Background: Severe sinus pneumatisation often prevents implant placement in the posterior maxilla. Sinus floor elevation is the best-documented solution, but some patients decline it. Two cortical structures can be used instead: the cortical plate of the sinus floor, engaged by the apex of a crestal implant to obtain bicortical primary stability, and the pterygomaxillary buttress, engaged by a pterygoid implant that bypasses the sinus cavity entirely. Case presentation: A 60-year-old woman, edentulous from teeth 24 to 28 for twelve years, requested a fixed rehabilitation and declined any sinus grafting. Cone beam imaging showed 10 mm of sub-antral bone at the premolar sites but only 1 mm at site 27, a Cawood and Howell class V ridge. Three implants were placed flaplessly in a single procedure, without graft material: two 10 mm crestal implants whose apices engaged the sinus floor cortex without intrusion into the cavity (insertion torques 40 and 35 N·cm), and a 22 mm pterygoid implant anchored in the pterygomaxillary buttress (50 N·cm). Sinus membrane integrity was confirmed by a negative Valsalva manoeuvre. Loading was delayed for 4 months because postoperative compliance could not be guaranteed; a four-unit screw-retained bridge on angled multi-unit abutments then restored the arch to the molar region without a distal cantilever. Results: At 4 months after loading, the peri-implant tissues were healthy, with no bleeding on probing, no mobility, no detectable marginal bone loss relative to the postoperative baseline, and no prosthetic complication. Cone beam imaging confirmed apical cortical anchorage of all three implants, the pterygoid implant lying entirely outside the sinus. Conclusion: Cortical anchorage throughout, the sinus floor cortex mesially and the pterygomaxillary buttress distally, splinted by a single rigid framework, allowed graftless, flapless and cantilever-free rehabilitation of the atrophic posterior maxilla in one surgical stage. The follow-up is short and the outcome must be regarded as preliminary.
Clinical coaching has gained recognition as a learner-centered educational strategy in dental education, providing structured opportunities for observation, reflection, feedback, goal setting, and deliberate practice across the preclinical-to-clinical continuum. This literature review synthesizes peer-reviewed evidence primarily published between 2015 and 2026, alongside foundational earlier work addressing coaching in dental and dental-adjacent health professions education. The literature identifies several coaching and related educational approaches, including faculty-led clinical coaching, peer and near-peer mentoring, self-development coaching, simulation-based coaching, structured formative assessment, and competency-based frameworks such as entrustable professional activities (EPAs). Across these approaches, studies report promising findings for selected measures of skill acquisition, self-efficacy, reflective practice, academic performance, professional development, and well-being, although not all interventions directly evaluate coaching. However, substantial heterogeneity remains in definitions of coaching, intervention design, coach preparation, outcome measures, and follow-up duration. These findings highlight the potential value of a structured, longitudinal coaching framework that establishes shared language, explicit coach-learner goals, and consistent expectations early in the preclinical curriculum and maintains flexibility for discipline-specific implementation. Future research should use multicenter designs, validated instruments, longitudinal follow-up, and quantitative and qualitative measures to determine the durability of coaching effects through graduation and early professional practice.
Introduction: In Hungary, public education institutions serve as the primary institutionalized venues for school-based health promotion. In primary schools, based on nationally unified requirements, basic education spans eight academic years, preparing students for secondary education. This comprehensive educational process is intertwined with a diverse array of health education initiatives, programs, and projects aimed at etablishing a healthy lifestyle, which are declared in our local pedagogical program in alignment with official educational laws, ministerial decrees, and the prevailing National Core Curricula (NCC). Methodology: This study presents a preventive- minded school health promotion model program that has already proven successful in practice and has been operating effectively for 34 years. By introducing "Health Education" as an independent subject across all eight grades of primary education, the program strengthens school-based health education, elevates it to the level of conscious awareness, and transforms it into applicable knowledge and geniune practical for children and adolescents. During this innovative development, the Debrecen Bolyai János Primary School and Elementary School of Arts became the third station of the health education teaching experiment. The school successfully adapted the complex program, objectives, health strategies, and modern methods of the health education experiments, expanding it in a globally unique way with task-level diagnostic assesment (input and output Knowledge Tests) to measure changes in students’ knowledge levels. Results: During the monitoring and assessment process, we conducted diagnostic measurements before (input) and after (output) each thematic module/topic. In the first measurement cycle (2008–2016), we observed an average knowledge gain, i.e., development, of 25% based on the institutional- level aggregated results, and 26% in the second cycle (2016-2024). The most important ultimate outcome is that we received measurable, evaluable feedback on the demonstrated progress in knowledge (proven competency expansion), which proves the necessity of teaching health education as an independent subject. Conclusions: The health promotion model program, operating as a "lifestyle program" that encompasses all educational and instructional activities of the Bolyai school and extends to both lower and upper grades (ages 6–14), launched its 18th term in the 2026/2027 academic year, proving the long-term sustainability and universal adaptability of systemic and curriculum-based school prevention.
Background: While reasonable accommodations are essential for supporting elementary school children who stutter, we still know little about the clinical and environmental factors that trigger the issuance of formal medical letters requesting school accommodations, particularly regarding routine classroom speech tasks such as daily classroom duties (“Nicchoku”). Reasonable accommodations in this context are operationally defined as structured environmental adaptations (e.g., paired duty formats, teacher co-speaking). Aims: This study aimed to investigate the clinical and environmental factors associated with the issuance of medical letters requesting reasonable accommodations for daily classroom duties among elementary school children who stutter over a 10-year period. Methods: We conducted a retrospective chart review of 53 elementary school children who stutter (40 boys, 13 girls) who visited the speech clinic at Kyushu University Hospital between April 2016 and December 2025, and whose medical records contained specific documentation regarding daily classroom duties. Data were collected on medical letter issuance, sex, grade level, stuttering frequency (%), and duty format (individual duty, one student vs. paired duty, two students). Demographic and clinical characteristics were compared between participants in the medical letter and no medical letter groups using Fisher’s exact test and the Wilcoxon rank-sum test. Results: Among 53 participants, 12 children (22.6%) had a medical letter requesting reasonable accommodations for daily classroom duties. The proportion of upper-grade students (Grades 4–6) was significantly higher in the medical letter group than in the no medical letter group (83.3% vs. 46.3%, p = 0.045). Individual duty format was significantly more frequent in the medical letter than in the no medical letter group (50.0% vs. 9.8%, p = 0.005). No significant differences were observed between the two groups regarding sex (75.0% vs. 75.6% male, p > 0.99) or objective stuttering frequency (mean: 11.3% vs. 7.2%, p = 0.90). Mentions of daily classroom duties in medical letters peaked in Grade 4 (60.0%) and Grade 5 (33.3%). Conclusion: Formal medical letter issuance for reasonable accommodations for children who stutter was significantly associated with upper grade levels and an individual daily duty format, not baseline stuttering severity or sex. These findings highlight the critical need for educators and healthcare providers to focus on classroom task structures and environmental barriers, not just speech metrics, when providing support to children who stutter.
Background: Morbidity and mortality from HIV and AIDS in sub-Saharan Africa (SSA) in general and Malawi in particular still remains high with adolescents disproportionately impacted. SSA commands the highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people. Despite that HIV prevention efforts for young people have expanded overtime, there is paucity of evidence on the effectiveness and /or efficacy of emerging approaches to prevention. Diverse intervention approaches have been implemented in the past decade but their impact has not been aptly synthesized or evaluated. This scoping review seeks to bridge this gap. Methods: Spanning May to July 2026 searches were made from different journals online. Databases searched included MEDLINE, EBSCO host, PsychINFO, Cochrane, and Google Scholar, Cambridge and Oxford journal websites, UNAIDS and WHO for studies published between 2005 and 2026. After excluding other studies by review of titles and then abstracts, the studies were reduced to 29. Six of these were randomized controlled trials and two quasi-experimental with the remainder including observational, systematic reviews, study designs and mixed method studies. Results: The review yielded some 860 titles and abstracts, 9 grey literature and 40 full text articles were critically analyses with 29 articles reviewed. Results show that a number of reviewed interventions [n = 8] registered positive outcomes for incidence, sexual behavior change and HIV self-testing. There is evidence of emerging interventions beyond the generic behavior change, some with novel promise to better improve outcomes. Conclusions: The review demonstrates heterogeneity of interventions, generic and emerging that target adolescents in SSA. There are mixed findings about the continued effectiveness of stand-alone behavior change (BCI) interventions for adolescents in SSA. This among others prompted this synthesis of integrated or combination frameworks or approaches to determine their plausible efficacy and/or effectiveness. Moving forward, combination options are identified as having greater potential to transform HIV intervention dynamics.
