One-Year Outcomes of a Piscine Soft Tissue Alternative Used in Mucogingival Procedures: A Clinical Case Series

The free gingival graft (FGG) has been used predictably for gingival procedures aimed to increase the width of keratinized tissue (KT). Several soft tissue alternatives, such as xenografts and allografts, have been studied and proven to be successful with varying degrees. This pilot clinical case series evaluated the efficacy, safety, and initial clinical outcomes (measuring KT width) of a piscine xenograft material (Omega3 Wound, Kerecis) compared to the FGG (harvested from the patient palate) in correcting mucogingival deformities around teeth. A convenience sample of six subjects with unilateral or bilateral lack of KT were enrolled in the study. The primary objective of this pilot study was to determine the gain in width of KT. Secondary objectives included investigating the probing depth, recession depth, bleeding on probing, and inflammation score. There were three FGG sites and six xenograft sites. In bilateral-site treatments, FGG or piscine xenograft were randomly assigned. For unilateral sites, the piscine xenograft was used. Postoperatively, the patients returned for follow-up at 1, 2, 4, 12, 24, 48, and 52 weeks. All six subjects completed the 12-month study and reported uneventful healing. On average, the xenograft sites had a 3.25-mm gain in KT width, and the FGG had an average gain of 3.67 mm. This pilot clinical series showed the piscine xenograft to be safe and efficacious during healing and to increase the width of KT. Future studies may include a more robust study design with a greater number of subjects.

Massachusetts Dental Schools Respond to the Prescription Opioid Crisis: A Statewide Collaboration

The prescription opioid crisis has involved all sectors of U.S. society, affecting every community, socioeconomic group, and age group. While federal and state agencies are actively working to deal with the epidemic, medical and dental providers have been tasked to increase their awareness of the issues and consider ways to safely prescribe opioids and, at the same time, effectively treat their patients' pain. The Commonwealth of Massachusetts, under the leadership of Governor Charles D. Baker and his administration, challenged the state's four medical schools and three dental schools to improve their curricula to prepare the next generation of clinicians to deal with this crisis in an evidence-based, effective, and sympathetic way. This Perspectives article outlines the national prescription opioid crisis, details its effects in Massachusetts, and describes the interdisciplinary collaboration among the Commonwealth, the three dental schools, the Massachusetts Dental Society, and a concerned student group. The article also describes the efforts each dental school is undertaking as well as an assessment of the challenges and limitations in implementing the initiative. The authors hope that the Massachusetts model will be a useful resource for dental schools in other states.

Do Standard Bibliometric Measures Correlate with Academic Rank of Full-Time Pediatric Dentistry Faculty Members?

The aim of this cross-sectional study was to assess the relationship between quantitative measures of research productivity and academic rank for full-time pediatric dentistry faculty members in accredited U.S. and Canadian residency programs. For each pediatric dentist in the study group, academic rank and bibliometric factors derived from publicly available databases were recorded. Academic ranks were lecturer/instructor, assistant professor, associate professor, and professor. Bibliometric factors were mean total number of publications, mean total number of citations, maximum number of citations for a single work, and h-index (a measure of the impact of publications, determined by total number of publications h that had at least h citations each). The study sample was comprised of 267 pediatric dentists: 4% were lecturers/instructors, 44% were assistant professors, 30% were associate professors, and 22% were professors. The mean number of publications for the sample was 15.4±27.8. The mean number of citations was 218.4±482.0. The mean h-index was 4.9±6.6. The h-index was strongly correlated with academic rank (r=0.60, p=0.001). For this sample, an h-index of ≥3 was identified as a threshold for promotion to associate professor, and an h-index of ≥6 was identified as a threshold for promotion to professor. The h-index was strongly correlated with the academic rank of these pediatric dental faculty members, suggesting that this index may be considered a measure for promotion, along with a faculty member's quality and quantity of research, teaching, service, and clinical activities.

Creation and Initial Outcomes of a Selective Four-Year Research Program for Predoctoral Dental Students

Educators agree that dental students' involvement in research plays an important role in their development and contributes to the future of dental education. However, dental schools are challenged to provide the time and support necessary to nurture their students in undertaking research activities. The aim of this study was to examine student participation in a predoctoral student research program at one U.S. dental school and to track participants' outcomes both before and after introduction of an additional, highly selective research scholarship program. Research participation was recorded for all predoctoral dental students in the graduating classes of 2005-15. The number of years of participation was also tracked for each student who participated in research. The results showed that, since the inception of the research honors scholarship in 2005, there has been a more than threefold increase in the number of dental students participating in research each year. The number of students who do multiple years of research has tripled, and the number of students' poster presentations at national academic meetings has risen tenfold in those ten years. The introduction of a competitive award that recognizes exceptional research by students has added to the research profile of the school and has shown success in encouraging students to become involved in research throughout their four years in dental school.

OSCE and Case Presentations As Active Assessments of Dental Student Performance

The aim of this study was to evaluate whether the objective structured clinical examination (OSCE) and case presentation (CP) as forms of active assessment were effective measures of overall didactic knowledge and clinical performance in a predoctoral dental curriculum. This evaluation was conducted by statistical analysis of quality points (QP) awarded for didactic and clinical performance, CP grades, and OSCE scores for 185 students at Harvard School of Dental Medicine who graduated during the period 2010-14. As part of the requirements for graduation, each student takes three OSCEs and presents two patient cases. Data for the study were obtained from the Office of the Registrar. The results showed no direct correlation between QP and CP grades and no correlation between CP grades and OSCE scores. However, there was a correlation between OSCE scores and QP. Students with honors-level scores on any of the three OSCEs received significantly more QP than students who did not receive honors. In addition, students with passing scores on OSCEs 2 and 3 received significantly more QP than students with failing or marginal OSCE scores. Innovative formats of active assessment such as OSCEs and CPs can promote a student-centered learning environment. These data indicated that, within this study population, there was a positive association between OSCE scores and clinical and didactic performance, supporting the value of OSCEs as a means of assessment.

Integration of Basic-Clinical Sciences, PBL, CBL, and IPE in U.S. Dental Schools' Curricula and a Proposed Integrated Curriculum Model for the Future

The integration of basic and clinical sciences in dental curricula enhances the application of basic science principles to clinical decision making and improves students' critical thinking. The aim of this study was to define the characteristics of U.S. dental schools' curricula with regard to level of course integration and degree of incorporation of problem-based and case-based learning. A second aim was to propose a dental curriculum that supports effective integration of courses and addresses some of the concerns facing academic dentistry. A survey was sent to 58 academic deans in U.S. dental schools. The survey included questions about integrating courses in the schools' curricula and major changes in curricular structure or teaching pedagogy that respondents anticipated in the immediate future. A total of 31 schools responded to the survey, for a 53.4% response rate. The results showed that three-quarters of the responding schools still teach basic and clinical sciences separately, although 61.3% reported having an integrated curriculum. Among the responding schools, 16 had a PBL component integrated into their curricula (two had integrated PBL in all courses and 14 used a hybrid PBL approach). Two schools had CBL integrated in all courses, and ten had CBL integrated in >75% of courses. Only slightly more than half agreed that their curricula foster students' thinking "outside the box." Faculty shortages and lack of protected time and resources were the most frequent reasons given for a lack of integrated courses. The integrated model proposed in this article has the potential to provide a low stress environment for students and to address important issues like faculty shortages.

Growth factor-mediated vertical mandibular ridge augmentation: a case report

Posterior vertical alveolar ridge deficiencies are challenging defects to treat predictably and often require autogenous bone-harvesting procedures. Traditional treatment modalities, eg, guided bone regeneration, distraction osteogenesis, and autogenous grafts, present with a number of potential complications and limited success when used to restore vertical ridge height. Recent advances in recombinant growth factor technology may provide viable, alternative therapies for the treatment of significant alveolar ridge deficiencies. This proof-of-principle case report examines the utility and effectiveness of using a composite graft of freeze-dried bone allograft and recombinant human platelet-derived growth factor BB in conjunction with an overlying titanium mesh to regenerate well-vascularized bone in a significant posterior mandibular ridge defect prior to implant placement. The important role of the overlying periosteum as a possible key source of osteogenic cells during growth factor-enhanced regenerative procedures is emphasized.