Underrepresented minority students' experiences at Baylor College of Dentistry: perceptions of cultural climate and reasons for choosing to attend.

A study was conducted at Texas A&M University Baylor College of Dentistry (TAMBCD) in fall 2011 to identify the reasons underrepresented minority (URM) students chose to attend TAMBCD, the factors that supported their success as enrolled students, and their perceptions of the institution's cultural climate. A survey distributed online to all URM students received a 79 percent response rate (129/164). The respondents were primarily Hispanic (62 percent Mexican American and other Hispanic) and African American (33 percent) and had attended a college pipeline program (53 percent). The top reasons these students chose TAMBCD were reputation, location, and automatic acceptance or familiarity from being in a predental program. Alumni had most influenced them to attend. Regarding support services, the largest percentage reported not using any (44 percent); personal advising and tutoring were reported to be the most commonly used. In terms of climate, discrimination was reported by 22 percent (n=29), mostly from classmates and clinical faculty. The majority (87 percent) reported their cultural competence program was "effective" and agreed that faculty (83 percent), staff (85 percent), and students (75 percent) were culturally competent. Overall, the students were "satisfied" with how they were treated (88 percent), their education (91 percent), and the services/resources (92 percent). This information is being used to continue to improve the school's cultural climate and to conduct a broader assessment of all students.

A tool for assessing cultural competence training in dental education.

Policies exist to promote fairness and equal access to opportunities and services that address basic human needs of all U.S. citizens. Nonetheless, health disparities continue to persist among certain subpopulations, including those of racial, ethnic, geographic, socioeconomic, and other cultural identity groups. The Commission on Dental Accreditation (CODA) has added standards to address this concern. According to the most recent standards, adopted in 2010 for implementation in July 2013, CODA stipulates that "students should learn about factors and practices associated with disparities in health." Thus, it is imperative that dental schools develop strategies to comply with this addition. One key strategy for compliance is the inclusion of cultural competence training in the dental curriculum. A survey, the Dental Tool for Assessing Cultural Competence Training (D-TACCT), based on the Association of American Medical Colleges' Tool for Assessing Cultural Competence Training (TACCT), was sent to the academic deans at seventy-one U.S. and Canadian dental schools to determine best practices for cultural competence training. The survey was completed by thirty-seven individuals, for a 52 percent response rate. This article describes the use of this survey as a guide for developing culturally competent strategies and enhancing cultural competence training in dental schools.

Achieving student diversity in dental schools: a model that works.

It is well known that there is a large disparity between the proportions of African Americans, Hispanics, and American Indians in the general U.S. population and in the nation's dental profession. While these underrepresented minorities (URMs) together make up almost 30 percent of the population, they comprise only about 6 percent of U.S. dentists. For years, the American Dental Education Association has been diligently working with U.S. dental schools to reduce this disparity by increasing the diversity of their student bodies. However, with approximately 13 percent of first-year dental students coming from URM groups, the proportion of URM students entering dental school continues to remain significantly below that of the general population. Diversifying the dental profession is important for improving access to care for underrepresented groups, and student diversity provides better educational experiences for all students. Texas A&M Health Science Center Baylor College of Dentistry's strategy for increasing the number of URM dentists was to create a series of initiatives that together form a successful comprehensive program addressing students' awareness of and attraction to a dental career, academic enrichment, admissions, and graduation. The cumulative impact of this program is that the college enrolled greater numbers and proportions of URM students than any other non-minority U.S. dental school from 2006 to 2009. This article describes the program that led to these successes.

Retention of underrepresented minority students in dental school: one dental schools story.

There is a large disparity between the proportions of African-Americans, Hispanics, and Native Americans in the general population and in the dental profession. While these underrepresented minorities (URMs) as a group make up almost 30% of the United States population, they constitute only about 6% of the nation's dentists. Eliminating this disparity is important in addressing access to care for underrepresented groups. Texas A&M Health Science Center Baylor College of Dentistry (TAMHSC-BCD) enrolled greater numbers and proportions of URM students than any other non-minority school from 2006-2010. Strategies used to achieve this level of diversity include a Whole File Review process; career awareness activities for elementary, junior high and high school students; and academic enrichment programs for college students and college graduates. Retaining and graduating URM students is just as important as enrolling them. TAMHSC-BCD's retention rate over the last five years is 95.7% for all students and 92.5% for URM students. A wide range of services aids in the retention process. These services are available to all students and include monitoring of students' academic performance followed up with academic advisement as appropriate, peer tutoring, an alternative five-year curriculum, professional psychological counseling, professional learning assessments, social support; and mentoring through student organizations. The retention program at TAMHSC-BCD can serve as a model for other dental and other health professions schools seeking ways to ensure the academic success of their URM students. The more of these students we enroll and graduate, the more the problem of access to dental care is addressed.

Guide for the mentoring dentist: the admissions office perspective.

There is no better way to give back to dentistry--which has given us so much as dentists--than to mentor a young person into the profession. With the size of the applicant pool dramatically increasing over the past 10 years (73.6 percent), the challenge of the admissions process has increased as well. To put it simply, the "line" of those desiring dentistry as a profession has become quite long. In 2010, based upon data from the Texas Medical and Dental Schools Application Service, the ratio of dental applicants to positions exceeded the ratio of applicants to medical school positions! We haven't seen ratios like this since the late 1970's. This guide will aid mentoring dentists in the process of helping their mentees to be successful as applicants, dental students and, ultimately, dental practitioners.

Failure modes with point loading of three commercially available denture teeth.

PURPOSE: A common problem associated with implant-supported prostheses is the fracture of denture teeth. This study was designed to compare the fracture modes of three denture teeth by compressive load at a 30 degrees off-axis angle. MATERIAL AND METHODS: Three denture teeth (Vident Duostat, Ivoclar Vivadent, and Dentsply Trubyte) processed to two denture base processing systems [injection-molded (IM) SR-Ivocap system and compression-molded (CM) denture base resin] were evaluated. Each specimen was processed to a metal framework. Ultimate failure strength of each system when point loaded at a 30 degrees off-axis angle was recorded, along with a visual inspection of each specimen. RESULTS: The average load fracture for each group was (in N): Vident CM 1106.97 +/- 223.20, Vident IM 1168.18 +/- 322.52, Dentsply CM 1098.08 +/- 286.32, Dentsply IM 1023.80 +/- 282.45, Ivoclar CM 1616.98 +/- 204.87, and Ivoclar IM 1373.54 +/- 282.58. There was a significant difference between the groups and the Ivoclar CM group. The Ivoclar CM group had the highest average load force, and the Dentsply IM group had the lowest average load force. On average, the teeth within the groups fractured at a higher compression force than the average maximum occlusal force in natural dentition. Dentsply and Vident denture teeth fractured more horizontally, and the Ivoclar denture teeth fractured more vertically within the groups. There was no significant difference among the groups between the IM and CM processing methods. CONCLUSIONS: In the present in vitro study, all specimens were able to withstand 30 degrees off-axis loading with the exception of one specimen. With these results, this would indicate that these denture teeth are able to withstand normal occlusal forces.

Orthodontic bonding with varying curing time and light power using an argon laser.

OBJECTIVE: To test the effects of curing time and light intensity on the shear bond strength of adhesive composites for stainless-steel orthodontic brackets. MATERIALS AND METHODS: An argon laser at four different power settings (100, 150, 200, and 250 mW) and four different exposure times (5, 10, 15, and 20 seconds) was used to bond adhesive-precoated (APC) stainless-steel incisor brackets to the facial surfaces of 154 bovine incisors. The shear bond strength of each specimen in 16 randomly divided groups was randomly tested to failure using an Instron universal testing machine. Each mode of failure was described using the adhesive remnant index (ARI). RESULTS: The ARI scoring system showed that the location of bond failure did not differ significantly in relation to exposure time (P = .40). However, the location of bond failure was significantly different in relation to light power (P = .03). CONCLUSIONS: A short exposure time and a low power setting produce shear bond strengths equivalent to those produced by longer exposure times and higher power settings.

Distance and time effect on shear bond strength of brackets cured with a second-generation light-emitting diode unit.

OBJECTIVE: The aims of this study were to evaluate increasing exposure times and distance between source (light-emitting diode) and adhesive composite on the shear bond strength (SBS) of stainless steel brackets. MATERIALS AND METHODS: Stainless steel maxillary incisor brackets (3M Unitek, Monrovia, Calif) were bonded to the facial surfaces of 120 bovine incisors. The bond of each specimen in eight randomly divided groups was tested to failure using an Instron Universal Testing Machine (Instron Corp, Canton, Mass). The mode of failure was evaluated using the adhesive remnant index (ARI). RESULTS: There were significant SBS differences between exposure times; 5-second exposures were significantly less than at 20-and 40-second exposures; SBS increased in a curvilinear fashion. Significant differences were recorded neither in the frequencies of ARI scores nor the SBS in relation to distance. Significant differences in the frequencies of ARI scores were observed when comparing the 5-second cure time to other time periods, indicating incomplete polymerization in the bracket base. CONCLUSIONS: SBS increased with increasing time periods in a curvilinear fashion, with no difference between the distances evaluated from source to specimen.

Immediate bonding to bleached enamel.

This research sought to determine the shear bond strength, degree of resin infiltration and failure mode when organic solvent-based adhesives (acetone or ethanol) were used in immediate bonding to enamel bleached with 10% carbamide peroxide or 38% hydrogen peroxide systems. Seventy-two non-carious bovine incisors were randomly assigned to three groups of 24 specimens each-control group (deionized water), 38% hydrogen peroxide bleach group and 10% carbamide peroxide bleach group. Each group was further subdivided into two subgroups of 12 specimens each according to the adhesive system used to bond the resin composite to enamel surfaces. The two adhesive systems used were Single Bond, an ethanol-based adhesive, and One Step, an acetone-based adhesive. The shear bond strengths of 38% hydrogen peroxide and 10% carbamide peroxide were significantly lower compared to the non-bleached controls. Fractography revealed an adhesive failure mode in all specimens. Qualitative comparisons of resin tags present in the bleached and unbleached specimens using scanning electron microscopy (SEM) revealed few, thin and fragmented resin tags when 38% hydrogen peroxide and 10% carbamide peroxide were used.

Resin bonding to sclerotic, noncarious, cervical lesions.

Noncarious, cervical, wedge-shaped, sclerotic lesions are commonly encountered in clinical practice. In such lesions, dentin has been pathologically altered, often resulting in partial or complete obliteration of the dentinal tubules. These lesions are known to respond to etching and bonding differently from normal dentin, leading to complications during clinical treatment. A search of the literature was performed to obtain background information on the most commonly cited etiologic factors, clinical diagnoses, and morphologic and chemical characterizations along with an extensive review of all potential obstacles to bonding the most recent adhesives to such a dentinal substrate. Recent progress in adaptive strategies to render dentin more receptive to resin bonding is emphasized in this article, and the major drawbacks of these strategies are discussed.

Mycobacteria inhibit nitric oxide synthase recruitment to phagosomes during macrophage infection.

Inducible nitric oxide synthase (iNOS) is a cytoplasmic protein responsible for the generation of nitric oxide (NO. ) in macrophages. In this work, we hypothesized that the intracellular localization of iNOS is significant for effective delivery of NO. to phagosomes containing ingested microorganisms. Using immunofluorescence microscopy and Western blot analysis, iNOS was shown to localize in the vicinity of phagosomes containing latex beads in stimulated macrophages. iNOS also localized to phagosomes containing Escherichia coli. The colocalization of iNOS with ingested latex beads was an actin-dependent process, since treatment with the actin microfilament disrupter cytochalasin D prevented iNOS recruitment to latex bead phagosomes. In contrast to E. coli and inert particle phagosomes, mycobacterial phagosomes did not colocalize with iNOS. This study demonstrates that (i). iNOS can be recruited to phagosomes; (ii). this recruitment is dependent on a functional actin cytoskeleton; (iii). certain microorganisms have the ability to prevent or reduce colocalization with iNOS; and (iv). spatial exclusion of iNOS may play a role in Mycobacterium tuberculosis pathogenesis.

Evaluation of the ITI Morse taper implant/abutment design with an internal modification.

PURPOSE: The purpose of this study was to compare internal Morse taper connections in 2 separate modes: repeated torque/reverse-torque values and compressive bending at a 30-degree off-axis angle. MATERIALS AND METHODS: Three sample groups (n = 12 in each group)--a solid-screw implant paired with a 5.5-mm solid abutment (SSI), a synOcta implant with a 5.5-mm solid abutment (SOI), and a synOcta implant with a synOcta 5.5-mm solid abutment (SOSA)--were torqued to 35 Ncm, and the reverse torque to remove the abutment was recorded. This was repeated for 3 trials. Additionally, the sample groups were loaded 30 degrees off-axis, and the ultimate compressive values were recorded. RESULTS: There was a significant difference in the initial reverse-torque values. The SOSA setup showed significantly lower torque than the SOI and SSI setups (P < .05). In addition, the compressive bending test showed that the SOSA setup was significantly different (P < .05) from the SSI and SOI setups. Radiographic survey of the test groups following compressive bending revealed no implant fractures, but bending of the implant-abutment complex occurred. DISCUSSION: The alteration within the Morse taper did not reduce the strength of the implant-abutment connection, ie, the reduction in surface area did not significantly reduce the torque properties or tensile properties. The new 2-piece synOcta 5.5-mm solid abutment was shown to have a stronger implant-abutment connection when torqued down a second time. CONCLUSIONS: In this in vitro study, alteration of the Morse taper with an internal octagon indexing did not significantly reduce the strength of the implant connection. Sufficient strength was exhibited, which would indicate this implant-abutment design for anterior as well as posterior edentulous sites.

Effects of bur abrasive particle size and abutment composition on preparation of ceramic implant abutments.

STATEMENT OF PROBLEM: Amid increasing use of preparable ceramic implant abutments, there is a lack of quantitative data to show which abrasive particle size of diamond bur yields the fastest reduction and provides the smoothest surface. PURPOSE: The research aim was to determine the effects of diamond bur abrasive particle size and abutment material composition on preparation efficiency, prepared surface roughness, and surface deterioration of diamond burs. MATERIAL AND METHODS: Fifteen alumina (Cera Base) and 15 zirconia (ZiReal) implant abutments were each machined using a high-speed hand piece with a diamond bur having 1 of 3 abrasive particle sizes (150, 100, or 30 microm) (n=5). Control abutments (n=5) were analyzed without machining. Abutments were weighed before starting and between machining cycles. Three profilometry measurements (root mean square surface roughness) were made for each abutment. Scanning electron micrographs were made of each bur. Lost abrasive particles were then counted on each micrograph through a randomly placed template. Two-way analysis of variance (alpha=0.05) was used to test for significant effects. RESULTS: Bur abrasive particle size and ceramic type had a significant interactive effect on the amount of material removed (P<.001). Super coarse (150 microm) burs yielded the roughest surfaces for each abutment material (P<.001), and prepared alumina surfaces were rougher than zirconia surfaces (P<.001). Super coarse burs showed the highest proportion of lost particles (P<.001). Abutment composition did not significantly affect bur wear. CONCLUSION: Super coarse burs yielded the most efficient material removal for alumina abutments. All abrasive particle sizes removed a similar amount of material from zirconia abutments. Fine-grained alumina abutments experienced greater material removal and rougher prepared surfaces compared with zirconia abutments. Material was removed by an intergranular fracture mechanism for alumina abutments, in contrast to transgranular fracture for zirconia abutments.

Effects of high-speed curing devices on shear bond strength and microleakage of orthodontic brackets.

This study evaluated the shear-peel bond strength and mode of bond failure of 3 curing devices (plasma arc light, argon laser, and conventional halogen light) and 2 orthodontic bracket adhesives with different filler contents (Transbond XT and Adhesive Precoated [APC]). Observations of microleakage were also reported. Ninety human adolescent premolars were randomly divided into 6 groups, and standardized brackets were bonded according to the manufacturers' recommendations. The plasma arc light produced significantly (P =.006) higher bond strength than did the halogen light or the argon laser when Transbond was used. When APC was used, the plasma arc light and the halogen light produced similar results, and they both produced significantly (P =.015) higher bond strengths than did the argon laser. Overall, the APC showed substantially less variation in bond strength than did the Transbond. Although all curing methods showed significant microleakage (P <.001), differences among the 3 curing lights occurred only when APC was used. Microscopic evaluations demonstrated that 95% of the specimens failed for adhesion at the bracket or tooth surface; the argon laser produced the highest adhesive remnant index scores. On the basis of bond strength and microleakage results, the plasma arc light was comparable with or superior to the other curing devices, depending on the adhesive used.