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Biomedical subjects

L Martens

Publications and source records attributed to L Martens.

At least 19 recordsLinked to original sources

Oral hygiene in 12-year-old disabled children in Flanders, Belgium, related to manual dexterity.

As part of a larger epidemiological survey of a stratified sample of 12-year-old handicapped children in Flanders, Belgium, the present study describes gingival health, gingival hypertrophy, oral cleanliness and the presence of calculus. Statistical analysis was performed with motor skills, brushing help, the use of chemical agents, the use of anti-epileptic drugs, the knowledge of parents and educators (or caregivers) and their opinion of the oral hygiene of their children/ pupils as response variables. From this study, it became clear that mildly mentally retarded and learning-impaired children had significantly better manual dexterity skills than moderately and severely mentally retarded and physically impaired children. However, this was not reflected in improved oral hygiene. The use of chemical plaque controlling agents was found to be extremely low and, with the exception of children with gingival hyperplasia, the users of these agents did not have better oral hygiene. No difference was found between subtypes in the opinion of parents and educators on oral status. There was, however, a difference between their assessment and the clinical picture. It was concluded that there was a need for in-service training programmes in oral health care for educators as well as for parents.

Analysis of Variance↗

Reliability of laser Doppler flowmetry in a 2-probe assessment of pulpal blood flow.

OBJECTIVE: The reliability of using 2 probes with laser Doppler signals when adjacent teeth are being measured simultaneously to determine pulpal blood flow is unknown. The purpose of this study was to determine whether 2 probes are more reliable than 1 in a single-tool assessment. STUDY DESIGN: Tooth pulp vitality was studied in 19 adults through use of laser Doppler flowmetry tests. In each subject, testing was carried out on 2 successive occasions with 2 probes positioned on the maxillary central incisors. RESULTS: Significant mean differences of 31% for blood flux and 96% for concentration were found between the 2 probes, although they shared equal coefficients of variation. The reproducibility for each probe was found to be consistent, and the probes were highly correlated with each other. Flux and concentration, however, were not systematically correlated. CONCLUSIONS: Simultaneous measurements with 2 probes were clearly more reliable. The necessity for a calibration control was evident.

Adult↗

Major costs associated with pressure sores.

Cost drivers in the treatment of full-thickness pressure sores were identified from the literature, Medicare data tapes and interviews with health-care providers. The following were identified as cost drivers in pressure sore treatment: nursing time related to wound care; nursing time devoted to patient position changes; dressing products; patient support devices; antibiotics; room charges for nursing home care; doctor visits for nursing home and home care patients; surgical debridement for nursing home and home care patients; hospital admissions for medical treatment for pressure sores; admissions for surgical treatment for pressure sores; and additional costs for hospital stays when patients who are admitted for other diagnoses develop sores. These cost drivers may be useful to health-care providers in developing cost-effective strategies for treating and preventing pressure sores.

Bandages↗

Linking postdoctoral general dentistry programs with managed care programs and settings.

This report presents the results of a small workgroup convened by the American Association of Dental Schools to examine experiences related to postdoctoral general dentistry programs linked with managed care systems and clinical settings. The workgroup was a component of an Association effort to identify and promote innovative and nontraditional methods by which the number of postdoctoral general dentistry (PGD) positions can be increased to meet current demand for PGD education. The participants identified factors and conditions that they believed to be critical to the planning, development, and conduct of PGD programs with substantial linkages with managed care systems and settings. The information should be helpful to others as they consider opportunities to establish PGD programs or increase their number of PGD training positions.

Academic Medical Centers↗

Oral health condition of 12-year-old handicapped children in Flanders (Belgium).

The dental condition of 626 12-year-old handicapped children with mild mental or moderate to severe mental retardation or learning impairment, being 25% of the population of each of these groups, was examined in Flanders. An evaluation of oral cleanliness showed poor oral hygiene in 31.8% of the children. No significant differences were found in oral cleanliness among types of handicapping conditions. The mean DMFT score was 2.9 (s: 2.6) and DMFS score was 5.4 (s: 5.6). Almost 21% of the children were free of caries or fillings. No significant differences were found among groups of handicapped children. Handicapped children presented a low level of restorative care (restorative index score: 48.7%). Mildly mentally retarded children demonstrated the lowest restorative index (43.9%). The caries experience of first permanent molars represented the largest part of the DMFT score (64.1%). Sealants were present in 7.9% of children examined. A considerable percentage of mildly mentally retarded children and learning impaired children did not brush daily (22.1% and 20.9%) and did not receive help with toothbrushing from their parents or carers (91.0% and 94.7%, respectively).

Belgium↗

[The use of chlorhexidine as a preventive and therapeutic means of plaque control in the handicapped. Review of the literature and definitive advise for application].

With respect to oral hygiene, most of the handicapped are very dependent. Moreover, it is shown that the higher the dexterity level, the poorer the oral hygiene. It's well documented that the use of Chlorhexidine (CHX) is an essential tool in oral care for the handicapped. The efficacy however, only becomes optimal after thorough plaque and calculus removal. From the literature, it becomes clear that the application of a 1% gel in prefabricated trays is the most efficient. Regarding mouthrinses, it's important to use big volumes in order to reach optimal contact with tooth surfaces. The use of a spray seems very handy but is quiet inefficient; no homogeneous diffusion of CHX can be obtained. The choice of any device for CHX application depends on the handicapping condition and on the knowledge and motivation of educators, and medical care takers. The present article summarizes the dental literature on the use of CHX in handicapped. An advice for well indicated use of CHX is proposed.

Aerosols↗

[Dental care in autism].

The syndrome of autism is not characterized by typical orofacial features. Regarding caries experience, no differences with the normal population are found. The dental health situation on the other hand, depends upon the care devoted to oral hygiene and when necessary, upon the auxiliary help of parents and educators. As far as dental care is concerned, the autistic patient is inherently unresponsive to demonstrations, resists eye-to-eye contact and will frequently resist any effort to establish personal contacts with the dental personnel. Patient management will therefore be qualitatively different from person to person and shall be based on a unique management of the behavioral characteristics. Where the classical 'tell, show, do"-method fails, the 'tell, show, FEEL, do"-method will lead to a successful approach.

Anesthesia, Dental↗

[Evaluation of long-term release of fluoride by type II glass ionomer cements with a conventional hardening reaction].

As a part of a fundamental investigation on the fluoride release of glass ionomer cements (GIC), this study investigates the operator dependency of the fluoride release. In this respect the GIC fluoride release of a classical powder-liquid based system (Fuji II) and a capsule-based system (Fuji Cap II) in water during 14 days was determined on the hand of 5 specimens per formulation, made by 5 different operators. The data reveal that the variance on the fluoride release as well as the mean fluoride release at a given time are independent of the operator for both Fuji II and Fuji Cap II. In order to derive fundamental factors affecting the GIC fluoride release, the long-term fluoride release of 10 conventional setting type II GIC is investigated. In this respect the fluoride release profiles (FRP) of each of 5 cylindrical specimens (d = 6 mm, h = 3 mm) of Fuji II (FP), Fuji Cap II (FC), Miracle Mix (MM), Chemfil II (CP), Chemfil II in caps. (CC), Chelon-Fil (CF), Ketac-Fil (KF), Shofu II (SH), Chelon-Silver (CS) and Ketac-Silver (KS) were determined. The specimens were made according to the manufacturer's instruction and equilibrated at 37 degrees C in 25 mL distilled water up to 140 days. The water was regularly renewed and the fluoride concentration [F] of the equilibrated solution determined. A Multivariate Data Analysis of the ¿[F]],t¿-profiles on the basis of Principal Component Analysis (PCA) reveals that the FRP can be classified into 4 distinct groups: ¿CS,KS,FP¿ - ¿FC,CC¿ - ¿CF,KF¿ and ¿MM¿, leaving SH and CP apart as unclassifiable. When the cumulative amount of fluoride released ([F]c) for each individual sample is calculated and fitted as a function of time, a regression analysis shows that [F]c is most adequately fitted (r > 0.99) by [F]c = [F]I/t + t1/2 + beta. Square root of t, indicating that 2 kinetic processes are responsible for the FRP. A comparison of the parameters of this equation ([F]I, t1/2 and beta) shows that the physicochemical rationale for this classification of the GIC conforms to differences in the kinetics of these processes. From the classification, it becomes apparent that different formulations can result in the same FRP.

Dental Caries↗

[Evaluation of the long-term release of fluorides from type II glass ionomer cements with conventional setting reactions].

As a part of a fundamental investigation on the fluoride release of glass ionomer cements (GIC), this study investigates the operator dependency of the fluoride release. In this respect the GIC fluoride release of a classical powder-liquid based system (Fuji II) and a capsule-based system (Fuji Cap II) in water during 14 days was determined on the hand of 5 specimens per formulation, made by 5 different operators. The data reveal that the variance on the fluoride release as well as the mean fluoride release at a given time are independent of the operator for both Fuji II and Fuji Cap II. In order to derive fundamental factors affecting the GIC fluoride release, the long-term fluoride release of 10 conventional setting type II GIC is investigated. In this respect the fluoride release profiles (FRP) of each of 5 cylindrical specimens (d = 6 mm, h = 3 mm) of Fuji II (FP), Fuji Cap II (FC), Miracle Mix (MM), Chemfil II (CP), Chemfil II in caps. (CC), Chelon-Fil (CF), Ketac-Fil (KF), Shofu II (SH), Chelon-Silver (CS) and Ketac-Silver (KS) were determined. The specimens were made according to the manufacturer's instruction and equilibrated at 37 degrees C in 25 mL distilled water up to 140 days. The water was regularly renewed and the fluoride concentration [F] of the equilibrated solution determined. A Multivariate Data Analysis of the [[F], t]-profiles on the basis of Principal Component Analysis (PCA) reveals that the FRP can be classified into 4 distinct groups: [CS,KS,FP]-[FC,CC]-[CF,KF] and [MM], leaving SH and CP apart as unclassifiable. When the cumulative amount of fluoride released ([F]c) for each individual sample is calculated and fitted as a function of time, a regression analysis shows that [F]c is most adequately fitted (r > 0.99) by [F]c = [F]I/t+t1/2 + beta, square root of t, indicating that 2 kinetic processes are responsible for the FRP. A comparison of the parameters of this equation ([F]I, t1/2 and beta) shows that the physicochemical rationale for this classification of the GIC conforms to differences in the kinetics of these processes. From the classification, it becomes apparent that different formulations can result in the same FRP.

Capsules↗

Magnetic field induced currents in a human head from use of portable appliances.

The induced currents in a model of the human head resulting from use of small hand-held appliances were computed. The source of the induced currents, i.e. the alternating (60 Hz) magnetic field was modelled as a magnetic dipole. The limits of applicability of this model are given. The model of the human head was obtained by translating MRI data into tissue conductivity data. Computations of the distribution of the induced currents were performed using the impedance method. The induced current density rapidly decreases with the distance from the appliance. The maximum, however, predictably is not at the surface, because of the geometry of the head. For typical appliances, the values of the maximum current densities are high as compared to those induced by a uniform magnetic field. Generalized graphs were obtained for the maximum induced current density normalized to the appliance magnetic moment, as a function of the distance from the appliance. These graphs are given for two representative locations of the appliance with respect to the head.

Electromagnetic Fields↗

[Oral hygiene of handicapped subjects in Flanders].

As part of an epidemiology survey within the population of handicapped 12-year old in Flanders this article describes several parameters related to oral health. On the average, it became obvious that oral hygiene had to be seriously increased. The presence of plaque and calculus is very typical for types 1, 2, 4 and 8. In addition, it is most striking to conclude that groups where a maximum of self-handiness is expected, do not score any better. The application of chemical controlling agents and the use of fluoride supplements is found extremely low. Finally, a lack was found, with respect to adequate oral hygiene instructions. There is a real need for in-service training programs for educators as well as for parents.

Belgium↗

[Status of the teeth and degree of care in handicapped in Flanders].

In general, handicapped 12-year old do not show statistical relevant differences with non-handicapped age-matched children in Flanders regarding general caries prevalence, caries distribution and total caries experience. However, important differences were found for the restorative index showing a higher caries treatment need in handicapped children. When the results were analysed according to the type of handicapping condition, it was seen that children with borderline and mild mental handicap and children with speech-, language and/or learning difficulties show the most unfavorable picture. They have a high caries prevalence and caries experience and a low restorative index. Additional analysis of the results can throw some light on the presence of additional caries risk indicators and contributing caries risk factors.

Belgium↗

Comparison in shear bond strength of orthodontic brackets between five bonding systems related to different etching times: an in vitro study.

New adhesives are continuously being marketed. The adhesive-bracket bond is still the weakest point in orthodontic bonding. A new device for the measurement of shear bond strength values (SBS) of orthodontic brackets is presented in this article. With this device, five commercial products were evaluated for their SBS: Lee Bond (LB), Concise (C), Super C (SC), Achieve-no-mix (ANM), and Panavia Ex (PE). After applying Begg brackets of laminated minimesh on lower human incisors, the specimens were thermocycled. The products investigated produced high bond strengths. The products tested showed shear bond strengths that were significantly lower than those stained with PE. The application of PE yielded the highest shear values. Nevertheless, some characteristics of this product might be clinically somewhat inconvenient. There was no significant difference in shear bond strength between 15 and 60 seconds enamel etching before bond application.

Acid Etching, Dental↗

[Determination of tooth length in endodontics].

Determination of the exact tooth length and subsequent working length remains a corner stone of proper endodontic treatment. Up to now, no system has proven to provide the exact location of the apical constriction under all circumstances. Several possibilities of determining tooth length are discussed. Factors influencing the outcome of the different techniques are described. A simple and rather accurate way for calculating tooth length on X-rays is elaborated. Apparently, electronic devices are becoming increasingly accurate, and may become a challenge for the radiographic tooth length determination. Actually, dentists have most of all to rely on X-rays for tooth length determination.

Humans↗

The preventive Class II restoration: clinical application.

A renewed interest in conservative cavity preparations has emerged in recent years. In this paper, a substance-saving cavity preparation for the treatment of small, interproximal carious lesions, the preventive Class II preparation, is presented. The indications, the cavity preparation, and the obturation are discussed. The combined use of both amalgam and a light-curing pit and fissure sealant is suggested. Clinically, this type of restoration seems to be acceptable. Nevertheless, more clinical experience and in vitro research regarding this type of restoration is needed.

Dental Amalgam↗

Effects of a multidisciplinary management program on neurologically impaired patients with dysphagia.

Dysphagia is a major problem in patients with neurologic disorders. Aspiration pneumonia and impaired nutritional status are consequences of dysphagia that result in high morbidity and mortality rates. Assessment and treatment of the dysphagic patient by a multidisciplinary team have been advocated but to date the effects of such an approach have not been demonstrated quantitatively. This prospective study was conducted to determine if a dysphagia program would improve patients' caloric intake and body weight, decrease the instances of aspiration pneumonia, or improve patients' feeding ability. Patients were referred from a 26 bed neurology/neurosurgery unit. A time series design was utilized. The control group consisted of 15 patients (mean age = 46.1 years), managed according to the existing ward routine. Subsequently, nursing staff attended a dysphagia training program. Following this, the treated group of 16 patients, (mean age = 49.3 years) was assessed by the dysphagia team, using bedside and videofluoroscopic examinations to determine the specific swallowing disorder. An individualized treatment program was designed for each patient. The groups were compared on the basis of deviation from their baseline weight, deviation from ideal energy intake, and the incidence of aspiration pneumonia. Statistical analysis revealed that the groups were comparable in age, number of days on the study, and Glasgow Coma Scale score; and that a significant weight gain and increase in caloric intake occurred in the treated group. No incidence of aspiration pneumonia was reported in either group. We speculate that this may have been influenced by the meticulousness of the care delivered in an acute unit as well as greater attention to prevention given in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A decision tree for the treatment of caries in posterior teeth.

Because of a better understanding of the caries process, a decrease in the prevalence of caries, and the rapid development of dental materials, a renewed approach to the treatment of dental caries in the posterior region is possible. A decision tree for the treatment of caries in posterior teeth, taking into account some of the most recent tooth substance-saving treatment options, is presented. These possibilities gradually evolve from nondestructive to conventional cavity preparations. In addition, the "preventive Class II restoration" is introduced. The application of this conservative attitude toward invasive techniques offers great advantages for both the patient and the dentist. Unfortunately, this approach is time-consuming. Long-term clinical evaluation of the application of the proposed decision tree on a wide scale is needed to confirm its potential benefits or to modify and improve treatment options.

Bicuspid↗