• Title/Summary/Keyword: Clinical adaptation

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A 48-month clinical performance of hybrid ceramic fragment restorations manufactured in CAD/CAM in non-carious cervical lesions: case report

  • Michael Willian Favoreto;Gabriel David Cochinski;Eveline Claudia Martini;Thalita de Paris Matos;Matheus Coelho Bandeca;Alessandro Dourado Loguercio
    • Restorative Dentistry and Endodontics
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    • v.49 no.3
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    • pp.32.1-32.12
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    • 2024
  • From the restorative perspective, various methods are available to prevent the progression of non-carious cervical lesions. Direct, semi-direct, and indirect composite resin techniques and indirect ceramic restorations are commonly recommended. In this context, semi-direct and indirect restoration approaches are increasingly favored, particularly as digital dentistry becomes more prevalent. To illustrate this, we present a case report demonstrating the efficacy of hybrid ceramic fragments fabricated using computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and cemented with resin cement in treating non-carious cervical lesions over a 48-month follow-up period. A 24-year-old male patient sought treatment for aesthetic concerns and dentin hypersensitivity in the cervical region of the lower premolar teeth. Clinical examination confirmed the presence of two non-carious cervical lesions in the buccal region of teeth #44 and #45. The treatment plan involved indirect restoration using CAD/CAM-fabricated hybrid ceramic fragments as a restorative material. After 48 months, the hybrid ceramic material exhibited excellent adaptation and durability provided by the CAD/CAM system. This case underscores the effectiveness of hybrid ceramic fragments in restoring non-carious cervical lesions, highlighting their long-term stability and clinical success.

Reliability and Validity of Korean Version of Nursing Students' Anxiety and Self-Confidence with Clinical Decision Making Scale (한국어판 간호대학생 임상의사결정능력 자신감과 불안 측정도구의 타당도와 신뢰도)

  • Yu, Mi;Eun, Young;White, KA;Kang, KyungJa
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.411-422
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    • 2019
  • Purpose: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale ($NASC-CDM^{(c)}$) for Korean nursing students. Methods: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the $NASC-CDM^{(c)}$ were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. Results: The Korean version of the $NASC-CDM^{(c)}$ (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's ${\alpha}$ was .93 for self-confidence and .95 for anxiety. Conclusion: The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original $NASC-CDM^{(c)}$ version.

The Effect of Shift Directions of Clinical Nurses on the Circadian Rhythm (임상 간호사의 교대근무 방향아 circadian rhythm 변화에 미치는 영향)

  • Hwang Ae-Ran;Chung Hyun-Sook;Kang Kyu-Sook;Lee Kyu-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.1
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    • pp.77-97
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    • 1994
  • The circadian system represents a temporal order which is mediated by the mutual coupling of oscillators and by the synchronizing effects of zeitgebers. It is known that well-being of man depends partly on the maintenance of this order, and that repeated or long lasting disturbances to it such as shift work will Cause harmful effects. This study was a quasi-experimental study to test the effect of shift directions for the clinical nurses on the circadian rhythm. Fourteen nurses working at the general units of Y hospital were selected according to the established criteria. Fourteen subjects were assigned to a weekly shift but the directions of shift work were phase delay first and then phase advance or vice versa. Oral temperature, total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom were measured during these days except holidays. The data collection period was from April 26, 1993 to July 3, 1993. MANOVA and Wilcoxon signed rank test were used for statistical analysis. The results are summarized as follows. 1. Having worked on evening and night shifts in either phase delay or phase advance schedules, temperature rhythms of shift workers were gradually adapted to the new sleep-wake cycles. A complete adaptation to work on the night shift was achieved the sixth day of the night shift in the phase delay schedule compared to the partial adaptation to the work on the night shift in the phase advance schedule. Accordingly, by putting evening shift between day and night shifts, it will be possible for circadian rhythm to adapt easily to the night shift. 2. There were differences in the total sleeping time, frequency of steep-wake cycle, fatigue, and physical symptom except for mental performance between night shift and day, evening shift. This indicates further that shift workers working on the night shift have a hard time adapting to the shift work compared to the other shifts. 3. Evaluating all the acrophases of temperature rhythm either in phase delay or phase ad-vance schedules, it was shown that night to evening shift in the phase ad-vance schedule revealed the smallest phase move. Also phase advance schedule showed poorer adaptation to shift work than phase delay schedule in connection with total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom. It is suggested, taken together, these findings reflect that phase delay schedule facilitated the degree of adjustment to the shift work compared to the phase advance schedule.

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Evaluation of marginal and internal gap under model-free monolithic zirconia restoration fabricated by digital intraoral scanner (디지털 구강스캐너로 모형 없이 제작한 전부지르코니아 수복물의 변연 및 내면 적합도 평가)

  • Lee, Jong-Won;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.210-217
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    • 2016
  • Purpose: The aim of this study was to evaluate the marginal and internal adaptation of monolithic zirconia restoration made without physical model by digital intraoral scanner. Materials and methods: A prospective clinical trial was performed on 11 restorations as a pilot study. The monolithic zirconia restorations were fabricated after digital intraoral impression taking by intraoral scanner (TRIOS, 3shape, Copenhagen, Denmark), computer-aided designing, and milling manufacturing process. Completed zirconia crowns were tried in the patients' mouth and a replica technique was used to acquire the crown-abutment replica. The absolute marginal discrepancy, marginal gap, and internal gap of axial, line angle, and occlusal part were measured after sectioning the replica in the mesiodistal and buccolingual direction. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test (${\alpha}=.05$). Results: From the adaptation analysis by replica, the statistically significant difference was not found between mesiodistal and buccolingual sections (P>.05), but there was significant difference among the measurement location (P<.01). The amount of absolute marginal discrepancy was larger than those of marginal gap and internal gap (P<.01). Conclusion: Within the limitations of this study, the adaptation accuracy of model-free monolithic zirconia restoration fabricated by intraoral scanner exhibited clinically acceptable result. However, the margin of zirconia crown showed tendency of overcontour and cautious clinical application and follow up is necessary.

Radiation Doses and Quality Assurance in Cone Beam CT(CBCT) (임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량)

  • Choi, Yong-Suk;Kim, Gyu-Tae;Hwang, Eui-Hwan
    • The Journal of the Korean dental association
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    • v.52 no.3
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

The Factors Influencing Employment Stress of Nursing Students (간호대학생의 취업스트레스에 미치는 영향요인)

  • Cho, Eui-Young;Kim, Jung Ae;Kim, Ji-Young;Kim, Hyun-Ji;Ra, Eun-Soo;Lee, Hye-Yeon
    • The Journal of the Convergence on Culture Technology
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    • v.2 no.1
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    • pp.35-43
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    • 2016
  • The purpose of this study was to analyze the relationship between general characteristics, clinical practice stress, major satisfaction and employment stress, and check the effect on employment stress in order to provide baseline data of reduced amount of stress from nursing undergraduates. Methods: The cross-sectional descriptive study design was used. We selected 388 nursing undergraduate students from nursing college located in Daejeon, Jinju, Naju city by convenience random sampling and analyzed the data using SPSS 22.0 program. Results and Conclusion: Factors that effects on employment stress was clinical practice stress, major satisfaction and family economic status, and the explanatory power was 23.8%. The results show the need for development of pre-clinical practice adaptation education program and applying it for nursing students to reduce the clinical practice stress. Also, development of counseling program is needed, since nursing has higher employment rate compare to other major however it is difficult to get a job at wanted hospital, moreover there are students who are pressured from license examination.

A Survey on Korean Medicine Treatment for Traffic Injuries: A Second On-line In-depth Survey (교통사고 상해 증후군의 한의 임상진료 현황 조사: 2차 온라인 심층 설문 조사)

  • Lim, Kyeong-Tae;Hwang, Eui-Hyoung;Hwang, Man-Suk;Park, In-Hwa;Park, Sun-Young;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.89-101
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    • 2018
  • Objectives To understand current status of clinical practice patterns on Korean Medicine treatment practice of traffic injury patients by 2nd on-line survey for developing Korean Medicine treatment clinical pratice guideline (CPG) for traffic injuries. Methods A revised questionnaire about current practice patterns of Korean Medicine treatments for traffic injuries was distributed by e-mail survey to 19,385 respondents of Korean Medicine doctors from May 21th in 2018 to June 21th in 2018. All data were statistically analysed. Results The response rate was 3.5%. Most of the respondents felt necessity of the development of Korean Medicine CPG for traffic injuries. The results showed the detailed usage and trend of current Korean Medicine treatment such as acupuncture, pharmacopuncture, moxibustion, Chuna manual therapy, cupping, Korean Medicine physiotherpy for traffic injury patients. Conclusions This survey helps to determine current Korea Medicine treatments' clinical practice patterns for traffic injury patients. All data from the survey will provide basic data for future clinical studies and adaptation for the revision of Korean Medicine CPG for traffic injuries.

A Study on Clinical Status for Development of Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology (사상체질병증 임상진료지침 개발을 위한 임상 현황 조사연구)

  • Cho, IL-Hyun;Kwon, Jin-Hyeok;Lee, Eui-Ju;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.29-44
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    • 2020
  • Objectives We surveyed clinical status of Sasang Constitutional Medicine (SCM) for preparation of adaptation of Clinical Practice Guidelines for Sasang Constitutional Symptomatology. Methods We emailed Google survey form to Doctors of Korean Medicine registered the Association of Korean Medicine on 10/13/2020 and 10/21/2020 and closed survey 10/23/2020. We got a data of 654 cases, removed a case of error, analyzed data of 620 responses by frequency analysis Results and Conclusions Out of 620 respondents, 499 have answered that they refer to or make use of SCM. SCM is mainly applied in the field of treatments using Herbal Medicine. Doctors of Korean Medicine participated in survey of SCM, they think Diseases of digestive system are the most effectively treated by the methods of SCM. Sasang Constitutional Symptomatology most frequently observed are Soeumin Congestive Hyperpsychotic symptomatology, Soyangin Chest-Heat congested Symptomatology, Taeeumin Liver Heat-based Interior Heat disease. The diseases that are mainly applied by SCM are 'Diseases of digestive system' for Soeumin, 'Diseases of digestive system' for Soyangin, 'Diseases of respiratory system' for Taeeumin and 'not applicable' for Taeyangin. The important diagnostic methods of SCM are Inspection-listening and smelling examination-Inquiry-Palpation and survey. In the majority of cases, Prescription of Herbal medicine is used by adding or subtracting some herbal medicine from the original prescription suggested in the oriental medical classics and Saam acupuncture method is the most frequently used for the acupuncture therapy. Diet therapy is the most frequently used for the method of prevention and care.

Development of Korean Nurse Residency Program for Tertiary Hospitals (국내 상급종합병원 신규간호사의 실무적응지원 프로그램 개발)

  • Kwon, In Gak;Cho, Yong Ae;Kim, Kyeong Sug;Kim, Mi Soon;Cho, Myung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.149-164
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    • 2021
  • Purpose: The purpose of this study was to develop a Korean Nurse Residency Program (KNRP) in order to facilitate new nurses' transition to clinical practice working at tertiary hospitals in Korea. Methods: The KNRP was developed through a literature review, investigation of NRP cases in United States, two rounds of expert consultation, and appropriateness survey. For appropriateness survey of the program, a questionnaire with 118 items and 14 subcategories including overview and operation of KNRP, education programs, staffing criteria for new nurses' education, preceptor supporting strategies, evaluation standards for new nurse's education, infrastructure, and KNRP benefits was used. Data were collected from 369 nurses including nurse educators, nurse managers, preceptors, and new nurses working at 43 tertiary hospitals in Korea from February 16, 2021 to March 22, 2021. Data were analyzed with descriptive statistics. Results: Appropriateness score of KNRP was 3.42±0.31 (out of 4) and those of 14 subcategories ranged from 3.18±0.47 to 3.58±0.46. The final version of the KNRP postulated is a one-year program, which is composed of off-job training and on-site training including preceptorship over 3 months, and competency reinforcement and adaptation supporting programs. Conclusion: The application of the one-year KNRP will facilitate new graduate nurses' transition to clinical practice. In order for effective application of the KNRP, cooperative efforts of the government, professional associations, and hospitals are needed.

Clinical comparison of marginal fit of ceramic inlays between digital and conventional impressions

  • Franklin Guillermo Vargas-Corral;Americo Ernesto Vargas-Corral;Miguel Angel Rodríguez Valverde;Manuel Bravo;Juan Ignacio Rosales Leal
    • The Journal of Advanced Prosthodontics
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    • v.16 no.1
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    • pp.57-65
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    • 2024
  • PURPOSE. The aim of this stuldy was to compare the clinical marginal fit of CAD-CAM inlays obtained from intraoral digital impression or addition silicone impression techniques. MATERIALS AND METHODS. The study included 31 inlays for prosthodontics purposes of 31 patients: 15 based on intraoral digital impressions (DI group); and 16 based on a conventional impression technique (CI group). Inlays included occlusal and a non-occlusal surface. Inlays were milled in ceramic. The inlay-teeth interface was replicated by placing each inlay in its corresponding uncemented clinical preparation and taking interface impressions with silicone material from occlusal and free surfaces. Interface analysis was made using white light confocal microscopy (WLCM) (scanning area: 694 × 510 ㎛2) from the impression samples. The gap size and the inlay overextension were measured from the microscopy topographies. For analytical purposes (i.e., 95-%-confidence intervals calculations and P-value calculations), the procedure REGRESS in SUDAAN was used to account for clustering (i.e., multiple measurements). For p-value calculation, the log transformation of the dependent variables was used to normalize the distributions. RESULTS. Marginal fit values for occlusal and free surfaces were affected by the type of impression. There were no differences between surfaces (occlusal vs. free). Gap obtained for DI group was 164 ± 84 ㎛ and that for CI group was 209 ± 104 ㎛, and there were statistical differences between them (p = .041). Mean overextension values were 60 ± 59 ㎛ for DI group and 67 ± 73 ㎛ for CI group, and there were no differences between then (p = .553). CONCLUSION. Digital impression achieved inlays with higher clinical marginal fit and performed better than the conventional silicone materials.