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PubMed1983

Effect of mandibular molar anatomy on the buccal Class I cavity preparation.

In mandibular molars, enamel dramatically increases in thickness at the buccal pit area and progresses occlusally due to an extensive concavity in the buccal dentinal core. In order to comply with the principles of operative dentistry, this anatomic variance dictates that, if the ultimate restoration is to be placed in dentin, the axial wall of a Class I buccal pit preparation should incline medially rather than follow the external contour of the tooth. The occlusal cavosurface angle of the preparation should be obtuse to coincide with enamel rod direction. Retention, when needed, should be placed at the mesio-axial and disto-axial line angles to avoid undermining occlusal intercuspal enamel, especially as the preparation approaches 2 mm occlusal to the buccal pit.

Dental Bonding↗
PubMed1976

The use of epsilon-aminocaproic acid for the management of hemophilia in dental and oral surgery patients.

The use of epsilon-aminocaproic acid has proved to be an efficient and practical method for treating hemophiliacs who require dental work. In the past, patients requiring extractions were admitted to a hospital for approximately ten days and received replacement infusions every 12 hours during their stay. This resulted in a large expense because of the cost of the material and the hospitalization itself, not to mention the trauma sustained by the patient both physically and psychologically. Also, by decreasing the number of factor infusions, the risk of complications such as the transmission of hepatitis, allergic reaction, or inhibitor formation decreased. The same protocol using a single infusion of the appropriate factor replacement with supplementary epsilon-aminocaproic acid can be used for the management of patients with other coagulation disorders such as factor IX deficiency (Christman disease), factor XI deficiency, and von Willebrand's disease. Since this paper was submitted, seven more patients have been treated using this protocol. An additional seven odontectomies, 33 extractions, operative dentistry in 18 quadrants, and alveoloplasties in two full arches have been performed. This brings the total to 23 treatment sesions with 18 patients undergoing 124 procedures. One additional minor bleeding episode occurred, resulting in a total rate of four bleeding episodes in 23 treatment sessions and 124 procedures. Our incidence of complications secondary to epsilon-aminocaproic acid specifically remains zero.

Adolescent↗
PubMed1989

Radiolucent halos associated with radiopaque composite resin restorations.

Since the introduction of radiopaque composite resins, clinicians and researchers have occasionally noticed radiolucent halos adjacent to composite restorations. Such halos have frequently been thought to be recurrent caries or voids in the material. Fifteen of 45 radiopaque composite resin restorations placed by students enrolled in a first-year preclinical operative dentistry course exhibited such halos. Micrographs showed that a thick layer of unfilled resin bonding agent was present. These halos were reproduced in other teeth when excess bonding was not blown off. The results indicate the importance of meticulous technique.

Adhesives↗
PubMed2000

A laser-powered hydrokinetic system for caries removal and cavity preparation.

BACKGROUND: Laser systems have been developed for the cutting of dental hard tissues. The erbium, chromium:yttrium-scandium-gallium-garnet, or Er,Cr:YSGG, laser system used in conjunction with an air-water spray has been shown to be efficacious in vitro for cavity preparation. METHODS: The authors randomly selected subjects for cavity preparation with conventional air turbine/bur dental surgery or an Er,Cr:YSGG laser-powered system using a split-mouth design. They prepared Class I, III and V cavities, placed resin restorations and evaluated subjects on the day of the procedure and 30 days and six months postoperatively for pulp vitality, recurrent caries, pain and discomfort, and restoration retention. Sixty-seven subjects completed the study. RESULTS: There were no statistical differences between the two treatment groups for the parameters measured with one exception; there was a statistically significant decrease in discomfort levels for the laser system at the time of cavity preparation for subjects who declined to receive local anesthetic. CONCLUSIONS: The Er,Cr:YSGG laser system is effective for preparation of Class I, III and V cavities and resin restorations are retained by lased tooth surfaces. CLINICAL IMPLICATIONS: Hard-tissue cutting lasers are being introduced for use in operative dentistry. In this study, an Er,Cr:YSGG laser has been shown to be effective for cavity preparation and restoration replacement.

Adult↗
PubMed2004

Efficacy of camphorated paramonochlorophenol to a mixture of honey and mustard oil as a root canal medicament.

OBJECTIVE: To compare the efficacy of camphorated paramonochlorophenol to a mixture of honey and mustard oil as a root canal medicament. DESIGN: An in vitro comparative study. PLACE AND DURATION OF STUDY: This study was carried out in collaboration with microbiology department of Armed Forces Institute of Pathology, Rawalpindi and was conducted from Aug-2001 to Nov-2001. MATERIALS AND METHODS: A sample of 90 infected root canal contents of decayed teeth was collected from Operative Dentistry Department of Armed Forces Institute of Dentistry, Rawalpindi. Each sample was inoculated aerobically as well as an-aerobically. Organisms were identified and isolates were preserved and refrigerated for experiments. Medicaments were procured and prepared in comparable dilutions. Minimum inhibitory concentration of both medicaments was compared by susceptibility testing against already preserved isolates. RESULTS: The tested mixture (honey and mustard oil equal v/v ) demonstrated antibacterial activity against all isolates at concentration of 12.5%(mean of effective conc.17.11%) while that of camphorated paramonochlorophenol was comparably at higher concentration 3.1%(mean of effective conc. 3.35%). However the mixture revealed better results than that of individual agents, which was 12.5% to 25% respectively. CONCLUSION: Mixture (honey and mustard oil) was effective, viable alternate endodontic medicament.

Anti-Infective Agents, Local↗
PubMed1978

An international look at school-based children's dental services.

School-based dental clinics, when well-managed, can bring good quality care to children where they normally congregate, thus avoiding many of the problems found where children must be taken to private offices out of school hours. Both capital and running expenses for primary care can be substantially reduced. Utilization figures for school-based dental services now reach 98 per cent of eligible children in New Zealand, where dental nurses do simple operative dentistry including cavity preparation and fillings. Australia, where a modified New Zealand plan has been expanding for about 12 years, is moving rapidly to attain similar utilization. In Sweden, 95 per cent of the school-age population is reported to receive school-managed dental service through a government program. In the United States, however, it is commonly reported that less than one-half the school-age population receives good periodic dental care.

Adolescent↗
PubMed1992

Clinical evaluation of preventive and class-I composite resin restorations.

This study was initiated in 1986 in response to increased interest in restorative procedures favoring preservation of tooth substance and in the search for alternatives to dental amalgams. Eighty-seven preventive resin restorations in permanent molars and 35 occlusal composite resin restorations in primary molars (limited size) and 13 in premolars were followed up for 2 years. They were placed by a large number of operators, mainly dental students under supervision, and rated by five calibrated instructors in accordance with an internationally accepted system for the evaluation of the clinical performance of dental materials. One composite resin (Occlusin) was used. A survival model was used to calculate the cumulative theoretical number of successful treatments of children who had dropped out. For none of the 6 clinical variables was the success rate lower than 91%, and only 3 of 26 failures were of a nature requiring remake or correction. The failures occurred, with a few exceptions, during the 1st year of observation. The two types of restoration have thus proved to be efficient treatments fulfilling all reasonable requirements in modern operative dentistry.

Adolescent↗
PubMed1999

Caries management.

This article has attempted to gather up the evidence presented in the rest of this issue to give dentists a practical overview of the management of the carious process. The major points are that a caries risk assessment is not only logical, it is achievable; management of caries is by preventive treatment, but operative dentistry has a role to play; in the final analysis, it is the patient who manages caries.

Dental Caries↗
PubMed1976

Pins and posts--why, when and how.

Pins and posts retain restorations and protect remaining tooth structure; they are indispensable to conservative operative dentistry. Effective utilization of these pin-post systems requires application of proper biomechanical principles for each clinical situation. No one design will suffice in every case. A parallel, serrated, cemented device in a precise matched channel is the ideal combination of characteristics. When tooth morphology or heavy function require increased retention, it may be achieved by increasing pin-post length, diameter, and number or by utilizing the resilience of dentin. However, the dentist must be aware that the price for more retention is the increasing risk of damaged tooth structure. Optimal long range results will be obtained by utilizing pins and posts in conjunction with veneer types of restorations. When used in this manner, they will save many teeth each year and simultaneously reduce the rate of failures.

Dental Pins↗
PubMed1976

A taxonomy for behavioral objectives in a dental school.

This paper describes a taxonomy proposed for use by dental school faculties as an aid in specifying their course objectives in behavioral terms. This taxonomy, developed and tried at the Harvard School of Dental Medicine, is simpler than taxonomies previously proposed because it reduces the number of categories. In addition, the categories themselves are designed to communicate to and be interpreted by dental educators. The six categories are (1) knowledge of facts, concepts, and principles; (2) comprehension; (3) perceptual ability; (4) diagnosis and treatment planning skills; (5) motor skills; and (6) interactive skills. Each category is briefly defined and illustrated with two samples from operative dentistry.

Behavior↗
PubMedDate not supplied

Searching for consensus.

Although caution is expressed by some in relying solely on caries detector dye for diagnosis until more research is done, many aspects of microdentistry are bringing exciting potential to operative dentistry. Perhaps pediatric dentists will find microdentistry the most promising because of its application for long-lasting sealants and less traumatic restorations. To dentistry's benefit, fewer injections and less frequent drilling are predicted to create a whole new generation of nonphobic adults.

Air Abrasion, Dental↗
PubMed2000

Longevity of oroincisal ceramic veneers on canines--a retrospective study.

PURPOSE: The longevity of oroincisal veneers on canines of IPS-Empress ceramic for the restoration of lost canine guidance was determined in a retrospective study. MATERIALS AND METHODS: Since 1992, all ceramic restorations made in the Department of Operative Dentistry have been entered in a data base. In that time period, 17 patients with 36 oroincisal veneers on canines to restore lost canine guidance have been documented. The survival rate of the restorations was calculated with the Kaplan-Meier method. RESULTS: The mean follow-up period was 6.74 years. The 6.5-year survival rate was 76%. The 6.5-year survival rate of canine oroincisal ceramic veneers in the maxilla was 74%, and in the mandible 78%. The difference in the survival rate of maxillary and mandibular restorations was not statistically significant. In the follow-up period, 8 of the 36 IPS-Empress canine veneers failed. Reasons for failure were ceramic fracture, fracture of the adhesive bond, and loss of function. CONCLUSION: In view of the longevity, the excellent properties of the IPS-Empress ceramic material, i.e., minimum abrasion of the opposing teeth, and good esthetics, we consider the restoration of lost canine guidance using this technique a viable alternative to the classical precious-metal pinledge or composite buildup.

Adult↗
PubMed1999

Dentin bonding--questions for the new millennium.

PURPOSE: The objective of this review article is to summarize the most recent concepts in dentin bonding and, simultaneously, challenge some convictions that have not been backed up by sound, convincing research. After the introduction of the enamel acid-etch technique by Dr. Buonocore in 1955, the increasing demand for restorative and non-restorative esthetic treatments, as well as the refinement in the utilization of fluoride-containing products, have totally transformed the practice of operative dentistry. While bonding to enamel is a reliable technique, bonding to dentin represents a greater challenge: dentin is an intrinsically wet organic tissue penetrated by a tubular labyrinth containing the odontoblastic process, which communicates with the pulp. The manufacturers of new adhesive systems recommend the application of their adhesive materials on moist dentin. The main reason is that the spatial alteration that occurs upon drying demineralized dentin may prevent the monomers from penetrating the labyrinth of nano-channels formed by dissolution of hydroxyapatite crystals between collagen fibrils. Several of the current concepts in dentin bonding have been built from the observation of clinical studies, which measure retention rates, and from laboratory bond strength studies, which measure the force needed to debond a composite post from a flat dentin area. Although their utility is doubtful as far as clinical performance is concerned, bond strength studies are still necessary in order to compare similar parameters among materials. However, both clinical and laboratory studies lack information on the dynamic behavior of the substrate in a vital environment. For example, the changes induced by adhesive systems in the resin-infiltrated demineralized dentin have not been fully characterized. Also, the role of collagenous and non-collagenous proteins in dentin bonding has been generally overlooked.

Acid Etching, Dental↗
PubMed2001

The use of air abrasion and glass ionomer cements in microdentistry.

Microdentistry principles are based on the early control of and intervention in the effects of the caries process. Once a decision to treat a lesion has been made, a further understanding of the biomechanical functioning of the tooth in relation to anatomical structures is required. Preservation of these structures requires the development of skills to allow the preparation of minimally invasive cavity designs. This may involve learning to use magnification, air abrasion, caries detection dye, or a diagnostic laser. Autocure glass ionomer cements complement minimally invasive cavity designs. The preservation of healthy tooth structure using noninvasive treatment techniques or minimally invasive cavity designs is now one of the primary goals of modern operative dentistry.

Air Abrasion, Dental↗
PubMedDate not supplied

[Louis Maurice Champagne and the "Ecole dentaire française"].

The Royal Edict of Louis XIV had created a new category of practitioners, "The Teeth Experts", and at the dawn of the second half of the 19th century, France had no dental school nor specific legislation. The situation worsened when many American dentists settled in France. Thus the creating of the "Ecole dentaire de Paris" in 1880 constituted a significant event which was followed by the opening of the "Ecole Dentaire de France" in 1884 and of the "Ecole Dentaire Française" in 1896. Louis Maurice Champagne will be its director from 1926. At the St Ouen Jules Vallés Market, we fortuitously discovered a framed document containing three photographs of Louis Maurice Champagne's surgery located, 3 Place de la Madeleine in Paris. Thanks to his son and through various documents, we could trace the exceptional professional carrier of this practitioner who eventually bought the "Ecole Dentaire Française" from Dr Louis-Jules Rousseau. Then, we discuss the legal frame work of the 1892 law created the "Chirurgien-dentiste" diploma and we describe the scientific and practical teaching for the "Ecole dentaire française". The operating layout of the clinical rooms is presented by opposing the ergonomic aspect of the demonstration surgery of the director and the two large operative dentistry rooms used for students. We conclude by emphasizing Louis Maurice Champagne's determination to overcome adversity which was peculiar to him as a young orphan immigrant without resources. To solve the problem of the "Chirurgien Dentiste" statute considered by its promoters as a stage of transition towards fuller reforms, we present various projects like from Dr Hulin's. This practitioner presided the Dental Section of the Medical Council Order before being voted in the first President of the "Chirurgien Dentiste" National Council Order in 1945. In 1942 he was the first to advocate a legislation based on the independence of the dental profession, still in force nowadays.

Education, Dental↗