Frequency of restoration replacement in posterior teeth for U.S. Navy and Marine Corps personnel.

STATEMENT OF PROBLEM: There are no recent data that describe the replacement rates of resin composite and dental amalgam restorations placed by US Navy dentists. Information is needed to provide the best possible care for our military personnel which would minimize the probability of dental emergencies, especially for those who are deployed. PURPOSE: The purpose of this study was to determine if the frequency of posterior restoration replacement in military personnel differed based on the type of restorative material utilized. METHODS AND MATERIALS: Data contained in dental records in an observational study (retrospective cohort) were evaluated to identify resin composite and dental amalgam restorations placed by navy dentists in posterior teeth. The status of all erupted, unerupted, missing, and replaced teeth was documented. The type and condition of all existing restorations were recorded for each posterior tooth. Investigators reviewed 2921 dental records, and of those, 247 patients met the criteria for inclusion in the study. A total of 1050 restorations (485 resin composite and 565 amalgam) were evaluated. RESULTS: A Cox proportional hazards model was adjusted for number of tooth surfaces restored, caries risk, and filled posterior surfaces at initial exam. The overall rate of replacement for all restorations in the sample was 5.7% during the average 2.8-year follow-up. No significant elevation of risk for restoration replacement existed when comparing resin composite and amalgam. Both the number of restored surfaces and caries risk status were independent risk factors for replacement. When restoring multisurface cavity preparations, providers placed amalgams by an approximate 2:1 ratio over resin composites for this study population. CONCLUSION: The results for this study show that no difference existed in the rate of replacement for amalgam vs resin composite. When restorations increased from just a single occlusal surface to additional surfaces, the rate of replacement was elevated and statistically significant for both materials. A higher caries risk status was also significant in elevating replacement rates for both materials.

Dental emergencies among Marines ashore in Operations Desert Shield/Storm.

The purpose of this study was to determine the incidence of dental emergency visits for Marine Corps personnel ashore during Operations Desert Shield/Storm. We investigated the period of August 18, 1990, through April 19, 1991, during which 16 dental treatment facilities treated 4,776 dental emergencies in Marine Corps personnel. All dental treatment facilities maintained log books of dental treatment rendered, from which data were obtained. For the 35 weeks, a rate of 100.5 emergencies/1,000 Marines was calculated. The range, on a per week basis, was 1.4 to 4.6 emergencies/1,000 Marines. Caries, defective restorations, and endodontic complaints accounted for 54.3% of emergency visits.

The evaluation of a managed dental delivery concept.

Phased dentistry (PD) is a philosophy of managed oral health care that emphasizes an orderly approach to dental risk assessment, prevention, and disease management. PD is divided into two stages. Phase I (PH1) care is intended to eliminate all conditions that may produce a dental emergency within 12 months. PH1 care is directed primarily to recruits and apprentice training students. Phase 2 (PH2) care strives to attain and maintain optimal oral health for Navy and Marine Corps personnel after their initial training period and throughout their military career. The purpose of this study was to evaluate the feasibility of introducing PH1 into a recruit dental treatment facility. Data were obtained at Naval Dental Center (NDC), Orlando from 4,571 recruit dental patients who were in-processed and completed recruit training between May 27 and October 1, 1993. The incoming operational dental readiness (ODR) of recruits during the PD trial was 28.5%, whereas the ODR of graduating recruits was 85.8%. During this same period there was a 34% increase in completed dental treatments per provider full time equivalent. Although dramatic increases in ODR and productivity were noticed during PD, other variables may have contributed to these results.

Dental emergency visits of Marine Corps personnel.

The purpose of this study was to determine the incidence and distribution of dental emergencies in Marine Corps personnel. Dental emergencies were recorded from June 1989 to June 1990 for personnel who were in garrison, deployed, or participating in field exercises. A standardized data-collection form was distributed to participating Marine Corps dental clinics and to dental officers assigned to Marine Corps deployments or field exercises. A total of 890 dental emergency visits by Marines were recorded: 699 for Marines while in garrison, 136 while deployed, and 55 while participating in field exercises. Tooth/restoration fracture without pulpal involvement and pericoronitis were the most frequent diagnoses at emergency visits in each of the three environments. The mean incidence rate of dental emergencies per 1,000 person-years for deployed Marine Corps personnel was 57.2.

Effects of gender-related factors on the incidence of localized alveolar osteitis.

Numerous literature references have suggested increased risk for localized alveolar osteitis associated with female gender, use of oral contraceptives, and point in menstrual/contraceptive cycle. However, the available information has not been systematically considered with the intent to accurately estimate the magnitude of these effects. The present review suggests that under certain conditions, some of which may be avoidable, females may have at least a two to threefold increase in osteitis risk compared with males. It appears that this greater risk may be reduced by considering hormonal cycles when scheduling elective exodontia.