Criteria leading to patient loss from dental school clinics

The study was conducted at two different dental school clinics. The summary of the questionnaires revealed that patients in both cities are similar in their dental needs and expectations of treatment. In order to solve the problem of losing patients from dental school clinics, several recommendations have been made.     

Safety-net dental clinics

BACKGROUND: Federal policy supports and funds community-based clinics to provide health care to low-income and underserved groups. This study examines the role of community dental safety-net clinics in providing dental care for these populations. METHODS: The authors administered a cross-sectional survey of all identified safety-net dental clinics in Illinois. Seventy-one of 94 clinics responded (response rate, 76 percent), describing their history, operations, patients, staffing and dentist relationships. An in-depth analysis of 57 clinics presents comparisons of three categories of clinics, sponsored by community health centers (23), local health departments (21) and private services agencies (13). RESULTS: Clinics were distributed across the state; 80 percent were located in facilities with other health care providers, and all provided dental care to low-income and other underserved groups. Clinics provided more than 3100 annual dental visits, operated with limited staffing and budgets, and had referral relationships with local dentists. Clinics with full-time dentists or any dental hygienists had higher annual numbers of dental visits. CONCLUSIONS: These clinics provide dental care to groups with traditional access barriers. Although they represent a small portion of all dental care, their mission and role make them a key component of strategies to address the dental access problem. PRACTICE IMPLICATIONS: Local and state dental practitioners and coalitions seeking to expand dental access should consider their community dental safety-net clinics as partners. Efforts to expand theese clinics should include considering optimizing staffing for better dental productivity.     

Tissue hypersensitivity to dental materials

Five cases of tissue hypersensitivity to Scutan and two to Impregum are reported. The reaction to Scutan was a burning sensation in the mucosa in contact with the material, followed by swelling and erythematous ulcers producing heavy discomfort. All symptoms gradually disappeared after removal of the material. To Impregum the reaction was basically the same, only less vigorous since contact with the material is of limited duration. All the cases were women in the menopause. Attention is drawn to the possibility of hormonal imbalance being a factor of importance in the development of hypersensitivity reactions to materials of this sort.     

Tissue response to dental caries

Abstract Caries still represents the most widespread human disease. The pulp tissue sequelae of den tin caries are of utmost importance, because prevention of pulpal damage considerably reduces the need for extensive restorations and endodontic therapy. There is, however, considerable disagreement in the literature regarding how early the pulpal response to caries can be detected. The material in this article, gathered from the author's and his coauthors' earlier investigations, deals with pulp reactions from initial caries to increasingly extensive caries; caries in combination with attrition; the effect of carious den tin in experimental cavities of intact dentin; the effect of medicaments, restorative procedures and materials, and indirect pulp capping in the treatment of deep caries; microbiologic aspects of dentin caries; diagnosis criteria for treatment; light and electron microscopic study of teeth with carious exposure; periodontal disease and root caries in the geriatric population; pulp biopsies of teeth with periapical lesions, and the breakdown of the remaining pulp and its periapical sequelae. Pulpal reactions to initial caries detected as early as bacteria reach the dentinal tubules arc also discussed. As in medium and deep caries, this can be reversible following the removal of the infected dentin, except for irritation dentin and calcifications on the canal walls or free in the lumen. Bacteria remaining in dentinal tubules combined with iatrogenesis may be the reason for pulpal disintegration under deep restorations. Indirect pulp capping is not an acceptable procedure. Pain (or lack thereof) is not a predictable indicator of the inflammatory stage of the pulp. Root caries must be treated early to prevent pulpal destruction. Vital pulp tissue can be found in the roots of teeth with periapical radiolucencies that will ultimately show the presence of bacteria.     

人牙源性间充质细胞构建牙本质-牙髓复合体样结构的实验研究

目的以复合生长因子的陶瓷化骨和Collagraft为载体建立人牙源性间充质细胞的体内立体培养模型，构建牙本质-牙髓复合体样结构。方法将经生长因子诱导的人牙源性间充质细胞接种于复合同种生长因子的陶瓷化骨和Collagraft复合材料上，将细胞-支架复合物移植到裸鼠皮下，建立牙源性间充质细胞的体内立体培养模型。4周和10周后取材，对移植物进行组织学观察和人牙本质涎蛋白（DSP）的免疫组化染色。结果10周的实验组标本中，植入细胞在复合生长因子支架上形成了较典型的牙本质-牙髓复合体样结构，人DSP在新生牙本质样组织中呈阳性表达。对照组及4周标本中未观察到此现象。结论用人牙源性间充质细胞和复合生长因子的陶瓷化骨或Collagraft支架材料在裸鼠体内可成功构建出牙本质-牙髓复合体样结构。     

Experience of 2 dental clinics registered to ISO 9002

This paper describes the 3-year experience of managing 2 hospital-based dental clinics registered to ISO 9002:1994; it also examines the revision of previous quality management standards in 2 separate institutions to prepare for registration under the new ISO 9001:2000 standard. Daily equipment and process checks, combined with internal audits, were the backbone of the quality system at both locations. Corrective and protective actions had been underused, because of the partial duplication produced by 2 different institutionally mandated risk management and incident reporting systems. ISO 9002 registration provided both dental clinics with responsive quality systems, emphasizing patient satisfaction and providing measurable continuous quality improvement.     

Tissue engineering

Tissue engineering is a fast developing multidisciplinary field. Both from a medical and social point of view, there is great need to safe tissues and organs to overcome the shortage of donor organs and to reduce the health care cost. At the same time, progress made in the field of molecular sciences as well as in biomaterials and chemical engineering, offers great possibilities to manipulate cells, growth factors and carrier materials in such a way that growth of tissues can be achieved.     

颌骨牙源性囊肿袋形术/减压术引流装置的设计与临床应用

 颌骨牙源性囊肿是一组来源于与牙发生相关组织的病变，上皮衬里的囊腔包含液体或半流体。由于囊腔内的压力、骨吸收因子释放及上皮增生引起囊肿不断增大，导致颌骨膨隆、牙松动移位，面部畸形及咬合功能障碍。牙源性囊肿的袋形术/减压术是一种简单易行而有效的保守性治疗方法。成功的治疗需要术后采用不同引流装置保持囊肿引流。较大的囊肿常在术后配戴囊肿塞或阻塞器，而较小的病变则通过减压管保守引流。大多数病例是在袋形术/减压术后囊肿缩小时二期行囊肿刮除术，可减少邻近结构的损伤或手术并发症，仅少数病例中袋形术作为惟一的治疗方式。文章简要介绍了袋形术/减压术的相关治疗机制以及多种引流装置的设计与临床应用。