This multifaceted study documents validates, and verifies the changes in oral surgery teaching in Dundee University Dental School, which have changed with time to accommodate the demands of an ever increasingly complex discipline. Availability of instructive teaching material in hard copy and as video and text on the internet combined with close clinical supervision and detailed assessment with feedback allows students to attain competency in exodontia with falling patient numbers. It has been demonstrated that the undergraduate training in the oral surgery clinics still attains competency or BDS standard of ‘safe beginner’ for simple extractions and minor oral surgery, despite fewer procedures being carried out. The criteria used for undergraduate assessment and marking of exodontia have been validated in house and nationally. These are appropriate, objective and reliable. Using Thiel cadavers is a valid and reliable method of teaching undergraduate students the technique of extraction with forceps prior to their clinical exposure. Further employment of the cadavers for continuing practice and the introduction of new skills has been mooted. The use of the ‘Blackboard’ was investigated and found not to be well used; the effort to produce the work was not well directed since it was not taken advantage of by the whole year nor very frequently by those who do use it. Alternative methods of engaging the student to investigate and research the discipline have been suggested. Encouragement of the students to interact more when the exodontia clinic time is available for this opportunity has been introduced and suggestions to increase this activity to enhance the teaching of core topics have been made. From apprehension to enjoyment our student assure us that they find this discipline worthwhile whilst acknowledging that it will not be a practice builder and that they are equipped to deal with simple oral surgery procedures.

Introduction: The use of CBCT to visualize the relationship between the inferior alveolar canal and the mandibular third molar roots continues to grow as it is becoming the standard of care. It becomes important to understand the impact that luminance, one of the factors that affects the viewing conditions of digital images, has on appropriately assessing the third molar-canal relationship. To date, no study has assessed the impact of luminance on visualizing anatomic structures on CBCT. The aim of this study is to determine if there is a difference in the ability to appropriately assess the root development and the third molar-canal relationship on a medical grade monitor with four different luminance settings on CBCT. Materials and methods: 285 scans were randomized and evaluated by three calibrated and masked evaluators. The evaluations were completed on a Barco MDNC-3321 Nio Color 3MP monitor (Kortrijk, Belgium) monitor at four different luminance settings; 200 cd/m2, 300 cd/m2, 400 cd/m2, and 500 cd/m2. The gold standard was established by two board-certified oral and maxillofacial radiologists. All evaluations were performed in a controlled subdued environment lighting of less than 15 lux. There was a washout period of at least one week between each of the four evaluations by an observer. Results: The accuracy of two of the three evaluators was substantial to almost perfect independent of luminance. None of these assessments showed any statistical significance (P = 0.05). The accuracy of one evaluator was moderate to almost perfect for all evaluations with one assessment of one canal showing statistical significance (P = 0.05). Conclusion: There is no difference in the ability to appropriately assess the third molar canal relationship or the root development of third molars on a medical grade monitor at luminance settings between the range of 200 cd/m2 and 500 cd/m2 when viewed in a dimly lit room.

This thesis aimed to investigate the role of alveolar epithelial cells (AEC) on immune responses against mycobacterial infections, specifically, the role of AEC in modulating macrophage functions through the secretion of broad variety of factors. In paper I, we compared murine AEC with interstitial macrophages (PuM) in their ability to take up and control mycobacterial growth and their capacity as antigen-presenting cells. We found that AEC were able to internalize and control bacterial growth and present antigens to T cells from immunized mice. In addition, both AEC and PuM exhibited distinct patterns of secreted factors, and a more comprehensive profile of AEC responses revealed that AEC were able to secrete different factors important to generate various effects in other cells. Paper II: Since AEC secrete a broad variety of factors, we hypothesized that being in the interface; AEC may play an important role in transmitting signals from the external to the internal compartment and in modulating the activity of PuM. Thus, we prepared AEC-derived media and tested their effect on bacteria and a number of macrophage functions a) migration, b) phagocytosis and control of intracellular bacterial growth, and c) alteration in cell morphology and expression of surface markers. We found that AEC-secreted factors had a dual effect, in one hand controlling bacterial growth and on the other hand increasing macrophage activity. In paper III, we first investigated the responsible mechanisms of intracellular bacterial growth control mediated by AEC-derived media. We found that infected macrophages upon AEC-secreted factors increased the control of intracellular bacterial growth by iNOS-independent pathways. Compared with other macrophage types, PuM, did not control the intracellular bacterial growth upon the well-known potent macrophage activator, IFN-γ. We found that SOCS1 was involved in the un-responsiveness to IFN-γ by PuM to control the intracellular bacterial growth. We suggested that PuM are restricted in their inflammatory responses perhaps for avoiding tissue damage. Overall, the current findings highlight the importance of AEC in the defense against bacterial infection in the lungs by secreting factors involved in activation and differentiation of immune cells such as macrophages. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 3: Manuscript.</p>

Background: Several studies have suggested that the likelihood of paraesthesia may depend on the local anaesthetic (LA) used. The purpose of this study was to analyze reports of paraesthesia among dental LAs used in the U.S. Methods: Reports of paraesthesia involving LAs between November 1997 through August 2008 were obtained from the U.S. Food and Drug Administration Adverse Event Reporting System. Chi-Square analysis compared expected frequencies, based on U.S. LA sales data, to observed reports of oral paraesthesia. Results: During the study period 248 cases of paraesthesia following dental procedures were reported. Most (94.5%) cases involved mandibular nerve block. The lingual nerve was affected in 89.0% of cases. Reports involving 4%-prilocaine and 4%-articaine were 7.3-times and 3.6-times, respectively, greater than expected (χ2, p<0.0001) based on LA usage by U.S. dentists. Conclusions: Consistent with previous reports, these data suggest that paraesthesia is more common following use of 4% LA formulations.

Background: Several studies have suggested that the likelihood of paraesthesia may depend on the local anaesthetic (LA) used. The purpose of this study was to analyze reports of paraesthesia among dental LAs used in the U.S. Methods: Reports of paraesthesia involving LAs between November 1997 through August 2008 were obtained from the U.S. Food and Drug Administration Adverse Event Reporting System. Chi-Square analysis compared expected frequencies, based on U.S. LA sales data, to observed reports of oral paraesthesia. Results: During the study period 248 cases of paraesthesia following dental procedures were reported. Most (94.5%) cases involved mandibular nerve block. The lingual nerve was affected in 89.0% of cases. Reports involving 4%-prilocaine and 4%-articaine were 7.3-times and 3.6-times, respectively, greater than expected (χ2, p<0.0001) based on LA usage by U.S. dentists. Conclusions: Consistent with previous reports, these data suggest that paraesthesia is more common following use of 4% LA formulations.

Thesis (Ph. D.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains x, 98 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 76-88).

Thesis (Ph. D.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains x, 130 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 120-130).

Thesis (Ph. D.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains xii, 73 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 64-70).

Thesis--University of Oklahoma. / Bibliography: leaves 76-79.

Pulmonary fibrosis is a potentially deadly pathology characterized by excessive deposition of extracellular matrix (ECM), increased tissue stiffness, and loss of tissue structure and function. Recent evidence has suggested epithelial to mesenchymal transition (EMT), the transdifferentiation of an epithelial cell into a mesenchymal fibroblast, is one mechanism that results in the accumulation of myofibroblasts and excessive deposition of ECM. EMT is a highly orchestrated process involving the integration of biochemical signals from specific integrin mediated interactions with ECM proteins and soluble growth factors including TGFβ. TGFβ, a potent inducer of EMT, can be activated by cell contraction mediated mechanical release of the growth factor from a macromolecular latent complex. Therefore, TGFβ activity and subsequent EMT may be influenced by both the biochemical composition and biophysical state of the surrounding ECM. Based on these knowns it was first investigated how changes in the biochemical composition of the matrix and changes in tissue rigidity together modulate EMT due to changes in epithelial cell contraction and TGFβ activation. Here we show that integrin specific interactions with fibronectin (Fn) variants displaying both the RGD and PHSRN binding sites facilitate cell binding through α3β1 and α5β1 integrins, and that these interactions maintain an epithelial phenotype despite engagement of increased tissue rigidities. Conversely, Fn fragments that facilitate cell binding through αv integrins drive TGFβ activation and subsequent EMT even while engaging soft underlying substrates. Adding to the complexity of studying mechanisms that contribute to pulmonary fibrosis, is exposure of the lung to injuries from environmental particulates. Therefore, we investigated how EMT is altered in response to particulate matter (PM). Here we show that PM exposure further drives TGFβ activation, EMT, and increases intracellular levels of reactive oxygen species (ROS). Additionally, cells binding the ECM through α5β1 and α3β1 integrins only partially recover an epithelial phenotype, suggesting ROS may be a secondary driver of TGFβ and EMT. Taken together these results suggest dynamic changes to the ECM microenvironment are major contributors to the control of EMT responses and provide insights into the design of biomaterial-based microenvironments for control of epithelial cell phenotype.