A phase I trial of aminolevulinic acid-photodynamic therapy for treatment of oral leukoplakia.

BACKGROUND: Photodynamic therapy with aminolevulinic acid (ALA PDT) for oral leukoplakia has shown promising effects in regression of oral leukoplakia. Although ALA has been extensively studied and is an ideal photosensitizer, the optimal light dose for treatment of oral leukoplakia has not been determined. We conducted a phase I study to determine MTD and DLT of PDT in patients treated with ALA for leukoplakia. METHODS: Patients with histologically confirmed oral leukoplakia received a single treatment of ALA PDT in cohorts with escalating doses of light (585nm). Clinical, histologic, and biologic markers were assessed. RESULTS: Analysis of 11 participants is reported. No significant toxicity from ALA PDT was observed in patients who received ALA with a light dose of up to 4J/cm(2). One participant experienced transient grade 3 transaminase elevation due to ALA. One participant had a partial clinical response 3months after treatment. Biologic mucosal risk markers showed no significant associations. Determination of MTD could not be accomplished within a feasible timeframe for completion of the study. CONCLUSIONS: ALA PDT could be safely administered with a light dose up to 4J/cm(2) and demonstrated activity. Larger studies are needed to fully elucidate the MTD and efficacy of ALA-PDT.

Teaching casual random blood glucose screening to second-year dental students.

In our project, archived casual random blood glucose levels of second-year dental students who were taught the mechanics of self-testing were retrieved. Material data were analyzed by calculating means, medians, standard deviations, and ranges for 161 dental students screened by this casual and random self-monitoring of blood glucose levels as described by the American Diabetes Association's 2008 Standards of Medical Care in Diabetes. Three types of data were assessed in this study. The first was the casual blood glucose levels of second-year dental students. The second was the data retrieved from student questionnaires regarding the value of teaching casual random blood glucose screening. The third was the U.S. dental schools' responses regarding inclusion of casual blood glucose screening in their current curricula. Second-year dental students self-reported hypoglycemia in three instances and hyperglycemia in eight, based on current American Diabetes Association standards. Students agreed or strongly agreed that the value of teaching was informative (92.3 percent), beneficial (95 percent), and something that might be included in their practices (78.2 percent), with 19.2 percent being neutral on the inclusion. Only six U.S. dental schools reported teaching casual random glucose screening.

Segmental odontomaxillary dysplasia presenting with facial hypertrichosis, commissural lip clefting, and hyperlinear palms.

Segmental odontomaxillary dysplasia is a rare disorder that unilaterally affects the maxilla causing facial asymmetry and presenting with hypertrichosis and hypoplastic or missing teeth in the affected area. Lip clefting has only been reported in one other case. We report a case of segmental odontomaxillary dysplasia presenting with hypertrichosis of the face, hyperlinear palms with faint erythema, and commissural lip clefting.

Preserving the pipeline: a model dental curriculum for research non-intensive institutions.

Current advanced degree and research training programs no longer attract adequate numbers of students. The present system of dental education severely limits the appeal of these programs due to overcrowded curricula and clinical components that operate in an environment segregated from the academic/research enterprise. To make research-oriented education/training programs more accessible and increase the number of interested students, the culture of dental schools and dental education must change. Programs for future dental researchers and academicians must be supported by curricula that foster an appreciation of research/discovery, an interest in academic/research careers, and the application of biomedical/clinical advances to practice. The Marquette University School of Dentistry has designed a comprehensive new curriculum that supports student research and scholarly activity throughout all four years of dental education. The curriculum minimizes discipline-based courses and is structured into interdisciplinary content tracks that integrate biomedical, behavioral, and clinical sciences while emphasizing the application of science to patient care. A specific research/scholarly track represents dedicated didactic time that exposes all dental students to material not traditionally included in dental curricula. This track includes mentored research/scholarly experiences at local and national sites that are individually structured for each student. Customized student schedules facilitate participation in these experiences without hardship or penalty. This curriculum structure may serve as a model for research non-intensive institutions seeking to increase student interest in academic and research careers.

Comparison of computer-assisted brush biopsy results with follow up scalpel biopsy and histology.

Oral brush biopsy results were compared with scalpel biopsy and histology to determine the positive predictive value of an abnormal brush biopsy finding. Of 243 patients with abnormal brush biopsies, 93 proved positive for dysplasia (79) or carcinoma (14) and 150 were negative for either dysplasia or carcinoma. Therefore, the positive predictive value of an abnormal brush biopsy was 38% (93/243). By using the oral brush biopsy, dentists can inform their patients that abnormal findings have a strong positive predictive value for dysplasia or carcinoma and therefore require follow-up confirmation by scalpel biopsy.