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PubMed2004

Evaluation of the diagnostic advantage of intraoral D and E film for detecting interproximal caries.

Clinicians strive to reduce the exposure of patients to X-ray radiation in an effort to decrease its harmful effects on the body. A potential strategy for achieving this goal is the use of high-speed films that require less exposure to radiation to generate a diagnostic image. There are two film types commonly used in intraoral radiography: high speed or "Ekta-speed" film (Type E) and normal speed or Ultra-speed film (Type D). Type E film requires nearly half of the exposure time that is required by Type D films to produce an acceptable diagnostic image; however, the diagnosis quality and usability of these film types are under question. The purpose of this research is to compare the diagnostic quality of Type E with Type D film when used to diagnose proximal caries. In this study 40 pairs of extracted maxillary premolar teeth were chosen and divided into four groups of 10 pairs. Cavities were made on proximal surfaces at different depths (0.5, 1, 1.5, and 2 mm) for each group. Bitewing radiographs were then taken on each pair of teeth using Type E film and then again using Type D film. Radiographs were evaluated by two oral radiologists and two operative dentistry specialists who recorded the perceived diagnostic depth of the prepared cavities. Our data showed both Type D and E films are suitable for use in diagnosing proximal caries, and despite a minor discrepancy between them no significant difference was found with regard to their value in diagnosing proximal caries.

Dental Caries↗
PubMed1992

An assessment of the application of psychomotor learning theory constructs in preclinical laboratory instruction.

The purpose of this paper is to report the results of a survey assessing the application of constructs related to the acquisition of psychomotor skills in the preclinic curriculum. Questionnaires were mailed to all departments of operative dentistry, fixed prosthodontics, removable prosthodontics, pediatric dentistry, and periodontics. Personal and institutional anonymity were maintained. Approximately 70 percent of all surveys were returned. Results suggest that there are insufficient opportunities for students to define desired outcomes and performances. Students usually are not required to generate knowledge of results or knowledge of performance, both of which appear to be closely related to the acquisition of motor skill. Finally, the conditions under which dental motor skills are acquired do not simulate those characteristic of clinical practice, and adequate simulations of actual dental conditions often are not utilized. Significant improvement in preclinical instruction can be attained through application of findings in the motor skill literature.

Clinical Competence↗
PubMed1979

A pilot study using remote broadcasting equipment to provide instruction in pedodontics.

This study investigates the value of remote broadcasting equipment in instruction in pedodontics. Twenty students, between their junior and senior years, were randomly chosen and videotaped during an operative dentistry appointment with a child. Ten students reviewed and critiqued their own tapes immediately after the clinic session. Ten students received instruction using remote broadcasting equipment in an attempt to provide cues and immediate feedback. Results indicate the usefulness of remote broadcasting equipment as a new pedagogic technique in pedodontics.

Child Behavior↗
PubMed2005

Onset and duration periods of articaine and lidocaine on maxillary infiltration.

OBJECTIVES: The aim of this study was to compare the onset and duration of pulpal anesthesia by maxillary infiltration using 2% lidocaine with 1:100,000 epinephrine, 4% articaine with 1:200,000 epinephrine, and 4% articaine with 1:100,000 epinephrine. METHOD AND MATERIALS: Twenty healthy patients randomly received 1.8 mL of one of the three local anesthetics during operative dentistry procedures of low complexity on three maxillary posterior teeth. Onset and duration were determined using an electric pulp tester. RESULTS: The mean values for pulpal onset were 2.8, 1.6, and 1.4 minutes and for pulpal duration were 39.2, 56.7, and 66.3 minutes, respectively, for 2% lidocaine with 1:100,000 epinephrine, 4% articaine with 1:200,000 epinephrine, and 4% articaine with 1:100,000 epinephrine. Statistical analysis by the Kruskal-Wallis nonparametric test showed significant differences with better results (shorter onset and longer duration periods) for both articaine solutions compared with the lidocaine solution. Although 4% articaine with 1:100,000 epinephrine clinically presented the shortest onset and the longest duration periods, there was no statistically significant difference between the articaine solutions. CONCLUSION: Both articaine solutions produced shorter onset and longer duration of pulpal anesthesia by maxillary infiltration than the lidocaine solution did. Statistical analysis did not confirm better clinical results of 4% articaine with 1:100,000 epinephrine than with 4% articaine with 1:200,000 epinephrine.

Adolescent↗
PubMed2004

Reduction of oral levels of volatile sulfur compounds (VSC) by professional toothcleaning and oral hygiene instruction in non-halitosis patients.

PURPOSE: The aim of the study was to determine the longitudinal effect of an oral hygiene program on oral levels of volatile sulfur compounds (VSC). MATERIALS AND METHODS: The study subjects were randomly selected from patients attending a student course in operative dentistry and from staff members of our dental clinic. The test group (n = 30) received an oral hygiene training including professional toothcleaning (PTC), oral hygiene instruction, and motivation. The control group (n = 10) received no particular treatment. None of the subjects suffered from bad breath nor performed regular tongue cleaning. At baseline, immediately after PTC, one week, and four weeks thereafter we measured the oral hygiene status by means of the papillary bleeding index (PBI) and the oral concentrations of VSC by using a portable sulfide monitor (Halimeter). RESULTS: Immediately after PTC, as well as one week, and four weeks after entering the program the PBI and the VSC-levels were significantly decreased as compared to the baseline values and the control group. VSCs were decreased by 34.9% (+/- 6.3) after PTC, 33.2% (+/- 7.1) one week, and 27.9% (+/- 5.8) four weeks thereafter. CONCLUSION: The present study shows that in a group of patients without bad breath, an oral hygiene training program including professional toothcleaning, motivation and instruction of self-applied oral hygiene procedures is capable of reducing both papillary bleeding and oral levels of VSC Halimeter readings over the observation period of four weeks.

Adult↗
PubMed2006

Do admissions data and NBDE Part I scores predict clinical performance among dental students?

The purpose of this study was to evaluate possible associations between a variety of measures used to evaluate didactic knowledge and clinical performance within a predoctoral dental program. In this study, clinical performance was assessed by clinical productivity and clinical proficiency across four different competency areas: operative dentistry, major restorative dentistry, fixed prosthodontics, and removable prosthodontics. Predental and preclinical predictors were undergraduate GPAs (overall and science), DAT subtest scores (including the Perceptual Ability Test, PAT), and performance on subtests of Part I of the National Board Dental Examination. The sample consisted of eighty-four students at the Harvard School of Dental Medicine who graduated during the period 2002-04. Associations between predictors and outcomes were first evaluated individually. Any associations that were near statistically significant (p=0.15) were then included in a multiple linear regression model. The criterion for statistical significance in the multiple linear regression model was p=0.05. While a number of measures were associated in bivariate analyses, few predictors were statistically significantly associated with clinical outcomes in the multiple regression analyses. Those predictors that were associated with clinical outcomes were also not consistently associated with the different outcomes studied. These data indicate that, within this study population, there is little to no uniform association between preclinical didactic performance and measurements of clinical productivity and clinical proficiency. It is possible that the overlap in skill sets required for success in the predental/preclinical and clinical areas is minimal.

Clinical Competence↗
PubMed2006

Demographic, socio-economic, behavioural and clinical variables associated with caries activity.

This study investigated the association between several demographic, socio-economic, behavioural and clinical variables on caries activity. One hundred and two patients were randomly retrieved from the files of the Operative Dentistry Clinic (UFPel-Brazil). The patients gave written consent to participate in the study. They were interviewed reporting demographic (sex and age), socio-economic data (income, educaional level) and oral health behaviours (tooth-brushing frequency, dental floss usage and snacks frequency). Intraoral examination was performed to investigate the clinical variables (presence and quality of biofilm, DMFT and modified DMFT index and bleeding points). Patients were divided between caries-active (n=51) and caries-inactive (n=51), according to the presence of white spot lesions and/or active cavity lesions. Statistical analysis was carried tout using Chi-square or Fischer's exact test, with the confidence level at 95%. Results demonstrated that several conditions (younger subjects, lower educational or income levels, lower tooth-brushing frequency, higher snacks frequency, adherent biofilm, presence of bleeding points and higher modified DMFT index) were associated with caries activity in the studied population. Within the limitations of the experimental design, and considering the population under investigation, it was verified that demographic (age), socio-economic (income and educational levels), behavioural (tooth brushing and snacks frequencies) and clinical (modified DMFT index, presence and quality of biofilm, and bleeding points) variables were associated with caries-active patients.

Adolescent↗
PubMed2007

Effect of different types of enamel conditioners on the bond strength of orthodontic brackets.

AIM: A unique characteristic of some new bonding systems in operative dentistry is they combine conditioning and priming agents into a single acidic primer solution for simultaneous use on both enamel and dentin. Combining conditioning and priming into a single treatment step results in improvement in both time and cost-effectiveness to the clinician and, indirectly, to the patient. The purpose of this study was to determine the effects of the use of a self-etching primer on the bond strength of orthodontic brackets and on the bracket/adhesive failure mode. METHODS AND MATERIALS: Thirty-six fresh bovine incisors were collected and stored in a solution of 0.1% (weight/volume) thymol. The criteria for tooth selection included intact buccal enamel, no cracks caused by the presence of the extraction forceps, and no defects. The teeth were cleansed and polished with pumice and rubber prophylactic cups for ten seconds. Brackets were bonded to the teeth according to one of three protocols following the manufacturers' instructions--Group 1: Conventional multistep bonding system (control group) (n=12); Group 2: Self-etching primer system (n=12); and Group 3: Acid+self-etching primer system (n=12). Specimens were loaded to failure in a Zwick test machine (Zwick GmbH & Co, Ulm, Germany). Shear bond strengths were measured at a crosshead speed of 5 mm/min. RESULTS: The mean shear bond strength in megapascals (Mpa) (standard deviation) were 11.7 (4.2), 10.5 (4.4), and 10.9 (4.8) for Groups 1, 2, and 3, respectively. The analysis of variance (ANOVA) was used to compare the three groups. The results indicated no significant difference in the bond strength between the three groups (P=0.800). The results of the Chi square test, evaluating the residual adhesives on the enamel surfaces, revealed no significant difference between the three groups (P=0.554). CONCLUSION: Results of the present in vitro study indicate the use of self-etching primers may be an alternative to conventional phosphoric acid pre-treatment in orthodontic bonding.

Acid Etching, Dental↗
PubMed1991

[Conservation concerns in multiband treatment].

If (secondary) caries or amalgam fractures occur during fixed orthodontic treatment, the general dentist usually faces difficulties. Often temporary fillings are inadequate. Due to marginal leakage or break down they may jeopardize an orthodontic result. Step by step four cases of operative dentistry during fixed orthodontics are presented. A wait-and-see attitude or temporary measures for a longer period of time are definitely contraindicated.

Adolescent↗
PubMedDate not supplied

[Clinical application of carious dentin detectors].

The authors present a quite unused technique that helps to simplify the cavity preparation in Operative Dentistry. As a sequence of his investigations that established a clear distinction between hardness and bacterial invasion of dentin, Fusayama searched for a simple clinical method that could avoid excessive removal of remineralizable dentin. The use of "Caries Detector" may provide in few minutes an immediate clinical distinction between "infected dentin" and "remineralizable dentin", by the direct application of a selective dye. The fundamental, mechanism of action, and the application technique of this product are described.

Dental Caries↗
PubMedDate not supplied

[Study of caries using axial-mesial-distal sections and interproximal and periapical radiographs with paralleling and bisecting technics].

The authors, considering the radiographic complementary survey importance in Operative Dentistry, has made an analysis on the three main radiologic technics (Bite-Wing and Bisecting Angle and Paralleling Technic), in an attempt to compare the per cent magnification grade of the carious lesion radiographic image, by measurements taken at the tooth sections, and over the patient's radiographs, to contribute with a more accurate diagnosis performed by the dentist.

Bicuspid↗
PubMedDate not supplied

[Motives for placement and replacement of dental restoration].

Aiming to evaluate placement and replacement of dental restorations, a questionnaire has been elaborated and distributed in Clinics of the Operative Dentistry Department, Bauru Dental Scholl--USP, for the students to point out some information about the operatory procedures performed. The analysis of the results made possible the observation that of the 241 restorations achieved, 45.64% were made due to primary caries and 54.36% were replacement of deficient restorations. The reasons for replacement as well as the possible factors responsible for failure of tooth-colored and amalgam restorations are analyzed and discussed.

Composite Resins↗
PubMedDate not supplied

Sealing efficacy of therapeutic varnishes used with silver amalgam restorations.

The sealing abilities of three therapeutic varnishes were compared with that of a conventional copal varnish in vitro under Tytin silver amalgam restorations. The therapeutic varnishes comprised two commercial fluoride varnishes and one experimental chlorhexidine-containing varnish. Leakage was traced using a basic fuchsin dye and was found to be considerable, particularly on root surfaces. The therapeutic varnishes performed as well as, and in some cases better than, the control. It is suggested that the use of preventive therapeutic varnishes in operative dentistry merits attention and further study.

Dental Amalgam↗
PubMed1990

[Systematic procedures in endodontics].

Endodontic treatment is an important part in operative dentistry. While quantity of treatment increases, the quality should not be neglected. Means to improve the individual success rate are shown in the article. The simplification of the armamentarium and systematics of procedures are of utmost importance. As the basic technique the hand instrumentation is described.

Dental Instruments↗
PubMed1989

The status of a chemomechanical caries removal system in dental education.

A survey on the status of a chemomechanical caries removal system was mailed to the operative dentistry departments of each dental school in the United States and Canada. Eighty-eight percent of the respondents reported they were not presently teaching this technique. The most frequent reasons given for noninclusion in their curriculum were a lack of available clinical data and a variety of specific objections primarily related to limited applicability. Very few schools presently anticipate teaching this technique in the near future, and those that do are basing their final decision upon outcomes of further research. Consensus opinion indicated that additional studies and more definitive information would be required before final judgement could be made regarding the clinical value of this modality.

Aminobutyrates↗
PubMed1989

[Dental equilibration by selective grinding or occlusal adjustment].

Oclusal adjustment or selective grinding is an operative procedure that must be diagnosed and well planned before making in the patient the clinical steps. Thus it's critical to make the diagnosis and treatment planning by means of casts mounted on semiadjustables articulators, over which is necessary to work first. Remember that the oclusal adjustment is an irreversible media of dental structures substraction that can be made as a unique type of treatment before the operative dentistry and prostodontics. The elimination of the symptoms are the goal of the treatment, and a step that can't be avoided after an ortodontic treatment.

Dental Articulators↗
PubMed1989

Glass-ionomer cements in dental practice: a national survey.

Certain characteristics of glass-ionomer cements would appear to make them desirable dental materials; however, many practitioners are reluctant to use them because of reports of postoperative sensitivity. The members of the Academy of Operative Dentistry were surveyed in order to assess quantitatively and qualitatively the use of glass-ionomer cements in their practices, as well as the incidence and nature of postoperative sensitivity. The following data were collected: 1) the past and present use of glass-ionomer cements, 2) reasons for disuse of glass-ionomer cements, 3) products which are or have been used, and 4) the incidence of and resolution of postoperative sensitivity. The results are presented and discussed. An interesting secondary finding identified that zinc phosphate when used as a luting agent may contribute to postoperative sensitivity more often than is appreciated.

Dental Cements↗