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Source at https://doi.org/10.1002/cre2.240. Background - Dog‐assisted therapy in the dental clinic may be an attractive alternative to sedation for anxious patients. Including a dental therapy dog in a clinical setting introduces new hazards and potential risks to health and safety for both humans and animal. Objectives - The study aims to describe potential hazards associated with risks to humans by having a therapy dog present in the dental clinic and to provide guidance on best practices to minimise and control risks for the patients, the dentist, and the dental clinic staff. Materials and Methods - Literature searches in Medline, Clinicaltrials.gov, and Google Scholar for qualitative and quantitative assessments of hazards and risks associated with the use of therapy dogs in health care settings, in combination with a review of the reference list of the included studies. Identified hazards and risks were analysed with respect for the health and welfare of humans in a dental clinic setting that involves the presence of a therapy dog. Results - Potential risks to health and safety for humans in dental clinics that offer dog‐assisted therapy can be categorised within four general categories of hazards: the dog as a source of zoonotic pathogens and human diseases, exposure to canine allergens, adverse animal behaviour, and dangers associated with high activity in a congested dental clinic operatory. Risks to humans are reduced by maintaining awareness amongst the dental clinic staff and the dog handler of all potential hazards in the dental clinic, and on how to reduce these hazards as well as adverse events that may scare the dental therapy dog. Conclusions - Risks to the health and safety of humans in the presence of therapy dog in the clinics are present but are low if the dental clinical staff and dog handlers comply with best practices.

Source at https://doi.org/10.1002/cre2.239. Background - A dental therapy dog may help anxious patients in the dental clinic overcome their fear and facilitate the completion of necessary dental care. Dental clinic activities are associated with hazards that may pose potential risks to the health and safety of the dental therapy dog. Objectives - To describe potential hazards associated with risks to health and safety to therapy dogs in dental clinics and to present suggestions for risk minimisation by adopting best practices in dental clinic settings. Materials and method - Literature searches in Medline, Clinicaltrials.gov, and Google Scholar for qualitative and quantitative assessments of occupational hazards and risks in dental clinics, in combination with a review of the reference list of the included studies. Identified hazards and risks were analysed relative to their relevance for the health and welfare of a therapy dog present in a dental clinic setting. Results - Workplace hazards in the dental clinic that apply to both humans and therapy dogs are allergies, sharps injury, eye injury, stress, rhinitis, hearing impairment, and other hazards. Additional concerns associated with risks for the dental therapy dog are situations involving erratic patient behaviour and threats if the patient is an undisclosed disease carrier. Risks to the health and safety of the dental therapy dog in the clinics are present but are low if the dental clinical staff and dog handlers comply with best practices. Conclusions - Best practice includes awareness amongst the clinic staff and the dog handler of all potential hazards in the dental clinic and on how to reduce these hazards as well as adverse events that may scare the dental therapy dog. The dental therapy dog team must be specially trained to work in a dental clinic. Each treatment session has to be exclusively tailored to that specific appointment and the individual patient.

Purpose: The aim of this noninterventional, retrospective study was to benchmark the outcomes of patients with partial fixed prostheses supported by implants treated at the University of Toronto at least 10 years earlier. A study protocol for assessing outcomes on like patients developed at the University of Bern, Switzerland, was followed. Materials and Methods: All patients who had received at least one implant before 2002 were considered eligible to be included in the study (n = 298). The treatment histories were recorded from the patient chart of the participants, or from the participants' dentists by consent. Calibrated clinicians examined the study participants clinically and radiologically and recorded peri-implant mucosal status and observable technical and mechanical failures. Past adverse events were identified in the patient charts. Independent assessors measured bone levels on digitized radiographs. Statistical analysis included descriptive statistics at implants, teeth, and study participant levels, respectively. Results: Of the 298 eligible patients, 121 attended a clinical examination (41%), while 12 declined (4%). The 121 study participants had received 321 implants between 1983 and 2001. The implants showed a success rate of 88.9% and a survival rate of 94% after an average of 17.5 years (SD 5.2, range 10 to 28 years). Approximately 5% of the surviving implants showed signs, or were associated with a prior history, of peri-implantitis. The distance from the implant shoulder to the first bone contact varied from -3 mm to 7 mm (mean = 1.52 mm [SD 1.57], median = 2.2 mm). Approximately half of the study participants had experienced at least one defect of their superstructure, representing a 52% "success rate," while the survival rate was 70%. The majority were very satisfied or satisfied with the treatment (102/121). Conclusion: A high proportion (94%) of conventional machined Branemark System implants placed between 1983 and 2001 remained in function after an average of 17.5 years. The original superstructures predominantly fabricated as prefabricated acrylic teeth and acrylic resin reinforced with a cast palladium-silver alloy core were still in place for 70% of the participants, and 48% of the superstructures had never undergone any form of repairs.

Objectives: Appraise the feasibility of interchanging conventional components of a fixed dental prosthesis (FDP) with those of Cresco in two different early loading protocols. Material and methods: In five centers patients with an edentulous, fully healed maxilla were recruited to partake in a three-arm blinded randomized-controlled trial (RCT). Each patient received 5/6 implants using a single-stage surgery approach to support a 10/12-unit FDP. The implants used were SLA solid screw two-part implants. In test groups 1 and 2 components from Cresco were used and the implants loaded 10 days or 6–8 weeks post-implant placement. Group 3 received their FDP fabricated with conventional components 6–8 weeks post-implant placement. Patients were followed up 3 years. Results: Of 36 patients, 30 remained after 3 years. The adjusted means and ranges of changes in crestal bone levels were −0.65, −0.5 and −0.4 mm in groups 1, 2 and 3, respectively. The change from baseline was statistically significant in all treatment groups. Adjusting for the difference in implant depth, there was an expected additional change in bone level of −0.29 mm by each 1 mm the implant was placed deeper. There was no significant difference between the 6-8 weeks post-implant placement loading Cresco group vs. the control group or between the two Cresco groups. Conclusions: The vertical placement has more effect on bone loss than the fabrication technique used for the suprastructure and whether the implants were loaded after 10 days vs. 6–8 weeks. To cite this article: Jokstad A, Ellner S, Gussgard A. Comparison of two early loading protocols in full arch reconstructions in the edentulous maxilla using the Cresco prosthetic system: a three-arm parallel group randomized-controlled trial. Clin. Oral Impl. Res. 22, 2011; 455–463. doi: 10.1111/j.1600-0501.2010.02156.x

BackgroundSelf-reported pain and impairment of oral functions varies markedly and often in spite of extensive oral mucositis (OM). The aim of the current study was to appraise how patient-reported debilitation caused by OM is influenced by the extent and possibly location of the OM lesions.MethodsPatients with head and neck cancer undergoing radiotherapy were examined before treatment, twice weekly during 6-7 weeks of therapy, and 3-4 weeks after therapy completion. OM signs of 33 participants were evaluated using the Oral Mucositis Assessment Scale (OMAS), while OM symptoms were recorded using Patient-Reported Oral Mucositis Symptom (PROMS)-questionnaires. Changes in OM experience as a function of OM signs was undertaken by comparing the aggregated and individual PROMS scale values at the point of transition of OMAS ulceration scores between 0 to 1, 1 to 2 and 2 to 3, respectively in the nine intra-oral locations designated in the OMAS. ANOVA with pairwise contrasts using the LSD procedure was applied for comparisons of mean changes of PROMS scale values for the participants who experienced an OMAS score of 2 or more during therapy (n=24).ResultsImpairment of eating hard foods was more when the OMAS score for ulceration anywhere in the mouth or in the soft palate changed from 1 to 2, compared to between score 0 and 1 (p=.002 and p=.05) or between score 2 and 3 (p=.001 and p=.02). Mouth pain increased more upon transition of OMAS score anywhere in the mouth from 1 to 2 compared to 0 to 1 (p=.05).ConclusionThe relationship between patient-reported impairment of oral function and pain caused by OM ulceration is not linear, but rather curvilinear. Our findings should prompt investigators of future interventional trials to consider using a less severe outcome than maximum OM scores as the primary study outcome.

To improve understanding of how patient-reported outcomes following radiation therapy for head and neck cancer may be influenced by factors beyond the local effects of the radiotherapy.Initially, 50 patients with head and neck cancer who were scheduled to undergo radiation therapy consented to participate in this prospective observational study. The participants underwent an oral examination before commencement of therapy and twice weekly over the therapy period. The 33 participants who finished the therapy underwent one more examination 4 to 6 weeks after its completion. At each session, clinical signs of oral mucositis were recorded with clinician-based scoring tools, and participants completed a questionnaire based on a visual analogue scale to record the perceived degree of impairment of common oral functions caused by oral mucositis. The strength of the correlation between these signs and symptoms at various points throughout the study period was appraised using a linear mixed model with robust repeated measures. The study participants with the most extensive manifestations of oral mucositis but only minor pain and limited adverse effects on oral functions (n=6) were contrasted with those who had limited mucositis but more severe pain and adverse effects (n=7). In addition, study participants with poor to moderate correlations between signs and symptoms (n=5) were contrasted with those who had very good correlations (n=10). Simple bivariate tests were used for these comparisons.Correlations between various signs and symptoms at all time points varied markedly at the individual level. The characteristics of study participants in the 2 subcohorts defined by poor to moderate and very good correlations between signs and symptoms were comparable, except perhaps in terms of age (p0.05, t test). Similarly, the participants in the 2 subcohorts defined by high manifestation with minor complaints and vice versa did not differ with regard to the variables recorded.Patients with head and neck cancer often report adverse effects of radiation-related oral mucositis on daily oral functions that are discordant with objective clinical findings. Patient-reported outcomes should be included in any interventional studies of oral mucositis, and trends over time should be analyzed within individuals, rather than between individuals.