WHAT WE DO

The Postgraduate Dental College supports the Army, Navy, and Air Force Postgraduate Dental Schools through education, consultation, statistical support, and research funding as available. Our goal is to provide a dental research infrastructure capable of sustaining military-relevant research programs in alignment with MHS and DoD priorities.

Our research is focused in five primary areas that are relevant to the DoD.

Areas of Research

PREVENTION AND SAFETY

Although the percentage of wrong site events within dentistry is relatively small, wrong site surgeries and procedures remain a concern within the Military Health System. Our research aims to minimize - and hopefully eliminate - potentially harmful wrong site events within the military dental community. Areas of investigation include: the introduction of guidelines which forbid the interruption of in-process clinical procedures; the development of mandatory clinical checklists; the utilization of clinical guides/barriers which limit the probability of wrong site procedures; and the development of restrictive surgical guides to increase the accuracy of dental implant placement. Our efforts have driven notable changes in clinical processes and procedures. The long-term effects of these changes remain under investigation.

Military researchers continue to assess the most common causes of wrong-site procedures via coordinated data mining efforts. Probable causes of clinical error are identified and addressed. Outcomes are evaluated and procedures are refined. This evolution will continue in efforts to prevent wrong site procedures and optimize safety efforts.

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HEALTH AND HUMAN PERFORMANCE REPRESENT CRITICAL CONSIDERATIONS IN MILITARY HEALTHCARE

Sleep disordered breathing has been linked to multiple difficulties within the health and human performance arenas and affect a broad array of active duty and retired military personnel. The rapidly growing percentage of personnel impacted by sleep disordered breathing has garnered significant attention within the Military Health System. We have undertaken multiple studies targeting the early identification of personnel at risk for sleep disordered breathing. In addition, our personnel have investigated oral therapies which may address the effects of breathing disturbances.

We have identified processes for the identification of military personnel at risk for sleep disordered breathing. This has permitted early entry into appropriate segments of the healthcare system (e.g., Sleep Medicine), and has resulted in the mitigation of risks associated with undiagnosed sleep-mediated breathing disorders. In addition, the effectiveness of oral appliances in the treatment of mild-to-moderate obstructive sleep apnea has been corroborated. This has led to greater collaboration between the military medical and dental communities.

We continue to assess effective means for the early identification of personnel at risk for sleep disordered breathing. This includes targeted clinical assessments, the employment of affordable home monitoring, and the evaluation of improved oral devices.

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MATERIALS, DEVICES, AND TECHNIQUES

New materials, devices, and techniques must be assessed and tested to determine their suitability within laboratory and clinical settings. We perform materials testing in accordance with ISO/ADA standards and inform military policy regarding suitability and longevity of associated restorations. Newly-introduced dental devices are assessed under military-relevant clinical and field conditions to determine maintenance requirements and survivability of such products. Novel techniques are evaluated to determine potential applications and benefits in military settings. This commitment to the unbiased evaluation of dental materials, devices, and techniques has informed military and civilian healthcare policy for decades. Our investigative efforts have also led to the identification of suitable restorative materials, as well as the development and refinement of indispensable dental devices and techniques.

Representatives of the uniformed services will continue to evaluate materials, devices, and techniques which constantly enter the dental marketplace. Emphasis will be placed upon continued development of polymer- and ceramic-based restoratives, as well as technology-driven improvements in dental devices and techniques.

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TECHNOLOGY AND INNOVATION

The emergence of technologies with important dental implications continues to occur at an ever-accelerating pace. For decades, military providers have explored dental applications for emerging technologies, and have advanced scientific efforts via innovation and perseverance. Personnel continuously monitor technological developments to assess potential applications within the healthcare arena. Upon identification, such technologies are aggressively and systematically examined.

We pioneered efforts within CAD/CAM, diagnostic imaging, surgical planning, and surgical execution environments. Notably, we developed an accurate method to combine spatial data resulting from light-based topographic scanning devices with spatial data gathered via computed tomography. This technique was adopted by industry to develop commercial implant-planning softwares. In addition, we have developed a process by which three-dimensional imaging and three-dimensional printing may be used to enhance the accuracy and clinical success of endodontic surgical procedures. These developments form the basis for guided surgical procedures which are used throughout this profession.

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PAIN

Pain has significant implications across the uniformed services. Pain impacts overall health, human performance, and readiness which are critical to military effectiveness. Pain control is central to the practice of contemporary clinical dentistry. Dental providers and dental researchers continuously seek improvements in the anesthetic agents, associated techniques, and outcomes. A logical extension of dental processes involves post-operative pain control. While a variety of pharmaceutical agents have been used to effect post-operative pain control, current concerns over opioid use have mandated the exploration of non-opioid agents and techniques.

Auricular acupuncture represents a promising means for the non-pharmaceutical control of post-operative discomfort and we have initiated investigations in this potentially important arena. Initial results are pending and will be released following review and data analysis. Favorable results in this arena may provide alternative mechanisms for post-operative pain management, and may reduce the necessity for moderate- and high-risk pharmacotherapies. If auricular acupuncture proves effective in such scenarios, additional applications will be explored.

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