Self-management education for adults with type 2 diabetes (T2DM) improves knowledge, skills and motivation; yet, new strategies to more effectively educate patients and improve adoption of insulin therapy are still needed. We conducted a prospective, non-randomized multi-center pilot, using a novel Patient Experience Cloud to deliver microlearning education focused on survival skills, insulin injection technique, and lifestyle management. Content was culturally relevant and tailored to minority patients with T2DM who recently initiated insulin treatment to enhance engagement. Consented T2DM adults, ages 20 to 70 years, were presented an online library of 56 education videos (1-4 minutes each). Pre and post surveys of self-reported attitudes towards insulin and patient activation measures (using the validated PAM scale) were obtained. The study enrolled 201 patients: 78 non-Hispanic whites (NHWs), 74 African Americans (AAs), 39 Hispanic whites (HWs) and 10 Other. Of these, 181 (90%) were engaged (defined as completing baseline surveys and watching 4+ videos). The number of videos viewed differed by race, p=0.012; with median number of 23 for AAs, 13 for NHWs and 5 for HWs. One week later, 83 participants (41%) continued engagement via viewing and completion of post questionnaires. Highest engagement was seen among AAs (51%) vs. 40% of NHWs and 26% of HWs. Overall attitudes towards insulin improved significantly, with a mean change of 0.29 points (on a 6 point Likert scale, 95% CI 0.02 to 0.56, p=0.03). Similarly, the PAM score increased significantly after viewing (by 0.17 point on a 4 point scale, 95% CI 0.to 0.26, p<0.001), independent of race. After viewing culturally tailored microlearning delivered via a cloud platform, patient attitudes towards insulin and activation measures for self-care improved significantly. This novel approach should be further investigated for its ability to improve adherence to insulin and glycemic outcomes. Disclosure M.M. Bogun: Other Relationship; Self; Mytonomy. N.E. Jelesoff: None. C.M. Nassar: None. C.R. Thacker: Other Relationship; Self; Amylin Pharmaceuticals, AstraZeneca, Mytonomy. J. Camacho Rivera: Research Support; Self; Mytonomy. C.J. Bourges: None. K. Sethi: None. L. Egbuonu-Davis: Employee; Self; Sanofi. A.C. Beal: Employee; Self; Sanofi. Board Member; Self; AcademyHealth. D.A. Greenwood: Advisory Panel; Self; Novo Nordisk A/S. Consultant; Self; Verily Life Sciences LLC.. Speaker's Bureau; Self; Becton, Dickinson and Company. Employee; Self; Mytonomy, Inc. Advisory Panel; Self; American Association of Diabetes Educators. H. Chatha: Employee; Self; Mytonomy. Employee; Spouse/Partner; Medstar Health. A. Kataria: Stock/Shareholder; Self; Mytonomy, Inc. Stock/Shareholder; Spouse/Partner; Mytonomy, Inc. D.B. McNeill: None. R. Goland: None. M.F. Magee: Research Support; Self; Sanofi, Eli Lilly and Company, MedStar Health Research Institute. Advisory Panel; Self; Merck & Co., Inc.. Research Support; Self; PRIMED. Speaker's Bureau; Self; IMNE, American Diabetes Association. Advisory Panel; Self; Endocrine Society. Speaker's Bureau; Self; Sanofi. Research Support; Self; MedStar Health.

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and the signifi cance of the defl uoridated water, rationalizing the distribution of defl uoridated water, facilitating collection of rain water, protection of available low fl uoride surface water from contamination with agro-chemicals and household defl uoridation can be recommended. Awareness campaigns on preventive measures, such as eating proper foods, micronutrient supplementation, rainwater harvesting and the use of defl uoridation kits should also be undertaken.A concerted approach with sound planning and community participation remains the only answer towards alleviation of the problem and thus winning the lost smiles back.

Aim:The success of implant therapy is of greatest concern for clinicians because a minor negligence can lead to ultimate failure of treatment. However, comprehensive and precise treatment planning can ensure high success rate of implant therapy. Cone-beam computed tomography (CBCT) is an innovation that allows clinicians to explore all related factors in details. This study was conducted to evaluate different preosteotomy determinants as affecting the success of implant therapy in the maxillary anterior region using CBCT. Materials and methods: This study was conducted on 98 partially or complete denture patients willing for artificial replacement of their missing teeth by implant or implant over-denture. Demographic details of participating patients were collected. Furthermore, comprehensive local examination was also done to finalize the site of placement of implant. Cone-beam computed tomography was attempted in all patients for determining accurate implant location, status of bone, and other interrelated determinants of implant success. Cone-beam computed tomography was also prescribed for patients so as to have presurgical idea of implant dimensions as shown in virtual placement of implant. To rule out any interobserver bias, the interpretations of CBCT images were completed by two independent experienced observers. Results: In the 98 studied patients, 61 were males and 37 were females. The study was restricted to the maxillary anterior region only. The studied preosteotomy determinants were available bone height and width in the edentulous region from ridge crest up to the maxillary sinus floor or the nasal fossa floor. A total of 107 implants were placed virtually (on CBCT) in the maxillary anterior region and compared quantitatively in postosteotomy phases. Implant placement sites were the maxillary central incisor region (39), the lateral incisor region (31), and canine (37). Authors also noticed that the relative length and width of virtual implant remained unaffected in 97% of the cases. Conclusion: Cone-beam computed tomography showed accurate status of various presurgical determinants like trabeculae, peri-ridiculer pathology, and amount of horizontal and vertical bone losses. Hence, it was further concluded that all these presurgical determinants greatly affect the final success rate of implant therapy. It is therefore deemed necessary to judiciously consider and clinically manage such factors before attempting implant in the maxillary anterior region. Clinical significance: Presurgical evaluation of factors associated with implant dimensions significantly assists clinicians in deciding the finest treatment option. All additional information provided by CBCT genuinely led to a change in the treatment plan that provides enhanced clinical outcome with lesser postoperative complications.

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