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Biomedical subjects

S L Handelman

Publications and source records attributed to S L Handelman.

At least 19 recordsLinked to original sources
PubMed1996

Michael Buonocore and the Eastman Dental Center: a historic perspective on sealants.

Dr. Michael Buonocore is known for his innovative research on the preparation of the enamel surface with a weak acid to enhance adhesion of an organic plastic chemical sealant and the polymerization in situ of a sealant with ultraviolet light. His co-workers at Eastman Dental Center aided and extended his research findings. The purpose of his original research was the development of a sealant to prevent occlusal caries on posterior teeth. However, the major impact of his work has been the development of adhesive restorative techniques. Although it has been demonstrated that (i) bacteria tend to die out and caries does not progress if early caries lesions are inadvertently sealed, (ii) sealant retention rates are favorable, and (iii) sealants are cost-effective, the use of sealants by the profession is still far short of early expectations.

Acid Etching, Dental↗
PubMed1996

A survey of faculty practices in U.S. dental schools.

In addition to providing a mechanism for maintenance and enhancement of the clinical skills of the faculty, intramural faculty practices are seen as an increasingly important source of revenue for dental schools. In this paper, we report on a survey conducted during academic year 1993/94 of United States dental schools as to the existence, organization, physical structure, finances and governance of their faculty practices. Results showed that all dental schools surveyed had some form of faculty practice or plan to establish a faculty practice in the future. The mean gross income of schools with established faculty practices in the 1993/94 academic year was 1.55 million dollars. Almost all sub-disciplines were represented in these faculty practices. More than 90 percent of the practices are housed within the dental school. The major cost to the faculty practice was staff salaries, with approximately 40 percent of the gross going to faculty reimbursement. Although 60 percent of the faculty practices surveyed were under the direct control of the dental school administration, a significant number of faculty practices were either corporations or partnerships. The results of the survey indicate a continuing trend towards the establishment of dental school-based intramural practices as a means of supporting the dental school budget.

Budgets↗
PubMed1993

Practice characteristics of graduates of postdoctoral general dentistry programs.

A mail questionnaire was sent to 900 dentists who completed a Postdoctoral General Dentistry (PGD) program in 1985 and 900 dentists who graduated from dental school in 1985 but did not participate in a PGD program. The response rate was 57 percent. Three-quarters of the PGD graduates trained in civilian programs with the remainder being equally divided between military and Veterans Administration (VA) programs. Graduates of military programs continued to be employed by the military five years after graduation in contrast to the VA where less than 2 percent of graduates were employed after five years. The percent of dentists who are specialists or are enrolled in specialty programs five years after graduation was approximately 13 percent and the rates were similar for PGD and non-PGD dentists. The patterns of care in private practice tended to be similar for both groups; however, in institutions GPR graduates provided more treatment for special care patients and patients who were economically disadvantaged. GPR graduates also were more involved in teaching and in hospital activities.

Community Health Centers↗
PubMed1991

The clinical predictability of internal derangements of the temporomandibular joint.

The value of clinical parameters as predictors of the arthrographic findings in patients with temporomandibular joint (TMJ) pain and dysfunction was examined in this study. We developed a series of simplified clinical prediction rules based on previous studies correlating clinical signs and symptoms with arthrographic diagnosis of the condition of the TMJ meniscus. One hundred eighty-six patients with signs and symptoms of TMJ dysfunction were clinically examined before TMJ arthrography. Arthrograms were performed on 246 joints (126 unilateral, 60 bilateral). The rules predicted 91 of the 246 joints to be normal when actually 59 were shown to be normal arthrographically. The rules slightly underpredicted those patients with positive arthrographic findings for internal derangements. Although there were some individual variations in the predictability of unilateral versus bilateral arthrograms (patients), there was very little overall difference, 58% and 60%, respectively. This study confirms previous suggestions that clinical findings alone are not consistently accurate in diagnosing the exact type of TMJ internal derangements depicted by arthrographic criteria.

Adult↗
PubMed1991

Effects of fluoride, lithium, and strontium on growth and acid production of mutants streptococci and Actinomyces viscosus.

Eight strains of mutants streptococci and two strains of Actinomyces viscosus were studied to determine (1) their relative sensitivities to fluoride, lithium, and strontium and (2) whether lithium or strontium interact to enhance the known antimicrobial effects of fluoride. Analyses of variance of the data revealed a major inhibition of growth and acid production by fluoride, but not by lithium or strontium. Fluoride (5 mg/l) inhibited cell growth of all strains tested by a mean of 17% and total titratable acid production by a mean of 31%. However, there were marked differences between the strains. Mean total titratable acid was inhibited by fluoride least with the A. viscosus strains (15%) and most with the mutans streptococci (34%). Although interactions among the elements were statistically significant, they were generally slight in magnitude.

Acids↗
PubMed1991

Therapeutic use of sealants for incipient or early carious lesions in children and young adults.

Although the overall caries rate has declined significantly in the past decade, recent studies have shown that caries in occlusal pits and fissures continues to be a significant problem in adolescents and young adults. Radiographic and bacteriologic studies of sealed carious teeth were originally designed to allay the profession's concerns about continued progression of the carious process. These studies have demonstrated that caries is inhibited and may in fact regress under intact sealants. The changes in patterns of caries incidence and the positive results of the sealant studies suggest that alternative approaches to the treatment of incipient or early occlusal caries should be considered. In addition to the radiographic and bacteriological studies of sealed carious teeth, studies on retention over carious pits and fissures, wear, cost effectiveness and changing attitudes of dentists indicate that sealing incipient or early carious lesions is a viable alternative to restoration with amalgam.

Adolescent↗
PubMed1990

Patient satisfaction in four types of dental practice.

There has been a significant growth in alternative types of dental practice. To determine satisfaction, patients were surveyed in urban private practices, a hospital dental clinic, a neighborhood health center, and a large group practice situated in a shopping center, using a 14-item survey and a 5-point rating scale. Patient satisfaction was related to the following factors in descending order: dentist, staff, efficiency, time-cost, and accessibility. Patients rated private practice most favorably for all factors with the exception of accessibility, which was rated highest for the shopping center practice. Patients rated the hospital least favorably for all factors with the exception of dentist, which was rated least favorably for the shopping center practice. Although private practices were the most favorably perceived, alternative types of practice were also highly rated and met specific patient needs. Satisfaction was greater for older patients, for patients with less education, and for white compared with black patients.

Adult↗
PubMed1989

Using latent class models to characterize and assess relative error in discrete measurements.

Whenever a definitive standard is not available to mark accuracy in a classification process, discrete measurement error can be discussed only in relative terms. If strong assumptions concerning the underlying discrete processes can be made, latent class models allow one to characterize patterns of agreement/disagreement among raters while simultaneously producing "consensus" estimates of prevalence. A hypothetical definitive standard serves as the latent factor. The discrete data are treated as incomplete and log-linear models can be used to parameterize latent class models and extensions of latent class models. Data from the radiographic diagnosis of dental caries by five dentists were explored to estimate prevalence, assess relative error, and examine the validity of several traditional assumptions concerning diagnostic reliability. Latent class analysis allowed a more detailed description of diagnostic error than provided by commonly used summary statistics.

Biometry↗
PubMed1989

Patients' knowledge of caries prevention. A study.

This study explored the caries prevention awareness of a population of regular dental patients. Although regular dental patients have an overall high knowledge about certain aspects of caries population, they do not have accurate information about fluoride, tooth-brushing and minimal knowledge about sealants. Establishing the patients' knowledge of the prevention of tooth decay is important in determining strategies and implementation of public health education programs and education programs in individual dental offices.

Adult↗
PubMed1988

Correlation of clinical parameters to the arthrographic depiction of temporomandibular joint internal derangements.

This prospective clinical investigation of 188 patients with signs and symptoms of temporomandibular joint (TMJ) pain and dysfunction examines the correlation between clinical signs and symptoms versus the arthrographic characteristics of intracapsular disease related to displacement of the meniscus. An attempt has been made to establish which specific clinical signs and symptoms, as determined by arthrography, best predict the condition of the joint. Our findings suggest that most of the clinical signs and symptoms are not sufficiently reliable in themselves to permit prediction of the condition of the meniscus. Those clinical parameters that did show a strong correlation were tested in combinations using stepwise discriminant analysis to evaluate clinical tendencies. Thus, patients with normal meniscal position and function were often noted to have normal mandibular ranges of movement, no joint noises on opening and closing of the jaw, and no tomographic evidence of degenerative joint disease. Subjects with meniscal displacement with reduction were often found to have joint clicking, deviation of the jaw upon opening, and an absence of degenerative joint disease by multidirectional tomography. Patients who had meniscal displacement without reduction were often found to have limitation in jaw movement, crepitation on opening and closing of the jaw, and associated degenerative changes on multidirectional tomograms. If specific treatment plans are to be tailored for different stages of TMJ internal derangements, clinical findings alone or clinical findings in conjunction with plain radiographs of the TMJ are not consistently accurate.

Adult↗
PubMed1987

The relationship of drug use to denture function and saliva flow rate in a geriatric population.

This study investigated an "old elderly" population and the relationships between the use of hyposalivatory drugs and denture function, including saliva flow rates and denture-supporting structures and health. There was a high prevalence of drug use and medical problems. Hyposalivatory drugs were prescribed for more than half of the subjects. There was a significant relationship between increased hyposalivatory drug use and reduced saliva flow rates. Reduced values for denture-supporting structures were found to be related to increased medical problems and hyposalivatory drug use. Reduced values for denture-supporting tissue health were found to be related to masticatory performance and retention and stability. Bite force showed a strong positive relationship with masticatory performance. Some of the subjective evaluations by the subjects showed statistically significant relationship with their respective objective measures: perceptions of dry mouth were related to saliva flow rates, perceptions of denture rocking or looseness were related to retention and stability ratings, and reports of pain on chewing were related to masticatory performance. It may be concluded that the use of drugs with hyposalivatory side effects may have a deleterious influence on the denture-bearing tissue. Direct influence on denture function, however, was not found. These findings provide valuable insights into the effects of drug usage in old age and their impact on oral health and denture function. Diagnostic and treatment capabilities are thus enhanced in that physicians, pharmacists, and other health-related professionals can be alerted to the problems accompanying hyposalivatory drug use. This may permit alternatives in medication when possible, and dentists may more effectively plan and conduct prosthodontic care for these individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Comparison of arthrographic findings of the temporomandibular joint with palpation of the muscles of mastication.

Two hundred five patients were examined for temporomandibular joint pain and dysfunction and specifically for tenderness to muscle palpation. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). Significant findings were ascertained for the middle portion of the temporal muscle in "normal" patients versus "with and without meniscus reduction" patients. The superficial masseter muscle was more tender in "normal" patients and in "reducing meniscus" patients than in "without meniscus reduction" patients. The medial pterygoid muscle was more tender in "normal" patients and in "without meniscus reduction" patients than in "reducing meniscus" patients. Though there are some significant findings with respect to muscle palpation, by itself muscle palpation is not a specific indicator of temporomandibular joint internal derangement.

Arthrography↗