IU Indianapolis ScholarWorks :: Browsing by Author "Roche, James R., 1924-"

Browsing by Author "Roche, James R., 1924-"

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The attitudes of dentists in Indiana toward the treatment of patients with cerebral palsy
(1977) Wickliffe, Thomas James, 1946-; Gish, Charles W., 1923-; Koerber, Leonard G.; Roche, James R., 1924-; Starkey, Paul E.; Barton, Paul
The attitudes of Indiana dentists toward the treatment of cerebral palsied patients were investigated. A two-page questionnaire constructed by the investigator was used. A sample of 506 dentists were selected: 402 general practitioners chosen on the basis of year of graduation, location and community size; and 104 specialists chosen on the basis of geographic location and type of practice. All of the practicing specialties were represented. Eighty percent of the questionnaires were returned, including 75 percent of general practitioners and 97 percent of specialists. The first hypothesis, that general practitioners are reluctant to treat cerebral palsied patients, was disproved. Forty-eight percent of the general practitioners had treated one or more such patients in the past year and 84 percent indicated willingness to treat these patients. The general practitioners cited a lack of proper equipment and a feeling of apprehension as problems. The second hypothesis, that the general practitioner in a community of less than 2,500 is more reluctant to treat cerebral palsied patients than those in a larger city, was also disproved. No statistically significant difference was found based on community size. The third hypothesis, that the general practitioner who has graduated from dental school within the last 10 years is less reluctant to treat these patients than earlier graduates, was also disproved. No statistically significant difference was found between these groups. The fourth hypothesis, that the general practitioner feels that he did not receive adequate education concerning treatment of these patients and is willing to acquire more knowledge, was verified. The fifth hypothesis, that the specialist is less reluctant to treat patients with cerebral palsy than is the general practitioners was verified. Nearly 90 per cent of the specialists indicated a willingness to treat patients with cerebral palsy.
A comparison of maxillary arch form between groups of cerebral palsied and normal children
(1971) Dummett, Clifton Orrin, Jr.; Gish, Charles W., 1923-; McDonald, Ralph E., 1920-; Roche, James R., 1924-; Shafer, William G.; Garner, La Forrest Dean, 1933-
The purpose of this study was to compare the maxillary dental arch form and palatal vault form between 98 cerebral palsied and 76 normal children. All subjects were divided into three categories based on their dental eruption. The cerebral palsy subjects were further divided into the regional classifications of diplegia, paraplegia, hemiplegia, and quadriplegia, and the descriptive classifications of spasticity, athetosis, and mixed. The maxillary dental arch form was described by an index number which reflected intercuspid width, intermolar width, anterior-posterior length, and degree of divergence of the posterior segments. The palatal vault form v1as described by the angle of divergence of the palatal walls at an established reference point from a cross-sectional view. All measurements were made from study models and Xerox photocopies of study model cross-sections. In addition, those occlusal discrepancies that were thought to influence arch form, i.e., posterior unilateral and bilateral crossbite, anterior crossbite, anterior open bite, and posterior dental asymmetry were tabulated. Statistical analysis of the results revealed no significant difference in maxillary dental arch form between the cerebral palsied and normal children. The same held true for palatal vault form. Significant differences did occur between primary, mixed, and permanent dentitions for both cerebral palsied and non-handicapped groups. The results suggest that the neuromuscular handicap has little effect on the form of the maxillary dental arch. On the basis of this study, it appears that there is no particular type of maxillary arch form that is peculiar to cerebral palsy.
Effectiveness of oral hygiene instruction to parents of preschool cerebral palsy children
(1974) Ditto, Roland R., 1943-; Roche, James R., 1924-; Katz, Simon, 1920-1987; Starkey, Paul E.; Koerber, Leonard G.; Barton, Paul
The lack of an effective method for teaching oral hygiene procedures to parents of handicapped children prompted this investigation. Seventy-nine preschool cerebral palsy children were randomly distributed according to age and sex into three groups. The parents of these groups received the following instruction: Group I - written instructions for a detailed approach to oral hygiene maintenance in the home as if the child were without handicap; Group II - written instructions for a specialized approach to home oral hygiene maintenance with emphasis on two people providing the care, and mouth propping for access and stability of the arms and legs; Group III - no specific oral hygiene instructions. Each child in each group received a thorough oral examination and deposits of dental plaque were disclosed, numerically scored and recorded. Each parent of the three study groups participated in a written examination of dental knowledge at each visit. After each examination, the correct answers were given to the parent by both a verbal and written response. Parents and children returned at 90-day intervals. Variables such as transportation, surgery performed during the period of study, deteriorating health in the child, parental apathy about dental problems, and change in family job or location, reduced the sample from seventy-nine to fifty-four subjects, with data being obtained for pre- and post- examination periods. Both test group of parents significantly improved their dental knowledge scores after ninety days. However, none of the children decreased their plaque enough to show statistical significance. Perhaps there was some motivational improvement in the Group II parents, as they returned for the examination at a better rate, judged to be significant as compared to the other groups. Further investigation is recommended either to study the technique by itself without a time interval between scores or to evaluate the factors of intelligence, economic level, gravity of medical situation, and sibling support as they offset changes in behavior. Until then, it appears on the basis of this study that it is possible to increase the parent's knowledge of oral health but that changing the behavior of the parent actually performing the task is much more difficult.
The effects of a dietary supplement of fresh oranges on the oral health of children
(1973) Dilley, Gary J.; Roche, James R., 1924-; Starkey, Paul E.; House, James E., 1925-; Barton, Paul
The effects of additional citrus fruit in the diet on the periodontium have been a debated subject for some time. This study attempted to measure the effects of eating three additional oranges per day by 123 children ages six through twenty years and an equal number of controls over a 23-week period. To measure any changes that might take place, the following were evaluated clinically, and the decayed, missing and filled surfaces were also evaluated radiographically: 1. gingival status 2. plaque formation 3. D.M.F.S. and d.m.f.s. 4. white spots Results after the 23 week test period showed that the gingival scores increased significantly in both groups (increased inflammation). The plaque formation score also increased in both groups, but only the non-orange eaters' score increased significantly over their original score and over the orange eaters' score. The decayed, missing, and filled surfaces and white spots did not change significantly in either group. Therefore with this study sample over the 23-week test period, the additional oranges in the diet had limited measurable effect on the hard and soft tissues of the oral cavity.
The effects of apical modification on the vitality of replanted permanent monkey teeth
(1977) Walsh, John Senan, 1951-; Roche, James R., 1924-; El-Kafrawy, Abdel Hady, 1935-; Koerber, Leonard G.; Starkey, Paul E.; Stookey, George K.
A study was conducted on the effects in a rhesus monkey of increasing the surface area of pulpal tissue available for revascularisation and regeneration of nerves after replantation of permanent teeth. Four teeth were replanted and used for controls, including two with incomplete apical development. Twelve teeth with completed apical development were replanted immediately after apical modification to increase the surface area of exposed pulp. The technique consisted of creating a facial and lingual groove in the apical region and exposing additional pulpal tissue. Radiographs were taken periodically and the replanted teeth were stable during the study period. The monkey was sacrificed after 93 days. The first hypothesis, that the apically modified teeth would sustain a healthy periodontium clinically for a period of ninety days, was disproved. Histological sections of the teeth and their supporting tissues showed varying amounts of root resorption and ankylosis. All of the apically modified teeth showed pulp necrosis, while three of the four control teeth had reestablished blood and vascular supplies and appeared vital. Ingrowth of granulation tissue was seen in the replanted teeth with pulp necrosis including one control tooth which had failed to revascularize. The second hypothesis, that the apically modified teeth would demonstrate significantly more apical revascularisation and nerve regeneration than the control teeth, was also disproved. In conclusion, the apical modification technique as performed to increase the area available for regeneration of nerves and vessels was not a success. As expected, however, immediate replantation of avulsed teeth resulted in reestablishment of periodontal membrane attachments.
Environmental effects on dental student attitudes
(1972) Walker, Paul O., 1941-; Koerber, Leonard G.; Bixler, David; Englander, Meryl E.; Barton, Paul; Roche, James R., 1924-
The purpose of this thesis was to investigate the influence of the dental school environment upon certain attitudes of dental students. An initial attitudinal profile of beginning first-year dental students was established by means of the Allport-Vernon-Lindzey Study of Values. Using the same instrument, pre-test and post-test profiles were established for dental students at the beginning of the third year and after eight months of clinical exposure. A cross-sectional comparison was made of the initial profile of the first-year students with the pre-test and post-test profiles of the third-year students. A significant difference, at the .05 level of confidence, was observed in a comparison of the religious values of the first-year students with the pretest of the third-year students. No significant differences were observed in the other five values. In addition, no significant differences in any values were observed when the first-year students were compared to the post-test of the third-year students. A longitudinal comparison of the pre-test and post-test profiles were made. No significant differences were demonstrated for the entire sample and for each quartile in any of the six areas with which the Study of Values is concerned. Additional information was gathered for the third-year students by using a questionnaire. The questionnaire revealed dissatisfaction and frustration with various aspects of the dental school environment. Within the defined limitations of this study, it appears that the sample of third-year dental students at Indiana University School of Dentistry did not demonstrate measurable changes in values despite an indication of dissatisfaction and frustration with the dental school environment. From the answers to the questionnaire, it seems likely that some of this frustration could be reduced by an educational approach which would provide clearly stated course objectives and criteria for evaluation, earlier clinical exposure, elimination of repetitive course content, more individualized instruction, and more informality in the teaching-learning environment.
Evaluation of a sterile pulpotomy procedure
(1983) Roche, James R., 1924-
Pulpotomy procedures for the treatment of pulp exposure or disease have traditionally used an approach from the occlusal surface in primary molars, with a rotating bur or a spoon excavator being used to excise the pulp under clean conditions and with a medicament being applied to the amputation site. The purpose of this study was: (1) to determine the feasibility of performing a sterile scalpel excision of coronal pulpal tissue and (2) to evaluate wound healing after a shield has been placed to prevent all substances from touching the blood clot at the amputation site. Using sterile operating room procedures, four of five teeth in five dogs were rendered free of cultivable bacteria after antimicrobial treatments were applied. These findings replicated a preliminary in vivo experiment of 45 teeth which demonstrated that antimicrobial agents applied to tooth enamel in dogs were effective beyond the 0.001 level of significance, as compared to a control group. Furthermore, in the main study, negative cultures were obtained during 72 percent of the trials following each of the five major steps in the pulpotomy procedure. This included 80 percent negative cultures for bacteria after pulpal excision and blood clot formation, and 100 percent freedom from cultivable bacteria after a resin diaphragm was cemented to place. In eight experimental teeth (three from the preliminary study and all five from the main study) the buccal dentin over the coronal portion of the pulp was removed by use of a tissue-protecting device without grossly macerating the pulpal tissue. In seven of these eight teeth, the coronal portion of the pulp tissue was amputated with a scalpel severance and pulpal biopsies were removed through the buccal preparation. In all eight teeth, the cavity preparation was accomplished without applying medicaments to the blood clot at the amputation site. A resin-stainless steel diaphragm was constructed under sterile conditions and secured in a buccal preparation without touching the pulpal amputation for a convalescence of 14-21 days, and this shield provided a buccal wall for closure with an amalgam restoration. In one animal which had not received a previous autotransfusion for medical research, histologic sections of the pulp tissue in two root canals demonstrated satisfactory wound healing (a moderate and a mild inflammatory infiltrate was considered reversible). Three of the five dogs in the main study exhibited pulpal necrosis which was attributed to an interference in the immune system by previous autotransfusion research, and histologic evaluation of pulpal wound healing was therefore inconclusive. This study demonstrates that the enamel surface can be rendered free of cultivable bacteria in the dog and the operative site can be maintained in this condition throughout pulpotomy, with the coronal portion of the pulp being removed without grossly macerating the pulp. Under these conditions there appears to be a potential for satisfactory wound healing, with possible implications for the clinical situation.
An evaluation of tetracycline stain removal by bleaching vital rabbit incisors
(1974) Fleege, Patrick A.; Roche, James R., 1924-; Klein, Arthur Irving, 1922-2004; Katz, Simon, 1920-1987; Koerber, Leonard G.; Mitchell, David F.
This study evaluated the effectiveness of bleaching tetracycline-stained teeth by measuring the loss of fluorescent intensity from teeth that were bleached. Nineteen male New Zealand white rabbits, with 58 incisors stained with oxytetracycline and 16 incisors as unstained controls, were used. Three rabbits were sacrificed to determine whether the tetracycline stain was comparable between incisors in the same jaw. Of the remaining 16 animals, 6 were bleached once and 10 were bleached twice. One maxillary and one mandibular incisor were bleached in each jaw with 30 percent hydrogen peroxide and heat for ten minutes per tooth; the other incisors were protected with a rubber dam. The animals were sacrificed 24 hours after the last bleach. The fluorescent intensity of 374 select ground sections 100 ± 5 microns thick from the incisal, middle and gingival thirds of the teeth were measured with an ultraviolet light microscope coupled to a television electronic measurement system. These measurements were statistically analyzed by t-test, and observations correlated. The dentin of tetracycline-stained maxillary incisors which were bleached twice and the dentin in the incisal one-third of the mandibular incisors which were bleached twice had a significantly (P ≤ 0.001, P ≤ 0.005) lower tetracycline fluorescent intensity than the dentin of unbleached tetracycline-stained teeth. The greatest loss of fluorescent intensity of tetracycline occurred in dentin closest to the dentino-enamel junction and varied from about 150 to 350 microns from the outer enamel surface. Clinical Kodachromes indicate that the loss of tetracycline pigment is associated with the loss of tetracycline fluorescence; The ground sections showed that the tetracycline fluorescence was never totally removed by two bleaches.
A laboratory comparison of the adhesion of unfilled and composite resins to acid etched enamel
(1973) Aubuchon, Robert W. (Robert Wayne), 1946-; Starkey, Paul E.; Swartz, Marjorie L.; Koerber, Leonard G.; Barton, Paul; Roche, James R., 1924-
The purpose of this laboratory study was to determine if the bond strengths of composite resins and unfilled resins was affected similarly when applied to enamel surfaces which had been previously etched with 50 per cent phosphoric acid. The test specimens were subjected to 24 hours, 30 days, and 6 months storage in water and then subjected to temperature stress cycling and intermittent tensile stress cycling. A tensile test was used to measure the bond strengths of the composite resins (Adaptic and HL-72) and the unfilled resin (Sevriton). The following results were obtained: (1) Pretreating the enamel surface with 50 per cent phosphoric acid for 60 seconds significantly increased the bond strength of composite resins; (2) when placed on acid etched enamel, there was no significant difference in initial bond strengths obtained for the Adaptic and unfilled Sevriton resins; (3) with prolonged water storage, the Adaptic composite resins developed significant loss of bond strength when compared to the unfilled Sevriton resins and the composite HL-72 resins; (4) when Adaptic resins and the HL-72 resin specimens were compared, there was no significant difference in initial bond strengths but the HL-72 specimens were less affected by storage time. Ca45 was used to assess the marginal seal of Adaptic, HL-72, and Sevriton in acid etched and non-etched Class V restorations. One-half of the specimens were thermal cycled 2500 times and stored in water for one week. Control specimens were tested at the end of one week without the thermal cycle. On the basis of these results, it was concluded that acid etching enhances the marginal seal of both composite and unfilled resins. Both composite and unfilled resins experienced increased marginal leakage when the acid etch preparations were thermal cycled, but there were no observable difference in the marginal seal of unfilled resins and composite resins when placed in acid etched restorations.
Vitamin - Fluoride supplements: effect on dental caries and fluorosis in sub-optimum fluoride areas
(1975) Hennon, David Kent, 1933-; Roche, James R., 1924-; El-Kafrawy, Abdel Hady, 1935-; Bixler, David; Katz, Simon, 1920-1987; Standish, S. Miles, 1923-2003; Mitchell, David F.
This study was designed to determine if additional fluoride, ingested as a sodium fluoride - vitamin supplement would provide added protection against dental caries without causing any significant fluorosis. A total of 456 children, one to 14 months of age, residing in cities having 0.6 - 0. 8 ppm F in the water supply were randomly assigned according to age, sex and community to the following groups : Group A, 0. 5 mg F to age 3 then 1. 0 mg thereafter; Group B (control), vitamins throughout the study; and Group C, 0.5 mg F throughout the study. Dental examinations were started at approximately 2 1/2 to 3 years of age and were repeated every six months. A fluorosis examination ended the study after about seven years. When compared according to length of time on product, Group A had a significant reduction in deft and defs of 42.2 and 47.1 percent at 60 months. Group C had a 32.1 and 37.4 percent reduction. When compared by age, Group A had a 37.5 and 44.8 percent reduction in deft and defs at 66 months. Group C had a 34.3 and 40.1 percent reduction for the same period. No significant reductions were observed in permanent teeth. Based on the fluorosis index (Group A - 0.250; Group B - 0.033; and Group C - 0.188) none of the groups had any unacceptable amounts of fluorosis. The results indicate that up to 1.0 mg per day of additional fluoride does not cause objectionable fluorosis and may be ingested safely by children residing in areas containing 0. 6 - 0. 8 ppm F in the water supply. A 0.5 mg F supplement was almost as effective as a 1.0 mg level in providing added protection against dental caries in primary teeth.

Browsing by Author "Roche, James R., 1924-"

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