Three-year survival of single- and two-surface ART restorations in a high-caries child population

The aim of this study was to evaluate the survival of single- and two-surface atraumatic restorative treatment (ART) restorations in the primary and permanent dentitions of children from a high-caries population, in a field setting. The study was conducted in the rainforest of Suriname, South America. ART restorations, made by four Dutch dentists, were evaluated after 6 months, 1, 2, and 3 years. Four hundred seventy-five ART restorations were placed in the primary dentition and 54 in first permanent molars of 194 children (mean age 6.09 ± 0.48 years). Three-year cumulative survivals of single- and two-surface ART restorations in the primary dentition were 43.4 and 12.2%, respectively. Main failure characteristics were gross marginal defects and total or partial losses. Three-year cumulative survival for single-surface ART restorations in the permanent dentition was 29.6%. Main failure characteristics were secondary caries and gross marginal defects. An operator effect was found only for two-surface restorations. The results show extremely low survival rates for single- and two-surface ART restorations in the primary and permanent dentitions. The variable success for ART may initiate further discussion about alternative treatment strategies, especially in those situations where choices have to be made with respect to a well-balanced, cost-effective package of basic oral health care

Understanding the Mismatch Between Coaches' and Players' Perceptions of Exertion

A mismatch between the training exertion intended by a coach and the exertion perceived by players is well established in sports. However, it is unknown whether coaches can accurately observe exertion of individual players during training. Furthermore, the discrepancy in coaches' and players' perceptions has not been explained. Purpose: To determine the relation between intended and observed training exertion by the coach and perceived training exertion by the players and establish whether on-field training characteristics, intermittent endurance capacity, and maturity status explain the mismatch. Methods: During 2 mesocycles of 4 wk (in November and March), rating of intended exertion (RIE), rating of observed exertion (ROE), and rating of perceived exertion (RPE) were monitored in 31 elite young soccer players. External and internal training loads were objectively quantified with accelerometers (PlayerLoad) and heart-rate monitors (TRIMPmod). Results of an interval shuttle-run test (ISRT) and age at peak height velocity (APHV) were determined for all players. Results: RIE, ROE, and RPE were monitored in 977 training sessions. The correlations between RIE and RPE (r = .58; P <.01) and between ROE and RPE (r = .64; P <.01) were moderate. The mean difference between RIE and RPE was -0.31 +/- 1.99 and between ROE and RPE was -0.37 +/- 1.87. Multilevel analyses showed that PlayerLoad and ISRT predicted RIE and ROE. Conclusion: Coaches base their intended and observed exertion on what they expect players will do and what they actually did on the field. When doing this, they consider the intermittent endurance capacity of individual players

Nonergodicity in Load and Recovery:Group Results Do Not Generalize to Individuals

PURPOSE: The study of load and recovery gained significant interest in the last decades, given its important value in decreasing the likelihood of injuries and improving performance. So far, findings are typically reported on the group level, whereas practitioners are most often interested in applications at the individual level. Hence, the aim of the present research is to examine to what extent group-level statistics can be generalized to individual athletes, which is referred to as the "ergodicity issue." Nonergodicity may have serious consequences for the way we should analyze, and work with, load and recovery measures in the sports field. METHODS: The authors collected load, that is, rating of perceived exertion × training duration, and total quality of recovery data among youth male players of a professional football club. This data were collected daily across 2 seasons and analyzed on both the group and the individual level. RESULTS: Group- and individual-level analysis resulted in different statistical outcomes, particularly with regard to load. Specifically, SDs within individuals were up to 7.63 times larger than SDs between individuals. In addition, at either level, the authors observed different correlations between load and recovery. CONCLUSIONS: The results suggest that the process of load and recovery in athletes is nonergodic, which has important implications for the sports field. Recommendations for training programs of individual athletes may be suboptimal, or even erroneous, when guided by group-level outcomes. The utilization of individual-level analysis is key to ensure the optimal balance of individual load and recovery

Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis

The purpose of this study is to perform a systematic investigation plus meta-analysis into survival of atraumatic restorative treatment (ART) sealants and restorations using high-viscosity glass ionomers and to compare the results with those from the 2005 ART meta-analysis. Until February 2010, four databases were searched. Two hundred four publications were found, and 66 reported on ART restorations or sealant survival. Based on five exclusion criteria, two independent reviewers selected the 29 publications that accounted for the meta-analysis. Confidence intervals (CI) and or standard errors were calculated and the heterogeneity variance of the survival rates was estimated. Location (school/clinic) was an independent variable. The survival rates of single-surface and multiple-surface ART restorations in primary teeth over the first 2 years were 93% (CI, 91–94%) and 62% (CI, 51–73%), respectively; for single-surface ART restorations in permanent teeth over the first 3 and 5 years it was 85% (CI, 77–91%) and 80% (CI, 76–83%), respectively and for multiple-surface ART restorations in permanent teeth over 1 year it was 86% (CI, 59–98%). The mean annual dentine lesion incidence rate, in pits and fissures previously sealed using ART, over the first 3 years was 1%. No location effect and no differences between the 2005 and 2010 survival rates of ART restorations and sealants were observed. The short-term survival rates of single-surface ART restorations in primary and permanent teeth, and the caries-preventive effect of ART sealants were high. Clinical relevance: ART can safely be used in single-surface cavities in both primary and permanent teeth. ART sealants have a high caries preventive effect

Sports teams as complex adaptive systems: manipulating player numbers shapes behaviours during football small-sided games

Small-sided and conditioned games (SSCGs) in sport have been modelled as complex adaptive systems. Research has shown that the relative space per player (RSP) formulated in SSCGs can impact on emergent tactical behaviours. In this study we adopted a systems orientation to analyse how different RSP values, obtained through manipulations of player numbers, influenced four measures of interpersonal coordination observed during performance in SSCGs. For this purpose we calculated positional data (GPS 15 Hz) from ten U-15 football players performing in three SSCGs varying in player numbers (3v3, 4v4 and 5v5). Key measures of SSCG system behaviours included values of (1) players’ dispersion, (2) teams’ separateness, (3) coupling strength and time delays between participants’ emerging movements, respectively. Results showed that values of participants’ dispersion increased, but the teams’ separateness remained identical across treatments. Coupling strength and time delay also showed consistent values across SSCGs. These results exemplified how complex adaptive systems, like football teams, can harness inherent degeneracy to maintain similar team spatial–temporal relations with opponents through changes in inter-individual coordination modes (i.e., players’ dispersion). The results imply that different team behaviours might emerge at different ratios of field dimension/player numbers. Therefore, sport pedagogists should carefully evaluate the effects of changing RSP in SSCGs as a way of promoting increased or decreased pressure on players

Contemporary operative caries management:consensus recommendations on minimally invasive caries removal

The International Caries Consensus Collaboration (ICCC) presented recommendations on terminology, on carious tissue removal and on managing cavitated carious lesions. It identified 'dental caries' as the name of the disease that dentists should manage, and the importance of controlling the activity of existing cavitated lesions to preserve hard tissues, maintain pulp sensibility and retain functional teeth in the long term. The ICCC recommended the level of hardness (soft, leathery, firm, and hard dentine) as the criterion for determining the clinical consequences of the disease and defined new strategies for carious tissue removal: 1) Selective removal of carious tissue - including selective removal to soft dentine and selective removal to firm dentine; 2) stepwise removal - including stage 1, selective removal to soft dentine, and stage 2, selective removal to firm dentine 6 to 12 months later; and 3) non-selective removal to hard dentine - formerly known as complete caries removal (a traditional approach no longer recommended). Adoption of these terms will facilitate improved understanding and communication among researchers, within dental educators and the wider clinical dentistry community. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious dentine lesions are either non-cleansable or can no longer be sealed, are restorative interventions indicated. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralised tissues close to the pulp do not need to be removed. The evidence and, therefore these recommendations, supports minimally invasive carious lesion management, delaying entry to, and slowing down, the destructive restorative cycle by preserving tooth tissue, maintaining pulp sensibility and retaining the functional tooth-restoration complex long-term

Positive correlation between fluoride release and acid erosion of restorative glass-ionomer cements.

OBJECTIVE: The aim of this study was to determine whether there is a correlation between acid erosion and fluoride release of conventional glass ionomer cements. METHODS: Ten specimens for each material were prepared for fluoride release tests and five for acid erosion tests separately. After placed in pH cycling solution, concentration of fluoride was measured by a fluoride-ion selective electrode each day for 15 days. For the acid erosion test, specimens were immersed in a lactic acid solution and their depth measured with a spring-loaded dial gauge. The data were submitted to 3-way ANOVA, followed by Tukey's test (p0.05). The highest acid erosion values were registered for Magic Glass, Ion Z, VitroFil and Maxxion R, which exceeded the maximum stipulated by the relevant ISO test (ISO 9917-1). A positive linear correlation (r2=0.4886) was found for both properties, i.e., higher fluoride release is related to higher acid erosion. SIGNIFICANCE: Acid erosion and fluoride release are related properties of GICs, though factors such as pH and P/L ratio lead to differences between actual values for individual brands of these materials

Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania

There is a lack of studies considering social disparity in oral health emanating from adolescents in low-income countries. This study aimed to assess socio-demographic disparities in clinical- and self reported oral health status and a number of oral health behaviors. The extent to which oral health related behaviors might account for socio-demographic disparities in oral health status was also examined. A cross-sectional study was conducted in Kilwa district in 2008. One thousand seven hundred and forty five schoolchildren completed an interview and a full mouth clinical examination. Caries experience was recorded using WHO criteria, whilst type of treatment need was categorized using the ART approach. The majority of students were caries free (79.8%) and presented with a low need for dental treatment (89.3%). Compared to their counterparts in opposite groups, rural residents and those from less poor households presented more frequently with caries experience (DMT>0), high need for dental treatment and poor oral hygiene behavior, but were less likely to report poor oral health status. Stepwise logistic regressions revealed that social and behavioral variables varied systematically with caries experience, high need for dental treatment and poor self reported oral health. Socio-demographic disparities in oral health outcomes persisted after adjusting for oral health behaviors. Socio-demographic disparities in oral health outcomes and oral health behaviors do exist. Socio-demographic disparities in oral health outcomes were marginally accounted for by oral health behaviors. Developing policies and programs targeting both social and individual determinants of oral health should be an urgent public health strategy in Tanzania

Numerical relations and skill level constrain co-adaptive behaviors of agents in sports teams

Similar to other complex systems in nature (e.g., a hunting pack, flocks of birds), sports teams have been modeled as social neurobiological systems in which interpersonal coordination tendencies of agents underpin team swarming behaviors. Swarming is seen as the result of agent co-adaptation to ecological constraints of performance environments by collectively perceiving specific possibilities for action (affordances for self and shared affordances). A major principle of invasion team sports assumed to promote effective performance is to outnumber the opposition (creation of numerical overloads) during different performance phases (attack and defense) in spatial regions adjacent to the ball. Such performance principles are assimilated by system agents through manipulation of numerical relations between teams during training in order to create artificially asymmetrical performance contexts to simulate overloaded and underloaded situations. Here we evaluated effects of different numerical relations differentiated by agent skill level, examining emergent inter-individual, intra- and inter-team coordination. Groups of association football players (national - NLP and regional-level - RLP) participated in small-sided and conditioned games in which numerical relations between system agents were manipulated (5v5, 5v4 and 5v3). Typical grouping tendencies in sports teams (major ranges, stretch indices, distances of team centers to goals and distances between the teams' opposing line-forces in specific team sectors) were recorded by plotting positional coordinates of individual agents through continuous GPS tracking. Results showed that creation of numerical asymmetries during training constrained agents' individual dominant regions, the underloaded teams' compactness and each team's relative position on-field, as well as distances between specific team sectors. We also observed how skill level impacted individual and team coordination tendencies. Data revealed emergence of co-adaptive behaviors between interacting neurobiological social system agents in the context of sport performance. Such observations have broader implications for training design involving manipulations of numerical relations between interacting members of social collectives