An RCT of atraumatic restorative treatment for older adults: 5 year results.

OBJECTIVES: to compare the survival of ART and a conventional restorative technique (CT) for restoring carious lesions in older adults after 5 years. METHODS: In this parallel randomised controlled clinical trial, 219 independently-living adults were recruited from a dental hospital/community and a geriatric day hospital. Ninety-nine patients who met the inclusion criteria and presented with carious lesions were randomly allocated to receive either ART or conventional restorations (anaesthesia, rotary instruments and resin-modified glass ionomer). The status of restorations was assessed 6 months, 1, 2 and 5 years after restoration placement. Estimates of cumulative survival were calculated for each interval between assessments and a Cox Proportional Hazards (PH) model was fitted to the interval-censored survival time. RESULTS: Three hundred restorations (ART n=142; CT n=158) were placed on 99 patients, 46 males and 53 females, with a mean age of 73.2, SD: 6.8 (65-90 yrs). After 5 years, ART and CT presented cumulative probability of survival of 85% and 79% (p=0.8095), respectively. CONCLUSIONS: ART presents survival rates comparable to a conventional technique, when treating older adults after 5 years. The ART approach could be a useful tool to provide dental care for older adults particularly in the nonclinical setting. (Trial Registration number: ISRCTN 76299321). CLINICAL RELEVANCE: This study shows that ART presents survival rates comparable to conventional techniques to treat carious lesions in older patients after 5 years. It is well accepted by this age cohort, and therefore could be an alternative to treat the elderly, especially those who are homebound or cannot attend the dentist.

The effect of superoxide dismutase enzyme inhibition on renal microcirculation of spontaneously hypertensive-stroke prone and Wistar rats.

A significant factor in the development of hypertension may be excessive vasoconstriction within the renal medulla. This study therefore investigated the role of superoxide dismutase (SOD) in the regulation of renal medullary and cortical blood perfusion (MBP and CBP, respectively) in both stroke-prone spontaneously hypertensive rats (SHRSP) and normotensive Wistar rats. CBP and MBP were measured before and after intra-renal infusion of the SOD inhibitor, diethyldithio-carbamic acid (DETC). Under basal conditions, mean arterial pressure was significantly greater in SHRSP than Wistar rats, but both MBP and heart rate (HR) were significantly lower in SHRSP relative to Wistar rats (P<0.05, n=7 in both groups). Infusion of DETC (2 mg/kg/min) into the cortico-medullary border area of the kidney significantly decreased MBP in the SHRSPs (by 28+/-3 %, n=7, P<0.05), indicating a greater vasoconstriction within this vascular bed. However, DETC also significantly decreased MBP in Wistar rats to a similar extent (24+/-4 %, n=7, P<0.05). These results suggest that superoxide anions play a significant role in reducing renal vascular compliance within the renal medulla in both normotensive and hypertensive animals, although the responses are not greater in the hypertensive relative to the control animals.

The use of the Oral Health Impact Profile to measure the impact of mild, moderate and severe hypodontia on oral health-related quality of life in young adults.

There is limited understanding of the subjective impact of congenital absence of teeth in patients with hypodontia. This study aimed to investigate the impact of mild, moderate and severe hypodontia on oral health-related quality of life (OHRQoL) and its relationship to age, gender and extent of hypodontia prior to treatment. 82 patients (43 females and 39 males, age range from 16 to 34 years) with a confirmed diagnosis of non-syndromic hypodontia were recruited for this study prior to treatment. Demographic details were recorded and a clinical examination documented the number and location of missing teeth. Participants were also asked to complete an oral health-related quality of life measure, the OHIP-49. The impact was of hypodontia was significant, with appearance concerns being the most prevalent impacts on oral health-related quality of life. Gender was a significant predictor of the overall OHIP-49 score, with females having higher level of impacts. The number and location of missing permanent teeth was not a good predictor of quality of life. However, location of missing teeth was a predictor of the psychological discomfort subscale score. There was a positive correlation between age and the functional limitation and physical disability subscale scores. This study shows that the impact of hypodontia on oral health-related quality of life is substantial.

The impact of hypodontia: a qualitative study on the experiences of patients.

Congenital absence of teeth affects 2-6 per cent of the population, but its impact on quality of life (QoL) is not fully understood. The symptoms of hypodontia can vary and therefore also the treatment and management of this condition. Determining and understanding the possible impact of hypodontia on patients could inform and improve the management of such patients. A purposive sample of 10 participants aged 16-25 years (five males and five females) with mild, moderate, or severe hypodontia at various stages of treatment was recruited. The participants had previously completed a 49-item Oral Health Impact Profile (OHIP) questionnaire with summary scores ranging from 24 to 143. All subjects participated in semi-structured interviews, and these were transcribed and analysed using NVivo software. The results show that the role of hypodontia patients in the treatment decision-making process changes significantly as they move from childhood to adulthood. Participants indicated dissatisfaction with the lack of communication with dental services throughout early adolescence as they became more cognizant of their condition which in turn led to concerns with regard to appearance which impacted on their psychosocial well-being. Hypodontia patients expect improved communication with dental practitioners and services as they become more cognizant of their condition and wish to become more actively involved in the decision-making process regarding their current and future treatment.

The clinical performance of hybrid bridges delivered by undergraduate dental students: a retrospective study.

The aim of this study was to retrospectively analyse the clinical performance of hybrid bridges and their effect on periodontal health. All the bridges in this study were delivered by undergraduate dental students at the University Dental School and Hospital Cork. The recall protocol took the form of a questionnaire and a full clinical examination of the abutments, retainers and contra lateral control teeth. In all, 22 patients with 25 bridges were examined. The periodontal response was generally favourable and soft tissue alteration was minimal. The outcome of the performance hybrid bridges is not encouraging, as 32% (8) of the bridges failed and 68% (17) were in service with a mean duration of clinical service of 48 months.