PubMed Health⌕ Search

Biomedical subjects

W D'Hoore

Publications and source records attributed to W D'Hoore.

At least 19 recordsLinked to original sources
PubMed2006

Effects of irradiation on bone remodelling around mandibular implants: an experimental study in dogs.

This research focuses on the effects of radiotherapy on bone remodelling around mandibular implants in dogs. After bilateral extraction of the mandibular premolars and first 2 molars, each of 11 beagles received 8 mandibular implants. Four animals were irradiated 4 weeks after implantation and 4 others 8 weeks before implantation; the remaining 3 did not receive radiotherapy. Irradiation consisted of 10 daily fractions of 4.3Gy (60)Co. Fluorochromes were given at implantation and irradiation to allow the measurement of bone apposition. The dogs were killed 6 months after implantation. Each hemi-mandible was processed according to bone-specific histological techniques. New bone formation was visible around 85 of the 88 implants. Stimulated mandibular remodelling was attested in both irradiated groups by increased porosity and numerous labelled osteons. Resorption was more pronounced in the group irradiated after implantation, but osteon formation appeared unvarying. Osseointegration was thus shown to be compatible with bone irradiation as bone turnover activities were maintained throughout the experiment. As the apposition stage of the remodelling cycle appears crucial to achieve optimal osseointegration, its normal completion should be taken into account in clinical practice by respecting a 6-month period between irradiation and implantation.

Animals↗
PubMed2004

The opinion of general practitioners on the treatment of prostate and breast cancer in elderly people: results of a survey based on clinical models.

AIMS: Several publications have reported age-related differences in the management of people with cancer. Most data have been derived retrospectively from hospital or cancer-centre databases. The aim of the present study was to identify major decisional factors observed in general practitioner (GP) practices, outside the hospital setting, regarding the clinical management of patients with prostate and breast cancer. MATERIALS AND METHODS: During three national GP meetings in Belgium, questionnaires presenting two simulated patient cases were presented to GPs who were asked two questions: one regarding further staging and referral of the case and the second regarding the treatment of the case. A total of 678 questionnaires were distributed. GPs received two randomly selected cases each: a breast cancer history and a prostate cancer history. Three variables were assessed simultaneously: age, performance status and medical history (comorbidity). RESULTS: The analysis indicated that elderly patients were more likely to be referred for non-curative treatment (OR 13.71; 95% CI 5.67-33.12; P < 0.0001 for prostate cancer and OR 17.67; 95% CI 4.04-77.31; P < 0.0001 for breast cancer). The other variables (performance status and medical history) did not affect treatment orientation. However, GPs were prepared to seek assistance from oncologists in both cases, irrespective of the patient's age. CONCLUSION: Age seems to be more important among GPs in deciding how to manage cancer patients than performance status and comorbidity. This is a very common prejudice. They are, nevertheless, inclined to refer people with cancer to oncologists independently of the patient's age.

Age Factors↗
PubMed2004

Caries decline in the primary dentition of Belgian children over 15 years.

OBJECTIVES: (1) To investigate changes in caries prevalence in the primary dentition of children resident in Brussels, Belgium between 1983 and 1998, (2) to analyse associations between changes in caries and children's socioeconomic and ethnic aspects. METHODS: In the Brussels region, children in the first grade at the same schools were sampled in cohort 1983 (n = 396) and cohort 1998 (n = 473). Caries experience of Belgian and non-Belgian nationals was summarized in dmf scores. The socioeconomic status of the children was established based on their parents' education and profession. The children were categorized in eight subgroups in relation to their socioeconomic status, ethnic origin and cohort (SESEC subgroups). RESULTS: The percentage of caries-free children increased significantly from 31.5% to 47.5%. A reduction was observed in the dmft scores from 3.9 to 2.3 (P < 0.001) and in the dmfs scores from 6.9 to 5.0 (P < 0.001). The odds ratio of being caries-free was 2.5 times higher for privileged children and 2.3 times higher for children belonging to cohort 1998. The ANCOVA analyses revealed that most of the SESEC subgroups showed significant reduction in dmft scores from 1983 to 1998 (P < 0.003). CONCLUSIONS: Children resident in Brussels showed caries decline in their primary dentition over 15 years. Diversity in caries decline was associated with children's socioeconomic status and ethnic origin.

Analysis of Variance↗
PubMed2003

Long-term evaluation of extensive restorations in permanent teeth.

OBJECTIVES: The present prospective, longitudinal study assessed the outcome of posterior extensive restorations and identified risk factors for failure of the restorations. MATERIALS AND METHODS: The sample consisted of 722 amalgam restorations, 115 composite resin restorations and 89 crowns placed in 428 adults by one dentist from 1982 to 1999 in Belgium. Well-defined criteria were used for cavity preparation design, type of retention and selection of restorative material. RESULTS: At the closure of the study 48% of the restorations were well functioning, 24% were lost to lack of follow-up, and 28% had failed. The most frequent reasons for failure were fracture of restoration (8%), secondary caries (6%) and fracture of cusp (5%). Failures were more often found in premolar teeth (34%) than in molars (27%) (P=0.05) and occurred in 28% of the amalgam restorations, 30% of the resin restorations and 24% of the crowns (P=0.55). Molar restorations were more frequently repaired than replaced in contrast to premolar restorations. The highest percentage of extractions was related to complete amalgam restorations in premolars. The Kaplan-Meier median survival times were 12.8 years for amalgam restorations, 7.8 years for resin restorations, and more than 14.6 years for crowns, considering all retreatment as failures (P=0.002). The survival was influenced by extension of restoration, age of patient, pulpal vitality, 3-year period of treatment, use of base material and dentinal retentive pins. CONCLUSION: Within the limits of the study the data support the view that extensive amalgam restorations but not composite resin restorations can be used as an appropriate alternative to crowns, with due consideration to the longevity of the restorations.

Adolescent↗
PubMed2003

Treatment with removable partial dentures: a longitudinal study. Part I.

The aim of this study was to evaluate the effectiveness of an oral rehabilitation by removable partial denture (RPD). Between 1983 and 1994, 629 patients were provided with an RPD at the Dental School of the Université catholique de Louvain. All the RPDs were constructed with a cobalt-chromium framework. All the treatments were provided by dental students under the supervision of clinical instructors. At recall time (1998-2000), 269 patients could not be reached neither by telephone nor by mail and 27 had died. Consequently, 333 patients were called for clinical examination and 254 of these (76.3%) actually attended. For a total of 292 RPDs fitted for these 254 patients, 218 (74.7%) were still being worn at the time of the check-up. Seventy-four dentures were considered to be 'failures', either because they were replaced by another RPD or by a complete denture, or because they had actually never been worn. The statistical analysis (Mantel-Haenszel and Kaplan-Meier) shows that the number of failures is significantly higher at the lower jaw compared with the upper jaw. Most of the failures are attributable to RPDs with free-end saddles and, in particular, to class I mandibular dentures. The patients are wearing their denture(s) mostly continuously (63.6%) and award a high degree of satisfaction to their denture. In general, the results recorded may be considered as very satisfactory, all the more so as we have no regular recall procedures established at our school and as check-up asked for spontaneously by the patients in the course of the period of observation are most of the time occasional or non-existent.

Chromium Alloys↗
PubMed2003

Treatment with removable partial dentures: a longitudinal study. Part II.

The aim of this study was to evaluate the effectiveness of an oral rehabilitation by removable partial denture (RPD). Between 1983 and 1994, 629 patients were provided with an RPD at the Dental School of the Université catholique de Louvain. All the RPDs were constructed with a cobalt-chromium framework. All the treatments were provided by dental students under the supervision of clinical instructors. At recall time (1998-2000), 269 patients could not be reached neither by telephone nor by mail and 27 had died. Consequently, 333 patients were called for clinical examination and 254 of these (76.3%) actually attended. For a total of 292 RPDs checked 1893 persistent teeth were listed, with 804 serving as abutments; more than half (57.6%) of these were crowned, for which 51 debondings were recorded. For the period of observation we listed 79 abutments lost (37 at the upper jaw and 42 at the lower jaw), i.e. 9.8% of the total number of abutments. No relation could be established between the type of the abutments (natural or crowned teeth) and the losses observed (Test of Mantel-Haenszel: P=0.9496). In the upper jaw, the percentage of abutments lost was significantly higher in the presence of free-end edentulous areas as compared with bounded edentulous areas (Test of Mantel-Haenszel: P=0.0002); this difference does not appear for the lower jaws (P=0.9558). If we deduct the 25 abutments related with the 11 non-worn RPDs and the 79 abutments lost, no change becomes apparent for 92.2% of the maxillary abutments and for 85.8% of the mandibular abutments. For the 1089 other teeth, we observed the loss of 40 teeth and the appearance of caries or new fillings for 95 teeth. The fractures of cast clasps represent 3.4%.

Chromium Alloys↗
PubMed2003

[Validation of a triage scale: first step in patient admission and in emergency service models].

INTRODUCTION: At present, most emergency services handle the multitude of various demands in the same unity of place and by the same team of nurses aides, with direct consequences on the waiting time and in the handling of problems of varying degrees of importance. Our service examines other administrative models based on a triage of time and of orientation. METHODS AND RESULTS: In a prospective study on 679 patients, we have validated a triage tool inspired from the ICEM model (International Cooperation of Emergency Medicine) allowing patients to receive, while they wait, information and training, based on the resources provided, in order to deal with their particular medical problem. CONCLUSION: The validation of this tool was carried out in terms of its utilization as well as its reliability. It appears that, with the type of triage offered, there is a theoretical reserve of waiting time for the patients in which the urgency is relative, and which could be better used in the handling of more vital cases.

Adult↗
PubMed2002

Influence of removable partial denture on periodontal indices and microbiological status.

Thirty patients (19 men and 11 women) were provided with a removable partial denture (RPD) and assigned randomly to two groups: 15 patients were called back twice a year for plaque control, reinforcement of instructions, denture hygiene control and professional prophylaxis; the other 15 were not called back. The 30 patients were examined after 2-3 weeks following the end of the prosthetic treatment, after 1 and 2 years. At each examination, the following parameters were recorded [gingival inflammation, plaque index (Pl I), tooth mobility, attachment level, pocket depth] and a bacteriological examination of subgingival plaque was carried out. Few differences appeared between the two groups; the values observed show a relatively low level of hygiene and but little motivation with regard to prophylaxis techniques.

Adult↗
PubMed2002

[Status of dental caries in Belgium and neighboring countries].

The present review describes the evolution of dental health in the Belgian population in the last 30 years, comparing it to other European countries. The studies carried out in the individual regions of Wallonia, Brussels and Flanders and in some municipalities, give a general idea about dental health in the country. In the last decade, dental health in Belgian children and adolescents has improved markedly. However, a specific health policy is required for risk groups such as socio-economically underprivileged, disabled and immigrant children. Belgium may be placed among other European countries which show low caries prevalence in schoolchildren population. Further investigation in young adults and adults are required. The lack of representative data for the whole country suggests that the implementation of a data base system for monitoring the evolution of dental health in Belgium would be useful.

Adolescent↗
PubMed2001

Meta-analytical review of factors involved in dentin adherence.

Literature data on adherence tests of dentin-bonding systems (DBS) may differ widely, even for the same DBS. The problem of bond testing is that materials are seldom compared with a standard, and experimental conditions often vary. We sought to identify the parameters that influence this variability. Using inclusion and exclusion criteria, we conducted a meta-analytical review of 75 articles, published between 1992 and 1996 in SCI reviews, that give bond strength data for 15 dentin-bonding agents of the so-called third and fourth generations. Seventeen selected parameters were classified into four groups: Group A includes factors related to the dentin substrate (i.e., nature of teeth); group B, composite and bonding area (i.e., composite stiffness); group C, storage conditions of the bonded samples (i.e., thermocycling); and group D, test design (i.e., crosshead speed). For each report, the experimental features, the bond strength means and standard deviations, and the failure mode were extracted and tabulated. Statistical Analysis System software was used to perform Pearson correlation analysis and analysis of variance, with bond strength as the dependent variable and experimental conditions as the independent variables. The meta-analytical review highlighted the significant influence of various parameters in the different groups: origin of dentin, types of teeth, pulpal pressure, tooth storage temperature, maximum storage time of teeth, and dentin depth in group A; type and stiffness of composite and bonding area in group B; storage of bonded samples (medium, temperature, and time) in group C, and testing mode and crosshead speed in group D. A significant positive correlation was observed between the mean bond strength and the rate of cohesive failure. It can be concluded from this study that some of these parameters should be controlled by the use of a standardized protocol. Unfortunately, the substrate-related variables are more difficult to control, even though their influence is consistent.

Analysis of Variance↗
PubMed2001

The decline in dental caries among Belgian children between 1983 and 1998.

OBJECTIVES: to investigate cross-sectionally a probable dental caries decline in Belgian 12-yr-olds and to analyse some factors that may be associated with dental caries during the study period. METHODS: In the region of Brussels, children in the 7th grade at the same schools were sampled in 1983 (n=533) and 1998 (n= 496). DMFT, DMFS and dental fluorosis were clinically recorded. Data on children's home-based and professional dental health care habits were registered. RESULTS: Caries-free children increased from 4% to 50%. A reduction of the mean number of teeth attacked by dental caries from 7.5 to 1.6 and of tooth surfaces from 11.5 to 2.5 (P<0.001) was observed. Early signs of dental fluorosis were identified in 5% in 1983 and 30% of the subjects in 1998. Multiple linear regression analyses revealed that tooth brushing with fluoridated toothpaste, dental appointments and dental fluorosis were significantly related to dental caries reduction. CONCLUSIONS: A remarkable decline in dental caries was observed during the 15-yr period. The factors related to the children's home-based and professional dental health care were associated with the observed decline.

Adolescent↗
PubMed2001

[Oral hygiene and gingival condition among 12-year-old children in the Brussels Region].

The study analyses oral hygiene and gingival status in a group of 12-yr-old children from the Region of Brussels. In 1998, a total of 496 children from eight selected schools participated in the sample. All children were interviewed about their socio-economic status and oral health care. Records of the plaque index and the gingival index were made. The mean plaque and gingivitis were 1.24 (+/- 0.03) and 1.32 (+/- 0.03), respectively. Seventy percent of the examined sites presented plaque and gingivitis. Privileged children showed lower means than non-privileged counterparts. Multiple linear regression showed that dental plaque was significantly associated to age, toothbrushing and appointment in case of discomfort or pain (P = 0.02). Age, gender, type of the toothbrush and use of dental floss were associated to gingivitis (P = 0.05). Daily home-based mechanical plaque removal is critical for the maintenance of gingival health and when efficiently performed it leads to remission of gingivitis. Dentists should be encouraged to give information and training on regular plaque removal to their patients.

Adolescent↗
PubMed2001

Reliability of in vitro microleakage tests: a literature review.

PURPOSE: The literature contains conflicting data about in vitro microleakage evaluations and their usefulness and reliability. No standardization has yet been established. Here we consider features of published studies that might affect the results of the in vitro microleakage tests. MATERIALS AND METHODS: We reviewed 144 in vitro microleakage studies, published in 14 international reviews between 1992 and 1998, which comprised 917 sets or groups of experiments. The published studies were entered in a database and compared using selected literature criteria: sample, cavities, restoration procedures, thermocycling and mechanical cycling, evaluation method. RESULTS: The methods employed vary widely. The most frequent methodological choices (%) were (1) specimen storage after extraction: duration (unspecified, 59.2), medium (distilled or deionized water, 33.8), temperature (unspecified, 52.2), additives (none, 47.0); (2) aging method (79.1): duration before aging (< 24 h, 35.9); medium and temperature of storage before aging (distilled or deionized water, 26.8; 37 degrees C, 54.3); (3) medium of cycling (tap water, 50.5), number of cycles ([250-500], 34.6), number of baths (2, 84.0), bath temperature (5 degrees C to 55 degrees C, 60.6), immersion dwell time (30 s, 44.3); (4) tracer: type (basic fuchsin, 40.7), time of immersion (after thermocycling and/or mechanical cycles, 64.1), immersion duration (basic fuchsin: 24 h, 59.5); assessment of dye penetration of sections (91.7): direction (perpendicular, 88.5), number (1, 47.1). CONCLUSION: The great variability in the methods used in these 144 studies prevented meta-analysis and comparison of the results, thus reducing the value of these methods.

Coloring Agents↗
PubMed2000

Endodontic retreatment decisions: no consensus.

AIM: The objectives of the present study were to: (i) evaluate the consensus, if any, amongst dental schools, students and their instructors managing the same clinical cases, all of which involved endodontically treated teeth; and (ii) determine the predominant proposed treatment option. METHODOLOGY: Final year students, endodontic staff members and instructors of 10 European dental schools were surveyed as decision makers. Fourteen different radiographic cases of root canal treated teeth accompanied by a short clinical history were presented to them in a uniform format. For each case the decision makers were requested to: (i) choose only one out of nine treatment alternatives proposed, from 'no treatment' to 'extraction' via 'retreatment' and 'surgery' (ii) assess on two 5-point scales: the difficulty of making a decision, and the technical complexity of the retreatment procedure. RESULTS: The results indicate wide inter- and also intra-school disagreements in the clinical management of root canal treated teeth. Analysis of variance showed that the main source of variation was the 'school effect', explaining 1.8% (NS) to 18.6% (P < 0.0001) of the treatment variations. No other factor explained as much variance. Decision difficulty was moderately correlated to technical complexity (Pearsons' r ranging from 0.19 to 0.35, P < 0.0001). CONCLUSIONS: No clear consensus occurred amongst and within dental schools concerning the clinical management of the 14 cases. The lack of consensus amongst schools seems to be due mainly to chance or uncertainty, but can be partly explained by the 'school effect'.

Analysis of Variance↗
PubMed2000

[Test your decision-making. When to do endodontic retreatment? Results of a study].

The goals of this survey were to determine the most frequent therapeutic option and to evaluate the consensus among a sample of Belgian practitioners managing the same simulated cases of root treated teeth. On average, conservative options (nonsurgical retreatment 35.27% and no retreatment 29.61%) are the most selected alternatives. Surgical options and extraction respectively constitute 21.18% and 13% of the treatment propositions. As expected, the presence of radiographic and/or clinical signs resulted in a more aggressive attitude, but the presence of symptoms does not seem to be a valid reason for reintervention. The results of the study demonstrate considerable interindividual variations in clinical management of root treated teeth, regardless of personal factors, such as gender, years of experience and graduation institution. Even if a consensus appears within a group of professionals, it is not necessarily applied by a majority of practitioners; this contributes certainly to the explanation of the geographical or institutional variations noted in the medical practices.

Adult↗
PubMed2000

[Test your decision-making. When to do endodontic retreatment? Some therapeutic alternatives].

The aim of the present article was to propose examples of treatment alternatives for the management of 14 clinical cases. All these cases involved endodontically treated teeth and have been managed by the same practitioner. In this paper, the authors tried to show the variety of treatment alternatives as well as the complexity of the decision-making process and, not to consider that proposed alternatives were the most adequate.

Adult↗
PubMed1999

Two-level non-invasive positive pressure ventilation in the initial treatment of acute respiratory failure in an emergency department.

There are few data on the use of two-level non-invasive positive pressure ventilation (two-level nIPPV) in the initial treatment of severe acute respiratory failure in emergency departments (ED). In a prospective, non-randomized, pilot study, we assessed (1) the feasability of this method in an ED, (2) its effect on clinical and laboratory data, and (3) its effect on the need of intubation and the final outcome of patients. During a 1-year period all eligible patients admitted for acute respiratory failure, with absence of improvement after periods of specific classic treatments, were included in the study. Each patient received a specific classic treatment and two-level nIPPV with a two-level positive pressure ventilator through a face mask. We recorded parameters on admission, after 15 and 45 minutes of nIPPV and at the end of nIPPV. Sixty-two patients were included: 29 with acute pulmonary oedema (APO), 16 with acute exacerbation of chronic obstructive pulmonary disease (COPD), four with asthma, and 13 with various diseases. In the APO-group, we observed a statistically significant improvement of respiratory and pulse rates, diastolic blood pressure, pH, PaCO2 and SaO2. In acute exacerbation of COPD, we observed only a statistical improvement of respiratory and pulse rates without any significant change of PaCO2 and pH. In the two other groups, there was a clinical, gasometric and haemodynamic improvement in all patients. Four patients were intubated and 10 died, but none in the ED or in the first 24 hours after hospital admission. We were able to institute two-level nIPPV for severe acute respiratory failure in an ED without complications. Its addition to the rest of classic specific treatment seems to bring about a rapid improvement of various clinical and laboratory parameters in most patients. We found no deleterious effect of nIPPV when implemented for short periods of time in the emergency department setting.

Acute Disease↗
PubMed1999

[Test your decision making skills. When should endodontic treatment be redone?].

Research has shown wide variations in dentists' clinical attitude towards root canal treated teeth. Simulated cases are used as tools in the investigation of practitioners' clinical behavior and decision making. We therefore used simulated cases (clinical histories and radiographs) of 14 endodontically treated teeth to: (1) determine the predominant proposed treatment strategy for each case, (2) evaluate the consensus, if any, among practitioners, (3) identify pathology and dentist factors influencing the treatment choice.

Adult↗