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Biomedical subjects

M I MacEntee

Publications and source records attributed to M I MacEntee.

At least 37 records · Page 2Linked to original sources
PubMed1993

Biologic sequelae of tooth replacement with removable partial dentures: a case for caution.

The evolution of denturism in many parts of the world may present a serious challenge to the oral health of many patients. Recent demands by denturists for permission to provide a full removable prosthodontic service directly to the public has met some success. This article reviews the health hazards associated with removable partial dentures, and presents the biologic arguments against the expansion of denturist activities to treatment that repeatedly tests the knowledge and skills of the most experienced dentists.

Adult↗
PubMed1993

Influence of age and gender on oral health and related behaviour in an independent elderly population.

Previous studies have been unable to determine the influence of advanced age on oral health because they included relatively few subjects, particularly men, over 75 yr of age. In this study a disproportionate and stratified random sample of subjects over 70 yr and living independently was selected from a list of voters in Vancouver, B.C. The sample of 521 elders was structured to provide similar numbers of men and women in three 5-yr age-groups. All of the subjects were interviewed, and 255 of them, representing a similar distribution of age and gender, were examined to investigate the influence of aging on oral health and related behaviour. In bivariate analyses neither age nor gender was associated significantly with oral health or complaints. The use of dental services during the preceding year was associated with female and younger subjects, while men and older subjects usually went to dentists only to relieve pain. Logistic regression in a multivariate model confirmed the importance of natural teeth in predicting the use of dental services (by improving the prediction from 60% to 73%). Other models offered less useful improvements in predicting complaints (64% to 70%) or oral health (56% to 60%). Overall the study demonstrates that the age and gender of independent elders have very little direct influence on the oral health or related behaviour established early in life.

Age Factors↗
PubMed1993

Predictors of caries in old age.

This study measured the incidence of dental caries for one year and identified factors associated with the risk of caries in a sample of 156 elderly subjects. The subjects were examined at baseline and after one year to record the number of missing, filled and decayed teeth, to measure oral hygiene and flow of saliva, and to estimate the numbers of Streptococcus mutans and Lactobacilli cultured from samples of saliva. All subjects were interviewed on both occasions for information on their use of medications and dental services and on their ingestion of sugar. At baseline the elders had a mean of 19 natural teeth with 5 decayed surfaces (DS), 38 filled surfaces and a mean Plaque Index (PI) of 1. The independent group, on average, had more teeth and fillings but a lower PI and less caries. At the end of the year more than two-thirds (71%) of the 98 institutionalised subjects and over half (59%) of the 58 independent subjects had at least one new decayed/filled surface (DFS). The mean net DFS increment per subject was 4.6 and 2.0 respectively. Regression analyses on multivariate models identified caries at baseline, residence in long term care facilities, high numbers of Lactobacilli, poor oral hygiene and frequent sugar consumption as the variables contributing most significantly to the risk of caries in old age.

Aged↗
PubMed1993

The influence of social, economic, and professional considerations on services offered by dentists to long-term care residents.

Many studies have focused on the disabilities and behavior of the elderly population in an attempt to explain the frequent reports of poor oral health among residents of long-term care (LTC) facilities, but little attention has been given to the experiences and opinions of dentists relating to the problem. This study was conducted to discover how dentists feel about older patients and about working in LTC facilities. A response to a questionnaire was obtained from 334 (55%) of the 603 dentists in Vancouver who treated adults. The responses were subjected to bivariate and multivariate analyses. Three models were constructed from factors that might interest a dentist in attending a patient in a facility; the factors in each model were ranked in order of importance. Interest was associated significantly with lack of concern for time lost in practice, with training in managing medically compromised patients, and with a positive attitude toward elderly patients. Dentists with fewer years in practice were attracted by the economic potential of the service, while the older and busier dentists were less involved because of the disruption to their practice and leisure. Dentists who made home visits also were more likely to be interested. The model based on professional considerations was superior to either the social or economic model in explaining an interest in the service.

Adult↗
PubMed1992

Discrepancy between need for prosthodontic treatment and complaints in an elderly edentulous population.

Most reports indicate that about two-thirds of the elderly population have poor oral health but that only about one-third complain of a problem. The reason for this discrepancy has never been explained adequately. The objective of this study was to estimate the need for prosthodontic treatment in an edentulous elderly population, and to identify factors associated with complaints, needs for treatment, and the use of dentures. Interviews and examinations were conducted to determine the oral health and dental concerns among 269 residents of longterm care facilities in Vancouver. The need for prosthodontic treatment was considered under theoretical, clinical, and practical conditions, and related to various factors that might help to predict this need. During the interview, about half (54%) of the sample identified a problem, and 83% of the subjects were either using a denture with a major fault or were missing a denture. Seventeen percent of the sample would not benefit from treatment because of a severely resorbed residual ridge, while the presence of a complaint combined with a prosthodontic need indicated that about one-third (36%) would seek and benefit from treatment. The proportion of subjects with complaints was larger among the more educated subjects, and among those who had been recently to a dentist. It was not possible to predict the need for treatment from any of the socioeconomic factors considered. No significant association was observed between the need for treatment and the complaints, and many subjects seemed to be resigned to their discomfort or had unrealistic expectations from their dentures.

Aged↗
PubMed1992

Opinions of dentists on the treatment of elderly patients in long-term care facilities.

The high prevalence of disorders in the mouths of elderly residents in long-term care (LTC) facilities suggests that the dental services available to the residents are inadequate. A questionnaire was sent to most of the dentists practicing in Vancouver (British Columbia) to solicit their opinions on treating older patients in LTC facilities, and a response was obtained from 334 (55%). It indicated that 19 percent of the respondents had treated old people within this context, although few of them felt they had been educated adequately for the service. Many reasons were offered to explain the small participation. Most respondents had never been asked to attend a facility. Many felt that it interfered with their practice and leisure, and they were concerned about the limited options available for treatment. Dentists who had attended facilities were motivated by a sense of professional or public responsibility, but they were uneasy about the limited options and about the inadequate space and equipment available. In general, the dentists were not interested in attending an institutionalized geriatric population, and they felt ill-prepared for the service.

Adult↗
PubMed1992

Early bond strength of luting cements to a precious alloy.

Previous studies have reported that glass-ionomer and adhesive resin cements can bond to various alloys, while zinc phosphate cements lack this adhesive property. This study evaluated the bonding properties of three luting cements during the first seven days after cementation. Thirty cylinders were cast with a high-noble porcelain-fused-to-metal (PFM) alloy and luted in pairs with one of the cements. The joints were stored in water at 37 degrees C for one, two, or seven days before being fractured in shear. The cylinders were re-used to provide 40 joints within each test group. The data were subjected to a Weibull analysis, a curve-fitting method shown to be appropriate for comparing the bond strengths of dental materials. The results showed that the zinc phosphate cement was the weakest material, whereas the adhesive resin produced the strongest joints. Microscopic observations of the fractured samples did not reveal any specific differences between the samples in terms of their mechanism of fracture. The glass-ionomer cement reached its maximum bond strength after two days, whereas storage time had no influence on the zinc phosphate cement. The adhesive resin cement was slightly, but not significantly, weaker after one week in water. We suggest that excessive loading of restorations cemented with glass ionomer should be avoided for the first two days after the placement. The use of an adhesive resin cement can be recommended on endodontically treated teeth, but further studies are needed to evaluate its biocompatibility and adhesion to dentin.

Acrylic Resins↗
PubMed1992

Seniors' assessment of their health and life satisfaction: the case for contextual evaluation.

Health care professionals have been puzzled by the highly positive statements on health and life satisfaction made by seniors, particularly when compared to professionally collected data. In 1987-1988, a stratified, random sample of 520 seniors living independently in the community (70-99 years) were interviewed in their own homes. The above response pattern again held. However, it was apparent that opinions on life satisfaction vary with type of health problem. Content analysis of the spontaneous remarks made by the participants indicates that the overall, current, and anticipated levels of satisfaction expressed were associated significantly with the historical perspective or lifeview of the participants, and with their state of health. Utilizing the theoretical concept "sense of coherence" gives direction to understanding these phenomena.

Aged↗
PubMed1991

Predicting concerns for the mouth among institutionalized elders.

There is a widespread belief that old people do not have healthy mouths, although the reason for this neglect is not clear. A random sample of 41 long-term care facilities in Vancouver was selected--653 residents were examined and about three-quarters of them were interviewed--to find associations between variables that might influence a concern for oral health and to assess the effectiveness of multivariate models for predicting this concern. A bivariate analysis of the data, using chi-square tests, assessed any significant associations between the variables, and three classification techniques--discriminant analysis, logistic regression, and CART (classification and regression trees)--were used to assess the usefulness of the multivariate models. Complaints of oral problems were heard from half (53%) of the sample. Most (85%) of the participants expressed a desire for treatment, while fewer than half (44%) of the participants had used a dental service since entering the facility or in the previous year. The complaints were associated significantly with the subjects who had been to a dentist recently, with those dissatisfied with the cost or quality of previous treatment, and with women. The desire for treatment was associated significantly with the recent use of dental services, and with a lack of concern for the cost of dental treatment, while the use of services was associated significantly with subjects who were younger, dentate, or from the higher socioeconomic groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1991

Issues in the amalgam debate.

This paper reviews the facts available on the biological effects of mercury released from amalgam restorations in teeth. There seems to be no doubt that mercuric vapor is released from restorations, but we do not know how much of this mercury is deposited in human tissues. There is no scientific evidence to support the belief that vapors from dental restorations either cause or exacerbate human diseases. Therefore, there is no clinical justification at present for replacing amalgam with other less durable or less predictable restorative materials.

Animals↗
PubMed1990

Longitudinal study of caries and cariogenic bacteria in an elderly disabled population.

A 2-yr longitudinal study was conducted among elderly disabled residents of a longterm care facility. Each of the 50 subjects examined at the beginning of the study had a mean of 14 teeth, with a mean of 6 carious and 6 restored teeth, per person. Most of the subjects had very poor oral hygiene, and 26 of them had dental plaque that produced cultures of mutans streptococci and lactobacilli in excess of 10(5) CFU/ml. At the end of the first year, 40 subjects were examined again and, apart from a decrease in the mean number of carious root lesions per person, there was very little change in their dental or microbial status. Although only 18 subjects were available at the end of the second year, they presented with fewer carious lesions after 2 yr. The reduction in caries appeared to result from the remineralization of tooth structure, but new lesions did appear in 33% of the 1-yr group, and in 78% of the 2-yr group. This dynamic environment around the teeth produced a mean net incidence of one lesion in the first year, and three lesions over 2 yr. There was a significant (P less than 0.05) association between large (greater than 10(5) CFU/ml) numbers of mutans streptococci and the development of new lesions, but there was no association between the dental status of the subjects and the dental treatment they received. Overall, the results indicate that caries is not rampant in this population.

Aged↗
PubMed1990

Does the dental profession care for disabled elders? Some practical questions.

The information available on elderly people in Canada indicates that they are part of an expanding population with limited financial resources. Despite the many reports of disinterest in oral health among LTC residents, there is convincing evidence that people in general, regardless of age, dental status, or deteriorating general health, want help when they believe that it is available. The current inequity in dental services can be corrected, and it is the responsibility of all health providers-physicians and nurses no less than dentists-to show that oral disease, discomfort, and disfigurement, are not an inevitable consequence of old age.

Aged↗
PubMed1989

Maximum bond strength of dental luting cement to amalgam alloy.

Although dental amalgam is used frequently under artificial crowns for restoration of severely damaged teeth, there is little information available on the bond between luting cements and this alloy. This study was designed for determination of the strength of the bond between a dental amalgam alloy and three crown-luting cements. Cylinders of dental amalgam were joined in pairs, with use of a zinc-phosphate, a glass-ionomer, and an acrylic-adhesive resin cement. The tensile-fracture stress of 45 samples of each cement was measured with a universal testing machine, and subjected to a Weibull analysis. The fractured surfaces were examined under low magnification with use of a light microscope, and at low and high magnifications with use of a scanning electron microscope, for evaluation of the appearance of the fractured joints. The Weibull analysis demonstrated that the adhesive resin cement provided a stronger and more predictable bond than either the zinc-phosphate or the glass-ionomer cement. The appearance of the fractured surfaces gave no indication of the strength of the joints, a feature that is common to brittle materials. The results suggest that crowns placed on teeth offering a large amalgam-alloy surface could be retained more predictably with an adhesive resin cement.

Acrylic Resins↗
PubMed1988

Fixed restorations produced by commercial dental laboratories in Vancouver and Geneva.

A survey of commercial dental laboratories in Geneva and Vancouver has been carried out using both questionnaires and telephone enquiries. It was concerned with the types of fixed prostheses constructed and the impact of recent technical developments. The results of the study revealed that cosmetic factors played a major role in deciding the use of new techniques. Porcelain was used on the occlusal surface of most restorations and metal margins were preferred on PFM crowns. Precious and base alloys were used frequently to cast PFM protheses in Vancouver, whereas semi-precious alloys were favoured in Geneva. Most of the laboratories used precious alloys for all-metal restorations.

British Columbia↗
PubMed1988

Oral disorders and treatment implications in people over 75 years.

The oral health of subjects over 75 yr and living independently in the southwest of Britain was assessed. The majority (80%) of the sample were edentulous, and a large proportion of both edentate and dentate subjects were using dentures. More than half of the denture wearers were using loose, very unhygienic, or structurally defective dentures. Mucosal pathoses were quite common, although most of the lesions were denture-induced stomatitis found in association with unhygienic dentures. The dentate subjects had, on average, 11 natural teeth, frequently with evidence of root caries and deep periodontal pockets or extreme bone loss. The oral health problems suggest that there is a significant need to develop effective methods of improving oral hygiene in this age group. The prosthetic treatment is related principally to denture repairs while there is a need to control root caries among the growing population of elderly dentate people.

Aged↗
PubMed1988

Oral health concerns of an elderly population in England.

A group of 437 subjects from a random sample of 737 persons, over 75 yr of age and living independently in the southwest of England, were interviewed about their oral health concerns and desires for dental treatment. Most of the subjects could have received dental treatment without unusual risk, although a third of the sample said they could not move around or attend a dentist without assistance. A dentist had visited the homes of only 2% of the sample, while 22% expressed a desire for this service. Nearly half of those interviewed complained of a mouth problem and a third were experiencing oral pain, yet the majority had not been to a dentist for at least 10 yr, and had no wish to see a dentist. Many of the subjects, even among those with complaints, said they had not visited a dentist recently because they had nothing wrong, while only a small proportion (3%) of the sample identified fear, expense or transport as a barrier to dental treatment. The results indicate that elderly people do not have many oral health concerns or expectations.

Aged↗