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The largest minority population in the U.S. without adequate dental care

SPECIAL CARE IN DENTISTRY 2017年第4期37卷 159-163页

作者： Waldman, H. Barry Perlman, Steven P. Wong, Allen SUNY Stony Brook Dept Gen Dent Stony Brook NY 11794 USA Boston Univ Goldman Sch Dent Med Special Olymp Special Smiles Boston MA 02215 USA Boston Univ Goldman Sch Dent Med Pediat Dent Boston MA 02215 USA Univ Pacific AEGD Program Arthur A Dugoni Sch Dent San Francisco CA USA Univ Pacific Hosp Dent Program Arthur A Dugoni Sch Dent San Francisco CA USA

A recent series of reports in Health Affairs reviewed the disparities in securing needed oral health services in the U.S. Despite an extensive oversight of the many issues involved, no direct mention is made of the particular conditions of the largest minority population in the U.S. unable to access dental care-the tens of millions of individuals with special health care needs. A review is provided of the particular barriers and conditions faced by this increasing population in its efforts to secure needed services.

关键词： access barriers care education-postdoctoral

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Studying the prevalence and etiology of Class II subdivision malocclusion using cone-beam computed tomography

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JOURNAL OF THE WORLD FEDERATION OF ORTHODONTISTS 2016年第4期5卷 126-130页

作者： Anderson, William M. Marsh, Curtis M. Kessel, Neil C. Dunn, William J. US Naval Hosp Naples Caserta Italy Air Force Postgrad Dent Sch Triserv Orthodont Program Orthodont JBSA Lackland TX USA AEGD 2 Residency Program JBSA Lackland TX USA Uniformed Serv Univ Hlth Sci JBSA Lackland TX USA

Background: The purpose of this study was to investigate the prevalence of subdivision malocclusions in Class II/1 and Class II/2 patients and to see if the II/2 group had greater skeletal asymmetry. Methods: From a sample of more than 1500 records, 256 Class II malocclusions met inclusion criteria. Of these, 214 were Class II/1 and 42 were Class II/2. Seven landmarks identified on cone-beam computed tomography scans were used to make eight bilateral linear measurements. Right and left side differences were calculated for each subject, and median values were compared. Linear measurements from the Class I side of the subdivision malocclusion to the Class II side were compared. Results: Of II/1 subjects, 22.9% had a subdivision malocclusion versus 50% of the II/2. There were no significant side-to-side differences between Class II/1 and II/2 subjects. There were greater differences in the II/2 group between the Class I side of subjects to the Class II side than in the II/1 group. Conclusion: All mandibular variables indicated greater degrees of mandibular asymmetry in the II/2 group;only condylion to pogonion proved statistically significant. (C) 2017 Published by Elsevier Inc. on behalf of World Federation of Orthodontists.

关键词： Asymmetry Cone-beam computed tomography Orthodontics Subdivision malocclusion

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Foreign service special care opportunity in SCDA

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SPECIAL CARE IN DENTISTRY 2015年第5期35卷 206-213页

作者： Hicks, Jeff Schaffer, Rebecca Frances, Denise Usher, Sarah Barnes, Jeff Sabbah, Ahmed Univ Texas Hlth Sci Ctr San Antonio San Antonio TX 78229 USA Arizona Sch Dent & Oral Hlth Mesa AZ USA Lutheran Med Ctr AEGD Program New York NY USA Univ New Mexico AEGD Program Albuquerque NM USA Univ Texas Hlth Sci Ctr San Antonio AEGD Program San Antonio TX USA

A foreign service clinic in Guatemala caring for patients with special needs was initiated by joining SCDA efforts with the Open Wide Foundation. The trip included five SCDA members: two aegd residents and three support staff. Open Wide participants included the Executive Director, the Clinical Director in Guatemala, as well as two dentists, dental support staff, and Guatemalan dental students. Two physician anesthesiologists provided general anesthesia. Care adjuncts included general anesthesia, oral sedation, and medical stabilization. Lessons learned: (1) Conducting a dental clinic for patients with special needs is possible and relatively easy to accomplish, given a partnership with a foundation that agrees with and facilitates this service;(2) advance planning is required to maximize the service provided;(3) committed and flexible team members can accomplish a significant amount of care in a short period of time;and (4) limited but invaluable training of in-country healthcare providers is possible. The Special Care Dentistry Association is long known for service and care delivery to patients with special needs by its members, and for its advocacy and organizational support for these activities. A foreign service opportunity in Guatemala, Central America, was sought out by members of the SCDA to further the outreach efforts of the organization, give members clinical experience in a foreign setting, and train in-country providers to deliver care to patients with special needs. This was the first effort by SCDA members to host a clinic to deliver care specifically to patients with special needs outside of North America.

关键词： special care foreign service international

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Postdoctoral Dental Education Training program and Community Health Centers:Partnership and Collaboration Towards Blending Mutual "Service-Learning" Missions& Goals in Dental Education and Oral Healthcare

Postdoctoral Dental Education Training Program and Community...

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2015第二届国际口腔与牙科医学大会

作者： Anna D'Emilio Susan Dietrich AEGD Program NYU Lutheran Medical Center USA

NYU Lutheran Medical Center Department of Dental Medicine sponsors nine Commission on Dental Accreditation(CODA) accredited postdoctoral dental residency training *** these programs is the Advanced Education in General *** in1989,this program is one year in duration with on optional second year of training and both years are fully accredited by *** program undertook the approach of partnering with community health centers throughout the *** serve as clinical training sites for dental *** intent was to establish a unique postdoctoral dental residency program that would provide advanced education and training for new graduates,while working collaboratively with community health centers to meet national and locally established public healthcare initiatives towards providing access to the oral healthcare needs of a particular community of patients in the *** established and continued partnership and collaboration,both the program and the community health center network have experienced mutually beneficial results towards blending the "service-learning" mission and goals;advanced level of learning for residents,service& access to the patients most in need of quality oral healthcare,and providing to the residents an experience in public healthcare that could potentially model their way towards their approach in future practice.

关键词： Service-Learning Goals in Dental Education and Oral Healthcare Missions Postdoctoral Dental Education Training program and Community Health Centers:Partnership and Collaboration Towards Blending Mutual

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The dangers of dental devices as reported in the Food and Drug Administration Manufacturer and User Facility Device Experience Database

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 2015年第2期146卷 102-110页

作者： Hebballi, Nutan B. Ramoni, Rachel Kalenderian, Elsbeth Delattre, Veronique F. Stewart, Denice C. L. Kent, Karla White, Joel M. Vaderhobli, Ram Walji, Muhammad F. Univ Texas Hlth Sci Ctr Houston Sch Dent Houston Dept Diagnost & Biomed Sci Houston TX 77054 USA Harvard Univ Sch Dent Med Dept Oral Hlth Policy & Epidemiol Boston MA 02115 USA Harvard Univ Sch Dent Med Dept Oral Hlth Policy & Epidemiol Boston MA 02115 USA Univ Texas Hlth Sci Ctr Houston Sch Dent Houston Dept Gen Dent & Publ Hlth Houston TX 77054 USA Oregon Hlth & Sci Univ Sch Dent Dept Community Dent Portland OR 97201 USA Oregon Hlth & Sci Univ Sch Dent Qual Improvement Portland OR 97201 USA Oregon Hlth & Sci Univ Sch Dent Dept Integrat Biosci Portland OR 97201 USA Univ Calif San Francisco Dept Prevent & Restorat Dent Sci Sch Dent San Francisco CA 94143 USA Univ Calif San Francisco Sch Dent LMC UCSF AEGD Postgrad Residency program San Francisco CA 94143 USA Univ Calif San Francisco Sch Dent Dept Prevent & Restorat Dent Sci San Francisco CA 94143 USA Univ Texas Hlth Sci Ctr Houston Sch Dent Houston Technol Serv & Informat Houston TX 77054 USA

Background. The authors conducted a study to determine the frequency and type of adverse events (AEs) associated with dental devices reported to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. Methods. The authors downloaded and reviewed the dental device-related AEs reported to MAUDE from January 1, 1996, through December 31, 2011. Results. MAUDE received a total of 1,978,056 reports between January 1, 1996, and December 31, 2011. Among these reports, 28,046 (1.4%) AE reports were associated with dental devices. Within the dental AE reports that had event type information, 17,261 reported injuries, 7,777 reported device malfunctions, and 66 reported deaths. Among the 66 entries classified as death reports, 52 reported a death in the description;the remaining were either misclassified or lacked sufficient information in the report to determine whether a death had occurred. Of the dental device-associated AEs, 53.5% pertained to endosseous implants. Conclusions. A plethora of devices are used in dental care. To achieve Element 1 of Agency for Healthcare Research and Quality's Patient Safety Initiative, clinicians and researchers must be able to monitor the safety of dental devices. Although MAUDE was identified by the authors as essentially the sole source of this valuable information on adverse events, their investigations led them to conclude that MAUDE had substantial limitations that prevent it from being the broad-based patient safety sentinel the profession requires. Practical Implications. As potential contributors to MAUDE, dental care teams play a key role in improving the profession's access to information about the safety of dental devices.

关键词： Dental equipment dental public health dental records informatics quality of care safety management

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The comparative efficacy of 0.12% chlorhexidine and amoxicillin to reduce the incidence and magnitude of bacteremia during third molar extractions: a prospective, blind, randomized clinical trial

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ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY 2013年第6期115卷 752-763页

作者： DuVall, Nicholas B. Fisher, Tommy D. Hensley, Donna Hancock, Raymond H. Vandewalle, Kraig S. AEGD 1 Residency Program Keesler AFB MS 39534 USA San Antonio Mil Med Ctr San Antonio TX USA Uniformed Serv Univ Hlth Sci Bethesda MD 20814 USA Joint Base San Antonio Wilford Hall Ambulatory Surg Ctr Lackland AFB TX USA AFPDS Adv Educ Gen Dent Residency Program Joint Base San Antonio Lackland AFB TX USA

Objective. The purpose of this study was to directly compare the incidence and magnitude of bacteremia of a 0.12% chlorhexidine pre-procedure rinse to the AHA and the ADA/AAOS recommended 2 g amoxicillin antibiotic prophylaxis during third molar extractions. Study Design. This study was a randomized, blind, placebo-controlled prospective clinical trial involving subjects assigned to a placebo, rinse, or antibiotic group. The incidence and magnitude of bacteremia were analyzed via chi(2) and Kruskal-Wallis/Friedman tests, respectively. Results. There was no statistically significant difference in the incidence and magnitude of bacteremia between the three groups. However, the placebo group apparently resulted in the largest range and highest mean magnitude of bacteremia, followed by the rinse then the antibiotic group. Conclusions. The results of this novel study may reasonably conclude an oral rinse or systemic antibiotic antimicrobial intervention does not statistically reduce the incidence and magnitude of bacteremia compared to no antimicrobial intervention.

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A connectivity model for assessment of HIV transmission risk in injection drug users (IDUs)

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EVALUATION AND program PLANNING 2013年 39卷 23-27页

作者： Flaer, Paul J. Cistone, Peter J. Younis, Mustafa Z. Parkash, Jai Dade Cty Dent Res Clin AEGD Residency Program Community Smiles Diag & Treatment Planning Sect Miami FL USA Florida Int Univ Coll Educ Miami FL 33199 USA Jackson State Univ Sch Hlth Sci Jackson MS USA

The purpose of this study was to produce models composed of mapping of connectivity networks of HIV transmission risk in injection drug users (IDUs). This methodology provided a novel approach and diagnostic tool for understanding HIV infection transmission risk and drug use in the typical niche of IDUs, i.e., a "shooting gallery" (a gathering site for injection drug activity). Furthermore, component IDUs may have memberships in multiple "shooting galleries" revealing subsequent interconnectivities. Charting of IDU connectivity diagrams illustrated the relationships of peripheral sites to the critical central core of high HIV transmission risk. Members of this highly interlinked and infectious central core of IDUs had high HIV transmission risk and severe drug use producing high morbidity and mortality that resulted in great public health concern. In addition, connectivity diagrams reveal very high HIV transmission risk in component IDUs in "dual memberships", i.e., membership in more than one central core (with the highest number of partners). Therefore, IDUs with "dual memberships" were the most infectious members of the "shooting gallery". In summation, network mapping of HIV transmission risk in IDUs allows for subsequent socio-behavioral analysis and the development of focused individual and programmatic interventions. (C) 2013 Elsevier Ltd. All rights reserved.

关键词： Injection drug users (IDUs) HIV transmission risk "Shooting gallery"

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Effect of year of study on stress levels in male undergraduate dental students

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ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2013年 4卷 217-222页

作者： Alzahem, Abdullah M. Van der Molen, Henk T. De Boer, Benjamin J. King Saud bin Abdulaziz Univ Hlth Sci Natl Guard Hlth Affairs King Abdullah Int Med Res Ctr Adv Educ Gen Dent AEGD Residency Program Riyadh Saudi Arabia Erasmus Univ Fac Social Sci Inst Psychol Rotterdam Netherlands Princess Nora Univ Clin Psychol Riyadh Saudi Arabia

Objective: Stress among dental students can be a significant threat, resulting in physical and/or mental illness, and have a negative effect on students' performance and the professional practice of dentistry. Stress can occur from different sources. The purpose of this study is to test whether the year of study has an effect on the stress levels of dental students. Method: Our study consisted of a cross-sectional survey using a modified version of the Dental Environment Stress (DES) questionnaire. The questionnaires were filled out by male undergraduate dental students at King Saud University in Riyadh City during the 2010-2011 academic year (n = 214). Results: The results show the most common sources of stress: examinations and completing clinical requirements. Moreover, in the five-year lecture-based traditional curriculum, the third year students reported the highest level of stress, whereas the first year reported the lowest level of stress. Conclusion: Third year undergraduate dental students reported the highest level of stress. This stress could be reduced by reviewing and modifying the dental curriculum by allowing students to have contact with patients more gradually, starting from the first year, in addition to adding stress prevention and intervention programs in dental curricula.

关键词： dental education students stress study year

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Effect of JPEG compression on the diagnostic accuracy of periapical images in the detection of root fracture

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DENTAL TRAUMATOLOGY 2012年第3期28卷 233-237页

作者： Noujeim, Marcel Geha, Hassem Shintaku, Werner Bechara, Boulos Kashi, Khosrow Aroni Univ Texas Hlth Sci Ctr San Antonio Dept Comprehens Dent San Antonio TX 78229 USA Univ Tennessee Ctr Hlth Sci Div Imaging Sci Dept Biol & Diagnost Sci Memphis TN 38163 USA Tufts Univ Sch Dent Med AEGD Residency Program Boston MA 02111 USA

The ability of a periapical radiograph to exhibit the fracture depends on many factors including, but not limited to, the resolution of the image. The quality can be reduced by the image compression. The purpose of this study is to evaluate the effect of Joint Photographic Experts Group (JPEG) compressions on the diagnostic capability of periapical images in the detection of root fractures. Ten dry human mandibles containing 151 teeth were used in this study. Mandibles were radiographed with direct digital imaging sensor using the paralleling technique. Four observers detected root fracture on the images saved in one uncompressed and two compressed formats. Receiver operating characteristic (ROC) and anova analyses were performed to compare the performance of the three different systems and evaluate the effect of the compression on the accuracy of root fracture detection. Results did not show any statistically significant difference between the original, large images presented in tagged image file format (TIFF) and the two compressed images (JPEG medium file and JPEG small file images) in the detection of root fractures. The intra-rater comparison showed a significant consistency in the detection of the fracture. The compression reduced the file size considerably (from 1.77 MB to 453 and 95 Kb), but it did not affect the accuracy of root fracture detection. The file size reduction, on the other hand, is very beneficial for image electronic storage and mainly in teleradiology.

关键词： FRACTURES TEETH -- Roots DIGITAL image processing TELERADIOLOGY ENDODONTICS

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Fracture resistance of composite resin restorations and porcelain veneers in relation to residual tooth structure in fractured incisors

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DENTAL TRAUMATOLOGY 2012年第1期28卷 75-80页

作者： Batalocco, Guido Lee, Heeje Ercoli, Carlo Feng, Changyong Malmstrom, Hans Univ Rochester Sch Med & Dent Div Prosthodont Eastman Inst Oral Hlth Rochester NY 14627 USA Univ Rochester Sch Med & Dent Dept Biostat & Computat Biol Rochester NY 14627 USA Univ Rochester Sch Med & Dent Div Gen Dent AEGD ProgramEastman Inst Oral Hlth Rochester NY 14627 USA

The aim of the present study was to investigate whether there is a direct correlation between the amount of residual tooth structure in a fractured maxillary incisor and the fracture resistance of composite resin restorations or porcelain veneers after cyclic loading. Sixty human-extracted maxillary central and lateral incisors were mounted in an acrylic block with the coronal aspect of the tooth protruding from the block surface. The teeth were assigned to two groups: 2-mm incisal fracture and 4-mm incisal fracture. Then, the teeth were further divided into two different restoration subgroups, porcelain laminate veneer and composite resin restoration, therefore obtaining four groups for the study (n = 15). The specimens were subjected to 1000 cycles of thermocycling and were mechanically tested with a custom-designed cyclic loading apparatus for 2 x 106 cycles or until they failed. The specimens that survived the cyclic loading were loaded on the incisal edge along the long axis of the tooth with a flat stainless steel applicator until they fractured using a universal testing machine to measure the failure load. Two-way anova was used to assess the significance of restoration, amount of fracture, and interaction effect (a = 0.05). During the cyclic loading, for the composite resin group, two specimens with 2-mm fracture and three specimens with 4-mm fracture failed. For the porcelain veneer group, two specimens with 2-mm fracture and one specimen with 4-mm fracture failed. The 2-way anova did not show statistical significance for restoration (P = 0.584), amount of fracture (P = 0.357), or interaction effect (P = 0.212). A composite resin restoration and a porcelain veneer could perform similarly for replacing a fractured incisor edge up to 4 mm. Other factors such as esthetic and/or cost would be considerations to indicate one treatment over the other.

关键词： DENTISTRY MEDICINE INCISORS DENTITION (Tooth development) PEDIATRIC physiology

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