience Questionnaire). A Spearman's correlation test and a principal component analysis were used to assess the relation between the variables of the questionnaire. Results: The response rate was 99.4%. The most stressful items were "the number of tasks to be performed during clinical practice," "the waiting time before opinion from teachers," and "the administrative part and computer problems." Fifty-four percent of the students claimed to be satisfied with their studies, showing a score of seven or higher. There was a negative correlation between the level of student satisfaction and the level of perceived stress. Conclusion: Although most of the students were globally satisfied with their curriculum, this study highlighted dysfunctions in the clinical education with a level of stress correlated with the student's dissatisfaction. Most of all, students found that examinations were too stressful and that the clinical requested task quotas were overestimated.

7.
Syst Rev ; 6(1): 174, 2017 08 29.
Artículo en Inglés | MEDLINE | ID: mdl-28851449

RESUMEN

BACKGROUND: Individuals living in rural and remote settings face oral health problems and access-to-care barriers due to the shortage of oral health care providers in these areas, geographic remoteness, lack of appropriate infrastructure and lower socio-economic status. E-Oral Health technology could mitigate these barriers by providing the delivery of some aspects of health care and exchange of information across geographic distances. This review will systematically evaluate the literature on patient satisfaction with received E-Oral Health care in rural and remote communities. METHODS: This systematic review will include interventional and observational studies in which E-Oral Health technology is used as an intervention in rural and remote communities of any country worldwide. Conventional oral health care will be used as a comparator when provided. Patient satisfaction with received E-Oral Health care will be considered as a primary outcome for this review. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and Global Health will be searched using a comprehensive search strategy. Two review authors will independently screen results to identify potentially eligible studies and independently extract the data from the included studies. A third author will resolve any discrepancies between reviewers. Two independent researchers will assess the risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation. DISCUSSION: The potential implications and benefits of E-Oral Health care can inform policymakers and health care professionals to take advantage of this technology to address health care challenges in these areas. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016039942 .


Asunto(s)
Salud Bucal/normas , Satisfacción del Paciente , Población Rural , Telemedicina/métodos , Personal Administrativo , Personal de Salud , Humanos , Revisiones Sistemáticas como Asunto
8.
Int J Prison Health ; 13(2): 124-134, 2017 06 12.
Artículo en Inglés | MEDLINE | ID: mdl-28581375

RESUMEN

Purpose In France, all incarcerated prisoners are required to undergo a dental examination (Ministère de la santé et de la protection sociale, 2004 and Ministère de la justice, 2004). However, only one in two prisoners benefits from this oral health check-up. Oral teleconsultation could improve the quality of oral care in prisons. The paper aims to discuss these issues. Design/methodology/approach The focus of this study was therefore to apply oral teleconsultation as an experiment. Using an oral teleconsultation system, a dentist and a nurse were separately asked to give patients a score, according to how urgently their dental issue needed to be treated. This score will henceforth be referred to as the "dental emergency scores given". Findings The separate dental emergency scores given by the dentist and the nurse were compared and the results demonstrate the following: - 36.7 per cent (11) of the two scores were equal - 53.3 per cent (16) of the two scores differed by 1 point - 10 per cent (3) of the two scores differed by 2 points. The average score of the nurse was 2.23 and that of the dentist was 2.13. The small disparity should not obscure the fact that 63 per cent of the diagnoses turned out to be incorrect. Practical implications Dental care could easily be improved with oral teleconsultation as a care plan could be developed for each patient. Social implications The condition of one's dental health is, of course, very important for general health, but it also affects social aspects. Good oral hygiene and health are very important when looking for a job after having been released from prison. Originality/value This is the first study on oral teleconsultation in prisons. Dental care is rarely studied on prisoners. Telemedicine in dentistry is just beginning all over the world. This study is the first step of an extensive project in the University Hospital of Montpellier and the Villeneuve-les-Maguelone prison.


Asunto(s)
Salud Bucal , Prisiones , Consulta Remota , Adulto , Política de Salud , Humanos , Prisioneros , Encuestas y Cuestionarios
9.
Int J Technol Assess Health Care ; 33(2): 147-154, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28554342

RESUMEN

OBJECTIVES: The evaluation of telemedicine from the patient's point of view has focused on the patient pathway and patient satisfaction. However, research in this field does not provide us with the means to assess a patient's perception of the procedure if their reasoning ability is impaired. In this study, we use direct observation of a patient's behavior and mood to assess their perception of an oral teleconsultation procedure. METHODS: This study has been conducted in the context of a pilot project using an asynchronous teleconsultation to improve access to dental care for the dependent elderly, disabled people, and prisoners, some of whom may be cognitively impaired. We use a direct observation form consisting of five behavioral variables and eight affect variables to reflect the patient's experience of the oral teleconsultation procedure. RESULTS: A total of 135 patients were evaluated; 10 refused the procedure. Psychotic patients (n = 33) had a somewhat negative experience during the oral teleconsultation procedure. Patients who were not psychotic had a positive experience; this decreased as we moved from the autonomous to the semi-autonomous and then to the dependent sub-group. Some gender differences were also noted. CONCLUSIONS: Improving evidence on evaluating the acceptance of the cognitively impaired is required to improve the technology development process so that it can be translated into an improved patient experience and adherence. Although the study was specifically focused on teledentistry, the approach described in this study could be adapted to other forms of teleconsultation.


Asunto(s)
Satisfacción del Paciente , Consulta Remota , Telemedicina , Humanos , Proyectos Piloto
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