The purpose of this research was to analyze child and clinician factors affecting language therapy outcomes and to analyze the potential bi-directional relationship between child and clinician factors. Transcripts of intervention sessions with one child and one trained examiner were coded for factors relating to children's language ability, examiners' strategies for reaching session targets, and differences in examiners' interactional styles. It was found that differences in children's language ability and examiners' interactional styles did not have a strong relationship with therapy outcomes. Differences were observed in the overall frequency of examiners' strategy use across children; however, examiners were not sensitive to individual children's responsiveness to particular strategies. This is a secondary data analysis on an intervention study, which affects interpretation of the results: variability in examiner and child behaviors was decreased due to adherence to intervention protocol. However, the mismatch between examiner strategies and child responses is of interest. Making clinicians explicitly aware of the many types of elicitation and response strategies available may increase examiners' effectiveness, efficiency, or responsiveness.

Improper dowel design can cause the failure of a restoration in an endodontically treated single-rooted tooth. A three-dimensional finite element stress analysis was used to evaluate stress patterns on an endodontically treated single-rooted tooth restored with a tapered dowel and core and a complete crown under an angular load applied to the tip of the crown. Results showed that, on the loading side, peak dentin and cement tensile stresses were located at the level of the alveolar crest and at the crown margin, respectively. Increasing the diameter and/or stiffness of the dowel decreased these peak stresses; however, it increased the dentin and cement stresses at the dowel apex level, and at the bone level, respectively. The role of the dowel length was to change the location of the stress concentrations in the dentin occurring at the dowel apex. A large and short dowel or a large and stiff (200 GPa) dowel might cause the root fracture to occur across the dowel apex region. The ferrule had no effect on both the dentin and cement stresses below the alveolar crest level. Increasing the ferrule height diminished the stress propagating in the cement layer from the crown margin toward the tooth-core junction. If root fracture occurred, the model predicted a horizontal fracture when the cement layer was perfectly intact. A vertical root fracture was predicted when the cement was broken at the crown margin on the loaded side. The ferrule effectively prevented the vertical fracture. Reducing the bone height resulted in increasing the dentin and cement stresses at and below the bone level. Extending the crown margin toward the bone level increased the cement stress at the crown margin. With an application of the composite theory, it could be demonstrated that while dowels might increase the stiffness of the system, it might not strengthen the tooth under a transverse loading. In conclusion, dowel diameter, dowel length (below the alveolar crest), dowel material, and ferrule are important factors in predicting the failure of the dowel-core restoration. All factors have to be considered together in the dowel design.

Objectives: Extraction of a tooth leads to a series of healing events that are intimately associated with dimensional changes in the alveolar ridge that typically result in a net volume loss. Previous studies have evaluated the extent and pattern of those resorptive changes, however it remains challenging to predict the degree of change that will occur, as numerous local and systemic factors may play a role in the biologic events that follow tooth extraction. The purpose of this study was to assess the role that phenotypic characteristics of the periodontium play in the alveolar ridge remodeling processes that take place following single tooth extraction. Methods: Healthy patients in need of a single tooth extraction in the maxillary arch from second premolar to second premolar (inclusive) and who met a predefined eligibility criteria were enrolled in this study. An impression of the maxillary arch was made and a cone beam computed tomography (CBCT) scan of the maxilla was obtained immediately prior to tooth extraction at the baseline visit. At the time of the extraction, clinical measurements were made including probing depth, bone sounding, buccal keratinized mucosa width, buccal and palatal alveolar bone thickness, and buccal and palatal soft tissue thickness. Fourteen weeks following the baseline intervention, patients returned to the clinic for a second impression of the maxillary arch and a second CBCT of the maxilla. Linear and volumetric bone measurements were made using the data obtained from the CBCT scans. The casts obtained from the impressions were digitally scanned and volumetric measurements were made from the digitized data to assess volume changes of the residual ridge. The primary outcome of interest was the volumetric percent reduction of the alveolar ridge following single tooth extraction. Spearman correlations were utilized to evaluate relationships between variables and modeling was completed to predict the percentage of volumetric change in the hard and soft tissues using the clinical variables. Results: A total of 21 patients participated in the study, 19 patients are included in this analysis (one patient has yet to complete the study, one patient was later excluded due to lack of compliance). Of the 19 extraction sites included, 17 were maxillary premolar teeth. At baseline, the average buccal plate thickness was 1.09 mm. After 14 weeks, the average loss of alveolar bone width was 1.66 mm. The average loss of buccal bone height was 1.10 mm and mean loss of palatal bone height was 1.36 mm. The average percentage volumetric reduction of the bone as measured from a CBCT scan was 26.42% after 14 weeks of healing. Mean percentage volumetric reduction of the ridge, as measured from a digitized cast, was 18.89%. There was no statistically significant correlation noted between the bone and ridge volumetric measurements. While there were no statistically significant correlations noted between the thickness of the buccal bone and the amount of volumetric remodeling, statistically significant negative correlations were found between the buccal bone thickness and the loss of alveolar bone width (rs = -0.66418, p-value = 0.0019). In addition, a statistically significant correlation was noted between the reduction in alveolar bone width and the loss of buccal ridge height (rs = 0.55707, p-value = 0.0132). Modeling methods found that increased thickness of the buccal soft tissue was predictive of increased percentage volumetric reduction of hard tissues (coeff = 37.24, p-value = 0.0301). Conclusions: Increased buccal soft tissue thickness was found to be predictive of increased percent volumetric reduction of alveolar bone. Thinner buccal bone was correlated with increased loss of alveolar bone width. While statistically significant correlations were identified, further studies with larger sample size are needed to better understand these relationships.

Objectives: The aim of this study is to investigate the impact of multiple factors in the Oral Health Related Quality of Life of patients being treated with Conventional Complete Dentures, including: a) Level of expertise of the dental provider (third year dental student vs. fourth year dental student); b) Length of time edentulous; c) Number of previous prostheses; d) Race; e) Sex; f) Age; g) Systemic conditions; h) Condition of the bone ridge; i) Economic factor and insurance coverage, in patients at the University of Iowa College of Dentistry (D3 and D4 Clinics). Materials and methods: Eighty-one subjects who had been completely edentulous (49 men and 32 women; age range from 23 to 93 years old, mean of 58.9+13) for a minimum of 3 months were recruited. Out of the eighty-one, eleven subjects were not included in the final analysis because their prostheses were not delivered due to various reasons (time, death, discontinued treatment). Subjects were asked to complete the OHIP-EDENT (Oral Health Impact Profile for Edentulous Patients) and the patient satisfaction questionnaire to record data at baseline, at 1-week post-delivery and at 1-month post-delivery of the new prostheses. Additional to these two instruments, the PDI Classification instrument (to assess bone/tissue condition) and the Kapur Index (to assess retention/stability of the new prostheses) were also used. Baseline comparisons of subjects seen at the D3 vs. the D4 clinic were carried out using chi-square tests of association for nominal ordinal variables, and the Wilcoxon-Mann-Whitney test for ordinal and quantitative outcomes. Bivariate analyses were conducted to assess potential relationships between covariates and the primary outcomes (total OHIP-EDENT and total Patient Satisfaction Questionnaire scores at one-week and one-month follow-ups). The Spearman rank correlation was used to identify increasing or decreasing relationships between primary outcomes and quantitative and ordinal variables; the Wilcoxon-Mann-Whitney test was used to assess relationships between primary outcomes and categorical covariates. Results: Overall, there was not enough statistical evidence to conclude that patient satisfaction and quality of life were significantly affected by most of the factors being studied. However, there was suggestive evidence of the presence of higher level of quality of life for patients seen in the D4 clinic (students with higher level of expertise). At the one-month follow-up, the comparison of the total OHIP-EDENT score between the D3 and D4 clinics was significant at the 0.05 level (p=0.018, exact Wilcoxon-Mann-Whitney test). The total OHIP-EDENT scores tended to be lower (indicating greater satisfaction) in the subjects seen in the D4 clinic. Two of the nineteen items from the patient satisfaction questionnaires also suggested a greater level of patient satisfaction for patients seen in the D4 clinic (students with higher level of expertise). Conclusion: 1) Oral health related quality of life at 1-week follow-up was not significantly different between patients treated by D3 and D4 students. 2) Oral health related quality of life at 1-week follow up was significantly better for patients who had been edentulous for a longer period of time than those who were recently edentulous. However, this result can only be considered suggestive due to the need for adjustment for multiple comparisons. 3) Oral health related quality of life at 1-month follow up was significantly better for patients treated by D4 students in comparison to D3 students. However, this result can only be considered suggestive due to the need for adjustment for multiple comparisons. 4) Overall, patient satisfaction at 1-week follow-up was not significantly different between patients treated by D3 and D4 students. However, patients treated in the D4 clinic reported significantly better outcomes in regard to speaking with their new prostheses. 5) Overall, patient satisfaction at 1-month follow-up was not significantly different between patients treated by D3 and D4 students. However, patients treated in the D4 clinic reported that they could chew better with their new prostheses compared to those treated by D3 students.

Source: Dissertation Abstracts International, Volume: 38-11, Section: B, page: 5305. / Thesis (Ph.D.)--The Florida State University, 1977.

Source: Dissertation Abstracts International, Volume: 38-11, Section: B, page: 5308. / Thesis (Ph.D.)--The Florida State University, 1977.

Source: Dissertation Abstracts International, Volume: 33-06, Section: B, page: 2852. / Thesis (Ph.D.)--The Florida State University, 1972.

Source: Dissertation Abstracts International, Volume: 33-06, Section: B, page: 2852. / Thesis (Ph.D.)--The Florida State University, 1972.

Source: Dissertation Abstracts International, Volume: 33-08, Section: B, page: 4012. / Thesis (Ph.D.)--The Florida State University, 1972.

Source: Dissertation Abstracts International, Volume: 33-10, Section: B, page: 5048. / Thesis (Ph.D.)--The Florida State University, 1972.