共查询到20条相似文献，搜索用时 62 毫秒
1.
Sonia K. Makhija Daniel A. Shugars Gregg H. Gilbert Mark S. Litaker James D. Bader Rebecca Schaffer Valeria V. Gordan D. Brad Rindal Daniel J. Pihlstrom Rahma Mungia Cyril Meyerowitz 《Journal of the American Dental Association (1939)》2017,148(12):922-929
Background
A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically.Methods
Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster.Results
The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P = .03), luster (P = .04), and roughness (P = .01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P = .07).Conclusions
Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives.Practical Implications
Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention. 相似文献2.
Raymond A. Kuthy Susan C. McKernan Mark Pooley M. Bridget Zimmerman 《Journal of the American Dental Association (1939)》2018,149(4):308-316
Background
In this study, the authors used observational data from 2014 to evaluate the association between the number of general dentists and several community characteristics.Methods
The authors collected community-level characteristics from secondary sources for all 947 Iowa incorporated communities to study their relationships with the mean number of general dentists per 1,000 population per square mile (population density), the dependent variable. The authors used zero-inflated negative binomial models to examine the association between the dependent and predictor variables.Results
Only 22.8% of communities had a dentist. Urban, young, well-educated, fluoridated communities with at least 1 elementary school had the highest estimated mean concentration of dentists. Isolated communities with older, less educated adults and lacking fluoridation and an elementary school had the fewest dentists.Conclusions
Although population is an important determinant for where a dentist practices, other variables such as urbanization, demographic characteristics, fluoridation status, and presence of at least 1 elementary school are also predictors of the number of dentists in a community.Practical Implications
These findings provide dental students and young practitioners useful information by highlighting community characteristics that are associated with office locations. 相似文献3.
Carrigan L. Parish Margaret R. Pereyra Stephen N. Abel Karolynn Siegel Harold A. Pollack Lisa R. Metsch 《Journal of the American Dental Association (1939)》2018,149(2):112-121
Background
The dental setting is a potential venue for identifying patients experiencing intimate partner violence (IPV). The study objective was to assess dentists’ current practices and attitudes about IPV screening.Methods
A nationally representative survey of US general dentists assessed dentists’ use of health history forms that queried about IPV and their acceptance of IPV screening as part of their professional roles. Parsimonious Poisson regression models were used in multivariable analysis to estimate risk ratios for the 2 dependent variables.Results
Almost all dentists did not include a question to screen for IPV on their patient history forms. More than one-half of dentists also did not know of a referral place for patients experiencing IPV and did not believe that IPV screening should be part of their professional roles.Conclusions
Uptake of IPV screening and favorable attitudes toward screening were low among dentists studied. However, prior IPV training and clinical knowledge plus awareness of IPV referral mechanisms were positively associated with greater screening uptake and attitudes.Practical Implications
The inclusion of brief, focused IPV interventions in dental education and the establishment of collaborations between dentists and IPV agencies for referral mechanisms, in conjunction with an overall shift in dentists’ attitudes about their professional responsibilities, may facilitate IPV screening uptake in the dental setting. 相似文献4.
Paulo Nadanovsky Ana Paula Pires dos Santos Ronaldo Lira-Junior Branca Heloisa de Oliveira 《Journal of the American Dental Association (1939)》2018,149(1):18-24
Background
The authors assessed whether dentists’ diagnostic inferences differ when test accuracy information is communicated using natural frequencies versus conditional probabilities.Methods
A parallel, randomized controlled trial with dentists was carried out in Rio de Janeiro, Brazil. The dentists received a question on the probability of a patient having interproximal caries, given a positive bite-wing radiograph. This question was asked using information that was formulated into either natural frequencies or conditional probabilities.Results
Only 14 (13.9%) of the dentists gave the correct answer; 13 in the natural frequencies group, and 1 in the conditional probabilities group (P < .001). There were 7 nearly correct answers in the natural frequencies group and none in the conditional probabilities group (P = .005).Conclusions
Representing diagnostic test accuracy in natural frequencies substantially helped dentists make diagnostic inferences. Nearly twice as many dentists overestimated the presence of interproximal caries when given information in conditional probabilities.Practical Implications
Our study findings show information shared using natural frequencies may be more accurately interpreted by dentists than that based on conditional probabilities. Patients will probably receive different standards of care depending on the format in which dentists receive diagnostic test accuracy information. 相似文献5.
Maria Auxiliadora Pereira Reginaldo Batista dos Santos-Júnior Johnny Alexandre Tavares Alaíde Hermínia Oliveira Pollyana Caldeira Leal Wilton Mitsunari Takeshita Antônio Márcio Barbosa-Júnior Luiz Eduardo Braga Bertassoni André Luis Faria-e-Silva 《Journal of the American Dental Association (1939)》2017,148(6):369-376
Background
Clinicians often use calcium hydroxide liners during stepwise treatment of advanced caries. In this randomized clinical trial, the authors compared the short-term outcome of stepwise caries removal with and without use of a calcium hydroxide liner in conjunction with provisional resin-modified glass ionomer (RMGI) restorations.Methods
The authors included in the trial 98 patients aged 15 to 30 years who had a deep carious lesion in a posterior tooth. The authors measured the dentin thickness radiographically and recorded its color, consistency, and moisture, as well as the bacterial count of the lesions. After partial caries removal, the authors assigned patients randomly to have their caries provisionally restored using RMGI with (control group) or without (test group) a calcium hydroxide liner. The primary outcome measure was tooth vitality after 90 days. Secondary outcomes included changes in dentinal, radiographic, and microbiological characteristics of the lesions.Results
The authors found no statistically significant difference between the test and control groups in tooth vitality after 90 days. Irrespective of calcium hydroxide liner use, the authors observed darker, harder, drier, and less contaminated dentin after the provisional restorations, but dentin thickness remained unchanged.Conclusions
On the basis of this 3-month clinical trial’s results, the use of a calcium hydroxide liner during stepwise caries excavation and provisional restoration did not provide any additional benefit.Practical Implications
After 3 months, using a calcium hydroxide liner does not appear to offer any additional benefit when clinicians use RMGI provisional restorations during stepwise caries removal. Longer studies are needed to confirm these results. 相似文献6.
Mahshid Majlessi Koopaeei Marita R. Inglehart Neville McDonald Margherita Fontana 《Journal of the American Dental Association (1939)》2017,148(2):64-74
Background
There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists’ (GDs), pediatric dentists’ (PDs), and endodontists’ (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs.Methods
A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey.Results
Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions.Conclusions
Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs.Practical Implications
Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. 相似文献7.
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9.
Myrto Piperidou Rana N.S. Sodhi Kamil P. Kolosowski Bettina R. Basrani 《Journal of endodontics》2018,44(11):1714-1719
Introduction
SmearOFF (Vista Dental Products, Racine, WI) is an irrigation solution containing chlorhexidine (CHX), EDTA, and a surfactant. This study examined the chemical interaction of SmearOFF with sodium hypochlorite (NaOCl) on the dentin surface, specifically the formation of precipitate and/or parachloroanaline (PCA).Methods
Dentin blocks prepared from human maxillary molars were mounted in resin. Dentinal tubules were exposed in a perpendicular orientation using an ultracryomicrotome. The blocks were divided into 2 groups: the CHX group, irrigation with 6% NaOCl, 17% EDTA, 6% NaOCl, and 2% CHX, and the SmearOFF group, irrigation with 6% NaOCl and SmearOFF. The dentin surface was analyzed with time-of-flight secondary ion mass spectrometry and X-ray photoelectron spectroscopy to determine the formation of precipitate or/and PCA on the surface of dentin.Results
Precipitation with PCA and occlusion of the dentinal tubules were noted on the dentin surface in the CHX group. No precipitate and no PCA were detected on the surface of dentin in the SmearOFF group.Conclusions
Interaction of SmearOFF with NaOCl on the dentin surface did not result in the formation of precipitate or PCA. 相似文献10.
11.
Assessing dentists’ human papillomavirus–related health literacy for oropharyngeal cancer prevention
Coralia Vázquez-Otero Cheryl A. Vamos Erika L. Thompson Laura K. Merrell Stacey B. Griner Nolan S. Kline Frank A. Catalanotto Anna R. Giuliano Ellen M. Daley 《Journal of the American Dental Association (1939)》2018,149(1):9-17
Background
Oropharyngeal cancers related to human papillomavirus (HPV) are on the rise. Dentists may be the next group of providers participating in the prevention of HPV. The aim of this study was to assess dentists’ health literacy regarding the connection of HPV and oropharyngeal cancer.Methods
The authors conducted 4 focus groups with dentists (N = 33) during a regional dental conference in 2016. Guided by the health literacy competencies (that is, access, understand, appraise, and apply), the authors used constant comparison methods for data analysis.Results
Dentists mentioned a variety of informational sources (for example, dental journals and colleagues). Knowledge about the link between HPV and oropharyngeal cancer varied among participants. Participants appraised multiple patient and practice factors when deciding to have the discussion with patients. Some dentists discussed the HPV and oropharyngeal cancer connection with patients, and most conducted secondary screenings.Conclusions
Findings indicate areas for intervention, including creating awareness of trusted informational sources, as well as increasing HPV knowledge and understanding the multiple patient (for example, age) and practice (for example, open operatories) appraisal factors. Moreover, enhancing the communication skills of dentists with patients is needed to improve HPV-related cancer prevention education.Practical Implications
Addressing dentists’ HPV-related health literacy has the potential to improve dentists’ HPV-related prevention practices, including expanding patient education about this topic and increasing HPV vaccination knowledge, ultimately contributing to the reduction of oropharyngeal cancers. 相似文献12.
Vinícius C. Brigagão Luis F.D. Barreto Kellem A.S. Gonçalves Marina Amaral Rafael P. Vitti Ana C.C. Neves Laís R. Silva-Concílio 《The Journal of prosthetic dentistry》2017,117(6):792-798
Statement of problem
Despite the advances in materials and techniques, adhesion to dentin is challenging because of the complex composition of dentin’s mineral, organic, and fluid phases.Purpose
The purpose of this in vitro study was to evaluate the bond strength of 2 different resin cements (conventional and self-adhesive) with or without previous dentin sealing and the effect of interim cement.Material and methods
Forty-five molars were embedded into acrylic resin blocks and a flat dentin surface was exposed. Twenty teeth (n=5 per group) were treated with the conventional resin cement associated with etch-and-rinse or self-etch adhesive approaches, applied before (immediate dentin sealing) or after (delayed dentin sealing) the application/removal of interim cement. Another 25 teeth (n=5, per group) were treated with self-adhesive resin cement with (self-etch mode [immediate dentin sealing or delayed dentin sealing]) or without adhesive application. Furthermore, in the self-adhesive resin cement group, the application of polyacrylic acid for dentin etching before cementation was evaluated. Composite resin blocks were cemented onto flat, treated dentin surfaces, and the assemblies were sectioned into bar-shaped specimens for microtensile bond strength testing. The data were subjected to 1-way ANOVA followed by the post-hoc Tukey test (α=.05). The failure patterns were classified as cohesive, adhesive, or mixed.Results
The application of adhesive before interim cement (immediate dental sealing) promoted the highest values of bond strength for both resin cements (P<.001). For self-adhesive resin cement, polyacrylic acid-enhanced bond strength after the application of interim cement.Conclusions
The application of dental adhesive immediately after tooth preparation (immediate dentin sealing) and before the use of an interim cement promoted the highest values of bond strength to dentin with the resin cements tested. 相似文献13.
14.
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15.
Bruno Ramos Chrcanovic Ricardo Santiago Gomez 《Journal of cranio-maxillo-facial surgery》2018,46(3):504-510
Purpose
To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features.Materials and methods
An electronic search was undertaken in January 2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm a definite diagnosis.Results
A total of 74 publications reporting 110 SOTs (102 central, 8 peripheral) and 60 SOT-LPOC were included. Compared to SOT-LPOC, SOT showed lower mean age, no preference regarding maxilla or mandible localization, significant association with cortical bone perforation, multilocular radiographic appearance, and mobility of the tooth/teeth associated with the lesion. While 5 recurrent SOT were reported after enucleation, no recurrent SOT-LPOC was found.Conclusions
SOT shows a more aggressive biologic behavior than SOT-LPOC, which supports the hypothesis that the two lesions are distinct clinicopathological conditions. 相似文献16.
Introduction
The aim of this review was to analyze the potential of successful bonds of endodontic posts to radicular dentin as well as the limitations of the post–endodontic adhesive interface.Methods
The MEDLINE/PubMed and Web of Science electronic databases were searched. The search was augmented by a manual search of the pertinent bibliographies.Results
The post–endodontic adhesive interface finds application in the endodontic cohesive units. Many techniques and materials exist to improve the bond between endodontic posts and resin-based materials as well as between resin-based materials and radicular dentin. Different techniques used for the adhesion of metallic and fiber-reinforced posts are discussed and critically analyzed.Conclusions
Although adhesive cementation of endodontic posts is popular, a long-term predictable bond may be compromised because of procedures related to the endodontic treatment and/or the adhesive cementation procedures. Microleakage and degradation phenomena may further jeopardize the post–endodontic adhesive interface. 相似文献17.
18.
Anatolii Savychuk Marianthi Manda Christos Galanis Christofer Provatidis Petros Koidis 《The Journal of prosthetic dentistry》2018,119(6):965-974
Statement of problem
Pertinent evidence regarding the mechanical integrity of mandibular anterior teeth restored with a post-and-core is limited.Purpose
The purpose of this finite element analysis study was to compare the impact of the post type (glass fiber post-and-resin core or cast post-and-core) along with the ferrule effect on the stress fields generated in endodontically treated mandibular lateral incisors and canines.Material and methods
Three-dimensional models of the segmented mandible were developed. Mandibular incisors and canines with or without a 2-mm circular ferrule and restored with a cast post-and-core or glass fiber post-and-resin core were simulated and subjected to linear elastic static analysis. The principal stress values were calculated. von Mises equivalent stresses were used to evaluate the stress.Results
Maximum principal stresses in dentin were highest in incisors, with a ferrule. Stress parameters in composite resin core in both incisors and canines were critically close to the tensile failure limit of the core material. Cast post-and-cores cemented in incisors without a ferrule accumulated the highest stresses, exceeding the tensile failure limit of resin-modified glass ionomer cement.Conclusions
Tooth preparation with a ferrule led to a remarkable rise in stress in the dentin of mandibular incisors but favored the mechanical integrity of the restoration. 相似文献19.
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20.
Domenico Ricucci Simona Loghin Lucio S. Gonçalves Isabela N. Rôças José F. Siqueira 《Journal of endodontics》2018,44(3):405-413