Investigating correlations between the PAT and three hand-skill exercises to performance in preclinical laboratory courses.

OBJECTIVES: Perceptual ability test (PAT) is a valid determinant for spatial perceptions. However, proven psychomotor skill tests for dentistry do not currently exist. This study aimed to determine whether performance on the PAT, Operation game, mirror tracing, and wax carving exercises correlate to preclinical laboratory performance in Dental Anatomy and Restorative Dentistry courses. METHODS: First-year dental students (n = 96) participated in the study. Final laboratory grades were obtained from course directors of preclinical Restorative Dentistry and Dental Anatomy courses. Admissions committee provided participants' PAT results. Participants completed a wax carving exercise by carving a cube and a semicircle into a wax block using the wax subtraction method. Two calibrated faculty graded the carvings as Ideal (5), Satisfactory (3), or Unsatisfactory (1). Time to complete the Operation game and number of infractions were recorded. Participants traced the six-pointed star pattern on the Auto Scoring Mirror Tracer instrument in both clockwise and counterclockwise directions. Completion times and number of instances outside the pattern were recorded. Spearman Rank Correlations were used to determine associations at 0.05 confidence interval. RESULTS: Mean PAT score was 21.7; mean times to complete the Operation game and mirror tracing exercise were 4:20 and 1:30, respectively. Mean score on the wax carving exercise was 3.19. Correlations between the independent and dependent variables were minimal to weak. The wax carving exercise was the most reliable predictor of performance. CONCLUSIONS: When PAT scores are striated into low (less than 20), middle (21-22), and high (23-30), it was possible to predict performance in both preclinical laboratory courses.

An evaluation of factors affecting dental shade matching in first-year dental students.

STATEMENT OF PROBLEM: Shade selection has become more important and challenging as it becomes more emphasized in esthetic dentistry. It would be beneficial to screen dental students early in their predoctoral education for any deficiencies in color discrimination. Specific tests that reliably predict dental shade-matching ability have not been fully established. PURPOSE: The purpose of this study was to determine whether the Farnsworth-Munsell 100 Hue Test (FM-100), Perceptual Ability Test (PAT), ethnicity, age, sex, and time to complete the tests affect dental shade-matching ability and value discernment in first-year dental students. Secondary aims were to determine whether correlations exist between performance on the PAT and FM-100 and between FM-100 and dental shade matching. MATERIAL AND METHODS: The FM-100 test was administered to 98 first-year dental students in a Judge II booth (color temperature=6500 K, color rendering index=90). The Vita Toothguide 3D-Master shade guide was used in this study. For the Value Test, students arranged 3 sets of 5 masked shade tabs from lightest to darkest. In all 3 sets, the value ranged from 1 to 5. In set #1, each shade tab had the same hue and chroma. In set #2, the hues were constant, but the chroma varied. In set #3, the hue and chroma varied. For the Matching Test, students matched together 11 pairs of masked shade tabs from 2 shade guides. Ethnicity (white, African American, Hispanic, Middle Eastern, and Asian), PAT scores, age, sex, and time to complete tests were recorded. Data were analyzed by using least square means, Wilcoxon Rank Sum, Kruskal-Wallis, and Spearman correlation tests (α=.05). RESULTS: FM-100 total error scores (TES) ranged from 0 to 188. Forty-three students had superior color discrimination (TES 0 to16), 51 had average (TES 20 to 100), and 4 had poor color discrimination (TES>100). Ethnicity, age, and sex did not significantly affect performance on any tests. Longer completion time resulted in better performance on FM-100 (P=.002) and Matching Tests (P=.032). However, increased time resulted in fewer correct answers on the Value Test (P=.016). There was a significant effect of PAT on FM-100 results (P<.001). As PAT scores increased, TES scores decreased, indicating better color discrimination. Similarly, lower TES scores resulted in higher Matching Test results (P<.001). However, this was not observed on the Value Test (P=.302). Correlation between the PAT and FM-100 was weak (r=-0.217), as well as between the FM-100 and Matching Test (r=-0.364). CONCLUSIONS: Ethnicity, age, and sex did not affect dental shade-matching ability. Participants with higher PAT scores demonstrated higher color discrimination on the FM-100 and were better at matching dental shade tabs. Time had different effects on the Matching and Value tests.

Wax carving exercises predict performance on practical examinations for first-year dental students.

Perceptual ability test (PAT) is a valid determinant for spatial perceptions. However, a validated psychomotor skill test for dentistry does not currently exist. PURPOSE/OBJECTIVES: This study aimed to determine whether the results of two wax carving exercises (E1 and E2), PAT, quantitative reasoning (QR), and academic average (AA) tests predict students' performance on dental anatomy practical examinations. METHODS: First-year dental students (n = 69) participated in the study. Results of the PAT, QR, and AA were obtained from the Admissions Office. Participants completed wax carving exercises during the first (E1) and last weeks (E2) of the dental anatomy course. Carving instruments, instruction, and rubrics, were provided to participants who were instructed to carve a cube and a semicircle shape into a wax block using the wax subtraction technique. Two calibrated and blinded faculty graded the exercise as ideal, satisfactory, or unsatisfactory in four categories: finish, sharpness, symmetry, and accuracy. During the dental anatomy course, participants completed wax carving practical examinations for a maxillary central incisor and a mandibular first molar. Examinations were graded by calibrated faculty as ideal, satisfactory, or unsatisfactory. The linear mixed effects model assessed influences of independent variables on the practical examinations. RESULTS: estimates of the independent variables on the practical examinations were PAT (0.027), AA (0.088), QR (-0.014), E1 (0.235), and E2 (0.175). CONCLUSIONS: wax carving exercises were stronger predictors of performance on the practical examinations than the PAT, AA, and QR. This simple exercise may help identify students early in their preclinical education requiring additional assistance.

Microshear bond strength of resin luting agents to monolithic zirconia.

The objective of this study was to evaluate the effects of different surface treatments on the microshear bond strength (µSBS) of resin cements to zirconia. Twenty-four zirconia wafers measuring 2.0 × 9.0 × 15.0 mm were sintered and randomly distributed into 3 groups based on the resin cement (n = 8): Panavia F 2.0, NX3, and RelyX Ultimate. The resin cement groups were divided into 4 subgroups based on the surface treatment: a control subgroup (air abrasion with 50-µm alumina particles) and 3 experimental surface treatments (Alloy Primer, Ea-Z-y Primer, and tribochemical silicoating using CoJet Sand). Each surface treatment was applied to the zirconia wafers according to its manufacturer's instructions. The resin cements were mixed and placed in thermoplastic tubes, producing cylinders measuring 0.8 mm in diameter × 2.0 mm in height. Five tubes containing the resin cements were placed on each of the pretreated zirconia wafers, resulting in a sample size of 10 specimens per treatment per resin cement. The luting agents were allowed to cure chemically for 4 minutes and then light cured for 30 seconds. The thermoplastic tubes were removed after 24 hours, and specimens were stored in deionized water (37°C) for 24 hours. A shear force was applied using a wire loop attached to a universal testing machine with a crosshead speed of 0.5 mm/min, and the microshear forces required for failure were recorded. The parametric data were analyzed with a 2-way analysis of variance with post hoc Tukey and Dunnett tests (P < 0.05). The mean (SD) µSBS values ranged from 3.6 (0.9) to 9.3 (2.4) MPa. Surface treatment with Alloy Primer and Ea-Z-y Primer increased the µSBS of the 3 cements compared to their controls, but the difference was not always statistically significant. CoJet Sand only increased the µSBS of Panavia F 2.0. The results suggest that the effects of different surface treatments may be specific for each cement.

Effectiveness of CAD/CAM technology: A self-assessment tool for preclinical waxing exercise.

INTRODUCTION: This study assessed the utility of CAD/CAM technology as a self-assessment tool for preclinical waxing compared to traditional student self-assessment to evaluate preclinical work. MATERIAL AND METHODS: Thirty-seven students completed the wax-up of the maxillary left central incisor with the goal of recreating original anatomy and completed a traditional self-assessment. The original, unreduced cast and waxings were scanned with an intraoral scanner (E4D, Planmeca). Using CAD/CAM software (Compare, Planmeca), each waxing was superimposed over the original. Tolerance (250 µm) was set to illustrate under- and over-contoured areas, enabling visualisation of the waxing compared to original in three dimensions. Students then completed another self-assessment and an exit survey. RESULTS: Twenty-four per cent of self-assessment responses changed after using Compare Software. 20% changed from satisfactory to unsatisfactory. Four per cent changed from unsatisfactory to satisfactory. Greatest change in response occurred in the Incisal Edge (49%) rubric category. Interproximal Contact Area (3%) demonstrated least change in response. Seventy per cent strongly agreed that Compare Software enabled more effective assessment of Lingual Contour. Eight per cent strongly disagreed that Compare Software enabled more effective assessment of finishing. DISCUSSION: CAD/CAM software can improve student's critical self-assessment. Different rubric categories demonstrated differing rates of response change, indicating more critical of certain aspects of the waxing. Majority strongly agreed that the software enabled more effective self-assessment. CONCLUSION: CAD/CAM technology enhances student's learning in dental wax-up through improving self-assessment. This technology may improve teacher-student communication, reduce one-on-one teaching time and allow higher student-teacher ratio.

Dental Shade Matching and Value Discernment Abilities of First-Year Dental Students.

PURPOSE: To determine if Farnsworth-Munsell 100 Hue Test, Perceptual Ability Test, gender, age, ethnicity, and time predict dental shade matching and value discernment in first-year dental students. MATERIALS AND METHODS: Farnsworth-Munsell 100 Hue Test was administered to 95 first-year-dental students beneath a Judge II booth (color temperature of 6500°K, and color rendering index of 90). Students also arranged 16 masked shade tabs from a Vita Classic shade guide by value (lightest to darkest) and matched together 16 pairs of masked shade tabs from two Vita Classic shade guides. Ethnicity, age, Perceptual Ability Test scores, gender, and time to complete the tests were recorded. Associations and correlations were investigated using chi-square, Tukey-Kramer HSD, standard least square, and multilinear regression (p < 0.05). RESULTS: Total error scores on the Farnsworth-Munsell 100 Hue Test ranged from 0 to 144. Forty-eight students exhibited superior color acuity, 45 average, and two poor. The mean number of correct answers for matching shade tabs together was 11.6, and 6.1 for arranging the shade tabs by value. Females performed statistically better than males on the Farnsworth-Munsell 100 Hue Test and shade tab matching. Better color discrimination identified by lower total error scores on the Farnsworth-Munsell 100 Hue Test was directly correlated to greater ability to match shade tabs together. Perceptual Ability Test scores had slight significance. As the scores increased there was slightly better performance on the Farnsworth-Munsell 100 Hue Test. Older participants performed better than younger subjects on the value test. No other correlations were significant for any of the tests. CONCLUSIONS: Females and individuals who performed better on the Farnsworth-Munsell 100 Hue Test have improved dental shade-matching ability.

Predicting Performance in Technical Preclinical Dental Courses Using Advanced Simulation.

The aim of this study was to investigate whether advanced simulation parameters, such as simulation exam scores, number of student self-evaluations, time to complete the simulation, and time to complete self-evaluations, served as predictors of dental students' preclinical performance. Students from three consecutive classes (n=282) at one U.S. dental school completed advanced simulation training and exams within the first four months of their dental curriculum. The students then completed conventional preclinical instruction and exams in operative dentistry (OD) and fixed prosthodontics (FP) courses, taken during the first and second years of dental school, respectively. Two advanced simulation exam scores (ASES1 and ASES2) were tested as predictors of performance in the two preclinical courses based on final course grades. ASES1 and ASES2 were found to be predictors of OD and FP preclinical course grades. Other advanced simulation parameters were not significantly related to grades in the preclinical courses. These results highlight the value of an early psychomotor skills assessment in dentistry. Advanced simulation scores may allow early intervention in students' learning process and assist in efficient allocation of resources such as faculty coverage and tutor assignment.

Quantifying Appointments, Treatment Time, Impressions, and Diagnostic Data of Cases Staffed by General Dentists and Prosthodontists in a Dental School Clinic.

The aim of this retrospective study was to quantify differences between general dentists and prosthodontists regarding appointments, treatment time, impressions, and preoperative diagnostic data in teaching predoctoral clinical fixed prosthodontics. Electronic dental records (n=356) of patients treated at one dental school in academic year 2012 were randomly selected for review to obtain the following data: faculty and student demographics, number of appointments and treatment time from preparation to cementation, number of impressions made, completion of oral disease control treatment (ODCT), and presence of preoperative periapical radiographs and diagnostic casts. The results showed that ODCT was completed in 78%, preoperative radiographs were present in 76%, and diagnostic casts made in 53% of the cases reviewed. There was no statistically significant difference in number of appointments, treatment time, or number of final impressions when students were staffed by general dentists or prosthodontists. When students were supervised by multiple faculty members, there was generally an increase in treatment time and number of appointments and final impressions. Although this study found no statistically significant differences between general dentists and prosthodontists regarding the criteria evaluated, the results suggest that faculty development and calibration are needed to ensure ODCT is completed and preoperative radiographs are present prior to initiating fixed prosthodontic procedures.

Quality of Impressions and Work Authorizations Submitted by Dental Students Supervised by Prosthodontists and General Dentists.

Preclinical fixed prosthodontics is taught by Department of Prosthodontics faculty members at Virginia Commonwealth University School of Dentistry; however, 86% of all clinical cases in academic year 2012 were staffed by faculty members from the Department of General Practice. The aims of this retrospective study were to quantify the quality of impressions, accuracy of laboratory work authorizations, and most common errors and to determine if there were differences between the rate of errors in cases supervised by the prosthodontists and the general dentists. A total of 346 Fixed Prosthodontic Laboratory Tracking Sheets for the 2012 academic year were reviewed. The results showed that, overall, 73% of submitted impressions were acceptable at initial evaluation, 16% had to be poured first and re-evaluated for quality prior to pindexing, 7% had multiple impressions submitted for transfer dies, and 4% were rejected for poor quality. There were higher acceptance rates for impressions and work authorizations for cases staffed by prosthodontists than by general dentists, but the differences were not statistically significant (p=0.0584 and p=0.0666, respectively). Regarding the work authorizations, 43% overall did not provide sufficient information or had technical errors that delayed prosthesis fabrication. The most common errors were incorrect mountings, absence of solid casts, inadequate description of margins for porcelain fused to metal crowns, inaccurate die trimming, and margin marking. The percentages of errors in cases supervised by general dentists and prosthodontists were similar for 17 of the 18 types of errors identified; only for margin description was the percentage of errors statistically significantly higher for general dentist-supervised than prosthodontist-supervised cases. These results highlighted the ongoing need for faculty development and calibration to ensure students receive the highest quality education from all faculty members teaching fixed prosthodontics.

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

PURPOSE: The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. MATERIALS AND METHODS: A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. RESULTS: Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. CONCLUSION: This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods.

The Use of Telemedicine in Oral and Maxillofacial Surgery.

PURPOSE: To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). MATERIALS AND METHODS: Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. RESULTS: There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P < .0001), rural practitioners referred more patients (P = .0038), and rural GPs referred more single-tooth implant cases (P = .0039). GP respondents moderately agreed to statements about the benefits of telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. CONCLUSION: According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery.

Effect of restoration volume on stresses in a mandibular molar: a finite element study.

STATEMENT OF PROBLEM: There can be significant disagreement among dentists when planning treatment for a tooth with a failing medium-to-large--sized restoration. The clinician must determine whether the restoration should be replaced or treated with a crown, which covers and protects the remaining weakened tooth structure during function. PURPOSE: The purpose of this study was to evaluate the stresses generated in different sized amalgam restorations via a computational modeling approach and reveal whether a predictable pattern emerges. MATERIAL AND METHODS: A computer tomography scan was performed of an extracted mandibular first molar, and the resulting images were imported into a medical imaging software package for tissue segmentation. The software was used to separate the enamel, dentin, and pulp cavity through density thresholding and surface rendering. These tissue structures then were imported into 3-dimensional computer-aided design software in which material properties appropriate to the tissues in the model were assigned. A static finite element analysis was conducted to investigate the stresses that result from normal occlusal forces. Five models were analyzed, 1 with no restoration and 4 with increasingly larger restoration volume proportions: a normal-sized tooth, a small-sized restoration, 2 medium-sized restorations, and 1 large restoration as determined from bitewing radiographs and occlusal surface digital photographs. RESULTS: The resulting von Mises stresses for dentin-enamel of the loaded portion of the tooth grew progressively greater as the size of the restoration increased. The average stress in the normal, unrestored tooth was 4.13 MPa, whereas the smallest restoration size increased this stress to 5.52 MPa. The largest restoration had a dentin-enamel stress of 6.47 MPa. A linear correlation existed between restoration size and dentin-enamel stress, with an R(2) of 0.97. CONCLUSIONS: A larger restoration volume proportion resulted in higher dentin-enamel stresses under static loading. A comparison of the von Mises stresses to the yield strengths of the materials revealed a relationship between a tooth's restoration volume proportion and the potential for failure, although factors other than restoration volume proportion may also impact the stresses generated in moderate-sized restorations.

Hand-washing knowledge and practices among dentists and dental specialists.

OBJECTIVE: Hand washing is the most important way to prevent the spread of infection. However, studies have shown that there is a lack of knowledge among physicians about proper hand hygiene. The purpose of this study was to determine the knowledge of general dentists and dental specialists regarding the correct agents to use and the appropriate times to wash hands. METHOD AND MATERIALS: A questionnaire asking for demographic information and the answers to questions about proper hand hygiene practices and agents was sent via email to a list of general dentists and dental specialists. A total of 480 completed surveys were received (approximately 15% response). RESULTS: None of the respondents answered all the questions correctly. Six percent answered 4 questions correctly, 23% answered 3 questions correctly, and 47% answered only 2 questions correctly. There was no correlation between the number of correct answers and whether the respondent was a general dentist or a specialist. CONCLUSION: There is a lack of knowledge among dentists regarding proper hand hygiene. For the benefit of both the patient and the doctor, this situation must be remedied.

Evaluating EDTA as a substitute for phosphoric acid-etching of enamel and dentin.

Matrix metalloproteinases (MMPs) are proteolytic enzymes released when dentin is acid-etched. The enzymes are capable of destroying unprotected collagen fibrils that are not encapsulated by the dentin adhesive. Chlorhexidine applied after etching inhibits the activation of released MMPs, whereas neutral ethylenediamine tetra-acetic acid (EDTA) prevents the release of MMPs. The purpose of this study was to determine if conditioning enamel and dentin with EDTA can be a substitute for treating acid-etching enamel and dentin with chlorhexidine. A column of composite resin was bonded to enamel and dentin after conditioning. Shear bond strengths were evaluated after 48 hours and after accelerated aging for three hours in 12% sodium hypochlorite. Shear bond strengths ranged from 15.6 MP a for accelerated aged EDTA enamel specimens to 26.8 MPa for dentin conditioned with EDTA and tested after 48 hours. A three-way ANOVA and a Tukey HSD test found statistically significant differences among the eight groups and the three independent variables (P < 0.05). EDTA was successfully substituted for phosphoric acid-etched enamel and dentin treated with chlorhexidine. Interactions of conditioning agent and aging were significant for dentin but not for enamel. In an effort to reduce the detrimental effects of MMPs, conditioning enamel and dentin with EDTA is an alternative to treating acid-etched dentin and enamel with chlorhexidine.

The role of volume of multi-surface restorations in posterior teeth: Treatment options.

Teeth containing large defective restorations are frequently indicated to receive crowns to prevent catastrophic fracture. There is a considerable lack of consensus as to when the size of an existing restoration needing retreatment is sufficiently large to warrant a crown. In addition, the treating dentist's gender, age, and location also have been found to influence this decision. An in vitro method was developed to estimate a restoration's volume proportion (VP). This study validates and investigates correlations between the restoration's VP, the decision to indicate a crown, and the responding dentist's demographic information. The coronal portions of occlusal view and bitewing radiographic images of restored posterior teeth were traced to yield four surface areas used in estimating the restoration's VP. An online survey of 15 patients, including intraoral and radiographic images of defective restorations, was created. Dentists were invited to select treatment for each patient's tooth, with options including replacing the restoration only or indicating a crown. Analysis was accomplished using repeated-measures logistic regression. Of the 300 respondents, 17% were female and 14% were from outside the U.S. The relationship between a responding dentist indicating a crown and the restoration's VP, the tooth type (molar or premolar), and nationality (U.S. or foreign dentist) were all deemed statistically significant. Crowns were indicated for molars significantly more often than for premolars, with a significant VP interaction. The final model of tooth, VP, nationality, and the interaction of tooth and VP was used to generate mean predicted proportions for indicating a crown.

Accuracy and dimensional stability of extended-pour and conventional alginate impression materials.

BACKGROUND: The authors conducted a study to determine if two irreversible hydrocolloid impression materials (Cavex ColorChange, Cavex Holland BV, Haarlem, Netherlands; Jeltrate Plus Antimicrobial Dustless Alginate Impression Material, Dentsply Caulk, Milford, Del.) stored for five days were dimensionally accurate. METHODS: The authors modified Ivorine teeth (Columbia Dentoform, Long Island City, N.Y.) on a Dentoform model (1560 series model, Columbia Dentoform) to allow measurements of tooth and arch width. They made impressions and generated casts immediately and at five additional times. They recorded tooth and arch widths on the casts and compared the measurements with those for the standard model. RESULTS: Compared with measurements for the model, the greatest measured difference in casts was 0.003 inches for Cavex ColorChange (extended-pour alginate) and 0.005 inches for Jeltrate Plus Antimicrobial Dustless Alginate Impression Material (conventional alginate). The percentage of dimensional change ranged from -0.496 to 0.161 percent for the extended-pour alginate and from -0.174 to 0.912 percent for the conventional alginate. CONCLUSIONS: Results of analysis of variance and paired t tests indicated that when generated immediately and at day 5, casts produced from both impression materials were not statistically different from the standard model (P < .05). CLINICAL IMPLICATIONS: When stored properly, both alginate materials can produce accurate impressions at day 5 for diagnostic casts and for fabrication of acrylic appliances.

An evaluation of dentin conditioners for resin-modified glass ionomer cements.

This study sought to test the null hypothesis that there was no difference between three dentin conditioners in terms of how they affected the shear bond strength to dentin of three resin-modified glass ionomer (RMGI) cements. One hundred twenty caries-free third molars were mounted in acrylic resin and their occlusal surfaces were reduced to within 2 mm of their cemento-enamel junction (CEJ). Of the three cements tested, Rely-X Plus (22.7 MPa) and Fuji CEM (19.0 MPa) produced the highest bond strengths when dentin was treated with 37% phosphoric acid and followed by the application of Optibond Solo Plus and BondLink. Among the dentin conditioners tested, Fuji Plus Conditioner increased bond strengths for all three cements more than leaving the smear layer intact, although the increase was not statistically significant. Dentin treated with Cavity Conditioner demonstrated the weakest bond strengths.

Rural and urban differences in prosthodontic care provided by Virginia general dentists.

Virginia dentists were surveyed to reveal how changes in practice activities affected rural and urban practices in terms of prosthodontics and to assess the impact these changes may have on dentists, continuing education courses, and school curricula. Six hundred licensed dentists were selected at random and were mailed a survey containing questions about their demographics and the types of prosthodontic treatment they performed. Of the 333 respondents, 195 were considered eligible to represent general dentists. Based on this study, rural dentists devote slightly more practice time to providing removable prosthodontic treatment and oral surgery than urban dentists and slightly less time to providing implant restorative treatment. Rural dentists provide significantly more patients with removable partial dentures, complete dentures with no implants, and complete dentures of any type. Most prosthodontic fees were significantly lower for rural dentists.

Survey of prosthodontic service provided by general dentists in Virginia.

STATEMENT OF PROBLEM: Activities in prosthodontic treatment may be changing due to prevalence of disease and new treatment options. Studies cite conflicting evidence in regard to prosthodontic services, particularly removable prosthodontics. PURPOSE: This project was designed to describe the amount of prosthodontic services provided by general dentists in Virginia. Results may enhance understanding practice patterns in Virginia and regions with similar demographics. MATERIAL AND METHODS: Licensed Virginia dentists (n=600) were randomly selected from the Virginia Department of Health Professions website. Each individual was mailed a survey of questions about his or her demographics and practice activities with regard to prosthodontics. RESULTS: Of the 333 respondents, 195 provide prosthodontic treatment and function as general dentists. On average, they spend 25% of their practice time providing prosthodontic services (17% fixed and 8% removable). They provide at least 1 complete denture for a mean total of 24.3 patients per year, at least 1 removable partial denture for a mean total of 28.7 patients per year, at least 1 fixed partial denture for a mean total of 23.0 patients per year, at least 1 implant-supported crown for a mean total of 12.3 patients per year, and at least 1 implant-supported fixed partial denture for mean total of 3.3 patients per year. Data were analyzed using descriptive statistics. Data for total population and median income were analyzed with the Wilcoxon signed rank test. CONCLUSION: Virginia dentists continue to provide considerable numbers of fixed prosthodontic restorations, removable partial dentures, and complete dentures, while providing a growing number of implant-supported restorations.