Master of Dental Surgery / At the present time in Australia (1992) there exists no undergraduate training for dental students in auxiliary utilisation. The result of this is that new dental graduates have no understanding of the concept of practicing sit-down four-handed dentistry in a comfortable and efficient manner. This compares with the United States of America (USA) where, since 1961, every dental student receives formal instruction in Dental Assistant Utilisation (DAU) and, since 1973, Training in Expanded Auxiliary Management. In this treatise the history and development of “four-handed dentistry” is presented along with a literature review of the fundamental principles of DAU. The intial pilot programmes and the subsequent federally funded national DAU programme in the USA are analysed. Four undergraduate DAU programmes from the USA and the current graduate continuing education DAU programme at Westmead Hospital Dental Clinical School are examined. Finally, guidelines for the establishment and operation of a DAU programme are outlined. The aim of this treatise therefore, is to provide the necessary information for a thorough understanding of the fundamentals and philosophy of Dental Assistant Utilisation. This information is presented in the hope that at some stage in the future training in assistant utilisation would become an integral and important part of the undergraduate dental curriculum in Australia. The purpose of this would be to fill a major void that currently exists in the undergraduate training of dental students in auxiliary utilisation.

Master of Dental Surgery / At the present time in Australia (1992) there exists no undergraduate training for dental students in auxiliary utilisation. The result of this is that new dental graduates have no understanding of the concept of practicing sit-down four-handed dentistry in a comfortable and efficient manner. This compares with the United States of America (USA) where, since 1961, every dental student receives formal instruction in Dental Assistant Utilisation (DAU) and, since 1973, Training in Expanded Auxiliary Management. In this treatise the history and development of “four-handed dentistry” is presented along with a literature review of the fundamental principles of DAU. The intial pilot programmes and the subsequent federally funded national DAU programme in the USA are analysed. Four undergraduate DAU programmes from the USA and the current graduate continuing education DAU programme at Westmead Hospital Dental Clinical School are examined. Finally, guidelines for the establishment and operation of a DAU programme are outlined. The aim of this treatise therefore, is to provide the necessary information for a thorough understanding of the fundamentals and philosophy of Dental Assistant Utilisation. This information is presented in the hope that at some stage in the future training in assistant utilisation would become an integral and important part of the undergraduate dental curriculum in Australia. The purpose of this would be to fill a major void that currently exists in the undergraduate training of dental students in auxiliary utilisation.

Made available in DSpace on 2014-06-11T19:24:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-04-02Bitstream added on 2014-06-13T18:20:15Z : No. of bitstreams: 1 rodrigues_tp_me_arafo.pdf: 1069391 bytes, checksum: 7966c77359cded07d74e880c53342fc2 (MD5) / Universidade Estadual Paulista (UNESP) / O objetivo deste estudo foi verificar os procedimentos realizados pelos cirurgiões-dentistas durante a seleção de cor dental, analisar a prática de utilização do método visual para a seleção da cor, avaliar a diferença de cor entre a escala Vitapan Classical e diversas resinas compostas e a fluorescência de diferentes cores de uma resina composta e da estrutura dental. Sessenta cirurgiões-dentistas foram selecionados para responder um questionário referente à seleção de cor dental. Observou-se que todos os profissionais utilizavam o método visual, apenas 2 utilizavam o método digital e 52% desconheciam o método digital. Para a análise da prática de utilização do método visual de seleção da cor com o auxílio da escala Vitapan Classical foi verificada a concordância nas classificações de cor entre o consenso de dois observadores e a dada pelo fabricante da resina composta Helio Fill (Vigodent), obtendo um nível de concordância sofrível (k = 0,3774). Por meio do sistema CIE L*a*b* foram calculadas as diferenças de cor entre a escala Vitapan Classical e cada uma das diversas resinas compostas avaliadas. Observou-se que oito resinas compostas não diferem visualmente da escala Vitapan Classical e duas apresentaram esta diferença. Para a análise da fluorescência foram coletadas 16 imagens para cada uma das 11 cores da resina composta Helio Fill (Vigodent) e estrutura dental sob iluminação UV. Estas processadas matematicamente, quantificando a intensidade de fluorescência. Verificou-se que a cor A1 apresentou maior média de intensidade de fluorescência e a tonalidade C3 apresentou a menor. Porém, a estrutura dental apresentou valor médio inferior a todas as cores avaliadas. / The purpose of this study was to evaluate the procedures carried out by dentists during dental shade selection, assess the practice of the visual method to select dental shade, to evaluate the shade difference between Vitapan Classical shade guide and several composite resins, to evaluate the fluorescence in different shades of a composite resin and dental structure. Sixty professionals were selected, who answered to questions of the form about to select dental shade. The totality of the professionals selected dental shade by visual method; only 2 used digital methods; 52% did not know about the digital method. To assess the practice of the use of visual method to select dental shade, it was observed the agreement in shade classification between two examiners and the classification established by the composite resin manufacturer Helio Fill (Vigodent) which resulted in a suffering level of agreement (k = 0.3774). Through CIE L*a*b* system the difference of the total shade between Vitapan Classical shade guide and the composite resin was calculated and it was observed that eight of the composite resins assessed do not differ visually from Vitapan Classical shade guide, and two showed a perceptive difference to human eye. For the fluorescence analysis sixteen images were captured by the camera for the different shades of Helio Fill (Vigodent) composite resin and dental structure under UV LED illumination, and they were processed mathematically, quantifying the fluorescence intensity. It was observed that A1 shade showed the higher mean of fluorescence intensity, whereas C3 shade showed the lower mean among the composite resin shades. However, the mean intensity of dental structure was lower than those related to all the shades evaluated. (Complete abstract, click electronic access below)

Third molar surgery may be associated with a number of complications the most common of which are postoperative pain, swelling and trismus, and dry socket formation. The appearance of these post-operative sequelae is intimately related to the manifestations of inflammation in response to tissue injury. There is significant post-operative morbidity associated with these complications and it was thus the objective of this study to - investigate the effect of a combined antibiotic/anti-inflammatory intrasocket medication on post-operative pain, swelling and dry socket formation. The medication chosen for the study was Covomycin D®. Covomycin D® is a commercially prepared opthalmological preparation - each 1 millilitre contains 2 mg chloramphenicol, 5 mg neomycin sulphate and 0,5 mg dexamethasone. Nineteen subjects were included in the study after fullfilling certain criteria. All subjects were operated under general anaesthesia by the same surgeon. The patients were blinded to the side of the medication and were asked to complete a pain visual analogue scale and note the side of the worst swelling in the post¬operative period. All patients were followed up in the first week following surgery by an independent oral and maxillofacial surgeon who was also blinded to the side on which the medication was placed. The results showed a significant difference (p<0.6) in the pain experienced on the non-medicated compared to the medicated side on day one in eleven of the nineteen patients (57.9%). When the data was analysed over the six day postoperative period sixteen of the nineteen patients (84.2%) had significantly less pain on the medicated side compared to the non-medicated side (p<0.6). The swelling was reported as being worse on the non-medicated side in fourteen out of the nineteen patients (73.7%). Dry socket occurred in three out of nineteen patients or three out of thirty eight surgical extraction sites; an overall incidence of 7.9% or an incidence of 0% for the medicated side and an incidence of 15.8% on the non-medicated side i.e. all the dry sockets occurred on the non-medicated side. In conclusion, this double-blinded prospectve study, showed that the use of a combined antibiotic/anti-inflammatory intrasocket medication favourably influences the common adverse post-operative sequelae following the removal of lower third molars. / Dissertation (MChD (Chir Max-Fac Med))--University of Pretoria, 2007. / Maxillo-Facial and Oral Surgery / unrestricted

O presente estudo teve por objetivo observar os níveis de concordância entre a avaliação clínica e fotográfica digital no diagnóstico de desempenho de restaurações posteriores (Classe I e Classe II) em resina composta. As avaliações clínicas foram feitas por dois examinadores (C1 e C2) calibrados (e-calib) usando critérios da Fédération Dentaire Internationale (FDI) considerando propriedades estéticas, funcionais e biológicas. Em cada momento de avaliação clínica, uma fotografia digital padronizada de cada restauração foi realizada. Dois examinadores digitais (D1 e D2), igualmente calibrados e usando os mesmos critérios avaliaram todas as imagens obtidas nas avaliações clínicas. Os dados foram analisados com Coeficiente de Cohen Kappa e teste não paramétrico de Kruskal-Wallis e o teste de Dunn de comparação múltipla, com nível de significância de 5%. Comparações intra (mesmo método) e inter (métodos diferentes) examinadores foram feitas. Os resultados revelaram que os níveis de concordância variaram de \"Perfeito\" a \"Justo\". Houve diferença significante (p < 0.05) intra-examinadores; entre C1 e C2 para o manchamento marginal; entre D1 e D2 para brilho superficial, estabilidade de cor e translucidez, forma anatômica, e fratura do material e retenção; inter-examinadores foram encontradas diferenças significantes em todas as propriedades estéticas (brilho superficial, manchamento marginal, estabilidade de cor e translucidez e forma anatômica) e funcionais (fratura do material e retenção e adaptação marginal) observadas. A associação entre a imagem digital e o exame clínico pode ser uma ferramenta promissora para detecção de falhas precoces em restaurações de resina composta, necessitando de mais estudos que investiguem o método digital. / The present study aimed to evaluate the agreement levels between clinical and digital photographic assessments on the performance of posterior composite resin restorations (Class I and Class II). The clinical assessments were made by two examiners (C1 and C2) calibrated through e-calib with the Fédération Dentaire Internationale (FDI) criteria considering esthetic, functional and biological properties. In each moment of clinical assessment, standard digital photographs of each restoration were obtained. Two digital examiners (D1 and D2), equally calibrated and using the same criteria, evaluated all the images obtained in the clinical assessment. The data were analyzed with the calculation of Cohen Kappa coefficient, Kruskal-Wallis non-parametric test and Dunn\'s multiple shared test, with significance of 5%. Intra (same method) and inter (different methods) comparisons were realized. The results showed that agreement levels varied from \"Perfect\" to \"Fair\". There was a significant difference (p < 0.05) intra-examiners; between C1 and C2 to the marginal staining parameter; between D1 and D2 in the parameters surface luster, colour match and translucency, esthetic anatomical form and fracture of material and retention; inter-examiners was noticed significant difference in all the esthetic (surface luster, colour match and translucency, marginal staining, esthetic anatomical form) and functional properties (fracture of material and retention and marginal adaptation) observed. The association between the digital image to the clinical exam may be a promising tool associated with the clinical method to detect early failures in composite resin restorations, requiring further studies investigating the digital method.

O presente estudo teve por objetivo observar os níveis de concordância entre a avaliação clínica e fotográfica digital no diagnóstico de desempenho de restaurações posteriores (Classe I e Classe II) em resina composta. As avaliações clínicas foram feitas por dois examinadores (C1 e C2) calibrados (e-calib) usando critérios da Fédération Dentaire Internationale (FDI) considerando propriedades estéticas, funcionais e biológicas. Em cada momento de avaliação clínica, uma fotografia digital padronizada de cada restauração foi realizada. Dois examinadores digitais (D1 e D2), igualmente calibrados e usando os mesmos critérios avaliaram todas as imagens obtidas nas avaliações clínicas. Os dados foram analisados com Coeficiente de Cohen Kappa e teste não paramétrico de Kruskal-Wallis e o teste de Dunn de comparação múltipla, com nível de significância de 5%. Comparações intra (mesmo método) e inter (métodos diferentes) examinadores foram feitas. Os resultados revelaram que os níveis de concordância variaram de \"Perfeito\" a \"Justo\". Houve diferença significante (p < 0.05) intra-examinadores; entre C1 e C2 para o manchamento marginal; entre D1 e D2 para brilho superficial, estabilidade de cor e translucidez, forma anatômica, e fratura do material e retenção; inter-examinadores foram encontradas diferenças significantes em todas as propriedades estéticas (brilho superficial, manchamento marginal, estabilidade de cor e translucidez e forma anatômica) e funcionais (fratura do material e retenção e adaptação marginal) observadas. A associação entre a imagem digital e o exame clínico pode ser uma ferramenta promissora para detecção de falhas precoces em restaurações de resina composta, necessitando de mais estudos que investiguem o método digital. / The present study aimed to evaluate the agreement levels between clinical and digital photographic assessments on the performance of posterior composite resin restorations (Class I and Class II). The clinical assessments were made by two examiners (C1 and C2) calibrated through e-calib with the Fédération Dentaire Internationale (FDI) criteria considering esthetic, functional and biological properties. In each moment of clinical assessment, standard digital photographs of each restoration were obtained. Two digital examiners (D1 and D2), equally calibrated and using the same criteria, evaluated all the images obtained in the clinical assessment. The data were analyzed with the calculation of Cohen Kappa coefficient, Kruskal-Wallis non-parametric test and Dunn\'s multiple shared test, with significance of 5%. Intra (same method) and inter (different methods) comparisons were realized. The results showed that agreement levels varied from \"Perfect\" to \"Fair\". There was a significant difference (p < 0.05) intra-examiners; between C1 and C2 to the marginal staining parameter; between D1 and D2 in the parameters surface luster, colour match and translucency, esthetic anatomical form and fracture of material and retention; inter-examiners was noticed significant difference in all the esthetic (surface luster, colour match and translucency, marginal staining, esthetic anatomical form) and functional properties (fracture of material and retention and marginal adaptation) observed. The association between the digital image to the clinical exam may be a promising tool associated with the clinical method to detect early failures in composite resin restorations, requiring further studies investigating the digital method.