Immediate implantation of pure titanium implants into extraction sockets of Macaca fascicularis. Part I: Clinical and radiographic assessment.

Immediate implants have the advantages of few surgical exposures, short treatment time, and maintenance of alveolar bone height and width. The purpose of this study was to compare immediate implants with conventional implants (implants placed into ossified extraction sites) in adult monkeys. Forty-eight implants were placed and allowed to heal for a 6-month period. Following a 7-month loading period, the monkeys were sacrificed, and implant sections were evaluated histologically. Clinical and radiographic measurements showed few significant differences between immediate and control implants.

Caries risk assessment in a longitudinal discrimination study.

Our objective was to develop and perfect a model for the assessment of risk of dental caries onset in children. Even though dental caries prevalence in children is continuing to decline, there is still a significant minority for whom it is a problem. In this study, we sought to ascertain whether a set of variables selected in a previous cross-sectional study could be used to differentiate between caries-free six-year-olds who would or would not subsequently present with clinically-detectable caries. A total of 472 caries-free six-year-olds--286 from a fluoridated community and 186 from a fluoride-deficient community--was selected. Clinical examinations for DMFS, dental fluorosis, and plaque were conducted. Stimulated whole saliva was collected for analysis of mutants streptococci, lactobacilli, total viable flora, and fluoride, calcium, and phosphate concentrations. A questionnaire was used for collection of demographic data as well as information on prior fluoride exposure, dietary habits, and oral hygiene practices. By means of linear discriminant analyses, it was possible to predict correctly which children would develop caries within six to 12 months (sensitivity) in 82.8% of cases and which children would not develop caries during that period (specificity) in 82.4% of cases.

Caries risk assessment by a cross-sectional discrimination model.

Although the prevalence of dental caries is continuing to decline, it still affects a majority of the US population and can be a serious problem for those afflicted. The objective of this project was to develop and perfect a model for assessment of risk of dental caries onset in children. In the first study, reported herein, a set of clinical, microbiological, biochemical, and socio-demographic variables was identified that distinguished, with an acceptable level of sensitivity and specificity, between children who had no previous caries experience and children who had high caries levels. A total of 313 children--age 12-15 years, 140 from a fluoridated community and 173 from a fluoride-deficient community--was selected on the basis of previous caries experience, either zero DMFS or high DMFS (> or = 6 in the fluoridated or > or = 8 in the fluoride-deficient community). Clinical exams for DMFS, dental fluorosis, and plaque were conducted. Stimulated whole saliva was collected for analysis of mutans streptococci, lactobacilli, total viable flora, and fluoride concentration. A questionnaire was used for collection of demographic data as well as information on prior fluoride exposure, dietary habits, and oral hygiene practices. By means of discriminant analyses, with use of seven key clinical and laboratory variables, it was possible for zero-DMFS subjects to e classified correctly (specificity) in 77.6% of cases in the fluoridated community and in 86.1% of cases in the fluoride-deficient community. High-caries subjects were classified as such (sensitivity) in 79.3% and 88.1% of cases, respectively.

Patient satisfaction in four types of dental practice.

There has been a significant growth in alternative types of dental practice. To determine satisfaction, patients were surveyed in urban private practices, a hospital dental clinic, a neighborhood health center, and a large group practice situated in a shopping center, using a 14-item survey and a 5-point rating scale. Patient satisfaction was related to the following factors in descending order: dentist, staff, efficiency, time-cost, and accessibility. Patients rated private practice most favorably for all factors with the exception of accessibility, which was rated highest for the shopping center practice. Patients rated the hospital least favorably for all factors with the exception of dentist, which was rated least favorably for the shopping center practice. Although private practices were the most favorably perceived, alternative types of practice were also highly rated and met specific patient needs. Satisfaction was greater for older patients, for patients with less education, and for white compared with black patients.