Sealant use and placement techniques among pediatric dentists.

BACKGROUND: Pit and fissure sealant use varies widely among dentists. The authors conducted a survey to determine the current variations and patterns of sealant placement among pediatric dentists. METHODS: The authors mailed a 20-question survey to American Academy of Pediatric Dentistry members from six states, who represented one-third (1,210) of the membership, as well as to all 52 pediatric dentistry departments in U.S. dental schools. The authors examined selection criteria, placement techniques, evaluation methodologies, and the one- and three-year estimated success and reapplication rates of sealant placement. RESULTS: The response rates were 70 percent for practitioners and 90 percent for dental schools. Approximately 80 percent of respondents said they sealed caries-free and questionable carious surfaces. Only 20 percent of the respondents said they sealed incipient carious surfaces; none said they would seal overt caries. Surface preparation was used always or sometimes by 87 percent of the respondents. The estimated one- and three-year sealant retention rates were 89 percent and 78 percent, respectively, for practitioners and 83 percent and 71 percent, respectively, for dental schools. CONCLUSIONS: The survey demonstrated wide variations in selection criteria, placement techniques and evaluation methodologies, yet showed remarkable similarities between practitioners and dental schools. The reported retention rates were consistent with those reported in the literature. PRACTICE IMPLICATIONS: The survey results suggested that pediatric dentists were searching for evidence-based selection criteria and a technique protocol for sealant placement that improved clinical success. The wide technique variations reported were likely a result of training diversity, diagnostic uncertainty, technique and material sensitivity, and an attempt to improve the success rate.

Use of nickel-titanium rotary files for root canal preparation in primary teeth.

This article reviews the use of nickel-titanium rotary files for root canal instrumentation in primary teeth. The pulpectomy technique is described and the advantages and disadvantages of using rotary files are discussed. Specific recommendations for the selection of materials and devices are made.

Use of nickel-titanium rotary files for root canal preparation in primary teeth.

This article reviews the use of nickel-titanium rotary files for root canal instrumentation in primary teeth. The pulpectomy technique is described and the advantages and disadvantages of using rotary files are discussed. Specific recommendations for the selection of materials and devices are made.

Enhancing staff performance through a customized evaluation form.

Using a customized staff performance evaluation form identifies specific behaviors characteristic of an ideal staff person. The form assists the manager in addressing how each staff member displays these characteristics and helps the manager and employee coauthor a written plan designed to enhance self-development and teamwork.

The experiences of women pediatric dental residents: a survey.

A survey of 430 female pediatric dentists in the United States determined concerns and experiences they had during their advanced training programs. The return rate was 54%. Up to 83% (24) of the women who were pregnant during their residencies asked not to be exposed to certain environmental hazards during pregnancy and the postpartum period. They requested that program directors establish policies on known environmental hazards. Eighty-eight women (41%) commented that programs should offer flexible, preestablished and preannounced maternity leave policies. Survey respondents also expressed concerns about personal safety (5%), the lack of female role models (9%), and the need for more information on business management (30%). When the women were analyzed according to age, the following were significant (P less than .05): professional acceptance was of greatest concern to women ages 41-48; pregnancy and maternity leave, and balancing career with parenthood, significantly concerned women 25-32; and women ages 33-40 said business management was the issue causing the greatest frustration as a practicing pediatric dentist. While most respondents felt that they have the same professional opportunities as men, their greatest frustrations are a lack of acceptance by the professional and lay communities and trying to balance a career and motherhood.

A study of endodontically apexified teeth.

This study was undertaken to determine the clinical and radiographic success of calcium hydroxide apexification in a group of 48 patients requiring endodontic therapy because of pulpal necrosis prior to root-end closure. The study examined tooth number, etiology of pulpal necrosis, age, sex, size of root-end opening, size of radiolucency, crown discoloration, interappointment symptoms, and total treatment time from initial instrumentation to completion of apexification. Apexification required an average of 1 year +/- 7 months. A statistically significant relationship was found between: the presence of a radiolucency and development of interappointment symptoms (p less than 0.04); and the size of apex opening and development of interappointment symptoms (p less than 0.02). If symptoms did develop, apexification was delayed an additional 5 months when compared to patients who did not have symptoms. Calcium hydroxide apexification was found to be statistically highly successful regardless of the clinical variables encountered.

A retrospective radiographic evaluation of primary molar pulpectomies.

Relatively few long-term studies have been performed to evaluate the clinical success of one-appointment pulpectomies in primary molar teeth. The purpose of this retrospective study was to evaluate the radiographic appearance of nonvital primary molars before and after treatment with a one-appointment formocresol pulpectomy technique. The mean length of time since pulpectomy treatment for the 62 primary molars was 40.2 months. Based upon strict radiographic criteria, the one-appointment pulpectomy procedure was considered to be successful in 82.3% (51) of the cases, with 3.2% (2) of pulpectomized primary molars needing retreatment, and 14.5% (9) of pulpectomy procedures failing. The pulpectomy procedure is indicated when inflammation of the pulpal tissue extends into the root canals, and possibly involves the periapical and/or bifurcation areas. This procedure provides an alternative to extraction and space maintenance when the pediatric dentist encounters a nonvital primary molar tooth.

Radiographic evaluation of pulpal therapy for primary anterior teeth.

A total of 144 anterior primary incisors with formocresol pulpotomies or pulpectomies comprised the study sample. Although the former had a moderately high success rate, those incisors treated with the latter procedure had a better prognosis. It may be the preferred treatment when the extent of pulpal involvement cannot be determined.

Men and milestones in optics. VI: The rise of infrared spectroscopy in the U.S.A. to World War II.

This survey reviews the rise of ir spectroscopy in the United States from about 1845 to about 1941 in terms of the discoveries and activities of the individuals who contributed importantly to this field. Generally speaking, the emphasis is on molecular, rather than atomic, spectra and on experimentation, rather than theory. The presentation is chronological with respect to the birth dates of the contributors, and a limited amount of biographical material is included for some of them. Some quantitative information about the institutions where ir spectroscopy was carried on, and for the journals in which the results appeared, is appended.

The elfin facies syndrome.

The elfin facies syndrome is characterized by idiopathic infantile hypercalcemia; mental retardation; cardiovascular anomalies, usually supravalvular aortic stenosis and peripheral pulmonary artery stenosis; a peculiar elfin facies and oral anomalies, primarily enamel hypoplasia and oligodontia. The dental features found in the three cases reported include enamel hypoplasia, severe dental decay, oligodontia, pulp stones, microdontia, and abnormally small roots. Some consistent cephalometric abnormalities were thought to contribute to the unusual facial appearance of these patients.