PBL core skills faculty development workshop 1: An experiential exercise with the PBL process

This report describes the first in a series of foundation-building faculty development workshops focused on the instructional methodology of problem-based learning (PBL). The PBL Process workshop reported here introduced the learning theory topics supporting PBL and utilized an extended roleplay method to provide participants with personal experience with the PBL learning cycle. Overall, participants were satisfied with the methods and content of the workshop. A majority of survey respondents indicated that simulating a complete iteration of the PBL process was an effective way to learn about PBL. Participants expressed relatively greater difficulty understanding and performing activities related to qualitative assessment of learning processes. The workshop was developed to align with adult learning principles, and continued refinement of the workshop has enhanced the learning theory components underpinning PBL as well as the experiential aspects. These dual goals have resulted in blending the existing experiential workshop with an online distance-learning component addressing the learning theory topics relevant to PBL pedagogy.     

Age,period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

Background

Microbial communities inhabiting human mouth are associated with oral health and disease. Previous studies have indicated the general prevalence of adult gingivitis in China to be high. The aim of this study was to characterize in depth the oral microbiota of Chinese adults with or without gingivitis, by defining the microbial phylogenetic diversity and community-structure using highly paralleled pyrosequencing.

Methods

Six non-smoking Chinese, three with and three without gingivitis (age range 21-39 years, 4 females and 2 males) were enrolled in the present cross-sectional study. Gingival parameters of inflammation and bleeding on probing were characterized by a clinician using the Mazza Gingival Index (MGI). Plaque (sampled separately from four different oral sites) and salivary samples were obtained from each subject. Sequences and relative abundance of the bacterial 16 S rDNA PCR-amplicons were determined via pyrosequencing that produced 400 bp-long reads. The sequence data were analyzed via a computational pipeline customized for human oral microbiome analyses. Furthermore, the relative abundances of selected microbial groups were validated using quantitative PCR.

Results

The oral microbiomes from gingivitis and healthy subjects could be distinguished based on the distinct community structures of plaque microbiomes, but not the salivary microbiomes. Contributions of community members to community structure divergence were statistically accessed at the phylum, genus and species-like levels. Eight predominant taxa were found associated with gingivitis: TM7, Leptotrichia, Selenomonas, Streptococcus, Veillonella, Prevotella, Lautropia, and Haemophilus. Furthermore, 98 species-level OTUs were identified to be gingivitis-associated, which provided microbial features of gingivitis at a species resolution. Finally, for the two selected genera Streptococcus and Fusobacterium, Real-Time PCR based quantification of relative bacterial abundance validated the pyrosequencing-based results.

Conclusions

This methods study suggests that oral samples from this patient population of gingivitis can be characterized via plaque microbiome by pyrosequencing the 16 S rDNA genes. Further studies that characterize serial samples from subjects (longitudinal study design) with a larger population size may provide insight into the temporal and ecological features of oral microbial communities in clinically-defined states of gingivitis.     

The sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening

OBJECTIVES: To assess the sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening. METHODS: Following screening at a clinic, 87 subjects were given an array of tooth whitening products to use at home and reviewed 8 weeks later. Subjects self-completed the 49-item Oral Health Impact Profile (OHIP) at baseline and follow-up, and rated their satisfaction with the whiteness of their teeth compared to baseline on a global transition scale. RESULTS: In terms of sensitivity, observed changes were apparent in overall OHIP scores (P<0.05) and across several domains, notably functional limitation (P<0.01). However, the magnitude of change (effect size) was generally small except for the functional domain. There was an observed gradient in observed change in OHIP scores and in the magnitude of such changes (effect sizes) in relation to global rating of satisfaction with the outcome, supporting the responsiveness of the measure. CONCLUSION: The OHIP scale is sensitive and responsive to the effects of tooth whitening. Greatest sensitivity and responsiveness was in relation to functional limitations. These findings have implications for the use of oral health related quality of life measures as an outcome measure of interventions aimed at improving dental aesthetics through tooth whitening.     

A simple method of making an implant-level impression when presented with limited space,unfavorable implant positions,or problematic implant angulations

Making an implant-level impression for the purpose of abutment selection when implants are placed in limited space, unfavorable positions, or compromising angulations can be a time-consuming procedure. An impression procedure is presented that makes use of either prefabricated screw-retained titanium implant index copings or plastic snap-on implant index copings to help resolve problematic implant placement. Both the titanium and plastic implant index copings are easy to modify and therefore make impression procedures more predictable.     

Glass ionomer cements: some factors in film thickness

Investigation of the film thicknesses of four luting glass ionomer cements over a range of powder/liquid ratios indicated that the four cements had a similar potential film thickness of approximately 28 μm. Scanning electron-microscopic examination revealed that the glass ionomer cement powders contain a small number of relatively large particles and an abundance of very fine particles.     

The influence of incorporated and adsorbed fluoride on the dissolution of powdered and pelletized hydroxyapatite in fluoridated and non-fluoridated acid buffers

The effects of fluoride (F) incorporated into hydroxyapatite (HA), adsorbed onto the HA surface, and fluoride in solution were studied during HA dissolution. Dissolution rates at pH 5.0 and 25 degrees C were determined in fluoridated (0.1, 5.0 micrograms/mL) and non-fluoridated buffers for the following powdered and pelletized synthesized HAs: non-fluoridated HA, partially-fluoridated (100, 1000, 37,000 micrograms/g) HA, and surface-adsorbed fluoridated (100, 1000 micrograms/g) HA. The dissolution rate curves were used to derive two components we have called 'diffusion' and 'surface chemical reactivity'. With powders, the rate-determining factor was surface chemical reactivity during the first 60 min. Diffusion was reduced by increasing the F levels in the apatite or buffer. In non-fluoridated buffers, diffusion was reduced 29% for apatite with 100 micrograms/g incorporated F and 99% with 37,000 micrograms/g. Diffusion was reduced by 37% and 81% by 0.1 and 5.0 micrograms/mL F, respectively, in the buffer. With pelletized HA, the rate-determining factor during the first 10 min was surface chemical reactivity. Diffusion then became relatively more important, but the diffusion rate was independent of F content. During the dissolution of powdered apatites, F was taken up by the remaining apatite solid, as evidenced by the lower F concentration in solution than that calculated to be released during dissolution. There was also a decrease in the F concentration of the 0.1 microgram/mL buffer as reaction progressed. Pelletized apatites did not release enough F to influence dissolution significantly. Surface-adsorbed F was more effective than incorporated F in reducing HA dissolution.(ABSTRACT TRUNCATED AT 250 WORDS)     

Treatment considerations in a geminated maxillary lateral incisor

A patient with anomalous maxillary lateral incisor was referred for endodontic therapy. A diagnosis of irreversible pulpitis of a geminated maxillary lateral incisor was made. The preoperative radiograph revealed an image of a single root canal but in fact the tooth had two separate and distinct root canals. Treatment considerations of this anomaly are discussed.     

One clinical visit for a multiple implant restoration master cast fabrication

The making of a one-piece, long-span, implant-supported prosthesis with conventional procedures frequently has difficulties associated with the accuracy of fit. This article presents a clinical and laboratory procedure for making an accurate implant working cast that facilitates fabrication of the casting on the master cast. The procedure demonstrates the process of sectioning and rejoining of the resin between the transfer copings and then pouring the impression by first joining the analogs alone with impression plaster, sectioning it, and rejoining it again to stabilize the analogs, and finally, using dental stone to pour the impression. Clinical, radiographic, and laboratory (optical microscope) measurements for one clinical implant restoration confirm the accuracy of fit of this one prosthesis made with this procedure. Its advantage is that it can allow fabrication of the final casting on the cast, thereby eliminating the clinical time necessary to obtain repetitive solder indexes, and thus minimizing inconvenience to the patient. (J Prosthet Dent 1997;78:550-3.)     

A retrospective evaluation of the eruption of impacted permanent incisors after extraction of supernumerary teeth

AIMS: Delayed eruption of teeth may be caused by the presence of one or more supernumerary teeth. The purpose of this study was to evaluate findings, predisposing factors and differentiate different techniques used that affect the outcome following removal of supernumerary teeth. A comprehensive literature review was also undertaken. METHODS: A longitudinal retrospective study was carried out at the Royal Liverpool Children's Hospital. A total of 120 patients were identified from the general anesthesia records that had supernumeraries extracted. Only 43 cases had delayed eruption of teeth caused by supernumeraries. The pre and post extraction record data collected were the gender, radiographic assessment, position of the supernumerary, age at time of referral and extraction of the supernumerary, age at time of eruption of the impacted tooth and the orthodontic and surgical management. RESULTS: The mean age of referral was 9.1 years with a male to female ratio of 4.4:1. There was a greater predilection for supernumeraries to be on the left side and be positioned palatally. Tuberculate type supernumeraries were the most frequent followed by the conical type. Spontaneous eruption of the impacted tooth occurred in 49% of cases. Eruption of the impacted tooth within eighteen months following removal of the supernumerary was observed in 91% of cases. The chronological age and space availability were the two factors that were critical in determining if eruption was spontaneous following removal of the supernumerary. CONCLUSIONS: The findings of this study reiterates the fact that given early referral, sufficient space and time, the majority of teeth prevented from erupting by a supernumerary tooth would erupt spontaneously following removal of the supernumerary alone. Randomized multi-centre prospective studies are suggested.