Electronic periodontal tool integration to enrich clinical diagnosis.

PURPOSE/OBJECTIVES: The objective of this study was to evaluate the effectiveness of an Electronic-Periodontal-Diagnosis-Tool (EPDT) to facilitate the formulation of a correct periodontal diagnosis and analyze students' perceptions of the use of the EPDT. METHODS: Fifty Year-3 students who recently started their clinical training, were randomly assigned to two groups. Two clinical scenarios involving challenging periodontal diagnoses, each one with unique components, variables, and categories were distributed with specific instructions. The cases were analyzed to determine the correct periodontal diagnosis-half without the use of the EPDT and half with the use of the EPDT. A post-exercise discussion conducted by the faculty explained the answer rationales. The students completed an anonymous/voluntary survey to evaluate their perceptions. Statistical analysis using likelihood ratio chi-square tests and a generalized linear model evaluated whether the use of the EPDT resulted in higher percentages of correct diagnoses. RESULTS: EPDT use resulted in a three times higher percentage of correct classifications than no tool use (48% versus 16%), which the investigators considered an important effect of the EPDT. The generalized-linear-model assessment confirmed that EPDT resulted in better classifications (p < 0.0001). The feedback about the perceptions of the EPDT was favorable. CONCLUSION: Students using the EPDT resulted in higher percentages of correct diagnoses. The EPDT provided students with a useful framework to determine the correct periodontal diagnoses, which is essential in providing appropriate treatments.

The periodontal senior case clinical challenge: Students' opinions of a formative virtual assessment during the COVID-19 emergency.

INTRODUCTION: Due to COVID-19, innovative, virtual educational methods are being developed to provide students with learning experiences comparable to established clinical practices. Our objective was to produce the Periodontal Senior Case Clinical Challenge (PSCCC) that would provide fourth-year students an alternative for senior case presentations and would be a formative assessment for which student opinions would be provided and analysed. The PSCCC would utilise an online, case-based, written, clinical assessment and follow-up, structured discussion to challenge students to demonstrate ability to apply didactic periodontal knowledge to patient-based experiences. We hypothesised the PSCCC would provide effective learning and a formative assessment. MATERIAL AND METHODS: Relevant didactic resources were distributed to 48 students for independent review. The PSCCC was delivered in two sections, (1) a case-based assessment via a virtual classroom with written student responses, and (2) oral discussions conducted via virtual meetings that were moderated and assessed by ten periodontists, with the collaboration of nine residents. A voluntary six-statement survey was used to evaluate the students' opinions of the PSCCC. The scores for 75% (36/48) of students who participated were evaluated for statistical and clinical importance. RESULTS: The value of our PSCCC was supported by 91.7% (33/36) of the analyses (p < .0008). DISCUSSION: The PSCCC was a successful alternative pathway to assess students' clinical and didactic integrated knowledge in periodontics. It provided a unified vision of treatment of the selected case, building on all aspects of the students' periodontal education whilst allowing interaction in a simultaneous, three-tiered educational approach, involving dental students, periodontal residents and faculty. CONCLUSION: In support of our hypothesis, for each of the 6 statements, ≥94.44% (34/36) of the scores given by the students were considered exceptionally strong clinical support for our pedagogical strategy that combines educational resources and can be successfully implemented in other programmes.

Early Failure Rate and Associated Risk Factors for Dental Implants Placed With and Without Maxillary Sinus Augmentation: A Retrospective Study.

PURPOSE: Dental implant treatment is one of the most successful methods to replace lost teeth. However, several factors play a role in the early failure of implants, which could occur prior to the insertion of the restorative component. This study aimed to investigate the rate of early implant failure in the maxillary posterior area with and without sinus augmentation and other related risk factors. MATERIALS AND METHODS: Data were collected from the records of patients who received implant treatment in the posterior maxilla (premolars and molars). The information included whether the sinus was augmented or not, method of augmentation, sex, age, smoking, and medical history. In addition, length and diameter of the implant, whether the sinus membrane was perforated or not, implant sites, patients who received implants both with and without sinus augmentation, and manufacturers of the implants were also recorded. RESULTS: A total of 1,343 patients who received 2,323 implants were included with a failure rate equal to 4.4%. Logistic regression showed that failure rate was significantly associated with smoking (odds ratio [OR]: 7.843), diabetes (OR: 3.190), older age groups (OR: 1.027), and long implants (OR: 1.177). Failure rate significantly decreased with the lateral augmentation procedure (OR: 0.345). CONCLUSION: The results suggested that the lateral augmentation procedure was negatively associated with failure rate. Yet, old age, smoking, diabetes, and longer implants showed a positive association with the increased rate.

Retrospective assessment of survival rate for short endosseous dental implants.

PURPOSE: The aim of this study was to determine the survival rate of short implants that were placed in a residency program. In addition, the potential influence of diabetes, smoking, sinus grafting, guided bone regeneration, and implant type on survival was analyzed. METHODS: Through a retrospective chart review, patient information and parameters for short implants being equal or less than 10 mm and regular implants being more than 10 mm were collected. The cumulative survival rate and implant and patient information from 213 consecutively placed implants from May 2002 through October 2011 were analyzed. RESULTS: The average survival time for short implants was 47.3 months, with a range of 6 to 141 months. The implant survival rate was 95.77% for short implants, which was not statistically significant from the regular implants. Smoking had a statistically significant negative effect on the survival rate of short implants. No statistical differences were found with implant survival rates for other factors. CONCLUSION: It can be concluded that short implants can be predictably placed in the mouth with a high survival rate and that smoking has a negative influence on the survival rate of the short implants.

Abfractions and attachment loss in teeth with premature contacts in centric relation: clinical observations.

BACKGROUND: It has been suggested that eccentric occlusal forces may be an etiologic factor for abfraction lesions. It has also been suggested that traumatic occlusal forces may have a damaging effect on the periodontal tissues. The purpose of this study was to determine whether associations were present between premature contacts in centric relation (PCCR), clinical attachment loss, and abfraction lesions. METHODS: Forty-six subjects were examined. Within subjects, the mean attachment loss was determined for teeth with and without PCCR and for teeth with and without abfractions. In addition, teeth with PCCR (experimental group) were matched with contralateral teeth without PCCR (control group). Comparisons between groups were made with the Wilcoxon signed rank test, Wilcoxon rank sums test, and the Spearman rho correlation coefficient. RESULTS: The results demonstrated that attachment loss increased with age. Within subjects, teeth with abfraction lesions had significantly more buccal attachment loss than teeth without abfraction lesions (P <0.01). The majority of abfractions and PCCR occurred in premolars. The presence of PCCR had no influence on the appearance of an abfraction lesion or increased attachment loss. Similarly, subjects who exhibited abfractions had similar attachment loss as those subjects without abfraction lesions. CONCLUSIONS: Within the same patient, teeth with abfractions presented more attachment loss than those without abfractions. However, associations were not demonstrated between PCCR and the presence of abfractions or increased attachment loss. Future studies are needed to improve the knowledge regarding interactions among occlusal factors, attachment loss, and abfractions.