Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice.
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Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice. The confidence interval for the Gow-Gates method excludes this value, while the confidence interval for the Akinosi technique includes zero percent. We conclude that, in the study population, formal clinical training in the Gow-Gates and Akinosi injection techniques lead to a small but significant increase in current primary utilization of the Gow-Gates technique. No significant increase in current primary utilization of the Akinosi technique was found. (+info)
Provisional crown failures in dental school predoctoral clinics.
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Following a preliminary study indicating that at least 10 percent of single-unit crown temporary restorations failed in patients who received treatment by predoctoral students, a comprehensive examination of provisional crown failure was initiated to identify strategies to reduce the failure rate. For all provisionalized, natural tooth, single-unit crown preparations in University of North Carolina School of Dentistry predoctoral clinics for one year (N=1008), we noted tooth type, type of crown, student level, faculty coverage experience, treatment clinic, temporary material and luting agent, and retreatment (failure) of the provisional restoration. For failures, we also noted the stage of crown preparation at failure and the time since initial placement of the temporary. We analyzed these data using simple cross-tabs and logistic regression on need for retreatment (alpha =0.05). The failure rate was 18.75 percent (N=189). The median time to failure was twelve days; the 25(th) and 75(th) percentiles were six and twenty-six days. Significant risk factors, in order of odds ratio estimates, were molar tooth, second- or third-year student, and inexperienced faculty. Most provisional failures occurred during the final preparation phase of treatment. Provisional restoration failure is more frequent than was initially suspected from preliminary studies. Strategies for institutional intervention to reduce provisional restoration failure include greater attention to evaluating provisional crowns placed by inexperienced students (sophomores and juniors) and placing more emphasis on the retentiveness of provisional restorations reused following the final impression. Review of provisional evaluation procedures is also indicated for faculty who do not routinely supervise these procedures. (+info)
Does exposure to a procedural video enhance preclinical dental student performance in fixed prosthodontics?
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To try to alleviate the issue of dental students having an inadequate field of view during live demonstrations of fixed prosthodontic preparations, an instructional video depicting the step-by-step procedures involved in an all-ceramic tooth preparation and provisional crown fabrication (practical exam 1, PE1) was created. Fifty-five second-year dental students were given a personal copy of the video after a lecture and an in-class viewing of the material. Throughout the course, students watched live demonstrations of tooth preparations and then practiced individually on mannequins. The scores achieved by the students on three practical exams (PE1, PE2, and PE3) were compared to those recorded by a class one year prior to the development of the video. The students exposed to the video performed significantly better on PE1 in comparison to the previous year's class, as well as compared to their own performance on the other two practical exams that had no supplementary teaching aids. A significant, moderate-level correlation was detected between exposure to the video and PE1. Ninety-six percent of the students reported on their end-of-year evaluation that the video helped them to prepare for PE1. The results of this study suggest that instructional videos may aid in the teaching of fixed prosthodontics. (+info)
Dental students' self-assessment of preclinical examinations.
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Accurate self-assessment is an important attribute for practicing dentists and, therefore, an important skill to develop in dental students. Our purpose was to examine the relationship between faculty and student assessments of preclinical prosthodontic procedures. Seventy-six second-year students completed two consecutive examinations and two self-assessments. The examinations involved setting maxillary denture teeth on a model to simulate the clinical procedure of a complete maxillary denture. Results indicated no significant increases in examination or student self-assessment mean scores; however, regression analysis indicated changes in student self-assessment scores explained 16.3 percent of the variation in examination scores. In essence, improvement in student self-assessment predicted improvement in examination scores among dental students completing a preclinical dental procedure. (+info)
The extent of the psychological impairment of prosthodontic outpatients at a German University Hospital.
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A model for an integrated predoctoral implant curriculum: implementation and outcomes.
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The implementation of an implant dental curriculum in U.S. dental schools has been consistently increasing from 33 percent in 1974 to 97 percent in 2004. Among these, only 51 percent have clinical components implemented. A survey of students conducted in 2004 at New York University College of Dentistry (NYUCD) showed an inadequacy in clinical implant restoration experience by graduation. This prompted the development of an extensive dental implant curriculum at NYUCD to meet the needs of the dental students. This report addresses the challenges in implementing such a curriculum and describes a step-by-step approach to develop a program that encompasses didactic, simulation, and patient care components. In 2005, a fully integrated predoctoral implant curriculum was initiated. In 2008, nearly all of the NYUCD students (91.8 percent) completed implant restorations/prosthesis on patients. An assessment revealed a 30 percent increase in students' positive perceptions of the implant curriculum. Based on our experiences at NYUCD, it is recommended that an implant curriculum become part of the core predoctoral curriculum and be integrated throughout the four years of dental education. This article reports on a model for a pre-doctoral implant curriculum, which includes planning, curriculum implementation, program management, and post-implementation stages. Using this model, dental schools can develop implant education for their students that is adapted to their institutional missions, priorities, and resources. (+info)
Effect of dental students as instructors on preclinical performance in prosthodontics.
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Dental schools continue to have difficulty recruiting and retaining faculty. One approach to augment student learning would be to train and utilize senior dental students as instructors in preclinical courses. This study was undertaken to evaluate the effect of using senior dental students as instructors on the performance of second-year students in two preclinical prosthodontic courses. In the spring term of 2007, four senior dental students and four or five full-time faculty were assigned as instructors for the fixed prosthodontics and complete denture prosthodontics preclinical courses. Each course has previously been conducted with a total of seven to nine faculty instructors. The performance of two groups of second-year students on preclinical projects was compared based upon their source of instruction for the project. The scores for the two groups were compared using the Wilcoxon rank sum tests and the corresponding 95 percent confidence intervals for the median difference in scores for the two instructor types. This study found no significant difference in performance between sophomore students instructed by full-time faculty or those instructed by senior dental students in either the fixed or removable prosthodontics preclinical courses (p>.05). The use of senior dental students as instructors in the preclinical prosthodontics courses may be one option to partially address the shortage of full-time dental faculty. (+info)
The evolution of the Journal of Applied Oral Science: a bibliometric analysis.
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