RESUMEN
The current Ebola virus epidemic continues to pose a threat to the UK. Junior clinicians are often at the frontline of medical care in hospitals and their awareness of the clinical features and management of the Ebola virus disease (EVD) may significantly influence the timely implementation of infection control measures. In view of this, we carried out a cross-sectional survey of 119 junior doctors across four different hospitals in England in order to assess their level of knowledge of EVD. We demonstrate that there is currently a deficiency of knowledge about critical aspects of EVD in this population.
Asunto(s)
Ebolavirus/aislamiento & purificación , Fiebre Hemorrágica Ebola/epidemiología , Cuerpo Médico de Hospitales/educación , Concienciación , Estudios Transversales , Brotes de Enfermedades , Inglaterra/epidemiología , Fiebre Hemorrágica Ebola/diagnóstico , Humanos , Control de Infecciones/métodos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: A five-year follow up of patients with epilepsy to examine the change in their oral health and seizure condition. BASIC RESEARCH DESIGN: A prospective observational controlled epidemiologic study under natural treatment settings. PARTICIPANTS: The epilepsy group consisted wholly of patients participating in an epidemiologic survey performed five years previously. The gender- and age-matched control (non-epilepsy) group consisted partly of subjects recovered from the previous study, and partly of new subjects. INTERVENTIONS: Data pertaining to the disease were collected and a thorough dental examination was performed. MAIN OUTCOME MEASURES: Indices quantifying oral hygiene, the number and condition of the remaining teeth and periodontium, and the degree of prosthetic treatment were measured. Statistical comparison was performed between the patient and the control group of the present study, and pair wise between the previous and the present survey. RESULTS: The epileptic condition of the patients showed significant improvement upon follow-up, in contrast to a significant deterioration in their oral health as compared to the control group. Concerning oral health, dental indices describing oral hygiene and periodontal condition showed the most pronounced decline. CONCLUSIONS: The improvement in the epileptic condition of patients is attributed to changes in treatment strategies. As the epileptic condition and oral health of patients changed in opposite directions, socioeconomic and educational factors appear to play a more important role in the poor oral health of these patients than disease-specific factors (e.g. oral cavity injuries, increased exertion on the teeth, antiepileptic drug effects). Furthermore, the periodontal condition seems to be main factor responsible for the unfavourable dental status.
Asunto(s)
Epilepsia/complicaciones , Epilepsia/tratamiento farmacológico , Salud Bucal , Enfermedades Periodontales/complicaciones , Convulsiones/complicaciones , Abrasión de los Dientes/complicaciones , Adulto , Análisis de Varianza , Estudios de Casos y Controles , Índice CPO , Prótesis Dental/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Índice de Higiene Oral , Índice Periodontal , Estudios Prospectivos , Estadísticas no Paramétricas , Encuestas y CuestionariosRESUMEN
Epileptic patients seem to have generally poorer dental condition in comparison with the healthy population for many reasons. It is important to endeavor to provide the same dental care to epileptic patients than to others, however certain factors in connection with their disease must be taken into consideration. Among these, the most important is to concern about the type of seizure with special emphasis on the involvement of the masticatory apparatus and the chances of oral soft tissue injuries and aspiration. In addition seizure frequency and patients' mental compliance might also play a decisive role. According to these factors epileptic patients were grouped into four categories with special regard to their dental manageability from the prosthodontic point of view. The planning of their dental prosthesis was carried out according to the Fábián-Fejérdy classification like in case of any other healthy patients.
Asunto(s)
Prótesis Dental , Epilepsia/clasificación , Humanos , Índice de Severidad de la EnfermedadRESUMEN
Sz. S. a 39-years-old patient was referred to our department in 1968. Patient's masticatory dysfunction, orofacial pain syndrome and substantial weight loss was due to a combined genuine and acquired deep vertical overbite aggravated by a marked difference between the size of the lower and upper jaw bones. The premolars and molars had already been extracted. The lower incisors bit onto the palatal gingiva in centric occlusion causing direct mechanical irritation on the palate. Consequently the centric occlusion position of the mandible was only defined by the contact between the lower central incisors and the palatal soft tissue. According to the literature this kind of defect can only be corrected by a combined surgical prosthodontic therapy (increasing the mandibular arch by vertical osteotomy combined with bone grafting followed by complex prosthodontic reconstruction). Because patient refused any kind of surgical treatment a special upper full arch bridge was constructed with an extended occlusal surface on the palatal surfaces of the front crowns to provide full occlusal contact for the mandibular anterior teeth. The OVD was raised by 11 mm. The present paper reports the history of a 31 years long prosthodontic treatment and patient's follow up. It is shown how the correct centric occlusion, the masticatory functions, the phonetics and also the esthetics could have been maintained by a series of gradually changing fixed restorations meeting the demands imposed by the continuing tooth loss.
Asunto(s)
Arco Dental/anomalías , Anomalías Maxilomandibulares/complicaciones , Anomalías Maxilomandibulares/terapia , Maloclusión/complicaciones , Maloclusión/terapia , Procedimientos Quirúrgicos Preprotésicos Orales , Prostodoncia/métodos , Adulto , Arco Dental/cirugía , Implantación Dental , Prótesis Dental , Femenino , Estudios de Seguimiento , Humanos , Anomalías Maxilomandibulares/cirugía , Maloclusión/cirugía , Persona de Mediana EdadRESUMEN
Inspite of the antiepileptic therapy, both of our patients were suffering from grand mal seizures. They belong to class III according to our previously described clinical guideline from prosthetic treatment at epileptic patients. Since during these seizures, loading is great on the remaining teeth and on the denture, we tried to reduce it with all disposable appliances in prosthetic dentistry. In class III we suggest metal baseplate for the treatment of full edentulousness. In some of the cases of Fábián-Fejérdy class 2B, we approve great allowance in the interest of planning solely fixed denture. Otherwise we suggest combined, fixed and removable part with precisional attachment, rigidly, securely fixed together. In our two cases, we followed the mentioned guiding principles.
Asunto(s)
Prótesis Dental , Epilepsia Tónico-Clónica/complicaciones , Arcada Edéntula/rehabilitación , Prótesis Dental/métodos , Humanos , Arcada Edéntula/etiología , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
The data of 3778 examined persons were processed. The effect of distally free end bridges made for replacing terminal endentulousness on the remaining teeth was compared with the condition of the remaining teeth of patients untreated, provided with partial dentures as well as with combined fix + partial denture. It was ascertained that in cases of replacements by distally free end bridges deterioration of the remaining teeth is essentially less.