Teaching strategy adaptations in undergraduate dental education during the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, dental institutions were challenged to rapidly adapt to the inability of teaching in-person lectures and pre-clinical simulations. Strategies had to be quickly developed to guarantee the safety of faculty and students, while also adhering to national guidelines to ensure that educational standards were met and students' graduations and entrance into residency programs were not delayed. This literature review assesses the novel strategies that dental schools created and implemented to teach in a distance-learning platform and evaluates the advantages and disadvantages of these strategies. In addition, this review talks about the lessons learned during the pandemic and the incorporation of successful strategies after the pandemic ended. METHODS: This review evaluated the literature using PubMed and ScienceDirect with the following keywords: "teaching strategies," "dental education," and "COVID-19." The search strategy yielded 15 articles that assessed relevant teaching strategies that were implemented during the COVID-19 pandemic. RESULTS: The literature described the swift response of dental institutions in implementing teaching strategies in response to the inability of continuing in-person teaching. An overwhelming majority of institutions moved their didactic lectures to online platforms. Several institutions implemented online simulations with virtual reality models, videos and discussion boards, standardized patient actors, and case-based discussions. CONCLUSION: Many of the teaching strategies that were implemented as a result of the COVID-19 pandemic were highly effective. Dental schools were able to satisfy Commission on Dental Accreditation standards and meet students' requirements for graduation during the pandemic despite the rapid and unplanned shift away from in-person instruction and simulation secondary to the COVID-19 pandemic.

Is Female Representation Increasing in Society and Journal Editorial Boards in Oral and Maxillofacial Surgery?

PURPOSE: Surgical specialties, including oral and maxillofacial surgery (OMS), are traditionally male-dominated fields. This study aimed to analyze the proportions of female surgeons on specialty society boards and journal editorial boards in OMS in the United States and to assess whether they were proportionate with female representation in OMS academic faculty between 2011 and 2020. METHODS: A retrospective cohort study was performed using information obtained from the websites of two major OMS journals and information obtained directly from six American specialty societies for OMS. The predictor variable was time. The outcome variable was gender. Temporal changes in the proportion of women on society and journal editorial boards were compared with those amongst full-time board-certified faculty. Chi-squared test and simple linear regression were used for statistical analyses. RESULTS: Between 2011 and 2020, the proportion of women on editorial and society boards was 6.7% (31 women among 463 editorial board members) and 7.8% (43 women among 553 society board members), respectively. The proportion of women on editorial boards increased from 4.5% in 2011 to 10.6% in 2020 (ß = 0.656 [95% confidence interval, 0.336-0.975], P = .001) and that of women on society boards increased from 4.3% in 2011 to 10.3% in 2020 (ß = 0.645 [95% confidence interval, 0.252-1.037], P = .005). The proportion of women on editorial boards in 2011-2012 was significantly lower than that in full-time board-certified faculty positions (4.3% vs 11.0%, P = .045), whereas by 2019-2020, there was no difference between the 2 groups (9.8% vs 12.5%, P = .454). Similarly, the proportion of women on society boards in 2011-2012 tended to be lower than that in full-time board-certified faculty positions (5.6% vs 11.0%, P = .111), while in 2019-2020, no difference was observed between the 2 groups (10.4% vs 12.5%, P = .531). CONCLUSION: The proportion of women on society and journal editorial boards in OMS remains low but has progressively increased from 2011 to 2020, resulting in proportionate female representation in these positions compared with the gender composition of academic faculty in recent years. The current upward trend of female representation in leadership positions will hopefully present more diverse opportunities and mentorship/role models for trainees.

Preclinical Local Anesthesia Education in Dental Schools: A Systematic Review.

The aim of this systematic review was to evaluate the published literature on current educational techniques used to teach local anesthesia administration in U.S. dental schools to determine the methods by which potential complications may be minimized and efficacy maximized. A PubMed search was performed in June 2017 on the following terms: (local anesthesia, education, dental) AND (Humans[Mesh]). Out of 136 articles identified, 13 met the study criteria and were included for review. Of those, the nine with outcome measures were included in the qualitative synthesis. With a quality assessment tool designed for this study, the quality of each included article was assessed independently by three of the authors. Three main pedagogies were identified: didactic instruction based on textbooks and lectures, student-to-student injections, and use of anatomic models. However, the effects of these pedagogies on local anesthesia administration efficacy, patient satisfaction, and student confidence in administering local anesthesia were largely not assessed in these studies. Quality assessment of the reviewed articles yielded a mean score of 62% (range 44-83%) for the observational studies and a mean score of 56% (range 47-63%) for the interventional studies. Due to the heterogeneity of the studies assessed, no meta-analysis could be performed. While the experimental and observational studies reviewed provided some insight into the efficacy of current educational techniques, they had numerous methodological inconsistencies. The inconsistency of the available evidence made it difficult to make fully informed curriculum recommendations based on the existing literature.

Tranexamic Acid as a Hemostatic Adjunct in Dentistry.

Clinicians often perform dental procedures and dentoalveolar surgery on patients who take prescribed anticoagulant medications. Such medications can present clinical challenges with regard to modifying or temporarily discontinuing a patient's anticoagulant regimen, which may not be medically indicated. In many instances discontinuation or altering of anticoagulation can be avoided through use of local hemostatic factors while patients are therapeutically continued on their prescribed warfarin doses. This article discusses a useful adjunct to dental treatment for the warfarin-anticoagulated patient- tranexamic acid (TA). The purpose of TA in these dental patients is to promote safe surgical site hemostasis for improved intraoperative visibility and postoperative hemostasis.

Low quality evidence for treatment approaches for oro-antral communications.

Data sourcesCochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline via Ovid, Embase via Ovid, US National Institutes of Health Trials Registry and the World Health Organisation (WHO) International Clinical Trials Registry Platform were searched until July 2015 followed by hand searching of relevant references.Study selectionUsing no language restrictions, two authors independently assessed for inclusion of randomised controlled trials (RCTs) evaluating any intervention for treating oro-antral communications (OAC) and oro-antral fistulae (OAF) due to dental procedures. Quasi-RCTs and crossover trials were excluded.Data extraction and synthesisTwo authors independently assessed for inclusion, resolved disagreement by discussion and a third reviewer was consulted if necessary.Qualitywas determined independently by using GRADE 2004.For the dichotomous outcome complete closure, they expressed the estimate effect as risk ratio (RR) with 95% confidence interval (CI).ResultsA single study that started with 22 participants was included in the review where the overall risk of bias was judged as unclear. The main outcome was complete closure. The study compared pedicled buccal fat pad flap (PBFPF) with buccal flap (BF) and showed no difference in the closure of OAC, with a calculated RR of 1.00, 95% CI 0.83 to 1.20.ConclusionsVery low quality evidence from a small single study provided insufficient proof to judge if there is a difference in the effectiveness of the interventions.

Introduction and overview of bone grafting.

Implants are becoming the standard of care for the replacement of missing teeth; therefore, an in-depth understanding of bone grafting and bone healing is essential for the modern practitioner. We provide an overview of basic bone biology and graft classifications that are frequently used in these procedures. In it, we present the three different properties of bone grafting materials, including osteoinduction, osteogenesis and osteoconduction. And we describe different types of bone grafting materials, including natural and artificial bone sources.

Inferior alveolar nerve canal position: a clinical and radiographic study.

PURPOSE: To document a clinically relevant position of the inferior alveolar nerve (IAN) in dentate patients and identify patient factors associated with IAN position. MATERIALS AND METHODS: The investigators used a cross-sectional study design and a study sample of subjects who had a radiographically identifiable IAN canal and at least 1 mandibular first molar was enrolled. Predictor variables were age, gender, and race. Outcome variables were the linear distances between the buccal aspect of the IAN canal and the outer buccal cortical margin of the mandible, and the superior aspect of the IAN canal and the alveolar crest. Appropriate uni-, bi-, and multivariate statistics were computed. RESULTS: The study sample was composed of 50 patients with a mean age of 42 years, 42.0% were male, and 73.2% were white. On average, the buccal aspect of the canal was 4.9 mm from the buccal cortical margin of the mandible. The superior aspect of the IAN canal was 17.4 mm inferior from the alveolar crest. Age and race were statistically associated with IAN position relative to the buccal cortical mandibular margin (P<.05). None of the demographic variables were associated with vertical position. CONCLUSIONS: The IAN canal was 4.9 mm and 17.4 mm from the buccal and superior cortical surfaces of the mandible, respectively. The bucco-lingual IAN canal position was associated with age and race. Older patients and white patients, on average, have less distance between the buccal aspect of the canal and the buccal mandibular border. To minimize the risk of IAN injury, these variables should be considered when planning mandibular osteotomies or using monocortical plates.

Nerve growth factor is expressed in rat femoral vein.

PURPOSE: Entubulization is a well known method of nerve repair for defects too large to be reconstructed by direct suturing without tension. Vein grafts and alloplastic tubes have been used for entubulization in peripheral and cranial nerves, but the mechanism by which they promote healing is poorly understood. The overall hypothesis of this laboratory is that nerve growth factor (NGF) plays an important role in nerve regeneration after entubulization with a vein graft. The purpose of this pilot study was to localize NGF protein expression in the rat femoral vein. MATERIALS AND METHODS: Sciatic nerves and femoral veins were harvested from adult male Sprague-Dawley rats. Femoral arteries were also collected and used for comparison and validation of the analysis. All specimens were fixed in paraformaldehyde and embedded in paraffin. Specimens were either stained with hematoxylin and eosin or used for immunohistochemical reaction with anti-NGF antibody. RESULTS: Sciatic nerve was used as a positive control to identify the monofascicular architecture with hematoxylin and eosin and to document the positive immunohistochemical reaction. NGF immunoreactivity was present in the tunica intima and tunica adventitia of femoral vein and artery but not in the tunica media. CONCLUSION: The results of this pilot study indicate that NGF is detectable in both the intimal and adventitial layers of the rat femoral vein and artery but not in the smooth muscle wall. These findings suggest that vein grafts could potentially promote nerve regeneration by supplying NGF to the injured nerve.