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PubMed2005

Treatment decisions and conservation of tooth structure.

New technology is becoming available to help establish an early diagnosis of incipient and hidden pit and fissure caries, and microdentistry techniques are being developed to follow the principles of minimal intervention. Following the accurate diagnosis of suspected lesions, early intervention can be in the form of chemotherapeutics to promote remineralization or conservative intervention to minimize tooth structure loss. Patient risk factors should have a role in developing and individualized treatment program. The life cycle of a restored molar is used in this article to illustrate the long-term value of early diagnosis, preventive therapy, and conservative intervention to preserve tooth structure and to extend the retention of healthy teeth.

Decision Making↗
PubMed2006

The safety of nickel containing dental alloys.

Nickel is a constituent of many dental alloys. This paper reviews mainly papers published after 1985 with regards to biological reactions to nickel in dentistry. Nickel is an allergen, but there is no evidence that individual patients are at a significant risk of developing sensitivity solely due to contact with nickel-containing dental appliances and restorations. Hypersensitivity reactions to nickel are only likely to occur with prior sensitization from non-dental contacts and even these are rare. Clinical evidence has been presented to show that small doses of nickel, e.g. from dental appliances, may induce tolerance to this allergen. The papers reviewed report low rates of release of nickel from dental alloys. Some nickel compounds, which are mildly cytotoxic, have been implicated as carcinogens by inhalation in industrial settings, but these compounds are not present in dentistry-related operations, including dental technology procedures. Nickel-containing alloys and compounds have not been associated with increased cancer risk by oral or dermal routes of exposure. It is concluded that, subject to use according to established techniques, nickel-containing dental alloys do not pose a risk to patients or members of the dental team.

Carcinogens↗
PubMed2004

Curricular issues changing from amalgam to tooth-coloured materials.

OBJECTIVE: To provide an overview of curriculum issues in changing from amalgam to tooth-coloured materials. KEY POINTS: Changing from amalgam to tooth-coloured materials in teaching the restoration of posterior teeth may be found to have a considerable enriching effect on the dental curriculum. Subject to meeting a number of prerequisites, the change from amalgam to tooth-coloured materials may cause relatively little curriculum disruption, with the added bonus of a consequential shift from reparative to preservative, minimal invasive dentistry. CONCLUSION: Changing from amalgam to tooth-coloured materials may enrich the typical dental curriculum.

Composite Resins↗
PubMed2004

The amalgam-free dental school.

OBJECTIVES: To review the change in teaching of Restorative Dentistry at Nijmegen dental school over the period 1986 to the present. KEY POINTS: In 1986, class I and II resin composite restorations were included in the pre-clinical program. However, these courses still started with class I and II amalgam restorations. From 1990 on, the number of amalgam restorations placed in the clinic gradually decreased while the number of resin composite restorations increased. Meanwhile, resin composite had become the first choice for treatment of primary caries (class I and class II) lesions. Finally in 1994, the pre-clinical training started with resin composite restorations before dental amalgam was taught and the advantage of a minimal preparation was further emphasized. Since 2001 the teaching of dental amalgam ceased at the dental school. This was not an abrupt change but the result of a long transitional stage during which it was gradually substituted by resin composite. This step-by-step introduction allowed the acceptance of composite resin by the staff as an alternative for dental amalgam in posterior restorations. As in 2001 students placed only 2.5 amalgam restorations before graduation, it was decided to stop with the pre-clinical training program. CONCLUSIONS: The introduction of resin composites meant an important change in teaching restorative dentistry at Nijmegen dental school. It was not just a change in materials and techniques but also a change in treatment philosophy. The reduced need for preparation and the strengthening effect on the remaining tooth were the principal reasons for the shift from dental amalgam to adhesive dentistry with resin composite at Nijmegen dental school.

Composite Resins↗
PubMed2006

Effect of reducing frequency of augmented feedback on manual dexterity training and its retention.

OBJECTIVE: The study addressed the impact of the frequency of tutorial-enriched augmented visual feedback, provided by a virtual simulation system (DentSim), on the skill acquisition for a cavity preparation task in novice dental students. METHODS: Thirty-six subjects were assigned to two training groups and a control group. The task consisted of a geometrical cross preparation on the lower left first molar. All subjects performed a pre-test to assess their basic skill level. The training groups received simulation feedback, enriched with tutorial information, across acquisition. One group trained under continuous augmented feedback, while a second group trained under an intermittent (66% of the time) feedback. At both 1-day and 4-month interval, subjects performed a retention test to explore learning specific effects. Two transfer tests were added to assess the extrapolation of the learned skills to an adjacent molar. All tests were performed in the absence of feedback. A control group performed all the tests, without preceding training. All preparations were graded by the simulation system. RESULTS: The training groups performed similarly across acquisition and improved with practice (ANOVA, P<0.001). After 1 day and 4 months of no practice, the training groups outperformed the control group on a retention test (ANOVA, P<0.001) and transfer test (ANOVA, P<0.001). CONCLUSIONS: Performance and learning of a cavity preparation task on a simulation unit was independent of the frequency of tutorial-enriched augmented visual feedback within the range tested. Training sessions on a simulation unit could be alternated with training sessions in the traditional phantom head laboratory.

Adolescent↗
PubMed2005

Influence of tooth resection in piglets on welfare and performance.

In six commercial pig farms, we compared the effects of two methods of tooth resection (tooth clipping with pliers and tooth grinding with a rotating grindstone) on teeth themselves, on skin lesions of piglets and of sow udders as well as on litter growth and survival. An intact group was included for control. Treatments were balanced within herds with sows assigned to one of the three experimental treatments. Observations were from 107 sows and their litters (n = 35 or 36 litters/group) at farrowing (day 0) and approximately 8, 15 and 27 days later. Tooth resection was done within 24 h of birth after cross-fostering. Data concerning sows' lesions were analyzed on a farm basis and those concerning piglets' mortality, growth and skin lesions were analyzed on a litter basis. Frequency and severity of udder lesions differed between treatments at farrowing and on day 8; differences depended on the location of the teats (front, median or rear). Litter size and liveweight of piglets on day 0 (11.9+/-0.1 pigs, 1.51+/-0.03 kg) and on day 27 (10.8+/-0.1 pigs, 8.08+/-0.10 kg) were similar in the three groups (mean+/-S.E.M., n = 107). Skin lesions on piglets were more frequent and/or severe in intact than in clipped piglets on days 8 and 27, whereas ground piglets had intermediate results. Because the length of the teeth was similar after clipping and grinding (P > 0.1), tooth shortening itself does not explain the differences between treatments. Overall, tooth resection had very little effect on sow mammary injuries and litter performance. It might reduce skin damage to piglets (especially, when it is performed by clipping) but teeth are severely injured.

Animals↗
PubMed1995

Dental surgery standards for perioperative nurses. Medical Center of Central Georgia.

Practice standards for dental surgery are necessary to maintain quality care for dental patients. Specific standards or recommended practices for dental surgery have not been addressed by AORN, and none are available from the American Dental Association or the Georgia Dental Association. We incorporated the Centers for Disease Control and Prevention guidelines, and Occupational Safety and Health Administration regulations had to be incorporated into existing perioperative standards to institute dental surgery standards for our facility. The standards for dental surgery at the Medical Center of Central Georgia, Macon, evolved with the leadership of perioperative nurses.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Midline odontogenic infections: a continuing diagnostic problem.

Cutaneous sinus tracts and facial swellings of odontogenic origin have been well documented in the literature. These lesions however continue to be incorrectly diagnosed resulting in inadequate and unnecessary treatment. This paper reports two cases of midline odontogenic infections presenting as skin lesions. Neither patient complained of dental problems, and intraoral examination failed to reveal pathology. Both had been treated over an 18-month period, undergoing multiple surgical procedures before the correct diagnosis was made. Lesions on the face can be the result of occult chronic odontogenic infection. Awareness of a possible dental cause, especially with facial lesions that recur after excision is essential. The use of vitality testing of the teeth and appropriate radiographs ensures the correct diagnosis should not be missed.

Adult↗