上海地区口腔医师对牙髓再生治疗认知及应用情况调查

目的: 调查上海地区口腔医师对牙髓再生治疗认知及应用状况。方法: 采用多级、整群、随机抽样方法: ,从上海城区和郊区各随机抽取5个区,选取区内三级医院、牙防所、二级医院、民营医院诊所及私人诊所,以及3家口腔特色三级甲等医院的儿童口腔、牙体牙髓病及口腔综合医师,对每个调查单位内的所有相关口腔医师进行问卷调查。采用SAS 9.13软件包对数据进行统计学分析。结果: 共调查三级医院13家,牙防所8家,二级医院15家,民营医院及私人诊所20家,以及3家口腔特色三级甲等医院。调查相关口腔医师834人,回收有效问卷588份（70.5%）。知晓牙髓再生治疗者占总调查人数的68.2%,其中应用牙髓再生治疗者占20%。继续教育学习班是上海地区口腔医师学习牙髓再生治疗的主要途径（33.3%）,且对牙髓再生治疗感兴趣（85.8%）。对操作流程不熟悉是未应用的最主要原因（41.5%）。结论: 受教育程度较高的中青年牙体牙髓病及儿童口腔专业医师对牙髓再生治疗认知和应用率均较高,且对牙髓再生治疗继续教育学习班更感兴趣。应增加牙髓再生治疗继续教育学习班并增加实训课内容,以解决应用过程中对流程不熟悉的瓶颈。     

Relationship between periapical and periodontal status

Abstract The purpose of the present investigation was to explore possible relationships between clinical periodontal status in periodontally involved teeth with and without endodontic infection. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically-involved single-rooted teeth from a selected patient sample were evaluated and correlated to their periodontal status. There was a significant correlation between periapical pathology and vertical bony destructions. An intra-individual comparison between pocket depth in teeth with and without periapical pathology showed that periapical pathology was significantly correlated to an increased pocket depth in the absence of a vertical bony destruction. It was concluded that an endotontic infection, evident as a periapical radiolucency. promotes periodontal pocket-formation on an instrumented marginal root surface and, consequently, should be regarded as a risk factor in periodontitis progression and be given appropriate consideration in periodonlal treatment planning.     

Cynical hostility as a determinant of poor oral health status in an adult population

Our aim in this study was to determine whether there is an association between cynical hostility and clinically determined poor oral health, and whether this association is confounded by socioeconomic position and mediated by health behavior. The sample consisted of 4,207 dentate Finns, 30–64 yr of age. Oral health was measured in terms of numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets (≥ 4 mm). Cynical hostility was measured using the cynical distrust self-administered questionnaire. The subjects with the highest level of cynical hostility had fewer teeth, and a greater number of decayed teeth as well as teeth with deepened periodontal pockets compared to subjects with the lowest level of cynical hostility. The associations between cynical hostility and number of missing and decayed teeth were clearly confounded by level of education. Poor oral health behavior was shown to be a possible mediator between cynical hostility and number of decayed teeth, but not of missing teeth or teeth with deepened periodontal pockets. General health-related behavior did not serve as a possible mediator in any of the associations. In conclusion, cynical hostility can be considered as a risk marker for poor oral health. Interventions aimed to improve oral health should focus on psychosocial factors and on less-educated subjects.     

Effect of sociodemographic variables on complete denture satisfaction

PURPOSE

The objective of this study was to evaluate the effect of sociodemographic factors on quality of satisfaction towards denture treatment.

MATERIALS AND METHODS

One hundred subjects (filling inclusion criteria) who were wearing a denture for at least two months were enrolled and divided into five groups on the basis of sociodemographic variables (age, gender, literacy level, socio-economic and marital status). Questionnaires consisting of 38 questions (positive and negative attitude towards denture satisfaction) related to patients'' perception of clinical outcome in different domains such as mastication, appearance, speech, comfort, health, denture care and social status were scored by the subjects. Questions reflecting positive attitude were scored as 2, 1, or 0 (yes, uncertain and no, respectively) and reversely for the negative questions. Statistical analysis was done by using Statistical Package for Social Sciences (α = .05).

RESULTS

Level of denture satisfaction was higher in age subgroup belonging to 45 - 65 years of age in relation to comfort, health and denture care. Female and male showed significant priority for denture treatment because of esthetic and function respectively. Level of satisfaction was statistically significant with literacy level. Upper high income group showed significantly higher level of satisfaction only in case of social status. Married group showed significantly higher satisfaction level only with comfort.

CONCLUSION

Patients'' sociodemographic variables were influential factors on denture satisfaction.     

Associations between self-reported dental status and diet

The purpose of this study was to develop a battery of dental, nutritional and psychological health survey measures and to use this survey instrument to explore links between age, tooth loss and dietary risk. The survey was undertaken in a dental school and hospital. Forty-nine consecutive patients (age range 25-74 years) participated in this pilot study and completed the health survey instrument. A quarter of the patients reported changing dietary habits due to dental problems, 56% reported difficulty in chewing as a result of problems with their teeth or dentures, and 36% reported having to interrupt meals due to dental difficulties. Tooth number was associated with MNA scores (0.35, P=0.03, Pearson's correlation coefficient) and reported number of foods eaten (0.33, P=0.04, Pearson's correlation coefficient) from the questionnaire checklist. Lower MNA scores were associated with age (F=6.54; d.f.=1, 46; P<0.01) indicating that older adults were more at risk of poor nutritional status. Overall health was not rated as an important factor influencing food choice, and only 14% of the sample felt that they had nutritional problems. Poor diet and impaired food choice was associated with declining numbers of teeth and increasing age. Older adults may require dietary advice to increase awareness of the importance of a healthy diet.     

The influence of insurance status on treatment and outcomes in oral cavity cancer: an analysis on 46,373 patients

The purpose of this study was to determine the influence of insurance status on treatment and outcomes in oral cavity cancer. Patients were identified in the National Cancer Database (NCDB). Data were collected and analyzed using χ² tests, Kaplan–Meier methods, and multivariable Cox regression models. Those uninsured or on Medicaid were more likely to be younger (P < 0.001), minority race (P < 0.001), have a lower median household income (P < 0.001), lower educational attainment (P < 0.001), not undergo primary resection (P < 0.001), present with higher T (P < 0.001), N (P < 0.001), and M (P < 0.001) stage of disease, and have a higher tumor grade (P < 0.001). On univariate analysis, those with private insurance had significantly better overall survival than those uninsured (hazard ratio (HR) 1.481), under Medicaid (HR 2.006), or on Medicare (HR 1.921). On multivariable Cox regression analysis, insurance status remained an independent prognosticator even after accounting for multiple demographic, socioeconomic, treatment, and clinicopathological factors. These data suggest that insurance status is associated with treatment and outcomes in patients with oral cavity cancer. Being uninsured or on Medicaid was found to be associated with a higher risk of a poorer prognosis when compared to private insurance, and the data suggest the need to expand comprehensive medical coverage and optimize access to adequate medical care in vulnerable patient populations.     

Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children

The main objective of this study was to assess whether dental caries status was related to nutritional status in preschool urban Brazilian children aged 12–59 months. Dental and anthropometric examinations were conducted on 1,018 12–59-month-old children during the National Day of Children Vaccination. Dental caries prevalence and severity were measured using the decayed, missing or filled surfaces (dmfs) index. The World Health Organization (WHO) Child Growth Standards Reference was used to evaluate nutritional status. Results on nutritional status were presented as Z-scores. The data collected included socio-economic conditions. Multilevel linear regression was applied to investigate the effect of nutritional, socio-economic, and demographic factors on the status of children's dental caries. Caries was present in 23.4% of children. The final hierarchical logistic model showed a significant association between nutritional status and caries experience. Children with low Z-scores in some indexes had an increased risk of having caries. In addition, children whose mothers had < 8 yr of education and were from lower-income families had an increased risk of high levels of dental caries. There was an association between nutritional and socio-economic factors, and dental caries. In conclusion, underweight children and those with adverse socio-economic conditions were more likely to have caries experience.     

Attributions to dental and diabetes health outcomes

Previous studies have proposed common psychological factors between oral health behavior and diabetes self-care. The aim here was to describe and analyse more comprehensively the relationships between dental and diabetes health behavior on the basis of attribution theory. The likeness between subjects' own assessments, similarities of the causes given to success and failure, and the predictive power of own dental assessments concerning the metabolic balance of diabetes were studied. The research population was composed of 149 IDDM patients. Data were collected by means of a quantitative questionnaire, a clinical oral examination and from patient records. It was found that from the patients reporting success with avoiding gingivitis 82% also reported success with metabolic status and they also had lower mean HbA1c levels than patients assessing failure with gingivitis. There were some correlations between causes of failure: not bothering to clean approximal surfaces correlated with non-adherence to diabetes treatment instructions, and laziness as the cause of caries correlated with non-adherence to diabetes treatment instructions and with poor motivation for diabetes care. It can be concluded that there are some common determinants for both dental health behavior and diabetes self-care. This connection should be taken into account in health education by health care professionals.     

Periodontal conditions of teeth adjacent to extraction sites

The purpose of the present clinical study was to evaluate the effect of tooth extractions on the periodontal conditions of adjacent teeth. 40 patients were selected for the study. Prior to the extractions, baseline data of the adjacent teeth were obtained. Plaque (PII) and gingival indices (GI), pocket probing depths and probing attachment levels were scored. In addition, the alveolar bone height was determined radiographically in relation to the CEJ adjacent to the extraction sites. The contralateral side of the jaw, where no tooth had to be removed, was examined as a control. A limited hygienic phase (scaling and root planing of all surfaces examined) was performed immediately prior to the extractions. Using the same parameters, all sites were reexamined 2-4 months and 6-9 months following the extractions. After the hygienic phase, the teeth adjacent to the extraction sites indicated a decrease in the pocket probing depths by 0.5 to 1.5 mm. In shallow pockets (1-3 mm), this decrease was less pronounced than in moderate to deep pockets (4-9 mm), where it was composed of shrinkage of the gingival tissues and gain of probing attachment. The radiographic level of the bony alveolar crest in relation to the CEJ of the adjacent teeth was not altered by the extraction procedure. The oral hygiene performances of the patients were not influenced during the 9-month observation period. Therefore, neither PII nor GI scores showed relevant improvements.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dental status of pregnant women attending a Brisbane maternity hospital

A sample of 314 consecutive women attending for their first antenatal visit at a public hospital were examined according to the WHO survey procedure. The women's age ranged from 16 to 42 yr with a mean of 23.5 yr. Only 3% were edentulous in both jaws, but 13% had some form of denture. A quarter had pocketing in at least one sextant and only 16% were free of gingivitis. The average number of DMF teeth was 15.8, comprising 2.7 decayed, 4.5 missing and 8.6 filled teeth; 70% had teeth needing restoration and 10% had at least one tooth needing extraction. There were significant relationships between DMF score and age (positive) and between number of teeth needing restoration and age, educational level, and the woman's own perception of her dental health (all inverse). Some form of dental attention was needed by 86% of the women; 12% had conditions needing immediate attention. By comparison with a 1971 study of pregnant women in Brisbane, there has been a marked decline in DMFT score (from 19.1 to 15.8).     

How dental conditions handicap the elderly

A sociodental investigation was carried out among 254 elderly people living at home in Nottinghamshire. The aim of the inquiry was to ascertain whether this group of people were handicapped by their dental conditions. The dental status of the sample was generally poor. 74% were edentulous and the condition of the full dentures worn by many of the subjects was unsatisfactory. A high proportion (59%) of the subjects had lesions of the oral mucosa. Many members of the sample were orally handicapped, either functionally or socially. 32% complained of oral pain and 30% claimed to have difficulty chewing. Also, subjects were embarrassed by the appearance of their teeth and by their dentures dropping during social contact. The perception of handicap, however, was not strongly related to dental status.     

Gender-dependent associations between socioeconomic status and tooth loss in working age people in the Study of Health in Pomerania (SHIP), Germany

Mundt T, Polzer I, Samietz S, Grabe HJ, Dören M, Schwarz S, Kocher T, Biffar R, Schwahn C. Gender‐dependent associations between socioeconomic status and tooth loss in working age people in the Study of Health in Pomerania (SHIP), Germany. Community Dent Oral Epidemiol 2011; 39: 398–408. © 2011 John Wiley & Sons A/ S Abstract – Objectives: Individual impact and the effect magnitude of socioeconomic key indicators (income, education and occupation) and of gender on oral health are ambiguous. In primary analyses of cross‐sectional data among participants of the Study of Health in Pomerania (north‐east Germany), women with low school education and low income were at highest risk for missing teeth, whereas being single was a risk indicator for missing teeth in men. Using the 5‐year follow‐up of this study, we aimed at verifying these findings and at investigating the gender‐dependent impact of key socioeconomic indicators on tooth loss. Methods: The longitudinal data originate from 1971 subjects (1062 women) aged 25–59 enrolled from 1997 to 2001 and again from 2002 to 2006. The effects of marital status, household income, school education and occupational prestige for tooth loss were examined by gender using negative binomial regression analyses. Results: Low education and low income were moderately [relative risks (RR) between 1.6 and 2.0] associated with tooth loss among both women and men, whereas occupational prestige was not. After multiple imputations of missing data, less‐educated women with lower income exhibited the highest risk of tooth loss [RR = 3.1; 95% confidence interval (CI) = 1.7–5.5 for <10 years of school education and the lowest income tertile] and tooth loss was more likely in single men (RR = 1.5; 95% CI = 1.0–2.2) than in single women (RR = 0.9; 95% CI = 0.6–1.3). Conclusions: The primary cross‐sectional results were partly confirmed. Socioeconomic factors help to explain differences in tooth loss, although the causal pathways are speculative. To improve dental health, the policies should target not only the individual, e.g. oral health promotion, but also an entire population by better education and higher wage employment.     

The impact of educational level on oral health-related quality of life in older people in London

There are socioeconomic inequalities in oral health, but the relationship between education and oral health-related quality of life (OHRQoL) among older adults has not been adequately studied. This study assessed whether there is an educational gradient in OHRQoL among older people in London. We employed secondary analysis of baseline data ( n  = 1,090) from a randomized controlled trial of health-risk appraisal on community-dwelling non-disabled people 65 yr of age and older, registered with three group medical practices in suburban London. Multiple linear regressions were used to analyze the association between OHRQoL [measured using the Geriatric Oral Health Assessment Index (GOHAI)] and education, adjusted for age, gender, pension status, and denture wearing. Overall, 30.6% reported low levels of OHRQoL. Eating discomfort was the most frequent problem (24% reported 'often/always'), while concerns about appearance were also prevalent. Significant variations in OHRQoL existed between socioeconomic groups. In adjusted analyses, there was a clear education gradient in OHRQoL, with worse perceptions at each lower level of education. Low educational level has an independent negative impact on OHRQoL in older people, which is not explained by differences in income or in denture wearing between educational groups. Policies targeting lower educated groups should be complemented with whole-population strategies for the reduction of oral health inequalities.     

氟牙症对广州公众社会心理影响的分析

目的了解氟牙症对广州公众社会心理影响的范围和程度.方法由广州口腔医生35名、口腔专业学生42名、非口腔专业学生30名、职员33名及领导30名作为评价者,对不同程度氟牙症照片20张进行评价,共包括10个社会心理评价题(五点语义分度).用SPSS10.0进行统计分析.结果广州公众评价均值随氟牙症的加重而升高(1.84-4.79),且存在显著性差异,即广州公众认为社会心理影响随氟牙症程度加重而加大不同程度氟牙症与各项公众评价之间均存在显著相关(r=0.677-0.904).口腔医生的评价值较其他类型公众的评价值要低,即氟牙症对口腔医生社会心理影响较小,且与其他人群相比有显著性差异.广州公众评价最显著的相关因素是氟牙症程度,偏相关系数均在0.7以上,评价者人口学特征也与评价结果相关.结论广州公众认为轻度以下氟牙症对患者造成的社会心理影响较小,且受多种因素影响.     

家长及老师对患氟牙症学生社会心理状况的评价

目的：通过调查家长及老师对氟牙症学生社会心理状况的评价，探讨氟牙症对患者社会心理的影响。方法：随机抽取河北省邢台市农村高氟区12岁及15岁不同程度氟牙症患者115名，包括12岁60人，15岁55人，对其进行Dean氏氟牙症指数（DI）的口腔流行病等调查，并对其家长及老师进行问卷调查，各涉及5个方面5度分法的心理评价题。结果：河北省邢台农村高氟区氟牙症患病率为89．6％，家长对氟牙症学生的评价随氟牙症程度的减轻（D1分值降低），“牙齿健康程度”、“牙齿满意度”及“主观幸福感”的评价得分也减少。比较对照组及轻度、重度氟牙症患者家长的评价，在5个评价题上均有显著性差异。老师对不同程度氟牙症学生的评价无统计学差异。家长及老师对不同性别学生的评价无显著性差异。结论：氟牙症对学生的社会心理状况有一定影响，尤其家长对此影响较敏感。     

高氟区公众对氟牙症社会心理影响的评价

目的调查高氟区不同人群对氟牙症可能造成的社会心理影响的评价。方法在高氟区河北省邢台市,调查35名口腔医生、30名口腔专业学生、36名非口腔专业学生、34名职员及30名领导对20张不同程度氟牙症照片的社会心理影响评价,分别包括7个不同社会心理方面的五度分法评价题。采用SPSS10.0进行统计分析。结果高氟区公众评价均值随氟牙症的加重而升高(2.27~4.71),氟牙症照片的严重程度与对应的社会心理评价之间均存在显著相关,Spearman相关系数为0.657~0.767。口腔医生的评价值低于其他人群。高氟区公众评价最显著的相关因素是氟牙症程度,偏相关系数均在0.7以上,评价者人口学特征也与评价结果相关。结论高氟区公众认为轻度及以下氟牙症不会对患者的社会心理状况造成明显影响,且公众评价结果与多种因素相关。     

Evaluation of salivary total oxidant-antioxidant status and DNA damage of children undergoing fixed orthodontic therapy

Objective:To determine the total oxidant status (TOS), total antioxidant status (TAS), and the 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels and their interrelationship in the saliva of children undergoing fixed orthodontic therapy.Materials and Methods:Thirty children were randomly divided into three groups. The attachments were bonded to all of the teeth using three different orthodontic composites: Transbond XT, Kurasper F, and GrenGloo. The salivary levels of TOS, TAS, and 8-OHdG were determined three times, as follows: before treatment (T₁) and at 1 month (T₂) and 3 months (T₃) following appliance placement. All data were statistically analyzed.Results:There were no significant differences in TOS, TAS, and 8-OHdG within the same time periods among the three different orthodontic composites (P > .05). TAS in all composite groups decreased over time. These decreases were found to be significant for Kurasper F and GrenGloo at the T₁–T₃ and T₂–T₃ time periods (P < .05). In all composite groups 8-OHdG decreased between T₁ and T₂ (P < .05). However, 8-OHdG in all composite groups increased from T₂ to T₃. These differences in 8-OHdG were significant in Kurasper F and GrenGloo (P < .05).Conclusions:Fixed orthodontic appliances bonded with the tested composites did not increase the cytotoxicity markers in saliva.