Research in general dental practice.
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Attitude of Health Personnel↗
Biomedical subjects
F J Burke
Publications and source records attributed to F J Burke.
Patient attitudes to glove use by orthodontists.
The aim of this study was to evaluate the awareness of orthodontic patients of the importance of glove wearing by orthodontists, and consisted of a patient completed questionnaire carried out at an orthodontic clinic in Ireland. The subjects were 194 consecutive patients [122 (63 per cent) female, 72 (37 per cent) male; mean +/- SD age: 15.5 +/- 2.2 years] attending an orthodontic clinic. They completed a questionnaire designed to determine their attitudes to the wearing of gloves by orthodontists. Most patients (97 per cent; n = 188) considered that orthodontists should routinely wear gloves. However, approximately 15 per cent of patients (n = 30) would attend an orthodontist who did not wear gloves. Ninety-four per cent (n = 182) of patients considered that gloves were worn to protect both the orthodontist and the patient. A total of 86.5 per cent (n = 168) of patients thought that the orthodontist should change gloves between patients. The overwhelming majority of patients surveyed demonstrated a strong awareness of the importance of glove wearing by orthodontists. The results suggest that many patients will not attend an orthodontist who does not wear gloves during treatment.
Adolescent↗
Latex exposure and allergy: a survey of general dental practitioners and dental students.
Gloves are now worn routinely by most general dental practitioners and dental students while treating patients, with latex being the most commonly used glove material. By means of a questionnaire, this study surveyed 160 students in one dental school and 300 randomly selected general dental practitioners in respect of their exposure to latex. Response rates were 74.4 per cent and 57.3 per cent for dental students and practitioners respectively. Adverse skin reactions to the wearing of latex gloves was reported by 18.5 per cent of dental students and 22.8 per cent of practitioners. Analysis of the data indicated that there was an association between student year and adverse skin reaction to latex, an association between years in dental practice and adverse skin reaction to latex and a strong relationship between dentist's gender and adverse skin reaction to latex. Respondents who suffered from eczema or food allergies were more likely to have experienced an adverse skin reaction to latex glove wearing. It is concluded that adverse reactions to latex occur in significant numbers of dental students and dental practitioners, with those who reported personal and familial atopy being more likely to be affected.
Adolescent↗
Dentin-bonded all-ceramic crowns: current status.
Dentin-bonded all-ceramic crowns employ contemporary techniques to lute the crown to the tooth using a resin luting material and dentin-bonding system. The advantages of these crowns are that they provide good esthetics and fracture resistance and can be used in cases of substantial tooth loss. Their principal disadvantages are that the luting procedure is more time-consuming and that these crowns should not be used where margins are subgingival. Dentin-bonded all-ceramic crowns may be a useful addition to the dentist's armamentarium, but long-term clinical studies are needed to fully assess their performance.
Contraindications↗
Evaluation of the handling of a new compomer and novel dispensing system in general dental practice.
OBJECTIVE: Easy handling of materials is essential to the production of good clinical results. The handling properties of a new compomer material and its novel primer/adhesive-dispensing system were tested in clinical use. METHOD AND MATERIALS: Ten general dental practitioners used the new material and dispenser for 3 weeks and completed a questionnaire regarding the handling, esthetics, and ease of use. They were asked to compare the new material to the compomer, resin composite, and glass-ionomer materials normally used in their own practice. RESULTS: The material scored a mean of 4.4 for dispensing convenience on a linear scale of 1 (inconvenient) to 5 (convenient) and 4.6 for ease of use (5 = easy to use, and 1 = difficult to use). The dispensing system achieved a high rating of 4.9 for convenience (5 = convenient, and 1 = inconvenient). CONCLUSION: The new material received ratings that were superior to those of the glass-ionomer and compomer materials normally used by the evaluators and similar to ratings of the resin composite normally used.
Adult↗
Effect of differing resin luting systems on fracture resistance of teeth restored with dentin-bonded crowns.
OBJECTIVE: This study investigated the effect of differing bonding and luting system combinations on the fracture resistance of teeth restored with dentin-bonded all-ceramic crowns. METHOD AND MATERIALS: Standardized preparations were carried out on five groups, each of 10 sound, unrestored, maxillary premolar teeth. Ceramic crowns were constructed, their internal surfaces were etched with hydrofluoric acid, and the crowns were placed with the following dentin bonding and resin-based luting system combinations: group A, Mirage ABC and Mirage FLC; group B, Metabond luting material; group C, All-Bond 2 and Duo-link; group D, Scotchbond MP Plus and 3M Indirect Porcelain Bonding Kit; and group E, All-Bond 2 and 3M Indirect Porcelain Bonding Kit. The restored teeth were loaded in compression at 1.0 mm/min. RESULTS: Mean fracture loads of 0.77 kN, 0.81 kN, 0.71 kN, 1.24 kN, and 1.03 kN were recorded for groups A, B, C, D, and E, respectively. Statistical analysis indicated that the mean fracture resistance of the restored teeth of groups D and E was significantly greater (P < .05) than that of the other three groups. CONCLUSION: The fracture resistance of dentin-bonded crowns used in this laboratory study was dependent on the bonding and luting systems used.
Analysis of Variance↗
A retrospective evaluation of a series of dentin-bonded ceramic crowns.
OBJECTIVE: This study assessed the clinical performance of dentin-bonded crowns, in which ceramic crowns are bonded to underlying dentin with a resin composite-based luting material and a dentin bonding agent. METHOD AND MATERIALS: Twenty-five patients who had received such restorations more than 1 year previously were recalled for evaluation of their crowns. RESULTS: Sixty dentin-bonded complete-coverage restorations were assessed. Forty-one of the crowns had been placed on incisor teeth. The mean time since placement of the restorations was 2.43 years. Fifty-seven of the 60 restorations were intact. The three failures had resulted from cracks in the restorations, which had not clinically debonded. No secondary caries was detected at the crown margins, and anatomic form was assessed as excellent for 56 crowns. Root canal treatment had been required in one case. Color match was rated very good for 47 crowns. All 25 patients were satisfied with their restorations. CONCLUSION: Dentin-bonded crowns may be found to have a low rate of failure and to provide a high level of patient satisfaction.
Adult↗
Autoclave performance and practitioner knowledge of autoclave use: a survey of selected UK practices.
OBJECTIVE: It is essential that the dental surgery autoclave be tested regularly to ensure that it is operating at a temperature and pressure that will kill all microorganisms. The aims of this study were to investigate the knowledge of general dental practitioners on aspects of autoclave use, to examine their autoclaving routines, and to test the effectiveness of the sterilization cycle of their practice's autoclave. METHOD AND MATERIALS: A 35-question questionnaire was distributed to 840 dental practitioners in the United Kingdom. They were also sent three spore test ampules with details of their function and instructions on their use. The practitioners were asked to use the spore test ampules in their own practice's autoclave and to return these for testing. RESULTS: Four hundred one questionnaires and associated spore test ampules were returned for analysis, a 47.7% response rate. Eight practice autoclaves (2.0%) failed to sterilize the spores. These practices were offered a retest following counseling. A total of 77.8% of respondents had received formal training in infection control. Of the 71.3% of respondents who stated that they check the performance of their autoclave routinely, 31.5% use a chemical strip every cycle, 17.5% use it once per day, and 30.4% use it once per week. However, only five respondents (1.2%) use a spore test; two of these respondents use it every cycle, one once per day, and two once per week. CONCLUSION: Further education of practitioners may be necessary to enhance their awareness of the need for routine checking of autoclave effectiveness.
Dental Equipment↗
Extending the use of a 4-META material: repair of fractured metal/ceramic crowns and bridges.
The dentist who undertakes to carry out fixed bridgework or crowns will be faced with the fracture of a number of these restorations. Repair of such fractures may provide a faster, less traumatic and less expensive form of treatment than replacement of the restoration. Alternative methods of repair of metal/ceramic crowns and bridges are suggested, but further work is required to evaluate the long-term success of these repairs and, if required, to develop reliable methods of repair of metal/ceramic restorations.
Acrylic Resins↗
When should we restore lesions of secondary caries and with what materials?
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Dental Caries↗
When is caries caries, and what should we do about it?
Treatment of initial caries, albeit an everyday occurrence for the dental practitioner, presents considerable demands of patient assessment and diagnosis. Whatever decisions are made--to restore caries or to attempt to arrest its progress--the adoption of a maintenance program is of paramount importance. Patient motivation, in respect to dietary control and satisfactory oral hygiene, is central to a successful outcome, and in the future, practice management programs may include RAC as a diagnostic aid. New methods of caries management are more dynamic than traditional methods and place restoration of the lesion toward the bottom of the list of possible treatments, with the biologic rather than the mechanistic approach being a priority. However, the teaching of RAC in dental schools and the third-party funding of diagnostic tests and diagnosis are also required to reflect the increasing complexity of management of initial caries. If restorative intervention is indicated following diagnosis and RAC, treatment of initial caries should involve a minimal-intervention adhesive technique.
Decision Making↗
Scientific validity.
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Data Interpretation, Statistical↗
The relative cost of different restorations in the UK.
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Adolescent↗
The practice of dentistry: an assessment of reasons for premature retirement.
AIM: To assess reasons for premature retirement among practising dentists and to evaluate their association with occupational stress. DESIGN: Retrospective analysis. SETTING: Records from one organisation operating in the private medical sickness industry in the UK. MATERIALS: Reasons for premature retirement of 393 dentists due to illness between 1981 and 1992. RESULTS: The most frequent causes of premature retirement were musculoskeletal disorders (29.5%), cardiovascular disease (21.1%), and neurotic symptoms (16.5%), 82.7% of cases examined were in the > 50 years age group. CONCLUSIONS: Musculoskeletal disorders and stress related illnesses were the two most important groups which influenced premature retirement.
Adult↗
Reasons for placement and replacement of restorations of direct restorative materials by a selected group of practitioners in the United Kingdom.
This article reports the findings of a study on reasons for the placement and replacement of direct restorations in general dental practice in the United Kingdom. Twenty-two selected practitioners recorded information pertaining to up to 250 consecutive direct restorations placed by themselves during a 6-week period. From data derived from 2,379 restorations, it was found that about 60% of restorative practice in the United Kingdom may be found to comprise the replacement of existing restorations. For restorations of amalgam and glass-ionomer cement, the principal reason for replacement was secondary caries. For restorations of resin composite, secondary caries and poor appearance accounted for equal proportions of failures. Apart from the need for more extensive surveys of the type reported, the data emphasize the need to monitor treatment trends in contemporary clinical practice.
Composite Resins↗
The effect of different ceramic materials on the fracture resistance of dentin-bonded crowns.
This in vitro study investigated the fracture resistance of dentin-bonded crowns constructed from four ceramic materials: feldspathic porcelain, aluminous porcelain, a glass-ceramic core material (Dicor), and a leucite-enriched ceramic (Empress). Forty sound maxillary premolar teeth were chosen and divided at random into four equal groups. The teeth were prepared with a standardized crown minimal preparation. The restored teeth were subjected to compressive loading. When the mode of fracture of the specimens was examined, it was found that four mode V (severe) fractures occurred in the Empress group, compared with none in the aluminous porcelain group and one each in the feldspathic porcelain and Dicor groups. Statistical analysis indicated that the loads required to fracture Dicor specimens were significantly greater than those required to fracture the feldspathic and aluminous porcelain crowns but were not significantly different from the loads achieved by the Empress specimens.
Analysis of Variance↗