Student perception and assessment outcomes using a pilot condensed format ("boot camp") in a Fixed Prosthodontics course.

INTRODUCTION: The purpose of this study was to assess student perception as well as course outcomes (final written examination grades) when using a pilot condensed format in an undergraduate Fixed Prosthodontics course, which was implemented as a response to the global pandemic of Covid-19. MATERIALS AND METHODS: The course was delivered in a condensed format, with a total of 28 direct contact hours in the Simulation Clinic within a 4 day period. Asynchronous remote learning was employed for the didactic portion of the course. Students completed surveys before and after the course, to assess their perception of the condensed format, and written examination grades were compared with previous years' grades. Data were entered in an Excel database (Microsoft Excel 2016) and analysed using a statistical analysis software program (IBM SPSS Statistics, v26; IBM Corp). The level of significance was set to α = 0.05. RESULTS: Overall, student perception of the condensed format was positive. At the beginning of the course, female students had less confidence in their skills compared to male students (p < .05). Written examination grades were significantly lower compared to previous years' grades (p = .04). CONCLUSION: The use of a condensed format can allow a course to be delivered in smaller student cohorts and provides the ability to reduce the total number of direct contact hours allotted to the course, creating space within the curriculum. Student perception of this format was generally positive. However, written examination scores were negatively impacted, indicating possible knowledge gaps resulting from the condensed course format. More studies are needed to assess the effect of the various curricular modifications that have been implemented due to the Covid-19 pandemic.

Interproximal contact loss between implant-supported restorations and adjacent natural teeth: A retrospective cross-sectional study of 83 restorations with an up to 10-year follow-up.

STATEMENT OF PROBLEM: Interproximal contact loss between implant-supported restorations and adjacent natural teeth is a frequently encountered complication that could negatively affect surrounding tissues and/or patient satisfaction with treatment. The effect of interproximal contact loss on peri-implant tissue health and patient awareness of food impaction is currently unknown. PURPOSE: The purpose of this retrospective cross-sectional study was to explore the effect of interproximal contact loss on peri-implant tissue health and determine whether interproximal contact loss leads to increased patient awareness of food impaction around the affected area. This study also aimed to identify whether specific patient or local factors could cause interproximal contact loss. MATERIAL AND METHODS: Eighty-three participants with posterior single-unit implant-supported restorations were examined. The mean follow-up time after prosthesis insertion was 4 ±2.2 years (range 4 months to 10.6 years). Interproximal contacts were evaluated by using waxed dental floss. Patient age, sex, implant location, opposing tooth status, presence of endodontically treated adjacent tooth, and regular use of an occlusal device at night were recorded. Peri-implant probing depths and the presence of bleeding on probing were also recorded. Each participant was asked to indicate whether they had noticed increased food impaction around their implant-supported restoration. Statistical analysis included nonparametric Mann-Whitney U tests, the Spearman rank-order correlation, the Pearson chi-squared tests, and the paired t test (α=.05). RESULTS: Among all examined mesial contacts, 34.1% were recorded as open, with an overall mesial interproximal contact loss (open and loose contacts combined) incidence of 48.8%. Restorations placed in premolar sites exhibited significantly tighter mesial interproximal contacts compared with those placed in molar sites (U=566, P=.041). A significant negative correlation was found between follow-up time after insertion and mesial contact tightness (rs=-0.226, P=.041). CONCLUSIONS: Interproximal contact loss appears to increase over time, with more surfaces being affected after longer periods of service. This study did not find an association between interproximal contact loss and peri-implant inflammation as measured by bleeding on probing, with the exception of the distolingual implant surface. Participants with interproximal contact loss were more aware of food impaction around their implant crown. Use of an occlusal device at night did not prevent interproximal contact loss.

Clinical Performance of CAD/CAM Monolithic Lithium Disilicate Implant-Supported Single Crowns Using Solid or Predrilled Blocks in a Fully Digital Workflow: A Retrospective Cohort Study With Up To 33 Months of Follow Up.

PURPOSE: To assess the clinical performance of CAD/CAM monolithic implant-supported restorations manufactured using a fully digital workflow and two different types of ceramic blocks. MATERIALS AND METHODS: One hundred and one patients received single-unit implant-supported restorations at a University predoctoral clinic. All restorations were designed and fabricated using either a predrilled LS2 block (group P, n = 59) or a conventional solid LS2 block with an occlusal opening drilled manually prior to crystallization (group M, n = 42). The mean follow-up time after restoration delivery was 18.4 ± 4.8 months (range 12 to 33 months). Patients with less than a 12-month follow-up were excluded. Electronic health records were reviewed to identify number and type of complications during the follow-up time. Clinical outcomes were classified as success, survival, and failure of the restoration. Chi-square tests were used to identify differences in success and survival rates between the groups. Nonparametric Mann-Whitney U tests were used to identify differences in the number of major and minor complications as well as the total number of complications that were observed among groups. RESULTS: Overall success and survival rates were 80.2% and 97%, respectively. Seventy one restorations (70.3%) were complication-free. There were no significant differences between the groups with regards to the number of complications or success and survival rates. CONCLUSIONS: Single-unit CAD/CAM monolithic implant-supported restorations that are fabricated in a fully digital workflow present relatively high complication rates and moderate short-term clinical outcomes. Clinical studies with longer follow-up times are needed to evaluate long-term outcomes of these restorations.

Dentist-laboratory communication and quality assessment of removable prostheses in Oregon: A cross-sectional pilot study.

STATEMENT OF PROBLEM: When fabricating a removable dental prosthesis, it is unclear if the information received by the dental laboratory technician is clear and sufficient. PURPOSE: The purpose of this survey study was to evaluate the dentist's work authorizations for removable prostheses as well as determine common practices used by laboratories during the fabrication of removable prostheses. MATERIAL AND METHODS: A 24-item questionnaire was developed based on previously published questionnaires and incorporating new topics. A public uniform resource locator (URL) survey link was generated and sent to the office of the Oregon Association of Dental Laboratories (OADL). The executive director of the board then sent out the link to 163 participants that included members and nonmembers of the OADL who were still active in the state of Oregon. Two reminder e-mails were sent 2 weeks apart. Study data were collected and managed by using the Research Electronic Data Capture (REDCap) software program. Descriptive statistics were tabulated, and responses displayed as a percentage of the total. RESULTS: From the 163 invited participants, 26 responded to the survey representing a 15.9% response rate. Only 11% of the laboratories stated that they routinely receive work authorizations with clear instructions. All participants stated that they always (62.5%) or frequently (37.5%) design the partial prostheses frameworks. Only 37.5% of the laboratories stated that they usually receive adequately extended and accurate definitive casts to fabricate the framework. Fifty percent of the laboratories stated that they very rarely perform altered cast procedures and 50% indicated that half or more of the removable partial prostheses they fabricate were entirely made of acrylic resin. Most laboratories stated that thermoplastic resin partial dentures were less than 25% of their produced volume of removable prostheses. Only 22% of respondents stated that they usually receive adequate information to complete a denture tooth arrangement and most (78%) dentists do not routinely specify the type of occlusal scheme desired for their complete denture tooth arrangements. In most prostheses (77%), posterior palatal seal was marked by the prescribing dentists rarely or very rarely. CONCLUSIONS: Work authorizations provided by the dentists were less than adequate and left much decision-making to the dental laboratory technician.

Clinical and Patient-Reported Outcomes of Single Posterior Implant-Supported Restorations Completed by Predoctoral Students: A Retrospective Study with Up to 10 Years of Follow Up.

PURPOSE: To assess clinical outcomes of screw-retained implant-supported restorations as well as patient satisfaction and Oral Health-related Quality of Life (OHQoL), when treatment is performed in an academic setting by supervised predoctoral students. MATERIALS AND METHODS: Ninety patients (n = 129 restorations) consented to participate in the study. The mean follow-up period was 4.2 years (range: 4 months to 10.6 years) after crown insertion. All patients filled out a modified Oral Health Impact Profile questionnaire, consisting of 14 questions (OHIP-14). A comprehensive examination of the implant-supported restoration was completed and restorative complications were recorded. Statistical analysis was performed using SPSS (IBM SPSS Statistics, v25; IBM Corp). Restoration survival rates were calculated using Kaplan-Meier survival analysis. RESULTS: The most frequent complication was loss of the mesial interproximal contact (32.2%). The overall restoration survival and success rates were 93.8% and 74.4%, respectively. The majority of patients (95.6%) reported high satisfaction with their decision to get implant treatment in the predoctoral clinic. CONCLUSIONS: In the context of this study, clinical and patient-based outcomes of implant treatment rendered in an academic setting are favorable and comparable to those reported in the literature for restorations completed by experienced dentists.

Fracture Resistance of Pressed and Milled Lithium Disilicate Anterior Complete Coverage Restorations Following Endodontic Access Preparation.

PURPOSE: This in vitro study evaluated the fracture resistance and clinical prognosis of anterior lithium disilicate crowns (e.max Press and e.max CAD), following endodontic access and repair. The research design simulates intraoral loading conditions to produce clinically applicable results. MATERIALS AND METHODS: Monolithic anterior crowns, based on #8 anatomy, were fabricated from e.max Press ingots and e.max CAD blocks and adhesively bonded on identical dies milled out of a dentin analog material (NEMA G10). Specimens were divided into 4 groups: intact pressed, repaired pressed, intact milled, and repaired milled (n = 15/group). Repaired pressed and repaired milled were prepared with a standardized endodontic access and repaired using a porcelain repair system and composite resin. All crowns were cyclically loaded under simulated oral conditions and then loaded to failure in water, using a universal testing machine. Data were interpreted using ANOVA/Tukey post-hoc test (α = 0.05). RESULTS: Mean loads to failure ranged from 758.9 to 931.4 N for the 4 groups, indicating that both fabrication techniques, pressed and milled, yielded restorations that could reasonably withstand maximum masticatory forces. The pressed groups (923.7 N) exhibited significantly higher fracture resistance than the milled groups (797.5 N), p = 0.0002. When milled and pressed groups were categorized into intact and repaired subgroups, no difference was found in fracture resistance between the subgroups. Differences were noted in the modes of fracture, where the milled groups (intact and repaired) exhibited higher frequency of catastrophic fractures than the pressed groups. CONCLUSIONS: Endodontic access preparation does not appear to affect fracture resistance of an anterior lithium disilicate restoration, suggesting that replacement may not be necessary. Fabrication technique had a significant effect on fracture resistance and fracture mode of lithium disilicate restorations. The pressed fabrication technique resulted in significantly greater crown strength and fracture resistance than the milled technique.

Fracture resistance of lithium disilicate restorations after endodontic access preparation: An in vitro study.

STATEMENT OF PROBLEM: Endodontic access preparation through a lithium disilicate restoration is a frequently encountered clinical situation. The common practice of repairing the accessed crown with composite resin may result in a weakened restoration. PURPOSE: The purpose of this in vitro study was to determine the effect of endodontic access preparation on the fracture resistance and microstructural integrity of monolithic pressed and monolithic milled lithium disilicate complete coverage restorations. MATERIAL AND METHODS: Twenty monolithic pressed (IPS e.max Press) and 20 monolithic milled (IPS e.max CAD) lithium disilicate restorations were fabricated. Ten of the pressed and 10 of the milled crowns were accessed for a simulated endodontic treatment and subsequently repaired by using a porcelain repair system and composite resin. All specimens were submitted to cyclic loading and then loaded to failure. Force data were recorded and analyzed with 2-way ANOVA followed by a post hoc test (Sidak correction) to indicate significant differences among the groups (α=.05). A Weibull analysis was also performed for each group. Eight (4 pressed and 4 milled) additional restorations were fabricated to complete a scanning electron microscope (SEM) analysis and evaluate the surface damage created by the endodontic access preparation. RESULTS: A statistically significant difference (P=.019) was found between the pressed intact and pressed repaired restorations and between the pressed intact and milled repaired restorations (P=.002). Specimens that were examined with an SEM showed edge chipping involving primarily the glaze layer around the access openings. CONCLUSIONS: Endodontic access preparation of lithium disilicate restorations resulted in a significantly reduced load to failure in the pressed specimens, but not in the milled specimens.

Women in leadership positions in dentistry: A scoping review.

BACKGROUND: The objectives of this scoping review were to calculate the prevalence of women in leadership positions in dentistry, present existing research on gender (male, female) disparities affecting dentistry globally, identify gaps in the literature that can drive future research, and provide recommendations for achieving gender parity in leadership positions. TYPES OF STUDIES REVIEWED: A search of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases was performed using search terms. The search strategies were developed to cover English-language articles from January 2016 through April 2022 that examined the prevalence of women in leadership positions in dentistry. Abstracts, newsletters, qualitative reports, and letters to the editors were excluded. RESULTS: Eighteen studies met all inclusion criteria and were included in the final analysis. Low prevalence was noted of women in leadership positions in dentistry globally. Multiple reasons that have led to gender disparities were identified and recommendations for decreasing gender disparities and achieving gender equity in dentistry were provided. PRACTICAL IMPLICATIONS: Over the years, several factors have contributed to gender inequalities in dentistry. However, during the past decade, gender equity, inclusion, and diversity have been recognized increasingly as core values of the dental profession. Presenting and analyzing all available data surrounding this topic are of paramount importance to start formulating appropriate strategies to achieve gender parity in all areas of dental leadership.

Resin-Based Composites for Direct and Indirect Restorations: Clinical Applications, Recent Advances, and Future Trends.

Continuous advancements in resin-based composites can make selection of the appropriate system a daunting task for the clinician. This review aims to simplify this process and clarify some new or controversial topics. Various types of composites for direct and indirect applications are discussed, including microfilled and microhybrid composites, nanocomposites, single shade, bulk fill, fiber-reinforced, high temperature/high pressure processed, CAD/CAM, and three-dimensional printable composites. Recent material advancements that lead to improved seal and toughness, degradation resistance, antimicrobial and self-healing capabilities are presented. Future directions are highlighted, such as the development of "smart" materials that are able to interact with the host environment.

Gender diversity and senior leadership in academic dentistry: Female representation at the dean position in the United States.

PURPOSE/OBJECTIVES: The purpose of this study was to calculate the male to female dean ratio in the US dental schools, assess whether the dean's gender is affected by specific school characteristics (such as geographic location or class size), and determine whether the dean's gender affects the percent of women in the school leadership team. METHODS: Each US school's website was reviewed to capture the name and gender of each dean and others holding assistant, associate or vice dean positions. All data were entered in an Excel database (Microsoft Excel 2016) and analyzed using a statistical analysis software program (IBM SPSS Statistics, v26; IBM Corp). The level of significance was set to α = 0.05. RESULTS: The male to female dean ratio (approximately 5:1) differed significantly from the hypothesized ratio 1:1 (z = 5.22, p < 0.001). Mean class size (χ2  = 0.869, p = 0.351) and school funding source (χ2  = 0.430, p = 0.512) did not differ between schools with a male versus female dean. The percentage of women in the school's leadership team was higher in schools with a female dean (U = 151, p = 0.004). CONCLUSIONS: In the US dental schools, there is one female dean for every five deans who are male, indicating underrepresentation of women at the highest role in academic leadership. Schools with female deans tend to have more women in other administrative roles as well. Change is needed in order to promote equity, diversity, and inclusion in academic dentistry.

3D printed versus conventionally cured provisional crown and bridge dental materials.

OBJECTIVES: To optimize the 3D printing of a dental material for provisional crown and bridge restorations using a low-cost stereolithography 3D printer; and compare its mechanical properties against conventionally cured provisional dental materials. METHODS: Samples were 3D printed (25×2×2mm) using a commercial printable resin (NextDent C&B Vertex Dental) in a FormLabs1+ stereolithography 3D printer. The printing accuracy of printed bars was determined by comparing the width, length and thickness of samples for different printer settings (printing orientation and resin color) versus the set dimensions of CAD designs. The degree of conversion of the resin was measured with FTIR, and both the elastic modulus and peak stress of 3D printed bars was determined using a 3-point being test for different printing layer thicknesses. The results were compared to those for two conventionally cured provisional materials (Integrity®, Dentsply; and Jet®, Lang Dental Inc.). RESULTS: Samples printed at 90° orientation and in a white resin color setting was chosen as the most optimal combination of printing parameters, due to the comparatively higher printing accuracy (up to 22% error), reproducibility and material usage. There was no direct correlation between printing layer thickness and elastic modulus or peak stress. 3D printed samples had comparable modulus to Jet®, but significantly lower than Integrity®. Peak stress for 3D printed samples was comparable to Integrity®, and significantly higher than Jet®. The degree of conversion of 3D printed samples also appeared higher than that of Integrity® or Jet®. SIGNIFICANCE: Our results suggest that a 3D printable provisional restorative material allows for sufficient mechanical properties for intraoral use, despite the limited 3D printing accuracy of the printing system of choice.

Dental Impression Materials and Techniques.

Dental impression making is the process of creating a negative form of the teeth and oral tissues, into which gypsum or other die materials can be processed to create working analogues. Contemporary dentistry generates new information every year and digital dentistry is becoming established and influential. Although dentists should stay abreast of new technologies, some of the conventional materials and time-tested techniques remain widely used. It is important to review the impression-making process to ensure that practitioners have up-to-date information about how to safely and effectively capture the exact form of the oral tissues to provide optimal patient management.