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Biomedical subjects

Robert J Weyant

Publications and source records attributed to Robert J Weyant.

At least 19 recordsLinked to original sources

A clinical trial of Damon 2 vs conventional twin brackets during initial alignment.

The objective of this study was to compare the effectiveness and comfort of Damon 2 brackets and conventional twin brackets during initial alignment. Sixty consecutive patients participated in a split mouth design. One side of the lower arch was bonded with the Damon 2 bracket and the other with a conventional twin bracket. The sides were alternated with each consecutive patient. The irregularity index (II) was measured for each half of the arch at baseline, at 10 weeks at the first archwire change, and at another 10 weeks at the second archwire change. Any difference in discomfort was assessed within the first few days of archwire placement and again at the first archwire change. Comfort on the lips, preferred look, and bracket failure rates were also recorded. The twin bracket was more uncomfortable with the initial archwire (P = .04). However, at 10 weeks, substantially more patients reported discomfort with the Damon 2 bracket when engaging the archwire (P = .004). At both archwire changes at 10 and 20 weeks (P = .001), the conventional bracket had achieved a lower II than the Damon 2 bracket by 0.2 mm, which is not clinically significant. Patients preferred the look of the twin bracket over the Damon 2 (P < .0005) and more Damon 2 brackets debonded during the study (P < .0005). The Damon 2 bracket was no better during initial alignment than a conventional bracket. Initially, the Damon 2 bracket was less painful, but it was substantially more painful when placing the second archwire and had a higher bracket failure rate.

Adolescent↗

Using biometrics for participant identification in a research study: a case report.

This paper illustrates the use of biometrics through the application of an iris-based biometrics system for identifying twins and their parents in a longitudinal research study. It explores the use of biometrics (science of measuring physical or anatomical characteristics of individuals) as a technology for correct identification of individuals during longitudinal studies to help ensure data fidelity. Examples of these circumstances include longitudinal epidemiological and genetic studies, clinical trials, and multicenter collaborative studies where accurate identification of subjects over time can be difficult when the subject may be young or an unreliable source of identification information. The use of technology can automate the process of subject identification thereby reducing the need to depend on subject recall during repeated visits thus helping to ensure data quality. This case report provides insights that may serve as useful hints for those responsible for planning system implementation that involves participants' authentication that would require a more secure form of identification.

Adult↗

A comparison of two indirect bonding adhesives.

The aim of this study was to compare and evaluate the clinical failure rates of the chemically cured composite bonding resin Maximum Cure (MC) and the flowable light-cured resin Filtek Flow (FF) when used in an indirect bonding technique. A total of 112 consecutive patients satisfying the selection criteria were assigned to alternating groups in a split-mouth study design. In Group 1, the maxillary right and mandibular left quadrants were indirectly bonded using MC adhesive, whereas the contralateral quadrants were bonded using FF adhesive. In Group 2, the sides bonded were opposite to those in Group 1. One patient was lost from group 1, so the adjacent patient from group 2 was excluded. Over a six-month observation period, all loose brackets were recorded and the data compared with a Wilcoxon signed ranks test. Of the 2468 brackets placed, 36 with the MC adhesive came loose (2.9% failure rate) compared with 30 in the FF group (2.4% failure rate, P = .95). In the maxillary arch, 12 brackets from the MC quadrants came loose vs 24 in the FF (P = .02). In the mandibular arch, 24 brackets from the MC quadrants came loose during the six-month observation period compared with six from the FF quadrants (P = .03). These results suggest that both adhesives examined in this study (MC and FF) were suitable for the indirect bonding of brackets. The failure rates were low for both adhesives, so either could be recommended for clinical use, the choice being dictated more by operator preference.

Acid Etching, Dental↗

Systemic inflammatory markers, periodontal diseases, and periodontal infections in an elderly population.

OBJECTIVES: To study the levels of systemic markers for inflammation with parameters of periodontal diseases in older people. DESIGN: A cross-sectional study was conducted in a cohort that is being followed prospectively on the effects of aging and body composition on morbidity. SETTING: University of Pittsburgh, Pittsburgh, and University of Tennessee, Memphis. PARTICIPANTS: One thousand one hundred thirty-one participants (mean age+/-standard deviation 72.7+/-2.8); 66% white and 50% male. MEASUREMENTS: Periodontal examination, including probing depth and attachment loss, was performed. Periodontal disease extent was divided into 0% of sites with probing depth of 6 mm or more, 1% to 10% of sites with probing depth of 6 mm or more and more than 10% of sites with probing depth of 6 mm or more. Subgingival plaque samples were collected from four molar teeth, and the levels of periodontal pathogens were determined using the benzoyl-DL-arginine-naphthylamide (BANA) test. Plasma interleukin-6 (IL-6), C-reactive protein (CRP), plasminogen activator inhibitor type-1 (PAI-1), and tumor necrosis factor alpha (TNF-alpha) levels were measured in all participants. Assessments of risk factors associated with elevated levels of markers of systemic inflammation were also determined. Multiple regression analysis was employed to analyze the data. RESULTS: IL-6 levels were significantly higher in participants with more-extensive periodontal disease than in other participants. Periodontal disease extent was significantly associated with higher TNF-alpha plasma levels, controlling for established risk factors for elevated TNF-alpha levels. Participants with BANA-positive species had significantly higher CRP plasma levels when controlling for risk factors for elevated CRP levels. CONCLUSION: Periodontal disease and infection may be modifiable risk indicators for elevated levels of systemic inflammatory markers in older people.

Aged↗

Periodontitis and airway obstruction.

BACKGROUND: The objective of this study was to examine the relationship between airway obstruction and periodontal disease. METHODS: Participants were a subset of 860 community- dwelling, well functioning elderly (aged 70 to 79, blacks and whites, males and females) selected from 2,732 participants enrolled in the Health, Aging, and Body Composition Study (Health ABC). The periodontal evaluations occurred over years 2 and 3 of the study and included four indices of periodontal health: plaque index (PI), gingival index (GI), probing depth (PD), and loss of attachment (LOA). The pulmonary evaluation took place in year 1: conducted according to American Thoracic Society criteria, based on the forced expiratory volume/forced vital capacity (FEV1/FVC) ratio and then using the percent of predicted FEV1 to categorize severity. RESULTS: GI (P = 0.023) and LOA (P = 0.009) were significantly better in participants with normal pulmonary function compared to those with airway obstruction after adjusting for age, race, gender, and field center. When stratified by smoking status and after adjusting for age, race, gender, center, and pack-years, there was a significant association between periodontal health and airway obstruction in former smokers. Within this group, those with normal pulmonary function had significantly better GI (P = 0.036) and LOA (P = 0.0003) scores than those with airway obstruction. All periodontal indices were elevated in smokers regardless of pulmonary status; however, the current smoker group was too small to detect a periodontitis effect. CONCLUSION: While the present cross-sectional study cannot provide direct inference of cause and effect, it does reveal a significant association between periodontal disease and airway obstruction, particularly in former smokers.

Aged↗

Edentulism and nutritional status in a biracial sample of well-functioning, community-dwelling elderly: the health, aging, and body composition study.

BACKGROUND: Edentulism may affect dietary intake in older adults, but the relation between edentulism and nutritional status is not completely understood. OBJECTIVE: The present study examined whether edentulism is associated with nutritional status and whether there is an interaction between race and edentulism on nutritional status among well-functioning, community-dwelling elderly. DESIGN: The study cohort included 3075 elderly aged 70-79 y (52% women, 42% black) in the Health, Aging, and Body Composition Study. Dietary intake, anthropometric variables, weight change, and serum albumin and lipid concentrations were compared between edentate and dentate participants by the use of multiple linear and logistic regressions. RESULTS: Edentulism was not associated with total energy or food intake but was associated with the food groups consumed, particularly fat, micronutrients, and hard-to-chew foods. Edentulism was more strongly linked to dietary intake in whites than in blacks. Unlike black edentate elderly, white edentate elderly consumed significantly lower energy-adjusted amounts of vitamin A and beta-carotene, higher amounts of energy-adjusted total and saturated fat and cholesterol, and higher percentages of energy from fat than did white dentate elderly. Anthropometry and biochemical indexes were not significantly different by edentulism status in both races. Edentulism was associated with weight gains of >5% in 1 y in both races. CONCLUSIONS: Edentulism was associated with differences in the nutritional status of well-functioning, community-dwelling elderly, more so in whites than blacks. Edentate elders may benefit from dental, medical, and nutrition interventions targeted to addressing these findings.

Aged↗

Periodontal disease and weight loss in older adults.

OBJECTIVES: To determine the association between periodontal disease and weight loss in an elderly cohort. DESIGN: A longitudinal design was used with participants from the Health, Aging and Body Composition (Health ABC) cohort study to determine the association between periodontal disease status and weight loss of at least 5% of baseline body weight over a period of 2 years. SETTING: Participants were examined in research clinics in Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: A randomly selected subset of 1,053 individuals from the Health ABC examination, aged 65 and older, ambulatory and community-dwelling at baseline. MEASUREMENTS: Periodontal disease was measured as mean pocket depth and attachment loss, extent (percentage) of pockets with at least 6 mm probing depth, extent of bleeding on probing, and tissue inflammation. RESULTS: In logistic regression models adjusting for variables that may explain weight loss, extent of periodontal pockets with at least 6 mm probing depth showed a significant association with weight loss (odds ratio=1.53, 95% confidence interval=1.32-1.77). CONCLUSION: Periodontal disease may be causally related to weight loss in the elderly and thus may increase risk of morbidity and mortality.

Aged↗

Medical and cognitive correlates of denture wearing in older community-dwelling adults.

OBJECTIVES: To examine the association between denture wearing and use of dental services, oral function limitations, and medical and cognitive status in a community-based cohort of rural older adults enrolled in an epidemiological study. DESIGN: This cross-sectional study was part of a larger cohort study, the Monongahela Valley Independent Elders Survey. Dental data were collected during the fifth wave of assessments (10 years after the start of the study in 1987). SETTING: Monongahela Valley, a rural western Pennsylvania community. PARTICIPANTS: The 805 participants were English-speaking community-dwelling (noninstitutionalized) persons, aged 73 and older, with at least a sixth grade education. MEASUREMENTS: A questionnaire was used to collect data on denture-wearing status, oral function limitations, and recency of the last dental visit. Other data collected included demographics, self-rated health, medication usage, depression, cognitive status using the Mini-Mental State Examination, and self-reports of weight loss and appetite. RESULTS: There were 44.7% of participants who had full dentures. Those with complete dentures were more likely to complain of oral function limitation, report poor health status, and take prescription medications. Additionally, 93.6% of those with complete dentures had not seen a dentist in more than 1 year. CONCLUSION: Denture wearing and edentulism are common in older patients and can be related to poor quality of life and risk for undiagnosed oral disease and may be a marker for other medical comorbidities. Geriatricians need to include oral health status evaluations and understand that attention to the oral cavity should be part of an older adult's care.

Aged↗

Dental caries status and need for dental treatment of Pennsylvania public school children in grades 1, 3, 9, and 11.

OBJECTIVES: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. METHODS: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale--no treatment need identified, routine treatment need, and urgent treatment need--and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. RESULTS: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. CONCLUSIONS: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence.

Adolescent↗

Relationship of malocclusion severity and treatment fee to consumer's expectation of treatment outcome.

Understanding consumer expectations is important if orthodontists are to be successful in marketing their elective services. The purpose of this study was to examine the relationship between consumer outcome expectations and treatment variables, including cost of treatment and malocclusion severity. The subjects were parents of patients recruited from 9 private orthodontic practices in southwestern Pennsylvania who were entering a single comprehensive phase of orthodontic treatment, characterized by a full fee and complete fixed appliances. The parents completed a questionnaire regarding outcome expectations for their child's orthodontic treatment. Pretreatment orthodontic study models of each child were evaluated with the peer assessment rating. The results of this study suggest that orthodontic consumers have very high outcome expectations. Also, the parents of patients with severe overall malocclusions, overjet, or midline deviations have expectations that exceed probable treatment outcomes. Orthodontists should consider that consumers seeking their services have increased expectations not related to the treatment outcomes.

Adolescent↗

Report of recommendations from the National Dental Public Health Workshop, February 10-12, 2002, Bethesda, MD.

A two-and-a-half day workshop was held beginning February 10, 2002, to review the current state of dental public health training in the United States with the aim of creating recommendations that would address identified problems and lead to improvements in the quality of dental public health training. This workshop, held in Bethesda, Maryland, was sponsored by the Health Resources and Services Administration (HRSA) through a contract with the American Association of Public Health Dentistry (AAPHD). Workshop invitees included the program directors of all accredited dental public health residency programs in the United States and Canada, selected dental public health residents, and additional consultants invited based on their expertise in dental public health education. The recommendations have been placed into three categories: training, financing, and workforce development. Along with background and process summaries, these recommendations are reported here.

Canada↗