The level of evidence in prosthodontics in relation to author's characteristics: An analysis of three leading prosthodontics journals.

Purpose: The purpose of this study was to examine the level of evidence (LOE) characteristics and associated factors that change over time in three leading prosthodontics journals. Materials and methods: Articles published in The Journal of Prosthetic Dentistry (JPD), International Journal of Prosthodontics (IJP), and Journal of Prosthodontics (JP) in 2013 and 2020 were reviewed by eight independent reviewers. After applying exclusion and inclusion criteria, the number of authors, the corresponding author's educational degree, corresponding author's origin in each clinical research article were recorded. The included articles were rated by reviewers according to the level of evidence criteria and proposed level of evidence-associated factors. Descriptive statistics, univariable, and binary logistic regression analysis were performed to investigate dependent variables and potentially associated factors. All independent variables with a significant effect were analyzed by using a multivariable test. The entry and exit alpha level were set at αE = 0.15. The statistical significance was set at α = 0.05. Results: A total of 439 articles from 3 selected journals for the years studied met the inclusion criteria. The percentages of level 1, 2, 3, 4, and 5 articles were 2.7 %, 11.4 %, 9.6 %, 13.4 % and 62.9 %, respectively. Univariable analysis results demonstrated significant associations related to the number of authors (P = 0.005), the corresponding author's educational degree (P = 0.022), and the corresponding author's geographic origin (P = 0.042). Multivariable analysis results demonstrated significant associations related to the number of authors (P = 0.002), and the corresponding author's geographic origin (P = 0.014). Conclusions: The number of authors, CA degree, and CA origin had a significant association with the LOE of included prosthodontic studies. Although there was an increase in the number of publications from 2013 to 2020, the level of evidence trend shows no improvement over the years.

Clinical Experience Comparison of Foreign-Trained Dentists and Domestic Dental Students: One Institution's Experience.

This study compared the clinical experiences of foreign-trained dentists (FTDs) enrolled in an Advance Standing DMD Dental Program (DMDAS) with those of the domestic dental students (DMD) at the University of Illinois Chicago, College of Dentistry (UIC-COD). A cross-sectional retrospective chart review of patients treated by 295 DMD and 253 DMDAS predoctoral dental students was completed at the UIC-COD. The data were retrieved from the electronic health record system (axiUm) for the graduated classes of 2018, 2019, 2020, 2021, and 2022 on various performed clinical procedures as measured by relative value units (RVUs). The retrieved data were used to compare the clinical experiences of DMDAS vs. DMD students. Descriptive (mean) and statistical (independent t-test) analyses were used (α = 0.05). The results indicated that DMD and DMDAS students had comparable clinical experiences in several disciplines, including diagnosis, prevention, direct/indirect restorations, endodontics, periodontics, complete dentures, removable partial dentures, implants/fixed partial dentures, and oral surgery. There was a statistical difference in total RVUs for diagnosis (p = 0.002) and direct restorations (p < 0.001), in which DMD students had more experience. The 28 month program for FTDs appeared to be a reasonable timeframe to obtain an adequate number of varied clinical experiences as compared with the traditional four-year program at the UIC-COD.

Artificial Intelligence (AI)-driven dental education: Exploring the role of chatbots in a clinical learning environment.

STATEMENT OF PROBLEM: Despite their widespread use in various educational contexts, the integration of chatbots into dental clinical education has not been thoroughly investigated. The noted discrepancy signifies a lack of understanding of how chatbots could enhance the personalized and interactive learning experiences of predoctoral dental students. PURPOSE: The purpose of this study was to evaluate the awareness and perceptions of artificial intelligence (AI) technology, interaction experiences, and concerns about a custom-developed chatbot (CB) intervention in the clinical education of predoctoral dental students at the University of Illinois Chicago, College of Dentistry (UIC-COD) compared with the traditional Blackboard (BB) online platform. MATERIAL AND METHODS: Eligible participants (n=86) providing verbal consent were allocated via the random block method into BB (n=43) and CB (n=43) groups and asked to engage with their designated platforms for 10 to 15 minutes by focusing on clinical inquiries in a predoctoral implant clinic and supported by a list of 35 typical questions. After the interaction, participants responded on a 5-point Likert scale to a 19-item survey probing AI awareness, platform engagement, and technological concerns. Survey data were anonymized and analyzed using descriptive, inferential statistics and nonparametric Mann-Whitney U tests to compare interventions. The Bonferroni correction for multiple comparisons was performed (α=.0045). RESULTS: Neither the BB or CB group showed any difference in their awareness and perception of AI technology. The CB group demonstrated improved timeliness (P<.001), more interaction (P<.001), reduced faculty workload (P=.001), enhanced receptiveness (P=.002), and less anxiety (P<.001) and was more satisfied (P<.001) when compared with the BB group. However, concerns regarding the potential for incorrect information (P=.003) were more pronounced in the CB group. CONCLUSIONS: The integration of chatbot technology into dental clinical education significantly enhanced learning and student engagement, highlighting the potential for future technological enrichment of the educational landscape.

Assessing methodological quality in dental education research using MERSQI: Analysis of publications from two journals.

PURPOSE: The Medical Education Research Study Quality Instrument (MERSQI) has been used frequently to assess the methodological quality of medical education but not for dental education. The present study aimed to assess the methodological quality using MERSQI scores of articles published in the Journal of Dental Education (JDE) and the European Journal of Dental Education (EJDE). METHODS: A cross-sectional assessment of the quality of manuscripts published in 2012, 2017, and 2022 JDE and EJDE was conducted. MERSQI data, numbers of authors, first and corresponding author degrees, geographic origins, and funding information were also extracted for each included study. Descriptive and analytical statistics were conducted, and significance level was set at α < 0.05. RESULTS: Four hundred ninety-five articles met the inclusion criteria. The most common study design was a single-group cross-sectional or single-group posttest and conducted in one institution for all studied years. In all journals and years, studies were assessed mainly by participants. The study outcome was mostly satisfaction, attitudes, perceptions, opinions, and general facts. The total mean MERSQI score for each journal and year varied. Year and geographic origin significantly affected the total MERSQI score. Papers originating from Asia had the highest score, followed by South America, Europe, North America, Oceania, and Africa. CONCLUSION: MERSQI score is applicable to the assessment of the methodological quality of dental educational research. The MERSQI score for most of the domains was similar for both journals. The MERSQI score was affected by publication years and geographic origins.

Evaluating augmented reality e-typodont to improve a patient's dental implant health literacy.

STATEMENT OF PROBLEM: Information regarding dental implants can be difficult to understand for participants. Improving patients' dental implant health literacy remains a challenging process. PURPOSE: The purpose of this clinical study was to develop and evaluate patients' understanding of the implant treatment procedure, components, and sequences using traditional typodont and augmented reality (AR) applications (e-typodont), with the goal of improving their oral health literacy. MATERIAL AND METHODS: Participants who had sought dental implant treatment at the group practice and implant clinic at the University of Illinois Chicago (UIC) College of Dentistry were invited to enroll in this study. Participants were asked to fill out the first questionnaire (Q1) assessing their understanding of implant treatment procedures, components, and sequences. The participants were randomly exposed to 1 of the 2 modes of delivering education, typodont or AR e-typodont. The participants were asked to complete the additional 2 questionnaires (Q2 and Q3), and the posttest questionnaire (Q1) to re-evaluate their understanding of the implant treatment procedure, components, and sequences. All data were entered and coded into a spreadsheet. Descriptive (mean) and statistical (Wilcoxon Signed Ranks and Mann-Whitney U test) analyses were used (α=.05). RESULTS: Both interventions significantly increased participants' understanding of implant treatments (typodont: P=.004; e-typodont: P<.001), implant components (typodont: P=.003; e-typodont: P<.001), and implant treatment sequences (typodont: P=.001; e-typodont: P<.001). The e-typodont group significantly improved participants' understanding of implant treatments (P=.006), implant components (P=.023), and implant treatment sequences (P=.008) compared with the typodont group. Participants perceived the e-typodont mode of delivery to be significantly more interesting (P=.002), interactive (P=.008), educational (P=.002), user-friendly (P=.016), and "Wow" (P=.002) compared with the traditional typodont mode of delivery. CONCLUSIONS: Both interventions improved participants' understanding of implant treatment procedures, components, and sequences. The e-typodont showed better improvement in participants' understanding of dental implants compared with the traditional typodont.

Profile of prosthodontics program directors in North America.

PURPOSE: To develop a current profile of prosthodontics program directors (PPDs) in United States dental schools and describe the current challenges and responsibilities of those serving in the position and assess the professional needs of the program directors (PDs) to better support them in their roles. MATERIALS AND METHODS: A survey was sent to 51 participants who were identified as PPDs in North America via Qualtrics in 2019 to assess the professional needs of PDs to better support their roles. The survey consisted of 29 items organized into six sections: (1) demographic information; (2) hours and time spent in various areas of the job; (3) greatest challenges; (4) perceived importance of specific competencies; (5) opinions on the greatest rewards of the position; (6) their needs for support from the American College of Prosthodontists and advice for the future PD. RESULTS: The response rate for this survey was 88.3%. Of the 45 respondents, the majority were white/non-Hispanic, followed by Asian/Pacific Islanders. The two largest and equal numbers of participants who worked for more than 10 years and between 1 and 3 years were observed with approximately 29% each, and PDs who worked less than a year occupied the least amount. Overall, 34% of PDs are on the tenure track and 80% of those are tenured. Teaching and clinical services took away the greatest time with approximately 42% and 22.1%, respectively. Thirty-five (78%) PDs listed the greatest challenge they encountered was the workload of the role. Skills listed in leadership and personnel competencies were all rated more important than most of the skills listed in management. CONCLUSIONS: There is a wide gender gap and a lack of racial diversity among the PPDs. The biggest challenge faced by them is the amount of workload followed by budget and fiscal constraints. And for their improved efficiency, they gave emphasis on learning time management and continuous clinical training of newer advances.

Level of evidence and characteristics of clinical studies published in leading prosthodontics journals.

STATEMENT OF PROBLEM: Data on the level of evidence and the characteristics of studies published in peer-reviewed prosthodontic journals are lacking. PURPOSE: The purpose of this study was to investigate the characteristics and level of evidence (LOE) scores of studies published in 3 leading peer-reviewed prosthodontic journals. MATERIAL AND METHODS: Clinical studies published in the Journal of Prosthetic Dentistry (JPD), the Journal of Prosthodontics (JP), and the International Journal of Prosthodontics (IJP) in 2013 and 2020 were included in the analysis. Abstracts, letters to the editor, book reviews, and animal and laboratory studies were excluded from the investigation. For each study, design, type and LOE scores (Levels 1 to 5), publication year, impact factor (IF) of the journals, geographic origins of the first and corresponding authors, and funding status were recorded. Level 1 and Level 2 were defined as high evidence (HE), and Level 3, Level 4, and Level 5 were defined as low evidence (LE). Descriptive statistics and logistic regression analysis were performed (α=.05). RESULTS: Among the 439 studies included in the analysis, the proportion of HE and LE studies was 14.1% and 85.9%, respectively. According to univariate and multivariate analysis results, year of publication (P=.010 and P=.029), geographic origin of the corresponding author (P<.001), and funding status (P<.001 and P=.002) were significantly associated with the LOE of a study. However, the journal IF was not associated with LOE (P=.328). CONCLUSIONS: Although the number of HE studies in 3 leading prosthodontic journals has increased over time, the total number was still limited compared with LE studies. A further improvement in the overall LOE of clinical studies in prosthodontics is needed.

Effect of Nano Ceramic Coating on Color Perceptibility and Acceptability of Polymethylmethacrylate: In Vitro and Clinical Study.

The effect of a novel nano-ceramic coating (TiO2) using an atomic layer deposition (ALD) technique on the surface of polymethyl methacrylate (PMMA) material was investigated. The patients' and clinicians' perception and acceptance of the PMMA color with TiO2 coating were also examined. In vitro color measurement was performed on thirty specimens (light, original, and dark pink) before and after TiO2 coating. Patients' and clinicians' perception and acceptance of color changes on PMMA were measured and compared. Descriptive and analytic statistics were analyzed (a = 0.05). TiO2 films were successfully deposited on the PMMA specimen by the ALD technique. Color changes after TiO2 coating were observed on all three PMMA shades, significantly higher than the established 50:50% perceptibility threshold, but below the established 50:50% acceptability threshold. The percentage of patients that perceived a color difference after TiO2 coating were 83.3%, 63.9%, and 77.8% for light, original, and dark pink, respectively. The percentages of clinicians that were satisfied with the color difference were 96.4%, 80%, and 69.2% for light, original, and dark pink, respectively. Color changes after TiO2 coating were observed, but below the acceptable threshold. The clinical survey demonstrated that a color difference was perceived but was clinically acceptable. In general, laypeople have lower perception and higher acceptance of changes in PMMA color than clinicians.

The Effect of Smoking and Brushing on the Color Stability and Stainability of Different CAD/CAM Restorative Materials.

This study aimed to investigate and compare the color stability and stainability of computer-aided design/computer-aided manufacturing (CAD/CAM) restorative materials in their glazed (G) and polished (P) state when exposed to cigarette smoke, as well as after brushing. Three CAD/CAM restorative materials were investigated: lithium disilicate CAD (LD), zirconia (Zr), and Telio PMMA CAD (PMMA), according to their surface finishing and assignment to cigarette smoking exposure or soaking in the saliva (control) group. The color change (∆E) was calculated before and after the intervention performed for all specimens, using the L*a*b values to quantitatively assess the shade differences. Statistical analysis was performed using one-way repeated measures ANOVA and Bonferroni multiple comparison analysis (α = 0.05). The surface finishing did not influence the materials' stainability. Color change was noted after smoking, LD and Zr-G and Zr-P had a comparable color change (p > 0.05), while PMMA presented lower ∆E values (p < 0.05). After brushing, all specimens had a significant color change that was high for LD-G and LD-P, and Zr-G, compared with Zr-P and PMMA (p < 0.05). In conclusion, the exposure to cigarette smoke showed that LD, Zr, and PMMA are all susceptible to staining, but brushing decreases surface staining.

Attachment systems for mandibular implant-supported overdentures: A systematic review and meta-analysis of randomized controlled trials.

STATEMENT OF PROBLEM: Although mandibular implant-supported overdentures have been highly recommended as a treatment option, a consensus on the type of attachment systems that can be used to increase implant and prostheses survivability is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to compare different types of attachments for retention by investigating outcome measures such as implant and prosthesis survival rates and biological and prosthesis complications in participants with a mandibular implant-supported overdenture. MATERIAL AND METHODS: The search was performed in the PubMed, Cochrane, Embase, and Scopus databases by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and registered with the International Prospective Register of Systematic Reviews (CRD42021253566). An analysis of association was conducted between different attachment systems and implant and overdenture survival rates in randomized controlled clinical trials. RESULTS: The initial search indicated 477 studies, of which 25 randomized controlled trials (RCTs) were included for analysis. A total of 2154 implants and 737 overdentures were analyzed in the meta-analysis. The main results indicated the failure rate for dental implants to be 2.0% (95% confidence interval [CI], 1.3 to 3.2) and overdentures 4.2% (95% CI, 1.6 to 10.5), respectively. With regard to different attachment systems, a similar failure rate was identified with bar-type retention (7.7% to 95% CI, 3.0 to 18.1), magnetic retention systems (7.6% to 95% CI, 2.2 to 22.7), and ball-type retention (6.8% to 95% CI, 3.0 to 14.3). No significant difference was found in biological complications for splinted and unsplinted implant overdentures (P=.902). Regarding prosthetic complications, the most favorable groups were LOCATOR attachments followed by telescopic and Conus, bar, and ball attachments. Magnet attachments had higher prosthetic complications (7.4 times) than the other attachments. CONCLUSIONS: Implants and implant-supported mandibular overdentures showed a high survival rate irrespective of the attachment system used. Splinting implants did not significantly affect the rate of biological complications. Prosthetic complications were most common for magnet and least common for LOCATOR attachments.

Status of Sleep Apnea and Snoring Disorder Curriculum in U.S. Advanced Education Prosthodontic Programs.

PURPOSE: To assess the management of sleep apnea and snoring disorders in Advanced Education Programs in Prosthodontics (AEPP) in the United States. MATERIALS AND METHODS: A 51 item, online survey was sent to program directors at 48 AEPPs in the United States in 2015. Data results were analyzed descriptively. RESULTS: Thirty-five program directors responded to the survey. Twenty-four (68.6%, N = 35) programs report not having a dedicated course for the treatment of sleep apnea and snoring disorders. The majority (94.3%) of programs chose to treat sleep disordered breathing with oral appliance therapy and 80.0% (N = 35) of programs utilize customized sleep apnea oral devices. However, only 48.6% (N = 35) and 51.4% (N = 35) of programs regularly address sleep apnea and snoring disorders at initial examination during the comprehensive exam and medical history questionnaire, respectively. CONCLUSIONS: The confidence interval for this survey is 8.71 at a confidence level of 95% due to a response rate of 72.9%. This confidence interval suggests there is responder bias in the survey results. Therefore, the results of this survey provide a suggestion of how sleep disorders are managed in AEPPs. Programs appear to be consistent among each other with regards to treatment modalities for sleep disordered breathing. The results suggest that patients are not screened enough to receive treatment addressing sleep disorders.

Prosthodontic Resident Selection by Postdoctoral Dental Matching Program: A National Survey by Participating Program Director.

PURPOSE: The purpose of this study was to obtain information about the resident selection and Match process that occurred for the Commission on Dental Accreditation (CODA)-accredited Advanced Education in Prosthodontics program in North America from the program directors' perspective, after the first year of implementation. MATERIALS AND METHODS: The list of Advanced Education in Prosthodontics program in CODA-accredited North American institutions was obtained from the ACP central office, and the directors of each program were identified. The surveys were distributed to 48 program directors online and results were compiled. RESULTS: Out of 48 programs, 43 directors responded to and completed the survey (90.0%), where 35 programs participated in the Match process, 5 did not, and 3 were omitted due to incomplete surveys. While the majority of programs did not see any changes in their applicant pool or their quality, 10 programs (25.0%) observed a number of increases in the application and 13 programs (32.5%) observed an increase in the quality of the applications. Among the 35 programs that participated in the Match process, the main reasons for their participation were "fairness" (48.2%), "did not want to keep moving up interview dates" (23.2%), and "have applicants come to interview as planned" (21.4%). Thirty-three programs reported that 75% to 100% of the invited applicants came to the interview (76.7%). The majority of programs that participated in Match expressed satisfaction with the process (29/33, 80.6%). Sixteen programs (45.7%) reported that they matched with 100% of their first selections. CONCLUSION: Overall response of reintroduction of the Match process for advanced prosthodontic resident selection was very positive for majority of the program directors.

Predoctoral Dental Education in Tooth Prognosis and Treatment Complexity: A Survey of U.S. Dental Schools.

The aim of this study was to determine the educational methods and tools used to teach tooth prognosis and treatment complexity determination in U.S. predoctoral dental programs. In 2018, an online survey was emailed to the academic deans of all 66 accredited U.S. dental schools. Of these, 42 schools responded (63.6%), and 36 schools completed the entire survey (54.5%). The methods reported for teaching tooth prognosis and case complexity determination varied widely among the participating schools. Among the respondents, 25% reported using the American Association of Endodontists' Endodontic Case Difficulty Assessment, while 10% reported having no specific method for teaching prognosis. The most common method for teaching overall treatment complexity was the Prosthodontic Diagnostic Index, which was used by 24% of the respondents. However, another 24% reported that their school did not have a specific method for teaching treatment complexity. Large percentages of the respondents reported that students sometimes or often made wrong tooth prognosis and case complexity determination (90% and 92%, respectively). The most prominent feedback provided by the respondents based on their experience was the importance of faculty standardization, the understanding of students' inexperience, and the need for an interdisciplinary approach. The majority of these respondents reported that their schools had specific methods of teaching prognosis and case complexity determination. However, there was a wide range of teaching practices related to the contents and levels of evidence.

Retrospective Evaluation of the Status of Advanced Dental Education in Prosthodontics from 2006 to 2016.

The aim of this study was to analyze information about advanced education programs in prosthodontics (AEPPs) collected in American Dental Association (ADA) surveys on advanced dental education from 2006-07 to 2016-17. Data recorded included number of AEPPs and information on program directors, applicants, and enrollees in AEPPs. The results showed that, from 2006 to 2016, there was an increase in the number of AEPPs and enrollment of prosthodontic residents, and the number of applicants per program more than doubled. Despite these increases, steps are needed to increase the number of underrepresented minority residents in prosthodontics. Also, a periodic survey of prosthodontic residents to identify their goals, experiences during training, and career plans could benefit the specialty by providing more insight into the future prosthodontic workforce.

Patient-Specific, Risk-Based Prevention, Maintenance, and Supportive Care: A Need for Action and Innovation in Education.

PURPOSE: To develop a competency-based curriculum framework for prevention, supportive care, and maintenance for use in educational and patient care programs and to seek consensus on an overarching competency statement that embraces these critical learning and patient care concepts. MATERIALS AND METHODS: A preliminary survey of current preventive and maintenance practices in U.S. dental and prosthodontic programs was completed and summarized with quantitative analysis. The American College of Prosthodontists organized a one-day consensus workshop with 14 participants from various U.S. dental schools with diverse backgrounds to develop a curriculum framework. The curriculum framework was used in the development of a joint competency statement using an iterative, online consensus process of debate and feedback. RESULTS: The preliminary survey helped frame the initiative and identify potential educational needs and gaps. Consensus was achieved for a recommended competency statement: "Graduates must be competent in promoting oral health through risk assessment, diagnosis, prevention, and management of the hard tissue, soft tissue, and prostheses, and as part of professional recall and home maintenance." This competency statement complements the proposed curriculum framework designed around 3 domains-caries prevention, periodontal supportive care, and prosthesis supportive care-with a set of recommended learning objectives. CONCLUSIONS: Commission on Dental Accreditation (CODA) learning standards do not outline patient-customized, evidence-based recall and home maintenance programs that highlight prevention of dental caries, periodontal supportive care, prosthesis maintenance, and patient education. The proposed competency-based curricular framework serves as an initial step in addressing student learning and patient care within the context of a recall system and home maintenance program while offering schools the needed flexibility for implementation within their curriculum.

Wear Characteristics and Volume Loss of CAD/CAM Ceramic Materials.

PURPOSE: In the field of prosthodontics, patients often require complex and extensive restorative care. This can involve the use of dental restorations to restore teeth on both the maxillary and mandibular arch. Current literature has evaluated the wear properties of different dental ceramics against enamel, but studies regarding dental ceramics opposing one another are limited. The purpose of this study was to assess the wear potential and wear behavior of CAD/CAM zirconia (ZR) and lithium disilicate (LD) materials against a similar ceramic material, and how the surface finish of these dental ceramics might affect patterns of wear. MATERIALS AND METHODS: Using a sphere-on-plate tribometer system, different surface finishes (glazed-G and glazed then polished-GP) of ZR and LD were evaluated following wear simulation. Artificial saliva of physiologic pH was used as a lubricant during wear simulation at 37°C. The coefficient of friction (COF) was calculated during the wear simulation. After wear simulation was complete, volume loss, surface roughness, and surface characterization of the specimens were analyzed using white-light interferometry and scanning electron microscopy (SEM). Statistical significance between materials and surface finish was established with two-way ANOVA and Bonferroni post hoc test (α = 0.05). RESULTS: Based on the 2-way ANOVA, material (p = 0.002) significantly affected the COF. LD showed a higher COF (p = 0.002) than ZR. Material (p < 0.001) and surface finish (p = 0.004) significantly affected the surface roughness inside the scar. ZR had significantly lower surface roughness compared to LD (p < 0.001). For outside scar, surface finish (p < 0.001) significantly affected the surface roughness. Polished specimens showed significantly higher roughness compared to glazed specimens for both inside (p = 0.004) and outside scar (p < 0.001). For volume loss, material (p < 0.001) and the interaction between material and surface finish (p < 0.001) were statistically significant. LD had higher volume loss than ZR (p < 0.001). For both glazed and polished finished, LD-G and LD-GP had significantly higher volume loss than ZR-G (p = 0.028), and ZR-GP (p < 0.001), respectively. SEM analysis indicated particle build-up and a grooving mechanism of wear for the LD-GP specimens. This suggested a three-body wear phenomenon occurring for LD-GP specimens, which was not visible in SEM imaging for other specimen types. CONCLUSIONS: This study demonstrated the resistance to wear and low abrasiveness of ZR when compared to LD in a simulated masticatory environment. This can be best explained by the increased strength of ZR, and the introduction of three-body wear to LD specimens from the accumulation of embedded wear debris onto its surface. Wear data and comparison of SEM images following wear simulation confirmed this interpretation.

Color stability of maxillofacial prosthetic silicone functionalized with oxide nanocoating.

STATEMENT OF PROBLEM: Maxillofacial prostheses made of silicone elastomers undergo undesirable color degradation over time. How this color change can be prevented is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the ability of an oxide nanocoating to prevent color degradation of maxillofacial silicone elastomers after artificial accelerated aging. MATERIAL AND METHODS: A silicone elastomer with functional intrinsic pigment was tested. Specimens (N=20) were fabricated, and half of them were coated with a nanolayer of titanium dioxide (TiO2) using atomic layer deposition. Both coated and noncoated specimens (control) were exposed to artificial aging at 450 kJ/m2 of total energy. Changes in the color of all the specimens with and without TiO2 nanocoating were measured before and after the atomic layer deposition coating and before and after aging. The obtained color data were analyzed by using independent t tests and the 1-sample t test (α=.05). RESULTS: Color change (ΔE1=3.4 ±1.4) was observed for the silicone elastomers after the specimens were surface coated with TiO2 nanofilm, although this change was not statistically significant (P=.369) compared with the acceptability threshold (ΔE=3.0). Upon exposure to artificial aging, the noncoated control specimens underwent color change (ΔE2=2.5 ±0.7, P=.083 compared with the acceptability threshold). The specimens with TiO2 nanocoated surface experienced the least color change (ΔE3=1.4 ±0.6) when subjected to artificial aging, and this change was significantly lower (P<.001) than the established acceptability threshold of ΔE=3.0. In addition, the chemical analyses confirmed that the TiO2 nanocoating remained on the surface after exposure to artificial aging. CONCLUSIONS: TiO2 nanocoating was shown to be effective in reducing color degradation of the silicone elastomer exposed to artificial aging for 120 hours with 450 kJ/m2 of total energy.

Research Productivity of Directors of U.S. Advanced Education in Prosthodontics Programs.

The aims of this study were to measure the research productivity of directors of U.S. advanced education in prosthodontics programs (AEPP) and to identify associations between the directors' publication metrics and professional characteristics. A list of AEPP directors was obtained from the American College of Prosthodontists website in December 2015. Information on gender, academic rank, and highest degree was collected from the institutional website for each individual. Citation databases (Scopus and Google Scholar) were searched for each director's h-index and i10-index (both indexes are based on numbers of citations of the author's articles) and total numbers of publications and citations. The search identified 50 AEPP directors. The majority were male and had a primary appointment at a university. Most held the rank of associate professor or professor and held both DDS and MS degrees. The mean h-index and i10-index of all directors were 6.32±6.97 and 6.84±10.77, respectively. Their mean numbers of publications and citations were 24.60±31.21 and 288.40±625.97, respectively. The analysis showed that the program directors affiliated with a university had significantly higher mean values for all indexes than those of non-university-affiliated program directors. Professors had productivity metrics significantly higher than those of other ranks in all measures of research productivity.

U.S. Maxillofacial Prosthetics Programs: Fellows' and Directors' Perspectives.

Maxillofacial prosthetics (MFP) programs in the U.S. select only a limited number of applicants for fellowship positions. The aims of this study were to survey MFP fellows about which factors influenced their choice of programs and to survey MFP directors about what they considered critical factors in the selection process. Surveys were sent to all eight directors and 13 fellows at all eight U.S. MFP programs in June 2015. The directors' questions asked about general information, resident selection process, letters of recommendation, interview process, and decision process. The fellows' questions addressed their demographics, program-related factors, and future goals. The directors' surveys were sent directly to the directors, and the fellows' surveys were sent to the directors for distribution. The survey response rate for the directors was 87.5% (N=7), and that of the fellows was 53.8% (N=7). In selecting fellows for programs, responding directors reported the interview process was most important, followed by letters of recommendation, personal statement, and prosthodontic program grades. Responding fellows reported that location, variety of treatment, patient volume provided, and clinical education were crucial components in their choice of program. This information may be useful to MFP programs and fellows in the continuing development of this specialty.