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To examine the optical properties of a dental restorative material manufactured from lithium aluminosilicate ceramic and reinforced with lithium disilicate. Translucency and the optical effects of various supporting materials on color were the primary focus.Five 10 × 10 mm samples were prepared in thicknesses of 0.5, 1.0, 1.5, and 2.0 mm of both high translucency (HT) and low translucency (LT) versions of the material in shade A3. A spectrophotometer was used to measure the illuminance of the samples with black and white backings in order to calculate contrast ratio (CR) and relative translucency parameter (RTP). A baseline relationship between translucency and material thickness was examined and the effects of composite, titanium, and zirconia abutments on color change were studied.No significant findings were identified for RTP or CR between the HT and LT material, regardless of the material thickness (p = 0.39, p = 0.14, respectively). Regardless of material thickness (HT vs. LT), translucencies (RTP and CR) were significantly different with composite, titanium, and zirconia backings compared to baseline values (p 0.0001). Titanium had the most significant decrease in translucency compared to composite and zirconia. There was no difference in ΔE00 between the HT and LT materials (p 0.05) regardless of the backing. Titanium had the most significant effect on color of both materials followed by composite then zirconia (p 0.0001).There is not a clinically significant difference in translucency between the high translucency and low translucency materials. Only zirconia supporting structures produced changes in color that are clinically acceptable.Understanding the optical properties of glass-ceramic restorative materials aids providers in selecting appropriate materials for optimum esthetic outcomes. The lithium-aluminosilicate reinforced with lithium disilicate material does a poor job masking supporting structures and resisting color change.

Curriculum transformations represent opportunities to innovate; however, there are few examples to inform this process. In 2018, the University of North Carolina at Chapel Hill (UNC) Adams School of Dentistry began to transform the predoctoral curriculum to improve content integration, enhance team-based experiences, and develop leaders. Part of this experience has been crafting a conceptual curriculum guide or "blueprint" that outlines a vision for the design process and ensures the transformation achieves its goals. We describe how we created the UNC Blueprint for our revised curriculum, which defines who our graduates are, what they know, and what they can do. This approach has led us to develop a mapping taxonomy to ensure the student outcomes are appropriately aligned with content, instruction, and assessment throughout the curriculum. Last, we encourage others to be agile in their approach, create a common language among their teams, and frequently engage faculty to facilitate the process.

This case report illustrates the successful nonsurgical treatment of an adult with a skeletal Class III malocclusion exacerbated by a functional anterior shift that resulted in a severe overclosure of the mandible and a reverse smile line. To maximize the soft tissue and smile esthetics while idealizing the occlusion, active clockwise rotation of the mandible was induced along with mandibular molar uprighting and sequential leveling. In the maxilla, full arch distalization was achieved after second molar extraction. The treatment provided a satisfying esthetic and functional outcome and has remained stable.

The University of North Carolina at Chapel Hill Adams School of Dentistry is developing a transformative curriculum that prepares students to enter contemporary practice. The Advocate, Clinician, and Thinker (ACT) framework will provide the basis for developing a resilient workforce capable of meeting emerging health care needs over the next 40 years.

PURPOSE The need to innovate predoctoral dental education is well established; however, there are few recent reports to guide substantial curriculum transformation. The purpose of this study was to describe faculty perspectives on their vision of future graduates, curriculum needs, and potential barriers to a successful redesign. This information would be used to inform strategic planning for the predoctoral curriculum transformation. METHODS Eighty full-time faculty from the University of North Carolina Adams School of Dentistry participated in 60-minute focus groups in March 2018. Focus group questions were developed to elicit perceptions about the current curriculum, what the dental graduate should know in 2040, and what is needed to engage faculty in curriculum change. Transcripts of the focus group sessions were analyzed by a third-party research group using qualitative thematic analysis to identify pertinent themes shared by participants. RESULTS Faculty identified that developing clinical skill that engages multiple specialties, student time to engage in advocacy activities, and opportunities to integrate biomedical, clinical, and behavioral sciences as critical features of the curriculum. They believed the 2040 graduate should be able to critically evaluate literature, exhibit strong leadership skills, and adapt to the changing healthcare environment. To better engage faculty in curriculum change, there needs to be dedicated time, sufficient resources, a clear plan, and greater collaboration across the school. CONCLUSION When embarking on curriculum transformation, engagement with faculty is a critical component of the change process. Focus groups can be used as a technique to better understand faculty perspectives about curricular needs and the overall vision.

This study examined the prevalence, socio‐demographic correlates, and clinical predictors of traumatic dental injuries (TDIs) in the primary dentition among a community‐based sample of preschool‐age children. The sample comprised 1,546 preschool‐age children (mean age 49 [range: 24–71] months) in North Carolina public preschools, enrolled in a population‐based investigation among young children and their parents in North Carolina. Information on socio‐demographic, extraoral, and intraoral characteristics was collected and analyzed with bivariate and multivariate methods, including logistic regression modeling and marginal effects estimation. The prevalence of dental trauma was 47% and 8% of TDI cases were “severe” (pulp exposure, tooth displacement, discolored or necrotic tooth, or tooth loss). In bivariate analyses, overjet and lip incompetence were significantly associated with TDI. Overjet remained positively associated with severe trauma in multivariate analysis, OR = 1.4, 95% confidence interval (CI) [1.2, 1.6], corresponding to an absolute 1.3%, 95% CI [0.7, 1.8], increase in the likelihood of severe trauma, per millimeter of overjet. Children with increased overjet (>3 mm) were 3.8, 95% CI [2.0, 7.4], times as likely to have experienced severe TDI compared with those with ≤3 mm. Overjet is a strong risk factor for TDIs in the primary dentition. Incorporating and operationalizing this information may help TDI prevention and related anticipatory guidance for families of preschool‐age children.

The use of 3D technology in orthodontics has increased recent years. 3D intra-oral scanning, cone beam computed tomography (CBCT), 3D printing and computer-aided design and computer-aided manufacturing (CAD/CAM) technology has been utilized to create “personalized” orthodontic appliances. While technological improvements to orthodontic appliances seem promising, do they truly improve treatment efficiency and/ or treatment quality? This article will review currently available orthodontic appliances which utilizes 3D technology such customized wires and CAD/CAM fabricated brackets. Customized archwires are planned from 3D virtual setup and robotically bent. Studies have shown a decrease in treatment time with the use of customized wires, however data on quality of treatment results are conflicting. While this technology is fairly accurate for mesial-distal tooth movements, it is less precise for crown tip and root torque. CAD/CAM brackets were initially shown to be more effective and efficient when compared to standard brackets, but a follow-up study showed no difference in the quality of treatment of outcomes. The study also showed the majority of the reduction in treatment time resulting from CAD/CAM brackets may be due to the indirect bonding process rather than the personalized milled slots.

The Growth and Development (G&D) curriculum at the University of North Carolina at Chapel Hill School of Dentistry uses self-directed web-based learning modules in the place of lectures and includes scheduled self-study times during the 8 am-5 pm school hours. The aim of this study was to use direct observation to evaluate dental students' access patterns with the self-directed, web-based learning modules in relation to planned self-study time allocated across the curriculum, proximity to course examinations, and course performance. Module access for all 80 students in the DDS Class of 2014 was recorded for date and time across the four G&D courses. Module access data were used to determine likelihood of usage during scheduled time and frequency of usage in three timeframes: >7, 3 to 7, and 0 to 2 days before the final exam. The results showed a statistically significant difference in the likelihood of module access during scheduled time across the curriculum (p

A new species of Eupsilia Hubner phenotypically allied to E. cirriplaea (Franclemont, 1952) and E. sidus (Guenee, 1852) is described from northeastern North America. Identification of E. schweitzeri, n. sp., is most reliably made on the basis of larval morphology or genetic data, although most adults can be determined using subtle forewing features, including their derived forewing scale type. The adult, genitalia, forewing scales, and larvae of the new species are illustrated. Keys are provided to adults and larvae of the seven northeastern Eupsilia. Eupsilia walkeri (Grote, 1864) is synonymized under E. vinulenta, n. syn. Scopelsoma colorado (Smith, 1903) is removed from synonymy with Eupsilia sidus and given valid species status as Eupsilia colorado, rev. stat., and a neotype is designated for E. sidus.

Objective GO-COLITIS aimed to measure the effectiveness of subcutaneous golimumab in tumour necrosis factor-α antagonist–naive patients with moderate to severe ulcerative colitis (UC) despite conventional treatment.\ud \ud Design GO-COLITIS was an open label, single arm, phase 4 study with a pragmatic design which reflected UK clinical practice. Adult patients were eligible if diagnosed with UC ≥3 months, partial Mayo score (PMS) 4–9. Patients received subcutaneous golimumab induction (200 mg initially and 100 mg at week 2) followed at week 6 by 50 mg or 100 mg (depending on weight) every 4 weeks until week 54 with a 12-week follow-up. Efficacy was measured by PMS at baseline, week 6, 30, 54 and 66. Health-related quality of life (HRQoL; Inflammatory Bowel Disease Questionnaire (IBDQ) and EuroQol Group 5 Dimensions Health Questionnaire (EQ-5D)) was assessed at baseline, week 6 and week 54. All safety adverse events (AEs) were recorded.\ud \ud Results 207 patients were enrolled and 205 received golimumab (full analysis set (FAS)205). At week 6, 68.8% (95% CI 62.0% to 75.1%) and 38.5% (95% CI 31.8% to 45.6%) of patients were in response and remission, respectively, using PMS. At the end of the induction phase, 140/141 patients in clinical response continued into the maintenance phase (Maintenance FAS). Sustained clinical response through week 54 was achieved in 51/205 (24.9%) of the FAS205 population and 51/140 (36.4%) of the Maintenance FAS population. Statistically significant improvements from baseline to week 6 were observed for the IBDQ total score and for each IBDQ domain score (bowel symptoms, emotional function, systemic symptoms and social function), as well as the EQ-5D index score and associated visual analogue scale score (p

Objectives To assess the effect of virtual surgical planning (VSP) on the accuracy of condylar seating in surgical cases involving Bilateral Sagittal Split Osteotomy (BSSO). An additional aim was to quantify differences between actual surgical outcome and planned virtual outcome. Setting and sample population A private practice in Charlotte North Carolina. Twenty-five consecutively operated subjects prepared with VSP and twenty consecutively subjects operated with conventional surgery planning were enrolled. Material and methods Cone beam computed tomography (CBCT) scans were obtained before surgery (T1) and post-surgery after splint removal (T2). The T1 and T2 CBCTs were superimposed on the anterior cranial base using voxel-based registration. Three dimensional (3D) models were built and oriented to a 3D Frankfurt horizontal. Displacement of corresponding condylar landmarks was measured. Results No significant difference was found between the VSP and conventional group in the magnitude of translation or rotation of the condyles following surgery. VSP surgical outcomes differed significantly from predicted positions at all landmarks. Virtual surgical planning does not prevent changes to condylar position as a result of surgery. Actual surgical results differed significantly from VSP-predicted outcomes. Conclusions Virtual surgical planning did not reduce the changes to condylar position and angulation that resulted from conventionally planned orthognathic surgery.