Authors:
M.T.P. Naphausen, M. Riemersma, E.H. Verdonschot
Source:
NTvT january 2002; 109: 003 - 7
Section:
Summary:
Recently, a device for detecting occlusal caries lesions (DIAGNOdent®) has been introduced. The reproducibility and validity of this laser-fluorescence device were investigated. In the in vivo part of the study, 45 sites at the occlusal surfaces of permanent molar teeth in 13 patients were measured by 2 observers using 2 DIAGNOdent® devices, one produced in 1998 and one in 1999. The interobserver reliability between both devices and both observers was established. In the in vitro part of the study, 49 permanent molars were measured by 2 observers using 2 DIAGNOdent® devices. In addition, visual inspection was performed. The teeth were sectioned to measure the histological depth and area of the caries lesions. The reproducibility of both DIAGNOdent® devices was high, and so was the interobserver reliability. The correlation between DIAGNOdent® measurements and the actual depth of the caries lesions was lower than that of visual inspection. The correlation with the enamel part of the lesion exceeded that of the dentine part. It was concluded that the validity of the DIAGNOdent®, expressed as the area under the Receiver Operating Characteristic (ROC) curve, was not statistically significantly different from that of visual inspection. Because of the high reproducibility, dental practitioners who wish to use the DIAGNOdent® for monitoring caries lesions, this investigation indicates that an old device may be replaced by a new one, provided that the same tip will be used.
Authors:
J.W. Verhoeven, J.M. Ruijter, M.S. Cune, M. Terlou, M.A.O.W. Zoon, R. Koole
Source:
NTvT january 2002; 109: 008 - 14
Section:
Summary:
The placement of endosseous implants in combination with iliac crest onlay grafting of the anterior mandible is one of the treatment modalities for extreme atrophy of the mandible. The remodelling of these onlay grafts was studied using standardized extraoral oblique lateral cephalometric radiographs (OLCRs). A group of 8 patients was used in this prospective study. The measurements obtained from the OLCRs indicated the existence of the following stages in the process of remodelling of the bone grafts: 1. decrease in thickness and radiographic density of the (upper) cortex of the graft, predominantly during the first half year after grafting; 2. no significant changes in the radiographic density of the upper spongeous part of the graft; 3. a mean decrease of approximately 25% in the overall thickness of the graft, particularly during the first half year; and 4. an increase in the radiographic density of the lower part of the spongeous bone in the second half year after grafting. It is concluded that the remodelling of the graft has a predictable pattern in time. Densitometric measurement using standardized OLCRs can be a useful tool to evaluate quantitative changes of bone grafts to the mandible. The treatment described can be used on very strict indications only.
Authors:
M. Bennema-Broos, E.M. Sluijs, C. Wagner
Source:
NTvT january 2002; 109: 015 - 19
Section:
Summary:
In the Netherlands over 20% of dentists participate in peer review groups. The peer review method is highly structured and consists of: setting standards for good dental care, measuring and evaluating performances against the standards and making improvements if necessary. An independent research institute (Nivel) investigated the perceived effects and advantages of and barriers to peer review. A postal questionnaire was sent tot 278 dentists who participate in peer review (response 60%). The results showed many effects of peer review. The most frequently reported effects were: more insight into the performances of colleagues, increased inter-professional contacts, a more critical attitude to performances, increased professional expertise and new inspiration and motivation. The respondents reported improvements in practice-organisation as well as in technical aspects of dental care. However, many dentists also mentioned some barriers to peer review. The method was evaluated as rather complex and it appeared to be difficult to reach consensus about standards for good dental care.In general, respondents perceived a positive balance between advantages and disadvantages of peer review, however many dentists were dissatisfied with the lack of financial compensation for participation in peer review.
Authors:
E.M. Sluijs, M. Bennema-Broos, C. Wagner
Source:
NTvT january 2002; 109: 020 - 24
Section:
Summary:
In 1998 mutual practice visitation has been introduced in the Dutch dental practice as a method to improve quality of dental care. The method is called ‘mutual visitation’ because groups of three dentists visit and evaluate each others practices. An independent research institute (Nivel) investigated the perceived effects, advantages and barriers of visitation. A postal questionnaire was sent to all 235 dentists who, by that time, participated in visitation. The response was 57%. The results showed that the effects reported most frequently were: a more critical attitude to dental practice, more insight into practices of colleagues and actual improvements in dental care. The majority of the respondents considered visitation suitable to improve practice-organization. A minority considered visitation suitable to increase professional expertise. The mutuality of the visitation was highly valued by the participants. The main disadvantage of visitation appeared to be the time investment (a mean of three days per dentist). In general, the respondents held the view that the positive effects outweighted the time and efforts, however, many dentists regretted the lack of financial compensation for visitation.
Authors:
M.J. Koudstaal, I. van der Waal
Source:
NTvT january 2002; 109: 025 - 26
Section:
Summary:
A six weeks old boy was referred to the Groningen University Hospital because of a swelling of the mucosa in the maxilla. The swelling existed for several weeks and was accidentally observed during breastfeeding by his mother. The lesions apparently did not result in oral discomfort. Clinical examination showed two white-yellow broad-based swellings on the labial site of the alveolar crest. The diagnosis was gingival cysts of newborn. No treatment was needed. After six months the cysts had disappeared spontaneously.
Authors:
P. Bol
Source:
NTvT january 2002; 109: 027 - 28
Section:
Summary:
This second of two articles on diabetes describes the therapy. Type 1 diabetes urges the daily injection of insulin. This hormone is available in many varieties, from fast till slow preparations. In the future it might be possible - apart from transplantation - to install beta-cells in the liver. Type 2 diabetes - often caused by a combination of insufficient insulin production and peripheral insulin resistance - mostly does not require insulin suppletion. Weight loss, diet and exercise are here the basics of therapy. In support, oral antidiabetic drugs are available. Lastly, some remarks are made about diabetes in relation to dentistry.
Authors:
S.L. Liem
Source:
NTvT january 2002; 109: 029 - 29
Section:
Summary:
The website of the School of Dentistry of the University of Indiana (IUSD) gives a perfect example of how good use of a website can make the complicated structures of a university transparent and clear. The goals of IUSD are high and with the help of a number of examples on the mentioned site it will be described in this article what has to be done to realise this. It will be clear that it is necessary in the American educational system to publish a lot of information to acquire sufficient (financial) means, students and patients. An outsider from the low-countries looks in astonishment at the open way in which this American dental school makes itself transparent and reports in this way to outsiders, via the digital highway.
