Melbourne Dental School - Research Publications
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ItemRefugee child oral health(WILEY, 2017-04)The number of people forced to flee their homes and move around the world is increasing rapidly. Such refugee populations are not only more likely to have poor physical, mental and social health outcomes but also to experience difficulties accessing health services in their new country. In particular, children from refugee backgrounds are at increased risk of poor oral health which in time is associated with poor adult oral health and impacts on child health (e.g. growth and development) and well-being. To date, there is little evidence about the nature and extent of their oral health problems nor interventions to improve their oral health status. This article summarises the evidence surrounding the oral health status of children from refugee backgrounds. In addition, a systematic review of the international literature over the past 10 years is presented which identifies interventions to improve the oral health of these vulnerable paediatric populations. Based on this evidence, potential strategies available to dental service providers to optimise provision of responsive dental care are discussed.
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ItemCarious lesion management in children and adolescents by Australian dentists(WILEY, 2019-09)BACKGROUND: The management of carious lesions in children and adolescents can have lifelong implications for the patient. The aim of this study was to assess the decision-making process of dentists when managing carious lesions in children and adolescents. METHODS: Approximately, 11 000 dentists listed as members of the Australian Dental Association Inc. (ADA) and Australian and New Zealand Society of Paediatric Dentistry (ANZSPD) were emailed a link in April 2017 to a 19-question survey delivered by SurveyMonkey™. RESULTS: In this study, 887 responses were received. In 'enamel-limited' carious lesions, dentists intervened most frequently in primary tooth approximal (365, 41.1%), followed by permanent tooth occlusal (295, 33.3%) and approximal (244, 27.5%), and primary tooth occlusal (203, 22.9%) surface carious lesions. Age, university of graduation, practicing state, decade of graduation and frequency of treatment of children between 6 and 15 years were significant demographic factors influencing the restorative threshold. CONCLUSIONS: Australian dentists reported significant variation in their management of approximal and occlusal carious lesions in both primary and permanent teeth. A substantial proportion of respondents would intervene surgically on non-cavitated enamel-limited lesions.
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ItemA review of contemporary inhalation sedation guidelines and regulations related to treating children(Royal College of Surgeons of England, 2017-07)Inhalation sedation (IS) with nitrous oxide (N2O) is classified as minimal sedation. In paediatric dentistry, IS works well for mildly anxious but potentially cooperative children, reducing the need for general anaesthesia for simple dental procedures. We review contemporary guidelines relating to ISN2O in Australasia, the UK, Europe and the US. As this is a multispecialty area, with differences in laws, regulations, guidance and governance from country to country, this review aims to illuminate global trends and assist with the designing of local regulations for the safe practice of ISN2O.
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ItemDental undergraduates' self-assessed confidence in paediatric dentistry(University of Malaya, 2015)Aim: Self-assessment based on benchmarked professional standards is an excellent tool to assist in improving the dental curriculum. Areas of strength and weaknesses can be identified. It can also act as a baseline standard when significant changes are introduced to the dental curriculum. The aims of this prospective cross-sectional study was to investigate self-assessed confidence of final year dental undergraduates in paediatric dentistry enrolled at University of Malaya in 2013. Methods: 65 undergraduates completed anonymised questionnaires which were formulated based on expected professional competencies in three domains namely clinical skills, patient management, and professional development and clinical governance. Visual analogue score (VAS) represented by a 10cm line with score ‘0’ no confidence at all and ‘10’ complete confidence was used to measure the level of confidence. Results: The overall analysis of self-assessed confidence was very positive with median VAS ≥ 5cm in; clinical skills, 7.66±1.31cm (range=2.41–9.97cm: n=62; 95.4%), patient management 7.73±1.27cm (range=5.09–9.95cm: n=64; 100.0%), and professional development and clinical governance, 8.13±1.21cm (range=5.22–10.00cm: n=64; 100.0%). High confidence was reported for routine dental care (fillings and preventive care) while lower confidence reported for basic life support (median VAS=5.65cm) and pulp therapy for immature permanent teeth (median VAS=5.95cm). Conclusions: The final year dental undergraduate students of the University of Malaya appear to have good overall self-assessed confidence in core areas in paediatric dentistry.
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ItemThe use of regenerative endodontic therapy in the management of non-vital immature permanent teeth: a systematic review(CRD University of York, 2014-01-16)
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ItemNo Preview AvailablePoster Sessions(Wiley, 2015-07)Background: Self-assessment based on benchmarked professional standards is an excellent tool to assist in improving the dental curriculum. Areas of strength and weaknesses can be identified. It can also act as a baseline standard when significant changes are introduced to the dental curriculum. Aim: The aims of this prospective cross-sectional study were two- folds: (i) to investigate self-assessed confidence of final year dental undergraduates in paediatric dentistry at University of Malaya, (ii) to gather baseline level of self-confidence for the old dental curriculum. Design: 65 undergraduates completed anonymised questionnaires which was formulated based on expected professional competen- cies in three domains namely clinical skills, patient management, and professional development and clinical governance. Visual analogue score (VAS) represented by a 10 cm line with score ‘0’ no confidence at all and ‘10’ complete confidence was used to mea- sure the level of confidence. Results: The overall analysis of self-assessed confidence was very positive with median VAS ≥5 cm in; clinical skills, 7.66 ` 1.31 cm (range = 2.41–9.97 cm: n = 62; 95.4%), patient management 7.73 ` 1.27 cm (range = 5.09–9.95 cm: n = 64; 100.0%) and professional development and clinical governance, 8.13 ` 1.21 cm (range = 5.22–10.00 cm: n = 64; 100.0%). High confidence was reported for routine dental care (fillings and pre- ventive care) while lower confidence reported for basic life sup- port (median VAS = 5.65 cm) and pulp therapy for immature permanent teeth (median VAS = 5.95 cm). Conclusions: The final year dental undergraduate students of Uni- versity of Malaya appear to have good overall self-assessed confi- dence in core areas in paediatric dentistry and similar areas of low confidence was reported by undergraduates at other dental schools.
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ItemRegenerative endodontischeTechnik unter Verwendung einer Kombination aus Amoxicillin und Metronidazol = Regenerative endodontic technique using a combination of amoxicillin and metronidazole(Quintessence Publishing Group, 2013)Die Behandlung von devitalen bleibenden Frontzähnen bei Kindern ist eine klinische Herausforderung. Sobald der Zahn devital wird, setzt die weitere Entwicklung der Wurzeln aus. Dies schwächt den Zahn, so dass er den physiologischen Kräften beim Kauvorgang nicht mehr standhalten kann. Aufgrund der resultierenden hohen Frakturhäufigkeit ergibt sich eine mittel- bis langfristig ungünstige Prognose. Seit einiger Zeit gibt es jedoch einen Paradigmenwechsel beim Herangehen an dieses klinische Problem, und zwar durch den Einsatz der regenerativen Endodontie. Trotz vieler Fallberichte und einiger veröffentlichter Fallserien ist dieses Verfahren noch recht undefiniert, da es unterschiedliche - wenn auch im Großen und Ganzen auf ähnlichen Prinzipien beruhende - Vorgehensweisen gibt. Die Abteilung für Kinderzahnheilkunde am Leeds Dental Institute verwendet eine besondere regenerative endodontische Technik, bei der eine Mischung von zwei Antibiotika (Amoxicillin und Metronidazol) eingesetzt wird. In dem Beitrag soll diese Technik erläutert und anhand von zwei erfolgreich behandelten sowie 2 Jahre lang nachverfolgten Patientenfällen vorgestellt werden. Treatment of permanent permanent anterior teeth in children is a clinical challenge. As soon as the tooth becomes devitalized, the further development of the roots ceases. This weakens the tooth so that it can no longer withstand the physiological forces during the chewing process. Due to the resulting high fracture frequency, the prognosis is unfavorable in the medium to long term. For some time now, however, there has been a paradigm shift in addressing this clinical problem through the use of regenerative endodontics. Despite many case reports and some published case series, this procedure is still rather undefined because there are different approaches, albeit largely based on similar principles. The Pediatric Dentistry Department at Leeds Dental Institute uses a special regenerative endodontic technique that uses a mixture of two antibiotics (amoxicillin and metronidazole). This article is intended to explain this technique and present it on the basis of two successfully treated patient cases and two patient cases followed up for two years.
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Item结合阿莫西林和甲硝唑混合抗生素的牙髓再生治疗技术(Roser Verlag International, 2013)
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ItemPulpal status of human primary molars with coexisting caries and physiological root resorption(WILEY-BLACKWELL, 2014-07)AIM: This study sought to investigate the effect of caries, in association with physiological root resorption, on the pulpal status of human primary molars. DESIGN: Fifty-three mandibular primary molars were obtained from children requiring extractions under general anaesthesia. Following extraction, teeth were split longitudinally and placed in Zamboni's fixative. Teeth were categorised according to i) the depth of caries (less than or greater than halfway through dentine thickness) and ii) the degree of physiological root resorption (<33%, 34-66% or >67% of the root length). Ten-micrometre pulp sections were subject to indirect immunofluorescence using a combination of PGP 9.5 (a general neuronal marker), CD45 (a general neuronal marker), and Ulex europaeus agglutinin I (a marker of vascular endothelium). Image analysis was used to determine the percentage area of staining (PAS) for innervation and immune cells. RESULTS: Marked differences were seen between different samples, but there were no significant differences in mean PAS for PGP 9.5 or CD45 according to the degree of caries or extent of physiological root resorption (two-way anova, P > 0.05). CONCLUSION: Findings suggest that even if primary molars are undergoing exfoliation, they show comparable caries-induced changes to teeth without physiological root resorption, thus retaining potential for healing and repair.