• The McKesson prop--an essential tool for the emergency physician?

      Murphy, A P; Doran, H J; O'Sullivan, I; Sleeman, D; Cusack, S P A; Department of Emergency Medicine, Cork University Hospital, Cork, Ireland. adrianmurphy06@eircom.net (2010-02)
      Facial trauma is a commonly encountered presentation to emergency departments. When associated airway compromise occurs, co-existing head and neck injuries serve to produce a challenging clinical situation. We describe two patients who suffered multi-system trauma, with severe maxillofacial injuries that necessitated prompt definitive airway management and mid-face stabilisation in the pre-hospital and emergency department phases of resuscitation. The McKesson prop is a simple yet highly effective tool for use in these injuries.
    • Milestones in oral health services in the Republic of Ireland

      McDonnell, M (Irish Dental Association, 2012-06)
    • 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.
    • 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.
    • A national study on the attitudes of Irish dental faculty members to faculty development.

      O'Sullivan, E M; Oral & Maxillofacial Surgery Department, Cork University Dental School & Hospital, University College Cork, Cork, Ireland. eleanor.osullivan@ucc.ie (2010-02)
      International studies suggest that dental faculty are resistant to the concept and practice of faculty development. This paper analyses the demographic and educational profile of Irish Dental Faculty, exploring their attitudes to educational initiatives.
    • NICE guideline on antibiotic prophylaxis against infective endocarditis: attitudes to the guideline and implications for dental practice in Ireland.

      Ríordáin, R Ní; McCreary, C; Cork University Dental School and Hospital, Wilton, Cork, Ireland. richeal.niriordain@ucc.ie (2009-03-28)
      To investigate attitudes of Irish dental practitioners, cardiologists and patients with cardiac lesions to the new NICE guideline for antibiotic prophylaxis against infective endocarditis and to determine the implications of this guideline for dental practice in Ireland.
    • Occlusal accommodation and mouthguards for prevention of orofacial trauma.

      Geary, Julian Lindsay; Clifford, Thomas Joseph; Kinirons, Martin James; Paediatric and Preventive Dentistry, School of Medicine and Dentistry, Queen's University Belfast, BT12 6BA, UK. l.geary@qub.ac.uk (2009)
      The aim of this study was to investigate the effect of two types of occlusal accommodation on the arch separation in centric and eccentric arch positions and to assess the opposing tooth contacts in professionally made, thermoformed sports mouthguards.
    • Oral cancer--current knowledge, practices and implications for training among an Irish general medical practitioner cohort.

      Ni Riordain, Richeal; McCreary, Christine; Oral Medicine Unit, Cork University Dental School and Hospital, Wilton, Cork, Ireland. richeal.niriordain@ucc.ie (2009-11)
      This study investigated the current knowledge and practices of general medical practitioners (GMPs) in Ireland regarding the examination of the oral cavity and the detection of oral malignancy and the training they had received at both undergraduate and postgraduate level and since commencing in practice. A questionnaire survey of GMPs in Ireland was conducted. One hundred and fifty four (65.3%) of the practitioners reported regularly examining the oral mucosa of their patients. Almost half of these (n=68) further qualified this response by stating that they only examined the oral mucosa if the patient reported pain in this area or if the patient specifically requested an oral examination for some reason. Eighty one (34.3%) practitioners surveyed felt confident in their ability to detect oral malignancies with the remaining two thirds unsure of whether they would be able to detect oral cancer. There was a significant association between the undergraduate and postgraduate teaching on examination of the oral cavity and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=4.811, p<0.05]. A statistically significant association was also found between the undergraduate and postgraduate teaching on the diagnosis of oral malignant disease and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=6.194, p<0.05]. In conclusion the level of knowledge of Irish general medical practitioners needs to be addressed with appropriate initiatives both at undergraduate level and via CME.
    • 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.
    • Periodontitis and type 2 diabetes: is oxidative stress the mechanistic link?

      Allen, E M; Matthews, J B; O'Connor, R; O'Halloran, D; Chapple, I L C; Dept. of Restorative Dentistry, Cork University Dental School & Hospital, Cork, Ireland. e.allen@ucc.ie (2009-05)
      Periodontitis is a common, chronic inflammatory disease initiated by bacteria which has an increased prevalence and severity in patients with type 2 diabetes. Recent studies indicate that the co-morbid presence of periodontitis can, in turn, adversely affect diabetic status and the treatment of periodontitis can lead to improved metabolic control in diabetes patients. Current evidence points to a bidirectional interrelationship between diabetes and inflammatory periodontitis. The importance of oxidative stress-inflammatory pathways in the pathogenesis of type 2 diabetes and periodontitis has recently received attention. Given the bidirectional relationship between these two conditions, this review discusses the potential synergistic interactions along the oxidative stress-inflammation axis common to both type 2 diabetes and periodontitis, and the implications of this relationship for diabetic patients.
    • A qualitative study of trends in patient preferences for the management of the partially dentate state.

      Cronin, Mary; Meaney, Sarah; Jepson, Nicholas J A; Allen, P Finbarr; Department of Public Health and Epidemiology, Brookfield, Cork, Ireland. (2009-06)
      To identify factors influencing attitudes of partially dentate adults towards dental treatment in Ireland.
    • Resin bonded bridges in patients with hypodontia: Clinical performance over a 7 year observation period.

      Anweigi, Lamyia; Azam, Ambreen; Mata, Cristiane de; AlMadi, Ebtissam; Alsaleh, Samar; Aldegheishem, Alhanoof (2019-12-11)
      Purpose: Resin bonded bridges (RBBs) are considered a conservative option in the management of hypodontia. This study targeted to analyze the survival of resin bonded bridges provided to patients with Hypodontia by staff and students at the Department of Restorative Dentistry, University Dental School and Hospital Cork, Ireland. It was also to determine the factors that may influence the survival of RBBs in patients with hypodontia. Methods: Forty patients with hypodontia who received 65 RBBs from 2001 to 2007 were identified and contacted to be recruited for this study. Of these, nine were not contactable, and five failed to attend. Accordingly, 26 patients (65%) participated in the study, with a total of 51 RBBs. Results: Of the 51 RBBs evaluated, 44 (86%) were still in situ and functional and 7 (14%) failed. The main reason for failure was repeated debonding. The effect of age, gender, the grade of operator and experience, bridge location, design of the bridge, span length and moisture control during cementation, could not be demonstrated. Conclusion: The effect of age, gender, the grade of operator and experience, bridge location, design of the bridge, span length and moister control on RBB survival could not be demonstrated. Majority of patients with hypodontia showed satisfaction with resin bonded bridges. In replacing congenitally missing teeth in patients with hypodontia, resin-bonded bridges would be an acceptable treatment option.
    • Stability of dental implants in grafted bone in the anterior maxilla: longitudinal study.

      Al-Khaldi, Nasser; Sleeman, Duncan; Allen, Finbarr; Private Dental Practice, Muscat, Oman. (2010-06-06)
      We aimed to assess the stability over time of dental implants placed in grafted bone in the maxilla using resonance frequency analysis, and to compare the stability of implants placed in grafted and non-grafted bone. Data were collected from 23 patients (15 test and 8 controls) in whom 64 implants (Brånemark system, Nobel Biocare, Göteborg, Sweden) were placed in accordance with the two-stage surgical protocol. In the test group 36 fixtures were placed in grafted bone, and in the control group 28 fixtures were placed in non-grafted bone. Resonance frequency analysis was used to assess the test sites at implant placement and abutment connection. The mean (SD) implant stability quotient (ISQ) for test sites at the time of implant placement was 61.91 (6.68), indicating excellent primary stability, and was 63.53 (5.76) at abutment connection. ISQ values at abutment connection were similar for test and control sites. Implants placed in grafted bone compared favourably with those in non-grafted bone, and showed excellent stability.
    • 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. lynchcd@cardiff.ac.uk (2010-08-14)
      Advances of composite systems and their application have revolutionised the management of posterior teeth affected by caries, facilitating a minimally invasive approach. Previous surveys have indicated that the teaching of posterior composites within dental schools was developing, albeit not keeping pace with clinical evidence and the development of increasingly predictable techniques and materials. Concurrently, surveys of dental practice indicate that dental amalgam still predominates as the 'material of choice' for the restoration of posterior teeth within UK general dental practice. In light of such considerations, the aim of this study was to investigate current teaching of posterior composites in Irish and UK dental schools.
    • A study of patient attitudes towards fasting prior to intravenous sedation for dental treatment in a dental hospital department.

      McKenna, Gerald; Manton, Sarah; Neilson, Avril; Cork University Dental Hospital, Cork, Republic of Ireland. g.mckenna@ucc.ie (2010-01)
      Intravenous sedation is the most commonly used method of sedation for the provision of adult dental care. However, disparity exists in pre-operative fasting times in use for patients throughout the United Kingdom.
    • A study of the management of 55 traumatically intruded permanent incisor teeth in children.

      Stewart, C; Dawson, M; Phillips, J; Shafi, I; Kinirons, M; Welbury, R; Dept Paediatric Dentistry, Cork University Dental School and Hospital, Cork, Ireland. (2009-01)
      These were to examine the main presenting, treatment and outcome factors for intruded permanent incisors in children, the effect of apical development and degree of intrusion on decisions on repositioning, the effect of apical development status on the maintenance of pulp vitality and the time of pulp extirpation and to compare the decisions made to the advice given in existing clinical guidelines.
    • Supporting career choices in dentistry

      Curtin, S; Ray, NJ; McKenna, G (Irish Dental Association, 2012-02)
      Abstract of Article
    • 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.
    • Technical quality of root canal fillings performed in a dental school and the associated retention of root-filled teeth: a clinical follow-up study over a 5-year period.

      Burke, F M; Lynch, C D; Ní Ríordáin, R; Hannigan, A; University Dental School & Hospital, University College, Cork, Ireland. (2009-07)
      The aim of this study was to examine the technical quality of root canal fillings performed in a dental school and to investigate the associated effect on the survival/retention of root-filled teeth. A review of case notes of patients who had root canal treatment performed in the department of Restorative Dentistry, University Dental School and Hospital, Cork, Ireland was carried out. The technical quality of the root canal filling was described according to its relationship with the radiographic apex on a post-treatment radiograph. Tooth status at review was defined as 'tooth present' or 'tooth absent' based on the presence or absence of the root-filled tooth recorded in the treatment records at a review appointment following placement of the root canal filling. One hundred and forty-eight teeth (129 patients) were considered. Of these, 69.6% (n = 103) were of acceptable technical quality, 23.6% (n = 35) were under-extended, and 6.8% (n = 10) were overextended. An increased number of intra-treatment radiographs to confirm the relationship of the canal preparation to the radiographic apex and operator experience were significant predictors of adequate root canal fillings (P < 0.05). Eighty-three per cent (n = 123) of teeth were present at a review appointment held an average of 40 months following completion of treatment (12-60 months). The technical quality of the root canal filling was the only significant factor in predicting tooth survival (P < 0.05), while the presence of pre-treatment periapical pathology had no significant effect on survival of the root-filled tooth. Determination and maintenance of the working length of the canal system is an important feature in producing good quality root canal fillings, which in turn, is associated with increased likelihood of survival/retention of root-filled teeth.
    • Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 1. Nasal changes.

      Ayoub, Ashraf; Garrahy, Ann; Millett, Declan; Bowman, Adrian; Siebert, Paul; Miller, James; Ray, Arup; Glasgow Dental Hospital and School. (2010-08-11)
      Abstract Objective: To evaluate 3D nasal morphology following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous non-cleft data Design: Prospective, cross-sectional, controlled study. Setting: Glasgow Dental Hospital & School, Faculty of Medicine, Glasgow University Patients and Participants: Two groups of 3-year old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a 3D vision based capture technique. Methods: 3D images of the face were reflected so the cleft was on the left side to create a homogenous group for statistical analysis. Three-dimensional co-ordinates of anthropometric landmarks were extracted from facial images by a single operator. A set of linear measurements was utilised to compare cleft and control subjects on right and left sides, adjusting for sex differences Results: the mean nasal base width and the width of the nostril floor on right and left sides differed significantly between control and Unilateral Cleft Lip and Palate (UCLP) groups. The measurements were greater in UCLP children. The difference in the mean nasal height and mean nasal projection between the groups were not statistically significant. Mean columellar lengths were different between the left and right sides in UCLP cases. Conclusions: There were significant nasal deformities following the surgical repair of UCLP. Keywords: child, cleft lip and palate, three-dimensional imaging.