Journal of the American Dental Association最新文献

英文中文

Delayed oral health care due to cost among US adults with diabetes, 2018-2019 2018-2019年美国成年糖尿病患者因费用问题而延迟口腔保健。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.08.004

Marvellous A. Akinlotan BDS, MPH, PhD, Liang Wei MS, Gina Thornton-Evans DDS, MPH, Shahdokht Boroumand DMD, MPH, Susan Griffin PhD

Background

Although untreated periodontitis increases the risk of developing diabetic complications, people with diabetes are less likely to use dental services. The authors estimated the prevalence of reporting delayed needed oral health care due to cost and associated risk indicators by diabetes status.

Methods

The authors analyzed data for 43,291 adults who participated in the 2018 and 2019 Medical Expenditure Panel Surveys. The authors used t tests to compare crude estimates of delayed oral health care by diabetes status. Adjusted estimates were obtained from logistic regression models that controlled for sociodemographic, medical and dental insurance, health status, and geographic variables. Multivariable logistic regression models were run separately for adults with and without diabetes to identify factors that were associated with delayed oral health care.

Results

After controlling for covariates, the difference in delayed oral health care prevalence between adults with diabetes (18%) and without diabetes (16%) remained significant. Lack of medical insurance and fair or poor self-rated health status were the highest predictors of delayed oral health care among those with diabetes.

Conclusions

Despite guidelines, factors other than biology and perceived need may impede access to oral health care for people with diabetes.

Practical Implications

For uninsured adults, policies should prioritize enhancing access to regular ambulatory care and promoting awareness about the importance of preventing and treating dental conditions. In addition, addressing the medical and psychosocial aspects of diabetes in affected patients could affect positively their overall sense of well-being and self-rated health status, potentially encouraging greater use of oral health care services.

背景：尽管未经治疗的牙周炎会增加患糖尿病并发症的风险，但糖尿病患者却不太可能使用牙科服务。作者根据糖尿病状态估算了因费用和相关风险指标而报告延迟所需口腔保健的普遍程度：作者分析了参加2018年和2019年医疗支出小组调查的43291名成年人的数据。作者使用 t 检验比较了糖尿病状态下延迟口腔保健的粗略估计值。调整后的估计值来自控制了社会人口学、医疗和牙科保险、健康状况和地理变量的逻辑回归模型。对患有糖尿病和未患有糖尿病的成年人分别运行多变量逻辑回归模型，以确定与延迟口腔保健相关的因素：结果：在控制了协变量后，糖尿病成人（18%）和非糖尿病成人（16%）之间延迟口腔保健患病率的差异仍然显著。在糖尿病患者中，缺乏医疗保险和自评健康状况一般或较差是延迟口腔保健的最大预测因素：结论：尽管有相关指南，但除生物学因素和认知需求外，其他因素也可能阻碍糖尿病患者获得口腔保健服务：对于没有保险的成年人，相关政策应优先考虑增加获得定期门诊护理的机会，并提高对预防和治疗牙科疾病重要性的认识。此外，解决糖尿病患者的医疗和社会心理问题会对他们的整体幸福感和自我健康状况产生积极影响，从而有可能鼓励他们更多地使用口腔保健服务。

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引用次数: 0

YouTube videos on gingival grafting procedures 有关牙龈移植手术的 YouTube 视频：内容与质量分析

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.09.004

Eman Aljoghaiman BDS, CAGS, DScD, Hussain Aljubran BDS, Israa Alkhalifah BDS, Ahmed Alsulaiman BDS, CAGS, DScD, Mishali AlSharief BDS, CAGS, MSD, DScD

Background

Periodontal surgery for gingival defects is widely recognized by dental care professionals and researchers for its effectiveness in treating gingival recession and improving oral health outcomes. YouTube (Google LLC) is 1 of the health information sources patients and clinicians use, and assessing its content quality is crucial. The authors aimed to examine the content and quality of YouTube videos on gingival graft procedures.

Methods

The online video streaming platform YouTube was searched using the key word gingival graft. Two independent examiners analyzed a total of 120 videos; a third examiner assessed interrater reliability. Fifty videos that met the inclusion criteria were included in the study. The assessed content topics for these YouTube videos consisted of 13 different categories, and their overall quality was evaluated using the Video Information and Quality Index (VIQI). Statistical analyses were performed using SAS software, Version 9.4 (SAS Institute).

Results

There were 23 videos in the high-quality content groups and 27 videos in the low-quality content group. Hospitals and universities uploaded most of the included videos. The most commonly discussed topics in the included videos were the patient’s condition (36 [72%]) and area of tissue graft (34 [68%]). The total VIQI score and flow had a significant impact on the overall content score (P < .05).

Conclusions

There was a direct correlation between total VIQI scores and total content scores and an inverse relationship between viewing rate and total content scores.

Practical Implications

To ensure patients receive accurate and up-to-date information about treatment, the authors recommend guiding them toward reliable resources by means of providing direct links to trustworthy websites, creating and sharing playlists of reliable educational videos, and offering printed materials with quick-response codes linking to verified sources. These actions will help patients easily access and trust the information they need for their treatment decisions.

背景：牙周手术治疗牙龈缺损因其在治疗牙龈退缩和改善口腔健康状况方面的有效性而得到牙科护理专业人员和研究人员的广泛认可。YouTube（谷歌公司）是患者和临床医生使用的健康信息来源之一，评估其内容质量至关重要。作者旨在研究 YouTube 上有关牙龈移植手术的视频内容和质量：方法：使用关键词 "牙龈移植 "搜索在线视频流平台 YouTube。两位独立审查员共分析了 120 个视频；第三位审查员评估了审查员之间的可靠性。符合纳入标准的 50 部视频被纳入研究。这些 YouTube 视频的评估内容主题包括 13 个不同的类别，其整体质量采用视频信息和质量指数 (VIQI) 进行评估。统计分析使用 SAS 软件 9.4 版（SAS Institute）进行：结果：高质量内容组有 23 个视频，低质量内容组有 27 个视频。医院和大学上传了大部分视频。视频中最常讨论的主题是患者病情（36 [72%]）和组织移植面积（34 [68%]）。VIQI 总分和流程对内容总分有显著影响（P < .05）：结论：VIQI 总分与内容总分之间存在直接相关性，而观看率与内容总分之间存在反向关系：为确保患者获得准确和最新的治疗信息，作者建议通过提供可信网站的直接链接、创建和共享可靠教育视频的播放列表以及提供带有快速反应代码链接到验证来源的印刷材料等方式，引导患者使用可靠的资源。这些行动将帮助患者轻松获取并信任他们在做出治疗决定时所需的信息。

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引用次数: 0

Ethics and equity 伦理与公平：并驾齐驱还是迎面相撞？

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.08.010

Kristina Petrich DDS, Paul Casamassimo DDS, MS

引用次数: 0

Embracing the need for a Whole Health Home 满足对 "全健康之家 "的需求。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.02.003

Michael Glick

引用次数: 0

Physician-dentist dual referral model concept for coordinated bone anabolic therapy 协调骨合成代谢疗法的医生-牙医双转诊模式概念。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.08.009

Jessica M. Latimer DDS, DMSc, Suncica Travan DDS, MS, Francine D. Berkey PhD, James V. Sugai MS, William V. Giannobile DDS, MS, DMSc

Background

Bone anabolic drugs used for the pharmacologic treatment of osteoporosis have the potential to enhance alveolar bone regeneration to improve implant success. There are no US Food and Drug Administration–approved drugs indicated to improve oral bone density around teeth or implants.

Methods

The authors summarized expert opinions on a novel coordinated treatment approach leveraging the effects of systemic bone anabolic drugs to enhance dental implant therapy in patients with osteoporosis and a dual referral model for physicians and dentists to address the clinical needs of patients with osteoporosis from a comprehensive perspective of oral-systemic health. Interviews of key opinion leaders were conducted with a bone health specialist group consisting of specialists in orthopedic surgery, internal medicine, geriatrics, endocrinology, and clinical densitometry and a surgical dental specialist group consisting of periodontists and oral surgeons.

Results

Overall, both groups shared positive feedback on the idea of strategically timing administration of anabolic osteoporosis drugs with dental treatment. Both groups expressed interest in the dual referral model.

Conclusions

The feedback of key opinion leaders supported the coordinated bone anabolic therapy concept and identified a need for improved interdisciplinary collaboration, education, and communication to realize the synergies of physician-dentist clinical cooperation.

Practical Implications

Strategic timing of osteoporosis therapy could improve skeletal bone health and reduce fracture risk while offering adjunctive dental benefits.

背景：用于骨质疏松症药物治疗的骨同化药物有可能促进牙槽骨再生，从而提高种植体的成功率。目前还没有美国食品和药物管理局批准的药物可用于改善牙齿或种植体周围的口腔骨密度：作者总结了专家们对一种新型协调治疗方法的意见，该方法利用全身性骨同化药物的作用来加强骨质疏松症患者的牙科植入治疗，并总结了内科医生和牙科医生的双重转诊模式，以便从口腔系统健康的综合角度来满足骨质疏松症患者的临床需求。对关键意见领袖进行了访谈，访谈对象包括骨科、内科、老年病科、内分泌科和临床骨密度测量专家组成的骨健康专家小组，以及牙周病专家和口腔外科医生组成的外科牙科专家小组：总的来说，两个小组都对在牙科治疗的同时有计划地使用同化性骨质疏松症药物这一想法给予了积极评价。两个小组都对双重转诊模式表示了兴趣：主要意见领袖的反馈意见支持协调骨质同化疗法的理念，并指出需要加强跨学科合作、教育和沟通，以实现医生-牙医临床合作的协同效应：实际意义：骨质疏松症治疗的战略时机可以改善骨骼健康，降低骨折风险，同时提供辅助性的牙科治疗效果。

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引用次数: 0

Diabetes and oral health 糖尿病与口腔健康。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-11-01 DOI: 10.1016/j.adaj.2024.09.006

Anita M. Mark

引用次数: 0

Destructive radiolucency of the anterior maxilla. 上颌骨前部的破坏性放射斑。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-10-29 DOI: 10.1016/j.adaj.2024.09.008

Austin J Davies, Lindsay L Graves, Darren P Cox

引用次数: 0

Yellowish nodule at the midline of the maxillary vestibule in a man. 一名男性上颌前庭中线处的淡黄色结节。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-10-04 DOI: 10.1016/j.adaj.2024.08.015

Brenda Corrêa Santos, Hélen Kaline Farias Bezerra, Pablo Agustin Vargas, Alan Roger Santos-Silva, Márcio Ajudarte Lopes

引用次数: 0

A papillary nodule of the hard palatal mucosa. 硬腭粘膜乳头状结节。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-10-04 DOI: 10.1016/j.adaj.2024.08.012

Richard J Vargo, Alivia M Shasteen, Emma K Barner, David E Greaves, Daniel C Stoeckel

引用次数: 0

Oral manifestations in pediatric patients with leukemia 儿童白血病患者的口腔表现：系统回顾和荟萃分析。

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the American Dental Association

Pub Date : 2024-10-01 DOI: 10.1016/j.adaj.2024.07.014

Bruna Bastos Silveira DDS, Larissa Di Carvalho Melo DDS, Juliana Amorim dos Santos DDS, Elaine Barros Ferreira PhD, Paula Elaine Diniz Reis PhD, Graziela De Luca Canto PhD, Ana Carolina Acevedo PhD, Carla Massignan PhD, Eliete Neves Silva Guerra PhD

Background

Leukemia is the most common malignancy in pediatric patients, and it has extramedullary involvement. Oral manifestations have been reported in the literature, but to the authors’ knowledge, no systematic review has presented the general prevalence of these manifestations. This review aimed to determine the prevalence of oral manifestations in pediatric patients with leukemia.

Types of Studies Reviewed

The authors conducted a search of PubMed-MEDLINE, Embase, Latin American and Caribbean Health Sciences Literature, Web of Science, and Scopus. Additional searches were carried out in the gray literature and via hand searching of reference lists of included studies. The inclusion criteria were observational studies that investigated the prevalence and occurrence of oral lesions in pediatric patients with leukemia. Two independent reviewers collected data from the selected articles in a prepiloted Excel (Microsoft) spreadsheet.

Results

From 67 included studies, 79 oral manifestations were reported. The most frequent alteration in children with acute lymphoblastic leukemia during the treatment were caries (81%), with moderate certainty of evidence. The prevalence of gingivitis was 73%, oral mucositis was 50%, and lymphadenopathy was 45%, with very low certainty of evidence. After the therapy, the prevalence of dental anomalies was 61%, and the most common were enamel hypoplasia (40%), dental agenesis (22%), and microdontia (22%), presenting very low certainty of evidence. The high heterogeneity among studies contributed significantly to reduce the certainty of the evidence.

Practical Implications

The findings of this study show that pediatric patients with leukemia have oral manifestations predominantly during and after treatment. Health care professionals must be aware of oral manifestations and refer the patients to dentists during the oncological treatment. Thus, the dentist must support pediatric patients with leukemia to help ensure a better quality of life.

背景：白血病是儿童患者中最常见的恶性肿瘤，而且会累及髓外组织。文献中也有关于口腔表现的报道，但据作者所知，还没有系统性综述介绍过这些表现的普遍流行情况。本综述旨在确定儿童白血病患者口腔表现的患病率：作者检索了 PubMed-MEDLINE、Embase、拉丁美洲和加勒比海健康科学文献、Web of Science 和 Scopus。此外，作者还对灰色文献进行了检索，并对纳入研究的参考文献目录进行了人工检索。纳入标准是调查儿童白血病患者口腔病变发生率的观察性研究。两名独立审稿人将所选文章中的数据收集到事先编制好的 Excel（微软）电子表格中：结果：67 项纳入研究共报告了 79 种口腔表现。急性淋巴细胞白血病患儿在治疗期间最常见的改变是龋齿（81%），证据的确定性为中等。牙龈炎发病率为 73%，口腔黏膜炎发病率为 50%，淋巴结病发病率为 45%，证据确定性极低。治疗后，牙齿畸形的发生率为 61%，最常见的是釉质发育不全（40%）、牙齿缺失（22%）和小牙畸形（22%），证据的确定性很低。研究之间的高度异质性大大降低了证据的确定性：本研究结果表明，儿童白血病患者主要在治疗期间和治疗后出现口腔表现。医护人员必须了解口腔表现，并在肿瘤治疗期间将患者转介给牙科医生。因此，牙医必须为儿童白血病患者提供支持，帮助他们确保更好的生活质量。

{"title":"Oral manifestations in pediatric patients with leukemia","authors":"Bruna Bastos Silveira DDS, Larissa Di Carvalho Melo DDS, Juliana Amorim dos Santos DDS, Elaine Barros Ferreira PhD, Paula Elaine Diniz Reis PhD, Graziela De Luca Canto PhD, Ana Carolina Acevedo PhD, Carla Massignan PhD, Eliete Neves Silva Guerra PhD","doi":"10.1016/j.adaj.2024.07.014","DOIUrl":"10.1016/j.adaj.2024.07.014","url":null,"abstract":"<div><h3>Background</h3><div>Leukemia is the most common malignancy in pediatric patients, and it has extramedullary involvement. Oral manifestations have been reported in the literature, but to the authors’ knowledge, no systematic review has presented the general prevalence of these manifestations. This review aimed to determine the prevalence of oral manifestations in pediatric patients with leukemia.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors conducted a search of PubMed-MEDLINE, Embase, Latin American and Caribbean Health Sciences Literature, Web of Science, and Scopus. Additional searches were carried out in the gray literature and via hand searching of reference lists of included studies. The inclusion criteria were observational studies that investigated the prevalence and occurrence of oral lesions in pediatric patients with leukemia. Two independent reviewers collected data from the selected articles in a prepiloted Excel (Microsoft) spreadsheet.</div></div><div><h3>Results</h3><div>From 67 included studies, 79 oral manifestations were reported. The most frequent alteration in children with acute lymphoblastic leukemia during the treatment were caries (81%), with moderate certainty of evidence. The prevalence of gingivitis was 73%, oral mucositis was 50%, and lymphadenopathy was 45%, with very low certainty of evidence. After the therapy, the prevalence of dental anomalies was 61%, and the most common were enamel hypoplasia (40%), dental agenesis (22%), and microdontia (22%), presenting very low certainty of evidence. The high heterogeneity among studies contributed significantly to reduce the certainty of the evidence.</div></div><div><h3>Practical Implications</h3><div>The findings of this study show that pediatric patients with leukemia have oral manifestations predominantly during and after treatment. Health care professionals must be aware of oral manifestations and refer the patients to dentists during the oncological treatment. Thus, the dentist must support pediatric patients with leukemia to help ensure a better quality of life.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"155 10","pages":"Pages 858-870.e30"},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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