Black and Hispanic predoctoral dental students' perceptions and considerations of careers in academic dentistry.

BACKGROUND: Dental schools aim to train and support a diverse dentist workforce. Among all faculty, full-time and part-time faculty who identify as members of historically underrepresented groups are 13.9% and 8.4%, respectively. The recruitment and retention of faculty is a known challenge, with growing faculty vacancies at dental schools. This study explored dental student perceptions of academic careers, specifically focusing on Black and Hispanic predoctoral students. METHODS: From August to November 2022, we conducted focus group with second-, third-, and fourth-year predoctoral dental students who identified as Black or Hispanic using a semi-structured interview guide that was developed for this study. Data were analyzed using inductive thematic analysis. RESULTS: Four themes emerged: (1) students perceived academic dental dentistry as inclusive but not diverse spaces for Black and Hispanic people; (2) academic dental careers were perceived as secondary careers; (3) academic dental careers were perceived as a career option with a lack of autonomy and less income, compared to clinical practice in other settings; (4) students expressed a lack of knowledge about pathways to academic dental careers. Despite these challenges, students expressed interest in academic dental careers and noted being inspired by younger faculty members. CONCLUSION: Dental schools must do more to encourage dental students to consider careers in academic dentistry. Pathway programs, mentoring, and the presentation of academic careers as a viable career option for students by faculty should be further emphasized practices. Increasing the diversity of faculty members is also key. Students cannot be who they cannot see.

Apexification Outcomes in the United States: A Retrospective Cohort Study.

INTRODUCTION: This epidemiological analysis used procedure codes from dental insurance claims data to identify apexification cases and evaluate survival at the tooth-level. METHODS: Dental insurance claims data from New York State (2006-2019) and Massachusetts (2013-2018) were used in an observational, retrospective cohort study to evaluate the provision and treatment outcomes of apexification. Statistical analyses included Kaplan-Meier survival estimates and Cox proportional hazards regression. Cox proportional hazard regression was used to evaluate the hazard of adverse event occurrence by age, gender, tooth type, placement of permanent restoration, and dental provider type. A sensitivity analysis evaluated potential bias in the survival estimates and adjusted hazard ratios (aHRs) due to differential loss to follow-up. Robust standard errors were used to account for potential dependence between teeth within an individual. RESULTS: The analytic cohort of 575 individuals included 632 teeth, with an average follow-up time of 64 months. The survival rates of apexification procedures were 95% at 1 year; 93% at 2 years; 90% at 3 years; and 86% at 5 years. Tooth retention following apexification was 98% at 1 year; 96% at 2 years; 95% at 3 years; and 90% at 5 years. Tooth type and subsequent placement of a permanent restoration were significant predictors of survival after apexification. CONCLUSIONS: The procedural and tooth survival outcomes of apexification were high and comparable to studies that analyzed clinical data on tooth survival following apexification.

Stress and Oral Health-Related Quality of Life Among a Sample of College-Educated Black Men.

This study assessed if higher levels of self-reported stress were associated with self-reported oral health-related quality of life (OHRQoL) among a sample of college-educated Black men. Using a community-based participatory approach, a questionnaire was developed and distributed using two validated instruments, the Holmes-Rahe Stress Inventory and the Oral Health Impact Profile-14. Eighty men completed the questionnaire, with 58.8% reporting Holmes-Rahe scores above 150 (mean=209, SD=175.2). The highest OHIP-14 mean ratings on a scale of 0 to 3 were for feeling self-conscious (mean=.67), painful aching (mean=.55), feeling embarrassed (mean=.49), and eating discomfort (mean=0.48). Among participants with Holmes-Rahe Stress Inventory scores above 150, mean OHRQoL levels were significantly higher for domains of painful aching (p=.007), eating discomfort (p=.038), feeling self-conscious (.006), and experiencing tense feelings (.049). Higher stress levels may be associated with college-educated Black men's experiences of oral health-related physical pain and psychological discomfort.

A decade of grassroots pathway programming: Saturday Academy at New York University College of Dentistry.

BACKGROUND: Successful pathway programs require early and sustained support of student participants. PURPOSE: We present the history and outcomes of a successful decade of continuous, grassroots, pathway programming at an individual dental institution. METHODS: Programmatic data were used to evaluate information on program participant demographics, academic pursuits, and career interests. Descriptive analyses were used to report on program enrollment as well as alumni academic and career outcomes. RESULTS: Between the years of 2013 and 2022, 346 high-school students participated in Saturday Academy at NYU Dentistry. Of the 240 college-aged and older program alumni, 72% (n = 172) have shared their academic and career plans after high-school. At the time of publication, 78% (134/172) of alumni that have maintained contact with Saturday Academy and have expressed interest in pursuing a career in the health professions. Of the 172 alumni, 14% (n = 24) have enrolled in or graduated from a health professional program (dental hygiene, nursing, accelerated dental or medical program, dental or medical school, or other health professional program). Of these alumni (24/172), half (n = 12) have pursued education in the dental professions, specifically. CONCLUSION: Saturday Academy at NYU Dentistry is an example of a sustainable and impactful pathway program in dental education and its outcomes support the merit of calls for increased institutional commitment and support of similar initiatives.

A comparative analysis of public and private dental benefit payer types for the provision and outcomes of root canal therapy on permanent teeth of children and adolescents in Massachusetts.

BACKGROUND: Despite substantial increases in dental benefits and improvements in the use of dental services among children and adolescents in the United States, oral health disparities according to dental insurance payer type persist. METHODS: The authors used an all-payer claims (2013-2017) database to perform a comparative analysis of the provision and treatment outcomes of an endodontic procedure (root canal therapy) in the permanent teeth of a pediatric population aged 6 through 18 years, according to dental insurance payer type. Statistical analyses, including logistic regression, Cox proportional hazards regression, and the Kaplan-Meier method, were performed at person and tooth levels. RESULTS: Compared with privately insured children and adolescents, public-payer children and adolescent beneficiaries were more likely to have had root canal therapy (adjusted odds ratio, 1.91; 95% CI, 1.73 to 2.11) and had poorer treatment outcomes associated with the procedure (adjusted hazard ratio, 2.19; 95% CI, 1.53 to 3.14; P < .0001) during the study period. Those enrolled in private insurance were more likely to receive treatment from an endodontist (specialist in providing root canal therapy) (P < .0001). Amounts allowed and paid by the insurer were significantly higher for private payers (P < .001). CONCLUSIONS: There were significant differences in the provision and outcomes of endodontic treatment between privately and publicly insured children and adolescents. PRACTICAL IMPLICATIONS: Despite ostensibly equal access to care, differences in the provision of oral health care exist between privately and publicly insured patients. These differences may be contributing to persisting oral health disparities.

A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State.

Objectives: This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. Methods: New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6-18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. Results: Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02-1.10), as was rurality (aOR = 1.15; 95% CI = 1.06-1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83-0.93 and aOR = 0.78; 95% CI = 0.74-0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92-0.94 and aHR = 0.86; 95% CI = 0.81-0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21-1.41 and aHR = 1.55; 95% CI = 1.43-1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71-0.88). Conclusion: Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.

Exploring Public Perceptions of Dental Care Affordability in the United States: Mixed Method Analysis via Twitter.

BACKGROUND: Dental care expenses are reported to present higher financial barriers than any other type of health care service in the United States. Social media platforms such as Twitter have become a source of public health communication and surveillance. Previous studies have demonstrated the usefulness of Twitter in exploring public opinion on aspects of dental care. To date, no studies have leveraged Twitter to examine public sentiments regarding dental care affordability in the United States. OBJECTIVE: The aim of this study is to understand public perceptions of dental care affordability in the United States on the social media site, Twitter. METHODS: Tweets posted between September 1, 2017, and September 30, 2021, were collected using the Snscrape application. Query terms were selected a priori to represent dentistry and financial aspects associated with dental treatment. Data were analyzed qualitatively using both deductive and inductive approaches. In total, 8% (440/5500) of all included tweets were coded to identify prominent themes and subthemes. The entire sample of included tweets were then independently coded into thematic categories. Quantitative data analyses included geographic distribution of tweets by state, volume analysis of tweets over time, and distribution of tweets by content theme. RESULTS: A final sample of 5314 tweets were included in the study. Thematic analysis identified the following prominent themes: (1) general sentiments (1614 tweets, 30.4%); (2) delaying or forgoing dental care (1190 tweets, 22.4%); (3) payment strategies (1019 tweets, 19.2%); (4) insurance (767 tweets, 14.4%); and (5) policy statements (724 tweets, 13.6%). Geographic distributions of the tweets established California, Texas, Florida, and New York as the states with the most tweets. Qualitative analysis revealed barriers faced by individuals to accessing dental care, strategies taken to cope with dental pain, and public perceptions on aspects of dental care policy. The volume and thematic trends of the tweets corresponded to relevant societal events, including the COVID-19 pandemic and debates on health care policy resulting from the election of President Joseph R. Biden. CONCLUSIONS: The findings illustrate the real-time sentiment of social media users toward the cost of dental treatment and suggest shortcomings in funding that may be representative of greater systemic failures in the provision of dental care. Thus, this study provides insights for policy makers and dental professionals who strive to increase access to dental care.

Outcomes of primary root canal therapy: An updated systematic review of longitudinal clinical studies published between 2003 and 2020.

BACKGROUND: A comprehensive effort to evaluate outcomes of primary root canal therapy (RCT) between 1966 and 2002 was published by Ng et al. (2007, International Endodontic Journal, 40, 921; 2008, International Endodontic Journal, 41, 6). Changes in endodontic materials and treatment methods warrant an updated analysis of outcomes. OBJECTIVES: This study aimed to (1) quantify the success rates of primary RCT published between 2003 and 2020; and (2) investigate the influence of some characteristics known/suspected to be associated with treatment outcomes. METHODS: An electronic search was performed in the following databases (01-01-2003 to 12-31-2020): Pubmed, Embase, CINHAL, Cochrane and Web of Science. Included study designs were longitudinal clinical studies (randomized control trials, cohort studies, retrospective observational studies). Studies with at least twelve-months of post-operative review and success rates based on clinical and radiographic criteria were analysed. The terms 'strict' (complete resolution of periapical lesion) or 'loose' (reduction in size of existing periapical lesion) were used to describe the outcome criteria. Weighted, pooled success rates were calculated. Random effects meta-regression models were used to investigate potential sources of statistical heterogeneity. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate for quality assessment of the included studies. RESULTS: Forty-two studies were included in the review. Meta-analyses showed that the weighted pooled success rates were estimated to be 92.6% (95% CI: 90.5%-94.8%) under 'loose criteria' and 82.0% (95% CI: 79.3%-84.8%) under 'strict' criteria. The most significant areas of study heterogeneity were year of publication and qualification of operator. The majority (64.29%) of studies were considered to be of low quality of evidence. DISCUSSION: Biological factors continue to have the most significant impact on RCT outcomes. The technological method of instrumentation had no significant effect. The quality of evidence was based primarily on study design and only randomized control trials were considered to be 'high' quality of evidence. CONCLUSIONS: The reported success rates show improvement over time. Weighted success rates for studies with a minimum of four-years follow-up had better outcomes, compared to those with less than four years, when 'strict criteria' were used. REGISTRATION: PROSPERO database (CRD42021226311).

Junior faculty perspectives on the academic environment: A call for development and onboarding.

BACKGROUND: One challenge in dental education is new faculty members can be hired with limited teaching experience or understanding of pedagogy. Recent publications document increasing initiatives of faculty development in US and Canadian dental schools. This study evaluates full-time faculty perspectives of their develop and academic environment. METHODS: A 33-item questionnaire distributed to senior administrators and forwarded to faculty, collected data on demographics and satisfaction, utilizing a 5-item Likert scale, multiple choice, and binary yes/no questions. Responses were descriptively and statistically analyzed utilizing an analysis of variance, chi-square, and two-sample t-test. RESULTS: There were 183 faculty respondents (37.7% male/62.3% female), age ranges were 20-29 (2.2%), 30-39 (53.5%), and 41-49(44.3). Respondents reported race/ethnicity: Caucasian (60.7%), Asian (19.1%), Hispanic (12.6%), Black/African American (5.5%), two or more races (2.2%), and Native American 0%. Length of employment was significantly associated with primary responsibility (p = 0.0023), recent publications (p < 0.0011), and short-term intent to remain in academia (p = 0.046). There was a statistically significant difference between age and satisfaction with professional development (p = 0.0411), achieving career objectives (p = 0.0151), well-being (p = 0.0492), access to resources for scholarly interests (p = 0.0114), communication (p = 0.0058), and assessment training (p = 0.0249). Non-Caucasian faculty reported greater dissatisfaction with being treated respectfully (p = 0.0302), departmental commitment to diversity and inclusion (p = 0.0075), and departmental cooperation/teamwork (p = 0.0323). CONCLUSIONS: A significant number of junior faculty have interest in academic dental careers. Institutions should invest in improving onboarding and professional development. Improve the early experiences of faculty, and foster diversity and inclusion and faculty well-being.

Epidemiological evaluation of the outcomes of initial root canal therapy in permanent teeth of a publicly insured paediatric population.

BACKGROUND: Previously published epidemiological outcome studies of nonsurgical root canal therapy (NSRCT) in the United States utilize data only from a single, private dental insurer for adult populations. AIM: This study aimed to investigate the outcomes of initial NSRCT, performed on permanent teeth, in a publicly insured paediatric population. DESIGN: New York State Medicaid administrative claims were used to follow 77 741 endodontic procedures in 51 545 patients aged 6-18, from the time of initial NSRCT until the occurrence of an untoward event (retreatment, apicoectomy, and extraction). The initial treatment and untoward events were identified by Current Dental Terminology codes. The Kaplan-Meier survival estimates were calculated at 1, 3, and 5 years. Hazard ratios for time to permanent restoration and restoration type were calculated using the Cox proportional hazards model. RESULTS: The median follow-up time was 44 months [range: 12-158 months]. Procedural, NSRCT, survival was 98% at 1 year, 93% at 3 years, and 88% at 5 years. Extraction was the most common untoward event. Teeth permanently restored with cuspal coverage had the most favorable treatment outcomes. CONCLUSIONS: Overall, 89% of teeth were retained and remained functional over a minimum follow-up time of 5 years. These results elucidate the expected outcomes of NSRCT in permanent teeth for paediatric patients with public-payer dental benefits.

Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study.

OBJECTIVES: Diagnosis and treatment of non-odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non-odontogenic pain, after evaluation and/or treatment by an endodontist. MATERIALS AND METHODS: A retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic. Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed. RESULTS: Thirty-five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non-compliance with orofacial pain appointments and treatments were documented for 66% of patients. CONCLUSIONS: Non-odontogenic pain diagnosis and treatment are challenging. Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non-odontogenic pain.

Exploring predoctoral dental student use of YouTube as a learning tool for clinical endodontic procedures.

PURPOSE/OBJECTIVES: The goal of the present study was to examine perceived barriers to achieving clinical competence in endodontics and explain how YouTube is used to supplement formal education in this discipline. METHODS: Postgraduate endodontic students conducted focus groups with fourth-year dental students at NYU College of Dentistry. The discussion was facilitated by a semistructured interview guide. Open-ended questions about participants' perceived barriers to clinical competency in endodontics, experiences using YouTube to learn about clinical endodontics, and preferences for video format learning were asked. Demographic information was gathered. Thematic analysis of data was conducted and data collection was terminated once saturation was achieved. RESULTS: Thirty fourth-year dental students were enrolled in the study. The majority, 96.7%, reported using YouTube as a learning tool for dental procedures and 83.3% to learn about endodontics, specifically. The following domains were explored during data analysis: barriers to clinical competency, YouTube uses/experiences, and content preferences. The following themes within barriers to clinical competency were identified: psychological, educational, and clinical. Within the YouTube domain, the following themes were examined: goals of use, timing and frequency of use, search strategies, benefit/ shortcomings of YouTube, and validity of content. Students primarily used YouTube to enhance confidence and understand procedural flow. CONCLUSION: YouTube videos were primarily used to help students overcome perceived educational and psychological barriers that resulted in gaps in confidence and knowledge of performing endodontic procedures. Dental students placed high value on easily accessible video content of limited duration, where clinical procedures were performed on live patients.

Reimagining the pipeline: Saturday Academy at New York University College of Dentistry goes virtual.

PURPOSE/OBJECTIVES: This study describes and evaluates efforts to transition an established pre-dental pipeline program to a remote platform, in response to the coronavirus disease 2019 pandemic. METHODS: The semester-long pipeline program, Saturday Academy at New York University College of Dentistry, was conducted remotely through Zoom, and materials for hands-on, pre-clinical activities, were mailed to participants. Saturday Academy aims to educate underrepresented minority and low-income high school students about the college application process and the dental profession. After the program's completion, program applications and engagement data were analyzed. An anonymous online survey was administered to the high school student participants. The survey questions included topics about their interest in the profession of dentistry, satisfaction with the Saturday Academy programming, and program engagement. RESULTS: In its remote format, Saturday Academy had an average attendance of 87.8% at each session. All (60/60, 100%) of the high school student participants responded to the anonymous program satisfaction survey. Sixty-seven percent reported an interest in the profession of dentistry before participating in the program and 82% after participating in the program. Ninety-eight percent agreed with the statement "I enjoyed my experience participating in Saturday Academy." Additionally, 97% agreed with the statement "Saturday Academy's virtual programming was effective." There were no statistically significant differences in program satisfaction when data from the virtual program were compared to 2 years of in-person program satisfaction data. CONCLUSION: Challenges to fulfilling the missions of dental institutions in response to the coronavirus pandemic impact service and recruitment efforts, in addition to formal dental education. Transitioning pipeline programming efforts, with hands-on components, to a remote format is possible and was met with favorable engagement and responses from program participants.

Assessing the pipeline: Perceived barriers to applying to dental school among pipeline program alumni.

PURPOSE/OBJECTIVES: The aim of this study was to increase the understanding of perceived barriers to applying to dental school experienced by underrepresented minority (URM), pipeline program alumni. METHODS: A qualitative study of alumni of New York University College of Dentistry pipeline programs, aimed at increasing the number of URM and low-income students in the dental profession, was conducted in 2020. Focus groups were convened to examine perceived barriers to applying to dental school and identified through a combination inductive and deductive thematic analysis. RESULTS: Twenty-three pipeline program alumni, ranging in age from 18 to 30 years old, participated in focus groups held between January and April 2020. All students identified as underrepresented minorities and 78% were first generation college students. Fifteen (65%) of the participants had not yet applied to dental school. Eight participants (35%) had applied to dental school, 3 (13%) were currently enrolled in dental school, and 5 (22%) were matriculating into dental school in Fall 2020. The following themes emerged as the most prominent challenges to applying to dental school: pre-health advisors (e.g., lack of knowledge about the pre-dental process and discouragement), and the cost of the application process (e.g., application fees, DAT and DAT preparation course costs, and interview costs). CONCLUSION: Through pre-dental pipeline programs, participants have access to informational resources and mentorship; however, despite participation in these programs, perceived barriers are still prevalent. Identification of the alumni's perceived barriers offer targeted areas where increased intervention may be helpful to reduce challenges and strengthen the pipeline.

YouTube use among dental students for learning clinical procedures: A multi-institutional study.

INTRODUCTION: The objective of this study was to evaluate the use of YouTube as a learning tool for clinical procedures among third- and fourth-year dental students. METHODS: A multiple choice survey was distributed through Qualtrics to third- and fourth-year dental students at 5 United States dental schools. Questions pertaining to YouTube use were asked related to the following categories: demographic information, general YouTube use, YouTube use as a tool to learn clinical procedures, YouTube video sharing, and validity. Descriptive and quantitative analyses were performed. RESULTS: Data were collected in 2019 and 2020 from 479 third- and fourth-year dental students (overall response rate 28.3%). Respondents ranged in age from under 23 to over age 50. Ninety-five percent of respondents considered YouTube videos on clinical procedures to be a helpful learning tool, and 89% would like for their dental school to post tutorials to YouTube/social media. No statistically significant differences were found between dental institutions; however, a statistically significant difference between third- and fourth-year students did exist regarding the frequency of YouTube use. While the use of YouTube as a learning tool for clinical procedures is high, 36% of students are uncertain about the evidence-base of the videos. CONCLUSIONS: As dental students use publicly available resources as adjuncts to the dental curriculum, it is important to analyze the quality of the material accessed. These findings may suggest a need for dental institutions to increase the development of evidence-based instructional videos as a part of their clinical educational curriculums.

Targeting the Pipeline to a Diverse Dental Student Body: Saturday Academy at New York University College of Dentistry.

Pipeline programs aim to increase the representation of underrepresented minorities in the dental profession. At New York University College of Dentistry (NYUCD), two dental students initiated the development of a pipeline program for high school students called Saturday Academy. The purpose of the program is twofold: to mentor and coach underrepresented minority and low-income high school students through the college application process, and to expose them to the field of dentistry as a viable career option through both didactic and hands-on learning. The aim of this pilot study was to determine outcomes for the first five years (2013-17) of the Saturday Academy pipeline program at NYUCD with regard to the high school students' experience with the program and their career interests after high school graduation. Across five cohorts, a total of 82 students participated in Saturday Academy. A "where are you now?" survey sent to 72 participants who reported high school graduation years between 2013 and 2018 received a response rate of 76%. The survey results showed that all (100%) of the responding Saturday Academy participants had graduated from high school and were enrolled in college, and 71% were interested in health profession careers. Almost half (47%) of the students self-identified as being pre-dental, and 96% reported that Saturday Academy had increased their interest in the dental profession. These pilot results justified an expansion of Saturday Academy at NYUCD in both size and creation of an alumni outreach initiative. Other dental schools may benefit from the strategies used by this program in establishing or expanding their pipeline programs.

Long-term Evaluation of Treatment Planning Decisions for Nonhealing Endodontic Cases by Different Groups of Practitioners.

INTRODUCTION: The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment. METHODS: A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants. RESULTS: In 2009, 262 dentists participated in the survey. Two hundred one participants were general practitioners (GPs: 76.7%), 26 endodontists (ENDOs: 9.9%), and 35 other specialists (prosthodontics, periodontics, and oral surgery [SPECs]: 13.4%) (n = 262). EXIMP, NSRTX, and SRTX were fairly equally selected but with great variation between practitioner groups (χ2 = 173.49, P < .05). A subset group of 104 participants (SUB) (39.7% of the original participants) retook the survey in 2016 (69 GPs [66.3%], 15 ENDOs [14.0%], and 20 SPECs [19.7%]). Comparisons among practitioner groups were significantly different in SUB (n = 104) for 2009 (χ2 = 95.536, P < .05) and 2016 (χ2 = 109.8889, P < .05). Intragroup reliability between 2009 and 2016 revealed no significant differences between the overall treatment planning choices for all practitioners (GPs, ENDOs, or SPECs). Intrapractitioner reliability showed many treatment planning decision changes on an individual level. Chances that individuals changed their original decision were 47.8% (95% confidence interval, 45.2%-50.4%) and were significantly different among the 3 practitioner groups (GPs > SPECs > ENDOs [χ2 = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520). CONCLUSIONS: No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.

Variability in Capsaicin-stimulated Calcitonin Gene-related Peptide Release from Human Dental Pulp.

INTRODUCTION: The unique innervation and anatomic features of dental pulp contribute to the remarkable finding that any physical stimulation of pulpal tissue is painful. Furthermore, when pathological processes such as caries affect teeth and produce inflammation of the pulp, the pain experienced can be quite intense and debilitating. To better understand these underlying neurobiological mechanisms and identify novel analgesic targets for pulpally derived pain, we have developed a powerful ex vivo model using human tooth slices. METHODS: Noncarious, freshly extracted teeth were collected and sectioned longitudinally into 1-mm-thick slices containing both dental pulp and the surrounding mineralized tissues. Tooth slices from 36 patients were exposed to 60 µmol/L capsaicin to stimulate the release of calcitonin gene-related peptide (CGRP) from nerve terminals in the pulp. Patient factors were analyzed for their effects on capsaicin-stimulated CGRP release using a mixed model analysis of variance. RESULTS: Approximately one third of the variability observed in capsaicin-evoked CGRP release was attributable to differences between individuals. In terms of individual factors, there was no effect of anesthesia type, sex, or age on capsaicin-stimulated CGRP release. Using a within-subject study design, a significant effect of capsaicin on CGRP release was observed. CONCLUSIONS: Capsaicin-stimulated CGRP release from dental pulp is highly variable between individuals. A within-subject study design improves the variability and maximizes the potential of this powerful translational model to test the efficacy of novel pharmacotherapeutic agents on human peripheral nociceptors.