Restorative Index Research Articles

Esthetic Index for Anterior Maxillary Implant‐Supported Restorations

The aim of this study is to develop and validate a complex esthetic index (CEI) designed for rating the esthetics of anterior maxillary implant-supported restorations with respect to the surrounding soft and hard tissues. Fifty patients (31 males and 19 females; age: 18 to 50 years; mean age +/- SD: 32.4 +/- 9.1 years) previously treated with dental implants were evaluated regarding the esthetic results of their restorations using the proposed CEI. Two calibrated oral surgeons did the evaluation and recording. The evaluation was carried out twice by each of the examiners 2 weeks apart. The weighted Cohen's kappa was used to calculate the intra- and interobserver agreement. An analysis of CEI for 50 anterior maxillary implant-supported restorations showed good intra- and interobserver agreement for the soft tissue index (S) and implant-supported restoration index (R). Only the interobserver agreement for the overall R was rated as moderate (0.54 and 0.52). The single-parameter analysis showed that the lowest (moderate) intra- and interobserver agreement was with the subjective parameters of S (soft tissue color and texture variations) and R (crown surface roughness and ridges and color and translucency). An adequate CEI of S100, P100, and R100 was scored by both examiners in 10% and 12% of cases for evaluations I and II, respectively. This study presents evidence that this newly developed CEI, which incorporates the implant restoration and adjacent soft and hard tissue parameters, is a reproducible tool for scoring anterior implant esthetic predictably. However, prospective clinical trials involving examiners with different training backgrounds are needed to further validate the long-term stability of this index.

Dental health of children and adolescents of Navarra, 2007 (4th edition)

With five years having passed since the last survey (2002), a new survey was carried out, the 4th since 1987. The aim is to determine the state of oral health of children and adolescents in Navarre and its evolution. The sample (n=1.397) was selected through multistage probability sampling, taking as a unit the classrooms of the 1st and 6th year of Primary Education and the 2nd of Compulsory Secondary Education. The fieldwork was carried out in the months of April and May 2007 by two calibrated teams of examiners. Health variables studied: caries (measured with WHO criterion and extended criterion), periodontal state and malocclusion. The data were computerised with Access XP 2003 SP3; the statistical analysis with SPSS Windows v.15.0. Ten point eight percent of the sample is of foreign origin. The prevalence of caries in temporary dentition at 6 years is 35.9% with a DFT of 1.26, in permanent dentition, 28.5% and 46.4% at 12 and 14 years; the average of affected teeth 0.63 and 1.28 respectively. The index of restoration is 26.1% in temporary dentition and 68.9 and 74.1% in permanent; those of foreign origin show more caries (p<0.05) and less treatment (p<0.05) than those of Spanish origin. Sixty-two point eight percent of 14 year olds show gingival bleeding and 16.8%, calculus; 14.7% malocclusion and 19.1% wear orthodontic appliances. Conclusions. Caries are stabilised in temporary dentition in the general population, but fall significantly amongst natives (those of Spanish origin); in permanent dentition they continue their tendency to fall, although more moderately. Navarre is amongst the regions with a lower level of caries and a higher index of restoration. Immigrants show significantly more caries. The index of restoration falls slightly with respect to previous years. The periodontal health figures are poor. Malocclusion and orthodontic appliance wearers are stabilised.

La salud dental de los niños y adolescentes de Navarra, 2007 (4ª edición)

Background. With five years having passed since the last survey (2002), a new survey was carried out, the 4th since 1987. The aim is to determine the state of oral health of children and adolescents in Navarre and its evolution. Population and methods. The sample (n=1.397) was selected through multistage probability sampling, taking as a unit the classrooms of the 1st and 6th year of Primary Education and the 2nd of Compulsory Secondary Education. The fieldwork was carried out in the months of April and May 2007 by two calibrated teams of examiners. Health variables studied: caries (measured with WHO criterion and extended criterion), periodontal state and malocclusion. The data were computerised with Access XP 2003 SP3; the statistical analysis with SPSS Windows v.15.0. Results. Ten point eight percent of the sample is of foreign origin. The prevalence of caries in temporary dentition at 6 years is 35.9% with a DFT of 1.26, in permanent dentition, 28.5% and 46.4% at 12 and 14 years; the average of affected teeth 0.63 and 1.28 respectively. The index of restoration is 26.1% in temporary dentition and 68.9 and 74.1% in permanent; those of foreign origin show more caries (p<0.05) and less treatment (p<0.05) than those of Spanish origin. Sixty-two point eight percent of 14 year olds show gingival bleeding and 16.8%, calculus; 14.7% malocclusion and 19.1% wear orthodontic appliances. Conclusions. Caries are stabilised in temporary dentition in the general population, but fall significantly amongst natives (those of Spanish origin); in permanent dentition they continue their tendency to fall, although more moderately. Navarre is amongst the regions with a lower level of caries and a higher index of restoration. Immigrants show significantly more caries. The index of restoration falls slightly with respect to previous years. The periodontal health figures are poor. Malocclusion and orthodontic appliance wearers are stabilised.

Income, Income Inequality, Dental Caries and Dental Care Levels: An Ecological Study in Rich Countries

Research has shown that beyond a certain level of absolute income, there is a weak relationship between income and population health. On the other hand, relative income or income inequality is more strongly related to health than absolute income in rich countries. The objective of this study was to assess the relationships of income and income inequality with dental caries and dental care levels in 35- to 44-year-old adults among rich countries. Income was assessed by gross domestic product and gross national income, income inequality by Gini coefficient and the ratio between the income of the richest and poorest 20% of the population, dental caries by DMFT and dental care levels by the care, restorative and treatment indices. Pearson and partial correlation were used to examine the relationships between income, income inequality, caries experience and dental care. Income measures were not related to either dental caries or dental care levels. However, income inequality measures were inversely and significantly related to number of filled teeth, DMFT, care index and restorative index, but not to number of decayed or missing teeth. It is concluded that DMFT scores were higher in more equal countries and may be explained by greater levels of restorative care in those countries.

Distribution System Restoration via Subgradient-Based Lagrangian Relaxation

Lagrangian relaxation with subgradient iterations is applied to the problem of optimal restoration of distribution systems after a blackout. The method breaks the restoration horizon into intervals and develops a restoration plan by finding the status of each of the feeders at each time interval. The Lagrangian relaxation approach allows a computationally efficient calculation of the timing and selection of feeders to be energized. The subgradient iterative approach relates to the selection of a vector of Lagrange multipliers in the optimization process. A restoration index obtained from the dual formulation of the problem is also shown. This index identifies the feeders that are closer to restoration. The proposed algorithm applies to radially configured distribution systems and is an operator-permissive, automated approach. Examples are shown including a 100-feeder restoration case.

Dental caries trend among adolescents in Lagos, South-West Nigeria

The past few decades have witnessed a changing trend in dental caries prevalence among Nigerians; thus the need to investigate the current trend of caries among adolescents Nigerians. To determine the prevalence and severity of dental caries among adolescents in Lagos, South-west of Nigeria. The World Health Organization (WHO) methodology for basic oral health surveys was employed. The study population was 11 to 16 year-old adolescents from primary and secondary schools in Surulere, Lagos, Nigeria. Surulere local government area (LGA) of Lagos State, South-West Nigeria was selected as the location of this study as the LGA is quite cosmopolitan having Nigerians of all walks of life. Information on sex, age, socioeconomic status and ethnicity was obtained. The dentition of subjects was examined for dental caries, fillings and missing teeth. Six hundred adolescents of age 11 to 16 years were studied. A high caries-free prevalence of 457 (76.2%) was found among the subjects. Mean(SD) DMFT (decayed, missing, filled teeth) of 0.72 (1.67) and mean DMF% (decayed, missing, filled per cent) of 2.62 (6.17) were recorded among the study population. Older adolescents had higher caries erates than the younger ones. More females than males had caries while the socioeconomic status did not seem to influence caries experience. DT (decayed teeth) was the major contributor of the DMFT index. Among the ethnic groups the Igbo and Edo/Delta had the highest caries experience while the Efik/Ibibio, Yoruba and Hausa had the lowest. A restorative index of 1% was recorded, showing poor utilization of dental health care services by the population. This study shows an increasing caries trend when compared to previous Nigerian studies despite the mean DMFT of 0.72 being better than the WHO target of 1.5DMFT. Ready availability of sweets and confectionaries to all classes of people in the country compounded by poor knowledge of and utilization of preventive and restorative oral health care services may be contributory to the current trend.

Is there a gradient by job classification in dental status in Japanese men?

The objective of this study was to assess whether there is a gradient in dental health status by job classification in male Japanese workers. The study subjects were 16,261 male Japanese workers aged 20-69 yr. Jobs were classified into seven job groups. Oral examination was conducted using World Health Organization criteria for decayed, missing or filled teeth (DMFT). Professionals, managers, and office workers had a better oral status than those in service occupations and drivers. Professionals had significantly more natural and sound teeth than those in other job classes. The DMFT of professionals was significantly lower than in workers of other job classes. Professionals had a significantly higher restorative index than did workers of other job classes. The restorative index of office workers was significantly higher than that in managers, skilled workers, salespersons, those in service occupations, and drivers. Drivers were 1.8 times, and those in service occupations 1.3 times, more likely to have one or more carious teeth compared with professionals. Skilled workers, salespersons, those in service occupations, and drivers were 1.3, 1.3, 1.4, and 2.1 times, respectively, more likely to have a missing tooth compared with professionals. Skilled workers, those in service occupations, and drivers were 1.7, 1.9, and 3.1 times, respectively, more likely not to have 20 or more teeth compared with professionals aged 50-69 yr.

Evaluation of a system for grading the complexity of root canal treatment

To evaluate the reproducibility of the Restorative Index of Treatment Need (RIOTN) system for grading the complexity of root canal treatment. The RIOTN system of grading the complexity of root canal treatment was applied to all endodontic referrals to a department of restorative dentistry in a district general hospital within a period of one year. Grading was repeated in 60 randomly selected teeth and weighted kappa analysis was used to test for intra-observer as well as inter-observer agreement with a consultant in restorative dentistry and a vocational trainee (VT). In all, 152 patients were referred for root canal treatment of 186 teeth within the period of study. Weighted kappa for intra-observer agreement when categorising complexity was 0.636. Weighted kappa for inter-observer agreement with the consultant was 0.570 and that for agreement with the VT was 0.223. The RIOTN system of grading the complexity of root canal treatment was incomplete; with moderate to poor reproducibility.

Restoration Index in Distribution Systems and Its Application to System Operation

To secure electricity supply to the customers is one of the most important jobs in the distribution system operation. This paper proposes a restoration index that indicates the restoration capability of the system and the fuzzy algorithm that identifies the load transfers to secure the complete restoration capability for any fault contingency. The operation strategy based on the proposed methodology is applied to the KEPCO distribution automation system and its current status is reported

A reassessment of recall frequency intervals for screening in low caries incidence populations

To reassess the recall frequency interval for dental examinations for children, based on annual caries increments. Cross sectional data collected on school children in eight rural and urban schools through the national Incremental Dental Care Programme (IDCP) for one district in Malaysia were analysed to assess their annual caries increment and trend lines. The Restorative Index was calculated to assess the success of the IDCP in rendering children dentally fit. The annual caries increments were low; the current caries levels were between 0.65 and 1.50 for 12 year-old children in Kota Tinggi District. Most of the caries experience was on pits and fissures. From 7 to 12 years old, the overall annual caries increment for the total study population was 0.19. The mean annual caries increment increased slightly between the ages of 12 to 14 years and 14 to 16 years and was 0.24 and 0.25 respectively. Two distinct caries incremental trend lines were observed for children aged 7 to 16 years. One group reached a mean DMFT of about 0.75 while the other group a mean DMFT of about 1.4 at 12 years. The trend lines continued over the next 4 years until the children were 16 years old. The Restorative Index was higher in urban schools that also had low DMFT levels. Based on the low annual caries increments of between 0.65 and 1.50, yearly dental examination intervals can safely be extended to 2-yearly intervals or even longer. Such a change of screening recall intervals would help improve resource allocation. Resources saved by extending recall intervals can be redirected to the small proportion of children with higher disease levels. This will help render more school children dentally fit and reduce inequalities in oral health.

배전계통 광역 정전복구 알고리즘 개발

This paper presents the service restoration in electric power distribution systems. The aim of the service restoration is to control an emergency taken place in distribution systems and to restore out-of service areas as soon as possible when a fault occurs in distribution systems. For this reason, new service restoration strategies in multi-outage area are suggested in this paper. The suggested algorithm consist of two schemes. One is an individual restoration scheme, the other is an integrated restoration scheme. The former determines a restoration order of outage areas based on a restoration index. Unless the former scheme can generate a feasible restoration plan, the latter one will try to find out a new configuration without an overloaded section through tie exchange method.

Nitric Oxide and Prostaglandins Potentiate the Liver Regeneration Cascade

The liver has the remarkable ability to regenerate following damage or surgical resection. Although this feature of the liver has been studied for over 100 years, the trigger of the liver regeneration cascade remains controversial. Recent experimental evidence supports the hypothesis that nitric oxide (NO) and prostaglandins (PGs), released secondary to an increase in the blood flow-to-liver mass ratio following two-thirds partial hepatectomy (PHx), work synergistically to trigger liver regeneration. To extend this research, the hypothesis that NO and PGs are potential therapeutic targets to potentiate the liver regeneration cascade is tested. The NO donor s-nitroso-n-acetylpenicillamine, the phosphodiesterase V antagonist zaprinast (ZAP) and PGI2 each potentiated c-fos messenger RNA expression, an index of initiation of the liver regeneration cascade, following PHx. Also, the triple combination of s-nitroso-n-acetylpenicillamine, ZAP and PGI2 potentiated c-fos messenger RNA expression. These results support the hypothesis that NO and PGs can potentiate initiation of the regeneration cascade. An additional index of liver weight restoration 48 h after PHx was also used to test the hypothesis, because this index encompasses the entire liver regeneration cascade. ZAP and 6-keto-PGF1alpha, a stable metabolite of PGI2, and the combination of ZAP and 6-keto-PGF1alpha, each potentiated liver weight restoration 48 h after PHx. These results also provide support for the hypothesis that NO and PGs are possible therapeutic targets to potentiate liver regeneration following surgical resection.

A Study of dental caries prevalence in 12–14 year old school children in Ibadan, Nigeria

The aim of the study was to determine dental caries prevalence among a representative sample of 12–14 year old school children in Ibadan, Nigeria with a view of determining Restorative Index and Met Need Index of the studied population. Dental caries was diagnosed according to the WHO method. Out of the 577 children in the age group, 65 children (11.2%) had dental caries experience as expressed with the DMFT index. More than 85% of the children were caries free. A mode of one DMFT was the highest score for the children although a 14-year-old pupil had DMFT score of 6. Female children had higher mean DMFT score of 2.03 ± 1.13 compared with 1.78 ± 1.0 for males ( P > 0.05). The Restorative Index (RI) and Met Need Index (MNI) for the children were very low as only the 14-year-old children had an RI of 3.45% and MNI of 0.11. Restorative Index reflects the restorative care of those who have suffered the disease and it is measured as a ratio of filled to filled plus decayed teeth percent that is F/F+D percent. Met Need Index is an indication of treatment received by an individual and it is measured by the ratio of the mean missing plus filled teeth to mean decayed, missing and filled teeth that is M+F/DMF. Since cost of management, which may be out of the reach of these children, has been identified as one of the factors militating against their receiving treatment, the result of this study suggest that oral health education with emphasis on correcting snacking habits of school children is desirable.

Oral health in Nigeria

Most oral health surveys in Nigeria have been sporadic and based on convenience samples. Periodontal disease with deep pocketing occurs in Nigerians at an early age, the prevalence being 15-58% in those aged above 15 years. Caries experience has been reported to vary between very low and low in most studies, but is moderate in some urban communities. Although mean DMFT is below 4 in most communities, the restorative index is extremely low, most carious teeth remaining unrestored. The higher caries prevalence in second than first permanent molars that has been reported is most likely due to a change from traditional to Western-type diet. Other oral health problems include malocclusion, truamatised teeth, dental fluorosis, and oral tumours. The scanty oral health services available in the country are mainly in urban areas. There is, therefore, a need to develop sustainable strategies for national preventive and therapeutic oral health services in Nigeria.

Nursing of eating disorder inpatient by trial of clinical-navigation (tentative name) program: Effect of the team approach trying to establish attachment

Among eating disorder patients there are many so-called good children with no external problems. It needs to be concerned with the inner conflict which is latent in such cases. However, the cause in connection with an inner problem has been hard to be acquired by the nursing team. Therefore, the focus of nursing becomes ambiguous and a patient and nursing team also tends to have impatience and a powerless feeling paying attention to the eating action itself, such as binge eating and purging. Then, in Goryokai Mental Hospital, the Clinical-Navigation (henceforth, Cli-Navi) which arranged the pathological model of eating disorder and the recovery model was created as a road map to reach the aimed direction. This is the new remission process model set on the basis of attachment theory, and a (Attachment-Detachment-Commitment) program with time progress develops the medical treatment indicator. We introduce Cli-Navi first and report the consideration for actual nursing problems accompanying this program. We attempt to clarify an advantage, a fault of Cli-navi, by considering a case progress. We inquired for the case of an eating disorder in which the informed consent for medical treatment by Cli-Navi was achieved by the doctor. We developed nursing in alignment with Cli-Navi to the 22-year-old woman. Medical treatment was advanced with the periodical conferences by us, a doctor, a psychologist and a nurse, and the result was analyzed. We considered the hospitalization for 4 months from the formation process of an attachment, and classified it at four terms. The first term is a period of encounter. The fourth term is a period of stable- independence. This case needed to take distance too much with others, and an attachment with others has not been established. Then, in the first term, we decided to watch concern. In the second term, we performed relation towards an attachment according to mitigation of wariness, consequently, the patient obtained a sense of security and came to open her heart to a staff member or other patients. Moreover, the patient understood that the eating disorder was a problem resulting from conflict of inside herself. In the third term, the physical bad condition continued and the patient became depressed. However, the patient confronted her problem and she gained a deeper insight. Furthermore, the patient established an attachment and the opportunity to tell a nurse and other patients was increased. In the fourth term, the patient came to control a binge eating impulse, maintained a sense of stability, and gained a deepened self-understanding. Even if the patient overate, she had the confidence to recover and wished to leave hospital. In this case, formation of the nursing attachment was especially important. Confrontation of the patient's problem progressed in parallel with attachment formation, and self-insight deepened. The viewpoint of attachment formation – nursing was able to have the relation which turns a viewpoint to the patient's inside and led to recovery, without being caught by direct binge eating and purging. The viewpoint of medical staffs’ occupational description was unified, and the conference based on Cli-Navi unified the patient image in the whole medical treatment team. Using Cli-Navi had the advantage that the advance state of medical treatment was sharable. Nursing using the Cli-Navi program was performed, and progress was analyzed. Consequently, it turns out that nursing to which the focus tended to become ambiguous since the restorative index was indefinite until now, can grasp a patient's action with the viewpoint of the formation process of an attachment, and it becomes easy to offer the effective relation for recovery. Moreover, integration of the patient image was completed as a medical treatment indicator common to a medical treatment team, and it was also suggested that each occupational description (a doctor, a psychologist and a nurse) can bear a role effectively. Also we considerd that the good medical treatment effect was brought since this patient was intellectual and could deepen self-insight. We want to apply Cli-Navi to various cases and continue to examine its effectiveness.

El Programa Dental de Atención Infantil (PADI) de Navarra y del País Vasco: logros y nuevas metas

This paper briefly analyses the results of the Infant Dental Care Program (PADI) of the Basque Country (1990) and Navarra (1991), aimed at children aged from 6 and 15 years. At the age 12, the lack of caries rose from 31% in 1988 to 57% in 1998 in the Basque Country, while it was 58% in Navarra (1997); the number of caries fell in Navarra by some 64% and by some 54% in the Basque Country, and the index of restoration was 81% in Navarra and 73% in the Basque Country (it was 17% in 1988). Emphasis is placed on the importance of a good evaluation of these programs and the opportunities that are opened up by the comparative analysis between Spanish autonomous communities for analysing the contribution of factors that are different, and for evaluating the impact of the programs on social inequalities in health. The results of the PADI exceed the initial aims of the Health Plans of Navarra (1991) and of the Basque Country (1990), and endorse the adoption of these programs by the Spanish autonomous communities. The development of these programs raises new objectives in dental health policy in Navarra and the Basque Country and, above all, makes it necessary to reflect on the need for Spain to include public dental health in its health policy and for the National Health System as a whole to include dental services within its services

Caries Prevalence among 6- to 16-Year-Old Students in Jamaica 12 Years after the Introduction of Salt Fluoridation

The aim of this descriptive cross-sectional study was to evaluate the caries prevalence among 6- to 16-year-old students in a rural community in Jamaica, where salt fluoridation was introduced in 1987. Data were obtained from dental examinations of 1,558 students in 1999. The mean (SD) dmfs/DMFS values were 7.9 (10.7) for the 6-year-old children, 4.1 (4.9) for the 12-year-old students and 8.2 (8.1) for the 15-year-olds; mean (SD) dmft/DMFT scores were 3.2 (3.5), 2.2 (2.1) and 3.8. (3.3), respectively. An Unmet Restorative Index of 88–99.9% was observed. Opacities due to fluorosis were recorded for 48% of the children examined. The results indicate a reduced caries prevalence for all age groups since salt fluoridation began. However, since various forms of fluoride might have contributed to the reduction, conclusions concerning salt fluoridation as the main factor must be drawn with caution. The effectiveness of salt fluoridation in Jamaica should be re-examined more closely.

A new adaptive filter and quality evaluation index for image restoration

This paper presents a new technique for image adaptive restoration called 3 σ-multiresolution plane fitting (3 σ-MPF) and the global restoration index (GRI) index, which evaluates the restoration performance of smoothing methods. The 3 σ-MPF filter is based on an adaptive plane fitting technique using variable-sized windows with different behavior for continuous regions or discontinuities. The criteria used to select the window size and detect discontinuities is the 3 σ- fidelity test. The GRI, integrates two independent indices measuring restoration smoothness and fidelity. Using this index, the 3 σ-MPF filter performance is compared with other traditional methods, demonstrating better performance under Gaussian noise and robustness against outliers.

Different Patterns of Aggregate Stability in Burned and Restored Soils

The merits of soil aggregate stability determination by rainfall simulator method were studied. This method is based on the supposition that in standard conditions aggregate breakdown is proportional to the kinetic energy of the rainfall applied. We compared three experiments using four different soils. Two of the experiments were in controlled conditions and the other at field conditions. In one of the laboratory experiments we applied sewage sludge to a degraded soil from a semiarid climate. In the other laboratory experiment a forest soil was heated to 200°C, 400°C and 600°C, and we studied the effect of heat and loss of organic matter in soil aggregation. In the third experiment, carried out in the field, we studied the response of two soils affected by forest fire in different intensities. Aggregate stability percentage and organic matter content of soils were determined to establish trends between these parameters. Aggregate stability in soils subjected to rainfall simulation was used as an indicator for potential degradation or restoration processes of the soils. In some burned soils positive and negative relationships were obtained between aggregate stability percentage and organic matter soil contents due to heat-aggregation processes. It showed that the aggregate stability percentage method based on disruptive energy of a rainfall simulator could not always be used as an index of degradation or restoration of soils or both.

Changes in Dental Caries Prevalence in 12–Year–Old Students in the State of Mexico after 9 Years of Salt Fluoridation

The purpose of this study was to describe the dental caries experience in 12–year–old students in the State of Mexico and to detect changes after 9 years of salt fluoridation (1988–1997). The 1987 WHO dental caries criteria were used in both surveys. The population studied encompassed 2,275 12–year–old students in 1988, and 1,138 in 1997. The proportion of ‘caries–free’ children was 10.3% in the first survey and 27.7% in the second one. The mean DMFT index was 4.39 (SD 2.9) in 1988 and 2.47 (SD 2.4) in 1997, the confidence interval of the differences between DMFT means was [95% CI 1.73, 2.11]; the caries reduction detected was 43.7%. The Unmet Restorative Index was 82.3% in 1988 and 72.8% in 1997. The results of the present study indicate that the oral health status of State of Mexico students has improved during the last decade; however, there is still a need for further caries reduction and an increment in access to dental treatment.