scholarly journals Dental restoration longevity among geriatric and adult special needs patients

2017 ◽  
Author(s):  
D. J. Caplan ◽  
Y. Li ◽  
W. Wang ◽  
S. Kang ◽  
L. Marchini ◽  
...  
Keyword(s):  
Special Needs ◽  
Regression Models ◽  
Cox Regression ◽  
Dental Treatment ◽  
Treatment Options ◽  
Dental Restoration ◽  
University Of Iowa ◽  
Restorative Treatment ◽  
Dental Restorations ◽  
Iowa College

AbstractThis study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-year span, with particular interest in longevity of subsequent restorations in teeth that received multiple restorations over time. Dental restorations of different types and sizes in patients age ≥65 years treated between 2000-14 at the University of Iowa, College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazards ratios for selected predictor variables. A total of 9184 restorations were followed in 1551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event; and overall the restorations had a median lifespan of 6.25 years. In multivariable regression models, after controlling for gender and age, composite restorations and greater number of restoration surfaces were associated with higher risks of failure; and the initial restoration recorded in the database for each subject tended to have lower risk of failure than restorations placed later that included any of those same surfaces. This information potentially could be helpful to elderly patients considering various restorative treatment options during the dental treatment planning and informed consent process.

scholarly journals Dental Restoration Longevity among Geriatric and Special Needs Patients

2018 ◽  
Vol 4 (1) ◽  
pp. 41-48 ◽  
Author(s):  
D.J. Caplan ◽  
Y. Li ◽  
W. Wang ◽  
S. Kang ◽  
L. Marchini ◽  
...  
Keyword(s):  
Informed Consent ◽  
Special Needs ◽  
Older Adult ◽  
Regression Models ◽  
Treatment Options ◽  
Informed Consent Process ◽  
Dental Restoration ◽  
Consent Process ◽  
Restorative Treatment ◽  
Dental Restorations

Introduction: Although the population is aging and retaining more teeth, there is a lack of studies that address the longevity of dental restorations placed among older adults. Objectives: This study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-y span, with particular interest in the longevity of subsequent restorations in teeth that received multiple restorations over time. Methods: Dental restorations of different types and sizes in patients aged ≥65 y treated between 2000 and 2014 at the University of Iowa College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazard ratios for selected predictor variables. Results and Conclusion: A total of 9,184 restorations were followed among 1,551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event, and overall the restorations had a median life span of 6.2 y. In multivariable regression models, after controlling for sex and age, a greater number of restoration surfaces were associated with higher risks of failure, and the initial restoration recorded in the database for each participant tended to have a lower risk of failure than that of restorations that included any of those same surfaces that were placed later. This information could be helpful to older adult patients considering various restorative treatment options during the dental treatment–planning and informed consent process. Knowledge Transfer Statement: Informed decision making with regard to potential treatment options is an important component of health and well-being. The present study could contribute to the improved health of older adult dental patients by providing baseline information that clinicians can use as they discuss different restorative treatment options with these patients and their caregivers during the informed consent process.

scholarly journals Treatment of a Patient with Oligodontia: A Case Report

2008 ◽  
Vol 9 (3) ◽  
pp. 121-127 ◽  
Author(s):  
Nursel Akkaya ◽  
Arlin Kiremitçi ◽  
Ŏzden Kansu
Keyword(s):  
Case Report ◽  
Dental Treatment ◽  
Treatment Options ◽  
Young Patients ◽  
Permanent Teeth ◽  
Missing Teeth ◽  
Conservative Care ◽  
Restorative Treatment ◽  
Dental Rehabilitation ◽  
Severity Of The Disease

Abstract Aim The aim of this report is to describe the management of a 16-year-old patient with oligodontia including six permanent teeth. Background Oligodontia is agenesis of six teeth or more, excluding third molars. The etiology of congenital absence of teeth is believed to be involved in heredity or developmental anomalies. It can be isolated or as part of a syndrome. There are a number of options available to restore space generated by missing teeth. Dental treatment can vary depending on the severity of the disease and generally requires a multidisciplinary approach. Treatment options include orthodontic therapy, implants, adhesive techniques, and removable prostheses. Report A 16-year-old male patient with oligodontia affecting six permanent teeth received conservative care that met his and his parent's expectations. The existing primary teeth were restored to resemble permanent teeth in order to achieve a favorable esthetic result using direct composite resin. The restorative treatment was provided for the psychosocial comfort of the young patient. The loss of teeth in young patients can cause esthetic, functional, and psychological problems particularly if the teeth of the anterior region are involved. Summary Adhesive techniques and new restorative materials represent current options in the management of the dental rehabilitation of young patients with oligodontia. Citation Akkaya N, Kiremitçi A, Kansu Ö. Treatment of a Patient with Oligodontia: A Case Report. J Contemp Dent Pract 2008 March; (9)3:121-127.

scholarly journals Porcelain veneer for a simple and esthetic treatment on anterior teeth with enamel hypoplasia: a case report

2020 ◽  
Vol 9 (2) ◽  
pp. 74
Author(s):  
Juni Jekti Nugroho ◽  
Andi Hermianti Aco
Keyword(s):  
Dental Treatment ◽  
Tooth Development ◽  
Treatment Options ◽  
Organic Matrix ◽  
Enamel Hypoplasia ◽  
Restorative Treatment ◽  
Long Term Stability ◽  
Anterior Teeth ◽  
Labial Surface

Introduction: the esthetic factor should be considered for every patient who seeks a comprehensive dental treatment, especially for women. The anterior teeth deformities will diminish the levels of confidence and decrease self-esteem of the patients. The tooth development disturbances, such as enamel hypoplasia, may present an esthetic problem. Enamel hypoplasia is an alteration of organic matrix formation which characterized by the defect or porosity on the enamel surface. It can be restored with a variety of restorative treatment options including indirect porcelain veneers. Case: a 30 years old female patient was referred with chief complaint of anterior teeth discoloration. Clinical examination on the maxillary left central and lateral incisors revealed the defects on nearly half of the labial surface. Case management: the incisal lapping technique were chosen to prepared teeth #21 and #22 for indirect porcelain veneer fabrications. Conclusion:  indirect porcelain veneers established an excellent esthetic result and restored the size, shape and color of anterior teeth with long term stability.

Human enamel veneer restoration: an alternative technique to restore anterior primary teeth

2006 ◽  
Vol 30 (4) ◽  
pp. 277-279
Author(s):  
Luciana Butini Oliveira ◽  
Tereza Keiko Tamay ◽  
Marta Dutra Machado Oliveira ◽  
Célia Regina Martins Delgado Rodrigues ◽  
Marcia Turolla Wanderley
Keyword(s):  
Primary Teeth ◽  
Dental Treatment ◽  
Resin Composite ◽  
Treatment Options ◽  
Dental Enamel ◽  
Pediatric Dentistry ◽  
Restorative Treatment ◽  
Anterior Teeth ◽  
Human Enamel ◽  
Space Maintainer

Restoration of severely decayed primary teeth is a clinical challenge in Pediatric Dentistry. Among the restorative treatment options, the use of prefabricated crowns and resin composite restorations, either by means of direct or indirect techniques is mentioned in the literature. The purpose of this article is to describe the rehabilitation of primary anterior teeth in a 5-year-old patient. Dental treatment consisted on an anterior space maintainer prosthesis made with natural primary teeth, plus human dental enamel veneer (facet) restorations. The advantages of this technique are better esthetics and the natural enamel has physiologic wear and offers superficial smoothness and cervical adaptation compatible with those of the surrounding teeth.

Multiple Bonded Restorations in a Patient with Severe Mental Disability: A Case Report

2011 ◽  
Vol 36 (1) ◽  
pp. 104-111 ◽  
Author(s):  
J. Chang ◽  
K-S. Seo
Keyword(s):  
Case Report ◽  
Special Needs ◽  
Clinical Relevance ◽  
Dental Treatment ◽  
Mental Disability ◽  
Mental Impairment ◽  
Dental Restorations ◽  
Patients With Special Needs

Clinical Relevance Dental treatment for patients with special needs may be restricted due to the patient's lack of understanding and/or inability to cooperate, as well as other circumstances. Bonded restorations may be especially appropriate in dental restorations of patients with severe mental impairment.

Female hormonal exposures and risk of rheumatoid arthritis in the French E3N-EPIC cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Carine Salliot ◽  
Yann Nguyen ◽  
Gaëlle Gusto ◽  
Amandine Gelot ◽  
Juliette Gambaretti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Prospective Cohort ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Smoking History ◽  
Nulliparous Women ◽  
Hormonal Exposures ◽  
Incident Cases

Abstract Objective To assess the relationships between female hormonal exposures and risk of rheumatoid arthritis (RA), in a prospective cohort of French women. Methods E3N is an on-going French prospective cohort that included 98 995 women aged 40–65 years in 1990. Every 2–3 years, women completed mailed questionnaires on their lifestyles, reproductive factors, and health conditions. Cox proportional-hazards regression models were used to determine factors associated with risk of incident RA, with age as the time scale, adjusted for known risk factors of RA, and considering endogenous and exogenous hormonal factors. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. Effect modification by smoking history was investigated. Results A total of 698 incident cases of RA were ascertained among 78 452 women. In multivariable-adjusted Cox regression models, risk of RA was increased with early age at first pregnancy (<22 vs ≥27 years; HR = 1.34; 95%CI 1.0–1.7) and menopause (≤45 vs ≥53 years; HR = 1.40; 95%CI 1.0–1.9). For early menopause, the association was of similar magnitude in ever and never smokers, although the association was statistically significant only in ever smokers (HR = 1.54; 95%CI 1.0–2.3). We found a decreased risk in nulliparous women never exposed to smoking (HR = 0.44; 95%CI 0.2–0.8). Risk of RA was inversely associated with exposure to progestogen only in perimenopause (>24 vs 0 months; multi-adjusted HR = 0.77; 95%CI 0.6–0.9). Conclusions These results suggest an effect of both endogenous and exogenous hormonal exposures on RA risk and phenotype that deserves further investigation.

scholarly journals Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
K. P. Thompson ◽  
◽  
J. Nelson ◽  
H. Kim ◽  
L. Pawlikowska ◽  
...  
Keyword(s):  
Hereditary Hemorrhagic Telangiectasia ◽  
Cox Regression ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Smoking Status ◽  
Treatment Options ◽  
Gi Bleeding ◽  
Cox Regression Analysis ◽  
Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

scholarly journals Clinical Management of Hypertension, Inflammation and Thrombosis in Hospitalized COVID-19 Patients: Impact on Survival and Concerns

2021 ◽  
Vol 10 (5) ◽  
pp. 1073
Author(s):  
Patricia Martínez-Botía ◽  
Ángel Bernardo ◽  
Andrea Acebes-Huerta ◽  
Alberto Caro ◽  
Blanca Leoz ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Clinical Management ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospitalized Patients ◽  
Thrombosis Prophylaxis ◽  
The Impact

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.

Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

2015 ◽  
Vol 40 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Camiel L.M. de Roij van Zuijdewijn ◽  
Menso J. Nubé ◽  
Piet M. ter Wee ◽  
Peter J. Blankestijn ◽  
Renée Lévesque ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Mortality Risk ◽  
Survival Benefit ◽  
Regression Models ◽  
Cox Regression ◽  
Treatment Time ◽  
High Volume ◽  
P Values ◽  
Hazard Ratios

Background/Aims: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time. Methods: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable. Results: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap. Conclusion: The survival benefit of high-volume HDF over HD is independent of treatment time.

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