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Cole JR, Dodge WW, Findley JS, Horn BD, Kalkwarf KL, Martin MM, Valachovic RW, Winder RL, Young SK. Interprofessional Collaborative Practice: How Could Dentistry Participate? J Dent Educ 2018; 82:441-445. [DOI: 10.21815/jde.018.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/30/2018] [Indexed: 11/20/2022]
Affiliation(s)
- James R. Cole
- Private oral/maxillofacial surgery group practice; Albuquerque NM
| | - William W. Dodge
- University of Texas Health Science Center at San Antonio School of Dentistry
| | | | | | - Kenneth L. Kalkwarf
- University of Texas Health Science Center at San Antonio School of Dentistry
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Cole JR, Dodge WW, Findley JS, Young SK, Horn BD, Kalkwarf KL, Martin MM, Winder RL. Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.5.tb05905.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - William W. Dodge
- University of Texas Health Science Center at San Antonio School of Dentistry
| | | | | | | | - Kenneth L. Kalkwarf
- University of Texas Health Science Center at San Antonio School of Dentistry
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Cole JR, Dodge WW, Findley JS, Young SK, Horn BD, Kalkwarf KL, Martin MM, Winder RL. Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice. J Dent Educ 2015; 79:465-471. [PMID: 25941139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.
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Affiliation(s)
- James R Cole
- Dr. Cole is retired from private oral/maxillofacial surgery practice in Albuquerque, New Mexico; Dr. Dodge is Dean, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Findley practices general dentistry in Plano, Texas; and Dr. Young is Dean Emeritus, University of Oklahoma College of Dentistry
| | - William W Dodge
- Dr. Cole is retired from private oral/maxillofacial surgery practice in Albuquerque, New Mexico; Dr. Dodge is Dean, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Findley practices general dentistry in Plano, Texas; and Dr. Young is Dean Emeritus, University of Oklahoma College of Dentistry
| | - John S Findley
- Dr. Cole is retired from private oral/maxillofacial surgery practice in Albuquerque, New Mexico; Dr. Dodge is Dean, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Findley practices general dentistry in Plano, Texas; and Dr. Young is Dean Emeritus, University of Oklahoma College of Dentistry
| | - Stephen K Young
- Dr. Cole is retired from private oral/maxillofacial surgery practice in Albuquerque, New Mexico; Dr. Dodge is Dean, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Findley practices general dentistry in Plano, Texas; and Dr. Young is Dean Emeritus, University of Oklahoma College of Dentistry
| | - Bruce D Horn
- Dr. Horn practices general dentistry in Tulsa, Oklahoma; Dr. Kalkwarf is Dean Emeritus, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Martin is retired from private general dentistry practice in Lincoln, Nebraska; and Dr. Winder practices pediatric dentistry in Tulsa, Oklahoma
| | - Kenneth L Kalkwarf
- Dr. Horn practices general dentistry in Tulsa, Oklahoma; Dr. Kalkwarf is Dean Emeritus, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Martin is retired from private general dentistry practice in Lincoln, Nebraska; and Dr. Winder practices pediatric dentistry in Tulsa, Oklahoma.
| | - Max M Martin
- Dr. Horn practices general dentistry in Tulsa, Oklahoma; Dr. Kalkwarf is Dean Emeritus, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Martin is retired from private general dentistry practice in Lincoln, Nebraska; and Dr. Winder practices pediatric dentistry in Tulsa, Oklahoma
| | - Ronald L Winder
- Dr. Horn practices general dentistry in Tulsa, Oklahoma; Dr. Kalkwarf is Dean Emeritus, University of Texas Health Science Center at San Antonio School of Dentistry; Dr. Martin is retired from private general dentistry practice in Lincoln, Nebraska; and Dr. Winder practices pediatric dentistry in Tulsa, Oklahoma
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Affiliation(s)
- Gene A. Kramer
- Department of Testing Services, American Dental Association; University of Colorado
| | - Judith E.N. Albino
- Department of Oral and Craniofacial Biology; School of Dental Medicine; Department of Community and Behavioral Health; Colorado School of Public Health; University of Colorado; Denver
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Kramer GA, Albino JEN, Andrieu SC, Hendricson WD, Henson L, Horn BD, Neumann LM, Young SK. Dental student assessment toolbox. J Dent Educ 2009; 73:12-35. [PMID: 19126764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Gene A Kramer
- American Dental Association, Chicago, IL 60611-2637, USA.
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Sanders JO, Browne RH, Mooney JF, Raney EM, Horn BD, Anderson DJ, Hennrikus WL, Robertson WW. Treatment of femoral fractures in children by pediatric orthopedists: results of a 1998 survey. J Pediatr Orthop 2001; 21:436-41. [PMID: 11433152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
SUMMARY This study aimed to determine treatment preference of various femoral fracture patterns in children by pediatric orthopedists and whether it is practice dependent. In September 1998, members of the Pediatric Orthopedic Society of North America were surveyed to determine their current preferences in treating each of four middle one-third femoral fracture patterns in four age groups. Forty-four percent (286/656) of those surveyed responded. For each fracture pattern, operative treatment was increasingly preferred over nonoperative as patient age increased, and the preferred treatments within the operative and nonoperative categories changed significantly as patient age increased. Fourteen specific cases of femoral head avascular necrosis were noted after rigid reamed and unreamed rodding. There is a statistically significant trend by pediatric orthopedists to treat older children's femur fractures operatively and younger children's nonoperatively. The consensus treatment is age dependent. The numerous cases of avascular necrosis after rigid rodding are a concern.
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Affiliation(s)
- J O Sanders
- Shriners Hospitals for Children, Erie, Pennsylvania 16505, U.S.A.
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Horn BD, Crisci K, Krug M, Pizzutillo PD, MacEwen GD. Radiologic evaluation of juvenile tillaux fractures of the distal tibia. J Pediatr Orthop 2001; 21:162-4. [PMID: 11242242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This study evaluated the accuracy of plain radiographs and computerized tomography (CT) in assessing juvenile Tillaux fractures of the distal tibia. A simulated Tillaux fracture was made in four cadaver specimens and displaced 0, 1, 2, 3, and 5 mm. Plain radiographs and CT were performed on each specimen at each amount of displacement, and the results were compared with the actual amount of displacement present. Plain radiographs and CT were accurate within 1 mm in depicting the actual fracture displacement about 50% of the time. CT was more sensitive than plain radiographs in detecting fractures with >2 mm of displacement. Fracture displacement of >2 mm is generally considered an indication for fracture reduction. Because of its sensitivity in detecting fractures displaced >2 mm, CT is the preferred imaging modality in the assessment of juvenile Tillaux fractures.
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Affiliation(s)
- B D Horn
- St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
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Abstract
Stubbing injuries to the great toe can be a cause of occult open fractures and osteomyelitis. Five such patients were identified after conducting a retrospective review of injuries to the hallux between January 1998 and December 1998. The study was conducted to draw attention to the association between this trivial trauma and its possible complications. All five children had open fractures of the distal phalanx of the great toe. Osteomyelitis did not develop in the children whose injuries were recognized early and who were treated with antibiotics. However, three children with delayed diagnoses and treatment developed osteomyelitis. At a mean follow-up of 10 months (range, 9-11) after injury, all five fractures had healed with no active signs of infection. Two of these children experienced a partial growth arrest and two experienced a full growth arrest of the distal phalanx of the great toe, the significance of which is yet unknown. Clinical signs such as bleeding from the eponychium and a laceration proximal to the nail bed should alert physicians to the presence of a possible open fracture. Early detection and treatment of these injuries may reduce or eliminate hospital stays and prolonged intravenous antibiotic treatment for osteomyelitis.
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Affiliation(s)
- D R Kensinger
- Saint Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA
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Horn BD, Crisci K, Pawel B, Horowitz S. Refusal to walk in a 3-year-old girl. Clin Orthop Relat Res 1997:248-53, 258-60. [PMID: 9418647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- B D Horn
- Orthopaedic Center for Children, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA
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Abstract
Cubitus varus may occur after supracondylar humerus fractures. Poor fixation, however, complicates operative treatment of cubitus varus. We discuss the use of external fixation in the treatment of cubitus varus. Five patients had humeral osteotomies with external fixation. The preoperative humeroulnar angle (HUA) averaged -24.2 degrees. The immediate postoperative HUA averaged 12 degrees, and the final angle averaged 13 degrees. Duration of external fixation averaged 8.9 weeks. Complications were one transient radial neurapraxia, one superficial pin infection, and one keloid. No loss of correction or motion occurred with external fixation; we recommend external fixation as safe and effective.
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Affiliation(s)
- M J Levine
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Abstract
PURPOSE To compare computed tomography (CT) and magnetic resonance (MR) imaging in the detection, localization, and characterization of tarsal coalitions. MATERIALS AND METHODS Preoperative CT and MR images were obtained for 10 feet in nine patients (eight male and one female patients), aged 11-18 years who were unresponsive to conservative therapy. Results from two blinded readers were compared with results from surgery. RESULTS Five calcaneonavicular and four medial subtalar coalitions were found at surgery. One patient had synovitis. CT depicted six coalitions and four were characterized correctly, but the fibrous coalitions were not characterized correctly. MR depicted all coalitions and seven were characterized correctly, including the fibrous coalitions. At MR imaging, proliferative synovitis was incorrectly characterized as a fibrous coalition. CONCLUSION These results suggest that MR imaging depicts all coalitions but may not be able to help differentiate synovitis from fibrous coalitions and that CT has limitations in the depiction of fibrous coalitions.
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Affiliation(s)
- R J Wechsler
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107
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Abstract
The Gustilo and Anderson classification system is widely used to categorize open fractures. To assess its interobserver reliability, 10 patients with open fractures had photographic slides taken of their wound before and after operative treatment. These slides were then shown to a group of orthopaedic surgeons. After an explanation of the Gustilo and Anderson classification system and each patient's pertinent history and physical examination, the physicians were asked to classify the fracture. Agreement among the various raters was determined by Kappa analysis, which is the preferred measurement of interobserver reliability for nominal data such as classification schemes. Kappa analysis demonstrated only moderate agreement among the observers classifying open fractures using the Gustilo and Anderson system. This seems to indicate that, although useful, the Gustilo and Anderson open fracture classification system does have limitations; studies and treatment recommendations based on it should be interpreted with caution.
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Affiliation(s)
- B D Horn
- Department of Orthopaedic Surgery, Bellevue Hospital Center, New York, New York
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Abstract
A wide variety of disorders affects the pediatric hip. The most common of these are developmental dysplasia of the hip, Legg-Calvé-Perthes disease, and slipped capital femoral epiphysis. Magnetic resonance imaging and ultrasound improve the imaging of these diseases, but the ultimate impact of this technology on treatment is unknown. Complications of treatment for these and other pediatric hip diseases can be devastating; so much recent research concentrates on the etiology, prevention, and effects of these complications. Finally, these diseases occur in skeletally immature individuals, and long-term follow-up is essential for accurate evaluation of results.
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Affiliation(s)
- B D Horn
- Shriners Hospital for Crippled Children, Los Angeles Unit, California
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