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Biomedical subjects

F J Hill

Publications and source records attributed to F J Hill.

At least 19 recordsLinked to original sources
PubMed2000

An investigation of patient management methods used for orthodontic extractions by general dental practitioners in north west England.

OBJECTIVE: To quantify the patient management methods used by dental practitioners for orthodontic extractions and to determine what factors influence their choice of method. DESIGN: Practitioners working in the General Dental Service in the area of the former North West Regional Health Authority were randomly sampled and sent a postal questionnaire. SETTING: General Dental Service in the North West of England. SUBJECTS: 204 completed questionnaires were returned; a response rate of 71.1%. INTERVENTIONS: Practitioners were asked about the patient management methods that they used for orthodontic extractions and what factors were important in choosing to use a general anaesthetic. OUTCOME MEASURES: The mean percentages of patients treated with local anaesthetic alone, general anaesthesia and inhalation sedation with local anaesthesia were calculated for the sample. Factors influencing the choice of method used were scored by the practitioners on a ten point scale. RESULTS: Local anaesthesia alone was used for two thirds of orthodontic extraction patients and general anaesthesia for one third. Inhalation sedation was rarely used. Poor patient cooperation and a nervous patient were the most important factors in choosing a general anaesthetic. CONCLUSIONS: Local anaesthesia is used for the majority of orthodontic extractions. However there remains an overuse of general anaesthesia and an underuse of inhalation sedation.

Anesthesia, Dental↗
PubMed2000

Orthodontic extractions: a comparative study of inhalation sedation and general anaesthesia.

OBJECTIVE: To compare directly inhalation sedation and general anaesthesia in terms of treatment success rate, various aspects of morbidity and time taken, when used for patients having orthodontic extractions. DESIGN: Patients requiring orthodontic extractions were treated with either inhalation sedation or general anaesthesia. The two groups were matched for age, sex, number of teeth extracted and pre-operative anxiety. Data were collected by questionnaires. SETTING: Unit of Paediatric Dentistry at the University Dental Hospital of Manchester. SUBJECTS: All patients referred for orthodontic extractions between November 1994 and May 1996 were invited to take part in the study. Total number of patients = 101. INTERVENTIONS: Sixty-six patients commenced treatment with inhalation sedation and 35 with general anaesthesia. Routine orthodontic extractions were carried out. OUTCOME MEASURES: Treatment success rate, various aspects of morbidity and total time taken were measured and compared for the two groups. RESULTS: Treatment success rates were high for both groups. Significantly less morbidity was found to be associated with inhalation sedation and the total time taken was significantly shorter with inhalation sedation than with general anaesthesia. CONCLUSIONS: Inhalation sedation is a successful alternative to general anaesthesia for orthodontic extractions with patients experiencing less morbidity and the time taken being shorter.

Anesthesia, Dental↗
PubMed1999

Bizarre parosteal osteochondromatous proliferation in the anterior maxilla: report of a case.

Bizarre parosteal osteochondromatous proliferations are a rare subgroup of the osteochondromatous lesions. They must be differentiated from reactive osteochondromatous proliferations, low grade parosteal osteogenic sarcoma, and chondrosarcoma. Their recognition is important from the point of view of management, which should be by simple excision. This article describes a case of bizarre parosteal osteochondromatous proliferation in a 2-year-old child; the lesion developed in the anterior maxilla, a previously unreported site.

Child, Preschool↗
PubMed1998

The use of inhalation sedation and local anaesthesia as an alternative to general anaesthesia for dental extractions in children.

OBJECTIVE: To determine the extent to which inhalation sedation might replace general anaesthesia for extractions in children and assess the success rate, cost and parental reaction in comparison to general anaesthesia. DESIGN: A matched pair design. SETTING: Unit of paediatric Dentistry at the University Dental Hospital of Manchester, UK between December 1992 and June 1994. SUBJECTS AND METHODS: Subjects aged 3 to 16 years who had been referred for extractions under general anaesthesia were used. Data were recorded for each visit and parents were asked to complete a simple post-operative questionnaire. OUTCOME: Treatment success was defined as completion of all treatment planned for the patient. Relative costs were derived from the time taken and staff costs. RESULTS: 265 subjects, mean age 7.63 (+/- 2.45) years had treatment attempted with sedation of whom 221 (83.4%) completed successfully. Young age, multiple extractions and irregular dental attendance predisposed to treatment failure, whereas orthodontic extractions had a similar success rate (97.6%) to general anaesthesia. The cost of sedation was less; parental reaction to sedation was also significantly better. CONCLUSION: Inhalation sedation can be used for many children referred for general anaesthesia. Greater use of this technique in the primary sector is needed to reduce the number of child referrals for general anaesthesia.

Adolescent↗
PubMed1998

A repeated criterion-based audit of radiographic usage by a paediatric dentistry unit.

AIMS: To report a simple clinical audit which was conducted within a single hospital paediatric dental unit and to demonstrate the potential value of such small-scale projects. DESIGN: A criterion-based audit of radiographic practice which was repeated after 3 years in order to evaluate changes. SETTING: Six 1 hour meetings of an audit group consisting of the staff and postgraduate students of the Unit. SAMPLE AND METHODS: Various aspects of radiographic usage were quantitatively assessed using a sample of patient records and a pre-planned check list to assess the extent to which agreed good-practice criteria were being met. The initial audit identified areas for improvement which were addressed before repeating the exercise 3 years later. RESULTS: Clinical note-keeping to accompany radiographic examinations was found to be the least satisfactory area of practice. When the exercise was repeated, encouraging improvements were demonstrated. CONCLUSIONS: The audit was worthwhile because it appeared to produce improvements in standards of patient care.

Child↗
PubMed1997

An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 2: Dentists' knowledge of management methods and their perceptions of barriers to providing care.

AIM: To assess dentists' knowledge of and perceived barriers to treatment of dental injuries. DESIGN: Cross-sectional postal questionnaire and personal interview. SUBJECTS AND METHODS: Questionnaires from 153 GDPs and 53 CDOs were received giving details of emergency options on 17 imaginary dental injuries and perceived barriers to treatment of trauma. Structured interviews with 21 of the GDPs and 19 CDOs seeking knowledge on diagnosis and long-term follow-up and treatment took place. Age and gender of dentist, type of practice and postgraduate courses attended were noted. MAIN OUTCOME MEASURES: Mean knowledge scores. RESULTS: Of a maximum of 14 correct responses on emergency treatment of injured teeth the mean was 7.5. Only 19% knew for how long avulsed teeth should be splinted. Of a maximum of 37 correct responses on long-term follow-up of treatment the mean was 15.4. Only 10% would correctly treat acute abscess on a traumatised tooth. 82% of dentists thought dental trauma should be treated in the primary care service, but 86% of GDPs thought fees for this type of treatment were too low. 72% of CDOs thought the treatment occupied too much clinic time and was not the responsibility of the CDS. CONCLUSIONS: Dentists in the primary care sector have insufficient knowledge to treat dental trauma.

Adolescent↗
PubMed1997

An investigation of dento-alveolar trauma and its treatment in an adolescent population. Part 1: The prevalence and incidence of injuries and the extent and adequacy of treatment received.

AIM: To measure the prevalence and incidence of dental trauma and to assess the extent and success of treatment provided. DESIGN: Cross-sectional and one-year incremental study. SUBJECTS AND METHODS: 2022 11-14-year-old pupils were examined in schools for clinical evidence of trauma of anterior teeth. 1891 were examined 15 months later. A history of the trauma and treatment provided were obtained together with some social data. Radiographs were taken of affected teeth. MAIN OUTCOME MEASURES: Degree of trauma, whether treatment was provided and its quality, ACORN classification. RESULTS: 34% had suffered trauma but only 12% needed treatment for 332 teeth. 47% of these teeth had received treatment, of which 59% was inadequate. After 15 months 4% had experienced new injuries. 42% of boys and 28% of girls (P < 0.01) had sustained injuries, as had 38% from ACORN group III and 30% from groups I and II. 67% of those with pain and 40% of those without attended for treatment (P < 0.01), while 69% who were unhappy with the appearance and 35% who were not (P < 0.01) attended. CONCLUSIONS: The primary care services currently available for the treatment of dental trauma are inadequate.

Adolescent↗
PubMed1997

Investigation of lay knowledge of the management of avulsed permanent incisors.

The prognosis of replanted avulsed permanent incisors depends largely on prompt and appropriate emergency management. The aim of this study was to investigate lay knowledge and attitudes in this respect. Postal questionnaires were sent to all physical education teachers, school nurses and secretaries, attendants in swimming baths and leisure centres and to 220 parents of teenage children in a defined area of North West England. The overall questionnaire response rate was 86.9%. Knowledge of methods of dealing with this problem was generally inadequate in both parents and the other groups. Although 53.6% of respondents claimed to have received first aid training only 3.1% could remember dental injuries being included. There was evidence that dental health education in this field can be effective, since the highest mean knowledge score was found in the 11.5% of respondents who recalled receiving advice from sources such as posters, magazines and newspapers. More than 80% of the respondents stated that they would not want to replant an avulsed incisor themselves, the main reason being lack of knowledge and training. It is suggested that there is a need for potentially effective dental health education in relation to this problem.

Caregivers↗
PubMed1996

An audit of anterior periapical radiographs taken in a paediatric dentistry unit.

The aim of this study was to audit the use of periapical radiographs taken during the endodontic treatment of traumatized incisor teeth in a Paediatric Dentistry Unit. Fifty consecutive radiographs and their accompanying written records were evaluated, using methods which were developed and applied by ten staff and postgraduate students working in the Unit. Less than half of the films and their accompanying records were considered to be completely satisfactory and the performance of permanent staff was no better than that of junior staff and postgraduate students. The audit suggested methods for improving the quality of this service, which were subsequently implemented.

Child↗
PubMed1994

Comparison of two calcium hydroxide pastes used for endodontic treatment of non-vital immature incisor teeth.

A proprietary calcium hydroxide paste, Reogan Rapid, that previously has been demonstrated to induce apical closure in non-vital immature incisor teeth, was becoming unavailable. A prospective clinical trial was conducted to compare Reogan Rapid with another proprietary paste, Hypo-cal. For teeth treated with Reogan Rapid apical closure was obtained in an average of 6.8 months involving 3.1 visits and the respective figures for teeth treated with Hypo-cal were 5.1 months and 2.4 visits. These results demonstrated that Hypo-cal was as effective as Reogan Rapid when used in a standardised technique for inducing apical closure.

Barium Sulfate↗
PubMed1993

A follow-up study of incisor teeth which had been treated by apical closure and root filling.

A follow-up study was conducted of 93 non-vital immature incisor teeth treated by apical closure and root filling. Only six teeth had been lost and these losses were due to trauma, failed restorative treatment or root resorption. Life table analysis suggested that 86% of teeth would still be present after 5 years. The number of teeth at risk was too small after 5 years to provide precise enough estimates of the percentage of survivors.

Adolescent↗
PubMed1993

Validity and reproducibility of clinical examination, fibre-optic transillumination, and bite-wing radiology for the diagnosis of small approximal carious lesions: an in vitro study.

This study measured validity and reproducibility of unaided clinical diagnosis, fibre-optic transillumination (FOTI), and bite-wing radiology in the diagnosis of approximal caries. Sixty models were made using extracted premolars and molars, each containing four teeth with six contacting approximal surfaces. The teeth were examined first using unaided clinical examination and then using FOTI. Bite-wing radiographs were then taken of the teeth set in the models and examined. The three examinations were repeated after 1 week. Histological sections of the undecalcified teeth were prepared following their removal from the models, and those showing signs of caries were examined to give the valid state of disease in each surface. The diagnostic threshold was caries penetrating into dentine. The reproducibility of all three methods was acceptable with kappa values exceeding 0.6. All specificity values exceeded 0.95. Statistically significant differences were seen between sensitivities for clinical (0.38) and bite-wing (0.59) diagnosis and between clinical and FOTI (0.67) examination, but not between bite-wing and FOTI. It is concluded that the validity of FOTI is at least as high as that of bite-wing radiology, and both are superior to unaided clinical diagnosis.

Bicuspid↗
PubMed1991

Uptake of fluoride by sound and artificially carious enamel in vitro following application of topical sodium and amine fluorides.

The aim of this investigation was to compare fluoride uptake and retention by sound and artificially carious enamel, after the topical application of a neutral sodium fluoride solution (NaF) or a commercial preparation containing aqueous amine fluorides (AF) 297 and 335 (Elmex Fluid, GABA International, Basel, Switzerland). Ten pairs of extracted premolars were used, one of each pair being treated with NaF and the other with AF. A lactic acid gel technique was used to produce artificial caries lesions on one-half of the buccal surface of the premolar crowns. Estimates at selected depths of pretreatment fluoride concentration, uptake and retention were made using a step-wise acid-etch sampling technique. AF produced much greater uptake than NaF, the difference being most marked in the deeper layers of the artificial lesions, suggesting that the amine fluorides had a strong affinity for demineralized enamel. After storage in normal saline for 1 week during which partial loss of the acquired fluoride occurred, the percentages retained ranged from 37 (NaF) to 65 percent (AF). It was concluded that AF enhanced both uptake and retention of fluoride by (artificial) early enamel caries lesions.

Adolescent↗
PubMed1991

Peribulbar anesthesia for the repair of orbital floor fractures.

Four patients underwent successful repair of an isolated orbital floor fracture under local anesthesia. The surgical approach was by antero-inferior orbitotomy, with placement of a Nylamid plate (S Jackson Inc, Washington, DC). The anesthetic technique used was a peribulbar and infratrochlear nerve block with local supplementation. Digital control of the globe was maintained during the peribulbar injection to prevent ocular perforation. We conclude that local anesthetic for this procedure in carefully selected cases is safe and efficacious, avoiding the morbidity of a general anesthetic.

Adult↗