Assessment of the use of problem-orientated, small-group discussion for learning of a fixed prosthodontic, simulation laboratory course.
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AIM: To evaluate a simulation laboratory course that used student-centred small-group problem-orientated discussion activities as the main medium of instruction. METHODS: A structured questionnaire using a six-point Likert scale with 30 statements relating to a fixed prosthodontics course was distributed to 4th-year and 5th-year students who had completed the course. RESULTS: A 93% response rate was achieved for both years with a mean score for the 4th-year being 94.2 (+/- 13.7) and the 5th-year 107.5 (+/-16.9). The differences between the scores of both years are highly significant (P = 0.0006) indicating that the 5th-year were more favourable about the course and learning approach used. Consistency and reliability of the questionnaire was judged reliable according to Cronbach's alpha (4th-year = 0.7, 5th-year = 0.83). Many aspects of the small-group student-centred activities were highly valued by students however, students expressed a preference for learning and interacting with teachers than colleagues. CONCLUSION: Small-group student-centred learning activities were reported as creating an active, safe learning environment with beneficial opportunities for peer-peer interaction such as questioning, teaching and learning from students. However, students expressed a preference for teacher-centred information dissemination and activities. An understanding of the rationale of student dependence to teacher-centred learning may allow improved modifications in a student-centred learning environment. (+info)
Implant prosthodontic management of anterior partial edentulism: long-term follow-up of a prospective study.
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OBJECTIVE: This paper reports on the long-term outcome of patients with Kennedy Class IV partial edentulism treated in the Implant Prosthodontic Unit (IPU) at the University of Toronto, Toronto, Ontario. METHODS: The information for this paper was gathered from the charts of the first 30 consecutive, partially edentulous patients treated at the IPU. These patients all had Class IV edentulism and formed part of the original prospective clinical studies that were initiated in 1983. The patients' dental history suggested maladaptive experiences with traditional removable prostheses or a reluctance to have intact or quasi-intact teeth prepared as retainers for fixed prostheses. Fifteen men and 15 women treated with 94 Br nemark dental implants, supporting 34 prostheses, were followed until June 2000 (25 patients) or until they were lost to follow-up (5 patients). The multiple missing teeth occurred in 19 maxillae and 15 mandibles. RESULTS: The original prosthodontic treatments were intended to result in 33 fixed partial prostheses and 1 overdenture. At the time of this report, 25 patients with 86 implants supporting 31 fixed prostheses and 3 overdentures had been followed for an average of 12 years (range 7 16 years). The overall survival of implants was 92%. The difference between men (94%) and women (89%) was not statistically significant. CONCLUSIONS: This report is an interim update on an ongoing long-term prospective study. The results so far demonstrate a high survival rate for Br nemark implants supporting tissue-integrated prostheses for the management of anterior partial edentulism. (+info)
Implant prosthodontic management of posterior partial edentulism: long-term follow-up of a prospective study.
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OBJECTIVE: This paper reports on the long-term outcome of implant-supported posterior-zone prostheses in the first 35 consecutive, partially edentulous patients treated in the Implant Prosthodontic Unit (IPU) at the University of Toronto, Toronto, Ontario. METHODS: A total of 106 Branemark dental implants were placed in 46 posterior edentulous spans in 35 patients for the management of multiple missing teeth; the patients were followed prospectively. Treatment planning principles involved a minimum of 2 or 3 implants at each edentulous site and scrupulous occlusal prosthodontic designs. RESULTS: The overall survival of posterior implants was 94%. No factors in the patients' history adversely affected implant survival. CONCLUSIONS: This clinical update suggests that the use of Branemark implants in the rehabilitation of patients who are partially edentulous in the posterior zone is highly effective and that survival of the implants is excellent. (+info)
Orthodontic aspects of the use of oral implants in adolescents: a 10-year follow-up study.
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The aim of the present study was to evaluate the long-term effect of implants installed in different dental areas in adolescents. The sample consisted of 18 subjects with missing teeth (congenital absence or trauma). The patients were of different chronological ages (between 13 and 17 years) and of different skeletal maturation. In all subjects, the existing permanent teeth were fully erupted. In 15 patients, 29 single implants (using the Branemark technique) were installed to replace premolars, canines, and upper incisors. In three patients with extensive aplasia, 18 implants were placed in various regions. The patients were followed during a 10-year period, the first four years annually and then every second year. Photographs, study casts, peri-apical radiographs, lateral cephalograms, and body height measurements were recorded at each control. The results show that dental implants are a good treatment option for replacing missing teeth in adolescents, provided that the subject's dental and skeletal development is complete. However, different problems are related to the premolar and the incisor regions, which have to be considered in the total treatment planning. Disadvantages may be related to the upper incisor region, especially for lateral incisors, due to slight continuous eruption of adjacent teeth and craniofacial changes post-adolescence. Periodontal problems may arise, with marginal bone loss around the adjacent teeth and bone loss buccally to the implants. The shorter the distance between the implant and the adjacent teeth, the larger the reduction of marginal bone level. Before placement of the implant sufficient space must be gained in the implant area, and the adjacent teeth uprighted and paralleled, even in the apical area, using non-intrusive movements. In the premolar area, excess space is needed, not only in the mesio-distal, but above all in the bucco-lingual direction. Thus, an infraoccluded lower deciduous molar should be extracted shortly before placement of the implant to avoid reduction of the bucco-lingual bone volume. Oral rehabilitation with implant-supported prosthetic constructions seems to be a good alternative in adolescents with extensive aplasia, provided that craniofacial growth has ceased or is almost complete. (+info)
Works in progress: a comparison of dental school experiences between passing and failing NERB candidates, 2001.
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The purpose of this report is to compare outcomes on the North East Regional Board of Dental Examiners (NERB) clinical examination to selected measures of academic performance in one U.S. dental school. The data came from results of the spring 2001 NERB examination at that school. Five measures of academic performance--number of Class II amalgam restorations completed, number of Class III/IV composite restorations completed, fixed prosthodontic units performed, fourth-year class rank, and GPA-were compared between those who passed and those who failed NERB's restorative exercise (RESTOR) and provisional fixed partial denture exercise (SIM). Analyses could not confirm a positive relationship between the school performance measures and the NERB outcome of passing RESTOR on the first attempt. On the other hand, those who passed SIM on the first attempt had, on the average, performed more amalgams, composites, and fixed prosthodontic units as students than those who failed; they also had, on average, better class rank and higher GPA. Therefore, only performance on SIM related to performance in school. However, both RESTOR and SIM had a similar number of failures from the top as well as the bottom portions of the class. These preliminary data from one dental school class raise questions about the validity of the NERB clinical examination for licensure decisions. (+info)
Complications of mandibular molar replacement with a single implant: a case report.
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This case report describes prosthodontic complications resulting from the surgical placement of a single implant and treatment following these complications. Both the surgical and prosthodontic procedures are described for the treatment of a 57-year-old man who had previously received a single implant for the replacement of a missing molar. Using 2 implants, 1 mesial and 1 distal to the previously placed single implant proved reliable. A logical treatment solution is to use 2 implants for the replacement of a single molar to avoid prosthodontic complications. (+info)
Changes in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate: a follow-up study.
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The purpose of this study was to evaluate the occlusion and maxillary dental arch dimensions in adults with repaired complete unilateral cleft lip and palate (UCLP) and to investigate the patterns of change in early adulthood. Study models from 39 patients (25 men, 14 women; mean age 24.7 years, range 20.2-29.3 years) with a diagnosis of complete UCLP taken at a follow-up examination were analysed and compared with the study models taken at baseline examination (mean age 19.1 years, range 16.0-20.6 years). Lip closure was carried out according to the Millard technique and palatal closure according to the Wardill-Kilner technique. All patients had received orthodontic treatment with fixed appliances. The patients were divided into three groups according to the type of retention in the upper arch: no retention (n = 15), retention with a bonded twisted retainer (n = 13), an onlay or fixed bridge (n = 11). Occlusion was evaluated according to a scoring system. The maxillary dental arch dimensions were measured with a video imaging system. There was a significant deterioration in the total occlusal score during the follow-up period and this was larger on the cleft than on the non-cleft side. There were no significant differences in the anterior scores. A comparison of the transversal and sagittal maxillary arch dimensions revealed significant differences in all measurements during the follow-up interval. The reduction was largest for the maxillary second premolar width, followed by the first molar width. The overjet differed significantly between the registrations. The occlusal score and the maxillary arch dimensions were reduced in all of the three subgroups, but there were no differences between the groups. (+info)
Fracture surface analysis of clinically failed fixed partial dentures.
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Ceramic systems have limited long-term fracture resistance, especially when they are used in posterior areas or for fixed partial dentures. The objective of this study was to determine the site of crack initiation and the causes of fracture of clinically failed ceramic fixed partial dentures. Six Empress 2 lithia-disilicate (Li(2)O x 2SiO(2))-based veneered bridges and 7 experimental lithia-disilicate-based non-veneered ceramic bridges were retrieved and analyzed. Fractography and fracture mechanics methods were used to estimate the stresses at failure in 6 bridges (50%) whose fracture initiated from the occlusal surface of the connectors. Fracture of 1 non-veneered bridge (8%) initiated within the gingival surface of the connector. Three veneered bridges fractured within the veneer layers. Failure stresses of the all-core fixed partial dentures ranged from 107 to 161 MPa. Failure stresses of the veneered fixed partial dentures ranged from 19 to 68 MPa. We conclude that fracture initiation sites are controlled primarily by contact damage. (+info)