Women in leadership positions in dentistry: A scoping review.

BACKGROUND: The objectives of this scoping review were to calculate the prevalence of women in leadership positions in dentistry, present existing research on gender (male, female) disparities affecting dentistry globally, identify gaps in the literature that can drive future research, and provide recommendations for achieving gender parity in leadership positions. TYPES OF STUDIES REVIEWED: A search of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases was performed using search terms. The search strategies were developed to cover English-language articles from January 2016 through April 2022 that examined the prevalence of women in leadership positions in dentistry. Abstracts, newsletters, qualitative reports, and letters to the editors were excluded. RESULTS: Eighteen studies met all inclusion criteria and were included in the final analysis. Low prevalence was noted of women in leadership positions in dentistry globally. Multiple reasons that have led to gender disparities were identified and recommendations for decreasing gender disparities and achieving gender equity in dentistry were provided. PRACTICAL IMPLICATIONS: Over the years, several factors have contributed to gender inequalities in dentistry. However, during the past decade, gender equity, inclusion, and diversity have been recognized increasingly as core values of the dental profession. Presenting and analyzing all available data surrounding this topic are of paramount importance to start formulating appropriate strategies to achieve gender parity in all areas of dental leadership.

Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation?

PURPOSE: The prevalence of tetrahydrocannabinol (THC) use is increasing in the general population due to its increased availability, legality, and cultural acceptability. The purpose of the current study was to measure the association of THC use on the vital signs and anesthetic requirements during intravenous (IV) sedation procedures in recreational marijuana users. METHODS: A retrospective cohort study was performed. A study sample was chosen from July 2018 to May 2022 based on the following inclusion criteria: patients who underwent toxicology screening due to their history of recent drug use and received IV sedation. The predictor variable of the present study is THC status grouped into THC+ and THC-. THC status was established using urine toxicology. Patients who screened positive for THC were coded THC+. Patients who screened negative for THC were coded THC-. Primary outcome variable was changes in vital signs, including mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) during IV sedation procedures in THC+ and THC- groups. Secondary outcome variable was difference in medication (midazolam, fentanyl, propofol, and ketamine) requirements in THC+ and THC- groups. Covariates included age, gender, race, weight, duration of surgery, smoking history, and alcohol use, data on psychiatric diagnosis and psychiatric medications. Descriptive statistics and 2-sample t test were calculated. Statistical significance was set at P < .05. RESULTS: In total, 53 patients met the inclusion criteria and were included in the study, with 27 patients in the THC+ group and 26 patients in the THC- group. There were no significant statistical differences in the MAP%, HR%, and RR% at T5, T10, T20, and T30 between the THC+ and THC- groups. When comparing THC+ and THC- groups, in bivariate analyses, the THC+ group required, on average, higher doses of fentanyl [83.82 mcg compared to 65 mcg (P = .02)] and propofol [70 mg compared to 45.26 mg (P = .03)] during IV sedation. However, after adjusting the effect of age, gender, and weight, THC had no significant effect on midazolam (P-value = .28), fentanyl (P-value = .12), propofol (P-value = .06) and ketamine (P-value = .86) requirements. CONCLUSIONS: These findings suggest there are no differences in vital signs or anesthetic requirements between the THC+ and THC- groups.

Accuracy of Telemedicine Consultations in Oral and Maxillofacial Surgery During the COVID-19 Pandemic.

PURPOSE: Telemedicine has been an emerging trend over the past few years and has seen an exponential rise due to the COVID-19 pandemic. The purpose of the present study was to determine the accuracy of planned oral and maxillofacial surgery (OMS) procedures for patients seen initially by telemedicine in the department of OMS during the pandemic. METHODS: This was a retrospective cohort study. Record review of all patients who received telemedicine consultations during the pandemic time frame of March 1, 2020, to March 1, 2021, was performed. The primary outcome was the accuracy of the planned OMS procedure. Accuracy was defined as the ability to conduct the planned surgery with chosen anesthesia (local anesthesia, diazepam + local anesthesia, intravenous sedation, general anesthesia) at the immediate follow-up appointment without the need for further preoperative testing, evaluation, and consultation. The secondary outcomes were to determine the change in surgical plan, anesthesia plan, and medical plan. Predictor variables included age at the time of telemedicine consultation, gender, race, ethnicity, and the type of consult. Descriptive statistics and logistic regression analysis were executed. RESULTS: The study sample comprised 286 (64.56%) females and 157 (35.44%) males. The age range of the study population was 9 to 92 years, with a mean age of 33.88 years (standard deviation = 16.29 years). In the cohort of 443 patients who obtained telemedicine consultations, 98.19% were successfully treated at the following appointment. Four hundred thirty-one (97.3%) out of the 443 telemedicine consults pertained to dentoalveolar concerns. Logistic regression analysis showed that neither age nor gender had significant effects on the change of surgical and anesthesia plans. CONCLUSIONS: Telemedicine can be effectively utilized in performing consultations for routine OMS procedures, especially dentoalveolar surgeries. Telemedicine consultation can also be used to conduct a preoperative assessment to determine anesthesia and setting of care. However, given the lack of control group and the observational nature of this study, the results must be interpreted with caution.

What Is the Success of Implants Placed in Fibula Flap? A Systematic Review and Meta-Analysis.

Objectives: The purpose of this systematic review and meta-analysis is to examine the success rate of osseointegrated dental implants placed secondarily in fibula free flaps using the Albrektsson and colleagues criteria. Material and Methods: A computerized database search was performed using PubMed, Embase, Web of Science and Cochrane CENTRAL. Specific ascertainment criteria were applied for the inclusion of the eligible studies. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all the included studies. Results: The meta-analysis was carried using ten studies that met the inclusion criteria. The present review pooled data obtained from 242 patients (167 males and 75 females), with the age range of 13 to 79 years. A total of 848 dental implants were placed in the free fibula flaps. All dental implants were placed in a delayed fashion, ranging from 14 to 192 months. The estimated proportion of successful implants placed in fibula flaps used to reconstruct the maxillomandibular complex was 0.94 or 94% (95% CI [confidence interval] = 0.91 to 0.96]) with an insignificant heterogeneity of 37%, P = 0.12. Using a random effect model the annual implant failure rate was 0.02 with a 95% CI = 0.01 to 0.03. Conclusions: The results of this systematic review and meta-analysis strongly indicate that using objective criteria, delayed implant placement in free fibula flaps is highly successful.

Aetiology and Epidemiology of Maxillofacial Injuries during the Stay-At-Home Period Due To the COVID-19 Pandemic: a Single Center Study.

OBJECTIVES: The aim of this retrospective comparative study was to evaluate the effects of implemented social and public health measures during the COVID-19 pandemic on the incidence and aetiology of maxillofacial injuries. MATERIAL AND METHODS: A retrospective chart review of all the patients who had sustained maxillofacial injuries and presented to the emergency department of Strong Memorial Hospital between March 20th and June 24th, 2019 and 2020, were included in our study. The total study sample comprised of 335 patients (n = 140 in 2019 group, n = 195 in 2020 group). The primary outcome variables of the study were the number of cases and aetiology of maxillofacial injuries. Statistical analysis consisted of descriptive statistics, Chi-square, and two sample t-tests. RESULTS: The number of patients in the 2020 group was higher (n = 195) than the number of patients in the 2019 group (n = 140). Comparatively, there was an increase in the maxillofacial injuries during the stay-at-home period by (n = 55 [39.29%]). Although not statistically significant, the aetiology of injuries differed during the stay-at-home period compared to the normal times. CONCLUSIONS: The number of maxillofacial injuries increased during the period of implemented social and public health measures during the early months of the COVID-19 pandemic. Such knowledge can provide valuable information for the establishment of prevention programs and effective health policies and help in the decision-making process pertaining to resource allocation in a dire situation of the pandemic.

Gender Gap in Leadership in Academic Medicine and Dentistry: What Are the Barriers? What Can Be Done To Correct It?

PURPOSE: The present study aimed to report the main barriers to women's advancement in leadership and high-rank academic positions in the fields of medicine and dentistry. MATERIALS AND METHODS: An electronic search was conducted of the MEDLINE database using the PubMed search engine. The Google Scholar search engine was also used to access scholarly articles across all disciplines. A total of 173 reports and abstracts published in the English language were retrieved and evaluated for their content. Of these, 32 were initially selected and reviewed. Finally, 16 studies focusing on gender-related discrepancies in healthcare concerning leadership and academic advancement were included. RESULTS: The following themes emerged as the main contributors to the gender disparity in academic medicine and dentistry: 1) the lack of appropriate role models and mentorship for successful socialization of female faculty; 2) the lack of peer support for women's promotion through the academic ranks and their selection for executive administrative roles at equal rates as their male counterparts; and 3) implicit bias and negative stereotypes. CONCLUSIONS: A need exists to increase the number of female role models and enhance mentorship to increase the attraction toward academic careers in medicine and dentistry. Cultural changes also are required at an institutional and organizational level to embrace diversity. The implicit biases against women's promotion to higher academic ranks must be addressed.

Is serum brain-derived neurotrophic factor related to craving for or use of alcohol, cocaine, or methamphetamine?

BACKGROUND: Data suggests that brain-derived neurotropic factor (BDNF) plays a neuroadaptive role in addiction. Whether serum BDNF levels are different in alcohol or psychostimulants as a function of craving is unknown. Here, we examined craving and serum BDNF levels in persons with alcohol versus psychostimulant dependence. Our goals were to explore BDNF as an objective biomarker for 1) craving 2) abstinence, and 3) years of chronic substance use. METHODS: An exploratory, cross-sectional study was designed. Men and women between 20-65 years old with alcohol, cocaine, or methamphetamine dependence were eligible. A craving questionnaire was used to measure alcohol, cocaine and methamphetamine cravings. Serum levels of BDNF were measured using enzyme linked immunoassay. Analysis of variance, chi-square, and correlations were performed using a 95% confidence interval and a significance level of P < 0.05. RESULTS: We found a significant difference in the mean craving score among alcohol, cocaine and methamphetamine dependent subjects. There were no significant influences of race, gender, psychiatric disorder or psychotropic medication on serum BDNF levels. We found that among psychostimulant users BDNF levels were significantly higher in men than in women when the number of abstinent days was statistically controlled. Further, a significant correlation between serum BDNF levels and the number of abstinent days since last psychostimulant use was found. CONCLUSION: These data suggest that BDNF may be a biomarker of abstinence in psychostimulant dependent subjects and inform clinicians about treatment initiatives. The results are interpreted with caution due to small sample size and lack of a control group.