Current status of predoctoral geriatric education in U.S. dental schools

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.     

Culture of human gingival fibroblasts on a biodegradable scaffold and evaluation of its effect on attached gingiva: a randomized, controlled pilot study

BACKGROUND: An adequate width of attached gingiva is necessary to maintain healthy periodontium, especially in orthodontics or restorative treatments in periodontics. The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique. METHODS: This study was conducted on nine patients (18 sites) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw. A small portion (approximately 3 x 2 x 1 mm) of attached gingiva (epithelial + connective tissue) was removed with a surgical blade. After culture of gingival fibroblasts, 2 x 10(5) cells in 250 microl nutritional medium were added to 250 microl collagen gel. One tooth in each patient was randomized to receive a periosteal fenestration technique for gingival augmentation (control) or a tissue-engineered mucosal graft (test). Clinical parameters measured at baseline and 3 months included width of keratinized tissue, probing depth, and width of attached gingiva. RESULTS: An increased amount of keratinized tissue was seen at all treated sites after 3 months. The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites; this difference was significant (P < 0.05). CONCLUSION: Based on the results of this investigation, the tissue-engineered mucosal graft is safe and capable of generating keratinized tissue.     

Ewing sarcoma of the jaws

Three cases of Ewing sarcoma in the jaw bones are presented. The first patient is a 43-year-old woman with a rapidly growing tumor in the hard palate. The second patient is a 9-year-old girl with tumor in the left mandibular ramus and body. In both patients, the tumors were excised with significant safe margins. However, postoperative histopathologic evaluation revealed the presence of tumor cells in bony margins, necessitating a second surgery. The third patient is a 9-year-old boy with tumor in the right mandibular ramus and body. In patients 1 and 2, chemotherapy failed to control the tumor; however, in patient 3, chemotherapy resulted in significant shrinkage of the tumor and no further growth.     

Childhood central nervous system tumors at MAHAK’s Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran,Iran

Purpose

As central nervous system (CNS) tumors account for second most common childhood malignancies and the first cause of mortality in children with cancer, improving treatment modalities can lead to increase the health care of patients. In this study, we examined the prevalence of childhood brain tumors in patients who referred to MAHAK’s Pediatric Cancer Treatment and Research Center (MPCTRC) for treatment.

Methods

A retrospective review of all children less than 15 years old with a CNS histologically proven tumor, who presented to MPCTRC from April 2007 to April 2010, was performed. Data was analyzed by SPSS version 19 with Kolmogorov–Smirnov and Chi-square tests.

Results

There were 198 (124 boys) children eligible for the study. The majority of the tumors were infratentorial (n?=?134), and the rest were supratentorial (n?=?60) and spinal (n?=?4) cases. The median age was 6.11?±?3.65 years old. Medulloblastoma (n?=?66), low-grade glioma (n?=?52), and high-grade glioma (n?=?40) were the most common tumors. The mean duration of follow-up was 21 months. At the time of this analysis, there were 105 (53 %) children alive, 82 (41.4 %) deaths, and 11 (5.6 %) lost for follow-up. The survival rate was 51.68?±?5.22 %.

Conclusions

In contrast of high rate of death in this study, other general characteristics can serve as benchmark for improving our care for children with brain tumors in Iran.     

Breast Cancer Risk and Aging—Misquoted Data and Public Information

The “risk of breast cancer in women increases with age” is a longtime misstatement that does not conform to statistical data. Contrary to the common perception and widely publicized statements, the overall risk of developing breast cancer decreases in women as they grow old.     

Secondary outcomes of a pilot randomized trial of azithromycin treatment for asthma

Objectives:     

Technique for methyl methacrylate cranioplasty to optimize cosmetic outcome

Background

Cranioplasty aims to reconstruct skull defects from fractures, decompressive craniectomies, tumors, and congenital anomalies in a cosmetically acceptable manner. We present a technique in methyl methacrylate cranioplasty that gives excellent cosmetic results by maintaining patient’s calvarial curvature.

Method

Cranioplasty material is placed into a plastic bag and packed inside the defect. Wire mesh cut larger than the defect is held in position to take the exact skull curvature. Once solid, the implant is fixed in position using titanium plates and mini-screws.

Conclusion

This is a simple, inexpensive method of achieving the most cosmetically desired cranioplasty results.