Assessment of quality improvement of simulation-based learning using an evidence-based framework in dental education.

INTRODUCTION: Simulation-based education is of paramount importance in a dental pre-clinical setting. Hence, continuous quality improvement is crucial to optimize students' knowledge and clinical skills. This study aimed to evaluate the impact of evidence-based simulation learning (EBSL) compared with traditional-based simulation learning (TBSL) using Plan-Do-Study-Act (PDSA) model. MATERIALS AND METHODS: This quality improvement project was undertaken at a private university. Guided by the PDSA model, rubber dam application tasks were conducted in the simulation lab in 2 phases. Phase 1 included TBSL and phase 2 included EBSL comprising of 2 PDSA cycles. 'Plan' stage involved obtaining feedback from students and the concerned staff. 'Do' stage included implementation of EBSL in eight steps adopted from Higgins's framework. 'Study' stage evaluated the outcomes and in 'Act' stage amendments were made to the first EBSL cycle. In the second PDSA cycle re-implementation and evaluation of the rubber dam application exercises were carried out. Descriptive data were presented as percentages and mean scores were compared using paired t-test. RESULTS: Thirty-seven year 2 students participated in this study. A significant improvement in the mean scores was observed between TBSL and EBSL (3.02 + 0.16 and 3.91 + 0.27, respectively, p < .001) using PDSA model with the highest mean score for rubber dam application in the second PDSA cycle for EBSL (4.00 + 0.01). Ninety-five per cent of the students provided positive feedback pertaining to EBSL. CONCLUSION: EBSL was effective in achieving high student satisfaction, desired knowledge, and skills required during simulation-based exercises. The PDSA cycle can be considered to optimize pre-clinical skills learning.

Structural, Physical, and Mechanical Analysis of ZnO and TiO2 Nanoparticle-Reinforced Self-Adhesive Coating Restorative Material.

This study aimed to modify an EQUIA coat (EC; GC, Japan) by incorporating 1 and 2 wt.% of zinc oxide (ZnO; EC-Z1 and EC-Z2) and titanium dioxide (TiO2; EC-T1 and EC-T2) nanoparticles, whereby structural and phase analyses were assessed using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD), respectively. Thermogravimetric analysis/differential scanning calorimetry, micro-hardness, and water absorption analyses were conducted, and the microstructure was studied by scanning electron microscopy/energy-dispersive spectroscopy. FTIR spectra showed a reduction in peak heights of amide (1521 cm-1) and carbonyl (1716 cm-1) groups. XRD showed peaks of ZnO (2θ ~ 31.3°, 34.0°, 35.8°, 47.1°, 56.2°, 62.5°, 67.6°, and 68.7°) and TiO2 (2θ ~ 25.3°, 37.8°, 47.9, 54.5°, 62.8°, 69.5°, and 75.1°) corresponding to a hexagonal phase with a wurtzite structure and an anatase phase, respectively. Thermal stability was improved in newly modified materials in comparison to the control group. The sequence of obtained glass transitions was EC-T2 (111 °C), EC-T1 (102 °C), EC-Z2 (98 °C), EC-Z1 (92 °C), and EC-C (90 °C). EC-T2 and EC-T1 showed the highest (43.76 ± 2.78) and lowest (29.58 ± 3.2) micro-hardness values. EC showed the maximum water absorption (1.6%) at day 7 followed by EC-T1 (0.82%) and EC-Z1 (0.61%). These results suggest that EC with ZnO and TiO2 nanoparticles has the potential to be used clinically as a coating material.

Facial antibioma formation: a case report

Odontogenic infections are associated with a variety of microorganisms. antibiotics are commonly used for the management of various dental infections and have a proven role in decreasing morbidity and mortality caused by infectious diseases. the frequent and over usage of antibiotics has been associated with a number of consequences such as the selection of drug resistant strains, and the formation of antibiomas. antibiomas are characterized by the formation of a localized pathology surrounded by thick fibrous tissues in response to long term antibiotics use. an established antibioma is characterized by a tough fibrous swelling accompanied by painful or painless swelling, intermittent fever and constitutional symptoms. in this article, we are reporting the case of a facial antibioma formed due to prolonged use of antibiotics prescribed for a residual periapical infection following endodontic treatment. in addition, the association of using antibiotics in this context is discussed.

Evaluation of Interference of Cellular Phones on Electronic Apex Locators: An In Vitro Study.

INTRODUCTION: Use of mobile phone has been prohibited in many hospitals to prevent interference with medical devices. Electromagnetic radiation emitted from cellular phones might interfere with electronic working length determination. The purpose of this in vitro study was to evaluate the effect of a smart phone (Samsung Galaxy Note Edge) on working length determination of electronic apex locators (EALs) Propex II and Rootor. METHODS: Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance. RESULTS: The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions. CONCLUSIONS: Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.

The effect of disinfecting solutions on the dimensional stability of dental alginate impression materials.

OBJECTIVES: Dimensional changes occur in set dental alginate impression materials when immersed in disinfecting solutions. In this contribution the dimensional changes of two alginates in two disinfecting solutions, and for two specimen thicknesses, have been studied. The results were analyzed theoretically. METHODS: The dimensional changes of two commercial alginates (Blueprint Cremix and Hydrogum), have been measured, in distilled water and two disinfecting solutions (Perform ID/sodium hypochlorite), using a traveling microscope, at 5 min intervals over a period of 1h. Samples of simple geometry have been studied, namely rectangular strips with thicknesses of 1.5 and 3mm, respectively. RESULTS: In all cases, both alginates continuously shrank with time, in the three immersion liquids, over the hour of measurement, indicating transfer of water from the alginate into the external water or disinfecting solution. The t(1/2) shrinkage plots were generally linear, but with an intercept on the t(1/2) axis, indicating the possibility of an initial expansion at very short times. In most cases, the ratios of slopes for both thicknesses were 1.33-1.54, in contrast to the theoretical value of 2. Perform ID however gave anomalous results for the 1.5mm thick samples. At 10 min their shrinkage was 1.34-1.72%, compared with -0.42% to 0.67% in the other two media. SIGNIFICANCE: The effects of thickness observed were not in accord with simple Fickian theory because of the various ions diffusing into and out of the alginate. Moreover, the water content of the alginate decreased consequent on the cross-linking process.

Dimensional changes in alginate impression during immersion in a disinfectant solution.

OBJECTIVE: To determine the effect of a commercially available disinfectant solution (Perform ID) on the dimensional stability of two different commercially available alginate impression materials. METHODS: Linear changes in standardized impression samples (1.5 mm & 3.0 mm thickness) made in two commercial alginates were recorded at 5 minute intervals, over a period of an hour after immersion in a disinfectant. The alginate impression samples were prepared placing the alginate mixes into a wax mould. After the material had set, each of the samples was removed from the mould. It was then placed in a Polytetraflouroethylene (PTFE) trough before measuring the dimensional changes using a Chesterman travelling microscope. RESULTS: 3mm BluePrint Cremix showed greater shrinkage than 3mm Hydrogum. While, 1.5mm Hydrogum appeared to have uniformly greater shrinkage as compared to 1.5mm BluePrint Cremix. There was significant difference between 1.5 and 3mm thicknesses of both Hydrogum and BluePrint Cremix (PAIRED SAMPLE t test p < 0.05). The 1.5mm samples showed much higher shrinkage than 3mm samples. CONCLUSION: Immersion of the alginates in the same disinfectant showed variable linear shrinkage indicating that slight changes in composition could lead to variable results. In addition, there were significant differences in the linear shrinkage between the two thicknesses of the same alginate material; this indicates the possibility of distortion in actual impressions where the geometry is complex.