Gerodontology最新文献

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Clinical parameters that affect performance and patient satisfaction of root-retained overdentures: A systematic review of randomised controlled clinical trials 影响根固位覆盖义齿性能和患者满意度的临床参数：随机对照临床试验的系统回顾。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology

Pub Date : 2024-01-21 DOI: 10.1111/ger.12739

Aspasia Pachiou, Panagiotis Karakostas, Panagiotis Roulias, Olga Naka

Objective

To evaluate clinical parameters that affect the performance of root-supported overdentures (ROD) and to identify the possible factors that may affect it.

Background

ROD still serve as an alternative and successful treatment plan nowadays for partially edentulous patients. Nonetheless, there is not yet conclusive evidence about their clinical evaluation.

Materials and Methods

A search strategy was developed following a PIO (Population, Intervention, Outcome) framework including an electronic search in the following databases: PubMed, Cochrane Library and Scopus. The systematic search included only randomised controlled clinical trials (RCTs), published until January 2023 in English language and was performed by two independent reviewers. Quality assessment of the included studies was conducted according to the Cochrane Risk of Bias tool.

Results

The final selection of studies included 11 RCTs. Clinically relevant variables derived from this search were: Complications, with caries being the most frequently reported, periodontal aspects and bone changes around abutment teeth. Additionally, methods and clinical suggestions for the maintenance of these restorations and patient-related outcomes were assessed. According to the risk of bias assessment, nine studies were considered of high risk, whereas only 2 of low risk. A meta-analysis was not feasible.

Conclusion

Within the limitations of this systematic review, ROD remain a viable treatment plan, offering better denture stability and bone preservation around abutment teeth and high patient satisfaction. Thorough oral hygiene and regular follow-ups are of utmost importance. Further well-designed RCTs are necessary for firmer conclusions.

目的评估影响根支覆盖义齿（ROD）性能的临床参数，并找出可能的影响因素：背景：对于部分无牙颌的患者来说，根支覆盖义齿仍是一种可供选择的成功治疗方案。背景：目前，ROD 仍是部分无牙颌患者的另一种成功的治疗方案，然而，关于其临床评估尚无确凿证据：根据 PIO（人口、干预、结果）框架制定了搜索策略，包括在以下数据库中进行电子搜索：PubMed、Cochrane 图书馆和 Scopus。系统性检索仅包括 2023 年 1 月之前用英语发表的随机对照临床试验（RCT），由两名独立评审员进行。根据科克伦偏倚风险工具对纳入的研究进行了质量评估：最终筛选出 11 项研究。此次搜索得出的临床相关变量包括并发症（龋齿是最常报道的并发症）、牙周问题和基牙周围的骨质变化。此外，还对这些修复体的维护方法和临床建议以及与患者相关的结果进行了评估。根据偏倚风险评估，9 项研究被认为具有高风险，只有 2 项研究具有低风险。荟萃分析不可行：在本系统综述的局限性范围内，ROD仍然是一种可行的治疗方案，它能提供更好的义齿稳定性和基牙周围的牙槽骨保护，患者满意度也很高。彻底的口腔卫生和定期随访至关重要。要得出更可靠的结论，还需要更多设计良好的 RCT。

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引用次数: 0

Editorial: Health services research in an ageing society 社论：老龄化社会中的医疗服务研究。

IF 2 3区医学 Q1 Dentistry

Gerodontology

Pub Date : 2024-01-10 DOI: 10.1111/ger.12737

Barbara E. Janssens, Moira B. Smith

引用次数: 0

Integration of a dental hygienist into the interprofessional long-term care team 将牙科保健师纳入跨专业长期护理团队。

IF 2 3区医学 Q1 Dentistry

Gerodontology

Pub Date : 2023-12-25 DOI: 10.1111/ger.12734

Nelly Villacorta-Siegal, Karen Joseph, Sandra Gardner, Jagger Smith, Christina E. Gallucci, Rosanne Aleong, David Chvartszaid

Background

To address poor oral health of residents in long-term care homes (LTCH), this study explored the process of integrating an educational resource and a dental hygienist on the interprofessional care team.

Methods

This convergent mixed-methods study took place at a 472-bed LTCH in Toronto, Canada from February to August 2018. Nurses employed at the LTCH participated in the study. During the study period, a dental hygienist was integrated into an interprofessional LTCH team. Nurses completed an online eLearning module about using the Oral Health Assessment Tool (OHAT) when referring residents' oral health concerns to a. Pre/post knowledge quizzes, module feedback and satisfaction surveys were administered. A retrospective chart review examined OHAT use and compared nurse and dental hygienist oral health assessments. Two cycles of semi-structured interviews with five nurses explored experiences with the eLearning module, OHAT and integration of the dental hygienist into the team.

Results

Nurses scored well on the knowledge quizzes and reported comfort in using the OHAT to refer oral concerns to a dental hygienist; however, actual use was minimal. oral health issues were under-reported by nurses on the Resident Assessment Instrument–Minimum Data Set (RAI-MDS); the dental hygienist reported significantly more debris, teeth lost and carious teeth (all P < 0.0001). Qualitative analysis indicated that the nurses valued dental hygienist integration into the team. Using knowledge mobilisation practices, a new oral health referral tool was developed.

Conclusions

This study highlights the feasibility and desirability of an oral health eLearning module, practical assessment tools and participation of a dental hygienist on the LTCH interprofessional care team.

背景：为了解决长期护理院居民口腔健康不良的问题，本研究探讨了将教育资源和牙科卫生学家纳入跨专业护理团队的过程：为了解决长期护理院（LTCH）居民口腔健康不良的问题，本研究探讨了将教育资源和牙科卫生学家纳入跨专业护理团队的过程：这项融合的混合方法研究于2018年2月至8月在加拿大多伦多一家拥有472张床位的长期护理院进行。长期治疗医院的护士参与了研究。在研究期间，一名牙科保健师被纳入了 LTCH 跨专业团队。护士们完成了一个在线电子学习模块，内容是在将居民的口腔健康问题转介给牙科医生时如何使用口腔健康评估工具（OHAT）。回顾性病历审查检查了 OHAT 的使用情况，并比较了护士和牙科保健师的口腔健康评估。对五名护士进行了两轮半结构式访谈，探讨了电子学习模块、OHAT 以及将牙科保健师纳入团队的经验：结果：护士们在知识测验中得分很高，并表示能自如地使用 OHAT 将口腔问题转介给牙科保健师；然而，实际使用却很少。护士们在住院病人评估工具-最低数据集（RAI-MDS）中对口腔健康问题的报告不足；牙科保健师报告的碎屑、脱落牙齿和龋齿明显较多（均为 P 结论：这项研究强调了电子学习模块的可行性，以及将牙科保健师纳入团队的可能性：本研究强调了口腔健康电子学习模块、实用评估工具和牙科保健师参与 LTCH 跨专业护理团队的可行性和可取性。

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引用次数: 0

Authors' response to Letter to the Editor regarding ‘Access to dental services in an elder population of African descent in Brazil’ 作者对关于“巴西非洲裔老年人获得牙科服务”的致编辑信的回应。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology

Pub Date : 2023-11-27 DOI: 10.1111/ger.12732

Adriano Referino da Silva-Sobrinho, Nathália Larissa Bezerra Lima, Letícia Francine Silva Ramos, Stefania Ferreira Jerônimo, Fábio Andrey da Costa Araújo, Pedro Henrique Sette-de-Souza

引用次数: 0

Proof of concept design for a toothbrush with on-board vacuum to reduce oral aspirates 一种牙刷的概念设计证明，带有机载真空，以减少口腔吸入。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology

Pub Date : 2023-11-27 DOI: 10.1111/ger.12730

Alexandra Griffith, Abhishek Roy, Sahitya Kulkarni, Glennon Simmons, Laura Osorno, Vivek Kumar

Background

Over the course of brushing, aerosolised particles develop in the mouth. In individuals who do not have the ability to expel these oral aspirates, they can be inhaled and cause aspiration pneumonia. This article showcases a novel vacuum toothbrush, termed “ToothVac,” and provides findings from its first human trial.

Methods

The ToothVac device suctions saliva and aspirates during brushing, storing them in a removable reservoir at the bottom of the brush, to minimise the risk of inhalation and subsequent infection. Further descriptions of the various components of the ToothVac are included. This trial involved 18 participants who brushed using the ToothVac with the vacuum suction turned on and then off.

Results

The volume of saliva produced was measured and compared. The ToothVac significantly reduced the amount of saliva that was produced by these participants when brushing.

Conclusion

The device has potential clinical potential in that it may reduce the risk of aspiration pneumonia and related lung infections. Potential future research may include clinical trials for specific indications or marketing for oral aspirate removal, as well as optimisation of brush design using injection moulding for scalable manufacturing.

背景:在刷牙过程中，口腔中会形成雾化颗粒。对于没有能力排出这些口腔吸入物的个体，它们可能被吸入并引起吸入性肺炎。这篇文章展示了一种新型的真空牙刷，被称为“ToothVac”，并提供了首次人体试验的结果。方法:在刷牙过程中，ToothVac装置将唾液吸出，并将其储存在牙刷底部的可移动储液器中，以尽量减少吸入和随后感染的风险。进一步的描述的各种组成部分的牙齿吸尘器包括在内。这项试验涉及18名参与者，他们使用牙签吸尘器刷牙，然后打开吸盘，然后关闭吸盘。结果:测定并比较了唾液的分泌量。这款牙刷显著减少了这些参与者刷牙时产生的唾液量。结论:该装置可降低吸入性肺炎及相关肺部感染的风险，具有潜在的临床应用潜力。潜在的未来研究可能包括特定适应症的临床试验或口腔抽吸清除的营销，以及使用注射成型优化刷设计以实现可扩展制造。

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引用次数: 0

Comment on ‘Access to dental services in an elder population of African descent in Brazil’ 对“巴西非洲裔老年人获得牙科服务的机会”的评论。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology

Pub Date : 2023-11-27 DOI: 10.1111/ger.12733

Natália Vitória de Araújo Lopes, John Lennon Silva Cunha

引用次数: 0

Comparing approaches to determining poor oral health among older adults in a national survey 在一项全国调查中比较确定老年人口腔健康状况不佳的方法。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology

Pub Date : 2023-11-27 DOI: 10.1111/ger.12729

Alice J. Horncastle, Taylor D. Gauld, Moira B. Smith, W. Murray Thomson

Objectives

To compare the clinical validity of the three approaches in residential care facility residents.

Background

In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurses for assessing oral status when new residents are admitted, but its validity has been questioned. Although Locker's global oral health item has been used to measure oral health in surveys and health services research, it is not routinely used in care facilities, yet its clinical validity has been demonstrated in population-based samples. Self-perceived oral health need may also be useful.

Materials and methods

Using a secondary analysis of clinical and self-reported data from a national survey of nursing home residents (the 2012 New Zealand Older People's Oral Health Survey, or OPOHS), we compared the validity of Locker's item, the interRAI tool and self-reported treatment need for identifying three key clinical indicators of poor oral health among dentate older adults; those were coronal caries (3+ teeth affected), root caries (1+ teeth affected) and xerostomia. Analyses were conducted using STATA, and survey weighting was used to obtain estimates for a source population of 25-843 individuals.

Results

The prevalence of 3+ teeth with coronal caries was 28.7% (23.9, 34.0), the prevalence of 1+ teeth with root caries was 33.7% (28.7, 39.0), the prevalence of xerostomia was 23.1% (18.4, 28.3). Marked gradients in prevalence risk ratio were seen across different categories of Locker's global oral health item and the interRAI assessment tooth for coronal caries and xerostomia. Locker's global oral health item gave a better fitting model and was more discriminative in detecting coronal caries than the interRAI assessment tool (Lockers AIC = 0.76, interRAI AIC = 0.81). None of the approaches was particularly discriminative for root surface caries experience.

Conclusion

Self-reported approaches are discriminative for poor oral health. Standardised assessment tools used in residential care facilities should consider including a self-assessment component such as Locker's global oral health item.

目的:比较三种方法在安老院舍的临床效度。背景:在新西兰的住宿护理机构中，经过培训的注册护士使用interRAI评估工具来评估新居民入院时的口腔状况，但其有效性受到质疑。尽管Locker的全球口腔健康项目已在调查和卫生服务研究中用于衡量口腔健康，但它并未在护理机构中常规使用，但其临床有效性已在基于人群的样本中得到证明。自我感知的口腔健康需求也可能有用。材料和方法:通过对全国养老院居民调查(2012年新西兰老年人口腔健康调查，或OPOHS)的临床和自我报告数据的二次分析，我们比较了Locker’s项目、interRAI工具和自我报告的治疗需求的有效性，以确定牙齿有牙的老年人口腔健康状况不佳的三个关键临床指标;冠状龋(3+颗)、牙根龋(1+颗)和口干症。使用STATA进行分析，并使用调查加权法获得25-843个源种群的估计值。结果:3+牙冠龋患病率为28.7%(23.9,34.0)，1+牙根龋患病率为33.7%(28.7,39.0)，口干患病率为23.1%(18.4,28.3)。在Locker的全球口腔健康项目的不同类别中，以及在冠状龋和口干症的rai评估牙齿中，患病率风险比存在显著的梯度。与interRAI评估工具相比，Locker的整体口腔健康项目提供了更好的拟合模型，并且在检测冠状龋方面具有更强的辨别性(Locker AIC = 0.76, interRAI AIC = 0.81)。没有一种方法对牙根表面的龋病有特别的区别。结论:自我报告方法对口腔健康不良具有鉴别作用。在寄宿护理机构中使用的标准化评估工具应考虑包括自我评估部分，如洛克的全球口腔健康项目。

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引用次数: 0

Oral mucosa and cutaneous manifestations of psoriasis in an older patient: A case report 老年银屑病患者口腔黏膜及皮肤表现1例

IF 2 3区医学 Q1 Dentistry

Gerodontology

Pub Date : 2023-11-16 DOI: 10.1111/ger.12694

Gunther Ricardo Bertolini, Lucas Ribeiro Teixeira, Fernando Chahud, Daniel Elias, Cacilda da Silva Souza, Alan Grupioni Lourenço, Ana Carolina Fragoso Motta

BACKGROUND Psoriasis is a common cutaneous disease; however, information about psoriasis-related oral mucosal lesions is scarce in the literature. CASE DESCRIPTION We report a case of a 73-year-old male patient with cutaneous and oral palatal alterations. An incisional biopsy of these lesions revealed psoriasis. CONCLUSION The current case highlights the importance of a systematic examination of the oral cavity in psoriasis patients for the appropriate diagnosis and management on the control of these lesions.

银屑病是一种常见的皮肤病;然而，文献中关于银屑病相关口腔黏膜病变的信息很少。病例描述我们报告一例73岁男性患者的皮肤和口腔腭改变。这些病变的切口活检显示为牛皮癣。结论本病例强调了对银屑病患者进行口腔系统检查对于正确诊断和控制这些病变的重要性。

引用次数: 0

Diary Dates 日记的日期

IF 2 3区医学 Q1 Dentistry

Gerodontology

Pub Date : 2023-11-16 DOI: 10.1111/ger.12644

引用次数: 0

Toothbrushing-induced vestibular ulcerations with severe gingival defects 刷牙引起的前庭溃疡伴严重牙龈缺损

IF 2 3区医学 Q1 Dentistry

Gerodontology

Pub Date : 2023-11-16 DOI: 10.1111/ger.12702

Beili Liu, Jie Cao, Weiqing Lu, Hui Yao

Background

Daily toothbrushing is a routine approach for helping to keep the oral cavity healthy. However, using a toothbrush as an ordinary oral hygiene habit can also lead to adverse events.

Case Presentation

A 75-year-old man was referred by a periodontist for vestibular ulcerations with gingival defects. The patient reported no significant medical or social history, which might be associated with his symptoms. On examination, wide labio-buccal gingival defects, white attached gingiva and linear vestibular ulcerations were observed. With the help of the periodontist, a diagnosis of inappropriate toothbrushing-induced traumatic ulcerations was reasoned via an approach of aetiological elimination. The patient was put on a trial course of topical dexamethasone powder with lincomycin. The resolution of vestibular ulcerations was apparent after two weeks. He reported no similar oral ulcerations during the following nine years.

Conclusion

To our knowledge, this is the first case reported in the literature of vestibular ulcerations with severe gingival defects caused by inappropriate toothbrushing. The establishment of a correct diagnosis needs a close collaboration between periodontists and oral medicine specialists. Instruction on correct toothbrushing, especially for older people can be beneficial.

背景每天刷牙是帮助保持口腔健康的常规方法。然而，使用牙刷作为一种普通的口腔卫生习惯也会导致不良事件。病例介绍一名75岁男子因前庭溃疡伴牙龈缺损被牙周病医生转诊。患者报告无可能与其症状相关的重要病史或社会史。检查发现唇颊龈宽缺损、白色附着龈、前庭线状溃疡。在牙周病医生的帮助下，通过病因消除的方法对不适当刷牙引起的创伤性溃疡进行诊断。病人局部应用地塞米松粉加林可霉素进行一个疗程的试验。两周后前庭溃疡明显消退。在接下来的九年中，他没有报告类似的口腔溃疡。结论这是文献中首次报道的因刷牙不当导致前庭溃疡合并严重牙龈缺损的病例。正确诊断的建立需要牙周病专家和口腔医学专家的密切合作。关于正确刷牙的指导，特别是对老年人来说是有益的。

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