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Comprehensive Dentition Intrusion in Hyperdivergent Patients Using Temporary Skeletal Anchorage Devices
No full textHyperdivergent skeletal Class II malocclusion is largely genetically determined and poses significant challenges in orthodontic treatment, particularly due to compromised facial aesthetics, reduced bite force and airway narrowing. Traditionally, orthognathic surgery has been the standard treatment for correcting such skeletal discrepancies. However, the advent of temporary skeletal anchorage devices (TSADs) has expanded the possibilities for orthodontic camouflage by allowing effective vertical control. This narrative review outlines key diagnostic considerations—including vertical maxillary excess (VME) and its regional distribution, mandibular morphology and rotational pattern, overbite depth and occlusal plane steepness—that determine the selection of treatment targets and mechanics. Based on these factors, the treatment target may be limited to just posterior intrusion or might be expanded to total arch intrusion, involving either the maxillary arch alone or both arches. Treatment mechanics vary accordingly, with diverse TSAD placement strategies and the use of adjunctive appliances to enhance control. Clinical studies have reported successful skeletal changes such as counterclockwise mandibular rotation and improved overbite. Total arch intrusion, particularly in patients without anterior open bite, requires proportionally greater incisor intrusion and often involves dual-arch mechanics. The ‘double arch intrusion’ technique provides a simplified and efficient protocol using a minimal number of TSADs. Long-term outcomes of such camouflage treatments are comparable to surgical approaches, with most relapse occurring within the first year. Proper retention strategies are essential for maintaining stability
Evaluation of the Oral Health Education for Nurses and Community Health Workers (Project OHE-NCHeW) in Nigeria
No full textIntroduction: Educating primary healthcare workers (PHCWs) on oral health and its association with systemic health, as well as equipping them with skills to identify common oral diseases for referral to the dentist, is crucial for improving overall health outcomes in underserved regions. However, traditional oral health education programs for PHCWs have yet to increase patient referrals to dental centers significantly, hence the need for competency-based oral health training. This study evaluated the effectiveness of a competency-based oral health training pilot program – Project OHE-NCHeW on the oral health knowledge and referral practices of nurses and community health workers (CHWs) in Nigeria. Methods: We utilized a quasi-experimental design with pre-and post-test assessments. One hundred twenty nurses and CHWs (60 intervention, 60 control) across Lagos, Kano, and Ibadan were recruited via cluster sampling. The intervention group underwent a 5-day competency-based oral health training, while the control group received a single-session lecture. Evaluations were conducted immediately after training and 3 months later to assess knowledge, attitudes, and referral practices (KAP) using a validated questionnaire. Results: Overall, the mean age of the participants was 41.4 ± 10.3 years, with an average of 15.3 ± 9.8 years of practice. Both groups had similar baseline KAP scores. Post-training, the intervention group showed significant improvements in oral health knowledge (P \u3c .0001) and practice scores (P = .0096) only. Referral outcomes varied by location, with Kano logging the highest number of referrals (60.0%), and many (57.5%) of the referred patients attended the clinic (57.5%). Decayed teeth (44.1%) and gum diseases (30.8%) were the most common reasons for referral across all sites. Conclusion: The pilot training significantly enhanced the PHCW\u27s oral knowledge and referral practices, demonstrating the potential to strengthen primary care and inform policies aimed at integrating oral health into primary care frameworks for broader public health impact
Management of Enterococcus faecalis associated endodontic infection using gold nanogel: An in-vitro study
No full textThis study evaluates the antimicrobial efficacy of gold nanogel as an endodontic medicament against Enterococcus faecalis in persistent root canal infections. It investigates whether gold nanogel can serve as an effective and biocompatible alternative to conventional medicaments in eliminating E. faecalis. Gold nanoparticles (\u3c 100 nm) were tested against E. faecalis using the agar diffusion method. Extracted teeth inoculated with E. faecalis were treated with gold nanogel (1000 µg/mL), chlorhexidine gluconate (2%), calcium hydroxide, or saline for seven days. Antimicrobial efficacy was assessed on days 1, 3, and 7 using agar diffusion and colony-forming unit (CFU) assays. Gold nanogel significantly reduced E. faecalis biofilm viability, showing greater efficacy than calcium hydroxide and comparable results to 2% chlorhexidine. Chlorhexidine eradicated E. faecalis by day 7, while gold nanogel exhibited sustained antibacterial action with minimal CFUs remaining. Gold nanogel demonstrated superior efficacy over calcium hydroxide and comparable effectiveness to chlorhexidine gluconate (2%) against E. faecalis. Further studies are recommended to evaluate its clinical applications and long-term biocompatibility
Effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on the volumetric contraction of post-extraction sockets: a double-blinded randomized controlled clinical trial
No full textObjective: This study aimed to evaluate the effect of recombinant human bone morphogenic protein type-2 (rhBMP-2) on the alveolar ridge in the post-extraction socket in humans. Method and materials: 20 subjects with 25 teeth of the maxilla were included (11 sockets in the control [blood clot] and 14 in the test group [rhBMP-2]). The teeth were minimally and traumatically extracted. CBCT images were obtained 2 (T0) and 120 (T1) days after extraction. The buccal bone wall height, palatal bone wall height, and alveolar area were compared between both groups, as well as the volumetric contraction through overlapped images (T1 − T0) using Mimics software. The data were compared using the Mann–Whitney test (P \u3c .05). Results: The intragroup evaluation showed a significant buccal and palatal crest height resorption in the control group (P\u3c .05). In the intergroup assessment, the test group was superior to the control group in maintaining the average alveolar ridge area since the control group showed an area loss of approximately 39% between T0 and T1, whereas this reduction was approximately 15% in the test group (P\u3c .05). Conclusion: It is possible to conclude that using rhBMP-2 after tooth extraction resulted in better socket preservation, maintaining 2.5 times greater bone availability in the alveolar ridge than that of the control group
Comparative evaluation of fluoride release among four commercially available dental restorative materials: An In-Vitro study
No full textINTRODUCTION. Several fluoride-containing dental restoratives are currently available, including glass ionomers (GIC), resin-modified glass ionomer cement (RMGIC), polyacid-modified composite resins (compomers), composites, and amalgams. The fluoride release capabilities of these materials differ due to their matrices and setting mechanisms, which in turn influence their antibacterial and cariostatic properties. Glass ionomer cements are particularly favored for their chemical bonding and fluoride release. However, their limitations include water sensitivity and reduced wear resistance, leading to the development of resin-modified glass ionomers. These materials aim to improve moisture sensitivity and mechanical strength while still providing fluoride release. Despite extensive research on fluoride release, comparative studies involving other fluoride-releasing materials are limited. AIM. This study aims to evaluate the fluoride release of two glass ionomer cements, a compomer, and a composite resin, and to assess the impact of topical fluorides on their fluoride-releasing abilities. MATERIALS AND METHODS. The present in-vitro comparative study was conducted at the College of Dental Sciences, Davangere, Karnataka. Four restorative materials were evaluated over 42 days: Conventional GlIC (GC Fuji II), RMGIC (Vitremer, 3M), Compomer (Dyract AP, Dentsply), and Composite (Tetric N Ceram, Vivadent). Specimens were prepared in disc-shaped molds, immersed in deionized water, and fluoride levels measured using a fluoride ion-selective electrode at various intervals. RESULTS. The study revealed distinct fluoride release patterns among the materials. Group I demonstrated the highest fluoride release on Day 1, significantly surpassing Groups II, III, and IV (p \u3c 0.001). While Groups I and II showed a pronounced decrease in fluoride release by Day 2, all groups exhibited a consistent decline over time, with notable intergroup differences. CONCLUSIONS. The fluoride release characteristics of the evaluated restorative materials varied significantly, emphasizing the importance of material selection based on their fluoride-releasing capabilities to enhance dental health
Uprighting a mesially-tipped molar with a mini-implant-supported lever
No full textThis case report presents a technique for uprighting a mesially-tipped mandibular second molar by using a mini-implant-supported lever designed to direct the force vector lingually and apically. A 38-year-old male was referred for molar uprighting before implant placement in the mandibular right second premolar and first molars. To avoid low bone density in the retromolar triangle and mobile soft tissue in the retromolar pad, a mini-implant was strategically placed on the distal side of the mandibular right second molar to ensure better bone quality and minimal soft tissue irritation. A lever extension was placed in the bracket slot on the mini-implant head using the novel subslot overtie method through the hole beneath the bracket. This setup directed the distal traction force through the molar\u27s center of resistance in the occlusal plane, preventing undesirable rotational moments. To generate an intrusive force on the distal marginal ridge, an elastomeric chain configured in a slingshot manner was applied from a button on the mesial surface of the second molar to the lever extension, crossing over the occlusal surface. The treatment was completed within 5 months. For retention, a minitube was bonded to the distal surface of the second molar and ligated into the lever. Using this lever extension allowed ideal placement of the mini-implant, enabling a straightforward force application that included an intrusive component while minimizing unwanted movements
A cross-sectional analysis of pathology exposure across COCA-accredited osteopathic medical schools: Gaps and opportunities in pathology undergraduate medical education
No full textOsteopathic medical schools emphasize a holistic approach to patient care, integrating Osteopathic Manipulative Treatment (OMT) with traditional medical education. Unlike allopathic (MD) programs, which focus heavily on biomedical sciences, osteopathic (DO) programs place additional focus on the musculoskeletal system and primary care. Clinical training in DO programs often takes place in community-based medical centers, which typically lack specialized resources, such as pathology departments, limiting exposure to certain specialties. Pathology education in osteopathic schools varies widely, with some schools integrating pathology into foundational sciences through lectures, case-based learning, and histopathology labs. However, clinical clerkships offer inconsistent pathology exposure, compounded by limited partnerships with specialized pathology labs. A study of 61 accredited osteopathic colleges revealed variability in pathology faculty, with some schools lacking pathologists entirely. Additionally, only 12% of these colleges had pathologist deans. From 2021 to 2024, only 1.06% of DO students matched into pathology residency, though the percentage of pathology positions filled by DO applicants increased from 9.8% to 16.7%. This variability highlights the need for curriculum reforms and stronger collaboration with pathology departments to ensure equitable and thorough pathology training. Addressing these gaps is crucial for preparing osteopathic physicians to provide holistic and effective patient care
Bloom\u27s taxonomy in health professions education: Associations with exam scores, clinical reasoning, and instructional effectiveness
No full textBackground: This scoping review examined how mapping examination questions to learning taxonomies (Bloom\u27s taxonomy), is used in health professions education. The review examined relationships between taxonomy level and exam performance, clinical reasoning, and student engagement. Methods: A literature search was conducted for studies published between 1980 and 2025. Articles were included if they reported student outcomes related to learning taxonomy mapping in undergraduate/graduate health professions education. At least two authors had to agree on the initial inclusion of each article. Final eligibility was confirmed through group review. Results: A total of 832 records were initially identified. After removing duplicates and confirming eligibility, 24 articles were included. The studies were categorized into six themes: relationship between cognitive complexity of examination items (based on taxonomy level), item difficulty, and examination performance; use of taxonomy mapping to compare outcomes associated with different teaching styles; outcomes associated with assessment styles; differences in outcomes based on students\u27 study approaches; correlations between examination question performance by taxonomy and performance during clinical or clinical reasoning assessments; and student engagement with/use of examination mapping. Studies showed decreased performance on higher-order questions. Some instructional strategies improved higher-order performance. Students reported that taxonomy mapping enhanced understanding and study strategies, though their interpretation of question complexity was inconsistent. Implications: Despite widespread practice, mapping examination questions to a learning taxonomy remains a time-intensive practice with limited empirical support for improving educational outcomes. Additional research is needed to determine whether mapping supports critical thinking, clinical reasoning, or licensure performance
Top 100 Cited Articles in Osteopathic Medical Education: A Bibliometric Analysis
No full textContext: Bibliometric analysis is a method for analyzing the existing literature of a specific research area. Because it provides information about current research trends, the analysis can highlight attributes of frequently cited articles and identify areas for future research. To our knowledge, no such investigation has been conducted for osteopathic medical education.
Objective: To conduct a bibliometric analysis of the 100 top-cited articles in osteopathic medical education to identify characteristics of the articles and to explore the thematic structure and connections among common topics.
Methods: In October 2020, the Web of Science (WoS) Core Collection was searched for osteopathic medical education articles authored by faculty associated with US colleges of osteopathic medicine (COMs). Search results include articles from 1975 to the present, based on the available dates of the indexes. Only articles in English were included in the search. Articles were identified using a 3-stage search strategy and group consensus. Once identified, the following bibliometric characteristics were collected: journal name, journal impact factor, year of publication, article title, medical education research topic, authors, number of citations, and the authors’ COM affiliation. Articles were then hand searched in several non-indexed osteopathic-related journals, collecting the same data and using Google Scholar for the number of citations. The 100 top-cited articles were extracted and included in our analysis. Bibliometric metrics were calculated and summarized to assess performance and impact. Science mapping by topics was conducted to assess article contents. Specifically, network analysis and clustering were used to explore the structure and relationship of topics covered in the articles.
Results: Our WoS search identified 193 381 records. The highest 50 000 top-cited results were downloaded for screening, and an additional 89 records were identified from journal website searches. After initial screening and removal of duplicates, the title and abstract of 134 records were independently screened by each team member. Of those, 28 were excluded because they were not a US study, authored by a non-COM author, or outside our study scope; 6 did not meet our exclusion criteria. The top-cited article was a systematic review that was cited 107 times. The journal with the most top-cited articles (28) was Academic Medicine, but BMC Medical Education had the highest number of citations per article (37.8). The Philadelphia College of Osteopathic Medicine and Ohio University Heritage College of Osteopathic Medicine tied for the highest number (15) of top-cited articles, but Lake Erie College of Osteopathic Medicine had the highest number of citations per article (39.8). Network analysis and clustering identified 4 thematic groupings: humanistic and whole-person care; clinical science and training; educational technology; and healthcare system. The topics within each cluster were cohesive, yet clusters also communicated with each other.
Conclusion: Results of the current study provided valuable information about the most frequent osteopathic medical education topics published by authors affiliated with COMs and suggested that journal impact factor was not a direct contributor to number of citations per article. The cluster analysis also provided insight about interconnected topics in osteopathic medical education. Results from this bibliometric analysis may be useful to inform future research, encourage collaboration, and provide guidance for advancing osteopathic medical education research in the United States
Understanding and Supporting the Health Education Specialist Role in Clinical Settings
No full textThere is a persistent misunderstanding in the interdisciplinary field of public health, particularly regarding the roles and titles associated with health education specialists. The confusion necessitates a focus on collaboration, professional development, and standardizing terms within the realm of public health, health education, and health education specialists. To contribute to clarifying these roles, a qualitative exploratory case study was conducted, specifically examining the challenges and skills of health education specialists in clinical care or hospital settings. During three virtual focus group discussions, 13 participants who were selected through convenience sampling from the National Commission for Health Education Credentialing expressed their perspectives. Thematic analysis revealed key themes associated with challenges that included respect, buy-in, and prioritization. Concerning skills, the data indicated an overlap when assessing the most and least utilized skills of health education specialists. The application of skills correlated to size of the health care system or clinical care setting as well as the title and function of the health education specialist. Those working in larger health care systems primarily utilized fewer skills as their tasks and efforts were more concentrated. The implications for practice suggest that health care organizations can fully utilize and integrate health education specialists with concerted efforts on buy-in from executive leadership, professional growth, and clear communication to promote awareness of the role. These efforts will empower health education specialists to elevate their expertise, bring awareness to the profession, and enhance the quality of patient education