Journal of the American Dental Association最新文献

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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。

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引用次数: 0

Innovative state oral health initiatives 创新的州口腔健康倡议：对医疗保险和医疗补助服务中心示范项目的定性分析。

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.2024.07.001

Alex Sheen DDS, MPH, Marcie S. Rubin DrPH, MPH, MPA, Burton L. Edelstein DDS, MPH

Background

US health care delivery and financing arrangements are changing rapidly as payers and providers seek greater efficiency, effectiveness, and safety. The Centers for Medicare & Medicaid Services uses grants and technical assistance to drive such development through innovative demonstration programs, including for oral health care. The authors reviewed these dental demonstrations to identify common themes and identify barriers to and facilitators of implementation.

Methods

The authors compared 12 identified demonstrations across 6 domains: grant and technical assistance, stakeholders, inner care settings, outer contextual settings, interventions, and outcomes. They developed program summaries for each demonstration and interviewed key informants using a semistructured guide to review, correct, clarify, and expand on program summaries.

Results

Common across all programs were engagement of nontraditional providers, care in nontraditional settings, payment as a critical externality for program adoption, interventions that integrate medical and oral health care, use of alternative payment models, and tracking process measures. Adoption facilitators included an engaged oral health champion and obtaining mission support and alignment among stakeholders. Common barriers included unanticipated organizational disruptions, poor information technology infrastructure, cultural resistance to nontraditional care models, and lack of providers in high-need areas.

Conclusions

Descriptive findings suggest that oral health care may evolve as a more accountable, integrated, and accessible health service with an expanded workforce; collaboration between providers and payers will remain key to creating innovative, sustainable models of oral health care.

Practical Implications

The Centers for Medicare & Medicaid Services’ efforts to advance health equity, expand coverage, and improve health outcomes will continue to drive similar initiatives in oral health care

背景：随着支付方和提供方寻求更高的效率、有效性和安全性，美国的医疗保健服务和融资安排正在迅速发生变化。医疗保险与医疗补助服务中心通过创新示范项目，包括口腔医疗项目，利用拨款和技术援助来推动这种发展。作者对这些牙科示范项目进行了审查，以确定共同的主题，并找出实施的障碍和促进因素：作者比较了 12 个已确定的示范项目，涉及 6 个领域：拨款和技术援助、利益相关者、内部医疗环境、外部环境、干预措施和结果。他们为每个示范项目编写了项目摘要，并使用半结构化指南对关键信息提供者进行了访谈，以审查、更正、澄清和扩充项目摘要：所有项目的共同点是：非传统医疗服务提供者的参与、非传统环境下的医疗服务、支付作为项目采用的关键外部因素、整合医疗和口腔保健的干预措施、使用替代支付模式以及跟踪过程措施。促进采用的因素包括口腔健康拥护者的参与以及获得任务支持和利益相关者之间的协调。常见的障碍包括意料之外的组织中断、信息技术基础设施薄弱、对非传统医疗模式的文化抵触以及高需求地区缺乏医疗服务提供者：描述性研究结果表明，口腔医疗保健可能会发展成为一种更负责任、更综合、更方便的医疗服务，同时劳动力队伍也会扩大；医疗服务提供者和支付者之间的合作仍将是创建创新的、可持续的口腔医疗保健模式的关键：实际意义：医疗保险和医疗补助服务中心为促进健康公平、扩大覆盖范围和改善健康结果所做的努力将继续推动口腔医疗保健领域的类似举措。

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引用次数: 0

Disruptive innovation events in dentistry 牙科领域的颠覆性创新事件。

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.2024.07.013

Jill Sirko PhD, Wenyuan Shi PhD

引用次数: 0

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