ABSTRACT
The literature pertaining to the extraction of third molars is extensive. There is a large individual variation and a multitude of practitioners' beliefs and biases relating to the extraction of especially asymptomatic and pathology free third molars. With the current emphasis in dentistry being placed on clinicians to make evidence-based decisions, the routine removal of third molars has been re-assessed and questioned. The purpose of this paper was to evaluate past and present knowledge of third molar extractions and relate it to logical considerations relevant to science and the evidence-based decision-making process. This paper endeavours to encourage and stimulate clinicians to re-evaluate their views on third molar extractions based on suggested guidelines and current evidence.
Subject(s)
Evidence-Based Dentistry , Molar, Third/surgery , Tooth Extraction , Cost-Benefit Analysis , Elective Surgical Procedures , Humans , Malocclusion/prevention & control , Pericoronitis/complications , Periodontal Pocket/etiology , Practice Guidelines as Topic , Risk Factors , Tooth Extraction/adverse effectsABSTRACT
The purpose of this investigation was to test for an association between the craniofacial morphologies of bruxers and nonbruxers. The sample for this retrospective descriptive comparative study consisted of 28 Caucasian dental school subjects. Sixteen were bruxers and 12 were nonbruxers. The determination of bruxism was based on a six-item questionnaire as well as objective measures of the severity of tooth wear as analyzed from dental casts. Craniofacial morphology was determined directly using anthropometric spreading calipers. Craniofacial measurements included glabella-opiscranion, euryon-euryon, nasion-gnathion, zygoma-zygoma, and gonion-gonion. From these measurements, the following indices were calculated: cephalic (Gla-Op/Eu-Eu), facial (Na-Gla/Zy-Zy), gonial (Zy-Zy/Go-Go), and gonial height (Na-Gla/Go-Go). This study found no differences in the craniofacial morphologies of bruxers and nonbruxers, nor was there a difference in overbite. There was, however, a statistically significant difference in the bizygomatic (Zy-Zy) and cranial (Eu-Eu) widths of bruxers compared with nonbruxers.
Subject(s)
Bruxism/pathology , Facial Bones/anatomy & histology , Skull/anatomy & histology , Adult , Analysis of Variance , Bruxism/diagnosis , Cephalometry , Chin/anatomy & histology , Humans , Incisor/pathology , Malocclusion/pathology , Mandible/anatomy & histology , Models, Dental , Multivariate Analysis , Nose/anatomy & histology , Occipital Bone/anatomy & histology , Orbit/anatomy & histology , Reproducibility of Results , Retrospective Studies , Temporal Bone/anatomy & histology , Zygoma/anatomy & histologyABSTRACT
Four orthodontic faculty at one dental school classified 25 dental casts according to the classification systems of Angle, Katz, and the British Incisor Classification. The dental casts were selected from a pool of 350 pretreatment graduate orthodontic cases and were those deemed the most atypical. The results demonstrated that Katz's classification was more reliable than both Angle and the British. Angle's classification was the least reliable of the three methods.
Subject(s)
Malocclusion/classification , Humans , Models, Dental , Observer Variation , Reproducibility of ResultsABSTRACT
The purpose of this study was to compare the reliability and validity of three occlusal indexes of orthodontic treatment need in predicting the opinion of treatment need of a panel of 18 orthodontists. A set of 160 study casts representing all types of malocclusion was used. The casts were scored with the following occlusal indexes: the Index of Orthodontic Treatment Need (IOTN), the Handicapping Labio-Lingual Deviations index (HLD), and the Handicapping Malocclusion Assessment Record (HMAR modified). The diagnostic accuracy or validity of each index was calculated using the mean opinion of the orthodontic raters as a "gold standard". Receiver Operating Characteristic curves were plotted for each index. The overall diagnostic accuracy, as determined by percent area under the curve, was similar for each index: IOTN 98.6%; HLD 96.1%; HMAR 96.6%. The score optimizing the sensitivity and specificity relationship for each index was as follows: IOTN (dental health component) 4; HLD 13; HMAR 12. These results indicate that the three occlusal indexes provided valuable information for determining orthodontic treatment need.
Subject(s)
Health Services Needs and Demand/statistics & numerical data , Malocclusion/epidemiology , Orthodontics, Corrective/statistics & numerical data , Esthetics, Dental , Forecasting , Humans , Malocclusion/classification , Malocclusion/therapy , Models, Dental , Observer Variation , Orthodontics , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , United States/epidemiologySubject(s)
Centric Relation , Dental Occlusion, Centric , Jaw Relation Record/instrumentation , Mandibular Condyle/pathology , Dental Articulators , Female , Humans , Male , Malocclusion/classification , Malocclusion/pathology , Mandible/pathology , Reproducibility of Results , Research Design , Temporomandibular Joint/pathologyABSTRACT
A checklist for verification of unethical business practices, originally formulated by Drs. Blanchard and Peale, is adapted to dental practice. A scenario is used as a model to demonstrate the applicability of this instrument to dental practice. The instrument asks three questions in regards to an ethical dilemma: 1) Is it legal? 2) Is it fair? 3) How does it make you feel? The paper concludes the giving of gifts to general dentists by dental specialists for the referral of patients is unethical.
Subject(s)
Dentists , Ethics, Dental , Gift Giving , Practice Management, Dental , Professional Misconduct , Clinical Competence , Ethics , Ethics, Business , General Practice, Dental/legislation & jurisprudence , Humans , Interprofessional Relations , Legislation, Medical , Morals , Practice Management, Dental/legislation & jurisprudence , Professional Practice/legislation & jurisprudence , Referral and Consultation/legislation & jurisprudence , SpecializationSubject(s)
Dental Records , Informed Consent , Practice Management, Dental , Forms and Records Control , HumansABSTRACT
The dentofacial morphology of 35 bruxers was compared with that of 28 non-bruxers. Direct head and facial measurements were made using anthropometric spreading calipers. Cephalic (head width vs. head length), facial (face height vs. face width), and "gonial" (gonial width vs. zygomatic width) indices were calculated, then headform and facial type were determined for all subjects. The findings demonstrated no difference in the dentofacial morphology between bruxers and non-bruxers (Chi square, P < or = 0.05). The predominant craniofacial type and dental morphology of both bruxers and non-bruxers were: dolichocephalic headform, euryprosopic facial type, and Angle Class I dental occlusion.
