The impact of an oral health preventive programme involving parents, educators and dental professionals, on the oral health status of children and young adults with special needs attending resource centres

2023-01-05T07:33:48Z

Title: The impact of an oral health preventive programme involving parents, educators and dental professionals, on the oral health status of children and young adults with special needs attending resource centres Abstract: The purpose of this study was to determine whether school-based oral health programs for children and young adults with special needs attending special schools Malta would be effective in bringing about behavioural change, improving oral hygiene levels and dietary choices. This cohort of the population have their particular realities that require unique approaches, unlike those employed in mainstream schools. Participants attending special schools grouped according to age [3 – 22 (n=153)] and abilities (complex communication difficulties, intellectual disabilities, multisensory impairments, profound and multiple learning difficulties) were screened twice, over a year apart, to determine their oral health needs and whether these were being met. Behaviour was scored according to the Modfied Frankl Behavior Index. The presence/absence of teeth, pain, untreated decay, restorations, missing teeth, trauma, gingivitis and the urgency for treatment were recorded using the Special Olympics International Healthy Athletes Screening (HAS) form while plaque and calculus were charted using the Oral Hygiene Index – Simplified (OHI-S). Parents and educators helped to provide insight into oral hygiene and dietary habits and barriers that individuals with special needs face regarding oral care and learning by answering two sets of questionnaires before and after the program. The Coronavirus disease 2019 (COVID-19) pandemic provided challenges but also created the possibility of exploring online teaching as a tool to connect students with healthcare professionals. Results showed that the School based Oral Health Program was effective in improving behaviour in a dental setting (p<0.001), in improving oral hygiene levels (p<0.001) and in reducing the daily exposure to cariogenic foods (p<0.001). The particular oral care and preventive advice needs for different groups of disabilities were highlighted. This study has shown that by collaborating with parents/ carers and educators, researchers succeeded in reaching and educating the people that form an essential part of the students’ support system, thus ensuring that the work done with the students can be followed up. The study has also shown that tailored school based oral health programs for students of special schools can be effective in improving the oral health experience for persons with special needs. Description: M.Sc.(Melit.)

On treatment outcomes of immediately loaded conventional diameter and mini-implant retained overdentures in the edentulous mandible

2021-12-14T06:13:53Z

Title: On treatment outcomes of immediately loaded conventional diameter and mini-implant retained overdentures in the edentulous mandible Abstract: Background: Little is known on the differences between conventional diameter and mini-implants immediately loaded with overdentures in the edentulous mandible. Objectives: To compare the biological-, prosthetic-, patient-based- and economic treatment outcomes using two immediately loaded conventional or mini-implants for mandibular overdentures. Materials and Methods: Edentulous patients receiving either conventional (4.1mm) or mini-implants (2.9 mm or less), based on available bone width were analyzed. All implants were immediately loaded with mandibular overdentures installed using Locator abutments. Biological, prosthetic, oral health related quality of life and denture satisfaction using OHIP-14, DSQ and GOHAI questionnaires, respectively, were assessed within a one-year follow-up. Finally, an economic cost comparison analysis was carried out between the two groups after collecting initial and long-term cost data. Results: A total of 50 patients (25 receiving conventional implants – 12 females, mean age of 65.3±7.3 years; and 25 receiving mini-implants 11 females, mean age of 66.8 ±8.1 years) were analyzed. Peak insertion torque (p=0.001) and bone loss (p=0.02), as well as change in plaque (p=0.02) and bleeding (p=0.04) indices at 12 months differed significantly between groups. Furthermore, linear regression revealed that height of Locator as risk factor for bone loss (p=0.038). Adjusted Odds Ratio (AOR) analysis showed a significant association between abutment loosening and overdenture fracture (AOR=12.00, 95% CI = 1.11-129.45; p=0.041). Prosthetic maintenance requirements, OHIP-14, DSQ and GOHAI results for overdentures on both implant diameter groups were comparable. Finally, the initial cost of the conventional group was significantly higher than the mini-implant group. Conclusions: The present findings suggest that two mini-implants are significantly more susceptible to bone loss after immediate loading, for which height of Locator might be considered a risk factor. Implant diameter does not affect number of prosthetic maintenance and complications, and that abutment loosening is a risk factor for overdenture fractures, regardless of the implant diameter used. Quality of Life outcomes were similar for both groups. A Cost minimization analysis showed that mini-implant overdentures may be a more attractive treatment option from an economic point of view. Description: Ph.D.(Melit.)

OAR@UM Collection:

The impact of an oral health preventive programme involving parents, educators and dental professionals, on the oral health status of children and young adults with special needs attending resource centres

On treatment outcomes of immediately loaded conventional diameter and mini-implant retained overdentures in the edentulous mandible