Small business needs assessment: a comparison of dental educators' responses with SBDC survey results.

A primary focus of dental education is to teach students the knowledge, skills, and values essential for practicing dentistry. However, the preparation of dentists to manage a business is frequently cited as inadequate. A survey was prepared to assess teachers' opinions of business instructional topics: challenges; desired training; employee benefits; learning resources; importance of business topics; and appropriateness of time allocations. The purpose of this project is to compare opinions of teachers of dental practice management with key management aspects reported for service businesses by the Small Business Development Center (SBDC). Practice management teachers from forty-eight (89 percent) schools responded to the survey. They indicated that several challenges confronting dentists are similar to other service businesses. Dentists, however, rank customer relations appreciably higher. In order of importance of teaching topics, the practice management teachers rank ethics and personnel management as a high priority and planning as a low priority. Awareness of the similarities and differences in the perceptions of practice management teachers and businesspeople may result in instructional improvements.

Pseudo-dental pain and sensitivity to percussion.

Two case reports examine a little-known cause of dental pain and sensitivity to percussion. Contrary to the traditional assumption that pain and sensitivity to percussion almost always are diagnostic of pulpal inflammation and/or necrosis, these symptoms actually may be referred to the sensitive tooth from trigger points in the masticatory muscles. Therefore, myofascial pain syndrome must be ruled out in patients who have dental pain and display sensitivity to percussion.

Enigmatic pain referred to the teeth and jaws.

A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.

Comparison of 5 protocols based on their abilities to use data extracted from digitized clinical radiographs to discriminate between patients with gingivitis and periodontitis.

BACKGROUND: This study was undertaken to compare 5 digital analytic protocols for their abilities to extract data from digital clinical radiographs and discriminate between patients with gingivitis and periodontitis. METHODS: Five digital-image analysis protocols were compared for their abilities to discriminate between two groups of 24 patients each. One group was diagnosed with healthy gingiva (or gingivitis) and the second with periodontitis. These groups were previously evaluated in published studies that used fractal and morphologic analyses. Pre-existing clinical radiographs for each patient were digitized and regions of interest (ROIs) were placed on interdental bone in mandibular posterior quadrants. The 5 protocols used were: 1) MGB: a median filtration to remove high-frequency noise, a Gaussian filtration to remove low-frequency noise, binarization of the resulting image, and quantification of the black pixels; 2) MGBS: the same protocol as MGB except for a skeletonization of the binary image and a quantification of the skeleton's pixels; 3) GBS: Gaussian filtration, binarization (thresholding on the mean pixel value) of the resulting image, skeletonization, and quantification of the pixels of the skeleton; 4) NS: normalization, skeletonization, and quantification of the skeleton's pixels; and 5) S: a variation of NS, except normalization was not used. The resulting values for the 2 patient groups were compared with Mann-Whitney U tests and effect likelihood-ratio test. RESULTS: For digitized radiographs, the mean gray-scale value (+/- standard deviation) for gingivitis patients was 183.22 +/- 18.53 and for periodontitis patients 181.26 +/- 17.20. Mann-Whitney U tests resulted in the following P values for these protocols: MGBS <0.01; S <0.01; GBS <0.01; NS <0.01; and MGB <0.83. Effect likelihood-ratio tests indicated that only MGBS and S significantly contributed to models containing the other factors. CONCLUSIONS: Small variations to protocols affected the strength of the discrimination between the gingivitis and periodontitis groups. While there is potential for morphologic analysis to be used to discriminate between patients with gingivitis and periodontitis, a robust technique was not identified.

The effect of autoclaving on energy transmission through light-curing tips.

The authors subjected three groups of curing lights to 25 sterilization cycles to test the effects of autoclaving on the curing tip's ability to transmit light. They also investigated whether polishing the tip at various intervals would reduce the effects of autoclaving on light transmission. They found that autoclaving does diminish the ability of the tips to transmit light, but that these effects can be minimized if the tip is polished at frequent intervals between autoclaving cycles.

Analyzing dental procedures performed by an HIV-positive dental student.

No evidence of HIV transmission was found between an HIV-positive dental student and 163 treated patients.

Dentin permeability: sealing the dentin in crown preparations.

Provisional restorations of full crown preparations may permit more microleakage of bacteria and their products than the final castings do. However, most investigations of the sealing qualities of cemented castings have reported that they too permit dye leakage. One approach to the problem is to seal the dentin with dentin bonding agents at the completion of the crown preparation. This study evaluated the ability of six different dentin bonding agents to seal the dentin of crown preparations of human teeth in vitro using two independent techniques. The first technique quantitated fluid filtration across dentin before and after treatment with dentin bonding agents at one hour, one day, one week, and one month and after thermocycling. The second method measured silver nitrate penetration of the thin veneers of dentin bonding agents into the dentin. Both methods correlated well with each other. The best seals were obtained with Prisma Universal Bond 2 or Superbond powder plus liquid. The worst seals were found using Gluma and Superbond liquid only. Clearfil PhotoBond, Amalgambond, and Scotchbond 2 gave intermediate results. Although the dentin bonding agents tend to accumulate on chamfers, thereby increasing their thickness to 200-300 microns, the method looks promising as a simple way to protect the pulp from the consequences of microleakage.

Amalgam buildups: shear strength and dentin sealing properties.

The retentive strength and sealing properties of amalgam buildups were compared in vitro in three groups of specimens. All teeth were prepared with flat, nonretentive surfaces. In the first group, the amalgam buildups were retained by four self-threading Minim pins. In the second group, retention was provided by a circumferential slot prepared in the dentin just inside the DEJ. The third group utilized an adhesive resin for retention. Dentin permeability was measured as a hydraulic conductance before and after placement of the amalgam buildups and before and after thermocycling. All methods of retention sealed dentin very well even in the absence of cavity varnish. The 90 degree retentive strength was: pins, 10.3 +/- 0.9 MPa; slots, 4.1 +/- 0.5 MPa; resin, 3.1 +/- 0.8 MPa (mean +/- SEM).

Management considerations for an HIV positive dental student.

Health care workers who are HIV positive or who have AIDS are faced with unique and perplexing problems. Likewise dental students who are HIV positive present a special circumstance that demands review of ethical, legal, managerial, and medical considerations. The purpose of this paper is to describe the management considerations at the Medical College of Georgia following a recent report of an HIV positive dental student. The administration assembled a diverse team of experts for advice in the situation. This group assumed that the circumstance was a potential crisis with possible serious long-term implications. Therefore detailed planning, appropriate announcements, and careful management have been the administration's principle goal for several weeks. The key management strategies and actions are described from the time of notification of the student's HIV antibody test results through the initial testing of the patient population subgroup.

The reduction of phenytoin-induced gingival overgrowth in a severely disabled patient: a case report.

Gingival overgrowth frequently occurs in patients medicated with phenytoin (5,5-diphenylhydantoin) to control epileptic seizures. In a recent study, gingival overgrowth was observed in a patient in an experimental group evaluating an automatic toothbrushing system for severely disabled patients. During the evaluation period, which included an oral hygiene regimen provided by an attendant or housemate and a regimen with the Mississippi Dental Care System (MDCS), the patient's gingival overgrowth was noticeably reduced. The results of this study indicate that control of local factors with the MDCS is significantly better than the routine home care regimen, and that the phenytoin-associated gingival overgrowth in this patient was reduced by MDCS.