Validation of a Dutch version of the Geriatric Oral Health Assessment Index (GOHAI-NL) in care-dependent and care-independent older people

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The caries assessment spectrum and treatment (CAST) instrument: its reproducibility in clinical studies

A new caries assessment instrument, the Caries Assessment Spectrum and Treatment (CAST), was developed. It covers carious lesion progression from no lesion, sealants and restorations to lesions in enamel and dentine, advanced stages in pulpal and tooth-surrounding tissues, and tooth loss owing to dental caries, in nine codes. The objective of this study was to determine the reproducibility of the CAST instrument in primary and permanent dentitions, using three age groups. Two epidemiological surveys were conducted in Brazil, covering three age groups: 2-6-year-old and 6-9-year-old children and 19-30-year-old adults. Four trained and calibrated examiners performed the examinations. Reproducibility was calculated for intra- and inter-examiner at surface and tooth levels and expressed as unweighted kappa-coefficient value (kappa) and percentage of agreement (Po) for CAST codes (0-7) and for the categories healthy (0-2) versus diseased (3-7), and non-cavitated (0-3) versus cavitated (4-7) teeth. Using CAST codes (0-7) for the 2-6-year-old age group in primary dentitions, inter-examiner consistency was kappa = 0.74 and Po was 98.3%. In the 6-9-year-old age group in primary dentitions, inter-examiner consistency ranged from kappa = 0.68 to kappa = 0.86 and Po was >/= 93.7%. In the 19-30-year-old age group inter-examiner consistency was kappa = 0.87 and Po was 94.1%. The reproducibility of the CAST instrument for use in the primary dentition of 2-6-year olds and of 6-9-year olds was 'substantial' to 'almost perfect'. The reproducibility for its use in the permanent dentition of 19-30-year olds was 'almost perfect'. The CAST instrument can reliably be applied in epidemiological studies covering these ages

Is high-viscosity glass-ionomer-cement a successor to amalgam for treating primary molars?

Item does not contain fulltextOBJECTIVES: To assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment (ART) restorations in primary molars over 3 years. METHODS: 280 children aged 6-7 years old were enrolled in a cluster randomized controlled clinical trial using a parallel group design covering two treatment groups: conventional restorative treatment with amalgam (CRT) and atraumatic restorative treatment (ART) using a high-viscosity glass-ionomer (HVGIC) Ketac Molar Easymix. Three pedodontists placed 750 restorations (364 amalgam and 386 ART in 126 and 154 children, respectively) which were evaluated at 0.5, 1, 2 and 3 years. The proportional hazard rate regression model with frailty correction, ANOVA and Wald tests, and the Jackknife procedure were applied in analysing the data. RESULTS: The cumulative survival rates over 3 years for all, single- and multiple-surface CRT/amalgam restorations (72.6%, 93.4%, 64.7%, respectively) were no different from those of comparable ART/HVGIC restorations (66.8%; 90.1% and 56.4%, respectively) (p=0.10). Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures (p<0.0001). A higher proportion of restorations failed because of mechanical reasons (94.8%) than of secondary caries (5.2%). No difference in reasons for restoration failures between all types of amalgam and ART/HVGIC restorations were observed (p=0.24). SIGNIFICANCE: The high-viscosity glass-ionomer used in this study in conjunction with the ART is a viable option for restoring carious dentin lesions in single surfaces in vital primary molars

Predictive factors for masticatory performance in Duchenne muscular dystrophy

Item does not contain fulltextPatients with Duchenne muscular dystrophy (DMD) report masticatory and swallowing problems. Such problems may cause complications such as choking, and feeling of food sticking in the throat. We investigated whether masticatory performance in DMD is objectively impaired, and explored predictive factors for compromised mastication. Twenty-three patients and 23 controls filled out two questionnaires about mandibular function, and underwent a clinical examination of the masticatory system and measurements of anterior bite force and masticatory performance. In the patients, moreover, quantitative ultrasound of the tongue and motor function measurement was performed. The patients were categorized into ambulatory stage (early or late), early non-ambulatory stage, or late non-ambulatory stage. Masticatory performance, anterior bite force and occlusal contacts were all reduced in the patient group compared to the controls (all p < 0.001). Mastication abnormalities were present early in the disease process prior to a reduction of motor function measurement. The early non-ambulatory and late non-ambulatory stage groups showed less masticatory performance compared to the ambulatory stage group (p < 0.028 and p < 0.010, respectively). Multiple linear regression analysis revealed that stage of the disease was the strongest independent risk factor for the masticatory performance (R(2) = 0.52). Anterior bite force, occlusal contacts and masticatory performance in DMD are severely reduced

Mandibular dysfunction as a reflection of bulbar involvement in SMA type 2 and 3.

OBJECTIVE: In a cross-sectional study, we aimed to determine (1) the effect of spinal muscular atrophy (SMA) type 2 and 3 on mandibular function reflected as masticatory performance, mandibular range of motion, and bite force and (2) the predictors of mandibular dysfunction. METHODS: Sixty patients with SMA type 2 and 3 (mean age 32.3 years, SD 17.4 years) and 60 age-matched controls filled out questionnaires about impairments of mandibular function. All participants underwent detailed clinical examination to document the mandibular range of motion including maximal mouth opening, bite force, and masticatory function. RESULTS: All mandibular movements, including mouth opening, lateral range of motion, and protrusion of the mandible, were reduced in patients with SMA type 2 and 3 compared to healthy controls (p < 0.001). Maximal bite force was 19% lower in patients than controls, and more in patients with SMA type 2 than type 3. The strongest predictive factor was SMA type for impairment of mandibular range of motion (R(2) = 0.82) and weakness of neck muscles for bite force (R(2) = 0.47). CONCLUSIONS: Reduced mandibular mobility and bite force are common complications in SMA. SMA type and neck muscle strength are important correlates of these complications. We provide further evidence for clinically relevant bulbar involvement in patients with SMA

Survival of multiple-surface ART restorations using a zinc-reinforced glass-ionomer restorative after 2 years: A randomized triple-blind clinical trial.

Item does not contain fulltextOBJECTIVE: To investigate the effectiveness of a new zinc-reinforced glass-ionomer in comparison to a common high-viscous glass-ionomer cement (HVGIC) used in multiple-surface ART-prepared cavities. The hypothesis tested was that the cumulative survival percentage of the new HVGIC is higher than that of the common HVGIC over 2 years. METHODS: A randomized triple-blind parallel group clinical trial was used. A total of 218 participants, average age 15.4 years (SD=0.2), with an occluso-proximal carious lesion in a permanent (pre-) molar were included. Restorations using test (ChemFil Rock) and control (Fuji IX GP) restoratives were placed according to the ART method by four calibrated operators. Restorations were evaluated after one week (baseline), and at 6-, 12-, 18- and 24 months from replicas and coloured photographs according to the ART restoration assessment criteria by two independent evaluators. Restoration survival curves were estimated using the Kaplan-Meier method and difference between dependent and independent variables tested with a Wald (chi-square) test. RESULTS: There was a statistically significant difference in cumulative survival percentages between the two types of restorations at 2 years (P=0.02). A higher percentage of multiple-surface restorations of Fuji IX GP (95.4%) than ChemFil Rock (85.3%) survived. Gender (P=0.64), operator (P=0.56) and cavity size (P=0.81) had no effect on the survival of the type of restoration observed. Type of tooth (P=0.004) and type of jaw (P=0.05) showed an effect. Severe wear was the major reason for restoration failure (ChemFil Rock=7; Fuji IX GP=1). SIGNIFICANCE: ChemFil Rock appears not to be a viable alternative to Fuji IX GP in restoring ART multiple-surface cavities in permanent posterior teeth.1 september 201