Quantitative assessment of sealant wear in vivo.
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Biomedical subjects
Publications and source records attributed to S L Handelman.
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The findings of this study support previous data on marginal leakage using enamel sealants in vitro. All sealants tested except Epoxylite 9075 were described for this study. However, all in vitro studies have limitations, and the ultimate evaluation of sealant behaviour must be based on in vivo experimentation.
This paper reports on a relatively uncomplicated and inexpensive computerized system for prospective evaluation of clinical dental programs from the point of view of effectiveness and efficiency. Availability of this system does away with some high start-up costs. Three forms of input data, new case information, examination findings and operative procedure information, are regularly collected on data sheets and specially designed Port-a-punch IBM cards. Easily interpreted output tables are generated monthly on such variables as completed cases according to treatment series and clinician, number of various procedures performed by clinicians, etc. Productivity is measured, in part, by application of monetary constants to procedure data. This paper describes the computer programs used, the cost of setting up and operating the system (which is within the budgetary constraints of most small, publicly funded programs) and the benefits that can be derived from the use of such a system. The system provides prompt feedback of relevant administrative data, thus allowing for relatively quick response to problems. Use of the system reduces clerical needs to a minimum and the program can easily be implemented on any except the very smallest digital computer.
Teeth in which caries had penetrated the pits and fissures were sealed with an ultraviolet-light-polymerized sealant. Samples of carious dentin were taken from teeth that were not sealed and from teeth that were sealed, up to two years after the sealant had been placed. The major reduction in viable microorganisms occurred during the first two weeks, and there was a gradual reduction in the total count thereafter. At the end of two years, there was a 2,000-fold decrease in the number of cultivable microorganisms. Preliminary clinical and radiographic findings suggest that there was no progression of the carious lesions, but further studies are needed before this technique can be considered an alternative to conventional procedures.
The detailed timing and recording of the sequence of tasks for dental restorative procedures was used to evaluate the effects of the location of the hand-piece and three-way syringe on the dental team performance. Sixty-four audiovisual tapes of ten dental teams, performing complete, actual restorative procedures, were made in two dental operatories that differed only in the location of the dentist's instrument cabinet. Total treatment sessions were divided into four major divisions and expressed as a percentage of the total time: patient preparation, 14%; tooth preparation, 32%; tooth restoration, 50%; and patient release, 4%. Tooth preparation and restoration took longer with the instruments in the 8-o'clock location than with them in the 12-o'clock location. When the teams were reversed, that is, changed to the other operatory, there was an increase in tooth preparation and restoration time. Instrument transfer and use, especially for the three-way syringe, tended to take longer for the 8-o'clock location. In contrast, the dentist's idle time tended to increase working with the 12-o'clock instrument location because of differences in work loads. Time line analysis provided a means of evaluating the impact of instrument location as well as an approach to assessing individual team performance.
Using audiovisual tapes of 150 actual dental treatment sessions, five dental teams working with handpieces positioned in the 8-o'clock location were compared with five dental teams working with hand pieces positioned in the 12-o'clock location. Criteria used for analysis were frequency and duration of instrument transfer, critical incidents that interfered with instrument movements, and subjective responses of the dental team members. The data showed that the handpiece transfers were faster and more frequent in the 12-o'clock location where they were done via the assistant. However, the reverse was true for transfers of the three-way syringe. Most critical incidents occurred with equal frequency and were common to both rooms, but some were related to instrument location. The subjective responses indicated that the assistant working with the 12-o'clock instrument location had many more tasks and must be more highly trained.
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The effect of low levels of strontium, boron, lithium, molybdenum, and fluorine, alone and in combination, on hydroxyapatite solubility, bacterial growth, and acid production in five antigenic types of Streptococcus mutans was investigated. Pour plates containing synthetic hydroxyapatite were used to compare dissolution of hydroxyapatite. The colonies of the five antigenic types of S mutans produced zones of dissolution that were measured. Acid production and growth were studied in broth culture media. The results show that low levels of strontium and fluorine can significantly reduce demineralization of synthetic hydroxyapatite by S mutans in vitro.
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Silver cations generated by passing low intensity direct current through pure silver electrodes were found to be sufficiently antibacterial to cause sterilization of samples of infected dentin. The optimal procedure involved a 5 microA current applied for 20 minutes with the anode then left in contact with the sample. Minimal inhibitory concentrations of electrically generated silver ions for representative oral bacteria were essentially equal to those for silver ions added as nitrate or fluoride salts, and medium constituents, including sodium thioglycolate, antagonized antibacterial action. A major advantage to the use of the electrode method is that it allows for continuous, focal application of antibacterial silver cations.