Treatment of Second to Third-Degree Burns in A 2-Day-Old Infant: A Case Report.

Burn injuries in newborns are particularly complex cases. Since these patients are rare, there is little experience and no existing standardized treatment. This report examines a case of accidental second to third-degree burning of the heel and toes on the left foot in a new-born girl. The burns covered an estimated 1% of the total body surface area (TBSA). After an initial debridement and 32 days of non-surgical wound therapy with Adaptic® fat gauze dressings, we were able to achieve an aesthetically and functionally satisfactory result including the complete preservation of all toes. Modern wound treatment following the principle of less frequent dressing changes allows the burn wound to have better re-epithelialization. New findings in stem cell research indicate that the high proportion of mesenchymal stem cells (MSC) in postnatal blood is also involved in the regeneration and healing of burns. To our knowledge, this is the first case report dealing with initial non-surgical combustion therapy in a newborn. In order to eliminate a scar contracture, we carried out a Z-plasty one year later.

Cone-Beam Computed Tomography in Orthodontics.

Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.

Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics.

Ionizing radiation is a known carcinogen. Its damaging effects can be deterministic or stochastic. Deterministic effects occur only after radiation exposure thresholds are reached, but stochastic effects are random, and there is no known threshold below which harmful effects will not occur. Therefore, the use of ionizing radiation in orthodontic treatment should bring a benefit to the patient that outweighs the risks. No legally binding statutes, rules, or regulations provide explicit radiographic prescription protocols for orthodontic practice. The objective of this article was to discuss guidelines and risk management strategies for appropriate and defensible use of ionizing radiation in orthodontics. Guidelines are discussed for radiographic acquisition at different points along the orthodontic treatment timeline. In addition, risk management strategies and best practices are presented regarding adequate and defensible radiographic interpretation. These guidelines are not rigid and do not establish standards of care; they should be modified as necessary for each patient and each clinical encounter.

Attitudes Towards Problem-Based Learning of Faculty Members at 12 U.S. Medical and Dental Schools: A Comparative Study.

Problem-based learning (PBL) is a teaching method used in medical and dental education to promote students' problem-solving skills. It may also be a viable tool for interprofessional education in which medical and dental students learn together, collaborate, and learn about, from, and with each other. The aim of this study was to compare medical and dental faculty members' attitudes about and perceptions of PBL at 12 U.S. medical and dental schools known to use PBL. In 2015, 111 medical and 132 dental faculty members (combined n=243) from six medical and six dental schools completed a survey containing ten statements and an open comment section. The response rate was 42% of those who received the survey. In the results, the medical faculty participants showed significantly higher enthusiasm for and agreement with PBL benefits than did the dental faculty participants (p˂0.05). The two groups agreed that PBL should be used to supplement conventional teaching (p>0.05). There were no opposite attitudes or contrasts found between the two groups with regards to PBL. The strongest themes expressed by both groups were that PBL should not be used as the sole method of instruction and that students needed a solid foundation in the subject prior to engaging in PBL.

Implementation of Problem-Based Learning by Faculty Members at 12 U.S. Medical and Dental Schools.

The aim of this study was to assess the perspectives of medical and dental faculty members regarding implementation of problem-based learning (PBL). A survey instrument was designed with demographic questions and two open-ended questions to investigate faculty members' perceptions of the most suitable subjects or courses in which to use PBL and examples of how they incorporated PBL into their instruction. The survey was sent to 12 U.S. medical and dental schools known to use PBL, and 73 medical faculty members and 88 dental faculty members completed the survey (n=161), for an overall response rate of 28% of those who were sent the survey at each school (not each's total faculty). In the results, 41% of the medical faculty respondents and 22% of the dental faculty respondents stated that PBL is applicable for all subjects. Members of both groups perceived that PBL is primarily applicable in clinical education, including clinical courses or the clinical applications of courses. The respondents' perceptions about PBL implementation varied significantly, and both groups reported a wide range of approaches in which they implement PBL in their instruction, some of which were not consistent with the purpose of PBL.

An Osteoblastoma of the Mandible: A Case Study.

This case study involves a 22-year-old male who experienced moderate pain in the left side of the mandible for two months. He was diagnosed with an osteoblastoma and treated with local excision, curettage and extraction of the involved teeth. Radiographic follow-up indicated that the site healed well. Clinical, radiographic and histopathologic features are discussed. Osteoblastoma requires interdisciplinary care and should be considered in the differential diagnosis of mixed-density lesions detected in the jaws.

Appropriate use of ionizing radiation in orthodontic practice and research.

Ionizing radiation revolutionized medicine and dentistry in the past century. It has well-documented benefits in orthodontics, and these benefits outweigh the risks. Three-dimensional cone-beam computed tomography produces images that contain significantly more information than do traditional radiographs but generally exposes patients to more radiation. A group of pediatric radiologists initiated the Image Gently Campaign to raise awareness of the need to adjust the radiation dose when imaging children. The key principles of this campaign are justification, optimization, and dose limits. Orthodontists should adhere to the directive to keep radiation "as low as reasonably achievable." Prescribing radiographic imaging is specific to each orthodontic patient and requires judicious clinical judgment to maximize the benefits and minimize the harm.

Attitudes and perceptions of U.S. dental students and faculty regarding dental licensure.

The aim of this study was to assess the attitudes and perceptions of U.S. dental students and faculty members about National Board Dental Examination (NBDE) pass/fail reporting, an Integrated NBDE, clinical examinations, licensure process and strategies, and validity of licensure. A survey instrument consisting of ten statements with response options on a five-point Likert scale and a free-text comment section was developed and distributed through SurveyMonkey. A total of 411 students and 186 faculty members from ten U.S. dental schools participated, with an estimated response rate of 17%. Faculty and student responses were compared using the Mann-Whitney U test. These students' and faculty members' attitudes and perceptions were similar. Both groups showed mixed attitudes about NBDE scores as pass/fail, rather than numerical scores. The Integrated NBDE solicited mixed opinions and concerns that it would be complicated and stressful because students would be challenged to memorize information from earlier years. However, a single national clinical examination was highly preferred by both groups, preferably with simulated rather than real patients. Other strategies, such as background checks and continuing education requirements, were supported by both groups. Most of the licensure process strategies and policies were supported by both student and faculty respondents in the dental schools surveyed.

Contrasting Perspectives of Dental Faculty and Their Students Concerning Dental Academia.

Attitudes of dental students and faculty towards research, faculty recruitment, new school openings, and academic career rewards and disadvantages were evaluated. Both groups believe that research should be discretionary. Faculty had significantly higher support for supervising and encouraging students to conduct research. Students favored recruitment of better quality (not more) faculty, and some displayed concerns about a tuition increase if additional faculty members were recruited. Both groups said there is no significant need for new dental schools. Faculty displayed a more favorable view toward an academic career and a significantly more favorable view of faculty recruitment.

Perspectives of dental students and faculty about evidence-based dental practice.

OBJECTIVE: The study aimed at evaluating attitudes and perceptions of dental students and faculty toward evidence-based practice, integration of technology and social media, general practitioners' and specialists' scope of practice, and dental practice rewards and disadvantages. METHODS: A survey instrument was designed with 10 statements rated on a five-point Likert scale (strongly agree to strongly disagree) and an optional comment section. The survey instrument was delivered through SurveyMonkey, whereby 401 students and 182 faculty members from ten U.S. dental schools participated (16% estimated response rate). Null hypotheses regarding the equality between the responses of the two groups were statistically tested using Mann-Whitney U test. Statistical significance was set at .05. RESULTS: Evidence-based practice is positively perceived by both groups, but with significantly higher support by faculty than students (P = 0.002). Both groups agreed that technological advancements are advantageous (P = 0.95), but do not constitute good dentistry and cannot mask poor clinical skills. Students showed higher support for social media than faculty (P = 0.000). Both groups perceived group practices positively. Faculty members showed higher agreement than students toward limitation of dental specialists' practices to their specialties (P = 0.000). Both groups are aware of practice disadvantages, such as increased litigation, health risks, and detriment to the dentist's posture. However, they both perceive dental practice positively despite all these challenges. CONCLUSIONS: Students and faculty share generally comparable perspectives toward dental practice. They are both in agreement with evidence-based practice and adoption of technology. They both acknowledge practice limitations.

U.S. Dental students' and faculty members' attitudes about technology, instructional strategies, student diversity, and school duration: a comparative study.

In this study, attitudes and perceptions of U.S. dental students and faculty members were evaluated regarding four aspects of dental education: technology integration, instructional strategies, student diversity, and school duration. A survey instrument with eight statements using a five-point Likert scale and a free-text comment section was developed and distributed through Survey Monkey. A total of 426 students and 187 faculty members from ten U.S. dental schools participated, a response rate of 17 percent of those surveyed. Faculty and student responses were compared using the Mann-Whitney U test. The results of this analytic procedure revealed that the groups differed in their average responses for seven of the eight statements. Analysis of the faculty and student comments revealed similar themes between the two groups. Both dental students and dental faculty members stated that technology integration should be viewed as only a supplement to conventional instruction and showed mixed opinions about electronic textbooks. Further, both groups had positive views of the roles of problem-based learning, community service, and the integration of research practice into dental education. Both groups also valued diversity in the student body and supported the current four-year duration of dental school.