Introducing dental students to clinical patient care: The complete denture prosthodontics transition clinic

Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience.     

Making clinical decisions for dental care: concepts to consider

Clinical decisions are often made with incomplete information, yet patient care decisions are made every day. Patients vary clinically, uncertainty exists in diagnostic and prognostic information, and many preventive and treatment alternatives have not been formally assessed for their effectiveness. Because scientific information will never answer all clinical questions, clinical decisions are partially based on probabilistic information.
This paper describes how to apply clinical decision making to diagnosing and managing dental caries and periodontal diseases. By using explicit information to quantify probabilities and outcomes, clinical decision making analyzes decisions made under uncertain conditions and the uncertain impact of clinical information.
Clinical decision making incorporates concepts for preventing, diagnosing and treating dental caries and periodontal diseases: risk assessment, evidence-based dentistry, and multiple oral health outcomes. This information can serve as a tool for clinicians to augment clinical judgment and expertise.     

A new index for evaluating horizontal skeletal discrepancies and predicting treatment outcomes

The cephalometric measurement known as Wits appraisal (AOBO) was studied to determine its importance in diagnosis, treatment, and prediction of treatment success. The Wits appraisal is used primarily to identify unreliable ANB values (those that do not accurately reflect the degree of horizontal jaw discrepancy, ie, those that differ greatly from the AOBO value). Therefore, differences between AOBO and ANB also were evaluated. Because neither measurement alone can assess jaw discrepancies with total accuracy, they were combined, plotted on a scattergram, and divided into equal zones to create a new index of horizontal skeletal discrepancies and treatment predictability. Pretreatment values correspond to treatment difficulty, and posttreatment values correspond to the effectiveness of treatment. Treatment time for each zone also was evaluated. We were able to draw several conclusions from this study. First, combining AOBO and ANB values results in a more accurate measurement of treatment difficulty. These combined values also can be used to predict both treatment time and the success of treatment for horizontal discrepancies. Second, the AOBO value predicts variations in treatment time at each ANB value. Finally, adding ANB and AOBO values and then dividing the total yields zones that represent statistically significant differences in treatment times and percentages of success. The zones also correlate with the difference between AOBO and ANB measurements.     

Chronic obstructive pulmonary disease with tracheostomy: report of case involving endodontic treatment

Modern medicine has made many advances in the capability to sustain life. The dental profession needs to keep up to date with these changes and be creative in caring for these individuals who are medically compromised and who require special care.¹¹ This sometimes requires the purchase of new equipment; other times it means modifying that which exists. In all instances, the level of care for these individuals requires a team approach and mandates education of all team members. In the case presented, the medical problems necessitated such a team effort to achieve optimal care.     

Color Stability of Dry Earth Pigmented Maxillofacial Silicone A-2186 Subjected to Microwave Energy Exposure

PURPOSE: The purpose of this study was to measure spectrophotometrically the color stability of pigmented A-2186 silicone maxillofacial elastomer with 10% by volume of titanium white dry earth opacifier before and after exposure to microwave energy over a simulated 1.5-year period of microwave sterilization. Materials AND METHODS: A-2186 silicone elastomer opacified with titanium white dry earth pigment, pigmented with 5 cosmetic dry earth pigment colors [no pigment (control) group (Pc), red (Pr), yellow ochre (Py), burnt sienna (Po), and a mixture of Pr + Py + Po color group (P3)], was used in this study. Each of the 5 experimental groups consisted of 5 specimens. All specimens were placed in a 250 ml glass beaker filled with 150 ml of water (replenished for each microwave exposure). An exposure of 6 minutes was used 18 times (simulating 1.5 years of microwave sterilization with one 6 minute exposure monthly). Reflectance values were measured by spectrophotometer. Three- and two-way analyses of variance with repeated measures were performed for the color difference (DeltaE*) with the factors of group/color/months, and group/months, respectively. Means were compared by Tukey Honest Significant Difference (HSD) multiple range test calculated at the 0.05 level of significance using SPSS. RESULTS: The trained human eye can detect color changes (DeltaE*) greater than 1.0. Most DeltaE* values of the red pigment group at all intervals and the mixed pigment group at 15- and 18- month intervals increased significantly greater than 1.0 (p < 0.001) compared with the control group. Yellow and burnt sienna groups remained the most color stable over time with DeltaE* values below 0.35. CONCLUSIONS: Lack of color stability of red dry earth pigmented A-2186 silicone maxillofacial elastomers was clinically significant after 12-month exposure to microwave energy as compared with yellow, burnt sienna, and opacified A-2186 dry earth pigments.     

Preventive dental prosthesis for the patient with bulimia

Bulimia is a distinct diagnostic eating disorder with its most noted manifestation being the rapid ingestion of large quantities of food followed by its elimination through the mouth. Because of the dental implications of highly acidic stomach contents chronically being regurgitated, the dentist is in a unique position to help identify the patient with bulimia. Dental erosion is not only the most easily noted but also the most destructive of the many oral problems caused by bulimia. This report of case describes a preventive dental prosthesis that can be used by the patient with bulimia to protect those teeth that are most affected by dental erosion. The construction of the prosthesis is easily completed with materials in the dental office and provides a great service to the patient with bulimia.     

腔内聚乙烯十二指肠-空肠导管对体重调节的作用:猪动物模型可行性研究

目的评估十二指肠-空肠导管（Endoluminal Duodeno-Jejunal Tube，EDJT）在活体猪实验动物模型中减缓体重增加的可行性，及其在中短期生存中的安全性。方法本项研究共用8只45kg重的Yorkshire猪，其中3只置入180emEDJT，1只置入360cm EDJT，另4只猪作为对照组。切开十二指肠，将EDJT导管缝合固定在十二指肠近Vater壶腹起始处。结果评估全部猪的不适反应和体重，每日一次，共7周，未发现严重并发症发生。术后7周3组动物的平均体重变化百分率：对照组、180cm组和360cm组分别是22．5％，6％和-2．8％。EDJT组（180cm组、360cm组）体重增加明显减慢，与对照组相比，有统计学意义（P=0．05）。结论EDJT可以安全使用，无肠梗阻、肠套叠或胰腺炎等并发症发生。EDJT可明显减缓体重增加。