Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Br Dent J ; 228(1): 33-38, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31925371

RESUMO

Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use.


Assuntos
Cárie Dentária , Criança , Estudos Transversais , Odontólogos , Humanos , Dente Molar , Padrões de Prática Odontológica , Inquéritos e Questionários , Dente Decíduo
2.
J Endod ; 45(11): 1403-1404, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31570174
3.
Br Dent J ; 227(5): 387-391, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520042

RESUMO

Introduction Child abuse and neglect present a significant global concern, therefore, it is imperative that dental professionals can identify children at risk. Previous literature has suggested that general dental practitioners (GDPs) do not feel adequately trained to do so and that there is a gap between the suspicion of abuse and onward referral.Aims To assess the experience of paediatric safeguarding reporting among GDPs in Greater Manchester and investigate the current barriers to reporting safeguarding concerns.Methods An anonymous questionnaire was distributed via email to a sample of general dental practices in Greater Manchester.Results Thirty-six questionnaires were completed, giving a 36% response rate. Fifty-eight percent of respondents had received undergraduate training and 83% had received postgraduate training. Eighty-one percent felt that GDPs require further training and support. Fifty-eight percent of GDPs had been suspicious of at least one case of child abuse or neglect, however, only 28% had completed an onwards referral. Common barriers to reporting included: fear of violence to the child; lack of certainty of diagnosis; and lack of confidence in their suspicions.Conclusion Barriers to the referral of suspected cases of abuse or neglect are still commonly reported. There is a strong demand for further child protection training among GDPs.


Assuntos
Maus-Tratos Infantis , Odontologia Geral , Atitude do Pessoal de Saúde , Criança , Bem-Estar da Criança , Humanos , Encaminhamento e Consulta , Inquéritos e Questionários
4.
Dent Traumatol ; 35(4-5): 241-250, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31038825

RESUMO

BACKGROUND/AIM: There is a lack of research into orthodontic movement and management strategies of traumatized teeth. The aim of this survey was to assess the knowledge of UK-based orthodontists in the orthodontic management of traumatized teeth. MATERIALS/METHODS: A 24-item questionnaire survey was electronically distributed to all members of the British Orthodontic Society. RESULTS: A total of 213 respondents completed the survey with the majority of these being UK registered specialists in orthodontics. Three responses were excluded as one was not based within the UK and two were orthodontic trainees with <1 year of experience, leaving a total of 210 respondents. The majority had orthodontically treated up to three patients with a history of dental trauma in the preceding 3 months. Obtaining a trauma history was done by the majority of respondents. A wide variation in times waited by respondents before orthodontically treating teeth with different types of traumatic injuries was observed. Similarly, the preferred orthodontic management strategies of traumatized teeth differed substantially among respondents. Almost all respondents were interested in further training in the management of dental trauma. CONCLUSIONS: The study showed a wide variation in the orthodontic management of traumatized teeth among UK-based orthodontists. Further training and national guideline establishment are indicated for orthodontic management of traumatized teeth in the UK.


Assuntos
Ortodontia , Ortodontistas , Traumatismos Dentários/reabilitação , Humanos , Sociedades Odontológicas , Inquéritos e Questionários , Reino Unido
5.
J Endod ; 45(5): 543-548, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30879774

RESUMO

INTRODUCTION: The aim of this study was to assess whether laser Doppler flowmetry is more accurate than the conventional pulp sensibility tests (electric pulp test and ethyl chloride) in assessing the pulpal status of permanent anterior teeth in children and to identify the laser Doppler flowmetry's Flux cut-off threshold. METHODS: A cross-sectional diagnostic accuracy study with randomization was performed and included 74 participants (8- to 16-year-old children). Participants had 1 maxillary central or lateral incisor with either a completed root canal treatment or an extirpated pulp and a contralateral tooth with vital pulp. Outcome measures included the sensitivity, specificity, and predictive values as well as the repeatability of all tests. RESULTS: A significant difference between the Flux values for teeth with vital and non-vital pulps was found. The cut-off ratio for laser Doppler flowmetry was 0.6, yielding a sensitivity of 53% and a specificity of 33%, which were lower than the values of the electric pulp test (sensitivity = 83.8%-94.6% and specificity = 89.2%-97.6%) and ethyl chloride (sensitivity = 81.1%-91.9% and specificity = 73%-81.1%). The repeatability of laser Doppler flowmetry, electric pulp testing, and ethyl chloride were 0.85, 0.86, and 0.81, respectively. CONCLUSIONS: Laser Doppler flowmetry was unable to differentiate between teeth with vital and non-vital pulps. The results of this study showed that there was a high probability for false results. Further development of laser Doppler flowmetry in assessing pulpal blood flow would be required before it could be recommended for clinical use, especially in children.


Assuntos
Teste da Polpa Dentária , Incisivo , Fluxometria por Laser-Doppler , Adolescente , Criança , Estudos Transversais , Polpa Dentária , Humanos
6.
Cochrane Database Syst Rev ; 2: CD006542, 2019 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-30720860

RESUMO

BACKGROUND: Traumatic dental injuries are common. One of the most severe injuries is when a permanent tooth is knocked completely out of the mouth (avulsed). In most circumstances the tooth should be replanted as quickly as possible. There is uncertainty on which interventions will maximise the survival and repair of the replanted tooth. This is an update of a Cochrane Review first published in 2010. OBJECTIVES: To compare the effects of a range of interventions for managing traumatised permanent front teeth with avulsion injuries. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 March 2018), Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 2) in the Cochrane Library (searched 8 March 2018), MEDLINE Ovid (1946 to 8 March 2018), and Embase Ovid (1980 to 8 March 2018). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We considered randomised and quasi-randomised controlled trials that included a minimum follow-up period of 12 months, for interventions for avulsed and replanted permanent front teeth. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, extracted data and assessed the risk of bias. Authors were contacted where further information about their study was required. MAIN RESULTS: Four studies, involving a total of 183 participants and 257 teeth were identified. Each of the interventions aimed to reduce infection or alter the inflammatory response or both at the time of or shortly after the tooth or teeth were replanted. Each study assessed a different intervention and therefore it was not appropriate or possible to numerically synthesise the data. All evidence was rated as being of very low quality due to problems with risk of bias and imprecision of results. This means that we are very uncertain about all of the results presented in this review.One study at high risk of bias with 69 participants (138 teeth) compared a 20-minute soak with gentamycin sulphate for both groups prior to replantation with the experimental group receiving daily hyperbaric oxygen for 80 minutes for the first 10 days. There was some evidence of a benefit for the hyperbaric oxygen group in respect of periodontal healing, tooth survival, and pulpal healing.One study at unclear risk of bias with 22 participants (27 teeth) compared the use of two root canal medicaments, Ledermix and Ultracal. There was insufficient evidence of a difference for periodontal healing or tooth survival. This was the only study to formally report adverse events with none identified. Study authors reported that Ledermix caused a greater level of patient dissatisfaction with the colour of avulsed and replanted teeth.A third study at high risk of bias with 19 participants compared extra- or intra-oral endodontics for avulsed teeth which were stored dry for longer than 60 minutes before replantation. There was insufficient evidence of a difference in periodontal healing.The fourth study at high risk of bias with 73 participants compared a 10-minute soak in either thymosin alpha 1 or saline before replantation followed by daily gingival injections with these same medicaments for the first 7 days. There was some evidence of a benefit for thymosin alpha 1 with respect to periodontal healing and tooth survival. AUTHORS' CONCLUSIONS: Based on the results of the included studies, there is insufficient evidence to support or refute the effectiveness of different interventions for avulsed and replanted permanent front teeth. The overall quality of existing evidence was very low, and therefore great caution should be exercised when generalising the results of the included trials. There is urgent need for further well-designed randomised controlled trials.


Assuntos
Incisivo/lesões , Avulsão Dentária/cirurgia , Reimplante Dentário/métodos , Desenvolvimento Ósseo/fisiologia , Hidróxido de Cálcio/uso terapêutico , Demeclociclina/uso terapêutico , Combinação de Medicamentos , Humanos , Oxigenação Hiperbárica , Ligamento Periodontal/crescimento & desenvolvimento , Cuidados Pré-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Irrigantes do Canal Radicular/uso terapêutico , Descoloração de Dente/induzido quimicamente , Triancinolona Acetonida/uso terapêutico
7.
J Orthod ; 45(4): 289-295, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30022713

RESUMO

Management of non-vital immature permanent teeth in children remains a challenge in paediatric dentistry. The resulting short roots, thin root dentinal walls, and compromised crown root ratios, not only affect the long-term survival of these teeth but also complicate any intended orthodontic treatment. This case report shows a successful orthodontic movement of a traumatised non-vital immature tooth treated using regenerative endodontics.


Assuntos
Endodontia Regenerativa , Coroa do Dente , Criança , Humanos
8.
Dent Traumatol ; 34(5): 311-319, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29953720

RESUMO

BACKGROUND/AIM: Pulp necrosis is a frequent complication following dental trauma. The diagnosis of the state of the dental pulp can be challenging as most commonly used diagnostic tools are subjective and rely on a response from the patient, potentially making their use unreliable, especially in the child population. The aim of the study was to systematically review the evidence on the use of laser Doppler flowmetry in the assessment of the pulp status of permanent teeth compared to other sensibility and/or vitality tests. METHODS: A systematic literature search, using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, www.clinicaltrials.gov and www.controlled-trials.com, in addition to citation and manual reference list searches, was conducted up to 15th January 2018. A risk of bias assessment was performed using the quality assessment for diagnostic accuracy studies tool (QUADAS-2) with all steps performed independently by two reviewers. RESULTS: Four studies with a high risk of bias were included in the final analysis. Laser Doppler flowmetry was reported to be more accurate in differentiating between teeth with normal pulps and pulp necrosis with a sensitivity of (81.8%-100%) and specificity of 100% in comparison to other vitality tests such as pulp oximetry (sensitivity = 81.3%, specificity = 94.9%) and sensibility tests such as electric pulp testing (sensitivity = 63.3%-91.5%, specificity = 88%-100%). CONCLUSION: Despite the higher reported sensitivity and specificity of laser Doppler flowmetry in assessing pulp blood flow, these data are based on studies with a high level of bias and serious shortfalls in study designs. More research is needed to study the effect of different laser Doppler flowmetry's parameters on its diagnostic accuracy and the true cut-off ratios over which a tooth could be diagnosed as having a normal pulp.


Assuntos
Necrose da Polpa Dentária/diagnóstico , Polpa Dentária/irrigação sanguínea , Dentição Permanente , Fluxometria por Laser-Doppler , Diagnóstico Diferencial , Humanos
9.
J Endod ; 43(9): 1453-1464, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28743431

RESUMO

INTRODUCTION: Although the protocols in previously published studies appeared to be largely similar, there were inadequate evidence-based guidelines to support a single protocol. Using a meta-analysis, this systematic review aimed to summarize and quantitatively evaluate the outcomes for nonvital immature permanent teeth treated using the regenerative endodontic technique (RET) as well as critically appraise the level and quality of evidence of the existing publications. METHODS: Risk of bias assessment and level of evidence grading were performed on all included studies. Meta-analyses using a random effects model were performed to combine the results of randomized controlled trials. The pooled success rate for each exposure was estimated for each outcome (event rates with 95% confidence intervals). The outcomes of all included studies were summarized. RESULTS: Success rates for tooth survival and resolution of periapical pathosis were excellent; however, results for apical closure and continued root development were inconsistent. There are few well-reported randomized prospective clinical studies. Reporting of long-term outcomes and late-stage effects was sparse. No study evaluated health economic outcomes and improvements to patients' quality of life. CONCLUSIONS: Many knowledge gaps still exist within the studies published. Current published evidence is unable to provide definitive conclusions on the predictability of RET outcomes.


Assuntos
Dente não Vital/terapia , Dentição Permanente , Endodontia/métodos , Humanos , Regeneração , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA