Developing agreement on never events in primary care dentistry:an international eDelphi study

Introduction: Never events (NEs) are a subset of serious patient safety incidents that should not occur if appropriate preventive measures are implemented. Although there is a consensus in medicine, there is no agreement on NEs in dentistry. Aim: To identify NEs in primary care dentistry. Method: We undertook an electronic Delphi exercise to develop an international agreement on NEs for primary care dentistry. Results: We initially identified candidate NEs through a scoping review of the literature and then analysed dentistry-related reports in a national incident reporting system. Next, we invited an international panel of 41 experts to complete two rounds of questionnaires; 32 agreed to participate (78%) and completed the first round and 29/41 (71%) members completed the second round. We provided anonymised controlled feedback between rounds and used a cut-off of 80% agreement to define consensus. Consensus was achieved for 23 out of 42 candidate NEs. These related to routine assessment, and pre-operative, intra-operative and post-operative stages of dental procedures. Discussion and conclusion: To our knowledge, this is the first international expert consensus-based approach that has identified NEs for primary care dentistry. We suggest that dental regulators consider these to support quality assessment and governance activities

Comparative Analysis of The Potential Effect of Phase I Therapy on Gingival Crevicular Fluid Myeloperoxidase Levels In Non-Diabetic And Diabetic Patients With Periodontitis

Objectives: To evaluate the effect of periodontal therapy on clinical parameters as well as on myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus and of systemically healthy individuals. Materials and Methods: 24 type 2 DM patients subjects, and 21 systemically healthy individuals, both groups with chronic periodontitis, and systemically and periodontally healthy individuals were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), and gingival bleeding time index (GBI), as well as GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy. GCF enzyme activity was spectrophotometrically analyzed. Possible correlation between clinical periodontal status and MPO activity was also evaluated. Results: Despite the relatively stable clinical measures and GCF MPO content in the periodontally-healthy subjects, the clinical periodontal status improved, as significant reductions were observed in all of the clinical parameters in periodontitis patients with and without diabetes (p<0.05). GCF MPO activity presented with significant reductions in both of the periodontally-diseased groups after phase I treatment (p<0.05), however it could not reach to the level of periodontal health (p<0.05). Conclusions: Periodontal inflammation is likely to play the major role in the higher MPO activity observed at diseased sites, while diabetes mellitus do not seem to further increase the production of this enzyme. Periodontal treatment can provide successful improvement in clinical periodontal parameters and reduction in enzyme profile of GCF in diabetics.Scopu

Inpatient Evaluation of Periodontal, Esthetic and Inflammatory Parameters Around Dental Implants and Natural Teeth

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