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R W Valachovic

Publications and source records attributed to R W Valachovic.

34 records · Page 2Linked to original sources
PubMed1988

Longitudinal radiographic analysis of carious lesion progression.

Information on the rate at which carious lesions progress through the enamel of human teeth in an adult population was obtained from dental radiographs taken at 3-yr intervals, over a 10-yr period on 602 men. Clinical measures of calculus deposition, plaque accumulation, gingival inflammation, tooth mobility, periodontal pocket depth, and gingival recession were studied to find predictors that might be of value to the clinician for determining how frequently radiographs should be taken. We estimate that 50% of the enamel lesions on mesial and distal surfaces, if left untreated, would not progress into the dentin until 73 months had elapsed after the lesion was initiated. Significant differences in the progression rate were associated with the arch and tooth type. Patient age, number of decayed or filled surfaces, degree of gingival inflammation, amount of recession, and plaque accumulation were positively associated with more rapid caries progression, while greater numbers of teeth present were predictive of slower disease progression.

Adult↗
PubMed1987

Longitudinal study of the diagnostic yield of panoramic radiographs in aging edentulous men.

Participants in the Veterans Administration Dental Longitudinal Study who were edentulous and for whom longitudinal panoramic radiographs were available were followed through four examination cycles, representing approximately 10 years. It was observed that 13 (39%) of the 33 subjects examined had one or more positive radiographic findings at the initial examination. No changes occurred in the findings noted during the initial panoramic radiographic examination, and no new findings were observed over the study period. Although the initial baseline panoramic examinations yielded several positive radiographic findings, few were of a nature that materially affected the initial treatment plan.

Adult↗
PubMed1986

Clinical efficacy of dental radiography in the detection of dental caries and periodontal diseases.

This article reports the ability of dental radiographs to correctly detect evidence of dental caries and periodontal disease (sensitivity) and to correctly establish the absence of these diseases (specificity). The analysis used a unique data set that was collected as part of the Veterans Administration Dental Longitudinal Study in Boston. Periapical, panoramic, and posterior bitewing radiographs were independently compared with a consensus radiographic standard of all three radiographs read simultaneously. Findings showed that the sensitivities of all three radiographs to detect dental caries were lower than expected, at approximately 60%, whereas the sensitivities to detect evidence of periodontal disease averaged approximately 85%. Panoramic radiographs were substantially less sensitive for detecting dental caries than periapical and posterior bitewing radiographs, but no difference between these modalities was observed in the analysis of sensitivity to periodontal disease. The proportion of false-negative and false-positive readings from dental radiographs was substantial and requires further investigation.

Adult↗
PubMed1986

The use of panoramic radiography in the evaluation of asymptomatic adult dental patients.

This article examines the efficacy of panoramic radiography alone and in combination with intraoral films as part of the "full-mouth" radiographic evaluation of asymptomatic dental patients in the diagnosis of dental caries and periodontal disease. Three full-mouth radiographic surveys--the panoramic alone, the panoramic plus posterior bitewing, and the periapical plus posterior bitewing--are compared. Two forms of measurement--comparative and incremental--were used to identify the radiographic survey with the highest single diagnostic yield when measured against the consensus standard. The findings show that the panoramic radiograph alone exhibits very low sensitivities to dental caries, ranging from 0.6% on anterior teeth to 25.6% on premolars. Even when posterior bitewing radiographs are added to the panoramic films, the sensitivities are significantly below those of the full-mouth periapical and bitewing survey. In contrast, the sensitivities of all three radiographic surveys in the diagnosis of periodontal disease are quite high, ranging from 87% to 96%, so that differences are not clinically significant. However, specificities tended to be low for periodontal disease and high for caries. Thus, for dental caries and (to a lesser extent) periodontal disease, the panoramic radiograph was inferior to the full-mouth intraoral series in its ability to correctly detect evidence of the disease.

Adult↗
PubMed1986

Examiner reliability in dental radiography.

In long-term investigations involving a large number of study participants, it is frequently necessary to employ the use of multiple examiners who must exhibit high levels of inter- and intra-examiner reliability in order to minimize examiner bias, which can distort scientific findings. This report on the calibration of four examiners in a large project investigating the efficacy of dental radiography shows high levels of examiner reliability using various statistical measures of agreement. Levels of intra-examiner agreement using Cohen's Kappa index were 0.75 and higher at baseline, and remained at approximately the same level (0.80) throughout the 24-month period of the study. The Kappa index of inter-examiner agreement among the six pairings of the four examiners ranged from 0.68 to 0.80 for caries and 0.72 and 0.83 for periodontal disease. Values of four statistical measures of agreement (proportional agreement, Kendall's rank correlation, Cohen's Kappa index, and Cohen's weighted Kappa index) were determined to show the importance of using measures, such as the Kappa index, which take chance agreement into account.

Adult↗
PubMed1980

Radiologic considerations in evaluation of radiolucent lesions of the mandible.

Careful attention to technique is of utmost importance in instances in which clinical evidence indicates that the osteolytic or osteogenic margins of a lesion may extend beyond those visible on a conventional radiograph. Procedures such as radionuclide scans should be used to establish the appropriate boundaries for surgical resection in such instances. Although early surgical intervention will usually lead to a definitive histopathologic diagnosis, there is some risk that manipulation will either compromise the validity of later radiological procedure or extend the disease by local dissemination or blood-borne metastases. Appropriate radiologic evaluation of lytic lesions of the mandible can provide a maximum amount of information so that surgical resection of the lesion will be complete, and the possibility of recurrence will be reduced.

Aged↗
PubMedDate not supplied

An analysis of dental services based in the emergency room.

This study evaluated the utilization, cost-effectiveness, and marketing of emergency dental services in a 700-bed university-affiliated hospital. Sequential analysis of 445 emergency room dental visits was performed during a 3-month period. Services were most used on weekend days by patients who had chief symptoms lasting varying lengths of time (43% had them 21 days). The majority of patients sought care for relief of pain. A diagnosis of infection was made in 82% of the patients. An analysis of costs, revenues, marketing, and service design is included.

Cost-Benefit Analysis↗
PubMedDate not supplied

Gender shifts.

Explore the source record for details and available documents.

Career Mobility↗
PubMedDate not supplied

A probable case of a cysticercosis presenting as an incidental intracranial calcification on a lateral cephalogram.

A 42-year-old female in whom intracranial calcifications were incidentally identified on a lateral cephalogram is presented. Follow-up CT scans and her social history led to the most probable diagnosis of cysticercosis, an infestation by larva of the tapeworm Taenia solium, of the brain. A differential diagnosis of intracranial calcifications on plain film skull views is presented.

Adult↗