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Clinical experiences of staff and students in transitioning from in-person to blended teaching 教职员工和学生从面对面教学过渡到混合式教学的临床经验
Pub Date : 2024-03-11 DOI: 10.3389/froh.2024.1306421
M. Nasseripour, Ana Angelova Volponi, Susha Rajadurai, Jonathan Turner, Muna Dahir Hassan, Anitha Bartlett, J. S. San Diego
This paper describes some of the lessons learned during the COVID-19 pandemic from a study conducted with a group of clinical teachers and undergraduate dental students at the Faculty of Dentistry, Oral & Craniofacial Sciences (FoDOCS) at King's College London about the use of a combination of remote, online and in-person teaching methods that resumed from June 2020. In the narrative research, participants shared their experiences delivering online clinical workshops and their previous experiences delivering face-to-face sessions online, both during and before the pandemic. We conducted remote interviews with the participants via video conferencing, which were recorded, transcribed, and analysed using thematic analysis. Narrative accounts revealed commonalities organised into seven themes, highlighting some of the challenges encountered during the pandemic and providing insights into addressing different curricular constraints and concerns when utilising various delivery modes during emergency situations, such as pandemics. In our study, we concluded that students and teachers benefit from dissociating clinical learning from clinical treatment sessions to focus on the educational intent and content before applying them chairside with patients. Throughout the course, students and teachers were challenged by a lack of engagement. In addition, it is important to examine the online fatigue highlighted by both students and teachers and identify ways to improve time, literacy, and facilitation to create a more conducive learning environment.
本文介绍了在 COVID-19 大流行期间,伦敦国王学院牙科、口腔和颅面科学学院(FoDOCS)的一组临床教师和牙科本科生就 2020 年 6 月起恢复的远程、在线和面对面相结合的教学方法的使用所进行的一项研究的一些经验教训。在叙事研究中,参与者分享了他们在大流行期间和之前提供在线临床研讨会的经验,以及他们以前在网上提供面对面课程的经验。我们通过视频会议与参与者进行了远程访谈,并对访谈进行了录音、转录和主题分析。叙事性叙述揭示了分为七个主题的共同点,突出了大流行期间遇到的一些挑战,并为在大流行等紧急情况下利用各种授课模式解决不同的课程限制和问题提供了启示。在研究中,我们得出结论认为,将临床学习与临床治疗课程分离开来,让学生和教师先关注教学意图和内容,然后再将其应用于患者。在整个课程中,学生和教师都面临着缺乏参与感的挑战。此外,重要的是要检查学生和教师都强调的在线疲劳,并找出改善时间、识字和促进的方法,以创造一个更有利的学习环境。
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引用次数: 0
Oral HPV-associated dysplasia: is koilocytic dysplasia a separate entity? 口腔人乳头瘤病毒相关发育不良:绒毛膜细胞发育不良是一个独立的实体吗?
Pub Date : 2024-02-16 DOI: 10.3389/froh.2024.1363556
Gabriela Anaya-Saavedra, Marcela Vázquez-Garduño
Oral epithelial dysplasia associated with high-risk HPV infection has received different names since its initial description, such as oral Bowenoid lesions, HPV-associated intraepithelial neoplasia, and oral koilocytic dysplasia. Some features, identified in more or less quantity in some of the descriptions, like apoptotic keratinocytes, karyorrhexis, and mitosoid figures, are intricately connected to viral transcriptional status and, consequently, viral load. Since the variety in terminology has introduced diagnostic confusion within medical and research communities, establishing a uniform and standardized approach to diagnosing HPV-oral epithelial dysplasia is crucial for accurate and early diagnoses and holds significant implications for patient outcomes, particularly in high-risk individuals.
与高危型人乳头瘤病毒感染相关的口腔上皮发育不良自最初被描述以来就有不同的名称,如口腔类鲍温病变、人乳头瘤病毒相关上皮内瘤变和口腔绒毛膜细胞发育不良。在一些描述中,或多或少地发现了一些特征,如凋亡的角质细胞、核分裂象和有丝分裂象,这些特征与病毒的转录状态以及病毒载量有着错综复杂的联系。由于术语的多样性给医学界和研究界带来了诊断上的混乱,因此建立统一的标准化方法来诊断人乳头瘤病毒口腔上皮发育不良对于准确和早期诊断至关重要,并对患者的预后,尤其是高危人群的预后具有重要意义。
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引用次数: 0
Salivary levels of inflammatory and anti-inflammatory biomarkers in periodontitis patients with and without acute myocardial infarction: implications for cardiovascular risk assessment 患有和未患有急性心肌梗死的牙周炎患者唾液中的炎症和抗炎生物标志物水平:对心血管风险评估的影响
Pub Date : 2024-02-16 DOI: 10.3389/froh.2024.1332980
Sudhir Varma, Biju Thomas, K. Subrahmanyam, K. Duarte, M. Alsaegh, Divya Gopinath, Sam T. Kuriadom, Jayaraj Narayanan, Vijay B. Desai, Al Moutassem B. Khair, Kelvin I. Afrashtehfar
Periodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated.This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls.Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI.Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI.Our study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events.
牙周炎是由菌群失调引起的,并进一步导致慢性炎症反应。促炎标志物的存在在炎症负荷中起着重要作用。巨噬细胞炎症蛋白-1α(MIP-1α)和C反应蛋白(CRP)是促炎症生物标志物,可量化心脏炎症和疾病中心脏缺血的临床和亚临床炎症。脂联素是一种与健康相关的抗炎标志物。本研究旨在评估患有或未患有急性心肌梗死(AMI)的牙周炎患者与对照组相比的生物标志物水平。通过收集三组(每组 20 人)未经刺激的唾液来检测促炎和抗炎分析物:健康人、患有 III 期牙周炎的人和患有 III 期牙周炎的心肌梗死后患者。与对照组相比,患有和未患有急性心肌梗死的牙周炎患者的脂肪连素水平明显较低,而患有和未患有急性心肌梗死的牙周炎患者的 CRP 和 MIP-1α 与对照组相比明显较高。我们的研究为牙周炎与唾液分析物之间的联系提供了可能的证据。牙周炎患者的脂肪连素水平较低,而 CRP 和 MIP-1α 水平较高,这表明牙周炎是心血管疾病的潜在危险因素。这些发现强调了早期发现和干预牙周炎患者以预防心血管事件的重要性。
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引用次数: 0
Investigating hope in oral health promotion for adolescents: an exploratory study based on observations at the dental clinic 调查促进青少年口腔健康的希望:基于牙科诊所观察的探索性研究
Pub Date : 2024-02-16 DOI: 10.3389/froh.2024.1303933
Arefe Jasbi, Kari Sand, Zoe Marshman, Marikken Høiseth
Maintaining well-being is crucial, especially in challenging conditions, considering the common public health issue of dental caries. Within the context of adolescent oral health, this research explores the techniques employed by dental professionals to potentially foster hope -a positive manner that promotes well-being- in adolescents during consultations, opening a window into the realm of patient engagement and well-being.Data were collected through observations conducted at public dental clinics in Norway, with the participation of three dental professionals and four adolescents between the ages of 12 and 15 years. The data were analyzed using thematic analysis. Practices were observed from dental professionals in their interactions with adolescents, which align with features of hope.Three core themes were identified: (1) bonding strategies; (2) verbal and non-verbal strategies for creating positive relationships; and (3) adolescents' empowerment in dental consultations.Although a new concept within oral health promotion, it seems that dental professionals in this study were observed to be facilitating hope in adolescents when they were providing their dental care. Consideration should be given to the potential for future approaches to be developed for use in dental consultations to facilitate hope strategically. While these approaches are likely to contribute to improving patient-centredness, consideration is needed of challenges and barriers to their implementation.
考虑到龋齿这一常见的公共卫生问题,保持身心健康至关重要,尤其是在充满挑战的条件下。在青少年口腔健康的背景下,本研究探讨了牙科专业人员在咨询过程中为促进青少年的希望--一种促进健康的积极方式--所采用的技巧,为患者的参与和健康领域打开了一扇窗。数据是通过在挪威公立牙科诊所进行的观察收集的,参与观察的有三名牙科专业人员和四名年龄在12至15岁之间的青少年。数据采用主题分析法进行分析。我们观察了牙科专业人员与青少年互动时的做法,这些做法符合希望的特征:(1)结合策略;(2)建立积极关系的语言和非语言策略;(3)青少年在牙科咨询中的授权。虽然这是口腔健康促进中的一个新概念,但在本研究中,我们似乎观察到牙科专业人员在为青少年提供牙科护理时促进了青少年的希望。我们应该考虑到未来在牙科咨询中使用这些方法的可能性,以便从战略上促进希望。虽然这些方法有可能有助于改善以患者为中心的理念,但也需要考虑在实施过程中遇到的挑战和障碍。
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引用次数: 0
The use of objective structured clinical examination in dental education- a narrative review 客观结构化临床检查在口腔医学教育中的应用--叙述性综述
Pub Date : 2024-02-02 DOI: 10.3389/froh.2024.1336677
Mohammad Ramadan Rayyan
The Objective Structured Clinical Examination (OSCE) is a performance-based assessment intended to assess medical students' clinical competency in a simulated, standardized environment. Because it measures the student's ability to use clinical knowledge, diagnostic skill, and decision-making, the OSCE is thought to be more objective than traditional tests. OSCE exams have been increasingly employed in dentistry schools, particularly in the last decade, and it is crucial to investigate instructors' and dental students’ experiences with this evaluation approach.
客观结构化临床考试(OSCE)是一种基于表现的评估方法,旨在模拟标准化环境中评估医学生的临床能力。由于 OSCE 可衡量学生运用临床知识、诊断技能和决策的能力,因此被认为比传统的测试更客观。口腔医学院越来越多地采用 OSCE 考试,尤其是在过去的十年中,调查指导教师和牙科学生对这种评价方法的体验至关重要。
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引用次数: 0
The dual role for probiotics use in dental practices 牙科诊所使用益生菌的双重作用
Pub Date : 2023-12-21 DOI: 10.3389/froh.2023.1336565
Debra A. Goff, Lynne V. McFarland, Stuart Johnson, Douglas Goff
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引用次数: 0
A reflection on COVID-19 and oral mucosal lesion: a systematic review 对 COVID-19 和口腔黏膜病变的思考:系统性综述
Pub Date : 2023-12-18 DOI: 10.3389/froh.2023.1322458
Wai Ying Kot, Jing Wen Li, Alice Kit Ying Chan, Li Wu Zheng
The aim of this systematic review is to provide a clinical update of the current knowledge on COVID-19 and oral mucosal lesions, to analyze the types and prevalence of oral mucosal lesions in patients with COVID-19, and to clarify the potential association between COVID-19 and oral mucosal lesions.The literature search was conducted using PubMed, Web of Science, Scopus and the Cochrane Library, as well as literatures via manual searches of the reference lists of included studies. Studies published in English that mentioned oral mucosal lesions in patients with COVID-19 were included, resulting in a total of 31 studies.Most of the included studies were considered to have a moderate to high risk of bias according to the Joanna Briggs Institute bias assessment tools. Based on COVID-19 severity, the characteristics and patterns of oral mucosal lesions in COVID-19 patients were described, analyzed and synthesized. Overall, ulcers without specific diagnosis had the highest prevalence in COVID-19 patients, followed by traumatic ulcers, candidiasis, petechiae and aphthous-like lesions. Homogeneity of data cannot be achieved in statical analysis, indicating randomness of outcome (ulcers without specific diagnosis, 95% CI: 28%–96%, I2 = 98.7%).Given the limited evidence from currently available studies, the association between COVID-19 and oral mucosal lesions remains difficult to clarify. Healthcare professionals should be aware of the possible association between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.
本系统性综述旨在提供有关 COVID-19 和口腔黏膜病变的最新临床知识,分析 COVID-19 患者口腔黏膜病变的类型和患病率,并阐明 COVID-19 与口腔黏膜病变之间的潜在关联。文献检索采用 PubMed、Web of Science、Scopus 和 Cochrane 图书馆,并通过人工检索纳入研究的参考文献列表进行文献检索。根据乔安娜-布里格斯研究所(Joanna Briggs Institute)的偏倚评估工具,大部分纳入的研究被认为具有中度至高度的偏倚风险。根据 COVID-19 的严重程度,对 COVID-19 患者口腔黏膜病变的特征和模式进行了描述、分析和综合。总体而言,无明确诊断的溃疡在 COVID-19 患者中发病率最高,其次是创伤性溃疡、念珠菌病、瘀斑和口疮样病变。统计分析无法实现数据的同质性,这表明结果具有随机性(无特异性诊断的溃疡,95% CI:28%-96%,I2 = 98.7%)。医疗保健专业人员应了解 COVID-19 与口腔黏膜病变之间可能存在的关联,我们在此讨论我们的研究结果。
{"title":"A reflection on COVID-19 and oral mucosal lesion: a systematic review","authors":"Wai Ying Kot, Jing Wen Li, Alice Kit Ying Chan, Li Wu Zheng","doi":"10.3389/froh.2023.1322458","DOIUrl":"https://doi.org/10.3389/froh.2023.1322458","url":null,"abstract":"The aim of this systematic review is to provide a clinical update of the current knowledge on COVID-19 and oral mucosal lesions, to analyze the types and prevalence of oral mucosal lesions in patients with COVID-19, and to clarify the potential association between COVID-19 and oral mucosal lesions.The literature search was conducted using PubMed, Web of Science, Scopus and the Cochrane Library, as well as literatures via manual searches of the reference lists of included studies. Studies published in English that mentioned oral mucosal lesions in patients with COVID-19 were included, resulting in a total of 31 studies.Most of the included studies were considered to have a moderate to high risk of bias according to the Joanna Briggs Institute bias assessment tools. Based on COVID-19 severity, the characteristics and patterns of oral mucosal lesions in COVID-19 patients were described, analyzed and synthesized. Overall, ulcers without specific diagnosis had the highest prevalence in COVID-19 patients, followed by traumatic ulcers, candidiasis, petechiae and aphthous-like lesions. Homogeneity of data cannot be achieved in statical analysis, indicating randomness of outcome (ulcers without specific diagnosis, 95% CI: 28%–96%, I2 = 98.7%).Given the limited evidence from currently available studies, the association between COVID-19 and oral mucosal lesions remains difficult to clarify. Healthcare professionals should be aware of the possible association between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.","PeriodicalId":12463,"journal":{"name":"Frontiers in Oral Health","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138964520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing the 5-year survival rate of oral cancer patients in the Mongolian population: a retrospective cohort study 影响蒙古口腔癌患者 5 年生存率的因素:一项回顾性队列研究
Pub Date : 2023-12-15 DOI: 10.3389/froh.2023.1292720
Oyuntsetseg Davaatsend, Munkhdul Altannamar, Badral Batbayar, Urjinlkham Jagdagsuren
The high mortality rate of head and neck cancers, particularly oral cancer, poses a significant health challenge in developing nations such as Mongolia. This retrospective survival analysis study was conducted to identify factors influencing the 5-year survival rate of oral squamous cell carcinoma patients.The study analyzed data from 173 patients diagnosed with oral squamous cell carcinoma, including multiple variables such as age, gender, residence, education, tobacco and alcohol consumption, oral health indicators, family history, precancerous conditions, cancer characteristics, treatment, rehabilitation, cancer recurrence, and 5-year survival. Survival analysis was conducted using the Kaplan–Meier method, and STATA was used for statistical analysis.The study revealed a 5-year survival rate of 50.3% for oral cancer patients, with a survival rate of 38% for tongue cancer patients. Age, residence, cancer stage, and cancer recurrence were identified as significant survival predictors. Compared to those aged 60 or younger, the hazard ratio (HR) for patients aged 61 or older was 1.52. Survival was associated with female gender (HR = 0.47, CI = 0.29–0.77). Urban residence was associated with decreased survival (HR = 1.92, CI = 1.22–3.05). Significantly worse survival was associated with the presence of cancer recurrence (HR = 1.99, CI = 1.15–3.04). Oral cancer patients in stage IV had a fourfold higher risk of mortality compared to those in stage I (HR = 4.08, CI = 1.2–13.84).This research highlights the influence of age, urban habitation, and cancer recurrence on oral cancer survival. Age, urban residence, and cancer recurrence were all associated with decreased survival, whereas cancer at stage IV substantially increased the risk of death. The significance of early detection, treatment, and active surveillance to identify oral cancer at an early stage is highlighted by these findings. Compared to industrialized nations, Mongolia's lower oral cancer survival rates emphasize the need to increase public awareness and education. A comprehensive approach is required to improve oral cancer patient survival rates and quality of life, including emphasizing early detection through active surveillance, implementing preventive measures, and advancing cancer education initiatives.
头颈部癌症,尤其是口腔癌的高死亡率给蒙古等发展中国家的健康带来了巨大挑战。这项回顾性生存分析研究旨在找出影响口腔鳞状细胞癌患者5年生存率的因素。研究分析了173名确诊为口腔鳞状细胞癌患者的数据,包括年龄、性别、居住地、教育程度、烟酒消费、口腔健康指标、家族史、癌前病变、癌症特征、治疗、康复、癌症复发和5年生存率等多个变量。研究显示,口腔癌患者的 5 年生存率为 50.3%,舌癌患者的 5 年生存率为 38%。研究发现,年龄、居住地、癌症分期和癌症复发是预测生存率的重要因素。与 60 岁或以下的患者相比,61 岁或以上患者的危险比(HR)为 1.52。生存率与女性性别相关(HR = 0.47,CI = 0.29-0.77)。城市居民与生存率下降有关(HR = 1.92,CI = 1.22-3.05)。生存率明显降低与癌症复发有关(HR = 1.99,CI = 1.15-3.04)。与处于 I 期的患者相比,处于 IV 期的口腔癌患者的死亡风险高出四倍(HR = 4.08,CI = 1.2-13.84)。年龄、城市居住地和癌症复发都与生存率下降有关,而处于 IV 期的癌症则大大增加了死亡风险。这些研究结果凸显了早期发现、治疗和积极监测以在早期阶段识别口腔癌的重要性。与工业化国家相比,蒙古的口腔癌存活率较低,这强调了提高公众意识和教育的必要性。要提高口腔癌患者的存活率和生活质量,需要采取综合方法,包括强调通过积极监测进行早期检测、实施预防措施和推进癌症教育活动。
{"title":"Factors influencing the 5-year survival rate of oral cancer patients in the Mongolian population: a retrospective cohort study","authors":"Oyuntsetseg Davaatsend, Munkhdul Altannamar, Badral Batbayar, Urjinlkham Jagdagsuren","doi":"10.3389/froh.2023.1292720","DOIUrl":"https://doi.org/10.3389/froh.2023.1292720","url":null,"abstract":"The high mortality rate of head and neck cancers, particularly oral cancer, poses a significant health challenge in developing nations such as Mongolia. This retrospective survival analysis study was conducted to identify factors influencing the 5-year survival rate of oral squamous cell carcinoma patients.The study analyzed data from 173 patients diagnosed with oral squamous cell carcinoma, including multiple variables such as age, gender, residence, education, tobacco and alcohol consumption, oral health indicators, family history, precancerous conditions, cancer characteristics, treatment, rehabilitation, cancer recurrence, and 5-year survival. Survival analysis was conducted using the Kaplan–Meier method, and STATA was used for statistical analysis.The study revealed a 5-year survival rate of 50.3% for oral cancer patients, with a survival rate of 38% for tongue cancer patients. Age, residence, cancer stage, and cancer recurrence were identified as significant survival predictors. Compared to those aged 60 or younger, the hazard ratio (HR) for patients aged 61 or older was 1.52. Survival was associated with female gender (HR = 0.47, CI = 0.29–0.77). Urban residence was associated with decreased survival (HR = 1.92, CI = 1.22–3.05). Significantly worse survival was associated with the presence of cancer recurrence (HR = 1.99, CI = 1.15–3.04). Oral cancer patients in stage IV had a fourfold higher risk of mortality compared to those in stage I (HR = 4.08, CI = 1.2–13.84).This research highlights the influence of age, urban habitation, and cancer recurrence on oral cancer survival. Age, urban residence, and cancer recurrence were all associated with decreased survival, whereas cancer at stage IV substantially increased the risk of death. The significance of early detection, treatment, and active surveillance to identify oral cancer at an early stage is highlighted by these findings. Compared to industrialized nations, Mongolia's lower oral cancer survival rates emphasize the need to increase public awareness and education. A comprehensive approach is required to improve oral cancer patient survival rates and quality of life, including emphasizing early detection through active surveillance, implementing preventive measures, and advancing cancer education initiatives.","PeriodicalId":12463,"journal":{"name":"Frontiers in Oral Health","volume":"19 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138970530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing the likelihood of dental service checkup: results from a survey in Saudi Arabia 影响牙科服务检查可能性的因素:沙特阿拉伯的调查结果
Pub Date : 2023-12-15 DOI: 10.3389/froh.2023.1208929
Majed S. Almutairi, Gerry McKenna, I. Alsumaih, Rasha Alhazzaa, Ciaran O’Neill
The funding and delivery of healthcare including dental care in the Kingdom of Saudi Arabia (KSA, or Saudi Arabia) is undergoing a process of reform. To inform this process, it is important that policymakers are aware of the relationships between service use, specific types of use, and the factors that influence this. Currently, there is a paucity of research in this area in KSA that examines dental service use for checkups at a national level and none that examines differences in this use across regions or that examines explicitly the role of income.This study uses the most recent version of the Saudi Health Interview Survey (SHIS) to examine the relationships between the use of dental services for a checkup and socio-demographic characteristics of respondents. Particular focus is given to the differences between regions in service use and the role of socio-demographics within regions.Data were taken from SHIS 2013. Descriptive statistics (means and standard errors) were used to characterize the sample. Logistic regression analyses were used to examine the relationship between checkups in the past 12 months and a range of covariates including income and region. The analysis was repeated for sub-samples based on specific regions. No attempt was made to impute missing values.A sample of 7603 respondents provided complete data for analysis. Fifty-one per cent of the respondents were male, 29% were educated at least to degree level, 25% reported that they floss at least once per day, 69% reported that they brushed their teeth at least once per day, and 11% reported that they had visited the dentist for a checkup in the preceding 12 months. Logistic regression analyses revealed income, region, and oral hygiene habits to be among the significant determinants of the likelihood of dental checkup in the preceding 12 months. In logistic regression analyses at the regional level, different relationships were evident between checkups and socio-demographic characteristics across regions.Region and income are significant determinants of dental service use for checkups. Differences exist between regions in the relationship between socio-demographic characteristics and the likelihood of getting checkups. Policy changes should reflect the potential differences they might have across regions for which the role of socio-demographic characteristics varies.
沙特阿拉伯王国(KSA,或沙特阿拉伯)正在对包括牙科保健在内的医疗保健的资金和服务进行改革。为了给这一进程提供信息,决策者必须了解服务使用、特定类型的使用以及影响因素之间的关系。目前,沙特在这一领域很少有在全国范围内研究牙科检查服务使用情况的研究,也没有研究不同地区牙科检查服务使用情况的差异或明确研究收入的作用。数据来自 2013 年沙特健康访谈调查。描述性统计(均值和标准误差)用于描述样本的特征。逻辑回归分析用于研究过去 12 个月中体检次数与一系列协变量(包括收入和地区)之间的关系。对基于特定地区的子样本重复进行了分析。共有 7603 名受访者提供了完整的分析数据。51%的受访者为男性,29%的受访者至少受过学位教育,25%的受访者表示他们每天至少使用一次牙线,69%的受访者表示他们每天至少刷牙一次,11%的受访者表示他们在过去 12 个月内曾去牙医那里检查过牙齿。逻辑回归分析表明,收入、地区和口腔卫生习惯是前 12 个月进行牙科检查可能性的重要决定因素。在地区层面的逻辑回归分析中,不同地区的体检与社会人口特征之间的关系明显不同。不同地区的社会人口特征与接受检查的可能性之间的关系存在差异。政策变化应反映出社会人口特征在不同地区可能产生的潜在差异。
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引用次数: 0
The protective role of CD73 in periodontitis: preventing hyper-inflammatory fibroblasts and driving osteoclast energy metabolism CD73 在牙周炎中的保护作用:防止高炎症性成纤维细胞并驱动破骨细胞的能量代谢
Pub Date : 2023-12-13 DOI: 10.3389/froh.2023.1308657
E. S. Ramos-Junior, Shantiece Dawson, W. Ryan, Braden Clinebell, Rogelio Serrano-Lopez, Marsha Russell, Rylee Brumbaugh, Roger Zhong, Jussara Gonçalves Fernandes, L. Shaddox, Christopher W. Cutler, A. C. Morandini
Periodontitis is an immune-mediated inflammatory disease affecting almost half of the adult population and is the leading cause of tooth loss in the United States. The role of extracellular nucleotide signaling including nucleotide metabolizing enzyme CD73 adds an important layer of interaction of purine mediators capable of orchestrating inflammatory outcomes. CD73 is able to catabolize 5′-adenosine monophosphate into adenosine at the extracellular level, playing a critical role in regulating many processes under physiological and pathological conditions. Here, we explored the role of CD73 in ligature-induced periodontitis in vivo comparing wild-type C57Bl/6J and CD73-deficient mice.We assessed gingival levels of inflammatory cytokines in vivo and in murine gingival fibroblasts in vitro, as well as bone loss, and RANKL-induced osteoclastogenesis. We have also analyzed CD73 mRNA in samples derived from patients diagnosed with severe periodontitis.Our results in mice show that lack of CD73 resulted in increased inflammatory cytokines and chemokines such as IL-1β, IL-17, Cxcl1 and Cxcl2 in diseased gingiva relative to the healthy-controls and in comparison with the wild type. CD73-deficient gingival fibroblasts also manifested a defective healing response with higher MMP-13 levels. CD73-deficient animals also showed increased osteoclastogenesis in vitro with increased mitochondrial metabolism typified by excessive activation of oxidative phosphorylation, increased mitochondrial membrane potential and accumulation of hydrogen peroxide. Micro-CT analysis revealed that lack of CD73 resulted in decreased bone mineral density, decreased trabecular bone volume and thickness as well as decreased bone volume in long bones. CD73 deficiency also resulted in increased alveolar bone loss in experimental periodontitis. Correlative studies of gingival samples from severe (Grade C) periodontitis showed decreased levels of CD73 compared to healthy controls, further supporting the relevance of our murine results.In conclusion, CD73 appears to play a protective role in the gingival periodontal tissue and bone homeostasis, regulating hyper-inflammatory state of stromal fibroblasts and osteoclast energy metabolism and being an important candidate for future target therapies to prevent or control immune-mediated inflammatory and osteolytic diseases.
牙周炎是一种免疫介导的炎症性疾病,影响着近一半的成年人,是美国牙齿脱落的主要原因。细胞外核苷酸信号(包括核苷酸代谢酶 CD73)的作用为能够协调炎症结果的嘌呤介质的相互作用增加了一个重要层面。CD73 能够在细胞外水平将单磷酸 5′-腺苷分解成腺苷,在生理和病理条件下调节许多过程中发挥关键作用。在此,我们比较了野生型 C57Bl/6J 小鼠和 CD73 缺陷小鼠,探讨了 CD73 在体内结扎诱导的牙周炎中的作用。我们评估了体内和体外小鼠牙龈成纤维细胞中的牙龈炎症细胞因子水平,以及骨质流失和 RANKL 诱导的破骨细胞生成。我们对小鼠的研究结果表明,与健康对照组相比,以及与野生型相比,缺乏 CD73 会导致病变牙龈中的炎性细胞因子和趋化因子(如 IL-1β、IL-17、Cxcl1 和 Cxcl2)增加。CD73缺陷型牙龈成纤维细胞也表现出愈合反应缺陷,MMP-13水平较高。CD73 缺陷动物还表现出体外破骨细胞生成增加,线粒体代谢增加,表现为氧化磷酸化过度激活、线粒体膜电位增加和过氧化氢积累。显微 CT 分析显示,缺乏 CD73 会导致骨矿物质密度降低、骨小梁体积和厚度减少以及长骨骨量减少。在实验性牙周炎中,CD73的缺乏也会导致牙槽骨流失增加。总之,CD73 似乎在牙龈牙周组织和骨平衡中发挥保护作用,调节基质成纤维细胞的高炎症状态和破骨细胞的能量代谢,是未来预防或控制免疫介导的炎症和溶骨性疾病的靶向疗法的重要候选者。
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引用次数: 0
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Frontiers in Oral Health
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