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Models for clinical assessment of oral analgesics.

Renewed interest in analgesic models has been stimulated by the development of several new nonsteroidal anti-inflammatory drugs. Many of these new analgesic agents appear to have higher peak effects and longer durations of action than acetylsalicylic acid. Sensitive models are necessary to determine the dose-effect relationships and relative analgesic efficacies of these new agents. The basic principles of clinical methods--double-blinding, identical appearance of study medications, and random allocation of treatments to subjects--must be adhered to. However, additional precautions must also be taken. The choice of pain models and further subdivision of subjects within a pain model are critical for assay sensitivity. The dental pain model has become popular because the surgical procedures can be easily categorized, and each subpopulation is relatively homogeneous. There now is a body of data that substantiates the assay sensitivity of the dental pain model, and its usefulness in predicting the general analgesic efficacy of nonsteroidal anti-inflammatory drugs. Other pain models, including general postsurgical, orthopedic postsurgical, and postpartum pain, also have demonstrated adequate assay sensitivity to determine the relative efficacy of new nonsteroidal anti-inflammatory drugs.

Administration, Oral↗

The development of a model and implementation process for clinical governance in primary dental care.

A model and an assessment tool have been developed to support clinical governance within the primary care sector. These bring together quality assurance and governance components to create a unified standard providing a single working model for service development. The model consists of 14 components that define structure, control the process and assure the outcome. Each consists of a number of indicators, which are scored in turn. The results are then weighted to emphasise those that are more critical. The model has been tested and found to be helpful in identifying weak areas to support action planning. Re-scoring will help to demonstrate that improvements have taken place. Other services and practices can now carry out baseline assessments, and demonstrate and measure improvements. General dental practitioners are provided with a scoring system, which identifies clinical governance areas in their practices that require attention and which facilitates prioritisation.

General Practice, Dental↗

A method for the measurement of the gingival sulcus of sheep.

A method for measuring and comparing the depths of the gingival sulcus of sheep in the incisor region at necropsy is described. The method was devised to assess and compare dental health in groups of sheep with and without premature loss of incisor teeth (broken mouth). The technique involves the use of paper spills in combination with dental plaster models.

Animals↗

The effectiveness of school dental screening: dental attendance and treatment of those screened positive.

OBJECTIVE: To determine dental attendance and treatment outcomes following two models of dental screening. DESIGN: An observational prospective cohort study. SETTING: Infant, primary and junior schools in the North West of England. SUBJECTS: Children aged six to nine years at the start of the study. INTERVENTIONS: Subjects received a screening examination according to either a 'Traditional model' or 'New model' of school dental screening. MAIN OUTCOME MEASURES: Attendance at a dentist within four months of the intervention and treatment received by children referred via the 'New model' with caries in their permanent teeth. RESULTS: In the 'New model' of school dental screening 46% of screened positive and 41% of screened negative children attended a dentist during the study period. Some 44% of children referred with caries in permanent teeth attended a dentist and 53% of those attending received treatment for the referred condition. Larger proportions of children from disadvantaged backgrounds were screened positive but higher proportions of children from more affluent backgrounds attended the dentist and subsequently received treatment. CONCLUSION: School dental screening has a minimal impact on dental attendance and only a small proportion of screened positive children receive appropriate treatment. The programme fails to reduce inequalities in utilisation of dental services.

Child↗

[The use of mathematical modelling in improving the orthodontic treatment of end defects of the dental arches].

Mathematical modelling allowed to use specially designed software package for calculation of the necessary number of variants of dimensions of denture carcass while planning the orthodontic treatment. This could be done for each patient individually, thus ensuring the correct choice of orthodontic technique to replace the end defects of the dentition.

Computer Simulation↗

Videotape modeling of the child dental patient.

One week before their first dental visit, 36- to 60-month-old children were shown a videotape to model their behavior in the dental situation. The behavior was then rated for three visits. The children who had been modeled did not behave significantly better than either children who had no previous contact with the dental setting or children who had visited the reception room one week before their first dental visit.

Anxiety↗

[An experimental study on human bitemarks digital analysis and its accuracy].

This experiment was designed to study the method of human bitemarks digital analysis and its accuracy. The human bitemarks were made on the dog skin by human dentition. The related parameters of human bitemarks and suspects criminal dentitions were digitally recorded and managed. The digital picture of human bitemark was obtained, and the dental study model, bite in wax and bitemark on pig skin of suspected criminal were scanned. The overlay was prepared with Adobe Photoshop 5. 5 and the parameters were measured with AutoCAD R14, then their matches were compared. The result shows that the human bitemarks digital analysis is a more accurate approach to human bitemarks identification. Three methods for collecting evidence dental study model, bite in wax and bitemark on pig skin all can be used as aids in forensic sciences. Dental study model is the most accurate one of all the three methods mentioned above.

Animals↗

Nutrition and health in childhood: causal and quantitative interpretations of dental caries.

The aim of the present study was to suggest a causal model of dental caries and to discuss some quantitative interpretations of this model. Three age groups of children (4, 8 and 13 yr) from three different areas in Sweden were included. The caries status of the children was examined. A 7-day record (4-and 8-yr-olds) and a dietary history (13-yr-olds) were used to estimate food intake. Sociodemographic data and data of caries preventive measures were obtained from parents/children. A causal model of dental caries is suggested and some quantitative interpretations are made by means of path analyses. Hypothetical examples of results of changes in caries determinants are given.

Adolescent↗

Class II treatment success rate in 2- and 4-premolar extraction protocols.

This study compared the occlusal success rate of Class II orthodontic treatment results with either 2- or 4-premolar extraction protocols. Group 1 comprised dental study models of 81 patients treated with 2 premolar extractions, and group 2 comprised dental study models of 50 patients treated with 4 premolar extractions. The initial mean ages of the groups were 13.9 and 12.9 years, respectively. Grainger's treatment priority index (TPI) was used to assess the initial and final occlusal status of each patient. Individual variables, such as maxillary canine anteroposterior positioning, overjet, and overbite improvements were also evaluated. Independent t tests were used to compare the variables at the pretreatment and posttreatment stages and their improvement between the groups. The results showed a statistically significant difference in most of the variables and in their improvement at the end of treatment between the groups. The variables showed a better dental relationship in group 1, and the improvements in group 1 were larger than in group 2. Treatment of Class II malocclusion with 2 premolar extractions gives a better occlusal success rate than treatment with 4 premolar extractions.

Adolescent↗

An overhead projection aid for teaching the principle of occlusion.

A technique has been presented whereby models which can be animated are used to form a projected image on a screen and thereby demonstrate the principles of occlusion together with principles of articulators. The system can be used alone or in conjunction with clinical slides interjected at relevant places in the discussion. This technique has been found to be a very useful aid in the teaching of occlusion to both graduate and undergraduate students.

Audiovisual Aids↗

Operational performance of the Reflex Metrograph and its applicability to the three-dimensional analysis of dental casts.

The purpose of the present study was to investigate the applicability of a new instrument (the Reflex Metrograph) to the three-dimensional analysis of dental casts. In this system, a dental cast, placed in front of a semireflecting mirror, creates an identical image behind the mirror. The measurement of a point is made by aligning a light source behind the mirror in coincidence with the image of a specific point on the object. The light source is carried on a three-dimensional slide system, and coordinates are digitized for sampling by the computer. Measurement accuracy of the instrument was evaluated for three measuring points determined on a maxillary dental cast placed in six different locations. In addition, differences in the performance skills of ten operators were evaluated. The results indicate that digitization of a point in three planes of space can be undertaken without direct contact of the object and that a consistent measurement accuracy can be obtained, regardless of differences in the location of the cast relative to the mirror or in the anatomic shape of the measured areas. In addition, operators with no previous experience can determine specific points to an accuracy of +/- 0.1 mm, with a minimal amount of training. Finally, measurement by the same operator for a pooled sample is recommended in order to avoid interoperator measurement error when determining linear distances.

Computers↗

A simplified acrylic resin cast technique.

A simple technique for construction of acrylic resin casts has been described. This procedure utilizes inexpensive and standard supplies found in a dental office.

Acrylic Resins↗

Time-dependent accuracy of elastomer impression materials. Part I: Condensation silicones.

1. Although condensation silicone elastomers can be used to produce multiple dies from a single impression, one can expect changes in dimensions of dies produced from successive pours. 2. Putty/wash systems exhibit variable behavior among different brands. Some products produce a series of dies of increasing diameter over a 4-day period, while other brands may produce a series of dies whose diameters decrease as they are successively poured. 3. Light-body wash silicone impressions made in adhesive-lined custom acrylic resin trays produce dies which increase in diameter with time. 4. Putty/wash system, in general, show a greater eccentricity of dies than is seen with custom-tray/adhesive/wash systems, but there were some significant exceptions among the brands tested. 5. There does not appear to be any difference in behavior between single-wash and double-mix techniques in the condensation-silicone systems. 6. For maximum accuracy, the condensation-silicone systems should be poured as soon as possible after making the impression.

Adhesives↗