Application of PERT/CPM in dental practice

Bo-Kuk Kim; Jae-Hyun Kim; Jin-Keun Dong

doi:10.4047/jkap.2014.52.3.186

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Kim, Kim, and Dong: Application of PERT/CPM in dental practice

Original Article

J Korean Acad Prosthodont 2014;52(3):186-194.

Published online: 9 February 2014

DOI: https://doi.org/10.4047/jkap.2014.52.3.186

Application of PERT/CPM in dental practice

Bo-Kuk Kim, Jae-Hyun Kim, Jin-Keun Dong^∗

Department of Prosthodontics, School of Dentistry, Wonkwang University, Jeonbuk, Republic of Korea

^∗Corresponding Author: Jin-Keun Dong Department of Prosthodontics, College of Dentistry, Wonkwang University, 460 Iksandae-ro, Iksan, 570-749, Republic of Korea +82 63 850 6852: e-mail, dong@wonkwang.ac.kr

This paper was supported by wonkwang university in 2014

Received 12 May 201410 July 2014 Accepted 16 July 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Process management is the activity which manages all procedure of construction by representing visually interrelation of operation or sequence setting. The purpose of this study was for reducing treatment period and higher efficiency of treatment through application of PERT/CPM (Program Evaluation & Review Technique/Critical Path Method) in dental clinic.

Materials and methods

The patients were selected for study who needed more than 2 departments' cooperation for prosthodontic treatment in Wonkwang Dental University Hospital. Control group is composed of the patient's whole treatment plan, treatment period, numbers of hospital visit, treatment costs, treatment results. On the other hand, experiment group contains the patient's virtual treatment data based on PERT/CPM technique. We applied PERT/CPM in operation analysis.

Results

Treatment period, numbers of hospital visit was decreased as 18.1% and 15.3% when we applied operation analysis based on charts. Also treatment cost in experiment group was 0.9% economized compared with control group's treatment cost.

Conclusion

Application of PERT/CPM in dental clinic can achieve reliable treatment and reduced treatment period and establish plan of minimum treatment cost.

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Keywords: Prosthodontics, Process management, PERT/CPM

REFERENCES

1. Johnston JF, Dykema RW, Goodacre CJ, Phillips RW, Johnston JF. Johnston's Modern practice in fixed prosthodontics. 4th ed.Philadelphia; PA: Saunders;1986.

2. Vanhoucke M. Project Management with Dynamic Scheduling: Baseline Scheduling, Risk Analysis and Project Control. 2 ^nd ed. Dordrecht;. Springer;2013. p. 45–50.

3. Vanhoucke M, Demeulemeester E. The application of project sched-uling techniques in a real-life environment. Proj Manage J. 2003; 34:30–42.

4. Vanhoucke M. On the dynamic use of project performance and schedule risk information during projecttracking. Omega. 2011; 39:416–26.

5. Kelley JE Jr. Critical-Path Planning and Scheduling: Mathematical Basis. Oper Res. 1961; 9:296–320.

6. Zarb GA, Bolender CL, Eckert SE. Prosthodontic treatment for edentulous patients: Complete dentures and implant-supported prostheses. 12th ed.St. Louis: Mosby;2004.

7. Kruger GO. Textbook of oral and maxillofacial surgery. 6th ed.C.V. Mosby;1980.

8. Albrektsson T, Bra�nemark PI, Hansson HA, Lindstro¨m J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981; 52:155–70.

9. Bryant SR, Zarb GA. Osseointegration of oral implants in old-er and younger adults. Int J Oral Maxillofac Implants. 1998; 13:492–9.

10. Lytle JD. Clinician's index of occlusal disease: definition, recognition, and management. Int J Periodontics Restorative Dent. 1990; 10:102–23.

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Fig. 1.

Flow chart of PERT/CPM. In the flow chart A to G is indicated as the event of project, arrows as activity of project, and numbers as period between events.

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Fig. 2.

Microsoft Office Project Professional 2010 (Microsoft, Seattle, Washington, USA).

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Fig. 3.

Example of patient's actual treatment process.

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Fig. 4.

Example of patient's virtual treatment process.

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Fig. 5.

Comparison of control group and experimental group in treatment period.

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Fig. 6.

Comparison of control group and experimental group in the numbers of hospital visit.

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Fig. 7.

Comparison of control group and experimental group in treatment cost.

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Table 1.

Cooperated departments for each patient

No.	Age	Sex	Departments
1	70	M	DPR, DOMR, DOMS, LAB
2	58	F	DPR, DOMR, DCO, DOMS, LAB
3	80	M	DPR, DOMR, DOMS, LAB
4	89	F	DPR, DOMR, LAB
5	58	M	DPR, DOMR, DOMS, LAB
6	47	M	DPR, DOMR, DCO, DOMS, LAB
7	68	M	DPR, DOMR, DCO, DOMS, LAB
8	60	M	DPR, DOMR, DOMS, LAB
9	74	M	DPR, DOMR, DPE, DCO, DOMS, LAB
10	63	F	DPR, DOMR, DPE, DOMS, LAB
11	80	M	DPR, DOMR, DOMS, LAB
12	80	M	DPR, DOMR, DOMS, LAB
13	84	F	DPR, DOMR, DOMS, LAB
14	81	F	DPR, DOMR, DPE, DCO, LAB
15	82	F	DPR, DOMR, DPE, DCO, LAB

^∗ DCO: Department of Conservative, DOMR: Department of Oral & Maxillofacial Radiology, DOMS: Department of Oral & Maxillofacial Surgery, DPE: Department of Periodontics, DPR: Department of Prosthodontics, LAB: Dental Laboratories.

Table 2.

Mean treatment period of procedure in other studies

Treatment procedure	Mean treatment period	Author
Immediate denture	3 months	Zarb et al.⁶
Tooth extraction	5 - 7 days	Kruger⁷
Implant placement	3 - 6 months	Albrektsson et al.⁸
	2 - 3 months	Bryant and Zarb⁹
Vertical dimension establishment	3 months	Lytle¹⁰

Table 3.

Mean manufacturing period of dental laboratory in Wonkwang Dental Hospital (2012.1.1 - 2012.12.31)

Work list	Manufacturing period (days)
Record base, occlusal rim	6.04
RPD framework	7.51
Wax denture	7.64
Ceramic metal framework	8.75
Denture polymerization	8.81
Gold crown, bridge	9.13
Ceramic crown, bridge	10.08
Implant temporary crown	8.24
Immediate denture (TPD)	5.67
Cast post	5.92

Table 4.

Treatment plan for each patient

No.	Treatment plan
1	Treatment planning
	Extraction on #15,17,21,25,31,32,36,41,42,45
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Removable partial denture
2	Treatment planning
	Extraction on #17,26,27,37,44,47, Mx. & Mn. TPD, F/U check
	#11,12,22,23,24 Caries Tx., #33 RCT
	Mx. & Mn. Removable partial denture
3	Treatment planning
	Mn. alveoloplasty, Mx. & Mn. TPD, F/U check
	Mx. & Mn. Complete denture
4	Treatment planning
	None
	Mx. & Mn. Complete denture
5	Treatment planning
	Extraction on #11,12,21,32,34,36,37,42,44,45,46,47
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Implant fixed prosthesis, Mn. fixed partial denture
6	Treatment planning
	Extraction on #18,28,38,48, Bite rasing, F/U check
	#13,21,22 RCT, #27,37,47 Caries Tx., #11,12,13,21,22 post&core
	Mx. fixed partial denture
7	Treatment planning
	Extraction on #22,34,35,41,42, #12,13,43 RCT
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Removable partial denture
8	Treatment planning
	Extraction on #11,12,21,22,24,25,44,45,48, Implant immediate loading
	Mx. & Mn. Implant fixed prosthesis
9	Treatment planning
	Extraction on #13,18,23,24,27,36,38,48, Mx. & Mn. TPD, F/U check
	#33,34,43,44 RCT, CLP, post&core
	Mx. Removable partial denture, Mn. fixed partial denture
10	Treatment planning
	Extraction on #11,12,15,16,26,31,34,41,42, Mx. & Mn. TPD, F/U check
	Mx. & Mn. Removable partial denture
11	Treatment planning
	Extraction on #21,22,32,33,42
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Complete denture
12	Treatment planning
	Extraction on #21,23,31,32,35,41,42,43,45,46
	Mx. & Mn. TPD, F/U check
	Mx. Complete denture, Mn Removable partial denture
13	Treatment planning
	Extraction on #11,12,13,14,15,16,17,21,22,23,24,31,32,33,41,42,43
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Complete denture
14	Treatment planning
	Extraction on #16,18,26,31,32,36,41,42,46,47
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Removable partial denture
15	Treatment planning
	Extraction on #11,16,21,22,25,26,31,32,38,41,42,43
	Mx. & Mn. TPD, F/U check
	Mx. & Mn. Removable partial denture

Table 5.

Each patient's actual treatment period, numbers of hospital visit, treatment cost in our study

No.	Treatment period (days)	Hospital visit (numbers)	Treatment cost (won)
1	189	26	7,115,486
2	166	24	3,436,282
3	63	13	2,553,213
4	27	7	2,223,947
5	302	47	37,539,531
6	156	20	7,935,805
7	117	25	6,370,396
8	263	42	416,789,321
9	168	31	12,565,284
10	131	22	11,180,424
11	65	9	2,510,430
12	80	18	4,701,877
13	120	17	3,656,572
14	301	28	5,251,530
15	240	30	7,122,147

Table 6.

Each patient's virtual treatment period, numbers of hospital visit, treatment cost in our study

No.	Treatment period (days)	Hospital visit (numbers)	Treatment cost (won)
1	162	21	6,895,886
2	147	19	3,392,931
3	66	12	2,508,573
4	29	7	2,223,947
5	276	36	37,411,191
6	97	16	7,882,085
7	87	21	6,207,692
8	168	36	41,250,764
9	129	27	12,457,580
10	84	19	11,173,939
11	62	9	2,510,430
12	82	16	4,665,037
13	98	15	3,627,292
14	256	22	5,163,690
15	212	25	7,048,947

Table 7.

Mean value and statistical significance of treatment period

	Object	Mean	SD	t	P
Treatment period	Control	159.20	85.526	4.243	.001
Treatment period	Experiment	130.33	72.691	4.243	.001

Table 8.

Mean value and statistical significance of the numvers of hospital visit

	Object	Mean	SD	t	P
Hospital visits	Control	23.93	11.026	6.122	.000
Hospital visits	Experiment	20.27	8.900	6.122	.000

Table 9.

Mean value and statistical significance of treatment cost

	Object	Mean	SD	t	P
Treatment cost	Control	10,389,457	12,269,799	3.299	.005
Treatment cost	Experiment	10,294,666	12,189,308	3.299	.005

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