A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy

Background While some medical associations provide guidelines for the implant‐prosthetic rehabilitation of head and neck cancer patients, the circulation and implementation in the everyday routine of practicing dentists remain unknown. Purpose To analyze patterns of care for the prosthetic rehabilitation of head and neck cancer patients after radiotherapy in German speaking countries. Materials and methods An online survey consisting of 34 questions separated into three sections, (a) general inquiries, (b) treatment concepts, and (c) patient cases, was forwarded to university hospital departments for Prosthetic Dentistry and Oral and Maxillofacial Surgery, and members of different medical associations. Statistical differences between groups were analyzed using chi‐squared test (P < .05). Results From May to October 2019, 118 participants completed the survey. The majority practiced in university hospitals, had more than 5 years of work experience, and reported to be involved in <10 post radiation prosthetic rehabilitation cases per year. Rehabilitation protocols involving dental implants were implemented by oral/oral‐ and maxillofacial surgeons and prosthetic dentists, while general dentists favored implant‐free solutions. Xerostomia was recognized as a common problem for a successful prosthetic rehabilitation. The subsequent treatment choice with either fixed dental prostheses or removable dentures was divided among participants. Conclusions As treatment planning differed with regard to the participants' field of expertise and work environment, and most practitioners only handle a low number of cases, patients might benefit from centralization in larger institutes with a multidisciplinary structure. A high agreement between the practitioners' treatment concepts and the current state of research was observed. While the choice between a mucosa‐ or tooth‐supported, and an implant‐supported restoration depends on numerous individual factors, guidelines derived from longitudinal studies would enhance evidence‐based treatment in this field

Infektionsprävention: Wissen und Compliance bei Studenten der Zahnmedizin

Objective: This study aimed to assess the level of knowledge, attitudes, and practices regarding infection control procedures among undergraduate dental students. Methods: This was a questionnaire-based cross-sectional survey. A self-administered questionnaire consisting of questions on students' vaccination status as well as knowledge and attitudes regarding infection control was sent to 600 undergraduate dental students in the fourth, fifth, and sixth year of the Al-Farabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. The collected data were analyzed using SPSS software. The significance level was set at P <0.05. Results: The response rate was 85% (512 out of 600). While the vast majority of students (90%) had been vaccinated against hepatitis, only 37.4% have been assessed for anti-HBs. A total of 98.8% and 90.8% reported always wearing gloves and masks, respectively, during dental procedures. The use of protective eyewear was reported by only 29.2%. A significantly higher proportion of sixth-year students showed a positive attitude toward the treatment of patients with infectious diseases than other students of lower academic years. Approximately one-third of students reported having one or more occupational injuries while treating their patients. Conclusion: Although the students had good knowledge and attitudes regarding infection control, the compliance and practice levels regarding the same were low. Such findings highlight the necessity of continued infection-control education of Saudi dental students.Zielsetzung: In der Studie sollten die Kenntnisse, die Einstellung und die praktische Umsetzung infektionspräventiver Maßnahmen bei Studenten der Zahnmedizin analysiert werden.Methode: In einer Querschnittsstudie wurde ein selbst zu beantwortender Fragebogen zur Erfassung des Impfstatus, der Kenntnisse und der Einstellung zur Infektionsprävention an 600 Studenten im 4., 5. und 6. Ausbildungsjahr des Al-Farabi College für Dentistry und Nursing, Riyadh, Saudi Arabia, verschickt. Die Daten wurden mittels SPSS analysiert. Das Signifikanzniveau wurde mit p<0,05 festgelegt.Ergebnisse: Die Responserate betrug 85% (512 von 600). Während die Mehrzahl der Studenten (90%) gegen Hepatitis B geimpft war, war nur bei 37,4% anti-HBs bestimmt worden. 98,8% bzw. 90,8% trugen stets Schutzhandschuhe bzw. Mund-Nasen-Schutz bei der zahnärztlichen Behandlung, während das Tragen einer Schutzbrille nur in 29,2% angegeben wurde. Ein signifikant höherer Anteil der Studenten zeigte im 6. Ausbildungsjahr eine positive Einstellung zur Behandlung von Patienten mit Infektionskrankheiten im Vergleich zum 4. und 5. Ausbildungsjahr. Etwa ein Drittel der Studenten gab an, dass sich ein oder mehrere arbeitsbedingte Verletzungen bei der Patientenbehandlung ereignet hatten.Schlussfolgerung: Obwohl die Studenten ein solides Wissen und eine gute Einstellung zur Infektionsprävention hatten, war die Compliance zur praktischen Umsetzung gering. Die Ergebnisse unterstreichen die Notwendigkeit der kontinuierlichen Erziehung Saudischer Zahnmedizinstudenten zur Infektionsprävention

Masticatory performance and oral health-related quality of life in edentulous maxillectomy patients:A cross-sectional study to compare implant-supported obturators and conventional obturators

Objective The aim of this cross-sectional study was to compare the masticatory performance and oral health-related quality of life (OHRQoL) of edentulous maxillectomy patients with and without implant-supported obturator prostheses. Material and methods Nineteen edentulous maxillectomy patients with completed prosthetic obturator treatment in the upper jaw participated in this study. In nine patients, the obturator prosthesis was supported by implants in the remaining bone of the midface and/or skull base to improve retention. Masticatory performance was measured objectively by the mixing ability test (MAT) and subjectively by three OHRQoL questionnaires: (a) the Oral Health Impact Profile for EDENTulous people (OHIP-EDENT), (b) the Obturator Function Scale (OFS), and (c) the Dutch Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3-NL). The independent t test and the Mann-Whitney U test were used to test for differences in outcomes of patients with and without implant-retention of their obturator prostheses. Results Patients with implant-supported obturator prostheses had significantly better masticatory and oral function, reported fewer chewing difficulties, and had less discomfort during food intake than did patients with a conventional obturator. Conclusion Supporting prosthetic obturators after maxillectomy with implants improve oral functioning, chewing, and eating comfort. This treatment modality is a viable technique to improve the functionality of prosthetic rehabilitation in patients who have undergone maxillectomy.</p