IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adReportar como inadecuado




IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate ad - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Oral Health

, 13:58

Clinical oral healthcare research

Abstract

BackgroundPeriodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care tooth brushing and interdental aids for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation PI, are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness if any of different types of Oral Hygiene Advice OHA. The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial RCT in primary dental care.

Methods-DesignThis is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis Basic Periodontal Examination Score 0–3. Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI current practice, or 12 monthly PI.

Baseline measures and outcome data during a three year follow-up will be assessed through clinical examination, patient questionnaires and NHS databases.

The primary outcome measures at 3 year follow up are gingival inflammation-bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits.

DiscussionIQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making.

Trial registrationProtocol ID: ISRCTN56465715

KeywordsOral hygiene advice Scale and polish Prevention Toothbrushing advice Periodontal instrumentation RCT Primary care AbbreviationsADHSAdult dental health survey

BPEBasic periodontal examination

CALClinical attachment loss

CHaRTCentre for healthcare randomised trials

DCEDiscrete choice experiment

DMECData monitoring and ethics committee

GCPGood clinical practice

ICCIntracluster correlation

ICHInternational conference on harmonisation of technical requirements for registration of pharmaceuticals for human use

NHSBSANHS business services authority England-Wales

NIHRNational institute for health research

OHAOral hygiene advice

OHIP – 14Oral health impact profile – 14

PIPeriodontal instrumentation

PSDPractitioner services division Scotland

RCTRandomised controlled trial

TCODTrial co-ordinating office in Dundee

TSCTrial steering committee

UDAUnit of dental activity

UNCUniversity of North Carolina

WTPWillingness to pay.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6831-13-58 contains supplementary material, which is available to authorized users.

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Autor: Jan E Clarkson - Craig R Ramsay - Paul Averley - Debbie Bonetti - Dwayne Boyers - Louise Campbell - Graham R Chadwick -

Fuente: https://link.springer.com/



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