Ouderen wonen langer zelfstandig en behouden steeds langer hun eigen dentitie. Een slechte mondgezondheid kan een negatieve invloed op de algemene gezondheid hebben. E-health heeft al zijn entree in de gezondheidszorg gemaakt en draagt bij aan de zelfzorg en gedragsverandering van patiënten. Toch wordt e-health in de mondzorgkunde nog beperkt gehanteerd. Artikel over 'Gebruik van informatietechnologie ter ondersteuning van de mondzorg van thuiswonende ouderen' verschenen in Nederlands Tijdschrift voor Tandheelkunde. 2018; 125: 461-466
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OBJECTIVES: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study.MATERIALS AND METHODS: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis.RESULTS: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05)..CONCLUSION: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function.
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AIM: To compare the shear bond strength (SBS) after aging of two dual-curing composite resin cements to multiphase composite resin (experiment) and glass-ceramics (control).METHODS: Seventy computer-aided design/computer-aided manufacturing (CAD/CAM) blocks were prepared: 24 multiphase composite resin blocks (Lava Ultimate; experiment), and 12 control blocks (groups 5 and 6: 6 IPS e.max CAD, 6 IPS Empress CAD). Surface treatments of the experiment groups were: 1) Al2O3 airborne particle abrasion; 2) bur-roughening; 3) silica-coated aluminum oxide particle abrasion; and 4) hydrofluoric (HF) acid etching. Per study group, Variolink II (a) and RelyX Ultimate (b) were used as cements. Per treatment group, four cement cylinders were adhered to the conditioned blocks (n = 12). After thermocyclic aging (10.000x, 5°C to 55°C), notch-edge shear testing was applied. Modes of failure were examined. A P value of 0.05 was considered significant.RESULTS: Groups 1a (18.68 ± 3.81) and 3a (17.09 ± 3.40) performed equally to 6a (20.61 ± 4.10). Group 5a (14.39 ± 2.80) did not significantly differ from groups 1a, 3a, and 4a (15.21 ± 4.29). Group 2a (11.61 ± 3.39) showed the lowest bond strength. For the RelyX Ultimate specimens, mean bond strengths were: 1b (18.12 ± 2.84) > 4b (15.57 ± 2.31) > 2b (12.34 ± 1.72) = 3b (11.54 ± 2.45) = 6b (12.31 ± 1.87) > 5b (0.78 ± 0.89). Failure mode analysis showed a significant association between bond strength values and modes of failure (chi-square).CONCLUSION: The SBS of the composite cements to the multiphase composite resin that was treated by Al2O3 or silica-coated aluminum oxide particle abrasion is comparable to the bond of the control groups.
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This prospective randomized clinical trial evaluated tooth sensitivity and patient satisfaction after the provision of partial ceramic restorations bonded using immediate (IDS) or delayed dentin sealing (DDS) on vital molar teeth through a within-subject comparison study. Between December 2013 and May 2016, a total of 30 patients (13 women, 17 men; mean age, 54 years old) received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N=60). The two teeth randomly received either IDS (test group, n=30) or DDS (control group, n=30). Partial preparations were performed on all teeth and directly after tooth preparation. IDS was achieved using self-etch adhesive (Clearfil SE Primer and Adhesive, Kuraray) followed by the application of flowable resin (Clearfil Majesty Flow, Kuraray). Partial ceramic restorations were bonded (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. The teeth were evaluated preoperatively and at one week, three months, and 12 months postoperatively using a cold test and a questionnaire for perceived tooth sensitivity. Patient satisfaction was evaluated using a visual analog scale (VAS). Data were analyzed using McNemar, chi-squared, and Wilcoxon signed rank tests (α=0.01). There was no significant difference in patient-reported tooth sensitivity between the preoperative phase and all other time points (p>0.01). There was also no significant difference between IDS and DDS (p>0.01) for all items on the questionnaire. VAS scores did not differ significantly between the IDS and DDS groups for all items in the questionnaire at all time points (p>0.01). No tooth sensitivity change was noticed with the application of partial ceramic indirect restorations. This clinical study could not confirm that IDS is more advantageous than DDS in terms of tooth sensitivity and patient satisfaction at 1 year of clinical service of partial ceramic restorations.
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OBJECTIVES: To evaluate the clinical performance of partial glass-ceramic (IPS e.max Press) posterior restorations.MATERIALS AND METHODS: A total of 765 restorations in 158 patients were placed between 2008 and 2018 and evaluated in a prospective study during regular dental care visits between 2015 and 2018. The restorations were luted with a conventional photo-polymerized resin composite (HFO) in conjunction with an Immediate Dentin Sealing procedure (IDS). Intra-oral photographs and radiographs were made and evaluated using USPHS criteria.RESULTS: The mean observation time was 53.3 months (range 3-113 months). Three absolute failures occurred (tooth fractures, n = 2; apical re-infection, n = 1) all leading to the loss of the restored tooth. Repairable and salvageable failures occurred in 9 teeth (endodontic complications, n = 7; secondary caries, n = 1; debonding, n = 1). The survival and success rates according to Kaplan-Meier after 5 years cumulated to 99.6% and 98.6%, respectively. Location (premolar/molar and mandibula/maxilla), pre-restorative endodontic status (vital/devitalised) and extension of the indirect ceramic restoration (number of sides and cusps involved) did not significantly affect the cumulative success rate (log rank test, p > 0.05). The condition of the vast majority of the restorations remained unaffected for 5 years.CONCLUSIONS: Partial glass-ceramic posterior restorations (pressed lithium disilicate (IPS e.max press, Ivoclar Vivadent) luted by means of a conventional photo-polymerized resin composite in conjunction with the use of an IDS procedure have an excellent medium-term prognosis.CLINICAL RELEVANCE: Partial glass-ceramic posterior restorations can be considered as a highly reliable treatment option. Location and extension of the restoration and pre-restorative endodontic status do not affect success rate.
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BACKGROUND: Regular inspection of the oral cavity is required for prevention, early diagnosis and risk reduction of oral- and general health-related problems. Assessments to inspect the oral cavity have been designed for non-dental healthcare professionals, like nurses. The purpose of this systematic review was to evaluate the content and the measurement properties of oral health assessments for use by non-dental healthcare professionals in assessing older peoples' oral health, in order to provide recommendations for practice, policy, and research.METHODS: A systematic search in PubMed, EMBASE.com, and Cinahl (via Ebsco) has been performed. Search terms referring to 'oral health assessments', 'non-dental healthcare professionals' and 'older people (60+)' were used. Two reviewers individually performed title/abstract, and full-text screening for eligibility. The included studies have investigated at least one measurement property (validity/reliability) and were evaluated on their methodological quality using "The Consensus-based Standards for the selection of health Measurement Instruments" (COSMIN) checklist. The measurement properties were then scored using quality criteria (positive/negative/indeterminate).RESULTS: Out of 879 hits, 18 studies were included in this review. Five studies showed good methodological quality on at least one measurement property and 14 studies showed poor methodological quality on some of their measurement properties. None of the studies assessed all measurement properties of the COSMIN. In total eight oral health assessments were found: the Revised Oral Assessment Guide (ROAG); the Minimum Data Set (MDS), with oral health component; the Oral Health Assessment Tool (OHAT); The Holistic Reliable Oral Assessment Tool (THROAT); Dental Hygiene Registration (DHR); Mucosal Plaque Score (MPS); The Brief Oral Health Screening Examination (BOHSE) and the Oral Assessment Sheet (OAS). Most frequently assessed items were: lips, mucosa membrane, tongue, gums, teeth, denture, saliva, and oral hygiene.CONCLUSION: Taken into account the scarce evidence of the proposed assessments, the OHAT and ROAG are most complete in their included oral health items and are of best methodological quality in combination with positive quality criteria on their measurement properties. Non-dental healthcare professionals, policymakers and researchers should be aware of the methodological limitations of the available oral health assessments and realize that the quality of the measurement properties remains uncertain.
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Last decennia much attention has been paid to improve the oral health of schoolchildren. The purpose of this study was to examine the present caries prevalence and the state of oral health of schoolchildren. Therefore 1.147 children from group 2 and group 8 of the primary school (6 and 12 years of age) in the province Drenthe were examined. Of the children 33% had caries and 13% had gingivitis. The highest percentages of caries were found in the low SES-group and among children that have education at schools for children with special needs. The study showed that these children brushed their teeth less often, they visited the dentist for the first time at an older age and they were eating many snacks. Children who had received an instruction in how to brush one's teeth, did not score better in the caries prevalence compared to children without previous instruction. Also the children whose parents had information about oral health, did not score better than the other children.
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OBJECTIVE: To evaluate the influence of abutment geometry on papillary fill in the esthetic zone in a delayed crown protocol.MATERIALS AND METHODS: Twenty-six subjects received two non-adjacent endosseous implants in the esthetic zone. Functional temporary crowns were installed 17-19 weeks later, using conventional (control) and curved (experimental) abutments. The abutments were randomized in each patient independently. Final crowns were cemented after 2 months (T0). Standard intraoral photographs and radiographs were made to evaluate papillary fill after 12 months (T12). The interproximal papilla fill was measured by means of the papilla index score (PIS) and related to the maximum bone level between the implant and the adjacent root as well as the peri-implant marginal bone level at T12, both measured radiographically.RESULTS: No statistically significant difference between the experimental and the control group could be demonstrated (P = 0.25). Ordinal regression analysis showed a positive correlation between the maximum bone level and papilla fill (P < 0.01) and a negative correlation between the peri-implant marginal bone level and papilla fill (P < 0.05).CONCLUSION: A concave abutment does not exhibit a better fill of the papilla compared with a straight abutment in single-tooth implant placement using a delayed protocol in the esthetic zone after 12 months of function.
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Hoofdstuk 2 in Klinisch redeneren voor verpleegkundigen L. van Straalen & M. Schuurmans (redactie) Het boek geeft inzicht in het klinisch redeneerproces van de verpleegkundige, en helpt de verpleegkundige bij het kritisch leren gebruiken van verschillende soorten kennis in specifieke patiëntsituaties. Dit boek legt uit waarom het belangrijk is dat zowel studenten als verpleegkundigen aandacht besteden aan klinisch redeneren. Klinisch redeneren voor verpleegkundigen beschrijft hoe je klinisch redeneren kan leren en toepassen en hoe je daarbij gebruik maakt van kennis, ervaring en reflectie. Klinisch redeneren voor verpleegkundigen laat ook zien hoe je van gegevens tot een probleemstelling en interventies komt en waarom standaard diagnoses niet altijd passen. Als laatste gaat klinisch redeneren voor verpleegkundigen in op de relatie tussen indirecte zorg en klinisch redeneren. Ook het belang van continue professionele ontwikkeling voor het klinisch redeneren komt aan de orde
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Van AWBZ naar Wmo, de jeugdzorg van provincie naar gemeente; beschutte arbeid verdwijnt in een onbestemd gat tussen publieke middelen en markt. In deze turbulentie schept 'De sociale kwestie hervat' opnieuw orde. Aan bod komen de consequenties van de belangrijkste wetgevende kaders (waaronder Wmo, AWBZ, Zvw), regelgeving op het gebied van stedelijke vernieuwing, veiligheid en onderwijs voor sociaal werk. De praktische opdrachten voor de verschillende beroepsgroepen (met de nadruk op cmv, mwd en sph) worden op een rij gezet aan de hand van kritische praktijksituaties. De praktijk wordt in deze publicatie langsgelopen aan de hand van een inzichtelijke schets van domeinen als ggz, schuldhulpverlening, onderwijs, veiligheid.
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