The funding of dental services among U.S. children 2 to 17 years old: recent trends in expenditures and sources of funding

BACKGROUND: This article is the first of two that focus on recent changes in the funding of dental services in the United States. METHODS: This study is based on analyses of data regarding dental expenditures among children 2 to 17 years of age from the 1987 National Medical Expenditure Survey and the 1996 Medical Expenditure Panel Survey. Both of these surveys were designed to produce national estimates of annual medical expenditures in the United States. RESULTS: Overall, real per capita dental expenditures among 2- to 17-year-old children who had had a dental visit fell from $578.05 in 1987 to $498.57 in 1996. Large increases per patient were reported for the poorest children, while decreases were reported for children from families with higher incomes. CONCLUSIONS: Much of the increase from 1987 to 1996 in dental expenditures among economically disadvantaged children who had had a dental visit was due to an increase in care provided by dentists that was not reimbursed. PRACTICE IMPLICATIONS: More needs to be done to increase the number of economically disadvantaged children who visit a dentist. All segments of society must cooperate to achieve this result.     

Immediate function with NobelPerfect implants in the anterior dental arch

This study examined the clinical performance of the scalloped NobelPerfect implant in a one-stage procedure (immediate provisionalization in the esthetic zone). In 20 patients, immediate prosthetic restorations were placed on 31 NobelPerfect implants and followed for up to 27 months. Outcome variables were success rates, marginal bone levels, and Pink Esthetic Score (PES) assessed per implant. One implant failed (success rate: 96.8%). Marginal bone levels averaged 1.7 mm above the first thread and remained stable during the observation period. Mean PES ratings were 11.3 (range, 8 to 14). Survival rates, marginal bone levels, and esthetic results suggest proof of principle for the preservation of the interproximal bony lamella with a scalloped implant design.     

The development of air medical services in Czechoslovakia

The Czechoslovakian system of centralized dispatch of all emergency medical services prevents competition between ground ambulances and air medical services. Although this program is less than two years old, remarkable progress has pushed Czechoslovakia to the forefront of modern-day air medical transport. However, the future of Czechoslovakian air medical transport will require the acquisition of better-performing EMS helicopters and accessibility to medical equipment using Western technology. As with all current United States helicopter EMS systems, Czechoslovakia will face many of the financial considerations required in funding this extensive and elaborate project.     

Comparison of coconut water, propolis, HBSS, and milk on PDL cell survival

Coconut water is biologically pure and sterile, with a rich presence of amino acids, proteins, vitamins, and minerals. The purpose of this study was to use a collagenase-dispase assay to investigate the potential of a new storage medium, coconut water, in comparison with propolis, Hank's balanced salt solution (HBSS), and milk in maintaining viable periodontal ligament (PDL) cells on simulated avulsed teeth. Seventy freshly extracted human teeth were divided into 4 experimental groups and 2 control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry times, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in 1 of the 4 media (coconut water, propolis, HBSS, and milk). The teeth were then treated with dispase grade II and collagenase for 30 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed. Statistical analysis showed that coconut water kept significantly more PDL cells viable compared with propolis, HBSS, or milk. Coconut water can be used as a superior transport medium for avulsed teeth.     

In-vitro Investigations on Suitability of Light-cured Resins for Interocclusal Splints

OBJECTIVE: It was the aim of the present study to investigate the material properties of different resins and their suitability for the fabrication of occlusal and intermaxillary splints. MATERIAL AND METHOD: We subjected auto-polymerized resins (Palapress, Orthocryl, Steady-Resin M) and light-polymerized resins (Acrylight, Primosplint, Triad TranSheet Colorless and Pink) to investigation. The Targis Power light oven was used to polymerize the light-cured resins. After the auto-polymerized resins had been mixed by hand and filled into the forms, they were polymerized for 15 minutes in a high-pressure polymerization machine (Palamat) at 2 bar. The parameters examined were flexural strength, water adsorption, and polymerization shrinkage. Tests carried out according to DIN EN ISO 1567 served to determine flexural strength, flexural modulus, and water adsorption. Polymerization shrinkage was determined via the buoyancy test. RESULTS: The resins' flexural strength ranged from 60 to 101 MPa. Flexural moduli lay between 1.3 and 5.3 GPa. The water adsorption noted in light-cured resins amounted to 2.1-4.6 mass percent. Palapress and Steady-Resin displayed the lowest water adsorption with 2.0 mass percent. The light-polymerized resins revealed significantly less shrinkage (p < 0.05) than the autopolymerized resins tested in this study. CONCLUSION: Our results demonstrate that the light-cured resins-with the exception of Acrylight -easily match and even exceed the material properties of the cold-polymerized resins regarding flexural strength, flexural modulus, water adsorption and polymerization shrinkage. The light-cured resins examined thus seem suitable for use as splint material.     

Comparative evaluation of the microleakage of two modified glass ionomer cements on primary molars. An in vivo study

This in vivo study was conducted to compare and evaluate the microleakage of two modified glass ionomer cements on deciduous molars. Thirty children (10-16 years) were selected. In each patient, standardized class V cavities were prepared on the buccal surfaces of two different retained deciduous molars and these cavities were restored with GC Fuji II LC (Improved) and GC Fuji IX GP, respectively. Following a period of four weeks after the restoration, these teeth were extracted and immersed in 2% Basic Fuschin dye solution for 24 hours. The depth of dye penetration was assessed after sectioning the teeth and the microleakage determined. The results were statistically analyzed using Student 't' test. It was concluded that both the materials, GC Fuji II LC (Improved) and GC Fuji IX GP were comparable in performance and can be considered to be materials safe for Pedodontics usage, and decrease bacterial penetration.     

Matches,clips, needles,or pins

Several methods for positioning dowel pins used in the fabrication of removable dies have been presented. Needles, pins, paper clips, hairpins, and matches are all useful in positioning dowel pins in the impression. The use of paper matches is a simple and effective method for holding the dowel pin in the proper relation while the die stone portion of the cast is being poured.     

The effect of timing of surgery for velopharyngeal dysfunction on speech

The timing of surgery for velopharyngeal dysfunction has been based on assumptions about the relation between age, speech development, and velopharyngeal dysfunction. Cleft palate teams often counsel parents to have an intervention for velopharyngeal dysfunction performed earlier rather than later, believing that earlier interventions result in more rapid or better normalization of speech. The objective of this retrospective chart review study is to determine whether the age at surgical intervention for velopharyngeal dysfunction has an effect on the subsequent length of speech therapy. Of 174 patients included in the study database, 36 had velopharyngeal dysfunction for which further velopharyngeal management was required. Of the 36 patients who received surgical velopharyngeal dysfunction management, 27 had verifiable speech therapy records. These 27 patients represent the study population. The outcome measure was the total length of subsequent speech therapy until speech normalization. The data suggest that there is no relation between the age at velopharyngeal dysfunction surgical management and the amount of speech therapy needed to achieve normalization of the speech impairments secondary to velopharyngeal dysfunction after that management. In conclusion, 1) the age at surgical velopharyngeal dysfunction management (pharyngeal flap or sphincter pharyngoplasty) does not have an effect on subsequent normalization of speech as measured by the duration of speech therapy necessary to achieve normalization of the speech impairments secondary to velopharyngeal dysfunction after that management, and 2) the age at surgical velopharyngeal dysfunction management does not affect the likelihood of subsequent surgical velopharyngeal dysfunction management procedures.     

VDR deficiency affects alveolar bone and cementum apposition in mice

Objective

To compare the mineralisation density (MD), morphology and histology of alveolar bone and cementum amongst VDR +/+, VDR −/−, and VDR −/− groups supplemented with a diet TD 96348, containing 20% lactose, 2.0% calcium and 1.25% phosphorous.

Methods

Four groups of mice (6 mice/group) were identified by genotyping: VDR +/+ mice (VDR wild type), VDR −/− mice (VDR deficient), VDR −/− offsprings derived from VDR −/− parents receiving a supplemental diet (early rescued), and VDR −/− mice fed with a supplemental diet beginning at age one month (late rescued). All mice were sacrificed at age 70.5 days. Micro-CT was used to compare MD and morphology of alveolar bone and cementum. H–E and Toluidine blue staining was used to examine the ultrastructure of the alveolar bone and cementum at matched locations.

Results

In VDR −/− group, alveolar bone and cementum failed to mineralise normally. Early rescue increased MD of alveolar bone in VDR −/− mice with excessive alveolar bone formation, but which not observed in late rescue group. MD and morphology of cementum–dentine complex in both early and late rescue groups were comparable with VDR +/+ group when feeding with high-calcium rescue diet.

Conclusions

VDR affects alveolar bone mineralisation and formation systemically and locally. However, cementum apposition and mineralisation is mainly regulated by calcium concentrations in serum.