Case report of spongiotic gingivitis in an adult male treated with novel 9,300-nanometer carbon dioxide laser low-energy ablation.

BACKGROUND AND OVERVIEW: To date, only about 125 cases of juvenile or adult spongiotic gingivitis have been described in the literature, primarily from retrospective biopsy searches. Spongiotic gingivitis is a relatively new, often misdiagnosed, periodontal pathology that was originally attributed only to juveniles. This is the first case report to our knowledge on spongiotic gingivitis diagnosed in a middle-aged adult man and treated with a novel carbon dioxide (CO2) laser low-energy ablation therapy. CASE DESCRIPTION: A 56-year-old man sought treatment for a localized erythematous lesion on the facial gingiva of the maxillary left central incisor (tooth no. 9). Initial treatment was conventional excisional surgery and biopsy. Diagnosed as spongiotic gingivitis, it reoccurred in the same location within 4 months. It was then treated in 3 sessions using a novel 9,300-nm CO2 laser low-energy ablation set at 0.4 W and 1.25-mm cut width for an irradiance of 33.3 W/cm2 and energy density of 0.21 J/cm2. The lesion was significantly reduced and has shown no hyperplastic reoccurrence to date. CONCLUSIONS AND PRACTICAL IMPLICATIONS: This case report brings to dental professionals' attention that acute spongiotic gingivitis may occur in older adults, not just juveniles. As such, spongiotic gingivitis may be underreported in adults with localized gingivitis, possibly attributed to toothpastes containing sodium laurel sulfate. 9,300-nm CO2 laser therapy may successfully treat lesions such as acute spongiotic gingivitis without the need for anesthesia or additional medications. This report may also encourage further research on treatment modalities, biopsy of lesions resembling this entity, and improved reporting of adult spongiotic gingivitis to better understand this unique gingival pathology.

Effect of a Pilot Preclinical Incentive Program on Dental Students' Performance on a Clinical Competency Exam.

The aim of this study was to investigate the effect of a pilot preclinical incentive program on dental students' performance on a clinical competency (mock board) exam at Midwestern University College of Dental Medicine-Arizona. To assess the effect of preclinical grade incentives in a program called SUCCEED, scores from a clinical competency exam administered during the fall quarter of the fourth year were compared between the graduating classes of 2014 and 2015 (pre-SUCCEED curriculum) and the graduating class of 2016 (post-SUCCEED curriculum). The study hypothesized that the class participating in the SUCCEED program, with its incentives for greater preclinical preparation and practice, would score higher than the other classes on the exams. The results showed that the endodontics and periodontics pass rates and test scores from the Class of 2016 were higher than those from the Classes of 2014 and 2015; the prosthodontics pass rates were similar; and the operative dentistry pass rates and test scores were lower than the Classes of 2014 and 2015. While the results of two of the four subsections of the competency exam showed an improvement in clinical performance for the Class of 2016, the operative dentistry test scores for that class were less than expected. Based on the increased number of operative dentistry procedures performed in preclinical simulation and the clinic, the authors conclude that the competency exam should not be the only measure to evaluate success of the SUCCEED program.

Correlation Between Students' Dental Admission Test Scores and Performance on a Dental School's Competency Exam.

The aim of this study was to investigate whether there was a statistically significant positive correlation between dental students' Dental Admission Test (DAT) scores, particularly on the Perceptual Ability Test (PAT), and their performance on a dental school's competency exam. Scores from the written and clinical competency exam administered in the fall quarter of the fourth year of the curriculum at Midwestern University College of Dental Medicine-Arizona were compared to DAT scores of all 216 members of the graduating classes of 2012 and 2013. It was hypothesized that students who performed highly on one or more sections of the DAT would perform highly on the competency exam. Backward stepwise regression analyses were used to analyze the data. The results showed that the PAT scores were most strongly correlated with the competency exam scores and were a positive predictor for all three clinical sections of the exam (operative dentistry, periodontics, and endodontics). Positive predictors for the written portion of the exam were total DAT score for patient assessment and treatment planning and the DAT reading comprehension score for prosthodontics; there were no predictors for periodontics. The total variance explained by the results ranged from 4% to 15%. While statistically significant relationships were found between the students' PAT scores and clinical performance, DAT scores explained relatively little variance in the competency exam scores. According to these findings, neither the PAT nor any of the DAT components contributed to predicting these students' clinical performance.