“Spontaneous” oral hygiene: a predictor for future preventive behavior?

The aim of this study was to establish whether a patient's "spontaneous" hygiene could be a reliable predictor of his or her tendency to maintain a certain permanent level of hygiene. The sample comprised 147 private periodontal patients whose plaque indices were recorded before (index 1) and after (index 2) a standardized hygiene program was carried out. According to their initial indices the patients were distributed in 10 classes (Class 0: from 0 to 10% using O'Leary's plaque index, class 1: from 11% to 20%, etc.). The two biggest classes were greater than 50% (48.3% of the subjects of the whole sample belonged to classes 5 and 6). A coefficient (IC) = Index 1 - Index 2/Index 1 + Index 2 was conceived to appreciate the different degrees of improvement. There was a marked difference in behavior between patients whose initial plaque index was less than 50% and those whose initial index was greater than 50%. The former improved noticeably, whereas the latter did not. Within the limits of the investigated population the following conclusions can be drawn: 1) initial plaque index and possibilities of improvement are correlated; 2) initial plaque index, recorded prior to any periodontal treatment, may be a reliable predictor of a patient's future compliance.     

Targeting school‐based dental sealant programs: who is at “higher risk?”

Objectives: To assess the effect of various school‐level Free and Reduced Price Meal Program (FRPMP) enrollment‐based risk thresholds on the ability of school‐based sealant programs (S‐BSPs) to reach higher risk children. Methods: We used data from a statewide third grade oral health survey to compare: a) prevalence of dental caries for higher‐risk children, using three different sets of child risk criteria based on social determinants; and b) dental caries and other access‐related indicators for children at higher‐risk schools based on four FRPMP‐based thresholds (≥ 60 percent of children FRPMP‐enrolled, ≥ 50 percent, ≥ 40 percent, ≥ 30 percent). In addition, we used school enrollment and FRPMP enrollment data to compare the percentages of eligible schools and of higher‐risk children resulting from the various thresholds. Results: The prevalence of caries experiences and untreated caries were not significantly different for higher risk children categorized by the respective child caries risk criteria. Regardless of school‐level risk threshold, children at higher risk schools were more likely to have caries experience, untreated caries, and no recent dental visit and less likely to have private dental insurance than children at lower risk schools. For these measures, children at higher risk schools were similar to each other regardless of risk threshold and were similar to higher risk children at all schools. The number of additional higher risk children per additional higher risk school showed a large decline between the 40‐49 percent and 30‐39 percent FRPMP enrollment tiers. Conclusions: Targeting higher risk schools to reach higher risk children is a practical and effective approach for increasing sealant prevalence through S‐BSPs.     

IMPACT OF THE BITEWING RADIOGRAPHY EXAM INCLUSION ON THE PREVALENCE OF DENTAL CARIES IN 12-YEAR-OLD STUDENTS IN THE CITY OF FRANCA,S?O PAULO,BRAZIL

Introduction:

The pattern of development of carious lesions has changed. The carious lesion has been progressive and reaches the dentin without showing alterations in the clinical aspects.

Objectives:

To determine the prevalence of caries in 12-year-old students in the city of Franca – São Paulo, Brazil, during the year of 2003, and to evaluate the additional value of bitewing radiograph to detect hidden carious lesions in permanent molar dentin.

Materials and Methods:

A probabilistic sample composed of two hundred and fifty six (256) students, from public and private schools, was submitted to a cross-sectional study through examination by a calibrated examiner, in order to detect the caries prevalence, using the methodology recommended by the World Health Organization (WHO). For 66% of the sample, bitewing radiographs of the permanent molar region were obtained. The images were analyzed by a calibrated examiner, who established the presence of hidden caries in teeth with radiolucency in dentin, yet considered healthy in the epidemiological survey.

Results:

The prevalence of dental caries in epidemiological exam without (WHO) and with (WHO/R) the inclusion of hidden caries lesion was 54% and 64%, and the DMFT index was 1.73 and 1.92 respectively.

Conclusion:

Utilization of the method of bitewing radiographic diagnosis significantly increased (p<0.001) the prevalence of caries in the studied population.     

微创拔牙201颗临床总结

目的:探讨和总结微创拔牙技术在临床应用中的效果。方法:2009-03—2011-03间采用微创拔牙技术拔除195例共201颗牙齿。记录并分析术中患者的感觉和表现,术后1、3、7d复诊时患者的感觉、症状及拔牙创情况。结果:应用微创拔牙技术,本次所选病例术后感染或干槽症发生率为0%,拔牙畏惧率2.56%,术中断根1.03%,术中疼痛11.79%,术后疼痛4.62%,术后肿胀4.10%,术后张口受限2.56%。结论:微创拔牙技术疗效可靠,操作简便,是值得推广的较好拔牙方法。     

201例盘状红斑狼疮的临床,病理与免疫金银染色检测分析

作者对２０１例盘状红斑狼疮的临床、病理与免疫金银染色检测作了分析。结果显示：损害好发于下唇（６０％）。在系统因素中，患消化系统疾病为２５％，占首位。全部病例均经病理证实，其中８例伴有轻度上皮异常增生，３例发生癌变，１例盘状红斑狼疮和扁平苔藓共存。免疫金银染色检测显示：在组织切片的基底膜区除了有Ｆｇ的沉积之外，尚有多类免疫球蛋白或多类免疫球蛋白伴补体Ｃ３的共同沉积。说明盘状红斑狼疮是一种由多种因素引起的自身免疫性疾病，具有癌变可能，盘状红斑狼疮与扁平苔藓共存现象可能提示是一种疾病的不同发病阶段，其机理有待于作更深入的研究。     

201例拔牙断根的临床分析

２０１例拔牙断根的临床分析陕西省公路局职工医院口腔科李殿光拔牙断根是拔牙术中常见的并发症之一。为了探讨断根原因、特点、预防断根发生和摘除断根注意事项，笔者将我院口腔科门诊所遇到的２０１例拔牙术中断根分析如下：一、临床资料２０１例断根，其中男１０７例，...     

Objective,Subjective, and Self‐Assessment of Preadolescent Orthodontic Treatment Need – A Function of Age,Gender, and Ethnic/Racial Background?

Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES.     

Hygiène : structures,matériels,méthodes

The number of measures and regulations related to the increased risk of transmission of infections during hospital treatment has grown exponentially over the past twenty years. The alarming nature of nosocomial infections related to such risk has led to the creation of committees specifically aimed at fighting the risk of nosocomial infection. The recrudescence of infectious diseases is due to several factors: occurrence of new diseases, resistance to antibiotics, and increased number of debilitating conditions with intercurrent effects and, as a corollary, in subjects with lowered resistance. The therapeutic environment concerning the oral sphere is a major domain for the prevention of nosocomial infections. Today, numerous hygiene measures enable such problems to be controlled. In odontology, the practitioner, the dental prosthesis laboratory and the designers are equally involved. In his chapter, this subject is discussed not only in an overall manner to give an overview of the inseparable aspects of the problem, but also to convince the reader of its necessity. The process as a whole is aimed at eliminating the risk of cross infection related to the potential existence of reservoirs of micro-organisms and transmission pathways. In addition to the implementation of disinfection, sterilization and antisepsis procedures, knowledge, understanding and application of asepsis rules are expected to achieve protection of exposed subjects.     

Ⅲ.THE JAW LEVERS

Normal Class Ⅲ Jaw Lever:The jaw functions as a lever system.Ideally this lever system should be aClass Ⅲ type lever,both unilaterally and cross arch,in order to reduce thestress placed upon the teeth.When we consider chewing food,unilaterally,in an anteroposterior direction,on the working side we should have a Class Ⅲ lever system.The temporomandibular     

201例患者根管再治疗的临床分析

目的 评价根管再治疗的临床现况.方法 随机选择需行根管再治疗的201例患者的254颗患牙为研究对象,分析根管再治疗的就诊情况和疗程情况.结果 254颗需行根管再治疗的患牙中,前牙65颗,占25.59%;前磨牙64颗,占25.20%;磨牙125颗,占49.21%.根管内充填物为牙胶尖/AH糊剂者 208颗,曾做过干髓术者29颗,塑化治疗者0颗,根管内单纯糊剂允填者8颗,根管内存在器械分离者9颗.平均疗程为2～7次,2次完成者89颗;3次完成者150颗;4次完成者5颗;5次及以上完成者10颗.结论 254颗患牙其根管于治疗情况复杂,根管再治疗的疗程较首次根管治疗延长.