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Title:	Effectiveness of a clinical pathway for non-surgical management of moderate and severe generalized chronic periodontitis
Authors:	Ooi Yow Hian (P77120)
Supervisor:	Tuti Ningseh Mohd Dom, Associate Professor Dr.
Keywords:	Clinical Pathway (CP) Non surgical periodontal therapy (NSPT) Periodontitis Dissertations, Academic -- Malaysia
Issue Date:	9-Apr-2017
Description:	The wide range of adjuncts and treatment options available in non surgical periodontal therapy (NSPT) and conflicting evidences have been seen to complicate clinicians decision in treatment planning. This study was a multi-centre, experimental study aimed to develop and implement a Clinical Pathway (CP) to reduce unjustified variations and to benefit decision making in NSPT of moderate and severe chronic periodontitis patients. The new CP was developed via an expert panel discussion then implemented on a group of newly-recruited patients. Both clinical and patient-based outcome (PBO) measures were monitored and evaluated up to 24 weeks post instrumentation. Findngs were compared using a group of matched historical cohort as controls. Variant activities not following the CP for the test group was recorded and analysed. 36 patients were recruited as test group while another 36 patients who were treated previously in the usual care from respective centres were recorded restrospectively as control group. PBO outcome such as OHIP-14 and EuroQoL for test group and clinical parameters such as probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index and visible plaque index for both groups were recorded at baseline, 6 weeks, 12 weeks and 24 weeks post instrumentation. Both groups showed statistically significant improvements in all clinical parameters after NSPT. However, test group had significantly reduced number of sites for PPD ≥ 7mm and CAL gain compared to control group at 12th week (p=0.040) and 24th week (p=0.041), as well as within baseline to 24 weeks (p=0.039) with effect size 0.87, respectively. The change in OHIP-14 median scores and EuroQol visual analogue scores over the study period was significant (p < 0.001) after the use of CP in NSPT. Three episodes of variances were recorded however expert panel decided modification of the CP was not needed. In conclusion, the use of CP developed could lead to significant improvement of oral health related quality of life, generic health status as well as clinical parameters. Furthermore, use of CP would significantly reduce number of sites with PPD ≥7mm at 3 and 6 months as well as significantly gain CAL between baseline to 6 months post instrumentation than patients managed with usual care.,Ijazah Doktor Pergigian Klinikal
Pages:	114
Call Number:	WU20.5.O59e 2017 9
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Dentistry / Fakulti Pergigian

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