Deckerbyrne7525

Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. Poly(vinyl alcohol) cost We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood.

Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3±1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used.

The mean number of visits was significantly higher in the AI group 43.3±19.7 (controls 17.5±19.8; p<.001). Mean total costs were 8.5 times higher for patients with AI €16,257±5,595 (controls €1,904±993). Mean number of crowns made in patients with AI was 12±7 (range 1-31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were €18,475 for prosthetic rehabilitation began at age 12 years compared with €20,227 if treatment began at 20 years of age.

Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits.

Early crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.

Early crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.

To evaluate whether the cutting-off and rescanning procedures have an impact on the accuracy (trueness and precision) of the intraoral digital scan.

A right quadrant digital scan (reference scan) of a participant was obtained using an intraoral scanner (IOS) (TRIOS 4; 3Shape A/S, Copenhagen, Denmark). The reference scan was duplicated 135 times and divided into 3 groups based on the number of rescanned mesh areas 1 (G1 group), 2 (G2 group), and 3 (G3 group) mesh holes. Each group was subdivided into 3 subgroups depending on the mesh hole diameter 2 mm- (G1-2, G2-2, and G3-2), 4 mm- (G1-4, G2-4, and G3-4), and 6 mm- (G1-6, G2-6, and G3-6) (n=15). A software program (Geomagic; 3D Systems, Rock Hill, SC, USA) was used to assess the discrepancy between the reference and the experimental scans using the root mean square (RMS). Kruskal-Wallis and post hoc multiple comparison Dunn's tests were used to analyze the data (α=0.05).

Trueness ranged from 5 to 20µm and precision ranged from 2 to 10µm. For trueness as-normality of the data, groups G1 and G2 also showed lower IQR values or higher precision than groups G3.

Cutting-off and rescanning procedures decreased the accuracy of the IOS tested. The higher the number and diameter of the rescanned areas, the lower the accuracy.

Cutting-off and rescanning procedures should be minimized in order to increase the accuracy of the IOS evaluated. The intended clinical use of the intraoral digital scan is a critical factor that might determine the scanning workflow procedures.

Cutting-off and rescanning procedures should be minimized in order to increase the accuracy of the IOS evaluated. The intended clinical use of the intraoral digital scan is a critical factor that might determine the scanning workflow procedures.

The oral biofilm structure or composition can affect the penetration of remineralizing agents. Therefore, this study evaluated the remineralizing efficacy of fluoride using a pH-cycling model with oral microcosm biofilms.

Artificial carious lesions were formed in 80 bovine incisors. The pH-cycling conditions with or without oral microcosm biofilms were applied to 40 specimens each. The pH-cycling scheme was repeated for 12 days. Fluorescence loss (ΔF,%) of early carious lesions was measured for all specimens using a quantitative light-induced fluorescence-digital camera, before and after fluoride application. Biofilms on specimens were further analyzed for red fluorescence intensity (red/green ratios) and colony-forming unit counts. The effects of pH-cycling conditions and treatments on changes in ΔF (ΔΔF) and the effects of interactions between factors were analyzed using two-way analysis of variance.

The fluoride-treated group with oral biofilms had an approximately 0.89-fold lower ΔΔF than the fluoride-treated group without oral biofilms (p<0.0001). When oral biofilms were absent, the fluoride-treated group showed a 1.31-fold greater ΔΔF compared to that in the distilled water-treated group (p<0.0001). When oral biofilms were present, the fluoride-treated group showed a 1.14-fold greater ΔΔF compared to that in the distilled water-treated group; however, this difference was not statistically significant.

There was a significant difference in fluoride remineralizing efficacy based on the presence of biofilms on early carious lesions. Therefore, fluoride remineralization assessment in the absence of oral biofilms could lead to an overestimation of efficacy.

Fluoride application might not have a robust remineralization effect on early carious lesions in the presence of a mature biofilm on the tooth surface.

Fluoride application might not have a robust remineralization effect on early carious lesions in the presence of a mature biofilm on the tooth surface.

We aimed to assess the impact of an artificial intelligence (AI)-based diagnostic-support software for proximal caries detection on bitewing radiographs.

A cluster-randomized cross-over controlled trial was conducted. A commercially available software employing a fully convolutional neural network for caries detection (dentalXrai Pro, dentalXrai Ltd.) was randomly employed by 22 dentists, supporting their caries detection on 20 bitewings randomly chosen from a pool of 140 bitewings, with 10 bitewings randomly being supported by AI and 10 not. The reference test had been established by 4+1 independent experts in a pixelwise fashion. Caries was subgrouped as enamel, early dentin and advanced dentin caries, and accuracy and treatment decisions for each caries lesion assessed.

Dentists with AI showed a significantly higher mean (95% CI) area under the Receiver-Operating-Characteristics curve (0.89; 0.87-0.90) than those without AI (0.85; 0.83-0.86; p<0.05), mainly as their sensitivity was significantly hred, and dentists should be guided as to which therapy to choose when detecting caries lesions using AI support.

Opioid prescribing to cancer patients is declining, but it is unknown whether reductions have been tailored to those at highest risk of opioid-related harms.

Examine whether declines in opioid dispensing to patients receiving active cancer treatment are sharper in patients with substance use disorder (SUD) or mental health diagnoses.

We used 2008-2018 national, commercial healthcare claims data to examine adjusted and unadjusted trends in opioid dispensing (receipt of ≥1 fill; average daily dosage; receipt of high-dose opioids; receipt of concurrent opioids and benzodiazepines) to patients ages ≥18 receiving treatment for one of four cancer types (breast; colorectal; head and neck; sarcoma; N=324,789 patients). To compare declines across subgroups with varying risk of opioid-related harms, we stratified by SUD and mental health diagnosis. To address potential confounding, we estimated subgroup-specific trends using generalized estimating equations, adjusting for covariates.

Across groups, rate of ≥1 oeded.

Palliative care is an essential component of comprehensive care for patients with critical illnesses. In Japan, little is known about palliative care in intensive care units (ICUs), and palliative care approaches are not widespread. This study aimed to better understand the attitudes of physicians toward palliative care and the utilization and needs of specialized palliative care consultations in ICUs in Japan.

A nationwide, self-administered questionnaire was distributed ICU physician directors in all hospitals with ICUs.

Questionnaires were distributed to 873 ICU physician directors; valid responses were received from 436 ICU physician director (50% response rate). Among the respondents, 94% (n = 411) felt that primary palliative care should be strengthened in ICUs; 89% (n = 386) wanted ICU physicians to collaborate with specialists, such as palliative care teams (PCTs); and 71% (n = 311) indicated the need for specialized palliative care consultations; however, only 38% (n = 166) actually consulted, and only 6% (n = 28) consulted more than 10 patients in the past year. Physicians most commonly consulted PCT for patients with serious end-of-life illness (24%) (n = 107), intractable pain (21%) (n = 92), and providing psychological support to family members (43%, n = 187). The potential barriers in providing primary and specialized palliative care included being unable to understand the patients' intentions (54%, n = 235), lack of knowledge and skills in palliative care (53%, n = 230), and inability to consult with PCTs in a timely manner (46%, n = 201).

These data suggest a need for primary palliative care education in ICUs and improved access to specialized palliative care consultations.

These data suggest a need for primary palliative care education in ICUs and improved access to specialized palliative care consultations.

Since pediatric palliative care (PPC) aims to improve the health-related quality of life (HRQoL) of children with life-limiting conditions (LLC), assessment of their HRQoL and identification of its determinants is crucial.

To examine the clinical and family factors associated with HRQoL of children with LLC METHODS This was a cross-sectional study of 136 pediatric patients with LLC who were enrolled in the PPC services at Seoul National University Hospital in South Korea. Patients' HRQoL was measured using the Pediatric Quality of Life 4.0. Clinical and family characteristics were gathered from the medical records and PPC registry database.

Most children with LLC have a poor HRQoL at their enrollment for PPC services with significant variation in their total HRQoL scores according to the diagnostic categories. Patients with nonmalignant conditions showed significantly lower HRQoL scores than patients with malignancy. Lower HRQoL scores were associated with more caregiver depressive symptoms. In a multivntervention in palliative care for children with nonmalignant conditions and family-centered intervention to address caregivers' psychosocial problems.

Palliative care aims to support patients' spiritual needs with the intention of promoting their spiritual well-being (SWB), an important dimension of quality of life. SWB is one of the less-studied dimensions of QoL, particularly in a secular country such as the Netherlands.

In this study we aimed to get a better understanding of SWB in Dutch patients with advanced cancer. We therefore examined its prominence and associated factors.

We used the baseline data of a cohort study on experienced quality of care and quality of life (eQuiPe study), which included 1,103 patients with advanced cancer. In addition to sociodemographic and religious/spiritual characteristics, study measures comprised the SWB subscales Meaning, Peace, and Faith of the revised FACIT-Sp-12, spiritual problems and needs (PNPCsv), quality of life (EORTC-QLQ-C30) and satisfaction with healthcare professionals' interpersonal skills (INPATSAT-32).

On average, patients experienced quite a bit of Meaning (8.9, SD 2.3), a little bit to somewhat Peace (6.