共查询到20条相似文献，搜索用时 225 毫秒
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Gerardo Maupomé Juan F. Yepes Madison Galloway Qing Tang George J. Eckert Timothy Downey LaQuia Vinson 《Journal of the American Dental Association (1939)》2017,148(10):760-766
Background
The effectiveness of stainless steel crowns (SSCs) versus direct restorations when placed in primary mandibular molars (teeth nos. L and S) is uncertain. The authors evaluated effectiveness by gauging longevity of treatment.Methods
The authors obtained private dental insurance claims (2004-2016) from a national dental data warehouse. Paid insurance claims records (n = 1,323,489) included type of treating dentist, treatment placed, and patient age.Results
Dentist specialty, type of treatment, and patient age were significant in predicting failure after the first restoration. The authors found high survival rates for all treatments (> 90%) after 5 years; however, as soon as within 3 years after treatment, SCCs had approximately 6% better survival.Conclusions
Teeth nos. L and S first treated with SSCs lasted longer without new treatment compared with teeth first treated with direct restorations; the difference was small. Teeth treated by pediatric dentists had better survival rates.Practical Implications
Primary mandibular first molars initially treated with SSCs lasted longer without new treatment compared with direct restorations. Overall dental care costs of the former were considerably higher. 相似文献3.
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Clayton J. Warder Burton L. Edelstein 《Journal of the American Dental Association (1939)》2017,148(1):26-32.e2
Background
The availability of dentists to care for Medicaid beneficiaries is a longstanding concern of many families and those who serve them in the dental profession as well as policy makers. Yet, little information beyond the number of enrolled dentists has been reliably determined. The American Dental Association (ADA) Health Policy Institute has called for more nuanced measures that better reflect dentistry’s contribution to the care of Medicaid beneficiaries.Methods
The authors calculated percentages of general and pediatric dentists who enrolled in Medicaid, billed Medicaid, and treated Medicaid beneficiaries in each state for which data were available from the ADA’s 2008 study, the Association of State and Territorial Dental Directors’ 2013 report, and the 2013 federal Web site InsureKidsNow.org. To determine the number of primary dentists available to treat Medicaid beneficiaries, the ADA masterfile list of clinically active dentists was adjusted to remove nonpediatric dental specialists.Results
The authors determined that the ADA’s 2015 analysis of dentists enrolled in Medicaid was the most rigorously assessed source for enrollment but did not report numbers of billing or treating dentists. Increasingly stringent metrics of participation are associated with considerable declines in dentist participation. They found the underlying data sources unreliable, inaccurate, and incomparable within and among states.Conclusions
The authors concluded that no consistent, comparable, ongoing source of dentist participation in Medicaid exists that reliably provides substantive information to the profession and policy makers.Practical Implications
Dentistry’s ability to respond to policymakers’ concerns about service to Medicaid beneficiaries depends on the development and implementation of a standardized, reliable, systematic, and ongoing method to measure meaningful participation. 相似文献5.
He Cai Shuying Yang Xibo Pei Hai Qing Jian Wang 《The Journal of prosthetic dentistry》2017,117(3):405-409
Statement of problem
Gingival displacement is recognized as a substantive and difficult procedure in fixed prosthodontics. However, a realistic simulation of gingival displacement is unavailable for preclinical dental students.Purpose
The purpose of this study was to evaluate whether practice-based preclinical instruction of gingival displacement with animal models could improve students’ skill in patient care.Material and methods
Isolated bovine mandibles (calves were younger than 6 months of age) and isolated porcine hemimandibles were prepared for this study. Twenty-two general dental practitioners with at least 5 years of experience were randomly selected and assigned to perform gingival displacement on both bovine and porcine jaws. Those practitioners were then asked to assess the clinical similarity of gingival displacement between human teeth and animal teeth. The data were analyzed with the paired t test (α=.05). Upon confirmation that the animal jaw provided a similar gingival displacement environment to that of human teeth, 80 predoctoral dental students were enrolled and randomized into 2 groups. Half of them underwent the new practice-based instruction, while the others underwent traditional preclinical teaching only (lectures, online video, or live demonstration). After preclinical learning, clinical performance in gingival displacement was evaluated for all students in terms of the effect of gingival displacement and quality of impression. The data were analyzed with the chi-square test (α=.05).Results
The dentogingival environments of porcine and bovine jaws were similar to those of human jaws, and no significant difference was detected between these 2 animal models (P=.178). A significant increase occurred in the acceptable rate of the effect of gingival displacement (P<.001) and the quality of impression (P<.001) among students who received the practice-based instruction compared with those who received traditional teaching.Conclusions
These findings suggest that this practice-based instruction of gingival displacement with animal models is an effective method of promoting dental students’ learning of gingival displacement. 相似文献6.
Michael S. McCracken Mark S. Litaker Ashley J. George Scott Durand Sepideh Malekpour Don G. Marshall Cyril Meyerowitz Lauren Carter Valeria V. Gordan Gregg H. Gilbert 《Journal of the American Dental Association (1939)》2017,148(11):788-796.e4
Background
Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates.Methods
The authors developed a questionnaire that asked dentists about techniques used to fabricate single-unit crowns. The authors showed dentists photographs of 4 impressions and asked them to accept or reject each impression. The authors correlated answers with dentist and practice characteristics. Other questions pertained to laboratory use and crown remake rates.Results
The response rate was 83% (1,777 of 2,132 eligible dentists). Of the 4 impressions evaluated, 3 received consistent responses, with 85% agreement. One impression was more equivocal; 52% accepted the impression. The likelihood of accepting an impression was associated significantly with the clinician’s sex, race, ethnicity, and practice busyness. Clinicians produced 18 crowns per month on average, and 9% used in-office milling. Most dentists (59%) reported a remake rate of less than 2%, whereas 17% reported a remake rate greater than 4%. Lower remake rates were associated significantly with more experienced clinicians, optical impressions, and not using dual-arch trays.Conclusions
Although dentists were largely consistent in their evaluation of impressions (> 85%), nonclinical factors were associated with whether an impression was accepted or rejected. Lower crown remake rates were associated with more experienced clinicians, optical impressions, and not using dual-arch trays.Practical Implications
These results provide a snapshot of clinical care considerations among a diverse group of dentists. Clinicians can compare their own remake rates and impression evaluation techniques with those in this sample when developing best practice protocols. 相似文献7.
Cameron G. Estrich Stephen E. Gruninger Ruth D. Lipman 《Journal of the American Dental Association (1939)》2017,148(3):164-171
Background
In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure.Methods
The authors obtained demographic characteristics and dental practice behaviors from participants in the annual American Dental Association Health Screening Program survey administered from 2002 through 2012. The authors assayed serum samples obtained from participants for L pneumophila antibodies. The authors used an adjusted logit model to evaluate predictors of positive results.Results
Among 5,431 participants, approximately 10% were positive for L pneumophila, with no significant differences between dental practitioners and nonpractitioners. Geographic location was the only significant predictor of seropositivity, with no increased risk of being exposed to L pneumophila associated with age, race, sex, years in practice, hours of practice per week, use of barrier protection, or infection control practices.Conclusions
Prevalence of L pneumophila antibodies was 10.4% among dental and nondental personnel. US Census division was the only significant predictor of seropositivity. The authors conclude that provision of dental care did not increase the risk of being exposed to Legionella.Practical Implications
Dentists should be aware of the prevalence of Legionella species in their practice areas to understand their personal risk of developing an infection. 相似文献8.
Hasan Kocaağaoğlu Halil Ibrahim Kılınç Haydar Albayrak 《The Journal of prosthetic dentistry》2017,117(1):102-108
Statement of problem
Proper marginal, axial, and occlusal adaptation of dental restorations is essential for their long-term success. Production protocols including digital impression systems have been developed, but little information is available on the adaptation of zirconia restorations produced via them.Purpose
The purpose of this in vitro study was to compare the effects of digital impression protocols on the marginal, axial, and occlusal adaptation of zirconia copings.Material and methods
Thirty extracted human maxillary premolar teeth without caries or defects were used. The teeth were prepared for zirconia crowns and randomly divided into 3 groups. Zirconia copings were designed at a thickness of 0.5 mm with 30 μm of simulated die spacer starting 1 mm from the margin of preparations. They were produced using computer-aided design-computer-aided manufacture (CAD-CAM) protocol with a conventional impression (group Cn) and 2 different production protocols with digital impressions (group C) and group Tr. The marginal, axial, and occlusal discrepancies of these copings were measured using the silicone replica technique with stereomicroscopy at ×50 magnification, and the data were analyzed with 1-way ANOVAs (α=.05).Results
The mean marginal discrepancy values were 85.6 μm for group Cn, 58.7 μm for group C, and 47.7 μm for the Tr group. Significant differences were found among the production protocols in marginal, axial, and occlusal discrepancies (P<.05). Copings fabricated with the aid of digital impressions had significantly fewer marginal discrepancies than those of group Cn (P<.05). Group Tr exhibited the lowest marginal discrepancy, whereas groups Cn and C demonstrated similar axial adaptations (P>.05), and group Tr revealed the lowest axial discrepancy (P<.05). With regard to the occlusal discrepancy evaluation, group Tr had the lowest discrepancy. However, no significant differences was found between groups C and Cn (P>.05).Conclusions
The copings produced with the aid of digital impression systems exhibited better marginal and occlusal adaptation than those of the copings produced with the aid of conventional impression. 相似文献9.
Ronald E. Goldstein Wendy Auclair Clark 《Journal of the American Dental Association (1939)》2017,148(6):387-391
Background
Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations.Methods
The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment.Results
The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism.Conclusions
Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism.Practical Implications
Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities. 相似文献10.
Jason Clague Thomas R. Belin Vivek Shetty 《Journal of the American Dental Association (1939)》2017,148(6):377-386
Background
The authors clarified the causal mechanisms underlying the high prevalence of dental disease encountered in people who habitually use methamphetamine (meth).Methods
Using a stratified sampling approach, the authors conducted comprehensive oral examinations and psychosocial assessments for 571 study participants who used meth. Three calibrated dentists, who used National Health and Nutrition Examination Survey (NHANES) protocols, characterized the study participants’ dental disease. The authors also collected data related to study participants’ history of meth use and other attributes linked to dental disease.Results
Study participants who used meth manifested higher rates of xerostomia and caries experience compared with NHANES control participants. Participants who used meth had a higher level of daily consumption of sugary beverages compared with NHANES control participants. Smoking meth did not increase caries experience over other modes of intake. Dental hygiene was a significant determinant of dental health outcomes.Conclusions
Mode of intake and frequency of meth use have a minimal impact on dental health outcomes. Behaviors, such as sugary beverage consumption and poor oral hygiene, better explain dental health outcomes.Practical Implications
Having a better understanding of the causal mechanisms of “meth mouth” sets the stage for clinicians to provide more personalized interventions and management of dental disease in people who use meth. 相似文献11.
Background
The authors examined the relationship between education debt and career choice, particularly dentists’ decisions to specialize, participate in public health insurance programs, and join dental management service organizations (DMSOs).Methods
The authors used data from the American Dental Association 2015 office database, which contains dentist demographic information and identifies dentists who participate in public health insurance programs for pediatric dental care services. The authors merged this database with the 2002-2015 American Dental Association Survey of Dental Graduates, which contains information about education debt, to assess the relationship between education debt and career choices. The authors used probit and multinomial logit models to determine the relationships among education debt, demographic characteristics, and dentist career choices.Results
For each $10,000 increase in education debt, dentists were 0.9% more likely to join a DMSO (relative risk ratio, 1.009; 95% confidence interval, 1.0021 to 1.0164) and 0.6% less likely to join a non-DMSO group practice (relative risk ratio, 0.994; 95% confidence interval, 0.9897 to 0.9987) over a solo practice. Education debt did not have a statistically significant association with the decision to participate in public health insurance programs, but it did have a statistically significant association with the decision to specialize.Conclusions
Education debt had a modest association with some career choices among dentists. Demographic characteristics, such as race and sex, had a greater association.Practical Implications
Dental education debt has increased substantially in recent years. Debt had only a modest association with some career choices. Policy makers could consider this when considering education debt relief. 相似文献12.
Liang Chen Cornelis Johannes Kleverlaan Kunneng Liang Deqin Yang 《The Journal of prosthetic dentistry》2017,117(4):552-558
Statement of problem
Polyvinyl siloxane impression material has been widely used as a lingual matrix for rebuilding missing tooth structure with composite resin. The composite resin is light polymerized in contact with the polyvinyl siloxane impression material. However, polyvinyl siloxane impression material has been shown to interact with other dental materials.Purpose
The purpose of this study was to assess the effect of polyvinyl siloxane impression materials on the polymerization of composite resins by assessing the Vickers microhardness and degree of conversion of polyvinyl siloxane.Material and methods
The composite resins were light polymerized in contact with 3 polyvinyl siloxane impression materials (Flexitime Easy Putty; President Light Body; Xantopren L Blue) (n=8) and in contact with a matrix strip as the control group (n=8). Vickers microhardness and degree of conversion on contact surfaces were measured to evaluate the polymerization of composite resins. The depth of the effect was assessed by Vickers microhardness on section surfaces and observed with scanning electron microscopy. The results were analyzed by 1-way analysis of variance and the post hoc Tukey honest significant differences test (α=.05).Results
The Vickers microhardness and degree of conversion values on the contact surfaces of the experiment groups were significantly lower than those of the control group (P<.05); the Vickers microhardness values on the section surfaces indicated that there was no significant difference at the same depth of different groups (P>.05). The scanning electron microscope observation showed that an approximately 10-μm deep unpolymerized layer was found in the experimental group.Conclusions
Polyvinyl siloxane impression materials have an inhibitory effect on the polymerization of the composite resins, but just limited to within approximately 10 μm from the surface in contact with the impression material. 相似文献13.
Giacomo Derchi Michele Vano Antonio Barone Ugo Covani Alberto Diaspro Marco Salerno 《The Journal of prosthetic dentistry》2017,117(5):669-676
Statement of problem
Both direct and indirect techniques are used for dental restorations. Which technique should be preferred or whether they are equivalent with respect to bacterial adhesion is unclear.Purpose
The purpose of this in vitro study was to determine the affinity of bacterial biofilm to dental restorative composite resins placed directly and indirectly.Material and methods
Five direct composite resins for restorations (Venus Diamond, Adonis, Optifil, Enamel Plus HRi, Clearfil Majesty Esthetic) and 3 indirect composite resins (Gradia, Estenia, Signum) were selected. The materials were incubated in unstimulated whole saliva for 1 day. The biofilms grown were collected and their bacterial cells counted. In parallel, the composite resin surface morphology was analyzed with atomic force microscopy. Both bacterial cell count and surface topography parameters were subjected to statistical analysis (α=.05).Results
Indirect composite resins showed significantly lower levels than direct composite resins for bacterial cell adhesion, (P<.001). No significant differences were observed within the direct composite resins (P>.05). However, within the indirect composite resins a significantly lower level was found for Gradia than Estenia or Signum (P<.01). A partial correlation was observed between composite resin roughness and bacterial adhesion when the second and particularly the third-order statistical moments of the composite resin height distributions were considered.Conclusions
Indirect dental restorative composite resins were found to be less prone to biofilm adhesion than direct composite resins. A correlation of bacterial adhesion to surface morphology exists that is described by kurtosis; thus, advanced data analysis is required to discover possible insights into the biologic effects of morphology. 相似文献14.
Statement of problem
No data are available on the ability of an impression coping to resist the manual placement of an abutment replica (implant analog) during prosthodontic laboratory procedures after a direct (pick-up) impression.Purpose
The purpose of this in vitro study was to evaluate the torque resistance of impression copings after a direct impression, that is, the amount of rotational torque sufficient to induce irreversible displacement of impression copings in the impression material bulk once the impression has been made.Material and methods
A reference model with 5 abutment replicas was constructed. Five impression copings were screwed onto the abutment replicas, and standardized impressions were made. A controlled twisting force was applied to each impression coping. A torque tester recorded the torque variation. Three elastomeric impression materials were tested. ANOVA and the Tukey test (α=.05) were performed using an average of 30 measurements per impression material, with and without adhesive.Results
ANOVA and the Tukey test results showed that the adhesive, cohesive, and mechanical bonds between the impression coping and the impression material depended greatly on the type of material and that the average rupture threshold of these bonds was statistically significantly different in pairwise comparisons (P<.05). The curve analysis showed that when the impression materials are used with adhesives, the deformation of the interface is irreversible beyond 5 Ncm of torque.Conclusions
The polyether impression material is the direct impression material that showed the highest breakdown threshold for adhesive bonding when used without an adhesive. The use of an adhesive on impression copings leads to irreversible deformation of the interface at torque stresses well below the adhesive bond threshold of the same materials used without an adhesive. 相似文献15.
Ana Neumann Elsbeth Kalenderian Rachel Ramoni Alfa Yansane Bunmi Tokede Jini Etolue Ram Vaderhobli Kristen Simmons Joshua Even Joanna Mullins Shwetha Kumar Suhasini Bangar Krishna Kookal Joel White Muhammad Walji 《Journal of the American Dental Association (1939)》2017,148(9):634-643.e1
Background
Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)–based dental quality measure to determine whether patients with diabetes received such evaluations.Methods
The authors selected a Dental Quality Alliance measure developed for claims data and adapted the specifications for EHRs. Automated queries identified patients with diabetes across 4 dental institutions, and the authors manually reviewed a subsample of charts to evaluate query performance. After assessing the initial EHR measure, the authors defined and tested a revised EHR measure to capture better the oral care received by patients with diabetes.Results
In the initial and revised measures, the authors used EHR automated queries to identify 12,960 and 13,221 patients with diabetes, respectively, in the reporting year. Variations in the measure scores across sites were greater with the initial measure (range, 36.4-71.3%) than with the revised measure (range, 78.8-88.1%). The automated query performed well (93% or higher) for sensitivity, specificity, and positive and negative predictive values for both measures.Conclusions
The results suggest that an automated EHR-based query can be used successfully to measure the quality of oral health care delivered to patients with diabetes. The authors also found that using the rich data available in EHRs may help estimate the quality of care better than can relying on claims data.Practical Implications
Detailed clinical patient-level data in dental EHRs may be useful to dentists in evaluating the quality of dental care provided to patients with diabetes. 相似文献16.
Vasiliki P. Koidou Stephen F. Rosenstiel Robert G. Rashid 《The Journal of prosthetic dentistry》2017,117(5):636-641
Statement of problem
Whether deviations in the angulation discrepancy between the intercanine and interpupillary line significantly affect attractiveness is unknown.Purpose
The purpose of this prospective study was to quantify dental and facial esthetics to determine whether smile angulation discrepancies in individuals identified as having attractive smiles are smaller than those in the average population.Material and methods
An Internet search for “best smile” and “celebrity” identified 108 celebrities (Test group). Photographs showing smiles within 10 degrees of a frontal view were gathered. In mannequin testing, small head rotation (<10 degrees) was found not to affect the measurements. Photographs of dental students were used for the control group. The angulation discrepancy between the intercanine and interpupillary line was measured using computer software. Groups were compared using the Mann-Whitney U test (α=.05).Results
Usable photographs were obtained for 94 celebrities (62 women, 32 men) and were compared with photographs of 97 dental students (54 women, 43 men). Significant (P<.01) differences in angulation discrepancy were found, with celebrities having smaller mean angulation discrepancies (0.97 degrees) than dental students (1.33 degrees). The differences between men and women were not statistically significant (P>.05).Conclusions
Celebrities identified as having “best smile” had significantly smaller mean angulation discrepancies than the control group. 相似文献17.
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Wenhao Li Jingming Liu Su Chen Yao Wang Zhenting Zhang 《The Journal of prosthetic dentistry》2017,117(1):48-54
Statement of problem
Gastroesophageal reflux disease (GERD) is typically diagnosed based on symptoms of regurgitation and heartburn, although it may also manifest as asthma-like symptoms, laryngitis, or dental erosion.Purpose
The purpose of this prospective, cross-sectional study was to assess the prevalence of dental erosion in people with GERD and to evaluate the association between GERD and dental erosion.Material and methods
The presence, severity, and pattern of dental erosion was assessed in 51 participants with GERD and 50 participants without GERD using the Smith and Knight tooth wear index. Medical, dietary, and dental histories were collected by questionnaire. Factors potentially related to dental erosion, including GERD, were evaluated by logistic regression.Results
Dental erosion was observed in 31 (60.8%) participants with GERD and 14 (28%) participants without GERD. Bivariate analysis revealed that participants with GERD were more likely to experience dental erosion (crude odds ratio [cOR]: 2.74; 95% CI: 1.19, 6.32) than participants without GERD. Multivariate analysis also revealed that participants with GERD had a higher risk of dental erosion (adjusted odds ratio [aOR]: 3.97; 95% CI: 1.45, 10.89). Consumption of grains and legumes, the most frequently consumed foods in China, did not correlate with dental erosion. However, carbonated beverage consumption was significantly associated with GERD and dental erosion (aOR: 3.34; 95% CI: 1.01, 11.04; P=.04).Conclusions
GERD was positively correlated with dental erosion. Carbonated beverage consumption can increase the risk of both GERD and dental erosion. 相似文献20.