Are There Differences in Technical Assessment Grades Between Adjunct and Full-Time Dental Faculty? A Pilot Study.

Some dental students preferentially schedule graded assessments with adjunct faculty members in expectation of obtaining a higher grade. The aim of this pilot study was to compare the grades given by full-time and adjunct faculty members in clinical periodontics to determine if a difference in grading existed. Grades for students given by seven full-time and 11 adjunct faculty members for various technical and competency assessments in D3 and D4 clinical periodontics courses in academic year 2015-16 were compared. Associations between grades and faculty type were sought using mixed model regression to account for correlations among a student's scores. A total of 845 technical assessment and competency scores from 208 students in the two classes were included in the analysis. Scores were for four procedures: periodontal examination and treatment planning, scaling and root planing, evaluation of initial therapy, and periodontal maintenance. Full-time faculty members graded 58% of the assessments, and 42% were scored by adjunct faculty members. Grades for the adjunct faculty were on average 0.14 (out of 5) higher than those for the full-time faculty (p<0.0001). The number of graded assessments was also significantly associated with a higher average score, suggesting potential student bias toward selecting faculty members who grade more favorably (p<0.0001). These students generally received higher grades from adjunct faculty members, whereas the grades given by full-time faculty members were closer in average and more consist with each other. The results point to the need for more calibration training for adjunct faculty members.

Influence of Self-Assessment on Dental Students' Performance on Technical Assessments in Periodontics.

Self-assessments were introduced into a third-year clinical periodontics course to enable dental students to self-assess and receive faculty feedback prior to technical assessment. The aims of this study were to determine if there was an improvement in the pass rate and average grade on the technical assessments following implementation of self-assessments and to analyze the accuracy of the student self-assessments by comparing them with faculty assessments. Scores from 106 third-year dental students for four periodontal procedures were included in the analysis. Faculty and student self-assessment scores, along with self-assessment and final technical assessments scores, were compared, as were the average number of self-assessment attempts for the various procedures and the pass rates. The average number of self-assessments per student was 6.5 compared to 4.2 for the technical assessments. There was no significant difference between students' self-assessment scores and faculty scores (average difference=0.005; p=0.7894). However, there was a significant increase in overall scores between students' self-assessments and technical assessments (average difference: 0.30 out of 5; p=0.0001). There was also a significant difference in pass rate between self-assessments and technical assessments (92.3% and 99.7%, respectively). The individual technical assessment with the greatest improvement was for scaling and root planing (average difference=0.47; p=0.0001), which also had significantly more self-assessments (2.3 vs. 1.2-1.7, p=0.0001). These results suggest that self-assessment and the subsequent faculty feedback provided students with information that enabled them to improve their performance on technical assessments.

Serum anticardiolipin concentrations in patients with chronic periodontitis following scaling and root planing.

BACKGROUND: Anticardiolipin antibodies (antiCl), present in some patients with autoimmune disease, are associated with thrombosis, fetal loss, and other conditions. A significant proportion of patients with chronic periodontitis (CP) test positive for antiCl, likely because some periodontal pathogens contain antigens homologous to the target antigen of antiCl on the serum protein ß-2 glycoprotein-I (ß2GPI) and thus can induce antiCl by molecular mimicry. The authors hypothesized that treatment of periodontitis by scaling and root planing (SRP) could therefore decrease serum titers of antiCl in patients with CP. METHODS: Thirty patients with CP received complete periodontal examinations at baseline including assessment of probing depth, attachment loss, gingival index, and plaque index. SRP was performed in two sessions at 2-week intervals. Eight weeks later, patients were reexamined. Blood samples were taken at baseline, 2 weeks after the initial therapy appointment, and 8 weeks after the completion of treatment for assessment of immunoglobulin (Ig)G and IgM antiCl levels. RESULTS: All periodontal parameters improved significantly. Consistent with previous observations, five (16.7%) of the 30 patients exhibited elevated levels of IgG or IgM antiCl at baseline. Following treatment, the concentrations of IgG and IgM antiCl remained unchanged for the entire cohort of 30 patients. However, in the five patients with elevated antiCl at baseline, IgM antiCl concentrations decreased significantly (P = 0.0008) owing to therapy, while IgG antiCl did not. CONCLUSION: The oral microflora is a likely source of antigen inducing antiCl in CP, since IgM antiCl levels can be reduced in the short term with conservative therapy.

Anti-cardiolipin from periodontitis patients induces MCP-1 production by human umbilical vein endothelial cells.

AIM: Periodontal diseases are associated with a variety of systemic diseases, including cardiovascular disease and stroke, and patients with periodontitis demonstrate elevated levels of anti-cardiolipin antibodies. We sought to determine if anti-cardiolipin antibodies from periodontitis patients induced monocyte chemotactic protein-1 production by human vascular endothelial cells. MATERIALS AND METHODS: IgG was purified from sera from 53 subjects, including chronic and aggressive periodontitis patients and periodontally healthy controls, with elevated or normal IgG anti-cardiolipin levels. In addition, anti-cardiolipin antibodies were specifically removed from some sera by immunoabsorption. RESULTS: We found that, irrespective of diagnostic category, IgG from subjects with elevated anti-cardiolipin induced significantly greater monocyte chemotactic protein-1 production by human vascular endothelial cells than IgG from those subjects with normal anti-cardiolipin titres. Removal of anti-cardiolipin from IgG preparations from periodontitis patients significantly reduced their ability to induce monocyte chemotactic protein-1. CONCLUSIONS: Since elevated titres of anti-cardiolipin are found in a significantly greater proportion of patients with periodontitis than in periodontally healthy individuals, and these antibodies activate endothelial cells to produce monocyte chemotactic protein-1, they may explain some of the associations noted between periodontal infections and systemic conditions.

Birth weight of infants of mothers with aggressive periodontitis.

BACKGROUND: It was hypothesized that if periodontal infections predispose low birth weights and premature birth, then such outcomes should be apparent when the mother has aggressive periodontitis (AgP). METHODS: Birth weight data were collected by questionnaire from females with AgP, their periodontally healthy siblings, and unrelated periodontally healthy women. Both prospective and retrospective birth outcome data were used. Because many of the periodontal evaluations were performed after the births, there were incomplete data regarding most of the risk factors for low birth weight. We determined associations between mothers' periodontal diagnoses and clinical variables and the reported birth weights. RESULTS: There were no significant differences in mean birth weights of babies born to control subjects or AgP patients. This was true whether all the births were considered or only those reported <1 or 2 years before periodontal examination. For periodontally healthy controls, 13.2% of babies born to siblings of AgP patients and 12.8% of babies born to unrelated mothers weighed <2,500 g, whereas 9.9% of those born to mothers with generalized AgP and 10.3% of those born to mothers with localized AgP weighed <2,500 g. CONCLUSIONS: Because of the relative rarity of AgP in the population, and attendant difficulties in performing a prospective study of its association with pregnancy outcomes, we used a compromised approach using prospective data as well as weaker retrospective data assuming that disease onset was likely before the births. Our results, within the limitations of this approach, indicate no evidence that AgP in the mother predisposes low birth weights. AgP has many unique biologic characteristics that differentiate it from chronic forms of periodontal disease, and the possible lack of its association with birth weight may be another such characteristic.