Download Draft of minutes of Dec 3 meeting

Minutes
Dentistry SIG
December 3, 2013
Go to Meeting attendees: Marie Braithwithe, Penni Hernandez, Gerry Wade, Jim Case, Jean
Narcisi, Ornela Besho, Dave Preble, Elsbeth Kalenderian, Joel White, Tim Brown, Doug
Gordon, Jorn-Andre Jorgensen, Carla Evans, Mark Jurkovich
The minutes of the previous meeting were not reviewed, but a follow up email recommended a
correction of an orthodontic concept discussion from using the word plan to the correct word
plane.
A discussion of caries severity terms and modeling was held next. Dr. Wade provided a review
of the severity qualifier within SNOMED CT. Following that, a number of points were
reviewed:
1) There is a need to identify active versus arrested versus chronic caries.
2) Tooth and surface is recorded within an odontogram and likely do not need to be part of
the development, as they are currently represented within the odontogram in most
systems (this may be a separate issue that needs more discussion in the future).
3) Extent and activity are probably the key elements we need to determine and evaluate.
4) There are many terms already existing for caries and the SIG will likely need to make
recommendation on the preferred terms, synonyms, and possibly those that are no longer
used in the profession.
5) Jim Case pointed out that severity and extent should not be used in the same qualifier
value and that extent is not supported as a separate concept.
6) Joel White commented that this may result in a need to pre-coordinate terms to meet the
editorial requirements.
7) Joel White will develop a preliminary diagram and suggestions as a starting point for
analyzing terms and possible design/modeling suggestions.
8) Jean Narcisi will provide Joel White with the work that has been done by ADA Councils
on caries severity indices.
This discussion will be continued at the next Dentistry SIG meeting.
Next, Jorn-Andre Jorgensen led a discussion on developing similar terms for each tooth, using
the fully specified name of each permanent and primary tooth as the basis for identifying
synonyms. Jorn-Andre provided an Xcel spreadsheet (available on the Collabnet under this
meeting list of documents). Jim Case and Gerry Wade provided the SIG with information on
how we might need to make recommendations involving the various systems that use numbers to
represent teeth. They normally need to include a written description, much like the FSN. The
ISO, Universal, Halderup, and possibly Palmer systems may need to be added. Jorn-Andre will
update the spreadsheet and we can review and possibly finalize our recommendations at the next
meeting. One term appears to be contradictory and Mark Jurkovich will work with the editors to
learn how to correct this term. The term is identified in red on the spreadsheet.
The next discussion involved the ability to properly represent substances/materials when
identifying the type of restoration that is currently present on/in a tooth. In particular, the
concern is that it is often difficult to identify the specific substance. Further, electronic dental
systems generally allow for planning of future treatment that includes specific teeth and
materials and reporting those services for payment generally involves the use of a different
terminology, at least within the United States. Terminologies used for reimbursement, such as
CPT are not mapped or represented within SNOMED CT. Thus, while the PowerPoint
(available in the document section of the Dentistry SIG for the Dec 3 meeting) has arrows to
these three “phases”, it appeared to be the consensus of the group that the primary need at this
point was to be able to document the current status of findings in a way that could include
substances. Gerry Wade pointed out that some of this might already be covered within the
“situation” concept of SNOMED CT. The history of the substances/materials and those that are
planned are already modeled. However, Gerry Wade suggested that we look at what is currently
included in SNOMED CT and then determine what the Dental SIG believes in needed.
Jim Case made the group aware that physical objects cannot be used in a procedure model but
can be used in clinical findings. Within the procedure category, it is possible to use devices
(direct and indirect). It may be worth considering modeling certain dental “materials” as objects
or substances or devices. Joel White pointed out that it is possible that no dental materials are
actually devices.
Mark Jurkovich agreed to take the current flow chart and revise it to include known substances
and compare it to current SNOMED CT terms already available to identify any gaps. Doug
Gordon suggested that we make sure Zirconia is included and Joel White made a similar point
about silicates. A new chart will be forwarded to the group prior to the next meeting for
discussion at that meeting.
Gerry Wade next gave a brief PowerPoint presentation concerning editorial content guidelines.
It is also posted and available on the Colabnet.
Due to time constraints, Mark Jurkovich postponed discussion on what recommendations the
group might make concerning administrative codes, and periodontal codes, which might be
modeled either pre or post coordinated and that review was also postponed until the next
meeting.
A brief discussion was held concerning two orthodontic concepts and the group affirmed Gerry
Wade’s interpretation of them.
Mark Jurkovich provided a brief update on the possible face to face meeting in April in
Copenhagen. We are waiting to finalize the plans, based on availability of IHTSDO staff to
assist at our meeting. As soon as it is finalized, SIG participants will be notified. Mark
Jurkovich will send out the tentative date for this meeting and the next SIG meeting planned for
February.
The meeting was then adjourned.