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A cost-effective simulation curriculum for preclinical endodontics.

A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

Clinical Competence↗

Quality of materials supplied to dental laboratories for the fabrication of cobalt chromium removable partial dentures in Ireland.

The adequacy of prescription for fabrication of cobalt chromium removable partial dentures is often regarded as being less than ideal. This study examines the nature and quality of written instructions and master impression sent to dental laboratories in Ireland for fabrication of cobalt chromium removable partial denture frameworks. Questionnaires were issued to dental laboratories seeking specific information relating to the materials (impression materials and trays) and written instructions supplied, as well as the technicians' opinion regarding the suitability of these materials. One hundred completed questionnaires were returned. One-third of master impressions were made using a plastic stock tray and alginate; technicians felt that one-fifth of master impressions were unsuitable; almost three-fifths of written instructions were inadequate. The quality of clinical information examined was found to be less than adequate.

Alginates↗

Effective laboratory communication...it's a two-way street.

Working as part of your team, your dental laboratory can increase your predictable success and decrease the stress of daily practice. This partnership should begin during the treatment planning phase and continue through to the insertion appointment. Many dentists are beginning to view their laboratory technician as a bonafide member of their patient care team. Thorough communication on both sides is crucial to reaching this predictable success. A trusting relationship will enable the dentist and the laboratory technician to communicate effectively. The laboratory must take the responsibility to communicate its concerns to the dentist, just as the dentist must take the responsibility to communicate effectively with the laboratory his or her needs and desires for each case. When effective communication techniques are followed, everyone is a winner. The dentist is more productive per hour and has reduced stress. The dental laboratory does not have to bear the burden of remakes, and spends less time on the phone or sending e-mail for routine cases. And most importantly, the patient receives an exceptional restoration that meets his or her expectations. In the end, the true measure of a great relationship between the dentist and the laboratory is happy patients who refer friends and family to your practice for years to come.

Communication↗

Antimicrobial effects from incorporation of disinfectants into gypsum casts.

Five microorganisms--Escherichia coli, Streptococcus mutans, Staphylococcus aureus, Serratia marcescens, and Bacillus subtilis--were placed into the canine, first premolar, first molar, and second molar of sterilized quadrant addition-reaction silicone impressions. Four disinfectant solutions--iodophor, neutral glutaraldehyde, phenol, and sodium hypochlorite--were spatulated with sterilized Type IV stone and vibrated into the intentionally contaminated impressions. The casts were removed at 1 and 24 hours, and the surfaces were swabbed, plated on BHI agar, and incubated at 37 degrees C for 3 days. Colony forming units were counted. At 1 hour, only sodium hypochlorite and glutaraldehyde effectively reduced the number of bacteria to the negative control. Incorporation of sodium hypochlorite, glutaraldehyde, and iodophor into gypsum casts reduced viable bacteria to a level equal to the negative controls at 24 hours.

Bacteria, Aerobic↗

Variability of palatal dimensions in South Australian twins.

Estimates of genetic contributions to variability in three palatal dimensions were obtained from a sample of 70 pairs of South Australian twins aged between 11 and 26 years. Palatal width and length were measured directly from dental models, while palatal height was assessed indirectly from moiré contourographs. For each of the three palatal variables there was evidence of significant genetic variance, with heritability estimates for palatal width and height generally exceeding those for palatal length. Furthermore, palatal height measurements displayed greatest relative variability and strongest correlation between monozygous twins (r = 0.95), suggesting that this dimension could be useful as an additional comparative feature in forensic odontological investigations.

Adolescent↗

[Lingual orthodontics: a system for positioning the appliances in the laboratory].

The author presents the advantages and the drawbacks of two systems of lingual brackets positioning which allows to obtain a very good finish of the treatments. The Class System is a protocol made from a Set-Up but which does not allow the bonding of the teeth with unfilled resins. The other system uses the T.A.R.G. with the Thicknesses Measure Appliance and the Ideal Drawing of Lingual Arch program; it allows to program the torque, the angulations, the heights and the thicknesses (from the bottom of the throat to the vestibular side) of each tooth.

Computer Systems↗

[Eruption of lateral segments of permanent dentition--differences between right and left sides].

The following results were obtained from a study on differences in eruption of the lateral segments of permanent dentition; that is, 3 (canine), 4 (first premolar), and 5 (second premolar). This study has been conducted for 9 years and 6 months on the same individuals (30 males and 29 females, aged between 6 years and 15 years and 6 months). Every 3 months, oral examinations using dental models of the upper and lower jaws were performed. In studying eruption order, teeth in the lateral segment were treated as a group. Replacement period started with the initial eruption of any of the teeth listed above and ended with the eruption of the last tooth in the group. comparisons were made between right and left lateral segments. Results 1. In the upper jaw of males, eruption orders 4----3----5, 4.3----5, and 4----3.5 were dominant in 76.90% of the right sides and 77.78% of the left sides. Corresponding percentages for females were 56.00% for the right and 57.90% for the left side. The difference between right and left sides was 0.8% in male subjects and 1.69% in female subjects. Dominant types of eruption order in the lower jaw were 3----4----5, 3.4----5, and 3----4.5. In males, these types occurred in 77.77% of right sides and 82.29% of left sides. Corresponding percentages for females were 96.00% for the right and 99.99% for the left side. The difference between right and left sides was 11.52% in male subjects and 3.99% in female subjects. 2. Initiation of replacement period varies according to eruption-order type.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Model test on the change of position of the mandibular condyle after sagittal splitting of the mandible].

On two acrylic copies of a cranium with mandibular prognathy, the mandible was moved back by sagittal cut of the ascending ramus. It is shown that with both methods of immobilization, circumferential and screw-osteosynthesis, the segments cause a change in the position of the condyles. There are no clear advantages or disadvantages of either method. Observed cases of circumferential wiring showed practically no arthrotic symptoms after 2-10 years, which indicated that the t.m. joint has a large degree of adaptability. However, such a statement can be made definitely only after an observation time of 20-30 years.

Humans↗

Dentist and laboratory: a "love-hate" relationship.

The author's intent has been to promote a close working relationship between the dentist and the technician. Certainly, McCracken was doing that when he said that he hoped they could "work together in proper sequence to develop restorations that are biologically and mechanically sound and to produce removable partial dentures that reflect continuous progress in prosthetic dentistry". That's the secret. The dentist and the technician should work together and in proper sequence. Too often dental education and the dental profession have seemed to espouse the idea that the technician must function as an automaton in the fabrication of removable partial dentures. The practitioner of general dentistry can certainly ask for ideas and suggestions from the technician and still control the ultimate outcome. The dentist can share thoughts with the technician to ameliorate the "love-hate" relationship and still be responsible for the removable partial denture treatment.

Communication↗