Education Solutions to the Medical-Dental Divide.

Arbitrarily cordoning off the mouth from the rest of the body is the educational approach that, since 1840, has been responsible for the medical-dental schism that persists today, preventing oral health's integration with overall health. This divide has also thwarted oral disease prevention initiatives, access to services, and health equity. This article offers an educational plan for reunifying medicine and dentistry, which involves interprofessional education, dual degree training, integrating oral health into medical education, and integrated residency training.

Interdisciplinary rehabilitation of a primary intraosseous carcinoma including orthodontic archform management.

Squamous cell carcinomas arising from keratocystic odontogentic tumors are a rare phenomenon in head and neck cancer, accounting for only 1.45% of oral squamous cell carcinomas, and are classified as primary intraosseous carninomas. This cancer is locally aggressive, has a high potential for recurrence, and requires radical resection and subsequent rehabilitation. This case report describes a patient diagnosed with this uncommon tumor who was treated by dental specialists at Mayo Clinic. During convalescence, orthodontic changes to the maxillary dental archform were observed secondary to alterations in the soft tissue equilibrium following mandibulectomy and reconstruction with a microvascular fibula free flap. This highlights the need for treatment plan adaptability, the role of orthodontists in maintenance or treatment of pre-resection archforms, and the interdisciplinary nature necessary in managing the complex oncologic, functional, and esthetic needs in patients undergoing treatment for head and neck cancer.

Implementation of a Scholarly Activity Program in a Small Academic Medical Center Department.

Small departments within academic medical centers have fewer numbers of clinicians, less time devoted to research, and fewer staff with senior faculty academic ranks available as mentors. This report describes the rationale behind Mayo Clinic's Department of Dental Specialties' scholarly activity program, implemented to combine mentorship with scholarship provided in a variety of formats. Program objectives focused on providing mentorship, disseminating existing scholarship, and bringing a diversity of scholarly activities into departmental mainstream.

Facial Versus Skeletal Landmarks for Anterior-Posterior Diagnosis in Orthognathic Surgery and Orthodontics: Are They the Same?

PURPOSE: The purpose of this investigation was to evaluate diagnostic agreement in anterior-posterior (AP) categorization of the maxilla and mandible between a skeletal-landmark analysis and a facial-landmark analysis for treatment planning of orthognathic surgery and orthodontics. MATERIALS AND METHODS: This retrospective, consecutive case series of adult patients who presented to the Mayo Clinic orthodontic department compared maxillary and mandibular AP diagnoses. Steiner's analysis of the sella-nasion-A point angle and sella-nasion-B point angle was used for a skeletal-landmark diagnosis. Element II of Andrews' 6 elements of orofacial harmony was used for a facial-landmark diagnosis. Both diagnoses were categorized as either deficient, optimal, or excessive for each jaw. Categorization of the skeletal landmark was determined by normative data, whereas the facial landmark provides a customized categorization unique to each individual. RESULTS: Weighted κ statistics were completed to test agreement between the categories determined by the skeletal and facial landmarks. The maxilla showed poor agreement, and the mandible showed slight agreement. CONCLUSIONS: No agreement was found for AP categorization of the maxilla and mandible between skeletal-landmark and facial-landmark analyses. Most mandibles were diagnosed as retrognathic by the facial landmark, whereas most were diagnosed as optimal by the skeletal landmark. When the 2 landmarks disagreed, the facial landmark defined the optimal position farther anterior. The landmark chosen for diagnosis will impact the optimal jaw position and can affect orthognathic and orthodontic outcomes.

A Small-Group Stratified-Learner Modification of Team-Based Learning (SGSL-TBL) for Resident Education.

Providing learner-specific didactic instruction to a small group of residents can be a challenge in postdoctoral education programs. To date, no data has been published reporting Team-Based Learning (TBL) outcomes when modified for a small group of resident learners, nor on stratifying information presented to learners based on postgraduate year (PGY). Stratification of the advance assignment appears effective as each individual resident outperformed their peers on information assigned to their training level. The group performed significantly better on questions pertaining to their assigned reading than on questions from reading assigned to other residents (p = 0.02), due to the significant difference in PGY1 performance (p = 0.01). Overall performance is similar to traditional TBL, shown by a significantly better group Team Readiness Assurance Test (TRAT) score over Individual Readiness Assurance Test (IRAT) scores (p = 0.01). The Accreditation Council for Graduate Medical Education (ACGME) and Commission on Dental Accreditation (CODA) require evaluation of residents relative to their training level and to their peers. This Small-Group Stratified-Learner TBL (SGSL-TBL) may offer useful resident evaluation tools, providing quantitative data not previously available to small-group resident-training programs through application of TBL.