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International Journal of Environmental... Feb 2022This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health...
This study analyzed patient preferences using travel time from residence to dental institution when selecting dental care services. We used data from the Korean Health Panel from 2008 to 2017 and analyzed each dental service episode. Since the distribution of travel time was skewed to the left, median travel time was analyzed. The association of travel time with services was analyzed via the population-averaged generalized estimating equation (GEE) with the Poisson family. The median of the average travel time per episode was longer for non-National Health Insurance (NHI)-covered services and shorter for NHI-covered services. The first quintile of low-income subjects traveled the longest for all services and utilized dental care the most. In the GEE analysis, travel time was approximately three times longer for implant treatment and gold inlay/resin fillings and >2 times longer for orthodontic care than for NHI-covered services. Patients residing in rural counties traveled for longer than residents of large cities. Income was statistically significant; however, the coefficient was close to zero. Travel time was related to the type of service and reflected patient preference. This was more prominent for expensive non-NHI-covered services than for NHI-covered services. The findings suggest patients' subjective preferences for dental clinic selection are expressed as rational deliberation considering each individual's situation.
Topics: Dental Care; Health Services Accessibility; Humans; Income; National Health Programs; Patient Preference; Travel
PubMed: 35206239
DOI: 10.3390/ijerph19042051 -
Operative Dentistry Sep 2023To assess the accuracy of selective enamel etching (SEE) in a laboratory setup simulating clinical conditions.
OBJECTIVE
To assess the accuracy of selective enamel etching (SEE) in a laboratory setup simulating clinical conditions.
METHODS AND MATERIALS
A model with permanent human teeth was fabricated. It included a first mandibular molar with a mesio-occlusal-distal inlay preparation, a maxillary central incisor, and a canine with a class IV and class V cavity, respectively. Two dentists (with 1 year and 10 years work experience) repeatedly (n=10 per cavity) performed SEE with a custom gel that had identical rheological properties as a commercially available phosphoric acid etchant. An intraoral scanner was used for image acquisition. To assess the accuracy of SEE, special software was used (OraCheck, Cyfex, Zurich, Switzerland). Two independent investigators analyzed baseline scans and scans taken of the cavities while the gel was in place. The statistical analysis comprised t-tests, Pearson correlation, and analysis of variance (α=0.05).
RESULTS
The level of accuracy, whose average values ranged from 61.1% to 87.0%, showed significant differences between teeth, with the highest level observed in the class V cavity, followed by the class II inlay preparation and the class IV cavity (p<0.001). Across the cavities, no significant correlation was observed between the application time and the accuracy of SEE (p=0.07).
CONCLUSION
This laboratory study suggests that inadvertent conditioning of dentin adjacent to enamel may be common during SEE. Investigations involving larger samples of dentists are needed to corroborate this finding.
Topics: Humans; Dental Enamel; Dental Caries; Image Processing, Computer-Assisted; Incisor; Computers
PubMed: 37635464
DOI: 10.2341/22-114-L -
Indian Journal of Ophthalmology Aug 2022Research and awareness on refractive solutions for presbyopia, commonly known as the "Curse of the 40's," is essential as a large population in the world suffer from...
BACKGROUND
Research and awareness on refractive solutions for presbyopia, commonly known as the "Curse of the 40's," is essential as a large population in the world suffer from vision impairments. Population-based surveys have shown that one billion people in the world are in presbyopic age.
PURPOSE
Many structural and physiological changes occur in the eye with the onset of presbyopia, including the decrease in amplitude of accommodation. At present, various static and dynamic techniques have been attempted to give presbyopes good vision at near-, intermediate-, and far-viewing distances. The aim of the video is to familiarize the modern-day ophthalmologists to these modalities.
SYNOPSIS
In this video, we tried to summarize the indications and contraindications of presbyopic laser. Preoperative investigations like dominance testing and micro monovision testing are described. The role of neuroadaptation and patient counselling is emphasized. Static techniques described in the video include spectacles, contact lenses, surgical options like corneal inlays and onlays, corneal laser ablation, conductive keratoplasty, corneal implant lenses, INTRACOR and IOLs. Dynamic presbyopia correction (accommodative) is always surgical. This is split into lenticular (accommodating IOLs, piggyback, lens refilling, lentotomy) and scleral treatment (laser-assisted presbyopia reversal and scleral expansion bands).
HIGHLIGHTS
The types of corneal laser ablation, which is otherwise very confusing, is elaborated in a step-wise manner here. The difference in approach of PresbyLasik (Nidek), Presbyond (Zeiss) - Laser Blended Vision, PresbyMax (Schwind), INTRACOR (Technolas) are explained with examples. Each approach has its pros and cons. Our challenge as a surgeon is to identify the best combination for the patient. This video illustrates the treatment options which can help break the curse of presbyopia.
ONLINE VIDEO LINK
https://youtu.be/rTxMIqMrgaw.
Topics: Accommodation, Ocular; Contact Lenses; Eyeglasses; Humans; Presbyopia; Vision Tests
PubMed: 35919011
DOI: 10.4103/ijo.IJO_1086_22 -
Journal of International Society of... 2022The aim of this study was to assess and compare the coronal microleakage of e-Temp (DiaDent, Korea), intermediate restorative material (IRM) (Dentsply, Sirona), and...
AIM
The aim of this study was to assess and compare the coronal microleakage of e-Temp (DiaDent, Korea), intermediate restorative material (IRM) (Dentsply, Sirona), and Systemp Inlay (Ivoclar Vivadent, Germany) temporary restorative materials used to seal the class I cavity preparations.
MATERIALS AND METHODS
In this experimental study, three temporary restorative materials were assessed for microleakage. A standardized class I access cavities (2 mm × 4 mm) were prepared in 30 freshly extracted intact human premolar teeth. Teeth were then divided randomly into three groups consisting of 10 samples each. Teeth were restored with e-Temp ( = 10), IRM ( = 10), and Systemp Inlay ( = 10), temporary restorations, and subjected to thermocycling 5000 times in a cold bath followed by a temperature of 55°C with a dwell time of 30 seconds. Teeth were painted with two layers of nail polish except for 1 mm around the restoration margin, soaked in 1% methylene blue dye solution (pH 7.4), and kept for 24 h. Sticky wax was used to seal the apical foramina. All the teeth were sectioned mesiodistally, and the specimens were examined for the amount of dye penetration (microleakage) through the restoration using Digital Microscope under 50× magnification. Data were analyzed using descriptive statistics, Mann-Whitney , and Kruskal-Wallis tests.
RESULTS
e-Temp showed 1 (10%) specimen with dye penetration up to 1 mm (Score 1). The specimens restored with IRM showed a 1 (10%) and 9 (90%) of scores for 1 and 3 dye penetration. However, 2 (20%) teeth restored with Systemp Inlay showed a dye penetration up to 3 mm or more (Score 3). A comparison of mean microleakage values of e-Temp (0.03 ± 0.10), IRM (2.69 ± 0.77), and Systemp Inlay (0.78 ± 1.64) showed a statistically significant difference ( < 0.001). IRM specimens showed significantly higher microleakage values than e-Temp and Systemp Inlay specimens ( < 0.05).
CONCLUSION
All the temporary restorative materials tested in this experiment showed a certain extent of microleakage. The temporary restorative material e-Temp showed the least microleakage values followed by Systemp Inlay and IRM.
PubMed: 36777014
DOI: 10.4103/jispcd.JISPCD_183_21 -
Clinical Ophthalmology (Auckland, N.Z.) 2022Presbyopia may represent the largest segment of refractive errors that is without an established and effective refractive surgery treatment. Corneal Inlays are materials... (Review)
Review
Presbyopia may represent the largest segment of refractive errors that is without an established and effective refractive surgery treatment. Corneal Inlays are materials (synthetic or allogenic) implanted in the stroma of patients' corneas to improve presbyopia. These inlays, introduced into the United States in 2015 via the small-aperture corneal inlay (KAMRA, SightLife Surgical/CorneaGen, Seattle, Washington, United States), were met with an initial wave of enthusiasm. Subsequent models like the shape-changing corneal inlay (RAINDROP, Revision Optics, Lake Forest, California, United States) offered excellent results for patients, but longer-term research raised questions about patient safety. At the time of this article, no synthetic corneal inlays are available in the United States for the correction of presbyopia. Other options for presbyopia correction include allograft corneal inlays, trifocal synthetic corneal inlays, pharmacologic therapies, scleral incisions or additive techniques and PresbyLASIK. Presently, allograft inlays consist of corneal lenticules removed from patients undergoing Small Incision Lenticule Extraction (SMILE). We will review corneal inlays and other alternative procedures that may provide effective and predictable treatments for patients with presbyopia.
PubMed: 36042913
DOI: 10.2147/OPTH.S375577 -
International Journal of Dentistry 2023Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving...
Dental Students' Perception and Self-Perceived Confidence Level in Key Dental Procedures for General Practice and the Impact of Competency Implementation on Their Confidence Level, Part I (Prosthodontics and Conservative Dentistry).
BACKGROUND
Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort).
MATERIALS AND METHODS
An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, = 153), and the other in 2019 after the implementation of this system (group 2, = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and -test for Equality of Means calculated.
RESULTS
Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied.
CONCLUSIONS
This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date.
PubMed: 37868108
DOI: 10.1155/2023/2015331 -
International Journal of Computerized... Jun 2021The aim of the present study was to compare inlay and onlay restorations fabricated from conventional impressions and two different digital impression systems in terms... (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluation of clinical success and marginal adaptations of inlay and onlay restorations manufactured after conventional and digital impressions: a prospective randomized controlled clinical study.
AIM
The aim of the present study was to compare inlay and onlay restorations fabricated from conventional impressions and two different digital impression systems in terms of clinical features and marginal fit.
MATERIALS AND METHODS
Participants were randomly assigned to three groups according to the type of impression system used. The impressions were taken with polyvinyl siloxane silicone material for the control group (CON). For the digital impressions, Trios Pod Scanner (3Shape) was used for the TRIOS group and Cerec AC Omnicam (Sirona) for the CEREC group. A total of 40 IPS e.max CAD and 20 IPS e.max Press (both Ivoclar Vivadent) inlay and onlay restorations were then placed in 24 participants. Clinical evaluations, Plaque Index, Gingival Index, and pocket probing depth measurements were taken at baseline, 6 months, and 12 months using FDI criteria. The continuous margin percentages were quantitatively examined by scanning electron microscopy at baseline and 12 months.
RESULTS
All the restorations showed clinically acceptable measurements at baseline, 6 months, and 12 months. The continuous margin evaluations showed no statistically significant difference between the groups.
CONCLUSIONS
Based on the 12-month follow-up results, inlay and onlay restorations fabricated with digital impressions were found to be a reliable alternative to conventional impressions.
Topics: Computer-Aided Design; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Humans; Inlays; Prospective Studies
PubMed: 34085505
DOI: No ID Found -
Journal of Esthetic and Restorative... Dec 2022Evaluation of the effect of preparation type (inlay, onlay, and crown) on the accuracy of different intraoral scanning (IOS) systems at the preparation and arch segment...
OBJECTIVE
Evaluation of the effect of preparation type (inlay, onlay, and crown) on the accuracy of different intraoral scanning (IOS) systems at the preparation and arch segment levels.
MATERIALS AND METHODS
Three molars were prepared for inlay, onlay, and crown. Each preparation was scanned 10 times by CEREC Omnicam, Trios 3 (TS), and Medit i500 scanners. Each image was trimmed twice. The first trimming produced a preparation image (PI), and the second trimming extracted a segment image (SI) that involved the preparation with the adjacent teeth. Trueness and precision were calculated at the PI and SI levels.
RESULTS
At the PI level, all IOS systems had similar trueness pattern for all preparations, where the inlay had the best trueness followed by the crown and onlay. At the SI level, the different preparations showed similar trueness. The precision did not show a clear pattern of superiority for any preparation. The TS was significantly more precise than other IOS systems at the PI and SI levels, for every preparation. The proximal areas suffered from the greatest errors, regardless of preparation type.
CONCLUSIONS
The preparation type influenced PI trueness, and the IOS system affected PI and SI precisions.
CLINICAL SIGNIFICANCE
The smaller and less complex preparations have greater IOS accuracy than larger and more complex preparations. As the proximal areas are more affected regardless of the preparation, a more accessible proximal area for scanning is desirable.
Topics: Dental Impression Technique; Models, Dental; Dental Arch; Computer-Aided Design; Imaging, Three-Dimensional
PubMed: 36415928
DOI: 10.1111/jerd.12949 -
Contact Lens & Anterior Eye : the... Apr 2024It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power....
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
PubMed: 38641525
DOI: 10.1016/j.clae.2024.102156 -
Journal of the Mechanical Behavior of... Jan 2023The purpose of this in-vitro study was to investigate the effect of framework design on fracture resistance and failure modes of cantilever inlay-retained fixed partial...
PURPOSE
The purpose of this in-vitro study was to investigate the effect of framework design on fracture resistance and failure modes of cantilever inlay-retained fixed partial dentures (IRFDPs) fabricated from two multilayered monolithic zirconia materials.
MATERIALS AND METHODS
Seventy-two natural premolar teeth were prepared as abutments for cantilever IRFDPs using three designs: mesial-occlusal (MO) inlay with short buccal and palatal wings (D1), MO inlay with long palatal wing (D2), MO inlay with long palatal wing and occlusal extension (D3). Full-contoured IRFDPs were fabricated from two monolithic zirconia materials; IPS e.max ZirCAD Prime and Zolid Gen-X. Adhesive surfaces were air-abraded and bonded with MDP-containing resin cement. Specimens were subjected to thermocycling (5-55 °C, 5000 cycles); then, mechanical loading (1.2 × 10⁶ cycles, 49 N). Surviving specimens were loaded until failure in the universal testing machine. All specimens were examined under stereomicroscope, and two samples from each group were evaluated using Scanning Electron Microscope.
RESULTS
Mean failure loads were not significantly different between different framework designs or between two materials. However, IPS e.max ZirCAD Prime showed significantly higher failure rate than Zolid Gen-X during dynamic fatigue (p = 0.009). Samples with D1 design showed higher debonding rate, D2 failed mainly by fracture of the palatal wing and debonding, and D3 failed mainly by fracture of the abutment tooth. Debonded restorations showed mainly mixed failures.
CONCLUSION
Cantilever IRFDPs with framework designs that maximize adhesion to enamel exhibited promising results. IPS e.max ZirCAD Prime was more susceptible to fractures with the long palatal wing design.
Topics: Denture Design; Zirconium; Ceramics; Denture, Partial, Fixed; Dental Restoration Failure; Dental Stress Analysis; Dental Porcelain; Materials Testing
PubMed: 36370641
DOI: 10.1016/j.jmbbm.2022.105547