Aims
To provide information regarding the different types of soft drinks and critically reviewing their risk on the dental and general health of children and adolescents, as well as the cost ...associated with such drinks.
Methods
The literature was reviewed using electronic databases, Medline, Embase, Cochrane library, and was complemented by cross-referencing using published references list from reviewed articles. Search words; soft drinks, juices, carbonated drinks, sports and energy drinks, soft drink and dental diseases, soft drink and health, cost of soft drinks, soft drink advertising, sugar tax on soft drinks were used for this review. In total, 104 papers were reviewed by both authors; of these, 62 papers were found to have relevant information.
Results
The consumption of soft drinks was found to have increased dramatically over the past several decades. The greatest increase in soft drink consumption has been among children and adolescents. Some commercial soft drinks are high in sugar content and acidity. In addition, they supply energy only and are of little nutritional benefit and lack micro-nutrients, vitamins and minerals. Soft drink consumption can contribute to detrimental oral and general health. Efforts have been made by manufacturers and government agencies to reduce the potential harmful effects of sugar-containing soft drinks on teeth and general health. These include banning the sale of soft drinks in schools, restricting soft drinks advertising, modifying the composition of soft drinks and introducing tax on sugar-containing soft drinks.
Conclusions
The consumption of soft drinks with high sugar content and acidity can contribute to detrimental oral health and may also affect general health. Therefore, it is necessary to educate patients about the harmful effects of different types of soft drinks as it is not always easy for individuals to identify from drink labelling the ingredients which they contain.
The objective of this study was to compare early postoperative functional outcomes and time to hospital discharge between conventional jig-based total knee arthroplasty (TKA) and robotic-arm assisted ...TKA.
This prospective cohort study included 40 consecutive patients undergoing conventional jig-based TKA followed by 40 consecutive patients receiving robotic-arm assisted TKA. All surgical procedures were performed by a single surgeon using the medial parapatellar approach with identical implant designs and standardized postoperative inpatient rehabilitation. Inpatient functional outcomes and time to hospital discharge were collected in all study patients.
There were no systematic differences in baseline characteristics between the conventional jig-based TKA and robotic-arm assisted TKA treatment groups with respect to age (p = 0.32), gender (p = 0.50), body mass index (p = 0.17), American Society of Anesthesiologists score (p = 0.88), and preoperative haemoglobin level (p = 0.82). Robotic-arm assisted TKA was associated with reduced postoperative pain (p < 0.001), decreased analgesia requirements (p < 0.001), decreased reduction in postoperative haemoglobin levels (p < 0.001), shorter time to straight leg raise (p < 0.001), decreased number of physiotherapy sessions (p < 0.001) and improved maximum knee flexion at discharge (p < 0.001) compared with conventional jig-based TKA. Median time to hospital discharge in robotic-arm assisted TKA was 77 hours (interquartile range (IQR) 74 to 81) compared with 105 hours (IQR 98 to 126) in conventional jig-based TKA (p < 0.001).
Robotic-arm assisted TKA was associated with decreased pain, improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based TKA. Cite this article: Bone Joint J 2018;100-B:930-7.
Purpose
The primary objective of this study was to determine the surgical team’s learning curve for robotic-arm assisted TKA through assessments of operative times, surgical team comfort levels, ...accuracy of implant positioning, limb alignment, and postoperative complications. Secondary objectives were to compare accuracy of implant positioning and limb alignment in conventional jig-based TKA versus robotic-arm assisted TKA.
Methods
This prospective cohort study included 60 consecutive conventional jig-based TKAs followed by 60 consecutive robotic-arm assisted TKAs performed by a single surgeon. Independent observers recorded surrogate markers of the learning curve including operative times, stress levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy of implant positioning, limb alignment, and complications within 30 days of surgery. Cumulative summation (CUSUM) analyses were used to assess learning curves for operative time and STAI scores in robotic TKA.
Results
Robotic-arm assisted TKA was associated with a learning curve of seven cases for operative times (
p
= 0.01) and surgical team anxiety levels (
p
= 0.02). Cumulative robotic experience did not affect accuracy of implant positioning (n.s.) limb alignment (n.s.) posterior condylar offset ratio (n.s.) posterior tibial slope (n.s.) and joint line restoration (n.s.). Robotic TKA improved accuracy of implant positioning (
p
< 0.001) and limb alignment (
p
< 0.001) with no additional risk of postoperative complications compared to conventional manual TKA.
Conclusion
Implementation of robotic-arm assisted TKA led to increased operative times and heightened levels of anxiety amongst the surgical team for the initial seven cases but there was no learning curve for achieving the planned implant positioning. Robotic-arm assisted TKA improved accuracy of implant positioning and limb alignment compared to conventional jig-based TKA. The findings of this study will enable clinicians and healthcare professionals to better understand the impact of implementing robotic TKA on the surgical workflow, assist the safe integration of this procedure into surgical practice, and facilitate theatre planning and scheduling of operative cases during the learning phase.
Level of evidence
II.
The outcome of total knee arthroplasty (TKA) is not always satisfactory. The purpose of this study was to identify satisfaction and biomechanical features characterising the gait of patients who had ...undergone TKA with either an anatomical single radius design or a medial pivot design. We hypothesised that the latter would provide superior function.
This is a study of a subset of patients recruited into a prospective randomised study of a single radius design
a medial pivot design, with a minimum follow-up of one year. Outcome measurements included clinical scores (Knee Society Score (KSS) and Oxford Knee Score (OKS)) and gait analysis using an instrumented treadmill.
There was no statistically significant difference between the two groups for both the KSS and OKS. There was also no statistical significance in cadence, walking speed, stride length and stance time, peak stride, mid support and push-off forces.
This study corroborates a previous study by the same authors that showed equally good results in clinical outcome and gait between the conventional single radius and medial pivot designs under stringent testing conditions. Cite this article:
2018;(1 Supple A)100-B:76-82.
The primary aim of this study was to determine the surgical team's learning curve for introducing robotic-arm assisted unicompartmental knee arthroplasty (UKA) into routine surgical practice. The ...secondary objective was to compare accuracy of implant positioning in conventional jig-based UKA versus robotic-arm assisted UKA.
This prospective single-surgeon cohort study included 60 consecutive conventional jig-based UKAs compared with 60 consecutive robotic-arm assisted UKAs for medial compartment knee osteoarthritis. Patients undergoing conventional UKA and robotic-arm assisted UKA were well-matched for baseline characteristics including a mean age of 65.5 years (sd 6.8) vs 64.1 years (sd 8.7), (p = 0.31); a mean body mass index of 27.2 kg.m2 (sd 2.7) vs 28.1 kg.m2 (sd 4.5), (p = 0.25); and gender (27 males: 33 females vs 26 males: 34 females, p = 0.85). Surrogate measures of the learning curve were prospectively collected. These included operative times, the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire to assess preoperative stress levels amongst the surgical team, accuracy of implant positioning, limb alignment, and postoperative complications.
Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time (p < 0.001) and surgical team confidence levels (p < 0.001). Cumulative robotic experience did not affect accuracy of implant positioning (p = 0.52), posterior condylar offset ratio (p = 0.71), posterior tibial slope (p = 0.68), native joint line preservation (p = 0.55), and postoperative limb alignment (p = 0.65). Robotic-arm assisted UKA improved accuracy of femoral (p < 0.001) and tibial (p < 0.001) implant positioning with no additional risk of postoperative complications compared to conventional jig-based UKA.
Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time and surgical team confidence levels but no learning curve for accuracy of implant positioning. Cite this article: Bone Joint J 2018;100-B:1033-42.
The aim of this study was to evaluate the ten-year clinical and functional outcome of hip resurfacing and to compare it with that of cementless hip arthroplasty in patients under the age of 55 years. ...Between 1999 and 2002, 80 patients were enrolled into the study: 24 were randomised (11 to hip resurfacing, 13 to total hip arthroplasty), 18 refused hip resurfacing and chose cementless total hip arthroplasty with a 32 mm bearing, and 38 insisted on resurfacing. The mean follow-up for all patients was 12.1 years (10 to 14). Patients were assessed clinically and radiologically at one year, five years and ten years. Outcome measures included EuroQol EQ5D, Oxford, Harris hip, University of California Los Angeles and University College Hospital functional scores. No differences were seen between the two groups in the Oxford or Harris hip scores or in the quality of life scores. Despite a similar aspiration to activity pre-operatively, a higher proportion of patients with a hip resurfacing were running and involved in sport and heavy manual labour after ten years. We found significantly higher function scores in patients who had undergone hip resurfacing than in those with a cementless hip arthroplasty at ten years. This suggests a functional advantage for hip resurfacing. There were no other attendant problems.
Aim
To review the current literature on the effectiveness of using music as an intervention to reduce dental anxiety in children.
Methods
At the University of Leeds, the School of Music and the ...School of Dentistry collaborated to conduct an online search strategy. The Cochrane Library and Medline databases were used to find the current available evidence.
Results
Systematic reviews and clinical trial studies as well as cohort studies containing pertinent information on the effect of music on anxiety in the clinical setting were reviewed. The literature showed that music can have a biological and psychological impact on emotion and consequently has been used effectively as an aid to moderate anxiety in the clinical setting. With regard to paediatric dentistry, majority of studies were found to support the use of music in reducing dental anxiety in children, however several additional studies showed that music did not significantly reduce the children’s dental anxiety. The studies employed a number of methods to measure dental anxiety including the Venham’s Picture Test, the Venham’s clinical anxiety rating scale and pulse oximetry. They also used a range of music types; some studies allowed for patient self-selection of music whereas others dictated the music the children listened to.
Conclusions
There is an increasing body of evidence to support the use of music to moderate anxiety within the clinical setting in both medicine and dentistry. However, the current evidence for the effectiveness of using music to reduce dental anxiety in children is inconclusive and of limited quality.
Introduction
Photodynamic therapy (PDT) is a treatment modality involving a dye that is activated by exposure to light of a specific wavelength in the presence of oxygen to form oxygen species ...causing localised damage to microorganisms.
Aim
To determine the most effective bactericidal incubation and irradiation times of erythrosine-based PDT on
in vivo
-formed dental plaque biofilms.
Methods
A randomised controlled study; 18-healthy adult participants wearing intraoral appliances with human enamel slabs to collect dental plaque samples in two separate periods of two weeks each for use in arm-1 and arm-2. These accumulated dental plaque samples were treated with PDT under different experimental conditions. Incubation times with photosensitiser (erythrosine) of 15 min and 2 min were used in arm-1 and arm-2, respectively, followed by light irradiation for either 15 min (continuous) or as a fractionated dose (5 × 30 sec). Following treatment, percentage reductions of total bacterial counts were compared between the different groups. In addition, confocal laser scanning microscopy (CLSM) and LIVE/DEAD® BacLight™ Bacterial Viability Kit were used to visualise the effect of PDT on
in vivo
-formed biofilms.
Results
Significant reductions in the percentage of total bacterial counts (~93–95%) of
in vivo
-formed biofilms were found when using either 2 min or 15min incubation times and applying 15 min continuous light. Although when applying fractionated light, there was more cell death when 15 min incubation time was used (~ 91%) compared with the 2 min incubation time (~ 64%). CLSM results supported these findings.
Conclusion
Improving the clinical usefulness of PDT by reducing its overall treatment time seems to be promising and effective in killing
in vivo
-formed dental plaque biofilms.
Purpose
To assess maternal knowledge, attitudes and beliefs of Early Childhood Caries (ECC) risk factors and to determine barriers in seeking dental treatment among children with ECC.
Methods
A total ...of 600 mothers of healthy children, aged 3–5 years, with ECC attending maternity and child health centres in Jordan completed a questionnaire using face-to-face interviews. ECC was diagnosed clinically by the chief investigator, based on the diagnostic criteria suggested by American Academy of Paediatric Dentistry (AAPD), and caries was recorded using dmft index.
Results
The majority of the children had poor oral health status (99.2%) with a dmft index of 6.04 (± 1.2). Less than third (25.7%) of the mothers believed that their child had poor oral health with more than half (53.3%) not being aware that their child had dental caries. Most of the mothers had poor knowledge, attitudes and beliefs regarding their children’s oral health (82%). Participants` oral health knowledge was significantly associated with mothers` level of education and profession (
p
< 0.05). In addition, there was delay in seeking dental treatment for their children by the majority (65.9%) of mothers. Maternal profession, family income and time needed to reach a nearby health centre were found to be significant barriers in seeking dental treatment (
p
< 0.05).
Conclusion
The majority of the mothers of children in Jordan with ECC had poor knowledge about their children’s oral health status. Moreover, seeking dental treatment was delayed by a large number of mothers of children with ECC.
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