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Biomedical subjects

C M Russell

Publications and source records attributed to C M Russell.

97 records · Page 6Linked to original sources

Oxygen saturation and diffusion hypoxia in children following nitrous oxide sedation.

Oxygen saturation of arterial blood (SaO2) was assessed in children after discontinuing N2O/O2 sedation for dental procedures. Two post-treatment methods were used: breathing 100% O2 for 5 min after the procedure, and breathing room air for 5 min. Participants were 24 healthy children ages 41 to 113 months. Each child was treated twice and a crossover design was used. The mean length of procedures that were followed by O2 was 28.8 (+/- 10.9 SD) min; for those followed by room air, 28.3 (+/- 12.4 SD) min. SaO2 was monitored continuously by pulse oximetry and recorded at predetermined intervals before, during, and after N2O/O2 administration. When participants received post-treatment O2, the mean SaO2 at 1 min after N2O cessation (99.91 +/- 0.63 SD) and 5 min after cessation (99.94 +/- 0.17 SD) was statistically significantly higher than the pretreatment value of 99.28 (+/- 0.63 SD). When participants received post-treatment room air, the mean SaO2 1 min after N2O cessation (99.44 +/- 0.8) was also statistically significantly higher than the pretreatment mean (99.08 +/- 0.96). After 2 min, however, the mean SaO2 decreased and was statistically indistinguishable from the pretreatment level after 5 min (99.13 +/- 0.9 SD). Fluctuations in SaO2, though statistically significant, were less than 1%. Allowing children to breathe room air immediately after cessation of N2O/O2 inhalation did not reduce SaO2 below clinically acceptable levels. This study further documents the safety of N2O/O2 sedation, and gives the clinician additional information concerning the safe and effective administration of inhalation sedation. (Pediatr Dent 15:88-92, 1993).

Analysis of Variance↗

An outcomes assessment of 15 years of patient care experiences in predoctoral pediatric dentistry.

The purpose of this study was to examine the trends in numbers, demographic characteristics, and treatment history of pediatric dental patients under the care of dental students over the period 1980 through 1994. Data were collected for: exams, sealants, surfaces of amalgam, composite resin surfaces, pulpotomies, stainless steel crowns, and extractions. Correlations were done across the 15-year period to determine significant trends over time. During the 15-year period, the average number of patient visits required for each student to complete the requisite number of patients, declined from 45 appointments to complete 10 patients in 1980, to 35 visits to complete 13 patients in 1994. Over time, the numbers of amalgam surfaces, pulpotomies, extractions and stainless steel crowns decreased significantly, while the number of composite resin surfaces increased (P < 0.05). Based on a previous outcome assessment that indicated declining numbers of procedures performed between 1980 and 1985, the required number of patients treated per student was raised from 10 to 13, beginning with the 1986 class.

Adolescent↗

Leucite crystallization during processing of a heat-pressed dental ceramic.

This investigation was conducted in an effort to elucidate the mechanism of the strengthening that occurs during processing of a heat-pressed dental ceramic (IPS Empress). The effect of processing on leucite content was determined via quantitative x-ray diffraction. A significant effect of processing was revealed by analysis of variance (P < .0001). Post-hoc comparisons by Student-Neuman-Keuls and Duncan's Multiple Range tests revealed no difference in leucite content after pressing, but the leucite content was significantly higher (P < .05) after a single surface colorant firing. A second colorant firing produced a further significant increase in leucite content (P < .05), but no further increase in leucite content was observed following the remaining colorant and glaze firings. The increase in leucite after firing is consistent with the increase in flexural strength following firing observed by Dong et al in 1992.

Aluminum Silicates↗

Perceptions associated with dentists' decisions to report hypothetical cases of child maltreatment.

The purpose of this study was to examine case-specific perceptions associated with dentists' decisions to report hypothetical cases suggestive of child maltreatment. Surveys were mailed to 500 general dentists (GDs) in Georgia and all 200 pediatric dentists (PDs) in Georgia and Florida. The GDs were chosen from a pool of 1500 by a stratified randomization scheme. Each survey contained two brief vignettes suggestive of, but not conclusive for, child neglect and abuse. Identical questions followed each vignette that were designed to assess five perceptions of the incident and whether the respondent would be likely to report the case. Responses were received from 185 GDs (37%) and 103 PDs (51.5%), for a total of 288 (41.1%). A majority of respondents considered each vignette to be serious, but only a minority believed that they were required to report the neglect (7.3%) and the abuse (33.7%) vignettes. The percentages of likely reporters of the neglect (n = 28) and abuse (N = 103) vignettes were 9.7 and 36%, respectively. No significant differences were noted in the response patterns of GDs and PDs. Decisions to report child maltreatment described in the vignettes were associated with perceptions of 1) the seriousness of the incident, 2) the incident being defined as neglect or abuse, and 3) a requirement to report. The possibility that a maltreatment report would have a negative impact on the child was associated with a decision not to report. The perception that a report would have a negative impact on the family was common among likely reporters and nonreporters.

Attitude of Health Personnel↗

Demographic, educational, and experiential factors associated with dentists' decisions to report hypothetical cases of child maltreatment.

The purpose of this study was to examine demographic factors associated with dentists' decisions to report hypothetical cases suggestive of child maltreatment. Surveys were mailed to 500 general dentists (GDs) in Georgia and all 200 pediatric dentists (PDs) in Georgia and Florida. The general dentists were chosen from a pool of 1500 by a stratified randomization scheme. Each survey contained two brief vignettes suggestive of, but not conclusive for, child neglect and abuse. Respondents were asked about their likelihood of reporting each vignette. General demographic questions were asked about the population served by the dentist, the year of dental degree and speciality certificate acquisition, and gender of the respondent. Further questions were asked about the individual's exposure to continuing education in child maltreatment, knowledge of legal requirements to report and the agency to which reports should be directed, and experience with suspected and filed cases. Responses were received from 185 GDs (37%) and 103 PDs (51.5%), a total of 288 (41.4%). PDs had more practitioners in larger communities and had more female respondents. PDs were more likely to answer yes to the questions about education/experience with child maltreatment. Factors associated with likely reporting of neglect were: 1) serving communities with populations < or = 100,000; 2) PDs acquiring specialty certificates after 1980; 3) being female; 4) exposure to continuing education; 5) having suspected cases in practice; and 6) having filed a maltreatment report. Factors associated with likely reporting of abuse were: 1) PDs acquiring specialty certification after 1980 and 2) self-reported recognition of the legal obligation to report.

Attitude of Health Personnel↗

Performance of sealants applied to first permanent molars in a dental school setting.

PURPOSE: The purpose of this study was to assess the performance of sealants placed by senior dental students as part of a comprehensive dental care program that included periodic patient recall. METHODS: The dental records of 100 patients ranging in age from 6 to 13 years were selected for review to determine the treatments provided for first permanent molars over time. Criteria for inclusion were: 1) at least five documented recall examinations and 2) all four first permanent molars had to have been treated with an occlusal pit and fissure sealant. The data collected included: 1) the age of the patient at the time of initial sealant placement; 2) the subsequent treatment provided to the first permanent molars, including retreatment with sealant or restoration and the date the services were provided; 3) the last date of follow-up examination in the pediatric dental program. RESULTS: A total of 400 molars were followed for an average of 54 months. Fifty-two percent of all molars received no further treatment after initial placement of sealant. Approximately 35% received retreatment with sealant only. The total number of molars receiving sealant material only was 343 (86%). The total number of teeth that were judged to require restoration was 57 (14%). No relationship was noted between the patient's age at placement of the occlusal sealant and sealant performance. CONCLUSION: In a dental school clinic, occlusal sealants were effective at preventing caries in a comprehensive care program that included periodic recall.

Adolescent↗