Has the Health Insurance Coverage of Scaling Contributed Positively to Periodontal Health in Korea?

This study aimed to evaluate the effectiveness of the health insurance coverage of dental scaling (introduced in 2013) using the Community Periodontal Index of Treatment Needs parameter among Korean adults aged 20 years or older. We used the Korea National Health and Nutrition Examination Survey data from before and after 2013 to analyze the statistical significance and associations of the covariates with the prevalence of healthy periodontal tissues, prevalence of people in need of scaling, and prevalence of periodontal diseases. The results showed that the prevalence of healthy periodontal tissues increased by 4.9% (from 34.2% to 39.1%), the number of people in need of scaling decreased by 5% (from 65.9% to 60.9%), and the prevalence of periodontal diseases increased by 7.2% (from 23.4% to 30.6%). Moreover, after the scaling coverage policy, the odds ratio of the prevalence of healthy periodontal tissues was 1.10 times higher, the prevalence of the need for scaling was 1.5 times higher, and the prevalence of periodontal diseases was 0.90 times lower. Therefore, the state should formulate policies that provide dental biofilm management through a disclosing agent, impart education about oral hygiene, and develop a health management system that enables the concurrent management of periodontal diseases and systemic diseases.

Cost-effectiveness of non-surgical peri-implantitis treatments.

AIM: The purpose of the present study was to assess the cost-effectiveness of various alternatives of non-surgical peri-implantitis treatment. MATERIALS AND METHODS: A decision analytical model was constructed and populated with parameter estimates from recent literature for reduction in pocket probing depth (PPD) in response to eight different treatment alternatives. A micro-costing approach combined with an online expert survey was applied to simulate a decision-making scenario taking place in Germany. The treatment alternatives providing the most advantageous cost/outcome combinations were identified according to the net benefit criterion. Uncertainties regarding model input parameters were incorporated via simple and probabilistic sensitivity analysis based on Monte Carlo simulation. RESULTS: In the base case scenario, debridement alone, Air-Flow, debridement combined with PerioChip, and debridement combined with local antibiotics were identified as treatment strategies with comparably better value for money than Er:YAG laser monotherapy, Vector System, debridement combined with CHX, and photodynamic therapy. Sensitivity analysis revealed considerable decision uncertainty corresponding to limited evidence about different treatment alternatives for peri-implantitis treatment. CONCLUSIONS: Derivation of robust treatment recommendations for peri-implantitis requires more comprehensive and patient-centred evidence on peri-implantitis treatments.

Adjusting dental ceramics: An in vitro evaluation of the ability of various ceramic polishing kits to mimic glazed dental ceramic surface.

STATEMENT OF PROBLEM: During the insertion appointment, the practitioner is often faced with the need to adjust ceramic surfaces to fit a restoration to the adjacent or opposing dentition and soft tissues. PURPOSE: The purpose of this study was to assess the ceramic surface smoothness achieved with various commercially available ceramic polishing kits on different commonly used ceramic systems. The reliability of the cost of a polishing kit as an indicator of improved surface smoothness was assessed. MATERIAL AND METHODS: A total of 350 ceramic surfaces representing 5 commonly available ceramic systems (IPS Empress Esthetic, IPS e.max Press, Cergo Kiss, Vita PM 9, Imagine PressX) were treated with 5 types of ceramic polishing systems (Cerapreshine, 94006C, Ceramiste, Optrafine, Zenostar) by following the manufacturers' guidelines. The surface roughness was measured with a profilometer (Taylor Hobson; Precision Taylor Hobson Ltd). The effects of ceramic systems and polishing kits of interest on surface roughness were analyzed by 2-way ANOVA, paired t test, and Bonferroni corrected significance level. RESULTS: The ceramic systems and polishing kits statistically affected surface roughness (P<.001).The polishing kit Zenostar on IPS e.max Press created the smoothest ceramic surface. No correlation could be established between the high cost of the polishing kit and low surface roughness. None of the commonly used ceramic polishing kits could create a surface smoother than that of glazed ceramic (P<.001). CONCLUSIONS: The inclusion of a diamond polishing paste step is recommended to improve surface smoothness (P<.001). The cost of ceramic polishing kits is not recommended as a reliable indicator of better performance of ceramic polishing kits (P>.30).

A comparison of different techniques for finishing and polishing amalgam.

Three different methods for finishing and polishing amalgam surfaces were studied by determining the roughness (Ra) of specimens at different stages of the procedures. Method I consisted of green stone, followed in sequence by finishing bur and pastes of pumice, powdered chalk, and SnO2. Method II was similar to method I but included brown and green Shofu polishers after the finishing bur. In method III medium and fine sandpaper and fine cuttle-paper discs were used before the pastes. A dramatic decrease in the Ra values was observed after the specimens had been ground with green stones, finishing burs, and sandpaper discs. Pumice resulted in a further reduction in Ra values. However, no significant differences in Ra values were found between the brown Shofu polisher, the fine cuttle-paper disc, and the different pastes. The lowest Ra value--that is, the highest smoothness--was obtained with green Shofu polisher.

Cost benefit analysis of direct posterior restorations.

A clinical study was conducted in which three operators made 232 Class I and Class II composite and amalgam restorations in a group of 49 adult patients. The time for different parts of the operative process was measured. The time periods were analysed as to the influence of the factors operator, tooth type and number of surfaces, by an analysis of variance (ANOVA). Results show that the various factors have a significant influence on the total treatment time. The treatment time for amalgam restorations is equal to the treatment time of composite restorations. The productivity of making restorations from the 'best' available amalgams, i.e. the amalgam with an extrapolated half-life time of more than 20 yr, turns out to be more than 3-4 times better than that of the 'worst' amalgams (half-life time 4 1/2-8 yr) and more than two times better than that of making restorations of the best composite material, used in this study (extrapolated half-life time of Estic MF is 10 yr).