A multi‐country comparison of reasons for dental non‐attendance

The purpose of this study was to describe differences across countries with respect to the reasons for dental non‐attendance by Europeans currently 50 yr of age and older. The analyses were based on retrospective life‐history data from the Survey of Health, Ageing, and Retirement in Europe and included information on various reasons why respondents from 13 European countries had never had regular dental visits in their lifetime. A series of logistic regression models was estimated to identify reasons for dental non‐attendance across different welfare‐state regimes. The highest proportion of respondents without any regular dental attendance throughout their lifetime was found for the Southern welfare‐state regime, followed by the Eastern, the Bismarckian, and the Scandinavian welfare‐state regimes. Factors such as patients’ perception that regular dental treatment is ‘not necessary’ or ‘not usual’ appear to be the predominant reason for non‐attendance in all welfare‐state regimes. The health system‐level factor ‘no place to receive this type of care close to home’ and the perception of regular dental treatment as ‘not necessary’ were more often referred to within the Southern, Eastern, and Bismarckian welfare‐state regimes than in Scandinavia. This could be relevant information for health‐care decision makers in order to prioritize interventions towards increasing rates of regular dental attendance.     

The efficacy of non‐narcotic analgesics on post‐operative endodontic pain: A systematic review and meta‐analysis

The objective of this review was to evaluate the efficacy of non‐narcotic analgesics including non‐steroidal anti‐inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of post‐operative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta‐regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n = 27, representing 2188 patients), meta‐analysis was performed using a random‐effect inverse variance method. Meta‐regression analysis was conducted to examine the associations between effect sizes and study‐level covariates (P < 0·05). The results showed that administration of non‐narcotic analgesic was more effective than placebo in the management of post‐operative pain, resulting in a lower pain scores with a standardised mean difference of ?0·50 (95% CI= ?0·70, ?0·30), ?0·76 (95%CI= ?0·95, ?0·56), ?1·15 (95% CI= ?1·52, ?0·78), ?0·65 (95% CI= ?1·05, ?0·26) for immediately after the procedure, 6?, 12? and 24 h post?operative follow‐ups (test for statistical heterogeneity: P = 0·000, P = 0·000, P = 0·000 and P = 0·001), respectively. Our meta‐regression analysis provided the evidence for association between some study covariates with treatment effect, each at different follow‐ups. We concluded that the clinicians can manage post‐operative endodontic pain by administration of NSAIDs and/or paracetamol. However, analgesic regimens should be considered as important determinants when prescribing a pharmacological adjuvant.     

Clinical investigation of G‐Bond resin‐based adhesive to non‐carious cervical lesions over five years

Background: The aim of this study was to evaluate the clinical performance of G‐Bond all‐in‐one adhesive with Gradia Direct resin composite placed in non‐carious cervical lesions (NCCLs) over a five‐year period. Methods: Forty‐seven restorations were placed in NCCLs in 10 subjects (age 45–75 years) after written informed consent was obtained. Institutional ethical approval for the trial was obtained before recruitment. Restorations were placed according to the manufacturer’s instructions and using 50% phosphoric acid to etch uncut enamel margins. Patients were recalled annually for five years and restorations reviewed for presence and marginal staining. Photographic records were obtained prior to restoration, immediately after placement and at each recall. Results: At five years, 6 of the original 10 subjects were available for recall, meaning 27 restoration sites could be evaluated. All restorations remained intact apart for one partial failure at four years. This resulted in a cumulative retention rate of 97.5% of restorations at five years. Marginal staining occurred around seven restorations during the study. Staining tended to be isolated to a few patients. Conclusions: It was concluded that G‐Bond with Gradia Direct resin composite showed excellent results over the five years of the study. This material combination seems very suitable for the restoration of NCCLs.     

Head and neck squamous cell carcinoma in non‐smoking and non‐drinking patients with multiple tumors: etiologic significance of p53 and Ki‐67 in non‐tumorous epithelium

Background: Non‐smoking and non‐drinking patients with head and neck squamous cell carcinoma have different clinical characteristics than their smoking and drinking counterparts. They are predominantly older female patients with oral cavity tumors, however, both groups show the same percentage of second primary tumors. Expression of tumor suppressor gene p53 and proliferation marker Ki‐67 in mucosal epithelial cells was analyzed to study whether biomarker expression is associated with a history of smoking and drinking and with single and multiple tumors. Methods: Non‐smoking and non‐drinking patients with multiple (n = 18) and single tumors (n = 15), smoking and drinking patients with multiple (n = 15) and single tumors (n = 14) were selected. For all groups, p53 and Ki‐67 expression patterns in non‐tumorous (tumor‐adjacent) mucosa including positivity of dispersed single cells and clusters for p53 and for suprabasal expression of Ki‐67 were immunohistochemically analyzed and compared. Results: p53 expression was significantly higher in users of tobacco and alcohol than in non‐users. Ki‐67 expression was not affected by tobacco and alcohol usage. Both Ki‐67 and p53 were similarly expressed in the groups with single and multiple tumors and hence not significantly related to the number of tumors. Conclusions: Non‐smoking and non‐drinking patients with squamous cell carcinoma have the same risk for developing multiple tumors as their smoking and drinking counterparts. As this occurs without an increased expression of p53 or Ki‐67, the significance of these proteins as biomarkers indicating pre‐malignant mucosal alterations is doubtful. Further research is needed to clarify this predisposition for developing multiple head and neck cancer.