作者：
KONSTANTIN I.RUSINM.D
Ph.D.Associate ProfessorWayne State University Associate Director of Residency ProgramDepartment of AnesthesiologyDetroit Medical Center/Wayne State University
作者：
Kaban, Leonard B.[]Associate Professor and Residency Program Director
Department of Oral & Maxillofacial Surgery Harvard School of Dental Medicine Massachusetts General Hospital Boston MA.[]Student DMD Program Harvard School of Dental Medicine Boston MA.[]Walter C. Guralnick Professor and Chairman Department of Oral & Maxillofacial Surgery Harvard School of Dental Medicine Massachusetts General Hospital Boston MA.[?ì]Assistant Professor of Pediatrics Division of Pediatric Hematology Oncology Harvard Medical School Massachusetts General Hospital Boston MA.[]Associate Professor and Director of the Center for Applied Clinical Investigation Department of Oral & Maxillofacial Surgery Harvard School of Dental Medicine Massachusetts General Hospital Boston MA.
PURPOSE: To further evaluate a novel treatment protocol for the management of aggressive giant cell lesions (GCLs) consisting of enucleation followed by adjuvant subcutaneous interferon alpha therapy. PATIENTS AND MET...
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PURPOSE: To further evaluate a novel treatment protocol for the management of aggressive giant cell lesions (GCLs) consisting of enucleation followed by adjuvant subcutaneous interferon alpha therapy. PATIENTS AND METHODS: Using a retrospective case series study design, a sample of patients with aggressive GCLs was enrolled between April 1995 and June 2006. Lesions were enucleated with preservation of vital structures. Postoperatively, the patients received daily subcutaneous interferon alpha (3 million units/m2 of body surface area). Interferon treatment continued with regular clinical and radiographic follow-up until the surgical defects filled in with bone, as demonstrated by panoramic radiographs and confirmed by computed tomography. Side effects, such as fever, fatigue, weight loss, decreased white blood cell count, decreased platelet count and elevated liver enzymes, were monitored. After completion of interferon therapy, patients followed for 2 years without evidence of recurrence were considered cured of disease. RESULTS: The study sample was comprised of 26 subjects (65% female) with a mean age of 18.5 years. At the time of this writing, 16 of the subjects have completed the protocol and are cured of disease, 6 are in remission, and 4 are in active treatment. Four subjects experienced significant side effects from the interferon, requiring modification of treatment. CONCLUSIONS: Enucleation of aggressive GCLs with preservation of vital structures and adjuvant interferon is an excellent strategy for managing aggressive GCLs. Approximately 15% of subjects developed significant side effects limiting interferon administration and necessitating alternative therapies.
Improving access to dental care for patients experiencing barriers such as financial, transportation, or mental health is a public health concern. Dental schools have an obligation to assist patients experiencing such...
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Improving access to dental care for patients experiencing barriers such as financial, transportation, or mental health is a public health concern. Dental schools have an obligation to assist patients experiencing such barriers as well as to educate future dentists and allied professionals on how to assist these patients in overcoming barriers. Once admitted to the dental clinic, retention issues can further complicate the provision of dental care. This article will describe an innovative program designed to address biopsychosocial barriers to dental care. Needs assessments of patients sitting in the waiting room of the dental clinic were conducted by master's of social work (M.S.W.) students. Based on needs assessment results, common dental care barriers were identified and served as the foundation for the establishment of a social work program in the dental clinic. Dental students, faculty, and staff refer patients to the social work program when barriers to care are found. These biopsychosocial barriers are addressed by social workers, uniquely qualified professionals in providing case management, advocacy, referrals, education, and services (CARES). Over the course of three years, 80 percent of patients experiencing an identified barrier to the receipt of dental care were retained through social work intervention. These patients were able to receive dental care within the past year. Dental schools can collaborate with social work schools to establish a protocol and assistance program for dental patients experiencing difficulty accessing care, thereby improving oral health status, retention rates, and dental student education.
Special needs patients are one of the underserved dental patient groups in the United States. This study investigates whether undergraduate dental education about special needs patients affects general dentists’ a) p...
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Special needs patients are one of the underserved dental patient groups in the United States. This study investigates whether undergraduate dental education about special needs patients affects general dentists’ a) professional behavior, b) practice characteristics, and c) attitudes concerning special needs patients. Data were collected from 208 general dentists (178 male/30 female; average age: 49.85 years) who were members of the Michigan Dental Association. The more the respondents agreed that dental education had prepared them well, the more likely they were to treat various types of special needs patients and to set up their practices so they could treat them and the more they liked treating these patients. In conclusion, most general dentists did not think their undergraduate dental education had prepared them well to treat special needs patients. However, the better they reported to have been educated, the more likely they were to treat special needs patients. Given the access to care problems for many special needs patients, it seems crucial to revise dental curricula and provide more didactic and clinical education concerning the treatment of special needs patients.
One of the most serious challenges that dental educators face today is improving the level of student satisfaction with the curriculum and learning environment. To determine whether a particular teaching method might ...
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One of the most serious challenges that dental educators face today is improving the level of student satisfaction with the curriculum and learning environment. To determine whether a particular teaching method might enhance student satisfaction with the learning process, a learning preference survey linked to sensory modalities was given to students in the four classes of the Temple University School of Dentistry. New Zealand educator Neil Fleming developed the survey called VARK (an acronym for Visual, Aural, Read/Write, and Kinesthetic) in 1998. The purpose of this study was to measure the distribution of learning preference mean scores of the dental students and note any significant differences among classes, gender, and a sample population determined using 31,243 participants on the VARK website. Results clearly demonstrate that the dominant preference distributions for the two populations (dental student and sample population) are different. In particular, the proportions of learners who selected visual or kinesthetic are significantly different for the two populations, while the proportions of learners who selected aural or read/write are not significantly different. Dental students prefer visual learning at a higher percentage and kinesthetic learning at a lower percentage than the sample population measured in the VARK website. Inter-class differences varied, and gender differences were not significant. The distribution of dental student scores shows a preference for instructors who use strong visual presentations and facilitate note-taking during lectures. Dental educators should be aware of these differences in order to explore opportunities for making the educational experience more productive and enjoyable.
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