Educational strategies and atraumatic restorative treatment effect on salivary characteristics: A controlled clinical trial

Oral Diseases ◽  
2017 ◽  
Vol 23 (8) ◽  
pp. 1116-1126 ◽  
Author(s):  
CN Freitas ◽  
PM Castelo ◽  
KG Sousa ◽  
GC Alonso ◽  
FLA Fonseca ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Effect ◽  
Controlled Clinical Trial ◽  
Atraumatic Restorative Treatment ◽  
Educational Strategies ◽  
Restorative Treatment

Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial

2017 ◽  
Vol 41 (3) ◽  
pp. 219-224 ◽  
Author(s):  
AMG Abdul Khalek ◽  
MA Elkateb ◽  
WE Abdel Aziz ◽  
M El Tantawi
Keyword(s):  
Clinical Trial ◽  
Primary Teeth ◽  
Pediatric Dentistry ◽  
Controlled Clinical Trial ◽  
Kappa Statistics ◽  
Atraumatic Restorative Treatment ◽  
Public Health Department ◽  
Restorative Treatment ◽  
Randomized Controlled ◽  
Caries Removal

Objective: To compare the effect of Papacarie and Atraumatic Restorative Treatment (ART) on pain and discomfort during caries removal among children. Study Design: Fifty healthy, 4–8 year-old children were equally and randomly allocated to Papacarie and ART to remove caries from decayed primary teeth. A randomized, controlled, blinded, two parallel-arms clinical trial was conducted in the clinic of the Pediatric Dentistry and Dental Public Health Department, Alexandria University, Egypt in March 2014. Pain and discomfort were assessed blindly by two independent investigators watching videotaped treatment sessions using the Sound, Eye and Motor scale (SEM). Their reliability was assessed using Kappa statistics. The effect of caries removal methods, time spent to remove caries and other confounders on SEM score was assessed using regression analysis. Results: Mean time to remove caries using Papacarie and ART was 5.8 and 4.8 minutes, P= 0.005. Median Paparie and ART scores for the S, E and M components were 1, 1, 1 and 3, 2, 3. Adjusted mean SEM score= 3.6 and 7.8, P <0.0001. Method of caries removal was the only factor significantly affecting pain and discomfort. Conclusion: Papacarie is associated with minimal pain during caries removal from primary teeth compared to ART, although it has longer working time.

scholarly journals Explainable AI enables clinical trial patient selection to retrospectively improve treatment effects in schizophrenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monika S. Mellem ◽  
Matt Kollada ◽  
Jane Tiller ◽  
Thomas Lauritzen
Keyword(s):  
Clinical Trial ◽  
Patient Selection ◽  
Treatment Effect ◽  
Controlled Clinical Trial ◽  
Learning Approaches ◽  
Full Sample ◽  
Cohen’S D ◽  
Explainable Ai ◽  
Cohen's D ◽  
Analytical Approaches

Abstract Background Heterogeneity among patients’ responses to treatment is prevalent in psychiatric disorders. Personalized medicine approaches—which involve parsing patients into subgroups better indicated for a particular treatment—could therefore improve patient outcomes and serve as a powerful tool in patient selection within clinical trials. Machine learning approaches can identify patient subgroups but are often not “explainable” due to the use of complex algorithms that do not mirror clinicians’ natural decision-making processes. Methods Here we combine two analytical approaches—Personalized Advantage Index and Bayesian Rule Lists—to identify paliperidone-indicated schizophrenia patients in a way that emphasizes model explainability. We apply these approaches retrospectively to randomized, placebo-controlled clinical trial data to identify a paliperidone-indicated subgroup of schizophrenia patients who demonstrate a larger treatment effect (outcome on treatment superior than on placebo) than that of the full randomized sample as assessed with Cohen’s d. For this study, the outcome corresponded to a reduction in the Positive and Negative Syndrome Scale (PANSS) total score which measures positive (e.g., hallucinations, delusions), negative (e.g., blunted affect, emotional withdrawal), and general psychopathological (e.g., disturbance of volition, uncooperativeness) symptoms in schizophrenia. Results Using our combined explainable AI approach to identify a subgroup more responsive to paliperidone than placebo, the treatment effect increased significantly over that of the full sample (p < 0.0001 for a one-sample t-test comparing the full sample Cohen’s d = 0.82 and a generated distribution of subgroup Cohen’s d’s with mean d = 1.22, std d = 0.09). In addition, our modeling approach produces simple logical statements (if–then-else), termed a “rule list”, to ease interpretability for clinicians. A majority of the rule lists generated from cross-validation found two general psychopathology symptoms, disturbance of volition and uncooperativeness, to predict membership in the paliperidone-indicated subgroup. Conclusions These results help to technically validate our explainable AI approach to patient selection for a clinical trial by identifying a subgroup with an improved treatment effect. With these data, the explainable rule lists also suggest that paliperidone may provide an improved therapeutic benefit for the treatment of schizophrenia patients with either of the symptoms of high disturbance of volition or high uncooperativeness. Trial Registration: clincialtrials.gov identifier: NCT 00,083,668; prospectively registered May 28, 2004

scholarly journals The impact of minimally invasive restorative techniques on perception of dental pain among pregnant women: a randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
May M. Adham ◽  
Mona K. El Kashlan ◽  
Wafaa E. Abdelaziz ◽  
Ahmed S. Rashad
Keyword(s):  
Clinical Trial ◽  
Dental Caries ◽  
Pregnant Women ◽  
Dental Pain ◽  
Controlled Clinical Trial ◽  
Atraumatic Restorative Treatment ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Caries Removal ◽  
The Impact

Abstract Background The public dental care sector is striving to fulfill the preventive and restorative needs of Egyptians, including pregnant women, who may not receive timely care due to misconceptions about dental treatment during pregnancy. Because of this, they are likely to suffer dental pain, with higher risk of infection affecting their offsprings. Aim of the study To compare the effectiveness of chemo-mechanical caries removal using Papacarie-Duo and Atraumatic Restorative Treatment (ART) in reducing dental pain among pregnant women. Materials and methods A randomized controlled clinical trial was conducted, in 2019, and included 162 pregnant women visiting family health centers in Alexandria, Egypt, with dental pain due to dental caries not extending to pulp. Patients were randomly assigned to Papacarie-Duo group (n = 82) and ART group (n = 80) after stratification by number of treated surfaces. The outcome variables were reduction in pain assessed using Visual Analogue Scale (VAS), satisfaction with treatment, and time taken for dental caries removal. T test/ Mann Whitney U test were used to compare groups and Freidman test was used to compare change across time. Results Pain reduction was significantly greater in the Papacarie-Duo than the ART group (81.55% and 69.43%, P = 0.001). Patients in the Papacarie-Duo group were significantly more satisfied with treatment than those in the ART, immediately after treatment (mean = 9.60 and 8.00, P =  < 0.01) and after 6 months (mean = 9.63 and 8.16, P =  < 0.01). Significantly less excavation time was recorded in the Papacarie-Duo group than in the ART group (mean = 10.38 and 11.56 min, P =  < 0.01). Conclusion Chemo-mechanical caries removal using Papacarie-Duo is more effective in reducing dental pain, in pregnant women, and is associated with more satisfaction and less excavation time than ART. Trial registration: ID NCT04573608 (https://clinicaltrials.gov/); 5/10/2020, retrospective registration.

scholarly journals Atraumatic Restorative Treatment-Sealed versus Nonsealed First Permanent Molars: A 3-Year Split-Mouth Clinical Trial

2020 ◽  
Vol 55 (1) ◽  
pp. 12-20
Author(s):  
Daniela Hesse ◽  
Camila de Almeida Brandão Guglielmi ◽  
Daniela Prócida Raggio ◽  
Marcelo José Strazzeri Bönecker ◽  
Fausto Medeiros Mendes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Income ◽  
Cox Regression ◽  
Caries Experience ◽  
Rank Test ◽  
Atraumatic Restorative Treatment ◽  
Restorative Treatment ◽  
Permanent Molars ◽  
Caries Lesions ◽  
First Permanent Molars

To investigate the efficacy of atraumatic restorative treatment (ART) sealants vs. no sealant in preventing the development of dentine caries lesions in first permanent molars over a period of 3 years. A total of 187 schoolchildren (aged 6–8 years) from a low-income population presenting the 4 first permanent molars without clinically detectable dentine caries lesions were selected to be part of a split-mouth clinical trial. All 4 first permanent molars were investigated in this trial and the children’s mouth was split vertically into left and right sides; therefore, 2 molars were randomly allocated to receive ART sealants, while the other 2 molars remained nonsealed. All children received toothbrushing instructions and dietary advice every 6 months for a period of 3 years. Clinical evaluations were performed after 3, 6, 12, 18, 24, and 36 months and both sealant retention and dental caries were scored. Kaplan-Meier survival analysis, log-rank test, and Cox regression with shared frailty analysis were performed. A cavitated dentine caries lesion was considered a failure. The cumulative survival rates of dentine cavity-free first permanent molars were 90% for ART-sealed molars and 90.8% for nonsealed molars, with no statistically significantly difference between sealed and nonsealed molars (<i>p</i> = 0.70). The retention of sealants was not associated with the development of cavitated dentine caries and children presenting a higher baseline caries experience had greater chances of developing dentine lesions. In conclusion, the application of ART sealants was not more efficacious than nonsealing in reducing the development of dentine cavitated lesions in first permanent molars.

Sign in / Sign up

Export Citation Format

Share Document