Clinical Education 3A by Meifen https://padlet.com/wang_meifen/clinicaleducation3A Read the article and write your takeaways.Feel free to comment on other's takeaway. Participation marks will be given. en-us 2018-03-23 07:20:10 UTC 2018-03-23 07:31:24 UTC hello@padlet.com https://padlet-assets.s3.amazonaws.com/icons/Alarmclock.png Article 1 https://padlet.com/wang_meifen/clinicaleducation3A/wish/245338555 Abstract


Objectives

To assess and compare the survival rates of implant and root canal treatment as well as to investigate the effect of patient and tooth related variables on the treatment outcome in a large-scale population-based study.


Methods

Dental records of patients who received root canal treatment and implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic statusas well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure).


Results

A total of 13,434 records of patients who had implant (33.6%) or root canal therapy (66.4%) were included. The survival rate analysis and Kaplan-Meier table revealed the majority of the implants were removed within the first year (58.8%), while only 35.2% of the root canal treatments failed in the same time period. The overall survival rate was significantly (p < 0.001) higher for implant therapy (98.3%) compared to root canal treatment (72.7%). A statistically significant association was found between treatment (p <n0.001), age (p < 0.001) and anxiety (p = 0.004) with treatment outcome


Conclusions

Implant therapy exhibited significantly lower failures when compared to root canal treatment, but the selection of either treatment should be based on multiple factors. Higher age and anxiety were also significantly associated with root canal and implant treatment failure.


Clinical significance

Clinicians are in an increased dilemma that affects the decision-making process due to the inadequate evidence in regards to the question of retention or extraction of a tooth in the natural dentition. This study demonstrated that both root canal and implant treatments are sound options with high survival rates; however, root canal therapy exhibited a significantly higher failure rate.

]]> 2018-03-23 07:26:58 UTC https://padlet.com/wang_meifen/clinicaleducation3A/wish/245338555 Article 2 https://padlet.com/wang_meifen/clinicaleducation3A/wish/245339284 Abstract
 
Background
In the last few years, conventional restorations including complete removal of carious tissue (CT) with or without pulp therapy for the treatment of carious lesions (CL) in primary teeth have been challenged and a more biological approach has been suggested. This approach involves the use of less invasive techniques which alter the environment of the CL isolating it from the cariogenic biofilm and substrate. Two of these treatment approaches that are becoming increasingly widely accepted and used in paediatric dentistry are the Hall Technique and indirect pulp capping (IPC). 

Aim
To investigate the outcome of the conventional versus the biological approaches for the treatment of deep CL in the primary teeth in children, delivered in a specialist paediatric dentistry training environment. 


Design
This was a retrospective cohort study of 246 children aged 4–9 years, treated with either approach, conventional and biological, in two UK specialist hospital settings. Data were extracted from clinical dental records and post‐operative radiographs of patients treated during the period 2006–2012. The outcome of the treatment in this study was categorised into three main categories: clinical, radiographic, and final outcome. Clinical and final outcomes were further described as success, minor, and major failure. 


Results

In total, 836 primary teeth were included. In the conventional approach, 324 teeth had complete CT removal and 104 teeth had a pulpotomy. In the biological approach, 388 teeth had Hall Technique preformed metal crowns (PMC) placed and 20 teeth received indirect pulp capping. PMC were the restoration of choice for most of the cases where a pulpotomy had been carried out, and resin composite was most frequently used restorative material for the complete CT removal group. The majority of the primary teeth treated with either approach remained asymptomatic after a follow‐up period of up to 77 months, 95.3% in the conventional and 95.8% in the biological. No significant association was found between the final outcome and the approach used for treatment, age of the patient, gender and number of carious surfaces or tooth type. 


Conclusion

Both the conventional and biological treatment approaches had similar final outcomes and were equally successful for management of CL in the primary dentition. 

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