Successful splint therapy for embouchure dystonia in a trumpet player.

This clinical report describes a straightforward oral device technique that successfully allowed a patient with embouchure dystonia to regain his ability to play the trumpet.

Strategies to Avoid Underdiagnosing Pit-and-Fissure Caries.

Traditionally, testing for whether pit-and-fissure caries should be restored involved probing with a sharp explorer and evaluating resistance to withdrawal (ie, "stick"). Alternative visual methods of evaluation and classification have been proposed, validated, and accepted formally in the core curriculum on caries management in both Europe and North America. This article examines the resistance to occlusal breakdown of fluoridehardened enamel despite progression of underlying dentin caries with accompanying difficulty in diagnosis. Traditional methods of pit-and-fissure caries diagnosis, including radiographs or fissure probing with an explorer, have been shown to be inaccurate and potentially destructive. The clinical process of using the visual/tactile International Caries Detection and Assessment System (ICDAS) and/or the Caries Classification System (CCS) is described and illustrated through case examples.

Setting Expectations About Feedback in Dental Education.

INTRODUCTION: Many dental students find the amount of direct feedback they receive in dental school to be both unfamiliar and uncomfortable, as many new hand-skill courses are added to familiar lecture courses and traditional paper-and-pencil tests. In turn, when students react poorly to routine professional feedback, dental school faculty often complain they are too fragile. To address this clear gap in expectations between students and faculty in regard to feedback activities, this half-day workshop was developed for use during student orientation. METHODS: In this workshop, students learn the theory of deliberate practice and the role that professional feedback will play in their training. Small-group workshops discuss past student experiences with feedback and use an origami exercise to explore student reactions to feedback. As is commonly done in technique courses, discussions about self- and peer assessment raise students' comfort levels with respect to sharing their work with their peers. Additionally, addressing feedback issues early in their professional education makes students aware of feedback's necessity in their professional development and helps them to deal with the emotional impact. RESULTS: When we evaluated this course in 2014 and 2015, students rated this activity significantly higher than other orientation activities. DISCUSSION: After several years of working with students who have had this orientation, faculty and administrators consider it highly valuable for setting expectations about feedback. They have also experienced fewer student concerns and complaints regarding feedback issues.

The effect of initial irrigation with two different sodium hypochlorite concentrations on the erosion of instrumented radicular dentin.

OBJECTIVE: This study evaluated the effects of different NaOCl concentrations and contact times on removal of the organic phase from mineralized dentin with and without the adjunctive use of EDTA, and the effect of NaOCl concentrations on canal wall erosion after the use of EDTA as the final active irrigant. METHODS: Dentin powders were immersed in 5.25% or 1.3% NaOCl for different contact periods and then rinsed with 17% EDTA for 2 min. Before and after the use of 17% EDTA as the final rinse, the NaOCl-treated dentin powders were examined using ATR-FT-IR spectroscopy to analyze the relative loss of organic and inorganic components. Scanning (SEM) and transmission electron microscopy (TEM) were used to examine the erosion of instrumented canal walls irrigated with 5.25% NaOCl/EDTA or 1.3% NaOCl/EDTA. RESULTS: Compared with 1.3% NaOCl, less intact collagen remained within the subsurface of the mineralized dentin powder after the use of 5.25% NaOCl, irrespective of subsequent rinsing with 17% EDTA. Canal wall erosion was apparent only under SEM when root canals were irrigated 5.25% NaOCl followed by 17% EDTA. Under TEM examination, subsurface erosion extended 10-15 microm beneath the sealer-bonded dentin surface after the use of 5.25% NaOCl for 20 min. CONCLUSION: The superficial destructive effect of NaOCl on mineralized dentin is irreversible and is present irrespective of whether EDTA is subsequently employed as the final active irrigant. The EDTA removes the collagen-depleted apatite phase to expose the underlying cause of destruction that is morphologically perceived as canal wall erosion.