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Oh SL, Mishler O, Jones D. Evaluation of student readiness for clinical dental education at the end of preclinical education. J Dent Educ 2024; 88:472-479. [PMID: 38193239 DOI: 10.1002/jdd.13447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/19/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES This study examined results of a summative objective structured clinical examination (OSCE) at the end of preclinical periodontal education to identify deficient areas for dental students in patient care and to explore factors affecting the probability of passing the OSCE. METHODS The summative OSCE was administered to two consecutive cohorts, Classes A (class of 2024; n1 = 134) and B (class of 2025; n2 = 129). The questions for each station in the OSCEs were available to both classes 1 week before the OSCEs. Descriptive statistics were used to identify deficient areas. The multiple logistic regression model was built to predict the probability of passing the OSCE based on the cohort, gender, and the practical and written examination scores. RESULTS Fifty-one (38%) students in Class A and 66 (51%) students in Class B completed the OSCE by passing all stations. Students undergoing remediation showed deficiencies in demonstrating how to detect tooth mobility, performing periodontal probing, drawing the healthy positive bony architecture and the mucogingival junction, and using a universal and a Gracey 13/14 curette. The probability of passing the OSCE was significantly correlated with Class B (p = 0.035) and the practical examination score (p = 0.03) while not associated with gender (p = 0.53) and the written examination score (p = 0.11). CONCLUSION Students showed deficiencies in assessment skills at the end of preclinical education. The study findings suggest that the implementation of the OSCE at the conclusion of preclinical education would be beneficial since the written examination score might not accurately reflect student readiness for clinical patient care.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Oksana Mishler
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Deborah Jones
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
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Jones D, Oh SL. Correlation Between Student Performances on Case-Based Constructed-Response Formative Assessment and Summative Assessment. J Med Educ Curric Dev 2024; 11:23821205241239496. [PMID: 38516552 PMCID: PMC10956135 DOI: 10.1177/23821205241239496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES This study aimed to evaluate the impact of formative assessment with case-based constructed-response question (CRQ) formats on student performance on the final summative assessment in the second-year periodontics course. METHODS Classroom quizzes with case-based CRQs were implemented as the formative assessment during the course. Each student received feedback on their responses from the course director. After all students (N = 128) took the second-year final examination, the Friedman test was conducted to compare student performances in each assessment over time. The multiple linear regression (MLR) model was used to evaluate the association between the second-year final examination score and plausible predictors-student gender, the second-year formative and midterm examination scores, and time spent on the final examination. RESULTS The mean % scores in the formative assessment (51) and midterm (84) examination were significantly lower than that of the final (87) examination (P < .01). The number of students who failed the final (6) examination was significantly lower than the midterm (16) examination (P = .03). The midterm (P < .0001) and the formative assessment (P = .0009) scores significantly affected the second-year final examination score while student gender (P = .59) and time spending (P = .83) showed no correlations. CONCLUSION Within the limitations of the study, student performance on case-based CRQs was correlated with student performance on the summative assessment.
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Affiliation(s)
- Deborah Jones
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
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Oh SL, Swiec G, Jones D, Chung T. Effectiveness of distance learning for preclinical periodontal education. Eur J Dent Educ 2023; 27:1060-1066. [PMID: 36748958 DOI: 10.1111/eje.12899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/19/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study aimed to investigate the effectiveness of distance learning (DL) for the second-year periodontics course compared to classroom learning (CL). MATERIALS AND METHODS: DL for Class A (n1 = 126) and CL for Class B (n2 = 133) were implemented. The same instructors recorded or delivered the same lectures in the two learning modules during the second-year periodontics course. Classes A and B took the same final examinations (a total % score of 200). General linear model (GLM) and ordinal logistic regression (OLR) analyses were conducted after considering individual first-year final % scores as a covariate to test if the second-year final % scores and the distributions of letter grades were significantly different between Class A and B. RESULTS The mean second-year final % score of the DL group (166.4) was significantly higher than that of the CL group (160.8) (independent t-test, p = .019). However, in GLM, the first-year final % scores significantly affected the second-year scores (p = .016); the second-year final % scores between the two groups were not significantly different (p = .268) after considering the individual first-year scores. In OLR, there was no difference in the likelihood of getting lower grades in the second-year course between the two groups (odds ratio = 1.6; 95% confidence interval = [0.95, 2.72], p = .078) after considering the first-year final % scores. CONCLUSION Within the limitations of the study, the DL for preclinical periodontics resulted in comparable student learning outcomes when compared to the traditional CL.
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Affiliation(s)
- Se-Lim Oh
- Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland, USA
| | - Gary Swiec
- Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland, USA
| | - Deborah Jones
- Clinical Instructor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland, USA
| | - Thomas Chung
- Former Student, Department of Computer Science, University of Maryland, College of Computer, Mathematical, and Natural Sciences, College Park, Maryland, USA
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Oh SL, Kim JR, Engermann E, Shiau HJ. Survival analysis of root-resected molars from 1 to 13.4 years: A retrospective cohort study. J Prosthet Dent 2023:S0022-3913(23)00409-2. [PMID: 37468370 DOI: 10.1016/j.prosdent.2023.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 07/21/2023]
Abstract
STATEMENT OF PROBLEM While root resective therapy may extend the longevity of a molar, data on patient selection and outcomes of root resection are scarce. PURPOSE The purpose of this retrospective cohort study was to analyze the survival of root-resected molars and investigate factors affecting the decision and outcomes of the therapy. MATERIAL AND METHODS Patient- and tooth-related data from participants who had received root resection between 1999 and 2022 were collected. Cox regression was used to build predictive models for time-to-tooth loss based on predictors-initial diagnoses (carious, endodontic, periodontal, or endodontic-periodontal lesions), the presence of a complete-coverage crown, and the location of the tooth in the arch (P<.001). RESULTS Of 60 teeth, all from different participants, 31 molars were resected because of endodontic lesions. The failure rate was 35% with 21 teeth extracted. At 5 years, the survival probability was 0.58, considering all predictors. The survival of molars resected because of carious or endodontic lesions was significantly lower than those because of periodontal or endodontic-periodontal lesions (P<.05). The hazard ratio for tooth loss in the resected teeth was 15.6, 95% confidence interval (CI) (3.7 to 83.2) without complete-coverage crowns and 8.6, 95% CI (2.2 to 43.2) at the most posterior location. CONCLUSIONS Root resection provided to manage a localized periodontal lesion had the highest prognosis. The absence of a crown and the location as the most posterior tooth in the arch were associated with poor survival following resection.
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Affiliation(s)
- Se-Lim Oh
- Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Md.
| | - Jong Ryul Kim
- Associate Professor, Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pa
| | - Emmanuel Engermann
- Undergraduate student, School of Dentistry, University of Maryland, Baltimore, Md
| | - Harlan J Shiau
- Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Md
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Oh SL, Choi SK. Management of a prosthetic complication on an implant restoration placed when the patient was 10 years old: A case report. J Prosthodont 2023; 32:5-9. [PMID: 36272533 DOI: 10.1111/jopr.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
The use of dental implants in pediatric patients may create unique complications. A 38-year-old patient presented with a mobile, cement-retained implant crown due to an abutment screw loosening. The maxillary right central incisor implant was placed when the patient was 10 years old. Pus discharge from the peri-implant sulcus was observed. The mucosal margin of the implant was at the level of the mucogingival junction of neighboring teeth. Radiographically, the platform of the implant appeared to be at the level of the apical third of the adjacent roots. After removing the existing implant-retained crown, the inflamed peri-implant tissue covering the implant platform was removed and the stability of the implant was confirmed. A new screw-retained implant crown was made using an angulated screw channel to correct the labiopalatal angulation of the implant and allow for retrievability. Pink porcelain was used to match the mucosal margin of the implant crown to that of the maxillary left central incisor. This case report highlights the risk of implant placement in pediatric patients and agrees with previous reports that implants should be delayed until growth is complete.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Seung Kee Choi
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
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Oh SL, Abrera-Crum L, Yang JS, Choi SK. New approach to expedite the delivery of the final crowns for teeth requiring crown lengthening surgery: a pilot study. BMC Oral Health 2022; 22:462. [PMID: 36324171 PMCID: PMC9632148 DOI: 10.1186/s12903-022-02491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The healing period from crown lengthening procedures (CLPs) often delays the final crown delivery. This study aimed to explore the feasibility of a new approach expediting the delivery of the final crowns for teeth requiring CLPs. METHODS Teeth requiring CLPs and single-crown restorations between the canine and the second molar were included. After the initial tooth preparation, a CLP was performed. In the experimental group, the final tooth preparation and final impression were made during the CLP; the final crown was then delivered at the suture-removal appointment. In the control group, the final impression was made 8 weeks after the CLP. The level of gingival margin (GM), pocket depth (PD), and crestal bone levels (CBLs) were compared between the two groups before CLPs (T0), at delivery of the crowns (T1), and at 12 months in function (T2). RESULTS Twenty-one lithium-disilicate crowns were delivered to 20 subjects and followed up. The mean interval between the CLPs and the delivery of crowns was 2.5 weeks for the experimental group and 12 weeks for the control group. No significant differences were observed between the two groups in the level of GM, PD, and CBLs at each time point. No significant treatment difference in crestal bone loss was observed between the two groups at T2 (Experimental = -0.11 mm, Control = -0.03 mm; p = 0.67). CONCLUSION Making the final tooth preparation and the final impression at the CLP significantly reduced the time between the CLP and the delivery of the final crown and showed comparable clinical outcomes.
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Affiliation(s)
- Se-Lim Oh
- grid.411024.20000 0001 2175 4264Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD USA
| | - Luz Abrera-Crum
- grid.411024.20000 0001 2175 4264Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, MD USA
| | - Ji Seung Yang
- grid.164295.d0000 0001 0941 7177Department of Human Development and Quantitative Methodology, College of Education, University of Maryland, College Park, MD USA
| | - Seung Kee Choi
- grid.411024.20000 0001 2175 4264Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD USA
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Mishler O, Oh SL, Matthews E, Oates TW. Senior dental students' perceptions of evidence-based dentistry. Eur J Dent Educ 2022; 26:623-628. [PMID: 34904331 DOI: 10.1111/eje.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/12/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aimed to assess senior dental students' knowledge and attitudes regarding evidence-based dentistry (EBD), their use of the current literature and considerations for patient preferences. MATERIALS AND METHODS A modified Knowledge, Attitudes, Access, and Confidence Evaluation (KACE) survey was administered to collect data from senior dental students at the University of Maryland School of Dentistry (UMSOD). The chi-squared test was used to compare the correct response rates of each question in the knowledge of scientific evidence domain. Spearman's rank correlation coefficient was conducted to examine correlations between students' knowledge of scientific evidence and their confidence in appraising the study qualities. RESULTS 61 seniors (out of 130) answered all survey questions. Participants displayed an intermediate level of knowledge of EBD. Only 15% of participants correctly answered to the most appropriate design; the distribution of responses appeared significantly different amongst the questions in the basic knowledge section (chi-squared test, p < .0001). There was no or very weak correlation between students' knowledge of scientific evidence and their confidence in appraising study qualities (Spearman's ρ = 0-0.18). The participants highly valued the use of the current literature and patient preferences. However, their preferred sources of scientific evidence were the Internet excluding Cochrane reviews (60%) and colleagues (56%). Forty per cent of participants rarely or never used textbooks. CONCLUSION Whilst seniors felt confident in evaluating study qualities and implementing EBD in routine practice, their understanding of the study design was poor. Seniors' preferred sources of scientific evidence were non-peer-reviewed Internet sources and colleagues.
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Affiliation(s)
- Oksana Mishler
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore School of Dentistry, Baltimore, Maryland, USA
| | - Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore School of Dentistry, Baltimore, Maryland, USA
| | - Eric Matthews
- Doctor of Health Sciences, College of Graduate Health Studies, A.T. Still University, Kirksville, Missouri, USA
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore School of Dentistry, Baltimore, Maryland, USA
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Oh SL, Shiau HJ, Ashour I, Chen H, Cruz C. Early crestal bone loss around implants placed at previously failed sites compared with initially integrated implants: A retrospective cohort study. Clin Implant Dent Relat Res 2022; 24:233-241. [PMID: 35320613 DOI: 10.1111/cid.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is minimal information on early crestal bone loss (CBL) associated with implants placed at failed sites. PURPOSE This retrospective cohort study aimed to evaluate CBL of surviving and restored implants placed at previously failed sites (replaced implants [RIs]) compared to that of implants initially integrated and restored (pristine implants [PIs]), within the same subjects from implant placement to 17 months post-delivery of restoration. METHODS Subjects who had both PI(s) and RI(s) were recruited. The following data were retrieved: patient demographics, implant locations, types of implant failure, use of bone graft procedure(s), and intraoral radiographs at implant placement (T0), restoration delivery (T1), and the post-restoration follow-up (T2). A blinded evaluator measured crestal bone levels at T0, T1, and T2. RESULTS Forty-four implants (22 in the RI and 22 in the PI group) from the 22 subjects were reviewed. The 22 implants in the RI group were placed either at early failure (17) or late failure (5) sites. There was a 4.6 times higher likelihood of bone graft procedures performed in association with RIs compared to PIs when using a generalized linear mixed model. Differences in crestal bone levels were compared between the two groups at each time point. There were no significant differences in the mesial and mean crestal bone levels between the PI and RI groups. The RI group exhibited lower crestal bone levels on the distal side compared to the PI group at all time points. However, this difference was due to crestal bone level at T0 (p = 0.039) not due to implant replacement (p = 0.413) or bone graft procedure (p = 0.302) when using mixed regression modeling. CONCLUSION The effect of replacements of implants at failed sites on CBL was not significant. RIs, once integrated, exhibited the same pattern of CBL as pristine implants.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Harlan J Shiau
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | | | - Hegang Chen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Christopher Cruz
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
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Oh SL, Mishler O, Yang JS, Barnes C. Effectiveness of remote simulation-based learning for periodontal instrumentation: A non-inferiority study. J Dent Educ 2021; 86:463-471. [PMID: 34773246 DOI: 10.1002/jdd.12820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/08/2021] [Accepted: 10/19/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES While numerous virtual/remote simulation-based learning (SBL) modules were implemented due to the COVID-19 pandemic, limited data on their effectiveness are available. This study aimed to investigate the effectiveness of a remote SBL module for periodontal instrumentation compared to traditional onsite SBL modules. METHODS Calibrated faculty members have instructed in all modules. Synchronous remote SBL activities using a secure videoconferencing application, which replaced onsite practices, were conducted in a small group setting in the remote SBL module for the class of 2023. After the class took the onsite second-year practical examination, a set of multiple and logistic regression analyses (N = 389) were conducted to test if the second-year practical examination scores and the passing rates were significantly different between the remote SBL (class of 2023) and onsite SBL I and II (class of 2019 and 2022) groups. RESULTS Both mean practical examination score and passing rate from the remote SBL group (class of 2023) were significantly higher than those from the onsite SBL II group (class of 2022) when their first-year practical examination scores were not considered (p < 0.05). Once the first-year practical examination scores were considered, the remote SBL group was not significantly different from the onsite SBL I and II groups with respect to the mean second-year practical examination score and the passing rate. CONCLUSION The proposed remote SBL module achieved the comparable student learning outcomes compared to the onsite SBL modules while it utilized less staff, time, and material expenditure.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, USA
| | - Oksana Mishler
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, USA
| | - Ji Seung Yang
- Department of Human Development and Quantitative Methodology, University of Maryland College of Education, College Park, USA
| | - Christine Barnes
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, USA
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Joseph S, Oh SL, Pae EK, Joshi S. Use of transcortical miniscrews for alveolar ridge preservation following tooth extraction: A pilot study. Clin Oral Implants Res 2021; 33:150-157. [PMID: 34741321 DOI: 10.1111/clr.13875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/22/2021] [Accepted: 11/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this split-mouth pilot study was to investigate the effects of a transcortical miniscrew placed over the buccal plate of an extraction socket for alveolar ridge preservation in humans. METHODS One week after the extraction of bilateral maxillary premolars, cone-beam computed tomography (CBCT) and intraoral digital imaging were performed (T0). A transcortical miniscrew was placed over the buccal plate of the extraction socket on one side (experiment), and the extraction socket on the contralateral side was left untreated (control). Follow-up CBCT and intraoral digital imaging were performed at 8 months immediately after miniscrew removal (T8). Changes in the width of the alveolar bone and ridge were measure by superimposing T0 and T8 of CBCTs and intraoral digital scans. RESULTS Six participants completed the study protocol. Overall, the experimental side with the miniscrew demonstrated less bone loss and less alveolar ridge reduction than the control side. Bone loss on the experimental side (0.7 ± 0.2 mm) was significantly less than that on the control side (1.3 ± 0.7 mm) at the apical level of the socket on axial CBCT imaging (Wilcoxon signed rank test, p = .031). The experimental side (-18 ± 8%) exhibited less reduction in the alveolar ridge width than the control side (-21 ± 12%) at the crestal level on coronal superimposition of the intraoral digital scans. CONCLUSIONS Transcortical miniscrew placement over the buccal plate of the extraction socket resulted in less resorption of the alveolar ridge and bone 8 months after tooth extraction. CLINICAL TRIAL REGISTRATION NCT03205800: Temporary Anchorage Devices for Ridge Preservation (TAD).
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Affiliation(s)
- Surya Joseph
- Private Practice, The Smile Station, Roseburg, Oregon, USA
| | - Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Eung-Kwon Pae
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Shashank Joshi
- Private Practice, Umpqua Periodontics, Roseburg, Oregon, USA
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Goh SSN, Shelat VG, Lee BGW, Chen RY, Oh SL, Chia CLK. A multi-center study on recurrent inguinal hernias: assessment of surgeons' compliance to guideline-based repair and evaluation of short-term outcomes. Hernia 2021; 25:1223-1229. [PMID: 32862259 DOI: 10.1007/s10029-020-02288-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/17/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION As patients with recurrent inguinal hernia (RIH) are at a higher risk of perioperative complications, international guidelines have been developed to mitigate these risks by recommending the reverse approach for repair. We aim to study the characteristics of RIH, compliance to guidelines-based repair (GR) and determine factors influencing compliance to guidelines. METHODS A retrospective study of patients with RIH was carried out at two tertiary institutions in Singapore, over 10 years from January 2010 to 2020. RESULTS There were 16 patients with bilateral recurrences and 214 patients with unilateral recurrences. The characteristics of patients with non-guidelines-based repair (NGR) versus GR were similar, p > 0.05. GR was performed for 128 (52.1%) hernias as compared to NGR for 118 (47.9%) hernias. The open approach was more common in NGR than GR, 115/118 (89.8%) versus 58/128 (45.3%), p < 0.001. Forty (n = 40, 16.3%) RIH presented emergently, of which 37 underwent NGR while 3 underwent GR, p < 0.0001. More consultants were present during GR 103/128 (80.5%) as compared to NGR 78/118 (66.1%), p = 0.018. Emergency presentation of hernia recurrence, OR 7.74 (CI 6.11-9.20), p = 0.005, and open repair during the index repair were significantly associated with NGR, OR 6.63 (CI 4.42-8.84), p = 0.01. Median length of stay was shorter in the GR 1 day (IQR 1-2 days) versus 2 days (IQR 2-5 days) in the NGR group, p = 0.02. CONCLUSION The compliance rate of GR for RIH is 52%. NGR for RIH had acceptable short-term outcomes. For elective presentation of RIH, GR should be encouraged given a shorter length of hospital stay.
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Affiliation(s)
- S S N Goh
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore.
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
| | - V G Shelat
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
| | - B G W Lee
- Lee Kong Chian School of Medicine, Singapore, Singapore
| | - R Y Chen
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore
| | - S L Oh
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore
| | - C L K Chia
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore
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Hack G, Oh SL, Oates TW. Remote diabetes screening exercise in the second-year periodontics course and student perceptions. J Dent Educ 2021; 85 Suppl 3:1933-1935. [PMID: 33635560 DOI: 10.1002/jdd.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/01/2021] [Accepted: 02/20/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Gary Hack
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Se-Lim Oh
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Thomas W Oates
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Oh SL, Yang JS, Kim YJ. Discrepancies in periodontitis classification among dental practitioners with different educational backgrounds. BMC Oral Health 2021; 21:39. [PMID: 33482794 PMCID: PMC7821642 DOI: 10.1186/s12903-020-01371-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
Background The 2018 classification of periodontal disease characterizes the disease with a multidimensional staging and grading system.
The purpose of this multicenter study was to examine variations in periodontitis classification among dental practitioners with different postgraduate educational backgrounds at the University of Maryland School of Dentistry and the Loma Linda University School of Dentistry using the 2018 classification.
Methods This cross-sectional observational study included two cohorts: dental practitioners with periodontal backgrounds (n1 = 31) and those with other educational backgrounds (n2 = 33). The survey instrument contained three periodontitis cases presented with the guideline of the 2018 classification and a questionnaire including closed and open-ended questions. The participants were asked to review each case and to fill out the questionnaire independently. Fisher’s exact test was conducted to examine the differences in responses between the two cohorts. Polychoric correlations were calculated to examine the relation between the level of familiarity with the 2018 classification and the accuracy of the classification. Results The distribution of item responses was significantly different between the two cohorts regarding only one item, grading for Case 1 (p = 0.01). No significant differences in accuracy between the two cohorts were observed except for two items, grading in Case 1 (p = 0.03) and staging in Case 3 (p = 0.04). There were no significant differences in risk factor identification for each case among the two cohorts (p = 1.00, Case 1; p = 0.22, Case 2). Staging in Case 3 (\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\rho }$$\end{document}ρ^ = 0.52) and risk factor identification in Case 2 (\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\rho }$$\end{document}ρ^= 0.32) were significantly correlated with familiarity with the 2018 classification. Conclusion A fair level of agreement in periodontitis classification was observed among dental practitioners with different educational backgrounds when the 2018 classification was used. The periodontal cohort showed better agreement levels and partially better accuracy. Risk factor identification for periodontal disease was difficult regardless of the educational background.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, Room 4211, Baltimore, MD, 21201, USA.
| | - Ji Seung Yang
- Department of Human Development and Quantitative Methodology, College of Education, University of Maryland, College Park, MD, USA
| | - Yoon Jeong Kim
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
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Mishler O, Barnes C, Shiau HJ, Oh SL. Remote simulation-based learning for periodontal instrumentation in preclinical education. J Dent Educ 2021; 85 Suppl 3:2025-2027. [PMID: 33453707 DOI: 10.1002/jdd.12543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/09/2021] [Accepted: 01/14/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Oksana Mishler
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Christine Barnes
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Harlan J Shiau
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Se-Lim Oh
- University of Maryland School of Dentistry, Baltimore, Maryland, USA
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Oh SL, Gourley B, Idzik-Starr C. Student perception of pilot interprofessional education and care clinical experiences at dental clinics. Int J Med Educ 2020; 11:261-262. [PMID: 33361517 PMCID: PMC7883800 DOI: 10.5116/ijme.5fc7.7b93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Se-Lim Oh
- University of Maryland, Baltimore School of Dentistry, Maryland, USA
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Oh SL, Jones D. Sophomore-senior case studies: A case-based learning exercise with peer teaching. J Dent Educ 2020; 85:1117-1119. [PMID: 32761822 DOI: 10.1002/jdd.12371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Se-Lim Oh
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Deborah Jones
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Oh SL, Ji C, Azad S. Free gingival grafts for implants exhibiting a lack of keratinized mucosa: Extended follow-up of a randomized controlled trial. J Clin Periodontol 2020; 47:777-785. [PMID: 32096243 DOI: 10.1111/jcpe.13272] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 01/02/2020] [Accepted: 02/21/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study is an extended follow-up of a randomized controlled trial that evaluated 18-month outcomes following free gingival grafts (FGGs) around implants with <2 mm keratinized mucosa (KM) compared to implants without KM augmentation. MATERIALS AND METHODS Follow-up data were obtained over 48 months from 18 implants in the FGG group (11 subjects) and 8 implants in the no-surgery group (7 subjects) within the control group. FGGs were performed after 18 months for 8 implants in the control group; these 8 implants constituted a delayed FGG group (5 subjects). The width of KM, mucosal recession (MR) and crestal bone level (CBL) were obtained. RESULTS The increased width of KM and the reduced MR following FGGs were maintained for 48 months in the FGG group, which exhibited less MR than the no-surgery group. The amount of crestal bone loss (0.4 ± 0.4 mm) in the no-surgery group was significantly greater than that in the FGG group (0 ± 0.4 mm) at 48 months. In the delayed FGG group, reduced MR and no significant differences in CBL were observed compared with the pre-graft measurements. CONCLUSIONS FGGs can be a practical treatment option to maintain CBL around implants with limited KM.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Chao Ji
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA.,Department of Periodontology, Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Salar Azad
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
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Oh SL, Chung MK. Creeping attachment following free gingival grafts around dental implants exhibiting mucosal recession with a lack of keratinised mucosa: A case series. Int J Oral Implantol (Berl) 2020; 13:401-409. [PMID: 33491370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: Few case reports have been published on creeping attachment around dental implants. This study aimed to assess changes in the level of the mucosal margin following placement of free gingival grafts around single implants exhibiting mucosal recession with < 2 mm keratinised mucosa compared to that of implants with ≥ 2 mm keratinised mucosa. Materials and methods: A total of 12 subjects with one or more implants were included. Nineteen implants displaying implant thread and/or prosthetic abutment exposure with < 2 mm keratinised mucosa were treated using free gingival grafts (FGG group), and 11 implants exhibiting ≥ 2 mm keratinised mucosa did not receive free gingival grafts (control group). The width of keratinised mucosa and the amount of mucosal recession were measured by a blind evaluator (MC). Results: A continual reduction in mucosal recession was observed at the 6- and 12-month followups in all except two of the FGG group implants, while no change in the level of the mucosal margin was observed in the control group. This postoperative coronal migration of the mucosal margin resulted in a 0.7-mm mean reduction in mucosal recession after 12 months in the FGG group. Conclusion: The level of the mucosal margin around implants exhibiting mucosal recession along with a lack of keratinised mucosa migrated coronally following free gingival grafts, and creeping attachment was observed in a number of patients.
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Oh SL, Joshi S. Single-Flap Approach in Periodontal Regeneration for Intraosseous Defects: Case Series. Clin Adv Periodontics 2019; 10:69-74. [PMID: 31612636 DOI: 10.1002/cap.10082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/18/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION A single-flap approach (SFA) is the elevation of a periodontal flap to access the defect only from one side. Several studies have reported that the SFA is at least as clinically effective as the elevation of a flap at both buccal and palatal/lingual aspects. However, studies regarding the SFA have reported only 6 to 10 months follow-up clinical outcomes. The purpose of this case series was to investigate the outcomes of the SFA for periodontal regeneration with a collagen membrane and bone grafts in regard to linear bone defect fill and clinical parameters such as gingival recession (GR), pocket depth (PD), and clinical attachment level (CAL) for the 15-month follow-up. CASE SERIES Based on the deepest pocket depth site, the flap retraction side for each case, either buccal or palatal/lingual, was determined. After retraction of a one-side full thickness flap, complete removal of granulation tissue and thorough scaling and root planing were performed. Demineralized ground cortical bone grafts were gently packed into the defect areas and an absorbable collagen membrane was placed over the grafts in 13 cases from 11 patients. CONCLUSION This case series demonstrated that the SFA for periodontal regeneration with a collagen membrane and bone grafts resulted in decreased PD with minimum GR, gain in CAL, and bone fill at defect sites for the 15-month follow-up.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
| | - Shashank Joshi
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
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Oh SL, Shiau HJ, Reynolds MA. Survival of dental implants at sites after implant failure: A systematic review. J Prosthet Dent 2019; 123:54-60. [PMID: 31027959 DOI: 10.1016/j.prosdent.2018.11.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 12/16/2022]
Abstract
STATEMENT OF PROBLEM Despite an overall high survival rate for dental implants, the effectiveness of implant retreatment remains unclear. PURPOSE The purpose of this systematic review was to examine the survival rate of implants placed at sites which had an implant failure and to investigate factors that might affect outcomes after retreatment. MATERIAL AND METHODS A search of electronic databases limited to English language articles was conducted using the following MeSH terms: "dental implants," "dental implantation," or "dental restoration failure," combined with "retreatment," "replacement," or "reoperation." A hand search of selected journals was also performed. Of the retrieved 668 publications, 8 retrospective clinical studies met the inclusion criteria, providing the survival outcome for 673 implants in 557 patients after retreatment. Implant- and patient-related characteristics related to implant failures were assessed. RESULTS The weighted mean survival rate for implants after retreatment was 86.3%, with follow-up ranging from less than 1 year to over 5 years. The survival rates of smooth-surfaced and rough-surfaced implants were compared in 217 retreated implants, revealing a significantly higher survival rate for rough-surfaced implants than for smooth-surfaced implants (90% versus 68.7%). Insufficient data were available to evaluate the effect of patient- or treatment-related characteristics on the survival of implants after retreatment. CONCLUSIONS The survival rate of retreated implants is lower than that generally reported after initial implant placement. Higher survival rates were reported with rough-surfaced implants than with smooth-surfaced implants in retreatment. An overall implant survival rate of 86.3% after retreatment suggests that most initial implant failures are likely attributable to modifiable risk factors, such as implant architecture, anatomic site, infection, and occlusal overload.
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Affiliation(s)
- Se-Lim Oh
- Clinical Assistant Professor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD.
| | - Harlan J Shiau
- Clinical Associate Professor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
| | - Mark A Reynolds
- Professor, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
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Abstract
This case report presents a treatment of peri-implantitis associated with a pre-existing pathology. Peri-implantitis around implant #19 was detected from pus discharge upon probing. Guided bone regeneration was performed to treat the peri-implantitis with the administration of antibiotics. The histopathologic evaluation of soft tissue taken from the circumferential defect around the implant exhibited a cyst. The postsurgical CBCT and the follow-up radiograph confirmed the maturing bone graft and a reduced size of the defect around the implant.
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Affiliation(s)
- Se-Lim Oh
- Department of Endodontics, Periodontics and Prosthodontics, University of Maryland, School of Dentistry, Baltimore, MD
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Oh SL, Masri RM, Williams DA, Ji C, Romberg E. Free gingival grafts for implants exhibiting lack of keratinized mucosa: a prospective controlled randomized clinical study. J Clin Periodontol 2017; 44:195-203. [DOI: 10.1111/jcpe.12660] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Se-Lim Oh
- Department of Endodontics, Periodontics and Prosthodontics; University of Maryland, School of Dentistry; Baltimore MD USA
| | - Radi M. Masri
- Department of Endodontics, Periodontics and Prosthodontics; University of Maryland, School of Dentistry; Baltimore MD USA
| | - David A. Williams
- Department of Endodontics, Periodontics and Prosthodontics; University of Maryland, School of Dentistry; Baltimore MD USA
| | - Chao Ji
- Department of Endodontics, Periodontics and Prosthodontics; University of Maryland, School of Dentistry; Baltimore MD USA
| | - Elaine Romberg
- Department of Endodontics, Periodontics and Prosthodontics; University of Maryland, School of Dentistry; Baltimore MD USA
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Abstract
Implant fixture fracture is one of the reasons for late implant failure, with incidence rates ranging from 0.2% to 7.5%. Material defects, occlusal overload, prosthetic design, and nonpassive prosthesis fit have been identified as causative factors for implant fixture fractures. A custom-made prosthetic post was made to connect the remaining implant fixture and the implant-retained crown, as the fractured implant fixture exhibited no signs of infection and the fixture had adequate remaining length. In addition, complete removal of the implant could have resulted in significant bone loss at the site.
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Affiliation(s)
- Se-Lim Oh
- Assistant Professor, Department of Periodontics, University of Maryland, School of Dentistry, Baltimore, Md.
| | - Douglas Barnes
- Professor, Department of General Dentistry, University of Maryland, School of Dentistry, Baltimore, Md
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Oh SL. Biologic width and crown lengthening: case reports and review. Gen Dent 2010; 58:e200-e205. [PMID: 20829153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The biologic width includes both the connective tissue attachment and the junctional epithelium and has a mean dimension of approximately 2 mm. Invading the biologic width with a restoration can result in localized crestal bone loss, gingival recession, localized gingival hyperplasia, or a combination of these three. When restoring teeth that have subgingival caries or fractures below the gingival attachment, a clinical crown-lengthening procedure is needed to establish the biologic width. This article presents three case reports that utilized crown-lengthening procedures.
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Affiliation(s)
- Se-Lim Oh
- University of Maryland Dental School in Baltimore, USA
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Oh SL, Fouad AF, Park SH. Treatment Strategy for Guided Tissue Regeneration in Combined Endodontic-Periodontal Lesions: Case Report and Review. J Endod 2009; 35:1331-6. [PMID: 19801225 DOI: 10.1016/j.joen.2009.06.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 06/08/2009] [Accepted: 06/12/2009] [Indexed: 12/26/2022]
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Oh SL. Attached gingiva: histology and surgical augmentation. Gen Dent 2009; 57:381-387. [PMID: 19903619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The keratinized attached gingiva provides the periodontium with increased resistance to external injury, contributes to the stabilization of the gingival margin, and aids in dissipating physiological forces exerted by the muscular fibers of the alveolar mucosa on the gingival tissues. Increasing attached gingiva should be strongly considered in cases where the patient's plaque control is compromised. The apically positioned flap, free gingival graft, and subepithelial connective tissue graft are the most common surgical procedures used for augmenting the zone of attached gingiva effectively and predictably. The newly obtained keratinized gingiva can be maintained for a long period; in addition, these periodontal procedures halt the progression of gingival recession and could lead to gaining more keratinized gingiva from creeping attachment after the surgery. This article reviews the biology of attached gingiva and presents cases related to the functional role of periodontal plastic surgery.
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Affiliation(s)
- Se-Lim Oh
- University of Maryland Dental School, Baltimore, MD, USA
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