The purpose of this study was to evaluate the clinical performance of preformed beta-quartz glass-ceramic insert restorations.
Nine Class I and 30 Class II beta-quartz glass-ceramic insert restorations were placed in 16 patients who were seen regularly by personnel at Umeå University Dental School. The California Dental Association criteria were used to evaluate the restorations at baseline, 6 months, and 1, 2, and 3 years after luting. The occurrence of postoperative sensitivity, the time taken to manufacture each restoration, and certain periodontal conditions were also evaluated.
Sixty-nine percent of the restorations were rated satisfactory at the 3-year examination. During the follow-up period, 4 became loose and 7 were fractured or had flaking surfaces. Caries was registered in connection with 1 restoration. Excellent ratings were obtained for marginal integrity, anatomic form, surface, and color in 62%, 84%, 32%, and 44% of the restorations, respectively. There was no statistically significant difference in the occurrence of plaque and bleeding on probing in comparison with the controls. The mean overall time for placement was 38 minutes. The estimated survival rate (Kaplan-Meier) was 59% after 3.5 years.
The quality of the beta-quartz glass-ceramic restorations in the present study was inferior to that presented in most earlier studies of ceramic or resin composite posterior restorations placed in patients treated at university clinics. Both the technique and the beta-quartz glass-ceramic inserts have to be evaluated in more long-term studies to assess the possibility of their serving as an alternative restorative technique.
The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P
A dental examination was included in a mainly medically oriented population study of women in Gothenburg, Sweden. From panoramic radiographs the numbers of remaining teeth, restored teeth (fillings and crowns), pontics, and endodontically treated teeth were assessed in 1968-69 and in a 12-yr follow-up study in 1980-81. Women aged 38, 46, 50, 54 and 60 yr were initially studied. In the follow-up study, a group of 38-yr-old women was added. A comparison between cross-sectional data in 1968-69 and in 1980-81 in women aged 38 and 50 yr showed some marked differences. Dentulous women of the same age had in 1980-81 a larger mean number of teeth and a larger number of restored teeth (including crowns). The number of restored teeth in relation to remaining teeth was the same in the 38-yr-old women in 1980-81 but had increased in the 50-yr-olds. The absolute and relative numbers (in relation to remaining teeth) of crowns (also studied separately), pontics, and endodontically treated teeth were about the same in 1968-69 and 1980-81 both for the 38-yr-olds and the 50-yr-olds. There was a slight but statistically significant increase only in the absolute number of crowns for the 50-yr-olds. The follow-up study showed a moderate decrease of remaining teeth in all age groups. Related to remaining teeth, the number of restored teeth (including crowns), crowns, pontics, and endodontically treated teeth showed a statistically significant increase for all age groups except for the oldest, in which group a significant increase was only observed for crowns.
In a long-term series analysis the study had the aim of detecting how the used socioeconomic variables were related to the caries status development in the year group leaving the organised dental care. The study included caries epidemiological records of individuals at the Public Dental Service of Göteborg, leaving the organised dental care during 1986-2000. The City of Göteborg was divided into four districts. One incidence and one prevalence caries index was used, each presented in two subgroups: individuals with no caries record and patients with 20% of the highest index values. The socio-economical variable was individuals 18-64 years of age, seeking employment, as a percentage of the corresponding group of all inhabitants. The registered values were divided into three time sections of five years each. In the first, the socio-economic value curves were almost horizontal, in the second they showed a considerable increasing and in the third a declining tendency. The result curves for the caries-free patient groups and for patients with 20% of the highest caries index values compared to the three socioeconomical time sector results, showed an almost horizontal level concerning the incidence index values, and for the prevalence index values an inclined curve structure to the incidence curves. The result curves for the incidence index with respect to the caries-free patient group showed an almost horizontal structure, while the prevalence curves inclined towards the incidence curves during the study period. The linear structure of these curves deviated considerably from the result curves for the socio-economic time series. No correlation existed between the socio-economic data and the studied caries index values. The need for determining the time length concerning caries index observations was discussed. It must be of special interest to maintain the dental health of the studied patient group and the individuals' relation to regular dental care, when as adults they meet the dental care economy.
Knowing which factors influence restoration longevity can help clinicians make sound treatment decisions. The authors analyzed data from The National Dental Practice-Based Research Network to identify predictors of early failures of amalgam and resin-based composite (RBC) restorations.
In this prospective cohort study, the authors gathered information from clinicians and offices participating in the network. Clinicians completed a baseline data collection form at the time of restoration placement and annually thereafter. Data collected included patient factors, practice factors and dentist factors, and the authors analyzed them by using mixed-model logistic regression.
A total of 226 practitioners followed up 6,218 direct restorations in 3,855 patients; 386 restorations failed (6.2 percent) during the mean (standard deviation) follow-up of 23.7 (8.8) months. The number of tooth surfaces restored at baseline helped predict subsequent restoration failure; restorations with four or more restored surfaces were more than four times more likely to fail. Restorative material was not associated significantly with longevity; neither was tooth type. Older patient age was associated highly with failure (P
Cites: J Am Dent Assoc. 2005 Jun;136(6):790-616022046
During the last 10-20 yr there has been a marked increase in demand for dental services in most western countries. An important issue is how this increase in demand has influenced inequalities in use of services among different income groups in the population. It is of particular interest to study this in Norway, as almost all the costs for dental care among adults are borne by the patient. The aim of the present study was to examine how the effect of family income on demand for dental services has changed over time. The analyses were performed on three sets of national data from 1977, 1983, and 1989. The samples were representative of the non-institutionalized Norwegian population aged 20 yr and above. Inequalities in use of dental services among different income groups have decreased between 1977 and 1989. However, separate analyses on the data from 1989 showed that some inequalities still exist. A non-selective subsidizing policy for dental care is unlikely to have any great effect in reducing these inequalities. Subsidized dental care is likely to raise the total amount of dental care demanded. However, it is difficult to assess accurately the size of this increase as the elasticity of demand for dental care in Norway with respect to price is unknown.
A computer method enabling metric measuring in radiographs has been presented. The measurements are time saving and precise and accurate measurements can be made. The statistical analysis can be performed based on a ratio scale, allowing more reliable and conclusive statistics. The most useful field for the presented method is offered in epidemiology where great materials are being handled. Since small changes can be studied, the method can be useful in studying marginal bone level changes in large populations. Or marginal bone levels around implants. In age estimation the digitizer method has no direct valuable application during adolescence, when the lower third molar is used. Here the present series of studies showed the traditional age estimation method and the digitizer method to be fairly unprecise with rather large systematic error. The skeletal age estimation method according to Greulich and Pyle was found to be more accurate and useful during the ages 14 up to 18 years. In younger children, where more parameters or teeth are available, there may be advantages to use a digital dental method instead of a traditional dental one.
During recent decades, the duties and care rendered by Swedish dental hygienists have continuously expanded, and since 1991 they are licensed to practice dental hygiene independently. The aim of the present study was to investigate the accuracy of dental hygienists in examining and recording dental caries in comparison with dentists performing identical examinations. The study included two parts: A) Registration of carious lesions from radiographs of 100 extracted teeth, where the correct diagnosis could be verified, and B) clinical examination and registration of carious lesions in 213 patients. No statistically significant differences could be found between the dental hygienists' and their control dentists' accuracy to diagnose and record dental decay, with the exception of the number of initial lesions (white spot lesions) registered clinically, where the dental hygienists recorded more buccal and lingual lesions. Irrespective of the group of examiners (dental hygienists or dentists), however, the inter-examiner variation was wide. The variation decreased with the size of the lesion and increased with the age of the patient. This study suggests that no patient with a restorative treatment need would have been neglected if the dental hygienists had performed the examination, and, possibly, a more accurate non-restorative treatment need would have been addressed.
In a cross-sectional survey the age of restorations in situ was recorded in three patient groups. Group A were randomly examined regular attenders, group B were irregular attenders randomly chosen from patient treatment records, and in group C the age of posterior gold and composite resin restorations was recorded in selected regular attenders. The study material included 8310 restorations in group A, 1281 in group B, and 500 restorations in group C. The three materials amalgam, composite, and gold accounted for more than 90% of all restorations. In group A 3.3% of the restorations were scheduled for replacement. The most prevalent reasons for replacement were secondary caries, bulk fractures of the restoration, and tooth fractures. The median age of the failed restorations was fairly similar to the median age of the acceptable restorations in situ among the regular patients (group A). The data indicate median ages of 20 years for gold restorations, 12-14 years for amalgam restorations, and 7-8 years for composite resin restorations. The restoration ages were influenced by the type and size of the restoration, the restorative material used, and possibly also the intra-oral location of the restorations.
OBJECTIVE: Our objective was to study whether dental condition, measured by numbers of sound, decayed, missing, and restored teeth, was associated with dental fear, and whether age, dental attendance, and/or gender modified this association. MATERIAL AND METHODS: The sample (n=8,028) comprised Finnish adults aged 30 years and older and the study included people (n=6,335) who participated in a home interview and a clinical dental examination. Dental fear was measured by the question: "How afraid are you of visiting a dentist?" Multiple logistic regression analysis was used to determine the association between dental fear and dental condition variables, i.e. numbers of decayed, missing, sound, and restored teeth considering the effects of age, attendance, and gender. RESULTS: With the exception of number of restored teeth, all dental condition variables were associated with dental fear. The association between dental fear and number of decayed teeth was positive and was independent of age, gender, and attendance. Age modified the association between dental fear and number of missing and sound teeth. Among the oldest age group, the numbers of missing and sound teeth were positively associated with dental fear while being negatively associated among the youngest age group. CONCLUSIONS: People with high dental fear have poorer dental condition than those with lower fear. Neither gender nor dental attendance affects the association between dental fear and dental condition. The associations between dental fear and numbers of missing and sound teeth vary according to year of birth.