Ingrid Peroz

Randomized controlled trial comparing lecture versus self studying by an online tool

Objectives: Since 2001, an e-learning tool has been developed for dentistry. To compare online self study with traditional lectures, a module about instrumental occlusal analysis was offered by oral lecture and by a unit in the virtual library of the e-learning tool. Methods: 85 pre-clinical dental students were randomly divided into two groups: the computer assisted learning (CAL) group (n = 48) and the lecture group (n = 37). A pre-test was made to assess the students′ basic knowledge. The first post-test and the scoring of the teaching methods were performed immediately after the lecture or the self studying by the online tool and a second post-test six weeks later. Results: The oral lecture got better educational and enjoyment values. The students prefer CAL in addition to traditional lectures. The results of the pre-tests were not different between the two groups (p = 0.706). The lecture group significantly improved their scores in the first post-test (p = 0.011), but the scores of the second post-test did not differ significantly (p = 0.157). Conclusions: In the short term, knowledge acquisition seems to be better in oral lectures but in the long term there is no difference in knowledge retention between the two learning scenarios.

Fiber post placement with core build-up materials or resin cements—An evaluation of different adhesive approaches

Abstract Objective. To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin. Materials and methods. Forty maxillary first incisors were decoronated and endodontically treated. Specimens were randomly distributed into five groups (n = 8) and fiber-posts (DentinPost coated, Komet) were inserted using five different luting materials: etch-and-rinse adhesive systems and corresponding core-and-post material in groups 1 (DentinBond/DentinBuild, Komet) and 2 (XP Bond + SCA/Core-X flow, Densply), self-adhesive resin cements in groups 3 (RelyX Unicem, 3M Espe) and 4 (SmartCem 2, Dentsply) and a self-etch adhesive/resin cement in group 5 (ED-Primer II/Panavia F 2.0, Kuraray). The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated. Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05. The failure modes were analyzed using Chi square test. Results. The bond strength [MPa] (mean/min–max) for groups 3 (12.35/3.60–32.44), 4 (13.52/4.48–30.69) and 2 (11.15/5.23–35.58) were significantly higher (p < 0.001) compared to groups 1 (6.66/2.34–24.89) and 5 (7.41/0.28–34.18). Adhesive failure between dentin and luting agent was the most frequent failure mode. Conclusions. Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used. One (group 2) of the tested core-and-post materials/etch-and-rinse adhesive achieved comparable bond strength values.

A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus

The majority of tinnitus patients are affected by chronic idiopathic tinnitus, and almost 60 different treatment modalities have been reported. The present study is a multidisciplinary systematic analysis of the evidence for the different forms of treatment for chronic tinnitus. The results are used to form the basis of an S3 guideline. A systematic search was carried out in PubMed and the Cochrane Library. The basis for presenting the level of evidence was the evidence classification of the Oxford Centre of Evidence-based Medicine. Whenever available, randomised controlled trials were given preference for discussing therapeutic issues. All systematic reviews and meta-analyses were assessed for their methodological quality, and effect size was taken into account. As the need for patient counselling is self-evident, specific tinnitus counselling should be performed. Due to the high level of evidence, validated tinnitus-specific, cognitive behavioural therapy is strongly recommended. In addition, auditory therapeutic measures can be recommended for the treatment of concomitant hearing loss and comorbidities; those should also be treated with drugs whenever appropriate. In particular, depression should be treated, with pharmacological support if necessary. If needed, psychiatric treatment should also be given on a case-by-case basis. With simultaneous deafness or hearing loss bordering on deafness, a CI can also be indicated. For auditory therapeutic measures, transcranial magnetic or direct current stimulation and specific forms of acoustic stimulation (noiser/masker, retraining therapy, music, and coordinated reset) for the treatment of chronic tinnitus the currently available evidence is not yet sufficient for supporting their recommendation.

Zur interdisziplinären S3-Leitlinie für die Therapie des chronisch-idiopathischen Tinnitus

INTRODUCTION Tinnitus is a frequent symptom, which, particularly in combination with comorbidities, can result in a severe disease-related burden. Chronic idiopathic tinnitus (CIT) is the most frequent type of tinnitus. A considerable number of treatment strategies are used to treat CIT-for many of which there is no evidence of efficacy. In order to enable scientific evidence-based treatment of CIT, German interdisciplinary S3 guidelines have recently been constructed for the first time. Here we present a short form of these S3 guidelines. MATERIALS AND METHODS The guidelines were constructed based on a meta-analysis of the treatment of chronic tinnitus performed by the authors. Additionally, a systematic literature search was performed in the PubMed and Cochrane Library databases. Furthermore, a systematic search for international guidelines was performed in Google, as well as in the Guidelines International Network and National Guideline Clearinghouse (USA) database. Evidence was classified according to the Oxford Centre for Evidence-Based Medicine system. RESULTS According to the guidelines, alongside counselling, manualized structured tinnitus-specific cognitive behavioral therapy (tCBT) with a validated treatment manual is available as evidence-based therapy. In addition, the guidelines recommend concurrent treatment of comorbidities, including drug-based treatment, where appropriate. Particularly important is treatment of anxiety and depression. Where a psychic or psychiatric comorbidity is suspected, further diagnosis and treatment should be performed by an appropriately qualified specialist (psychiatrist, neurologist, psychosomatic medicine consultant) or psychological psychotherapist. In cases accompanied by deafness or hearing loss bordering on deafness, cochlear implants may be indicated. CONCLUSION No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations must remain open due to the lack of available evidence. Polypragmatic tinnitus treatment with therapeutic strategies for which there is no evidence of efficacy from controlled studies is to be refused.

On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus

INTRODUCTION Tinnitus is a frequent symptom, which, particularly in combination with comorbidities, can result in a severe disease-related burden. Chronic idiopathic tinnitus (CIT) is the most frequent type of tinnitus. A considerable number of treatment strategies are used to treat CIT-for many of which there is no evidence of efficacy. In order to enable scientific evidence-based treatment of CIT, German interdisciplinary S3 guidelines have recently been constructed for the first time. Here we present a short form of these S3 guidelines. MATERIALS AND METHODS The guidelines were constructed based on a meta-analysis of the treatment of chronic tinnitus performed by the authors. Additionally, a systematic literature search was performed in the PubMed and Cochrane Library databases. Furthermore, a systematic search for international guidelines was performed in Google, as well as in the Guidelines International Network and National Guideline Clearinghouse (USA) database. Evidence was classified according to the Oxford Centre for Evidence-Based Medicine system. RESULTS According to the guidelines, alongside counselling, manualized structured tinnitus-specific cognitive behavioral therapy (tCBT) with a validated treatment manual is available as evidence-based therapy. In addition, the guidelines recommend concurrent treatment of comorbidities, including drug-based treatment, where appropriate. Particularly important is treatment of anxiety and depression. Where a psychic or psychiatric comorbidity is suspected, further diagnosis and treatment should be performed by an appropriately qualified specialist (psychiatrist, neurologist, psychosomatic medicine consultant) or psychological psychotherapist. In cases accompanied by deafness or hearing loss bordering on deafness, cochlear implants may be indicated. CONCLUSION No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations must remain open due to the lack of available evidence. Polypragmatic tinnitus treatment with therapeutic strategies for which there is no evidence of efficacy from controlled studies is to be refused.

Sind Reinigungstabletten für die alltägliche Zahnprothesenhygiene geeignet

ZusammenfassungEine suffiziente Zahnprothesenhygiene ist insbesondere bei immunkompromittierten und bettlägerigen Patienten sehr wichtig, um das Risiko der Aspiration pathogener Keime zu verringern. Neben mechanischer Reinigung stehen auch chemische Prothesenreiniger (CPR) für den täglichen Hausgebrauch zur Verfügung. Sie gelten jedoch weithin als problematisch, weil sie die Prothesenmaterialien angreifen würden. Diese Vorurteile basieren auf Studien an Produkten mit hochalkalischen pH-Werten, die zudem stark bleichend wirkende Substanzen wie Hypochlorit enthalten. Die in Deutschland frei verkäuflichen Reinigungstabletten gehören zur Gruppe der neutralen oder schwach alkalischen Peroxide und folgen einem wesentlich weniger aggressiven Konzept, weswegen auch keine Nebenwirkungen nach versehentlicher Ingestion bekannt wurden. In-vitro-Studien zeigen, dass die auch vom Pflegepersonal einfach durchzuführende, regelmäßige Anwendung der CPR durchaus einen wesentlichen Beitrag zur Prothesenhygiene leisten kann. Gerade bei Bewohnern von Pflegeeinrichtungen ergänzt sie die mechanische Reinigung gut, ohne den Zahnersatz zu schädigen.AbstractSufficient denture hygiene is very important in particular for immunocompromised and bedridden patients to reduce the risk posed by the aspiration of pathogenic microorganisms. In addition to mechanical cleansing, chemical denture cleansers are suitable for daily use at home. However, they continue to be seen as problematic because they are said to damage the denture material. These prejudices are based on studies of products with highly alkaline pH values, which in addition contain strong bleaching agents, e.g., hypochlorite. In Germany, denture cleansing tablets available over the counter belong to the group of neutral or weakly alkaline peroxides and are much less aggressive, which is why no side effects are reported from accidental ingestion. In vitro studies show that nursing staff can significantly contribute to denture hygiene by regularly applying the easy-to-use method of chemical cleansing. In particular as regards the residents of care facilities, it reasonably supplements mechanical cleansing without damaging the dentures.Sufficient denture hygiene is very important in particular for immunocompromised and bedridden patients to reduce the risk posed by the aspiration of pathogenic microorganisms. In addition to mechanical cleansing, chemical denture cleansers are suitable for daily use at home. However, they continue to be seen as problematic because they are said to damage the denture material. These prejudices are based on studies of products with highly alkaline pH values, which in addition contain strong bleaching agents, e.g., hypochlorite. In Germany, denture cleansing tablets available over the counter belong to the group of neutral or weakly alkaline peroxides and are much less aggressive, which is why no side effects are reported from accidental ingestion. In vitro studies show that nursing staff can significantly contribute to denture hygiene by regularly applying the easy-to-use method of chemical cleansing. In particular as regards the residents of care facilities, it reasonably supplements mechanical cleansing without damaging the dentures.

Zur interdisziplinären S3-Leitlinie für die Therapie des chronisch-idiopathischen Tinnitus@@@On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus

INTRODUCTION Tinnitus is a frequent symptom, which, particularly in combination with comorbidities, can result in a severe disease-related burden. Chronic idiopathic tinnitus (CIT) is the most frequent type of tinnitus. A considerable number of treatment strategies are used to treat CIT-for many of which there is no evidence of efficacy. In order to enable scientific evidence-based treatment of CIT, German interdisciplinary S3 guidelines have recently been constructed for the first time. Here we present a short form of these S3 guidelines. MATERIALS AND METHODS The guidelines were constructed based on a meta-analysis of the treatment of chronic tinnitus performed by the authors. Additionally, a systematic literature search was performed in the PubMed and Cochrane Library databases. Furthermore, a systematic search for international guidelines was performed in Google, as well as in the Guidelines International Network and National Guideline Clearinghouse (USA) database. Evidence was classified according to the Oxford Centre for Evidence-Based Medicine system. RESULTS According to the guidelines, alongside counselling, manualized structured tinnitus-specific cognitive behavioral therapy (tCBT) with a validated treatment manual is available as evidence-based therapy. In addition, the guidelines recommend concurrent treatment of comorbidities, including drug-based treatment, where appropriate. Particularly important is treatment of anxiety and depression. Where a psychic or psychiatric comorbidity is suspected, further diagnosis and treatment should be performed by an appropriately qualified specialist (psychiatrist, neurologist, psychosomatic medicine consultant) or psychological psychotherapist. In cases accompanied by deafness or hearing loss bordering on deafness, cochlear implants may be indicated. CONCLUSION No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations must remain open due to the lack of available evidence. Polypragmatic tinnitus treatment with therapeutic strategies for which there is no evidence of efficacy from controlled studies is to be refused.