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Effective dose equivalent and effective dose: Comparison for common projections in oral and maxillofacial radiology

ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS 2000年第4期90卷 538-545页

作者： Gibbs, SJ Vanderbilt Univ Med Ctr Dept Radiol & Radiol Sci Nashville TN 37232 USA

Objectives. Effective dose equivalents (H-E) and effective doses (E) for radiographic projections common in dentistry, calculated from the same organ dose distributions, are presented to determine whether the 2 quantities can be directly compared. Study design. Doses to all organs and tissues in the head, neck, trunk. and proximal extremities were determined for each projection (intraoral full-mouth radiographic survey, panoramic, cephalometric, temporomandibular tomograms, and submentovertex view) by computer simulation with Monte Carlo methods. H-E and E were calculated from these complete distributions and by methods prescribed by the International Commission on Radiological Protection (ICRP). Results. H-E and E computed from complete dose distributions were found comparable within a few percentage points. However, those computed by strict application of ICRP methods were not. Conclusion. For radiographic projections with highly localized dose distributions, such as those common in dentistry, direct comparison of H-E and E may not be meaningful, unless both computation algorithms are known.

关键词：算法计算机模拟蒙特卡罗法器官特异性辐射剂量放射摄影术牙科/统计学和数值数据放射测量术/统计学和数值数据参考标准随机过程人类

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Effectiveness of sealant treatment

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 2000年第5期131卷 597-605页

作者： Dennison, JB Straffon, LH Smith, RC Univ Michigan Sch Dent Dept Cariol Restorat Sci & Endodont Ann Arbor MI 48109 USA Univ Michigan Sch Dent Dept Orthodont & Pediat Dent Ann Arbor MI 48109 USA Delta Dent Plan Michigan Lansing MI USA

Background, The authors analyzed an insurance claim database to evaluate the use and effectiveness of placing sealants on first and second permanent molars of children in private dental practices. Methods. A retrospective study was conducted using an insured population with sealant coverage at 70 percent of the usual fee in a preferred provider organization plan that limited reapplication to once every three years. Children were selected who were eligible for sealant benefits from July 1, 1990, to June 30, 1991. Two groups were selected for analysis;based on age, as determined by permanent molar eruption dates. Children who received sealants were compared with those who did not to determine post-sealant restorative outcomes after five years. Results, During the full year of coverage, sealants were used in only 16.3 percent of first permanent molars and 11.6 percent of second permanent molars. The five-year incidence of an occlusal restoration having been placed was 13.7 percent and 20.8 percent, respectively, on nonsealed first and second molars and 6.5 percent and 10.4 percent, respectively, on sealed first and second molars. From years three to five, sealant placement provided only nominal additional preventive effect. Conclusions, In the population selected, both the incidence of occlusal caries and the use of sealants were lower than expected for both age groups. However, within these groups, molar occlusal surfaces were only half as likely to have been restored in sealed teeth than in nonsealed teeth after five years. Clinical Implications. Based on the live-year data from a population with a low incidence of caries, the authors found that 15 sealed first permanent molars or 10 sealed second permanent molars prevented placement of one occlusal.. restoration. Therefore, sealants are more effective when placed in patients with risk factors for occlusal caries.

关键词：龋齿/预防和控制牙列恒按诊疗收费计划/统计学和数值数据保险索赔审核/统计学和数值数据保险牙科/统计学和数值数据密执安磨牙窝沟封闭剂/治疗应用回顾性研究时间因素青少年儿童儿童学龄前人类

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Views of academic dentists about careers in academic dentistry in the United Kingdom.

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BRITISH DENTAL JOURNAL 2000年第3期188卷 154-159页

作者： Goldacre, M Lee, P Stear, S Sidebottom, E Richards, R Univ Oxford Inst Hlth Sci Unit Healthcare Epidemiol UK Med Careers Res Grp Oxford OX3 7LF England Univ Oxford Merton Coll Oxford OX1 4JD England Univ Oxford St Hildas Coll Oxford OX4 England

The aim of this paper is to report the views of academic dentists about careers in academic dentistry assessed by method of a postal questionnaire survey. The subjects of the survey were dentists in academic posts in the United Kingdom. The incentives in pursuing an academic career which respondents rated most highly were the opportunity to teach and the variety of work in an academic career. The greatest disincentives were competing pressures from service work, teaching and research, and the difficulty of getting research grants. Many would like to spend more time on research and less on service work and teaching. The length of time required for training, and the quality of training, was a concern, particularly for junior academics. Most respondents rated the enjoyment of their job highly but scored much lower on satisfaction with the time their job left for domestic and leisure activities. By contrast with academic medicine, in academic dentistry there is typically greater emphasis on teaching and less on research. In conclusion, the balance of activities in academic posts, particularly between service work, teaching and research, needs to be regularly reviewed. The development of a more structured training programme for junior academics, which does not disadvantage academic dentists when compared with their NHS colleagues, may be required.

关键词：医务工作者的态度职业选择卡方分布牙医师/心理学牙医师/统计学和数值数据牙医师女/心理学牙医师女/统计学和数值数据教育牙科/统计学和数值数据职业满意统计学非参数工作负荷量/统计学和数值数据女(雌)性人类男(雄)性

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A survey of the teaching of conscious sedation in dental schools of the United Kingdom and Ireland

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BRITISH DENTAL JOURNAL 2000年第4期188卷 211-216页

作者： Leitch, JA Girdler, NM Univ Newcastle Dent Sch & Hosp Newcastle Upon Tyne Tyne & Wear England Glasgow Dent Hosp & Sch Glasgow Lanark Scotland

Aim To assess and compare, for the first time, the quantity and quality of dental undergraduate teaching in conscious sedation in the dental schools of the UK and ireland. This was achieved using a prospective, questionnaire-based survey. Methods Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final year dental undergraduates at the 16 dental schools in the UK and Ireland. Staff questionnaires were distributed to a nominated sedation teacher at each dental school and sought details of didactic and clinical sedation teaching methods, plus the quantity and perceived quality of sedation teaching. Student questionnaires were distributed to 5th year dental students and enquired about the quantity and quality of clinical sedation teaching received. The survey was undertaken during May-lune 1998. Results Thirteen dental schools returned staff questionnaires (81%). Seven also provided a student response (44%). The proportion of final year students within the 7 schools who returned completed questionnaires was 38%. Sedation teaching was undertaken primarily by oral surgery and paediatric dental departments. Three schools also utilised anaesthetic departments and 2 schools had dedicated dental sedation departments. All but 2 schools provided didactic teaching on sedation (mean: 4.2 lectures, 1.8 seminars). Of the 7 schools which returned staff and student questionnaires, all provided some clinical training using inhalational and intravenous demonstration cases (mean 5.1 and 4.4 cases, per student, respectively). All but one school provided hands-on inhalational sedation experience (mean 2.6 cases per student) but only two:schools provided any hands-on intravenous sedation experience. The quantity of hands-on experience was greater at the two dental schools with dedicated dental sedation departments. Across the schools students rated the overall quality of Sedation teaching at average or above, but most staff g

关键词：麻醉牙科麻醉学/教育清醒镇静教育牙科/统计学和数值数据评价研究(主题) 爱尔兰前瞻性研究院校牙科/统计学和数值数据人类

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A comparison of the experiences of newly qualified dentists and vocational dental practitioners during their first year of general dental practice

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BRITISH DENTAL JOURNAL 2000年第2期189卷 101-106页

作者： Ralph, JP Mercer, PE Bailey, H Univ Leeds Dept NHS Postgrad Med & Dent Educ Leeds LS2 9JT W Yorkshire England

The views of young dentists, both VDP and non-VDP, in their first year in dental practice were sought by means of a postal survey. The majority felt they had received guidance and support from their principals, though... 详细信息

关键词：医务工作者的态度牙医师/心理学牙医师/统计学和数值数据教育牙科/方法教育牙科/统计学和数值数据开业医生牙科/教育开业医生牙科/统计学和数值数据职业满意导师导师制/统计学和数值数据成年人女(雌)性人类男(雄)性

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Dental services: Use, expenditures and sources of payment, 1987

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第4期130卷 500-508页

作者： Manski, RJ Moeller, JF Maas, WR Univ Maryland Sch Dent Dept Oral Hlth Care Delivery Baltimore MD 21201 USA

Background This article pro rides per capita estimates of dental care utilization, expenditures mix of services and sources of payment for each of several socioeconomic and demographic categories. Methods. The focus of the analyses presented here is on dental cafe utilization by the U.S, population during 1987. Specifically, national estimates are provided for dental visits, expenditures, sources of payment and procedure type for each of several socioeconomic and demographic categories using household data from the 1987 National Medical Expenditure Survey, or NMES. Results. During 1987, less that 50 percent of Americans visited a dental office. Americans made approximately 292 million dental visits and received approximately $30 billion worth of dental care, of which $10 billion was paid by insurers, $17 billion was paid out of pocket and $1.6 billion was not reimbursed. Conclusions. These analyses establish the magnitude of the dental care market and the amounts paid by individual patients, private insurance companies and Medicaid. They also reveal that the type of care received varies among people in distinct socioeconomic and demographic groups. Practice Implications. Although the dental care market is substantial, many Americans do not visit a dentist. By understanding these analyses. practitioners will be better positioned to meet the dental needs of all Americans.

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Medical emergencies in general dental practice in Great Britain - Part 1: their prevalence over a 10-year period

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BRITISH DENTAL JOURNAL 1999年第2期186卷 72-79页

作者： Atherton, GJ McCaul, JA Williams, SA Univ Dent Hosp Manchester Dept Orthodont Manchester M15 6FH Lancs England Halifax Gen Hosp Calderdale Healthcare NHS Trust Halifax NS HX3 0PW Canada Univ Glasgow Western Infirm Dept Surg W Scotland Basic Surg Training Scheme Glasgow G11 6NT Lanark Scotland Univ Leeds Leeds Dent Inst Leeds LS2 9LU W Yorkshire England

Objective To assess the prevalence, nature and outcome of medical emergencies experienced by general dental practitioners (GDPs) over a 10-year period. Design Postal questionnaire survey of a random sample of GDPs in Great Britain. Subjects 1500 GDPs, 1000 in England & Wales and 500 in Scotland. Results There was a 74% response. Emergency events were reported by 70.2%: the number reported by a single individual ranged from none to 33. The most commonly experienced events, including those associated with general anaesthesia, were (as a percentage of the total) for England & Wales and Scotland, respectively: fits and seizures (31.0%, 36.3%);swallowed foreign bodies (15.7%, 18.1%);attacks of asthma (13.8%, 11.1%);chest pain associated with angina pectoris (10.1%, 11.0%) and diabetic events (10.6%, 9.0%): none of these resulted in any serious sequelae. More events were reported in Scotland. Overall, there were 20 deaths resulting from medical emergencies reported in the survey, 4 affecting passers-by and none associated with general anaesthesia. 8849 years of practice experience were represented (by 94% of respondents), from which an estimate of the frequency of events was made. Conclusions An emergency event was reported, on average, for every 4.5 practice years in England & Wales and 3.6 years in Scotland and death associated with general dental practice, on average, once in 758 and 464 years, respectively.

关键词：死亡原因急症/分类急症/流行病学急救医疗服务/统计学和数值数据开业医生牙科/统计学和数值数据患病率治疗结果人类

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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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Patterns and appropriateness of referral from general dental practice to specialist oral and maxillofacial surgical services

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BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 2000年第4期38卷 320-325页

作者： Coulthard, P Koron, R Kazakou, I Macfarlane, TV Univ Manchester Dent Hosp Manchester M15 6FH Lancs England

In this study we investigated patterns of referral and appropriateness of referrals to specialist oral and maxillofacial surgery services, using postal questionnaires and referral letters. The most common reasons for referral were the expected difficulty of the operation, the medical condition of the patient and the lack of facilities for general anaesthesia, Most referrals were made to the oral and maxillofacial surgery department of a general hospital but almost three-quarters of the respondents stated that they would refer patients to specialist surgical dentistry practices in the future. Few referrals to a university department of oral and maxillofacial surgery were considered to be inappropriate, nor were requests for a particular type of anaesthesia. Any future transfer from secondary to primary care for oral surgery may be hindered by the reduction in facilities for general anaesthesia in the primary care setting.

关键词：麻醉牙科/统计学和数值数据临床工作能力牙医诊疗模式/统计学和数值数据英格兰开业医生牙科/统计学和数值数据卫生服务滥用/统计学和数值数据问卷调查转诊和会诊/统计学和数值数据外科口腔/统计学和数值数据成年人女(雌)性人类男(雄)性中年人

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Repeat general anaesthesia for paediatric dentistry

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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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