2 research outputs found
Pathways in multidisciplinary oral health care as a tool to improve clinical performance
PURPOSE: To investigate the optimization of multidisciplinary and interdisciplinary oral health care through the introduction of pathways. MATERIALS AND METHODS: A prospective randomized clinical trial was carried out in a tertiary referral academic institution. Ninety-one patients admitted for multidisciplinary oral health care from January 1, 2001, to March 31, 2003, were randomized to the test group (n = 50) or to the control group (n = 41). Pathways were implemented by means of the Medical Patient Management program, a computerized planning and coordination system specifically developed for a population with multidisciplinary oral rehabilitation needs. The efficiency of pathways in interdisciplinary oral health care was assessed. RESULTS: Statistically significant differences between test and control groups were found for variables regarding the process of care, such as "number of planned versus actual disciplines," "length of planned versus actual treatment," and "average length of a treatment session." For variables regarding patient satisfaction, significant differences between test and control groups were found for questions regarding patient involvement with the treatment and patient satisfaction with the outcome of multidisciplinary treatment. Regarding practitioner satisfaction, the results of the questionnaire indicate that implementation of pathways into everyday clinical practice is desired but remains difficult. CONCLUSION: The findings of this study show that the implementation of pathways in multidisciplinary oral health care improved some aspects of the process of care and increased patient satisfaction. The predictive capability of the Medical Patient Management program in managing oral health care has been demonstrated.status: publishe
Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement
The replacement of teeth lost by children because of trauma can be an important indication for early implant therapy. Osseointegrated dental implants, like ankylosed teeth, alter position as growth-related changes occur within the jawbones (displacement, remodeling, mesial drift). Facial growth of the child and even of the adolescent, as well as the continuous eruption of the adjacent anterior teeth, create significant risk of a less favorable esthetic and/or functional outcome. For patients with a normal facial profile, the placement of an implant should be postponed until growth is complete. For patients with a short or long face type, further growth, especially the continuous eruption of adjacent teeth, creates a serious risk even after the age of 20 years, as illustrated by some recent clinical studies. This review aims to explain these phenomena and provides some recommendations for implant placement.status: publishe