Current data show many older adults to have poor oral health, deteriorating even more when they b... more Current data show many older adults to have poor oral health, deteriorating even more when they become frail or care dependent. In order to achieve a structural and sustained improvement of this situation, it is necessary to have a clear view of the factors determining oral health in older adults, such as (endogenous (biological, lifestyle), environmental determinants and determinants associated with the organisation of healthcare. The various determinants show oral health in older adults is the result of thecombined effects of very diverse factors and for that reason, a solution will have to be based on a multidisciplinary approach, also involving people outside of clinical care. To promote good oral health over the full course of life, it is important to invest in a good start in life, that helps accumulate oral health gains, and at the same time it is essential to adapt the healthcare system and prevention strategies to the individual's needs in order to make oral care effective for the full course of life.
Revista Internacional De Protesis Estomatologica, 2010
Objetivo: el objetivo de este estudio fue evaluar los cuidados globales, tanto quirurgicos como p... more Objetivo: el objetivo de este estudio fue evaluar los cuidados globales, tanto quirurgicos como protesicos, de las sobredentaduras superiores soportadas por 6 implantes endooseos y una mesoestructura de barra microfresada con anclajes Ceka. Materiales y metodos: treinta y nueve pacientes consecutivos con un maxilar superior edentulo que refirieron problemas con sus protesis superiores convencionales fueron tratados mediante una sobredentadura soportada por 6 implantes endooseos y una mesoestructura de barra microfresada (barra solida con colocacion de anclajes Ceka). Los cuidados globales protesicos y quirurgicos se puntuaron desde la primera visita hasta 10 anos despues del aumento del maxilar superior. La satisfaccion del paciente se evaluo al final del seguimiento. Resultados: se diferenciaron 3 grupos de pacientes en funcion de los problemas que sufrieron con sus protesis convencionales: pacientes sin retencion en la protesis convencional debido a problemas anatomicos (n=24), pacientes con problemas de nauseas (n=9), y pacientes que no toleraron una protesis superior convencional debido a problemas subjetivos no relacionados con el sustrato anatomico (n=6). La necesidad de los cuidados globales fue comparable en los 3 grupos. La tasa de supervivencia global de los implantes tras 10 anos fue del 86, 1%. La perdida de implantes se produjo, principalmente, durante el primer ano tras la colocacion. Los cuidados postoperatorios estuvieron relacionados basicamente con la retirada y sustitucion de los implantes (es decir, incremento, sustitucion de implantes y conexion de los pilares). Los cuidados posprotesicos consistieron principalmente en inspecciones rutinarias, cuidados de higiene oral y activacion o sustitucion de los anclajes Ceka. Por ultimo, las sobredentaduras funcionaron bien en todos los pacientes y estuvieron satisfechos durante todo el estudio. Conclusion: independientemente de los motivos subyacentes mencionados para la ausencia de funcionalidad de las protesis superiores convencionales, la sobredentadura superior implantorretenida, en oposicion a una sobredentadura inferior implantorretenida o a la denticion natural, demostro ser una opcion terapeutica eficaz, predecible y fiable que no necesito muchos cuidados postoperatorios o posprotesicos mas que los ajustes de los anclajes Ceka.
International Journal of Environmental Research and Public Health
Many older individuals with dementia (OIWD) show care-resistant behavior for oral care. Providing... more Many older individuals with dementia (OIWD) show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. Although involuntary care should be minimized, in some OIWD it may be necessary to avoid health risks. This study aims to assess the attitudes of healthcare providers with regard to involuntary oral care provision for OIWD who show care-resistant behavior. An online questionnaire consisting of general questions and case specific questions was administered via social media and networking to individuals involved in the oral care of OIWD. A total of 309 participants were included in this study. The outcomes of the questionnaires were categorized per case. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful (range: 73.1–93.5%) and the willingness to provide involuntary care (range: 31.1–63.4%). Hence, many healthcare providers are aware of the subsequent potential health risk...
Low muscle mass is associated with adverse outcomes after surgery. This study examined whether fa... more Low muscle mass is associated with adverse outcomes after surgery. This study examined whether facial muscles, such as the masseter muscle, could be used as a proxy for generalized low muscle mass and could be associated with deviant outcomes after carotid endarterectomy (CEA). As a part of the Vascular Ageing study, patients with an available preoperative CT-scan, who underwent an elective CEA between December 2009 and May 2018, were included. Bilateral masseter muscle area and thickness were measured on preoperative CT scans. A masseter muscle area or thickness of one standard deviation below the sex-based mean was considered low masseter muscle area (LMA) or low masseter muscle thickness (LMT). Of the 123 included patients (73.3% men; mean age 68 (9.7) years), 22 (17.9%) patients had LMA, and 18 (14.6%) patients had LMT. A total of 41 (33.3%) patients had a complicated postoperative course and median length of hospital stay was four (4–5) days. Recurrent stroke within 5 years occ...
Current data show many older adults to have poor oral health, deteriorating even more when they b... more Current data show many older adults to have poor oral health, deteriorating even more when they become frail or care dependent. In order to achieve a structural and sustained improvement of this situation, it is necessary to have a clear view of the factors determining oral health in older adults, such as (endogenous (biological, lifestyle), environmental determinants and determinants associated with the organisation of healthcare. The various determinants show oral health in older adults is the result of thecombined effects of very diverse factors and for that reason, a solution will have to be based on a multidisciplinary approach, also involving people outside of clinical care. To promote good oral health over the full course of life, it is important to invest in a good start in life, that helps accumulate oral health gains, and at the same time it is essential to adapt the healthcare system and prevention strategies to the individual's needs in order to make oral care effective for the full course of life.
Revista Internacional De Protesis Estomatologica, 2010
Objetivo: el objetivo de este estudio fue evaluar los cuidados globales, tanto quirurgicos como p... more Objetivo: el objetivo de este estudio fue evaluar los cuidados globales, tanto quirurgicos como protesicos, de las sobredentaduras superiores soportadas por 6 implantes endooseos y una mesoestructura de barra microfresada con anclajes Ceka. Materiales y metodos: treinta y nueve pacientes consecutivos con un maxilar superior edentulo que refirieron problemas con sus protesis superiores convencionales fueron tratados mediante una sobredentadura soportada por 6 implantes endooseos y una mesoestructura de barra microfresada (barra solida con colocacion de anclajes Ceka). Los cuidados globales protesicos y quirurgicos se puntuaron desde la primera visita hasta 10 anos despues del aumento del maxilar superior. La satisfaccion del paciente se evaluo al final del seguimiento. Resultados: se diferenciaron 3 grupos de pacientes en funcion de los problemas que sufrieron con sus protesis convencionales: pacientes sin retencion en la protesis convencional debido a problemas anatomicos (n=24), pacientes con problemas de nauseas (n=9), y pacientes que no toleraron una protesis superior convencional debido a problemas subjetivos no relacionados con el sustrato anatomico (n=6). La necesidad de los cuidados globales fue comparable en los 3 grupos. La tasa de supervivencia global de los implantes tras 10 anos fue del 86, 1%. La perdida de implantes se produjo, principalmente, durante el primer ano tras la colocacion. Los cuidados postoperatorios estuvieron relacionados basicamente con la retirada y sustitucion de los implantes (es decir, incremento, sustitucion de implantes y conexion de los pilares). Los cuidados posprotesicos consistieron principalmente en inspecciones rutinarias, cuidados de higiene oral y activacion o sustitucion de los anclajes Ceka. Por ultimo, las sobredentaduras funcionaron bien en todos los pacientes y estuvieron satisfechos durante todo el estudio. Conclusion: independientemente de los motivos subyacentes mencionados para la ausencia de funcionalidad de las protesis superiores convencionales, la sobredentadura superior implantorretenida, en oposicion a una sobredentadura inferior implantorretenida o a la denticion natural, demostro ser una opcion terapeutica eficaz, predecible y fiable que no necesito muchos cuidados postoperatorios o posprotesicos mas que los ajustes de los anclajes Ceka.
International Journal of Environmental Research and Public Health
Many older individuals with dementia (OIWD) show care-resistant behavior for oral care. Providing... more Many older individuals with dementia (OIWD) show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. Although involuntary care should be minimized, in some OIWD it may be necessary to avoid health risks. This study aims to assess the attitudes of healthcare providers with regard to involuntary oral care provision for OIWD who show care-resistant behavior. An online questionnaire consisting of general questions and case specific questions was administered via social media and networking to individuals involved in the oral care of OIWD. A total of 309 participants were included in this study. The outcomes of the questionnaires were categorized per case. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful (range: 73.1–93.5%) and the willingness to provide involuntary care (range: 31.1–63.4%). Hence, many healthcare providers are aware of the subsequent potential health risk...
Low muscle mass is associated with adverse outcomes after surgery. This study examined whether fa... more Low muscle mass is associated with adverse outcomes after surgery. This study examined whether facial muscles, such as the masseter muscle, could be used as a proxy for generalized low muscle mass and could be associated with deviant outcomes after carotid endarterectomy (CEA). As a part of the Vascular Ageing study, patients with an available preoperative CT-scan, who underwent an elective CEA between December 2009 and May 2018, were included. Bilateral masseter muscle area and thickness were measured on preoperative CT scans. A masseter muscle area or thickness of one standard deviation below the sex-based mean was considered low masseter muscle area (LMA) or low masseter muscle thickness (LMT). Of the 123 included patients (73.3% men; mean age 68 (9.7) years), 22 (17.9%) patients had LMA, and 18 (14.6%) patients had LMT. A total of 41 (33.3%) patients had a complicated postoperative course and median length of hospital stay was four (4–5) days. Recurrent stroke within 5 years occ...
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