Ceramic Coatings Confer No Survivorship Advantages in Total Knee Arthroplasty-A Single-Center Series of 1641 Knees.

Background: Ceramic coatings in total knee arthroplasty have been introduced with the aim of reducing wear and consequently improving implant survivorship. We studied both cobalt-chrome-molybdenum (CoCrMo) and ceramic-coated components of the same implant design from a single center to identify if the ceramic coating conferred any benefit. Methods: We identified 1641 Columbus total knee arthroplasties (Aesculap AG, Tüttlingen, Germany) from a prospectively collected arthroplasty database. Of the 1641, 983 were traditional CoCrMo, and 659 had the Columbus AS ceramic coating. Patients were followed up until death or revision of any component of the implant. Results: There was no significant difference in implant survivorship using any component revision as the endpoint between the CoCrMo femur and the ceramic-coated femur at a mean of 9.2 years in follow-up for the CoCrMo group and 5 years for the ceramic-coated group (37 vs 14; P = .76). There was no reduction in the proportion of components revised for aseptic loosening or infection in the ceramic-coated cohort. Conclusions: At midterm follow-up, there was no benefit in terms of implant survivorship in using a ceramic coating.

Factors affecting oral health care for asylum seekers and refugees in England: a qualitative study of key stakeholders' perspectives and experiences.

Aims To investigate factors influencing oral health behaviours and access to dental services for asylum seekers and refugees (ASRs).Methods A qualitative research study using purposeful sampling was undertaken in South West England. Online semi-structured interviews with stakeholders working with or supporting ASRs were analysed through reflexive thematic analysis.Results Twelve participants providing support to ASRs in various capacities participated. Two interviewees had lived experience of forced displacement and the UK asylum process. Key themes into what hinders ASRs' oral health care were: prioritising safety and survival; variations in cultural norms and practice; lack of knowledge about dental care; financial hardship and affordability of care; a gulf of understanding of what dental care would be like and experiences of it; and structures of dental services that leave vulnerable groups behind. Opportunities for improving oral health care were: accessible oral health education; partnership working and creating supportive environments; translation; providing culturally sensitive and person-centred care; and incorporating ASRs' views into service design.Conclusions Several factors affect to what extent ASRs can and are willing to engage with oral health care. Co-developing accessible and relevant prevention programmes and ensuring equitable access to dental services for ASRs is important. Future research should explore ASRs' views and experiences of dental care and explore informed suggestions on how to optimise oral health promotion and provision of care.

Should dental technicians play a greater role in the education of foundation dentists?

In some dental foundation training (DFT) practices, many generations of foundation dentists (FDs) have benefited from being encouraged to build close working relationships with dental technicians. Recent work suggests that new graduates may require additional support with the technical aspects of clinical work due to reduced clinical exposure in undergraduate education. This opinion paper therefore describes how involvement of technical colleagues in the education of FDs could provide important additional feedback on their work and draws upon the concept of 'spiral learning'. It goes on to argue that these opportunities are vital in building mutual respect and the ability to communicate effectively with members of the dental team. Ingraining this approach in FDs is important for their future careers and for the dental profession.

The self-perceived role of sedation-trained dental nurses within a Community Dental Service: a qualitative study.

Background Dental nurses trained in assisting with relative analgesia with nitrous oxide (RA) play an important role in patient care. Provision of RA is a service provided in the Community Dental Service based in Doncaster, Barnsley and Rotherham.Aim To explore how sedation-trained dental nurses perceive their role within a Community Dental Service, and to explore what motivates them and how they feel changes could enhance the provision of care.Methods Twelve nurses who had experience of assisting with RA for at least one year in three community clinics in a South Yorkshire-based Community Dental Service were recruited and undertook a semi-structured interview. All interviews were transcribed verbatim and subsequent thematic analysis of the manuscripts was undertaken.Results Five major themes were identified: 1) motivation; 2) role; 3) training and continuing professional development; 4) pressures on the service; and 5) service enhancements.Conclusion Within this qualitative study, the dental nurses perceived that they had a crucial role in patient and parent behavioural management and keeping the patient safe during treatment. Helping patients to accept planned dental treatment gave them significant job satisfaction. Overall, this study has shown that they feel that they have a crucial role in assisting with RA treatment.