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Biomedical subjects

P Mojon

Publications and source records attributed to P Mojon.

33 records · Page 2Linked to original sources
PubMed1995

Examiner agreement on caries detection and plaque accumulation during dental surveys of elders.

Indices used to evaluate plaque accumulation and coronal caries have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of clinical criteria used in coronal and root caries diagnosis and oral hygiene evaluation as applied in elders. Nineteen elderly subjects, 73 years old on average, were examined at a first appointment by two independent examiners. They were re-examined two weeks later. Plaque accumulation was evaluated using the Plaque Index (PI) and coronal and root caries were detected according to the WHO criteria and Fejerskov et al. (1991), respectively. Recurrent caries was recorded as recommended by WHO and by probing at the interface tooth-restoration. Inter- and intra-examiner agreement was evaluated using kappa statistics. The PI score showed good reliability except for examiner b, for whom a simplification of the 4-point scale in 3-point scale improved significantly the reliability. The prevalence of coronal caries was very low and intra- and inter-examiner agreement was poor. Most of the root caries lesions were covered by plaque and the kappa values indicated only poor agreement. Recurrent caries were found with good agreement using WHO criteria but the detection with the probe was not reliable. In conclusion, it seems that examiners should be trained carefully to maximise their reliability and that plaque should be removed to obtain reliable diagnoses of caries. Retraining and calibration may be necessary for surveys continuing over a long period.

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PubMed1995

Nutrition, general health status and oral health status in hospitalised elders.

Biological malnutrition was assessed and correlated with salivary flow rates and oral health in 99 elderly, hospitalised non-psychiatric patients. The indicators of protein malnutrition used were arm circumference and serum albumin level and the indicators of energy malnutrition the body mass-index and the triceps skin-fold thickness. Unstimulated and stimulated salivary flow rates were measured according to Sreebny et al. Of the patients, 40% showed severely and 46% moderately reduced serum albumin levels and the anthropometric measurements indicated malnutrition in about 50%. Unstimulated hyposialia (< or = 0.1 ml/min) and stimulated hyposialia (< or = 0.5 ml/min) were observed in 17% and 26.5%, respectively. Significant associations (P < or = 0.05) were found between stimulated/unstimulated hyposialia and biological malnutrition. There was a negative relationship between the number of masticatory movements until swallowing a standard biscuit and skin fold thickness (P < or = 0.05). Current weight loss and biological malnutrition were related to poor appetite (P < or = 0.05). The study has confirmed poor general and oral health status as well as protein-energy malnutrition among elderly hospitalised patients. This situation was associated with loss of appetite, reduced salivary flow rates and a certain impairment of masticatory function which could jeopardise the reversibility of malnutrition and lead to increased morbidity and mortality.

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PubMed1995

[The orodental situation of aged patients hospitalized at the Hôpital de Gériatrie of Geneva].

The purpose of the present study was to identify the major oral and dental problems and treatment needs among 216 patients who had been consecutively hospitalized at Hôpital de Gériatrie de Genéve. The patients were interviewed and examined during the week following their hospitalization. There were 150 women (73.6%) and 57 men with a mean age of 84 years. Of these 44.4% were completely edentulous. The patients with remaining teeth had on average 11 teeth, of which 24.1% showed active caries. Active root caries was observed in 54.2% of the patients with natural teeth. Of the remaining teeth 27.4% were crowned and three quarters of these had poorly adapted margins. Removable dentures were observed in 81% of the patients. Of the complete dentures 18.5% were poorly adapted and 30.3% of the removable partial dentures were unstable. Denture stomatitis was observed among 20.5% of the denture wearers. It appears from this study that elderly patients have many oral, dental and prosthetic problems and that their treatment needs are generally important. In order to improve the situation it seems necessary to introduce dental care programs for homebound and institutionalized elderly patients.

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PubMed1994

Estimates of time and propensity for dental treatment among institutionalised elders.

The oral health and concerns of elderly residents were surveyed in a stratified random selection of 41 long-term care facilities in Vancouver. The residents who could participate were examined and interviewed to determine their oral health and concerns about dental treatment. The need and time required for treatment were estimated in six groups to reflect the propensity for treatment in dentate and edentate subjects. The propensity for treatment was high in about one-third of the participants whereas it was unlikely that one-tenth of those examined would ever use a dental service. In general, there was a widespread need for a diagnostic service because so few had been examined by a dentist in the previous year. Prosthodontics accounted for most of the treatment in all of the propensity groups, with substantially more time required by the dentate residents. There was also a substantial need for management of mucosal pathoses and oral hygiene and, to a lesser extent, for dental restorations and endodontics. Overall, our estimates indicate a substantial need for dental treatment among residents of long-term care facilities, although the need is reduced by half if the propensity for treatment is considered.

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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.

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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↗
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

Polymerization shrinkage of index and pattern acrylic resins.

Inadequate dimensional stability caused by polymerization shrinkage has been reported concerning the various applications of acrylic resins. The objective of the study was to evaluate dimensional changes of two self-curing acrylic resins marketed as pattern and index material. Early volumetric changes were measured with a dilatometer and late linear changes were recorded with an inductive transducer. After 24 hours the volumetric shrinkage was 7.9% for Duralay resin and 6.5% for Palavit G resin; 80% of the change appears before 17 minutes at room temperature. Shrinkage was significantly increased when the proportion of powder in the mix was diminished. Results suggest that these resins should be used with some method to compensate for the shrinkage, when used as index material. However, the dimensional change might provide significant advantages for intracoronal castings.

Acrylic Resins↗
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↗
PubMedDate not supplied

Dental care of elderly in nursing homes: perceptions of managers, nurses, and physicians.

Epidemiologic studies have shown that the oral health of residents in nursing homes is poor. This can be due to their impaired ability to maintain appropriate oral hygiene or to a lack of interest in oral care among those responsible for the care. The purpose of this study was to assess the attitudes of managers, caregivers, and physicians with regard to oral health care issues of their residents. A questionnaire sent to the managers of the 65 nursing homes in Geneva was returned by 47 (69%). According to the managers, 85% of the nursing homes organized transportation for the residents to a dental office; dental care with follow-up treatment was organized in 79% of the facilities; 68% of the facilities organized treatment for dental emergencies. Another questionnaire was distributed to 169 caregivers in 13 nursing homes. A majority had received no education in oral hygiene care of the residents. The caregivers did accept responsibility for oral hygiene care, but preferred to share it with a dentist responsible for the oral health care of the residents. Only 33% of the physicians indicated that they carried out a systematic examination of the oral cavity, and 20% agreed that the oral cavity might be an integrated part of the body. The majority of the physicians were in favor of more information on oral diseases and regular visits by a dentist; however, close collaboration with a dentist on oral health issues had a low priority.

Administrative Personnel↗
PubMedDate not supplied

A comparison of two methods for removing zinc oxide-eugenol provisional cement.

Two methods of removing zinc oxide-eugenol (ZOE) luting cement from amalgam were compared by determining their effect on the tensile bond strength of amalgam cylinders luted together using a 4-META resin cement. The samples were examined using scanning electron microscopy and energy dispersive x-ray analysis. Results showed that mechanical cleansing with pumice leaves ZOE residue mixed with pumice, which inhibits bonding, while the bond strength of samples cleansed with a dental degreasing agent was similar to that of an uncontaminated control group.

Acrylic Resins↗
PubMedDate not supplied

Relationship between prosthodontic status, caries, and periodontal disease in a geriatric population.

This study evaluated the influence of prosthodontic status on caries a and periodontal disease in a hospitalized population of elderly people. Among the data gathered was information on caries, gingival condition, oral hygiene, plaque accumulation, and factors related to the prevalence, type and quality of the prostheses present. There was no significant association between the type of rehabilitation and the economic, social, or educational variables, but it appeared that removable partial denture wearers had less concern for oral health. Root caries and periodontal diseases were more frequent when the restoration, either fixed or removable, was defective. Th results of this study indicate the importance of oral hygiene instruction and regular recalls among removable partial denture wearers.

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