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1.
Artigo em Inglês | MEDLINE | ID: mdl-32610664

RESUMO

The purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a 25-item online questionnaire, to assess their GD curriculum, and were included in the study. GD was a mandatory course in 56 dental schools (67.5%), an independent subject in 14 schools (16.9%), and was taught as a series of lectures in 31 schools (37.4%). Clinically, 56 dental schools (67.5%) had some form of mandatory education in GD. The type of school, location and method of presentation were not associated with greater interest in expanding their curriculum in GD (p = 0.256, p = 0.276, and p = 0.919, respectively, using the Chi-square test). We found GD is a curriculum requirement in most of the surveyed dental schools and is becoming more common among dental school curricula. This survey is the first study to present data from dental schools from all continents, using a web-based survey which is a resourceful, less-expensive tool to gather data.

2.
J Am Dent Assoc ; 151(7): 519-526, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32593354

RESUMO

BACKGROUND: The US population is aging. Most older adults are retaining their natural teeth for longer, and fewer are becoming edentulous. METHODS: Among people 65 years and older, there is greater heterogeneity than at any other time in the life cycle because these cohorts are influenced by historical experiences and the sociodental events during their life spans. These events and experiences have affected their health behaviors and, consequently, their systemic and oral health. This article is an update on 2 previous articles that described birth cohorts spanning from 1900 through 1945, whereas this article describes 5 specific cohorts born from 1920 through 1980. RESULTS: The authors used data from the literature to describe the historical and socioeconomic influences, as well as the key events in the history of dentistry, that have affected each of these cohorts' attitudes and expectations toward the use of health care and dental care services. CONCLUSIONS: The authors identified cohort differences regarding health behaviors, which included attitudes toward dentistry and dental care service use. PRACTICAL IMPLICATIONS: Dentists should be aware of cohort differences in regard to dental care service use, in addition to modifiers that are specific to each patient, to offer the most customized and age-appropriate oral health care.


Assuntos
Boca Edêntula , Saúde Bucal , Idoso , Envelhecimento , Estudos de Coortes , Assistência à Saúde , Humanos
5.
Braz. dent. sci ; 23(2,supl): 1-7, 2020.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1100187

RESUMO

Older adults may face many barriers when accessing oral health care. The most vulnerable groups are people living in long term care institutions and the homebound. These barriers are related but not limited to socio-economic issues, medical and oral health problems. Some socio-economic problems are lack of finances, absence of dental insurance, lack of social support networks, and being institutionalized. Some general health problems are multiple co-morbidities, polypharmacy, dementia, and reduced autonomy. Some oral health problems are having heavily restored dentitions, dry mouth, root caries, and inability to maintain adequate oral hygiene independently. In addition to these existing barriers, many new barriers have arisen which are expected to further reduce access to oral health care for older adults due to the emergence of the COVID-19 pandemic. Older adults are at greater risk of fatal outcomes from COVID-19 infection and many dental procedures have an increased risk of creating aerosols, thereby spreading COVID-19 infection. Consequently, older adults due to fear are less likely to seek or receive oral health care until a treatment or vaccine is developed for COVID-19 infections. In this article, the authors discuss the implications of the COVID-19 pandemic to the practice of geriatric dentistry, and what is expected to be the "new normal" in this field of dentistry (AU)


Os idosos geralmente enfrentam muitas barreiras para acessar os serviços de saúde bucal. Os grupos mais vulneráveis são formados por pessoas que vivem em instituições de longa permanência ou estão restritos às suas casas. Essas barreiras estão relacionadas, entre outras, a questões socioeconômicas e problemas de saúde geral e oral. Alguns problemas socioeconômicos são: problemas financeiros, falta de convênio odontológico, falta de redes de apoio social e institucionalização. Alguns problemas gerais de saúde são: múltiplas comorbidades, polifarmácia, demência e autonomia reduzida. Alguns problemas de saúde bucal são: dentição muito restaurada, boca seca, cárie radicular e incapacidade de manter uma higiene bucal adequada de forma independente. Além das barreiras já existentes, devido ao surgimento da pandemia de COVID-19 surgiram novas barreiras que deverão reduzir ainda mais o acesso aos cuidados de saúde bucal para idosos. Idosos correm maior risco de complicações fatais da COVID-19 e muitos procedimentos odontológicos têm um risco aumentado de gerar aerossóis, espalhando assim a COVID-19. Consequentemente, os idosos têm menor probabilidade de procurar ou receber cuidados de saúde bucal devido ao medo, até que um tratamento ou vacina seja desenvolvido para a COVID-19. Neste artigo, os autores discutem as implicações da pandemia de COVID-19 na prática da odontologia geriátrica e o que se espera ser o "novo normal" nesse campo da Odontologia.(AU)


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Idoso , Envelhecimento , Saúde Bucal , Infecções por Coronavirus , Betacoronavirus , Odontologia Geriátrica
6.
J Prosthodont ; 28(2): 113-121, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28273692

RESUMO

PURPOSE: The purpose of this questionnaire was to ask general dentists in private practice in the state of Iowa about the extent and scope of their prosthodontic practice. MATERIALS AND METHODS: A 22-item questionnaire was developed and tested on 5 general dentists. The Iowa Dental Association agreed to electronically distribute the survey to all general practice dentists in their database. After three rounds, a total of 289 responses were received from the 996 general dentists in the database. RESULTS: The average age of the respondents was 50.3 ± 13.2 years (range 28 to 78 years), and 56.3% were in solo practice. The respondents stated that 68.1% had made at least one set of complete dentures and 88.9% had made a removable partial denture (RPD) in the last 3 months, while 76.4% had restored a least one implant in the last 3 months and 11.6% had surgically placed one. Nearly 20% of the respondents had a digital impression scanner in their office. There was a statistically significant difference between the dentists who had made complete dentures in the past 3 months and those who had not with regard to age, gender, and years in practice (p < 0.05 for all instances). No significant difference was found between the general dentists who had made an RPD in the past 3 months and those who had not. Compared to their counterparts, general dentists who had an AEGD or GPR training (p = 0.0312), whose primary practices were in cities of 50,000+ (p = 0.0065), or had a digital scanner (p = 0.0062) and a CAD/CAM milling machine (p = 0.0504) in their office were more likely to have restored an implant in the last 3 months. Furthermore, the general dentists who had surgically placed an implant in the last 3 months were more likely to be male (p = 0.0301) or have a digital impression scanner (p < 0.0001) and/or a CAD/CAM milling machine (p = 0.0007) in their office. CONCLUSIONS: The majority of general dentists in this survey are still making complete and partial removable dentures, and a majority is using implants, while only a minority is surgically placing them. PRACTICAL  IMPLICATIONS: Although Iowa general dentists are carrying out sophisticated procedures such as implant placement and restoring implants, as well as using digital technology, there is still a need for removable prosthodontic services in their practices. Therefore, these skills will still need to be taught in dental school.


Assuntos
Padrões de Prática Odontológica/estatística & dados numéricos , Prostodontia/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Iowa , Masculino , Pessoa de Meia-Idade , Prática Privada , Área de Atuação Profissional , Inquéritos e Questionários
7.
J Prosthodont ; 28(1): 22-29, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29380448

RESUMO

PURPOSE: To evaluate the longitudinal denture maintenance needs of a tooth-supported overdenture population. MATERIALS AND METHODS: This prospective cohort study was composed of patients who had received tooth-supported overdentures from 1974 to 1994 in the Department of Prosthodontics, University of Iowa. There were 272 persons with 662 abutments who fulfilled the inclusion criteria. To simplify analysis and reduce the number of confounding variables, only those participants wearing complete maxillary dentures and opposing complete mandibular overdentures supported by teeth #22 and #27 were included in this analysis. The denture maintenance needs of these participants were identified and related to age, gender, length of time wearing overdentures, number of medications, and denture-wearing habits. Descriptive statistics and bivariate analyses were used for the statistical analysis (α = 0.05). RESULTS: Of the 91 participants (mean age = 59.5 ± 10.1 years; 63.7% male) who fulfilled the inclusion criteria at baseline, 48.4% took 1 to 3 medications daily, and 84.6% wore their dentures day and night. The percentages of participants who needed one or more of the following denture treatments were: 91.2% denture base adjustments, 76.9% laboratory processed relines, 61.5% denture remakes, 33% laboratory remount and occlusal adjustment, 22% repaired bases, and 19.8% needed denture teeth replaced. Bivariate analyses indicated that participants who were 65 years and older needed more denture adjustments than patients younger than 65 years (p = 0.0343). Participants who had worn overdentures for more than 5 years were more likely to require denture remakes (p = 0.0304). Participants who wore their dentures only during the day were less likely to require repairs (p = 0.0403). Participants who did not take any medications were significantly less likely to require denture base repairs (p = 0.0258). For the 35 participants who returned for recalls at all 4 time points, males were more likely to need denture teeth repaired or replaced (p = 0.0335) and those aged 50 to 64 were more likely to need 2 or more adjustments (p = 0.0311). No overdenture abutments were lost by the participants in this study. CONCLUSIONS: According to the results of this study, age, medication usage, denture-wearing habits, and age of the overdentures were significant factors associated with denture maintenance needs. Persons wearing overdentures need regular recalls, because they have continuing maintenance needs.


Assuntos
Reparação em Dentadura/estatística & dados numéricos , Revestimento de Dentadura , Adulto , Fatores Etários , Idoso , Projeto do Implante Dentário-Pivô/estatística & dados numéricos , Prótese Dentária Fixada por Implante , Bases de Dentadura , Prótese Total , Revestimento de Dentadura/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
8.
Gerodontology ; 35(1): 11-17, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29063645

RESUMO

OBJECTIVES: The aim of this study was to re-examine the teaching of geriatric dentistry in the USA dental schools, to identify curriculum content and compare the findings to previous reports. METHODS: All dental schools in the United States were contacted via email with a questionnaire to assess the teaching of geriatric dentistry. Non-responding schools were sent a minimum of three reminder emails to complete the survey. A statistical analysis was performed. Descriptive statistics were conducted to profile the variables of interest. Bivariate analysis was performed to explore if any of the variables were related using Fisher's exact test, non-parametric Wilcoxon rank-sum test and the Kruskal-Wallis test. RESULTS: Fifty-six of the 67 dental schools completed the questionnaire. Geriatric dentistry was taught in all dental schools; for 92.8%, the course was compulsory. We found that 62.5% were teaching it as an independent course, 25% as an organised series of lectures and 8.9% as occasional lectures in parts of other courses. Clinically, 84.2% have some form of compulsory education in geriatric dentistry. Public schools were marginally associated with an increased interest in expanding the geriatric dentistry curriculum (P = .078). No differences were found between these variables and school location. CONCLUSIONS: Geriatric dentistry is now required in 92.8% of dental schools. The teaching of traditional topics has not changed much; however, the number of gerontological topics has increased. Clinical teaching needs to be expanded, as in only 57.1% of schools was it a requirement. The ageing imperative will require research to determine the impact of teaching on services to the geriatric community.


Assuntos
Currículo , Odontologia Geriátrica/educação , Faculdades de Odontologia/estatística & dados numéricos , Currículo/estatística & dados numéricos , Humanos , Inquéritos e Questionários , Estados Unidos
9.
J Dent Educ ; 81(10): 1220-1226, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28966187

RESUMO

The aim of this study was to determine the number and size of postdoctoral teaching programs in geriatric dentistry in U.S. dental schools and other health professions educational institutions and those programs with Health Resources and Services Administration (HRSA) funding. In 2015, all 67 U.S. dental schools were contacted via email with a questionnaire to ask if they had a postdoctoral program in geriatric dentistry; if they did, they were asked to report the length and size of the program. Directors of all 16 HRSA-funded geriatric fellowships were also invited to participate in the survey. Fifty-six of the 67 (83.6%) dental schools and 15 of the 16 (93.8%) HRSA-funded programs completed the questionnaire. Postdoctoral geriatric dentistry programs were reported in 12 dental schools and six medical institutions, although only six programs were currently accepting fellows. The length of the programs was 12-36 months. The maximum number of residents in any program was ten. The oldest program was in Minnesota; it began in 1981. The newest program was beginning in 2017 at Boston University as a revised version of its previous HRSA-funded program. The loss of HRSA funding has had a major negative impact on the number of training programs. Future research is needed to determine how the loss of HRSA-funded programs has affected the availability of educators in geriatric dentistry for dental schools and the services provided to the geriatric community.


Assuntos
Educação de Pós-Graduação em Odontologia/estatística & dados numéricos , Odontologia Geriátrica/educação , Faculdades de Odontologia , Inquéritos e Questionários , Estados Unidos , United States Health Resources and Services Administration
10.
J Dent Educ ; 81(8): 921-928, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28765436

RESUMO

The aim of this study was to assess the current teaching of geriatric dentistry in U.S. dental schools and compare the findings to previous reports. Academic deans at all 67 U.S. dental schools were contacted in November 2015 via email, asking them to complete a questionnaire about the teaching of geriatric dentistry or gerodontology at their institution. Questionnaires were received from 56 of the 67 schools (84% response rate). The results showed that geriatric dentistry was taught in all responding schools; for 92.8% of the respondents, the instruction was compulsory. Among the responding schools, 62.5% were teaching it as an independent course, 25% as an organized series of lectures, and 8.9% as occasional lectures in parts of other courses. In addition, 57.1% had some form of compulsory clinical education in geriatric dentistry. Public schools, as opposed to private schools, were marginally associated with an increased interest in expanding geriatric dentistry teaching (p=0.078). No differences were found between any teaching variables and school location. This study found that the form of education in geriatric dentistry in U.S. dental schools differed in many ways, but the teaching of geriatric dentistry had increased among all respondents and had been increasing for over 30 years. Future research is needed to determine the impact of this teaching on services to the geriatric community.


Assuntos
Currículo , Odontologia Geriátrica/educação , Idoso , Currículo/estatística & dados numéricos , Odontologia Geriátrica/estatística & dados numéricos , Humanos , Faculdades de Odontologia/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
11.
J Prosthet Dent ; 115(5): 617-23, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26774313

RESUMO

STATEMENT OF PROBLEM: The accuracy of interim crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems has not been well investigated. PURPOSE: The purpose of this in vitro study was to evaluate the marginal integrity of interim crowns made by CAD/CAM compared with that of conventional polymethylmethacrylate (PMMA) crowns. MATERIAL AND METHODS: A dentoform mandibular left second premolar was prepared for a ceramic crown and scanned for the fabrication of 60 stereolithical resin dies, half of which were scanned to fabricate 15 Telio CAD-CEREC and 15 Paradigm MZ100-E4D-E4D crowns. Fifteen Caulk and 15 Jet interim crowns were made on the remaining resin dies. All crowns were cemented with Tempgrip under a 17.8-N load, thermocycled for 1000 cycles, placed in 0.5% acid fuschin for 24 hours, and embedded in epoxy resin before sectioning from the mid-buccal to mid-lingual surface. The marginal discrepancy was measured using a traveling microscope, and dye penetration was measured as a percentage of the overall length under the crown. RESULTS: The mean vertical marginal discrepancy of the conventionally made interim crowns was greater than for the CAD/CAM crowns (P=.006), while no difference was found for the horizontal component (P=.276). The mean vertical marginal discrepancy at the facial surface of the Caulk crowns was significantly greater than that of the other 3 types of interim crowns (P<.001). At the facial margin, the mean horizontal component of the Telio crowns was significantly larger than that of the other 3 types, with no difference at the lingual margins (P=.150). The mean percentage dye penetration for the Paradigm MZ100-E4D crowns was significantly greater and for Jet crowns significantly smaller than for the other 3 crowns (P<.001). However, the mean percentage dye penetration was significantly correlated with the vertical and horizontal marginal discrepancies of the Jet interim crowns at the facial surface and with the horizontal marginal discrepancies of the Caulk interim crowns at the lingual surface (P<.01 in each instance). CONCLUSIONS: A significantly smaller vertical marginal discrepancy was found with the interim crowns fabricated by CAD/CAM as compared with PMMA crowns; however, this difference was not observed for the horizontal component. The percentage dye penetration was correlated with vertical and horizontal discrepancies at the facial surface for the Jet interim crowns and with horizontal discrepancies at the lingual surface for the Caulk interim crowns.


Assuntos
Desenho Assistido por Computador , Coroas , Adaptação Marginal Dentária , Planejamento de Prótese Dentária/métodos , Restauração Dentária Temporária/métodos , Humanos , Técnicas In Vitro
12.
Gerodontology ; 33(3): 373-9, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25439267

RESUMO

OBJECTIVE: The purpose of this study was to identify the status of pre-doctoral geriatric dentistry education among all Chilean dental schools. BACKGROUND: Chile is one of the most rapidly ageing countries in Latin America. Consequently, specific knowledge and training on the needs of elderly populations need to be emphasised in dental schools. The current extent and methods of teaching geriatric dentistry among the dental schools in Chile are unknown. MATERIALS AND METHODS: A web-based questionnaire was developed and sent to all 19 Chilean dental schools to identify which schools had a formal programme on geriatric dentistry and ask about their format, content and type of training of the faculty who taught in the programmes. Data were analysed, and a comparison was made among the schools. RESULTS: Sixteen (84%) of the participant schools reported teaching at least some aspects of geriatric dentistry, using various methodologies, but only 7 (37%) had specific courses. Of those schools reporting a didactic content on geriatric dentistry, 71% included clinical training, either in the school's dental clinics or in an extramural service. Contents mostly included demographics of ageing, theories of ageing and medical conditions. More than half of the faculty (57%) stated that they had formal training in geriatric dentistry, 43% were trained in prosthodontics, public health or other areas. CONCLUSIONS: Although most dental schools taught geriatric dentistry, only some had a specific course. Most schools with formal courses followed the international curriculum guidelines for geriatric dentistry.


Assuntos
Currículo/normas , Educação em Odontologia/normas , Odontologia Geriátrica/educação , Faculdades de Odontologia/normas , Chile , Humanos
13.
Spec Care Dentist ; 35(6): 303-11, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26494518

RESUMO

PURPOSE: To quantify differences and recent changes in health status among patients attending the Geriatric and Special Needs Dentistry (GSND) and Family Dentistry (FAMD) clinics at the University of Iowa College of Dentistry. METHODS: A total of 388 randomly selected records from patients attending the GSND or FAMD clinics from 1996-2000 or from 2006-2010 were reviewed. Univariate and bivariate analyses were conducted, followed by multivariable logistic regression analyses to compare characteristics of patients across clinics. RESULTS: Between the two GSND cohorts, the mean number of medications reported increased from 4.0 to 6.5 (p < 0.001).  Within both cohorts, mental health conditions were significantly more prevalent among patients attending the GSND than FAMD clinic (p < 0.001). CONCLUSIONS: Within cohorts, patients seen in the GSND clinic tended to have more medical problems than patients attending the FAMD clinic, particularly mental health conditions; and medication use was more common in the recent cohort in both GSND and FAMD clinics.


Assuntos
Assistência Odontológica para Idosos , Assistência Odontológica para Doentes Crônicos , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Feminino , Odontologia Geral , Odontologia Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade
14.
Spec Care Dentist ; 35(3): 123-31, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25644960

RESUMO

The purpose of this study was to investigate perceived comfort levels, behaviors, and barriers reported by group home caregivers who provide oral hygiene measures to consumers with special health care needs (SHCN) who physically resist the care. A 24-item survey was sent to 884 caregivers employed at six care facilities in Iowa. Bivariate analyses and logistic regression models were used to analyze the data (alpha = 0.05). The overall response rate was 52%. An analysis of the data indicated that caregivers who felt more comfortable providing oral hygiene for consumers who physically resisted the care experienced a higher frequency of consumers not opening their mouths (p = 0.0003), pushing the caregiver away (p = 0.0002), moving their heads uncontrollably (p = 0.0004), spitting at (p = 0.0099), hitting and/or kicking the caregiver (p = 0.0011). Furthermore, these caregivers provided weekly direct care for a greater number of consumers (p = 0.0044), received oral care training from their current facility (p = 0.0424), brushed the teeth of uncooperative consumers at least 75% of the time (p < 0.0001), and felt "somewhat comfortable to very comfortable" flossing their teeth (p < 0.0001). The caregivers' comfort level in providing oral hygiene measures to those consumers with SHCN who physically resist the care appears to be significantly associated with their training and experience working with this population.


Assuntos
Cuidadores , Assistência Odontológica para Pessoas com Deficiências , Lares para Grupos , Higiene Bucal , Cooperação do Paciente , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Iowa , Masculino , Inquéritos e Questionários
15.
J Prosthet Dent ; 112(6): 1356-63, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25277034

RESUMO

STATEMENT OF PROBLEM: Caries and periodontal disease are the most common cause of tooth loss in overdenture populations. Longitudinal data on attachment loss in this population have not been well reported. PURPOSE: The purpose of this longitudinal study was to measure periodontal attachment loss in overdenture abutments. MATERIAL AND METHODS: In this longitudinal overdenture study, 272 persons fulfilled all of the inclusion criteria. These persons had 662 teeth, 465 (70.2%) of which were canines. This report focused only on participants with canines who returned for 3 consecutive recalls in the 42 months of the study and included 53 persons with 116 canines. During this 42-month period, 6 teeth were extracted. Attachment loss was measured at baseline and at 6 to 18 months, 19 to 30 months, and 31 to 42 months at the mesial, distal, mid-buccal, and mid-lingual surface of each tooth, and was calculated as the combination of pocket probing depth plus height above the gingiva. Attachment loss was compared at each recall. A single examiner made all the measurements. RESULTS: At baseline, the greatest amount of loss was at the mid-buccal surface (5.43 mm), followed by the mid-lingual (4.95 mm), distal (4.41 mm), and mesial (4.35 mm) surfaces. This pattern of attachment loss did not change over the 3 time periods, except that, at the 6 to 18-month recall, the distal measurement was less than at baseline. This decrease could be due to the wear of the abutment or loss of a restoration due to caries. Attachment loss was greater on the mandibular abutments than on the maxillary abutments and could be due to the greater amount of movement of the mandibular overdenture, especially in a buccolingual direction. CONCLUSION: Attachment loss varied by arch and by site in patients who wore overdentures.


Assuntos
Dente Canino/patologia , Dente Suporte/estatística & dados numéricos , Revestimento de Dentadura/estatística & dados numéricos , Perda da Inserção Periodontal/epidemiologia , Estudos de Coortes , Cárie Dentária/epidemiologia , Placa Dentária/epidemiologia , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Humanos , Incidência , Iowa/epidemiologia , Estudos Longitudinais , Masculino , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Índice Periodontal , Bolsa Periodontal/epidemiologia , Estudos Prospectivos , Tratamento do Canal Radicular/estatística & dados numéricos , Extração Dentária/estatística & dados numéricos , Desgaste dos Dentes/epidemiologia
16.
J Prosthet Dent ; 112(5): 1257-64, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25277038

RESUMO

STATEMENT OF PROBLEM: Caries development under overdentures has been a continuing problem and requires the daily use of fluoride to prevent demineralization. PURPOSE: The purpose of this in vitro study was to compare the effectiveness of dentifrices containing tricalcium phosphate or calcium phosphosilicate in combination with fluoride to prevent the demineralization of overdenture abutments and root surfaces. MATERIAL AND METHODS: A total of 56 caries-free extracted teeth were prepared as overdenture abutments. The teeth were painted with acid-resistant varnish, leaving one 1×4-mm window on occlusal and root surfaces. The teeth were randomly divided into 4 groups: a control group treated with distilled/deionized water only, a group treated with ClinPro 5000, a group treated with ReNew, and a group treated with Prevident 5000 gel. Each tooth was subjected to a demineralizing/remineralizing cycling protocol for 12 days with the appropriate treatment products. The teeth were sectioned longitudinally through both windows. Photomicrographs were made of 3 representative sections from each tooth. A representative section was defined as one that included both windows and was cut from the part of the tooth that had the flattest surface to reduce the edge effect. The depths of the lesions were measured on representative sections from each group. A 1-way MANOVA and a 1-way ANOVA with the post hoc Tukey-Kramer test were used to evaluate the treatment effects on the criterion variables (α=.05). RESULTS: The total lesion depths of the control teeth on the occlusal surface were not statistically significantly deeper than for the 3 dentifrices (P=.7705). However, all 3 dentifrices had narrower cavitation depths than the control (mean cavitation band depth, 43.59 [ReNew] versus 37.99 [Prevident 5000 gel] versus 36.70 [ClinPro 5000] versus 246.86 [control]) (P<.001). The mean remineralization band depth for ClinPro 5000 was significantly greater than for the other 2 treatment groups (118.03 [ClinPro 5000] versus 107.80 [ReNew] versus 102.28 [Prevident 5000 gel]) (P<.001). On root surfaces, the total lesion depth for the control group was statistically significantly deeper than for the 3 dentifrices (mean total lesion depth, 150.31 [control] versus 82.05 [ReNew] versus 68.10 [ClinPro 5000] versus 56.97 [Prevident 5000 gel]) (P<.001). The data indicated that teeth treated with Prevident 5000 gel had the shallowest total lesion depth and were statistically significantly different from those treated with ReNew and ClinPro 5000. Moreover, teeth treated with ReNew were found to have the largest remineralization band depth, which was statistically significantly different compared with ClinPro 5000 and Prevident 5000 gel (mean remineralization band depth, 49.66 [ReNew] versus 36.14 [ClinPro 5000] versus 23.27 [Prevident 5000 gel]) (P<.001), but no difference was found in cavitation depth of the root lesions between the 3 dentifrices. CONCLUSIONS: The addition of tricalcium phosphate or calcium phosphosilicate to fluoride-containing dentifrices (5000 ppm) does not significantly improve their ability to prevent demineralization of the cut dentin surface of overdenture abutments. However, on root surfaces, ReNew, which contains calcium phosphosilicate, was found to improve remineralization of the lesions compared with Prevident 5000 gel or ClinPro 5000.


Assuntos
Cariostáticos/uso terapêutico , Dente Suporte , Dentifrícios/uso terapêutico , Revestimento de Dentadura , Fluoretos/uso terapêutico , Desmineralização do Dente/prevenção & controle , Raiz Dentária/efeitos dos fármacos , Dente/efeitos dos fármacos , Compostos de Cálcio/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Dentina/efeitos dos fármacos , Dentina/patologia , Humanos , Concentração de Íons de Hidrogênio , Processamento de Imagem Assistida por Computador/métodos , Técnicas In Vitro , Microscopia de Polarização , Distribuição Aleatória , Saliva Artificial/química , Silicatos/uso terapêutico , Fatores de Tempo , Dente/patologia , Desmineralização do Dente/patologia , Remineralização Dentária/métodos , Raiz Dentária/patologia , Resultado do Tratamento
17.
J Calif Dent Assoc ; 42(7): 455-63, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25076628

RESUMO

Traditional approaches to caries prevention and management are unlikely to result in successful outcomes for individuals with special health care needs. Intensive prevention-oriented and minimally invasive restorative approaches have the greatest potential to address oral health disparities affecting vulnerable populations. This paper introduces readers to oral health-related issues for patients with special health care needs across the life course and outlines clinical strategies to prevent and manage caries in high-risk patients.


Assuntos
Assistência Odontológica para Pessoas com Deficiências , Cárie Dentária/prevenção & controle , Fatores Etários , Restauração Dentária Permanente/métodos , Necessidades e Demandas de Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Saúde Bucal , Populações Vulneráveis
20.
Spec Care Dentist ; 32(6): 251-8, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23095068

RESUMO

This study investigated the frequency of Iowa dentists' provision of in-office and out-of-office dental care for people who are homebound, as well as comparing the practice and educational characteristics among dentists who did and did not provide care for patients who were homebound. The authors mailed a survey form to all licensed dentists on the Iowa State Health Professional license database (n = 1,168), excluding pediatric dentists and orthodontists. A second mailing was sent to all nonrespondents four months later, resulting in 638 returned forms for a 54.6% response rate. The questionnaire included two outcome responses associated with the treatment in the dentist's office or in the patient's home for patients who are homebound. About 40% of Iowa dentists reported providing care in the office to patients who are homebound, but care outside of the office was provided by fewer dentists (6%) who had more years of practice experience. These results suggest an increased sense of professional or community responsibility among these older Iowa dentists. Education efforts may increase homebound care and more involvement of younger dentists.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Pacientes Domiciliares/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Consultórios Odontológicos/estatística & dados numéricos , Odontólogos/psicologia , Educação em Odontologia , Educação Continuada em Odontologia , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Iowa , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , Prática Privada/estatística & dados numéricos , Prática Profissional/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , Responsabilidade Social
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