Texas dental journal最新文献

Objectives: The epidemiology of oral cancer is changing. From 1988 to 2004, there has been a dramatic increase in Human Papilloma virus (HPV) positive oropharyngeal squamous cell carcinoma (OPC) in the U.S. At the same time there have been decreasing rates of OPC associated with the traditional risk factors of smoking and alcohol consumption. The epidemiology of oral cancer is changing. As the epidemiology changes, it is important that the dental community recognize these factors. The goal of this study was to assess the baseline level of knowledge about HPV and OPC within the Texas dental community.

Methods: Practicing dentists and dental hygienists from Texas dental professional networks and dental students from the three Texas schools of dentistry were recruited to participate in the study. Participants were requested to access and complete a 7-item online survey. To ensure anonymity, a third party practice facilitator or department administrator disseminated the survey link to participants.

Results: Of the 457 surveys completed, 100% of respondents reported conducting oral soft tissue examinations at least annually. However, only 73% included the oropharynx in their exam. Less than 50% of dental professionals selected the correct location of the greatest increase in oral cancer incidence during the last 10 years. Less than 30% of each of the groups answered correctly in indicating the age group with the most rapidly increasing incidence of oral cancer. Approximately 40% of all groups indicated that a biopsy from the posterior oropharynx should be tested for HPV.

Conclusion: Survey results across Texas dentists, dental hygienists, and Texas dental students demonstrated a lack of knowledge of the changing profile of oral cancer regarding HPV-associated OPC. This aim of this initial phase was to determine the baseline level of knowledge surrounding the risks associated with oropharyngeal cancer in the survey population. Our goal is to utilize these findings to develop educational interventions that will be disseminated throughout the dental community in Texas to improve diagnosis of these devastating cancers.

The 5-year survival rate for oral cancer (66%) is still one of the lowest among major human cancers, and delayed diagnosis until an advanced stage is thought to be the main factor contributing to this low survival rate. The detection and diagnosis of oral cancer is currently based on clinical visual examination and histopathological evaluation of a biopsy specimen. In response to the need for early detection of oral cancer, several diagnostic adjuncts have been developed and sold commercially over the years, including vital tissue staining, brush cytology, light-based visualization adjuncts, and the most recently developed test for salivary biomarkers for oral cancer. The purpose of this article is to review the current knowledge and research regarding these diagnostic adjuncts developed for early detection of oral cancer. Clinicians are best served by an awareness of the advantages and disadvantages of each adjunct, and to always consider and correlate with the clinical findings when interpreting the test results from these adjuncts.

Objectives: To evaluate how restoration characteristics are associated with the decision to repair or replace an existing restoration. The following hypotheses were studied: dentists who placed the original restoration are more likely to repair instead of replace restorations (H1) that are in molar teeth; (H2) that are in the upper arch; (H3) that have amalgam restorative material; (H4) if a fracture is not the primary reason for the defect; and (H5) when the restoration comprises more than one surface.

Methods: This cross-sectional study used a consecutive patient/restoration recruitment design. 194 dentists members of a dental practice-based research network recorded data on restorations in permanent teeth that needed repair or replacement.

Results: For 6,623 of the 8,770 defective restorations in 6,643 patients, the treatment was provided by the dentist who had not placed the original restoration (75%). The 2-way interaction revealed that dentists who had placed the original restoration often chose to repair when the defective restoration was in a molar, relative to premolar or anterior teeth (OR = 2.2, p <.001); and chose to replace when the restoration had amalgam (OR = 0.5, p < .001), and when it was a fracture compared to another reason (OR = 0.8, p = 001).

Conclusion: Most dentists are not conservative when they revisit a restoration that they originally placed regardless of type of failure, number of surfaces or material used. However, dentists who had placed the original restoration were significantly more likely to repair it when the defective restoration was in a molar tooth.

Clinical significance: Most dentists who placed the original restoration were prone to replace it, however if the defective restoration was located in a molar tooth they would consider repairing it.