Production increases due to chairside assistance.
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Conventional mouth props are an essential part of a dentist's armamentarium and are irreplaceable in certain dental situations. These props, however, may provide too harsh an approach or be injurious in other situations. The custom-made finger prop is a valuable alternative to the other mouth props when treating the young or handicapped.
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There are problems involving permanent posterior teeth for which the stainless steel crown may provide the most desirable short-term solution. In placing the crown, emphasis should be given to recognition of the wide variation of available crowns, occlusal considerations, the importance of the rubber dam, and the use of a precementation radiograph to confirm margin adaptation of the crown.
With the use of the two types of fixtures described in this paper and some precautions taken to reduce glare, the quality of lighting in the dental operatory can be improved.
Though state boards may be necessary, let them be less anachronistic in the expectations they have for current graduates. Let us hope that the state and regional boards will change and keep pace with the current literature. The boards can have an influence on upgrading dentistry but only if they are progressive, and if they do not hold back the profession by demanding antiquated means of looking at dental care for the patients.
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Each time the handpiece turbine is stopped while the bur is still in the patient's mouth, almost 1 ml of microbe-laden oral fluids may be aspirated into the average dental unit water line by the retraction valve present in the dental unit. This fluid may contain an average in excess of 54,000 microorganisms per milliliter, including both facultative and obligate anaerobic bacteria of medium to high virulence. Other infectious agents including hepatitis, herpes, influenza, and other upper respiratory viruses may also be present. This germ-laden water may then be sprayed into the mouth of the next patient, possibly initiating an oral or upper respiratory tract infection. Sterilizing the handpiece between appointments, although of great significance in the prevention of disease transmission, will not totally eliminate the problem discussed here as almost 95% of the oral fluid aspirated into the dental unit went past the handpiece and into the handpiece cooling water line. Complete elimination of the retraction valve in the unit is the most effective means of solving this problem, but, with present dental unit designs, this may result in water dripping onto the patient. A viable alternative is the installation of a check valve (anti-retraction valve) downstream from the retraction valve. Installation of a check valve resulted in an almost 4,000-fold decrease in this contamination. The attachment of a check valve will have no effect on normal less virulent bacteria already present in tap water. These bacteria colonize the water lines of the dental unit and are then continually shed into the water in numbers often as high as 1,000,000 CFU/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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This literature review and discussion has presented evidence that some additional research needs to be done in this area. Particular attention should be paid to control certain variables: kind and type of waveform, shape and size of electrode, and speed of the electrode through the tissue so that meaningful results may be given to the dental profession. The evaluation of the literature seems to show that when the variables are controlled, untoward results of wound healing after electrosurgery seem unwarranted.