Research undertaken by staff affiliated to Cork University Dental Hospital

Recent Submissions

  • Multiple myeloma presenting as mandibular pain

    Crowley, Miriam (Irish Dental Association, 2016-10)
    Introduction: Multiple myeloma (MM) is a systemic malignancy of plasma cells defined by monoclonal production of circulating immunoglobulins. Bone pain is a presenting feature in the majority of cases. Treatment may involve intravenous use of bisphosphonates, chemotherapy or haematopoietic stem cell transplantation. Here, we illustrate a first presentation of MM in a patient with mandibular pain and discuss radiographic, diagnostic and treatment challenges of orofacial issues in patients with MM. Case report: A 69-year-old lady presented to an emergency oral surgery clinic with a month-long history of unilateral left-sided pain in her jaw. Examination revealed a buccolingual swelling of 2cm diameter in the lower left premolar region. Radiographic images demonstrated a 2cm lytic lesion in her mandible corresponding with the symptomatic region. Aspiration of the lesion was performed and histological analysis indicated an abundance of atypical plasma cells. Subsequent biopsy revealed sheets of plasmacytoid cells suggesting evidence of a plasmacytoma. Skeletal survey, bone marrow biopsy and serum analysis confirmed the presence of MM. Discussion: MM, although a systemic malignancy, can present via a variety of orofacial manifestations. The presence of a lytic lesion on plain radiographs should alert the dental practitioner to the possibility of the diagnosis. Treatment of orofacial bone pain may respond to intravenous bisphosphonates but care must be taken to avoid osteonecrosis of the jaw. Conclusion: This case is an important reminder of the potential oral presentations of MM and underlines the importance of radiographic evaluation in patients with atypical symptoms and presentations.
  • Adverse reactions to facial dermal fillers: a case report

    Kehily, Elaine; Hayes, Martina; McCreary, Christine (Journal of the Irish Dental Association, 2015-02)
    Our current social and cultural environment places great importance on our appearance. Collagen, the major structural component of the dermis, serves to strengthen and support the skin. As we get older, decreased production of collagen by fibroblasts occurs, leading to loss of tissue bulk and elasticity.1 As a result, deep folds, wrinkles and rhytides can develop. Injectable soft tissue fillers (ISTFs) provide an attractive option in facial rejuvenation. ISTFs can be categorised into biodegradable and non-biodegradable substances. Biodegradable fillers (such as bovine collagen and hyaluronic acid) are safer to use; however, they have a relatively short lifespan (three to 12 months).2 Non-biodegradable fillers (such as silicone) have a longer tissue presence but cause more adverse reactions than the biodegradable fillers.3 ISTFs are usually injected into the deep dermis or the dermal-subdermal junction (Figure 1).4
  • Dentists’ requirements for continuing professional development in Ireland. A pilot study conducted at University College Cork

    Stewart, Christopher; Kinirons, Martin (Journal of the Irish Dental Association, 2015-02)
    This research was a pilot study of the ways in which the continuing professional development (CPD) needs of dentists could be provided. A web-based questionnaire facility was used to enable dental practitioners to register their level of interest in a range of clinical topics presented as CPD lectures and practical courses to provide hands-on experience. The findings were reviewed with reference to the available literature on dental CPD. The study sought to inform development of dental CPD programmes.
  • An audit of orthodontic treatment eligibility among new patients referred to a Health Service Executive orthodontic referral centre

    Meade, Maurice J; Millett, Declan T (Irish Dental Association (IDA), 2013-10)
    Aim: The aim of this audit was to evaluate orthodontic treatment eligibility among new patients referred for assessment from primary dental care clinics in the Health Service Executive (HSE) South region to a HSE orthodontic referral centre. Method: A data collection form was designed and applied prospectively to consecutive new patient referrals who attended diagnostic clinics at the Orthodontic Unit, Cork University Dental School and Hospital, between October 2011 and February 2012. Orthodontic treatment eligibility was based on guidelines introduced by the HSE in 2007. Results: Data on 291 patients (147 males and 144 females) with a mean age of 11.6 years (SD ± 2.4 years; range 8-19 years) were evaluated. Of the 83 (29%) patients eligible for orthodontic treatment under the guidelines, the most commonly diagnosed malocclusion traits were a crossbite with greater than 2mm discrepancy between retruded contact position and intercuspal position (24 patients), followed by an overjet greater than 9mm (21 patients). Conclusions: A total of 29% of new patient referrals were deemed eligible for orthodontic treatment under HSE eligibility guidelines introduced in 2007. Reduction of new patient referrals not eligible for treatment, under these guidelines, is required to enable more efficient use of resources.
  • Intracranial abscess secondary to dental infection

    Brady, Paul; Bergin, Sarah; Cryan, Bartley; Flanagan, Oisin (Irish Dental Association, 2014-03)
    The oral cavity is considered as being home to a rich and abundant microflora, including Aggregatibacter actinomycetemcomitans (A. ac tinomyc etemcomitans), which is recognised as one of the major pathogens in destructive periodontal disease.1 A cerebral abscess linked to a dental source is a rare occurrence, since in most individuals the blood-brain barrier, along with the immune response, will exclude bacteria. In this age of antibiotics and with modern living conditions, pyogenic brain infections of odontogenic origin are uncommon in western society. It has been postulated that oral microorganisms may enter the cranium by several pathways: 1) by direct extension, 2) by haematogenous spread, 3) by local lymphatics, and 4) indirectly, by extraoral odontogenic infection. Brain abscesses thought to be of dental origin have been reported to have a lethal outcome.2
  • Motivational interviewing for dental clinicians

    Curtin, Sharon; Trace, Anna; Ziada, Hassan (Irish Dental Association, 2014-03)
    Motivational interviewing (MI) is a client centred therapeutic approach, which has been found to be an effective intervention for healthcare change, as it helps to enhance clients’ commitment to the process of change and enables them to resolve their ambivalence to it.1 It is also highly effective when used as a prelude to treatment, for example cognitive behavioural therapy, and its effects appear to endure over time.2 This endurance is attributed to its effects on retention of what is learned and on adherence to the treatment. MI is relevant for healthcare professionals, especially those working in the medical setting where, as Miller and Rollnick3 point out, “motivational issues in patient behaviour change are quite common” (p.35). Furthermore, research has shown that clients working with MI-trained healthcare practitioners were more highly motivated to change.
  • Unilateral coronoid hyperplasia associated with early childhood facial trauma: a case presentation

    Sleeman, Duncan; Warren, Emma; McAuliffe, Micheal (Irish Dental Association, 2012-08)
  • The clinical relevance of orthognathic surgery on quality of life

    Murphy, C.; Kearns, G.; Sleeman, D.; Cronin, M.; Allen, P.F. (2012-09-19)
  • Factors influencing the provision of removable partial dentures by dentists in Ireland.

    Allen, Finbarr; Cork Dental School and Hospital, Wilton, Cork. (Irish Dental Association, 2010-10)
    Factors influencing clinical treatment of partially dentate patients are varied, and there is a need to identify factors influencing success in the provision of removable partial dentures. The aim of this study was to assess the attitudes of general dental practitioners (GDPs) in Ireland towards tooth replacement and use of RPDs, in partially dentate older adults. The sample frame was the Register of Dentists in Ireland; data were also collected from a sample of dentists practising under NHS regulations in Northern Ireland. Validated questionnaires were sent to all dentists on the Register of Dentists in the Republic of Ireland, and dentists working under NHS regulations registered with the Central Services Agency in Northern Ireland. Content of the questionnaire included details of the dentist themselves, their dental practice and the profile of partial denture provision. They were also asked to give their views on factors influencing the success or failure of an RPD, the process of providing RPDs and their attitudes to RPD provision. A total of 1,143 responses were received, a response rate of 45%. A mean number of 61 RPDs per annum were provided, with 75% of dentures provided being acrylic based. Respondents indicate their belief that cobalt-chromium based dentures had a longer prognosis than acrylic dentures, but less than half (46%) claim to design the frameworks themselves. Patients' attitudes are considered influential in the success of RPD provision, and their influence on appearance is considered the most important factor influencing success. The most important factors influencing failure are: the patient not requesting a denture; an RPD restoring unbounded saddles; and, lower RPDs. Although considered important, approximately 60% of the sample do not routinely organise follow-up appointments for patients provided with RPDs. The fee structures in the DTSS and DTBS are considered a barrier to quality in the provision of partial dentures.
  • Demographics of implant placement and complications of a patient subgroup in a dental hospital population.

    Brennan, Maire; Houston, Frank; O'Sullivan, Michael; O'Connell, Brian; Department of Restorative Dentistry, University Dental School and Hospital, Wilton, Cork. (Irish Dental Association, 2010-05)
    Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information.
  • The demographic and academic profile of Irish dental school faculty members.

    O'Sullivan, Eleanor M; Cork University Dental School and Hospital, Wilton, Cork. (Irish Dental Association, 2009-12)
    This paper reviews the demographic, academic and professional profile of Irish dental school faculty members. Faculty duties are explored.
  • Career choices on graduation a study of recent graduates from University College Cork.

    McKenna, Gerald; Burke, Francis; School of Dentistry, University College Cork. (Irish Dental Association, 2009-12)
    Irish dental graduates are eligible to enter general dental practice immediately after qualification. Unlike their United Kingdom counterparts, there is no requirement to undertake vocational training (VT) or any pre-registration training. VT is a mandatory 12-month period for all UK dental graduates who wish to work within the National Health Service. It provides structured, supervised experience in training practices and through organised study days.
  • Milestones in oral health services in the Republic of Ireland

    McDonnell, M (Irish Dental Association, 2012-06)
  • An audit of the caries status of patients about to start orthodontic treatment

    Meade, Maurice J; Millett, Declan T (Irish Dental Association, 2011-06)
  • Supporting career choices in dentistry

    Curtin, S; Ray, NJ; McKenna, G (Irish Dental Association, 2012-02)
    Abstract of Article
  • Gerodontology – how big is the challenge in Ireland

    Allen, Dr Finbar; McKenna, Dr Gerald; Mata, Dr Cristiane (Irish Dental Association, 2010-06)
  • Impact of chronic oral mucosal disease on daily life: preliminary observations from a qualitative study.

    Riordain, R Ni; Meaney, S; McCreary, C; Cork University Dental School and Hospital, Wilton, Cork, Ireland. (2011-04)
    Chronic oral mucosal conditions impact upon the experience of daily life of patients in a variety of areas from physical health and functioning, to concerns about their future. The role of the oral medicine practitioner in treating patients with chronic oral mucosal diseases extends beyond active management and symptomatic relief to the management of all aspects of these conditions that impact upon their daily lives.
  • State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools.

    Lynch, C D; Frazier, K B; McConnell, R J; Blum, I R; Wilson, N H F; Restorative Dentistry, Tissue Engineering & Reparative Dentistry, School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY. (2010-08-14)
    The teaching of posterior composites in the Irish and UK dental schools has substantially increased over the last five years. Dental students in these schools often gain more experience in the placement of posterior composites than amalgam. However, practice trends indicate that a majority of GDPs continue to place amalgam in preference to composite, thereby suggesting a source of tension as current dental students emerge into the dental workforce over the coming years. There is, as a consequence, a challenge to the dental profession and its funding agencies in the UK to encourage more of a shift towards the minimally interventive use of composite systems in the restoration of posterior teeth, in particular among established practitioners.
  • Oral medicine and the elderly.

    McCreary, Christine; Ní Ríordáin, Richeal; Cork University Dental School and Hospital, Wilton, Cork, Ireland. (2011-03-15)
    A focus often exists in dental practice on the maintenance and management of the dentition and the periodontium, however, conditions of the oral mucosa and orofacial pain can cause significant problems for older patients. Oral mucosal conditions are more prevalent in older patients and many orofacial pain disorders, such as burning mouth syndrome and trigeminal neuralgia, are more common in patients over the age of 50 years. Although these conditions may not be routinely managed in general practice, identification of these patients in primary care and appropriate referral will lead to more prompt and effective treatment. CLINICAL RELEVANCE: Dental practitioners need to be able to identify what is considered to be within the normal physiological limits of the ageing oral tissue and hence what is abnormal and requires further investigation to facilitate appropriate referral.
  • Systemic diseases and the elderly.

    McCreary, Christine; Ni Riordáin, Richeal; Oral Medicine Unit, Cork University Dental School and Hospital, Wilton, Cork, Ireland. (2010-11)
    Although systemic diseases can occur at any age, they are more common in older patients. Accurate and detailed medical and drug histories are important in dental practice as many conditions and medications can influence oral health and dental care in patients. Not only can these conditions influence patient care in the surgery and oral hygiene at home, but access to dental services may also be adversely affected. Clinical Relevance: The systemic diseases can impact upon oral care or can have oral manifestations. Many of the pharmacological interventions prescribed for chronic conditions can have multiple and diverse adverse effects on the oral environment.

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