Using classification and regression tree modelling to investigate response shift patterns in dentine hypersensitivity

BACKGROUND: Dentine hypersensitivity (DH) affects people's quality of life (QoL). However changes in the internal meaning of QoL, known as Response shift (RS) may undermine longitudinal assessment of QoL. This study aimed to describe patterns of RS in people with DH using Classification and Regression Trees (CRT) and to explore the convergent validity of CRT with the then-test and ideals approaches. METHODS: Data from an 8-week clinical trial of mouthwashes for dentine hypersensitivity (n = 75) using the Dentine Hypersensitivity Experience Questionnaire (DHEQ) as the outcome measure, were analysed. CRT was used to examine 8-week changes in DHEQ total score as a dependent variable with clinical status for DH and each DHEQ subscale score (restrictions, coping, social, emotional and identity) as independent variables. Recalibration was inferred when the clinical change was not consistent with the DHEQ change score using a minimally important difference for DHEQ of 22 points. Reprioritization was inferred by changes in the relative importance of each subscale to the model over time. RESULTS: Overall, 50.7% of participants experienced a clinical improvement in their DH after treatment and 22.7% experienced an important improvement in their quality of life. Thirty-six per cent shifted their internal standards downward and 14.7% upwards, suggesting recalibration. Reprioritization occurred over time among the social and emotional impacts of DH. CONCLUSIONS: CRT was a useful method to reveal both, the types and nature of RS in people with a mild health condition and demonstrated convergent validity with design based approaches to detect RS

An overview of periodontal regenerative procedures for the general dental practitioner.

The complete regeneration of the periodontal tissues following periodontal disease remains an unmet challenge, and has presented clinicians with a remarkably difficult clinical challenge to solve given the extensive research in this area and our current understanding of the biology of the periodontal tissues. In particular as clinicians we look for treatments that will improve the predictability of the procedure, improve the magnitude of the effect of treatment, and perhaps most importantly in the long term would extend the indications for treatment beyond the need for single enclosed bony defects to allow for suprabony regeneration, preferably with beneficial effects on the gingival soft tissues. A rapid development in both innovative methods and products for the correction of periodontal deficiencies have been reported during the last three decades. For example, guided tissue regeneration with or without the use of bone supplements has been a well-proven treatment modality for the reconstruction of bony defects prior to the tissue engineering era. Active biomaterials have been subsequently introduced to the periodontal community with supporting dental literature suggesting that certain factors should be taken into consideration when undertaking periodontal regenerative procedures. These factors as well as a number of other translational research issues will need to be addressed, and ultimately it is vital that we do not extrapolate results from pre-clinical and animal studies without conducting extensive randomized clinical trials to substantiate outcomes from these procedures. Whatever the outcomes, the pursuit of regeneration of the periodontal tissues remains a goal worth pursuing for our patients. The aim of the review, therefore is to update clinicians on the recent advances in both materials and techniques in periodontal regenerative procedures and to highlight the importance of both patient factors and the technical aspects of regenerative procedures

Pacifier use modifies infant's cardiac autonomic controls during sleep

Objective: The risk for sudden infant death (SIDS) was postulated to decrease with the use of a pacifier and by conditions increasing parasympathetic tonus during sleep. We evaluated the influence of a pacifier on cardiac autonomic controls in healthy infants. Study design: Thirty-four healthy infants were studied polygraphically during one night: 17 infants regularly used a pacifier during sleep and 17 never used a pacifier. Thumb users or occasional pacifier users were not included in the study. The infants were recorded at a median age of 10 weeks (range 6-18 weeks). Autonomic nervous system (ANS) was evaluated by spectral analysis of the heart rate (HR). The high frequency component of HR spectral analysis reflected parasympathetic tonus and the low frequency on high frequency ratio corresponded to the sympathovagal balance. Results: Most infants (63.6%) lost their pacifier within 30 min of falling asleep. Sucking periods were associated with increases in cardiac sympathovagal balance. During non-sucking periods, in both REM and NREM sleep, infants using a pacifier were characterized by lower sympathetic activity and higher parasympathetic tonus compared with non-pacifier users. Conclusions: The use of pacifiers modifies cardiac autonomic controls during both sucking and non-sucking sleep periods. Non-nutritive sucking could regulate autonomic control in infants. These findings could be relevant to mechanisms implicated in the occurrence of sudden infant deaths during sleep. © 2004 Elsevier Ireland Ltd. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Ambient temperature is associated with changes in infants' arousability from sleep

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Inverse association between Slow Wave Activity per cycle and the number of ultradian sleep cycles per night in healthy humans.

OBJECTIVE: Comparisons of sleep Slow Wave Activity (SWA) during successive sleep cycles rely on the assumption that SWA in a given cycle is independent of the number of ultradian cycles present in a night. This assumption was evaluated here. METHODS: Twenty-six healthy controls with no medical, sleep or psychiatric disorders were selected among 84 candidates and their sleep was recorded at home across 2 consecutive nights after two habituation nights. RESULTS: In comparison with nights with less cycles, nights with more cycles showed significantly more REMS but not more NREMS. No correlation was found between the number of cycles and the integrated SWA per night (epochs visually scored as NREMS). However, inverse correlations were found between the number of cycles and the SWA per cycle. This was significant on both nights in Cycle 1 and strong trends were found for the two subsequent cycles on Night 2. Comparable results were found after removal of nights containing suspected Skipped First REMS episodes. CONCLUSIONS: The SWA in a cycle was found to be inversely correlated to the number of cycles in the first 3 cycles in at least one of the two analyzed nights. SIGNIFICANCE: Differences in the number of cycles per night are a potential bias in the comparisons of SWA per cycles.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

Dentine hypersensitivity in a private practice patient population in Australia

Although dentine hypersensitivity (DH) has been widely investigated, studies based on randomly selected general practice populations are scarce. This study aimed to examine the intra-oral distribution of DH and its association with age, sex, symptoms, stimuli, pre-disposing factors and management strategies in a private practice patient population in Australia. A randomly selected sample of 800 Australian private dental practice dentists was invited to participate in a questionnaire-based survey. A log diary about the total number of patients seen during a typical week in practice and the details of patients with DH were recorded. The details included teeth and sites involved with DH and the age and sex of people affected, symptoms, stimuli, pre-disposing factors and management strategies. The prevalence of DH was 9.1% among patients seen over the typical week with 2.3 teeth/person and 1.2 surfaces/tooth affected. Women (60.7%) were more affected than men (39.3%) whilst 30- to 49 -year-olds (48.8%) were the most common among those affected. Premolars (36.5%) and buccal surfaces (54.8%), respectively, were the most commonly affected teeth and tooth sites. Although cold stimulation (80.1%) was the commonest stimulus, dietary acid was the only stimulus that was significantly associated with DH. Gingival recession and erosion emerged as significant pre-disposing factors, whereas using desensitising toothpastes was the most important management strategy. The findings suggested that dietary acid, gingival recession and erosion were significantly associated with DH, while desensitising toothpastes was the key management strategy used for DH in this patient population.N. Amarasena, J. Spencer, Y. Ou & D. Brenna