Development of an innovative educational escape game to promote teamwork in dentistry.

BACKGROUND: Escape games have proven to be an innovative pedagogical tool that allows students to use the professional skills they acquired. The appeal of the game lies in the stimulation of the players' minds and in the diversity of the puzzles. PURPOSE/OBJECTIVES: To evaluate the effectiveness of an educational tool aimed at cultivating team spirit and group cohesion in dentistry students through a fun collaborative activity that mobilises their knowledge and skills. MATERIALS AND METHOD: Twenty-four students participated to the escape game over a one-day period. In order to win, they had to solve dentistry-related puzzles. RESULTS: Feedback was strongly positive. The balance between manipulations and theoretical questions stimulated them. Students did favour this type of activity which allows to increase interactions between students as well as with the teaching team. CONCLUSION: Escape games in dental schools foster a supportive learning environment and stimulated students' motivation and group cohesion.

[Representation of the oral sphere in medical comics, the child's perception]. / Représentation de la sphère buccale dans la bande dessinée médicale, la perception de l'enfant.

Medical comics are a suitable educational tool for paediatric populations. The emotions conveyed by the characters should not evoke negative feelings, which could then be associated with care or caregivers. The eyes and mouth are the first areas of the face to be analysed. One study attempted to assess the ability of children to perceive the emotions of one of the protagonists through the representation of their mouth.

Temporomandibular Joint Regenerative Medicine.

The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. The ideal approach for TMJ regeneration is a unique scaffold functionalized with an osteochondral molecular gradient containing a single stem cell population able to undergo osteogenic and chondrogenic differentiation such as BMSCs, ADSCs or DPSCs. The key for this complex regeneration is the functionalization with active molecules such as IGF-1, TGF-ß1 or bFGF. This regeneration can be optimized by nano/micro-assisted functionalization and by spatiotemporal drug delivery systems orchestrating the 3D formation of TMJ tissues.

Entrustable professional activities in dental education: a scoping review.

Background Competency-based education has led to the introduction of entrustable professional activities (EPAs) in health sciences education. EPAs are assessment tools that serve to certify a trainee's preparedness to conduct a given clinical activity. Objective Given its modest introduction into dental education, we sought to examine the current situation of EPAs in our field and identify possible barriers and facilitators. This review aimed to summarise evidence about EPA introduction in dental education programmes.Data sources A review of articles published between January 2005 and December 2021 was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews methodology in three databases (PubMed, Cochrane and Embase).Data selection Keywords were 'entrustable professional activity' OR 'entrustable professional activities' AND 'dentistry' OR 'dental education'.Data extraction Eligibility criteria targeted papers published in English describing dental education EPA.Data synthesis Ten publications were selected: six reported on new EPAs, three discussed their relevance for dental education and one article described a process for developing validated EPAs. EPAs focused on clinical examination, health promotion, treatment planning, pain and/or anxiety control and topics related to a specific discipline or care procedures.Conclusion Topics covered by EPAs described in our study adequately reflect the specificities of today's dental professional. The benefits of EPAs will ensure tomorrow's dentists consistently meet societal expectations.

[Aesthetic rehabilitation of a case of maxillary fibrous dysplasia in a child]. / Réhabilitation esthétique d'un cas de dysplasie fibreuse maxillaire chez l'enfant.

Fibrous dysplasia (FD) is a rare, congenital, benign bone disorder in which healthy bone tissue is replaced by abnormal scar-like (fibrous) connective tissue. The lesions may affect one or more bones, including the jawbones. A 13-year-old girl visited the dentist for failed eruption of her left maxillary permanent teeth and facial asymmetry. Radiological analysis revealed impactions of the permanent teeth in hypertrophic, hyperdense, weakly trabeculated bone tissue. To restore the aesthetics of the smile, a treatment combining decoronation and bonded restorations was performed. FD enlargement would slow down after puberty, allowing for long-term therapies. But there is no information about implantology in this type of bone lesion. The aesthetic and functional consequences of a maxillary FD should be managed as soon as possible. Treatment involves a multidisciplinary team and follow-up care into adulthood.

Primary failure of eruption: From molecular diagnosis to therapeutic management.

Introduction: Primary Failure of Eruption (PFE) is a rare condition affecting posterior teeth eruption resulting in a posterior open bite malocclusion. Differential diagnosis like ankylosis or mechanical eruption failure should be considered. For non-syndromic forms, mutations in PTH1R, and recently in KMT2C genes are the known etiologies. The aim of this work was to describe the variability of clinical presentations of PFE associated with pathogenic variants of PTHR1. Material and methods: Diagnosis of non-syndromic PFE has been suggested for three members of a single family. Clinical and radiological features were collected, and genetic analyses were performed. Results: The clinical phenotype (type and number of involved teeth, depth of bone inclusions, functional consequences) is variable within the family. Severe tooth resorptions were detected. A heterozygous substitution in PTH1R (NM_000316.3): c.899T > C was identified as a class 4 likely pathogenic variant. The multidisciplinary management is described involving oral biology, pediatric dentistry, orthodontics, oral surgery, and prosthodontics. Conclusion: In this study, we report a new PTH1R variant involved in a familial form of PFE with variable expressivity. Therapeutic care is complex and difficult to systematize, hence the lack of evidence-based recommendations and clinical guidelines.

Primary failure of eruption and tooth resorption / Défaut primaire d'éruption et résorption radiculaire externe

Introduction: The number of adult patients who seek an orthodontic treatment is increasing. These Primary failure of eruption (PFE) is defined as the partial or complete failure of eruption of at least one posterior tooth, without any mechanical obstacle. A better understanding of the biological mechanisms involved in PFE would enable to refine the diagnostic and prognostic criteria. This rare disease is currently related to PTHR1 gene variants. This gene codes for a transmembrane receptor involved in bone metabolism. However, there is few evidence associating PFE and bone remodeling abnormalities such as external root resorption. External root resorption is the loss of cementum and dentin tissues, resulting from the activation of clastic cells. Materials and Methods: Human teeth affected by PFE were extracted and histological sections were made after fixation of the tissues in 4% PFA. The observations were correlated with three-dimensional imaging by cone beam computed tomography (CBCT) carried out in the preoperative phase. Results: Histological and radiographic analysis confirm the presence of ankylosis area in patients with no history of orthodontic treatment. Large areas of resorption of external root replacement were detected. Discussion: The results call the causal link between the appearance of ankylosis areas and the establishment of orthodontic traction in patients with PFE into question. The installation of an orthodontic force in this context could be only an aggravating factor, accelerating the processes of ankylosis or triggering them more prematurely. Conclusion: With or without orthodontic treatment, teeth with PFE are likely to progress to ankylosis and resorption of replacement external root.

Introduction: Les défauts primaires d'éruption (DPE) se caractérisent par l'échec total ou partiel de l'éruption d'une ou plusieurs dents postérieures, sans obstacle mécanique. Une meilleure compréhension des mécanismes biologiques impliqués dans les DPE permettrait d'affiner les critères diagnostiques et pronostiques. Cette pathologie rare est actuellement imputée à des variants du gène PTHR1. Ce gène code pour un récepteur transmembranaire impliqué dans le métabolisme osseux. Cependant, on trouve peu de données associant DPE et anomalies du remodelage osseux de type résorption radiculaire externe. La résorption radiculaire externe correspond à la perte de tissus cémentaire et dentinaire résultant de l'activation de cellules clastiques. Matériels et méthodes: Des dents d'origine humaine atteintes de DPE ont été avulsées et des coupes histologiques réalisées après fixation des tissus. Les observations ont été corrélées avec l'imagerie tridimensionnelle par tomographie volumique à faisceau conique (TVFC ou encore CBCT). Résultats: Les analyses histologiques et radiographiques montrent la présence de plage d'ankylose chez des patients sans antécédent de prise en charge orthodontique. De larges zones de résorptions radiculaires externes de remplacement ont été détectées. Discussion: Les résultats remettent en cause le lien de causalité entre l'apparition d'ankylose et la mise en place de traction orthodontique chez les patients atteints de DPE. La mise en place d'une force orthodontique dans ce contexte pourrait n'être qu'un facteur aggravant, accélérant les processus d'ankylose ou les déclenchant plus prématurément. Conclusion: Avec ou sans traitement orthodontique, les dents atteintes de DPE sont susceptibles d'évoluer vers l'ankylose et la résorption radiculaire externe de remplacement.

[Surgical acceleration of tooth movement: a systematic review to optimize communication between the orthodontist, the oral surgeon and the patient]. / Accélération chirurgicale du déplacement dentaire : revue systématique pour optimiser les échanges entre l'orthodontiste, le chirurgien oral et le patient.

This systematic review aims to compare conventional corticotomy with minimally-invasive protocols (MIP). Electronic database, in MEDLINE and CENTRAL, and hand search were performed. Randomized controlled trials (RCTs) and randomized split-mouth designed studies (RSMSs) were selected for inclusion, reporting either the use of a corticotomy procedure or a MIP. The main outcomes were the rate/velocity of tooth movement, type of tooth movement observed, loss of anchorage, periodontal indexes, inflammatory mediators, root resorption, patient's pain experience, impact on the quality of life, and satisfaction. Twenty-two papers were included for the qualitative synthesis, from which ten RCTs and twelve RSMSs. Eighteen of them compared a conventional orthodontic treatment without and with a surgical adjunctive procedure, two with conventional corticotomy and sixteen with a MIP (piezocision, micro-osteoperforations (MOPs) or interseptal bone reduction). Four trials compared a surgical procedure to another one. Corticotomy, piezocision and MOPs are likely to accelerate tooth movement, in decreasing order. Pain is reported to be higher in experimental groups only on the first day after surgery. Patient satisfaction is high after surgical procedures. Loss of anchorage, periodontal indexes, or root resorption occurrence show no differences between groups. Corticotomy stands as the gold-standard procedure for surgically-assisted orthodontics, but piezocision appears as a good compromise solution as well as MOPs, in a lesser extent. MIP are known to accelerate tooth movement only during the first three months.

In vitro comparison of the mechanical behaviour of archwires after computer-assisted and conventional bracket positioning protocols.

INTRODUCTION: The mechanical properties of orthodontic archwires can be defined using experimental setups incorporating brackets that provide conditions closer to those encountered in vivo. We aimed to compare a methodology based on computer-aided design with the gold standard protocol, performed when brackets are engaged to a full-size archwire to test the behaviour of wires in this condition. METHODS: Three models simulating a dental arch with an orthodontic fixed appliance (0.018-inch aesthetic conventional brackets) were designed. The brackets were positioned with a stainless-steel full-size wire on the first two models, with different interbracket distances. The setup 3, based on a computer-assisted design, allowed individualized placement of each bracket. Mean forces recorded and standard deviation were compared for a 0.016×0.022-inch copper-nickel-titanium wire deflected until 2mm. RESULTS: The inter-bracelet distances do not cause a statistical difference in the average maximum force recorded (12.6N and 11.4N; P=0.081) whereas the behaviour of the wires is affected. With setup 3, the recorded efforts (mean value: 8N) are statistically lower than with setup 1 and 2 respectively (P=0.018; P=0.012). CONCLUSION: An individualization of the housings by CAD-CAM dedicated to each bracket optimizes their placement. In our test conditions, the mechanical behaviour of the wires is more influenced by the positioning methods of the brackets than by the value of the interbracket distance. In perspective, our innovative methodology can be extended to other types of brackets.

Eruption of Bioengineered Teeth: A New Approach Based on a Polycaprolactone Biomembrane.

Obtaining a functional tooth is the ultimate goal of tooth engineering. However, the implantation of bioengineered teeth in the jawbone of adult animals never allows for spontaneous eruption due mainly to ankylosis within the bone crypt. The objective of this study was to develop an innovative approach allowing eruption of implanted bioengineered teeth through the isolation of the germ from the bone crypt using a polycaprolactone membrane (PCL). The germs of the first lower molars were harvested on the 14th day of embryonic development, cultured in vitro, and then implanted in the recipient site drilled in the maxillary bone of adult mice. To prevent the ankylosis of the dental germ, a PCL membrane synthesized by electrospinning was placed between the germ and the bone. After 10 weeks of follow-up, microtomography, and histology of the implantation site were performed. In control mice where germs were directly placed in contact with the bone, a spontaneous eruption of bioengineered teeth was only observed in 3.3% of the cases versus 19.2% in the test group where PCL biomembrane was used as a barrier (p < 0.1). This preliminary study is the first to describe an innovative method allowing the eruption of bioengineered tooth implanted directly in the jawbone of mice. This new approach is a hope for the field of tooth regeneration, especially in children with oligodontia in whom titanium implants are not an optimal solution.

A New Polycaprolactone-Based Biomembrane Functionalized with BMP-2 and Stem Cells Improves Maxillary Bone Regeneration.

Oral diseases have an impact on the general condition and quality of life of patients. After a dento-alveolar trauma, a tooth extraction, or, in the case of some genetic skeletal diseases, a maxillary bone defect, can be observed, leading to the impossibility of placing a dental implant for the restoration of masticatory function. Recently, bone neoformation was demonstrated after in vivo implantation of polycaprolactone (PCL) biomembranes functionalized with bone morphogenic protein 2 (BMP-2) and ibuprofen in a mouse maxillary bone lesion. In the present study, human bone marrow derived mesenchymal stem cells (hBM-MSCs) were added on BMP-2 functionalized PCL biomembranes and implanted in a maxillary bone lesion. Viability of hBM-MSCs on the biomembranes has been observed using the "LIVE/DEAD" viability test and scanning electron microscopy (SEM). Maxillary bone regeneration was observed for periods ranging from 90 to 150 days after implantation. Various imaging methods (histology, micro-CT) have demonstrated bone remodeling and filling of the lesion by neoformed bone tissue. The presence of mesenchymal stem cells and BMP-2 allows the acceleration of the bone remodeling process. These results are encouraging for the effectiveness and the clinical use of this new technology combining growth factors and mesenchymal stem cells derived from bone marrow in a bioresorbable membrane.

Influence of parathyroid hormone on periodontal healing in animal models: A systematic review.

OBJECTIVES: The purpose of this systematic review was to determine the potential interest of parathyroid hormone (PTH) as an adjunct to periodontal treatment based on studies performed in rodents. MATERIALS & METHODS: Electronic databases (MEDLINE, Web of Science) were searched up to December 2019. Studies assessing the impact of PTH administration in experimental periodontitis in rodents have been identified. RESULTS: Amongst the 247 identified articles, 10 met the inclusion criteria and were included in this systematic review. Experimental periodontitis was mainly induced by ligature placement or surgically with a dental bur. All studies considered bone healing after PTH administration at different frequencies as primary outcome. Results showed that an intermittent administration of PTH promoted bone healing and neovascularization. Nevertheless, a decrease of soft tissue inflammation was also observed. CONCLUSION: Intermittent administration of PTH appears to enhance significantly periodontal healing and to promote alveolar bone regeneration. However, due to the risk of side effects, the development of scaffolds allowing its local and time-controlled delivery is of importance.

Mobile Dental Delivery System: An Effective Protocol for Hygiene and Disinfection.

Mobile dental delivery systems (MDDSs) are receiving growing interest for reaching isolated patients, as well as in dental care for fragile and hospitalized patients, with the advantage of being able to be used from room to room or during general anesthesia (GA) in an operating room. Therefore, ensuring the care safety is crucial. The aim of this study was to elaborate and assess an MDDS maintenance protocol, containing the management of dental unit waterlines and adapted to specific conditions such as dental care under GA. A step-by-step protocol was established and implemented for an MDDS used during dental care under GA in children. Samples of the output water were collected at J0, J+1, 3, 6, 12, and 24 months, and cultured to observe the microbiological quality of the water. All the results (heterotrophic plate count at 22 °C, at 37 °C, and specific pathogenic germs sought) showed an absence of contamination. The protocol presented was effective over time and allowed ensuring the safety of care to be ensured when using MDDS, even during dental procedures under GA. As a result, it could be implemented by any dental care delivery structure wanting to reinforce the safety of its practice.

Efficacy, tolerability, and safety of an innovative medical device for improving oral accessibility during oral examination in special-needs patients: A multicentric clinical trial.

BACKGROUND: People with special needs have high unmet oral healthcare needs, partly because dentists find it difficult to access their oral cavity. The Oral Accessibility Spatula aims to improve oral accessibility. This prospective multicenter interventional open-label non-randomized patient-self-controlled trial assessed the ability of the spatula to improve the oral accessibility of special-needs patients during dental examinations. METHODS: The cohort was a convenience sample of minor and adult patients with special needs due to physical, intellectual, and/or behavioral disorders who underwent dental check-up/treatment in five French tertiary hospitals/private clinics in 2016-2018 and evinced some (Venham-Score = 2-4) but not complete (Venham-Score = 5) resistance to oral examination. After inclusion, patients underwent oral examination without the spatula and then immediately thereafter oral examination with the spatula. Primary outcome was Oral Accessibility Score (0-12 points; higher scores indicate visualization and probing of the tooth sectors). Secondary outcomes were patient toleration (change in Venham-Score relative to first examination), safety, and Examiner Satisfaction Score (0-10; low scores indicate unsatisfactory examination). RESULTS: The 201 patients were mostly non-elderly adults (18-64 years, 65%) but also included children (21%), adolescents (11%), and aged patients (3%). One-quarter, half, and one-quarter had Venham-Score = 2, 3, and 4 at inclusion, respectively. The spatula significantly improved Oral Accessibility Score (4.8 to 10.8), Venham-Score (3.1 to 2.6), and Examiner Satisfaction Score (3.4 to 7.2) (all p<0.001). There were no severe spatula-related adverse events. CONCLUSION: The spatula significantly improved oral access, was safe and well-tolerated by the patients, and markedly improved oral examination quality.

Temporomandibular joint damage in K/BxN arthritic mice.

Rheumatoid arthritis (RA) is an autoimmune disease affecting 1% of the world population and is characterized by chronic inflammation of the joints sometimes accompanied by extra-articular manifestations. K/BxN mice, originally described in 1996 as a model of polyarthritis, exhibit knee joint alterations. The aim of this study was to describe temporomandibular joint (TMJ) inflammation and damage in these mice. We used relevant imaging modalities, such as micro-magnetic resonance imaging (µMRI) and micro-computed tomography (µCT), as well as histology and immunofluorescence techniques to detect TMJ alterations in this mouse model. Histology and immunofluorescence for Col-I, Col-II, and aggrecan showed cartilage damage in the TMJ of K/BxN animals, which was also evidenced by µCT but was less pronounced than that seen in the knee joints. µMRI observations suggested an increased volume of the upper articular cavity, an indicator of an inflammatory process. Fibroblast-like synoviocytes (FLSs) isolated from the TMJ of K/BxN mice secreted inflammatory cytokines (IL-6 and IL-1ß) and expressed degradative mediators such as matrix metalloproteinases (MMPs). K/BxN mice represent an attractive model for describing and investigating spontaneous damage to the TMJ, a painful disorder in humans with an etiology that is still poorly understood.

[Primary failure of eruption: a French prospective survey among the orthodontists from the Grand Est and Bourgogne-Franche-Comté regions]. / Défauts primaires d'éruption : état des lieux auprès des spécialistes en orthopédie dento-faciale des régions Grand Est et Bourgogne-Franche-Comté.

INTRODUCTION:  Primary failure of eruption (PFE) can be defined as the partial or complete failure of eruption of at least one posterior tooth, without any mechanical obstacle; isolated and syndromic forms exist. PFE results from an abnormal dental eruption process that can affect temporary teeth and / or permanent teeth. Molars are the main affected teeth, inducing posterior infraclusions. Orthodontists are the specialists most often concerned by this rare pathology. Unsuccessful orthodontic-surgical traction therapies are commonly reported. MATERIALS AND METHODS:  The aim of our study using a prospective survey was to evaluate the level of knowledge reported by the orthodontists and the therapeutic difficulties they reported. An anonymous questionnaire was submitted to practitioners practicing in north-eastern France (Grand Est and Bourgogne-Franche-Comté regions). RESULTS:  The participation rate was 33.5%. In France, until 2015, specialization in orthodontics was obtained thanks to a local qualification, the Certificat d'Etudes Cliniques Spéciales - Mention Orthodontie (CECSMO), which has now been replaced by specialization following a national ranking competition. Most respondents obtained their qualification between 1980 and 2009 (80%), via the CECSMO (87%). Eighty-six per cent were aware of PFE but only 20% of them knew that PTHR1 (Parathyroid Hormone Receptor 1) gene could be involved in this pathology. The wide range of proposed therapies and the variable satisfaction rates highlight the difficulties encountered by practitioners. DISCUSSION:  Phenotypic variability complicates the diagnosis and makes any therapeutic systematization uncertain. CONCLUSION:  New clinical research projects, particularly in the field of molecular diagnosis, may improve understanding of genotype-phenotype correlations, and may potentially pilot therapeutic management.

Semaphorin 3A receptor inhibitor as a novel therapeutic to promote innervation of bioengineered teeth.

The sensory innervation of the dental pulp is essential for tooth function and protection. It is mediated by axons originating from the trigeminal ganglia and is spatio-temporally regulated. We have previously shown that the innervation of bioengineered teeth can be achieved only under immunosuppressive conditions. The aim of this study was to develop a model to determine the role of Semaphorin 3A (Sema3A) in the innervation of bioengineered teeth. We first analysed innervation of the dental pulp of mandibular first molars in newborn (postnatal day 0: PN0) mice deficient for Sema3A (Sema3A-/- ), a strong inhibitor of axon growth. While at PN0, axons detected by immunostaining for peripherin and NF200 were restricted to the peridental mesenchyme in Sema3A+/+ mice, they entered the dental pulp in Sema3A-/- mice. Then, we have implanted cultured teeth obtained from embryonic day-14 (E14) molar germs of Sema3A-/- mice together with trigeminal ganglia. The dental pulps of E14 cultured and implanted Sema3A-/- teeth were innervated, whereas the axons did not enter the pulp of E14 Sema3A+/+ cultured and implanted teeth. A "Membrane Targeting Peptide NRP1," suppressing the inhibitory effect of Sema3A, has been previously identified. The injection of this peptide at the site of implantation allowed the innervation of the dental pulp of bioengineered teeth obtained from E14 dental dissociated mesenchymal and epithelial cells reassociations of ICR mice. In conclusion, these data show that inhibition of only one axon repellent molecule, Sema3A, allows for pulp innervation of bioengineered teeth.

Periodontal Tissues, Maxillary Jaw Bone, and Tooth Regeneration Approaches: From Animal Models Analyses to Clinical Applications.

This review encompasses different pre-clinical bioengineering approaches for periodontal tissues, maxillary jaw bone, and the entire tooth. Moreover, it sheds light on their potential clinical therapeutic applications in the field of regenerative medicine. Herein, the electrospinning method for the synthesis of polycaprolactone (PCL) membranes, that are capable of mimicking the extracellular matrix (ECM), has been described. Furthermore, their functionalization with cyclosporine A (CsA), bone morphogenetic protein-2 (BMP-2), or anti-inflammatory drugs' nanoreservoirs has been demonstrated to induce a localized and targeted action of these molecules after implantation in the maxillary jaw bone. Firstly, periodontal wound healing has been studied in an induced periodontal lesion in mice using an ibuprofen-functionalized PCL membrane. Thereafter, the kinetics of maxillary bone regeneration in a pre-clinical mouse model of surgical bone lesion treated with BMP-2 or BMP-2/Ibuprofen functionalized PCL membranes have been analyzed by histology, immunology, and micro-computed tomography (micro-CT). Furthermore, the achievement of innervation in bioengineered teeth has also been demonstrated after the co-implantation of cultured dental cell reassociations with a trigeminal ganglia (TG) and the cyclosporine A (CsA)-loaded poly(lactic-co-glycolic acid) (PLGA) scaffold in the jaw bone. The prospective clinical applications of these different tissue engineering approaches could be instrumental in the treatment of various periodontal diseases, congenital dental or cranio-facial bone anomalies, and post-surgical complications.

Maxillary Bone Regeneration Based on Nanoreservoirs Functionalized ε-Polycaprolactone Biomembranes in a Mouse Model of Jaw Bone Lesion.

Current approaches of regenerative therapies constitute strategies for bone tissue reparation and engineering, especially in the context of genetical diseases with skeletal defects. Bone regeneration using electrospun nanofibers' implant has the following objectives: bone neoformation induction with rapid healing, reduced postoperative complications, and improvement of bone tissue quality. In vivo implantation of polycaprolactone (PCL) biomembrane functionalized with BMP-2/Ibuprofen in mouse maxillary defects was followed by bone neoformation kinetics evaluation using microcomputed tomography. Wild-Type (WT) and Tabby (Ta) mice were used to compare effects on a normal phenotype and on a mutant model of ectodermal dysplasia (ED). After 21 days, no effect on bone neoformation was observed in Ta treated lesion (4% neoformation compared to 13% in the control lesion). Between the 21st and the 30th days, the use of biomembrane functionalized with BMP-2/Ibuprofen in maxillary bone lesions allowed a significant increase in bone neoformation peaks (resp., +8% in mutant Ta and +13% in WT). Histological analyses revealed a neoformed bone with regular trabecular structure, areas of mineralized bone inside the membrane, and an improved neovascularization in the treated lesion with bifunctionalized membrane. In conclusion, PCL functionalized biomembrane promoted bone neoformation, this effect being modulated by the Ta bone phenotype responsible for an alteration of bone response.

Evaluation of an ethical method aimed at improving hygiene rules compliance in dental practice.

BACKGROUND: The objective of this study is to determine the efficiency of an ethical method, based on a thought experiment in ethics, on hygiene rules compliance for dental health care team members. METHODS: This is a prospective study that assesses hygiene compliance in dental practice before and after a thought experiment in ethics, using 2 questionnaires. Participants included 130 clinician students in dentistry at Strasbourg University Hospital, France. RESULTS: The results emphasize a better implementation of hygiene rules after the thought experiment in ethics, when comparing the relative frequencies of completed hygiene items. A Wilcoxon signed-rank test shows significant differences between the first questionnaire and the second one after the thought experiment in ethics (P < .001). CONCLUSIONS: This ethical method provides efficiency on hygiene rules compliance, which makes it beneficial to implement. However, far from being an absolute unit method, this thought experiment in ethics appears to be an original, supplemental, and complementary method.