Status of North American Graduate Programs in Periodontics Providing Laser Education and Clinical Training: A Cross-Sectional Survey.

The aim of this cross-sectional study was to evaluate the status of laser use and training in the U.S. and Canadian graduate periodontology programs. A survey questionnaire was sent electronically to 55 periodontology program directors in North America. The questions focused on laser implementation, types of lasers used, for which procedures lasers were used, and level of education/clinical training provided to residents. Data were analyzed using descriptive statistics and Fisher's exact test. Twenty-two directors responded (40%). Most programs (86%) used lasers and 89% used a diode laser. Laser treatment was the most used for periimplantitis (84%). Fifteen programs (79%) provided didactic and clinical training, with 47% programs giving 4-12 h of didactic training. In 53% of programs, residents completed 4 to10 procedures. Only 29% of programs had residents who had received a certification in lasers, with most (80%) programs requiring between 1-9 cases for certification. Of the participants not providing laser training, the major barrier was indicated as being "expense", with 68.7% reporting plans to implement laser education. Conclusions: Most graduate periodontics programs were providing laser training and treatment. There was great variability regarding the training methods, specifically in number of dedicated laser courses, time allocated for laser training, and prerequisites for laser certification.

Symmetry of horizontal and sagittal condylar path angles: an in vivo study.

The specific aims of the study were to determine (1) the mean condylar path inclination (CP) and Bennett angles (BA) in occlusally healthy dentate subjects and (2) whether there was right-left asymmetry of CP and BA. Eccentric movements of three mm and five mm from reference positions were recorded for 45 subjects using a Cadiax system. The mean right CP angles: 48.8 +/- 8 degrees (three mm) and 48.2 +/- 7 degrees (five mm); the mean left CP angles: 48.8 +/- 8 degrees (three mm) and 49.5 +/- 70 (5mm) were steeper than suggested means for setting articulators. The mean right BA: 7.7 +/- 3 degrees (3mm) and 7.9 +/- 4 degrees (five mm); and the mean left BA: 8.1 +/- 4 degrees (three mm) and 8.5 +/- 4 degrees (five mm) were lower than suggested means for setting articulators. Paired-t-tests showed no significant differences between right-left CP and right-left BA. These results suggest that current recommended average settings for semi-adjustable articulators for dentate individuals need to be reassessed.

Virtual reality distraction for pain control during periodontal scaling and root planing procedures.

BACKGROUND: Although pain management during periodontal treatment usually is achieved with anesthesia, alternative methods are available. The authors conducted a study to evaluate the analgesic effect of immersive virtual reality (VR) during periodontal scaling and root planing (SRP) procedures. METHODS: The authors recruited 38 patients. They used a within-patient/split-mouth design. Patients received SRP under three treatment conditions in three quadrants. The three conditions were control, watching a movie and VR. After each SRP procedure, patients responded to questions about their discomfort and/or pain by using a visual analog scale (VAS) (range, 0 to 10 in which lower numbers indicate less pain or discomfort). The authors also recorded patients' blood pressure (BP) and pulse rate (PR). Patients were asked which of the three treatment modalities they preferred. RESULTS: The mean (+/- standard deviation) VAS scores for five questions pertaining to control, movie and VR were 3.95 +/- 2.1, 2.57 +/- 1.8 and 1.76 +/- 1.4, respectively. Paired t tests revealed that VAS scores were significantly lower during VR compared with the movie (P <.001) and control (P <.001) conditions. Similarly, BP and PR were lowest during VR, followed by the movie and control conditions. Patients reported that they preferred the VR condition. CONCLUSION: The results of this study suggest that use of immersive VR distraction may be an effective method of pain control during SRP procedures. CLINICAL IMPLICATIONS: Practitioners can use immersive VR distraction for pain control during SRP procedures.

Shade-matching abilities of dental laboratory technicians using a commercial light source.

PURPOSE: The purpose of this study was to evaluate dental laboratory technicians' abilities to match shades using a light-corrective device under conventional laboratory conditions. The variables measured were years experience, gender, and light source. MATERIALS AND METHODS: A 14-item shade-matching quiz (SMQ) was field-tested and deemed adequate. Information included age, gender, number of years experience, and Ishihara's Colour-Blindness Assessment. Forty-two dental technicians from five northeast Ohio laboratories were invited to participate. The SMQ was administered twice: under the lighting conditions in the individual laboratories (SMQ-Lab) and with a light-corrective source (SMQ-LC). For each item, the technicians were to select the matching Vita shade tab from five preselected shade tabs. SMQ scores equaled the number of correct matches. Statistical analysis included calculation of means, standard deviations, correlation coefficients, and independent and paired t-tests. Significance was set at p

Prophylactic third molar extractions: US dental school departments' recommendations from 1998/99 to 2004/05.

OBJECTIVE: To review the recommendations by dental faculties regarding prophylactic removal of third molars (PR-3M) and to determine if the recommendations at institutions differed and whether there have been changes since 1998/99. METHOD AND MATERIALS: In 1998/99 and 2004/05, a questionnaire was sent to department chairpersons of oral surgery, orthodontics, and restorative dentistry/prosthodontics of US dental schools. They were asked to characterize their department's PR-3M recommendations for adolescents (< 21 years of age), young adults (21 to 35 years), and adults (> 35 years). Third molars were categorized as fully erupted, semierupted, and unerupted. Participants also were to indicate their rationale for PR-3M. Nonparametric and independent t tests were applied to the data (P

Comparison of the shade matching ability of dental students using two light sources.

STATEMENT OF PROBLEM: Shade selection is affected by a host of variables, including lighting. PURPOSE: The purpose of this study was to assess the ability of dental students to match shades under natural lighting and using a light-correcting device, specifically to determine whether there are differences based on: (1) year in school, (2) gender of student, and (3) light source. MATERIAL AND METHODS: A 14-item shade matching quiz (SMQ) and a questionnaire were field tested. No major modifications were made to SMQ or questionnaire. Demographic information included year in school, age, gender, previous experience, and Ishihara's Tests for Color-Blindness. The SMQ was administered on separate occasions during the spring and summer, under natural light (SMQ-NL) and using the light-correcting device (SMQ-CL). For each of the 14 items, students (n=216) were to select the matching shade tab from 5 preselected tabs. Statistical analyses included ANOVAs, paired t tests, and independent t tests (alpha=.05). RESULTS: A total of 165 male and 51 female students participated, with an average age of 26 years. SMQ scores of 10 color-deficient students were excluded. There were no significant differences in SMQ-NL and SMQ-CL among the first through fourth year students (ANOVA), nor between men and women (t tests). The SMQ scores were significantly higher with the light-correcting device than with natural light: 11.4 +/- 1.9 and 10.4 +/- 2.0, respectively (paired t test, P<.001). With and without the light-correcting device, the Vita C shades were less likely to be matched than the Vita A or B shades (paired t tests, P<.001). CONCLUSIONS: Dental students' shade matching abilities were better with a light-correcting source than under natural light. Gender and experience were not found to be factors in matching shades. The Vita C shades were least likely to be matched.

The angle of the articular eminence in modern dentate African-Americans and European-Americans.

The purpose of this study was to determine if there were differences in the angle of eminentia of two 20th century populations based on race, age, gender, and number of teeth and whether there was asymmetry of the angles of eminentia. The sample included dry skulls from the Hamann-Todd Osteological collection as follows: 80 African-Americans (AA, 53 males and 27 females) and 62 European-Americans (EA, 49 males and 13 females), ranging in age from 16-77 years. The lateral, central, and medial aspects of the right and left slopes of the articular eminence were measured in a parasagittal plane. Independent t-tests, paired t-tests, and Pearson correlation coefficients were computed. For the AA population, the right central, lateral, and medial angles of eminentia were steeper than the corresponding left angles (paired t-test, p<0.05); for the AE males only the right lateral and medial angles were significantly steeper than the corresponding left angles (paired t-test, p<0.05). There were no significant relationships between age or number of teeth and the angle of eminentia measurements, nor were there differences in angle of eminentia by gender. There were two differences by race: the EA males had steeper left central and left medial angles than the AA males (independent t-test, p<0.05). The central angle of eminentia was consistently steeper than the medial angle (paired t-test, p<0.01), and the lateral was generally steeper than the medial.

Nursing home executive directors' perception of oral care in long-term care facilities.

Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.

An evaluation of two dental simulation systems: virtual reality versus contemporary non-computer-assisted.

Contemporary dental simulation systems were developed to improve dental students' transition from the preclinical laboratory to the clinic. The purpose of this study was to compare the efficacy of a virtual reality computer-assisted simulation system (VR) with a contemporary non-computer-assisted simulation system (CS). The objectives were to determine whether there were differences between the two systems in the quality of dental students' preparations and the amount of faculty instruction time. Students who completed their first year of dental school and had no previous experience preparing teeth were group matched according to their performance in the first-year Dental Anatomy laboratory course and assigned to VR (n=15) or CS (n=13). In the summer, they spent two weeks (approximately 3 hrs/day) executing amalgam and crown preparations on typodont teeth. Short presentations describing the preparations were given to both groups; however, preparation criteria were available on the computer for the VR group, while the CS group received handouts. Both groups could request feedback from faculty, although VR also obtained input from the computer. A log was kept of all student-faculty (S-F) interactions. Analysis of the data indicated significant differences between groups for the following variables: mean number of S-F interactions was sixteen for the VR group versus forty-two for the CS group; and mean time of S-F interactions was 1.9+/-2 minutes versus 4.0+/-3 minutes (p<0.001) for VR and CS, respectively. Faculty spent 44.3 hours "interacting" with twenty-eight students, averaging 0.5 hours per VR student and 2.8 hours per CS student. Thus, CS students received five times more instructional time from faculty than did VR students. There were no statistical differences in the quality of the preparations. While further study is needed to assess virtual reality technology, this decreased faculty time in instruction could impact the dental curriculum.