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Repeat general anaesthesia for paediatric dentistry

BRITISH DENTAL JOURNAL 2000年第1期189卷 37-39页

作者： Harrison, M Nutting, L Guys Kings & St Thomas Dent Inst Dept Orthopaed & Paediat Dent London SE1 9RT England

Aims To investigate patterns of referral, disease and treatment for healthy children who had received two or more dental general anaesthetics (DGA) for exodontia. Methods Records from 200 episodes of repeat DGA were studied retrospectively. Results The mean age of patients at first referral was 5y4m, and the mean interval before repeat was 22 months. Self-referrals rose from 14% at DGA1 to 30% at DGA2. New caries at second referral, where all diagnosed disease had been treated at DCA1, accounted for only 15% of the total. Where a specific request was made in the referral, only 8% of letters matched the charting made in hospital. 30% of all specific requests were honoured, but then required treatment for previously diagnosed caries at DGA2. 75% of single-tooth extractions required repeat DGA for caries left at DGA1. Conclusions It may be too optimistic to address only the most grossly diseased teeth when a child requires GA exodontia. A more radical treatment-planning approach, combining primary care, secondary care and public health considerations, may be required to avoid the unnecessary use of DGA.

关键词：麻醉牙科/统计学和数值数据麻醉全身/统计学和数值数据儿童口腔保健/统计学和数值数据龋齿/流行病学龋齿/外科学转诊和会诊/统计学和数值数据回顾性研究拔牙/统计学和数值数据儿童学龄前人类

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A 12-year retrospective audit study of tooth loss in a general dental practice

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BRITISH DENTAL JOURNAL 2000年第2期189卷 98-99页

作者： Nicholls, C Charminster House Dent Practice Bournemouth BH8 8JL Dorset England

Objectives To determine the incidence of periodontal disease in a general dental practice, and to evaluate the effectiveness of treatment in preventing tooth loss over a period of 12 years. Design This was a single centre retrospective analysis. Setting A general dental practice in Bournemouth. Subjects and methods Over a 6-month period from February 1997 to August 1997 records were made of all patients attending: at the practice who had presented for dental examination between September 1985 and September 1986. A database was constructed to record the number of teeth present at the beginning of the study, those which at their initial exam had probing depths of between 5 and 6 mm, and those with 7 mm and greater. If teeth were lost, the date of the extraction was recorded. Interventions All patients were treated by conventional dental therapy. Main outcome measures Tooth loss was chosen as the endpoint. Results 13% of the patients presenting initially had periodontal problems, and conventional treatment resulted in very few teeth being lost over the study period. Conclusions Periodontal disease affected only a small number of the patients in the general dental practice. Those patients affected responded well to conventional therapy, resulting in very few teeth being lost during the period of study.

关键词：口腔医疗质量评定英格兰/流行病学开业医生牙科/统计学和数值数据发病率牙周疾病/治疗牙周指数回顾性研究拔牙/统计学和数值数据牙缺失/流行病学牙缺失/预防和控制成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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More than lip service: Facial esthetics in orthodontics

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第8期130卷 1173-1181页

作者： Bowman, SJ Portage MI 49024 1314 Wast Milham Ave. United States

Background. Current trends in orthodontic care emphasize alternatives to the extraction of premolars, despite a lack of support from the refereed literature for many of the nonextraction treatments. Description of the Situation. Anecdotal reports published in non-peer-reviewed journals have called into question the esthetic effects of extraction treatment. As calls for evidence-based treatments increase throughout dentistry, reports on the effects-both positive and negative-of different orthodontic options have appeared in growing numbers. Clinical Implications. Given the results of a variety of reports in the peer-reviewed literature, it may be concluded that orthodontic treatment involving extractions can produce improved esthetics for many patients who have some combination of crowding and protrusion. However, careful diagnosis followed by evidence-based treatment decisions should be the accepted clinical norm as the specialty of orthodontics embarks on its second century.

关键词：美学牙科错|牙合|/治疗正畸学矫正/方法病人满意度拔牙/统计学和数值数据人类

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TOOTH MORTALITY IN AN ADULT RURAL-POPULATION IN KENYA

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JOURNAL OF DENTAL RESEARCH 1988年第2期67卷 496-500页

作者： MANJI, F BAELUM, V FEJERSKOV, O ROYAL DENT COLL DEPT PERIODONTOL & ORAL GERONTOL DK-8000 AARHUS DENMARK ROYAL DENT COLL DEPT ORAL ANAT DENT PATHOL & OPERAT DENT DK-8000 AARHUS DENMARK

This paper reports on the pattern of tooth loss in a random sample of 1131 adults aged from 15 to 65 years in a rural area of Kenya in which access to formal dental care is minimal. We found that the majority of the population retained most of their dentition in a functional state even up to the age of 65 years. In all age groups, more than 50% had a least 26 teeth present, and more than 90% had at least 16 teeth present. The prevalence of edentulousness was less than 0.3%. The principal cause of tooth loss in all age groups was caries, and this was true for all tooth-types except incisors, for which peridontal disease was the main cause of tooth loss. The cultural practice of removing lower central incisors was observed only in those over 40 years of age. More teeth were lost due to caries among women than among men, while the reverse was true for teeth lost due to periodontal diseases. In view of the fact that most people retain most of their teeth throughout life, it is suggested that the most appropriate strategies for dental health care in this population should be those promoting self care, rather than the introduction of a formal treatment-oriented approach provided by dentists.

关键词：聚类分析龋齿/并发症龋齿/流行病学发展中国家健康计划肯尼亚/流行病学口腔无牙/流行病学牙周疾病/并发症牙周疾病/流行病学患病率抽样研究拔牙/统计学和数值数据牙缺失/流行病学牙缺失/病因学青少年成年人老年人女(雌)性人类男(雄)性中年人

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Provision of dental general anaesthesia for extractions in child patients at two centres

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BRITISH DENTAL JOURNAL 1999年第9期187卷 498-501页

作者： Holt, RD Al Lamki, S Bedi, R Dowey, JA Gilthorpe, M UCL Eastman Dent Hosp Dept Transcultural Oral Hlth London WC1X 8LD England Mancunian Community Hlth & NHS Trust Manchester M21 7RL Lancs England

Aim At two contrasting centres, to describe the provision of dental general anaesthesia (DGA) for simple non-surgical extractions in terms of the type of treatment provided, including the number of primary and permanent teeth extracted, and the characteristics of child patients attending in terms of their age group and gender. Design Retrospective analysis of hospital records. Method Data were drawn from records of services over a 12-month period in 1996/97 at: a) a London dental hospital (Centre 1), and b) in the community dental services inRochdale, Lancashire (Centre 2). Information was collated and analysed using the SPSS statistical software package. Results The majority of patients at both centres were aged less than 9 years. Almost one third (31%) of those seen at Centre 1 were below 5 years of age, but fewer of this age group were treated at Centre 2. Children aged 9 years or less had an average of 5.4 (SD = 3.0) primary teeth extracted at Centre 1 and 3.0 (SD = 2.0) at Centre 2. For permanent teeth, an average of 3.2 (SD = 1.2) and 2.7 (SD= 1.4) were extracted at Centres 1 and 2 respectively. Conclusions Both services were used primarily for the extraction of primary teeth although the services differed in the ages of patients who used them and in the numbers of teeth extracted. Numbers of patients attending the service at Centre 1 had declined over time but numbers of teeth extracted per child had increased.

关键词：麻醉牙科/统计学和数值数据麻醉全身/统计学和数值数据儿童口腔保健/统计学和数值数据牙列恒英格兰拔牙/统计学和数值数据牙乳青少年儿童儿童学龄前女(雌)性人类男(雄)性

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The impact of the ART approach on the treatment profile in a Mobile Dental System (MDS) in South Africa

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INTERNATIONAL DENTAL JOURNAL 1999年第3期49卷 132-138页

作者： Mickenautsch, S Rudolph, MJ Ogunbodede, EO Frencken, JE Univ Witwatersrand Dept Community Dent ZA-2017 Braamfontein South Africa

The changing profile of oral care rendered through the Mobile Dental System (MDS), after the introduction of the Atraumatic Restorative Treatment (ART) approach is described. During the first year of introduction of ART, the percentages of amalgam restorations and tooth extractions decreased significantly (P<0.0001). This is partly ascribed to a change in choice of treatment by dental operators in favour of ART and also due to an increase in acceptance by patients because of the reduced fear, and the patient-friendly nature of the ART approach. The reduction in amalgam restorations was 16.0 per cent for permanent and 1.4 per cent for primary posterior teeth. Extraction of posterior teeth was reduced by 17.4 per cent in the permanent and 35.7 per cent in the primary dentitions. The restorative component of oral care increased by 33.4 per cent in the permanent and 37.1 per cent in primary posterior teeth. The one-year survival of one-surface ART restorations using Fuji IX and KetacMolar was 93.6 per tent. Full and partial (more than 90 per cent) retention of the sealant part of the ART restoration was obtained in 75 per cent of the cases after one-year. During the one-year period, infection control was made more simple and this facilitated easier maintenance of mobile dental equipment. The introduction of the ART approach reduced extraction, restored more teeth and made oral care in the MDS more preventive, less threatening and thus more patient-friendly.

关键词：牙科汞合金牙科治疗焦虑/预防和控制牙黏合儿童口腔保健龋齿/预防和控制龋齿/治疗牙科设备/微生物学牙修复永久/方法牙修复永久/统计学和数值数据牙医病人关系设备污染/预防和控制玻璃离聚物黏固剂感染控制口腔巡回卫生队病人接受卫生保健的程度南非/流行病学存活率分析牙拔牙/统计学和数值数据牙乳儿童人类

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The cost, effectiveness and cost effectiveness of removal and retention of asymptomatic, disease free third molars

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BRITISH DENTAL JOURNAL 1999年第7期187卷 380-383页

作者： Edwards, MJ Brickley, MR Goodey, RD Shepherd, JP Univ Wales Coll Cardiff Coll Med Sch Dent Dept Oral Surg Med & Pathol Cardiff CF4 4XY S Glam Wales

Purpose of investigation The study was undertaken to identify the least costly, most effective and most cost-effective management strategy for asymptomatic, disease free mandibular third molars. Methods and patients A decision tree model of the outcomes of mandibular third molar retention and removal was constructed. Probability data for possible outcomes were obtained from a comprehensive literature review and entered into the decision tree. The cost to the NHS in treating each outcome was calculated. 100 patients attending the oral surgery clinics, University of Wales Dental Hospital rated the effect of each outcome on their own life. The cost and effectiveness data for each outcome were entered into the decision tree and the analyses were conducted by 'folding back' the decision tree based on the probabilities. Main findings Mandibular third molar retention was less costly (pound 170), more effective (69.5 effectiveness units on a 100 point scale) and more cost-effective (pound 2.43 per unit of effectiveness) than removal (pound 226, 63.3 and pound 3.57 respectively). These findings were sensitive to changes in the probability of pericoronitis, periodontal disease and caries. Principal conclusions Mandibular third molar retention is less costly to the NHS, more effective for the patient and more cost-effective to both parties than removal. However, should the likelihood of developing pericoronitis, periodontal disease and caries increase substantially then removal becomes the more cost-effective strategy.

关键词：费用效益分析决策树龋齿/经济学龋齿/病因学卫生保健费用/统计学和数值数据磨牙第三/外科学结果与过程评价(卫生保健)/方法冠周炎/经济学冠周炎/病因学牙周疾病/经济学牙周疾病/病因学公费牙科医疗/经济学拔牙/经济学拔牙/统计学和数值数据牙阻生/并发症牙阻生/经济学人类

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Extracting premolars

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第12期130卷 1696-1696页

作者： Altomare, JM Orlando Fla.

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Extraction vs. nonextraction

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第12期130卷 1695-1696页

作者： Mew, JRC London Sch Facial Orthotrop Surrey England

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正畸拔牙率的回顾

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中华口腔正畸学杂志 2003年第3期10卷 119-119页

作者：肖永芳山西大同三二二医院口腔科第四军医大学口腔医学院正畸科

本研究的目的是估计进行下颌侧向扩展时的牙弓周长的增加量。下颌扩弓通过三维(3D)有限元方法(FEM)和计算机图样技术模拟。侧向扩展时磨牙的旋转中心通过使用3DFEM来计算,几何模型的确定使用了一个东印度人骨骼标本中的下颌骨及间距为1m... 详细信息

本研究的目的是估计进行下颌侧向扩展时的牙弓周长的增加量。下颌扩弓通过三维(3D)有限元方法(FEM)和计算机图样技术模拟。侧向扩展时磨牙的旋转中心通过使用3DFEM来计算,几何模型的确定使用了一个东印度人骨骼标本中的下颌骨及间距为1mm厚的计算机体层摄影(CT)。3D排列模拟是通过3D计算机图样技术而不是手工操作来引导的。在后牙段即从第一前磨牙到第二恒磨牙产生了旋转运动,在3D排列模型中通过有限元方法可以

关键词：拔牙/统计学和数值数据回顾性研究正畸学矫正综述人类

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