Soft Tissue Grafting to Improve Implant Esthetics

Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft) to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures

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

Designing Dental Student Portfolios to Assess Performance

The purpose of this poster is to share a project developed by Marquette University’s liaisons to the American Dental Education Association’s Commission on Change and Innovation in Dental Education with others interested in learning about the use of portfolios to assess the quality of student performance in dental school. Sample components from the pilot portfolios will be integrated into the poster to provide participants with a view from portfolio design to completion. Portfolios are becoming a more common method of assessing the quality of student performance in health professions education. Portfolios can assist in documenting evidence of specific competencies at the student level and also serve as a longitudinal measure of a student’s development

A Retrospective Review of Clinical International Normalized Ratio Results and Their Implications

Background. Warfarin is a key element in therapy for atrial fibrillation, deep venous thrombosis (DVT), stroke (cerebrovascular accident) and cardiac valve replacement. Often, patients’ warfarin blood levels are not tightly controlled with regard to accepted therapeutic ranges, by virtue of the drug’s unpredictable nature. Methods. The authors searched 16,017 active clinical charts for active patients of record from the three campuses of the School of Dentistry, Marquette University (MU), Milwaukee, for the years 2009 and 2010. Dental records of 315 patients contained entries including “INR,” the abbreviation for the term “international normalized ratio.” Only 247 of those records contained an indication of whether the patient’s INR values were within therapeutic range. The authors found that 1.96 percent of the total MU dental clinic patient population had a history of warfarin use. Results. When the authors compared the INR values for patients with diagnoses of atrial fibrillation, DVT, stroke and cardiac valve replacement, they found that INR values for 107 of the 247 patients (43.3 percent) were not within therapeutic range for the respective diagnoses. For example, only 50 percent of the patients being treated for atrial fibrillation presented themselves for surgical dental treatment while their INR values were in tight control. Conclusion. The INR values for a significant number of dental patients are not within the therapeutic range for their medical conditions. These patients need to seek follow-up care from their medical care providers. Clinical Implications. Screening for INR in the dental office—especially before invasive dental treatment such as periodontal surgery, tooth extraction and dental implant placement—can help prevent postoperative complications. It also can aid the clinician in evaluating whether a patient’s INR is within therapeutic range and, subsequently, whether the patient’s physician needs to adjust the warfarin dosage