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Biomedical subjects

M C M Wong

Publications and source records attributed to M C M Wong.

9 recordsLinked to original sources

Oral health-related quality of life of stroke survivors on discharge from hospital after rehabilitation.

The study aimed to investigate oral health-related quality of life (OHR-QoL) of stroke survivors on hospital discharge after rehabilitation. It was a cross-sectional study involving 43 elderly survivors of mild to moderate stroke about to be discharged from hospital after rehabilitation and a comparison group of 43 community-dwelling elderly people. The Medical Outcomes Short Form 36 (SF-36) measure, the General Oral Health Assessment Index (GOHAI) and an oral health transition scale were administered prior to a dental examination. Median SF-36 subscale scores were significantly different between groups (P < 0.05). In physical function, role-physical, role-emotional and mental health domains, stroke survivors had significantly lower scores indicating poorer health. The median GOHAI score for the stroke group was 52 and 54 for the comparison group with no significant difference between groups although more stroke survivors had difficulty speaking compared with the comparison group. About 75% of stroke survivors considered their appearance to be worse, half of them felt that speech was worse and about a third had difficulty chewing hard food compared with the pre-stroke condition (P < 0.05). Most participants were partially dentate with no significant difference in DMFT scores or prosthetic status between groups (P > 0.05). Health-related quality of life in general was significantly poorer after stroke although patients were considered physically well enough to be discharged from hospital. There was some impairment of OHR-QoL. The nature of the stroke, the hospital environment including diet, coping strategies and elderly Chinese peoples' perception of health should be taken into account when interpreting measures of health status in stroke survivors.

Activities of Daily Living↗

Bayesian analysis of clustered interval-censored data.

The recording of multiple interval-censored failure times is common in dental research. Modeling multilevel data has been a difficult task. This paper aims to use the Bayesian approach to analyze a set of multilevel clustered interval-censored data from a clinical study to investigate the effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting active dentin caries in Chinese pre-school children. The time to arrest dentin caries on a surface was measured. A three-level random-effects Weibull regression model was used. Analysis was performed with WinBUGS. Results revealed a strong positive correlation (0.596) among the caries lesions' arrest times on different surfaces from the same child. The software WinBUGS made the above complicated estimation simple. In conclusion, the annual application of silver diamine fluoride on caries lesions, and caries removal before the application, were found to shorten the arrest time.

Bayes Theorem↗

Oral health-related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma.

Although the complications of head and neck radiotherapy in the treatment of nasopharyngeal carcinoma (NPC) have been described, there is limited information on the effect of oral complications on oral health related quality of life. The aim of this study was to describe the psychosocial and functional impact of oral conditions in southern Chinese following radiotherapy for NPC. A cross-sectional study design was used with a sample of 109 subjects including NPC survivors, newly diagnosed NPC cases and a control group. Oral health related quality of life was assessed through the SF-36 and the Oral Health Impact Profile measures and a dry mouth measure. Data on socio-demographic variables and treatment seeking were also collected. The psychosocial and functional impact of oral conditions as revealed by the health status measures was significantly greater in NPC survivors than newly diagnosed NPC cases and controls. The oral specific and condition specific measures appeared to discriminate more effectively between groups than the generic measure. NPC survivors sought significantly more dental treatment than the other groups. The oral complications of radiotherapy for NPC, notably sequelae of salivary gland damage, have a significant negative effect on oral health related quality of life and result in an increased burden of dental care in the long-term.

Adult↗

Impact of Sjögren's syndrome on oral health-related quality of life in southern Chinese.

The effect of oral symptoms of Sjögren's syndrome (SS) on health-related quality of life is presently uncertain. This study aimed to investigate oral health-related quality of life (OHRQOL) among southern Chinese people with SS. Twenty-six primary SS cases, 25 secondary cases and 29 matched controls took part in this cross-sectional study. Each participant completed a SF-36 questionnaire, the Oral Health Impact Profile and a dry mouth measure, assisted by a trained interviewer. Data on socio-demographic variables were also collected. The dry mouth measure revealed that people with primary and secondary SS had significant problems associated with subjective symptoms of dry mouth generally, and dry mouth when eating and speaking (P < 0.01). Sticky saliva and coughing were also problems in some primary SS cases. OHIP summary and sub-scale scores did not reveal differences in negative impacts between groups. Mean SF-36 sub-scale scores were significantly different between groups (P < 0.05). In physical function, role-physical and general health domains, primary and secondary SS sufferers had lower scores indicating poorer health. Oral symptoms of SS, notably xerostomia, had a negative effect on OHRQOL. Health-related quality of life in general was also impaired in SS sufferers. The OHIP did not appear to discriminate oral problems of concern to SS sufferers.

Adult↗

Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem.

OBJECTIVE: To measure the oral health status of southern Chinese nasopharyngeal carcinoma (NPC) survivors 1-4 years after radiotherapy. SUBJECTS AND METHODS: A total of 109 subjects participated in this cross-sectional study. Thirty-eight subjects were NPC survivors, 40 subjects were patients newly diagnosed with NPC and 31 were healthy subjects. Verified clinical examination techniques were used to assess limitation of jaw opening, the presence of mucositis, candidiasis, dental caries, periodontal disease [community periodontal index (CPI)] including attachment loss (ALoss) and prosthetic status/need. Differences among three groups were tested by chi-squared and Kruskal-Wallis tests. Relationships between selected clinical variables and radiation parameters were analysed using Spearman's rank correlation coefficients. RESULTS: The NPC survivors attended for dental treatment more frequently than the other groups (P < 0.01). NPC survivors had significant xerostomia (92%, P < 0.01), trismus (29%, P < 0.01), a higher prevalence of clinical candidiasis (24%, P < 0.01), a greater DMFT (16.4 +/- 7.0, P < 0.01), more decay/filled roots (2.1 +/- 2.9, P = 0.01) compared with new NPC patients and controls. No difference was found in CPI, ALoss, prosthetic status and need between groups. Dry mouth and tooth hypersensitivity were the most common oral problems perceived by the NPC survivors. CONCLUSION: Despite having regular dental follow-ups, oral health was compromised in NPC survivors 1-4 years postradiotherapy.

Candidiasis, Oral↗

The impact of oral disease among the institutionalized and non-institutionalized elderly in Hong Kong.

The study aimed to describe and compare the psychosocial and functional impact of oral disease on the quality of life of the institutionalized and non-institutionalized elderly in Hong Kong. A total of 268 institutionalized and 318 non-institutionalized elderly aged 60-80 years took part. The 49-statement Oral Health Impact Profile (OHIP) was administered in a structured interview format and sociodemographic information collected prior to a clinical, oral examination. A greater number of the institutionalized were edentulous (19%); they also had more untreated dental disease. The number of elderly reporting negative impacts was generally low. The percentage of institutionalized elderly reporting a negative impact was significantly lower in one of the OHIP subscales (handicap, P < 0.001) and similar in the other six. The main factors affecting the OHIP score were living location, socio-economic status, dental disease and treatment seeking behaviour. In conclusion, the psychosocial and functional impact of oral conditions was low and similar in the institutionalized and non-institutionalized elderly although the pattern of oral disease was different. Life events and socially and culturally derived values appeared to affect the elderly perception of the impact of oral disease.

Aged↗

Reconstruction of maxillectomy defect by transport distraction osteogenesis.

The study aimed to explore the feasibility of posterior maxillectomy reconstruction by transport distraction in a primate model. In each of 14 male adult rhesus monkeys, posterior partial maxillectomy was performed on one side of maxilla to create a posterior maxillary deflect. Immediately after the maxillectomy, a dentoalveolar segment anterior to the defect was osteotomized as transport segment and a custom-made transport distractor was fixed on the residual maxilla. After a latency period of 5 days, the distractor was activated 1 mm daily to move the transport segment backward to the defect. This process lasted about 2 weeks. The transport segment was allowed to consolidate and the animals were sacrificed at different defined intervals. Transport distraction was successful in six animals. Three other cases were completed with minor wound dehiscence and one had a small oro-antral fistula with subsequent maxillary sinusitis. New bone bridging the distraction gap was confirmed by radiography and histology in the animals completing distraction. Reconstruction of posterior maxillectomy defect is proven feasible by transport distraction osteogenesis.

Alveolar Process↗

Oral perception and oral motor ability in edentulous patients with stroke and Parkinson's disease.

Oral perception and oral motor ability were assessed in edentulous patients with stroke, Parkinson's disease, and an age and gender matched control group. Standard stereognosis and oral motor ability tests were performed, with and without complete dentures in situ. Statistical comparisons were made using ANOVA, Levene's test and paired t-tests. Stroke patients had significantly poorer stereognostic measures than Parkinson's disease patients and controls (P < 0.02). Stereognostic measures were better in all groups when dentures were worn. There were no differences in oral motor ability between groups. Oral stereognosis was significantly impaired in stroke patients. Oral stereognostic ability was better in all groups when dentures were worn. The oral motor ability test lacked the sensitivity to detect differences in motor ability between experimental groups. Edentulous patients with stroke should be encouraged to wear dentures during the rehabilitation phase as oral stereognosis is then less impaired.

Aged↗

Refinement of facial reconstructive surgery by stereo-model planning.

The development of rapid prototyping has evolved from crude milled models to laser polymerized stereolithographic models of excellent accuracy. The technology was advanced further with the recent introduction of fused deposition modelling and a three-dimensional ink-jet printing technique in stereo-model fabrication. The concept of using a three-dimensional model in planning the operation has amazed maxillofacial surgeons since its first application in grafting a skull defect in 1995. It was followed by many bright ideas for applications in the field of facial reconstructive surgery. Stereo-models may assist in diagnosis of facial fractures, joint ankylosis and even impacted teeth. The surgery can be simulated prior the operation of complex craniofacial syndromes, facial asymmetry and distraction osteogenesis. The stereo-model can be used for preparation of reconstructive plate or joint prostheses. It is of enormous value for educational teaching and as a patient information tool when obtaining the consent for surgery.

Ankylosis↗