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1
Percy, Daphne Helen. "A Study of Five Cincinnati Health Department Dental Clinics: An Assessment of Emergency Dental Patients Needs." University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1029530616.
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Percy, Daphne H. "A study of five Cincinnati Health Department dental clinics an assessment of emergency dental patients needs /." Cincinnati, Ohio : University of Cincinnati, 2002. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=ucin1029530616.
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Woolley, Stephen Mark. "Patients, performance and parlours : the perception and socially constructed practises of dental sedation clinics." Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/38882/.
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Conscious Sedation is a pharmacological intervention which enables anxious patients to have dental treatment. Although there is a strong research tradition into the efficacy of sedation modalities, there is a weak evidence base for the experience of sedation by those who use it. The aim of this thesis was to explore patients’, referrers’ and providers’understandings and experiences of conscious sedation and the Secondary Care Sedation Clinics which use it. A qualitative study was undertaken of stakeholders’ experiences of conscious sedation provided by five Secondary Care Sedation Clinics within the United Kingdom. Data were collected through thirty one semi-structured interviews, which were transcribed verbatim and subsequently analysed using a constant comparative method. The data show that sedation and secondary care sedation clinics are imbued with a variety of interpretations by differing participants. Patients primarily perceive sedation clinics as access points for addressing dental needs, whilst clinicians also anticipate an influential role in rehabilitating patients to primary care and recognise the importance of such settings for training future dentists. Successful sedation provision requires a variety of work, and sedation clinics play a hosting role to visiting patients as hinterlands to the dental world. The outcome of patients’engagement with sedation clinics varies from breaking avoidant patterns to creating a cycle of sedation dependency, whilst the process of sedation performance has a potential negative impact for providers. 2 The purposes and processes reported by participants mirror those of Victorian domestic parlours. This thesis suggests a novel theoretical construct of clinical ‘Parlours’. Such frontier social structures provide safe interaction for patients in a temporarily hosting environment. They require front-stage performance augmented by back-stage work, and seek to influence patients in the long-term whilst providing short-term clinical services. Further research is required to explore the transferability of such a concept to other clinical settings.
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Raan, F. J. du. "Using a mathematical model to determine dental arch- perimeter in class ii patients presenting at UWC orthodontic clinics." University of the Western Cape, 2021. http://hdl.handle.net/11394/7976.
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Doctor Scientiae - DScDetermining arch perimeter is of importance in both a clinical setting, where it is used to determine space requirements, as well as in an epidemiological setting where it is used to describe large populations. Physical measurement of arch perimeter is time consuming and may be prone to operator errors when done on study casts and even more so in a clinical situation. The use of a simple mathematical model to predict arch perimeter, using a few measurements that can be done easily and reliably, would be of great use to the practitioner.
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García, Loera José Miguel. "Patient satisfaction and oral health-related quality of life outcomes in edentulous patients being treated with complete dentures by dental students at the University of Iowa College of Dentistry and Dental Clinics." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6421.
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Objectives:
The aim of this study is to investigate the impact of multiple factors in the Oral Health Related Quality of Life of patients being treated with Conventional Complete Dentures, including: a) Level of expertise of the dental provider (third year dental student vs. fourth year dental student); b) Length of time edentulous; c) Number of previous prostheses; d) Race; e) Sex; f) Age; g) Systemic conditions; h) Condition of the bone ridge; i) Economic factor and insurance coverage, in patients at the University of Iowa College of Dentistry (D3 and D4 Clinics).
Materials and methods:
Eighty-one subjects who had been completely edentulous (49 men and 32 women; age range from 23 to 93 years old, mean of 58.9+13) for a minimum of 3 months were recruited. Out of the eighty-one, eleven subjects were not included in the final analysis because their prostheses were not delivered due to various reasons (time, death, discontinued treatment). Subjects were asked to complete the OHIP-EDENT (Oral Health Impact Profile for Edentulous Patients) and the patient satisfaction questionnaire to record data at baseline, at 1-week post-delivery and at 1-month post-delivery of the new prostheses. Additional to these two instruments, the PDI Classification instrument (to assess bone/tissue condition) and the Kapur Index (to assess retention/stability of the new prostheses) were also used.
Baseline comparisons of subjects seen at the D3 vs. the D4 clinic were carried out using chi-square tests of association for nominal ordinal variables, and the Wilcoxon-Mann-Whitney test for ordinal and quantitative outcomes. Bivariate analyses were conducted to assess potential relationships between covariates and the primary outcomes (total OHIP-EDENT and total Patient Satisfaction Questionnaire scores at one-week and one-month follow-ups). The Spearman rank correlation was used to identify increasing or decreasing relationships between primary outcomes and quantitative and ordinal variables; the Wilcoxon-Mann-Whitney test was used to assess relationships between primary outcomes and categorical covariates.
Results:
Overall, there was not enough statistical evidence to conclude that patient satisfaction and quality of life were significantly affected by most of the factors being studied. However, there was suggestive evidence of the presence of higher level of quality of life for patients seen in the D4 clinic (students with higher level of expertise). At the one-month follow-up, the comparison of the total OHIP-EDENT score between the D3 and D4 clinics was significant at the 0.05 level (p=0.018, exact Wilcoxon-Mann-Whitney test). The total OHIP-EDENT scores tended to be lower (indicating greater satisfaction) in the subjects seen in the D4 clinic. Two of the nineteen items from the patient satisfaction questionnaires also suggested a greater level of patient satisfaction for patients seen in the D4 clinic (students with higher level of expertise).
Conclusion:
1) Oral health related quality of life at 1-week follow-up was not significantly different between patients treated by D3 and D4 students.
2) Oral health related quality of life at 1-week follow up was significantly better for patients who had been edentulous for a longer period of time than those who were recently edentulous. However, this result can only be considered suggestive due to the need for adjustment for multiple comparisons.
3) Oral health related quality of life at 1-month follow up was significantly better for patients treated by D4 students in comparison to D3 students. However, this result can only be considered suggestive due to the need for adjustment for multiple comparisons.
4) Overall, patient satisfaction at 1-week follow-up was not significantly different between patients treated by D3 and D4 students. However, patients treated in the D4 clinic reported significantly better outcomes in regard to speaking with their new prostheses.
5) Overall, patient satisfaction at 1-month follow-up was not significantly different between patients treated by D3 and D4 students. However, patients treated in the D4 clinic reported that they could chew better with their new prostheses compared to those treated by D3 students.
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Aartman, Irene Helena Adriana. "Treating highly anxious dental patients in a dental fear clinic." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/57439.
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Lawson, Kristin M. "Characteristics of Patients Seeking Care From a Hospital-Based Infant Dental Clinic." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1404603761.
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Sowole, Adejumobi A. "Patient satisfaction with care provided by a district dental clinic." Thesis, University of the Western Cape, 2007. http://hdl.handle.net/11394/2444.
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Magister Scientiae Dentium - MSc(Dent)Patient satisfaction is critical for the growth of oral health service and practice. The present study was a descriptive study on patient satisfaction with oral health care provided by a district dental clinic. The aim of the study was to determine whether patients attending the dental clinic of the Lagos State University hospital were satisfied with the care they received.
South Africa
9
Namana, Subhadra, and Sanar Al-Dori. "Healthcare Management : Measuring patient satisfaction of service quality in Swedish dental clinics." Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-37082.
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ABSTRACT:Healthcare management is a field that is related to management, leadership, and service of anorganization. Due to high competition and change in the environment of healthcare organizations,managers need to embrace the innovation to respond to those changes and make the organizationsuccessful by improving the process, structure, and culture of the organization as well as to provideefficient and effective care that will lead to achieve patient satisfaction. Service quality is one ofthe key factor among the service innovations that contribute to business development and leadingposition in the business world with high competition. Patient satisfaction is important for anyhealthcare organization. Patient satisfaction improves hospital/clinic image, which changes into anincrease in the use of services provided by the healthcare systems and increases market share.Patient satisfaction is dependent on the service quality which is the main factor in healthcareinnovations.Purpose: The purpose of this study is to understand experience levels of the patient satisfaction ofservice quality in Swedish dental clinics, based on the factors affecting dental service quality.Data Sources: Interviews with staff from six clinics in Sweden, 240 patient surveys from twopublic and two private Swedish dental clinic, group interviews with three Swedish dental clinics,Science-Direct, Research Gate, ABI Inform, Google Scholar, Academia.edu.Method: This study is based on the quantitative and qualitative analysis (i.e., mixed methodapproach) and abductive approaches to measure patient satisfaction in Swedish dental clinicsthrough service quality. The problem is analyzed through interviews with the staff in private andpublic dental clinics. The factors affecting the dental service quality are analyzed throughtheoretical and empirical analysis. The patient’s satisfaction was measured by SERVQUAL toolthrough using patients’ survey that consists of 12 questions based on the four factors (tangibility,empathy, responsiveness, and Assurance). Patient survey is conducted in four dental clinics. SPSSwas used to calculate mean and standard deviation for the survey’s result. After analyzing the result,group interviews with clinic 1, clinic 3 and clinic 5 was conducted to understand different valuesin the tool i.e., the value created, value destroyed, and value missed based on the customerperception to analyze the service quality of the dental clinics.Findings: The result from the surveys showed that the factor empathy has highest positive affectand responsiveness has the lowest effect in four dental clinics. The lowest effect in the factorresponsiveness is based on the waiting time to meet a dentist. The group interviews gave us thedifferent values which are based on the idea of the value mapping tool in customer perspective.The value that the clinics gained trust from their patients. The value missed\destroyed is the waitingtime to meet a dentist. The new opportunities are to improve the services by installing newtechnology products and changing the appearance of the clinic.
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Albert, Jeremy M. "Clinical evaluation of the Prophy-Jet in routine plaque debridement of orthodontic patients." [Gainesville, Fla.]: University of Florida, 2003. http://purl.fcla.edu/fcla/etd/UFE0000627.
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Eckley, Brett. "A microbiological and clinical assessment of orthodontic patients with poor oral hygiene." Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=79.
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Thesis (M.S.)--West Virginia University, 2004.Title from document title page. Document formatted into pages; contains ix, 108 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 63-67).
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Steele, Timothy P. "Design and implementation of a patient tracking and recall system for Branch Dental Clinic Monterey." Thesis, Monterey, California. Naval Postgraduate School, 1992. http://hdl.handle.net/10945/23626.
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Lam, Lok-tao Otto, and 林樂濤. "A randomized clinical trial of oral health promotion interventions among patients following stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hdl.handle.net/10722/207561.
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OBJECTIVES: The primary objective of this study was to evaluate the effectiveness of of oral health promotion interventions on both clinical oral health, and oral opportunistic pathogens in hospitalized patients following acute stroke. Secondary objectives were to investigate the development of infectious complications, as well as health-related quality of life during the hospitalization period, and to monitor clinical oral health, oral opportunistic pathogens, and health-related quality of life following hospital discharge.
METHODS: A total of 102 patients were recruited into a clinical trial conducted among stroke patients in a rehabilitation ward. Patients were randomly assigned either: 1) oral hygiene instruction 2) oral hygiene instruction and chlorhexidine mouthrinse or 3) oral hygiene instruction, chlorhexidine mouthrinse, and assisted brushing. Dental plaque, gingival bleeding, oral opportunistic pathogens, health-related quality of life, oral health-related quality of life, and functional status were assessed at baseline and review. The development of infectious complications was also monitored during the clinical trial. Patients completing the clinical trial were assessed at six months following hospital discharge.
RESULTS: Eighty-one patients were available for review at the end of the clinical trial. Reductions in dental plaque (PI) scores were significantly greater in the two groups receiving chlorhexidine compared to the group receiving oral hygiene instruction alone (p<0.001). Reductions in gingival bleeding (GBI) scores were three to four-fold greater in groups receiving chlorhexidine. Almost three quarters (72.8%) of patients harbored oral aerobic and facultatively anaerobic Gram-negative bacilli (AGNB) at baseline. Over half of the patients had detectable Staphylococcus aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed between groups (p>0.05). No cases of pneumonia were observed during the course of the clinical trial. Health-related quality of life (p<0.001), oral-health related quality of life (p=0.014), general functional disability (p<0.001), and toothbrushing ability (p=0.001) improved significantly during hospitalization. A total of 52 patients were reviewed six months following hospital discharge. PI scores were significantly higher than those observed at the end of the clinical trial (p<0.001), but were still significantly lower than those documented at baseline (p<0.001). Changes in GBI scores did not reach statistical significance (p>0.05). Percentage frequencies of AGNB (p=0.001), and viable counts of both AGNB (p<0.001) and yeasts (p=0.028) were significantly reduced at six months. No significant gains in life quality or oral functional disability were observed following hospital discharge (p>0.05).
CONCLUSIONS: The clinical oral health condition of stroke patients may be safeguarded following acute stroke with the use of chlorhexidine mouthrinse in conjunction with a standard mechanical plaque removal regimen. These interventions are acceptable to the majority of patients, and their administration poses a minimal burden to rehabilitation ward staff. There was, however, no significant difference in the effectiveness of the three different oral health promotion interventions in combating oral opportunistic pathogens. Gains in quality of life and oral functional disability were largely limited to the in-hospital rehabilitation period.published_or_final_version
Dentistry
Doctoral
Doctor of Philosophy
14
Bhoopathi, Vinodh. "Determining the Level of Patient Satisfaction in a Dental Hygiene Setting." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1035.
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Not many studies have been conducted in the past to determine patients' level of satisfaction in academic dental hygiene settings. This patient satisfaction study analyzed the level of patient satisfaction with the dental hygiene clinic at East Tennessee State University, Johnson City, TN. The purpose of the study was to determine if there was a statistically significant influence of demographic characteristics of the patients and the affective behavior of the care providers on level of patient satisfaction. It was concluded that except for age, other demographic variables did not have any statistically significant influence on patient satisfaction. Also, care provider's affective behavior significantly influenced patient satisfaction. Overall, the dental hygiene patients were satisfied with the clinic. As patients' needs are prioritized in this customer-driven industry, such positive patient satisfaction data can be used for the welfare of the patients, the care providers, and the health care organization.
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Tsang, Wing-keung Boyd, and 曾永強. "Effect of systemic antibiotics on clinical and patient-centered outcomes of implant therapy: preliminary dataanalysis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46960521.
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The use of antibiotics as prophylaxis against postsurgical infection has been propagated. However, in the field of oral implant dentistry, the use of systemic antibiotics remains a controversial issue, with various antibiotic regimens being advocated. The aims of this multi-center randomized clinical trial were to determine the effect of various systemic antibiotic prophylaxis regimens on patient-centered outcomes and perceptions, postsurgical complications in patients undergoing standard oral implant therapy.
In this preliminary study, 107 medically healthy adults who were consecutively admitted to 5 study centers for standard oral implant therapy were randomly assigned to one of the 4 groups (3 test and 1 control groups). Pre-operative antibiotics of 2 g amoxicillin 1 hour prior to standard implant placement were prescribed to test group 1 (positive control), post-operative antibiotics of 2g amoxicillin following implant placement for test group 2, and pre-operative antibiotics of 2g amoxicillin 1 hour prior to standard implant placement and 500mg three times daily on days 2 through 3 after standard implant placement for test group 3. The control group was given a placebo tablet of 2g 1 hour prior to standard implant placement without any antibiotics. Subjects were examined clinically by blinded examiners at 1 week, 2 weeks, 4 weeks and 8 weeks from implant installation for post-operative complications. In addition, Visual Analogue Scales (VAS) on pain, swelling, bruising and bleeding were obtained from the patients from Day 1 through Day 7 and 14.
From the results of this preliminary study, in standard single implant placement with non-submerged healing, the postoperative complications (Flap closure, Swelling, Pain, Suppuration and Implant stability) and patient-centered outcomes (VAS of bleeding, pain, swelling and bruising) will neither be affected by using antibiotics prophylaxis in different regimens nor not using antibiotics prophylaxis.
It should be reiterated that dental practitioners should be cautious when using antibiotics as a prevention of postoperative infection in dental implant therapy. The indiscriminate use of antibiotics will eventually lead to more serious consequences including allergy and the development of resistance strains.published_or_final_version
Dental Surgery
Master
Master of Dental Surgery
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Nagtegaal, Hendrik. "Fast track assessment of the conscious sedation patient at the pre treatment consultation in a dental day clinic." Thesis, University of Westen Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=init_3700_1180440464.
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This thesis covered the fast track assessment of the referred dental patient for conscious sedation in a day clinic. The assessment took in consideration patient information, medical history, anatomical observations, treatment required, phobic aspects and patient expectations.
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Manton, Jesse West. "Medical Emergency Management in the Dental Office: A Simulation-Based Training Curriculum for Dental Residents." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1565360422025093.
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Valtersson, Jonna, and Kaveh Bordbar. "Evaluation of endosseous implant treatment and patient related outcome measures at the undergraduate clinic at Malmö University." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19648.
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SyfteSyftet med studien var att utvärdera det kliniska resultatet av implantatbehandlingar utförda på studentkliniken på Malmö Högskola, samt att utvärdera de patientrapporterade resultaten efter behandlingarna.Material och metodMellan 2008-2012 fick 144 patienter totalt 328 implantat, alla patienter som utvärderats enligt det Nationella kvalitetsregistret för dentala implantat (NQRDI) inkluderades i sammanställningen av data. Ytterligare, kompletterande data om patienterna och implantaten som installerats samlades in via journaler, även information om patientens hälsa och dentala historik samlades in.Totalt skickades 223 OHIP-14S enkäter ut till patienter som fått implantatbehandling på studentkliniken och haft konstruktionen i bruk i minst ett år. Data från utvärderingarna, journaler samt enkätsvar extraherades och sammanställdes i Excel-dokument.ResultatTotalt hade 71 av de 144 patienter genomgått sin 3-års utvärdering, sammanställningen visade på hög success (96,8%) och survival (100%) hos de 156 installerade implantaten.121 (54%) av de 223 enkäterna som skickades ut besvarades. Utfallet visar att majoriteten av patienterna inte har några problem med sina tänder, mun eller proteser.KonklusionUtvärderingen av implantatbehandlingar gjorda på studentkliniken på Malmö Högskola visar på acceptabla resultat som är jämförbara med liknande studier inom området. Överlevnaden för suprakonstruktionerna är jämförbart med studier som utvärderat efter 5 år. Majoriteten av patienterna som behandlats med dentala implantat på studentkliniken har även rapporterat att de är nöjda med sin implantatbehandling och att de har en god självskattad munhälsa.AimThe study aims to evaluate the success and survival rates of the implants installed at the undergraduate clinic at Malmö University, and to assess the patient reported outcomes of the treatments performed.Material and MethodBetween 2008-2012, 144 patients at the undergraduate clinic received a total of 328 implants, and all patients that were evaluated according to the National Quality Register for Dental Implants (NQRDI) after three years were included in the compilation of data. Additional and complementary data regarding patient and implant variables were also extracted from dental journals, as well as medical and dental history.A total of 223 OHIP-14S questionnaires were sent to an extended group of patients that have received implant treatment at the undergraduate clinic and had their construction in use for at least one year. The data from the evaluations, dental journals and the responded questionnaires were extracted and compiled in Excel-documents.ResultsOut of the 144 patients, 71 had undergone their 3 year evaluation, the compilation revealed high success (96,8%) and survival (100%) rates among the 156 installed implants.Out of the 223 questionnaires, 121 (54%) responses were received. The compilation present that the majority of the patients have a good self-assessed oral health and does not have any problems with their teeth, mouth or dentures.ConclusionThe outcome of implant treatments performed at the undergraduate clinic at Malmö University shows acceptable results comparable to outcomes in similar studies. The survival of supraconstructions is comparable to studies with a follow-up of 5 years. Furthermore, the majority of patients who received implant treatment at the undergraduate clinic are satisfied with their implant treatment and experience a good self-assessed oral health.
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Riley, Cara Joy DMD MS. "A Single-Center, Randomized, Partially Blinded Clinical Trial of Fospropofol Versus Midazolam for Moderate Sedation in Patients Undergoing Oral Surgery of 30-45 Minute Duration." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1320163603.
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Zinke, Alexander, Christian Hannig, and Hendrik Berth. "Psychological distress and anxiety compared amongst dental patients- results of a cross-sectional study in 1549 adults." BioMed Central, 2019. https://tud.qucosa.de/id/qucosa%3A33824.
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Background
This study aimed to identify anxiety in dental patients visiting a dental clinic using the Dental Anxiety Scale, their level of psychological distress using the Brief Symptom Inventory-18 and therefore identifying a correlation between these groups as well as their gender and age.
Methods
An adult sample of N = 1549 patients (865 females, 779 males) was examined over the course of three years using the Brief Symptom Inventory-18 to evaluate psychological distress and the Dental Anxiety Scale to determine anxiety before dental treatment. Evaluations were conducted according to age and gender.
Results
There was no correlation between different age groups of the sample the Dental Anxiety Scale. Anxiety, depression and GSI were more frequent in patients below the age of 46 than above. Women were more susceptible to signs of Anxiety and Somatization and scored higher on the Dental Anxiety Scale and the Global Severity Index than male patients. There was a significant positive correlation between scores of the BSI-18 categories: Somatization, Anxiety and Depression and the DAS for dental patients.
Conclusions
This study showed that a relationship between dental anxiety and psychological distress exists. It would be an improvement to use a short questionnaire like the Dental Anxiety Scale to evaluate a patient before his first treatment so that more appropriate treatments can be pursued.
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Laimutytė, Dovilė. "Odontologijos klinikos "X" klientų lojalumo vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_232856-81023.
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Darbo tikslas: įvertinti odontologijos klinikos „X“ klientų lojalumą ir pateikti pasiūlymus pacientų lojalumo didinimui. Uždaviniai: 1. Atlikti vartotojų lojalumo teorinę analizę. 2. Atlikti odontologijos klinikos „X“ veiklos situacijos analizę. 3. Ištirti odontologijos klinikos „X“ pacientų lojalumą. 4. Identifikuoti klinikos problemines sritis, kurias patobulinus įmonė pasiektų didesnį vartotojų pasitenkinimą ir lojalumą. Tyrimo metodika. Anketinės apklausos. Tyrimo metu buvo apklausti klinikos pacientai ir personalas. Išvados: Nustatyta, kad įmonės pacientai yra patenkinti klinikos teikiamomis paslaugomis ir dažniausiai apie šią kliniką sužinojo iš kitų asmenų rekomendacijų. Tačiau nors ir klientai yra patenkinti įmonėje vyrauja didelė pacientų kaita. Lojalūs klientai nesudaro daugumos klinikos pacientų, tačiau tie, kurie jau yra lojalūs rodo stiprų lojalumą ir yra pastovūs įmonės klientai. Odontologijos klinikos „X“ silpniausios sritys lojalių vartotojų formavime yra: klinikos darbo laikas, didelės susidariusios eilės, ilgalaikiai santykiai ir aukšti įkainiai.Aim of the study: to evaluate the loyalty of the dental clinic “X“ clients’ and to provide recommendations for patients’ loyalty growth. Objectives: 1. To make a theoretical analysis of the customers’ loyalty. 2. To make an analysis of the dental clinic “X” current bussiness situation. 3. To explore the loyalty of patients’ of the dental clinic “X”. 4. To indentify the problematic areas of clinics’ business, which, if improved, would help to increase the loyalty and satisfaction of the clinic’s customers. Research methods. The questionnaire surveys. During the reasearch, the clinics’ patients and personnel were questioned. Conclusions. It was identified that patients are satisfied with the services provided by the clinic. Most of the patients learned about the clinic from other peoples‘ recommendations. Although clients are contented the high turnover of the customers existence. Loyal customers are not a big part of all clinic patients, but those who are already loyal are showing strong loyalty. Dental Clinic "X" the weakest areas of the formation of loyal customers is: clinic time, long queues and high rates.
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Blom, Åsa, and Marie Mahlberg. "The clinical success, survival and failure of titanium-ceramic tooth-supported constructions submitted to patients at the Faculty of Odontology, Malmö University - A retrospective clinical study." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19743.
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Syfte:Syftet med föreliggande studie var att utvärdera kliniskt lyckande, överlevnad och misslyckande för metal-keramiska singelkronor och broar med underkonstruktion av titan som lämnats ut till patienter på Odontologiska fakulteten, Malmö högskola. Material och metod:För att svara på den aktuella frågeställningen identifierades patienter som mellan åren 2011-2015 fått fastsittande protetiska konstruktioner i titan-keramik, på Odontologiska fakulteten, Malmö högskola. Patienterna undersöktes av två tandläkarstudenter, under deras åttonde termin (april 2016), med visuell-taktil metod. Resultat:47 stycken patienter ingick i studien, detta motsvarade 69% av alla patienter som matchade inklusions - och exklusionskriterierna. Hos dessa 47 patienter fanns totalt 67 konstruktioner med en medelålder på 35 månader och en medianålder på 29 månader. Av de inkluderade konstruktionerna var 47 stycken singelkronor och 20 broar. Den kliniska lyckande, överlevnad och misslyckande frekvensen för singelkronorna var 55%, 43% och 2%, medan den för broarna var 15%, 70% och 15%. Slutsats:Inom studiens begränsningar har följande slutsatser dragits: •De titan-keramiska singelkronorna utlämnade till patienter på Odontologiska fakulteten, Malmö högskola, hade en högre lyckandefrekvens än de titan-keramiska broarna.•Resultatet indikerade en övergripande hög lyckande- och överlevnadsfrekvens för titan-keramiska konstruktioner.Aim:The aim of this study was to evaluate the clinical success, survival and failure rate of titanium-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) submitted to patients at the Faculty of Odontology, Malmö University. Materials and Method:To answer the research question, patients with SCs and/or FDPs made in titanium-ceramic at the Faculty of Odontology, Malmö University, between year 2011-2015, were identified and later examined by, two dental students during their eight semester (April 2016), with a visual-tactile method. Results:The study contained a total of 47 participating patients, this outcome represented 69 % of all the patients found matching the inclusion and exclusion criteria during the patient selection. Out of the 47 participants, 67 restorations were obtained and examined. The 67 restorations that were included in the study had a mean age of 35 months and a median age of 29 months. Out of these, 47 were SCs and 20 were FDPs. The clinical success, survival and failure rate of the SCs were 55%, 43% and 2%, respectively. The clinical success, survival and failure rate of the FDPs were 15%, 70% and 15%, respectively. Conclusion:Within limits of this study the following conclusions were made:•The titan-ceramic SCs submitted to patients at the Faculty of Odontology, Malmö University had a higher success rate compared to the FDPs.•The results indicate an overall high and acceptable success and survival rate for the titan-ceramic restorations.
23
Pavani, Caio César. "Avaliação clínica prospectiva randomizada do monitoramento digital de pacientes submetidos ao clareamento caseiro : efeito do tempo de uso do produto clareador nos graus de colaboração e satisfação do paciente, na efetividade e ocorrência de sensibilidade. /." Araçatuba, 2019. http://hdl.handle.net/11449/182505.
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Orientador: Renato Herman SundfeldCoorientador: Lucas Silveira Machado
Banca: Ticiane Cestari Fagundes Tozzi
Banca: Leandro Azambuja Reichert
Resumo: Este estudo prospectivo, randomizado e paralelo analisou a alteração de cor, sensibilidade dental, grau de cooperação e satisfação de voluntários quando submetidos ao clareamento dental com peróxido de carbamida a 10%, empregado durante 21 dias por 2, 4 e 8 horas/dia. O tempo preciso do uso diário das moldeiras/produto clareador foi mensurado por meio de um microssensor TheraMon (Sales Agency Gschladt, Hargelsberhg, Áustria). Sessenta e seis voluntários, de ambos os gêneros, com idades entre 18 e 22 anos foram selecionados e distribuídos aleatoriamente em três grupos de estudo (n = 22), os quais receberam as informações sobre a presença do microssensor em suas moldeiras. O fator estudado foi o tempo de uso das moldeiras em três níveis: 2 (GI), 4 (GII) e 8 (GIII) hrs/dia. Para a análise clínica, as variáveis de resposta foram: grau de cooperação diária dos voluntários de acordo com o tempo de uso diário das moldeiras; grau de satisfação dos voluntários com o clareamento dental; eficácia do clareamento dental nos incisivos e caninos superiores e inferiores pelo método visual (Vita Classical) e digital (Vita Easyshade), assim como o grau de sensibilidade dental que foi avaliado com método analógico-visual. Os voluntários foram avaliados no período inicial (baseline), aos 7, 14 e 21 dias após o início do tratamento clareador e 14 dias após apenas para as observações da cor, sensibilidade e grau de satisfação. Os dados foram analisados com aplicação do teste ANOVA e pelo post test... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: This prospective, randomized, parallel study analyzed the color change, tooth sensitivity, degrees of cooperation, and satisfaction of volunteers when submitted to at home dental bleaching with 10% carbamide peroxide (Opalescence -Ultradent Products, Inc. South Jordan, USA) for 21 consecutive days for 2, 4 and 8 hours/day. The wear time of acetate trays/dental bleaching was measured through a TheraMon microsensor (TheraMon® microelectronic system; Sales AgencyGschladt, Hargelsberhg, Austria). Sixty six volunteers, both sexes, with ages ranging from 18 to 22 years were selected and randonly distributed into 3 study groups (n=22). The volunters received information about presence of the microsensor in their trays. The fator studied was the wear time of the trays in three levels: during 2 (GI), 4 (GII) and 8 (GIII) hours/day. For the clinical analysis the response variables were: the degree of daily cooperation of the volunteers as the wear time/daily of the trays, microelectrically collected by micro sensor TheraMon®; the degree of satisfaction of volunteers with dental bleaching; the effectiveness of dental bleaching in the upper and lower incisors and canines teeth, by the visual method (Vita Classical) and digital (Vita Easyshade) and dental sensitivity was evaluated by the volunteers with a scale visual analog method on a scale of 0 to 10. The volunteers were evaluated at baseline period, at one, two and three weeks after the beginning of the bleaching treatment, and again ... (Complete abstract click electronic access below)
Mestre
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Lindholm, Raila, and Lisbeth Svensson. "Faktorer av betydelse för att uppnå god munhygien vid behandling av patienter med parodontit - en enkätundersökning bland tandhygienister på specialistkliniker för parodontologiFactors of importance to achieve a good level of oral hygiene in patient´s subjected to periodontal theraphy - a survey among dental hygienists working at periodontal clinics." Thesis, Kristianstad University College, Department of Health Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-4181.
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En enkätundersökning sändes ut till tandhygienister (n=79), som arbetade på samtliga Specialistkliniker för Parodontologi i Sverige under maj månad 2005. Syftet var att undersöka vilka faktorer som ansågs vara av betydelse för att uppnå goda och bestående resultat av munhygieninstruktioner hos patienter som behandlas för parodontit, samt vilka faktorer man ansåg försämrade möjligheten att uppnå framgångsrika resultat. Följande faktorer undersöktes; patientfaktorer, instruktionsmetoder, hjälpmedel vid munhygien och vårdmiljö. Resultatet visade att stressituationer hos patienten och återbud till bokade behandlingar var betydande faktorer som försvårade goda och framgångsrika resultat för att uppnå god munhygien. Extremt viktig faktor ansågs tandhälsoinformation vara, speciellt personlig sådan, där tandhygienistens engagemang och även vårdmiljön spelade stor roll. Uppföljning av utförd behandling under lång tid ansågs påverka resultaten positivt. Individanpassning av munhygien till parodontitpatienter i form av information, instruktion, god kommunikation, entusiasm och engagemang från vårdteamet, har stor betydelse för att uppnå goda och bestående munhygienresultat hos patienter som behandlas för parodontit.
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Vale, Hugo Felipe do 1985. "Prospective, parallel, controlled trial of implants placed in patients diagnosed with generalized aggressive and chronic periodontitis = clinical, microbiological and immunollogical evaluations = Estudo clínico prospectivo e paralelo de implantes dentários instalados em pacientes com histórico de doença periodontal agressiva e crônica : Estudo clínico prospectivo e paralelo de implantes dentários instalados em pacientes com histórico de doença periodontal agressiva e crônica." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287902.
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Orientador: Márcio Zaffalon CasatiTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo deste estudo foi avaliar os parâmetros clínicos, imunoenzimáticos e microbiológicos de implantes dentais de estágio único instalados em pacientes com histórico de periodontite agressiva, periodontite crônica e saúde, considerando a hipótese de nulidade de que não existe diferença entre os grupos. Foram selecionados pacientes que apresentaram histórico de periodontite agressiva generalizada (PAG) e periodontite crônica generalizada (PCG) com indicação de reabilitação protética implanto suportada. Os pacientes com necessidade de reabilitação unitária foram divididos em 3 grupos: Grupo PAG (n=13): pacientes apresentando histórico de periodontite agressiva generalizada; Grupo PCG (n=18): pacientes com histórico de PCG ; e Grupo Controle (n=14): pacientes sem histórico de periodontite. Todos os implantes foram instalados em estágio único e, após 3 meses, receberam reabilitação com próteses metalocerâmicas unitárias aparafusadas. Profundidade de sondagem, nível clínico de inserção relativo e posição da margem gengival relativo foram avaliados nos implantes no momento da instalação da prótese e 1, 3 e 6 meses após o carregamento. Avaliação radiográfica foi feita no momento 7 dias após a cirurgia, na instalação da prótese e 6 meses após o carregamento protético. Avaliação microbiológica foi realizada imediatamente após a instalação da prótese, 1, 3 e 6 meses após, por meio de PCR real time, determinando a quantidade dos microrganismos A. actinomycetemcomitans, P. gingivalis e, T. forsythia Avaliação imunológica foi realizada utilizando o sistema LUMINEX/MAGPIX® com amostras de fluido periimplantar coletado aos 15 dias após a cirurgia, imediatamente após a instalação da prótese e 6 meses após o carregamento protético, avaliando as concentrações de IL1?, IL4, IL6, IL8, IL10, TNF?, INF? e GM-CSF, além de marcadores de osteogênese e osteoclasia (OPG e RANKL). Não foram observadas diferenças entre os perfis de pacientes quanto aos parâmetros clínicos e radiográficos ao redor dos implantes em nenhum dos períodos de avaliação. No primeiro mês após a instalação das próteses verificou-se maior concentração de Aa (p<0,05) no grupo PAG. Seis meses após a instalação das próteses o grupo Controle apresentou menores concentrações de Pg (p<0,05). A avaliação dos marcadores de osteogênese/osteoclasia indicou alta concentração de OPG no grupo controle no momento da instalação da prótese. Ainda neste grupo, alta concentração de IL4 foi observada 6 meses após o carregamento dos implantes. Dentro das limitações deste estudo, pode ser concluído que 6 meses após a instalação das próteses, não há diferenças clínicas nem adicional reabsorção óssea em implantes dentários instalados em pacientes com histórico de doença periodontal
Abstract: The aim of this study was to evaluate clinical, microbiological, and immunological patterns of dental implants placed in healthy, partially edentulous, patients (HH), and those with a history of aggressive (HGAgP) or chronic periodontitis (HGCP), considering the null hypothesis that there are no difference between groups. This prospective, parallel, controlled trial enrolled 45 patients (HGAgP, n = 13; HGCP, n = 18; HH, n = 14) followed up from implant insertion until six months after implant loading. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), relative clinical attachment level (rCAL), gingival margin position (rGMP), implant stability (IS), and radiographic marginal bone resorption (RMBR) around implants were evaluated. Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), and Tannerella forsythia (Tf) levels were evaluated by real-time PCR. Also, IL-1?, TNF?, IL-6, IL-8, IFN?, GM-CSF, IL-4, IL-10, RANKL, and OPG levels were evaluated with the LUMINEX/MAGPIX® platform. No inter-group differences were observed around dental implants when the clinical parameters (PI, BOP, PD, rCAL, rGMP, IS, and RMBR) (p > 0.05) were considered at any evaluation period. At the first month after implant loading, those in the HGAgP group presented a higher level of Aa (p < 0.05). Six months after implant loading, those in the HH group presented a lower level of Pg (p < 0.05). The immunologic evaluation showed higher values of OPG in those in the HH group at implant loading, and a higher IL-4 level in those in the HH group six months after implant loading. It can be concluded that, after six months of implant loading, despite some micro- and immunological differences, there are no clinical differences or additional RMBR around implants placed in patients with a history of periodontal disease
Doutorado
Periodontia
Doutor em Clínica Odontológica
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Visconti, Maria Augusta Portella Guedes. "Influência do posicionamento maxilo-mandibular em exames de tomografia computadorizada de feixe cônico para planejamento de implantes." Universidade Federal de Juiz de Fora (UFJF), 2011. https://repositorio.ufjf.br/jspui/handle/ufjf/2462.
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Com a introdução dos implantes dentários osteointegráveis, novos métodos de imagem vêm sendo utilizados para garantir um planejamento mais acurado, sendo a tomografia computadorizada de feixe cônico (TCFC) um dos maiores avanços nesse sentido. O objetivo nesta pesquisa foi avaliar a influência das alterações do posicionamento maxilo-mandibular durante a aquisição dos cortes ortorradiais de TCFC, para planejamento de implantes dentários. Foram utilizados dez crânios secos, que receberam, bilateralmente, marcadores metálicos em quatro regiões distintas: incisivos, canino, pré-molares e molares. Foram obtidos exames tomográficos dos crânios em sete posições: padrão (PN), com deslocamentos superior e inferior de 10° e 20° (P10+, P20+, P10- e P20-), bem como deslocamentos laterais de 10° e 20° (PL10 e PL20). Posteriormente, foram realizadas medidas de altura e espessura ósseas implantares nas imagens padrão e naquelas obtidas com deslocamentos. Estas medidas foram realizadas nas quatro regiões distintas identificadas pelos marcadores, bilateralmente, tanto para maxila como para mandíbula. Os resultados mostraram que a posição P20+ foi a que apresentou maior diferença nas médias das medidas de altura e espessura ósseas, quando comparada com a posição PN. Na comparação bilateral, para as regiões de incisivo, canino e pré-molar, a posição P20+ foi a que apresentou maior diferença em relação à PN. No entanto, para região de molar, a posição P20- apresentou diferença nos valores das médias. Pôde-se concluir que variações do posicionamento maxilo-mandibular produzem alterações dimensionais nas medidas de altura e espessura ósseas nas imagens ortorradiais de TCFC, podendo acarretar em erros no planejamento de implantes.
With the introduction of osseointegration dental implants, new imaging methods have been used to ensure a more accurate planning, and the cone beam computed tomography (CBCT) a major advance in this direction. The aim of this study was to evaluate the influence of changes in the maxilo-mandibular positioning during th acquisition of the CBCT ortorradial cuts, for planning of dental implants. We used ten skulls, which received, bilaterally, metallic markers in four distinct regions: incisors, canines, premolars and molars. We obtained tomographic scans of the skulls in seven positions: standard (PN), with displacements above and below 10 ° and 20 ° (P10 +, P20 +, P10- and P20-), as well as lateral displacement of 10 ° and 20 ° (PL10 and PL20). Subsequently, we performed measurements of implant bone height and thickness in standard images and for those obtained with displacements. These measurements were performed in four distinct regions identified by markers, bilaterally, for both maxilla and jaw. The results showed that P20+ position presented the greatest difference in mean measures of bone height and thickness, when compared to the NP position. In bilateral comparison, for the regions of incisor, canine and premolar, the P20+ position showed the greatest difference compared to the PN. However, for the molar region, the P20- position showed the greatest difference in mean values. It was concluded that maxillo-mandibular positioning variations produce dimensional changes in bone height and thickness measures in ortorradial CBCT images, which may lead to errors in implants planning.
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Pinto, Clarice Maia Soares de Alcântara 1986. "Metallographic, gas and energy dispersive x-ray analyses of osteosynthesis plates and screws and dental implants removed from patients with clinical indication = Análise metalográfica, de gases e espectrometria por energia dispersiva de raios-x de placas e parafusos para osteossíntese e de implantes dentários removidos de pacientes com indicação clínica." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287888.
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Orientador: Márcio de MoraesDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo do presente trabalho foi avaliar a microestrutura e a composição química dos implantes dentários, placas e parafusos para osteossíntese removidos de pacientes em casos com indicação clínica. No trabalho 1, foram realizadas análises metalográfica, de gases e de espectrometria por energia dispersiva de raios-X de placas e parafusos de titânio utilizados para osteossíntese e removidos de 30 pacientes. Os prontuários destes pacientes foram avaliados para obtenção de dados referentes à idade, gênero, procedimento cirúrgico que havia motivado a inserção das placas e parafusos para osteossíntese, a razão clínica para remoção e o tempo de permanência destes dispositivos in situ. Quarenta e oito placas e 238 parafusos foram removidos no total. Infecção consistiu na principal causa para remoção destes dispositivos, correspondendo a 43.3% dos casos. O principal sítio do qual as placas e os parafusos foram removidos foi a mandíbula, equivalendo a 66.6% dos casos. Todas as placas e parafusos analisados estavam dentro das normas F67 e F136 da ASTM (American Society for Testing and Materials) de acordo com a análise metalográfica e a espectrometria por energia dispersiva de raios-X. Na análise de gases, cinco amostras apresentaram valores acima do regulamentado pela ASTM para os elementos Hidrogênio e/ou Oxigênio. A partir do estudo, pôde-se concluir que as propriedades físicas e químicas das amostras não estavam associadas à condição clínica que ocasionou a remoção destes dispositivos e que o tempo de permanência destes implantes in situ não determinou alterações em suas propriedades. No trabalho 2, foram realizadas análises metalográfica e de espectrometria por energia dispersiva de raios-X para avaliação de 38 implantes dentários de titânio removidos de 29 pacientes com indicação clínica. Os prontuários destes pacientes foram avaliados para obtenção de dados referentes à idade, gênero, razão clinica para remoção e tempo de permanência dos implantes. Falta de osseointegração sem sintomatologia ou sinais de infecção associados foi a principal causa para falha dos implantes, correspondendo a 55.1% dos casos. A maxila foi o sítio de falha dos implantes dentários em dezessete pacientes (58.6%) enquanto doze pacientes (41.4%) apresentaram falha de implantes instalados na mandíbula. Todos os implantes analisados eram constituídos de titânio comercialmente puro e apresentaram-se dentro da norma F67 da ASTM. A partir do estudo, pôde-se concluir que as propriedades físicas e químicas dos implantes dentários analisados não estavam associadas ao insucesso no tratamento e à falha destes dispositivos
Abstract: The aim of this study was to evaluate the microstructure and chemical composition of dental implants, bone plates and screws removed from patients in cases of clinical indication. In the first study, metallographic, gas and energy dispersive X-ray analyses were performed to evaluate osteosynthesis plates and screws retrieved from 30 patients. The medical records of these patients were evaluated to obtain data regarding age, gender, surgical procedure that had motivated the insertion of osteosynthesis plates and screws, the reason for removal and the period of time of these devices in situ. Forty-eight plates and 238 screws were removed in total. Infection was the main reason for these devices removal, representing 43.3% of cases. Mandible was the main site for plates and screws removal, corresponding to 66.6% of cases. All plates and screws analyzed were within the specifications F67 and F136 of ASTM (American Society for Testing and Materials) according metallographic and energy dispersive X-ray analyses. In gas analysis, five samples had hydrogen and/or oxygen values above the regulated by ASTM. From the study, it was concluded that the physical and chemical properties of the samples were not associated with the clinical condition that caused the removal of these devices, and retention time of these implants did not determine changes in their properties. In the second study, metallographic and energy dispersive X-ray analyses were performed for evaluation of 38 dental implants removed from 29 patients with clinical indication. Medical records of these patients were evaluated to obtain data regarding age, gender, reason for removal and period of time in situ. Lack of osseointegration without symptomatology or signs of infection was the main reason for dental implants failure, corresponding to 55.1% of cases. Maxilla was the site of implants failure in seventeen patients (58.6%) while twelve patients (41.4%) had failure of dental implants installed in mandible. All dental implants analyzed were manufactured of commercially pure titanium and were within the ASTM F67 specification. From the study, it was concluded that physical and chemical properties of dental implants analyzed were not associated with failure of these devices.
Mestrado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Mestra em Clínica Odontológica
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chen, Shu Hua, and 陳淑樺. "A cross level research of professional competency, experiential environment and doctor-patient interaction on patients’ satisfaction--take dental clinics as Examples." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/94523996598949113531.
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碩士輔仁大學
管理學研究所
97
With the implementation of national health insurance, the availability of medical treatment is improved and the medical burden expenses is decreased; moreover, the trend makesthe patients’ behavior change and patients have higher expectation toward the medical results. In the exoteric society, the right-protected viewpoint is emphasized and the medical dispute issues emerge in an endless stream, so there are more and more protective medical behavior; furthermore, doctor -patient relationship and medical management has become more and more important than before. Previous studies mainly focused on the patients’ feelings such as doctor-patient relationship, medical dispute or patients’ satisfaction; however, the professional competency and experiential environment are seldom discussed. The purpose of the research is to investigate the whole picture of the decision-making behavior between doctors and patients. The research takes trust as the independent variable and patients’ satisfaction as the dependent variable; then we add professional competency, experiential environment and doctor-patient interaction in the macro level to examine how these variables impact on trust and satisfaction. The data is from the patients in dental clinics through questionnaire and the quantity of effective questionnaire is 396, then the effective ratio is 36%.The research uses hierarchical linear modeling (HLM) to examine the model and results are as below 1.Doctors’ professional competency has positive effect on patients’ satisfaction. 2.Well service attitude in medical clinics has positive effect on patients’ satisfaction. 3.Trust has positive effect on patients’ satisfaction. 4.Better doctor-patient interaction can strengthen the positive relationship between trust and patients’ satisfaction. The research suggests doctors try to improve their professional competency by advanced study, obtaining licenses, learning from experts’ work; moreover, the medical knowledge training for the nurses is necessary as the essential medical knowledge can help the nurses give brief explanation of the symptom to the patients and assist patients to alleviate their pains. The active and friendly service attitude can also improve the trust and satisfaction of the patients. To improve doctor-patient interaction, doctors should communicate with their patients frankly and patiently; furthermore, doctors should help their patients to understand their health conditions and make the decision of the treatments together. With the patients’ recognition toward the doctors, patients’ satisfaction toward the medical clinics will be improved.
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Huang, Chieh-Liang, and 黃介良. "An Investigation on the Expenditure Behaviorof Patients in Chain Dental Clinics by using Probit 、Logit and Tobit Models." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/85444961047173288987.
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碩士國立高雄大學
高階法律暨管理碩士在職專班(EMLBA)
98
The serious financial problem of National Health Insurance in Taiwan is getting difficult because of the political reason. Therefore, the way that government can do to improve the uprising medical insurance budget is to restrict the insurance payment limits. Meanwhile, private clinics will need to expand their income by increasing more self-payment services. Most of existing researches focused only on the investigation regarding factor analysis, as well as the expected value of patients’ satisfaction. This study hence tries to explore the spending behavior of dental patients by using Probit, Logit and Tobit econometric models. We hope to find certain expenditure patterns of dental patients from econometric methods to provide key information for clinic managers. This study uses the data from patients of specific chain dental clinics to randomly choose 6 observations in each age ranging from 19- to 69-year-old. Finally, we utilizes 1,695 observations to conclude that dental patients’ self-payment behaviors are significantly affected by regressors such as “Clinic,” “Age,” “Appointment” and “Chief complain.” The noise to signal ratio of Probit and Logit models are 0.23 and 0.26, respectively, which are acceptable in predicting dental patients’ self-payment probabilities. The Tobit regression also provides valuable information in forecasting the self-payment amount for each specific patient of the chain dental clinics.
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Argumedo, Tobies Angélica Cecilia, and Contreras Katia Jhojhana Portocarrero. "Asociación entre la cancelación de la cita odontológica y el método de confirmación utilizado en pacientes atendidos en un Centro Universitario de Salud de Lima, Perú." 2020. http://hdl.handle.net/10757/653865.
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Objetivo: Determinar la asociación entre la cancelación de la cita odontológica y el método de confirmación utilizado en pacientes atendidos en un Centro Universitario de Salud de Lima, Perú.
Materiales y métodos: Se evaluaron a 355 participantes que cumplieran los criterios de inclusión. La cancelación de la cita odontológica, los métodos de confirmación y recordatorios fueron evaluados mediante un cuestionario de autoreporte. Asimismo, para evaluar las variables “motivo por el cual el paciente cancela su cita” y “posición socioeconómica” se utilizó la Encuesta Nacional de hogares 2017. Para el análisis estadístico se utilizó la prueba de Chi-cuadrado y prueba exacta de Fisher.
Resultados: Se observó un alto porcentaje de cancelación con 83.10%, siendo el motivo de inasistencia más frecuente la falta de tiempo con 32.39% y el método de confirmación más utilizado fue el envío de mensaje por teléfono con 46.48%. También, se encontraron diferencias estadísticas entre la cancelación de citas según la edad del paciente (p=0.008). Por otro lado, no se encontraron diferencias estadísticamente significativas entre la cancelación y los métodos de confirmación(p=0.383).
Conclusiones: No existe asociación entre la cancelación de la cita odontológica con los métodos de confirmación utilizados en los pacientes atendidos en un Centro Universitario de Salud. Sin embargo, se encontraron diferencias estadísticas entre la cancelación de citas según edad e ingreso monetario.Objective: Evaluate the association between cancellation of the dental appointment and the confirmation method used in patients treated at a university health center of Lima, Peru. Materials and methods: 355 participants who accomplish the inclusion criteria were evaluated. Cancellation of the dental appointment, confirmation methods and reminders were evaluated using a self-report questionnaire. Also, to evaluate the variables the reason for the patient canceling his appointment and socioeconomic position, the 2017 National Household Survey was used. For statistical analysis, the Chi-square test and Fisher's exact test were used. Results: A high percentage of cancellation was detected with 83.10%, the most frequent reason for non-attendance being the lack of time with 32.39% and the most used confirmation method was the sending of SMS with 46.48%. Also, statistical differences were found between the cancellation of appointments according to the age of the patient. On the other hand, the study did not find statistically found differences between the cancellation and the confirmation methods. Conclusions: There is no association between the cancellation of the dental appointment with the confirmation methods used in patients treated at a University Health Center. However, cancellation of the dental appointment could be associated with age and monetary income; it is observed that the youngest and female patients are the ones that cancel more frequently.
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Hsieh, Chia-fen, and 謝佳芬. "The Research on Dental Clinic Medical Quality for Patient Satisfaction and Patients Recognition – The Case of Dental Clinic in Tainan City." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/65315358921972786728.
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碩士國立臺南大學
科技管理碩士班
101
The study integrated previous research findings about medical quality, patient satisfaction and patient recognition, and investigated patients'' actual perception of dentistry medical quality, patient satisfaction to the dentist medical and patient recognition for the clinic. A questionnaire survey was designed to collect samples from patients for dental clinics, and 186 effective questionnaires were collected finally. Descriptive statistics analysis, Pearson correlation analysis and regression analysis were used to do hypothesis testing and conclusions were developed as following: (1.) Dentistry clinic patients'' actual perception of medical quality and patient satisfaction between positive relation. (2.) The medical quality and patient recognition between positive relation. (3.) The patient satisfaction and patient recognition between positive relation. (4.) Patients'' doctors awareness level of technology and attitudes of the highest scores, on behalf of patients with the most attention is the doctors expertise and attitude. The research conclusions showed that the medical environment, dentists professional skills, waiting time, follow-up care and health education to provide information and guidance, grant price medicine, medication instructions and social responsibility, in practice put forward relevant proposals.
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Bhayat, Ahmed. "Patient attendance at Soweto dental clinics before and after introduction of free dental services." Thesis, 2014.
Find full textAbstract:
Knowledge of how attendance loads at dental clinics have changed since free dental services were introduced in April 1996 is vital for the proper implementation of services. The objective of this study was to compare monthly attendances in Soweto dental clinics one year before and one year after the introduction of free dental treatment.
Details of the total number of attendances, casual and booked, at all ten dental clinics in
Soweto were noted from the central records at Lillian Ngoyi clinic, as well as the number of operators. These data were stored in the Wits computer network for analysis with SAS and Prism3 computer software.
A patient attendance index was defined as the number of attendances per clinic corrected for the number of operators. Patient attendance fluctuated by day and season throughout the study period. There was a mean 46% increase in patient attendance when the years before and after free treatment were compared. Casval patient attendance [pain and sepsis treatment] increased by a mean of 52% and booked attendance [restorative treatment] increased by 8%.There was a mean increase of 19% in the patient to operator ratio.
Casual patient attendance has increased the workload on operators and has kept the booked attendance at a low level. Furthermore, the preventive school programmes can no longer be maintained as a result of the staff workload. This could have serious consequences for the future generations and operators alike.
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Sowole, A. A. "Patient satisfaction with care provided by a district dental clinic." Thesis, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6618_1257334787.
Full textAbstract:
Patient satisfaction is critical for the growth of oral health service and practice. The present study was a descriptive study on patient satisfaction with oral health care provided by a district dental clinic. The aim of the study was to determine whether patients attending the dental clinic of the Lagos State University hospital were satisfied with the care they received.
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Yang, Chiang-hua, and 楊強華. "A Study on Key Factors of Patient’s Choice for Changing Dental Clinics." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/18064538798806065531.
Full textAbstract:
碩士國立中山大學
高階經營碩士班
100
Due to the development of society, the rise of living standards, the increase of population, the availability of information, and the establishment of health care systems, the medical industry is not as prestigious as it was in the past. Under the economy where the market is changing from supplier-oriented to consumer-oriented, competitions between various medical facilities and patients’ demands for better medical care quality grow, which then result in the rise of medical risks. Medical institutions no longer just focus on the treatment effects, but must also fully understand the conditions of the patients and effectively manage and utilize the resources at hand in order to raise the treatment quality and to stand above other competitors. The purpose of this research is to identify the various factors that prompt patients to seek medical treatments, and to raise patients’ satisfaction and faithfulness towards medical institutions. The research was carried out using a survey/questionnaire approach. Patients that have been to two or more dental clinics were asked to participate in the survey, and those who were interested were chosen. The PZB service quality SERVQUAL scale was used. Out of the 150 questionnaires distributed, 123 were retrieved (82%), and 111 of those retrieved were valid for consideration (74%). The survey showed that (1) a gap exists between patients’ expected treatment service and the actual service received; (2) patients hold high expectation towards the service quality; (3) patients decision to switch clinics partially depends on the received service; (4) the main factor that prompt patients to switch clinics is their concerns towards the ability of their doctors/physicians; (5) Instead of the actual service, assurance and reliability are more essential to the patients; and (6) clinics showing sincerity and making sure the patients feel secure are most important towards the patients. The research concludes that patients choose their medical institutions base on the received services. The five aspects of service all have almost equal importance, and all are influential towards patients’ choices of medical institutions.
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Pei-TeinWu and 吳培填. "A Research of the Dental Patient’s Choice concerning Dental Implants: A Case Study of the dental clinic in Tainan." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/3y27fj.
Full textAbstract:
碩士國立成功大學
高階管理碩士在職專班(EMBA)
102
Due to the development of economy and maturity of dental implant, edentulous patients gradually give up traditional bridges and dentures. They tend to choose implant restore, edentulous area and occlusal function. This way, revenue of implant has become the main source of self-pay in dental clinic. Therefore, this study tried to investigate and analyze whether patients choose implant or not. Based on the basic principle of econometrics, we conduct investigation by Eviews and statistical analysis. Most recipients said that they will undertake dental implant（80.0%） under edentulous. In addition, under hardware and precision equipment, items of operating scale; under word of mouth marketing, items of mass media, great reputation on Internet, introduction by relatives and experience; under dental implant quality, items of service morality, improve function and way to keep healthy all positively correlated to patients’ willingness.
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Chen, Wen Feng, and 陳文豐. "The Influence of Satisfaction with Dental Clinic Design on Patient Loyalty." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/k34n9e.
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CHEN, HUI-CHEN, and 陳惠珍. "The Impact of Medical Environment on Patient Preference – A Case Study in Dental Clinics." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/c56pcn.
Full textAbstract:
碩士國立臺北科技大學
工業工程與管理系EMBA班
105
The medical industry system of production orientation has gradually decline in the era, followed by the marketing orientation that patients determine the direction of medical treatment based on personal preference; especially, first-visit patients tend to be affected by the perceived value of self-assessment. In addition to the improvement of the software, the medical clinics in recent years also efforts to improve hardware facilities for providing patients the best medical care and thereby enhancing their willingness to visit again. This study aims to explore the correlation between medical environment and patient preference by adopting dental clinics as an empirical investigation. The results indicate that the medical environment has no direct impact on the patient preference, but it has indirect influence on patient preference through perceived value. This finding can provide practice a reference to develop marketing strategies.
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Chun-MaoLee and 李俊茂. "The Influences of Music and Scent at Dental Clinic’s on Patient Waiting Behavior." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/20655551409983214022.
Full textAbstract:
碩士國立成功大學
高階管理碩士在職專班
98
After a few years of the honeymoon period of full implementation of health insurance, dentists are faced with the fact that each year more and more new dentists are entering the health care profession and share the market, as well as the fact that due to the increasingly heavy financial load, the health care authority began to control health care cost or expenses, on the basis of the implementation of global dental budget or quota, and the implementation of the analyses through various indicators of health care payment on the medical model. Under the limited health care revenue, dentists have to put the medical market at their own expense to create more profit. Strategically, dental clinics must place emphasis not only on medical quality but also on doctor-patient relationship, to promote patient satisfaction, and to create a high-quality medical environment. There are studies indicating that the substantial health care environment can be used to create the appropriate physical environment for customers and staff in their feelings and interactions. Besides, the design of service environment settings can also help enhance service access and increase productivity, so strategies of hospital management must not only intensify its balance of quality and cost-effective enterprise management, but also actively encourage the benign interaction with customers, thus patients will have a good feeling and then take the initiative to treatment. However, many studies show that the smell and music in the service settings can influence the mood and the satisfaction of both staff members and consumers. This study explores the effect of the music and smell under various situations on the behavior of patients in the dentist waiting room, aiming at studying the effect of different music and scents on time perception and mood of patients in the waiting room in which patients tend to experience displeasure and irritability due to long waiting, and further explore the effect of time perception and mood of patients on their satisfaction, to serve as reference of market assessment and marketing strategy for dental clinics, hoping to bring new dental clinic opportunity. This study was conducted in a dentist's waiting room in Tainan City, with a total of 150 people as a sample a day, under different smells and music combinations at different time periods. This study consists of four groups (2x2), in addition to a control group with no smells and music provided, so there are a total of five groups to be analyzed. Dependent measure is the data collected from questionnaires filled out by patients after 5 minutes of waiting, to identify the most appropriate scents and music in a dentist waiting room.
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Whang, Rong-Tien, and 黃榮田. "FACTOR OF UNDERGOING MEDICAL TREATMENT IN PATIENTS WHO GO TO THE SELF-PROVIDED DENTAL CLINIC." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/42735014090890958679.
Full textAbstract:
碩士高雄醫學院
口腔衛生科學研究所
84
The National Health Insurance extended implement now. There are lots of patients give up the payment of insurance, and choose the self-provided clinic which does not join the National Health Insurance system.This research trys to figure out the reason of patients who choose a self-provided clinic. The main subjects of this research are the self- provided clinics between Kaohsiung and Tainan area, meanwhile pick up two local clinics in each place which have joined the insurance system at the same time. Four hundreds and eight questionnaires are valuable in this process. The result shows that the main significant differences of the patients'' undergoing medical treatment between self-provided clinic and insured-clinic are: (1)In eight sections of undergoing medical treatment, the effects of "insurance covered or not","the environment of the clinic", and"popularand famous".(p<0..05) (2)Patients'' attitudes about the benefit of the insurance payment.(p<0.05) (3)Patients'' desires of paying porcelain crown cost.(p<0.05) (4)Patients'' recognition of Composited resin or Amalgam filled cost .(p<0.05) (5)Patients'' acceptable reservation time.(p<0.05) But there are no significant difference about family monthly income between these two patient-groups. We doubt if the questionnaire''s answer is true in this item. Inthe payment of dental insurance, some people(19.6%)think that the benefitis quite much, much people(41.4%)think it''s little, and less people(12.7%)think it''s none, there still are a few(23.0%)answered"unknown". We consider about the payment of dental insurance if there were some defect in it. The recognition of the patient in dental knowledge is absolutely not enough. The "unknown" answers of understanding of using prosthetic material are more than half. The effects of clinic out-appearance and assistant-attitude had a positive significant correlation. In the issuer of the concern about dentist explanation of self-oral condition, most of people(66.4%) cared about "How to treat?"first. The dentist must shared more information and knowledge of oral health to the people and do it as a duty.
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Hsu, Hui-Hsien, and 許慧嫻. "The Relationship among Patients’ Relationship, Perceived Value, Satisfaction and Loyalty in a Group Practice Dental Clinic." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/j6n7mc.
Full textAbstract:
碩士國立臺灣大學
健康政策與管理研究所
105
The doctor-patient relationship plays an important role in dental healthcare services. The quality of the doctor-patient relationship affects clinical outcomes and medical malpractice claims. Patient satisfaction and loyalty are commonly used indicators for measuring the quality in health care. They are also effective indicators to understanding the keys to a good doctor-patient relationship. This is a cross-sectional study that aims to explore the correlation among relationship quality, perceived value, satisfaction and loyalty in the patients of a group practice dental clinic. The purpose is to explore the following: (1) the correlation between relationship quality and perceived value; (2) the correlation between perceived value and satisfaction; (3) the correlation between perceived value and loyalty; (4) the correlation between satisfaction and loyalty. In this study, patients were recruited from a group-practice dental clinic in Taipei, Taiwan. Data were obtained using a structured questionnaire designed by the researcher. A total of 305 questionnaires were collected. Statistic software packages including SPSS 20.0 and AMOS 20.0 were used in the data analysis. The results showed that a significant positive correlation between relationship quality and perceived value. Additionally, a significant positive correlation could be seen between perceived value and satisfaction. The results also demonstrated a significant positive correlation between perceived value and loyalty. Likewise, a significant positive correlation between satisfaction and loyalty was found. Future research propositions and practical implications for the improvement of dental healthcare systems were proposed based on the findings of this study.
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Kung, Yun-Jung, and 龔韻融. "The Impact of Service Quality and Relational Benefits on Patient’s Loyalty- The Case of Dental Clinics Service." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/xygfge.
Full textAbstract:
碩士國立臺中科技大學
企業管理系事業經營碩士班
102
In this study, 494 copies of valid questionnaires from ten dental clinics located in Taichung were selected randomly to investigate the impact of dental physician service quality, dental clinic service quality, relational benefits and relationship strength on patient loyalty to the dentist and to the dental clinics. This sample was analyzed by means of the following method, including Analysis of Variance, Pearson product-moment correlation coefficient, regression methods to test our hypothesis. The results show the factors affecting patient’s loyalty to the dental physician including dental physician service quality, dental clinic service quality, relational benefits, relationship strength, marriage, family and age. On the other hand, dental physician service quality, dental clinic service quality, relational benefits, relationship strength and patient’s occupation affect patient loyalty to the dental clinics. I found out relational benefits as the most important factor affecting patient loyalty to the both dental physician and the dental clinics. The dental physician can provide appropriate and effective treatment to patient if a good relationship between them will be established, then the patient loyalty to the both dental physician and the dental clinics can be enlarged. Furthermore, patient loyalty to a dental physician is relatively higher than that to dental clinics. The positive patient’s sentiment resulting from dental physician service quality and relational benefits will indirectly affect their interaction with the clinic, thus improve patient loyalty to the clinic.
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朱晉熙. "The Effect of Medical Service Quality and Physician-patient Relationship on Patient Satisfaction - A Case Study of A Dental Clinic." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/79ut8c.
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Su, Pei-Hung, and 蘇佩虹. "The relationship between dental patient satisfaction and the value of medical quality among various clinic Models." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/74605670763989665177.
Full textAbstract:
碩士高雄醫學大學
口腔衛生學系碩士在職專班
103
Background：Under the classification system for current Taiwan medical institutions, the dental clinics can be to classified as medical center clinic, regional hospital clinic and private dental clinic. Furthermore, according to the characteristics of human resource composition, the dental clinics are classified into greater dental clinics, chain dental clinics and union dental clinics. This study was attempted to investigate the relationship between satisfaction and quality of the dental services based on the medical center faculties in different dental clinic models. To comprehend the important factors in selection of dental treatment for patients seek for medical services in medical center, through the analysis of the satisfaction and importance in each dental treatment services provided by the medical center dentistry faculties, this study could propose the best model for dental clinics. This study also expects to improve the quality of dental treatment services in a medical center. Materials and methods：These samples of the presont study were collected at the dental departments at: a medical center and its downtown dental clinic in Kaohsiung city and two Kaohsiung Municipal Hospital(Cianjin district and Hsiaokang district) with structured questionnaires. A total of 1,163 questionnaires were valid, 546 questionnaires from the dental department of a medical center, 283 questionnaires from its downtown dental clinic, 173 questionnaires from Cianjin municipal hospital and 161 questionnaires from Hsiaokang municipal hospital. All data were encoding with Microsoft Excel to establish the database and then used IBM SPSS Statistics 19 statistical software for statistical analysis. Results：The results of this study revealed the major factors which affected patients, about their choice of dental clinics were well-equipped medical instruments, excellent medical services and doctor’s professionalism. The patients emphasize the dental treatment abilities and techniques, treatment by the same dentist, fine attitudes of dentists and complete ness of treatment plan explanation. On the contrary, recall services for care, facilities in the waiting area and decoration and partition of clinic were the least important factors. The highest satisfaction for patients was related to academic background, specialist of dentists, abilities, techniques of dentists and treated by the same dentist. On other hand, patients were the least in treatments by interns, satisfied convenience for car parking and facilities in waiting area. Conclusion：This study concluded that patients tended to like their treatments by the a same dentist. Patient consider the abilities and techniques of dentists and treatment by the same dentist the most important factors affecting the satisfaction of dental service. These results also revealed that order to provide high satisfaction dental service, the dental department of a medical center should not only maintain the standard level in dental treatment services but also renew its facilities in waiting area and convenience for car parking. The suitable dental clinic model was that patients, treatments by different specialists in the same clinic and based on the medical center faculties. In view of current relationship between patients and doctors, the improvement of medical service qualities and rise up the patient’s satisfaction are the most important issue.
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Tai, Ting-Yu, and 戴庭瑜. "A Study of the Relationship among the Word-of-Mouth, Patient Loyalty and Patient Satisfaction- An Example for Self-Paid Dental Clinic in Taoyuan County." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/26311063671947439513.
Full textAbstract:
碩士中原大學
國際經營與貿易研究所
101
Because of medical regulatory restrictions in the medical services industries, clinics usually use the method of "word-of-mouth" to attract patients. The purpose of this study is to investigate word-of-mouth, patient loyalty and patient satisfaction for self-paid dental clinic. 360 questionnaires were sent out, and only 301 questionnaires are useful, with an rate of return is 83.6%. This thesis adopts descriptive statistics, analysis of variance and Pearson’s relative to test our assumption. According to the results of statistics, the conclusions are as followed ： 1. The key factors which affect patient to choose dental clinics are：physician's technology, recommendation of family and professional knowledge. When patients need to pay a lot of money on medical, they will inquire into their friends or family about the information. 2. The quality of medical service would positively influence the patients' choice. If clinics can enhance patient satisfaction, patient loyalty may enhance as well. It shows that the raise of patient satisfaction will help increasing patients return rate. 3. If patients are satisfied with the dental clinic, their loyalty will increase. Patients will spread the information by sharing and chatting with one another. Medical services industry should target "patient loyalty" as the primary goal of business strategy, because a dissatisfied patient comparing with a satisfied patient will retell his unpleasant experience to more than three or four times. Loyal patient is the best spokesperson of the word-of-mouth effect.
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Chao, Tzu-Yu, and 趙子祐. "Clinical evaluation of the association between dental anxiety and the pain experience related to cavity preparation of composite resin filling in adult patients." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/88290158774976628793.
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碩士國立陽明大學
牙醫學系
104
Dentine hypersensitivity is the short-lasting acute pain, commonly evoked by cold, hot or tactile stimuli, which cannot be attributed to other dental lesions or diseases. It is widely known that pain is not only influenced by the condition of a physical lesion, but also by emotional and cognitive factors. Among these factors, dental anxiety and pain catastrophizing are associated with dental pain. In the current study, we investigated 40 patients who received composite resin restoration in Taipei Veterans General Hospital. We assessed the pain during cavity preparation, clinical hypersensitivity experience in different treatment stages, and patients’ degree of dental anxiety and pain catastrophizing. The association between pain during cavity preparation, dental anxiety, pain catastrophizing, and the clinical hypersensitivity experience in different treatment stages is analyzed and discussed. Our results show that (1) the degree of dental anxiety is statistically positively correlated to the pain during cavity preparation. (2) Among the patients with different diagnoses for receiving composite resin restoration, including caries, cervical abrasion or previous failure in restoration, the pain during cavity preparation, dental anxiety and pain catastrophizing do not significantly differ. (3) Each of the clinical hypersensitivity experiences (intolerability, motivation to receive treatment and duration of symptoms) significantly differ across different treatment stages (before treatment, after cavity preparation, after filling and one week post-treatment), and the clinical hypersensitivity experiences in the second treatment stage(i.e., after cavity preparation) are statistically positively correlated to the pain during cavity preparation. In the study, we used a customized labeled magnitude scale – the Clinical Hypersensitivity Experience Questionnaire (CHEQ). The CHEQ combines the advantages of the traditional verbal descriptor scale and visual analog scale of pain assessment, and it is able to assess multiple aspects related to hypersensitivity, including intolerability, motivation to receive treatment and duration of symptoms. The findings would contribute to our knowledge about the dynamic experience of hypersensitivity during composite resin restoration. It highlights that both pain control and anxiety management is critical to the patients who receive composite resin restoration.
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Alesawy, Aminah. "Within-subject comparison of two- versus three-implant-assisted mandibular overdenture : patient-based outcomes." Thèse, 2018. http://hdl.handle.net/1866/21349.
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Menassa, Melanie. "Les attentes, la satisfaction et la qualité de vie des édentés suite à une réhabilitation par mise en charge immédiate d'une prothèse totale reliée à deux implants non jumelés : une étude pilote expérimentale." Thèse, 2013. http://hdl.handle.net/1866/10083.
Full textAbstract:
Problématique : La majorité des études publiées sur la réhabilitation par mise en charge immédiate de deux implants non jumelés avec une prothèse totale mandibulaire de recouvrement n’ont rapporté que des mesures cliniques objectives et très peu ont évalué les mesures centrées sur le patient, et ce, avec des erreurs de mesure. Aucune étude n’a évalué les attentes des patients vis-à-vis d'un tel protocole.
Objectifs : Évaluer les attentes, le niveau de satisfaction ainsi que la qualité de vie reliée à la santé bucco-dentaire des édentés complets suite à un protocole de mise en charge immédiate.
Méthodologie : Cet essai clinique de phase 1 utilise un design pré-post afin d’évaluer les mesures centrées sur le patient. Dix-huit individus, complètement édentés et âgés en moyenne de 62,39 ± 7,65 ans, ont reçu une prothèse totale mandibulaire de recouvrement sur deux implants non jumelés suite à un protocole de mise en charge immédiate, conjointement à une prothèse totale conventionnelle maxillaire. Un instrument adapté pour mesurer leurs attentes à l’aide d’échelles visuelles analogues, le questionnaire « McGill Denture Satisfaction Instrument » ainsi que le questionnaire OHIP-20 ont été remis aux patients avant de procéder aux traitements (T0), ainsi qu’aux rendez-vous de suivi à 2 semaines (T1), 1 mois (T2) et 4 mois (T3). De plus, l’inventaire de personnalité révisé (NÉO PI-R) ainsi qu’un questionnaire sociodémographique ont été remplis par les participants. Les « change scores » ont été calculés puis des tests non paramétriques et des analyses de variances en mesures répétées suivies de comparaisons par paires ont été utilisés afin d’analyser les données recueillies. La taille d’effet a été estimée.
Résultats : Les participants avaient différentes attentes par rapport à la mise en charge immédiate. Certains s’attendaient à un effet positif à court terme par rapport à leur apparence esthétique (83,3 %) et à leur vie sociale (55,7 %), alors que d’autres avaient des craintes envers leur confort (5,6 %), leur habileté à mastiquer (11,1 %) et à nettoyer leur prothèse inférieure (11,1 %). À 4 mois, le protocole de mise en charge immédiate avait rencontré la majorité des attentes des patients par rapport à l’esthétique (94.4 %), la mastication (83.3 %), la phonétique (61.1 %), le confort (94.4 %), l’hygiène (88.9 %) et leur vie sociale (88.9 %). Une amélioration statistiquement significative de la satisfaction en générale, du confort, de l’esthétique, de la stabilité de la prothèse inférieure et de l’habileté à mastiquer a été notée à 2 semaines (p<0,001). Également, les comparaisons par paires ont révélé une diminution statistiquement significative du score total de l’OHIP-20 (p < 0,001) de même que la majorité des domaines de l’OHIP (p < 0.01), sauf pour l’handicap social qui n’a diminué significativement qu’après 1 mois (p = 0.01). Ces changements (pour la satisfaction et la qualité de vie) sont restés stables au cours des suivis subséquents. Indépendamment des traits de personnalité et des variables sociodémographiques, le protocole immédiat a satisfait 94,4 % des participants et a amélioré leur qualité de vie avec une large magnitude d’effet (d = 1.9; p < 0.001). Bien que deux patients aient perdu des implants au cours du traitement, 100 % des participants étaient d’accord pour recommander cette procédure à leurs pairs.
Conclusions: Le protocole de mise en charge immédiate semble satisfaire les patients quelles que soient leurs attentes. Le protocole MCI peut améliorer, à court terme, la qualité de vie des patients totalement édentés. Les résultats prometteurs de la phase 1 devraient être corroborés lors de la 2e phase de cette étude.Statement of problem: Most published research on the immediate loading of a mandibular 2-implant overdenture has only reported on clinical outcomes. Few studies have evaluated patients centered-outcomes but with measurement errors. Consequently, there is a need to assess clinical and patient-reported outcomes in this regard. Objectives: To examine patients’ level of satisfaction, expectations and quality of life with regard to the implants’ immediate loading protocol in edentate individuals. Methods: This phase-I trial used a pre-post design to assess patient-centered outcomes in 18 edentate individuals (mean age 62.39 ± 7.65 years) who have received a 2-implant (unsplinted) mandibular overdenture through an immediate loading protocol. The McGill Denture Satisfaction Instrument, a VAS instrument assessing expectations and the OHIP-20 questionnaire were used to evaluate patients’ outcomes at baseline, 2 weeks, 1 and 4 months. Socio-demographic and personality trait data were obtained using the Revised NEO Personality Inventory and a self-administered questionnaire. Change scores were calculated and non-parametrical tests were used to analyse the data. Repeated measures ANOVAs and paired t-tests were also conducted, and effect size was estimated. Results: The participants had a wide range of expectations regarding the immediate loading protocol. Expectations included short-term positive impact on aesthetics (83.3 %) and social life (55.7 %). Other expectations included negative effects on comfort (5.6%), the ability to chew (11.1 %) and to clean their lower denture (11.1%). At 4 months, the immediate loading protocol had met most patients’ expectations regarding aesthetics (94.4%), the ability to chew (83.3%), ability to speak (61.1%), comfort (94.4%), the ability to clean their lower denture (88.9%) and their social life (88.9%). The statistical analysis showed an overall satisfaction increase with a median change score of 66 (range=7-98), 68 (range=7- 95), and 70 (range= 17- 99), at 2 weeks, 1 month and 4 months respectively. There was a statistically significant improvement in overall satisfaction, comfort, perceived aesthetics, stability of the overdenture, and ability to chew at 2 weeks (p < 0,001). Pairwise comparison (within-subjects comparisons) revealed significant decreases in total OHIP scores (P < 0.001), as well as fewer functional limitations, physical pain, psychological discomfort, physical disability, psychological disability, and handicap (P < 0.01) from baseline to 2 weeks, 1 month and 4 months follow-up. Social disability score decrease significantly only after 1 month follow-up (p = 0.01). These changes remained stable during subsequent follow-ups. The protocol satisfied 94.4% of the participants and improve their quality of life with an estimated effect size of 1.9 (p < 0.001), regardless of socio-demographic and personality profiles. There was 100% agreement among patients on recommending this procedure to their peers. Conclusions: Immediate loading of two unsplinted implants with a mandibular overdenture seemed to fulfill patients’ satisfaction regardless of their expectations and may improve oral health-related quality life of edentate individuals in short-term. Encouraging results from phase I should be confirmed and approved in Phase II clinical trials.