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PubMedDate not supplied

Occlusal sealant success over ten years in a private practice: comparing longevity of sealants placed by dentists, hygienists, and assistants.

PURPOSE: The purpose of this 10-year, retrospective, cohort study was to evaluate the success of permanent molar sealants by comparing the effectiveness of sealants placed by dentists, dental hygienists, and dental assistants in a private dental practice, with all operators using an identical, standardized, application technique and 4-handed dentistry. METHODS: From 810 patient records that met entry criteria, the long-term follow-up records of 3,194 permanent first molars were evaluated. Data were collected and evaluated by survival analyses methods for: (1) time to first failure (caries or restoration of the sealed surface); (2) fluoride history; (3) caries experience; (4) operator type; (5) behavior at sealant placement; (6) tooth type; (7) age at placement; and (8) patient gender. RESULTS: Cumulative survival probability for 10 years in this practice was 87%, using Kaplan Meier analyses. The factors associated with an increased risk of failure included: (1) age (P<.001); (2) dmft (P<.003); (3) no fluoride (P<.001); (4) dentist (P<.001); and (5) registered dental assistant (P<.001). While all operator groups had success rates equal to or exceeding previous studies, dentists and registered dental assistants showed 3 times and 2 times the risk of failure, respectively, compared to the registered dental hygienists. The no-fluoride group showed almost twice the risk of failure as compared to the optimal fluoride group. Behavior showed a slightly higher risk of failure that approached significance. Age and dmft were highly significant, with slight increased risk of failure. Supplemental fluoride showed a protective effect, but this was marginally significant. Gender and tooth-type were not significant in this model. Major variations in success rates were observed in the dental assistant group, with 2 individuals accounting for most of the failures. CONCLUSIONS: This study supports delegation of sealant delivery to auxiliaries, since dental assistants and dental hygienists were equal to or better than the dentists in long-term sealant effectiveness.

Adolescent↗
PubMed1996

A model for the incorporation of intracytoplasmic sperm injection into a private practice in vitro fertilization program.

OBJECTIVE: To describe a method for the training of personnel and the implementation of intracytoplasmic sperm injection (ICSI) into an IVF program. The results of the first 75 cycles are reviewed. DESIGN: Retrospective review of the first 75 consecutive ICSI procedures. SETTING: Private, community-based IVF program. MAIN OUTCOME MEASURES: The fertilization rate, damage rate, ongoing pregnancy rate (PR), and implantation rate were measured. RESULTS: Nine percent of the injected oocytes were damaged. The fertilization rate was 60%, and the cleavage rate was 98%. Fifty-nine percent of the cycles resulted in an ongoing pregnancy, and the implantation rate per embryo was 26%. CONCLUSIONS: A high initial PR can be obtained with ICSI using a systematic training regimen.

Adult↗
PubMed1993

[Patients of private practice physicians--selected results of a survey in general practice offices].

The structural changes in outpatient medical care in the new Federal Laender were characterised by the fact that doctors now established their own medical practice whereas previously they had been part of a state-controlled and state-organised system of medical centres for outpatient treatment. The aim of the present study consisted in analysing the opinions of patients on these changes in ambulatory medical care from state control to a physician in own medical practice. The standardised questionnaire used in this study contained questions on the conditions of organisation within the practice, e.g. waiting period, consultation period, home visit and accessibility of the doctor. Furthermore the patients were asked for important criteria of medical care by a family doctor. Selected results of this inquiry of patients are compared to a study realised in 1988/89 under conditions of the former public health system of the GDR. Comparison of both studies results in significant differences. In a practice of a consulting-room practitioner the waiting period is shorter, the accessibility of the doctor is better and the time of consultations is positively changed compared to the former public health system. In 1992 about 94% of patients considered the general practitioner in his own practice as their family doctor, in 1988/89 under the conditions of the public health system only 66% of patients did so. These differences are due to the higher degree of realisation of the criteria of medical care by a family doctor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗