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ABSTRACT: Current insight of the caries process demands new, more selective and less invasive techniques and methods for excavation. Nowadays the biological aspects of teeth and pulp tissue in reaction to caries need to be respected and even used. The general practitioner is confronted with a wide range of new techniques and methods and needs to choose the best suitable. The purpose of this article is to inform the general practitioner about the current views concerning treatment of caries profunda and the different treatment concepts. Thereby the authors hope to assist the general practitioner in their choice for the proper treatment.
Nederlands tijdschrift voor tandheelkunde 01/2004; 110(12):510-5.
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A J Plasschaert
Nederlands tijdschrift voor tandheelkunde 01/2004; 110(12):522-3.
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A J Plasschaert
Nederlands tijdschrift voor tandheelkunde 01/2004; 110(12):474-5.
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ABSTRACT: The objectives were to assess the prevalence of substance use among Dutch dental students and to determine their attitudes about substance use and its consequences.
In association with a national study of drug use among US dental students, a questionnaire was translated from English into Dutch and administered to dental students at two dental schools in The Netherlands. Students received an anonymous 115-item questionnaire in the fall of 1996.
Alcohol was the students' drug of choice for lifetime (95%), past year (94%) and past month (88%) use. No significant correlations were found between alcohol use and gender, schools, and years in dental education. In the past month, 58% of students reported drinking on 5 or more days; 53% had 5 or more drinks on the same occasion, 20% had 5 or more drinks on the same occasion on 5 or more days; and 17% reported getting drunk at least monthly. Prevalence rates for past month use of tobacco was 24% and marijuana, 4%. Male students smoked twice as much as females, with significant differences found for all three periods of use (X2>19.00, P<0.01). When asked whether their schools offered policies and education programs on alcohol and other drugs, 52% of students reported that these were not available.
Dental schools should develop effective programmes to educate students about responsible use of alcohol and other licit and illicit drugs. Schools should also inform students about their susceptibilities to substance abuse and dependency.
Community Dentistry And Oral Epidemiology 02/2001; 29(1):48-54. · 1.89 Impact Factor
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ABSTRACT: A questionnaire was sent to 328 dentists graduated from the University of Nijmegen in the period 1990-1998, to ask their opinion concerning the way they were prepared by dental education for their professional career. Comparison with similar data from Amsterdam Academic Centre for Dentistry has been carried out. The results show unanimity among graduates that they have been adequately prepared for the requirements in general dental practice as far as knowledge is concerned related to cariology, periodontology, crown and bridgework and dental radiology. They also have a positive assessment regarding other dental cognitive domains, except implantology. There is positive unanimity regarding their skills in various clinical areas. Shortcomings in dental education have been experienced in practice management and infection prevention, treatment of medically compromised patients, treatment of anxious patients and handicapped patients. Almost all responders have the opinion that they gained enough experience throughout their dental education to be competent to start their dental career independently. In general the Nijmegen graduates have a positive opinion concerning their dental education, although preparation for professional life could be strengthened in some specific areas. Comparison with ACTA-graduates shows that in both programmes the weakest areas are implantology and practice management.
Nederlands tijdschrift voor tandheelkunde 02/2000; 107(1):3-7.
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ABSTRACT: Aim of the study was to evaluate a method for selecting topics suitable for developing dental clinical practice guidelines in the Netherlands, based on an analysis of Dutch dental journals. A search for dental clinical topics was conducted by analysing Dutch dental journals, magazines and series over the period 1992-1997. The numbers of publications per topic were plotted against the publication years. The number of publications as well as the value of the slope of the linear regression were considered to be indicators of the importance of a topic. 'Dental implants (indication)' had the highest number of publications, followed by 'orthodontic treatment planning' and 'periodontology (indication)'. The topic 'practice hygiene' showed the highest value of the slope of the linear regression, followed by 'TMJ dysfunction' and 'dental implants (indication)'. With this method, it is feasible to detect changes and tendencies in the Dutch dental literature. It permits a selection of clinically relevant topics over a time span. It was concluded that this method may be very useful in the selection of a topic, but should probably be combined with other methods.
Nederlands tijdschrift voor tandheelkunde 11/1999; 106(10):366-8.
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A J Plasschaert
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ABSTRACT: In this article two important issues in dental ergonomics are discussed: physical and mental stress. It is important for a dentist to stay aware of the balance between on one hand short term profit against various forms of stress, and on the other hand long term negative effects. Possible problems are described without going in more deeply into theoretical backgrounds. Practical suggestions for action are given for the dentist who wants to work with pleasure and in good health over a long period of time.
Nederlands tijdschrift voor tandheelkunde 03/1999; 106(2):46-50.
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ABSTRACT: In this study an attempt was made to explain some of the interobserver variation in re-restoration decision making using.
A simplified re-restoration case was shown to 22 dentists who were asked what treatment decision they would make, and what factors would play a role in their decision. The treatment decisions were compared to the outcomes of a knowledge-system on re-restoration decision making.
The dentists unanimously selected re-restoration as the treatment alternative. Half of the dentists preferred amalgam, and the other half chose composite as restorative material. This variation could be explained almost fully by the dentists' weighs on the factors 'tissue loss during preparation', 'restoration and preservation of the chewing function' and 'prognosis and durability of the restoration'. The knowledge system indicated that more than 80% of the dentists actually should have selected composite resin for a restorative material.
It was concluded that the availability of knowledge and its application can explain variation in re-restoration decisions. Knowledge systems can be used in designing practice guidelines.
Nederlands tijdschrift voor tandheelkunde 04/1998; 105(3):84-6.
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Nederlands tijdschrift voor tandheelkunde 02/1998; 105(1):21.
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ABSTRACT: To estimate the role of computer-CPED in the Netherlands to the year 2008.
Computer-assisted learning is currently employed in many modern undergraduate dental curricula. It could also play an important role in providing continuing professional education in dentistry (CPED) to general dental practitioners. Computer-CPED offers teacher-independent and individualized interaction by distance learning.
A simulation study was conducted. Entry data were either derived from publications or were estimated.
The results indicate that the demand for CPED will exceed the supply by 2002.
The introduction of Computer CPED may substantially contribute to the supply of CPED-courses in de first decade of the next century. By 2008 about 25% of the CPED-courses could be provided by computer education.
Nederlands tijdschrift voor tandheelkunde 02/1998; 105(1):11-3.
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ABSTRACT: New technology may create additional opportunities for learning in dental education. One of these new features is a multimedia approach, courseware combining sound, text, stills and video with interactive learning. A multimedia program was developed to train dental students and dental practitioners in decision making and problem solving in endodontics. This study compared the effects of the multimedia program with a more traditional approach consisting of written information, without interaction. 28, 4th-year dental students at the University of Kentucky in Lexington, KY, USA were randomly assigned to the multimedia or the text-based groups. They were given a written pre-test using 2 cases of dental pain and were instructed to study independently using either the multimedia program (group A) or the written information (group B). No restrictions were imposed on the amount of time to be invested, and the total study time was recorded for each student. 3 weeks after the pre-test, the students completed the post-test. A total of 18 students completed both the pre-test and the post-test and their scores were included in the final data. Statistical analysis of the average scores using paired t-tests revealed no significant difference between the performance of the students in either group, indicating that the multimedia approach to learning endodontic problem solving may successfully replace traditional learning strategies.
European Journal Of Dental Education 06/1997; 1(2):66-9. · 1.18 Impact Factor
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ABSTRACT: Practice guidelines provide opportunities for monitoring and improving dental health care. A survey was conducted among 78 departments at dental societies, scientific dental associations and health care insurance companies in the Netherlands to obtain insight into the number and quality of practice guidelines available. The response rate was 67%. Written materials were analysed and 21 practice guidelines were identified as such. The results of the analysis indicate that many initiatives to construct and implement practice guidelines have been taken. However, these initiatives were insufficiently coordinated and existing guidelines may be subject to improvement. Main improvement would be to demonstrate the validity and reliability of the existing guidelines and, more in general, to provide a sound scientific basis to the development and implementation of practice guidelines.
Nederlands tijdschrift voor tandheelkunde 04/1997; 104(3):99-103.
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ABSTRACT: This study assessed the opinions and attitudes of faculty and students concerning the use of computer-assisted learning (CAL) at three different dental schools on two continents (Manchester, U.K.; Nijmegen, The Netherlands; and Lexington, Kentucky, U.S.A.). In each school students and faculty received a questionnaire; faculty by internal mail, students at the end of a lecture. Response rates for students were 76 percent in Manchester, 64 percent in Nijmegen, and 91 percent in Lexington. The respective figures for faculty were: 42 percent, 47 percent, and 39 percent. In all three schools approximately 50 percent of students had a computer at home. Students in Lexington and Manchester seemed to be more advanced in the use of computers for self-instructional learning. Students and faculty in Lexington had more experience with interactive multimedia than did those in Manchester and Nijmegen. In general, Lexington students were somewhat more familiar with computers and CAL than Manchester students, with Nijmegen showing the lowest percentages. Few CAL programs were available at any school, with small numbers of dental students having been exposed to programs involving animation (vision, sound). The majority of students are of the opinion that the use of computers for learning is not impersonal, nor difficult, but challenging and motivating. There is good agreement that if a program is to be bought or developed, it should be a combination of text, images, and sound. It is postulated that concerted action by dental schools is required to realize the potential of CAL in dental education, and that international organizations should give consideration to coordinating this action.
Journal of dental education 12/1995; 59(11):1034-40. · 0.91 Impact Factor
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ABSTRACT: Monitoring and improving the quality of rendered health care in a systematic way has been laid down in Dutch legislation. In Dutch family health care particularly, many initiatives have already been taken to improve the quality of health care utilizing a pre-defined systematic approach. In recent years various groups in The Netherlands took initiatives to maintain and improve quality of care in dentistry. This publication reports on some of the frequently used constructs and the state of the art in The Netherlands. A proposition for the development of a system of quality monitoring and improvement is presented. It is furthermore suggested that all parties involved should collaborate to achieve the joint goal.
Nederlands tijdschrift voor tandheelkunde 10/1995; 102(9):344-8.
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British dental journal 06/1995; 178(9):320-1. · 0.92 Impact Factor
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ABSTRACT: Information pertaining to the research directions and output of dental schools in different countries is of importance in understanding intra- and inter- national differences amongst groups of dental practitioners. The research output of European dental schools has been assessed quantitatively and qualitatively on the basis of published abstracts of research presentations at IADR-meetings during 1993. These data are compared with comparable data for 1990/91. The results indicate that European dental schools are substantially different in terms of research output relative to total population, with the UK at one extreme and Italy at the other. The UK, Denmark, The Netherlands, Sweden and Norway are highly ranked while Portugal, Spain, Italy, Germany and France have low rankings, according to the method used. Periodontology, plaque, dental materials, and restorative dentistry would appear to be the principal foci of research. Possible ways of strengthening the coordination and the efficiency and effectiveness of dental research at the European level are discussed. It is suggested that the creation of centres of excellence and research networks are approaches to be considered. An unresolved problem will be the contradictory requirements from educational and research perspectives in relation to the training of dental practitioners.
International Dental Journal 05/1995; 45(2):129-34. · 0.96 Impact Factor
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ABSTRACT: The decline in caries prevalence in The Netherlands has incited dentists to focus their attention to the detection of small carious lesions rather than large cavities. The diagnosis of primary caries is, however, still predominantly being accomplished by the traditional diagnostic methods, used in the high caries prevalence era. Today's appearance and behaviour of caries lesions have led to the situation that incipient enamel lesions, dentinal caries and cavities are frequently missed during routine recall examinations. There is increasing concern with the occurrence of large caries lesions underneath visually intact enamel. These problems have induced diagnostic research aimed at developing and evaluating new caries diagnostic methods and some of them are already used in general practice. Visual inspection and bitewing radiography, however, still constitute the most important methods in the diagnosis of primary caries. The results from these examinations are used to classify an individual's caries risk, to monitor the progression of existing caries lesions, and to aid preventive or restorative treatment decision making.
Nederlands tijdschrift voor tandheelkunde 01/1995; 101(12):464-9.
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ABSTRACT: Evaluation of the long-term behaviour of restorations in clinical trials can be time-consuming. A partial alternative to the clinical trial can be found in mechanical fatigue testing. The aim of this study was to evaluate the failure behaviour of post and core restored teeth when subjected to cyclic mechanical loading and to compare it with quasistatic failure. Eighty seven premolar teeth were restored with a titanium alloy post and an amalgam or composite core. Five to 21 days after restoration, the specimens were subjected to cyclic loading (frequency 5 Hz), at an angle of 45 degrees to the long axis of the tooth. The load levels were 50, 60, 65 and 70% of mean quasistatic failure loads. The specimens were divided into three groups according to their survival time: short (S) (< 10(4) cycles), intermediate (I) (10(4) < or = life < 10(5) cycles) and long (L) (> or = 10(5) cycles). For both core materials failure behaviour changed after approximately 10(5) cycles, and the change was most marked for the composite group. Catastrophic fatigue failure consisted of core fracture in the amalgam group (three times) and of post fracture in the composite L group (four times). Three post fractures occurred at a site theoretically predisposed to fatigue failure. It was concluded that fatigue failure characteristics of post and core restorations may be very different from those of quasistatic failure. Therefore, in addition to quasistatic tests, fatigue tests are necessary, covering at least 10(5) load cycles.
International Endodontic Journal 09/1993; 26(5):294-300. · 2.18 Impact Factor
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ABSTRACT: Rapid developments in dental health and science have resulted in an increasing number of teeth receiving post and core restoration. The dentist can choose from a wide range of restoration-modalities. Success or failure of these restorations largely depends on their ability to meet functional demands. This article presents a review of the literature on the mechanical behaviour of post-core restorations, as it is determined by functional forces, shape of the tooth and restoration and properties of the materials the construction encorporates. Some attention is drawn to the importance of failure characteristics in view of re-restoration possibilities. As a conclusion some guide-lines for the use of post and core restorations in the general dental practice are formulated.
Nederlands tijdschrift voor tandheelkunde 08/1993; 100(7):308-11.
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ABSTRACT: In this study, data on initial failure loads of direct post and core-restored premolar teeth were analyzed using the Weibull distribution. Restorations consisted of a prefabricated titanium alloy post, and an amalgam, composite or glass cermet core buildup in human upper premolar teeth. The specimens were subjected to compressive forces until failure at angles of 10, 45 and 90 degrees to their long axis. The two- and three-parameter Weibull distributions were compared for applicability to the failure load data. For estimation of the parameters of the two-parameter distribution: sigma 0 (reference stress) and m (Weibull modulus), linear regression was used. In this distribution, it is assumed that the third parameter, sigma u (cut-off stress), equals 0. The Maximum Likelihood (MLH) method was used to estimate all three parameters. It was found that the choice of distribution has a strong influence on the estimated values and that the three-parameter distribution is best fitted for the failure loads in this study. Comparisons were made between the failure probability curves as found by MLH estimation for the different core materials and loading angles. The results indicated that the influence of loading angle on the failure mechanism was stronger than that of core material.
Dental Materials 08/1992; 8(4):283-8. · 3.13 Impact Factor
