Exploring gamified learning for inculcating patient safety concepts in dentistry: A mixed-methods study

INTRODUCTION

Freshly graduated dentists transition from a supervised undergraduate school clinic into their workplace with limited knowledge on patient safety goals. Many studies have demonstrated benefits of using gamified media in clinical education, but no research has yet been conducted to find out its application in teaching patient safety concepts in dentistry. This study therefore aimed to find out the value of gamified learning in inculcating patient safety concepts in dentistry.

MATERIALS AND METHODS

This mixed-methods study was conducted on general dentists working in NDCS with a post-bachelor's degree graduation work experience of ≤5 years using a conceptual framework consisting of pre/post-knowledge assessment, game data and game performance review. A pre-intervention knowledge test was conducted before a gamified learning educational intervention involving participants assuming the role of a clinician avatar managing different clinical scenarios in a game. After the intervention, participants completed an online survey. Focus group interviews were then organised to find out more about their game experience. A post-intervention knowledge test was also conducted.

RESULTS

Quantitative results showed a significant improvement in test scores of participants after gamified learning. Qualitative feedback of the gamified learning experience was largely positive with majority of participants finding it beneficial though it also revealed some negative aspects and areas of improvement to work on.

CONCLUSION

Gamified learning was valuable in improving knowledge and enhancing learning of patient safety in this study group and has the potential for greater educational benefits given more funding to improve on the game prototype.

Second Attempt of Guided Tissue Regeneration on a Previous Successfully Grafted Site with Periodontal Breakdown-A 5-Year Follow-up

Guided tissue regeneration (GTR) has been proven to promote attachment and regeneration of periodontal tissue. However, there is a 20 to 40% incidence of attachment loss on regenerated attachments reported in the literature. To my knowledge, this is the first case report on a second attempt in GTR on a previous successful grafted site with clinical attachment loss. A healthy 17-year-old Chinese male patient had GTR performed with xenograft particles and bovine resorbable membrane on his root-canal treated, fused upper right lateral incisor and upper right canine (#12-#13) in 2007. Probing depth on the mid-palatal region of #12-#13 was reduced to 4 mm and maintained for the next 4 years. But in the fifth year, probing depth increased to 11 mm with no endodontic symptoms, and a second attempt of GTR using the same materials was carried out. The probing depth at the surgical site was reduced to 4 mm and successfully maintained for another 5 years. Irregular maintenance and the presence of plaque retentive factor could have caused the clinical attachment loss on #12-#13. This case shows it is possible to attempt GTR on a previous successfully grafted site. GTR did not increase tissue resistance against periodontal breakdown. Hence, proper maintenance planning for GTR sites is important to prevent periodontal breakdown.

Role of the oral microbiome, metabolic pathways, and novel diagnostic tools in intra-oral halitosis: a comprehensive update

Halitosis or oral malodor is one of the most common reasons for the patients' visit to the dental clinic, ranking behind only dental caries and periodontitis. In the present times, where social and professional communications are becoming unavoidable, halitosis has become a concern of growing importance. Oral malodor mostly develops due to the putrefaction of substrates by the indigenous bacterial populations. Although culture-based studies have provided adequate information on halitosis, the high throughput omics technologies have amplified the resolution at which oral microbial community can be examined and has led to the detection of a broader range of taxa associated with intra-oral halitosis (IOH). These microorganisms are regulated by the interactions of their ecological processes. Thus to develop effective treatment strategies, it is important to understand the microbial basis of halitosis. In the current review, we provide an update on IOH in context to the role of the oral microbiome, metabolic pathways involved, and novel diagnostic tools, including breathomics. Understanding oral microbiota associated with halitosis from a broader ecological perspective can provide novel insights into one's oral and systemic health. Such information can pave the way for the emergence of diagnostic tools that can revolutionize the early detection of halitosis and various associated medical conditions.

Relationship between vitamin D status, body composition and physical exercise of adolescent girls in Beijing

Little is known about the prevalence of actual vitamin D deficiency in healthy school-aged adolescents, particularly in China. The aim of this study was to examine the prevalence of hypovitaminosis D and to identify whether there was any association between vitamin D status, body composition and physical exercise in 323 Chinese adolescent girls in Beijing, China (40 degrees N).

INTRODUCTION

It is well recognized that persistent severe vitamin D deficiency is associated with the bone abnormalities of rickets and osteomalacia. However, there is now evidence suggesting that low vitamin D status, not previously considered to be a state of deficiency is associated with secondary hyperparathyroidism, increased bone remodelling and other clinical signs thought only to be found in severe vitamin D deficiency. Hypovitaminosis D in healthy children and adolescents has been reported frequently in many countries, especially in winter.

METHODS

We performed a cross-sectional analysis of 323 Chinese adolescent girls in Beijing in winter. Mean age of the subjects was 15.0 (+/-0.4) years. About 32.8%, 68.4% and 89.2% of the subjects were at risk of vitamin D deficiency when defined as plasma concentrations of 25OHD of 25, 37.5 or 50 nmol/L, respectively.

RESULTS

This cross-sectional analysis of 323 Chinese adolescent girls in Beijing in winter showed that hypovitaminosis D was common in these subjects. In addition, body mass index, milk intake, participation in organized sports and total physical activity were all significant independent determinants of vitamin D status. An inverse association was found between plasma 25OHD and intact-parathyroid hormone (iPTH) concentration. Body mass index (BMI), milk intake, participation in organized sports and total physical activity all emerged as major independent determinants of vitamin D status as assessed by plasma 25OHD concentration. Vitamin D status was positively associated with lean body mass (LBM), but there was no association with the degree of body adiposity. Regardless of the concentration of 25OHD in blood used to define vitamin D deficiency, hypovitaminosis D was common in these subjects.

CONCLUSION

It is recommended that policies be developed to prevent vitamin D deficiency in adolescent girls. Further studies are needed to identify the mechanisms whereby vitamin D status is related to exercise and to body composition during growth.

Gene expression analysis of osteoblasts seeded in coral scaffold

Coral matrix of Porites sp. has the suitable properties for bone cell growth. This study was aimed to study the gene expression levels of osteoblast specific genetic markers; RUNX2, osteopontin, alkaline phosphatase and osteocalcin from osteoblasts seeded in coral scaffold, which are important in determining the feasibility of osteoblasts. Human osteoblasts were inoculated onto the processed coral in Dulbecco's Minimum Essential Medium. The cells were trypsinized on day 1, 7, 14, 18, and 21 and added with RNALater for preservation of RNA in cells. The RNA was extracted using commercial RNA extraction kit and the respective genes were amplified using RT-PCR kit and analyzed qualitatively on 1.5% agarose gel. The expressions were evaluated with the Integrated Density Value based on the intensity of band for different periods of cell harvest. Increased expressions of the RUNX2, osteopontin, alkaline phosphatase and osteocalcin genes in the present study proved that coral is a favorable carrier for osteogenetically competent cells to attach and remain viable.