ABSTRACT
OBJECTIVE: The objective of this study was to assess the efficacy of a tobacco cessation intervention conducted by different dental specialists directed at a group of patients with tobacco-related oral diseases or undergoing implant treatment. METHODS: The study design was a multicentre, nonrandomized prospective cohort study to examine the effects of smoking cessation. The target patients were current smokers (aged ≥20 years) with an oral potentially malignant disorder or periodontitis and those seeking dental implants. A total of 74 patients were enrolled in the study. All dental specialists who participated in the trial completed an e-learning Japan Smoking Cessation Training Outreach Project (J-STOP) tobacco cessation education programme. Nicotine dependence was evaluated by the Fagerstrom Test for Nicotine Dependence. Cessation status was verified biochemically by measurement of salivary cotinine or exhaled carbon monoxide. Tobacco cessation intervention was implemented for 8 weeks with or without nicotine replacement therapy with follow-up for 12 months. RESULTS: A total of 61 patients agreed to the tobacco cessation intervention. The mean biochemically confirmed tobacco abstinence rate was 37.7% at month 3, 34.4% at month 6, and 32.8% at month 12. The highest rate of biochemically confirmed tobacco abstinence at month 12 was among patients receiving implant treatment (42.9%) followed by patients with oral potentially malignant disorder (37.1%), and those with periodontitis (21.1%). CONCLUSION: This interventional study demonstrates the challenges encountered and the feasibility of tobacco cessation intervention among Japanese patients attending dental specialists who had completed an e-learning course on smoking cessation. Making tobacco cessation an integral part of patient management by dental specialists requires further evaluation.
Subject(s)
Smoking Cessation , Tobacco Use Cessation , Humans , Japan , Prospective Studies , Smoking , Tobacco Use Cessation DevicesABSTRACT
OBJECTIVE: This retrospective cohort study was conducted to investigate the influence of wearing dentures in the initial occurrence site of bisphosphonate-related osteonecrosis of the jaws (BRONJ). STUDY DESIGN: A questionnaire regarding the prevalence, therapy, and outcome of jawbone lesions during 2006-08 was mailed to 248 medical institutions with an oral and maxillofacial surgery department in Japan. RESULTS: Ninety-nine patients wearing dentures had significantly shorter duration until occurrence than 151 patients not wearing dentures. In addition, remission of BRONJ affecting the mandibular canine and premolar region in denture-wearing patients was significantly more difficult. Poor oral hygiene status was found to affect significantly the prognosis of BRONJ in denture-wearing patients. Alcohol habit also delayed remission, but high body mass index promoted remission. CONCLUSION: Wearing a denture in the initial occurrence site of BRONJ was shown to influence the prognosis of BRONJ, especially in mandibular denture-wearing patients.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/pathology , Dentures , Administration, Intravenous , Administration, Oral , Age Factors , Aged , Alcohol Drinking , Bicuspid/pathology , Bisphosphonate-Associated Osteonecrosis of the Jaw/surgery , Body Mass Index , Bone Density Conservation Agents/administration & dosage , Chronic Disease , Cohort Studies , Cuspid/pathology , Denture, Complete , Denture, Partial , Diphosphonates/administration & dosage , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Mandibular Diseases/pathology , Mandibular Diseases/surgery , Oral Hygiene , Prognosis , Retrospective Studies , Smoking , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: A nationwide retrospective cohort study was conducted by the Japanese Society of Oral and Maxillofacial Surgeons to assess the occurrence of bisphosphonate (BP)-related osteonecrosis of the jaws (BRONJ) during 2006 to 2008 and to elucidate the outcome and factors associated with remission of BRONJ. MATERIALS AND METHODS: A written questionnaire, including the clinical characteristics, management, and outcome of patients with BRONJ, was sent to 248 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons in 2008. RESULTS: A total of 568 patients with BRONJ, including suspicious cases, were registered. Of these 568 patients, 263, including the maxilla in 81, the mandible in 160, and both in 22, met the working definition of BRONJ proposed by the American Association of Oral and Maxillofacial Surgeons. The patients included 219 women (83.3%) and 44 men (16.7%). Of these patients, 152 (57.8%) had received intravenous BPs, 104 (39.5%) had received oral BPs, and 7 (2.7%) had received both. The mean duration of administration until onset of BRONJ was 23.6 months for intravenous BPs and 33.2 months for oral BPs. BRONJ was stage 1 in 42 patients (16.0%), stage 2 in 187 (71.1%), stage 3 in 32 (12.2%), and unknown in 2. Of these patients, 34.2% had remission of BRONJ, 46.0% had persistent or progressive disease, and 19.7% died of malignancy or were lost to follow-up. Statistical analysis revealed that surgical treatment, including tooth extraction, sequestrectomy, and segmental mandibulectomy, contributed to the remission of BRONJ. In contrast, conservative treatment, concurrent anticancer drugs, poor oral hygiene, and the use of intravenous BPs did not. CONCLUSIONS: The relative ratio of BRONJ related to the use of oral BPs was greater in Japan than in the United States and European Union. Surgical treatment contributed to remission of BRONJ, and conservative treatment, concurrent anticancer drugs, poor oral hygiene, and intravenous BPs did not.
Subject(s)
Bone Density Conservation Agents/adverse effects , Diphosphonates/adverse effects , Jaw Diseases/epidemiology , Osteonecrosis/epidemiology , Administration, Oral , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Bone Density Conservation Agents/administration & dosage , Cohort Studies , Diphosphonates/administration & dosage , Disease Progression , Female , Follow-Up Studies , Humans , Injections, Intravenous , Japan/epidemiology , Jaw Diseases/chemically induced , Jaw Diseases/therapy , Male , Mandibular Diseases/chemically induced , Mandibular Diseases/epidemiology , Mandibular Diseases/therapy , Maxillary Diseases/chemically induced , Maxillary Diseases/epidemiology , Maxillary Diseases/therapy , Middle Aged , Neoplasms/mortality , Oral Hygiene , Osteonecrosis/chemically induced , Osteonecrosis/therapy , Osteotomy/statistics & numerical data , Retrospective Studies , Risk Factors , Time Factors , Tooth Extraction/statistics & numerical data , Treatment OutcomeABSTRACT
The purpose of this article is to report changes to dental hygiene education in Japan and to evaluate the successful implementation of these changes in 2010. The legislative change that began in 2005 revised the length of education for dental hygiene students from two years to three or four years (the mandate was three years), which has led to a dramatic change in program curriculum. After a five-year moratorium, a new curriculum has been established for dental hygiene education in Japan. The new curriculum provides students the requisite knowledge to effectively perform the latest dental hygiene procedures. Although the change of the educational system from the present mandatory three-year to the new four-year programs poses many administrative problems, we believe this shift will ultimately provide a more thorough and in-depth education for students.
