Ward Massey

Insights into Functional Erythromycin/Antioxidant Containing Chitosan Hydrogels as Potential Bio-active Restorative Materials: Structure, Function and Antimicrobial Activity

Substantial data are available in the literature on the role of Reactive Oxygen Opecies (ROS) and antioxidants in disorders such as the inflammatory and in chronic immune mediated conditions such as rheumatoid arthritis. However, remarkably little information is available on the periodontal diseases, which show many of the pathological features of other chronic inflammatory diseases. The periodontal tissues also provide an ideal medium within which to study mechanisms of ROS mediated tissue damage and of antioxidant defense in response to bacterial colonization, through the non-invasive collection of GCF. Bio-adhesive polymers appear to be particularly attractive for the development of alternative etches free dentin bonding system with an added advantage of additional therapeutic delivery systems to improve intradental administration of therapeutic and prophylactic agents if necessary. Chitosan, which is a biologically safe biopolymer, has been proposed as a bio-adhesive polymer and are of continuous interest to us due to their unique properties and flexibility in broad range of oral applications reported by others and us recently. The objectives of this study is to evaluate the novel chitosan based functional drug delivery systems which can be successfully incorporated into “dual action bioactive restorative materials” containing common antibiotic such as erythromycin, krill oil, aloe and aspirin as commonly used antioxidant species. Methods: The novel hydrogels will be investigated with respect to the antioxidant capacity and drug release capacity of the tetracycline as well as erythromycin from the designer drug delivery system, the use of SEM imaging for the characterization of the surfaces and reactive features of novel materials with antimicrobial potential as well asuse of the newly designed materials as an effective adhesive restorative materials. Results: A continuous release of erythromycin, while maintaining antibiotic effects against the tested bacteria,for at least 24 hours was shown from designer chitosan-antioxidant hydrogels. The increase antioxidant capacityof the designer material, significant antimicrobial capacity as well as adhesive dentine bond strength make thechitosan-containing restorative materials suitable and potentially advantageous materials for restorative andperiodontal applications in-vitro. The addition of antioxidants to the functionalized restorative material acts as aalternative free radical defense mechanism and therefor increases the shear bond strength teeth by managing theexcess of free radicals produced during common restorative procedure. Future investigations are necessary tovalidate this hypothesis.

Digital Cadavers: Online 2D Learning Resources Enhance Student Learning in Practical Head and Neck Anatomy within Dental Programs

Head and neck anatomy provides core concepts within preclinical dental curricula. Increased student numbers, reduced curricula time, and restricted access to laboratory-based human resources have increased technology enhanced learning approaches to support student learning. Potential advantages include cost-effectiveness, off-campus access, and self-directed review or mastery opportunities for students. This study investigated successful student learning within a first-year head and neck anatomy course at the School of Dentistry and Oral Health, Griffith University, Australia, taught by the same teaching team, between 2010 and 2015. Student learning success was compared, for cohorts before and after implementation of a supplementary, purpose-designed online digital library and quiz bank. Success of these online resources was confirmed using overall students’ performance within the course assessment tasks and Student Evaluation of Course surveys and online access data. Engagement with these supplementary 2D online resources, targeted at improving laboratory study, was positively evaluated by students (mean 85%) and significantly increased their laboratory grades (mean difference 6%, ), despite being assessed using cadaveric resources. Written assessments in final exams were not significantly improved. Expanded use of supplementary online resources is planned to support student learning and success in head and neck anatomy, given the success of this intervention.

Flipping a Dental Anatomy Course: A Retrospective Study Over Four Years

Flipped classrooms have been successfully used to increase student engagement and support student learning in a range of educational fields, including health education. These advantages for student learning supported implementation of the flipped classroom in introductory sciences and preclinical courses in dental education. We report on a 4-year retrospective study which compared two methods of delivery of a first-year dental anatomy course. The first method used the traditional method, consisting of face to face contact teaching hours, which was compared to a partial flipped classroom, where lecture contact was maintained but practical classes were flipped. A series of online videos demonstrating different practical tasks such as wax carving and tooth identification. An online digital library and online quizzes for self-reflected learning were developed and trialled. Students’ Evaluations of Course (SEC) and students’ overall performance in practical and theoretical assessments were used to evaluate the impact on student engagement and success, respectively, after implementation of the modified course offerings. This study evidences the success of the transition to a partially flipped course design. Careful design and consideration of implementation of the flipped classroom method in dental education are recommended to ensure that there is reliable availability of online resources and dedicated teaching staff for construction of resources and delivery of relevant in-class activities.

Simple cost analysis of a rural dental training facility in Australia

Introduction Student clinical placements away from the university dental school clinics are an integral component of dental training programs. In 2009, the School of Dentistry and Oral Health, Griffith University, commenced a clinical placement in a remote rural community in Australia. This paper presents a simple cost analysis of the project from mid-2008 to mid-2011. Methods All expenditures of the project are audited by the Financial and Planning Services unit of the university. The budget was divided into capital and operational costs, and the latter were further subdivided into salary and non-salary costs, and these were further analysed for the various types of expenditures incurred. The value of the treatments provided and income generated is also presented. Results Remote rural placements have additional (to the usual university dental clinic) costs in terms of salary incentives, travel, accommodation and subsistence support. However, the benefits of the placement to both the students and the local community might outweigh the additional costs of the placement. Conclusions and implications Because of high costs of rural student clinical placements, the financial support of partners, including the local Shire Council, state/territory and Commonwealth governments, is crucial in the establishment and ongoing sustainability of rural dental student clinical placements.INTRODUCTION Student clinical placements away from the university dental school clinics are an integral component of dental training programs. In 2009, the School of Dentistry and Oral Health, Griffith University, commenced a clinical placement in a remote rural community in Australia. This paper presents a simple cost analysis of the project from mid-2008 to mid-2011. METHODS All expenditures of the project are audited by the Financial and Planning Services unit of the university. The budget was divided into capital and operational costs, and the latter were further subdivided into salary and non-salary costs, and these were further analysed for the various types of expenditures incurred. The value of the treatments provided and income generated is also presented. RESULTS Remote rural placements have additional (to the usual university dental clinic) costs in terms of salary incentives, travel, accommodation and subsistence support. However, the benefits of the placement to both the students and the local community might outweigh the additional costs of the placement. CONCLUSIONS AND IMPLICATIONS Because of high costs of rural student clinical placements, the financial support of partners, including the local Shire Council, state/territory and Commonwealth governments, is crucial in the establishment and ongoing sustainability of rural dental student clinical placements.

Developing a transmucosal contour to achieve an optimal esthetic outcome in the esthetic zone

Background: Successful implant restorations in the esthetic zone often require demanding surgical and prosthetic therapeutic procedures in order to achieve long term stable results. Anatomical factors such as the thin buccal bone plate, the thin soft tissues and the high scalloping further complicate the decision-making and the treatment workflow. Despite the clinical and scientific evidence the clinical handling and the treatment sequence and workflow is of outmost importance determining the final outcome of the implant restoration. Aim/Hypothesis: The purpose of this report is to describe a methodology and treatment workflow in esthetic implant cases. This treatment sequence is utilizing socket preservation and bone grafting, soft tissue augmentation and temporary restorations to achieve optimum esthetic results. Material and methods: A 30 year old female patient presented with a sugingivally broken central incisor. The root was extracted and ridge preservation, using FDBA and a resorbable membrane was performed. An etched bonded Rochette-type bridge was used to temporarily restore the missing tooth. At 4 months the bone volume of the augmented site was adequate and an implant was placed. A two stage approach was selected and the implant was covered for the osseontegration period. At 4 months the implant was uncovered and a simultaneous soft tissue augmentation using a connective tissue graft was performed. The palate was used as a donor site. A provisional screw retained implant crown was inserted. The provisional crown was utilized to enhance tissue maturation and scalloping by consecutive modifications that created the desired emergence profile in a period of 4 months. The emergence profile was captured via a customized impression procedure. A custom all-ceramic abutment capturing the developed emergence profile was constructed. An all-ceramic crown was used to create the final esthetic result. Results: The soft and/or hard tissue enhancement in the majority if not all of the cases in the esthetic zone is absolutely necessary in order to achieve a highly esthetic and natural appearance of the implant restoration. The dentist can progressively develop the site to accommodate the implant in a perfect position. The interim restoration can be utilized to create the ultimate emergence profile and to allow the patient to evaluate its shape, size and color during the tissue maturation period. A customized impression procedure is utilized to transfer all these information to the laboratory for the construction of the final restoration. Conclusion and clinical implications: This staged approach is a step-by-step procedure that allows the clinician to carefully design and execute all the necessary steps to achieve an optimal result. The transition from the existing dentition to the final one is smooth and allows the patient to evaluate the result as the treatment progresses. The patient has the opportunity to have a significant input in the final esthetic outcome. The drawback of this procedure is the extended period of treatment, although the patient has constantly a fixed and esthetic restoration to accommodate his/her needs.