Online Case-Sharing to Enhance Dental Students' Clinical Education: A Pilot Study.

Dental students' clinical learning is dictated by patients' needs. Thus, not all students have identical educational experiences. Even routine treatment can require different approaches depending on concurrent dental problems, patients' health status, or unexpected complications. No curriculum can expose students to all treatment alternatives when issues arise. Consequently, mechanisms to facilitate students' learning from the collective experiences of their classmates can augment their clinical acumen. The aim of this pilot study was to investigate a blended learning experience consisting of a website on which third- and fourth-year students posted and discussed PowerPoint presentations depicting patient treatment and weekly seminars in which students and faculty discussed posted cases to retrospectively assess treatment decisions. All 49 students in two of the school's general practice groups (23 fourth-year and 26 third-year students) in academic year 2011-12 participated, using a PowerPoint template to create cases to share with their peers. The students completed the Clinical Education Instructional Quality Inventory (Clin-EdIQ) before and after the case-sharing experience. The results showed statistically significant pre- to posttest increases on the four ClinEdIQ dimensions: overall clinical learning experience, specific learning opportunities, interaction among students and instructors, and collaborative learning. These students also reported that the online case-sharing and follow-up seminars were a valuable educational experience. However, students not involved in case-sharing had similar pre to post ClinEdIQ score changes. The results suggest that online case-sharing supported by case analysis seminars facilitated exchange of clinical insight among students and instructors, but may not have altered students' perceptions of the clinical learning environment.

Three years in vivo wear: core-ceramic, veneers, and enamel antagonists.

OBJECTIVES: Test the hypotheses that there are equivalent wear rates for enamel-versus-enamel and ceramic-versus-enamel, analyzing the in vivo wear of crown ceramics, their natural enamel antagonists, and the corresponding two contralateral teeth; and, that bite force does not correlate with the wear. METHODS: A controlled, clinical trial was conducted involving patients needing full coverage crowns opposing enamel antagonists. Bite forces were measured using a bilateral gnathodynamometer. Single-unit restorations of metal/ceramic (Argedent 62, Argen Corp/IPS d.SIGN veneer); or, core-ceramic/veneer from either, Empress2/Eris, or e.max Press core/e.max Ceram glaze (ceramics: Ivoclar Vivadent, USA) were randomly assigned, fabricated and cemented. Impressions were made of the ceramic crowns, as well as each maxillary and mandibular quadrant at one week (baseline) and one, two and three years. Resulting models were scanned (3D laser scanner). Maximum wear was calculated by superimposing baseline with annual images. RESULTS: There were a total of thirty-six crowns required for thirty-one patients. Each restoration had three associated enamel teeth: crown, (1) antagonist, (2) contralateral and (3) contralateral-antagonist. SAS PROC MIXED (α=0.05) indicated no statistical significance for mean maximum wear among crown ceramics, enamel antagonists and contralaterals. However, enamel wear was statistically significant in relation to intraoral location (p=0.04) and among years (p<0.02). Analyzed alone, the enamel contralateral-antagonist exhibited significantly greater wear (p<0.001). Considering all wear sites, there was no correlation with bite force (p=0.15). SIGNIFICANCE: The ceramics and their antagonists exhibited in vivo wear rates within the range of normal enamel. Future studies should examine the wear implications of the contralateral-antagonist enamel.

Antifungal susceptibility testing of micafungin against Candida glabrata isolates.

OBJECTIVE: Antifungal susceptibility of micafungin against isolates of C. glabrata was performed to evaluate the hypothesis that micafungin may be a suitable alternative in treating those patients whose infections are from C. glabrata and have developed resistance to fluconazole. STUDY DESIGN: A total of 119 clinical isolates were obtained from the oral cavity of 22 patients with oropharyngeal candidiasis or oral colonization with C. glabrata. All strains evaluated were from patients who had either HIV infection or were receiving radiation therapy for head and neck cancer. Inocula were prepared using Clinical Laboratory and Standards Institute (CLSI) M27-A2 guidelines. The plates were incubated at 35 degrees C and the minimum inhibitory concentrations (MICs) were determined at 24 and 48 hours. RESULTS: Micafungin exhibited good in vitro activity against most isolates, including those showing marked resistance to fluconazole. CONCLUSION: Micafungin has excellent antifungal effects in vitro against C. glabrata isolates and appears to be a good treatment option even against those isolates resistant to fluconazole. A clinical trial should be performed to confirm these findings.