Digital radiography and California third parties

Acceptance of digital radiography is increasing but has not yet progressed to the mainstream. A key factor in widespread use of this advancement is acceptance--both theoretical and technological--by dental health plans for claim submissions. This article details a survey of California third parties to examine their practices, concerns, and plans regarding digital dental radiography.     

An investigation into the origin and nature of 'amyloid' in a calcifying epithelial odontogenic tumour

Fresh and fixed tissue from a resection specimen of a calcifying epithelial odontogenic tumour (CEOT) was prepared for histological, histochemical, immunological and biochemical investigation in order to study the nature of the amyloid-like material. The fixed tissue gave positive reactions with Congo-red, Thioflavin T and the dimethylamino benzene (DMAB)-method for tryptophan. The diazotization-coupling (DC) method for tyrosine was negative. The major protein purified from the unfixed tissue by sequential gel filtration had a molecular weight of 9,800. The amino acid analysis of this protein had similarities with tuft enamel protein, immune amyloid and the variable light chain component (VK). From the data obtained in this study, it is not possible to determine the precise nature of the amyloid-like material in this CEOT. However, the results do support the concept that 'amyloid' should be considered as a term describing a broad group of related proteins.     

The microflora of the erupting first permanent molar

The relationship between microflora, eruption status and caries status in the first permanent molar of young children was investigated in 177 children aged 6-7 years. A significantly greater proportion of fully erupted teeth were classified as sound and plaque-free compared to partially erupted teeth. Fully erupted teeth yielded greater numbers and proportions of mutans streptococci compared with significantly greater numbers and proportions of Actinomyces israelii in partially erupted teeth. Logistical regression analysis showed significant associations between white spot lesions in partially erupted teeth and increased numbers of Streptococcus oralis, mutans streptococci and Streptococcus salivarius whereas the presence of Actinomyces naeslundii was associated with health. Significantly greater numbers and proportions of S. oralis and S. salivarius were isolated from partially erupted teeth with white spot lesions whereas Streptococcus mutans was isolated in significantly greater numbers and proportions from fully erupted molars with white spots. This study suggests that organisms other than mutans streptococci are associated with caries development in erupting permanent molar teeth.     

A critical evaluation of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness

Orthopedic interocclusal appliances have been evaluated in a number of research papers and clinical reports over the years. Various theories have been proposed about the method of action of the different appliances, but at present no conclusive controlled testing of these theories has occurred. Certainly, when the potential influence of the nonspecific treatment factors is considered, as well as those cognitive awareness factors common to all appliances, the use of "symptom improvement" as the definitive proof of the need for mandibular realignment or repositioning must be questioned. Specific, well-controlled research using more quantifiable measures of the treatment effect is necessary to make valid comparisons between the different therapeutic approaches. The full-arch occlusal stabilizing appliance is the design that has the most valid evidence about its effectiveness. Partial coverage interocclusal appliances have significant irreversible complications with tooth intrusion or eruption when used on an extended basis. There is little or no experimental support at present about repositioning, realignment, and pivot appliances and their effectiveness. Therefore, these appliances must be considered experimental treatments. When used to treat TM dysfunction in a program along with other methods, such as occlusal adjustments, and prosthetic care, the effectiveness of this treatment method is between 70% and 90%. As a general approach to managing TM pain and dysfunction, interocclusal appliances appear to be a highly effective, commonly used method.     

Nocturnal electromyographic evaluation of myofascial pain dysfunction in patients undergoing occlusal splint therapy.

Twenty-five patients with symptoms of myofascial pain and abnormal jaw function were treated with use of a full arch maxillary occlusal splint. The level of nocturnal activity of the masseter muscle was monitored as were symptoms before, during, and after occlusal splint therapy. A decreased nocturnal EMG level during treatment was noted for 52% of the patients. A return to pretreatment EMG levels after removal of the splint was noticed in 92% of the patients; in 28% no change was shown and in 20%, an increase was shown in nocturnal EMG levels. The splint was most likely to reduce nocturnal EMG levels in patients with least severe symptoms.     

Catastrophizing, anxiety and pain during dental hygiene treatment

Objectives : This study examined the relations between catastrophizing, dental anxiety, and pain during dental hygiene treatment. Methods: Participants were 78 (32 men, 46 women) consecutive referrals to the Dalhousie University Dental Clinic. All patients were scheduled for a scaling procedure performed by senior dental hygiene students. Following treatment, patients completed the Pain Catastrophizing Scale and the Dental Anxiety Scale – Revised, and were asked to rate the degree of pain they experienced during the scaling procedure. Results: Regression analyses revealed that age and the rumination subscale of the Pain Catastrophizing Scale were signicant predictors of pain, even when controlling for gender, and oral hygiene status. Conclusions: Thendings suggest that excessive focus on pain sensations may be one of the mechanisms by which catastrophizing leads to increased pain. The clinical challenges will be to develop cost- and time-effective means of identifying individuals who catastrophize and to implement interventions to reduce their level of distress.     

Web-based continuing dental education in California

This article asks and answers a series of questions about Web-based continuing education for dentists. A summary of these answers are: (1) all indicators point to a substantive increase in the number and types of continuing education courses in the next five years; (2) the main reasons to take an online dental C.E. course are that it is available at any time from any location that has an Internet connection and the total cost per unit will be substantially lower compared to traditional C.E. courses; (3) the best type of online C.E. course would be one that has an identified experienced expert instructor, provides a case-based or problem-based approach, and provides an interactivity opportunity between the instructor and student via chat room or e-mail; and (4) online continuing dental education is simply one of many methods that can be used by dental practitioners and will not replace other continuing education methods but rather supplement them. In summary, as more and more online dental C.E. courses become available, it is hoped they will be designed to be more than a series of slides since this method does not take advantage of the unique features and opportunities provided by the Internet.