Biomedical subjects

G Maupomé

Publications and source records attributed to G Maupomé.

At least 19 recordsLinked to original sources

PubMed2004

Dietary fiber intake and dental health status in urban-marginal, and rural communities in central Mexico.

INTRODUCTION: Oral health status in older people is frequently poor which can contribute to inadequate dietary patterns and nutrition status. OBJECTIVE: To investigate whether an association between the number of teeth present and dietary fiber intake exists in elderly people living independently, across different geographic and socioeconomic locations. METHODS: A cross-sectional household survey was undertaken in three Mexican communities (urban, marginal urban, and rural), incorporating geographic and socio-demographic information and a 24-hour diet recall. Dental status (teeth present, coronal and root caries, and periodontal status) was determined by clinical examination. Data were analyzed using ANOVA, Pearson's chi2 and Tukey's range tests. RESULTS: 407 persons 60 years old and over participated in the study. Subjects in the rural community had better dental/periodontal status and more teeth present than urban and marginal-urban participants. Intake of fiber was 8.4 g/day for the urban, 7.6 g/day for the marginal-urban, and 13.5 g/day for the rural community. While gender had no detectable effect, the location of residence and the number of teeth present were associated with mean fiber intake; having more than 21 teeth and/or living in a rural location were associated with increased mean fiber intake.

Age Distribution↗

PubMed2003

Grand challenges in dental informatics.

When truly significant scientific challenges are overcome, it profoundly changes the daily activities, as well as the future research activities, of everyone involved in the related field. By identifying and describing the grand challenges facing a scientific field, we can help funding agencies identify and prioritize projects for support, stimulate and encourage new investigators to work on these intellectual and technological challenges, and help define the field itself. In this article, we present an informatics-oriented, future-patient-care scenario, then describe a series of applications and the related informatics grand challenges facing the dental field today. New techniques and technologies to help us overcome these challenges would facilitate the development of truly monumental applications, such as a comprehensive electronic oral health record, an automated dental treatment planning system for all diagnoses, or a system to profile patient risk for chronic oral diseases.

Databases, Factual↗

PubMed2001

Effects of diameter, chemical impregnation and hydration on the tensile strength of gingival retraction cords.

Gingival retraction cords are useful clinical aids but little information is available regarding desirable physical features that would preserve their integrity under tensile forces. The study aimed to establish under experimental conditions the extent to which tensile strength is affected by variation in cord diameter; impregnation with ferric sulphate (FS) or aluminium sulphate (AS); and cord hydration (wet/dry). Commercial cords and standard cotton cords were assayed in an Instron 1137 machine. Data were analysed using t-test, and one- and four-way ANOVA. Results indicated that tensile strength for 200 commercial cords was 1.4950 +/- 1.032 kg; and for 560 cotton cords was 1.2964 +/- 1.4560 kg. Cord hydration had no significant effect on tensile strength, whereas impregnation with AS or FS, a smaller diameter, and/or being a cotton cord decreased tensile strength (P < 0.001). Bivariate analyses showed that hydrated commercial cords had higher tensile strength than dry specimens; hydrated or dry cotton cords were not different. The FS-impregnated cotton cords had lower tensile strength than AS-impregnated or control cords, and the effect was greater at higher FS concentrations. This study is one of the first evaluations of the physical properties of cords, highlighting characteristics that may minimize the risk of tearing.

Alum Compounds↗

PubMed2001

Perceptions of the importance and control of professional problems in the clinical setting.

The objective of this study was to identify the relative importance of culturally relevant professional problems and the degree of control over them, as perceived by dentists and dental students in Mexico City, Mexico. The dentists and students ranked 13 problems according to importance and then according to the perceived degree of control over each one. Novice clinicians were less secure about their ability to cope with the legal, financial, and clinical performance problems, whereas experienced clinicians were more concerned about occupational hazards and the dental market and culture. Both reported similar perceptions of their control of the problems. This preliminary information should support introducing into dental schools relevant practice-management courses, targeting continuing education efforts, and instituting professional counseling measures to meet the challenges posed by these problems.

Adult↗

PubMed2001

Patterns of dental caries following the cessation of water fluoridation.

OBJECTIVES: To compare prevalence and incidence of caries between fluoridation-ended and still-fluoridated communities in British Columbia, Canada, from a baseline survey and after three years. METHODS: At the baseline (1993/4 academic year) and follow-up (1996/7) surveys, children were examined at their schools. Data were collected on snacking, oral hygiene, exposure to fluoride technologies, and socio-economic level. These variables were used together with D1D2MFS indices in multiple regression models. RESULTS: The prevalence of caries (assessed in 5,927 children, grades 2, 3, 8, 9) decreased over time in the fluoridation-ended community while remaining unchanged in the fluoridated community. While numbers of filled surfaces did not vary between surveys, sealed surfaces increased at both study sites. Caries incidence (assessed in 2,994 life-long residents, grades 5, 6, 11, 12) expressed in terms of D1D2MFS was not different between the still-fluoridating and fluoridation-ended communities. There were, however, differences in caries experienced when D1D2MFS components and surfaces at risk were investigated in detail. Regression models did not identify specific variables markedly affecting changes in the incidence of dental decay. CONCLUSIONS: Our results suggest a complicated pattern of disease following cessation of fluoridation. Multiple sources of fluoride besides water fluoridation have made it more difficult to detect changes in the epidemiological profile of a population with generally low caries experience, and living in an affluent setting with widely accessible dental services. There are, however, subtle differences in caries and caries treatment experience between children living in fluoridated and fluoridation-ended areas.

Adolescent↗

PubMed2001

Is there a sound basis for deciding how many dentists should be trained to meet the dental needs of the Canadian population? Systematic review of literature (1968-1999).

A systematic review was conducted of the literature on human resources planning (HRP) in dentistry in Canada, critically assessing the scientific strength of 1968-1999 publications. Inclusion and exclusion criteria were applied to 176 peer-reviewed publications and "grey literature" reports. Thirty papers were subsequently assessed for strength of design and relevance of evidence to objectively address HRP. Twelve papers were position statements or experts' reports not amenable for inclusion in the system. Of the remaining 18 papers, 4 were classified as projections from manpower-to-population ratios, 4 as dental practitioner opinion surveys, 8 as estimates of requisite demand to absorb current capacity and 2 as need-based, demand-weighted studies. Within the 30.5 years reviewed, 53.4% of papers were published between 1982 and 1987. Overall, many papers called for a reduction in human resources, a message that dominated HRP during the 1980s, or noted an increase in the demand for services. HRP publications often had questionable strength or analytic frameworks. The paradigm of busyness-scarcity evolved from a belief around an economic model for the profession into a fundamental tenet of HRP. A formal analysis to establish its existence beyond arbitrary dentist:population ratios has usually been lacking.

Canada↗

PubMed2001

Clinical decision-making for dental caries management.

Scientific information on diagnosis, prevention, and management of dental caries and associated indicators of risk continues to increase rapidly. Patients vary in clinically important ways, however, and uncertainty affects our understanding of risk; diagnostic and prognostic information; efficacy and effectiveness of many preventive, diagnostic, and treatment alternatives; and outcomes associated with clinical strategies. Consequently, challenges abound for clinicians to identify, evaluate, and incorporate new information, patient preferences, and uncertainties into clinical practice. Clinical decision-making--an analytical approach that makes explicit use of information to quantify probabilities and outcomes to analyze decisions under conditions of uncertainty--can provide a framework to analyze the impact of uncertainty of clinical information. Diagnostic, effectiveness, and outcome information is quantified and combined in an explicit way to serve as a tool for clinicians, not as a replacement for clinical judgment or experience. Such an approach has the potential to improve clinical practice and help dentists do their jobs better by structuring the decision problem and assessing probabilities and utilities. Clinical decision-making also helps dentists communicate with each other by identifying clinical controversies, thereby characterizing how and why disagreements may arise and what additional data may be needed to address a clinical question.

Decision Making↗

PubMed2000

Survey on attitudes toward HIV-infected individuals and infection control practices among dentists in Mexico City.

BACKGROUND: The teaching of infection control is gradually being introduced at dental schools in Mexico. However, most practicing dentists have limited access to current infection control standards. Deficiencies of knowledge with regard to blood-borne pathogens such as HIV and hepatitis B virus may influence attitudes toward infected individuals and reduce compliance with infection control recommendations. OBJECTIVE: The purpose of this study was to assess (1) attitudes toward HIV-infected patients and hepatitis B virus-infected patients and (2) infection control knowledge and practices among dental practitioners in Mexico City. METHOD: A total of 196 dentists were interviewed by means of a questionnaire with Likert-type scales and open-ended questions (response rate, 86.1%). RESULTS: Most respondents had no previous social or professional contact with HIV-positive individuals. Nine percent indicated that they had knowingly treated HIV-positive patients. Perceived professional and moral obligations to treat HIV-positive patients were high. Thirty-five percent of the respondents perceived the risk of HIV infection as "considerable" to "very strong." The risk of hepatitis B infection was considered significantly higher than the risk of HIV infection (P <.01); however, 78% of the respondents had not been immunized against hepatitis B. Reported use of personal protective equipment was high. Most respondents used dry heat sterilization. The principal disinfectants used were quaternary ammonium compounds, bleach, and glutaraldehyde. Fifty-four percent of the respondents acknowledged that clinical precautions reduced occupational risks. CONCLUSIONS: This survey revealed contradictory attitudes toward HIV-positive individuals and limited understanding of infection control recommendations. Educational and regulatory efforts are needed to promote better adherence to current infection control standards.

Adult↗

PubMed2000

Clinical decision-making in restorative dentistry. Content-analysis of diagnostic thinking processes and concurrent concepts used in an educational environment.

CONTEXT: Dental practice is affected by variation in diagnosis and treatment planning between clinicians. The process underlying the decisions leading to management of dental caries is poorly understood. OBJECTIVE: To explore diagnostic thinking and identify information used in the diagnosis, management and treatment of caries. SUBJECTS/MATERIALS: 15 senior dental students (mean age, 23.1 years; 66% female) in Mexico City were interviewed using a Simulated Patient Model (SPM). METHODS: The SPM consultation session and its review, aimed at eliciting an introspective recall description of the Diagnostic Thinking Processes (DTP) and the pieces of information (concepts) employed, were transcribed and content-analyzed (CA). CA reproducibility coefficients were 0.53 to 0.64. The cognitive psychology Gale & Marsden (GM) model was used to structure DTP and concepts. Data were analyzed with chi-squared tests. RESULTS: DTP utilization was similar to the original report in endocrinology and neurology cases. A wide variety of concepts were combined with DTP to describe the strategies and information preferentially resorted to while addressing four areas identified in the consultation. CONCLUSIONS: Narrow arrays of concepts of restorative concern (mostly physical features present in/on teeth) were often investigated using DTP 1, 2 and 4 in combination with the use of dental explorers. The heuristics detected link features common to the GM model and to an indirect pattern-recognition model, whereby reliance on visual/tactile concepts facilitates the acquisition of a clinically meaningful image. Non-clinical factors believed to be at play in the application of strategies were not investigated but were controlled for in the SPM.

Adult↗

PubMed2000

Structured review of enamel erosion literature (1980-1998): a critical appraisal of experimental, clinical and review publications.

OBJECTIVE: To attain an objective account of the methods to measure enamel erosion used in 1980-1998 publications, a structured review of the literature was undertaken. METHODS: Inclusion and exclusion criteria were applied to 731 clinical/experimental research and review reports. Eighty-five included papers were subsequently rated according to 'hierarchy of evidence' guidelines to assess the strength of the report's design and the relevance of the evidence to replicating enamel erosion in vivo in humans. Scores were assigned to rate each aspect in the guidelines. RESULTS: A total of 16 clinical, 13 review and 56 experimental papers were assessed; 36.4% were published during 1996-1998. Excluding reviews, 16 papers were qualitative and 56 quantitative; 51 used human enamel. Our classification yielded nine groups of methods (five scoring systems and 26 measurement techniques). CTFPHE (Can Med Assoc J 1992; 147: 443) grading of research reports indicated that 2.8% provided evidence grade I; 20.8%, grade IIa; 63.9%, grade III; and 12.5%, grade IV. CONCLUSIONS: There has been a consistent increase in the body of knowledge. The overall quality of publications has not substantially changed over time. Experimental studies were more often quantitative, and quantitative studies had better research designs. No single group of research methods had obviously superior research designs.

Analysis of Variance↗

PubMed2000

Dental caries experience in Mexican schoolchildren from rural and urban communities.

OBJECTIVE: To compare dental caries experience in Mexican rural and urban settings. DESIGN: Cross-sectional samples of schoolchildren. SETTING: A school in Mexico City and a rural school in a remote area of the Oaxaca State in Southern Mexico. SAMPLE AND METHODS: A total of 347, 9- to 10-year-old schoolchildren (rural area, 131 children; urban, 216) was examined by two standardised dentists using the WHO 1987 criteria. OUTCOME MEASURES: Data were analysed in terms of central tendency measures and 95 per cent confidence intervals. RESULTS: Caries prevalence was 91.6 per cent in the urban area, and 54.4 per cent in the rural area (P < 0.05). DMFT in 10-year olds was 1.93 (sd 1.72) and 0.40 (sd 0.76) in urban and rural areas respectively (95 per cent CI 1.16-1.89). The entire DMFT/dmft indices in the rural group were made up of the decayed component. CONCLUSIONS: There is a large difference in the prevalence and distribution of dental caries between rural and urban Mexican children. Dental treatment background also differs markedly. Findings highlight the need to establish distinct preventative and rehabilitative treatment strategies tailored to meet the specific needs of different population groups.

Child↗

PubMed1999

Perceptions of tooth loss and periodontal problems in an independent elderly population: content-analysis of interview discourse.

Oral health/illness and surrounding socio-demographic and behavioral phenomena are poorly documented in the Mexican elderly. To establish the rationales explaining oral health/illness and tailor a Health Promotion intervention (1995-1997) accordingly, an interview nested in a questionnaire was done at baseline, with the recording of 228 interviews transcribed verbatim. Every transcript was subsequently assessed by content-analysis. Results showed that lack of oral hygiene, inadequate calcium intake and old age were the most common explanations of tooth-loss. Only a few factors were felt to be under control: the same state of relative adaptation that characterized people affected by gum problems. The themes that explained them were lack of oral hygiene, and (non-specific) infections. When interviewees evaluated the impact of good oral health on their lives, many made evaluations pertaining to quality of life, adequate function, and an attractive appearance generally.

Journal Article↗

PubMed1999

In vitro quantitative microhardness assessment of enamel with early salivary pellicles after exposure to an eroding cola drink.

To assess the erosive effect of a cola drink on enamel incorporating early salivary pellicles, 72 groups of human enamel slabs were immersed in fresh cola, with groups differing in that slabs were (1) incubated in whole or in clarified saliva, (2) under three regimes of frequency intake (1, 5 and 10 times/day); (3) immersed with or without agitation, and (4) the pellicle was incubated for 20 min, 6 or 24 h. Quantitative assessments were done over an 8-day interval using surface microhardness testing. Results for primary enamel showed a sharp decrease from baseline (344.2+/-32.4 Vickers Units; mean +/-SD) to day 1 (268.9+/-36.8), and reached 155.2+/-68.6 on day 8. Results for permanent enamel were 350.8+/-42.2, 315.9+/-39.2, and 149.8+/-85.2. Microhardness was affected by agitation, level of intake and type of saliva, but not by the pellicle incubation interval nor the type of enamel. The joint effect of static baths and higher immersion frequency was the most important factor in decreasing hardness.

Adult↗

PubMed1999

Caries experience and treatment needs in a 6- to 12-year-old urban population in relation to socio-economic status.

OBJECTIVE: To report caries experience in the permanent dentition among Mexico City elementary school children and undertakes a comparative analysis of dental caries experience and treatment needs of children of different socio-economic status (SES). RESEARCH DESIGN: SES was established according to an official measure of economic well-being, that of the family income being high enough to allow the child to attend school in a private institution as opposed to a public school. PARTICIPANTS: A probabilistic sample of 4,048 6- to 12-year-old children (47.2% females) was examined using the 1987 WHO caries criteria (546 attended private schools and 3,502 were public school children). RESULTS: The proportion of caries-free 12-year-old children was 28.6% and 9.5% in the private and public schools, respectively (P < 0.01). In 12-year-old children, DMFT was 2.78 (SD 2.9) and 4.64 (SD 3.2) in the private and public school groups, respectively (P < 0.001). Higher treatment needs were found among public schoolchildren (TN = 83.0%) compared with private schoolchildren (TN = 27.6%) (P < 0.001). CONCLUSIONS: Dental caries and treatment needs were considerably higher in children of lower SES. Differences in dietary patterns and toothpaste use could be the more likely explanations for these findings, indicating markedly unequal burdens of disease according to socio-economic status. Special efforts should be developed to improve the oral health status in Mexico City children by implementing preventive health promotion and treatment programmes.

Chi-Square Distribution↗

PubMed1998

Prosthodontic profiles relating to economic status, social network, and social support in an elderly population living independently in Canada.

STATEMENT OF PROBLEM: Previous evaluations of life satisfaction and health have not completely explained the impact of social network, social support, and economics on the oral health-related behavior of elderly patients, particularly in relation to missing teeth. PURPOSE: This study measured the strength of associations between social network/support/class and the use of complete and removable partial dentures in elderly patients living independently. MATERIAL AND METHODS: A multiple stepwise logistic regression was used to contrast data from previous studies relating to the subject and to explore the influence of these social variables. RESULTS: The results substantiated the links observed in a previous study between some social features and oral fitness. More frequent use of complete dentures was identified among participants who reported higher incomes and among those who thought their incomes were sufficient for their needs. Unreplaced missing anterior teeth were associated more commonly with subjects less willing or able to leave their homes. CONCLUSIONS: Some salient features of prosthodontic care and oral health status were common to 2, comparable social environments. A minority within the elderly population may not see a need to make use of clinical dental services, regardless of how accessible these services are to them. Social network and social support issues may be important determinants in this perceived need to use clinical services.

Activities of Daily Living↗

PubMed1998

A comparison of senior dental students and normative standards with regard to caries assessment and treatment decisions to restore occlusal surfaces of permanent teeth.

STATEMENT OF PROBLEM: Even though assessments of borderline restorative items in terms of accuracy and interexaminer variation have been reported, no attempt has been made to simultaneously evaluate diagnostic and treatment planning decision using objective normative standards. PURPOSE: This study established the accuracy of caries presence assessment as compared with gold standards, interexaminer agreement in assessment of caries presence and restorative needs, and influences of perceived caries status and restoration quality on treatment planning in borderline restorative situations. MATERIALS AND METHODS: Fifteen senior dental students in Mexico City (66% women; mean age 23.2 years) evaluated predetermined areas in 109 restored and unrestored posterior teeth in an in vitro model. Teeth were subsequently assessed for restoration quality and the presence of enamel and dentinal caries by use of histologic and specific dye techniques. Student's t test, Cohen's kappa, and Pearson's correlation analyses were used to analyze the data. RESULTS: There were significant caries misdiagnoses and substantial overtreatment proposed. In a few instances, teeth were left untreated, but usually they were programmed for restoration. Interexaminer agreement varied markedly and was not high. However, performance while correctly detecting lesions was better than in treatment planning. CONCLUSION: There was a high correlation between a diagnosis of caries and restorative treatment in unrestored teeth; the correlation was lower for restored teeth, although they were allocated to restorative treatment more often. This difference hinged on perceived quality of the restoration, an important factor in the frequency of proposed re-restoration.

Adult↗

PubMed1998

Criteria for restoration replacement and restoration life-span estimates in an educational environment.

The present survey assessed the subjective estimates of restoration longevity, the relative importance of the reasons to replace a restoration and the proportion of restorative treatment perceived to be carried out to replace previous restorations in a clinical setting where caries experience has been reported to be high. Three hundred and eight-four final-year dental students in Mexico City (64% female, mean age 23.2 years) made subjective longevity estimates (minimum acceptable, 'average' and ideal) for small and large amalgam restorations and cast restorations. Students attributed greater responsibility for restoration failure to patient-related factors than to dentist-related factors. The most important reasons given for the replacement of restorations were the presence of an active carious lesion and the presence of a lesion. The next most important reasons were the presence of fractured restorations, proximal overhangs or proximal marginal defects, and marginal defects. No marked differences could be detected in the restoration longevity appraisals compared either with other subjective estimations or to actual longevity figures, nor in the relative ranking of reasons to replace restorations between the estimates done by participants in this study and reports originating in low-caries settings.

Adult↗

PubMed1998

In vitro quantitative assessment of enamel microhardness after exposure to eroding immersion in a cola drink.

Studies assessing the erosive potential of soft drinks have employed long time intervals of immersion that may not accurately depict the impact of frequent soft drink consumption on enamel. This in vitro study assessed the effect of a cola drink on enamel, replicating an actual drinking pattern. Six groups of 4 human enamel slabs were immersed (5 min each bath) in fresh cola drink, with immersions taking place with or without agitation, and under 3 regimes of frequency intake (low intake, 1 immersion/day; medium, 5/day; high, 10/day). Quantitative assessments of surface erosion were done over an 8-day interval using surface microhardness testing (Vickers). Results showed a sharp decrease from baseline (mean value 352.1 Vickers Hardness Number, SD 32.5) to day 1 (269.3, SD 41.0) and then continued decreasing throughout the assay, although less markedly, to reach 204.5, SD 45.4 on day 8. Microhardness decreased regardless of frequency regime, except on day 8, on which slabs from the low intake group were harder (233.2, SD 25.0) than slabs from the high intake group (169.8, SD 49.5; p < 0.05). Results from the ANOVA on the factorial experiment indicated that the role of agitation was statistically significant (d.f. = 1, F = 7.2, p = 0.020) while the level of intake was of borderline significance (d.f. = 2, F = 3.2, p = 0.075). The main effect resulting from the joint roles of agitation and intake indicated that there was an important interaction between the two variables (d.f. = 3, F = 4.5, p = 0.023).

Analysis of Variance↗