Revue belge de medecine dentaire最新文献

After a short explanation of the word value, the (cultural) value of teeth, the economic evaluation of dentistry and the payment criteria are being presented. The specific situation of health care as a service which deviates in quite a few aspects from the standard demand-supply model is being pointed out. Attention is drawn to key characteristics of the liberal professions such as the obligation to perform to the best of one's ability, not to a specific result. Function classification appears to offer possibilities for cataloguing the wide variation in practice settings. The well-known wage calculation of Professor De Lembre is being reviewed. Subsequently the analysis of cost variation and induced demand by extra services and profile shaping is being elaborated. Cost-benefit-analysis is the concluding item.

Facial two- or three dimensional reconstruction is a method of last resort trying to trigger indirect identification through primary recognition offering a new lead to personal identification. It may be used when odontological or physical data comparison, fingerprints, DNA or other conventional identification techniques have failed.

Recent experiences from mass disasters have shown that a structured and uniform methodology is the only good way to come to quick and correct results in disaster victim identification. It is therefore mandatory that everyone included in such operations is not only conscious of the procedures, but also willing to apply them. This can only be achieved by providing adequate information and training to all personnel involved, tactical and technical. It seems thus not unreasonable that in the future, DVI Interpol would only be willing to work with accredited personnel and DVI teams, in order to optimize the results of disaster victim identification operations.

Decompression of a large periapical lesion: a modified approach. Management of large periapical lesions that resist conventional root canal therapy or that are interpreted as cystic in nature is somewhat questionable. Surgery with complete enucleation might be the most expeditious method of management. This approach however may create certain undesirable complications as compromising the vitality of adjacent teeth, jeopardizing their osseous support or resulting in nerve damage. These complications should be avoided whenever possible. A decompression technique can eliminate the disadvantages of enucleation by surgery. A number of techniques employing long-term drainage and depressurization have been described in the literature and have been proved to be clinically successful. The purpose of this case report is to describe a modified approach to the technique of decompression that has proved to be effective and quite comfortable for the patient.

Calcium hydroxide has found its use in endodontic treatments. On the other hand, chlorhexidine is more and more proposedfor uses in clinical endodontics. Could chlorhexidine surpass calcium hydroxide and what are the benefits of chlorhexidine? This literature overview concludes that both medications are useful and that further studies are necessary before chosing one above the other.

Digital radiography has several advantages and has become an indispensable diagnostic tool for many dentists in daily practice. Once the digital captation appears on screen, the dental x-ray software allows image enhancement, to get a better vision and diagnosis. This image enhancement is acquired for example by adjusting the colour, density, sharpness, brightness or contrast. If the digital radiographs are exported, using various software packages created for graphic design and image manipulation, digital information can be altered, added or removed. Dental radiographs are easily duplicated, stored or spread in digital format. How can their authenticity be guaranteed, especially in insurance cases? Image enhancement features of digital radiography allow mishandling or potential abuse. Recently published studies illustrate the potential fraudulent use of digital radiography. In this article, some manipulated radiographic images are presented, to raise concerns about security, reliability and the potential for fraud.

The number of reported child abuse cases is increasing every year. This may indicate that the threshold of reporting child abuse has dropped or that the incidence of this kind of physical violence has increased in our society. Physicians, dentists, emergency care personnel, and educators are, because of their professional relation with children, in a privileged position for detecting and reporting signs and symptoms of child abuse and should play a crucial role in the protection of potential victims of abuse.

Precise photographs, supplemented by impressions are used to research and compare bite marks. Different materials for impressions are available to the forensic odontologist. Subsequently, the acquired information of the bite mark will be compared with the dentition of a suspect through photographs, intra- and extra oral examination and impressions. The overlay, which can be created using a variety of methods, allows the comparison between the bite mark and the dentition of the suspect. Among the most commonly used are hand-tracing of study models, wax bites or photocopies, or the radio-opaque wax bite method. Thanks to modern technology and the use of computers, analyses of bite marks have gradually become more accurate. Current research carried out at the Katholieke Universiteit Leuven will demonstrate whether the computer program ForensicIQ is able to offer an even more precise comparison between a given bite mark and the dentition of a suspect. By no means should bite mark analysis alone be allowed to lead to a guilty verdict, but it will offer the opportunity to exclude a suspect from a crime when the data do not correspond.

The role of the odontologist is crucial for the study of archaeological material. The excavations at the site of the ancient abbey of the Dunes of Koksijde led to the discovery of more than a thousand burial places. It is possible to estimate the age of the skeletons by studying molar dental wear. This method is however less appropriate for the industrialised populations of the 21st century, because of the switch to more diverse and processed (less abrasive) food.

Endodontic failures on premolars are statistically important. This is mainly due to insufficient knowledge of the typical anatomical diversity shown by premolars. Filling a second root canal is often omitted. Completely treating a complicated root canal system is technically quite difficult which results in a relatively high level of endodontic failure. There are not only the classical technical problems to deal with: calcification of the root canals and delicate probing, given the frequently bent and twisted premolar roots; special attention should also be given to upper premolars with three root canals and those showing a high bifurcation of a principal root canal (configuration IV), and to lower premolars with multiple root canals often showing configuration IV. An additional problem associated with the second lower premolars is a hazardous anatomical zone: the mandibular vasculonervous plexus of the chin.