PubMed Health⌕ Search

Biomedical subjects

N B Pitts

Publications and source records attributed to N B Pitts.

At least 91 records · Page 5Linked to original sources
PubMed1993

Occlusal caries diagnosis: a changing challenge for clinicians and epidemiologists.

The diagnosis of occlusal caries is an integral part of an epidemiologist's task, whether carrying out cross-sectional national caries prevalence surveys to assist with planning and the evaluation of service provision, or clinical trials of caries preventive agents. Similarly, the clinician also carries out this same overall diagnostic procedure in order to plan care for individual patients, although he/she will usually have access to improved facilities and diagnostic aids. This paper reviews the different problems now being encountered by both epidemiologists and clinicians in the face of changes in the presentation of the disease at this site and the qualifications which should now be appreciated when extrapolating from the results of surveys employing comparatively gross criteria. It explores recent developments in diagnostic aids and makes suggestions as to how further information might be obtained in future which would aid the valid comparison of diagnoses made by these two groups of dentists.

Age Factors↗
PubMed1993

CO2 laser and the diagnosis of occlusal caries: in vitro study.

The diagnosis of small lesions in pit and fissure sites is becoming increasingly problematical. This study was designed to evaluate, in vitro, the potential use of a carbon dioxide (CO2) laser technique as an aid to the diagnosis of incipient pit and fissure caries. Vaporization of the organic material in the 'early' carious lesion should lead to its carbonization and thus make it more conspicuous. Pilot studies were carried out to identify lasing parameters which produced no visible effect on sound enamel but which caused charring (carbonization) of white spot fissure lesions. Fifty extracted human molars and premolars were air-polished on the occlusal surfaces and independently scored clinically for caries, both before and after lasing. The teeth were subsequently sectioned and examined histologically. Of the 37 sites histologically scored as sound or exhibiting precavitation lesions, eight were correctly scored as sound both prelasing and postlasing. Of the 29 precavitation lesions detected histologically, five were detected clinically prelasing and 11 were detected postlasing. This 21% difference in the sensitivity of caries diagnosis between the prelasing and postlasing examinations was statistically significant (at the 95% level). There were no false-positive caries diagnoses. Further research, in particular the refining of lasing parameters employed, is indicated.

Carbon Dioxide↗
PubMed1993

Radiovisiography--a preliminary subjective assessment in a hospital paediatric dentistry department.

Recent reports on radiovisiography (RVG) have concentrated mainly on the physical characteristics of this relatively new, digital imaging dental radiographic technique. This paper reports a preliminary assessment of the Mark 2 mobile system in routine use in a hospital paediatric dentistry department. The evaluation encompassed patient acceptability, ease of operation and the clinicians' subjective assessments of the images obtained. It was concluded that RVG is, in general, an acceptable alternative to conventional intra-oral radiography.

Adolescent↗
PubMed1993

Assessment of reports by dentists of their restorative treatment thresholds.

Questionnaires have been used to determine the point when dentists think a filling ought to be placed (restorative treatment threshold). This study assesses the method. 211 general dental practitioners were interviewed and asked to identify the point at which they would instigate restorative treatment in a 12-yr-old patient from a list of descriptions of lesions affecting buccal/lingual, occlusal and approximal surfaces. They were also asked to judge the likely depth and lateral spread of the lesion they chose and to identify a photograph resembling it (buccal/lingual and occlusal surfaces) or a line drawing and description of its expected surface appearance (approximal surfaces). The Pearson correlation coefficients between reported treatment threshold and the characteristics expected to be associated with them were poor. This suggests that there may be considerable variation in opinion between dentists about the underlying condition of carious lesions of similar surface appearance. There was no evidence that the treatment opinions of these dentists have changed markedly between 1987 and early 1991.

Attitude of Health Personnel↗
PubMed1993

Radiovisiographic diagnosis of dental caries: initial comparison of basic mode videoprints with bitewing radiography.

Radiovisiography (RVG) is a commercially available, dental radiographic digital imaging system which is claimed to rival conventional techniques in terms of decreased radiation dose and the production of instantaneous images. The aim of this study was to compare in vitro the sensitivities and specificities derived from three examiners using conventional bitewing radiographic film (D and E speed) with those achieved by the same examiners using basic mode RVG bitewing videoprints of occlusal and approximal caries. Videoprints were used in this study, as they are the principal method of archiving radiovisiographic images, unless a separate compatible personal computer is used. The histological appearance of the subsequently sectioned teeth was used as the validating criterion. The in vitro results of basic mode RVG suggest that for occlusal caries, overall the sensitivity and specificity of RVG videoprints are similar to those of bitewing radiography. For approximal caries, the specificity of RVG videoprints was similar to that of bitewing radiography, but the sensitivity was slightly lower. Further work using the different modes available and electronically modified images is indicated.

Dental Caries↗
PubMed1993

Development and application of a quantitative method of monitoring macroscopic cavitation in smooth surface carious lesions in vivo.

Replica techniques have been widely used in dental research, but not previously applied to the in vivo study of carious cavities on free smooth surfaces. A replica method was developed using an epimine resin as the impression material, and a silicone elastomer as the casting material. Cavity areas were measured on the replicas using the Reflex microscope. The sources of method error were identified and quantified. The method was successfully incorporated into a conventional clinical trial and changes in cavity size with time were investigated.

Adolescent↗
PubMed1993

Radiovisiography: an update.

Comparatively little has been published regarding the recently developed (and rapidly developing) digital imaging dental radiographic system known as radiovisiography (RVG). This paper reviews the existing literature, describes various modifications and updates which have been made and discusses the clinical implications of RVG.

Humans↗
PubMed1992

General dental practitioners' needs for continuing education on the management of fissure caries.

A process of identifying GDPs' perceptions of their needs for continuing education on one topic area is described. The method employed a combination of two traditional approaches for assessing educational needs, the so-called 'wisemen' approach and interviews with members of the target audience. The process identified three groups of GDPs with differing educational needs. Their perceptions of their educational needs are described, and the advantages and disadvantages of the process discussed and compared with other methods of assessing educational needs. The study confirmed the importance of identifying educational needs in the development of an educational programme.

Dental Fissures↗
PubMed1992

The Scottish Health Boards' Dental Epidemiological Programme: initial surveys of 5- and 12-year-olds.

The Scottish Health Boards' Dental Epidemiological Programme, a joint venture between the Scottish Chief Administrative Dental Officers and the Dental Health Services Research Unit at the University of Dundee, was instigated in 1987 in response to the Chief Dental Officer's concern at the lack of any coordinated dental health information about children residing in the 15 Scottish Health Board areas. Each year a standardised dental survey of a random sample of children is now undertaken across Scotland. This paper reports, principally, the caries results of the first three surveys of 5, 12 and 5-year-olds undertaken at the end of 1987, 1988 and 1989, respectively. Marked variations in caries prevalence were found in different parts of Scotland, higher levels being recorded in the urbanised central belt and in the West. While there have been overall improvements since 1983, caries prevalence in Scotland remains substantially higher than in many other parts of the UK (mean DMFT for 12-year-olds in 1988 = 2.23, mean dmft for 5-year-olds in 1989 = 2.82), with 67.8% of 12-year-olds and 59.2% of 5-year-olds (in 1988 and 1989, respectively) still suffering from dentinal caries or past caries experience (DMFT/dmft greater than 0) when assessed by clinical examination alone. No continued improvement in caries prevalence was seen in the 1989 survey of 5-year-olds compared to the 1987 examination. Continued monitoring of this situation is indicated.

Child↗
PubMed1992

The prescription and timing of bitewing radiography in the diagnosis and management of dental caries: contemporary recommendations.

This 'personal view' makes recommendations on the use of the bitewing radiograph in the diagnosis of dental caries on the basis of published evidence about the disease and available diagnostic methods. It suggests that posterior bitewing radiographs are required for all new patients if the approximal surfaces of the teeth cannot be examined directly. At this initial visit, an assessment of the caries risk of the individual patient should be made. Subsequent radiographic recall intervals are suggested, which are determined on the basis of this risk assessment. It should be appreciated that risk status may change over time and that, in the future, an individual's radiographic recall interval may have to be changed.

Adolescent↗
PubMed1992

GDPs' and specialists' decisions in the management of fissure caries.

As part of a continuing education programme in dentistry, four specialists and 27 selected general dental practitioners were asked to rate 58 clinical management options relating to fissure caries in six simulated patient management problems called challenges. Their ratings are presented and the advantages and disadvantages of the approach are discussed. Areas of agreement and disagreement are highlighted and possible reasons for these explored.

Composite Resins↗
PubMed1992

Some of the factors to be considered in the prescription and timing of bitewing radiography in the diagnosis and management of dental caries.

This article describes some of the factors to be considered by the practitioner when prescribing bitewing radiographs in the diagnosis and management of dental caries and draws on the literature of a number of disciplines including restorative dentistry, cariology, epidemiology and oral radiology. It seems appropriate to re-assess current practice in the light of information on changes in the disease of dental caries, its behaviour and the way this behaviour may vary in high and low caries risk groups. The diagnostic potential of the bitewing examination appears, at present, to be unrivalled, but other diagnostic methods, such as fibreoptic transillumination and tooth separation, must also be considered. Some methods to minimize radiation doses and increase diagnostic yield are discussed. Current knowledge of prescribing patterns is reviewed and areas of ignorance are mentioned as findings from future research in these areas may influence decisions about when to use and re-use bitewing radiographs.

Dental Caries↗
PubMed1992

Continuing education for general dental practitioners using a printed distance learning programme.

This paper describes the development of a printed distance learning programme by a coordinated team approach. The programme has two components, a resource book and three patient management problem leaflets or challenges and is designed to update general dental practitioners on the management of fissure caries. It includes strategies to meet the educational needs of three groups of general dental practitioners with different educational requirements. It is concluded that the approach described meets the CRISIS criteria for effective continuing education and offers a useful approach to distance learning in dentistry.

Education, Dental, Continuing↗
PubMed1992

An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth.

At general dental practices in Scotland 211 children between the ages of 5 and 15 years were examined by 1 observer. A comparison of the status of 1,468 permanent and 756 primary posterior approximal surfaces was made on the basis of their appearance on posterior bite-wing radiographs and the findings of a direct in vivo visual examination, made after temporary tooth separation had been achieved over 1 week using elastomeric separation. For permanent tooth surfaces, 0% of radiolucencies in the outer half of enamel, 10.5% in the inner half of enamel, 40.9% extending to the outer half of dentine, and 100% extending to the inner half of the dentine were found clinically to be cavitated. The analogous results for primary teeth were that 2.0, 2.9, 28.3, and 95.5%, respectively, of radiolucencies appeared to be cavitated. Although further research with larger numbers of permanent teeth is indicated, these results may contribute to a re-evaluation of the optimal threshold for restorative intervention at approximal sites. Greater numbers of approximal radiolucencies and carious lesions (p less than 0.001) were found in those surfaces which initially had a normal anatomical contact when compared to those which did not.

Adolescent↗
PubMed1992

The differentiation of sealant restorations from preventive fissure sealants, in subjects with clear sealants.

The aim of this study was to assess whether preventive fissure sealants could be differentiated from sealant restorations. The problem of being unable to differentiate between these two tooth states has implications for practitioners and epidemiologists (Davies, 1990). One hundred and seventeen permanent molar teeth, all sealed with a clear sealant, were examined under two types of conditions. These were the Daray 'Versatile light'; mirror, wet teeth, and the Daray 'Operating light 2'; mirror, dry teeth. The subjects' records were subsequently consulted to provide the validating criteria. The results suggest that in a dental hospital environment, when a clear sealant material is in place, it is possible to differentiate between preventive fissure sealants and sealant restorations. It would seem, however, that the 'sealant-alone' variety of sealant restoration was the one most often mistaken for a preventive fissure sealant. The different examination conditions did not markedly affect the examiners' ability to differentiate between the two tooth stage.

Adolescent↗