Job requirements compared to dental school education: impact of a case-based learning curriculum.

INTRODUCTION: Case-based learning (CBL) is suggested as a key educational method of knowledge acquisition to improve dental education. The purpose of this study was to assess graduates from a patient-oriented, case-based learning (CBL)-based curriculum as regards to key competencies required at their professional activity. METHODS: 407 graduates from a patient-oriented, case-based learning (CBL) dental curriculum who graduated between 1990 and 2006 were eligible for this study. 404 graduates were contacted between 2007 and 2008 to self-assess nine competencies as required at their day-to-day work and as taught in dental school on a 6-point Likert scale. Baseline demographics and clinical characteristics were presented as mean ± standard deviation (SD) for continuous variables. To determine whether dental education sufficiently covers the job requirements of physicians, we calculated the mean difference ∆ between the ratings of competencies as required in day-to-day work and as taught in medical school by subtracting those from each other (negative mean difference ∆ indicates deficit; positive mean difference ∆ indicates surplus). Spearman's rank correlation coefficient was calculated to reveal statistical significance (statistical significance p<0.05). RESULTS: 41.6% recipients of the questionnaire responded (n=168 graduates). A homogeneous distribution quantity of the graduate groups concerning gender, graduation date, professional experience and average examination grade was achieved.Comparing competencies required at work and taught in medical school, CBL was associated with benefits in "Research competence" (∆+0.6) "Interdisciplinary thinking" (∆+0.47), "Dental medical knowledge" (∆+0.43), "Practical dental skills" (∆+0.21), "Team work" (∆+0.16) and "Independent learning/working" (∆+0.08), whereas "Problem-solving skills" (∆-0.07), "Psycho-social competence" (∆-0.66) and "Business competence" (∆-2.86) needed improvement in the CBL-based curriculum. DISCUSSION: CBL demonstrated benefits with regard to competencies which were highly required in the job of dentists. Psycho-social and business competence deserve closer attention in future curricular development.

Comparison of visual-tactile, radiographic, and histologic diagnoses of subgingival crown margin caries- an in vitro study.

The purpose of this study was to investigate the accuracy of diagnosing interproximal subgingival caries at crown margins. A total of 32 subgingival interproximal crown margin areas were examined by 10 clinicians (n = 320) using conventional diagnostic methods on extracted, crowned teeth mounted in a specially designed cast. Crown margins were located 1.5 mm below the level of the artificial gingiva. Clinical and radiographic diagnoses were compared to the histopathologic findings for each site. Both visual-tactile and radiographic evaluations revealed a weak diagnostic accuracy for interproximal subgingival crown margin caries.

Immediate and early loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: 1-year results from a prospective multicenter study.

OBJECTIVE: Immediate and early loading of implants can simplify treatment and increase patient satisfaction. This 3-year randomized-controlled trial will therefore evaluate survival rates and bone-level changes with immediately and early loaded Straumann implants with the SLActive surface. MATERIAL AND METHODS: Partially edentulous patients >or=18 years of age were enrolled. Patients received a temporary restoration (single crown or two to four unit fixed partial denture) out of occlusal contact either immediately (immediate loading) or 28-34 days later (early loading group), with permanent restorations placed 20-23 weeks after surgery. The primary endpoint was change in crestal bone level from baseline (implant placement) to 12 months; the secondary variables were implant survival and success rates. RESULTS: A total of 383 implants (197 immediate and 186 early) were placed in 266 patients; 41.8% were placed in type III and IV bone. The mean patient age was 46.3+/-12.8 years. Four implants failed in the immediate loading group and six in the early loading group, giving implant survival rates of 98% and 97%, respectively (P=NS). There were no implant failures in type IV bone. The overall mean bone level change from baseline to 12 months was 0.77+/-0.93 mm (0.90+/-0.90 and 0.63+/-0.95 mm in the immediate and early groups, respectively; P<0.001). However, a significant difference in implantation depth between the two groups (P<0.0001) was found. After adjusting for this slight difference in initial surgical placement depth, time to loading no longer had a significant influence on bone-level change. Significant influence was found for: center (P<0.0001), implant length (P<0.05) and implant position (P<0.0001). Bone gain was observed in approximately 16% of implants. CONCLUSIONS: The results demonstrated that Straumann implants with the SLActive surface are safe and predictable when used in immediate and early loading procedures. Even in poor-quality bone, survival rates were comparable with those from conventional or delayed loading. The mean bone-level change was not deemed to be clinically significant and compared well with the typical bone resorption observed in conventional implant loading.

Immediate and early non-occlusal loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: interim results from a prospective multicenter randomized-controlled study.

OBJECTIVE: Immediate and early loading of dental implants can simplify treatment and increase overall patient satisfaction. The purpose of this 3-year prospective randomized-controlled multicenter study was to assess the differences in survival rates and bone level changes between immediately and early-loaded implants with a new chemically modified surface (SLActive). This investigation shows interim results obtained after 5 months. MATERIAL AND METHODS: Patients > or =18 years of age missing at least one tooth in the posterior maxilla or mandible were enrolled in the study. Following implant placement, patients received a temporary restoration either on the day of surgery (immediate loading) or 28-34 days after surgery (early loading); restorations consisted of single crowns or two to four unit fixed dental prostheses. Permanent restorations were placed 20-23 weeks following surgery. The primary efficacy variable was change in bone level (assessed by standardized radiographs) from baseline to 5 months; secondary variables included implant survival and success rates. RESULTS: A total of 266 patients were enrolled (118 males and 148 females), and a total of 383 implants were placed (197 and 186 in the immediate and early loading groups, respectively). Mean patient age was 46.3+/-12.8 years. After 5 months, implant survival rates were 98% in the immediate group and 97% in the early group. Mean bone level change from baseline was 0.81+/-0.89 mm in the immediate group and 0.56+/-0.73 mm in the early group (P<0.05). Statistical analysis revealed a significant center effect (P<0.0001) and a significant treatment x center interaction (P=0.008). CONCLUSIONS: The results suggested that Straumann implants with an SLActive can be used predictably in time-critical (early or immediate) loading treatment protocols when appropriate patient selection criteria are observed. The mean bone level changes observed from baseline to 5 months (0.56 and 0.81 mm) corresponded to physiological observations from other studies, i.e., were not clinically significant. The presence of a significant center effect and treatment x center interaction indicated that the differences in bone level changes between the two groups were center dependent.

Factors influencing survival of reconstructions. Consensus report of Working Group 2.

In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.