| 1. |
- Bertl, Kristina, et al.
(författare)
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A survey on oral health-related standard of care for head and neck cancer patients in the EU
- 2023
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Ingår i: Oral Diseases. - : John Wiley & Sons. - 1354-523X .- 1601-0825.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care.Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.
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| 2. |
- Bertl, Kristina, et al.
(författare)
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Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status
- 2022
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Ingår i: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 26, s. 2937-2948
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo assess in a cross-sectional study the impact of including dental professionals in the multidisciplinary treatment team of head and neck squamous cell carcinoma (HNSCC) patients on the long-term oral health status.Materials and methodsOral health status, dental care behaviours, and oral health-related quality of life were assessed based on a clinical and radiographic examination, interview, and medical records in patients treated for HNSCC ≥ 6 months ago. This patient group (‘cohort 2’) was treated in a multidisciplinary treatment team including dental professionals and compared to a group of HNSCC patients previously treated at the same university, but without dental professionals included in the multidisciplinary treatment team (‘cohort 1’).ResultsCohort 2 consisted of 34 patients, who had received a dental check-up and if necessary, treatment by dental profes- sionals prior to the initiation of cancer treatment. This cohort showed significantly improved oral hygiene habits and a better periodontal health status compared to cohort 1. However, cohort 2 still presented high demand for treatment due to active carious lesions; only a few, statistically insignificant improvements were detected compared to cohort 1.ConclusionIncluding dental professionals in the multidisciplinary treatment team of HNSCC patients has a positive impact on patient oral health status — primarily in terms of periodontal disease — 6 months and longer after finishing cancer therapy.Clinical relevanceA team-based approach including dental professionals specialised in head and neck cancer improves oral health status.
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| 3. |
- Bertl, Kristina, et al.
(författare)
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Timeframe of socket cortication after tooth extraction : A retrospective radiographic study.
- 2017
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 29:1, s. 130-138
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the timeframe between tooth extraction and radiographically detectable socket cortication in humans. METHODS: Two hundred and fifty patients with a CT scan ≤36 months after tooth extraction were included. First, three orthoradial multiplanar reconstruction slices, representing the major part of the extraction socket, were scored regarding the degree of bone healing as (i) healed, that is, complete/continuous cortication of the socket entrance, or (ii) non-healed. Thereafter, based on the results of all three slices, the stage of cortication of the extraction socket, as one unit, was classified as (i) non-corticated, that is, all three slices judged as non-healed, (ii) partially corticated, that is, 1 or 2 slices judged as non-healed, or (iii) completely corticated, that is, all three slices judged as healed. The possible effect of several independent parameters, that is, age, gender, timeframe between tooth extraction and CT scan, tooth type, extent of radiographic bone loss of the extracted tooth, tooth-gap type, smoking status, presence of any systemic disease, and medication intake, on cortication status was statistically evaluated. RESULTS: Three to 6 months after tooth extraction, 27% of the sockets were judged as non-corticated and 53% were judged as partially corticated. After 9-12 months, >80% of the sockets were corticated, while some incompletely corticated sockets were detected up to 15 months after extraction. Each additional month after tooth extraction contributed significantly to a higher likelihood of a more advanced stage of cortication, while radiographic bone loss ≥75% significantly prolonged cortication time; no other independent variable had a significant effect. CONCLUSIONS: The results indicate a considerably long timeframe until complete cortication of an extraction socket, that is, 3-6 months after tooth extraction 3 of 4 sockets were still not completely corticated, and only after 9-12 months, complete cortication was observed in about 80% of the sockets.
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| 4. |
- Etöz, Onur, et al.
(författare)
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How old is old for implant therapy in terms of implant survival and marginal bone levels after 5-11 years?
- 2021
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 32:3, s. 337-348
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Tidskriftsartikel (refereegranskat)abstract
- AimTo evaluate implant survival and marginal bone levels (MBLevel) at least 5 years after implant installation in patients ≥ 65 years old.MethodsPatient records were screened retrospectively for the following inclusion criteria: (1) ≥ 65 years of age at the time of implant installation, and (2) ≥ 5‐year radiographic follow‐up or registered implant loss. Association between patient‐ and implant‐related data with radiographically assessed data [i.e., implant survival, mean MBLevel (i.e., average of mesial and distal level), maximum marginal bone loss (i.e., either mesial or distal loss; maximum MBLoss)] were statistically evaluated by mixed effects multi‐level regression models.ResultsTwo‐hundred‐eighteen implants in 74 patients were included with a mean follow‐up of 6.2 years (range: 5 to 10.7 years); 4 early and 6 late implant losses have been registered (implant survival rate: 95.4%). Mean MBLevel and maximum MBLoss was 1.24 ± 0.9 mm and 1.48 ± 1.0 mm, respectively. Maximum MBLoss < 2 mm, 2 to 5 mm, and ≥ 5 mm was found in 70.7, 28.8, and 0.5% of the implants, respectively. For both, mean MBLevel and maximum MBLoss, age presented a slightly protective effect (mean MBLevel: Coef. ‐0.041, p = 0.016; maximum MBLoss: Coef. ‐0.045, p = 0.014).ConclusionThe high implant survival rate (95.4%), low mean MBLevel (1.24 mm), and low frequency of maximum MBLoss ≥ 5 mm (0.5%) observed herein after 5 to 11 years follow‐up, suggest that older age should not be considered as a limiting factor for implant treatment.
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| 5. |
- Stavropoulos, Andreas, et al.
(författare)
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Timeframe of socket corticalization after tooth extraction : A retrospective radiographic study
- 2017
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 28:S14, s. 58-58
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background The formation of a hard-tissue bridge covering the tooth extraction socket is termed corticalization. In dogs this process takes >60d, however, this process has hardly been investigated in humans. Recent reports have indicated increased primary implant stability and reduced bone strain after immediate implant loading in the presence of a (thick) cortical layer, thus, knowledge of the timeframe between tooth extraction and hard-tissue bridging of the extraction socket appears clinically relevant in some situations. Aim/Hypothesis To determine the timeframe between tooth extraction and radiographically detectable corticalization of the socket in humans and to evaluate the possible impact of various factors on this process, e.g., history of periodontitis, smoking status, systemic disease, medications, etc. Material and Methods Two-hundred-fifty patients with a CT scan μ 8804, 36 months after tooth extraction and without any manipulation at the extraction site were included. Three orthoradial multiplanar reconstruction slices per extraction socket were scored, by a single calibrated examiner, regarding the degree of corticalization as: (a) healed, i.e., complete/continuous corticalization of the socket entrance, or (b) non-healed. Thereafter, each extraction socket was classified as (1) non-corticalized, i.e., all 3 slices classified as non-healed, (2) partially corticalized, i.e., 1 or 2 slices classified as non-healed, or (3) corticalized, i.e., all 3 slices classified as healed (Figure 1). The possible effect of several independent parameters, i.e., age, gender, timeframe between tooth extraction and CT scan, tooth type, periodontal status, gap dimension, smoking status, presence of any systemic disease, and medication intake, on the corticalization status was statistically evaluated. Results Three to 6 months after tooth extraction, 27% of the sockets were judged as non-corticalized, and 53% were judged as partially corticalized. After 9 to 12 months, >80% of the sockets were corticalized, but some non-corticalized sockets were detected up to 15 months post-extraction (Figure 2). Each additional month after tooth extraction contributed significantly to higher likelihood of a corticalized socket (OR 1.645, 95% CIs 1.471–1.841, P < 0.001). Periodontal attachment loss of μ 8805, 75% significantly prolonged corticalization time, i.e., teeth with <75% attachment loss were judged more often as corticalized (OR 1.984, 95% CIs 1.011–3.896, P = 0.047). No other independent variable had a significant effect on corticalization status. Conclusions and Clinical Implications Three to 6 months after tooth extraction one out of 4 sockets was still completely non corticalized, and only 9 to 12 months after tooth extraction complete corticalization was observed in about 80% of the sockets. The results, indicating a considerably long timeframe until corticalization of extraction sockets, imply that in cases where immediate loading requiring high primary implant stability is considered, waiting μ 8805,9 months post-extraction appears advisable.
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