Preformed metal crowns for decayed primary molar teeth

BackgroundPreformed metal crowns (PMCs) are recommended by the British Society of Paediatric Dentistry (BSPD) for restoring badly broken down primary molar teeth. However, few dental practitioners adopt this technique in clinical practice, citing cost and clinical difficulty as reasons for this. Whilst there is a subjective impression by clinical academics that PMCs provide a more durable restoration than filling materials, there appears to be little evidence within the literature to support this.ObjectivesThe primary aim of this systematic review was to compare clinical outcomes for primary molar teeth restored using PMCs compared to those restored with filling materials.Search methodsThe literature was searched using: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3); MEDLINE (1966 to August 2005); EMBASE (1980 to August 2005); System for Information on Grey Literature in Europe (SIGLE) (1976 to August 2005). Relevant publications' reference lists were reviewed for relevant articles. The most recent search was carried out on 24 August 2005.Selection criteriaRandomised controlled trials (RCTs) that assessed the effectiveness of PMCs compared with filling materials or where there had been no treatment in children with untreated tooth decay in one or more primary molar teeth.Data collection and analysisTwo review authors independently assessed the title and abstracts for each article from the search results to decide whether it was likely to be relevant. Full papers were obtained for relevant articles and all three review authors studied these.Main resultsForty‐seven records were retrieved by the search strategies of which some were duplicates. Of these, 14 studies were scrutinised. No studies met the inclusion criteria and six studies were excluded from the review as they were either retrospective in design or reported as prospective outcomes but not randomised. No data were available for extraction and analysis and therefore, no conclusion could be made as to whether PMCs were more successful than filling materials for restoring primary molar teeth.Authors' conclusionsNo RCTs were available for appraisal. Whilst this technique is recommended by the BSPD for use in clinical practice, the evidence to support this is not strong, consisting mainly of case reports and uncontrolled studies. It is important that the absence of evidence for PMCs is not misinterpreted as evidence for their lack of efficacy.There is a strong need for prospective RCTs comparing PMCs and fillings for managing decayed primary molar teeth. The lower levels of evidence that have been produced, however, have strength in that the clinical outcomes are consistently in favour of PMCs, despite many of the studies placing PMCs on the most damaged of the pair of teeth being analysed

Ecclesiastical Patronage in the Medieval Period: With Special Reference to Parochial Benefices in Scotland

Abstract Not Provided

Planar Josephson Tunnel Junctions in a Transverse Magnetic Field

Traditionally, since the discovery of the Josephson effect in 1962, the magnetic diffraction pattern of planar Josephson tunnel junctions has been recorded with the field applied in the plane of the junction. Here we discuss the static junction properties in a transverse magnetic field where demagnetization effects imposed by the junction geometry and configuration of the electrodes are important. Measurements of the critical current versus magnetic field in planar Nb-based high-quality junctions with different geometry, size and critical current density show that it is advantageous to use a transverse magnetic field rather than an in-plane field to suppress the Josephson tunnel current and Fiske resonances in practical applications.Comment: 5 pages, 2 figures, submitted to Journal of Applied Physic

Orientation to the sun by animals and its interaction with crypsis

1. Orientation with respect to the sun has been observed in a wide range of species and hasgenerally been interpreted in terms of thermoregulation and/or ultraviolet (UV) protection. For countershaded animals, orientation with respect to the sun may also result from the pres-sure to exploit the gradient of coloration optimally to enhance crypsis.2. Here, we use computational modelling to predict the optimal countershading pattern for anoriented body. We assess how camouflage performance declines as orientation varies using acomputational model that incorporates realistic lighting environments.3. Once an optimal countershading pattern for crypsis has been chosen, we determineseparately how UV protection/irradiation and solar thermal inflow fluctuate with orientation.4. We show that body orientations that could optimally use countershading to enhance crypsisare very similar to those that allow optimal solar heat inflow and UV protection.5. Our findings suggest that crypsis has been overlooked as a selective pressure on orientationand that new experiments should be designed to tease apart the respective roles of these different selective pressures. We propose potential experiments that could achieve this

Minimum intervention children's dentistry - the starting point for a lifetime of oral health

Child-friendly minimum intervention dentistry (MID) dominates modern thinking and practice around delivery of oral care for children. It is an enormous challenge for our profession to move away from the narrow focus of a mechanistic, cavity-orientated surgical approach for managing dental caries to one which embraces new strategies for caries prevention and management, delivered in the context of a partnership with children, families and other adults involved in the child's life environment. It is also time for a shift in the orientation of dentistry towards 'patient self-care' becoming a core goal of dental care, where dentists help their patients assume responsibility for achieving and maintaining their own oral health, and that of their children. Holistic care, which improves oral health and maximises ability to maintain oral health, should be regarded with the same importance and rewarded with a similar level of remuneration as 'traditional operative dentistry'. This paper gives an overview of a model of care involving the principles of this new approach, and the application of MID in clinical practice for primary teeth

A Comparison of Ultraviolet, Optical, and X-Ray Imagery of Selected Fields in the Cygnus Loop

During the Astro-1 and Astro-2 Space Shuttle missions in 1990 and 1995, far ultraviolet (FUV) images of five 40' diameter fields around the rim of the Cygnus Loop supernova remnant were observed with the Ultraviolet Imaging Telescope (UIT). These fields sampled a broad range of conditions including both radiative and nonradiative shocks in various geometries and physical scales. In these shocks, the UIT B5 band samples predominantly CIV 1550 and the hydrogen two-photon recombination continuum. Smaller contri- butions are made by emission lines of HeII 1640 and OIII] 1665. We present these new FUV images and compare them with optical Halpha and [OIII], and ROSAT HRI X-ray images. Comparing the UIT images with those from the other bands provides new insights into the spatial variations and locations of these different types of emission. By comparing against shock model calculations and published FUV spectroscopy at select locations, we surmise that resonance scattering in the strong FUV permitted lines is widespread in the Cygnus Loop, especially in the bright optical filaments typically selected for observation in most previous studies.Comment: 21 pages with 10 figures. See http://www.pha.jhu.edu/~danforth/uit/ for full-resolution figure

The challenges of implementing and evaluating a pilot music and movement intervention for people with dementia (innovative practice).

This paper reports on the challenges associated with implementing and evaluating an innovative pilot music and movement project. The evaluation documents that participants enjoyed the sessions and that they created the opportunity for social engagement although there is little to suggest this is unique to this particular type of intervention. Difficulties included matching the programme to the needs of participants, communicating effectively, and over burdensome paperwork. The paper also comments on the challenges associated with last minute, limited funding opportunities for both the organisation commissioning a project and the team evaluating it. In this case, the evaluation team found that many of the more difficult issues associated with the pilot could have been resolved with more time for planning and preparation

Outcomes in Trials for Management of Caries Lesions (OuTMaC):protocol

Background Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease. Methods To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy-makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel’s opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups. Discussion By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data. Trial registration Registered 12 April 2015 at COMET (http://www.comet-initiative.org