Dentists’ Leadership‐Related Educational Experiences, Attitudes, and Past and Current Behavior

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153576/1/jddj002203372014786tb05741x.pd

Oral health‐related concerns, behavior, and communication with health care providers of patients with breast cancer: impact of different treatments

AimThe objectives are to compare responses of breast cancer (BCa) treatment groups (chemotherapy, tamoxifen, and aromatase inhibitors (AIs) to each other and a control regarding (a) subjective oral health, (b) oral health‐related behaviors, (c) oral health‐related concerns, and (d) communication with health care providers.MethodsSurvey data were collected from 140 postmenopausal BCa patients and 41 healthy postmenopausal control respondents.ResultsBCa patients reported on average more frequent mouth sores/mucositis (5‐point scale with 1 = never: 1.63 vs. 1.14; p < .01), glossadynia (1.60 vs. 1.07; p < .01), xerostomia (2.48 vs. 1.40; p < .01), and dysgeusia (2.10 vs. 1.46; p < .01) than the control respondents. Patients undergoing chemotherapy were more aware that cancer treatment can affect their oral health than patients on tamoxifen/AI (93% vs. 55%/56%; p < .001). BCa patients reported being more frequently informed by oncologists about oral health‐related effects of cancer treatment than by dentists. Oncologists/nurses were more likely to communicate about oral health‐related treatment effects with patients undergoing chemotherapy than patients on tamoxifen or AIs. Few BCa patients perceived dentists as knowledgeable about cancer treatment‐related oral concerns and trusted them less than oncologists.ConclusionsBCa treatments impact oral health. Low percentages of BCa patients had received specific information about impacts of BCa treatments on oral health from their dentists.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141444/1/scd12266.pd

Periodontal health, perceived oral health, and dental care utilization of breast cancer survivors

ObjectivesThis population‐based analysis examined the prevalence of periodontal diseases along with the self‐perceived oral health and patterns of dental care utilization of breast cancer survivors in the United States.MethodsData from the 1999‐2004 National Health and Nutrition Surveys were utilized, examining information from 3,354 women between 50 and 85 years of age. Primary outcomes were gingivitis and periodontitis, self‐perceived oral health, and dental care utilization. Logistic regression analyses were used to estimate relationships of breast cancer diagnosis and primary outcomes while controlling for confounding factors.ResultsBreast cancer survivors were more likely to be older than 55 years, white, nonsmokers, have higher levels of education and income, and a higher prevalence of osteoporosis. Breast cancer survivors were significantly less likely to have dental insurance (P = 0.04). Utilization of dental services and reason for last dental visit did not significantly differ between groups. A history of a breast cancer diagnosis did not increase the odds of gingivitis [odds ratio (OR):  1.32; 95 percent confidence interval (CI): 0.53‐3.63], periodontitis (OR: 1.82; 95 percent CI:  0.89‐4.01), or poor self‐perceived oral health (OR: 0.89; 95 percent CI: 0.61‐1.33) after adjusting for age, race, education, dental care utilization, and smoking status.ConclusionsIn this sample, a history of breast cancer does not significantly impact periodontal health, self‐perceived oral health, and dental care utilization. However, efforts should be made to assure that breast cancer survivors have dental insurance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111973/1/jphd12084.pd

Tissue engineering a surrogate niche for metastatic cancer cells

In breast and prostate cancer patients, the bone marrow is a preferred site of metastasis. We hypothesized that we could use tissue-engineering strategies to lure metastasizing cancer cells to tissue-engineered bone marrow. First, we generated highly porous 3D silk scaffolds that were biocompatible and amenable to bone morphogenetic protein 2 functionalization. Control and functionalized silk scaffolds were subcutaneously implanted in mice and bone marrow development was followed. Only functionalized scaffolds developed cancellous bone and red bone marrow, which appeared as early as two weeks post-implantation and further developed over the 16-week study period. This tissue-engineered bone marrow microenvironment could be readily manipulated in situ to understand the biology of bone metastasis. To test the ability of functionalized scaffolds to serve as a surrogate niche for metastasis, human breast cancer cells were injected into the mammary fat pads of mice. The treatment of animals with scaffolds had no significant effect on primary tumor growth. However, extensive metastasis was observed in functionalized scaffolds, and the highest levels for scaffolds that were in situ manipulated with receptor activator of nuclear factor kappa-B ligand (RANKL). We also applied this tissue-engineered bone marrow model in a prostate cancer and experimental metastasis setting. In summary, we were able to use tissue-engineered bone marrow to serve as a target or "trap" for metastasizing cancer cells

Intra-Oral Colonization of Macaque Monkeys by Actinobacillus Actinomycetemcomitans

Actinobacillus actinomycetemcomitans was acquired by captive Macaca fascicularis 3 to 6 months after birth, and all monkeys aged over 6 months harbored detectable levels. This microorganism was most frequently isolated from the gingival plaque of the incisor (and other) teeth compared with other oral sites. Strains were leukotoxic by bioassay and Western blot analysis. Antibodies in macaque serum contained neutralized the leukotoxin of a human A. actinomycetemcomitans strain. High titres of maternal neutralizing anti-leukotoxin antibodies were detected in neonates; the titre then fell rapidly so that by 6 months the antibody titer was zero. Antileukotoxin antibody production was detected after 6 months of age, rapidly reaching a high level within 2 years after birth. The presence of leukotoxic strains of A. actinomycetemcomitans in the gingival region did not appear to be correlated with an increase in susceptibility to periodontal disease

Ability of Dental Students to Deliver Oxygen in a Medical Emergency

This study was conducted to evaluate the ability of dental students to administer emergency oxygen to a patient during a simulated emergency. Forty third‐year (D3) and fourth‐year (D4) dental students were recruited and asked to demonstrate their ability in managing a simulated angina attack. Students were tested on their knowledge related to emergency medical protocols, the time taken to obtain oxygen, and operation of the oxygen equipment. Of the subjects tested, 68 percent independently identified the need for oxygen and the correct location of the equipment in the dental school. Only 15 percent of the students completed the experiment within a predetermined optimal time frame, and 50 percent of all students did not successfully operate the tank regulator to administer oxygen correctly. Although most participants in the study were able to verbalize the proper protocol for managing medical emergencies, the chairside execution in this situation demonstrates room for improvement. Incorporation of periodic simulation exercises, in addition to classroom education, is likely to improve the ability of dental students to manage medical emergencies.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153567/1/jddj002203372009734tb04721x.pd

Human Very Small Embryonic-Like Cells Generate Skeletal Structures, In Vivo

Human very small embryonic-like (hVSEL) cells are a resident population of multipotent stem cells in the bone marrow involved in the turnover and regeneration of tissues. The levels of VSEL cells in blood are greatly increased in response to injury, and they have been shown to repair injured tissues. Adult hVSEL cells, SSEA-4+/CD133+/CXCR4+/Lin?/CD45?, express the pluripotency markers (Oct-4 and Nanog) and may be able to differentiate into cells from all 3 germ lineages. hVSEL cells isolated from blood by apheresis following granulocyte?colony-stimulating factor mobilization were fractionated and enriched by elutriation and fluorescence activated cell sorting. Collagen sponge scaffolds containing 2,000?30,000 hVSEL cells were implanted into cranial defects generated in SCID mice. Analysis by microcomputed tomography showed that a cell population containing VSEL cells produced mineralized tissue within the cranial defects compared with controls at 3 months. Histologic studies showed significant bone formation and cellular organization within the defects compared with cellular or scaffold controls alone. Antibodies to human leukocyte antigens demonstrated that the newly generated tissues were of human origin. Moreover, human osteocalcin was identified circulating in the peripheral blood. There was evidence that some level of hVSEL cells migrated away from the defect site, using quantitative real-time polymerase chain reaction to detect for human-specific Alu sequences. This study demonstrates that hVSEL cells are able to generate human bone tissue in a mouse model of skeletal repair. These studies lay the foundation for future cell-based regenerative therapies for osseous and connective tissue disorders, including trauma and degenerative conditions, such as osteoporosis, fracture repair, and neoplastic repair.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140198/1/scd.2012.0327.pd

Effect of Faculty Development Activities on Dental Hygiene Faculty Perceptions of and Teaching About Motivational Interviewing: A Pilot Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153716/1/jddjde017048.pd

New trends in the treatment of bone metastasis

Bone metastasis is often the penultimate harbinger of death for many cancer patients. Bone metastases are often associated with fractures and severe pain resulting in decreased quality of life. Accordingly, effective therapies to inhibit the development or progression of bone metastases will have important clinical benefits. To achieve this goal understanding the mechanisms through which bone metastases develop and progress may provide targets to inhibit the metastases. In the past few years, there have been advances in both understanding the mechanisms through which bone metastases develop and how they impact bone remodeling. Additionally, gains in promising clinical strategies to target bone metastases have been developed. In this prospectus, we will discuss some of these advances. J. Cell. Biochem. 102: 1095–1102, 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57363/1/21540_ftp.pd

Depot Medroxyprogesterone Acetate Use and Periodontal Health in 15‐ to 44‐Year‐Old US Females

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141038/1/jper1008.pd