Comparison of effectiveness of oral hygiene instruction methods in improving plaque scores among 8-9-year children: a randomized controlled trial.

PURPOSE: The relative effectiveness of different methods used for delivery of information regarding oral health in children has not been widely raised in the literature. This study aimed at evaluating the effect of verbal oral hygiene instruction (OHI) against the verbal instruction supplemented by three different methods (written, teeth teaching model, and videotape) on the mean plaque scores and to determine factors that may influence the effectiveness of methods used. METHODS: Prospective-comparative randomized controlled trial carried out on 120 children aged 8-9 years. Participants were randomly divided into four groups (verbal, verbal and written, verbal and teeth teaching model, and verbal and video). Plaque Control Index was evaluated at baseline and 4 weeks after OHI. ANOVA and post hoc, t test, and ANCOVA were used for statistical analysis. RESULTS: A statistically significant decrease of the mean percentage of plaque scores was found indicating the effectiveness of different methods of delivery of OHI (p < 0.01, 0.001). Verbal supported by teaching model was the most statistically effective method (p < 0.001) followed by the verbal (p < 0.001). There was a significant difference in the improvement in plaque score (p < 0.001) between the four methods of OHI after controlling for age, gender, monthly income, mother's and father's educational levels and plaque index before delivery of OHI. CONCLUSIONS: Regardless of the method used, a gradient of effectiveness was observed in improving plaque scores. Verbal instruction supplemented by teaching model was the most effective. Effectiveness was influenced by monthly income, mother's and father's educational levels and plaque index before OHI.

Quality of YouTube TM videos on dental implants.

BACKGROUND: Patients search YouTube for health-care information. PURPOSE: To examine what YouTube offers patients seeking information on dental implants, and to evaluate the quality of provided information. MATERIAL AND METHODS: A systematic search of YouTube for videos containing information on dental implants was performed using the key words Dental implant and Tooth replacement. Videos were examined by two senior Oral and Maxillofacial Surgery residents who were trained and calibrated to perform the search. Initial assessment was performed to exclude non- English language videos, duplicate videos, conference lectures, and irrelevant videos. Included videos were analyzed with regard to demographics and content's usefulness. Information for patients available from the American Academy of Implant Dentistry, European Association of Osseointegration, and British Society of Restorative Dentistry were used for benchmarking. RESULTS: A total of 117 videos were analyzed. The most commonly discussed topics were related to procedures involved in dental implantology (76.1%, n=89), and to the indications for dental implants (58.1%, n=78). The mean usefulness score of videos was poor (6.02 ±4.7 [range 0-21]), and misleading content was common (30.1% of videos); mainly in topics related to prognosis and maintenance of dental implants. Most videos (83.1%, n=97) failed to mention the source of information presented in the video or where to find more about dental implants. CONCLUSIONS: Information about dental implants on YouTube is limited in quality and quantity. YouTube videos can have a potentially important role in modulating patients attitude and treatment decision regarding dental implants.

Flap design and mandibular third molar surgery: a split mouth randomized clinical study.

The aim of this study was to investigate the effects of two commonly used flap designs (envelope and triangular) used for the removal of mandibular third molars (M3) on postoperative morbidity. 19 patients with bilateral symmetrically impacted mandibular M3 were studied using a split mouth design. Swelling, pain and trismus measures were recorded on days 2, 7 and 14; periodontal indices were recorded on days 7 and 14, one final measure of probing depth on the distal aspect of the mandibular second molar (M2) was taken at the last follow up appointment. Data were analysed using the χ(2) test, the Mann-Whitney U-test and Pearson's correlations. The mean age of the patients was 21.4 ± 2.3 years (± SD). Facial swelling and the reduction in mouth opening were significantly greater in the early postoperative period (P<0.05) with pyramidal flap designs. There was no significant difference in pain scores, plaque accumulation and bleeding on probing indices between the two flap designs (P>0.05). Probing depth was significantly greater with envelope flaps in the early postoperative period (P<0.005). In conclusion, flap design in mandibular M3 surgery has an effect on postoperative recovery.

Clinical profile of patients admitted to the coronary care unit with possible myocardial infarction without diagnostic ECG and/or enzyme changes.

Concern has been expressed about the cost-effectiveness of the Coronary Care Unit (CCU) and solution options offered on account of the large number of patients admitted to the CCU who turn out not to have acute myocardial infarction. In a prospective study over four years, we studied a group of patients admitted to the CCU with suspected myocardial infarction but who did not have diagnostic ECG and/or enzyme changes for the causes of their chest pain. We compared the clinical profile of these patients (Group A) with that of a random sample of patients with confirmed myocardial infarction (Group B). Gastrointestinal disorders, musculoskeletal chest pain, panic and anxiety disorders were the major causes of chest pain in Group A patients. A normal ECG and a normal creatine phosphokinase (CPK) within the first 24 hours, a normal initial random blood sugar, a younger age and absence of coronary risk factors effectively separated Group A patients as low risk from Group B patients as high risk for acute myocardial infarction. These simple parameters will assist physicians providing CCU care in most hospitals in early decision making and in the judicious use of the CCU.