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ABSTRACT: Aims To investigate the working patterns and patient base of registered clinical dental technicians (CDTs); their relationships with dentists and other professionals in the dental team; their willingness to work within the NHS and their expectations for the future as a new professional group.Methods Face-to-face qualitative interviews of registered CDTs, selected because of their geographic representation and mode of working, informed the development of a postal questionnaire survey of all early registrants with the General Dental Council (GDC).Results The majority of CDTs reported working part-time, often combining clinical practice with their role as a dental technician. They reported both positive and negative working relationships with dentists and dental technicians, demonstrating collaboration and/or competition depending on whether the scope of CDTs was respected and patient care was shared or lost. CDTs role in the NHS was limited because they did not have the status of becoming a recognised provider of dental care. There was a desire to expand their scope of practice in future.Conclusion CDTs are embracing their new status as an occupational group within dentistry. Core features of becoming a professional group were exhibited including the importance of social and financial status and the need to negotiate their current and future roles in the healthcare system.
British dental journal official journal of the British Dental Association: BDJ online 01/2013; 214(2):E3. · 1.09 Impact Factor
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ABSTRACT: The change of retentive force of three types of Locator inserts when the implant analogue was positioned perpendicular to horizontal, 5 degrees and 10 degrees to perpendicular after 4,200 cycles in vitro was measured using an EnduraTech fatigue testing machine lubricated with artificial saliva. The more rapid decrease in retention occurred up to three months and stabilized after one year of simulated use. The Locator inserts provided more retention when the analogue was placed at 5 degrees to perpendicular compared to 0 degrees and 10 degrees after 9 months of simulated clinical use. After 2 years of simulated clinical use, there was a reduction in retention for all the three inserts of between 70% and 80%.
The European journal of prosthodontics and restorative dentistry 12/2012; 20(4):168-74.
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ABSTRACT: The flexural strength and degree of polymerization of Diamond D acrylic resin prepared with a long cure monomer and a short cure monomer were investigated using Trevalon as a control. Flexural strength and degree of polymerization of Diamond D acrylic resin were not affected by either using a long cure monomer or the short cure monomer. There was no significant difference in the glass transition temperature Tg between the long and slow cure Diamond D. Provided the manufacturer's instructions are followed the flexural strength, degree of polymerization and glass transition temperature are comparable with more traditional products.
The European journal of prosthodontics and restorative dentistry 12/2012; 20(4):163-7.
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ABSTRACT: The aim of the study was to investigate the effect of varying the monomer/polymer mixing ratio, the time from mixing to packing heat cured acrylic resin and the effect of two bond assisting agents on the strength of the bond between denture base acrylic resin and acrylic resin denture teeth. Statistical differences were found in bond strength with monomer/polymer ratio and time between mixing and packing with one of the heat cured resins investigated. The benefit of using the bonding agents was not demonstrated.
The European journal of prosthodontics and restorative dentistry 09/2012; 20(3):131-4.
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ABSTRACT: The aim of the investigation was to study the effect of the laser welding parameters of energy and spot diameter on the penetration depth of the weld of cast Co-Cr alloy when a single weld was performed. Within the limitations of the study as voltage increased and the spot diameter decreased, penetration depth increased. However, SEM investigation showed more defects in the welded area under these circumstances. The clinical significance is that during selection of the welding parameters the thickness of the components to be welded should be considered to achieve an extended welded area without the induction of micro-structural defects.
The European journal of prosthodontics and restorative dentistry 03/2012; 20(1):11-6.
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ABSTRACT: To investigate current teaching of removable partial denture construction in British dental schools.
A questionnaire was sent by email to each of the 15 UK dental schools.
Replies were received from the 12 long established schools, although one declined to participate. The more recently established schools did not respond. All schools have a pre-clinical/technical course, which either precedes or runs in parallel with the early part of the students' partial denture experience, but students complete very little, if any technical work for their clinical cases. The majority of teaching takes place in multidisciplinary teaching clinics in years 2-5 although the majority of schools concentrate teaching of the basics early in the programme. Fewer cases appear to be treated than previously reported, especially cases requiring removable partial dentures with cobalt chromium frameworks. Students may only treat one such case, the remainder of dentures being constructed of acrylic resin. Lack of experience treating cases requiring a combination of complete and removable partial dentures was a concern.
Participating schools appear to meet the General Dental Council's requirements. The amount of clinical work undertaken by students may have decreased slightly. There has been a greater decrease in the technical component.
British dental journal official journal of the British Dental Association: BDJ online 01/2011; 211(11):531-5. · 1.09 Impact Factor
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ABSTRACT: Against the background of the publication of the General Dental Council's interim report on undergraduate dental education the aim was to investigate current trends in teaching of complete denture construction to undergraduates in the twelve long established dental schools and to gather the opinions of lead teachers of complete denture courses regarding students' competence on graduation.
A questionnaire containing twenty-five factual questions and eight opinion questions was sent by email to the lead teacher in each of the twelve long established dental schools.
Replies were received from all twelve schools. All schools teach complete denture construction although the number of cases students are required to treat varies from 5-6 to 1-2. Laboratory courses also varied in content and in most schools all technical work for patients was completed by technicians. Opinions varied regarding the level of competence achieved by students and their preparedness for Vocational Training. Three respondents thought students were adequately prepared, four thought they were, but with reservations and five thought their students were under prepared. The majority thought that the external examiner system, Teaching Quality Assessments and GDC visitations did not ensure GDC requirements for competence in complete denture construction were being met.
British dental journal official journal of the British Dental Association: BDJ online 03/2010; 208(5):E10; discussion 214-5. · 1.09 Impact Factor
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ABSTRACT: Traditionally long curing cycles have been recommended for heat cured acrylic resin denture base materials. Recently manufacturers have produced materials for which they recommend short curing cycles. Specimens conforming to British Standards Specification were made using three different brands of heat cured acrylic resin denture base material. Each material was processed in three batches using either the manufacturer's recommended short curing cycle, an arbitrary medium curing cycle or a traditional long cycle. Specimens were subjected to a three point bending test. With one exception using the arbitrary medium curing cycle, all specimens achieved the British Standard suggesting that the manufacturers' recommended cycles should be followed.
The European journal of prosthodontics and restorative dentistry 07/2009; 17(2):58-60.
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ABSTRACT: The General Dental Council states that 'good dental care is delivered by a team' and restorative treatment is enhanced by communication between team members. Commercial dental laboratories are ideally placed to comment on effective communication.
To investigate contemporary attitudes and communication between dentist and dental technician from the technician's perspective.
Eight hundred and three dental laboratories were invited to take part in a postal survey covering dentist/laboratory communication and the dentist's understanding of technical procedures.
Forty percent of laboratories responded. Only 9% scored communication as very good, 48% scored communication with newly qualified dentists better than with established dentists but only 26% considered that dental students were taught to communicate with dental laboratories effectively. The free comments that the respondents were invited to make identified three distinct themes, 'recognition within the dental team', 'effective communication between dentist and dental technician' and 'dentists lack of technical knowledge'.
Effective communication between dentist and dental technician is often poor. It was the view of the dental technicians who responded that newly qualified dentists do not have an appropriate understanding of technical techniques. Dental schools are still not preparing new graduates to communicate effectively with dental laboratories.
British dental journal official journal of the British Dental Association: BDJ online 06/2009; 206(10):E21; discussion 532-3. · 1.09 Impact Factor
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ABSTRACT: Poly(methyl methacrylate) dentures may exhibit dimensional changes when drying. Drying has been shown to destroy Candida albicans. This study investigates the effect of simulating overnight cyclic drying on dimensional changes of four complete denture base materials. Denture specimens used in this study had been prepared for a previous study. All dentures had been kept hydrated at room temperature for 2 years. The materials used were, group 1, conventionally packed and cured Trevalon, group 2 was injection moulded and conventionally cured (Trevalon Success), group 3 (Acron MC) and group 4 was Microbase, which is injection moulded and microwave cured. The measurements of the inter-molar and inter-premolar width, and anterior posterior dimension between the premolars and molars were recorded after 8 h drying and then after four cycles of dehydration and rehydration. The dentures were more dimensionally stable in the anterior posterior than the cross arch dimension. There was a statistically significant (P < 0.02) increase in the intermolar width for Trevalon, Trevalon Success and Acron after 8 h drying and after four cycles. There was a statistically significantly difference between Microbase and the other materials after 8 h drying and there was a significant difference between the injection moulded groups in the interpremolar width (Trevalon Success versus Acron, Trevalon Success versus Microbase) after cyclic drying. Although statistically significant dimensional changes were observed for all materials these were small and were considered not to be clinically significant. Microbase was the least dimensionally stable material during air-drying.
Journal of Oral Rehabilitation 09/2006; 33(9):654-9. · 1.53 Impact Factor
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ABSTRACT: Due to changes in the amount of curriculum time available for teaching complete denture construction to undergraduate students, course content requires reconsideration and possible modification. The idea that a replica complete denture technique may offer some advantages is explored. A review of the relevant literature fails to support many of the claimed benefits of this technique such as relative ease of adaptation by the elderly to new dentures. This article suggests that the replica denture technique should be considered as no more than an alternative method of making dentures. The relative demerits of the technique are discussed. A modification of the replica block technique to include important aspects of conventional complete denture courses is described. It is suggested that, because less clinical time is required, it may be a suitable way of introducing students to complete denture construction and educating them to a level which would encourage some to take further postgraduate study and would allow all graduates to treat routine cases or diagnose, treatment plan and refer to clinical dental technicians.
British dental journal 06/2004; 196(9):571-5. · 0.92 Impact Factor
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ABSTRACT: This study investigated the reactions to tooth loss in a partially dentate group of 100 people using a questionnaire-based method. Partially dentate people who experienced difficulties in accepting their tooth loss were more likely to feel less confident, restrict food choice, enjoy food less, avoid laughing in public and avoid forming close relationships than those people who had no difficulties accepting tooth loss. Also, they were more likely to feel that they had not been adequately prepared for the effects that tooth loss had on their confidence, daily living activities and appearance.
The European journal of prosthodontics and restorative dentistry 07/2001; 9(2):53-7.
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ABSTRACT: To establish how widespread the emotional effects of tooth loss are.
A questionnaire, distributed to 100 edentulous people undergoing routine prosthetic care in the Department of Prosthetic Dentistry at Guy's, King's and St Thomas' Dental Institute (GKT), was used to explore the emotional effects of tooth loss.
Ninety four people completed the questionnaire of whom 42 stated that they had experienced difficulties in accepting the loss of their teeth. In comparison with people who had no difficulties in accepting the situation, these people were: more likely to feel less confident about themselves; more likely to feel inhibited in carrying out everyday activities; and less able to accept the inevitable change in facial shape which occurs following the loss of teeth. Additionally, they took longer to come to terms with their tooth loss (All these differences were statistically significant). Just over three-quarters of the people who were unprepared for the loss of their teeth, felt that an explanation from the dentist prior to dental extractions would have helped.
The impact that tooth loss can have on people and their lives should not be underestimated. In this study it affected 45% of the participants.
British dental journal 06/2000; 188(9):503-6. · 0.92 Impact Factor
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ABSTRACT: This study examined the influence of six handling techniques on the strength of four phosphate-bonded investment (PBI) materials. The size and distribution of pores produced by the handling techniques were investigated and their effect on room temperature strength determined.
Specimens were tested for strength using four point bend at a cross-head speed of 1 mm min-1. The fracture surface of randomly selected specimens was viewed through a light microscope to determine the pore size. A three-parameter Weibull distribution was used to describe strength giving values of Weibull modulus and characteristic strength.
The handling technique that produced the smallest pore size resulted in the highest strength. Significant differences in strength (90% confidence level) were found between most handling techniques. The reduction of pore size by mechanical spatulation and setting under pressure was found to be the most effective method of increasing the strength of PBI.
Previous studies have related handling technique to the inclusion of air bubbles in dental investments but have not reported any consequent effect on strength. PBI materials are used in production of a range of dental appliances with a variety of different material forming processes and are required to withstand the loads applied without fracture or distortion to ensure accuracy of fit of these prostheses. The use of a handling technique that reduces pore size can significantly increase the strength of PBIs, thereby decreasing the possibility of die fracture or degradation.
Dental Materials 02/2000; 16(1):26-32. · 3.13 Impact Factor
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ABSTRACT: Loss of a part of the face or having a congenitally missing ear, nose, or eye is likely to have both a social and a psychologic impact on those affected. The nature and extent of this impact has not been explored previously. The provision of facial prostheses is an increasingly viable and beneficial treatment option, but the psychologic and social adjustment to the prosthesis has not been described.
This study performed a preliminary investigation of patients' responses to loss of part of the face, and their perceptions of the prosthetic restoration of their missing facial part.
Nine individuals who had experienced prosthetic replacement of an ear, nose, or eye were interviewed. Interviews were semistructured, each respondent was interviewed individually and the interviewer followed a predetermined interview schedule. Themes emerging in the interviews were identified.
The main themes relating to the loss of the facial part were the importance of the story of the loss, coping through bargaining, and the impact of the loss on relationships. The important themes identified in regard to the prosthesis were issues in the maintenance of the prosthesis and the reactions of other people to the prosthesis.
Loss of part of the face requires great adjustment. The reactions of other people were marked. Provision of a facial prosthesis can assist in the process of adjustment.
Journal of Prosthetic Dentistry 12/1999; 82(5):585-90. · 1.32 Impact Factor
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ABSTRACT: To examine the factors that influence editors of scientific dental journals in deciding whether or not to publish submitted manuscripts and to determine if there is a consistent pattern for their decisions.
The study was by a postal questionnaire.
The questionnaires were sent to editors of 50 major English language scientific dental journals in September 1996.
Respondents were asked to rank a number of frequently stated criteria for success in the production of papers. The editors were asked to suggest other factors which 'influenced their decision to accept or reject a manuscript'. Additionally they were asked to suggest factors that 'gave them most heartache', 'would make their life easier' and 'would expedite publication'. Information was sought on editorial policy regarding the use of referees.
Forty two editors responded (84%). 6 replies were from journals regarded as 'generalist', and excluded from the final analysis. Factors which most frequently led to rejection included 'poor construction of the paper' (cited by 49% of respondents) and 'poor research design' (37%). Factors which editors valued highly were 'scientific novelty and timeliness of the topic' (29%). Factors that caused most problems were 'poor use of English and careless preparation of the manuscript' (46%). 'Attention to guide lines to authors' was cited by 68% of editors as a means of expediting publication.
The application of these results can help authors to prepare manuscripts that are more attractive to editors of dental journals. Editors valued papers that were appropriate to the stated aims of their journal and regarded the significance and validity of the research work as the most important aspects of manuscripts submitted for publication.
British dental journal 11/1999; 187(7):376-9. · 0.92 Impact Factor
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ABSTRACT: This study examined flexural properties of acetal resin to determine the appropriate design for an acetal resin removable partial denture clasp. The effectiveness of various acetal resin polishing procedures was also evaluated using scanning electron microscopy.
Loads of up to 1,500 g were applied to cylindrical acetal resin specimen lengths of 5, 10, and 15 mm, and the degree of deflection of the specimen tip was measured. Specimens were 2 mm and 1.5 mm in diameter with a round cross-section (R2 and R1.5, respectively), as well as 2 mm in diameter and half-round in cross-section. Half-round specimens were loaded with their flat surface vertical and then horizontal (HRV and HRH, respectively). Contour plots showing load and deflection for varying lengths of resin were developed for each cross-sectional type based on specimen length, and the stiffness was calculated. Additional acetal resin specimens underwent polishing techniques including tungsten carbide burs, aluminium oxide stones, abrasive impregnated rubber points, and "Polish-D." Polished specimens were examined with scanning electron microscopy to compare surface roughness.
For the 5-mm-length specimens, the median stiffness values decreased in the following order: R2 > HRV > HRH > R1.5. The median stiffness values for the 10-mm and 15-mm lengths followed a similar trend. At each length, the R2 specimen was generally at least twice as stiff as other designs. Regarding polishing, the smoothest surface was seen on the specimen that was polished with the rubber point followed by "Polish-D."
To have stiffness similar to a cast cobalt-chromium clasp 15 mm long and 1 mm in diameter, a suitable acetal resin clasp must be shorter (approximately 5 mm) with greater cross-sectional diameter (approximately 1.4 mm). To obtain a smooth surface, the acetal resin clasp should be polished with a rubber point followed by a material such as "Polish-D."
Journal of Prosthodontics 09/1999; 8(3):188-95. · 1.01 Impact Factor
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ABSTRACT: A theme runs through discussions on dental undergraduate education, that 'they are not as good as they used to be'. Based largely on anecdotal evidence, we question whether this is true. Dentistry is changing. Today's graduates are different, but not worse. Graduates must qualify with basic competencies--agreed between all those responsible for their education. We maintain that vocational trainers are teachers, just as we are, and as such they have similar responsibilities. Close liaison between training practices and dental schools is essential.
British dental journal 05/1999; 186(7):318-9. · 0.92 Impact Factor
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ABSTRACT: The aim of this paper is to review our understanding of the mechanisms and clinical significance of adhesion of C. albicans to denture-base materials in relation to denture plaque and denture-related stomatitis. Earlier reports in the literature of a 65% prevalence level of denture-related stomatitis seem to be exaggerated. More recent studies indicate that denture-related stomatitis is considerably less common, particularly in normal healthy subjects. The etiology of the condition is discussed in this review, and although much of the literature supports the view that the condition is strongly associated with C. albicans, this is not always so. In some subjects, the cause appears to be related to a non-specific plaque. This review also considers the role of denture plaque in the pathogenesis of denture-related stomatitis, the sequential development of denture plaque, and its colonization by Candida organisms. Designing controlled in vivo studies is difficult, and as a consequence, many investigators have had to resort to in vitro studies. The majority of these studies have attempted to investigate the hydrophobicity of C. albicans, relating the surface free-energy of denture-base materials, particularly acrylic resin, to that of the organism. Surprisingly little work has been directed at surface roughness and how it affects retention of organisms. Further, no attention has been paid to the properties and character of the surface, other than average surface roughness, as it affects adhesion. A comparison of results from in vitro studies on the effect on adhesion of pre-coating the surfaces of denture-base materials with saliva has produced equivocal conclusions. This is largely due to little standardization of experimental protocols between studies, particularly in the collection and handling of the saliva used. In conclusion, the review strongly supports the suggestion that adherence of C. albicans to denture-base materials in vitro is related to the hydrophobicity of the organism. The clinical significance of the observation and the mechanisms for the development and maturation of denture plaque are yet to be understood. There is a clear need for further investigation of other factors that may moderate the adhesion of organisms and subsequent colonization of denture-base materials.
Critical Reviews in Oral Biology & Medicine 02/1999; 10(1):99-116.
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ABSTRACT: To assess the in vitro adherence of Candida albicans to heat-cured hard and soft denture-base materials with varying surface roughness, and to observe the effect of a mixed salivary pellicle on candidal adhesion to these surfaces.
In vitro adhesion assays on heat-cured acrylic resin (Trevalon), Molloplast B and Novus using the type strain of C. albicans (NCPF 3153A). Surfaces for the assays were prepared using clinically appropriate rotary instruments. Unstimulated, pooled and clarified whole saliva was used to assess its effect on adhesion.
Significantly greater adhesion of C. albicans to rough rather than smooth surfaces was found (P < 0.001), as well as increased adhesion to the machined soft lining materials compared with acrylic. Pre-coating denture-base materials with saliva reduced candidal adhesion on all materials.
Rough surfaces on denture-base materials promote the adhesion of C. albicans in vitro. However, saliva reduces adhesion of C. albicans and thus diminishes the effect of surface roughness and free surface energy differences between materials.
Journal of Dentistry 10/1998; 26(7):577-83. · 2.95 Impact Factor
