PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

The capacity to locate, access, and appraise information is an important skill required for success in dental school and beyond. An interdisciplinary course was implemented to teach first-year dental students at the University of Texas Health Science Center at Houston Dental Branch about evidence-based dentistry, search strategies, critical appraisal of the literature, and dental informatics. Students learned to develop a clinical question, conduct a search to find answers to that question, and critically appraise one of the retrieved resources. Over a period of four years, a total of 259 dental students completed a questionnaire that requested their assessment of this course. Seventy-five percent of the respondents agreed or strongly agreed that they learned to effectively search databases such as the Cochrane Collaboration and PubMed and to critically appraise websites and journal articles and that the information on evidence-based dentistry and critical thinking skills was valuable.In response to open-ended questions, approximately 35 percent of the respondents mentioned the importance of learning to search PubMed and Cochrane databases. Approximately 20 percent of the respondents felt the course did not contain new information. These results indicated the effectiveness of the course in familiarizing the students with the capacity of online resources to help them locate, access, and appraise information pertinent to oral health issues and the practice of dentistry. A future goal is to integrate information and skills associated with evidence-based practice into other courses in the dental curriculum.Dr. Levine is Associate Professor,

Expert pediatric dentists demonstrated greater knowledge of dental trauma compared to novice clinicians. The mobile app clinical decision support tool was a more effective means of improving the diagnosis and management of traumatic dental injuries by both dental students and pediatric dentists than the print CDST.

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Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.