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Biomedical subjects

H H Chauncey

Publications and source records attributed to H H Chauncey.

At least 19 recordsLinked to original sources
PubMed1991

Technology assessment in the Veterans Administration Dental Longitudinal Study.

Of the 52 studies emanating from the Veterans Affairs Dental Longitudinal Study, 6 were identified as technology assessments. Three of these studies evaluated dental radiographs used for the diagnosis of oral lesions. Two studies compared alternative technologies for the replacement of missing teeth, and one reported the effects of NSAIDs on alveolar bone loss. Four additional articles are discussed that provide data that will be useful in future assessments of dental technologies.

Aged↗
PubMed1991

Effect of Peroxyl mouthrinse on chlorhexidine staining of teeth.

The efficacy of Peroxyl mouthrinse in reducing the extrinsic stain produced by Peridex, a chlorhexidine mouthrinse, was evaluated in a double-blind, three-month clinical study. Intraoral safety, extrinsic tooth stain and plaque accumulation scores were determined on 119 healthy adult subjects at baseline and at 30-, 60- and 90-day intervals following use of Peroxyl or placebo formulations in combination with the Peridex product. Subjects were randomly assigned to two groups. The test group used the chlorhexidine mouthrinse plus Peroxyl mouthrinse, while the control group used the chlorhexidine mouthrinse plus a placebo mouthrinse. All participants were given an oral prophylaxis prior to use of the mouthrinses. The assigned mouthrinse combinations were used by 58 test and 61 control subjects, who followed specific toothbrushing and mouthrinse regimens throughout the three-month period. Both the examiner and the subjects were unaware of the identities of the products tested. Use of Peroxyl mouthrinse significantly reduced extrinsic tooth stain produced by chlorhexidine rinsing. The mean stain scores for all teeth were significantly lower for the Peroxyl/chlorhexidine group, at 60 and 90 days of use, compared to the placebo/chlorhexidine group. At all three time points, the mean stain scores of the anterior teeth of the individuals using Peroxyl/chlorhexidine rinses had significantly less stain compared to the placebo/chlorhexidine rinse group means. No intraoral soft tissue side effects, attributed to product use, were observed or reported throughout the study.

Adult↗
PubMed1990

Statistical methods for comparing dental diagnostic procedures.

In dental diagnosis, there are typically two or more clinical diagnostic procedures which may be used either independently or jointly to reach a conclusion regarding the presence of a particular disease in a patient. To determine which of these diagnostic procedures are more accurate, statistical methods may be applied to research data in which the true health status as well as the diagnosis provided by each clinical procedure are available on each observation. Results arising from this type of analysis can be of great interest to clinicians when the diagnostic procedures themselves are costly, painful, or even potentially harmful to the patient. Considered here is the special situation encountered in dental research in which each patient can have multiple concurrent cases of a certain disease such as caries, for then the statistical evaluation of diagnostic procedures is even further complicated. This report describes several statistical approaches for comparing the efficacy of diagnostic tests and illustrates their application on data from a study of diagnostic radiographs for dental caries.

Adult↗
PubMed1989

Effects of dentition status and personality on masticatory performance and food acceptability.

Missing natural teeth have been associated with a reduced acceptability for the taste and texture of hard foods as well as with an increase in the perceived difficulty of chewing these foods. The present study examined the role of the personality variables extroversion and anxiety in modulating the relationship between dentition status, masticatory performance, taste preference, texture preference, and perceived ease of chewing of an easy-to-chew food (pot roast) and a more difficult-to-chew food (raw carrots). Healthy adult men, participants in the Veterans Administration Dental Longitudinal Study, were examined. Results indicated that with increased age there was a tendency for texture acceptability to increase for the easy-to-chew food. Masticatory and swallowing performance were diminished in persons with artificial dentition, and these individuals also perceived an increase in the difficulty of chewing raw carrots. There was a significant association of anxiety, but not extroversion, with masticatory and swallowing performance.

Adult↗
PubMed1989

The eruption of third molars in adults: a 10-year longitudinal study.

Among 829 participants of the Veterans Administration Dental Longitudinal Study examined over four triennial cycles, 97 persons (11.7%) had one or more unerupted third molars, for a total of 151 teeth, when the study was initiated. During the first 10 years of the study, 10 subjects had 14 unerupted third molars extracted, while in 10 persons 11 third molars erupted. Four of the latter persons each had one third molar removed subsequent to eruption. Three of the 11 erupted third molars were in functional occlusion. The position of 4 of the 11 "erupting" third molars appeared to remain unchanged relative to radiographic landmarks. Thus, their apparent clinical eruption may have been due to a reduction in the level of the gingival tissue in the area distal to the second molar tooth in association with periodontitis. The eruption of third molars in older adults appears to be a more frequent phenomenon than was previously recognized. Most erupting third molars had some associated pathologic condition, including caries and periodontitis.

Adult↗
PubMed1989

Dental caries. Principal cause of tooth extraction in a sample of US male adults.

Comprehensive oral examinations carried out over a period of about 10 years on participants in the Veterans Administration Dental Longitudinal Study were evaluated to identify teeth extracted during this time and to ascertain the apparent reason for these extractions. The study population included 736 dentulous adult males, 49% of whom experienced 1,142 extractions. Caries was judged to be the primary cause of tooth loss, responsible for 33.3% of the teeth extracted. Extractions in preparation for a prosthesis (31.3%) and periodontal disease (18.7%) were the other major causes of tooth loss. Thus, dental caries was the prime cause of tooth extraction in this sample of US male adults, while a second major cause was preparation for a prosthesis which included the extraction of sound teeth and teeth with carious lesions which could have been restored. Periodontal disease was clearly not the major cause of tooth loss and was responsible for only 18.7% of the extractions in this population. The results of this study demonstrate that dental caries is a major problem in adults, leading to greater tooth loss than periodontal disease. A large percentage of the tooth loss in these individuals was clearly preventable. The same emphasis placed upon caries prevention in children should be applied to the adult population.

Adult↗
PubMed1988

Clinical indicators of radiographically detectable dental diseases in the adult patient.

A comprehensive analysis of the relationship between clinical observations in dental patients without symptoms and oral disease as detected by full-mouth and panoramic dental radiographs in a large population of patients has never been reported. Knowledge of these relationships is necessary in the design of a diagnostic decision process (clinical algorithm) that can predict which patients require dental radiographs for the diagnosis of dental caries or periodontal disease to be confirmed or refined. An accurate clinical algorithm could reduce the number of radiographs that are taken of certain routinely seen dental patients without symptoms, thus reducing unnecessary exposure x-radiation as well as potentially reducing health care costs for these patients. A sample of 602 adult men on whom a complete series of panoramic, posterior bitewing, and periapical dental radiographs and an independent oral examination were performed provided the opportunity to evaluate the relationship between clinically observed oral disease indicators and independent radiographic evidence of dental caries and periodontal disease. The analysis suggests that combinations of several clinical indicators can predict with some success which patients without symptoms will benefit most from oral radiographs. The presence of several carious lesions on oral examination was the best predictor of radiographic detection of dental caries. Clinical indicators tht appear to predict radiographic evidence of periodontal disease are clinical measures of pocket depth, mobility, and the patient's denture status. An important finding is that because of the high prevalence of gingivitis and plaque, these indicators were not related to radiographic evidence of periodontal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Longitudinal radiographic analysis of carious lesion progression.

Information on the rate at which carious lesions progress through the enamel of human teeth in an adult population was obtained from dental radiographs taken at 3-yr intervals, over a 10-yr period on 602 men. Clinical measures of calculus deposition, plaque accumulation, gingival inflammation, tooth mobility, periodontal pocket depth, and gingival recession were studied to find predictors that might be of value to the clinician for determining how frequently radiographs should be taken. We estimate that 50% of the enamel lesions on mesial and distal surfaces, if left untreated, would not progress into the dentin until 73 months had elapsed after the lesion was initiated. Significant differences in the progression rate were associated with the arch and tooth type. Patient age, number of decayed or filled surfaces, degree of gingival inflammation, amount of recession, and plaque accumulation were positively associated with more rapid caries progression, while greater numbers of teeth present were predictive of slower disease progression.

Adult↗
PubMed1988

The associations of age and dentition status with caries treatment in adult males.

This study explores patterns of treatment for caries in adults. Data were collected as part of the Veterans Administration Dental Longitudinal Study. The 698 subjects received comprehensive dental examinations at three-year intervals for approximately ten years. The subjects were classified into three age groups and three dentition status categories. Total need for treatment was defined as the number of surfaces that initially had caries plus those developing caries over the three subsequent examinations. Analysis of variance was used to determine if there were significant associations between age or dentition status groups and the percent of total need that was treated by extraction, treated by restoration, or remained untreated. Significant associations were noted: (1) between age and the percent of carious surfaces extracted, (2) between dentition status and the percent of carious surfaces restored, and (3) between dentition status and the percent of surfaces extracted. These findings were interpreted to indicate that future cohorts of older patients with greater numbers of teeth are likely to seek operative treatment for diagnosed caries.

Adult↗
PubMed1987

Longitudinal study of the diagnostic yield of panoramic radiographs in aging edentulous men.

Participants in the Veterans Administration Dental Longitudinal Study who were edentulous and for whom longitudinal panoramic radiographs were available were followed through four examination cycles, representing approximately 10 years. It was observed that 13 (39%) of the 33 subjects examined had one or more positive radiographic findings at the initial examination. No changes occurred in the findings noted during the initial panoramic radiographic examination, and no new findings were observed over the study period. Although the initial baseline panoramic examinations yielded several positive radiographic findings, few were of a nature that materially affected the initial treatment plan.

Adult↗
PubMed1987

Representativeness of the "Ramfjord teeth" for epidemiologic studies of gingivitis and periodontitis.

Data from the Veterans Administration Dental Longitudinal Study of 736 men each examined four times were analyzed to determine how representative the six "Ramfjord Teeth" (RT) were of the rest of the dentition for epidemiologic studies of gingivitis and periodontitis. Correlation coefficients were calculated between scores for gingival inflammation generated by the RT and scores for the teeth in the rest of the mouth; the correlation coefficients between the two scores tended to be high. Sensitivity, specificity and predictive values were calculated for periodontal pathology classified on the basis of the pocket depths of the six RT. Reliance on the RT resulted in systematic underestimation of the prevalence and incidence of deep periodontal pockets. The RT are more than adequately representative of the rest of the dentition for epidemiologic studies of gingivitis, but are inadequate surrogates of the rest of the mouth for epidemiologic studies of periodontitis.

Adult↗
PubMed1986

Clinical efficacy of dental radiography in the detection of dental caries and periodontal diseases.

This article reports the ability of dental radiographs to correctly detect evidence of dental caries and periodontal disease (sensitivity) and to correctly establish the absence of these diseases (specificity). The analysis used a unique data set that was collected as part of the Veterans Administration Dental Longitudinal Study in Boston. Periapical, panoramic, and posterior bitewing radiographs were independently compared with a consensus radiographic standard of all three radiographs read simultaneously. Findings showed that the sensitivities of all three radiographs to detect dental caries were lower than expected, at approximately 60%, whereas the sensitivities to detect evidence of periodontal disease averaged approximately 85%. Panoramic radiographs were substantially less sensitive for detecting dental caries than periapical and posterior bitewing radiographs, but no difference between these modalities was observed in the analysis of sensitivity to periodontal disease. The proportion of false-negative and false-positive readings from dental radiographs was substantial and requires further investigation.

Adult↗
PubMed1986

The use of panoramic radiography in the evaluation of asymptomatic adult dental patients.

This article examines the efficacy of panoramic radiography alone and in combination with intraoral films as part of the "full-mouth" radiographic evaluation of asymptomatic dental patients in the diagnosis of dental caries and periodontal disease. Three full-mouth radiographic surveys--the panoramic alone, the panoramic plus posterior bitewing, and the periapical plus posterior bitewing--are compared. Two forms of measurement--comparative and incremental--were used to identify the radiographic survey with the highest single diagnostic yield when measured against the consensus standard. The findings show that the panoramic radiograph alone exhibits very low sensitivities to dental caries, ranging from 0.6% on anterior teeth to 25.6% on premolars. Even when posterior bitewing radiographs are added to the panoramic films, the sensitivities are significantly below those of the full-mouth periapical and bitewing survey. In contrast, the sensitivities of all three radiographic surveys in the diagnosis of periodontal disease are quite high, ranging from 87% to 96%, so that differences are not clinically significant. However, specificities tended to be low for periodontal disease and high for caries. Thus, for dental caries and (to a lesser extent) periodontal disease, the panoramic radiograph was inferior to the full-mouth intraoral series in its ability to correctly detect evidence of the disease.

Adult↗