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Bariatric dentistry: implications for coordinated dental education and public health policy. 肥胖牙科:对协调牙科教育和公共卫生政策的影响。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-23 DOI: 10.3290/j.qi.b4656969
Nadejda Stefanova Stephens, Wayne Lipschitz, Jodi Psoter, Walter Psoter

Bariatric dentistry is the branch of dental medicine focused on preventive and comprehensive oral health care of overweight or obese patients. Obesity is an increasing US and international health problem and is a condition characterized by abnormal or excessive fat accumulation in the adipose tissue and is categorized by body mass index (BMI) according to the World Health Organization (WHO). With the increase of morbid obesity worldwide and the unfavorable effect on the overall health and life expectancy, it is necessary that proper accommodations are made for accessible dental care of this vulnerable population of patients. The following case report details the emergency and the subsequent elective dental treatment of a patient with a morbid obesity and demonstrates the importance of necessary equipment, a multidisciplinary approach, and broad networking communication needed to treat bariatric patients. The aim of the present case report was to bring awareness and start professional discussions on the importance of dental practitioners in the community and dental academic programs working together to assure access for primary oral health for bariatric patients.

肥胖牙科是牙科医学的一个分支,专注于超重或肥胖患者的预防和全面口腔保健。肥胖是一个日益严重的美国和国际健康问题,是一种以脂肪组织中异常或过量的脂肪堆积为特征的疾病,根据世界卫生组织(WHO)的体重指数(BMI)进行分类。随着世界范围内病态肥胖的增加以及对整体健康和预期寿命的不利影响,有必要为这一弱势群体的患者提供适当的牙科护理。以下病例报告详细介绍了一名病态肥胖患者的急诊和随后的选择性牙科治疗,并展示了治疗肥胖患者所需的必要设备、多学科方法和广泛的网络沟通的重要性。我们的目标是通过这个病例报告,让人们意识到社区和牙科学术项目中所有牙医的重要性,并开始进行专业讨论,以确保肥胖患者获得初级口腔健康。
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引用次数: 0
Caries prevalence and water fluoridation in Israel: a cross-sectionalstudy. 以色列的龋齿发病率与氟化水:一项横断面研究。
IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-21 DOI: 10.3290/j.qi.b4790573
Guy Tobias, Alexander Khaimov, Avi Zini, Harod D Sgan-Cohen, Jonathan Mann, Yael Chotiner Bar-Yehuda, Efrat Aflalo, Yuval Vered

Objectives: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5000 individuals was fluoridated. In 2014 CWF in Israel stopped.

Methods: Data on 12-year-old children from all areas in Israel from the national crosssectional epidemiological survey conducted in 2011-2012 were stratified by city water fluoridation and by city and school socio-economic status (SES). Two dependent variables were defined: (1) DMFT index -caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov (TF) classification of fluorosis.

Results: Data from 2181, 12-year-olds was analyzed. the average DMFT was 1.17+1.72 and 49% were caries free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs. 0.98 in fluoridated cities) and there were more caries free children 56.4% in fluoridated cities vs. 40.6% in non-fluoridated. DMFT was higher in cities with lower SES than high SES (1.29 vs. 1.05 respectively, p<0.001) and there were less caries free children in low SES (44.5% vs. 53% in high SES cities, p<0.0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in TF index), had questionable to mild fluorosis (9.3%).

Conclusions: CWF is a cheap, simple method of dental health protection that reaches all socio-economic levels and cessation of water fluoridation reduced the health of Israel's children.

Clinical significance: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

目的:评估社区水氟化对以色列 12 岁儿童龋齿和氟斑牙患病率的影响:评估社区水氟化(CWF)对以色列 12 岁儿童龋齿和氟斑牙患病率的影响。考虑到社区水氟化对预防龋齿非常重要。2002 年至 2014 年间,至少有 5000 人居住的社区的自来水进行了氟化处理。2014 年,以色列停止了氟化水的使用:2011-2012年进行的全国横断面流行病学调查中,以色列所有地区12岁儿童的数据按城市水氟化程度以及城市和学校的社会经济地位(SES)进行了分层。确定了两个因变量:(1)DMFT 指数--恒牙中的龋齿情况;(2)采用 Thylstrup-Fejerskov (TF) 氟斑牙分类法得出的中切牙氟斑牙情况:对 2181 名 12 岁儿童的数据进行了分析。平均 DMFT 为 1.17+1.72,49% 的儿童没有龋齿。根据 DMFT,无氟城市的患龋率明显较高(无氟城市为 1.38,有氟城市为 0.98),无龋儿童的比例在有氟城市为 56.4%,无氟城市为 40.6%。在社会经济地位较低的城市,DMFT高于社会经济地位较高的城市(分别为1.29和1.05,p结论:氟化水是一种廉价、简单的保护牙齿健康的方法,可覆盖所有社会经济水平的人群,停止氟化水会降低以色列儿童的健康水平:临床意义:氟化水能有效预防龋齿,惠及大量人群。这项工作的意义在于,政策制定者应考虑将氟化水作为经临床验证的减少健康不平等的方法。
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引用次数: 0
Olfactory and gustatory disorders associated with SARS-CoV-2 infection in children and adults: a topic review. 儿童和成人与SARS-CoV-2感染相关的嗅觉和味觉障碍:主题综述
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4313291
Galit Almoznino, Dana Gleicher, Johnny Kharouba, Sigalit Blumer
This paper is aimed at comprehensively reviewing olfactory and gustatory disorders (OGD) caused by SARS-CoV-2 in children and adults. An electronic and manual search was done on three databases: MEDLINE, Embase, and Web of Science (WoS). Inclusion criteria included publications written in English, involving humans in the age range of 0-99 years that were captured by a controlled vocabulary of thesaurus terms. OGD rates in COVID-19 ranged from 22-71.9% in adults to 16.6-25.8% in children. OGD might appear as the first symptom, and in adults might even be the only symptom (4.8-10%). Anosmia is the most common olfactory disorder (OD) and hypogeusia is the most common gustatory disorder (GD). In 33%-89% of cases, OGD resolves spontaneously within a few weeks, coinciding with the resolution of other COVID-19 symptoms, both in adults and children. However, in some patients, OGD persists beyond the resolution of other symptoms. Notably, children generally experience a swifter and more favorable recovery compared to adults. The precise pathogenesis underlying OGD in the context of COVID-19 remains unclear and is likely multifactorial. Presently, no established treatment protocol exists for OGD and current treatments reviewed lack robust evidence and are not readily available for clinical use. Olfactory training represents the only therapy currently recommended by international authorities. of Pediatric practitioners and general dentists should be aware of OGD in both pediatric and adult populations, including their biological mechanisms, treatment options, and recovery rates.
本文旨在全面综述SARS-CoV-2在儿童和成人中引起的嗅觉和味觉障碍。在三个数据库:MEDLINE、Embase和Web of Science上进行了电子和人工搜索。纳入标准包括用英语写的出版物,涉及年龄范围在0到99岁之间的人类,这些人类被同义词典术语的受控词汇表捕获。COVID-19的嗅觉和味觉障碍率在成人中为22%至71.9%,在儿童中为16.6%至25.8%。嗅觉和味觉障碍可能作为第一症状出现,在成人中甚至可能是唯一症状(4.8%至10%)。嗅觉缺失是最常见的嗅觉障碍,嗅觉减退是最常见的味觉障碍。在33%至89%的病例中,嗅觉和味觉障碍会在几周内自行消退,与成人和儿童的其他COVID-19症状的消退同时发生。然而,在一些患者中,嗅觉和味觉障碍持续存在超过其他症状的解决。值得注意的是,与成年人相比,儿童通常会经历更快、更有利的恢复。在COVID-19背景下,嗅觉和味觉障碍的确切发病机制尚不清楚,可能是多因素的。目前,尚无嗅觉和味觉疾病的既定治疗方案,目前的治疗方法缺乏强有力的证据,也不容易用于临床。嗅觉训练是目前国际权威机构推荐的唯一治疗方法。儿科医生和普通牙科医生应该了解儿童和成人人群的嗅觉和味觉疾病,包括其生物学机制、治疗选择和康复率。
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引用次数: 0
Corrigendum: Evaluation of the survival rate of short implants placed in the posterior atrophic mandible: 5-year clinical study. 勘误:评估后萎缩下颌骨短种植体的存活率:5年临床研究。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28
Naira Ghambaryan, Ashot Jilavyan, Gagik Khachatryan, Davit Mathevosyan, Gekham Tunyan, Gagik Hakobyan

The following amendments are made to the published article: Quintessence Int 2022;53:690-696; First published 17 August 2022; doi: 10.3290/j.qi.b3095013.

对已发表文章作如下修改:Quintessence Int 2022;53:690-696;首次出版于2022年8月17日;doi: 10.3290 / j.qi.b3095013。
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引用次数: 0
Implant-supported full-arch rehabilitation with immediate loading using two different digital impression techniques: a case report with 2-year follow-up. 采用两种不同数字印模技术的种植体支持全弓即时加载康复:1例2年随访报告。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4083477
Ignacio García-Gil, Jorge Cortés-Bretón Brinkmann, María Martínez Ferrero, Andrés Sánchez-Monescillo, Jesús Peláez Rico, María Jesús Suárez-García

Immediate full-arch loading is a highly complex and technique-sensitive procedure. Digital impression techniques aim to replace conventional analog systems to carry out dental treatments in a more predictive, safer, and less time-consuming way. This case report describes a patient with a guarded periodontal prognosis, who was rehabilitated with implant-supported fixed prostheses after full-mouth extractions. Immediate full-arch loading was performed by means of two digital impression systems: photogrammetric technology with PIC dental in the maxillary arch, and MedicalFit in the mandible. Immediate provisional prostheses in acrylic resin (polymethyl methacrylate) were milled and placed within 12 hours after implant placement surgeries. Both provisional structures fitted properly providing adequate esthetics and function. After the implant osseointegration period, final digital impressions were registered, and definitive zirconia full-arch implant-supported prostheses were delivered. The 24-month follow-up did not show biologic or mechanical complications.

立即全拱加载是一个高度复杂和技术敏感的过程。数字印模技术旨在取代传统的模拟系统,以更具预测性、更安全、更节省时间的方式进行牙科治疗。本病例报告描述了一名牙周预后不佳的患者,在全口拔牙后使用种植体支持的固定假体进行康复。通过两种数字印模系统进行即时全弓加载:上颌弓的PIC牙科摄影测量技术和下颌骨的MedicalFit。即刻临时假体采用丙烯酸树脂(聚甲基丙烯酸甲酯),在植入手术后12小时内研磨并放置。两个临时结构都很合适,提供了足够的美观和功能。种植体骨整合期后,记录最终数字印模,并交付最终的氧化锆全弓种植体支撑假体。24个月的随访未发现生物或机械并发症。
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引用次数: 0
Computer-assisted periodontal classification vs manual classification among dental students: a comparative pilot study. 计算机辅助牙周分类与人工牙周分类在牙科学生中的比较初步研究。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4225983
Haya Meir, Hadar Miller, Michael Saminsky, Yiying Huang, Liran Levin, Gil Slutzkey

Objective: The objective of the study was to assess whether computer-assisted periodontal diagnosis can improve the accuracy and homogeneity of classification results obtained by dental students using the 2017 classification of periodontal diseases.

Method and materials: All final year predoctoral dental students from two dental schools were invited to participate in the study. Participants who volunteered for the study were randomly divided into two groups for digital or manual diagnosis, and each participant classified 48 cases. A group of three experienced periodontists provided the reference or gold standard diagnosis.

Results: Overall, 27 students completed the evaluation of all cases; 14 students comprised the digital application group and 13 the manual group. The accuracy of the classification results compared with the gold standard committee was 82% for the digital group compared to 50% of the manual group in terms of the extent of gingivitis; 71% vs 56% for the stage of periodontitis; 67% vs 62% for grade of periodontitis; 76% vs 63% for extent of periodontitis; and 43% vs 30% for overall diagnosis accuracy of periodontitis cases respectively.

Conclusions: Computer-assisted classification using newly developed software, within the boundaries of this study, was shown to be a sensible support tool for dental practitioners to use when diagnosing periodontal disease. This digital tool can the clinicians' accuracy of diagnosis primarily in the extent and staging of periodontitis.

目的:本研究的目的是评估计算机辅助牙周诊断是否可以提高牙科学生使用2017牙周病分类获得的分类结果的准确性和均匀性。方法与材料:邀请来自两所牙科学院的所有在读博士研究生参加本研究。自愿参加这项研究的参与者被随机分为两组,分别进行数字诊断和手动诊断,每个参与者分类48例。一组三名经验丰富的牙周病医生提供参考或金标准诊断。结果:共有27名学生完成了所有病例的评估;数字应用组14人,手工组13人。就牙龈炎的程度而言,与金标准委员会相比,数字组的分类结果准确率为82%,而手工组为50%;牙周炎阶段为71%,牙周炎阶段为56%;牙周炎等级67% vs 62%;牙周炎程度分别为76%和63%;牙周炎病例的总体诊断准确率分别为43%和30%。结论:使用新开发的软件进行计算机辅助分类,在本研究范围内,被证明是牙科医生在诊断牙周病时使用的一种明智的支持工具。这个数字工具可以提高临床医生的诊断准确性,主要是在牙周炎的程度和分期。
{"title":"Computer-assisted periodontal classification vs manual classification among dental students: a comparative pilot study.","authors":"Haya Meir, Hadar Miller, Michael Saminsky, Yiying Huang, Liran Levin, Gil Slutzkey","doi":"10.3290/j.qi.b4225983","DOIUrl":"10.3290/j.qi.b4225983","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study was to assess whether computer-assisted periodontal diagnosis can improve the accuracy and homogeneity of classification results obtained by dental students using the 2017 classification of periodontal diseases.</p><p><strong>Method and materials: </strong>All final year predoctoral dental students from two dental schools were invited to participate in the study. Participants who volunteered for the study were randomly divided into two groups for digital or manual diagnosis, and each participant classified 48 cases. A group of three experienced periodontists provided the reference or gold standard diagnosis.</p><p><strong>Results: </strong>Overall, 27 students completed the evaluation of all cases; 14 students comprised the digital application group and 13 the manual group. The accuracy of the classification results compared with the gold standard committee was 82% for the digital group compared to 50% of the manual group in terms of the extent of gingivitis; 71% vs 56% for the stage of periodontitis; 67% vs 62% for grade of periodontitis; 76% vs 63% for extent of periodontitis; and 43% vs 30% for overall diagnosis accuracy of periodontitis cases respectively.</p><p><strong>Conclusions: </strong>Computer-assisted classification using newly developed software, within the boundaries of this study, was shown to be a sensible support tool for dental practitioners to use when diagnosing periodontal disease. This digital tool can the clinicians' accuracy of diagnosis primarily in the extent and staging of periodontitis.</p>","PeriodicalId":20831,"journal":{"name":"Quintessence international","volume":"0 0","pages":"792-801"},"PeriodicalIF":1.9,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing dentistry: fractal assessment of bone health in pediatric patients with celiac disease using dental images. 推进牙科:使用牙科图像对患有乳糜泻的儿童患者骨骼健康进行分形评估。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4325347
Muge Bulut, Muge Tokuc, Merve Nur Aydin, Hasret Ayyildiz Civan, Esra Polat, Guzide Dogan, Cansu Altuntas, Nevzat Aykut Bayrak, Omer Faruk Beser

Objectives: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs.

Method and materials: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs.

Results: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group.

Conclusions: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effectiveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease.

目的:应用全景x线片分形分析评价无麸质饮食对乳糜泻儿童骨结构的影响。方法与材料:将49例6 ~ 13岁的乳糜泻患者分为既往诊断组和新诊断组,另设32例健康对照。对已确诊和新确诊的乳糜泻患者计算体重指数z -评分,测量钙、碱性磷酸酶、维生素D3和甲状旁激素水平,并通过双能x线吸收仪获得骨密度z -评分。所有患者均采用全景x线片分形分析法评价左、右颞下颌髁的分形维数。结果:两组患者血清生物标志物水平、体重指数和骨密度z分数的平均值均在正常参考范围内。三组患者左右髁分形维数差异无统计学意义。左右髁分形维数两组间差异均有统计学意义。分形维值最高的是先前诊断的组。结论:在无麸质饮食的乳糜泻患者中观察到分形维值的差异。利用全景x线片的分形分析可以证明牙科医生在评估骨矿物质密度方面的价值,因为它具有成本效益,易于获取,减少患者的辐射暴露,使他们能够为乳糜泻患者提供全面的口腔保健和潜在的早期干预措施。
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引用次数: 0
Evaluation of platelet-rich fibrin in the treatment of decorticated intrabony defects: a randomized clinical trial. 评价富血小板纤维蛋白治疗去皮骨内缺损:一项随机临床试验。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4325359
Gauri Mahesh Ugale, Rohini Balaji Male, Vishnudas Dwarkadas Bhandari, Om Nemichand Baghele, Raghavendra Metri, Mahesh Sham Ugale
<p><strong>Objective: </strong>The objective of the present study was to evaluate the clinical and radiographic outcomes of intrabony defects treated with decortication (intramarrow penetration) alone versus decortication combined with platelet-rich fibrin in periodontitis patients followed up for 6 months postsurgery.</p><p><strong>Method and materials: </strong>A total of 46 intrabony defects from periodontitis patients with a mean age of 36.30 ± 6.10 years were randomly assigned into two treatment groups. The control group (n = 23) intrabony sites were accessed with simplified papilla preservation flap (SPPF) followed with debridement, decortication, and closure. The test group (n = 23) sites were accessed with SPPF, followed with debridement, decortication, platelet-rich fibrin placement, and closure. The clinical parameters Plaque Index, Gingival Index, probing pocket depth, relative attachment level, gingival marginal level, along with radiographic defect depth and defect width were recorded at baseline, 3 months, and 6 months postsurgery. Gain in clinical attachment level was the primary outcome, and probing pocket depth reduction and radiographic bone fill were secondary outcomes of the study.</p><p><strong>Results: </strong>The Plaque Index and Gingival Index scores showed nonsignificant difference on intra- and intergroup comparison at baseline, 3 months, and 6 months. The probing pocket depth was 8.17 ± 1.56 mm, 6.65 ± 1.30 mm, and 5.26 ± 1.18 mm for the control group, and 8.17 ± 2.01 mm, 6.26 ± 1.42 mm, and 4.78 ± 1.28 mm for the test group, at baseline, 3 months, and 6 months, respectively. The relative attachment level was 8.83 ± 1.40 mm, 6.78 ± 1.31 mm, and 5.39 ± 1.16 mm for the control group, and 8.39 ± 1.62 mm, 6.96 ± 1.36 mm, and 5.48 ± 1.20 mm for the test group at baseline, 3 months, and 6 months, respectively. Statistically significant reductions were observed for probing pocket depth for the control (2.91 mm, P < .001) and test groups (3.39 mm, P < .001), as well as for relative attachment level for the control (3.44 mm, P < .001) and test groups (2.91 mm, P < .001). However, intergroup differences were nonsignificant for probing pocket depth and relative attachment level. The radiographic defect depth was reduced by 0.31 mm for the control and 1.57 mm for the test group. The radiographic defect width was reduced by 0.18 mm for the control and 0.83 mm for the test group. Intergroup statistically significant differences were observed at the 6-month follow-up (P < .001) for radiographic defect depth and width.</p><p><strong>Conclusion: </strong>Within the limitations of the present study, the results demonstrate statistically significant intragroup improvements in clinical outcomes with decortication alone and decortication combined with platelet-rich fibrin in the treatment of intrabony defects in periodontitis patients. The addition of platelet-rich fibrin did not improve the clinical results beyond decortication alone, and
目的:本研究的目的是评估牙周炎患者术后6个月的临床和影像学结果:单纯去皮(髓内穿透)治疗骨内缺损与去皮联合富血小板纤维蛋白治疗。方法与材料:选取平均年龄36.30±6.10岁的牙周炎患者骨内缺损46例,随机分为两组。对照组(n = 23)采用简化乳头保存瓣(SPPF)进入骨内部位,然后进行清创、去皮和闭合。实验组(n = 23)采用SPPF进入,随后进行清创、去皮、富血小板纤维蛋白放置和闭合。在基线、术后3个月和6个月记录临床参数菌斑指数、牙龈指数、探测袋深度、相对附着水平、牙龈边缘水平以及影像学缺损深度和缺损宽度。临床附着水平的增加是主要结果,探查袋深度减少和x线骨填充是研究的次要结果。结果:斑块指数和牙龈指数评分在基线、3个月和6个月时组内和组间比较差异无统计学意义。在基线、3个月和6个月时,对照组探袋深度分别为8.17±1.56 mm、6.65±1.30 mm和5.26±1.18 mm,试验组为8.17±2.01 mm、6.26±1.42 mm和4.78±1.28 mm。对照组相对附着水平分别为8.83±1.40 mm、6.78±1.31 mm、5.39±1.16 mm,试验组在基线、3个月、6个月时相对附着水平分别为8.39±1.62 mm、6.96±1.36 mm、5.48±1.20 mm。对照组(2.91 mm, P < .001)和试验组(3.39 mm, P < .001)的探测袋深度以及对照组(3.44 mm, P < .001)和试验组(2.91 mm, P < .001)的相对附着水平均有统计学意义的降低。然而,在探测袋深度和相对依恋水平上,组间差异不显著。对照组x射线照相缺陷深度减小0.31 mm,试验组x射线照相缺陷深度减小1.57 mm。对照组x射线照相缺陷宽度减小0.18 mm,试验组x射线照相缺陷宽度减小0.83 mm。在6个月的随访中,两组间的x线缺损深度和宽度差异有统计学意义(P < 0.001)。结论:在本研究的局限性内,结果显示单独去皮和去皮联合富血小板纤维蛋白治疗牙周炎患者骨内缺损的临床结果在组内有统计学意义的改善。除了单独去皮外,添加富血小板纤维蛋白并没有改善临床结果,并且在两种方案中都观察到不可接受的术后残余口袋。考虑到样本量小,添加富含血小板的纤维蛋白比单独去皮更能产生显著的骨填充。
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引用次数: 0
Revisiting best practice guidelines and patient care workflow for managing the risk of medication-related osteonecrosis of the jaw: comparative summary and case studies. 重新审视最佳实践指南和患者护理工作流程,以管理与药物相关的颌骨骨坏死风险:比较总结和案例研究。
IF 1.9 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4213007
Jen Chen, Chia-Yu Wu, Kristina Gallagher, Chin-Wei Wang

Objective: Patients taking antiresorptive medications in dental clinics are at risk of medication-related osteonecrosis of the jaw (MRONJ), which poses daily challenges for their clinicians. This paper aimed to summarize and revisit the three most recognized practice guidelines for the management and prevention of MRONJ, which were proposed by the American Association of Oral and Maxillofacial Surgeons (AAOMS), and presented by the Journal of Bone and Mineral Research (JBMR) and the Journal of Clinical Oncology (JCO). Results and case studies: The AAOMS position paper focused on risk stratification by different medications, management decision trees, risk factors, pathophysiology, and disease staging. The JBMR international consensus presented eight focused questions, which were addressed by systematic reviews. The JCO clinical practice guideline presented six clinical questions, and each concluded with practical recommendations. Practical information was summarized and converted into an adoptable patient care workflow for clinicians to follow and apply in daily practice. Three case studies presented were treated following these guidelines. Each patient underwent advanced surgeries including alveoloplasty, tooth extraction, implant placement, and particulate bone grafting. Some of the considerations not fully informed were discussed and illustrated in each step of the patient care workflow, which included specifics for risk communication, updates on the use of antibiotics, biomarkers, and drug holidays.

Conclusion and practical implications: Structured risk communication with official informed consent documentation should be considered before initiating invasive treatments. Disease control phase with home care therapy should be provided prior to staged reconstructive therapy. Drug holidays and antibiotics coverage can be customized based on individual conditions and related procedures with interprofessional coordination.

目的:在牙科诊所服用抗吸收药物的患者存在药物相关性颌骨骨坏死(MRONJ)的风险,这给临床医生带来了日常挑战。本文旨在总结和回顾由美国口腔颌面外科医师协会(AAOMS)提出、《骨与矿物研究杂志》(JBMR)和《临床肿瘤学杂志》(JCO)发表的三个最受认可的MRONJ管理和预防实践指南。结果和案例研究:AAOMS的立场文件侧重于不同药物、管理决策树、危险因素、病理生理和疾病分期的风险分层。JBMR国际共识提出了八个重点问题,并通过系统评价加以解决。JCO临床实践指南提出了六个临床问题,每个问题最后都提出了实用的建议。总结实用信息并将其转化为临床医生在日常实践中遵循和应用的可采用的患者护理工作流程。提出的三个案例研究是按照这些指导方针处理的。每位患者都接受了先进的手术,包括牙槽成形术、拔牙、种植体植入和颗粒骨移植。在患者护理工作流程的每个步骤中,讨论和说明了一些未充分告知的注意事项,包括风险沟通的细节、抗生素使用的更新、生物标志物和药物假期。结论和实际意义:在开始侵入性治疗之前,应考虑与官方知情同意文件进行结构化风险沟通。疾病控制阶段的家庭护理治疗应在分期重建治疗之前提供。药物假期和抗生素覆盖范围可以根据个人情况和相关程序进行定制,并进行跨专业协调。
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引用次数: 0
Editorial: Learning health systems in dentistry: a lean challenge. 社论:学习牙科卫生系统:一个精简的挑战。
IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-28 DOI: 10.3290/j.qi.b4703583
Sorin Teich, Fabio Rizzante
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Quintessence international
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