Research Spotlight

Patterson, K. K., P. Ritwik, C. A. Kerins and A. Adewumi (2020). “Real-time measurement for effectiveness of novel educational endeavors during the COVID-19 pandemic.” J Dent Educ.

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While doors to dental and hygiene institutions close, the minds and educational pursuits of students and residents do not. Being removed from the standard learning environment due to the COVID‐19 pandemic posed unprecedented challenges to the educational infrastructure. Virtual classrooms and webinars became the mainstay of conveying didactic information during the shelter‐in‐place mandate. Several institutions created collaborative webinar sessions using virtual educational systems. Attendees used digital devices to access information during live electronic presentations. [No abstract; excerpt from article].

Patel, T., D. Vayon, S. Ayilavarapu, L. Zhu, S. Jensen and C. T. Lee (2020). “A comparison study: Periodontal practice approach of dentists and dental hygienists.” Int J Dent Hyg 18(3): 314-321.

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OBJECTIVES: The aim of this study was to investigate periodontal practice methods of dentists and dental hygienists to compare their knowledge and treatment approach in managing periodontal disease. METHODS: An electronic survey was designed to assess and capture three aspects of data: (a) knowledge of periodontics; (b) practice approaches in non-surgical periodontal therapy; and (c) factors affecting clinical care. The survey was distributed to dentists and dental hygienists who graduated from the same dental school within 5 years (2012-2016). Results were analysed by chi-square test, Fisher’s exact test and logistic regression model. RESULTS: Out of total 117 participants, 111 of them reported their profession (n = 77 in the dental programme, n = 34 in the dental hygiene programme). The results showed no statistical difference in basic periodontal knowledge between dentists and dental hygienists (P = .12). Only 13% of the surveyed population identified appropriate recall intervals for periodontal maintenance and more dental hygienists reported periodontal re-evaluations being performed within their offices compared with dentists (91% vs 70%, P = .02). Almost half of the participants who reportedly performed periodontal re-evaluations (46%) charged for the re-evaluation procedure, despite it not being covered by dental insurance. More hygienists reported being familiar with and performing adjunct therapy compared to dentists in the study (P < .01). CONCLUSION: In general, dentists and hygienists in the study were found to have similar periodontal knowledge and practice approaches. However, differences in performing periodontal re-evaluation and adjunct therapy were significant. Further studies are needed to investigate clinical barriers that impact evidence-based periodontal care.

Patel, N. A., J. K. Yun and S. Afshar (2020). “Relieving Emergency Department Burden During Corona Disease-2019: Section 1135 Waivers for Dental Case Diversion.” J Oral Maxillofac Surg.

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Many hospital emergency departments (EDs) are currently overburdened with evaluation and management of coronavirus disease-2019 (COVID-19) cases. Dental emergencies, generally attributed to infection or trauma, are costly and inefficiently managed in the ED setting, yet remain in the caseload. In addition, given the current scarcity of personal protective equipment, staff, and operating rooms, patients who present to EDs with dental pain would be best suited to be immediately referred to an independent dental office. Although current law mandates the evaluation of all patients who present to the ED, legislative carve outs made possible by recent US executive branch national emergency declarations make it possible for hospitals to immediately divert patients with dental pain to partnering dental offices and relieve valuable time and resources for EDs to direct their efforts at stemming COVID-19. [No abstract; excerpt from article].

Liu, S., H. Shu, J. Crawford, Y. Ma, C. Li and F. Tao (2020). “Optogenetic Activation of Dopamine Receptor D1 and D2 Neurons in Anterior Cingulate Cortex Differentially Modulates Trigeminal Neuropathic Pain.” Mol Neurobiol.

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Anterior cingulate cortex (ACC) is a critical brain center for chronic pain processing. Dopamine signaling in the brain has been demonstrated to contribute to descending pain modulation. However, the role of ACC dopamine receptors in chronic neuropathic pain remains unclear. In this study, we investigated the effect of optogenetic activation of ACC dopamine receptors D1- and D2-expressing neurons on trigeminal neuropathic pain. Chronic constriction injury of infraorbital nerve (CCI-ION) was carried out to induce trigeminal neuropathic pain in mice. We conducted optogenetic stimulation to specifically activate D1- and D2-expressing neurons in the ACC. Western blotting and immunofluorescence staining were used to examine ACC D1 and D2 expression and localization. The von Frey and real-time place preference tests were performed to measure evoked mechanical pain and nonreflexive emotional pain behaviors, respectively. We observed that dopamine receptors D1 and D2 in the ACC are primarily expressed in excitatory neurons and that the D2 receptor is differentially regulated in the early and late phases of trigeminal neuropathic pain. Optogenetic activation of D1-expressing neurons in the ACC markedly exacerbates CCI-ION-induced trigeminal neuropathic pain in both early and late phases, but optogenetic activation of D2-expressing neurons in the ACC robustly ameliorates such pain in its late phase. Our results suggest that dopamine receptors D1 and D2 in the ACC play different roles in the modulation of trigeminal neuropathic pain.

Hornung, R., A. Pritchard, P. R. Kinchington and P. R. Kramer (2020). “Reduced activity of GAD67 expressing cells in the reticular thalamus enhance thalamic excitatory activity and varicella zoster virus associated pain.” Neurosci Lett 736: 135287.

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Within the reticular thalamic nucleus neurons express gamma aminobutyric acid (GABA) and these cells project to the ventral posteromedial thalamic nucleus. When GABA activity decreases the activity of excitatory cells in the ventral posteromedial nucleus would be expected to increase. In this study, we addressed the hypothesis that attenuating GABAergic cells in the reticular thalamic nucleus increases excitatory activity in the ventral posteromedial nucleus increasing varicella zoster virus (VZV) associated pain in the orofacial region. Adeno-associated virus (AAV) was infused in the reticular thalamic nucleus of Gad1-Cre rats. This virus transduced a G inhibitory designer receptor exclusively activated by designer drugs (DREADD) gene that was Cre dependent. A dose of estradiol that was previously shown to reduce VZV pain and increase GABAergic activity was administered to castrated and ovariectomized rats. Previous studies suggest that estradiol attenuates herpes zoster pain by increasing the activity of inhibitory neurons and decreasing the activity of excitatory cells within the lateral thalamic region. The ventral posteromedial nucleus was infused with AAV containing a GCaMP6f expression construct. A glass lens was implanted for miniscope imaging. Our results show that the activity of GABA cells within the reticular thalamic region decreased with clozapine N-oxide treatment concomitant with increased calcium activity of excitatory cells in the ventral posteromedial nucleus and an increased orofacial pain response. The results suggest that estradiol attenuates herpes zoster pain by increasing the activity of inhibitory neurons within the reticular thalamus that then inhibit excitatory activity in ventral posteromedial nucleus causing a reduction in orofacial pain.