Dental education at The University of Adelaide: an evaluation

A bstract — Dental students, staff, and practitioners participated in an evaluation of the dental curriculum at The University of Adelaide between 1978 and 1981. The need for curriculum reform was expressed by all three groups, especially with respect to the teaching of basic sciences, some biomedical subjects, behavioural science, and practice management. Dental staff and practitioners have also indicated serious misgivings about the quality of clinical skills of new graduates. Proposals for reform are directed to resolving these and other curriculum problems revealed in the evaluation.     

Dental implications of narcotic addiction

The nature of dental problems peculiar to narcotic addicts is discussed. A high caries rate and severe periodontal disease are common and can be attributed to a combination of dietary considerations and oral neglect. Loss of customary accompanying analgesia may complicate an attempted withdrawal programme. An approach to dental treatment of the narcotic addict is suggested. This should aim primarily at relief of pain and be carried out in consultation with the drug treatment centre. The risk posed by these patients of transmission of Hepatitis B is emphasized.     

Specifications for the occlusal aspects of dental restorations.

A mandibular overdenture technique has been presented that utilizes the Dolder bar joint attachment. Endodontically treated lower canines were retained as abutments.Two techniques for attaching the bar to teeth with divergent root canals were discussed: (1) the Schubiger screw system for those teeth with extremely divergent canals and (2) the Stutz pivots system for teeth with only slightly divergent root canals.The use of the Dolder bar joint offers periodontally involved teeth an improved crown/root ratio and splinting of the teeth. Because the bar is close to the alveolar bone, forces of mastication exert much less leverage to the teeth. Finally, the bar joint offers slight vertical and rotational movement of the denture as well as a stressbreaker action.     

Fluoride in human saliva after ingestion of aluminium chloride and sodium fluoride or sodium monofluorophosphate

Four fasting adults were given 5 mg of F as NaF or Na₂PO₃F without and with 3.5, 7.1 or 14.2 mg Al as AlCl₃. Each salt combination was administered in 1 ml aqueous solution, and swallowed in a gelatine capsule with 10 ml of water. Samples of paraffin-stimulated whole saliva, collected before and at short intervals over a period of 3 hr after the administration, were analysed for total and ionic F. After ingestion of F without Al, there was a rapid increase in salivary F, with peak levels of about 0.2 ppm attained after approximately 50 min. When F was ingested with Al, the rate of increase of salivary F was depressed, and peak levels were reduced. This effect was slight for 3.5 mg Al, somewhat greater for 7.1 mg, and marked for 14.2 mg. No Al was detected in the saliva by spectrographic analysis. Fluorine given as PO₃F^2? gave a slower rise in salivary F, and lower peak levels in 3 of 5 subjects than NaF, but the response to Al was similar. Only ionic F was detected in whole saliva and in samples of parotid saliva collected after ingestion of PO₃F^2?. It is concluded that Al interferes with gastrointestinal absorption of F by forming poorly absorbable Al-F complexes, and that PO₃F^2? is subjected to hydrolysis prior to absorption of F. The findings suggest that the Al normally present in food and beverages may affect gastrointestinal absorption of F.     

2型糖尿病患者并发症数目与焦虑障碍的相关研究

目的 探究2型糖尿病(T2DM)患者并发症数目与焦虑障碍的相关性.方法 选取2018年9月至2019年10月于陕西省人民医院心血管疾病内一科住院治疗的295例T2DM患者,采用汉密尔顿焦虑量表(HAMA)对其进行焦虑障碍评估,并分析相关临床资料.结果 无并发症患者HAMA评分(5.06±2.10)分、合并1个并发症(8.24±3.66)分、合并2个并发症(12.93±3.54)分、合并3个并发症(16.88±4.60)分、合并4个并发症(18.50±2.66)分,组间比较差异有统计学意义(P＜0.001).Pearson相关性分析显示:HAMA评分与年龄(r=0.250,P＜0.001)、糖尿病病程(r=0.431,P＜0.001)、每天注射胰岛素次数(r=0.255,P＜0.001)、血红蛋白(HB,r=--0.209,P＜0.001)、总胆固醇(TC,r=0.134,P=0.021)、肌酐(Cr,r=0.230,P＜0.001)呈线性相关;Logistic回归分析显示在校正年龄、糖尿病病程、高血压、HB、Cr、是否使用胰岛素、聚居地、有无使用降糖药、每天注射胰岛素次数后,T2DM患者TC(OR=1.675,P=0.005)、B型钠尿肽(BNP,OR=1.013,P=0.045)、糖尿病并发症数目(OR=5.021,P＜0.001)与HAMA评分相关.结论 T2DM患者并发症数目、总胆固醇及BNP均可增加T2DM患者焦虑发生的危险性,其中糖尿病并发症数目对焦虑发生的影响力更大.     

Positive and negative bacterial associations involving Dialister pneumosintes in primary endodontic infections

Dialister pneumosintes is an anaerobic Gram-negative rod that has been recently implicated as a candidate endodontic pathogen. In this study, samples taken from abscessed teeth and infected root canals associated with asymptomatic or symptomatic periradicular lesions were examined for the occurrence of bacterial associations involving D. pneumosintes. DNA was extracted from the samples, and the presence of D. pneumosintes and 16 other bacterial species was determined by means of species-specific nested polymerase chain reaction. Positive and negative associations involving D. pneumosintes were investigated by computing the odds ratio of D. pneumosintes being found in a sample from endodontic infection in co-infection with one of the other target species. The association between the pairs containing D. pneumosintes and the occurrence of pain also was evaluated. D. pneumosintes was always detected in mixed infections with at least two of the other target species. D. pneumosintes was positively associated with Treponema denticola, Porphyromonas endodontalis, Fusobacterium nucleatum, Peptostreptococcus micros, Campylobacter rectus, Prevotella intermedia, T. pectinovorum, and T. vincentii. Negative associations were observed with Bacteroides forsythus, P. gingivalis, and Actinomyces israelii. No pair containing D. pneumosintes was found to be significantly associated with symptomatic cases (p > 0.01). The findings of this study lend considerable support to the notion of D. pneumosintes being an important endodontic pathogen, usually in a mixed infection. Positive associations of this species with other highly prevalent species, such as T. denticola and P. endodontalis, suggest that bacterial synergism can occur and thereby play an important role in the pathogenesis of different forms of periradicular lesions.     

Ten-year outcome of porcelain laminate veneers placed within the general dental services in England and Wales

Aim

It is the aim of this paper to consider the factors associated with the need for re-intervention on teeth restored with porcelain veneers.

Methods

A data set was established consisting of adult patients (18 years or older) whose restoration records contained the placement of one or more porcelain laminate veneers. For each tooth treated with a porcelain veneer, the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the extended data set, was obtained. Thus a data set was created of porcelain veneers which have been placed, with their dates of placement and their dates, if any, of re-intervention.

Results

Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 2562 porcelain veneer restoration occasions in 1177 patients were obtained from the data over a period of 11 years.Factors which were found to influence the survival of porcelain veneers include patient gender, patient age, changing dentist, patient's treatment need, patient charge-paying status and geographical area.

Conclusions

While dentist factors do not appear to play a part, a variety of patient factors have been found to influence veneer survival to re-intervention. Overall, 53% of porcelain veneers in the study survived without re-intervention at 10 years.