The outcome after surgical therapy of bisphosphonate-associated osteonecrosis of the jaw--results of a clinical case series with an average follow-up of 20 months.

OBJECTIVES: The present case series evaluates the success rate of osteotomy and primary wound closure in patients with bisphosphonate-associated osteonecrosis of the jaw (BRONJ). MATERIALS AND METHODS: Eighty patients suffering from BRONJ were included in the study. All patients received intravenous bisphosphonate therapy and underwent osteotomy and primary wound closure according to a standardised protocol. After discharge, the patients were reviewed on a regular basis over an average time period of 20 months. RESULTS: During follow-up in 11 patients, a recurrence of BRONJ occurred in the former operation field. Seventeen patients died due to their underlying disease. The success rate of osteotomy and primary wound closure in the treatment of BRONJ was calculated at 84.2 % 20 months after surgery. The results showed non-significant difference concerning the outcome of surgery in the different clinical stages of BRONJ. CONCLUSIONS: In accordance with previous studies, stage-independent osteotomy and primary wound closure combined with antibiotics shall be deemed a viable treatment option in patients suffering from BRONJ. CLINICAL RELEVANCE: With a high success rate, osteotomy in combination with primary wound closure seems to be a viable alternative to more conservative protocols in the treatment of BRONJ.

Acceptance of virtual dental implant planning software in an undergraduate curriculum: a pilot study.

BACKGROUND: Advances in healthcare such as virtual dental implant planning have the capacity to result in greater accuracy, speed, and efficiencies leading to improvement in patient care. It has been suggested that the acceptance of new technology is influenced by a variety of factors including individual differences, social and situational influences, user beliefs, and user attitudes. Despite the large volume of work in this area, only limited research has been conducted in the field of dental education. Therefore, the present study aimed at assessing the acceptance of virtual dental implant planning software by undergraduate students. METHODS: Forty-three third-year dental students of the University of Erlangen-Nuremberg, Germany, were included in the study. They filled in a questionnaire based on a combination of the technology acceptance model and the theory of planned behavior (C-TAM-TPB). Cronbach's α, Pearson product moment correlation coefficients, and squared multiple correlations (R2) were calculated. RESULTS: Cronbach's α exceeded .7 for all constructs. Pearson correlations were significant for the pairs perceived usefulness/behavioral intention, perceived usefulness/attitude, and attitude/behavioral intention. Perceived ease of use explained .09% of the variance of perceived usefulness (R2 = .09). Perceived ease of use and perceived usefulness accounted for 31% of the variance of attitude (R2 = .31). Perceived usefulness, attitude, subjective norm, and perceived behavioral control explain 37% of the variance of behavioral intention (R2 = .37). CONCLUSIONS: Virtual dental implant planning software seems to be accepted by dental students especially because of its usefulness and the students' attitude towards this technology. On the other hand, perceived ease of use does not play a major role. As a consequence, the implementation of virtual dental implant planning software in a dental undergraduate curriculum should be supported by highlighting the usefulness by the supervisors, who should also strengthen the attitude of the students towards this technology.

Spaced education activates students in a theoretical radiological science course: a pilot study.

BACKGROUND: The present study aimed at determining if the addition of spaced education to traditional face-to-face lectures increased the time students kept busy with the learning content of a theoretical radiological science course. METHODS: The study comprised two groups of 21 third-year dental students. The students were randomly assigned to a "traditional group" and a "spaced education group". Both groups followed a traditional face-to-face course. The intervention in the spaced education group was performed in way that these students received e-mails with a delay of 14 days to each face-to-face lecture. These e-mails contained multiple choice questions on the learning content of the lectures. The students returned their answers to the questions also by e-mail. On return they received an additional e-mail that included the correct answers and additional explanatory material.All students of both groups documented the time they worked on the learning content of the different lectures before a multiple choice exam was held after the completion of the course. All students of both groups completed the TRIL questionnaire (Trierer Inventar zur Lehrevaluation) for the evaluation of courses at university after the completion of the course. The results for the time invested in the learning content and the results of the questionnaire for the two groups were compared using the Mann-Whitney-U test. RESULTS: The spaced education group spent significantly more time (216.2 ± 123.9 min) on keeping busy with the learning content compared to the traditional group (58.4 ± 94.8 min, p < .0005). The spaced education group rated the didactics of the course significantly better than the traditional group (p = .034). The students of the spaced education group also felt that their needs were fulfilled significantly better compared to the traditional group as far as communication with the teacher was concerned (p = .022). CONCLUSIONS: Adding spaced education to a face-to-face theoretical radiological science course activates students in a way that they spend significantly more time on keeping busy with the learning content.

Acceptance of technology-enhanced learning for a theoretical radiological science course: a randomized controlled trial.

BACKGROUND: Technology-enhanced learning (TEL) gives a view to improved education. However, there is a need to clarify how TEL can be used effectively. The study compared students' attitudes and opinions towards a traditional face-to-face course on theoretical radiological science and a TEL course where students could combine face-to-face lectures and e-learning modules at their best convenience. METHODS: 42 third-year dental students were randomly assigned to the traditional face-to-face group and the TEL group. Both groups completed questionnaires before the beginning and after completion of the course on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning. After completion of the course both groups also filled in the validated German-language TRIL (Trierer Inventar zur Lehrevaluation) questionnaire for the evaluation of courses given at universities. RESULTS: Both groups had a positive attitude towards e-learning that did not change over time. The TEL group attended significantly less face-to-face lectures than the traditional group. However, both groups stated that face-to-face lectures were the basis for education in a theoretical radiological science course. The members of the TEL group rated e-mail reminders significantly more important when they filled in the questionnaire on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning for the second time after completion of the course. The members of the technology-enhanced learning group were significantly less confident in passing the exam compared to the members of the traditional group. However, examination results did not differ significantly for traditional and the TEL group. CONCLUSIONS: It seems that technology-enhanced learning in a theoretical radiological science course has the potential to reduce the need for face-to-face lectures. At the same time examination results are not impaired. However, technology-enhanced learning cannot completely replace traditional face-to-face lectures, because students indicate that they consider traditional teaching as the basis of their education.

Superficial skin sensitivity impairment and skeletal stability after sagittal split ramus osteotomy.

Adjustable osteosynthesis miniplates are used to facilitate positioning of the mandible after bilateral sagittal split osteotomy (BSSO) to avoid skeletal relapse and occlusal discrepancies. The short Obwegeser BSSO reduces neurosensory disturbances. Adjustable osteosynthesis plates suited for the Obwegeser BSSO are not commercially available. This study tested adjustable miniplates for the short Obwegeser BSSO in advancement of the mandible and correction of facial asymmetry, assessing (1) sensitivity impairment of the lower lip and (2) skeletal stability.A prototype of L-shaped, 6-hole, 2.0-mm miniplate with 2 sliding holes was used. Five patients with facial asymmetry (group 1) and 10 patients with mandibular hypoplasia (group 2) were operated on. Sensitivity of the lower lip was quantified using the pain and thermal sensitivity test before the surgery (T0), 1 week after the surgery (T1), and 12 months after the surgery (T2). The length of the ascending ramus (group 1) and the corpus (group 2) was determined at T1 and T2 using cone beam computed tomographic scans and lateral skull radiographs, respectively.After the surgery, occlusion was adequate. There was no need for revisional surgery. At T2, no patient showed a pathologically reduced sensitivity of the lower lip. The length of the ascending ramus in group 1 and the length of the corpus in group 2 did not have statistically significant changes between T1 and T2.The current study revealed that the adjustable osteosynthesis plates especially designed for the short Obwegeser BSSO can be safely used for the advancement of the mandible and the correction of facial asymmetry, with a minimum risk for neurosensory disturbance and a high skeletal stability.