Biomedical subjects

J A De Boever

Publications and source records attributed to J A De Boever.

At least 19 recordsLinked to original sources

PubMed2003

Efficacy of plaque removal and learning effect of a powered and a manual toothbrush.

BACKGROUND: Subjects with high plaque and gingivitis scores can profit most from the introduction of new manual or powered tooth brushes. To improve their hygiene, not only the technical characteristics of new brushes but also the learning effect in efficient handling are of importance. AIM: : The present study compared the efficacy in plaque removal of an electric and a manual toothbrush in a general population and analysed the learning effect in efficient handling. METHOD: Eighty healthy subjects, unfamiliar with electric brushes, were divided into two groups: group 1 used the Philips/Jordan HP 735 powered brush and group 2 used a manual brush, Oral-B40+. Plaque index (PI) and gingival bleeding index (GBI) were assessed at baseline and at weeks 3, 6, 12 and 18. After each evaluation, patients abstained from oral hygiene for 24 h. The next day a 3-min supervised brushing was performed. Before and after this brushing, PI was assessed for the estimation of the individual learning effect. The study was single blinded. RESULTS: Over the 18-week period, PI reduced gradually and statistically significantly (p<0.001) in group 1 from 2.9 (+/-0.38) to 1.5 (+/-0.24) and in group 2 from 2.9 (+/-0.34) to 2.2 (+/-0.23). From week 3 onwards, the difference between groups was statistically significant (p<0.001). The bleeding index decreased in group 1 from 28% (+/-17%) to 7% (+/-5%) (p<0.001) and in group 2 from 30% (+/-12%) to 12% (+/-6%) (p<0.001). The difference between groups was statistically significant (p<0.001) from week 6 onwards. The learning effect, expressed as the percentage of plaque reduction after 3 min of supervised brushing, was 33% for group 1 and 26% for group 2 at week 0. This percentage increased at week 18 to 64% in group 1 and 44% in group 2 (difference between groups statistically significant: p<0.001). CONCLUSION: The powered brush was significantly more efficient in removing plaque and improving gingival health than the manual brush in the group of subjects unfamiliar with electric brushes. There was also a significant learning effect that was more pronounced with the electric toothbrush.

Adult↗

PubMed2002

Plaque-inhibiting effect of bioadhesive mucosal tablets containing chlorhexidine in a 4-day plaque regrowth model.

BACKGROUND AND AIM: Compliance in the use of daily oral antiseptics can probably be enhanced by prescribing easily-applied bioadhesive tablets which slowly release chlorhexidine (CHX). This could also be of use in patients with difficulties in rinsing or performing mechanical plaque control. The aim of the present study was to evaluate the capacity of bioadhesive tablets containing either 30 mg or 40 mg of CHX to inhibit de novo plaque formation. METHOD: In this single, examiner-blinded, crossover study, 22 volunteers between 21 and 25 years of age refrained from oral hygiene for 4 days. Bioadhesive mucosal tablets containing 30 mg or 40 mg of CHX were applied in the canine region. Rinses with a 0.2% CHX solution and placebo tablets served as controls. Plaque regrowth was evaluated with the Quigley-Hein Index modification of Turesky and by an automatic image analysis system (AIA) using slides of stained plaque. Rinsing and application of the tablets were done under supervision twice daily. RESULTS: According to the plaque index, plaque regrowth was significantly inhibited by CHX rinses ( P<0.001) and by tablets with 40 mg of CHX ( P<0.02) for all teeth and surfaces. Placebo tablets and 30-mg CHX tablets had no plaque-inhibiting effect. For taste, the subjects preferred the placebo and the 30-mg tablets more than the rinses and 40-mg tablets. In 3/22 of the subjects, superficial mucosal lesions were found at the side of application of the 40-mg tablets. Using the AIA system for evaluation of plaque regrowth, similar results for plaque inhibition were found. CONCLUSION: It can be concluded that bioadhesive mucosal tablets containing 40 mg of CHX can inhibit plaque regrowth as well as 0.2% CHX rinses. However, unpleasant taste and superficial mucosal lesions are local side effects to be considered.

Adhesiveness↗

PubMed2002

[Woman and career: an unhappy marriage? A study model: dentistry].

Women's participation in the professions is steadily increasing. This study is a quantitative assessment of male and female career patterns in dentistry and of the role of marriage in any gender gap. A 1997 survey explored the professional activity of Flemish dentists. There is no educational disparity between dentists, female dentists enter the profession on an equal footing with their male colleagues. Therefore any other career influencing factors reveal themselves relatively clearly. Dependent variable was income; independent variables were gender and marriage. Female dentists scored lower than male dentists in each career phase; marriage made no significant difference. However, marriage turned out to be an important positive factor in the career of male dentists. Women dentists marry significantly later and less than their male colleagues. Further research, also of a qualitative nature, is necessary to evaluate the professional and social impact of this substantial gender difference.

Adult↗

PubMed2001

Short-term clinical study comparing supragingival plaque removal and gingival bleeding reduction of the Philips Jordan HP735 to a manual toothbrush in periodontal patients in a maintenance program.

The Philips Jordan HP735 was compared to a manual brush for plaque removal efficacy and reduction of gingival bleeding. Subjects in a periodontal maintenance program were randomly divided into two groups; Group I (n = 27), average age 36.9 years, brushed with the manual brush; and Group II (n = 22), average age 32.9 years, brushed with the Philips Jordan HP735 electric brush. A dichotomous plaque and bleeding index was used at six sites on all teeth at baseline, three, six and nine weeks. The subjects did not use any other cleaning devices during the study. No significant statistical difference in plaque score or bleeding score was found between the two groups at baseline. Plaque scores did not statistically significantly decrease over time in either group, and there was no significant difference in plaque removal between groups during the study. The bleeding index decreased significantly in the electric toothbrushing group; however, due to the large variation in bleeding scores between subjects, the difference in the number of bleeding sites was not statistically significant between the two groups. In conclusion, in a group of periodontal patients in a maintenance phase, using an electric toothbrush did not significantly enhance plaque removal, but did decrease bleeding compared to baseline. The difference in bleeding percentages was not statistically significant compared to a manual brush.

Adolescent↗

PubMed2000

Periodontal treatment of rapid progressive periodontitis in 2 siblings with Papillon-Lefèvre syndrome: 15-year follow-up.

AIMS: This paper reports the treatment of the periodontal component of the Papillon-Lefèvre syndrome in 2 siblings (case A, born 1974; case B, born 1976). METHOD: The initial treatment, in 1982, consisted of extraction of all primary teeth, scaling and rootplaning of the erupted permanent teeth and systemic antibiotic therapy. During 15 years, continuous and intensive periodontal treatment consisted of chlorhexidine 0.2% rinses, bi-weekly professional prophylaxis, scaling and rootplaning or surgery if indicated. Systemic antibiotics often accompanied mechanical therapy after bacteriological analysis. RESULTS: In case A, a favourable number of permanent teeth could be maintained, but in case B, all permanent teeth were lost in spite of the intensive treatment. Darkfield microscopy at different intervals revealed high numbers of spirochetes and motile rods in both siblings. Only in case A were they temporarily reduced to zero after scaling and rootplaning combined with metronidazole. Anaerobic cultering revealed high numbers of Actinobacillus actinomycetemcomitans (A.a) in both patients. In 1994, 2 years after combined amoxicillin/metronidazole therapy, no A.a could be detected in case A. In case B, A.a could still be detected and was found to be resistant to metronidazole. One year after extraction of all permanent teeth, could no A.a be detected in case B. CONCLUSION: Intensive periodontal treatment combined with antibiotic therapy was not able to prevent complete tooth loss in case B. In case A, the treatment was more effective, resulting in preserving a number of permanent teeth in a stable clinical situation. In these 2 cases, no attempt was made to create an edentulous period between the periodontally-diseased mixed dentition and the eruption of the remaining teeth, which may have contributed to treatment failure.

Aggregatibacter actinomycetemcomitans↗

PubMed2000

A multidisciplinary treatment approach to a complicated maxillary dental trauma: a case report.

This case report describes the treatment of an 18-year-old male who lost two central maxillary incisors due to dental trauma. Because of a deep overbite and serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a conventional fixed prosthesis. The vertical dimension of occlusion was increased using a Hawley-type appliance over a period of 1 year. When sufficient intermaxillary space was gained the alveolar ridge was augmented with a mandibular symphysis graft. Nine months later two one-stage non-submerged implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were placed on the two implants and the lateral incisors.

Adolescent↗

PubMed2000

Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment.

This review, divided into two parts, evaluates the literature on the relationship between dental occlusion and temporomandibular disorders (TMD) and the need for occlusal therapy in the management of TMD. The first part of the review focuses on the aetiological importance of occlusal interferences and the place of occlusal adjustment in the management and prevention of signs and symptoms of TMD. This has long been a controversial issue, which has not yet been resolved. The literature does not give strong support for the role of occlusion in the aetiology of TMD. Experienced clinicians also repudiate the need for occlusal adjustment in the management of TMD, whereas (less experienced) general dentists adhere to a concept focusing on the occlusion in diagnosis and treatment of TMD. There is a consensus that generalized prophylactic occlusal adjustment is not justified. There is an obvious need for research with evidence-based methods, to be able to answer the many remaining questions in this field.

Dental Occlusion, Traumatic↗

PubMed2000

Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part II: Tooth loss and prosthodontic treatment.

The second part of this review, evaluating the literature on the relationship between dental occlusion and temporomandibular disorders (TMDs), focuses on the aetiological importance of tooth loss and the place of prosthodontic replacement in the treatment of TMD. Loss of teeth and lack of posterior occlusal support seem to have little influence on the development of TMD, which calls into question the use of prosthodontic restoration as prevention or treatment for TMD. In addition, there are practically no studies assessing the benefit of instrumental analysis in diagnosis or comparing the outcome of prosthodontic treatment with simple reversible methods in the management of TMD. There is a trend in the current literature to abandon any treatment, including positioning appliances and prosthodontic measures, to 'recapture the disk' in patients with disk displacements because of the favourable, long-term results achieved after using more simple methods. It is concluded that prosthetic therapy in TMD patients is not appropriate for initial TMD treatment and should only be carried out on prosthodontic indications after reversible treatment has alleviated pain and dysfunction.

Bruxism↗

PubMed1999

Comparison of clinical profiles and treatment outcomes of an elderly and a younger temporomandibular patient group.

STATEMENT OF PROBLEM: Older temporomandibular disorder patients with more general complications and health problems may have a different clinical profile and be likely to react less favorably to conservative treatment. PURPOSE: This retrospective study compared the clinical profiles of a young (20 to 30 years) and an older (50 to 70 years) group of patients with pain and dysfunction in the temporomandibular region and to analyze treatment outcomes. METHODS: Clinical profiles and treatment outcomes were studied with a standardized protocol and the Helkimo Pain and Dysfunction Index up to 1 year after initial examination. RESULTS: Younger and older patients with temporomandibular disorder differed only in pain intensity at initial examination, but the outcome of conservation treatment was equally successful. CONCLUSION: Conservative treatment resulted in a significant alleviation of pain and dysfunction in almost 85% of patients. Both the younger and the older patient groups benefitted from this treatment protocol and therefore can be treated in the same fashion.

Adult↗

PubMed1998

[Periodontal aspects of cementation: materials, technics and their biologic reactions].

Cementation of crowns and bridges has an influence on the health of marginal periodontal structures. Ideally, the marginal discrepancy should be less than 50 microns which has been considered clinically acceptable. With discrepancies larger than 80 microns, the bleeding tendency and sulcus fluid flow rate increased. A shoulder-bevel preparation results in the smallest marginal discrepancy. Cytotoxicity of cements has been studied in cultures of gingival cells and fibroblasts. Composite has always a more pronounced cytotoxicity as compared to glass-ionomers and zinc phosphate cements. However, large differences exist in cytotoxicity between materials of the same group. Erosion of the cement leads to leakage of toxic materials and the formation of niches colonised by oral plaque bacteria. A number of clinical recommendations are made to minimize the effect of cements and cementation on the periodontal structures.

Cells, Cultured↗

PubMed1997

[The role of bruxism in the appearance of temporomandibular joint disorders].

Bruxism is a parafunction observed both in young and adult populations. The mean prevalence is about 20% and is decreasing with age. Women appear to clench more frequently than men. Often, bruxism is understood as both clenching with occasional tooth contact or grinding. A correct and validated definition has only recently been suggested. Many symptoms are assigned to this process, although few symptoms scientifically can be used as specific diagnostic criteria. The symptoms most often associated with bruxism like muscle-stiffness and -pain, limitation of mouth opening. TMJ-internal derangements, toothwear, are also found in TMD-patients. Because the bruxism-process is not only a problem for the patient, who suffers from pain, dysfunction and possible toothwear, it concerns also the dentist. It is essential that those who treat the bruxist-patient, have an understanding of the etiology, diagnosis and management of bruxism, of the many described oral parafunctional behaviors (oromotor behavior). This literature-review could not find a causal etiological mechanism between the occurrence of TMD-symptoms and the bruxism although a relationship between those two conditions has been described.

Adult↗

PubMed1997

[Clinical evaluation and psychological aspects of temporomandibular joint disorders].

Establishing the patient's clinical diagnosis depends on gathering as much information of the patient and his or her signs and symptoms as possible. This information can be gathered from history, physical and psychological examination, diagnostic analysis. It is also important to look upon pain as a disorder and to consider the relationship between pain and psychological factors. The differential diagnosis is constructed through a biopsychological model of illness rather than through a more traditional biomedical model of disease. To arrive at a consistently accurate clinical diagnosis in patients with TMJ and craniofacial pain, the technique of clinical diagnosis must be well defined, reliable and include examination of the head and the neck, cranial nerves and the stomatognathic system. The craniomandibular index provides a standardized examination of the stomatognathic system that has been tested on validity and reliability. This chapter focuses on the techniques of history taking clinical and psychological examination and diagnostic criteria for temporomandibular joint disorders and muscle pain.

Cranial Nerves↗

PubMed1997

[Dental aspects of the treatment of temporomandibular joint disorders].

Over the last years, aetiological concepts have changed drastically. The role of occlusal factors in the aetiology has been overestimated in the past. The role of occlusal therapy should be aimed at restoring function. In the initial phase of treatment an occlusal splint, counseling, physiotherapy and occasionally NSAID's, leads to relieve pain and reduction of dysfunction in most patients. A repositioning splint in cases of anterior disc dislocation is not longer recommended. Selective grinding can be done in "occlusally sensitive" patients with pain or dysfunction of muscular origin. The adjustment should have a limited character, and is not indicated as preventive measure. Occlusal prosthetic reconstruction is in most patients not indicated for reasons linked to TMD because the aetiologic relationships between TMD and loss of molars has not been established. In cases of rheumatoid arthritis, osteo-arthrosis and spondylitis ankylosans, occlusal changes can occur due to the degeneration of the joint components. After the initial phase of treatment replacing the lost molars by prostheses in these particular patients, results in unloading of the joints and in decreasing recurrence of symptoms.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1996

Otalgia in patients with temporomandibular joint disorders.

Otalgia without organic causes is a common symptom in temporomandibular dysfunction (TMD) patients even though the etiology is controversial. Investigations of the influence of TMD treatment on otalgia are scarce. This follow-up study analyzed the clinical profile of TMD patients with otalgia and evaluated the treatment outcome. A total of 400 consecutive TMD patients (75% women) were divided in two groups: group 1 consisted of 233 patients (58%) with no complaint of ear symptoms and group 2 consisted of 167 patients (42%) with complaint of otalgia. The patients were examined with a standardized protocol and treated similarly with conservative methods. Group 2 was referred and examined by otolaryngologists. Otalgia patients (group 2) had statistically significantly higher pain scores (p 0.02). They belonged to the greater dysfunction scores (Di III) according to the Helkimo Pain and Dysfunction index (41%) vs. 24%; p < 0.001). There was a statistically significant association with pain on condyle palpation and otalgia (p < 0.01). One year after the first examination, the patients exhibited no pain or occasionally mild pain in 66% (group 1) and 74% (group 2) (p 0.35). Of the otalgia patients, 48% no longer had otalgia and 32% of the patients experienced mild or occasional otalgia. The changes in dysfunction scores after 1 year revealed significant improvement. No difference was found between group 1 and 2 in pain and dysfunction score. For the dysfunction index readings 0 and I, 77% and 73% had no or only mild symptoms (Di 0 and I). The conclusions of this study are that TMD patients with otalgia are not a separate TMD group and they responded well to conservative treatment.

Adult↗

PubMed1996

The effect of sodium lauryl sulphate and triclosan on hamster cheek pouch mucosa.

It has recently been shown that triclosan protects the human skin from the inflammation that may be caused by exposure to sodium lauryl sulphate (SLS). The aim of the present study was to examine whether triclosan can protect the hamster cheek pouch mucosa from the irritation caused by exposure to SLS. After four daily applications of a paste containing SLS, the epithelium of the hamster cheek pouch showed consistently prominent structural changes, especially basal hyperplasia, acanthosis, hypergranulosis, and hyperkeratosis. Identical morphological changes were also observed after applications of a paste containing SLS together with triclosan. In contrast, after applications of a paste containing triclosan alone, the cheek pouch mucosa revealed a histological structure essentially similar to the non-treated control mucosa. From these results, we may conclude that SLS, but not triclosan, irritates the hamster cheek pouch epithelium. Moreover, triclosan does not protect the cheek pouch mucosa against structural changes induced by SLS. It must be taken into account that triclosan does not always offer protection against the side-effects of SLS.

Animals↗

PubMed1996

Trauma in patients with temporomandibular disorders: frequency and treatment outcome.

Controversy exists on the aetiological importance and the effect of jaw macrotrauma (fractures excluded) on the occurrence of temporomandibular joint disorders (TMD). The purpose of this study was to assess the incidence of jaw injury in TMD patients and to compare the severity of the symptoms, the clinical characteristics and the treatment outcome in TMD patients with or without a history of trauma to the head and neck region directly linked to the onset of symptoms. The study sample included 400 consecutive TMD clinical patients. In 24.5% of patients the onset of the pain and dysfunction could be linked directly to the trauma, mainly whiplash accidents. No significant differences could be found between the two groups in daily recurrent headache, dizziness, neck pain, joint crepitation and pain in the joints. Maximal mouth opening was less than 20 mm in 14.3% of patients with a history of trauma and in 4.1% of those without such a history. According to the Helkimo dysfunction index (DI), more trauma than non-trauma TMD patients belonged to the severe dysfunction groups (DI 4 and 5) at first examination. The outcome of a conservative treatment procedure (counselling, occlusal splint, physiotherapy, occasionally occlusal therapy and non-steroidal anti-inflammation drugs was not different between the two groups at the 1 year evaluation. The degree of maximal opening was similar: less than 20 mm in 3.7% and 2.2% in trauma and non-trauma patients respectively. Forty percent and 41% respectively were symptom free or had DI = 1. The results suggest that external trauma to the joint or to the jaw in general is an important initiating factor in the aetiology of TMD but also that the prognosis is favourable.

Adolescent↗

PubMed1996

Reasons that patients do not return for appointments in the initial phase of treatment of temporomandibular disorders.

Patients suffering form pain and dysfunction in the temporomandibular region sometimes ignore appointments after the initial examination. This from of noncompliance is well known and is often studied in patients suffering from recurrent headaches, arthritis, and lower back pain. Information on patients with temporomandibular disorders (TMD) who fail to attend the next visits and do not comply with the proposed treatment is scare. To 61 patients (aged 20 to 40 years) who did not attend the next visit after an initial examination and after discussing the treatment protocol, a questionnaire was mailed 6 months to 1 year after the first visit. The questions related to reasons for not attending and the possible treatment received. Some questions were also related to the present TMD state. The clinical profiles of the nonattenders were compared to those of a group of 400 TMD patients who did finish the proposed treatment (positive control). The nonattenders had more pain and dysfunction at initial examination than did the treated patients. The treated patients reported a shorter duration of symptoms before seeking treatment than did the nonattenders suggesting that the latter group had a more chronic pain state. The main reason for not returning was that symptoms improved enough or disappeared completely and spontaneously without the proposed treatment. Sixteen patients did not return for further treatment for reasons linked to the dentist-patient relationship. Fifty-seven percent of the nonattenders reported to be symptom free or sufficiently improved. One year after the initial examination and without the proposed treatment, most still had some symptoms such as clicking (59%) and reduced mouth opening (21%), but only 24% reported to be in need of treatment.

Chi-Square Distribution↗

PubMed1994

Histological changes in the hamster cheek pouch epithelium induced by topical application of sodium lauryl sulphate.

Dentifrices, two containing sodium lauryl sulphate (SLS) and one containing stearylethoxylate as surfactant, were gently rubbed on the mucosal surface of the medial wall of cheek pouches in adult male Syrian golden hamsters. Four daily applications were performed. On the fifth day, the animals were sacrificed and cheek pouch mucosal tissue was routinely processed for light microscopy. After applications of SLS containing dentifrices, the epithelium showed consistently prominent structural changes, especially hyperkeratinization, including ortho and para-keratinization, acanthosis with widening of the intercellular spaces, and varying degrees of basal hyperplasia. Identical morphological changes were also observed after application of a paste containing only SLS as an agent. In contrast, after application of the stearylethoxylate containing dentifrice, as well as a paste containing only stearylethoxylate as an agent, the epithelium remained essentially identical to the epithelium of cheek pouches treated with sterile saline, and to the nontreated cheek pouches. From these results, we may conclude that SLS is the agent responsible for the striking changes in the epithelial structure. The specific cytological effects of SLS on the epithelial cells remain to be further studied. Interestingly, application of SLS provides a useful system for the rapid production of acanthosis and hyperkeratinization in the stratified squamous epithelium of the hamster cheek pouch.

Administration, Topical↗