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Dental neglect in children and adolescents is a form of child maltreatment and can be an indicator of other forms of maltreatment. Early identification of dental neglect is essential to initiate preventive interventions and connect families to appropriate health and social services to avoid further harm and to reduce negative impacts on child development and well-being. Articles that systematically synthesise and compare models for early detection, intersectoral cooperation and care for dental neglect have not been published yet. This scoping review aims to map the evidence on strategies for the identification and prevention of dental neglect in children and adolescents.
The study is designed as a scoping review. Based on the Population, Concept and Context (PCC) scheme, the databases PubMed, PsycInfo and Scopus are searched for publications before July 2023. Publications in all languages will be considered in case an abstract in English or German is available. The review will include articles reporting on strategies for identification and prevention related to dental neglect in children and adolescents as conducted in health service and community settings. Data from included articles will be extracted to describe and categorise the available evidence. The review will follow recommendations of the Joanna Briggs Institute Reviewer’s Manual on scoping reviews and the Critical Appraisal Tool for Health Promotion and Prevention Reviews (CAT HPPR).
Ethical approval is not required, as no personal data will be collected in this literature-based study. The study’s findings will be disseminated through conference presentations, scientific publications and stakeholder meetings.
by Ann-Kathrin Einfeldt, Beate Legutko, Philipp-Cornelius Pott, Benjamin Bergmann, Berend Denkena, Christof Hurschler, Bastian Welke
IntroductionModular hip implants enables a more precise adaptation of the prosthesis to the patient’s anatomy. However, they also carry the risk of increased revision rates due to micromotion at the taper junction. In order to minimize this risk, one potential solution is to establish an adhesive bond between the metal taper junctions. Load-stable bonding techniques, already successfully employed in dentistry for connecting materials such as metals and ceramics or different alloys, offer a promising approach. Nevertheless, the bond strength of tapered adhesive bonds in modular hip implants has not been investigated to date.
Materials and methodsTwenty-eight tapered junctions, consisting of a taper (female taper) and a trunnion (male taper) were turned using TiAl6V4 ELI (n = 16) and CoCr28Mo6 (n = 12). The process parameters cutting speed (vc = 50 m/min or 100 m/min) and feed (f = 0.1 mm, 0.05 mm or 0.2 mm) were varied for the trunnions. For each set of process parameters, one trunnion and one taper were additionally subjected to sandblasting. To investigate the effect of geometry, angular mismatch in the samples were measured. The taper pairs were bonded with a biocompatible adhesive, and push-out tests were subsequently performed.
ResultsThe push-out forces generated from the taper connections where both tapers were sandblasted showed a mean push-out force of 5.70 kN. For the samples with only the trunnion sandblasted, the mean force was 0.58 kN, while for the samples with only taper sandblasted the mean push-out force was 1.32 kN. When neither of the tapers was sandblasted the mean push-out force was 0.91 kN. No significant effect of the process parameters on the push-out force was observed. Only the reduced valley depth Svk showed a slight correlation for the CoCr28Mo6 samples (R2 = 0.54). The taper pairs with taper mismatch (between trunnion and taper) greater than |0.1°| did not show lower push-out forces than the specimens with lower taper mismatch.
ConclusionsSandblasted and adhesive-bonded tapered connections represent a viable suitable alternative for modular hip implant connections. Slight differences in taper geometry do not result in reduced push-out forces and are compensated by the adhesive. In mechanically joined tapers these differences can lead to higher wear rates. Further investigation under realistic test conditions is necessary to assess long-term suitability.
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