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Results for “DENTAL MODELS”

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PubMed2002

The use of magnification in a preventive approach to caries detection.

OBJECTIVE: The aim of this study was to demonstrate the effect of low-powered magnification on the accuracy of caries detection and to compare it to the accuracy of unaided vision. METHOD AND MATERIALS: Five dental models were prepared with extracted, unrestored, human permanent premolars, molars, and canines. Dental examinations were undertaken in simulated clinical conditions by seven dentists using both unaided and magnified vision. A true diagnosis was obtained by histologic sectioning, thereby allowing diagnostic accuracy to be calculated. RESULTS: The sensitivity of diagnosis, representing the percentage of diseased sites found correctly, was significantly greater when magnification was used. There was no statistically significant difference in the specificities, or percentages of correctly identified healthy sites, between magnification and unaided vision. CONCLUSION: Magnification, although not perfect, improved significantly on the accuracy of diagnosis and can therefore be recommended for caries detection.

Bicuspid↗
PubMed1997

Manual and computer-aided space analysis: a comparative study.

Recently, computers have been used to measure key landmarks from photocopies of upper and lower study models to increase simplicity, accuracy, and informatics. This is a comparative study to evaluate the accuracy and reliability of computer-aided space analysis. Data were collected from a series of randomly selected study models. All subjects had Angle Class I molar relationships with minor malocclusions such as crowding, rotations, or diastemas. Two investigators independently measured teeth on models with a Vernier gauge that had sharpened caliper tips. Intraexaminer and interexaminer reliability was determined at 0.2 mm. All teeth, to and including the first molars, were measured. Two photocopies of each set of models were made on a photostat machine (Xerox, Japan) and were coded. A template with a ruler was used, to allow the investigator to compensate for any reduction or enlargement error during the photocopying process. The mesiodistal sizes were measured with a digitizer, and results were processed by using a dedicated computer program. Evaluations were done in a double-blind manner. The nonparametric Wilcoxon signed rank test for paired observations to compare median differences between measurements was used. Intraexaminer digitized measurements were almost identical and differed (p < 0.0001) for only one measurement. However, interexaminer manual and digitized measurements differed significantly (p < 0.001) for 20 of the 24 teeth. Nineteen of these digitized tooth measurements were smaller. The mean arch length measurements differed by 4.7 mm (p < 0.0001) in the maxilla and by 3.1 mm (p < 0.0001) in the mandible. The difference between the manual and digitized analyses may be due to the photocopying process. The inability to accurately measure a three-dimensional study cast that has been duplicated in two dimensions, convex structure of teeth, curve of Spee, tooth inclination, and tooth position may play a role. The computer-aided measuring system is reliable, but accurate mesiodistal measurements cannot be made from photocopies of dental models. Manual measurements that use a calibrated gauge produce the most accurate, reliable, and reproducible results.

Calibration↗
PubMed2005

Models for financing dental services. A review.

The aim of this review article is to give a brief description of the most important models for financing dental services, and then to describe the effects that the different models can have on patients' and dentists' behaviour. The advantages and disadvantages of the different models will be discussed. The first section focuses on the relationship between insured people and insurance providers. The justifications for a private insurance scheme and a public insurance scheme for dental treatment are discussed. A purely private insurance market for dental services will fail. This is because the benefits of a private dental insurance scheme are few in relation to the costs of having insurance, and because of the problem of adverse selection. There are also problems with public insurance schemes, for example, high transaction costs for collection of taxes and problems with cost containment as a result of moral hazard. The second section focuses on the relationship between the dentist and the patient, more specifically on how different remuneration schemes influence dentists' behaviour. The advantages and disadvantages of three types of remuneration scheme are discussed: fixed salary, per capita remuneration and pure fee-for-item remuneration. One important conclusion is that per capita payments secure effectiveness, while fee-for-item payments secure quality. With per capita payments there is a potential for patient-selection and undertreatment, while cost containment is a problem with fee-for-item payments. In order to counteract the adverse side-effects of each financing system, focus should be placed on the individual dentist in relation to ethics, norms and quality control.

Cost Control↗
PubMed2005

Understanding dental students' knowledge and perceptions of older people: toward a new model of geriatric dental education.

Increasing numbers of older people and the decreasing rates of edentulism highlight the importance of dental education that focuses on oral health and aging. This evaluation study assessed dental students' knowledge and beliefs about older people as well as their awareness of the biopsychosocial concerns that are potential barriers to oral health care. Dental students' (N=202) knowledge and perceptions of older people were evaluated before and after the first year of a new educational program. Students completed the Palmore Facts on Aging Quiz II (FAQ II) and answered questions about health problems and social concerns that may influence patient care. The intervention was twofold: 1) the CARES (Counseling, Advocacy, Referral, Education, and Service) Program, a clinical collaboration between the schools of Dental Medicine and Social Work, was initiated; and 2) all students were exposed to geriatric educational interventions. FAQ II scores did not significantly change, but dental students' awareness of mental health, independence, and social concerns increased between Times 1 and 2. The results of the study suggest that positive interactions with older adults by health care providers may depend more on positive perceptions toward older people than increased knowledge about aging. Future research will focus on positive experiences with older adults and attitudes of dental students toward the elderly.

Adult↗
PubMed2003

Effect of Veau-Wardill-Kilner type of cleft palate repair on long-term midfacial growth.

There is a common concern that the Veau-Wardill-Kilner type of cleft palate repair causes extensive denudation of the palate, resulting in inhibition of maxillary growth. The evidence for this belief is equivocal in the literature. The authors present some long-term results of this technique from a pure sample of nonsyndromic complete unilateral cleft lip and palate patients operated on by a single intermediate-volume cleft surgeon over a period of 25 years. Twenty-five patients, all born between 1977 and 1989, met the above inclusion criteria. Their age at the time of collection of study models and cephalograms was 9 to 17 years (average, 12 years). Midfacial growth was studied using 12-year dental models and lateral cephalograms taken before definitive orthodontic treatment. These were evaluated using the GOSLON Yardstick and digital cephalometric analysis. The final GOSLON results show that 72 percent of the patients had a good or satisfactory outcome, with a GOSLON score of 1, 2, or 3, and only 28 percent ended with a poor score of 4 or 5. The poor sensitivity of cephalometrics in discerning statistically significant differences was highlighted by the huge overlaps observed in the 95 percent confidence interval graph of mean sella-nasion-subspinale angle (S-N-A) values when comparing the results of the Eurocleft centers with those of the authors' center. The results suggest that satisfactory long-term midfacial growth can be obtained with Veau-Wardill-Kilner cleft palate repair.

Adolescent↗
PubMed1992

The clinical nurse specialist in the school setting: case management of migrant children with dental disease.

Dental disease is a major health problem for all school-age children in the nation; for migrant children the problem is most severe. This paper presents strategies for the clinical nurse specialist (CNS) in the school setting in case management of migrant children with dental disease. The barriers migrant families face in obtaining health care are addressed. Leininger's transcultural care theory serves as a conceptual framework. Examples of how the CNS functions in the roles of clinician, educator, consultant, and researcher are given. The federally funded Migrant Education Program is described, along with a model dental program developed by a CNS. Suggestions for documenting the effectiveness of the CNS's role in cost containment and in influencing positive outcome measures of school-age children are presented.

California↗
PubMed1994

Perceived need for dental care in dentate older adults.

Previous studies have observed a substantial difference between need for dental care as determined by professional dental examiners (determined by disease presence) and that reported by potential dental patients (which may or may not be based on perceived disease presence). In this study of community-dwelling dentate older adults a substantial difference was also observed. To explore the role that factors other than disease presence may have in determining perceived current need for dental care, subjects were queried about their current oral signs, oral symptoms, psychosocial impacts from oral disease, and other factors hypothesised as affecting current need for dental care. When reporting perceived current need, subjects apparently were not responding to overall assessments of their dental health or periodontal health; rather, they were responding to specific oral signs and symptoms, and their effects. In a multivariate model, dental pain was most strongly associated with perceived need, followed by the psychosocial effects of oral diseases, reported presence of cavities, and reported presence of loose teeth. However, substantial percentages of persons reported oral signs, symptoms, and effects that would be judged professionally as sufficient for reporting a current need for dental treatment, yet did not report a need. With oral signs and symptoms accounted for, persons with less discretionary income and those who were less satisfied with their last dental visit were actually more likely to perceive a current need for dental care.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1998

Dento-maxillofacial sequelae in a child treated for a rhabdomyosarcoma in the head and neck. A case report.

This case report describes severe dento-maxillofacial defects after chemoradiation therapy in a child aged 9 years 6 months with a parameningeal rhabdomyosarcoma. A clinical and radiologic (apical dental radiographs, orthopantograph, lateral skull roentgenogram) dental follow-up over 4 years showed such dental abnormalities as root blunting, mild to severe root shortening, premature closure of the root apices, and severe radiation caries. Craniofacial morphology evaluated by cephalometric analysis and dental models showed deficiency with mandibular and maxillary hypoplasia.

Child↗
PubMed1982

Some variables of the craniofacial complex in a Venezuelan population of Negroid ancestry.

A total of 226 individuals (101 males and 125 females), from La Sabana, a Venezuelan Negroid isolate, with ages between 8 and 60 years, were studied in order to characterize the population for its craniofacial variables and to study the behavior of these variables in relation to age and sex. The variables studied were grouped in three categories: direct cephalometric variables, which included 6 measurements taken directly on the individuals; indirect cephalometric variables, which included 18 measurements (9 angular and 9 linear), taken on lateral head films; and dental variables, which included 9 measurements taken from dental models. In general the direct variables showed the lowest coefficients of variation (CV), suggesting homogeneity within this sample. They were followed by the dental and the indirect variables, which had the highest CV values. In order to detect age and sex effects on the variables, sex and age group comparisons were performed with Student t tests. A greater proportion of significant differences were found among the direct variables, indicating that age and sex have more influence on this group of variables than upon the other two. Comparisons of our sample from La Sabana, with samples from African Negroid, Caucasoid, and Amerindian population show that La Sabana individuals have a craniofacial pattern basically Negroid, as we expected, although some contribution from Caucasoides and especially Amerindians is also suggested in our data.

Adolescent↗
PubMed2006

Tobacco cessation interventions in dental networks: a practice-based evaluation of the impact of education on provider knowledge, referrals, and pharmacotherapy use.

Tobacco is a significant risk factor for oral diseases. Dental care providers have the opportunity to inform patients about the risks associated with tobacco use and refer them to tobacco cessation resources. Although dental teams usually ask their patients about their tobacco use, most do not provide tobacco cessation counseling. This project involved four staff-model dental clinics and four contracted network dental clinics. Project goals were to 1) describe current practice patterns of tobacco cessation intervention, 2) increase the use of steps for treatment, known as the 5 As, recommended by the U.S. Public Health Service, 3) increase referrals to a tobacco helpline, and 4) increase use of pharmacotherapy for tobacco dependence treatment. The project included training and program support (e.g., sharing of project data, weekly newsletters, discussion at clinic meetings). Results indicate that this approach to addressing tobacco dependence in a dental clinic setting can effectively change dental provider knowledge and action.

Bupropion↗