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A comparison of maxillary posterior changes following facemask therapy: Skeletal anchorage versus tooth-borne anchorage
No full textAbstract Objective
To compare changes in the maxillary posterior structure as seen in cone-beam computed tomography (CBCT) images resulting from facemask therapy using skeletal (miniplate/FM) anchorage versus tooth-borne anchorage (RME/FM). Materials and Methods
A retrospective study was conducted on 20 patients divided into the miniplate/FM group (nine patients aged 9.5 ± 1.4 years) and the RME/FM group (11 patients aged 9.2 ± 1.4 years). CBCT images before and after facemask therapy were evaluated to assess changes in the maxillary posterior structure. Results
The miniplate/FM group had greater advancement of the maxilla and midface compared to the RME/FM group (p \u3c .05). Specifically, there was about three times more advancement of the pterygomaxillary suture in the miniplate/FM group than in the RME/FM group (p \u3c .05). Moreover, the advancement of the pterygomaxillary suture was about half the advancement of A point in the miniplate/FM group, while only about 25% in the RME/FM group. Finally, the miniplate/FM group showed an increase in the transverse dimension of the posterior and superior parts of the maxilla (p \u3c .05). Conclusion
There was greater forward movement of the pterygomaxillary suture with facemask therapy using the skeletal anchorage compared to tooth-borne anchorage, leading to a more significant advancement of the maxilla and midface
Bilingual lips: Motor activation for second language word processing
No full textAims and objectives: Current research suggests that motor articulatory representations are relevant for optimal speech processing under difficult circumstances. The challenging situation of a second language (L2) listener mimics this sub-optimal condition; therefore, activation of motor brain regions to support L2 processing is expected. This study aimed to investigate if the motor system associated with speech articulators exerts an influence on processing bilingual acoustic inputs. Methodology: Thirty proficient bilinguals performed twice on a word-to-picture matching task: (1) while producing constant contraction of the orbicularis oris (OO) muscle interfering with the articulator’s movement and (2) while producing constant contraction of the first dorsal interosseus (index finger) muscle. Data and analysis: Accuracy and reaction times (RTs) were collected from the bilingual task during the experimental and control conditions. Two-way repeated measures analyses of variance were conducted to assess if constant contraction of articulators yielded a significant effect on word recognition in L1 and L2. Findings: Word recognition was significantly slower in L2 compared with the native language (L1) during articulator contraction. Task accuracy in L1 was marginally better during the finger muscle contraction compared with OO muscle contraction, and no difference in accuracy was found in L2. An interesting distinct speed-accuracy trade-off strategy for L1 and L2 was observed. The findings support the hypothesis of a motor system facilitatory effect on processing acoustic inputs in bilinguals. Originality: The role of motor components in language processing has been studied in challenging linguistic environments, but little has been done to identify its role in L2 processing. This study used an innovative behavioral strategy to interfere with articulatory muscles during word recognition. Significance: Our results provide evidence of motor system processing support to L2 word recognition. In addition, a bilingual tendency to sacrifice speed for accuracy in L2 compared with L1 is suggested
The Influence of Root Prominence on the Onset of Gingival Recession: A Systematic Review
No full textThis systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was “In teeth with vestibular site-specific root or alveolar bone prominence, what are the chances that this will lead to gingival recession or difficulty in root coverage procedures, compared to teeth correctly positioned in the alveolar bone or without anatomical root prominence?”. A search was carried out on three databases: Embase, PubMed/MedLine, and Wiley Library. This initial search was complemented with manual research. It included any clinical study, such as a randomized clinical trial, controlled clinical trial, prospective/retrospective clinical study, case series, or case report, published in English from January 2012 to December 2023, which reported any involvement of the root/bone prominence approach. The exclusion criteria were clinical studies without report results/details of the case(s), studies based on questionnaires, editorial letters, any review, in vitro/in silica and animal studies, and interviews. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was applied for quality assessment. A total of 163 articles were found, but only three articles were included (k = 0.98). The included studies observed negative correlations when comparing the variables root prominence with linear root coverage, root surface area covered, and linear tissue thickness gain. It suggested a significant reduction in root coverage for prominences greater than 1 mm; therefore, relevant keratinized tissue gains can be achieved in gingival recession treatment after the application of the odontoplasty. The STROBE checklist evaluated 22 items, and all the included studies had a high-quality assessment (greater than 75%) with values greater than 85%. Then, it was not possible to draw conclusions due to the number of articles included, even though they had high-quality assessments. Otherwise, it is possible to suggest that the root prominence may impact gingival recession. Therefore, new and well-designed studies must be developed to establish a significant conclusion about this condition
Women faculty members’ challenges when pursuing leadership positions in academic dentistry: A survey
No full textPurpose/objectives: This study addresses persistent gender disparities in leadership roles in academic dentistry. The objectives were to identify the challenges and barriers to leadership that women face in general and during the COVID-19 pandemic, as well as to describe resources they need to reach their leadership potential. Methods: The American Dental Education Association Section on Women in Leadership (WIL), gathered survey data concerning leadership challenges and faculty development needs. The survey targeted 300 WIL members in leadership roles or aspiring to leadership roles. It was conducted from January to March 2021 and 128 participants responded (response rate: 42.7%). The data was analyzed quantitatively and qualitatively. Results: The most frequent reported leadership barriers indicated by the survey respondents were lack of mentoring, limited leadership training, lack of sponsorship from administration, family obligations and limited job opportunities. The participants stated that the COVID-19 pandemic exacerbated these challenges, affecting collaborations, increasing stress, and impacting scholarly productivity. The survey responses showed how external factors can challenge faculty productivity. Respondents identified mentoring, increased leadership opportunity awareness, and leadership development seminars as factors most helpful for their professional development. Conclusions: This study identified women faculty members’ perceptions of why disparities persist in gender equity in leadership in dental education. It suggests developing gender specific leadership strategies and resources. Addressing barriers requires concerted efforts at the institutional, national, and global levels. This is vital for achieving gender parity in leadership roles in dental education settings
Sentinel lymph node biopsy is unreliable in predicting melanoma mortality for both younger and older patients
No full textAbstract
Background: Melanoma disease patterns vary with patient age.
Aim: To evaluate sentinel lymph node biopsy (SLNB) in managing melanoma at differing patient ages.
Methods: Online prediction tools were applied to compare SLNB positivity (SLNB+) and survival risk at patient ages 20-80. Tübingen melanoma data were used to determine variations in the hazard ratio of SLNB+ for mortality at different patient ages.
Results: Regardless of tumour thickness, predicted SLNB+ rates were markedly higher than mortality rates for 20-year-old patients. For 80-year-old patients, it is the opposite.
Discussion: If 1000 20-year-olds with a 0.4 mm thickness non-ulcerated melanoma underwent SLNB, 100 would likely be positive. If all 100 were to be offered adjuvant drug therapy (ADT), fewer than three more melanoma deaths in those 1000 patients would be avoided. In total, 97 patients would have received medication they may never have needed. If 1000 80-year-olds with a 3 mm thickness non-ulcerated melanoma underwent SLNB, only 40 would likely be positive. In total, 274 patients would be predicted to die of melanoma, 245 being SLNB negative and 29 SLNB+. ADT linked to SLNB+ could deny treatment to 89% of these high-risk patients.
Limitations: The authors relied on published risk data.
Conclusion: SLNB has poor specificity at predicting mortality in young melanoma patients and poor sensitivity in older patients. SLNB is not indicated in managing cutaneous melanoma for patients under 40 or over 60 years of age. Many such patients could be managed with wide local excision alone in their clinician\u27s office-based practice. For all cutaneous melanoma patients at all ages, linking ADT to BAUSSS biomarker, (an algorithm of Breslow thickness, age, ulceration, subtype, sex and Site) rather than SLNB+ is likely more appropriate. BAUSSS provides a more accurate melanoma-specific mortality risk assessment for patients without burdening them with added surgery, hospitalization, costs or morbidity risk
Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education [Letter]
Get PDFAbstract Introduction
Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers. Objective
This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven tools and technology, on the performance of clinical and patient experience measures. Methods
A virtual care model, applied using a systems approach offered by the Value Transformation Framework (VTF), was combined with self-care tools and technology in twenty health centers across 17 states to drive improvement efforts. Changes in clinical measures and patient experience were compared. Results
A total of 385 patients were enrolled and 270 (70.1%) completed a baseline visit and at least four virtual visits during the six-month intervention period. Statistically significant improvements were seen in measures for HbA1c, systolic and diastolic blood pressure, and bodyweight. Among the 270 who completed the baseline and at least 4 virtual visits, the percentage up-to-date for colorectal cancer screening increased from 113/270 (41.9%) to 169/270 (62.6%) after six months, p\u3c0.001, a 20.7% increase. Patients completing the baseline visit and at least 4 virtual visits reported a 10.7% decrease in depression and increased satisfaction with virtual care visits compared to in-person visits (p\u3c0.001). Conclusion
Health centers applying the Value Transformation Framework’s organizing framework to the use of virtual care models together with patient self-care tools, technology, and education, had improvements in measures for chronic and preventive conditions and patient experience
Exploring workplace barriers faced by breastfeeding mothers who are PAs
No full textAbstract
Objectives: To explore physician associate/assistant (PA) mothers\u27 breastfeeding intention, duration, as well as workplace barriers for breastfeeding among working PA mothers and to determine if specialty has an effect on breastfeeding duration.
Methods: A cross-sectional online survey was administered to PA mothers who had at least one biological child while a PA student or practicing as a PA. Study participants were recruited through the American Academy of Physician Associates\u27 special interest group, PA Moms.
Results: The 545 participants reported a breastfeeding goal of 12 months in 76.8% of births. Breastfeeding rates among participants were 96.3% at birth, 83.8% at age 3 months, 78.1% at age 6 months, and 54.8% at age 12 months. Exclusive breastfeeding rates were 77.9% at birth, 75% at age 3 months, and 42.6% at age 6 months. Workplace support from colleagues and support staff was associated with longer exclusive breastfeeding duration and any breastfeeding duration. Adequate time and place for expression of breastmilk and support from supervising or collaborating physicians were associated with longer duration of breastfeeding. Specialty had a statistically significant effect on exclusive breastfeeding duration.
Conclusions: PA mothers failed to meet their breastfeeding goals, despite high initiation rates. Dedicated time and space to express breastmilk and workplace support may significantly improve PA mothers\u27 breastfeeding duration
Proceedings of the 18th Microbiology and Immunology Educational Strategies Workshop, July 18–22, 2022
No full textImpact of Digital Innovations on Health Literacy Applied to Patients with Special Needs: A Systematic Review
No full textMHealth strategies have been used in various health areas, and mobile apps have been used in the context of health self-management. They can be considered an adjuvant intervention in oral health literacy, mainly for people with special health needs. Thus, the aim of this study was to identify the improvement of oral health literacy in patients with special needs when using digital platforms. A systematic literature review, based on the Joanna Briggs Institute (JBI) guidelines, was the main research method employed in this study. A search was undertaken in PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases, according to the relevant Mesh descriptors, their synonyms, and free terms (Entry Terms). Studies published between the years 2012 and 2023 were included. Two researchers independently assessed the quality of the included studies by completing the Newcastle–Ottawa Quality Assessment Scale questionnaire. The analysis corpus comprised 5 articles among the 402 articles selected after applying the inclusion/exclusion criteria (k = 0.97). The evidence from the considered articles is consensual regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs. The interventions were based on using the Illustration Reinforcement Communication System, inspired by the Picture Exchange Communication System, Nintendo® Wii™ TV, virtual reality, smartphones, with software applications to read messages sent, Audio Tactile Performance technique, and Art package. One study had a low-quality assessment, and four had a high quality. The evidence from the articles included in this systematic review is consistent regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs
Antibacterial Efficacy of Graphene Nanoparticles against Enterococcus faecalis: In Vitro Study
No full textObjective(s) This study compared the antimicrobial efficacy of nanographene (NG) particles with chlorhexidine (CHX) and calcium hydroxide (Ca(OH) 2) against Enterococcus faecalis. Materials and Methods Forty extracted human mandibular premolar teeth were cleaned using a scaler, and the middle-third of the root (6 mm) was decoronated using a rotary diamond disk. The inner diameter of the teeth was made consistent using Gates Glidden Drills #3, treated with ethylene diamine tetra-acetic acid and sodium hypochlorite before sterilization. The samples were then contaminated with E. faecalis grown in Tryptic soy broth for 21 days. Tooth samples were then randomly divided into four groups: Group I (Control), untreated saline; Group II, Ca(OH) 2; Group III, CHX; and Group IV, NG. The assessment of bacterial growth was carried out by harvesting dentin chips at the end of 1, 3, and 7 days. The colonies were physically counted and tabulated after 24 hours from seeding. Statistical analysis of the collected data was performed with analysis of variance and Tukey\u27s post hoc test using SPSS Version 20.0. Results The contaminated dentine blocks irrigated with NG (0.5 μg) and CHX (0 ± 0; p \u3c 0.001) had no growth of E. faecalis colonies compared to blocks of Ca(OH) 2 (10 ± 21) and saline (927 ± 455). All concentrations of NG (0.5 and 1.0 μg) showed effectiveness higher (p \u3c 0.001) than 2% CHX when measured by the zone of inhibition against E. faecalis. Conclusion It may be concluded that NG is effective against growth of E. faecalis and may be used as a promising antimicrobial agent during root canal treatment. However, further studies should be done to investigate the effect of NG against other dental pathogens