A CLINICAL AND HISTOMORPHOMETRIC STUDY OF CALCIUM SULFATE (DENTOGEN®), COMPARED TO FREEZE DRIED BONE ALLOGRAFT (FDBA) FOR ALVEOLAR RIDGE PRESERVATION

poster abstractThere is significant ridge resorption following tooth extraction. Freeze dried bone allograft (FDBA) is most widely used for ridge preservation and calcium sulfate has begun to show popularity. The objective of this study is to evaluate if DentoGen® (calcium sulfate) is as effective in preserving post extraction ridge dimensions compared to FDBA. Thirty consecutive single rooted extraction sites were selected that met the inclusion criteria for the study. Post extraction clinical measurements were made with a pre-fabricated stent and dental calipers. The sites were then divided randomly into the test group (calcium sulfate) or the control group (FDBA). Patients were recalled after 3 months, sites were reentered and clinical measurements were again made. A trephine bone core was harvested and sent for histomorphometric analysis. A total of 21 subjects with 41 potential sites were recruited to this study (IRB approval # 1003-56). Following extraction, 29 sites met the inclusion criteria. To date, no significant change in vertical ridge height pre to post surgery was noted within the test and control groups (0.53 + 1.63mm, 0.35 ± 1.13mm, respectively). There was a significant decrease in buccal-lingual ridge width within both groups, (-1.23 + 1.14mm test group. 0.93 + 0.94mm control group) There was no significant difference in the preservation performance between the two treatment groups for both ridge width and vertical height. Histological samples are currently being analyzed. Results suggest no statically significant differences between the use of calcium sulfate versus FDBA in preserving post extraction ridge dimensions

Verruciform xanthoma of the buccal gingiva: two cases with different clinical presentations

Introduction: Verruciform xanthoma is an uncommon, benign, asymptomatic lesion commonly affecting the attached tissues in the oral cavity, especially the gingiva. Clinical presentation can be variable and requires biopsy to confirm the diagnosis. Case Series: Two cases of verruciform xanthoma in a 21‐year old male and a 46‐year old female are reported, emphasizing the need for thorough comprehensive analysis of all oral lesions. The clinical features, differential diagnoses, typical and atypical histological features and potential etiology are presented. Conclusions: Verruciform xanthoma should be considered in the differential diagnosis of solitary lesions in the oral cavity with a papillary, granular or verrucous surface texture, and confirmed with histopathological examination. Continued monitoring for recurrence at routine examination is necessary especially in sites where the lesion may not have been completely excised

Platelet-Rich Fibrin: Utilization in the Treatment of Periodontitis

Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth and results in loss of supporting bone around the teeth leading to eventual tooth loss. It is a multifactorial disease that involves bacteria and host responses. Advanced options to treat periodontitis are aimed at regeneration procedures to restore lost periodontal structures. These include bone replacement grafts and the use of biological materials to enhance regeneration. Platelet-rich fibrin (PRF) is an autologous platelet-rich concentrate derived from a fibrin clot and is a natural source of growth factors derived from platelets, which are released over time and have been shown to have potential in periodontal procedures to enhance wound healing and regeneration. This chapter will focus on the past, current and future scope of PRF for treating periodontitis

Life-Cycle Energy, Costs, and Strategies for Improving a Single-Family House

The life-cycle energy, greenhouse gas emissions, and costs of a contemporary 2,450 sq ft (228 m 3 ) U.S. residential home (the standard home, or SH) were evaluated to study opportunities for conserving energy throughout pre-use (materials production and construction), use (including maintenance and improvement), and demolition phases. Home construction and maintenance materials and appliances were inventoried totaling 306 metric tons. The use phase accounted for 91% of the total life-cycle energy consumption over a 50-year home life. A functionally equivalent energy-efficient house (EEH) was modeled that incorporated 11 energy efficiency strategies. These strategies led to a dramatic reduction in the EEH total life-cycle energy; 6,400 GJ for the EEH compared to 16,000 GJ for the SH. For energy-efficient homes, embodied energy of materials is important; pre-use energy accounted for 26% of life-cycle energy. The discounted (4%) life-cycle cost, consisting of mortgage, energy, maintenance, and improvement payments varied between 426,700 and 454,300 for a SH using four energy price forecast scenarios. In the case of the EEH, energy cost savings were offset by higher mortgage costs, resulting in total life-cycle cost between 434,100 and 443,200. Life-cycle greenhouse gas emissions were 1,010 metric tons CO 2 equivalent for an SH and 370 metric tons for an EEH.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75688/1/108819800569726.pd

Assessing the Medical Emergency Preparedness of Dental Faculty, Residents, and Practicing Periodontists: An Exploratory Study

With the increased number of elderly and medically compromised individuals receiving dental care and the presence of systemic comorbidities and associated treatment modalities in this patient population, it is imperative that dentists be prepared to manage a variety of medical emergencies. The aim of this study was to assess the knowledge of and preparedness to manage common medical emergencies of cohorts of practicing periodontists, specialty residents, and faculty members, both for comparative purposes and as an aid to refining a dental school’s standardized case scenarios. The study, conducted in 2017, was designed for four groups of randomly selected participants with at least 20 in each group; the actual number of voluntary participants was 28 private practice periodontists, 22 residents in specialty programs, 21 specialist faculty members, and 24 general practice faculty members. Participants were asked to evaluate ten clinical emergency cases and identify the diagnosis and indicated intervention for each. Groups were also evaluated for differences among correct responses for each case. Overall, there were no statistically significant differences for number of correct diagnoses or interventions among the four groups. However, several cases had varying degrees of incorrect diagnoses and management across all groups. Participants who had recently graduated or were still in school were able to treat cases appropriately more often than the other participants. Further refinement of cases to assess provider preparedness to correctly diagnose and manage medical emergencies is needed, specifically establishing case-specific features and addressing areas of potential confusion before the cases are used for educational purposes

Assessment of the Calibration of Periodontal Diagnosis and Treatment Planning Among Dental Students at Three Dental Schools

Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning

Histomorphological Comparison of Platelet Rich Fibrin Combinations for Ridge Preservation.

PosterBackground: Most commonly used techniques to preserve ridge dimensions following tooth extraction involve bone substitutes and membranes to cover the graft. The use of autologous Platelet Rich Fibrin (PRF) is a recent introduction to be used as a membrane as well as mixed with the graft material. PRF is an inexpensive autologous gel enriched with platelets from venous blood that is easily processed in a clinical setting and contains growth factors including PDGF, TGF-β, VEGF, EGF and IGF1. The aim of this case report is to compare the histomorphologic results of various combinations of PRF, freeze dried bone allograft (FDBA) and polylactic acid membranes (Guidor) in extraction sockets in a single patient. Material and Methods: A 49-year old female patient with a 12 pack-year smoking history presented for extraction of maxillary teeth for an implant retained complete denture. On the day of surgery, 40ml of venous blood was drawn and centrifuged to produce four PRF gels. Two PRF gels were minced and mixed with FDBA. Two clots were processed to be used as membranes to cover the sockets. Teeth #s 4, 6, 11, and 13 were extracted with minimal trauma and sockets were thoroughly debrided. Varying combination of FDBA, PRF, and Guidor membranes were used for ridge preservation grafting in the four sockets. Four and half months following extraction, trephine cores were taken at the time of implant placement and submitted for histological analysis. Results: Clinical healing was uneventful at all sockets but soft tissue healing appeared slightly rapid on sites covered with PRF membranes. However, histologic healing showed more vital bone formation around residual graft materials with Guidor membranes sites. Conclusions: Within the limits of this case report, although PRF membranes seemed to slightly enhance soft tissue healing, the use of Guidor membranes appeared to improve bone remodeling

Assessing Effectiveness of an Audiovisual Educational Tool for Improving Dental Students' Probing Depth Consistency

Dental students often underestimate their probing depth (PD) measurements, which emphasizes the need for effective and novel methods for teaching proper probing technique. The aim of this study was to evaluate the efficacy of audiovisual learning aids, recorded from the point of view of examiners, for improvement in PD agreement in dental students. In 2017‐18, 22 third‐year dental students were randomized into test and control groups. Each student and a single blinded faculty examiner performed PD measurements on a minimum of three patients. The test group viewed a video demonstrating proper probing technique, while the control group received only probing technique instruction from prior lectures. All measurements, the periodontal diagnoses, and the total time taken to complete PD measurements were recorded. A survey of student attitudes about the audiovisual tool was conducted after the intervention; all 22 students completed the survey. A total of 11,426 PD sites were measured. The test group had 10% greater accuracy in PD sites=4 mm. The control group had a minor but statistically significant increase in accuracy for 2 mm PD sites. For all incorrect measurements at sites PD≥4, the students tended to underestimate the PD. Tooth type, site location around tooth, and diagnosis had no significant effect on PD measurement agreement. No significant difference between groups was found for the proportions of gingivitis and periodontitis patients or for examination time. This study found that use of the audiovisual learning aid “Calibrated Periodontal Training Video” improved the students' probing depth accuracy for sites with PD of 4 mm

Comparative evaluation of mandibular canal visibility on crosssectional cone-beam CT images: a retrospective study

OBJECTIVES: The purpose of this study was to determine the visibility of the mandibular canal (MC) in CBCT images and if the visibility of the MC is affected by gender, location and/or age. METHODS: CBCT images were evaluated for the visibility of the MC by a board-certified oral and maxillofacial radiologist, a board-certified periodontist and a periodontics resident. Representative slices were examined for the first premolar (PM1), second premolar (PM2), first molar (M1) and second molar (M2) sites by all examiners. The visibility of the MC was registered as either present or absent. RESULTS: 360 total CBCT cross-sectional images were examined, with the MC identified in 204 sites (56%). Age had a significant effect on MC visibility, but it differed by location: for PM1, age 47–56 had lower visibility than age 65+ (p = 0.0377). Gender also had a significant effect on canal visibility, where females had lower visibility than males overall (p = 0.0178) and had the most pronounced difference for PM1 (p = 0.0054). Location had a significant effect on visibility, but it differed by age and by gender: for age 65+, M2 had lower visibility than PM1 (p = 0.0411) and PM2 (p = 0.0180), while for females, PM1 had lower visibility than M1 (p = 0.0123) and M2 (p = 0.0419). CONCLUSIONS: The MC was visualized only in just over half of the CBCT images. Age, gender and location had significant effects on the visibility