Leveraging the functionality of Research Electronic Data Capture (REDCap) to enhance data collection and quality in the Opioid Analgesic Reduction Study.

BACKGROUND: The Opioid Analgesic Reduction Study is a double-blind, prospective, clinical trial investigating analgesic effectiveness in the management of acute post-surgical pain after impacted third molar extraction across five clinical sites. Specifically, Opioid Analgesic Reduction Study examines a commonly prescribed opioid combination (hydrocodone/acetaminophen) against a non-opioid combination (ibuprofen/acetaminophen). The Opioid Analgesic Reduction Study employs a novel, electronic infrastructure, leveraging the functionality of its data management system, Research Electronic Data Capture, to not only serve as its data reservoir but also provide the framework for its quality management program. METHODS: Within the Opioid Analgesic Reduction Study, Research Electronic Data Capture is expanded into a multi-function management tool, serving as the hub for its clinical data management, project management and credentialing, materials management, and quality management. Research Electronic Data Capture effectively captures data, displays/tracks study progress, triggers follow-up, and supports quality management processes. RESULTS: At 72% study completion, over 12,000 subject data forms have been executed in Research Electronic Data Capture with minimal missing (0.15%) or incomplete or erroneous forms (0.06%). Five hundred, twenty-three queries were initiated to request clarifications and/or address missing data and data discrepancies. CONCLUSION: Research Electronic Data Capture is an effective digital health technology that can be maximized to contribute to the success of a clinical trial. The Research Electronic Data Capture infrastructure and enhanced functionality used in Opioid Analgesic Reduction Study provides the framework and the logic that ensures complete, accurate, data while guiding an effective, efficient workflow that can be followed by team members across sites. This enhanced data reliability and comprehensive quality management processes allow for better preparedness and readiness for clinical monitoring and regulatory reporting.

Implementation of a Digital Radiographic Image Acquisition and Retrieval System (DRIARS) using a wireless network in an orthodontic department.

AIM: The objective of this report is to describe the implementation and pilot-test of an integrated wireless local area network (WLAN) system that incorporated the Planmeca Promax CCD based digital panoramic/cephalometric x-ray system, Dolphin(R) software, and multiple remote user units to increase the efficiency of data management by the residents in the Department of Orthodontics. BACKGROUND: The Department of Orthodontics of the New Jersey Dental School (NJDS) acquired the Dolphin cephalometric analysis software and the Planmeca Promax digital panoramic/cephalometric x-ray units on separate occasions. Dolphin has been in use for many years at this institution, the current version being 10, and the Promax was acquired in the Fall of 2002. The digital panoramic and cephalometric radiographs were acquired and stored separately in the Planmeca's Dimaxis database. REPORT: During the incorporation of the WLAN, there was an opportunity to research and install the best available security system for the WLAN so it could be a network model for the other departments within the dental school and perhaps other dental schools around the nation. SUMMARY: Digital radiographs, once obtained, can be stored locally or transmitted securely to remote locations via a local area network. This article describes the selection criteria and methodology that would optimize the transmission and retrieval of such images instantaneously on demand at chair side locations. This will not only save significant clinical time but will enhance the productivity of the clinic in the long run.

Colony forming unit levels of salivary Lactobacilli and Streptococcus mutans in orthodontic patients.

The purpose of this study was to compare the levels of Lactobacilli (LB) and Streptococcus mutans (SM) colony forming units (CFU) in the saliva of subjects before and after orthodontic appliance placement. This was a controlled, prospective two-group, two-measurement, clinical trial performed on 64 study patients, 12-15 years old. Subjects in the experimental group were sampled for LB and SM in stimulated saliva collected on the same day but prior to band and bracket placement. The subjects in the control group were sampled on their first screening appointment two months prior to band and bracket placement. The second samples of LB and SM were taken from the experimental and control groups after two months. Saliva was transferred to a selective agar carrier and incubated for 48 hours at 37 degrees C / 99 degrees F. LB and SM colonies forming units were compared with standard densities. The experimental group wearing orthodontic appliances had significantly higher mean LB CFU counts than the control group at the 2 month follow-up (3.25 vs. 2.57, p = 0.0036). The two groups, however, did not show any difference in mean SM CFU counts at the 2 month follow-up (3.0 vs. 3.1, p = 0.66). The results of this study showed that a higher number of CFUs of LB were associated with the group wearing orthodontic appliances after two months and may play a role in the increased levels of plaque seen in many orthodontic patients.

Comparison of powered and manual toothbrushes for plaque removal by 4- to 5-year-old children.

PURPOSE: This study compared the small head Oralgiene 60 Second Time Machine powered toothbrush, used for 60 seconds, with the Braun Oral-B Mickey Mouse powered toothbrush and a manual toothbrush (Oral-B Rugrats 20), each used for 2 minutes, for efficacy in plaque removal and reduction of gingival inflammation in young children. METHODS: Fifty-eight children, ages 4 to 5 years old, were randomly assigned to one of the 3 toothbrush groups. At visit 1, plaque and gingival indices were recorded for all subjects. Then, the children did not brush for 24 hours. At visit 2, 24 hours later, plaque indices were recorded, the children brushed with their assigned toothbrush, and plaque indices were recorded again. Six weeks later, plaque and gingival indices were recorded again. The data was analyzed to detect plaque reduction after a one-time use (visit 2, prebrushing and postbrushing) as well as plaque and gingival inflammation reduction after 6 weeks of use. RESULTS: The Oralgiene toothbrush removed significantly more plaque during the one-time trial and reduced significantly more gingival inflammation during the 6-week trial. The Braun Oral B powered toothbrush removed significantly more plaque than the other toothbrushes during the 6-week trial. However, no clinically meaningful differences were found between any of the toothbrushes with regard to plaque removal or gingival scores. CONCLUSIONS: There were no clinically meaningful differences found between any of the toothbrushes tested during either of the trials with regard to plaque removal or improvement in gingival health.

Alumni perspectives on community-based and traditional curricula.

In 1994, the University of Medicine and Dentistry of New Jersey-New Jersey Dental School (UMDNJ-NJDS) launched the Community-Oriented Dental Education (CODE) program. The CODE program provides senior dental students the opportunity to spend four days per week providing dental care in a community-based clinic. A survey of graduates of CODE (n = 55) and randomly selected graduates of the traditional curriculum (n = 110) was conducted via mail to determine attitudes relating to community service (CS), community-based learning (CBL), reasons for participating in their clinical program, perceived levels of clinical preparedness at graduation, and practice choices. A total of 111 surveys (66.9 percent) were returned to NJDS, with 84.6 percent of CODE alumni responding and 59.0 percent of traditional alumni (TA) responding. Of the 111 surveys returned, sixty-five (58.6 percent) were completed by TA, and forty-six (41.4 percent) were completed by CODE alumni. There were no differences among CODE and TA regarding attitudes toward CS and tendency to practice in underserved areas or to accept Medicaid payments. There were, however, some differences in attitudes toward CBL, reasons for applying or not applying to the CODE program, perceived impact of clinical education on graduates' preparedness, views of the extent to which the programs encouraged students to choose public or private areas of practice, and perceptions of how the desire to help communities influenced career and practice decisions. Some of these findings may be useful to schools as they plan extramural education programs.

Relationship between tooth shade value and skin color: an observational study.

STATEMENT OF PROBLEM: There is limited scientific information on the relationship between tooth shade and skin color. This lack of knowledge may impact the ability of the prosthodontist to select artificial teeth that complement the facial complexion of the patient. PURPOSE: This observational study explored the possibility of a relationship between tooth shade and skin color. MATERIALS AND METHODS: A total of 119 individuals aged 18 to 80 years participated in this observational study. Two investigators calibrated for examining tooth shade performed all examinations. A Vita-Lumin shade guide was used to examine either the maxillary right or left central incisor, one of which had to be restoration- and caries-free for study inclusion. Tooth shades were divided into 4 categories according to value, and skin tones were divided into 4 categories (fair, fair/medium, medium, and dark) with the use of L'Oreal True Illusion compact makeup shades as a guide. Categorical modeling with chi-square analysis and Fisher's exact tests was used to analyze the data (alpha=.05). RESULTS: No interaction among age, skin color, and tooth shade or gender, skin color, and tooth shade was found; however, age was associated with tooth shade (P<.001). Older persons were more likely to have teeth with lower values (darker). Among those aged 60 and older, 85% had teeth in the medium and low range values compared with 17% of those younger than 31. Significant tooth shade differences were discovered among patients with different skin colors (P<.05). Among those with low values (darker teeth), 50% were of fair complexion and 17% were of dark complexion (P<.001). CONCLUSION: Within the limitations of this study, tooth shade value and skin color were inversely related. Older adults were more likely to have darker teeth (lower value).