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PubMedDate not supplied

Establishing soft tissue integration with natural tooth-shaped abutments.

The disparity in dimensions between implant fixtures and the exposed extraction sockets has resulted in the development of anatomically shaped abutments. Systems have been recently introduced that facilitate the fabrication of abutments to the configuration of natural teeth in the anterior maxilla. These systems permit development of an aesthetic emergence profile and contours for easy access in maintenance of oral hygiene of maxillary anterior single-tooth implant-supported restorations. The rationale for the development, indications, advantages, and clinical utilization of a recently introduced abutment system is discussed.

Ceramics↗
PubMed1997

Gateways to patient acceptance of cosmetic procedures.

Many clinicians have the desire to incorporate cosmetic dentistry into their everyday office procedures. It is often challenging to gain patient acceptance for these procedures. This review explores a way in which two services, tooth whitening and chairside esthetic mockups, can be used to introduce patients to cosmetic dentistry, to educate patients, and to increase happiness in the office while providing worthwhile services.

Esthetics, Dental↗
PubMed2001

Efficacy of peripheral morphine analgesia in inflamed, non-inflamed and perineural tissue of dental surgery patients.

In a clinical model of dental pain, the analgesic efficacy of local morphine treatment was examined under three different conditions. Patients undergoing dental surgery were randomly assigned to an injection of local anesthetic (articaine) plus 1 mg morphine either into inflamed (n = 14; trial 1) or non-inflamed (n = 24; trial 2) submucous tissue or perineurally n = 19; trial 3). Patients in the control group for each condition (n = 13, trial 1; n = 26, trial 2; n = 16, trial 3) received articaine plus saline. Postoperative pain intensity was assessed by the visual analog scale (VAS) and numeric rating scale (NRS) at 0, 2, 4, 6, 8, 10, 12, 16, 20, and 24 h. In addition, patients recorded the occurrence of side effects and the supplemental consumption of diclofenac. Immediately after the operation, pain scores were reduced to a similar extent in all groups, most likely due to the local anesthetic effect. Thereafter, pain scores and supplemental consumption of diclofenac were significantly lower in patients receiving 1 mg morphine into inflamed submucous tissue than in the control group for up to 24 h. Patients receiving 1 mg morphine into non-inflamed tissue or perineurally did not show any further reduction in pain scores compared to each control group. Our results show in patients undergoing dental surgery that injection of 1 mg of morphine into inflamed tissue results in significant and prolonged postoperative analgesia, whereas administration into non-inflamed tissue or perineurally is not effective. Thus, consistent with experimental studies, the requirement of an inflammatory process for the occurrence of peripheral opioid effects is also found in the clinical setting.

Adult↗
PubMed2001

The impact of behavioral technology on dental caries.

Models of self-regulation of patient adherence to specific health promotion recommendations by professionals are available and have been shown effective in changing behavior. However, it is a fundamental misspecification of the caries prevention problem to look to techniques that affect the regulation of individual behavior to directly impact dental caries. Behavioral techniques are used to enhance the probability an individual will initiate, increase, or maintain the use of established caries reduction/control strategies or cease or decrease behaviors that increase caries. Behavioral techniques can also be used to affect parental behavior in a cascade of effects that can eventually lead to healthier children. Studies are needed where behaviorally oriented caries prevention actions are thought of as manipulating self-regulatory behavior and the focus of action is either on the individual or on another, such as a parent. A third category of studies should center on provider competency. Studies are recommended in each of these areas.

Attitude of Health Personnel↗
PubMed1989

Increasing access to quality dental hygiene care. An educational model.

Restrictions on the manner in which dental hygienists practice are determined by individual state laws, each state's dental practice act, and how those are interpreted by the state board of dental examiners. Prior to 1986, state laws or regulations did not permit dental hygienists to practice independently of a dentist's supervision in public and private settings. These restrictions on the way hygienists practiced have been a barrier to expanding access to preventive dental hygiene care. Recently, the number of states that have eased the restrictions related to dental hygiene practice has increased. More hygienists have actively pursued legislation that would permit minimal supervision, and one state, Colorado, secured unsupervised practice. In addition to these legislative changes, the ADHA has made a commitment to expand the scope of dental hygiene practice. Given this focus, it is critical that dental hygiene practitioners receive the appropriate education to support their providing care directly to the public-functioning independently as licensed professionals. The purpose of this paper is to propose an educational model which will describe the advanced clinical and practical management skills necessary to practice unsupervised. Implications for how this model will increase access to care will also be addressed.

Dental Care↗
PubMedDate not supplied

Economic implications of evidence-based caries prevention in pediatric dental practice: a model-based approach.

OBJECTIVES: This paper presents an economic model which can be used to assess the potential implications of evidence-based caries prevention in pediatric dental practice. METHODS: Assessment of the evidence indicated that most children in the United States were likely to experience dental caries, though the severity of the disease would be minimal in most of them. Based on the evidence, it was concluded that annual recall examination and topical fluoride application would suffice as the norm for caries prevention. A model was developed to estimate the extent and cost of caries prevention in a traditional and an evidence-based pediatric dental practice. RESULTS: The model showed that evidence-based caries prevention resulted in a one-third decline in the number of recall examination visits provided, while the ensuing patient revenues from recall appointments declined by two-thirds in a calendar year. CONCLUSIONS: Evidence-based caries prevention will likely result in a significant decline in preventive services revenues and create additional capacity in pediatric dental practices. This economic impact will likely be absorbed by the current undersupply of pediatric dentists and by the reformulation of practice revenue streams.

Appointments and Schedules↗