A look at allied dental education in the United States

BACKGROUND: The American Dental Association conducts surveys of educational programs in dental assisting, dental hygiene and dental laboratory technology. The 2002-2003 survey included questions about enrollment, graduates, program information and trends. METHODS: The ADA Survey Center mailed the Survey of Allied Dental Education to 548 program directors of dental assisting, dental hygiene and dental laboratory technology educational programs. They also sent several follow-up notices as a reminder to complete the survey. A 100 percent response rate is mandatory for continued accreditation by the Commission on Dental Accreditation. Association staff members resolved inconsistencies in the data and analyzed them before producing a final report. RESULTS: The number of applications to, first-year enrollment in and number of graduates in dental hygiene and dental assisting educational programs have increased during the last five years. During the same period, the number of applications to, and graduates of, dental laboratory technology educational programs decreased, but first-year enrollment increased slightly. CONCLUSIONS: Results from these surveys help address the concerns of the public and the profession regarding allied dental manpower levels. They also provide information for those interested in applying to individual allied dental educational programs. PRACTICE IMPLICATIONS: Private dental practices employ the majority of graduates of allied dental educational programs. Recent graduates of dental assisting and hygiene programs continue to supply the office staff members needed to support the delivery of dental care.     

The trans-nasal Kirschner wire as a method of fixation of the unstable fracture of the zygomatic complex

A technique for the fixation of the unstable zygomatic complex is described and compared with other methods currently available.     

A new guide to mandibular resection for oral squamous cell carcinoma based on the Cawood and Howell classification of the mandible

A new guide for mandibular resection in the management of oral squamous cell carcinoma based on the Cawood and Howell classification of the jaws is suggested. This was a retrospective review of case records and pre-operative orthopantomograms (OPG), bone scintigraphy and magnetic resonance imaging (MRI). The classification of the mandible was based on the residual bone height as measured in the molar region of the OPG to be equivalent to the Cawood and Howell classification of the mandible (Class I-II dentate or immediate post-extraction), Class III-IV >20mm well-rounded or knife-edge ridge, and Class V-VI <20mm (flat or depressed ridge form). Of the 77 patients, 58% (22/38) of Class I-II, 43% (9/23) of Class III-IV and 6% (1/16) of Class V-VI were treated with a marginal (rim) resection of the mandible. The predictability of the pre-operative investigations was more accurate in the edentulous mandible (Class III-VI). A simple guide is suggested for mandibular resection taking into account the pre-operative investigations, the estimation of invasion clinically, and the Cawood and Howell classification of ridge resorption.     

Aggregatibacter actinomycetemcomitans leukotoxin is post-translationally modified by addition of either saturated or hydroxylated fatty acyl chains

Aggregatibacter actinomycetemcomitans, a common inhabitant of the human upper aerodigestive tract, produces a repeat in toxin (RTX), leukotoxin (LtxA). The LtxA is transcribed as a 114-kDa inactive protoxin with activation being achieved by attachment of short chain fatty acyl groups to internal lysine residues. Methyl esters of LtxA that were isolated from A. actinomycetemcomitans strains JP2 and HK1651 and subjected to gas chromatography/mass spectrometry contained palmitoyl (C16:0, 27-29%) and palmitolyl (C16:1 cis Δ9, 43-44%) fatty acyl groups with smaller quantities of myristic (C14:0, 14%) and stearic (C18:0, 12-14%) fatty acids. Liquid chromatography/mass spectrometry of tryptic peptides from acylated and unacylated recombinant LtxA confirmed that Lys(562) and Lys(687) are the sites of acyl group attachment. During analysis of recombinant LtxA peptides, we observed peptide spectra that were not observed as part of the RTX acylation schemes of either Escherichia coliα-hemolysin or Bordetella pertussis cyclolysin. Mass calculations of these spectra suggested that LtxA was also modified by the addition of monohydroxylated forms of C14 and C16 acyl groups. Multiple reaction monitoring mass spectrometry identified hydroxymyristic and hydroxypalmitic acids in wild-type LtxA methyl esters. Single or tandem replacement of Lys(562) and Lys(687) with Arg blocks acylation, resulting in a >75% decrease in cytotoxicity when compared with wild-type toxin, suggesting that these post-translational modifications are playing a critical role in LtxA-mediated target cell cytotoxicity.