Dental professionals' knowledge, attitudes, and practice behaviors related to human papillomavirus vaccination.

OBJECTIVES: In Arizona, human papillomavirus (HPV)-related cancers are declining, with the exception of oropharyngeal cancer (OPC). HPV-related OPC is largely caused by persistent infection with oncogenic HPV strains, many of which the 9-valent HPV vaccine offers protection. Little is known about dental professionals' willingness to promote the HPV vaccine to prevent OPC. The current study assessed Arizona dental professionals' knowledge, attitudes, willingness, and current practice behaviors related to HPV vaccine promotion. Responses between dentists and hygienists were also compared. METHODS: A convenience sample of 711 dentists and hygienists attending a regional conference were recruited and asked to complete a 34-item survey assessing knowledge and attitudes about HPV, the HPV vaccine, HPV-related OPC, and their willingness to promote and administer the HPV vaccine. Fisher's exact tests and Mann-Whitney U tests were used for data analysis. RESULTS: Most respondents answered HPV knowledge questions correctly but did not know HPV-related OPC has a more favorable prognosis than other head and neck cancers. Dentists were more confident discussing and recommending the HPV vaccine. Both dentists and hygienists were willing to refer patients to their non-dental primary care providers for vaccination; however, they were less confident in administering the vaccine if it fell within their scope of practice. They reported willingness to receive training to recommend the vaccine. CONCLUSIONS: Given the willingness of respondents to receive training related to HPV vaccine communication, future research should develop and test talking points and communication training to aid dentists and hygienists in their promotion of the HPV vaccine.

Squamous cell carcinoma presenting as peri-implantitis: a case report.

Dental implants have proved to be a useful adjunct in the rehabilitation of oral cancer patients. We describe the case of a 62-year-old woman who presented with a white patch in the oral cavity, diagnosed to be a squamous cell carcinoma. She underwent extensive surgery including microvascular reconstruction, followed by implant rehabilitation. Unfortunately, she suffered from multiple episodes of peri-implantitis and later on went on to develop oral squamous cell carcinoma around two of the dental implants. Here, we highlight the importance of regular follow-up and maintaining a high index of suspicion in high-risk patients.

Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate.

OBJECTIVE: To introduce a surgical technique for secondary alveolar bone grafting performed in conjunction with premaxillary osteotomy and guided tissue regeneration in children with bilateral clefts. This paper also looks at the outcomes of this surgery in a series of 15 consecutive patients. METHODS: Secondary alveolar bone grafting (with a premaxillary osteotomy and guided tissue regeneration with a collagen membrane) is usually carried out in the mixed dentition stage. This retrospective study used patients' medical records, radiographs, and clinical examination to assess the outcome of the surgery. Patients were followed up for an average of 3 years. RESULTS: Bone grafting was successful in all cases. No premaxillae were lost and there was no long-term morbidity of the donor site. Radiographic assessment of the bone heights showed an average of 94% retention, 3 months postoperatively. Preliminary assessment of maxillary canine eruption is encouraging, with 79% being fully erupted in those patients who are at least 3 years post-bone grafting. CONCLUSION: Premaxillary osteotomy allows repositioning of the premaxilla to its optimal preplanned position and successful closure of all fistulae. We have found that use of a collagen membrane is a useful adjunct.