A review of the study by Dame Margaret Seward.
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Child↗
Biomedical subjects
F J Burke
Publications and source records attributed to F J Burke.
New models for administering UK dental care.
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Community Dentistry↗
One-year retrospective clinical evaluation of hybrid composite restorations placed in United Kingdom general practices.
OBJECTIVE: The purpose of this study was to assess Pertac II restorations placed in general dental practice. METHOD AND MATERIALS: A total of 86 restorations (14 Class I, 10 Class II, 17 Class III, 5 Class IV, and 40 Class V) using a hybrid composite material (Pertac II) placed in 56 patients (mean age, 39 years) in 5 dental practices in the United Kingdom were assessed after 1 year by a trained evaluator and the dental practitioner who had placed the restoration. All the restorations were assessed for anatomic form, marginal adaptation, surface roughness, sensitivity or discomfort, gingival condition, and the presence or absence of secondary caries. RESULTS: Thirty-five (43%) restorations were placed in load-bearing situations, 9% of which were assessed as being in "heavy" occlusion. Five (6%) of the restorations were lost (all Class V restorations), 4 from premolars and 1 from a molar. Four were in wedge-shaped cavities and 1 small restoration was actually dislodged during examination. The remaining 81 (94%) restorations were found to be intact, with no secondary caries detected. A high percentage of optimal scores were recorded for both anatomic form and surface roughness. CONCLUSION: It is concluded that the evaluation demonstrated satisfactory clinical performance of Pertac II restorations after 1 year of clinical service in the wide variety of clinical situations seen in general dental practice. However, the potential for failure of hybrid composite materials in Class V situations appears high. It may be argued that clinicians who wish to use a resin-based material in a Class V situation should use a compomer or microfilled composite.
Adult↗
Ease of use versus clinical effectiveness of restorative materials.
"Ease of use," as applied to dental materials and techniques, means different things to different people. Factors that may contribute to ease of use include a minimum number of application stages, easy application and shaping ability, quickness of use, lack of stick, and moisture sensitivity. Ease of use may also imply that a material or technique does not cause stress for the dentist and patient, is cost effective, is easy to learn, and should provide the operators with a sense of satisfaction with their work. Similarly, "clinical effectiveness" of the treatments prescribed for patients is not always capable of being accurately defined. Suggested factors that may contribute to clinical effectiveness include a lack of patient complaints with respect to longevity and/or cost, no secondary caries, and preservation of the remaining tooth structure during functional loading. Ease of use and clinical effectiveness are not necessarily related, but they must be combined for a technique to be successful. The achievement of this demands a partnership between clinicians, manufacturers, and patients.
Chemical Phenomena↗
Scottish consortium for development and education in dental primary care.
A national consortium for dental primary care in Scotland has been formed as a result of integrated planning by groups involved in managing and delivering postgraduate dental education in Scotland. In 1998 a partnership was formed with representatives from the Scottish Council for Postgraduate Medical and Dental Education (SCPMDE) and the three Scottish dental institutions at Dundee, Edinburgh and Glasgow Universities. The principal aim of the Consortium is to promote evidence-based dental care through postgraduate education and research. The activities of the Consortium will provide a broadly based adjunct to current postgraduate provision with partner institutions contributing in different ways. Since its inception the Consortium has focused on two main areas: 'Higher Training' for Primary Care. Scottish Dental Practice Based Research Network.
Dental Research↗
Reasons for placement and replacement of restorations in student clinics in Manchester and Athens.
Data on reasons for the placement and replacement of restorations provide insight into patterns of clinical practice. This study investigated reasons for the provision of restorations in student clinics at the Universities of Manchester and Athens. Using the methods first described by Mjör, data were collected in relation to all initial and replacement restorations placed in adult patients in the main teaching clinics in the 2 schools over a 3-month period. The principal reason for intervention was recorded, according to approved treatment plans. Data were collected on 2620 restorations, 1431 (55%) of which were placed in Manchester. Primary caries was the main reason for the placement of initial restorations: 82% in Athens and 48% in Manchester (p<0.001). The principal reason for restoration replacement was secondary caries, accounting for 54% in Manchester and 33% in Athens (p<0.001). Other differences between the schools, included the ratio of initial placement to replacement restorations (Manchester 1:1.1; Athens 1:0.6: p<0.01) and significantly more 2-surface class II restorations having been placed in Manchester (p<0.001). Class III and IV restorations predominated in Athens. It is concluded, despite the acknowledged limitations of the methods employed, that the patterns of placement and replacement of restorations and the use of materials differ between the dental schools of Manchester and Athens. The differences are considered to relate more to local patterns of dental disease and patient selection for student clinics than to any differences in teaching philosophy. Subsequent studies of the type reported, despite acknowledged limitations would provide insight into the impact on patient care of the teaching of new materials, techniques and treatment philosophies.
Adolescent↗
Follow-up evaluation of a series of dentin-bonded ceramic restorations.
PURPOSE: The results of a retrospective evaluation of 60 dentin-bonded full-coverage restorations with an average time in service of 2.4 years previously have been reported. The purpose of this study was to evaluate the crowns after a further 2 years in service. MATERIALS AND METHODS: The 23 patients in the initial study whose restorations were found to be intact in June 1996 were contacted by mail and invited to present for review in October 1998. The restorations of 20 respondents were assessed by two examiners using modified United States Public Health Service criteria. RESULTS: The patients had received a total of 53 restorations (mean age of restorations, 4.4 years; range, 5.5-3 yr). At the time of examination, 48 restorations were found to be intact. No secondary caries was detected in these restorations, and optimal scores for gingival health, anatomic form, and marginal discoloration were recorded for 39, 47, and 33 crowns, respectively. Color match was assessed as being very good in 43 of the 48 restorations assessed. The reasons for replacement of the failed restorations were gingival recession (n = 1), restoration fracture (n = 1), core fracture (n = 1), and unknown (n = 2). Each patient's perception of his or her restorations was recorded by means of a questionnaire, with the responses indicating that all but two patients were satisfied. Only one patient had experienced any discomfort.
Adult↗
Treatment of dentinal hypersensitivity using a dentine bonding system.
AIMS AND OBJECTIVES: Many agents have been used in treatment of dentinal hypersensitivity in the past, but dentine bonding systems have recently been suggested as being effective. This study examined the effectiveness of a dentine bonding system in the treatment of dentinal hypersensitivity in dental practice conditions. METHODS: Dentists in two dental practices agreed to carry out the project. One practice was in the UK, the other in India. A total of 34 patients who were diagnosed to have dentinal hypersensitivity were treated using the dentine bonding system. Patients were requested to record their perception of their pain on a 100mm linear scale, pre-treatment, one day and one week post-treatment. RESULTS: All patients experienced relief of pain, both 1 day and 1 week after treatment. Profile plots of the patients' perceived pain scores for the two practices separately indicated that there was a general trend across both practices for these to fall quite sharply one day after treatment and then generally level out one week post-treatment. There was evidence indicating a possible difference in pain perception in the two communities from which the patients were drawn. CONCLUSION: The dentine bonding system evaluated was successful in reducing the pain of dentinal hypersensitivity, at least in the short term.
Analysis of Variance↗
Dentine bonding systems: 1. Mode of action.
The achievement of a reliable bond to dentine has been more difficult than bonding to enamel, due principally to the anatomy of the dentine substrate. The mechanisms of bonding are now much better understood than a decade ago and clinically-viable bond strengths to dentine are now achieved with many dentine bonding systems.
Acid Etching, Dental↗
Dentine bonding systems: 2. Clinical uses.
As the reliability of dentine bonding agents has improved, the clinical uses of these systems has increased and now include the bonding of directly and indirectly constructed restorations, amalgam bonding and treatment of dentinal sensitivity. Areas of potential use which require further evaluation include pulp capping and the attachment of fractured tooth fragments.
Adhesives↗
Investigation and treatment of patients with teeth affected by tooth substance loss: a review.
Tooth substance loss, an increasing problem, may result from erosion, abrasion and attrition, often with more than one of these acting together. Investigation requires a detailed history and examination. The aim of treatment may be prevention of further damage in less affected cases. The treatment of severe tooth substance loss may be complex, especially in view of the reduced amounts of tooth substance which may be available and the need to find space because of the compensatory over-eruption of worn teeth.
Bruxism↗
A synopsis of the adult dental health survey: oral health in the United Kingdom 1998.
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Adult↗
Contemporary resin-based composite materials for direct placement restorations: packables, flowables and others.
Resin-based composite (RBC) materials are composed of principal and diluent monomers, fillers, coupling agents and other components. These materials have been developed in recent years to produce packable and flowable materials, and materials which may release ions under specific conditions and which may contain fibres. Materials which are organic-inorganic copolymers have also become available. Long term clinical trial data are not available for the most recently introduced materials.
Aluminum Silicates↗
Allergy to a common component of resin-bonding systems: a case report.
Allergies to materials routinely used in dentistry are becoming more prevalent. The hydrophilic resin 2-hydroxyethyl methacrylate is a common constituent of systems designed to bond resin-based restorative materials to dentine. It has been considered to have a high sensitizing potential, although dental patient-related allergies to the resin appear to be rare. This report presents details of a patient who has such an allergy, which, it is suspected, manifested as an intra-oral lichenoid reaction to the closely approximating anterior restorations.
Aged↗
Techniques used by a group of United Kingdom-based dental practitioners during the provision of indirect tooth-coloured restorations.
A number of techniques involving the use of various instruments, brushes and devices have been described for the removal of excess luting material and subsequent finishing around the margins of indirect tooth-coloured restorations. There is little information available on the clinical techniques employed by UK dental practitioners in the placement of these restorations, or on the effectiveness of these techniques. A questionnaire was designed to elicit such information. This was distributed to 500 UK-based dental practitioners. A total of 301 practitioners returned completed questionnaires, giving a response rate of 60%. The results indicated that 88% of the respondents routinely provided porcelain veneers for their patients, with 94% of these respondents indicating that they routinely prepared teeth during the provision of such restorations. A light-cured resin composite luting material was used by 29% of the respondents in placement of veneers, while 69% used a dual cured composite. Excess uncured luting material was removed by a number of methods and a variety of methods were used by respondents to finish the margins of the veneers after placement. Of the respondents 68% indicated that they routinely provided tooth-coloured inlays and onlays, with 89% indicating that they routinely used a dentine bonding system when luting their indirect tooth-coloured restorations. It is concluded that a high proportion of the practitioners surveyed were providing porcelain veneers and tooth-coloured inlays and that a wide variety of materials and finishing techniques were being used.
Composite Resins↗
One-year clinical evaluation of compomer restorations placed in general practice.
OBJECTIVE: This study evaluated the in-service performance, after 1 year, of a sample of F2000 compomer restorations placed by 10 general dental practitioners as part of handling evaluation of this material. METHOD AND MATERIALS: Five general dental practitioners who participated in the handling evaluation were asked to cooperate in the 1-year assessment of the restorations. The practitioners were requested to contact patients and inquire if they were willing to attend at a specified time for examination of their restorations by a trained evaluator who would travel to the various practice locations. A total of 84 restorations were presented for examination. The mean age of the restorations at examination was 14 months. The restorations were assessed for anatomic form, marginal adaptation, surface roughness, sensitivity or discomfort, gingival condition, and presence or absence of secondary caries. RESULTS: Eighty-two restorations were intact. No secondary caries was detected. Optimal scores were obtained in a high proportion of the assessments. All patients reported satisfaction with the restorations, both in appearance and surface texture, and no symptoms were reported. CONCLUSION: The F2000 compomer restorations, placed in conjunction with its bonding system in general practice conditions, were found to be performing satisfactorily after 1 year.
Adult↗
Ethics in aesthetics?
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Esthetics, Dental↗