IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental pr
详细信息 查看全文
- 作者：Jan E Clarkson (1) (7)
Craig R Ramsay (2)
Paul Averley (3)
Debbie Bonetti (1)
Dwayne Boyers (2) (9)
Louise Campbell (2)
Graham R Chadwick (4)
Anne Duncan (2)
Andrew Elders (2)
Jill Gouick (1)
Andrew F Hall (4)
Lynne Heasman (3)
Peter A Heasman (3)
Penny J Hodge (5)
Clare Jones (6)
Marilyn Laird (1)
Thomas J Lamont (1)
Laura A Lovelock (1)
Isobel Madden (7)
Wendy McCombes (7)
Giles I McCracken (3)
Alison M McDonald (2)
Gladys McPherson (2)
Lorna E Macpherson (1)
Fiona E Mitchell (1)
John DT Norrie (2)
Nigel B Pitts (8)
Marjon van der Pol (9)
David NJ Ricketts (4)
Margaret K Ross (10)
James G Steele (3)
Moira Swan (3)
Martin Tickle (6)
Pauline D Watt (1)
Helen V Worthington (6)
Linda Young (7) - 关键词：Oral hygiene advice ; Scale and polish ; Prevention ; Toothbrushing advice ; Periodontal instrumentation ; RCT ; Primary care
- 刊名：BMC Oral Health
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：13
- 期：1
- 全文大小：423 KB
- 参考文献：1. Papapanou PN: Epidemiology of periodontal diseases: an update. / J Int Acad Periodontol 1999, 1:110-16.
2. Neely AL, Holford TR, L?e H, ?nerud ?, Boysen H: The natural history of periodontal disease in man. Risk factors for progression of attachment loss in individuals receiving no oral health care. / J Periodontol 2001,72(8):1006-015. CrossRef
3. Ekstrand KR, Bruun G, Bruun M: Plaque and gingival status as indicators for caries progression on approximal surfaces. / Caries Res 1998,32(1):41-5. CrossRef
4. Kelly M, Steele J, Nuttall N, Bradnock G, Morris J, Nunn J, / et al.: / Adult Dental Health Survey: Oral Health in the United Kingdom 1998. London: The Stationary Office; 2000.
5. Axelsson P, Nystrom B, Lindhe J: The long-term effect of a plaque control program on tooth mortality, caries, and periodontal disease in adults. / J Clin Periodontol 2004, 31:749-57. CrossRef
6. Watt RG, Marinho VC: Does oral health promotion improve oral hygiene and gingival health? / Periodontol 2005, 37:35-7. CrossRef
7. Renz A, Ide M, Newton T, Robinson P, Smith D: Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases. / Cochrane Database Syst Rev 2007. Issue 2. Art. No.: CD005097. doi: 10.1002/14651858.CD005097.pub2
8. Kay E, Locker DA: A systematic review of the effectiveness of oral health promotion aimed at improving oral health. / Community Dent Health 1998, 15:132-44.
9. Sprod AJ, Anderson R, Treasure ET: / Effective oral health promotion: literature review. Technical Report 20. Cardiff: Health Promotion Wales and University of Wales College of Medicine; 1996.
10. Elley K, Gold L, Burls A, Gray M: / Scale and Polish for chronic periodontal disease. WMHTAC, Department of Public Health & Epidemiology, University of Birmingham; 2000. [ / Report 22] ISBN: 07044 21739
11. Beirne PV, Worthington HV, Clarkson JE: Routine scale and polish for periodontal health in adults. / Cochrane Database Syst Rev 2007. Issue 4. Art. No.: CD004625. doi: 10.1002/14651858.CD004625.pub3
12. Gaunt F, Devine M, Pennington M, Vernazza C, Gwynnett E, Steen N, Heasman P: The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis. / J Clin Periodontol 2008,35(Suppl. 8):67-2. CrossRef
13. Bandura A: Health promotion from the perspective of social cognitive theory. / Psychol Health 1998, 13:623-49. CrossRef
14. Gollwitzer PM: Implementation intentions: strong effects of simple plans. / Am Psychol 1999, 54:493-03. CrossRef
15. Chapple ILC, Hill K: Getting the message across to periodontitis patients: the role of personalised biofeedback. / Int Dent J 2008,58(5 Supplement 1):294-06.
16. L?e H: The gingival index, the plaque index and the retention index systems. / J Periodontol 1967, 36:610-16. CrossRef
17. Slade GD: Derivation and validation of a short-form oral health impact profile. / Community Dent Oral Epidemiol 1997, 25:284-90. CrossRef
18. Ajzen I: The theory of planned behaviour. / Organ Behav Hum Decis Process 1991, 50:179-11. CrossRef
19. Goldstein H: / Multilevel Statistical Models. London: Arnold; 1996.
20. Fielding S, Fayers PM, Ramsay CR: Investigating the missingness mechanism in quality of life data: a comparison of approaches. / Health Qual Life Outcome [Online] 2009.,7(57): doi:10.1186/1477-525--57. Available from: http://www.hqlo.com/content/pdf/1477-525--57.pdf doi:10.1186/1477-7525-7-57.
21. Carpenter JR, Kenward MG: / Missing data in randomised controlled trials -a practical guide. 2007. [http://www.pcpoh.bham.ac.uk/publichealth/methodology/docs/invitations/Final_Report_RM04_JH17_mk.pdf]
22. Ryan M, Gerard K: Using discrete choice experiments to value health care: current practice and future prospects. / Appl Health Econ Policy Anal 2003, 2:55-4.
23. Louviere JJ, Hensher DA, Swait JD: / Stated Choice Methods. Analysis and Application. Cambridge: Cambridge University Press; 2000. CrossRef
24. Maddala G: / Limited dependent and qualitative variables in econometrics. Cambridge: Cambridge University Press; 1983. CrossRef
25. Pearmain D, Swanson J, Kroes E, Bradley M: / Stated preferences techniques: guide to practice. The Hague: Steer Davies Gleave and Hague Consulting Group; 1991.
26. McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, / et al.: Systematic review of the clinical effectiveness and cost-effectiveness of laparoscopic surgery for inguinal hernia repair. / Health Technol Assess 2005, 9:14.
27. Clarkson JE, Young L, Ramsay CR, Bonner BC, Bonetti D: How to influence patient oral hygiene behaviour effectively. / J Dent Res 2009,88(10):933-37. CrossRef
28. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6831/13/58/prepub - 作者单位：Jan E Clarkson (1) (7)
Craig R Ramsay (2)
Paul Averley (3)
Debbie Bonetti (1)
Dwayne Boyers (2) (9)
Louise Campbell (2)
Graham R Chadwick (4)
Anne Duncan (2)
Andrew Elders (2)
Jill Gouick (1)
Andrew F Hall (4)
Lynne Heasman (3)
Peter A Heasman (3)
Penny J Hodge (5)
Clare Jones (6)
Marilyn Laird (1)
Thomas J Lamont (1)
Laura A Lovelock (1)
Isobel Madden (7)
Wendy McCombes (7)
Giles I McCracken (3)
Alison M McDonald (2)
Gladys McPherson (2)
Lorna E Macpherson (1)
Fiona E Mitchell (1)
John DT Norrie (2)
Nigel B Pitts (8)
Marjon van der Pol (9)
David NJ Ricketts (4)
Margaret K Ross (10)
James G Steele (3)
Moira Swan (3)
Martin Tickle (6)
Pauline D Watt (1)
Helen V Worthington (6)
Linda Young (7)
1. Dental Health Services Research Unit, Dundee Dental School, The University of Dundee, 9th Floor, Park Place, Dundee, DD1 4HN, UK
7. NHS Education for Scotland, Edinburgh, UK
2. Health Services Research Unit, University of Aberdeen, Aberdeen, UK
3. Newcastle University, Newcastle Upon Tyne, UK
9. Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
4. Dundee Dental School, University of Dundee, Dundee, UK
5. School of Medicine, University of Glasgow Dental School, Glasgow, UK
6. School of Dentistry, University of Manchester, Manchester, UK
8. Kings College London Dental Institute, London, UK
10. University of Edinburgh, Edinburgh, UK - ISSN：1472-6831
文摘
Background Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. Methods/Design This is a 5?year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI. Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcome measures at 3?year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits. Discussion IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making. Trial registration Protocol ID: ISRCTN56465715