Blended learning compared to traditional learning for the acquisition of competencies in oral surgery by dental students: A randomized controlled trial.

OBJECTIVE: To determine whether blended learning results in better educational outcomes compared to traditional learning in the acquisition of oral surgery technical skills for 4th-year undergraduate dental students. MATERIALS AND METHODS: Seventy-three students participated in this two-arm parallel randomized controlled trial. Only students in the blended learning group had access to the online preparation platform for oral surgery practical work (PW) on a pig's jaw and to the debriefing. Kirkpatrick's four-level model was used to assess the educational outcomes directly after (levels 1 and 2) and 6 months later, after the start of the students' clinical activity (levels 3 and 4). RESULTS: For level 1, higher global satisfaction scores were found for students in the blended learning compared to the traditional learning group (p = .002). For level 2, blended learning resulted in an increase in knowledge score (p < .01), comparable to that observed in the traditional learning group. For level 3, students in the blended group made more progress in 6 months than those in the traditional group in terms of feeling able to assess and perform anaesthesia (p = .040) and surgical tooth extraction (p = .043). No difference in level 4 was found for the 6-month clinical surgical activity between groups, but students in the blended group felt more able to assess and perform the surgical management of a failed extraction requiring bone removal (p = .044). CONCLUSION: Blended learning for oral surgery PW had a positive impact on three of the four Kirkpatrick levels (level 1, 3 and 4). Efforts should focus on the procedures that are perceived as the most difficult.

Evaluation of the efficacy of a custom-made monoblock mandibular advancement device in treatment of obstructive sleep apnea hypopnea syndrome.

INTRODUCTION: Mandibular advancement devices (MAD) are an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). We aimed to evaluate the efficiency of a custom-made monoblock MAD for the treatment of OSAHS. MATERIALS AND METHODS: We carried out a monocentric retrospective observational study including patients with OSAHS (mild, moderate or severe) or isolated ronchopathy from January 2005 to March 2023. The primary objective was to evaluate the overall efficiency of the MAD assessed by the percentage of patients successfully treated. The secondary objectives included the global efficiency of the device in the treatment of snoring, the report of side effects, and the identification of predictive factors for efficacy or failure. RESULTS: The medical records of 586 patients were collected, and 293 patients (229 OSAHS and 64 isolated ronchopathy) were included in the analysis. After a mean 2.9 years follow-up, 72.5 % of patients were successfully treated by MAD. We observed a significant improvement in ronchopathy, both in terms of intensity and percentage of time per night. Regarding patients with isolated ronchopathy, 87.5 % reported an improvement in their symptoms and satisfaction with their treatment. Finally, 14.0 % of the patients declared side-effects, the dentoskeletal modifications being the most frequent (6.1 % of the patients). CONCLUSION: This study confirmed the long-term efficacy and good tolerance of a custom-made monoblock orthosis in OSAHS.

Another Look at the Contribution of Oral Microbiota to the Pathogenesis of Rheumatoid Arthritis: A Narrative Review.

Although autoimmunity contributes to rheumatoid arthritis (RA), several lines of evidence challenge the dogma that it is mainly an autoimmune disorder. As RA-associated human leukocyte antigens shape microbiomes and increase the risk of dysbiosis in mucosae, RA might rather be induced by epigenetic changes in long-lived synovial presenting cells, stressed by excessive translocations into joints of bacteria from the poorly cultivable gut, lung, or oral microbiota (in the same way as more pathogenic bacteria can lead to "reactive arthritis"). This narrative review (i) lists evidence supporting this scenario, including the identification of DNA from oral and gut microbiota in the RA synovium (but in also healthy synovia), and the possibility of translocation through blood, from mucosae to joints, of microbiota, either directly from the oral cavity or from the gut, following an increase of gut permeability worsened by migration within the gut of oral bacteria such as Porphyromonas gingivalis; (ii) suggests other methodologies for future works other than cross-sectional studies of periodontal microbiota in cohorts of patients with RA versus controls, namely, longitudinal studies of oral, gut, blood, and synovial microbiota combined with transcriptomic analyses of immune cells in individual patients at risk of RA, and in overt RA, before, during, and following flares of RA.