Long-term Evaluation of Treatment Planning Decisions for Nonhealing Endodontic Cases by Different Groups of Practitioners.

INTRODUCTION: The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment. METHODS: A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants. RESULTS: In 2009, 262 dentists participated in the survey. Two hundred one participants were general practitioners (GPs: 76.7%), 26 endodontists (ENDOs: 9.9%), and 35 other specialists (prosthodontics, periodontics, and oral surgery [SPECs]: 13.4%) (n = 262). EXIMP, NSRTX, and SRTX were fairly equally selected but with great variation between practitioner groups (χ2 = 173.49, P < .05). A subset group of 104 participants (SUB) (39.7% of the original participants) retook the survey in 2016 (69 GPs [66.3%], 15 ENDOs [14.0%], and 20 SPECs [19.7%]). Comparisons among practitioner groups were significantly different in SUB (n = 104) for 2009 (χ2 = 95.536, P < .05) and 2016 (χ2 = 109.8889, P < .05). Intragroup reliability between 2009 and 2016 revealed no significant differences between the overall treatment planning choices for all practitioners (GPs, ENDOs, or SPECs). Intrapractitioner reliability showed many treatment planning decision changes on an individual level. Chances that individuals changed their original decision were 47.8% (95% confidence interval, 45.2%-50.4%) and were significantly different among the 3 practitioner groups (GPs > SPECs > ENDOs [χ2 = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520). CONCLUSIONS: No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.

Current concepts of oral and maxillofacial rehabilitation and treatment in aviation.

Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

A terapia com laser em especialidades odontológicas / Terapia con rayos láser en especialidades dentales / Laser therapy in dental specialties

Introdução: a terapia com laser tem sido utilizada com muito êxito na clínica odontológica e é uma excelente opção para cuidados de saúde. Objetivo: identificar no Norte/Nordeste do Brasil o número de dentistas especializados en raios laser e identificar, dentro do territorio brasileiro, as regiões onde há maior demanda de cursos de capacitação em laserterapia. Métodos: estudo descritivo com base nas consultas de dados secundários disponíveis no site do Conselho Federal de Odontologia, na secção de serviços e consultas, em 2013. Os resultados foram avaliados pelos testes do chi-quadrado e exato de Fisher (nível de significância de 5 porcento). Resultados: a amostra do estudo foi formada por 29 profissionais. Nas regiões analisadas, a maioria dos profissionais que possuiam a especialização em laserterapia eran clínicos gerais (sem especialização). Verificpu-se que a região sudeste se destaca pela maior disponibilidade de cursos certificados laserterapia, seguido pelo sul e pelo norte. O nordeste não apresenta nenhum curso em laserterapia, embora tenha mais profissionais especializados que no norte. O laser não deve representar apenas um dispositivo novo na clínica odontológica, mas sim, como uma nova filosofia terapêutica, que permite una interação biofísica entre a luz e o tecido biológico, o qual favorece um melhor tratamento e uma melhor qualidade de vida dos pacientes. Conclusões: uma maior quantidade de profissionais especializados se encontram na região sul e sudeste do Brasil, porém já é possível notar um aumento deste número no nordeste(AU)

Introducción: la terapia con rayos láser se ha utilizado con mucho éxito en la clínica dental, actualmente constituye una excelente opción para la asistencia sanitaria. Objetivo: identificar en el norte/noreste de Brasil el número de dentistas especializados en rayos láser y identificar, dentro del territorio brasileño, las regiones donde hay mayor demanda de cursos de capacitación de terapia con rayos. Métodos: estudio descriptivo basado en las consultas de datos secundarios disponibles en el Consejo Federal de Odontología del sitio, la sección de servicios y consultas, en 2013. Los resultados se evaluaron mediante la prueba de chi cuadrado y la prueba exacta de Fisher (nivel de significación del 5 por ciento). Resultados: la muestra estuvo conformada por 29 profesionales. En las regiones analizadas, la mayoría de los profesionales que poseen la especialización en terapia con rayos láser son médicos generales (no especializados). Se encontró que la región sureste destaca por una mayor disponibilidad de cursos certificados en la terapia con rayos láser, seguido por el sur y el norte. El noreste no muestra ningún curso en la terapia con rayos laser, aunque hay más profesionales cualificados que en el norte. El rayo láser no debe definirse solo como un dispositivo nuevo en la clínica dental, sino como una nueva filosofía terapéutica, que permite una interacción biofísica entre la luz y el tejido biológico, lo cual favorece un mejor tratamiento y una mejor calidad de vida de los pacientes. Conclusiones: una mayor cantidad de profesionales especializados se encuentra en la región sur y sureste de Brasil pero ya es posible notar una ampliación de este número en el noreste(AU)

Introduction: laser therapy has been used with great success in dental clinics, and constitutes an excellent option in current health care. Objective: determine the number of dentists specializing in laser therapy in the north / northeast of Brazil and identify the regions in the Brazilian territory where there is a greater demand for courses on laser therapy. Methods: adescriptive study was conducted based on the examination of secondary data available from the Brazilian Federal Council of Dentistry of the area, the services section and consultations, in the year 2013. Results were evaluated with the chi-square test and Fisher's exact test (significance level of 5 percent). Results: the sample was composed of 29 professionals. In the regions analyzed, most professionals with specialization in laser therapy are general, non-specialized practitioners. It was found that the southeast stands out for its greater availability of certified courses on laser therapy, followed by the south and the north. No course about laser therapy was found in the northeast, despite the fact that there are more qualified professionals in that region than in the north. Laser therapy should not be defined as a new device in dental practice, but as a new therapeutic philosophy allowing biophysical interaction between light and biological tissue, thus providing better treatment and improving the quality of life of patients. Conclusions: alarger number of specialized professionals may be found in the south and southeast of Brazil, but an increase in their number is already noticeable in the northeast(AU)

Educational experiences and preparedness in dental anesthesia: five-year outcome assessment and conclusions.

A mail survey of 2003-07 dental school graduates was undertaken by the Department of Anesthesiology at the University of Pittsburgh School of Dental Medicine to assess the strengths and weaknesses of the predoctoral curriculum in anesthesia and to determine the preparedness of practicing dentists to provide anesthesia services for their dental patients. Subsets of the survey responses were created to specifically evaluate the effectiveness of an advanced selective program in sedation offered to approximately twenty third- and fourth-year predoctoral students. This fourteen-month Anesthesia Selective Program provides advanced didactic instruction and clinical experiences needed to establish competence in minimal to moderate sedation. Overall, graduates reported being best prepared in assessment of medical histories, physiology, and pharmacology, while being least prepared in oral sedation, intravenous sedation, and general anesthesia. For graduates currently in general practice, those who had participated in the Anesthesia Selective Program reported being better prepared in most subjects relating to anesthesia and patient care. Participants in the selective were also more likely to treat special needs patients in their private practices. Respondents' written comments indicated a desire for a greater number of clinical experiences involving sedation procedures within the predoctoral curriculum. This outcome assessment indicated that a greater emphasis should be placed on instruction and training experiences for enteral sedation within the predoctoral dental curriculum. Advanced training and increased clinical experiences in anesthesia may also be an effective means to better prepare graduates to assess medical histories, to manage medical emergencies, and to be willing to treat medically complex patients as well as patients with special health care needs.

A Homeopatia e a Odontologia / The Hoemeopathy and the Odontologia

O autor apresenta através da revisäo de literatura os conceitos fundamentais da Homeopatia desde Hahnemann até hoje, salientando a sua importância na Odontologia