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Biomedical subjects

R J Gruythuysen

Publications and source records attributed to R J Gruythuysen.

At least 19 recordsLinked to original sources
PubMed2002

Dental treatment of children using propofol and a laryngeal mask.

AIM: Sedation regimens for toddlers and preschoolers are still open for further studies. Propofol is rapidly finding its way into medical routine. The aim of this pilot study was to re-evaluate the need for sedation in young children and to further investigate the use of propofol as an intravenous agent combined with the use of a flexible laryngeal mask for treatment of the youngest group of dental patients. METHODS: A randomised clinical trial with 54 children involved was conducted comparing one group receiving propofol sedation only with a study group receiving propofol with the use of a reinforced laryngeal mask. Assessments were made as to depth of sedation, quantity of propofol used, desaturations and recovery times. RESULTS: The use of a laryngeal mask improved the treatment conditions by decreasing the number of desaturations during treatment (p</=0.001, t=5.74). When using a laryngeal mask, the average amount (in ml) of propofol used was significantly higher (p</=0.016, t=-2.22) and the average waking up time in minutes significantly longer (p</=0.016, t=-2.23). CONCLUSION: It was also found that deepening the sedation to be able to insert the laryngeal mask effectively reached such a level that it should be renamed as anaesthesia, thereby possibly limiting its use to hospital settings. The study supported, however, the safety aspects of the laryngeal mask.

Journal Article↗
PubMed2000

Pulp capping with adhesive resin-based composite vs. calcium hydroxide: a review.

The results of some short-term experiments suggest that direct capping of a vital pulp with the modern resin-based composite systems may be as effective as capping with calcium hydroxide. Total cavity etching with 10% phosphoric acid seems to be safe for the exposed pulp, but unless annulled by calcium hydroxide 35% phosphoric acid may be disastrous. For hemostasis and cleaning of the pulp wound both sodium hypochlorite and saline seem suitable, whereas the effectiveness of a 2% chlorhexidine solution is questionable. Although hard-setting calcium hydroxide cements may induce the formation of dentin bridges, they appear not to provide an effective long-term seal against bacterial factors. Within a few years, the majority of mechanically exposed and capped pulps show infection and necrosis due to microleakage of such capping materials and tunnel defects in the dentin bridges. It is unknown whether newer types of resin containing calcium-hydroxide-products will act as a permanent barrier. The cytotoxicity of the resin-based composites and the temperature rise during polymerisation may not be of concern, but microleakage, sensitisation and allergic reactions may pose problems. Based on available data, pulp capping with resin-based composites may be said to be promising, but more and long-term research is mandatory before the method can be recommended.

Acid Etching, Dental↗
PubMed1998

The analysis of restoration survival data in split-mouth designs.

OBJECTIVE: To report methodological difficulties with restoration survival data in controlled clinical trials on Class II amalgam restorations using a split-mouth design. The advantages and disadvantages of different ways of handling these data are described. METHODS: Three statistical methods (Kaplan-Meier estimation, logistic regression with random component and Friedman's statistic) are compared using data from a controlled clinical trial in which cavosurface angle (regular or non-standard) and cavity wall finish (applied or not applied) determine four treatment modalities of New True Dentalloy restorations. RESULTS: In this study logistic regression with a random component yields the best interpretable results. Cavity wall finish in combination with a regular cavosurface angle is indicated as the worst and cavity wall finish in combination with a non-standard cavosurface angle as the best treatment when the criterion is replacement or not within 15 years. CONCLUSIONS: The dependency between restorations within a patient needs to be taken into account. Logistic regression with a random component may be a valuable alternative to very advanced statistical survival modelling when restricting the research question to replacement within a certain time interval is not a major problem.

Dental Alloys↗
PubMed1998

Replacement risk of amalgam treatment modalities: 15-year results.

OBJECTIVES: This paper reports on the replacement risk of different treatment modalities for Class II amalgam restorations in a clinical trial of 15 years duration. METHODS: The performance of 1117 conventional Class II amalgam restorations in a controlled, longitudinal study were analysed using logistic regression with a random component. Primary variables regarding replacement risk were the treatment modality (cavity wall treatments) and alloy (conventional versus high copper). Secondly, the operator, type of tooth and type of restoration (MO/DO vs MOD) were considered. RESULTS: Over 15 years, 17% of the restorations were replaced (true failures). The application of copalite varnish or silver suspension and the type of alloy did not reduce the replacement risk. Reduced risks were observed by providing a 90-degree cavosurface angle combined with a cavity wall finish. The operator and the type of restoration determine replacement risk to a significant extent. CONCLUSIONS: Additional treatment modalities do not necessarily reduce replacement risks of Class II amalgam restorations within 15 years, while clinical variables affect the risk of replacement to a certain degree.

Adult↗
PubMed1996

15-year evaluation of Class II amalgam restorations.

In a clinical trial, 1544 Class II amalgam restorations were inserted. In this study 1213 restorations were evaluated after 15 years and the reasons for replacement were registered. Attention was also paid to patient drop-out and patients' variables such as gender, filling degree, type of tooth (premolar vs molar), type of restoration (MO or DO vs MOD), jaw (upper vs lower) and the patients' operator. Furthermore, replacement rates of three alloys applied in comparable circumstances (n = 394) are reported. Of the restorations, 214 (17.6%) were replaced during the trial period. Factors influencing the replacement rates are gender, type of restoration and operator. Factors such as type of tooth and type of alloy seemed to have no influence on the replacement rates in this study.

Adolescent↗
PubMed1995

Dentist's ratings of child dental-patients' anxiety.

This study investigates the extent to which dentists giving treatment are able to evaluate the (changes in) child patients' levels of fear, based on a comparison between direct behavior observations of a group of highly anxious children during sequential dental visits and video observations of the same group made by two independent evaluators using the measuring instrument described by Venham et al. (9). A significant difference was found between the fear scores given by the two dentists giving treatment and also between their fear scores and those by the independent observers. Both the fear and behavior scores of the two dentists giving treatment, however, clearly correlated with the fear scores of the observers. It is concluded that in this study the two dentists giving treatment were unable to award an unbiased fear score for each treatment given to a child but it was not possible to show that the bias was caused by experiences from previous sessions with the same child. After video training dentists giving treatment are capable of giving a picture of changes in children's fear levels during sequential dental visits.

Attitude of Health Personnel↗
PubMed1994

Dental hygienists--independent practice and pain control services.

In 1990, 78 dental hygienists who were members of the Dutch Dental Hygiene Association and working in an independent practice received a questionnaire (response rate: 79%) about the administration of local anesthesia. The main aim of this study was to determine the need for this service prior to deep scaling. The results of the survey showed that the need to administer local anesthesia for this purpose is limited in spite of the large number of patients with periodontal problems treated in independent dental hygiene practices. In most circumstances the cooperation with the dentist is satisfactory. However, 83% of the respondents indicate a limitation in the pain control services.

Anesthesia, Dental↗
PubMed1994

Influence of oral hygiene on early enamel caries.

For 548 children aged 4-16 years, mean (+/- SD) age 10.3 +/- 2.7 at visit 1, the dental status was recorded at four consecutive 6-monthly visits. Simultaneously oral hygiene was scored according to a modified patient hygiene performance (PHP) index after application of disclosing solution and before the dental examination. The following cariogenic changes could be observed: initiation (white spot formation), progression (cavitation), stabilisation and regression (disappearance of a white spot). The PHP score was examined in relation to these changes in smooth surfaces, as well as in fissures. For fissures when oral hygiene worsened, stabilisation of a white spot increased significantly. Also, regression of a white spot into sound enamel increased with poor oral hygiene, but the significance was only marginal. White spots turning into cavities, however, did not change with poor oral hygiene. It was speculated that under low oral hygiene conditions the remaining plaque of children receiving intensive fluoride treatment can bind fluoride to the fissure surfaces, thereby promoting enamel maturation concomitant with stabilisation and regression of white spots, which in an earlier study were also found to be dependent on posteruptive age.

Adolescent↗
PubMed1992

Cariogenic changes in dental enamel of boys and girls in relation to salivary properties. II. Radiological examination.

In earlier clinical studies of a group of children subjected to an intense fluoride treatment programme several salivary properties were related to cariogenic changes in the enamel surface, as assessed by mirror and probe. In this study the relationship between salivary parameters and cariogenic changes was investigated on bitewings taken from the same teeth. Inverse correlations were found between the acid producing capacity of the micro-organisms in the saliva (as determined in the Snyder test) and most cariogenic changes detected in bitewings particularly in boys. These radiologically detected changes in enamel were the reverse of those obtained clinically. These discrepancies were explained by differences in sensitivity between clinical and radiological techniques used to diagnose cariogenic changes. In contrast it was confirmed radiologically that for girls the P concentration in saliva and for boys the amount of resting saliva are important for preventing extension of caries into deeper layers of enamel.

Adolescent↗
PubMed1992

Relationship between cariogenic events and salivary tests in boys and girls: oral examination.

For boys and girls several salivary tests have been correlated with the following early cariogenic processes developing simultaneously in dental enamel: initiation, regression, stabilization and progression. These events were observed clinically during three consecutive intervals. Only correlations, significant during at least two random intervals were discussed. The Snyder test determined at 24 hours was significantly positively correlated with most events confined to the enamel surfaces and only the Snyder test determined at 48 hours in stimulated saliva appeared to be significantly positively related with deeper processes such as progression. In addition, the mineral composition of Ca2+, P and Mg2+ in saliva was significantly related to cariogenic events in the enamel surfaces of girls, and its viscosity for boys. Finally, and most interesting from a clinical point of view, was the fact that caries progression was negatively related with P concentrations in both unstimulated and stimulated saliva for girls. For boys a negative correlation was found between caries progression and flow of stimulated saliva.

Adolescent↗
PubMed1992

Differences between primary and permanent teeth in posteruptive age dependency of radiological changes in enamel during the development of approximal caries.

A longitudinal radiological study of children (N = 549) who participated in a comprehensive preventive maintenance program showed that caries related events in the approximal surfaces of permanent teeth differed from those in deciduous teeth. Changes in the approximal surfaces of the younger permanent teeth were more pronounced than of the older primary teeth and differed significantly from 1 year to 2.5 years. These findings can be explained by posteruptive maturation of tooth enamel.

Adolescent↗
PubMed1991

[Behaviour of dental students and dental hygiene students as judged by their patients].

In 1985 200 patients who had been treated by fourth year dental students and second year dental hygiene students have received a questionnaire from the Dentistry Department of the ACTA in Amsterdam. They have answered questions concerning the attitude, the management and the competency of both groups of students (response: 59%). The most important conclusion from this study is, that dental hygiene students were significantly more appreciated by the patients than dental students as far as attitude and competency is concerned.

Adult↗
PubMed1991

[Approximal caries in children].

A longitudinal radiological study in children (N = 549) who participated in a comprehensive maintenance program (they were treated in the clinic of the Department of Pedodontics of the Academic Centre for Dentistry Amsterdam) suggests that changes in the approximal surfaces of deciduous molars may differ from the changes in the approximal surfaces of permanent (pre)molars. Regression and initiation possibly occur more frequently in the deciduous teeth than in permanent teeth.

Adolescent↗