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#43 The Impact of Removal of Third Molars on Periodontal PathologyD.W. PARKER, G.H. BLAKEY, D.J. HULL, R.P. WHITE JR, S. OFFENBACHER, C. PHILLIPS, and RHHAUGDepartment of Oral and Maxillofacial SurgeryObjectives: Assess the impact of 3rd molar removal on periodontal pathology in subjects with 3rd molarsasymptomatic at enrollment. Methods: Subjects who had at least two 3rd molars removed were a sub-sample ofhealthy young subjects enrolled with four asymptomatic 3rd molars in an IRB-approved longitudinal study. Fullmouth periodontal probing (PD) data, 6 sites per tooth, were obtained as a measure of periodontal status at each ofthree visits: enrollment, prior to and after removal of 3rd molars. Data were aggregated to subject and jaw levels.The oral cavity was divided by jaw into segments; the 3rd molar region including the 3rd molar (12 probing sites)and distal of second molar (4 probing sites), and non-3rd molars (80 probing sites). A PD>4mm was consideredan indicator variable for periodontal pathology. The number and percent of sites with a PD>4mm were calculatedfrom the total number of probing sites across all subjects. The frequency of subjects with at least one PD>4mmand all 3rd molars removed were compared to the frequency of subjects retaining at least one mandibular 3rdmolar by Fisher’s Exact Test with significance set at 0.05. Results: Sixty-nine subjects had 3rd molars removed:57% were female and 77% were Caucasian. Median age at surgery was 26.3 years (IQR 23.3-31.5y.). Medianinterval from enrollment to surgery was 2.4 years (IQR 1.5-4.2 y.). Median follow-up after surgery was 9 months(IQR 6.7-15.4 mo.). All 3rd molars were removed in 56 subjects; 13 retained at least one mandibular 3rd molar.More subjects had at least one PD>4mm around mandibular 3rd molars prior to surgery as compared toenrollment, 52% vs. 45%, respectively. Of the total possible mandibular 3rd molar probing sites, 18% werePD>4mm presurgery compared to 12% at enrollment. Significantly fewer subjects who had all 3rd molarsremoved had a PD>4mm on the distal of mandibular 2nd molars post-surgery, compared to those retaining at leastone mandibular 3rd molar, 20% vs. 69%, respectively, P=0.001. The number of PD>4mm in the mandible was lesspost-surgery if all 3rd molars were removed, 1.4% vs. 6.6%. Conclusions: Removal of mandibular 3rd molarssignificantly improved the periodontal status on the distal of 2nd molars, positively affecting overall periodontalhealth. Supported by the Oral and Maxillofacial Surgery Foundation; American Association of Oral andMaxillofacial Surgeons; and the Dental Foundation of North Carolina#44 Pain Correlation to 3D Condylar Morphology in Temporomandibular DisorderD. WALKER, L.H.S. CEVIDANES, P.F. LIM, J. LUDLOW, M. STYNER, and C. PHILLIPSDepartments of Orthodontics, Orofacial Pain, Oral and Maxillofacial Radiology, and Computer ScienceOBJECTIVE: To elucidate the relationship between condylar morphology and signs and symptoms of ResearchDiagnostic Criteria (RDC) Group III TMD patients, using 3D surface models constructed from Cone-Beam CT (CBCT)images. METHODS: 3D Shape Correspondence was used to localize and quantify condylar morphological differencesof 29 female RDC/TMD group III (arthralgia, arthritis, arthrosis) patients (mean age= 38.7) as compared to a compositecondylar model generated from 35 female asymptomatic subjects (mean age=23.7). 3D models of the right and leftcondyles of each subject were constructed from CBCT images and shape analysis performed using the publiclyavailable SPHARM-PDM software. The condylar models were normalized using rigid Procrustes alignment to anoverall mean condylar model. Spearman rank tests were used to assess the local correlations of Visual Analog Scalepain intensity values and the time of pain onset to the parameterization of the shape of the condyles at every surfacepoint. RESULTS: The differences between the group mean surfaces were visualized with color-coded magnitude anddifference vectors on the combined mean surface. The average condylar morphology in the RDC/TMD group IIIpatients showed resorption of the antero-superior surface of the lateral pole and flattening of the articular surface,compared to the mean morphology in asymptomatic subjects. 3D shape correspondence color maps of both left andright condyles for the TMD subjects show areas in the anterior-superior surface of the condyle of strong positivecorrelation coefficients at every surface point with Pain Score and Pain Duration/Onset (r=0.6, surface red regions andp
#45 Usage Patterns of Web-Based Teaching Modules by Dental StudentsA. CAVENAUGH and L. KOROLUKDepartments of Pediatric Dentistry and OrthodonticsObjective: Web-based teaching modules have been used as adjuncts to traditional textbooks for self-directedlearning. However, there is a lack of evidence concerning the utilization patterns of online resources in thesesettings. This study investigated the time and frequency of module utilization by dental students and therelationship between module utilization and examination performance in a growth and development course.Methods: The course is divided into 4 units (A, B, C, D) with unit examinations and a final examination. Studentsaccessed the orthodontic online teaching modules with a user name and password. This log-in protocol was used torecord the date and time when a student accessed the modules. The date of each log-in was categorized as: 1-3days, 4-6 days and >6 days before each examination. Each student could access the modules multiple times. Thefinal examination was comprehensive covering all course material from all four units. The relationship of finalexamination scores and module usage was analyzed. Results: The total number of times logged in for each studentduring the entire course was significantly correlated with their final examination grade (Spearman correlationr=0.26, p=0.02). The percentage of students who logged in at least once for each unit was for Units A, B, C, D,and the Final Exam: 1-3 days: 85.0, 96.3, 97.5, 71.3, 93.8; 4-6 days: 95.0, 55.0, 45.0, 50.0, 0.0; >6 days: 46.2,0.0, 17.5, 32.5, 0.0. Fewer students accessed the modules early as the course progressed, the majority waiting until1-3 days before the examinations. Conclusions: The use of online teaching modules can positively affectperformance in dental school courses. The majority of students waited to access the teaching modules a few daysbefore the examinations.#46 Do They Really Differ from Us? -- Pattern of Tooth loss in Older Adult with DementiaX. CHEN 1 , S. K. SHUMAN 2 , J. S. HODGES 2 , and L. C. GATEWOOD 21 Department of Dental Ecology, UNC and 2 University of MinnesotaObjective: Older Adults with Dementia (OAD) experience more oral disease compared to non-demented elders.OAD are also considered having higher risk of tooth and oral functional loss. However, detailed pattern of toothloss among OAD remains unknown. Due to lack of information, dental professionals face great challenges incaring for OAD. The objectives of this study were to study the impact of dementia on tooth survival and detailpattern of tooth loss in OAD when treatment is available. Methods: 491 dentate older adults, including 119 OAD,were retrospectively recruited. Subjects were treated and brought to a state of health, and then assigned into twogroups based on the diagnosis of dementia. Medical and dental assessments were abstracted from dental records.Tooth loss events were recorded for subjects during follow-up (mean=39 months). Propensity score matching wasused to eliminate impact of differences in characteristics associated with tooth loss from comparison of dementedand not-demented subjects. Cox, Poisson and Negative Binomial regressions were used to study patterns of toothloss. Results: The mean number of remaining teeth at arrival among demented subjects was 18, 2 teeth less thanthat of non-demented subjects. 27% of the remaining teeth in demented group were roots or had caries at arrival,compared to 19% in non-demented subjects (P=0.0006). Pattern of tooth loss did not differ between demented andnon-demented subjects when treatment was available. On average, subjects started to lose teeth about 20 monthsafter enrollment. By 48 months, 31% of non-demented subjects and 37% of demented subjects lost at least onetooth (P=0.5). Incidence rate of tooth loss was 15% in both groups. Mean numbers of teeth lost in 5 years were1.21 for demented subjects and 1.01 for non-demented subjects (P=0.89). Conclusion: Oral health was poor inOAD. However, when intervention was given, the impact of dementia on tooth survival was not statisticallysignificant. Demented subjects did not lose more teeth than those without dementia. Rate of tooth loss in dementedsubjects also did not differ from that in non-demented subjects. Supported by University of Minnesota DoctoralDissertation Fellowship31
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