A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Purpose: Among various craniofacial defects, cleft palate is the most common congenital birth defect. Reconstruction of bony parts in the hard palate is important to preserve normal craniofacial growth. Autologous bone grafting is associated with donor site morbidity, extensive healing time, and scar formation. Tissue engineering techniques remain a viable option for the repair and reconstruction of bone. In this study, human gingiva-derived mesenchymal stem cells (HGMSCs) were used in combination with a self-assembled injectable hydrogel scaffold PuraMatrixTM for their ability to regenerate bone. The ability of bone formation of the cell-gel combination was assessed in rat ectopic bone formation system. Methods: HGMSCs were cultured under standard culture conditions. Cells obtained from 3rd passage were encapsulated in 0.5% PuraMatrixTM gel. The cell proliferation was monitored at day 1, 3, 5, and 7 using Live/Dead cell assay. Osteogenesis was determined by assessing matrix mineralization at 4 weeks. The cell-gel constructs were implanted in subcutaneous pockets of 4-week-old Sprague Dawley rats. The bone formation was followed at 2 and 4 weeks using histological and computed tomography scans. Results: Cells encapsulated in PuraMatrixTM were viable and cell growth was observed from day 3. Matrix mineralization was observed at 4 weeks in cell-gel inserts. The bone formation was observed after 4 weeks of implantation. Conclusion: The self-assembled injectable PuraMatrixTM scaffold in combination with HGMSCs can support bone tissue growth in 4 weeks.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Goals and objectives. To gather information intended to advocate for increased behavioral sciences integration into dentistry that could directly benefit the pediatric population by easing transitions to other dental specialists or into adult dental care. Furthermore, to facilitate the potential indirect effect of vertical transmission reduction through fearful adults pursuing dental care. Background. Extensive detail is provided regarding; the negative effects of DFA on the patient and practitioner, deficits in the literature on the topic, identification and management of different types of fear, and detailed behavior guidance techniques applicable to the adult population. Methods. A 28-question survey instrument was designed and sent to 6,117 ADA members in the United States via a medical marketing agency regarding attitudes and beliefs of dentists on behavior guidance techniques practiced on adults. Frequencies and one-tailed z-proportion tests were used to investigate dentists’ skills in treating dental fear and anxiety in adult patients, current strategies used in practice to treat these patients, and explore the need for additional education. Results. A total of 234 people responded to the survey; of which, 162 responses qualified for analysis. Overall, the majority of dental practitioners perceive that they understand the conceptual framework of techniques and can effectively apply them; yet, most experience stress, difficulty, and have very limited educational background in behavior guidance. There was an interest in learning the correct application of techniques, but unwillingness to pay for education that could teach such skills. The results of the analysis enable acceptance of the alternative hypothesis for portions of every aim. Conclusion. In relation to the study group, with very limited DFA knowledge, dentists are apt to be blinded to the potential understanding, application, and success that can come with behavior guidance education and integration into the dental field. This conclusion was supported by the contradictory answers provided by survey participants. Sufficient information was gathered to validate that a need exists to advocate for increased behavioral sciences integration into dentistry. With limited modern literature this study implies a need to invest into well-designed studies to prove a behavior guidance deficit exists in the U.S. dentist population, in addition to benefits that accompany a knowledgeable provider. This is a replication of a study done by Brahm et al. and we thank those authors for their assistance in the development of the measurement instrument.

June 2009. A thesis presented by Claudia Tammy Succar, D.M.D. Submitted to the College of Dental Medicine of Nova Southeastern University in partial fulfillment of the requirements for the degree of Master of Science in Dentistry.

The replacement of missing teeth with dental implants has become a routine and well-documented procedure in healthy patients. However, several systemic diseases have been suggested as potential risk factors for dental implant failure. By collaborating with the applicable medical providers to manage systemic disease symptoms and making appropriate treatment plan modifications, dental practitioners can mitigate challenges brought about by systemic diseases and provide successful rehabilitation with dental implant therapy. The aim of this paper is to evaluate the recent literature to assess the impact of systemic diseases on dental implant treatment and determine whether a consensus can be made regarding contraindications to implants in patients affected by systemic diseases. There is a consensus that patients with osteoporosis are not contraindicated for dental implants. The level of available evidence regarding congenital bleeding disorders, namely hemophilia and von Willebrand disease, is overall weak regarding dental implant usage and safety because a majority of the publications are case series or case report studies. Furthermore, there are few, if any, published randomized controlled trials. The most concise conclusion that was made across all studies is that the dental risk management of patients with congenital bleeding disorders is dependent upon close collaboration between hematologists and oral surgeons. The literature on dental implant use in patient with diabetes mellitus is overall heterogenous however most concludes that patient cohorts that exhibit well-controlled diabetes when undergoing dental implant procedures have success rates comparable to that of healthy patient cohorts. Best practice in regards to dental implant placement in patients affected by systemic diseases requires careful, case-by-case basis treatment planning.

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