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At least 685 records · Page 38Linked to original sources
PubMed2004

The integration of clinical research into dental therapeutics: the role of the astute clinician.

BACKGROUND: Although productive, traditional research approaches may not always address clinically relevant outcomes or translate into changes that can be made in practice. Conversely, clinical observations often result in therapeutic innovations but require verification of safety before widespread use. OVERVIEW: As a strategy for greater integration of research findings and clinical practice, the authors suggest approaches for clinicians to document clinical observations through best case series as a basis for more controlled clinical trials. The aim is to engage clinicians in the process of therapeutic innovation through clinical research. CONCLUSIONS AND PRACTICE IMPLICATIONS: This approach represents a necessary first step for practitioners to formulate hypotheses for further testing, to identify clinically relevant outcome measures and to contribute to the evidence base for clinical practices in dentistry.

Clinical Trials as Topic↗
PubMed2005

What has happened to conservative tooth restorations?

There is an obvious tendency in dental practice to place more full crowns than may be necessary. This article has discussed some of the reasons for this increased use of full crowns, and for a reduction in the use of full crowns. I have supported the desirability of placing more conservative restorations, and I have discussed the financial and longevity implications offered by more conservative restorative dentistry.

Crowns↗
PubMed2005

Teeth with large amalgam restorations and crowns: factors affecting the receipt of subsequent treatment after 10 years.

BACKGROUND: The authors evaluated the factors associated with the receipt of subsequent treatment by teeth restored with a large amalgam restoration or a large amalgam restoration and crown restoration after 10 years. METHODS: The authors used retrospective data from the University of Iowa College of Dentistry (Iowa City, Iowa) administrative database and patient records to evaluate patient and tooth factors for their association with the two primary outcomes: receipt of any subsequent treatment and receipt of catastrophic treatment (extraction, endodontic therapy). RESULTS: The authors followed 518 teeth over a 10-year period (49 percent with large amalgam restorations and 51 percent with crowns). Sixty-four percent of the large amalgam restorations and 32 percent of the crowns received subsequent treatment during the 10 years. In addition to restoration type, the patient's sex, history of grinding teeth and having a broken tooth were related to the tooth's receiving subsequent treatment. Twenty-two percent of large amalgam restorations and 12 percent of crowns received catastrophic treatment with the odds of teeth with large amalgam restorations receiving a catastrophic treatment being 2.1 times the odds of teeth with crowns receiving catastrophic treatment. CONCLUSIONS: Teeth with crowns were less likely to receive any treatment or catastrophic treatment over 10 years than were teeth with large amalgam restorations. Patient and tooth factors also were related to a tooth experiencing subsequent treatment. CLINICAL IMPLICATIONS: Teeth with crowns received less subsequent treatment than teeth with large amalgam restorations. This could be related to both the difference in longevity between the two restorations, as well as how appropriately treatment was planned for each procedure. Cost differences between the two restorations need to be factored into the decision-making process.

Adult↗
PubMed2005

Characteristics of infection control programs in U.S. Air Force dental clinics: a survey.

BACKGROUND: National organizations and regulatory agencies have issued a number of guidelines on proper infection control procedures in dentistry. The objective of the authors' research was to gather information about current infection control practices in U.S. Air Force (USAF) Dental Corps clinics for the purpose of updating previously issued guidelines and developing infection control training programs. METHODS: The authors mailed a 60-item self-administered survey to the commanders of all USAF dental clinics located in the United States and overseas (n=82). The survey used primarily fixed-response questions to gather information about aspects of the clinics' infection control programs. The authors obtained descriptive statistics of the returned data by means of a statistical software package. RESULTS: The results indicated a high degree of compliance with existing USAF dental infection control guidelines. All clinics had personnel assigned to manage their programs, had a written exposure control plan and took measures to improve dental unit water quality. Facilities used a number of approaches to achieve and monitor compliance and exhibited a considerable amount of variation in infection control procedures when specific guidelines did not exist. CONCLUSIONS: In general, USAF dental clinics reported high levels of compliance with current infection control policies and procedures. Recurrent training, continual oversight, a highly motivated staff and teamwork are essential for reaching and maintaining these levels. Clinical Implications. Although compliance with recommended infection control guidelines is challenging, the results of this survey indicate that compliance is achievable, even in large group practices.

Dental Clinics↗
PubMed2006

Endodontic or dental implant therapy: the factors affecting treatment planning.

BACKGROUND: Clinicians are confronted with difficult choices regarding whether a tooth with pulpal and/or periapical disease should be saved through endodontic treatment or be extracted and replaced with an implant. METHODS: The authors examined publications (research, literature reviews and systematic reviews) related to the factors affecting decision making for patients who have oral diseases or traumatic injuries. RESULTS: The factors to be considered included patient-related issues (systemic and oral health, as well as comfort and treatment perceptions), tooth- and periodontium-related factors (pulpal and periodontal conditions, color characteristics of the teeth, quantity and quality of bone, and soft-tissue anatomy) and treatment-related factors (the potential for procedural complications, required adjunctive procedures and treatment outcomes). CONCLUSIONS: On the basis of survival rates, it appears that more than 95 percent of dental implants and teeth that have undergone endodontic treatment remain functional over time. CLINICAL IMPLICATIONS: Clinicians need to consider carefully several factors before choosing whether to perform endodontic therapy or extract a tooth and place an implant. The result should be high levels of comfort, function, longevity and esthetics for patients.

Bone Density↗
PubMed2003

Applications of pharmacogenomics in general dental practice.

The human oral cavity represents a complex ecology of approximately 500 microbial species existing as commensals, and interacting with human/host factors. Perturbation of this ecosystem can lead to diseases of the oral cavity. The oral cavity also acts as a mirror of complex systemic diseases. Unique challenges and opportunities in oral healthcare exist in the diagnosis and treatment of primary disorders of the oral cavity or manifestations of systemic diseases. The completion of human and microbial genome projects has provided a wealth of information that will permit the application of pharmacogenomics - how genetic variations within the commensal and the host will impact the efficacy of drugs, and the diagnosis and treatment of oral disease. This review highlights opportunities focusing on oral health where pharmacogenomics can be applied.

Diagnosis, Oral↗
PubMed1996

Judgement of removal of asymptomatic mandibular third molars: influence of position, degree of impaction, and patient's age.

Our aim was to study general dental practitioners' (GDPs') and oral surgeons' judgement of the need for removal of asymptomatic mandibular third molars, described by three cues. The judges were also asked to estimate the development of pathologic conditions. There was considerable variance with regard to the individual judgements. As a group, GDPs estimated the need for removal to be higher for patients less than 40 years than those more than 40 years old. The oral surgeons estimated the need to differ for three different age groups. The GDPs estimated the need to be highest for distoangular molars and lowest for vertical molars, whereas the oral surgeons estimated these positions to be equal. Molars partially covered by soft tissue were given the highest priority for removal by both groups of judges. The mean proportion of variation explained by the three cues was high, except for tumor development, indicating that the judges used the cues and the combination of them to a great extent in their judgement of the risk for development of pathologic conditions.

Adult↗
PubMed1997

Selection of restorative materials in general dental practice in Sweden.

The aim of this study was to record any differences in the selection of materials in private dental practices in Sweden during 1993-95, after a ban on amalgam had been proposed by politicians, compared with those obtained in a similar survey in 1978-79. A total of 177 clinicians participated in the present survey, which recorded the total number of restorations they placed and the number of composite, amalgam, and glass ionomers inserted in the treatment of primary caries and for replacement of restorations. Furthermore, the number of intact amalgam restorations replaced by composite and the number and types of inlays and laminates cemented were accounted for. Marked changes in the selection of direct restorative materials were noted in the present study compared with the survey in 1978-79. Resin-based composite materials are taking over the routine posterior restorative material, also in stress-bearing areas. Glass ionomer restorative materials are used preferentially in the treatment of primary caries. The use of amalgam restorations has decreased in relative and absolute numbers. Inlays are infrequently used but, when used, usually include three or more surfaces, and ceramic materials predominate.

Attitude of Health Personnel↗
PubMedDate not supplied

Methods used to select artificial anterior teeth for the edentulous patient: a historical overview.

PURPOSE: Selecting artificial teeth for a denture is complex when there are no remaining natural teeth and no pre-extraction records. The aim of this paper is to review the methods used to select artificial anterior teeth for the endentulous individual. MATERIALS AND METHODS: The review takes account of the majority of papers published during the last 100 years and is organized according to the methods used for determining artificial tooth form. RESULTS: Several factors have been proposed as aids for artificial tooth selection, and numerous methods have been devised for the evaluation of reliable esthetic factors in determining artificial tooth form. CONCLUSION: To date, no universally reliable method of determining tooth form has been found. The Williams classification (1914) is the most universally accepted method of determining anterior tooth form.

Denture Design↗
PubMed1997

An audit of antibiotic prescribing in general dental practice.

Clinical audit is widely recognised as the systematic and critical analysis of the quality of clinical care, including treatment regimes, the associated use of resources, and the resulting outcome and quality of life for the patient. The prescribing of antibiotics in general dental practice is an area 'wide open' for audit analysis since the profession must clearly accept its responsibility to use antibiotics sensibly; however, the definition of 'sensibly' is likely to vary from practitioner to practitioner. This audit reviews the need for antibiotic prescribing in general dental practice over two consecutive four-month periods. A consensus was achieved on the rationale for antibiotic prescribing and the number of prescriptions fell by 50% as a result.

Anti-Bacterial Agents↗
PubMed1997

Reasons for placement and replacement of restorations of direct restorative materials by a selected group of practitioners in the United Kingdom.

This article reports the findings of a study on reasons for the placement and replacement of direct restorations in general dental practice in the United Kingdom. Twenty-two selected practitioners recorded information pertaining to up to 250 consecutive direct restorations placed by themselves during a 6-week period. From data derived from 2,379 restorations, it was found that about 60% of restorative practice in the United Kingdom may be found to comprise the replacement of existing restorations. For restorations of amalgam and glass-ionomer cement, the principal reason for replacement was secondary caries. For restorations of resin composite, secondary caries and poor appearance accounted for equal proportions of failures. Apart from the need for more extensive surveys of the type reported, the data emphasize the need to monitor treatment trends in contemporary clinical practice.

Composite Resins↗