Survival of ART restorations assessed using selected FDI and modified ART restoration criteria

A new set of criteria for assessing the quality of restorations using modern restorative materials, named FDI criteria, was recently introduced. This study tested the null hypothesis that there is no significant difference in survival estimate percentages of ART restorations assessed using selected FDI and modified ART criteria after 1 and 5 years. One operator placed a total of 60 class I and 30 Class II high-viscosity glass-ionomer ART restorations in ninety 14- to15-year-olds. Two calibrated and independent evaluators using both criteria evaluated restorations on diestone replicas at baseline and after 1 and 5 years. Statistical analyses were done using the Kaplan–Meier method and log-rank test. The survival results of ART restorations assessed using both sets of criteria after 1 and 5 years (p = 0.27) did not differ significantly. Three ART restorations were assessed as failures according to the ART criteria, while they were assessed as survived using the FDI criteria. We conclude that the modified ART criteria enable reliable assessment of ART restorations in permanent teeth from diestone replicas and that there was no significant difference in survival estimates of ART restorations assessed using both sets of criteria. The null hypothesis was accepted

A cluster randomised controlled trial in primary dental care based intervention to improve professional performance on routine oral examinations and the management of asymptomatic impacted third molars: study protocol

BACKGROUND: Routine oral examination (ROE) refers to periodic monitoring of the general and oral health status of patients. In most developed Western countries a decreasing prevalence of oral diseases underpins the need for a more individualised approach in assigning individualised recall intervals for regular attendees instead of systematic fixed intervals. From a quality-of-care perspective, the effectiveness of the widespread prophylactic removal of mandibular impacted asymptomatic third molars (MIM) in adolescents and adults is also questionable. Data on the effectiveness of appropriate interventions to tackle such problems, and for promoting continuing professional development in oral health care are rare. METHODS/DESIGN: This study is a cluster randomised controlled trial with groups of GDPs as the unit of randomisation. The aim is to determine the effectiveness and efficiency of small group quality improvement on professional decision-making of general dental practitioners (GDPs) in daily practice. Six peer groups ('IQual-groups') shall be randomised either to the intervention arm I or arm II. Groups of GDPs allocated to either of these arms act as each other's control group. An IQual peer group consists of eight to ten GDPs who meet in monthly structured sessions scheduled for discussion on practice-related topics. GDPs in both trial arms receive recently developed evidence-based clinical practice guidelines (CPG) on ROE or MIM. The implementation strategy consists of one interactive IQual group meeting of two to three hours. In addition, both groups of GDPs receive feedback on personal and group characteristics, and are invited to make use of web-based patient risk vignettes for further individual training on risk assessment policy. Reminders (flow charts) will be sent by mail several weeks after the meeting. The main outcome measure for the ROE intervention arm is the use and appropriateness of individualised risk assessment in assigning recall intervals, and for the MIM-intervention group the use and appropriateness of individualised mandibular impacted third molar risk management. Both groups act as each other's control. Pre-intervention data will be collected in study months one through three. Post-intervention data collection will be performed after nine months

Clinical data from outpatient registers related to: outpatient records examined, consultations which included oral examination, diagnosis made on dental decay, diagnosis made on gum diseases and diagnosis made on suspected oral HIV lesions by PHWs in the intervention and control divisions, expressed in percentages of outpatient consultations.

<p><i>I</i> = intervention division.</p><p><i>C</i> = Control division.</p>1<p>pre-training data for PHWs.</p>2<p>post-training data for PHWs.</p>3<p>pre-trainig data for CHWs.</p>4<p>post- training data for CHWs.</p><p>OPD = outpatient department.</p

Pre- and post-training mean domain scores, standard deviations (sd), maximum scores and p-values in the CHW questionnaire for intervention and control divisions.

1<p>intervention group (I): n = 32; control group(C): n = 27.</p>2<p>intervention group (I): n = 27; control group(C): n = 15.</p><p>HROL – HIV related orofacial lesions.</p

Clinical data drawn from laboratory registers to compare pre-training (March to December 2009) and post-training (March to December in 2010) performance of professional health workers in the intervention and control divisions, regarding a)number of patients with HIV-related oral lesions(including types of lesions) that were diagnosed b) number of patients with HIV-related oral lesions who were given an HIV test c) percentages of HIV-positive test results for patients with HIV-related (non) oral lesions.

1<p>group one HIV-related oral lesions according European Economic Community (EEC) Clearinghouse on oral problems related to HIV infection (1993) criteria.</p><p>HROLs = HIV-related oral lesions.</p><p>OPC = oropharyngeal candidiasis.</p><p>OPD = Outpatients department.</p