European Federation of Periodontology Survey of Postgraduate and Specialist Training in Europe in 2020:Periodontal specialist training in Europe

AIMS: The survey's aim was to establish which universities and other educational organisations deliver postgraduate and specialist training in Periodontology in the 31 countries who are members of the European Federation of Periodontology (EFP) and to obtain details of how these programmes are organised, funded, regulated and evaluated. METHODS: A questionnaire and covering letter were emailed to all national periodontal societies. The questions were on the name of country, official recognition, training programmes, entry to specialist training, specialist training assessment and recognition after completion of training. RESULTS: Twenty‐nine (93%) of national periodontal societies responded. Key findings included the following: Periodontology was reported as being recognised at a national level in 17 countries, there was a three‐year full‐time programme in 12 countries, no fees were charged for specialist training in 10 countries, in 14 countries trainees received annual salaries, end of training (summative) assessments varied from country to country, 12 countries reported that they had a requirement for specialists in Periodontology to complete continuing education to maintain registration as specialists. CONCLUSIONS: This survey has established which universities and other educational organisations deliver postgraduate and specialist training in Periodontology and how these programmes are organised, funded, regulated and evaluated. To provide uniformly high‐quality periodontal care for patients in all European countries, further harmonisation of postgraduate and specialty training in Periodontology would be advantageous

Teaching of posterior composites in dental schools in Japan – 30 years and beyond

Objectives: The teaching of posterior composites has been a major part of the curriculum in Japanese dental education for several decades. The aim of this paper was to investigate the current trends in the teaching of posterior composites to undergraduate dental students in Japan by comparing the results of surveys conducted for over 30 years. Methods: In late 2016-early 2017, a questionnaire seeking information on the teaching of posterior composites was distributed via e-mail to the persons responsible for teaching operative dentistry in 29 dental schools having undergraduate dental degree programs in Japan. The results obtained were compared to those from surveys conducted in 1986, 1997, and 2007. Results: All 29 schools that were sent the questionnaire completed the responses (response rate = 100%). All 29 schools reported teaching the placement of composite in occlusal and two-surface occluso-proximal cavities in both premolars and molars. Four schools reported not teaching the placement of three-surface occluso-proximal composites in premolars and five schools reported not teaching it for molars. Twenty-seven (93%) schools taught composite first as a part of the preclinical curriculum, whereas 15 (65%) schools did so in the survey of 2007. Variations were noted between schools in the teaching of, cavity design. In contrast, greater consistency was observed in the teaching of techniques for protecting exposed dentin and light-curing technologies. Conclusions: It is hoped that measures intended to increase the clinical experience of restoring teeth with direct composite-resin for dental students in Japan will be effective, providing opportunity to bring dental education in Japan more into line with international norms

Contemporary teaching of restoration repair at dental schools in Germany - Close to universality and consistency

Objectives: To identify potential changes in various aspects of teaching and to ascertain whether previously found inconsistencies in the teaching of criteria, indications and operative techniques for the repair of defective composite restorations at German dental schools have been resolved. Methods: A validated questionnaire was used to gain the information sought. It was sent to all dental schools in Germany (n = 30). Whenever possible, data were compared to previous studies conducted in 2000 and 2009. Statistical analysis was performed using Fisher’s exact tests (p < 0.05). Results: Twenty-nine schools responded to the survey – a response rate of 97%. All respondents indicated positive experiences with the repair of restorations. The teaching of repairs in 2018 (90%) was found to be comparable to the findings from the 2009 survey (88%, p = 1.000), but significantly increased since the 2000 survey (50%, p = 0.006). Main reasons reported for teaching repairs are tooth substance preservation (97%) and reduction of pulpal damage (79%). Main clinical indications are marginal defects and secondary caries. When performing repairs, almost all dental schools were found to teach both mechanical and adhesive substrate surface conditioning. Marked variation was observed in the method of mechanical surface treatment, with air abrasion having gained widespread popularity. The average expected longevity of repairs was 7.4 ± 3.0 years. Conclusions: The teaching of the repair of resin composite restorations is widespread in dental schools in Germany. Aspects of this teaching were found to be more consistent between dental schools than in previous surveys, albeit variation in operative techniques still exists. Clinical significance: Graduates from dental schools in Germany may be found to be well equipped with the knowledge and skills to perform repairs of defective resin based composite restorations in clinical practice

An update on the reasons for placement and replacement of direct restorations

Aim: The aim of this study was to review patterns of restoration placement and replacement. A previous study had been carried out in the late 1990s and this study sought to update the literature in this important aspect of dental practice. Method: Studies based on the protocol of Mjör (1981) were selected. Such studies involved participating dentists completing a proforma each time a patient presented for a new or replacement restoration. Results: Twenty-five papers were included in this study, of which 12 were included in the original review. The pre-1998 review reported on the placement of 32,697 restorations, of which 14,391 (44%) were initial placements and 18,306 (56%) were replacements. The new studies included in the post-1998 review reported on an additional 54,023 restorations, of which 22,625 (41.9%) were initial placements and 31,398 (58.1%) were replacements. Therefore, across all studies considered, information is available on 86,720 restorations, of which 37,016 (42.7%) were new placements and 49,704 (57.3%) were replacements. Comparing review periods, there was a reduction in the placement of amalgam restorations from 56.7% (pre-1998 review) to 31.2% (post-1998 review), with a corresponding increase in the placement of resin composites from 36.7% to 48.5%. The most common use of amalgam was seen in Nigeria (71% of restorations), Jordan (59% of restorations) and the UK (47% of restorations). The most frequent use of resin composite was seen in Australia (55% of restorations), Iceland (53% of restorations) and Scandinavia (52% of restorations). Secondary caries was the most common reason for replacing restorations (up to 59% of replacement restorations). Conclusion: In the years subsequent to the initial review, replacement of restorations still accounts for more than half of restorations placed by dentists, and the proportion of replacement restorations continues to increase. Trends towards the increased use of resin composites is noted in recent years. Clinical significance: Further research is required in this area to investigate changes in the approaches to the restoration of teeth, especially with increased understanding of the concept of restoration repair as an alternate to replacement

A Kinetic Model of Dopamine- and Calcium-Dependent Striatal Synaptic Plasticity

Corticostriatal synapse plasticity of medium spiny neurons is regulated by glutamate input from the cortex and dopamine input from the substantia nigra. While cortical stimulation alone results in long-term depression (LTD), the combination with dopamine switches LTD to long-term potentiation (LTP), which is known as dopamine-dependent plasticity. LTP is also induced by cortical stimulation in magnesium-free solution, which leads to massive calcium influx through NMDA-type receptors and is regarded as calcium-dependent plasticity. Signaling cascades in the corticostriatal spines are currently under investigation. However, because of the existence of multiple excitatory and inhibitory pathways with loops, the mechanisms regulating the two types of plasticity remain poorly understood. A signaling pathway model of spines that express D1-type dopamine receptors was constructed to analyze the dynamic mechanisms of dopamine- and calcium-dependent plasticity. The model incorporated all major signaling molecules, including dopamine- and cyclic AMP-regulated phosphoprotein with a molecular weight of 32 kDa (DARPP32), as well as AMPA receptor trafficking in the post-synaptic membrane. Simulations with dopamine and calcium inputs reproduced dopamine- and calcium-dependent plasticity. Further in silico experiments revealed that the positive feedback loop consisted of protein kinase A (PKA), protein phosphatase 2A (PP2A), and the phosphorylation site at threonine 75 of DARPP-32 (Thr75) served as the major switch for inducing LTD and LTP. Calcium input modulated this loop through the PP2B (phosphatase 2B)-CK1 (casein kinase 1)-Cdk5 (cyclin-dependent kinase 5)-Thr75 pathway and PP2A, whereas calcium and dopamine input activated the loop via PKA activation by cyclic AMP (cAMP). The positive feedback loop displayed robust bi-stable responses following changes in the reaction parameters. Increased basal dopamine levels disrupted this dopamine-dependent plasticity. The present model elucidated the mechanisms involved in bidirectional regulation of corticostriatal synapses and will allow for further exploration into causes and therapies for dysfunctions such as drug addiction

Liver tissue graft rejection in murine major histocompatibility complex mutants

Liver tissue grafts between seven H-2 mutants and their parental strains have been studied. Each of these mutants was originally identified by reciprocal mutant—parental strain skin graft rejection. However, liver grafts among mutants and parental standard strains are not uniformly rejected. Liver graft rejection also fails to correlate with mutant—parental stimulation in CML and MLC. In addition, the immune reaction pattern of female mutant animals against grafts of male liver differs from the reaction pattern found in parental standard strains. Several explanations for the differences between immune response to liver and skin grafts are proposed, including different T cell subsets involved in recognition, availability of antigenic sites to immunocompetent cells, and structural differences between mutant and parental H-2 antigens.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46738/1/251_2004_Article_BF00364259.pd

Principles and practice of esthetic dentistry / edited by Nairn H.F. Wilson, CBE, DSc (h.c.), FDS, FFD, FFGDP, FCDSHK, FACD, FADM, FHEA, FKC, Professor of Dentistry, King's College London Dental Institute, London, UK.

Includes bibliographical references and index.xi, 256 pages :Contains information on key elements of cosmetic dental practice. This title includes an educational DVD