Simulation training involves reproducing the management of real patients in a risk-free environment. This study aims to assess the use of simulation training in the management of acutely ill patients for those in second year oral and maxillofacial surgery dental foundation training (DF2s). DF2s attended four full day courses on the recognition and treatment of acutely ill patients. These incorporated an acute life-threatening events: recognition and treatment (ALERT(™)) course, simulations of medical emergencies and case-based discussions on management of surgical inpatients. Pre- and post-course questionnaires were completed by all candidates. A maximum of 11 DF2s attended the course. The questionnaires comprised 1-10 rating scales and Likert scores. All trainees strongly agreed that they would recommend this course to colleagues and all agreed or strongly agreed that it met their learning requirements. All DF2s perceived an improvement in personal limitations, recognition of critical illness, communication, assessing acutely ill patients and initiating treatment. All participants felt their basic resuscitation skills had improved and that they had learned new skills to improve delivery of safety-critical messages. These techniques could be implemented nationwide to address the more complex educational needs for DF2s in secondary care. A new benchmark for simulation training for DF2 has been established.
Purpose
The pathology of peri-implantitis is still not fully understood and there have been recent challenges to the consensus on its aetiology and pathology, especially in comparison with periodontitis. The assessment of biomarkers allows a comparison of the pathology of these diseases. The aim of this systematic review was to answer the research question: “Is there a difference in the biomarkers associated with peri-implantitis compared with periodontitis in adult humans?”
Methods
Electronic databases were searched and screened, and a manual search was also undertaken. The inclusion criteria were adults with peri-implantitis who had been compared to adults with periodontitis with the outcome of biomarkers assessed via biopsies or crevicular fluid samples in primary or secondary care settings, as recorded in case-control, case series and retrospective, prospective and cross-sectional observational studies. Two reviewers independently screened titles and abstracts and assessed full text articles for eligibility and inclusion. Both reviewers independently extracted data and assessed risk of bias. Differences in biomarker levels were the primary outcome and a narrative review was undertaken due to the heterogeneity of studies.
Results
In total, 2,374 articles were identified in the search, of which 111 full-text articles were assessed for eligibility and 13 were included in the qualitative synthesis. Five of the 13 included studies were deemed to be at high risk of bias, with the others having moderate risk. All studies were cross-sectional and performed at university hospitals. Nine of the 13 included studies found significant differences in the levels of biomarkers or their ratios between peri-implantitis and periodontitis. Four of the studies found no significant differences.
Conclusions
Within the limitations of the included studies, it appears that there may be a difference in biomarker levels and ratios between peri-implantitis and periodontitis, suggesting that these disease processes are somewhat distinct.
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