Cork University Dental School and Hospital - Journal Articles
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Item World Workshop on Oral Medicine VIII: Development of a core outcome set for dry mouth: a systematic review of outcome domains for salivary hypofunction(Elsevier Inc., 2023-03-02) Simms, Melanie Louise; Kuten-Shorrer, Michal; Wiriyakijja, Paswach; Niklander, Sven Eric; Santos-Silva, Alan Roger; Sankar, Vidya; Kerr, Alexander Ross; Beier Jensen, Siri; Ni Riordain, Richeal; Delli, Konstantina; Villa, Alessandro; American Academy of Oral Medicine; European Association of Oral Medicine; Church and Dwight; Colgate-Palmolive CompanyObjective: To identify all outcome measures used to assess salivary gland hypofunction (i.e., objective measures used to determine actual changes in saliva quantity or to assess response to treatment of salivary gland hypofunction) and to group these into domains. Study Design: A systematic review including clinical trials and prospective or retrospective observational studies involving human participants with dry mouth, with any type of intervention where the objective assessment of salivary gland hypofunction was described. Results: Five hundred fifty-three studies involving 31,507 participants were identified. Most assessed salivary gland hypofunction and xerostomia (68.7%), whereas 31.3% assessed salivary gland hypofunction alone. Most studies investigated the “amount of saliva,” and the highest number of outcome measures were within the domain of “clinical/objective signs of salivary gland hypofunction.” Conclusions: Seven domains encompassing 30 outcome measures were identified, confirming the diversity in outcomes and outcome measures used in research regarding salivary gland hypofunction. Identified items will be used in conjunction with those identified regarding xerostomia to create a core outcome set for dry mouth quantification for use in future clinical trials, with the overall goal of improving the standardization of reporting, leading to the establishment of more robust evidence for the management of dry mouth and improving patient care.Item Reasons for placement and replacement of crowns in general dental practice(Springer Nature, 2018-08-10) Lynch, Christopher D.; Hale, R.; Chestnutt, I. G.; Wilson, N. H. F.; PRIME Centre, WalesObjectives: The aim of this study was to investigate the reasons for placement and replacement of crowns in general dental practice. Methods: Forty general dental practitioners recorded the principal reason for the provision of new (initial) and replacement crowns for a maximum of up to 20 patients over a 20-week period. Results: A total of 664 patients received 783 crowns during the period of this study. Of these, 69% (n = 542) were new (initial) placements and 31% (n = 241) were replacements. Overall, tooth fracture (45%, n = 241) was the most frequently reported reason for new/ initial crown placements. Aesthetics (21%, n = 53) and secondary/recurrent caries (20%; n = 47) were the most frequent reasons for crown replacement. Maxillary premolars (27%, n = 145) and mandibular molars (25%, n = 137) were the teeth that received most initial crown placements. In contrast, maxillary incisors (50%, n = 115) were the most common teeth to receive a replacement crown. Dentists were more likely to replace a crown if they had not placed the original crown: 74% of replacement crowns (n = 178) were placed by a different dentist. Most patients had only one crown placed or replaced per course of treatment (n = 611; 90%). Conclusions: The results of this study reveal the prescribing habits of dentists in relation to provision of initial and replacement crowns. The vast majority of patients had only one crown provided per course of treatment, which is probably a reflection of funding schemes and changing patterns of oral health. This sample reported fewer replacement crowns than previous studies. In keeping with existing literature, crowns were more frequently replaced when the treating dentist had not placed the initial crown. However, against this, more replacements were provided for more long-standing patients (5+ years attendance) compared to those with shorter attendance history (<5 years). In an area where high quality evidence is lacking, further consensus on the need for placement and replacement crowns is needed. Such information would assist dentists to provide high-quality care and commissioners in developing an evidence-based service.Item Teaching of implant dentistry in undergraduate dental schools in the UK and Ireland(Springer Nature, 2018-10-19) Chin, J. S.; Lynch, Christopher D.; Rees, J.; Locke, M.; Thomas, M. B. M.; Addy, L. D.Objective: The aim of this study was to assess the current status of implant teaching within dental undergraduate schools in the UK and Ireland. Methods: An online questionnaire relating to current and future possible trends in dental implantology education was developed and distributed to heads of departments of restorative dentistry, in each of the 18 dental schools with undergraduate dental programmes in the UK and Ireland. Results: Responses were received from 16 schools. All responding schools provided implant training for their students. The majority of schools offered students direct clinical experience in treatment planning (n = 13) however, direct clinical experience in restoring implants (n = 5) and implant placement (n = 1) was low. Barriers to implementing and developing the dental undergraduate implant programme include funding and lack of available time in the curriculum. Conclusion: There has been a significant improvement in the amount of implant teaching in the UK and Ireland since previous surveys. Further development and improvement of implant teaching in dental undergraduate schools are required, particularly with respect to the amount of direct clinical experience provided. This will ensure that newly qualified dentists will enter practice with a greater level of knowledge in this field and are best prepared for independent clinical practice.Item Contemporary teaching of bridges (fixed partial dentures) in Ireland and United Kingdom dental schools(Springer Nature, 2018-05-11) Virdee, S. S.; Lynch, Christopher D.; Sadaghiani, L.; Addy, L. D.; Gilmour, A. S. M.; Blum, I. R.; Wilson, N. H. F.Aim: The aim of this study was to investigate and describe the current teaching of bridges (fixed partial dentures) within dental schools in Ireland and the United Kingdom. The authors previously surveyed this teaching in 2009. Method: Following receipt of positive ethical approval, an online survey was distributed to the 18 dental schools in Ireland and the United Kingdom with primary dental degree programmes in 2017. This questionnaire sought information about the current nature and extent of dental school teaching of bridges, including clinical techniques taught. Information was also sought on current and future challenges to teaching in this area. Results: Responses were received from all 18 schools invited to participate (response rate = 100%). There was diversity in the range of exercises completed in preclinical courses for bridgework: the greatest commonality was seen in relation to preparation exercises for fixed-fixed posterior conventional bridges (n = 14 schools) and cantilever anterior resin-retained bridges (n = 13 schools). Fourteen schools required students to complete a preclinical assessment before they were permitted to provide bridgework in a clinical setting. Anterior cantilevered resin retained bridges were the most common clinical treatment provided (average = 1.67 bridges per student per respondent school; range = 0–3), representing a two-fold increase since the 2009 survey, which indicated that the equivalent mean was 0.83 per student. Two schools permitted their students to provide all-ceramic anterior bridges clinically. Five schools reported that their teaching of bridges had reduced over the past 5 years. Within the respondent schools, the most common challenges cited to teaching bridges was a lack of suitable patients (13 schools) and lack of time within the primary dental degree programme (7 schools). Conclusions: This study found increased student experience in the clinical provision of bridgework, in particular the provision of anterior cantilever resin-retained bridges, compared to the time of the last survey in 2009. Aspects of the teaching of removable partial dentures and implant dentistry should be surveyed to identify how these areas of teaching are adapting to changing patterns of oral healthcare and the further refinement of developing technologies in these areas.Item An RCT of atraumatic restorative treatment for older adults: 5 year results(Elsevier Ltd, 2019) da Mata, C.; McKenna, G.; Anweigi, L.; Hayes, M.; Cronin, M.; Woods, N.; O'Mahony, D.; Allen, P. F.Objectives: to compare the survival of ART and a conventional restorative technique (CT) for restoring carious lesions in older adults after 5 years. Methods: In this parallel randomised controlled clinical trial, 219 independently-living adults were recruited from a dental hospital/community and a geriatric day hospital. Ninety-nine patients who met the inclusion criteria and presented with carious lesions were randomly allocated to receive either ART or conventional restorations (anaesthesia, rotary instruments and resin-modified glass ionomer). The status of restorations was assessed 6 months, 1, 2 and 5 years after restoration placement. Estimates of cumulative survival were calculated for each interval between assessments and a Cox Proportional Hazards (PH) model was fitted to the interval-censored survival time. Results: Three hundred restorations (ART n=142; CT n=158) were placed on 99 patients, 46 males and 53 females, with a mean age of 73.2, SD: 6.8 (65–90 yrs). After 5 years, ART and CT presented cumulative probability of survival of 85% and 79% (p=0.8095), respectively. Conclusions: ART presents survival rates comparable to a conventional technique, when treating older adults after 5 years. The ART approach could be a useful tool to provide dental care for older adults particularly in the nonclinical setting. (Trial Registration number: ISRCTN 76299321). Clinical Relevance: This study shows that ART presents survival rates comparable to conventional techniques to treat carious lesions in older patients after 5 years. It is well accepted by this age cohort, and therefore could be an alternative to treat the elderly, especially those who are homebound or cannot attend the dentist. © 2019 Elsevier Ltd