RESUMEN
OBJECTIVE: To compare the diagnostic efficacy of a minipanel series to a conventional 18-radiograph full-mouth series in a disabled adult population in a university clinic. METHOD AND MATERIALS: Eighty patients who attended the New Jersey Dental School special care services clinic between 2004 and 2006 were selected for a double-blind quasiexperimental study based on existing full-mouth series radiographs. A minipanel series consisting of eight radiographs from the 18-radiograph full-mouth series was used as a comparison against a matched pair of an 18-radiograph exam. The diagnostic efficacy of this eight-radiograph series was tested against the more conventional 18-radiograph full-mouth series to determine whether the minipanel series was an acceptable substitute for the full-mouth series in this population group. Traditionally, it is difficult to obtain full-mouth series radiographs in patients with disabilities. RESULTS: From the 80 studied patients, a total of 2,219 teeth were available for study. A median of 29 teeth per patient was found in the full-mouth series and 28 teeth per patient in the minipanel series category. The difference was statistically significant (P < .001). Of the patients evaluated, 78 (97.5%) had at least one problem detected when the full-mouth series was used. Of these 78 with at least one problem, 74 (94.8%) were identified using the minipanel series. The sensitivity for the minipanel series when compared to the gold-standard full-mouth series was 63% (95% confidence interval [CI], 59.2 to 68.0) for tooth-specific disease; the specificity was 92% (95% CI, 92.2 to 94.5). CONCLUSION: Prospective studies are needed for the acceptance and use of minipanel radiographic series in conjunction with a clinical examination.
Asunto(s)
Atención Dental para la Persona con Discapacidad , Clínicas Odontológicas , Radiografía Dental/métodos , Adolescente , Adulto , Proceso Alveolar/diagnóstico por imagen , Estudios de Casos y Controles , Parálisis Cerebral , Caries Dental/diagnóstico por imagen , Esmalte Dental/diagnóstico por imagen , Dentina/diagnóstico por imagen , Método Doble Ciego , Femenino , Humanos , Discapacidad Intelectual , Masculino , Persona de Mediana Edad , Enfermedades Periapicales/diagnóstico por imagen , Ligamento Periodontal/diagnóstico por imagen , Radiografía Dental/estadística & datos numéricos , Estudios Retrospectivos , Facultades de Odontología , Sensibilidad y Especificidad , Adulto JovenAsunto(s)
Periodoncia/organización & administración , Administración de la Práctica Odontológica/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Análisis de Varianza , Distribución de Chi-Cuadrado , Humanos , Seguro Odontológico , Modelos Logísticos , Comercialización de los Servicios de Salud , New Jersey , Proyectos Piloto , Facultades de Odontología , Encuestas y CuestionariosRESUMEN
The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.