Rose-trellis periosteal release in oral mucosal advancement flaps in pigs.

The aims of this study were to find out whether scoring in a rose-trellis pattern improved the stretch of mucoperiosteal flaps more than conventional scoring in the horizontal plane, and to consider its application in the closure of oroantral communications. Sixteen sections of cadaveric porcine buccal mucoperiosteum were removed from the molar region of the maxilla and mandible. A three-sided flap was raised in the subperiosteal plane, excised, and pinned to a cork board with the periosteal side facing upwards. Eight samples were scored in the horizontal plane (control) using lines perpendicular to the line of simulated advancement, and eight in a rose-trellis or criss-cross pattern. Scoring using a rose-trellis pattern yielded a mean increase in stretch of 24.3% (p=0.0003) when compared with the conventional method. Buccal advancement flaps are widely used to close oroantral communications, and scoring of the mucoperiosteum facilitates the stretching of the tissue over the defect. To be successful, defects should be fully closed to prevent contamination, and closure should be tension-free. In this study, scoring in a rose-trellis pattern increased the stretch of the tissue sample more than scoring in the horizontal plane. The rose-trellis technique therefore could aid the effective closure of oroantral communications.

Review of the Intercollegiate Surgical Curriculum Programme for oral and maxillofacial surgery aesthetics: are we underselling ourselves?

Aesthetic facial surgery is considered to be within the remit of the maxillofacial surgeon but this is not reflected currently in the trainees' curriculum. In contrast, the plastic surgery curriculum demands detailed training in facial aesthetics. In this paper we have compared the UK OMFS, plastics, and otolaryngology curricula, and used the feedback of trainees to suggest a new aesthetics curriculum. Our method was based on the first three steps of Kern's 1998 six-step model of curricula development: identification of problems, assessment of need, and goals or objectives. The cosmetic certification criterion of the Royal College of Surgeons was used as a baseline for comparison. There was huge variation in the detail and specification of the three specialties' curricula: plastics covered 11/11 of the assessed procedures, while OMFS and otolaryngology covered 7/11 And 4/11, respectively. A total of 45 trainees provided feedback and there was an overall consensus that more training in aesthetics would be beneficial, though accessibility to resources would be an issue. With input from the BAOMS aesthetics lead, our ambitious curriculum increases the number of logbooks to reflect our expertise in the head and neck. It also broadens the span of training over all years of specialist training and, most importantly, relaxes the criteria for transferrable skills. Embracing aesthetics as part of the core curriculum will be beneficial for the future of OMFS, and will produce more rounded surgeons at the end of training. Even the most optimistic observers cannot ignore the financial and logistical setbacks that will have to be faced to achieve this, but we hope that this paper will stimulate a discussion.

Human papillomavirus (HPV) and its vaccine: awareness and opinions of clinical dental students in a UK dental school.

Introduction: Dental clinicians are in a position to educate their patients on the subject of HPV as part of a primary healthcare multidisciplinary team and to detect HPV-related disease. Attention needs to be paid to dental undergraduate teaching on the topic. This study aims to ascertain awareness and opinions of our dental undergraduate students about HPV, its relation to oral health and its vaccine. Method: A questionnaire was distributed to undergraduate dental students in clinical years 3, 4 and 5 of the BDS programme at Bristol Dental School. Results: Dental students demonstrated an understanding of HPV and oropharyngeal cancer and expressed that they felt dentists should play a role in health promotion in relation to oropharyngeal cancers. They also wished for more teaching on the subject and suggested topic areas that they wished to know more about. Conclusion: New teaching strategies on the topic of HPV should be considered for inclusion into undergraduate dental programmes and encompass both knowledge and communication skills training to prepare future dentists for their role in confronting this preventable disease.

Can UK undergraduate dental programmes provide training in non-surgical facial aesthetics?

Aim Recently, more and more dentists have found themselves engaging in the delivery of non-surgical facial aesthetics (NSFA) as part of their regular practice routine. NSFA is a growing field in aesthetic medicine that is practised by a range of clinicians including doctors, dentists and registered prescriber nurses and is an industry estimated to be worth over £3 billion in the UK alone. In the past few years, several public scandals in aesthetic medicine have prompted reactions by several bodies including the Government and Royal Colleges. With Health Education England (HEE) having recently released standards in education, it is clear that a shift in attitude towards training is imminent. With a large volume of dentists making up this NSFA workforce it is reasonable to consider the stance of undergraduate training and the relevance of the existing knowledge within dentistry in the context of the HEE standards.Method All dental schools in the UK were contacted to establish the range of subjects taught within the curriculum, with particular reference to those relevant to NSFA. The two largest aesthetic pharmacies were contacted regarding numbers of registered dentists they serve.Results Twelve out of 16 dental schools responded. Two-thirds of responding dental schools do not cover NSFA in their curricula. However, many dental schools cover related subjects including: facial anatomy/material science/neuromuscular junction physiology (100%), anatomy of the aging face (66%), pharmacology of botulinum toxin (25%) and ethical-legal implications of aesthetic dentistry/NSFA (50%/42% respectively).Conclusion Dentists are well placed to deliver NSFA given their background in relevant subjects and surgical training. With the emergence and growth of such a large multi-disciplinary field it is crucial that dentistry is not left behind. Just as most dental schools have embraced the evolution of cosmetic dentistry and implantology, it would be prudent to consider that training standards around NSFA are reflected in both undergraduate curricula and appropriate post-graduate clinical training for dentistry.

Limited impacts of truck-based ultra-low-volume applications of mosquito adulticides on mortality in honey bees (Apis mellifera).

Adulticides applied against mosquitoes can reduce vector populations during times of high arbovirus transmission. However, impacts of these insecticides on pollinators and other non-target organisms are of concern to mosquito control professionals, beekeepers and others. We evaluated mortality of Culex quinquefasciatus and Apis mellifera when caged insects were exposed to low and high label rates of four common adulticides (Aqua-Pursuit™ [permethrin], Duet® [prallethrin + sumithrin], Fyfanon® [malathion] and Scourge® [resmethrin]) at six distances up to 91.4 m from a truck-mounted ultra-low-volume sprayer. Honey bee mortality was both absolutely low (61 m had limited impacts on honey bee mortality while providing effective mosquito control.

Academic background of oral and maxillofacial specialty trainees in the United Kingdom.

INTRODUCTION: The academic profile of a specialty can be measured in a number of ways. In the selection process for entry into higher training in oral & maxillofacial surgery (OMFS) and for interface fellowships in surgery trainees are awarded points for papers published, presentations, teaching and learning, grants and higher degrees. General information about career development can provide trainers, and trainees, with information and guidance. METHODS: A web-based questionnaire was developed and distributed via electronic mailing lists to all OMFS specialist trainees. Basic demographic information was collected. Previous, current and future career plans were questioned, as was academic background in terms of publications, presentations, prizes and research grants as well as further degrees and examinations. RESULTS: One hundred and five OMFS specialty registrar trainees (StR) replied (76.6% response rate). 83.3% were male and the average age of all trainees was 37 years old. 74.7% obtained a training post on the first application. 62.6% of trainees were keen to practice in trauma surgery. 76.6% were keen to undertake a fellowship. 20.9% were keen to be involved in academia (teaching) and 9.9% in academia (research). 22.1% of trainees had obtained grants. CONCLUSION: Those involved in appointing to training programmes will now be able to see the level of competition. Future applicants to training programmes in oral and maxillofacial surgery in the United Kingdom are now aware of the level of competition. OMFS is not immune to the 'academic crisis' that exists in other surgical specialties, and the completion of higher degrees and entry in to academic careers should be encouraged and supported among trainees with an interest.

Qualitative comparison of curricula in oral and maxillofacial surgery training. Part 2: oral surgery.

A comparison between the curricula for specialist training in oral surgery (OS), and oral and maxillofacial surgery (OMFS) illustrates the overlap between the two specialties. We identified and compared relevant curricula for OMFS with competencies in the OS specialist-training curriculum using a qualitative assessment to establish the degree of overlap. All competencies within the OS curriculum are covered by OMFS curricula, and 21 of 96 OMFS clinical competencies are covered by OS core competencies. The majority of OMFS competencies are unique and are not directly comparable with those in the OS curriculum. Knowledge of this overlap may help to avoid unnecessary duplication in the training of those who wish to transfer specialty.

Qualitative comparison of curricula in oral and maxillofacial surgery training. Part 1: dental foundation training.

Dental foundation training (DFT) is a two-year programme being introduced for new dental graduates. It is not currently compulsory but there are plans to make it so. Those studying oral and maxillofacial surgery (OMFS) must complete both medical and dental degrees, and training, and if DFT becomes a requirement for dental registration, the process could be lengthened. We aimed to examine the overlap between DFT and medical foundation and core surgical training, to highlight areas of potential duplication for those who completed their surgical training before graduating from dental school. Relevant curricula for OMFS trainees were identified and compared with the DFT curriculum, and a qualitative assessment tool was developed to measure overlap between non-analogous curricula. Depending on previous experience, an OMFS trainee who completed core training in surgery before studying dentistry may already have covered 76% of the DFT curriculum. Areas with the least duplication in clinical skills (53%) were notably those related to restorative dentistry, prosthodontics, and periodontology, but there was considerable overlap in non-clinical areas such as communication skills (100%) and professionalism (90%). A method of standardised assessment of previous experience may allow for DFT to be shortened for OMFS trainees.

Short communication articles published in BJOMS during 2008-2009--an analysis of types of submission and subject material.

The British Journal of Oral and Maxillofacial Surgery (BJOMS) accepts many types of papers that include leading articles, reviews, full length articles, and short communications. Many of the latter are isolated case reports of rare or interesting pathology, or personal experience of a difficult or unexpected complication. Case reports are considered to have a relatively low value in the advancement of medical knowledge, and with increasing pressure for space in paper publications, many journals now limit them to online publication only. We evaluated all 142 short communications published in BJOMS during 2008/2009. Most (87%) were single case reports, and they covered virtually the whole remit of the specialty. There were also 14 formal studies that included two laboratory-based research projects; these were excluded from the analysis. We used established criteria to assess the possible educational value of each publication, and found that 61/128 papers (48%), while interesting and informative, probably added little to existing knowledge. The remaining papers described new or unreported cases, rare or unexpected outcomes, and adverse effects or complications of treatment. We discuss the possible implications of this study for readers of BJOMS and for the journal itself.

Radiology trainees in the UK and Ireland: academic background, publication rates and research plans.

To assess the level of achievement of current trainees, we investigated the academic qualifications, publication rates and future research plans of 240 radiology trainees in the UK and Ireland. All radiology trainees in the UK and Ireland were surveyed by a questionnaire enquiring about academic record and career ambitions. Our study shows that the level of academic achievement of radiology trainees is high, and provides interesting information concerning the current group of radiology trainees in these regions. It will be of interest both to radiology trainers and to doctors hoping to pursue a career in radiology. It also demonstrates that a potential recruitment crisis in academic radiology exists.

Canopy penetration and deposition of barrier sprays from electrostatic and conventional sprayers.

An experimental study was conducted to investigate the usefulness of electrostatic and conventional sprayers for barrier applications. Two conventional and three electrostatic sprayers were used in the study. Usefulness of the sprayers was rated based on penetration of spray into and deposition onto 2 sides of leaves on natural vegetation. Bifenthrin (Talstar adulticide) was applied at labeled rate, fluorescent dye was added to the tank mix as tracer, and all sprayers applied the dye and insecticide at the same rate. The results indicated that sprayers producing larger droplets produced significantly higher deposition on vegetation in barrier applications than the sprayers producing smaller droplets. Sprayers with higher air velocity at the nozzle discharge proved significantly better for barrier sprays than the sprayers with lower air velocity. Electrostatic sprayers did not show any improvement in deposition on vegetation or in penetration into vegetation over the conventional sprayers. There was no difference in deposition between truck-mounted and backpack sprayers.

Samplers for evaluation and quantification of ultra-low volume space sprays.

A field study was conducted to explore the suitability of 5 pesticide deposition samplers for airborne spray and ground deposits from ultra-low-volume (ULV) space sprays. Samplers included horizontally stretched stationary cotton ribbons at 2 heights, rotating ribbon, rotating Teflon slides, and filter paper. Slides were also used for droplet-size analysis. A set of 7 samplers of each type was placed at 1, 7, 15, 25, 40, 65, and 90 m from the spray line along the spray swath. Water and BVA13 oil with fluorescent dyes as tracers were sprayed with the use of a truck-mounted ULV sprayer at dusk and dawn. Results suggest that the horizontal and rotating cotton ribbons are best for quantification of airborne spray and filter paper is best for ground deposition collection. The rotating slide samplers only detected the BVA13 oil-based sprays.