Satisfaction of orthodontic Post-CCST training: A survey of trainee perceptions.

INTRODUCTION: This survey was undertaken as a second part to 'Barriers to Post-CCST training in orthodontics: A survey of trainee perceptions'. Recruitment of Post-CCST trainees in certain areas of the country has attracted concerns as it has become increasingly difficult. This survey was undertaken to assess trainee satisfaction with Post-CCST training and to look at possible ways to improve trainee satisfaction and make Post-CCST training more desirable. METHODS: The Training Grades Group (TGG) committee of the British Orthodontic Society (BOS) produced an online survey that was sent to all TGG members and newly qualified consultants in May 2021. All Post-CCSTs who entered training between February 2017 and October 2020, were asked to complete the survey. RESULTS: There were 37 respondents, which gave a response rate of 62%. While 61% of respondents were satisfied with their Post-CCST training, 17% were 'neither satisfied or dissatisfied' and 6% were either 'dissatisfied' or 'very dissatisfied'. Of the 37 respondents, 25 (67%) would apply for Post-CCST training again, 6 (16%) would not and 6 (16%) did not answer this question. When asked for possible suggestions for improvements to Post-CCST training to encourage greater satisfaction, the responses could be grouped into the following themes: Part-time training; Teaching; Time commitment; Salary; and Experience. CONCLUSION: In general, respondents were satisfied with Post-CCST training. There was a significant range of positive and negative responses to various aspects of training including multidisciplinary team clinic preparation, support, supervision and management experience. Suggestions for improvements echo the barriers to Post-CCST training survey.

Evaluation of user experience and satisfaction with workplace-based assessments (WPBAs) in dental postgraduate programmes.

Objectives: To explore the experience of and satisfaction with workplace-based assessment tools among dental postgraduate trainees. METHODS: The cross-sectional study was conducted from March to October 2022 at the Aga Khan University Hospital, Karachi, and comprised all Operative Dentistry, Prosthodontics and Orthodontics postgraduate trainees. A questionnaire with both open-ended and closed-ended questions was used to record the experiences and satisfaction level of the dental residents who had earlier been subjected to workplace-based assessment. Data was analysed using SPSS 20, while thematic analysis was used for open-ended questions. RESULTS: Of the 20 Subjects, 15(75%) were females. Also, 11(55%) participants had received prior training for workplacebased assessment. There were 16(80%) residents who were satisfied with workplace-based assessment tools in the dental residency programme, 15(75%) agreed that the tools improved their clinical skills and helped them identify their weak areas, all the 20(100%) participants said the feedback given to them was constructive, 18(90%) reported that they were allowed to put in their views. However, 7(35%) participants reported that being observed adversely affected their performance. CONCLUSIONS: Dental residents generally gave positive feedback related to workplace-based assessment tools in a clinical setting.

Royal London Space Planning as a learning tool for postgraduate Orthodontic students. A mixed methods study.

OBJECTIVE: To assess the effectiveness of the Royal London Space Planning (RLSP) as a learning tool among postgraduate orthodontic students as well as investigate students' attitudes to its use. The RLSP tool is a structured method of orthodontic case assessment and treatment planning. DESIGN: A prospective cohort study of first year postgraduate orthodontic students who attended teaching of the RLSP. SETTING: Postgraduate teaching institute. PARTICIPANTS: First year postgraduate orthodontic students. METHODS: The outcome measured was the accuracy in assessment and planning of a standardised orthodontic simulated case before and after teaching. Qualitative assessment was conducted through focus group and a semi-structured format after the teaching. RESULTS: Nineteen students were included in the study. There was an overall improvement in assessment and planning of 20% after the teaching intervention (P < 0.05). Assessment improved by 34% in comparison to treatment planning, which improved by 17% (P < 0.05). The impact of the RLSP was most noticeable on the assessment of crowding in the lower arch which improved by 37% after teaching (P < 0.05). Students felt using the RLSP tool made them more confident and was advantageous to use in training; most felt they would not use the tool after qualification. CONCLUSION: The RLSP tool is an effective method of teaching assessment and treatment planning to postgraduate orthodontic students. The effect of the RLSP is greater at assessments and less significant for treatment planning. The participant students felt the RLSP improved their confidence in assessment and treatment planning.

Orthodontic clinicians' attitudes and knowledge of dentogingival aesthetics: A cross-sectional survey of BOS members.

OBJECTIVE: To assess orthodontic clinicians' knowledge and attitudes towards dentogingival aesthetics and to explore characteristics that predict the knowledge of dentogingival aesthetics. DESIGN: Cross-sectional questionnaire. SETTING: On-line survey of members of the British Orthdontic Society. MATERIALS AND METHODS: An 11-item online questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered respondent demographics and questions relating to both knowledge and attitudes towards dentogingival aesthetics (six parameters). Descriptive statistics were calculated for study characteristics and summary values for the survey items. Responses to the eight knowledge-based questions were converted to a binary outcome (correct and incorrect answer). The maximum score that could be achieved was eight. Multivariable modelling was used in order to examine associations between the study characteristics and the aggregate score. RESULTS: A total of 252 responses were obtained resulting in a response rate of 17%. Within this cohort, the respondents were primarily women (52.8%) and aged 30-40 years (35.7%). The mean score for the eight knowledge-based questions was 3.8 ± 1.8 (range = 0-8). Knowledge of the ideal gingival margin position of the anterior teeth was high (92.4%). Knowledge of the other five dentogingival aesthetic parameters was variable. In the multivariable analysis, lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (-0.54; 95% confidence interval [CI] = -1.01 to -0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental aesthetics in the past five years (-0.80; 95% CI = -1.43 to -0.17; P = 0.01) and with increasing age (-0.43; 95% CI = -0.62 to -0.23; P < 0.001). CONCLUSION: Knowledge of ideal dentogingival parameters is generally suboptimal among orthodontists in the UK. The reported lack of knowledge of the ideal dentogingival parameters may also influence respondents' attitudes towards the importance of dentogingival aesthetics. Further teaching or courses related to dentogingival aesthetics is desired by orthodontic clinicians.

History of Orthodontics in Brazil - Postgraduate Education.

Orthodontics in Brazil underwent significant transformations in the 1950s when several dentists returned to the country after completing advanced education courses in the specialty abroad. The first two orthodontic associations, in Rio de Janeiro and São Paulo, were constituted in 1955 and 1959. The specialty's first event with characteristics of a professional meeting occurred in São Paulo in 1957, and Postgraduate Orthodontic education became available. This paper aims to describe the central insights of the constitution and evolving of the education of Orthodontics in Brazil.

Generational perspectives of orthodontists in the U.S. and Canada: A survey study.

INTRODUCTION: The objectives of this study were to identify differences between generations of orthodontists in the United States and to evaluate the perspective of each generation on widely debated topics in orthodontics. METHODS: A 22-item Institutional Review Board-approved survey was randomly distributed to orthodontists in the United States and Canada. Participants were asked questions about the use of technology, the future of clear aligner therapy, orthodontic education, student debt, marketing, and corporate orthodontics, among other topics. RESULTS: Significant increase in female orthodontists over generations and a decrease in orthodontic educators were found (P <0.001). Among generations, differences were found regarding the amount of student debt, use of specific diagnostic tools, marketing preferences, and their opinion on the future of clear aligner therapy. Most of the silent generation did not have student debt, whereas millennials reported paying off their debt in 1 year to >20 years and being most heavily burdened by student debt. Younger generations appeared more likely to use cone-beam computed tomography and intraoral imaging, whereas older generations preferred traditional diagnostic tools such as hand-wrist radiographs and alginate impressions. Most of the silent generation indicated not marketing their practices, whereas millennials rely heavily on social media and e-mails for marketing. CONCLUSIONS: Clear distinctions exist between different generations of orthodontists. Issues such as increasing student debt load and a decrease in orthodontic educators over generations should be addressed to preserve the future of the orthodontic specialty.

3-Dimensional simulations and student learning in orthodontic education.

INTRODUCTION: The electronic dental model (e-model) is an example of a digital 3-dimensional technology to support inquiry-based learning in undergraduate dental education. As student perceptions of and engagement with e-models vary, it is uncertain whether these perceptions have implications for their learning processes and outcomes. MATERIALS AND METHODS: Third-year dental students (N = 40) completed a questionnaire to identify their perceptions of and preferences for model modalities. They were divided into three groups based on their preference: Preferring plaster models (Group 1); Preferring e-models (Group 2); No preference (Group 3). Students from three groups (N = 9) attended a hands-on digital occlusion evaluation workshop, and then completed a case-based diagnostic evaluation test using digital occlusion evaluation software. Camtasia Studio™ recorded real-time and on-screen data of the number of mouse-clicks and time spent. RESULTS: Students reported positive feedbacks on the use of e-models, and 72.5% of the students preferred combination use of e-models and plaster models. After attending the hands-on digital dental occlusion evaluation workshop, Group 2 scored higher on the diagnostic evaluation test (p < .05) and registered more mouse-clicks than Group 1 when evaluating the arch symmetry (p < .05). Group 2 registered fewer mouse-clicks than Group 3 during tooth size measurement (p < .05). There was no significant difference regarding the time used to answer the knowledge questions amongst the three groups. CONCLUSION: Undergraduate dental students indicated a generally high acceptance of e-models for their learning in orthodontics, and more prefer a blended approach. Students preferring e-models presented higher performance outcomes, which supports cognitive load theory regarding prior exposure to simulation-based environments.

Postgraduate student perceptions of face-to-face and distance education in orthodontics: A cross-sectional qualitative study.

OBJECTIVE: To investigate postgraduate student perceptions of face-to-face and distance education on a three-year programme in orthodontics. DESIGN: Cross-sectional qualitative study. SETTING: UCL Eastman Dental Institute, London. PARTICIPANTS: A total of 25 current postgraduate orthodontic students in the first, second and third years of training were included in this study. METHODS: Postgraduate student perceptions were obtained by conducting online focus groups on Zoom Video Communications Inc. A focus group topic guide was developed, and a facilitator was trained to host the focus groups. There were separate focus groups for each year group, with a maximum of five participants in each group. The focus groups were audio recorded and transcribed verbatim. The transcripts were assessed by all members of the research team and analysed using a thematic content analysis, with a framework approach to identify themes and subthemes regarding perceptions of distance and face-to-face education. RESULTS: A total of 25 students participated. Six key themes were identified relating to student perceptions of face-to-face and distance education: (1) social support network; (2) technology; (3) learning experience; (4) education environment; (5) interpersonal interactions; and (6) effective teaching/learning. There were perceived benefits and drawbacks for both modes of teaching delivery. In particular, students highlighted the importance of reliable technology, peer support and accessibility of educational resources for their academic learning. Students favoured a blended approach to learning where practical skills were taught in person and some theoretical aspects taught remotely. CONCLUSION: The results aid the understanding of how educational tools and digital technology can enrich the student academic experience. The results provide important information for the future development and delivery of orthodontic postgraduate education.

History of Orthodontics in Brazil - First Brazilian Specialist.

At the beginning of the 20th century science was beginning to transform the world, including Brazil. All aspects of dentistry were considered essential to the welfare of the people and that may also have included orthodontics. It is possible then to assume that the manufacturing of some orthodontic appliances was already being taught in the educational courses. However, the lack of didactic orthodontic texts in Portuguese was a problem, when considering literature as one of the pillars that would support advancements in the science and practice of orthodontics. This difficulty, however, was solved in 1910, when the third edition of the Odontological Manual by Coelho e Souza was published including a chapter on orthodontics. Some years later Carlos Lustosa became interested in this subject after reading the paper by Angle that presented the ribbon arch appliance. He went to Pasadena (CA) and convinced Angle to accept him as a student. In 1923 he completed the course at the Angle School of Orthodontia, becoming the first Brazilian specialist in orthodontics. He treated patients with the ribbon arch until his death in 1937. However, did his search for knowledge outside the country influence the course of Brazilian orthodontics?

Influence of type of radiograph and levels of experience and training on reproducibility of the cervical vertebral maturation method.

INTRODUCTION: The objective of this study was to assess the reproducibility of cervical vertebral maturation (CVM) method based on the type of radiographic image and the level of experience and level of training of the evaluator. METHODS: Ten evaluators (5 orthodontic residents and 5 faculty members) were randomly divided into 2 groups: trained and untrained. All participants evaluated 80 radiographic images previously acquired in 4 different formats: (1) 2-dimensional (2D) digital (2D-digital), (2) 2D digitized hard copy from the Iowa Facial Growth Study (American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection), (3) 2D digital reconstructed from a 3-dimensional (3D) radiograph (2D-from 3D), and (4) 3D cone-beam computerized tomographic (3D-CBCT) images. Agreement among evaluators on the morphology of the cervical vertebrae (CV) and the CVM stage of each radiographic image was assessed using Randolph's kappa statistic and Kendall's W coefficient of concordance. RESULTS: Interobserver agreement on the determination of a curvature on the inferior border of the CV was substantial to perfect, whereas agreement on shape was fair to moderate. Overall, the level training in all image types, except 3D-CBCTs, but not the level of experience affected the agreement for shape and curvature of the CVs. Interobserver agreement on CVM staging for all combined images was substantial at 0.72. Faculty had a higher level of agreement than residents except for 2D-digital and 3D-CBCT images, whereas trained evaluators had an overall higher level of agreement than untrained evaluators except for 3D-CBCT images. CONCLUSIONS: Interobserver agreement in determining CVM stage was substantial for all images evaluated; experience and training resulted in higher level of agreement for some image types. The 3D-CBCT images did not provide increased interobserver agreement over current 2D-digital lateral cephalograms in determining CVM staging or shape of the CV. The highest agreement in CVM staging was obtained on 2D-digital lateral cephalograms with training.

Students' perspectives on the use of digital versus conventional dental impression techniques in orthodontics.

BACKGROUND: Despite the increasing use of digital impressions in orthodontics, this technique does not usually form part of the learning objectives in dental training. The aim of this study was to determine how students assess the user-friendliness of intraoral scanners compared to a conventional impression technique after a theoretical and practical teaching module. METHODS: Thirty-one dental students in their seventh semester (4th year) received and conducted digital (3 M, St. Paul, NM) and conventional (alginate) impressions from: (i) the dentist's perspective, and (ii) the patient's perspective. Each student completed four questionnaires to evaluate: (i) the user-friendliness of intraoral scanning, and (ii) intraoral scanning compared to the conventional method. RESULTS: Thirty (97%) students had not previously performed digital impressions. Twenty-four (77%) students were overall "very" or "rather" satisfied with the handling of the intraoral scanning method, and 18 (58%) preferred digital to alginate impressions from the dentist's perspective. From the "patient's" perspective, the students did not report any significant differences between the two methods. However, the impression tray in conventional impressions reduced "patient" comfort significantly more than the camera in digital impressions (Z = - 3.496, p < 0.001). CONCLUSIONS: Dental students were able to practice both conventional alginate and modern digital impressions without prior knowledge of intraoral impression techniques after basic training and an introduction from dentists. Students reported a preference for the digital technique. Implementing digital intraoral impressions into undergraduate training is recommended to familiarise students with this rapidly developing digital technique at an early stage.

Effectiveness of the Distance Learning Strategy Applied to Orthodontics Education: A Systematic Literature Review.

Introduction: Tele-education refers to the use of interactive distance learning technologies. The objective of this systematic review was to evaluate the impact of tele-education in the field of orthodontics.Methods: This systematic review has been registered in PROSPERO and followed PRISMA guidelines. Two independent researchers reviewed the literature available in the databases of PubMed/MEDLINE, Bireme, the Cochrane Library, EMBASE, TRIP, SCIELO, LILAS, SCIENCEDIRECT, and Google Scholar using the following descriptors: "Education, Distance" OR "e-learning" AND "Orthodontics," including only interventional studies. The descriptive synthesis was conducted according to the Center for Reviews and Dissemination. The analysis of the biases was conducted using the MINORS protocol, and the analysis of the interventions using Kirkpatrick's method was evaluated.Results: Of the 15 remaining articles for complete reading, 4 were excluded for not meeting the inclusion criteria, leaving 11 articles for evaluation in the systematic review. Eight articles emphasized the evaluation of the distance education materials available, achieving a high percentage of acceptability among students, two cited only satisfaction, and one article evaluated the practical performance of the students.Conclusion: The results showed that orthodontic distance learning is an effective but complementary element, with no significant differences, to the traditional method of teaching.

American Board of Orthodontics: Update on the new scenario-based clinical examination.

The American Board of Orthodontics has updated its clinical examination process to remove barriers to the case-based examination, strengthen the specialty, and further distinguish board-certified orthodontists from other dental practitioners providing orthodontic care. The ABO adopted a scenario-based clinical examination and discontinued case requirements. The first new exam was administered in February 2019. It consisted of 6 scenarios with 4-7 questions for each scenario. The scenarios represent a variety of problems and patients, and the questions relate to data gathering and diagnosis, treatment objectives and planning, treatment implementation and management, and critical analysis and outcomes assessment. Feedback from the February 2019 exam was positive, and 4 more have been scheduled. For more information about the ABO certification process, go to AmericanBoardOrtho.com.

Characteristics of an excellent orthodontic residency program.

INTRODUCTION: Although unquantifiable features, such as faculty passion and dedication to teaching, play a vital role in defining the quality of residency education, determinable features that are fundamental to the definition of a "top tier" orthodontic residency program also exist. The objective of this study was to identify those features. METHODS: A survey with 32 items was developed and validated to assess the features of an excellent orthodontic program based on the following 3 major domains: faculty, education, and resident/graduate student/alumni. The survey was sent to 62 orthodontic residency programs in the United States. RESULTS: Thirty-nine programs (63%) completed the survey. Recurring attributes that were identified in what constitutes an excellent program included the following: an adequate number of full-time clinical orthodontic faculty, with each member providing 1 day per week clinic coverage. The average of all respondents was 4, and the range was 1-6; a healthy mix of part-time faculty members with ≥1 full-time faculty member who monitors every clinical session; 80% full-time faculty members who are American Board of Orthodontics (ABO) certified; a craniofacial faculty member; 4 residents/graduate students per each faculty member who covers a clinical session; resident/graduate student exposure to a wide range of treatment modalities and appliances; approximately 70 new case starts per resident/graduate student (50%-60% of patients who are started are debonded by the starting resident/graduate student); patients with craniofacial anomalies and orthognathic surgery patients should be started by each resident/graduate student; 1.5 operatory chairs per resident or graduate student; 1 dental assistant per 4 residents/graduate students; 1 laboratory person; 1 receptionist/secretary per 4 residents; 100% of residents/graduate students successfully completing ABO written examination upon graduation; 60% of residents/graduate students obtaining ABO certification within 5 years of graduation; 50% of residents/graduate students presenting at national meetings would be ideal; and 50% of living alumni contributing financially to the department during the past 5 years. CONCLUSIONS: Based on the responses from the majority of the US orthodontic residency programs, this study has identified certain features that educators feel are ideal for an excellent orthodontic program.

Information retention of orthodontic patients and parents: A randomized controlled trial.

INTRODUCTION: A randomized controlled trial was undertaken to compare the efficacy of 3 methods of delivering information on short- and long-term recall of information in orthodontic patients and parents. METHODS: Participants who received an audiovisual presentation on orthodontic treatment were randomly allocated to 1 of 3 written information groups (leaflets, generic mind map, or participant's customized mind map). A questionnaire was used to assess short- and long-term retention of information (maximum score 30). RESULTS: Eighty-eight patients (94.6%) and 77 parents (86.5%) completed the study. The average knowledge scores at baseline for the patient groups were 17.71 95 CI 16.28-19.14), 16.58 (14.67-18.49), and 17.37 (15.92-18.81), respectively. The parents' knowledge scores for the 3 groups were 19.06 (17.51-20.62), 19.39 (17.44-21.35), and 18.76 (17.19-20.33), respectively. The short- and long-term knowledge scores improved over baseline in all 3 groups (P <0.0001). The parents achieved higher scores than the patients (P = 0.002) and their rate of forgetting information was less. The knowledge scores of the mind map groups were higher than that of the leaflet group for all cohorts (P = 0.025). No statistical difference was found between the type of mind map. The correlation between patient and parent knowledge scores was significant (P <0.0001) at all 3 time points. CONCLUSIONS: Provision of an audiovisual presentation supplemented with 1 of 3 written information methods is an effective way of delivering information. There was a significant improvement in the retention of information with the use of mind maps compared with leaflets. The generic mind map is equally as effective, more consistent in information delivered, and less labor intensive than the individual customized mind map and therefore would be our recommendation. Participation of parents is important because they comprehend and retain information better. In this study, 100% of parents shared information with their children, perhaps improving the patients' recall.

Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study.

BACKGROUND: Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention. METHOD: A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis. RESULTS: Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course. CONCLUSIONS: A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Evaluation of objective structured clinical examination for advanced orthodontic education 12 years after introduction.

INTRODUCTION: Advanced education programs in orthodontics must ensure student competency in clinical skills. An objective structure clinical examination has been used in 1 program for over a decade. The results were analyzed cross-sectionally and longitudinally to provide insights regarding the achievement of competency, student growth, question difficulty, question discrimination, and question predictive ability. METHODS: In this study, we analyzed 218 (82 first-year, 68 second-year, and 68 third-year classes) scores of each station from 85 orthodontic students. The grades originated from 13 stations and were collected anonymously for 12 consecutive years during the first 2 decades of the 2000s. The stations tested knowledge and skills regarding dental relationships, analyzing a cephalometric tracing, performing a diagnostic skill, identifying cephalometric points, bracket placement, placing first-order and second-order bends, forming a loop, placing accentuated third-order bends, identifying problems and planning mixed dentition treatment, identifying problems and planning adolescent dentition treatment, identifying problems and planning nongrowing skeletal treatment, superimposing cephalometric tracings, and interpreting cephalometric superimpositions. Results were evaluated using multivariate analysis of variance, chi-square tests, and latent growth analysis. RESULTS: The multivariate analysis of variance showed that all stations except 3 (analyzing a cephalometric tracing, forming a loop, and identifying cephalometric points) had significantly lower mean scores for the first-year student class than the second- and third-year classes (P <0.028); scores between the second- and third-year student classes were not significantly different (P >0.108). The chi-square analysis of the distribution of the number of noncompetent item responses decreased from the first to the second years (P <0.0003), from the second to the third years (P <0.0042), and from the first to the third years (P <0.00003). The latent growth analysis showed a wide range of difficulty and discrimination between questions. It also showed continuous growth for some areas and the ability of 6 questions to predict competency at greater than the 80% level. CONCLUSIONS: Objective structure clinical examinations can provide a method of evaluating student performance and curriculum impact over time, but cross-sectional and longitudinal analyses of the results may not be complementary. Significant learning appears to occur during all years of a 3-year program. Valuable questions were both easy and difficult, discriminating and not discriminating, and came from all domains: diagnostic, technical, and evaluation/synthesis.