One-year clinical evaluation of two composite materials used for anterior class V restorations

The purpose of the current study was to evaluate the clinical performance of two composite materials used for filling anterior cavity preparations. A total of 100 class V cavities of anterior tooth were restored with two different composite materials (Palfique Estelite and Palfique Toughwell, 50 cavities each, respectively) in combination with the same bonding agent (Mac Bond II). Colour match, cavosurface marginal discolouration, recurrent caries, wear, marginal integrity and surface texture were evaluated clinically for all restorations on the basis of the United States Public Health Service (USPHS) criteria immediately after insertion (baseline), after 6 months and after 1 year. In the comparison of baseline to 1-year evaluation, the Palfique Toughwell material showed significant changes in all factors except recurrent caries. The Palfique Estelite material, however, showed neither significant cavosurface marginal discolouration nor recurrent caries. No significant difference (P > 0b05) was observed between the two materials in clinical performance after 1 year, with the exception of caries rate, which was found to be significantly lower in the Palfique Estelite material. It was concluded that both composites were clinically reliable materials when used for anterior class V restorations.     

Dental Public Health Postdoctoral Education: a Survey on the Status of Funding and Career Opportunities

Objectives : This paper reports the results of a survey to determine the consequences of budget reductions on the status of dental public health postdoctoral training in the United States, and opinions of experts in education and practice regarding career opportunities in dental public health. Methods : A survey was mailed to 154 dental and public health education and service institutions. Results : Most respondents (74 of 103; 72%) agreed that training opportunities depend on funding, and 73 percent ( n =75) expressed the view that more dental public health specialists are needed. Respondents reported that funding for current dental public health master's degree and residency programs is less than satisfactory. Respondents involved in training of dental public health professionals held marginally statistically significant different opinions regarding career opportunities than those who were not involved. No significant differences in opinions of respondents existed by type of institution. Conclusion : With decreased numbers of dental graduates, improved funding for dental public health programs will be critical, particularly at the specialty entry level, to ensure that adequate numbers of specialists are trained and available to meet the oral health needs of all the US population.     

The gap between dental education and clinical treatment in temporomandibular disorders and orofacial pain

Implementation of research findings in patient care ideally will follow in a continuous cycle, and clinical questions from practitioners should stimulate research. Even in the most optimal situations, there will be a gap between the steady flow of new findings from research and their eventual implementation in clinical practice. In the clinical practice of temporomandibular disorders and orofacial pain (TMD/OFP) simple cases outnumber the more complex cases by far. Therefore, research implications for the general dental practitioner, whose patients are rarely represented in research populations, may differ from what is published and taught. Treatment options like counselling, occlusal treatments (reversible as a rule and irreversible by exception) and physiotherapy can be very successful in the hands of the general dental practitioner. European dental schools should define additional amendments to the recently proposed profile and competencies for the European dentist, in order to focus on the relevant and current knowledge on temporomandibular disorders and orofacial pain. These amendments should address the adequate diagnosis and management of non-complex TMD cases and the need to refer to a TMD/OFP specialist in complex cases. Professional organizations such as the European Academy of Craniomandibular disorders can endorse better TMD/OFP education and training.     

Changes in Dental Health and Dental Health Habits from 3 to 5 Years of Age

Objectives : This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. Methods : The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. Results : Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. Conclusion : Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk.     

The cost of endodontic procedures in a French university hospital

Clinical costs have become an important consideration in dental schools, and have been the subject of several recent studies. In order to determine the actual costs of endodontic procedures, we have attempted to identify the various components of root canal therapy. The present study is based on findings in a university hospital functioning within the context of the French health care system. A questionnaire was used to survey the major factors entering into the achievement of the clinical procedure. The endodontic treatments were performed on 100 1st or 2nd molars, by undergraduate students. The survey involves fixed, variable, direct and indirect costs, and takes into consideration the reimbursements made by the French health care system. Findings indicate that all procedures show an appreciable deficit with a significant difference between initial treatment and retreatment. The analysis of the survey questionnaire findings enables us to offer some recommendations in the area of undergraduate education, as well.     

Development of a Gerodontology course in Athens: a pilot study

AIM: To describe the development of an undergraduate Gerodontology course in Athens Dental School. BACKGROUND: Because of demographic changes, undergraduate dental curricula should place appropriate emphasis on the oral care of the elderly. Therefore, the Athens Dental School Curriculum Committee authorised the development of a new Gerodontology course. METHODS: The new course was introduced in the 10th (final) semester of undergraduate studies. Teaching responsibilities were shared amongst staff from various Dental School departments and the National Health System. The course was elective and mainly didactic, consisting of seminars within the Dental School, educational visits to hospitals and geriatric day centres and elective clinical work in the comprehensive care clinic. The students evaluated the course at the end of the semester and indicated its strengths and weaknesses from their perspective. CONCLUSION: The new course was generally satisfying. Based on the experience and evaluation of the first pilot year and taking into consideration the existing barriers, we plan to improve and expand educational activities, mainly including improved methods of teaching and assessment, and more clinical assignments.     

A survey of deans: trends, challenges, and mentoring in prosthodontics. Part 2.

PURPOSE: This study consists of two parts. Part 1, a survey of program directors, was conducted to examine current trends in advanced education in prosthodontics in the United States. Part 2 reports on the findings of a survey distributed to the deans of US dental schools to evaluate their observations of trends in prosthodontic education. MATERIALS AND METHODS: A national, electronic survey of 55 dental school deans was distributed by e-mail to evaluate an interest in specialty training, an interest in specialization in prosthodontics, faculty shortages, programs to address faculty shortages, predoctoral curriculum in prosthodontics, opinions regarding dental specialties, and the administrative position of prosthodontics within the schools. RESULTS: Of the 55 deans, 44 deans responded, an 80% response rate. Only five deans reported a decrease in the number of students seeking specialty training after dental school. The remaining 39 deans reported a large increase, slight increase, or no change in those seeking specialty training. In 29.6% of the deans' responses, an increased interest in prosthodontics was reported, whereas 16 deans reported no change in the level of interest. One or more open faculty positions in prosthodontics existed at 29 dental schools, and 28 schools offered at least one incentive or a variety of incentives to recruit faculty. The respondents to the deans' survey revealed predoctoral student exposure to prosthodontists was high, and exposure to postgraduate prosthodontics students was low. A survey of internal school programs that might have an impact on an increased interest in prosthodontics revealed the presence of a predoctoral mentoring program for prosthodontics in 80% of the institutions. The clinical curriculum included treatment of a variety of cases, including complex cases as defined by a diagnostic classification system. The response to whether dental specialties should be combined or remain individual provided some interesting data. Only 40.9% of the deans responded that prosthodontics was a separate department. CONCLUSION: Dental school deans reported an increased interest in specialty training. Predoctoral student exposure to prosthodontics was high due to the nature of their clinical experience and due to the exposure to full-time prosthodontics faculty. Many dental schools have programs, such as mentoring and new technology, which might have an impact on predoctoral students' increased interest in prosthodontics.     

Dietary supplements: clinical implications for dentistry

BACKGROUND: Sales of dietary supplements in the United States continue to increase; patients who seek dental care more than likely are taking or contemplating taking dietary supplements. The author reviews the background of dietary supplements, highlights popular over-the-counter supplements available in the United States and addresses the issues of safety, efficacy and contraindications that merit consideration in clinical practice. METHODS: The author reviewed the literature regarding effectiveness of common dietary supplements and mechanisms of action with drug interactions. The author assessed properties of dietary supplements within the context of clinical implications for oral health care professionals. CONCLUSIONS: Dietary supplement use may be prevalent among patients seeking dental care. While some dietary supplements may be effective and safe, their biological activity may interfere with treatment or medications in oral health care. CLINICAL IMPLICATIONS: Oral health care professionals can ascertain patients' use of dietary supplements and evaluate them with respect to treatment. Resources for additional information are provided.     

Root canal shaping with manual stainless steel files and rotary Ni-Ti files performed by students

AIM: To investigate root canal shaping with manual stainless steel files and rotary Ni-Ti files by students. METHODOLOGY: Two hundred and ten simulated root canals with the same geometrical shape and size in acrylic resin blocks were prepared by 21 undergraduate dental students with manual stainless steel files using a stepback technique or with rotary Ni-Ti files in crown-down technique. Preparation length, canal shape, incidence of fracture and preparation time were investigated. RESULTS: Zips and elbows occurred significantly (P < 0.001) less frequently with rotary than with manual preparation. The correct preparation length was achieved significantly (P < 0.05) more often with rotary Ni-Ti files than with manual stainless steel files. Fractures occurred significantly (P < 0.05) less frequently with hand instrumentation. The mean time required for manual preparation was significantly (P < 0.001) longer than that required for rotary preparation. Prior experience with a hand preparation technique was not reflected in an improved quality of the subsequent engine-driven preparation. CONCLUSIONS: Inexperienced operators achieved better canal preparations with rotary Ni-Ti instruments than with manual stainless steel files. However, rotary preparation was associated with significantly more fractures.     

Predoctoral Fixed Prosthodontics Curriculum Survey

Purpose In 1996, a survey of American dental schools was conducted. The purpose of the survey was to determine the curricular structure, techniques taught, and materials used in predoctoral fixed prosthodontics courses. Materials and Methods The survey was mailed to the course directors of predoctoral fixed prosthodontic programs at 53 American dental schools. Of these, 42 schools returned the completed survey, resulting in a response rate of 79%. The mean, median, and the range of responses were computed where applicable. Results The results from this survey show that the mean student-to-faculty ratio in the preclinical course was 11:1, with a median of 10:1 and a range of 5:1 to 25:1. The mean number of laboratory clock hours was 164, with a median of 148 and a range of 81 to 288. The mean number of lecture hours reported was 42, with a median of 35 and a range of 20 to 80. Fifty-five percent of the schools used the Hanau semiadjustable articulator. The most commonly used provisional technique was the thermoplastic custom external surface form (44%). The finish line of choice for the full metal restoration was the chamfer placed circumferentially (74%). The finish line of choice for the porcelain-fused-to-metal restoration was the shoulder placed facially and the chamfer placed lingually (38%). Conclusions Predoctoral fixed prosthodontics education and technical experience varies from school to school, yet a large percentage of schools agree on certain topics.