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  1 / 3591 MEDLINE  
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[PMID]:29235327
[Au] Autor:Seidel-Bittke D
[Ti] Título:Prophy or Perio Patient: What is your why?
[So] Source:Dent Today;36(3):10, 12, 2017 Mar.
[Is] ISSN:8750-2186
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Relações Dentista-Paciente
Planejamento de Assistência ao Paciente/organização & administração
Equipe de Assistência ao Paciente/organização & administração
Doenças Periodontais/terapia
Administração da Prática Odontológica/organização & administração
[Mh] Termos MeSH secundário: Profilaxia Dentária
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


  2 / 3591 MEDLINE  
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[PMID]:28966185
[Au] Autor:Jones VE; Karydis A; Hottel TL
[Ad] Endereço:Prof. Jones is Assistant Professor and Administrative Director, Predoctoral Clinical Program in Periodontology, Department of Periodontology, College of Dentistry, University of Tennessee Health Science Center; Dr. Karydis is Associate Professor, Department of Periodontology, College of Dentistry, University of Tennessee Health Science Center; and Dr. Hottel is Professor and Dean, College of Dentistry, University of Tennessee Health Science Center. vjones17@uthsc.edu.
[Ti] Título:Dental and Dental Hygiene Intraprofessional Education: A Pilot Program and Assessment of Students' and Patients' Satisfaction.
[So] Source:J Dent Educ;81(10):1203-1212, 2017 Oct.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Interprofessional and intraprofessional education (when students from two or more professions or within the same profession, respectively, learn about, from, and/or with each other) is crucial for effective interdisciplinary collaboration. The aims of this study were to assess the effectiveness of a clinical intraprofessional education program for dental and dental hygiene students, based on students' expectations and satisfaction with the program and patients' satisfaction with the team-based care. The pilot program was developed at the University of Tennessee Health Science Center College of Dentistry, where dental hygiene students were paired randomly with dental students scheduled for prophylaxis, scaling and root planing, or periodontal maintenance. Surveys with questions about the students' expectations and satisfaction were distributed to 89 senior dental students and 27 senior dental hygiene students before and after team-based procedures. Another survey was distributed to 17 patients asking about their satisfaction with the team-based care. All 27 dental hygiene students (100% response rate), 51 dental students (57.3% response rate), and all 17 patients (100% response rate) participated in the surveys. The results showed that both the dental and dental hygiene students had high expectations and were overall satisfied with the intraprofessional education. The students' expectations and perceived educational gap (difference between expectations and satisfaction) differed for the dental and dental hygiene students (p<0.001). The male dental students were also more satisfied than the female dental students (p<0.01). Overall, the program met or exceeded the students' expectations, and the patients were overwhelmingly satisfied with the team-based care. These results suggest that this intraprofessional practice model provided an effective educational experience for both dental and dental hygiene students and patients. The differences between the dental hygiene and dental students' expectations will help in the design of more effective training that promotes intraprofessional and interprofessional teamwork.
[Mh] Termos MeSH primário: Higienistas Dentários/educação
Profilaxia Dentária
Educação em Odontologia/métodos
Comunicação Interdisciplinar
Satisfação do Paciente
Satisfação Pessoal
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Projetos Piloto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.058


  3 / 3591 MEDLINE  
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[PMID]:28966184
[Au] Autor:Partido BB
[Ad] Endereço:Prof. Partido is Assistant Professor, Division of Dental Hygiene, College of Dentistry, The Ohio State University. partido.1@osu.edu.
[Ti] Título:Dental Hygiene Students' Self-Assessment of Ergonomics Utilizing Photography.
[So] Source:J Dent Educ;81(10):1194-1202, 2017 Oct.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Due to postural demands, dental professionals are at high risk for developing work-related musculoskeletal disorders (WMSDs). Dental clinicians' lack of ergonomic awareness may impede the clinical application of recommendations to improve their posture. The aim of this study was to determine whether feedback involving photography and self-assessment would improve dental hygiene students' ergonomic scores and accuracy of their ergonomic self-assessments. The study involved a randomized control design and used a convenience sample of all 32 junior-year dental hygiene students enrolled in the autumn 2016 term in The Ohio State University baccalaureate dental hygiene program. Sixteen students were randomly assigned to each of two groups (control and training). At weeks one and four, all participants were photographed and completed ergonomic self-evaluations using the Modified-Dental Operator Posture Assessment Instrument (M-DOPAI). During weeks two and three, participants in the training group were photographed again and used those photographs to complete ergonomic self-assessments. All participants' pre-training and post-training photographs were given ergonomic scores by three raters. Students' self-assessments in the control group and faculty evaluations of the training group showed significant improvement in scores over time (F(1,60)=4.25, p<0.05). In addition, the accuracy of self-assessment significantly improved for students in the training group (F(1,30)=8.29, p<0.01). In this study, dental hygiene students' self-assessments using photographs resulted in improvements in their ergonomic scores and increased accuracy of their ergonomic self-assessments. Any improvement in ergonomic score or awareness can help reduce the risks for WMSDs, especially among dental clinicians.
[Mh] Termos MeSH primário: Higienistas Dentários/educação
Profilaxia Dentária
Ergonomia/métodos
Saúde do Trabalhador/educação
Fotografia
Autoavaliação
[Mh] Termos MeSH secundário: Feedback Formativo
Seres Humanos
Estudantes
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.077


  4 / 3591 MEDLINE  
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[PMID]:28966183
[Au] Autor:Partido BB
[Ad] Endereço:Prof. Partido is Assistant Professor, Division of Dental Hygiene, College of Dentistry, The Ohio State University. partido.1@osu.edu.
[Ti] Título:Ergonomics Calibration Training Utilizing Photography for Dental Hygiene Faculty Members.
[So] Source:J Dent Educ;81(10):1187-1193, 2017 Oct.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dental and dental hygiene clinical faculty members often do not provide consistent instruction, especially since most procedures involve clinical judgment. Although instructional variations frequently translate into variations in student performance, the effect of inconsistent instruction is unknown, especially related to ergonomics. The aim of this study was to determine whether photography-assisted calibration training would improve interrater reliability among dental hygiene faculty members in ergonomics evaluation. The photography-assisted ergonomics calibration program incorporated features to improve accessibility and optimize the quality of the training. The study used a two-group repeated measures design with a convenience sample of 11 dental hygiene faculty members (eight full-time and three part-time) during the autumn 2016 term at one U.S. dental school. At weeks one and seven, all participants evaluated imaged postures of five dental students using a modified-dental operator posture assessment instrument. During weeks three and five, training group participants completed calibration training using independent and group review of imaged postures. All pre-training and post-training evaluations were evaluated for interrater reliability. Two-way random effects intraclass coefficient (ICC) values were calculated to measure the effects of the training on interrater reliability. The average measure of ICC of the training group improved from 0.694 with a 95% confidence interval (CI) of 0.001 to 0.965 (F(4,8)=3.465, p>0.05) to 0.766 with a 95% CI of 0.098 to 0.972 (F(4,8)=7.913, p<0.01). The average measure of ICC of the control group improved from 0.821 with a 95% CI of 0.480 to 0.978 (F(4,28)=7.702, p<0.01) to 0.846 with a 95% CI of 0.542 to 0.981 (F(4,28)=8.561, p<0.01). These results showed that the photography-assisted calibration training with the opportunity to reconcile different opinions resulted in improved agreement among these faculty members.
[Mh] Termos MeSH primário: Higienistas Dentários/educação
Profilaxia Dentária
Ergonomia/métodos
Docentes de Odontologia
Saúde do Trabalhador/educação
Fotografia
[Mh] Termos MeSH secundário: Calibragem
Variações Dependentes do Observador
Reprodutibilidade dos Testes
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.078


  5 / 3591 MEDLINE  
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[PMID]:28966182
[Au] Autor:McKenzie CT; Tilashalski KR; Peterson DT; White ML
[Ad] Endereço:Dr. McKenzie is Director of Communications and Assistant Professor, Department of Clinical and Community Sciences, University of Alabama at Birmingham; Dr. Tilashalski is Associate Dean for Academic Affairs and Associate Professor, University of Alabama at Birmingham; Dr. Peterson is Director of Sim
[Ti] Título:Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.
[So] Source:J Dent Educ;81(10):1179-1186, 2017 Oct.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.
[Mh] Termos MeSH primário: Competência Clínica
Comunicação
Profilaxia Dentária
Educação em Odontologia/métodos
Simulação de Paciente
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.075


  6 / 3591 MEDLINE  
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[PMID]:28864796
[Au] Autor:Fried JL
[Ad] Endereço:Prof. Fried is Associate Professor and Director of Interprofessional Initiatives, School of Dentistry, University of Maryland. jfried@umaryland.edu.
[Ti] Título:The Allied Dental Professions: Executive Summary.
[So] Source:J Dent Educ;81(9):1130-1136, 2017 Sep.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This executive summary for Section 5 of the "Advancing Dental Education in the 21 Century" project addresses the current and future educational systems for dental assisting, dental hygiene, dental therapy, and dental laboratory technology. Nineteen experts prepared six background articles on the educational changes necessary for future roles and practices. The key issues addressed relate to delivery system changes, educational curricula, scopes of practice, regulatory measures, and the public's oral health. The major finding is that substantial reforms will be needed to adequately prepare allied oral health professionals for the changes anticipated in 2040. A reconsideration of current accreditation guidelines, more flexibility with scopes of practice, and an adherence to rigorous academic programs are essential elements for the future of these professions.
[Mh] Termos MeSH primário: Pessoal Técnico de Saúde/educação
Assistência à Saúde
Profilaxia Dentária
Educação em Odontologia
[Mh] Termos MeSH secundário: Seres Humanos
Laboratórios Odontológicos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:170903
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.069


  7 / 3591 MEDLINE  
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[PMID]:28535137
[Au] Autor:Carter JE; Motsinger-Reif AA; Krug WV; Keene BW
[Ad] Endereço:From the Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia (J.E.C.); Department of Statistics and the Bioinformatics Research Center (A.A.M-R.), Department of Clinical Sciences (W.V.K.), and the College of Veterinary Medicine (B.W.K.), North Carolina Stat
[Ti] Título:The Effect of Heart Disease on Anesthetic Complications During Routine Dental Procedures in Dogs.
[So] Source:J Am Anim Hosp Assoc;53(4):206-213, 2017 Jul/Aug.
[Is] ISSN:0587-2871
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.
[Mh] Termos MeSH primário: Anestesia/veterinária
Profilaxia Dentária/veterinária
Doenças do Cão/etiologia
Cardiopatias/veterinária
Complicações Intraoperatórias/veterinária
[Mh] Termos MeSH secundário: Anestesia/efeitos adversos
Animais
Estudos de Casos e Controles
Cães
Cardiopatias/complicações
Complicações Intraoperatórias/etiologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.5326/JAAHA-MS-6512


  8 / 3591 MEDLINE  
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[PMID]:28362061
[Au] Autor:James P; Worthington HV; Parnell C; Harding M; Lamont T; Cheung A; Whelton H; Riley P
[Ad] Endereço:Oral Health Services Research Centre, Cork University Dental School and Hospital, Wilton, Cork, Ireland.
[Ti] Título:Chlorhexidine mouthrinse as an adjunctive treatment for gingival health.
[So] Source:Cochrane Database Syst Rev;3:CD008676, 2017 03 31.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dental plaque associated gingivitis is a reversible inflammatory condition caused by accumulation and persistence of microbial biofilms (dental plaque) on the teeth. It is characterised by redness and swelling of the gingivae (gums) and a tendency for the gingivae to bleed easily. In susceptible individuals, gingivitis may lead to periodontitis and loss of the soft tissue and bony support for the tooth. It is thought that chlorhexidine mouthrinse may reduce the build-up of plaque thereby reducing gingivitis. OBJECTIVES: To assess the effectiveness of chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for the control of gingivitis and plaque compared to mechanical oral hygiene procedures alone or mechanical oral hygiene procedures plus placebo/control mouthrinse. Mechanical oral hygiene procedures were toothbrushing with/without the use of dental floss or interdental cleaning aids and could include professional tooth cleaning/periodontal treatment.To determine whether the effect of chlorhexidine mouthrinse is influenced by chlorhexidine concentration, or frequency of rinsing (once/day versus twice/day).To report and describe any adverse effects associated with chlorhexidine mouthrinse use from included trials. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 28 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (searched 28 September 2016); MEDLINE Ovid (1946 to 28 September 2016); Embase Ovid (1980 to 28 September 2016); and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 28 September 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised controlled trials assessing the effects of chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for at least 4 weeks on gingivitis in children and adults. Mechanical oral hygiene procedures were toothbrushing with/without use of dental floss or interdental cleaning aids and could include professional tooth cleaning/periodontal treatment. We included trials where participants had gingivitis or periodontitis, where participants were healthy and where some or all participants had medical conditions or special care needs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results extracted data and assessed the risk of bias of the included studies. We attempted to contact study authors for missing data or clarification where feasible. For continuous outcomes, we used means and standard deviations to obtain the mean difference (MD) and 95% confidence interval (CI). We combined MDs where studies used the same scale and standardised mean differences (SMDs) where studies used different scales. For dichotomous outcomes, we reported risk ratios (RR) and 95% CIs. Due to anticipated heterogeneity we used random-effects models for all meta-analyses. MAIN RESULTS: We included 51 studies that analysed a total of 5345 participants. One study was assessed as being at unclear risk of bias, with the remaining 50 being at high risk of bias, however, this did not affect the quality assessments for gingivitis and plaque as we believe that further research is very unlikely to change our confidence in the estimate of effect. Gingivitis After 4 to 6 weeks of use, chlorhexidine mouthrinse reduced gingivitis (Gingival Index (GI) 0 to 3 scale) by 0.21 (95% CI 0.11 to 0.31) compared to placebo, control or no mouthrinse (10 trials, 805 participants with mild gingival inflammation (mean score 1 on the GI scale) analysed, high-quality evidence). A similar effect size was found for reducing gingivitis at 6 months. There were insufficient data to determine the reduction in gingivitis associated with chlorhexidine mouthrinse use in individuals with mean GI scores of 1.1 to 3 (moderate or severe levels of gingival inflammation). Plaque Plaque was measured by different indices and the SMD at 4 to 6 weeks was 1.45 (95% CI 1.00 to 1.90) standard deviations lower in the chlorhexidine group (12 trials, 950 participants analysed, high-quality evidence), indicating a large reduction in plaque. A similar large reduction was found for chlorhexidine mouthrinse use at 6 months. Extrinsic tooth staining There was a large increase in extrinsic tooth staining in participants using chlorhexidine mouthrinse at 4 to 6 weeks. The SMD was 1.07 (95% CI 0.80 to 1.34) standard deviations higher (eight trials, 415 participants analysed, moderate-quality evidence) in the chlorhexidine mouthrinse group. There was also a large increase in extrinsic tooth staining in participants using chlorhexidine mouthrinse at 7 to 12 weeks and 6 months. Calculus Results for the effect of chlorhexidine mouthrinse on calculus formation were inconclusive. Effect of concentration and frequency of rinsing There were insufficient data to determine whether there was a difference in effect for either chlorhexidine concentration or frequency of rinsing. Other adverse effects The adverse effects most commonly reported in the included studies were taste disturbance/alteration (reported in 11 studies), effects on the oral mucosa including soreness, irritation, mild desquamation and mucosal ulceration/erosions (reported in 13 studies) and a general burning sensation or a burning tongue or both (reported in nine studies). AUTHORS' CONCLUSIONS: There is high-quality evidence from studies that reported the Löe and Silness Gingival Index of a reduction in gingivitis in individuals with mild gingival inflammation on average (mean score of 1 on the 0 to 3 GI scale) that was not considered to be clinically relevant. There is high-quality evidence of a large reduction in dental plaque with chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for 4 to 6 weeks and 6 months. There is no evidence that one concentration of chlorhexidine rinse is more effective than another. There is insufficient evidence to determine the reduction in gingivitis associated with chlorhexidine mouthrinse use in individuals with mean GI scores of 1.1 to 3 indicating moderate or severe levels of gingival inflammation. Rinsing with chlorhexidine mouthrinse for 4 weeks or longer causes extrinsic tooth staining. In addition, other adverse effects such as calculus build up, transient taste disturbance and effects on the oral mucosa were reported in the included studies.
[Mh] Termos MeSH primário: Clorexidina/uso terapêutico
Placa Dentária/tratamento farmacológico
Gengivite/tratamento farmacológico
Antissépticos Bucais/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Quimioterapia Adjuvante
Criança
Clorexidina/efeitos adversos
Placa Dentária/complicações
Índice de Placa Dentária
Profilaxia Dentária
Feminino
Gengivite/etiologia
Seres Humanos
Masculino
Meia-Idade
Antissépticos Bucais/efeitos adversos
Higiene Bucal
Viés de Publicação
Ensaios Clínicos Controlados Aleatórios como Assunto
Fatores de Tempo
Descoloração de Dente/induzido quimicamente
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Mouthwashes); R4KO0DY52L (Chlorhexidine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008676.pub2


  9 / 3591 MEDLINE  
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[PMID]:28095728
[Au] Autor:Chang CT; Liu SP; Muo CH; Tsai CH; Huang YF
[Ad] Endereço:1 Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
[Ti] Título:Dental Prophylaxis and Osteoradionecrosis: A Population-Based Study.
[So] Source:J Dent Res;96(5):531-538, 2017 May.
[Is] ISSN:1544-0591
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to investigate the association of different dental prophylactic modalities and osteoradionecrosis (ORN) and determine the risk of ORN under different timing periods of scaling, with the use chlorhexidine mouth rinse after surgery and with different strategies of fluoride gel application in head and neck cancer (HNC) participants. A cohort of 18,231 HNC participants, including 941 ORN patients and 17,290 matched control cases, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients (LHID-CIP) in Taiwan. Based on different dental prophylactic modalities before radiotherapy, including chlorhexidine mouth rinse, scaling, and fluoride gel, all HNC subjects were stratified into different groups. The Cox proportional hazard regression was used to compare ORN incidences under different dental prophylactic modalities. The results revealed that scaling and chlorhexidine mouth rinse were significantly related to ORN risk ( P = 0.004 and P < 0.0001). Chlorhexidine mouth rinse was highly correlated to ORN occurrence (hazard ratio [HR], 1.83-2.66), as exposure increased the risk by 2.43-fold among oral cancer patients, regardless of whether they had received major oral surgery or not. Oral cancer patients receiving scaling within 2 wk before radiotherapy increased their incidence of ORN by 1.28-fold compared with patients who had not undergone scaling within 6 mo. There is no significance of fluoride application for dental prophylaxis in increasing ORN occurrence. In conclusion, dental prophylaxis before radiotherapy is strongly correlated to ORN in HNC patients. Chlorhexidine exposure and dental scaling within 2 wk before radiotherapy is significantly related to ORN risk, especially in oral cancer patients. The use of 1.1% NaF topical application did not significantly increase the risk of ORN in HNC patients. An optimal dental prophylaxis protocol to reduce ORN should concern cancer location, cautious prescription of chlorhexidine mouth rinse, and proper timing of scaling.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/efeitos adversos
Clorexidina/análogos & derivados
Profilaxia Dentária/efeitos adversos
Fluoretos Tópicos/efeitos adversos
Neoplasias de Cabeça e Pescoço/radioterapia
Antissépticos Bucais/efeitos adversos
Osteorradionecrose/epidemiologia
Osteorradionecrose/etiologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Clorexidina/efeitos adversos
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Guias de Prática Clínica como Assunto
Estudos Retrospectivos
Fatores de Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 0 (Fluorides, Topical); 0 (Mouthwashes); MOR84MUD8E (chlorhexidine gluconate); R4KO0DY52L (Chlorhexidine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:170119
[St] Status:MEDLINE
[do] DOI:10.1177/0022034516687282


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[PMID]:28042979
[Au] Autor:Park JH; Kim JW; Kim SJ
[Ad] Endereço:Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Republic of Korea.
[Ti] Título:Does the Addition of Bone Morphogenetic Protein 2 to Platelet-Rich Fibrin Improve Healing After Treatment for Medication-Related Osteonecrosis of the Jaw?
[So] Source:J Oral Maxillofac Surg;75(6):1176-1184, 2017 Jun.
[Is] ISSN:1531-5053
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the effect of the addition of bone morphogenetic protein 2 (BMP-2) to leukocyte-rich and platelet-rich fibrin (L-PRF) on the treatment of medication-related osteonecrosis of the jaws (MRONJ), this study compared the healing outcome of combined use of BMP-2 and L-PRF with single use of L-PRF. PATIENTS AND METHODS: Of 55 patients who were diagnosed with MRONJ, 25 were treated with L-PRF alone and 30 were treated with L-PRF and recombinant human BMP-2. For each patient, surgical sites were evaluated postoperatively at 4 and 16 weeks. Associations between the treatment method and the resolution of MRONJ were analyzed with the adjustment of patient-specific factors that may influence the treatment outcome. RESULTS: At 4 and 16 weeks postoperatively, patients with MRONJ who were treated with both L-PRF and BMP-2 showed favorable outcomes with complete resolution of the lesions, which was statistically significant compared with that of the therapy using L-PRF alone (P = .028). Therefore, the additional use of BMP-2 considerably improved MRONJ healing. Among patient-specific factors, the existence of a bacterial colony in the biopsy specimen was a significant factor that negatively affected disease resolution (P = .017). CONCLUSIONS: The combined use of BMP-2 and L-PRF leads to the early resolution of MRONJ; thus patients who need to continue antiresorptive therapy may benefit from the combined regimen.
[Mh] Termos MeSH primário: Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia
Proteína Morfogenética Óssea 2/uso terapêutico
Fibrina/uso terapêutico
Cicatrização/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antibioticoprofilaxia
Plaquetas
Terapia Combinada
Profilaxia Dentária
Feminino
Seres Humanos
Leucócitos
Masculino
Meia-Idade
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Morphogenetic Protein 2); 9001-31-4 (Fibrin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:AIM; D; IM
[Da] Data de entrada para processamento:170103
[St] Status:MEDLINE



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