Biomedical subjects

S Mickenautsch

Publications and source records attributed to S Mickenautsch.

10 recordsLinked to original sources

PubMed2005

Measurement of dental restorative material topography.

INTRODUCTION: The tracing of peaks and valleys produced during surface profiling of dental materials are read against a mean line which can be modified in the form of a line or arc. Roughness (R) is commonly used to measure the topography of restorative materials, but the profile (P) value is also generated during the tracing and includes both roughness and waviness of the surface. AIMS AND OBJECTIVES: The purpose of this study was to determine if line and arc modified tracings and R and P surface topography measurements give similar results. METHODS: Thirty six cavities (5 x 1.5mm) were prepared in Perspex discs, restored with Fuji IX, a high strength glass ionomer cement, following the Atraumatic Restorative Treatment (ART) technique and the surface of six cavities were each treated as follows: press finger with vaseline (Va); press finger with polyacrylic acid (Aa); carving (Ca); burnishing (Bu); Mylar strip (My); polishing (Po). Topography was assessed using a profilometer which ran three equidistant tracings (3.6mm) on each surface giving a total of 18 readings for each treatment (n=6). The results of Ra, Rv, Rp, R, and Pa, Pv, Pp, P, for all 6 surface treatments were compared and analysed using ANOVA and Tukey's studentised range test with significance set at P<0.05. RESULTS: Within R + line, R + arc, P + line and P + arc, significant differences were apparent between treatments. Pairwise comparisons showed fewer instances of significant differences between surface treatments when R + line (1 instance of significant difference) was compared to R + arc (2). P + line showed 12 instances of significant differences between surface treatments while P + arc showed no difference. CONCLUSION: Both line and arc tracings gave similar results for R and either may be used in assessing surface roughness. The total deviation of the profile P showed more significant differences between treatments with line than with arc and may be a more sensitive tool when dealing with small sample numbers or subtle differences between surface treatments.

Analysis of Variance↗

PubMed2004

Minimal intervention dentistry (MI) for South Africa.

The intention of Minimal Intervention Dentistry (MI) is to preserve as much tooth tissue as possible and to offer less threatening care to fearful patients. MI is based on a new understanding of cariology and the therapeutic value of biomimetic materials such as Glass lonomers. It has particular relevance to a new caries classification and employs treatment concepts such as selective caries removal and sealed restorations. The MI approach is appropriate for the vast majority of the population in South Africa; it addresses the public fear of dental treatment. It can be an effective private practice builder and is thus applicable to private and public services.

Biomimetic Materials↗

PubMed2002

Comparative cost of ART and conventional treatment within a dental school clinic.

BACKGROUND: The changing oral health needs in South Africa require that both the teaching and clinical techniques of atraumatic restorative treatment (ART) form a part of the restorative undergraduate curriculum. OBJECTIVE: This study was undertaken to establish and compare the estimated costing of an amalgam, composite resin and ART restoration within the Board of Health Funders (BHF) recommended scale of benefits at the School of Oral Health Sciences Oral and Dental Hospital, University of the Witwatersrand (SOHS). METHODS: Fixed and variable costs were calculated by pricing items and equipment used in each procedure. The output values were established according to the recommended scale of benefits (BHF, 1999). This enabled the calculation of contribution margins and net income for each of the three restorations. RESULTS: The annual capital cost for the ART approach is approximately 50% of the other two options (e.g. per multiple surface restoration ART = R1.58; amalgam and composite resin restorative procedures: R3.12 and R3.10 respectively), despite the fact that ART restorations are rendered in a modern dental setting. CONCLUSIONS: Our study shows that implementation of the ART approach within the clinic setting of the SOHS can be accomplished without additional cost. Furthermore ART can be performed as an economically viable alternative to conventional treatment procedures within the clinic setting. The study represents a first step towards determining the cost efficiency of implementing ART as a pragmatic and cost-effective restorative option within the SOHS, University of the Witwatersrand.

Capital Expenditures↗

PubMed2002

Undergraduate training in the atraumatic restorative treatment (ART) approach--an activity report.

The Division of Public Oral Health at the University of the Witwatersrand conducted a 2-week ART training course for 5th year dental students in the School of Oral Health Sciences. Students were taught both theoretical knowledge and clinical skills in ART. Course evaluation showed that the course achieved its aims and objectives and was considered a worthwhile experience by students. However, there were some limitations to the format of the programme. We recommend that ART should be integrated as part of clinical student training in the BDS curriculum.

Adolescent↗

PubMed2002

Microscope observations of ART excavated cavities and restorations.

This in vitro light and scanning electron microscope study examined 39 extracted tooth specimens, hand excavated and restored according to atraumatic restorative treatment (ART), using 'press finger', by 'skilled' and 'novice' operators. Surface features of five excavated cavities, 12 restoration surfaces and the tooth restoration relationships of 22 bisected restored tooth crowns were examined to better understand the clinical effect of the technique. Hand-excavated cavity surfaces were rough with a complex surface arrangement of grooves, crevices, ridges, furrows and overhangs. Enamel and dentine were covered with debris except where surface fractures exposed enamel prisms and occluded dentinal tubules. Ten of the 22 bisected restored specimens had large voids (1-3 mm in length) within the glass-ionomer cement (GIC) restoration or at the tooth-restoration interface. Smaller bubbles (< 50 microns) and irregular shaped inclusions were common in all restorations. Adaptation of the GIC to the cavity margin was extremely variable and easily distinguished from the effects of dehydration shrinkage. It is thought that cavity surface irregularities could cause placement problems making it difficult to adapt the GIC to cavity peripheries. While 'press finger' enabled excellent penetration of GIC into fissures, the technique left restoration surfaces rough. At low magnification, surfaces were irregular; at magnifications higher than X500 scratches, pits, porosities, chipping and voids were evident. However, the 'press finger' technique was able to merge the GIC to a fine edge on the occlusal surface so that the restoration margin was not obvious. No apparent difference was found between the restorations placed by the 'skilled' and 'novice' operators. Tooth-restoration relationships in the ART approach are entirely different to those of traditional restorative techniques. The ART approach requires skill, diligence and comprehension to be undertaken correctly.

Clinical Competence↗

PubMed2001

ART--what for?

Explore the source record for details and available documents.

Cariostatic Agents↗

PubMed2001

Implementation of the ART approach in South Africa: an activity report.

The Atraumatic Restorative Treatment (ART) approach has been adopted in public dental services in South Africa as an appropriate and economical means to provide basic restorative care in communities where it was not possible before. The approach also offers a less-traumatic treatment concept for fearful patients and children in the private dental practice. In 2000, the Division of Community Dentistry, University of the Witwatersrand, implemented a training, research and service programme in the ART approach. The aim of these activities was the promotion of ART at various levels within the oral health care system in the Republic of South Africa. The objectives of the programme were to initiate and provide training of oral health workers in ART, to evaluate the outcome of training and service programmes and to disseminate results. This paper describes the Division's ART activities in 2000, regarding public, private and refugee health services.

Adult↗

PubMed2000

Clinical evaluation of the ART approach and materials in peri-urban farm schools of the Johannesburg area.

In this study, 1,325 school children from 7 farm schools were examined. Their mean age (+/- SD) was 10.5 +/- 3.0 (range 6-11) years. At baseline, the mean DMFT score was 1.1 +/- 1.7 and 36.4% of the children had caries. The prevalence of fluorosis among the children was 12.6%. Curative treatment was offered to all the children. A total of 113 children (8.5%) with one-surface cavities on permanent teeth and without fluorosis were treated using the atraumatic restorative treatment (ART) approach. A total number of 163 cavities were included in the study, of which 82 were treated with Fuji IX glass-ionomer cement and 81 with Ketac-MOLAR (hand mix). One year after treatment, restoration and sealant parts of ART fillings were examined. Caries status was also determined. The placing of the ART fillings and their evaluation were performed by different practitioners. A total number of 108 restorations (58 with Fuji IX, 50 with Ketac-MOLAR) were evaluated. Results of ART fillings showed a survival rate of 93.1% with Fuji and 94.0% with Ketac-MOLAR. Retention of the sealant parts of ART fillings was observed in 81% of restorations with Fuji IX and 76% with Ketac-MOLAR, not connected to the filled cavity. Caries was absent on all teeth restored with Fuji IX and noted in only one tooth restored with Ketac-MOLAR, not connected to the filled cavity. The retention rate after a 12-month period was acceptable and ART approach proved to be an appropriate technique for restoring teeth in this population group. There were no statistically significant differences between the survival rates of the two glass-ionomer restorative materials (P > 0.05).

Child↗

PubMed1999

The impact of the ART approach on the treatment profile in a mobile dental system (MDS) in South Africa.

The changing profile of oral care rendered through the Mobile Dental System (MDS), after the introduction of the Atraumatic Restorative Treatment (ART) approach is described. During the first year of introduction of ART, the percentages of amalgam restorations and tooth extractions decreased significantly (P < 0.0001). This is partly ascribed to a change in choice of treatment by dental operators in favour of ART and also due to an increase in acceptance by patients because of the reduced fear, and the patient-friendly nature of the ART approach. The reduction in amalgam restorations was 16.0 per cent for permanent and 1.4 per cent for primary posterior teeth. Extraction of posterior teeth was reduced by 17.4 per cent in the permanent and 35.7 per cent in the primary dentitions. The restorative component of oral care increased by 33.4 per cent in the permanent and 37.1 per cent in primary posterior teeth. The one-year survival of one-surface ART restorations using Fuji IX and KetacMolar was 93.6 per cent. Full and partial (more than 90 per cent) retention of the sealant part of the ART restoration was obtained in 75 per cent of the cases after one-year. During the one-year period, infection control was made more simple and this facilitated easier maintenance of mobile dental equipment. The introduction of the ART approach reduced extraction, restored more teeth and made oral care in the MDS more preventive, less threatening and thus more patient-friendly.

Child↗

PubMed1999

Oral health among Liberian refugees in Ghana.

OBJECTIVE: To promote community involvement in the provision of oral health services. DESIGN: The project consisted of a four-week training course in oral health for selected refugees, an oral health survey based on WHO guidelines and conducted by the refugees themselves and the provision of oral health care services to the community by the trained refugees. SETTING: Liberian refugee camp, Gomoa Buduburam in Ghana. SUBJECTS: Liberian refugees of all ages. INTERVENTIONS: Twelve refugees were given short term training in oral health. In the oral health survey, 196 refugees were clinically examined for dental caries, periodontal disease and malocclusion. MAIN OUTCOME MEASURES: DMFT (for dental caries), CPITN (for periodontal disease), and malocclusion scores for selected subjects. Also clinical services rendered. RESULTS: Oral health survey revealed a mean age (+/- SD) of 25.7 (+/- 9.5) years. Only thirty nine (19.9%) of the subjects were caries-free, and total DMFT was 2.5 +/- 2.2. Based on the CPITN, 107 (54.6%) required oral hygiene instructions (OHI), and 41 (20.9%) required prophylactic scaling with OHI. Forty four (22.5%) of the subjects had normal occlusion and 152 (77.5%) mild to severe malocclusion. Periodontal (75.5%), prosthetic (52.5%) interventions and extractions (34.2%) constituted the bulk of the treatment needs required. Clinical treatment was rendered by the trained refugees to 846 patients over a twelve month period. CONCLUSION: Relief programmes for refugees should emphasise a primary health care approach, focusing on prevention, based on appropriate technology, and promoting involvement by the refugee community in the provision of services.

Adolescent↗