Effect of educational intervention on computer-aided-design and computer-aided-manufacturing technology to preclinical dental students.

INTRODUCTION: This study evaluated the effectiveness of a video presentation instruction compared to the prevailing traditional lecture provided in the preclinical classroom when introducing computer-aided design/computer-aided manufacturing (CAD/CAM) technology. MATERIALS AND METHODS: This study was conducted as a controlled educational trial (single-blind) on 120 first-year dental students. Students were assigned to two learning groups: the control (n = 60, traditional lecture) and the intervention (n = 60, video presentation). Both groups completed a self-efficacy scale (SES) survey before instruction. Then, the intervention group actively participated in a one-session video presentation while the control group was given a traditional lecture. After the presentations, student knowledge was assessed with a hands-on simulated exercise that was scored out of 60 points. At last, students completed a post-instruction student perception and attitude (SPA) survey. Inferential hypothesis testing was conducted with two-sample t-tests, and significance was defined as p ≤ .05. RESULTS: There were no significant differences in the student pre-instruction SES scores between the control and intervention groups. After the video learning, CAD/CAM knowledge application during the hands-on simulated exercise showed significantly higher results in the intervention group as the assessment scores from the intervention group averaged 13.6 ± 2.0 points higher than the control group (p < .001). The results from the post-instruction SPA survey showed no statistically significant difference between groups. CONCLUSION: With the video presentation technique, our first-year dental students were able to greatly enhance their CAD/CAM application skills. The results from this study could be applied at other dental educational institutions with potential similar outcomes.

Diagnosis and treatment planning using the 2017 classification of periodontal diseases among three dental schools.

OBJECTIVES: The American Academy of Periodontology and the European Federation of Periodontology developed a new classification system for periodontal diseases in 2017. The next step in its widespread implementation involves training dental students to improve consistency in clinical decisions. This study conducted in 2020-2021 aimed to evaluate knowledge in periodontal diagnosis and treatment planning using the new classification, among first, second, third- and fourth-year dental students at Indiana University School of Dentistry (IUSD), University of Texas School of Dentistry at Houston (UTSD), and University of Louisville School of Dentistry (ULSD). METHODS: A minimum of 20 dental students per class year from each of the three schools participated. Ten HIPPA de-identified case records and a questionnaire with a fixed list of answer options, comprising two demographic questions and two questions on diagnosis and treatment planning of each case, were presented to the participants. A group of three board-certified periodontists established the answers for all cases which were used to score the appropriateness of diagnosis and treatment planning among the participants. RESULTS: A total of 263 students participated. Overall, 22.6% of IUSD responses, 25.2% of UTSD, and 27.6% of ULSD responses were correct for diagnosis (no statistically significant differences). For the treatment plan, 64.9% of IUSD responses, 66.2% of UTSD, and 68.9% of ULSD responses were correct (no statistically significant differences). CONCLUSION: Based on the findings from our study, we suggest that additional training be considered to improve the understanding of the 2017 classification of periodontal and peri-implant diseases among dental students.

Implant Site Development Using Titanium Mesh in the Maxilla: A Retrospective Study of 58 Mesh Procedures in 48 Patients.

This article presents a retrospective case series of implant site development using titanium mesh (Ti-mesh) in the maxilla. A total of 58 mesh procedures in combination with several different bone grafts (allograft, cellular allograft, and bovine xenograft) and biologics (including recombinant human platelet-derived growth factor, autogenous platelet-rich growth factor, and recombinant human bone morphogenetic protein-2) were performed in 48 patients. Ti-mesh guided bone regeneration procedures were performed 2 to 3 months after extraction of nonrestorable/hopeless teeth, and the implants were placed 6 to 8 months postaugmentation. The mean initial ridge width was 2.0 ± 1.0 mm, and the mean horizontal gain after Ti-mesh procedures was 4.7 ± 1.6 mm. The ridge width was first measured on the cross-sectional presurgical CBCT image and then confirmed clinically during surgical procedures. No statistical difference in the horizontal gain was found among different combinations of bone grafts and biomaterials. Ti-mesh exposure occurred 22% of the time. The middle-aged adults (odds ratio [OR] = 8.59; P = .046) and older adults (OR = 16.66; P = .02) had significantly higher chances of mesh exposure compared to young adults. While all implants were successfully placed, about 56% of the implants had < 2 mm of bone to the facial aspect of the osteotomy and received additional contour augmentation when placed in a prosthetically appropriate position for a screw-retained restoration. This study demonstrates that although Ti-mesh procedures result in significant bone regeneration in narrow alveolar ridges to predictably allow implant placement, the age-related mesh exposure rate and frequency of need for additional contour grafting should be discussed with patients.

Early Loading of Posterior Nonsubmerged Titanium Implants with a Modified Sandblasted and Acid-Etched Surface: A Prospective Case Series with Up to 149 Months of Follow-up.

The purpose of this prospective study was to evaluate the success rates and prosthetic complications of implants with a modified sandblasted and acid-etched (SLA) surface inserted for posterior single-implant crown restorations. Final crowns were placed 3 to 4 weeks after surgery, and patient follow-up spanned 10 years in a private practice setting. A total of 22 patients (8 women, 14 men) with 25 posterior implants placed (16 mandible, 9 maxilla) were selected, including only implants for posterior single-implant crowns with insertion torque values of ≥ 35 Ncm at placement. Twenty-one implants passed the reverse torque test at 3 to 4 weeks after implant placement, and final restorations were placed. Three patients (4 implants) had "spinners," and there was one patient dropout after completion of the final restoration. All patients were recalled for clinical exams, digital periapical radiographs, and clinical photos at short-term (≤ 5 years) and long-term (> 5 years) follow-up appointments. The Community Periodontal Index of Treatment Needs was also determined at the initial and follow-up visits. Crestal bone level was measured at crown placement (T1), short-term follow-up (T2; mean: 29.4 months), and long-term follow-up appointments (T3; mean: 114.4 months). Twenty patients (23 implants) returned for examination at T2, and 15 (18 implants) were available at T3. For the 17 implants available at all evaluations, statistically significant bone loss was found from T1 to T2 (0.23 ± 0.30 mm), and the mean crestal bone level appeared stable from T2 to T3. Based on clinical and radiographic findings, the success rate for the implants and restorations at T2 and T3 was graded as 100%. Therefore, it can be stated that an early loading protocol of 3 to 4 weeks using a modified SLA surface at premolar/molar single-tooth locations can result in favorable clinical and radiographic long-term results.

A Comparison of the Effect of Barrier Membranes on Clinical and Histologic Hard and Soft Tissue Healing with Ridge Preservation.

Twenty patients completed this randomized, controlled, blinded clinical trial comparing ridge preservation with a bioabsorbable polylactic acid membrane (PLA group) compared to an acellular dermal matrix membrane guided bone regeneration (ADMG group). An intrasocket corticocancellous allograft plus a facial overlay xenograft was used for both groups. Final crestal ridge width was significantly greater for the ADMG group (P < .05). Soft tissue thickness, conversely, was thicker for the PLA group. Vertical ridge height change increased significantly for the midbuccal site of the ADMG group. Histologic evaluation showed high percentages of vital bone for both groups.

Successful Multidisciplinary Management of an Endodontic-Periodontal Lesion Associated With a Palato-Radicular Groove: A Case Report.

INTRODUCTION: This case report describes the collaborative management of an extensive combined endodontic-periodontal lesion related to a long palato-radicular groove (PRG) on a maxillary lateral incisor. Cases with similar severity have been reported minimally in the endodontic journals but even less in the periodontal journals. This case report illustrates the result of multidisciplinary treatment of the combined lesions associated with PRG. CASE PRESENTATION: A 63-year-old patient presented with a periapical radiolucency on tooth #10. After evaluation, the patient was diagnosed with an endodontic-periodontal lesion associated with PRG. After being informed of a guarded prognosis, the patient consented to a surgical procedure in an effort to retain the tooth. Management of the case involved a combination of endodontic therapy, odontoplasty under dental operating microscopy to attempt to eliminate the root anomaly, and periodontal regenerative procedures with allografts and a resorbable barrier membrane. Clinical examination and the cone-beam computed tomography scan at a 2-year postoperative visit revealed a substantial reduction in probing depth and significant bone fill of the defect. CONCLUSIONS: In the past, a long PRG in combination with a periapical lesion often resulted in extraction of the tooth. With accurate assessment of the etiology of the defect, patient education, and a multidisciplinary approach, teeth with a PRG may be retained with a stable outcome for years.

The Effect of Platform-Switching Plus Laser Grooving on Peri-implant Hard and Soft Tissue Level: A Randomized, Controlled, Blinded Clinical Trial.

Twenty patients were randomly assigned to receive either a platform-switched or platform-matched implant to replace a single maxillary anterior tooth. Primary outcome variables were the implant interproximal bone loss, facial recession, and papilla fill at 12 months. The platform-switched group showed crestal bone loss of 0.1 ± 0.3 (mesial) and 0 mm (distal) while the platform-matched group showed losses of 0.6 ± 0.5 mm (mesial) and 0.7 ± 0.7 mm (distal) (P < .05). Facial recessions for the platform-switched and platform-matched groups were 0.1 ± 0.3 mm and 0.4 ± 0.8 mm, respectively.