Is tooth structure not sacred anymore?
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Previous studies suggest a discrepancy between the way dentists and patients measure oral health. The purpose of this study was to determine the relationship between a dentist's rating of an older dentate person's oral health and the patient self-rating using a single-item indicator, and to compare the clinical (i.e., number of teeth, caries, etc.) and subjective (problems with function, pain, etc.) factors that influence the rating. The study sample consisted of 776 older dentate people. Results showed that dentists judged subjects' oral health significantly more positively than the self-ratings. Approximately 30 percent of the elders rated their oral health identically to the dentist and half rated their oral health lower than the dentist. Bivariate comparisons showed that similar clinical and subjective variables were associated with the dentist and patient ratings. Multiple regression findings, however, highlighted differences in the factors that influenced the ratings. In addition, the proportion of variance accounted for by the clinical factors as opposed to the subjective factors was greater for the dentist rating (R2 = .28 of .33) than the subject self-rating (R2 = .18 of .43).
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The clinical characteristics of four composite resins were assessed over a period or up to three years. Two hundred and sixty nine restorations of composite resins placed in anterior teeth were subjected to 380 examinations during a three year study. The restorations had been placed in the mouth of patients aged 11 to more than 51 years by a variety of operators and the clinical characteristics observed. An increase in defects and deficiencies occurred at the progressive examinations.
A method has been evolved for bonding aluminous porcelain to pure platinum foil used for making porcelain crowns by the conventional 'tinner's joint' technique. It was found that good bonding was achieved when the platinum was coated with 0.2-2.0 mum of tin before firing on the porcelain. This paper describes experimental work for determining the optimum composition and thickness of the coating and the applicability of the technique to substrates other than platinum.
This paper compares the colour matching ability of dentists, dental students, and ceramic technicians. It examines the roles that experience and colour defective vision may also play in the correct matching of dental colours.
Three composite resin materials gave reasonable results in the short-term, provided that they were placed and finished correctly. This would be easier to do with the small incisal fractures. Although slightly more defects became apparent with time, most could be corrected without the replacement of the restorations.
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Erosive tissue loss is part of the physiological wear of teeth. Clinical features are an initial loss of tooth shine or luster, followed by flattening of convex structures, and, with continuing acid exposure, concavities form on smooth surfaces, or grooving and cupping occur on incisal/occlusal surfaces. Dental erosion must be distinguished from other forms of wear, but can also contribute to general tissue loss by surface softening, thus enhancing physical wear processes. The determination of dental erosion as a condition or pathology is relatively easy in the case of pain or endodontic complications, but is ambiguous in terms of function or aesthetics. The impact of dental erosion on oral health is discussed. However, it can be concluded that in most cases dental erosion is best described as a condition, with the acid being of nonpathological origin.
A method is described for measuring the opacity of anesthetic dental filling materials using a goniophotometer. Procedures are given for converting measured opacity values to those referred to a 70% reflectance background (C0.7 values) as required by existing specifications. The conversion is involved, and, since most available white surfaces have reflectance of about 80%, it is recommended that in future specifications opacity be recorded as C0.8 values. Opacity values for 28 materials are reported. It was found that the opacity of dental cement decreases for several days following preparation and that powder/liquid ratio has little effect, while pigmentation has a marked effect on opacity.
A study has been made of attitudes towards the need for orthodontic treatment and its acceptability to fifth year high school pupils in two regional health authorities in England, selected because of differences in the number of orthodontists practising in the regions and in the amount of General Dental Service orthodontics undertaken in each. The respondents in both regions showed similar levels of awareness to the need for treatment, but treatment was found to be less acceptable to those in the region where less orthodontic appliance therapy was being undertaken. The differences between regions were greater in girls than boys. In both regions, girls were more aware of malocclusions than boys and were more prepared to accept treatment.
The criteria that dentists use to judge the need for orthodontic treatment are not clear. This study investigates variation in dentists' perception of orthodontic treatment need. Seventy-four dentists were asked to assess 320 dental casts in relation to aesthetic and dental health need. The results of this investigation revealed that the panel was divided as what constituted a need for orthodontic treatment on dental health grounds. It is suggested that one method of achieving a more uniform evaluation of orthodontic treatment need is the use of an occlusal index. Until an occlusal index is accepted and used by the profession, the distortion of need and demand for orthodontic treatment by dentists' unequal perceptions will continue.
The Index of Orthodontic Treatment Need (IOTN) was used to assess the need for orthodontic treatment before and after treatment, on a systematic sample of 1225 cases. On the whole, full upper and lower fixed appliances brought about a greater improvement in Aesthetics and Dental Health Components compared to other appliance techniques, and were less likely to make the occlusion worse. It was found that certain occlusal traits were more likely to be successfully treated than others. A common problem resulting from treatment was the development of a cross-bite.
The single-tooth implant restoration appears to be an ideal method of replacing missing natural teeth in a healthy dentition. Most follow-up studies report a high success rate. The restoration is seen by many clinicians as a relatively straightforward technique easily adapted to general dental practice and popular with patients, although it is not without complications. The purpose of this paper is to look at common problems following the placement of root-formed endosseous dental implants. A number of implant systems are reviewed and the results of the authors' clinical experiences reported.
The application of multi-surfaced posterior tooth-coloured restorations is an exercise in risk tolerance when dentine occupies the bulk of the tooth substrate. Success with posterior tooth-coloured restorations is dependent on interfacial integrity. Although the literature is full of guidelines on producing aesthetically pleasing restorations, most practising clinicians appreciate that clinical success involves more than aesthetics: success is strongly dependent on operative competence. This article describes a number of innovative clinical techniques and discusses the probationary status of current adhesive options and the need for excellence in all phases of these demanding restorative sequences.
The first paper discussed the clinical features of patients with hypodontia. A range of treatment options were considered with examples given. In this second paper, the implant treatment option for patients is discussed in detail.