Periodontally Accelerated Osteogenic Orthodontics (PAOO) technique in cleft patients: A complement to orthognathic surgery in dentoalveolar expansion. A case series report.

The aim of this study was to describe a surgical technique that can be used to solve dentofacial deformities in cleft palate patients with maxillary hypoplasia in order to increase maxillary alveolar bone width, without modifying the skeletal base, and therefore, keeping the velopharyngeal function unaltered. Four patients with a history of cleft palate not associated with syndrome and treated under conventional surgical protocol during their childhood, underwent PAOO surgery incorporating L-PRF, followed by an accelerated orthodontic treatment with checkups every two weeks. All patients reached the desired occlusion without modifying their skeletal bases and velopharyngeal function. Orthodontic treatments were finished between 10 and 14 months after surgery without complications. There were no observed complications in the velopharyngeal postsurgical function and an increase in the arch width was achieved in all cases, along with a reduced orthodontic treatment time. The clinical results obtained confirm that PAOO technique is a safe and reliable complement to orthognathic surgery in the surgical treatment of cleft patients. By increasing the perimeter of the maxillary dentoalveolar ridge, the segmentation of the maxilla could be avoided, increasing the post operatory stability of these patients.

Student experiences of two small group learning-teaching formats: Seminar and fishbowl.

INTRODUCTION: As teaching strategies, the seminar and fishbowl approaches promote active learning and shift the focus from the teacher to the learner. The aim of this study was to compare the self-reported perceptions of each student-centred teaching technique amongst a group of dental students as well as resultant quiz scores after each teaching technique. MATERIAL AND METHODS: During the first semester of 2017, all year-3 (N = 88) Semiology and year-5 (N = 71) Oral Surgery students participated in weekly seminars in which teams of students from both cohorts were given an actual clinical case to study; a diagnosis and treatment plan would be rendered, and an oral case presentation would be presented to the rest of the class. In the second semester, the same students tried to solve similar clinical cases using the fishbowl training format. A course coordinator provided final feedback, and the session culminated with a quiz. Students were invited to provide quantitative and qualitative perceptions whilst quiz scores obtained during seminar and fishbowl teaching formats were compared. RESULTS AND DISCUSSION: A total of 97 (61%) seminar and 92 (58%) fishbowl students provided insights regarding these teaching techniques. Both cohorts believed the fishbowl format allowed them to be actively involved. However, only year-3 students gave the fishbowl format a significantly higher score than the seminar format, considering it an attractive format that allowed them to learn. In contrast, year-5 students believed the seminars met their expectations better than the fishbowl format. Interesting clinical cases as well as the final round of feedback were qualitative themes reported by both cohorts. The mean seminar and fishbowl quiz scores were statistically significant different for year-3 students (P < 0.0001), but not for year-5 students (P = 0.09). CONCLUSIONS: These findings suggest that a more structured small-group learning-teaching format can be implemented for younger students whilst at the same time allowing more flexible organisation for senior students.

Laser Biophotomodulation in Patients with Neurosensory Disturbance of the Inferior Alveolar Nerve After Sagittal Split Ramus Osteotomy: A 2-Year Follow-Up Study.

OBJECTIVE: To evaluate the effect of the application of photobiomodulation in a 2-year follow-up period in patients who have been intervened with a sagittal ramus split osteotomy and present neurosensory disturbance of the inferior alveolar nerve. BACKGROUND: Photobiomodulation is a common clinical tool in dentistry, for its beneficial effects have been shown in surgical and periodontal wound healing, reducing of swelling and pain, neurosensory recovery, and treatment of temporomandibular joint disorders. METHODS: This is a 2-year follow-up study with an experimental (Laser) group (n = 33) that received photobiomodulation, and a control (Sham) group (n = 9), placebo. All patients from the Laser group received laser applications (continuous wave of 0.353 W/cm2, 27 J in 270 sec per session) on days 1, 2, 3, 5, 10, 14, 21, and 28 after surgery. Neurosensory disturbance was evaluated with five tests: Visual Analog Scale (VAS) for pain and sensitivity, sensitivity threshold test, two-point discrimination, and thermal discrimination. All tests were performed before (24 h before surgery) and after surgery (24 h, 28 days, 60 days, 6 months, 1 year, 2 years, more than 2 years). Participants and evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages, and medians. Ordinal and dichotomous variables were compared with Mann-Whitney's and Fisher's tests, respectively. RESULTS: Clinical improvement was observed during the follow-up period for the Laser group; general VAS for sensitivity was normal in 11 participants from the Laser group at 2 years postsurgery (40.74%), while no participants from the Sham group achieved this (p = 0.0341). Twenty-three participants recovered initial values for two-point discrimination (69.7%) after 2 years of follow-up (p = 0.0025) as well as sensitivity threshold test. General VAS for pain was normal in 31 patients from the Laser group after 2 years of follow-up (93.94%, p = 0.0254). CONCLUSIONS: Photobiomodulation was effective for neurosensory recovery on sample studied.