Revue belge de medecine dentaire最新文献

Many techniques of behavioral control of children have been developed to help the good performance of their health treatment. The objective of this study was to test the effect of the "modeling" technique on the pulse of the children during dental treatment. 69 girls and 86 boys were selected and divided into 3 groups A, B and C. Groups A and B were approached using the "modeling" technique and by taking respectively the mother or the father as a model. For the group C, the 'tell show do' approach was only used. The pulses of these children were registered during the check-up session and the cleaning therapy that followed. The results showed statistical significance (p < 0.001) of the two major factors investigated: gender of the children and choice of the model when using the modeling technique.

In the differential diagnosis of orofacial pain, the importance of referred pain from other anatomical regions should be taken into account. This contribution describes the neuroanatomical and -physiological background of referred pain and the role of peripheral and central sensitization in its genesis and maintenance. In addition to the effects of afferent neurons, also the resulting efferent effects like increased muscle tone are illustrated, as well as the role of the autonomic nervous system. Through practical examples out of the daily dental practice, it is elucidated how referred pain can interfere in the diagnosis, and how the source and the location of pain can be discriminated.

In order to maintain the quality of care, dental professionals must be enabled to update their knowledge on a regular basis. This can be achieved by continued education (lectures), but management techniques as well as regulations and legislation also have their influence. None of the aforementioned is equally effective or applicable. In 1998, peer review became a compulsory element of the system of accreditation for Belgian dentists. Peer review is an adaptation to the medical (dental) situation of what is known as a quality circle in management sciences. In contrast to former general opinion, today there is only little evidence of the effect of quality management on the quality level of (dental) care. Even continuous quality improvement experts admit that their expectations have not been met so far. The reason for this might be that quality management mainly focuses on side effects of care rather than on care itself; or that the strict methodology of the quality circle is violated. This article focuses at the methodology of the quality circle, compares with the medical literature and pays attention to the reasons why, at least in Belgium, peer review may not be very successful in improving quality of dental care. This is mainly due to mandatory participation at peer review within the Belgian accreditation system, and unfamiliarity with the methodology of peer review. In order to obtain quality improvement one must take integrated measures that effectively aim at multiple facets of a problem. If as many dentists as possible are to be involved, one has to guarantee a free choice between multiple alternatives in order to keep professional knowledge up to date.

Amalgam, composite resin and compomer are frequently used in operative dentistry today. Earlier studies have shown the periodontal consequences induced by these materials if they have intracrevicular restorative margins. This study was performed on dogs where Class V cavities with apical margin located at the alveolar bone crest were prepared and restored with these materials. Three months later, the experimental and control sites were prepared for histological analysis. Mean bone loss was significant only with compomer. The mean length of the supracrestal connective tissue was almost the same with the three fillings. The length of epithelial attachment was the highest with composites. There was a decrease in the length of the biologic width from Day 0 to Day 90.

From July 2007 on, Belgian dental graduates must complete one year of vocational training in general dentistry or a specialization in the field of either orthodontics or parodontology in order to obtain a licence for the Belgian Social Security System. This introduction of special professional titles required massive legislation in concert with State Health Insurance (RIZIV/INAMI), the Departments of Education of both Communities, manpower planning, comparable arrangements for physicians, and European Directives. Overall the process of subsequent changes in legislation and implementation took up to 15 years. The author includes some critical remarks and indicates what still needed to be done at the end of 2005 to conclude this far-reaching change in the organisation of dentistry in Belgium.

Th. van Nuijs, chief editor of the Revue Belge de Médecine Dentaire, interviews Professor Eric Fossion on the problematic of bisphosfonates and their role in the osteonecrosis of the jaws. Prof. Eric Fossion is maxillo-facial surgeon. Actually, he is professor part-time at the Catholic University of Leuven. He is Head Department of Dentistry, Oral and Maxillofacial Surgery, Middelheim Hospital, Antwerp.

Lichen planus (LP) is a chronic inflammatory disease of uncertain etiology. When the gingiva is affected, the LP can appear under several clinical forms. The diagnosis of the gingival lichen planus is based on the anamnesis, the clinical observation and the histological analysis. Various medicamentous and non medicamentous treatments are used to treat gingival LP with random results, due to the lack of knowledge on the etiology and the recidiving character of the lesions. The risk of malignant transformation of gingival LP is weak but it depends on clinical forms, justifying a periodic follow-up of all patients.

The desquamative gingivitis is the clinical term given to the gingival manifestation of mucocutaneous diseases. It is characterized by an erythematous, glazed, friable and hemorrhagic gingiva, which can be accompanied by pains. Except the gingiva, the lesions can be localised on other oral mucous membranes or on the skin. The three principal diseases at the origin of the desquamative gingivitis are by order of frequency: the cicatricial pemphigoïd, erosive lichen planus and pemphigus. The knowledge of the clinical, histological and immunohistochemical characteristics of these three affections is essential for the diagnosis and the suitable treatment of the desquamative gingivitis.