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PubMed2000

Periodontal surgery equipment.

Periodontal surgery requires the operator to have specific knowledge and skills. The use of proper equipment will improve the operator's skill and will decrease surgical time. It will also result in less tissue trauma, thus increasing healing time and reducing postoperative complications and patient discomfort. Various surgical procedures can be enhanced with the usage of equipment that is designed for specific tasks of the procedure. Proper care of equipment is essential for extended instrument life.

Animals↗
PubMed2004

Use of operating telescopes with multifocal corrective lenses.

Many older practitioners who wear spectacles with multifocal lenses for surgery work have been told that they cannot use flip-up magnifying telescopes with these owing to the difficulty of positioning them over the appropriate part of the lens and therefore must resort to normal bifocals. They thereby lose the advantages of clear vision at all distances which multifocals give. This article describes a way of overcoming this problem.

Dentistry, Operative↗
PubMed1986

Communication tendencies of senior dental students.

Although the importance of dentist-patient communication is generally recognized, the dental literature does not specify what interpersonal behaviors can be used as a basis for evaluating dental students' communication skills. A set of behaviors based on clinical observations is described, and an evaluation of 25 senior students' behavioral skills is presented. Students often did not: (1) spend much time orienting patients before beginning treatment; (2) update medical histories; (3) ask patients if they had any questions before beginning treatment; (4) explain the operation and use of equipment; (5) forewarn patients about uncomfortable procedures; (6) attend to signs of patient discomfort; (7) reinforce praiseworthy patient behavior; (8) caution patients about numbness, chewing, and sensitivity; (9) thank patients for their time; and (10) use leading/motivating questions. There is a need to provide students with systematic feedback on their interpersonal behaviors.

Communication↗
PubMedDate not supplied

Cutting on triangle mesh: local model-based haptic display for dental preparation surgery simulation.

A new method to realize stable and realistic cutting simulation using an impedance display haptic device and microcomputer is presented in this paper. Material removal or cutting simulation is a critical task in dental preparation surgery simulation. In this paper, a piecewise contact force model is proposed to approximately describe the cutting process. Challenging issues of minimizing the difference between the cutting simulation and haptic contact simulation are analyzed. The proposed contact-based simulation method is developed for a one-dimensional cutting task and can be expanded to three-dimensional cases. Local model-based multirate simulation cutting architecture is proposed and force control of the haptic device is decoupled from the cutting simulation loop, which can both ensure high fidelity of dynamical simulation as well as maintain stability of the haptic device. The cutting operation is realized using spherical and cylindrical shaped tools. An experiment based on the Phantom desktop proves that fidelity in one-dimensional cutting can be realized and stability in three-dimensional cutting can be ensured using the force-filtering method.

Computer Simulation↗
PubMed2004

Personal video monitor as an accessory to dental operating microscopes.

OBJECTIVE: The aim of this study was to perform a qualitative assessment of the personal video monitor (PVM) as an accessory to the dental operating microscope (DOM). METHOD AND MATERIALS: The PVM was attached to a color video monitor, which was already attached to a DOM through a beam splitter. One faculty clinician performed a complete oral examination on a patient wearing a binocular inclinable lens adapted to the DOM under different magnifications, while a second faculty watched the procedure simultaneously using a PVM. After completing the examination, the operators exchanged the viewing devices and repeated the procedure. RESULTS: When compared to a standard binocular lens attached to the DOM, the second operator using the PVM had an unencumbered view of his surroundings and was able to make head movements freely. However, when comparing the resolution of the standard binocular lens to the PVM, the binocular lens provided a sharper picture with better illumination, especially when using higher magnification. Statistical analysis was not incorporated, as the goal of this experiment was to qualify rather than quantify the established PVM resolution, in this initial analysis. CONCLUSION: The authors concluded that the PVM attached to the video camera and the DOM allowed a second operator to watch the procedure, and it could be used as an important teaching tool. Another application is that the patient may wear the PVM while the procedure is in progress. However, the resolution in the PVM needs to be significantly improved in order to achieve an adequate level of efficiency in four-handed microdentistry.

Computer Terminals↗
PubMed1980

Lorazepam as a premedicant in dental surgery.

In a double-blind study, 100 young, healthy (American Society of Anesthesiologists physical status 1) patients received lorazepam (Ativan; Wyeth) 2,5 mg or placebo orally as premedication before general anaesthesia for extraction of wisdom teeth. Lorazepam produced a significant reduction in the incidence of pre-operative anxiety and post-anaesthetic headache compared with placebo (P less than 0,01). Anterograde amnesia was also more frequent in the patients who had received lorazepam (P less than 0.001). The medicolegal implications of using lorazepam as a premedicant in dental surgery at a day clinic are discussed.

Adolescent↗
PubMed1993

An assessment of the incidence of punctures in gloves when worn for routine operative procedures.

The value of glove wearing as part of dental surgery cross-infection control regimen is negated if gloves are punctured during use. An assessment of the procedures most likely to give rise to glove puncture is therefore of importance. Accordingly, 892 gloves worn by two dentists in general practice were examined for punctures, after being used in one of seven common operative procedures. It was found that gloves used for the treatment procedures investigated had a significantly higher proportion of punctures than unused gloves of the same type. Gloves used for surgical extraction showed the highest proportion punctured (16%). There was no significant difference in puncture frequency between the gloves worn on left or right hands irrespective of procedure.

Crowns↗
PubMed1980

Temporary auditory threshold shift following sophomore operative technique laboratory.

Twenty sophomore dental students were studied for the "temporary threshold shift" (TTS) due to exposure to the noise of high-speed dental headpieces during technique laboratory sessions. TTS was experienced at all four frequencies tested--8000, 6000, 4000, and 3000 hertz, but tended to be greater and of longer duration at the higher frequencies. Approximately one-fourth of the students still had some hearing loss 15 minutes after leaving the laboratory.

Auditory Threshold↗
PubMed2001

An investigation into the use of a structured clinical operative test for the assessment of a clinical skill.

AIM: This study was designed to investigate the level of agreement between a group of assessors observing students undertaking a structured clinical operative test. METHOD: 3 assessors agreed a series of criteria to assess the performance of undergraduate students in the recording of a dental impression. Guidelines for assessing whether the students adequately performed in relation to each criteria were also agreed. Following preliminary validation between the assessors, 2 assessors independently scored the performance of each student by reference to the agreed criteria, and the levels of agreement between assessors were compared. The 3 assessors worked in pairs with each other on three groups of students who were in the early stages of their clinical course. RESULTS: A total of 39 clinical dental students were assessed in the recording of a dental impression. The 3 pairs of assessors had satisfactory levels of agreement in the study with similar judgements being made on 90% or more of the 12 criteria assessed. Some differences existed between the pairs of assessors. Certain criteria were more easily judged than others and this was reflected in the level of agreement seen. For over 90% of the criteria, positive assessments were made by each of the 3 assessors, and although there were minor variations between the pairs of assessors, this may have reflected the ability of the groups of students studied. CONCLUSION: The study showed that different assessors were generally able to make agreed judgements on performance criteria in a structured clinical operative test. In setting up performance assessment it is necessary to have close collaboration between assessors to make clearly defined criteria so that judgements are not too subjective. Furthermore, for the assessment of more complex clinical skills, great care is needed in assembling criteria that can be used reproducibly, and sufficient preparation time for the assessors is critical.

Clinical Competence↗
PubMed1983

[Pierre Fauchard (1677?-1761). Dental expert and master surgeon of Saint-Côme of Paris].

Pierre Fauchard has raised enigmas namely as regards his professional life which we try to elucidate by the analysis of his book. He began his dental training with a naval surgeon who did not sail anymore and he started practicing at the age of 19 with some dangerous interventions in the mouth of a friend. He benefited from the imbroglio of his time when the dental practice was not much supervised. In 1699 there was a compulsory examination to receive the title of 'Dental expert' which Fauchard obtained around 1708 in Paris. A short time afterwards it appeared that he undertook studies to become a Master-Surgeon, which title he obtained around 1714-1717, if one follows the 'Observations' in his book. As a matter of fact he operated already before 1715 with the great master-surgeons of his time, which would have been paradoxical if he had been only an Expert whose surgical operations described were not allowed by the strict regulations of the College Saint-Côme. His position as master-surgeon is revealed in the 1758 register of this company. The title-page of his book indicates it too by its presentation, as one reads 'by Pierre Fauchard surgeon' and at the next line: 'dentist in Paris'. The present paper intends to show that P. Fauchard was a practitioner with serious and long medical and surgical studies behind him.

Dentistry, Operative↗
PubMed1997

Musculoskeletal symptoms in New South Wales dentists.

This study describes the prevalence and distribution of symptoms of musculoskeletal disorders occurring in New South Wales dentists and investigates the relationship between these symptoms and work practices. Four hundred and forty two members of the Australian Dental Association (New South Wales Branch), were randomly selected and sent questionnaires. Eighty per cent (n = 355) responded. No significant differences in reported symptoms were found when considering age, experience, handedness, operating position or period of working without a break. Eighty-two per cent of the respondents reported experiencing one or more musculoskeletal symptoms during the previous month. Sixty-four per cent of the sample reported suffering pain (the majority reported back pain) and 58 per cent headaches. Most severe symptoms reported were pain (39%) and headaches (25%). Those in the youngest age category of less than 35 years (26%), were significantly more likely to have headaches (chi 2 4df p < 0.05). Female dentists were more likely to rate the severity of their most severe symptom higher (chi 2 1df p < 0.05), and to report more frequent pain (chi 2 2df p < 0.05) and headaches (chi 2 2df p < 0.05). Those practising four-handed dentistry were significantly more likely to be in the 35-44 age range (chi 2 4df p < 0.01), to work for longer periods before taking a 10-minute break (chi 2 5df p < 0.05) and to report frequent pain (chi 2 2df p < 0.05). The results support the findings of previous studies conducted overseas but additional information about musculoskeletal symptoms in this occupational group has been identified.

Adult↗
PubMed2003

Oral healthcare of clients with learning disability: changes following relocation from hospital to community.

OBJECTIVE: To investigate changes in the oral healthcare of adults with learning disability after transference from long stay hospital care to community-based care. SUBJECTS: Adults with learning disability who were former residents of a single long stay hospital and who had been resettled into the community during the period April 1995 to April 1998. DESIGN: Structured questionnaire with a covering letter sent to community-based carers. Hospital notes were reviewed to assess oral healthcare received as in-patients. RESULTS: There was a 68% response rate to the questionnaire from community-based carers with details obtained from 106 out of a possible 157 subjects. As residents in the hospital, all subjects were examined regularly by a dentist--yearly for edentulous and six-monthly for dentate individuals. However, attendance patterns were less regular as residents in the community. In the community, individuals were also less likely to receive operative dental treatment. Although oral hygiene regimes were generally on a daily basis only 37% of the subjects and/or their carers had received oral health education from dental professionals in the community. CONCLUSION: Changes from institutional living to community-based housing for adults with learning disability may be associated with changes in dental attendance and treatment patterns.

Adult↗
PubMedDate not supplied

[Althesin or CT 1341 as a drug to induce balanced anesthesia with ethrane or fluothane associated with type II NLA in dental, maxillofacial and plastic surgery of the head area].

The Authors have tried Althesin as a medicine for the induction and maintainement of the narcosis in the stomatological, maxillo-facial and extra and intra-oral surgery. They have deduced that CT 1341 does not constitute to the anaesthetics Ethrane and Fluothane because of the anaesthetic-level instability (restlessness of the patient and clonic movements of the limbs during the most painful operations in particular). The Authors, supporters of the balanced anaesthesia, suggest using Althesin in the narcosis induction, the maintaining of which is carried on by the N.L.A. type II medicine and by the Ethrane or Fluothane. The latest ones are to be given in very small, not dangerous quantities. The Authors have so obtained a remarkable oxygenation of the patient, a ready, calm and lucid awakening without any collateral and dangerous consequences.

Alfaxalone Alfadolone Mixture↗
PubMed1987

Effects of immediate introduction of indirect vision on performance and posture.

When students are taught psychomotor skills in the mandibular arch and transfer to the maxillary arch, there is a continued desire to depend upon direct vision, which results in early acquisition of poor postural habits. This study examined differences in psychomotor performance between dental students beginning with direct and indirect vision exercises. The investigation was conducted in a preclinical Performance Simulation Laboratory that allowed a high degree of accuracy in the evaluation of operator posture. No significant differences in performance were found between the groups. Within group variances indicated that there was a more uniform transition from maxillary to mandibular preparations than from the lower to upper arch preparations. Analysis of the postural data showed no significant relationship to the quality of cavity preparation, but indicated that student posture was better for the arch in which they first learned. The study was unable to substantiate the assumption that mirror management is better taught after direct vision skills are learned.

Clinical Competence↗
PubMed1998

Evaluating undergraduate preclinical operative skill; use of a glance and grade marking system.

OBJECTIVES: The purpose of the study was to evaluate the intra- and inter-examiner variability of a panel of examiners using a 'glance and grade' marking system when assessing Class II preparations. METHODS: The examination panel consisted of five university staff with varying clinical and teaching experience. The panel assessed 75 disto-occlusal preparations suitable for restoration with dental amalgam prepared in extracted human premolar teeth. The majority of the preparations were cut by undergraduates in their preclinical year of study and the remainder by an experienced staff member. The panel were blind to the identity of each operator. RESULTS: The study revealed a high degree of both intra- and inter-examiner variability, with some preparations being given a pass on one occasion and a fail on another and vice-versa. In addition, some of the panel, perhaps assuming that the practical exercise had been prepared entirely by undergraduates, were reluctant to award good grades. CONCLUSIONS: The study has highlighted the need for better staff training and a more comprehensive system of assessing preclinical skills.

Clinical Competence↗
PubMed2005

Conservative operative management strategies.

Operative conservatism, including delayed operative intervention, is recommended to promote tooth longevity. Effective conservative operative strategies for the permanent dentition are the occlusal preventive resin and the proximal only restoration. Conservative strategies for the primary dentition have proves less successful. Conventional and conservative restorations are vulnerable to caries recurrence, material failure, and technical deficiencies. Successful conservatism demands discerning diagnostic decisions, effective disease management, and technical excellence. The diagnostic accuracy of radiographs and visual criteria is briefly reviewed for proximal and occlusal caries. Improved visual ranking criteria are supported for occlusal caries diagnosis. The use of dyes for occlusal diagnosis is not recommended.

Composite Resins↗
PubMed2003

Implementation of the two-stage operation technique for the autotransplantation of teeth with closed apexes--a preliminary report.

Transplantation of teeth with incompletely formed apexes demonstrates a statistically better retention than the transplantation of fully-formed teeth because of the possibilities for reinnervation and revascularisation. However, with regard to the autotransplantation of teeth with completely developed roots, routine endodontic treatment is proposed, as the possibility to retain the vitality of dental pulp is doubtful. In this work the author wishes to present the implementation of the two-stage technique for the transplantation of fully-formed teeth. Observations confirm the possibility for reinnervation and revascularisation occurring after autotransplantation of teeth with closed apexes, which should encourage a cautious approach to the question of routine endodontic treatment following autotransplantation.

Adolescent↗
PubMed2001

Investigation of potential iatrogenic transmission of hepatitis C in Victoria, Australia.

OBJECTIVE: To determine the level of exposure to medical and surgical procedures among Australian-born patients whose mode of acquisition of the hepatitis C virus (HCV) is unknown. METHOD: Place and time of study: Melbourne, Australia, 1998-2000. DESIGN: Retrospective case series. INSTRUMENT: Structured questionnaire administered by one interviewer. SETTING: Referral centre for hepatitis C in a tertiary teaching hospital. PARTICIPANTS: Australian-born individuals persistently HCV antibody (anti-HCV) positive on at least two second-generation commercial assays. MAIN OUTCOME MEASURES: Demographic and self-reported exposure data. RESULTS: Of 135 anti-HCV positive individuals with no known mode of transmission, 54 (40%) individuals fulfilled all the entry criteria and agreed to participate. Of the 54 cases, 53 had at least one medical/surgical procedure and/or invasive dental work; 46 (85%) had dental extractions, 19 (35.2%) had complex dental work, e.g. root canal, 44 (82%) had an operation requiring general anaesthesia, 41 (75.9%) had a procedure requiring local anaesthetic, and a number of endoscopic procedures were reported: gastroscopy (n=3), colonoscopy (n=3), laparoscopy (n=4), arthroscopy (n=5), cystoscopy (n=2). CONCLUSION: We have documented exposure to medica/surgical procedures among HCV patients with no previously recognised mode of transmission. IMPLICATIONS: The findings of this study have important public health implications for current cleaning, disinfection and sterilisation procedures and protocols (or lack of these) as well as for the policies and guidelines relating to the re-use of medical equipment such as multi-dose vials, suturing material and anaesthetic circuits.

Cross Infection↗