Self-reported preparedness of final year undergraduate dental students and interns in Saudi Arabia: a multi-institutional study.

BACKGROUND: Contemporary undergraduate dental education aims to equip the dental students with clinical competence, empathy, and professionalism to enable them to deliver safe and effective dental care to the communities. The purpose of this study was to assess the self-reported preparedness of final year dental students and interns at three Saudi dental institutions, using the pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS). METHODS: A cross-sectional study design was employed to assess the self-reported preparedness of the participants using the DU-PAS. Following ethics approval, a probability sampling technique was used to recruit undergraduate dental students and interns from three dental institutions in Saudi Arabia. The data was collected online on Google Forms and all participants provided their consent to participate in the study prior to providing their responses to DU-PAS. RESULTS: Responses were received from 397 participants including 171 males and 226 females yielding a response rate of 60.3%. The total mean score of the participants was 81.85 ± 13.11. Although higher scores were reported in males, the interaction between gender and DU-PAS scores were not significant. Interaction between DU-PAS scores and stage of education showed significant effect of the stage of education with interns reporting higher overall scores. The participants reported that they were able to perform most clinical procedures independently. However, low confidence was reported in performing multi-rooted endodontics, fabrication of removable dentures and orthodontic assessment. The participants also expressed their confidence in a wide range of behavioural attributes related to communication, teamworking and professionalism. However, lack of experience was noted in referral for oral cancer, interpreting research, and evaluation of new dental products using an evidence-based approach. CONCLUSION: The study provides useful insights into the self-reported preparedness of undergraduate dental students and interns in three dental institutions. While the overall preparedness of the participants was comparable to their international peers, the findings underscore the need for further enhancements to the teaching and training of undergraduate students particularly in multirooted endodontics, removable prosthodontics and orthodontics.

Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students.

INTRODUCTION: COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic. MATERIALS AND METHODS: A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed. RESULTS: The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators. CONCLUSION: The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered.

Retratamientos endodónticos: una realidad que preocupa / Endodontic retreatment: a worrying reality

Las evaluaciones radiográficas de tratamientos endodón- ticos realizadas por graduados muestran un alto porcentaje de procedimientos incorrectos. Esta circunstancia lleva a la rea- lización de un elevado número de retratamientos ortógrados y retrógrados, con los inconvenientes y desventajas que conlle- va recurrir a una reintervención endodóntica. Es responsabili- dad de los profesionales, docentes y autoridades universitarias y gubernamentales revertir esta situación que afecta a la salud bucal de la sociedad. En el presente editorial se proponen di- ferentes alternativas para intentar modificar este preocupante panorama (AU)

Radiographic evaluations of endodontic treatments per- formed by graduates show a high percentage of incorrect procedures. This circumstance leads to the performance of a high number of orthograde and retrograde retreatments, with the inconveniences and disadvantages that entails resorting to an endodontic reintervention. It is the responsibility of pro- fessionals, teachers, university and government authorities to reverse this situation that affects the oral health of society. In this editorial, different alternatives are proposed to try to modify this worrying outlook (AU)

Clinical decision-making in complex endodontic cases between postgraduate students across dental specialties at a UK dental school: A pilot study.

INTRODUCTION: Treatment decisions for a heavily restored endodontically treated tooth vary amongst clinicians owing to multitude of factors. This phenomenon not only often poses dilemmas to clinicians of different clinical backgrounds, but also exerts a degree of treatment difficulty to the treating clinician. Previous studies indicated that specialty training and clinical experience significantly impacted clinical decision-making process. MATERIALS AND METHODS: Master of Science postgraduate students in endodontics, prosthodontics, periodontics, oral surgery and implantology participated in a questionnaire-based cross-sectional study. The dental specialties were further categorised into restorative and surgical dentistry. A multiple-choice questionnaire with three clinical cases was distributed to the students. Data were analysed for trends using descriptive statistics. RESULTS: There was a 44% response rate; the majority of respondents were from restorative dentistry specialties. Cases 1 and 2 were rated as moderate to high difficulty, and Case 3 was predominantly rated as high difficulty with procedure predictability being the main factor affecting their clinical decision-making in three cases. Endodontic retreatment was selected as the preferred treatment in Cases 1 and 2 and periradicular surgery in Case 3. The students were fairly confident in managing Cases 1 and 2, but not in Case 3. Referral patterns were consistent in Cases 1 and 2 with endodontists being the first choice of referral except for Case 3 where 48% preferred to refer to oral surgeons and 35% choosing endodontists. Some indication of differences between specialties were noted throughout. Years in practice appeared to be related to the importance of predictability in Case 3 only. CONCLUSION: Considerable inter-clinician variability was noted whereby specialty postgraduate training impacted on clinical decision-making. Overall, procedural predictability, technical difficulty, risk of damage to the tooth and patient preference were the most highly ranked factors affecting clinical decision-making. Evidence-based treatment guidelines and dental curricula should be reviewed to enhance inter-clinician agreement in clinical decision-making, ultimately improving patient care.

Evaluación del éxito de tratamientos endodónticos realizados por estudiantes de pregrado en una universidad chilena / Evaluation of success rate of root canal treatment performed by undergraduate dental students in a Chilean university

El tratamiento endodóntico tiene como finalidad prevenir o lograr la ausencia de periodontitis apical post-tratamiento, logrando la mantención del diente en la boca de manera funcional. La realización de tratamientos endodónticos de baja complejidad en la formación de pregrado es transversal a todas las universidades chilenas. El objetivo del presente estudio es evaluar la frecuencia de éxito de tratamientos endodónticos realizados por estudiantes de pregrado entre los años 2014-2017 de la Escuela de Odontología, Universidad Austral de Chile (UACh), Valdivia, Chile. Se realizó un estudio observacional descriptivo donde fueron evaluados 74 tratamientos endodónticos en dientes uniradiculares de 63 pacientes seleccionados a través de un muestreo aleatorio simple, que cumplieran con los criterios de selección. Los parámetros usados para la evaluación clínica fueron: ausencia de dolor a la palpación y percusión, ausencia de fístula y diente en función. En la evaluación radiográfica se utilizaron los siguientes parámetros: longitud de obturación en relación al ápice dentario, conicidad, densidad del material obturador y reducción de la lesión periapical. De los tratamientos evaluados se reportó un 78 % de éxito clínico y un 41 % de éxito radiográfico. Finalmente, se concluye que los resultados obtenidos a nivel clínico y radiográfico son similares a los reportados en la literatura.

The objective of endodontic treatment is to prevent or achieve the absence of post-treatment apical periodontitis, thereby maintaining functionality of the tooth in the mouth. In Chilean universities undergraduate programs, training in endodontics is limited to low level complexity cases and is transversal throughout the universities. The objective of this study is to evaluate the frequency of success of endodontic treatments performed by undergraduate students between the years 2014-2017 of the School of Dentistry, Universidad Austral de Chile (UACh), Valdivia, Chile. A descriptive observational study was conducted where 74 endodontic treatments were evaluated in uniradicular teeth of 63 patients, selected through a simple random sampling, that met selection criteria. The criteria used for the clinical evaluation were: absence of pain on palpation and percussion, absence of fistula and function tooth. In the radiographic evaluation the following criteria were used: length of obturation in relation to the dental apex, taper, density of the obturator material and reduction of the periapical lesion. Of the treatments evaluated, 78 % clinical success and 41 % radiographic success were reported. Finally, it is concluded that the results obtained at clinical and radiographic level are similar to those reported in the literature.

The value of assessing case difficulty and its effect on endodontic iatrogenic errors: a retrospective cross-sectional study.

The American Association of Endodontists (AAE) released a case difficulty assessment form to help general dentists and students treat cases within their expertise or refer advanced cases to reduce the risk of iatrogenic errors. The purpose of this study was to determine the incidence of iatrogenic complications after the use of the case difficulty assessment form. Arandom sample of 1000 cases that received root canal treatment in undergraduate clinics during the academicyear (2016-2017) was selected. Case difficulty assessment was made for each case before treatment onset. Once the case was approved for treatment in the undergraduate clinics, the endodontic treatments were performed following the standard procedure the endodontic department of the Dentistry School of King Abdulaziz University mandates. Digital radiographs were obtained during routine root canal treatment and were evaluated by four observers to detect any iatrogenic errors, after which the data were analyzed statistically. Iatrogenic errors were correlated significantly with case difficulty (p= 0.003), and were detected in 22.1% of all teeth treated in the undergraduate clinics. Underfilling accounted for the highestpercent of errors detected (8.4%), followed by ledge formation (4.2%). Molar teeth had the highest frequency of errors, and mesio-buccal roots of maxillary molars showed the highest percentage of errors. The AAE developed asignificantly useful tool to determine the difficulty of each case treated in undergraduate clinics, and following their recommendations will minimize the risk of iatrogenic errors.

Avaliação de dentes monorradiculares artificiais utilizados para treinamento endodôntico / Evaluation of artificial monoradicular teeth used for endodontic training

Introdução: É desafio do ensino pré-clínico em Endodontia fornecer aos alunos dentes artificiais que reproduzam a morfologia dos dentes humanos. Objetivo: Comparar a morfologia interna e externa de dentes artificiais monorradiculares com dados da literatura sobre dentes humanos. Material e método: Os dentes artificiais foram doados pelos fabricantes: Fábrica de Sorrisos, empresa A, (n=20), e IM do Brasil Ltda., empresa B, (n=20). Foi realizada mensuração do comprimento total do dente e da raiz, da altura, das dimensões vestibulopalatina e mesiodistal da coroa, com paquímetro digital. A descrição morfológica das raízes, coroas e câmaras pulpares foi realizada. A localização topográfica do forame apical principal foi avaliada após exploração dos canais com instrumento endodôntico tipo K #15 até este atingir visualmente o ápice radicular. Os dados foram dispostos em uma planilha de cálculo e realizou-se a análise estatística [ANOVA e pós-teste de Tukey (α=5%)]. Resultado: A amostra de caninos superiores da empresa B apresentou todas as variáveis dentro dos padrões morfométricos descritos na literatura. Em relação às morfologias interna e externa, a amostra de incisivos laterais superiores da empresa A foi a única a apresentar todas as variáveis dentro dos padrões descritos na literatura. Em relação à localização topográfica foraminal, os dentes da empresa A, assim como o canino inferior da empresa B, apresentaram tendência à posição distalizada e centralizada, vindo ao encontro da literatura. Conclusão: Nenhum dente artificial estudado apresentou total similaridade morfológica e morfométrica com a literatura analisada, diferindo em pelo menos uma das variáveis, sendo indicada aos fabricantes uma revisão dos seus modelos.

Introduction: It is a challenge of pre-clinical teaching in Endodontics to provide students with artificial teeth that reproduce the internal and external morphology of human teeth. Objective: To compare the internal and external morphology of single-rooted artificial teeth with data from the literature on human teeth. Material and method: The artificial teeth were donated from two companies: Fábrica de Sorrisos, company A, (n=20) and IM do Brasil Ltda, company B (n=20). Measurement of total tooth length, root, height, buccal-palatal and mesio-distal crown dimensions with digital caliper was performed. The morphological description of the roots, crown and pulp chamber was performed, the last one only after access. The topographic location of the main apical foramen was evaluated after canal exploration with a K #15 endodontic instrument until it visually reached the root apex. The data were arranged in a spreadsheet and statistical analysis was performed (ANOVA, followed by the Tukey post-test (α=5%)). Result: Regarding the morphometric parameters, the upper canine sample from company B presented all variables within the standards described in the literature. Regarding internal and external morphology, the sample of upper lateral incisors from Company A was the only one to present all variables within the standards described in the literature. Regarding the foraminal topographic location, the teeth of Company A, as well as the lower canine of company B, showed a tendency to the distalized and centralized position, in line with the literature. Conclusion: none of the artificial teeth studied showed total morphological and morphometric similarity with the control, differing in at least one of the variables, and a review of their models is indicated to the manufacturers.

Implant education patterns and clinical practice of general dentists in Australia.

BACKGROUND: This study aimed to understand trends in dentists' implant training attendance and correlation to treatment provision. Implant-specific oral hygiene instruction coverage in training programs was investigated. METHODS: A cross-sectional web-survey of dentists registered in Australia was conducted. Respondents were asked about their background, implant training history and treatment provision. Results were analysed by implant provision characteristics and graduation decade. RESULTS: Three hundred and three responses from general dental practitioners (GDPs) were received and analysed. The highest implant training levels attained post-graduation were postgraduate non-specialist qualification (7.9% of respondents), continuing professional development (CPD) (73.6%) versus none (18.5%), with differences between implant providers and non-providers (P < 0.001), different graduation decades (P < 0.001) and those restoring implants or performing surgery as well (P < 0.001). University-based CPD was attended less than dental association/society or implant company CPD. Non-providers were significantly less likely to recall implant oral hygiene instruction sources (P < 0.001). Most GDPs (74.9%) provided implant services, with younger GDPs beginning earlier after graduation. About 16% of respondents did not provide implants once established career-wise. CONCLUSIONS: Dentists might be providing implant treatments increasingly earlier in their careers. Respondents with more training were significantly more likely to perform more complex procedures, while implant training attendance trends varied by graduation decade.

Defining Endodontic Residents' Clinical Experiences: A National Survey.

Endodontic residency programs across the U.S. vary in the exposure they provide to residents in procedures, protocols, and equipment. Having information on the range of clinical experiences provided in programs would be useful for program directors and for applicants who are seeking the best fit for their residency. The aim of this study was to collect information from residents in U.S. endodontic residency programs about the procedures and equipment they experienced in their programs. In January 2018, a 14-question survey was emailed to all 437 endodontic residents with an email address in the 2016-17 American Association of Endodontists Membership Directory. Survey items asked about the number of endodontic procedures, techniques employed, and products used in residents' programs. A total of 133 endodontic residents responded to all or part of the survey, for a 30% response rate. The majority reported completing 151-250 nonsurgical root canals, 26-50 nonsurgical retreatments, 0-10 surgical retreatments, and 0-10 regenerative endodontic procedures during their residencies. All respondents said they used a surgical operating microscope (SOM), and 82% reported using a multi-file rotary system for nonsurgical procedures. Respondents reported that the main instruments they used were Dentsply Sirona file systems, and the most commonly used obturation technique was warm vertical compaction/condensation, reported by 92% of respondents. These endodontic residents reported being exposed to a variety of procedures, products, and protocols during their residency. Based on information they provided, prospective endodontic residency applicants can expect to use the SOM for treatment, to gain extensive experience in primary nonsurgical endodontic treatment, and to not perform endodontic surgery during their first year of postgraduate training.

Impact of Case Difficulty on Endodontic Mishaps in an Undergraduate Student Clinic.

INTRODUCTION: The aim of this study was to identify the effect of case difficulty on the number of endodontic mishaps and the number of treatment visits using 2 different instrumentation methods, hand files, and reciprocating engine-driven WaveOne files (Dentsply Maillefer, Ballaigues, Switzerland) in an undergraduate student clinic. METHODS: Endodontic treatment performed by fourth-year dental students using 2 different instrumentation methods was evaluated: hand files and reciprocating engine-driven WaveOne files. All cases were categorized according to the American Association of Endodontists case difficulty assessment form. Endodontic mishaps related to instrumentation and treatment visits needed to complete the treatment were recorded. RESULTS: Of the 257 teeth included in the study, 141 were instrumented with hand files and 116 with WaveOne files. Eighty-two teeth (31.9%) were registered with at least 1 endodontic mishap. The most frequent endodontic mishap was overinstrumentation (17.5%). This was followed by loss of working length (8.56%), obturation more than 2 mm from the radiographic apex (8.56%), overfill with gutta-percha (6.61%), canal transportation (4.28%), instrument separation (2.33%), and lateral or strip perforation (1.56%). Several endodontic mishaps were significantly correlated. Cases in the high difficulty category had significantly more endodontic mishaps (P < .001) and required more treatment visits (P < .01). There were no significant differences in endodontic mishaps or the number of treatment visits between the hand and engine-driven groups. Several endodontic mishaps were associated with significantly more treatment visits (P < .05). CONCLUSIONS: Case difficulty rather than the instrumentation method was the main determinant of endodontic mishaps in the undergraduate clinic. The American Association of Endodontists case difficulty assessment form is an important and valuable tool in undergraduate dental education to predict potential endodontic mishaps and the number of treatment visits.

Automated outcome scoring in a virtual reality simulator for endodontic surgery.

BACKGROUND AND OBJECTIVE: We address the problem of automated outcome assessment in a virtual reality (VR) simulator for endodontic surgery. Outcome assessment is an essential component of any system that provides formative feedback, which requires assessing the outcome, relating it to the procedure, and communicating in a language natural to dental students. This study takes a first step toward automated generation of such comprehensive feedback. METHODS: Virtual reference templates are computed based on tooth anatomy and the outcome is assessed with a 3D score cube volume which consists of voxel-level non-linear weighted scores based on the templates. The detailed scores are transformed into standard scoring language used by dental schools. The system was evaluated on fifteen outcome samples that contained optimal results and those with errors including perforation of the walls, floor, and both, as well as various combinations of major and minor over and under drilling errors. Five endodontists who had professional training and varying levels of experiences in root canal treatment participated as raters in the experiment. RESULTS: Results from evaluation of our system with expert endodontists show a high degree of agreement with expert scores (information based measure of disagreement 0.04-0.21). At the same time they show some disagreement among human expert scores, reflecting the subjective nature of human outcome scoring. The discriminatory power of the AOS scores analyzed with three grade tiers (A, B, C) using the area under the receiver operating characteristic curve (AUC). The AUC values are generally highest for the {AB: C} cutoff which is cutoff at the boundary between clinically acceptable (B) and clinically unacceptable (C) grades. CONCLUSIONS: The objective consistency of computed scores and high degree of agreement with experts make the proposed system a promising addition to existing VR simulators. The translation of detailed level scores into terminology commonly used in dental surgery supports natural communication with students and instructors. With the reference virtual templates created automatically, the approach is robust and is applicable in scoring the outcome of any dental surgery procedure involving the act of drilling.

Una experiencia con estudiantes de pregrado en el uso de la instrumentación mecanizada en conductos curvos simulados de Endo Training Blocks / An experience with undergraduate students in the use of mechanical instrumentation of simulated curved canals in Endo Training Blocks

Objetivo: analizar la habilidad técnica de estudiantes de pregrado en el uso de instrumentación mecanizada con ProTaper Next y WaveOne Gold, en conductos curvos simulados de Endo Training Blocks. Materiales y métodos: se utilizaron 60 Endo Training Blocks con conductos simulados curvos, instrumentados con ProTaper Next y WaveOne Gold, por tres estudiantes de pregrado de la Escuela de Odontología de USAL/AOA. El cateterismo de los conductos se realizó con una lima tipo K #10 hasta la longitud de trabajo fijada a 16 mm y se permeabilizaron con limas Proglider hasta la citada medida. A continuación, se instrumentaron 30 bloques con ProTaper Next X1 y X2 y 30 bloques con WaveOne Gold Primary. Finalizada la preparación, los conductos simulados fueron observados en un microscopio óptico a 5X. El análisis de la calidad de la conformación obtenida lo realizó un especialista en endodoncia, comparando un conducto simulado no instrumentado y los preparados por los estudiantes con los sistemas mencionados. Se consideró la siguiente categorización: adecuada, preparación cónica que respetada la anatomía original del conducto simulado y alcanzaba la longitud de trabajo; inadecuada, conformación que no alcanzaba la longitud de trabajo o presentaba transportación del conducto simulado. Los datos obtenidos fueron volcados en una planilla ad hoc. Resultados: en 59 de los 60 bloques, los conductos simulados instrumentados por los estudiantes con ambos sistemas mecanizados, mostraron una conformación adecuada, sin alteraciones de la morfología original. Conclusiones: considerando las limitaciones de este estudio, el uso de los sistemas mecanizados ProTaper Next y WaveOne Gold, sería una opción válida para el empleo de la instrumentación mecanizada por alumnos de pregrado de endodoncia.

Modelo teórico de la endodoncia actual / Theoretical model of the current endodontics

Para comprender en profundidad cada una de las técnicas endodónticas de aplicación clínica, propuestas en la actualidad por los autores de diferentesescuelas de endodoncia, debemos previamente conocer el modelo teórico o paradigma preconizado por cada una de ellas. Ello nos permitirá discernir yseleccionar la más adecuada a las necesidades clínicas de nuestros pacientes, dirigiendo la investigacióny desarrollo de nuevas propuestas en el marco de determinado paradigma. La ciencia es multidisciplinaria y generadora de diferentes modelos teóricos aplicables en la endodoncia. Un modelo esencialmente técnico-quirúrgico busca el éxito apoyado enla limpieza, conformación y obturación tridimensional de los conductos radiculares. Eso es necesario pero no suficiente; por cuya razón, Maisto dio un salto cualitativo preconizando un nuevo paradigma endodóntico basado en la reparación apical. Este nuevo modelo teórico nos permite la formulación de nuevas conductas terapéuticas, desarrollar nuevosmateriales y proponer técnicas de instrumentación y obturación que engloben tanto al conducto radicular,como a su zona de influencia en el sistema de inserción dental y el hueso alveolar que lo rodea.

To understand in depth each of the endodontic techniques of clinical application, currently proposed by the authors of different schools of endodontics,we must first know the theoretical model orparadigm advocated by each of them.This will allow us to discern and select the mostappropriate of the clinical needs for our patients, directing research and developmentof new proposals within the framework of agiven paradigm. The science is multidisciplinary and generates different theoretical modelsapplicable to endodontics. An essentially technical-surgical model seekssuccess based on cleaning, shaping and three-dimensional obturation of the rootcanals. That is necessary but not enough, which leadMaisto to make a qualitative leap by advocating anew endodontic paradigm based on apical repair.This new theoretical model allows us to formulate new therapeutic behaviors, develop new materials and propose techniques of instrumentation and obturation that concerns both the root canal and its area of influence in the dental insertion system and the surrounding alveolar bone.

Evaluación de un modelo de capacitación preclínica en el uso de los localizadores electrónicos del foramen, por alumnos de grado de endodoncia / Evaluation of a preclinical training model of undergraduatestudents in the use of electronic foramen locatorsin endodontics

Objetivo: evaluar la capacitación y los resultados del uso de localizadores del foramen en un curso preclínico destinado a alumnos de grado de la Escuela de Odontología de la Universidad del Salvador / AsociaciónOdontológica Argentina, entre 2005 y 2016. Materiales y métodos: Se emplearon 2053 incisivos, caninos y premolares inferiores y superiores humanos extraídos. Los dientes se montaron de modo tal que sus raí-ces quedasen sumergidas en una solución salina, utilizando dos métodos: a) tubos de plástico, b) modelos que simulan la arcada dentaria. Se realizaron los accesos coronarios al conducto radicular de forma convencional y se prepararonlos tercios cervical y medio. Para determinar la longitud de trabajo, se introdujo una lima tipo K de calibre acorde con el conducto radicular, ajustando en ella el terminal del localizador electrónico del foramen. El terminal labial se sumergió en la misma solución salina en que se encontraban las raíces dentarias. En la mayoría de los dientes se empleó, parala determinación, la técnica de ingreso, y en los restantes, la de regreso. El nivel de penetración se estableció con la señal lumínica y/o sonora de 0,5. Se ajustó el tope del instrumento al borde de referencia y se obtuvo una imagen radiográfica periapical del diente evaluado. Se retiró el instrumento del conducto radicular y se midió desde su punta hasta el tope respectivo. Las medidas obtenidas con los localizadores electrónicos del foramen se compararon con las conductometrías radiográficas, considerando una tolerancia de 0,5 mm. Para la evaluación estadística, se tomó en cuenta el cálculo de intervalo deconfianza (95 por ciento) realizado a partir de la distribución binomial.Resultados: De los 2053 dientes en los cuales se determinó la longitud de trabajo, 1743 (84,9 por ciento) fueron consideradas medidas correctas, y 310 (15,1 por ciento), incorrectas...

Aim: To assess the training process and results of the useof electronic apex locators in an Aim: To assess the training process and results of the useof electronic apex locators in an undergraduate preclinicalcourse for students from the University del Salvador / AsociaciónOdontológica Argentina between 2005 and 2016.Materials and methods: Two thousand fifty threeextracted human incisors, canines, maxillary and mandibularbicuspid teeth were used. The teeth were mounted withthe roots submerged in saline solution using two methods: a) plastic tubes, b) models simulating the dental arch. Conventionalcoronal access to the root canal was performedand the cervical and middle portions of the root canal wereflared. To determine the working length a K-file with a caliberaccording to the root canal was selected for each tooth andintroduced in the root canal with the clip adjusted in the file.The labial clip was immersed in the model saline solution. Inthe majority of the teeth the advanced and withdrawal techniquewas employed. The level of penetration was establishedusing the light and/or the acoustic signal at 0.5. Then, the rubberstop was adjusted to the reference line and a radiographwas obtained. The instrument was removed and measuredfrom its tip to the rubber stop. The measurements obtainedwith the electronic apex locators were compared with thoseobtained from the X rays considering a tolerance of 0.5 mm.For the statistical evaluation, 95% confidence intervals werecalculated using the binomial distribution.Results: Out of 2053 teeth in which the working lengthwas determined, 1743 (84.9%) were considered correct measurementsand 310 (15.1%) incorrects...

Una experiencia preclínica de enseñanza y aprendizaje en una carrera de especialización en endodoncia / A pre-clinical teaching and learning experiencein a specialization program in endodontics

Objetivo: desarrollar una estrategia para la enseñanza yel aprendizaje, que pueda derivar en una nueva metodología deevaluación individual y grupal de los procedimientos pre clínicosen la Carrera de Especialización en Endodoncia de la Universidad del Salvador / Asociación Odontológica Argentina. Materiales y métodos: Se llevaron a cabo dos experiencias pre clínicas donde cada alumno realizó un tratamiento endodóntico en dientes humanos unir radiculares extraídos, alinicio del curso preclínico –con los saberes y las destrezas previos–y al finalizar. Se consignaron y evaluaron 19 errores procedimentales.Los datos fueron analizados mediante la pruebano paramétrica del signo de Wilcoxon, con un valor de p≤0,05. Resultados: En la primera experiencia se constataron 63errores procedimentales, y en la segunda, 14. Entre la valoracióninicial y la final se hallaron diferencias significativasen las variables procesamiento radiográfico (α=0,014), apertura cameral exagerada (α=0,0013), alteración dela anatomía (α=0,05), pérdida de la longitud de trabajo(α=0,007), falta de adaptación del cono principal(α=0,008), y falta de compactación lateral (α=0,008).En el resto de las variables analizadas no se encontraron diferencias significativas. El índice de la mejoríaindividual fue del 50 al 100%, y el grupal, del 78,7%. Conclusiones: De acuerdo con los resultados obtenidosen esta experiencia, podría considerarse que la propuestapedagógica resultó válida para los objetivos planteados.

Aim: to develop a strategy for teaching and learning, which may lead to a new methodology for individual and group evaluation of pre clinical procedures in the Specialization Course in Endodontics of the Universidad del Salvador /Asociación Odontológica Argentina. Materials and methods: Two preclinical experiments were carried out where each student performed an endodontic treatment in single-rooted extracted human teeth, at the beginningand after finishing the preclinical course with his/herprevious knowledge and skills. Nineteen different proceduralerrors were recorded and evaluated. Wilcoxon’s sign test wasused to compare before and after results setting significanceat p≤0,05. Results: In the initial experiment 63 procedural errors were found and in the second, 14. Between the initial and final evaluations, significant differences were found in thevariables radiographic processing (α=0.014), exaggerated chamber opening (α=0.0013), anatomic form modification(α=0.05), loss of working length (α=0.007), lack of adaptation of the main cone (α=0.008), and lack of lateralcompaction (α=0.008). In the other variables that were evaluated, no significant differences were found. The rateof individual improvement was 50 to 100%, and the group of 78.7%. Conclusions: According to the results obtained in this experience, the pedagogical proposal can be considered to bevalid to reach educational goals.

Nueva herramienta móvil aplicada a la enseñanza universitaria / A new mobile application for undergraduate teaching

El objetivo del presente trabajo es describir y analizar una nueva herramienta de enseñanza creada e implementada en la Cátedra de Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires. Esta consiste en una aplicación para teléfonos móviles mediante la cual alumnos y docentes acceden a diferentes niveles de comunicación e información sobre los contenidos de la asignatura. Se evaluó, por medio de encuestas, el impacto en docentes y alumnos de la inclusión de esta herramienta tecnológica. Los resultados de dichas encuestas permiten concluir que nos encontramos frente a un nuevo instrumento que puede enriquecer y profundizar las propuestas de enseñanza tradicionales.

Comparing Integrated and Disciplinary Clinical Training Patterns for Dental Interns: Advantages, Disadvantages, and Effect on Students' Self-Confidence.

In China, the five-year program of undergraduate education for stomatology consists of four years of lecture courses and one year of internship focused on clinical training. Dental schools provide this clinical training either in their own clinics (referred to as the one-stage pattern because all forms of practice are completed together) or by placing students in external clinics usually at non-affiliated hospitals (referred to as the three-stage program because the three primary areas are taught separately). The aims of this study were to investigate differences in teaching effect between the one-stage and the three-stage patterns and to evaluate advantages and disadvantages of the two patterns. A three-section, 31-item questionnaire was designed to assess basic and clinic information about the interns' training and their self-confidence in performing clinical procedures. The survey was administered to graduates who finished the fifth-year internship in 2012-14. Of the 356 individuals invited to participate, 303 graduates who spent their intern years in 43 academic dental institutions returned completed surveys (response rate of 85%). The one-stage group (n=121) reported longer independent operation time than the three-stage group (n=182) (p<0.01). No significant difference was found between the groups for assessment of clinic infrastructure (p=0.121). The interns were most confident in oral hygiene instruction and scale and polish (overall median=5), but showed low confidence in rubber dam placement and four other procedures (overall median=2). The one-stage group rated their confidence level higher than the three-stage group on comprehensive skills such as arranging appointments and managing patients and procedures needing long treatment periods such as molar endodontics. The three-stage group showed higher confidence on more specialized procedures such as surgical extractions and suturing. This study found that both of the two intern patterns had advantages and shortcomings in clinical training in various procedures. Combining the two could be a way to improve clinical education in China.

Meeting Patient and Professional Needs: Views of Stakeholders on a Training Initiative for DwSIs in Endodontics in London.

BACKGROUND AND AIMS: A pilot scheme was established across London to train NHS primary dental care practitioners to provide endodontic treatment of moderate difficulty. It was co-led by the former London Deanery (Health Education England: North West London) and local NHS commissioners. This research aimed to explore key stakeholders' perceptions about the purpose of the initiative, its advantages, disadvantages and future implications. METHODS: Nineteen semi-structured interviews were conducted with stakeholders (commissioners and providers of the educational initiative; commissioners and providers of care, including trainees, principal dentists and specialists) involved in establishing, running and participating in the initiative and wider endodontic service provision in London. Interviews were based on a topic guide informed by the literature, and a workshop involving the London trainees. Interviews were recorded, transcribed and analysed using framework methodology. RESULTS: The project was perceived as supporting four key areas: addressing services, improving quality/outcomes, delivering education and enhancing professional status. There was evidence that dentists were harnessing health policy in facilitating 'reprofessionalisation' of dentistry with the creation of dentists with enhanced skills (DwSIs). Learning outcomes from the pilot were related to the accreditation of the participants, service tariffs, reimbursement for endodontic treatment on the NHS, and the need for continuity within and between services across the dental system. Uncertainty about funding and the changes within the NHS were among the concerns expressed regarding the future of the initiative. CONCLUSION: The findings of this research suggest that extending the skills of primary care practitioners may contribute to the reprofessionalisation of dentistry, which has much to contribute to patient care and the development of an integrated and accessible dental care system of quality, with improved outcomes for patients. The implications for health policy and further research are discussed.

La enseñanza y el aprendizaje de la endodoncia en el grado: nuestra experiencia docente / Teaching and learning endodontics in undergraduate education: our experience

El objetivo del presente trabajo es describir el estándar de la enseñanza impartida en las Cátedras de Endodoncia I y II de la Escuela de Odontología de la Universidad del Salvador / Asociación Odontológica Argentina, comparándola con el de otras escuelas dentales del ámbito internacional. Asimismo, se señala la implementación, en el ciclo de grado, de las diferentes tecnologías relacionadas con el uso de localizadores apicales, instrumentación mecanizada y técnicas de reblandecimiento de gutapercha...

Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.