An overview of characteristics of registered studies on dental implants.

OBJECTIVE: Clinical trials serve as the empirical basis for clinical decision making. The objective of the current study is to provide an overview of clinical trials examining dental implant outcomes. METHOD: All registered studies on Dental Implants were selected for analysis. The clinicaltrials.gov website was used to query the characteristics of registered studies. The search term used was dental implants. RESULTS: As of the study conduct date (01/01/2014), a total of 205 studies on dental implants were registered. These included 168 interventional and 37 observational studies. Results were available for only 14 studies. All observational studies and 98.8% of interventional studies included both male and female subjects. Close to 60% of studies had sample sizes between 1 and 50. NIH was listed as funding source in only 5 interventional studies and 3 observational studies. 80% of interventional studies were randomized. However, double masking was reported in only 15% of interventional studies with majority being open labeled. CONCLUSION: ClinicalTrials.gov registry was created with the intention of increasing the transparency of conducted or ongoing clinical studies and to minimize publication bias commonly seen with industry-sponsored studies. Results of the current study showed that a predominating number of registered studies are funded by industry and other sources, very few registered studies have made their results public, and the ClinicalTrials.gov registry does not provide sufficient information on the quality of study design and thus precluding the public and researchers to judge on the quality of registered studies and publication bias.

Economics of facial fracture reductions in the United States over 12 months.

OBJECTIVE: The face is a complex architectural structure in the body and is a high-risk site for fractures. Hospitalization is necessary for adequate treatment. The objective of this study is to examine hospitalization outcomes associated with reduction in facial fractures in the United States. METHODS: The Nationwide Inpatient Sample (NIS) of the health care cost and utilization project for 2008 was used. This database provides weighted estimates of all hospitalizations in the United States, which approximates 39.88 million admissions in the entire United States. Hospital discharges with primary procedure ICD-9-CM codes for reduction in facial fractures were selected. Outcomes examined included hospitalization charges, length of stay, and causes of injuries. All estimates obtained from the sample were projected to national levels. RESULTS: Reduction in facial fractures was performed as primary procedure in 21,244 hospitalizations. The total hospitalization charges were about $1.06 billion, and total hospitalization days was 93,808. About 80% of all hospitalizations occurred among men. The frequently occurring external causes of injuries leading to hospitalization for reduction in facial fractures include assault (36.5% of all hospitalizations), motor vehicle traffic accidents (16%), falls (15%), and other transportation accidents (3.5%). The frequently performed procedures were open reduction in mandibular fractures (52.2%), open reduction in facial fractures including those of orbital rim or wall (14.7%), closed reduction in mandibular fractures (12.1%), and open reduction in malar and zygomatic fractures (11.8%). CONCLUSIONS: National hospitalization outcomes related to reduction in facial fractures indicate an extensive consumption of hospital resources. If hospital emergency room protocols and inpatient protocols relating to the most expensive fractures and longest hospital stays that we have identified can improve, this may lead to improved outcomes and a reduction in hospital charges for facial fractures.

Factors associated with hospitalization charges for cleft palate repairs and revisions.

PURPOSE: The objective of this study is to provide nationally representative estimates of cleft palate correction and revision procedures performed in hospitalized patients, as well as to examine patient- and hospital-level factors associated with hospitalization charges. MATERIALS AND METHODS: The Nationwide Inpatient Sample for the year 2007 was used. All hospitalizations that had a cleft palate correction or revision of cleft palate repair were selected. Estimates of concomitant procedures performed during the index hospitalization were obtained. The roles of different patient- and hospital-level variables on hospitalization charges were examined by use of multivariable linear regression analysis. RESULTS: A total of 5,969 repairs and/or revisions of cleft palate procedures were performed in hospitals in the entire United States. The mean age per hospitalization was 3.2 years. Whites accounted for 51.3% of procedures, whereas blacks, Hispanics, Asian/Pacific Islanders, Native Americans, and other races accounted for 4.9%, 26.4%, 9.2%, 3.2%, and 5%, respectively. The mean charge per each hospitalization was $19,227, and the total hospitalization charge for the entire United States was $112.96 million. Patients aged less than 1 year (P = .02) and those aged between 8 and 12 years (P = .03) had significantly lower charges compared with those aged 18 years or older. Use of bone morphogenetic protein was associated with higher hospital charges (P = .0006). Compared with the uninsured, those covered by Medicaid (P = .04), private insurance plans (P = .02), and other insurance plans (P = .0005) were associated with higher charges. CONCLUSION: This study identified an association between hospital charges and insurance payer, race, treatments performed, and age. Our results provide insights into nationally representative estimates on management of cleft palate corrections and revisions.

Hospitalizations primarily attributed to dental conditions in the United States in 2008.

OBJECTIVE: The objective of this study was to provide estimates of hospitalizations attributed to oral health related conditions in the United States (US). STUDY DESIGN: The nationwide inpatient sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) for 2008 was used. Hospital admissions with a primary diagnosis of dental/oral health-related conditions were identified using ICD-9-CM diagnosis codes. RESULTS: A total of 50,658 hospital admissions were primarily attributed to oral health-related conditions in 2008. Total US hospitalization charges were $1.218 billion. Total US hospitalization days were 174,496 days. CONCLUSIONS: The current study examines outcomes in patients hospitalized primarily for dental/oral health-related conditions. Of 39,885,120 hospitalizations that occurred in the US, a total of 50,658 (1.27%) were primarily attributed to dental-related conditions. Substantial resources are spent in treating dental-related conditions in hospital settings.

Hospital emergency department visits attributed to pulpal and periapical disease in the United States in 2006.

BACKGROUND: Relatively localized conditions such as infection of the pulp or periapical tissues if left untreated could spread and require hospital care. The objectives of this study were to assess the prevalence of such hospital-based emergency department (ED) visits, to quantify hospital charges associated with those visits, and to identify characteristics of those members of the population who are likely to make such visits. METHODS: The experimental design of this study involves the use of The Nationwide Emergency Department Sample for the year 2006. All discharges with a primary diagnosis code for pulpal and periapical diseases (International Classification of Disease, Clinical Modification [ICD-9-CM] code of 522) were selected for analysis. All estimates were projected to national levels using the discharge weight variables. RESULTS: In the United States, during the year 2006, a total of 403,149 ED visits had a primary diagnosis code for pulp and periapical diseases. The average patient age was 32.9 years. The mean hospital charge for ED visits was $480, and the total charges for all the ED visits in the United States was $163,692,957. Among the ED visits, 5,721 were admitted to the same hospital for inpatient care. The mean length of stay after hospitalization was 2.95 days. The uninsured (39.92%) constituted the largest proportion of all ED visits. CONCLUSIONS: This study identifies high-risk groups that are likely to present to hospital-based EDs for the treatment of pulp and periapical diseases. This highlights the need for significant resources to treat such patients in a hospital care setting.