i.lect, a pre-graduate education model of implantology.

OBJECTIVE: In 2008, a consensus meeting of the Association for Dental Education in Europe stated that dental implant treatment represents a popular treatment alternative and, therefore, it should be an integral part of dental student pre-graduate education. In 2009, the Friedrich-Alexander University, Erlangen-Nuremberg implemented a voluntary, structured, education program for pre-graduate dental students, called 'i.lect'. The present study evaluated the effectiveness of the i.lect program. METHODS: Concurrent to the dental curriculum, the i.lect program provides 200 hours in 3 years of theoretical and practical education on all aspects of modern dental implantology. We recruited dental students in the i.lect program and additionally students from 15 other universities that voluntarily participated in a single, 3-day implantology camp (R = 58). To demonstrate their knowledge on dental implant issues, both student groups completed a written examination that covered 'Basic information and materials of implantology', 'Implant planning' and 'Soft tissue management'. RESULTS: The students in the i.lect program achieved higher scores than students from the implantology camp on questions concerning 'basic implantology' and 'implant planning'. CONCLUSION: The results indicated that the structured i.lect undergraduate curriculum enhanced individual knowledge in the specific field of implantology. This program could have pilot character for use in other universities.

Possibilities and limitations of implant placement by virtual planning data and surgical guide templates.

The use of computer-aided surgical systems for dental implant bed preparation and implant placement results in an average precision within 1 mm of implant position and within 5 degrees of deviation for implant inclination. The accuracy of axis and implant position is significantly more precise with the three-dimensional surgical guide than with the free-hand method. The three-dimensional assessment of the restorative goal (radiopaque simulation of prosthesis with scanning template) allows virtual planning of implants, which enables optimized positioning of implants with surgical guide templates in oral surgery. If there is a clear indication for three-dimensional diagnostics, it should always be checked whether the data can be used as planning data for a surgical guide template, otherwise the chance for guided surgery remains unused. Since uncertainties still exist despite the use of a drilling template, it is recommended that the minimum safety distance from adjacent structures be maintained. The successful use of surgical guide templates requires comprehensive knowledge of and experience in using three-dimensional information for the virtual planning of implant position.

Student attitudes towards computer-aided testing.

INTRODUCTION: Computer-aided learning (CAL) is a viable alternative to traditional teaching methods. While CAL is used for teaching only, computer-aided testing (CAT) can be applied as a computer-based examination method. The aim of the present study was to evaluate students' attitude towards CAT as compared to written multiple choice tests. MATERIALS AND METHODS: Forty-one undergraduate dental students underwent a mock examination consisting of 15 written multiple choice questions and 15 questions delivered using the interactive MobiTed® system. A questionnaire based on an eight-item seven-point Likert scale was used to evaluate the students' attitude towards CAT. The students' performance in both tests was analysed using paired t-tests. Correlations between test performance and questionnaire were expressed by Pearson correlation coefficients. RESULTS: Despite study-design-related differences, students' test performance between written multiple choice and MobiTed® was comparable. No correlations between test results and questionnaire could be set up. Students rated MobiTed® to be equivalent to written multiple choice and had no difficulties with the CAT set up. The pre-defined sequence of questions with each question being shown only once was considered to be a major disadvantage of the CAT system. Complex questions should be displayed longer compared to short questions. DISCUSSION: Computer-aided testing appeared to be equivalent to written multiple choice tests not only in terms of student performance but also to their perception. This is consistent with previous studies. CONCLUSIONS: Interactive multiple choice tests may provide an alternative to written tests, but should allow examinees to have control over the sequence, as well as the length of time the questions are displayed.

Automatic, computer-based speech assessment on edentulous patients with and without complete dentures - preliminary results.

Dental rehabilitation of edentulous patients with complete dentures includes not only aesthetics and mastication of food, but also speech quality. It was the aim of this study to introduce and validate a computer-based speech recognition system (ASR) for automatic speech assessment in edentulous patients after dental rehabilitation with complete dentures. To examine the impact of dentures on speech production, the speech outcome of edentulous patients with and without complete dentures was compared. Twenty-eight patients reading a standardized text were recorded twice - with and without their complete dentures in situ. A control group of 40 healthy subjects with natural dentition was recorded under the same conditions. Speech quality was evaluated by means of a polyphone-based ASR according to the percentage of the word accuracy (WA). Speech acceptability assessment by expert listeners and the automatic rating of the WA by the ASR showed a high correlation (corr = 0.71). Word accuracy was significantly reduced in edentulous speakers (55.42 +/- 13.1) compared to the control group's WA (69.79 +/- 10.6). On the other hand, wearing complete dentures significantly increased the WA of the edentulous patients (60.00 +/- 15.6). Speech production quality is significantly reduced after complete loss of teeth. Reconstitution of speech production quality is an important part of dental rehabilitation and can be improved for edentulous patients by means of complete dentures. The ASR has proven to be a useful and easily applicable tool for automatic speech assessment in a standardized way.

Biopsychosocial correlations in patients with chronic oro-facial pain. Part II. Experiences of pain and dramatic events before the 16th year of life.

Before the sixteenth year of life, biopsychosocial influences such as self-experienced and observed accidents/illnesses, adverse medical/dental treatments, dangerous events and self-experienced or observed force seem to affect the manifestation of chronic pain in the oro-facial area in the forms of temporomandibular disorder (TMD) and psychogenic denture-intolerance (PDI)/somatoform oro-facial pain (SOP). We evaluated the occurrence of these types of events before the age of 16 years in 50 TMD patients, 55 PDI/SOP patients and 55 randomly selected pain-free control group (CG) using the medical questionnaire 'Physical well-being and traumatic experiences (PTE). A separate dental questionnaire determined the effects of previous experiences of pain or force on the emotional self-assessment of the patients (pain localization and body feeling). The TMD group was significantly more likely to have experienced an accident and an illness before the age of 16 years than were the other two groups (PDI/SOP and CG) (P < 0.039). Temporomandibular disorder and PDI/SOP patients suffered frequent backaches significantly more than CG patients (P < 0.028). The PDI/SOP patients were least likely to report having felt threatened before or after the age of 16 years (P < 0.003) compared with the PDI/SOP and CG group. Sociodemographic parameters, experiencing an accident, previous medical incidents, experiences of force and emotional self-assessment influence the biopsychosocial dynamics that directly influence oro-facial symptoms with psychogenic components. Similar to medical history, age seems to play a decisive role in the manifestation of oro-facial psychic symptoms.

Three-dimensional cone beam computed tomography analysis of maxillary sinus and alveolar bone anatomy in the restorative axis of dental implants using radiopaque drill guides.

The objectives were to assess the sinus anatomy and alveolar ridge dimensions and to identify clinical factors and morphological relationships that may predict the characteristics of the sinus anatomy. A total 336 edentulous molar and 168 edentulous premolar regions were analyzed. The mediolateral maxillary sinus (5mm and 10mm above alveolar bone), lateral maxillary sinus wall, ostium height, and alveolar ridges were measured. Measurement regions were defined by radiopaque simulation of the restoration goal. Mean molar mediolateral dimensions were >10mm: first molar, 11.8mm (range 3.8-21.1mm); second molar, 12.2mm (range 7.9-20.1mm). The extent of the sinus differed significantly between premolars and molars (P<0.001). The first molar region had the highest mean value for the lateral sinus wall (2.4mm, range 0.2-7.9mm) and the greatest distance between the alveolar crest and simulated restorative goal (8.1mm, range 1.1-16.3mm). Septum prevalence was 46% in the molar region and 27% in the premolar region. A lower alveolar ridge height was associated with a wider transverse extent of maxillary sinus and consequently longer distances between the crest and restorative goal. Systematic three-dimensional analysis of the maxillary sinus yields precise preoperative information about sinus configurations. There were significant variations and relationships among characteristics of the maxillary sinus, ridge, and the restorative goal.

Comparison between computer-aided testing and traditional multiple choice: an equivalence study.

AIMS: Computer-aided learning (CAL) is a viable alternative to traditional teaching methods. While CAL is used for teaching only, computer-aided testing (CAT) can be applied as a computer-based examination method. The aim of the present study was to compare the performance of undergraduate students in computer-interactive tests and traditional multiple choice tests and to evaluate the influence of question length and language skills on test results. MATERIALS AND METHODS: Fifty-two native German-speaking students and five non-native speaking students were randomly assigned to two groups. They were required to answer 20 conventional multiple choice questions and 20 questions using the interactive MobiTed system. An analysis of variance and t-tests (alpha = 0.05) were used to compare scores. RESULTS: Non-native speakers scored significantly lower on the interactive test compared with the native speaking students (P = 0.048 for long questions and P = 0.003 for short questions). There were no significant group differences on the conventional multiple choice test (P = 0.052 for long questions and P = 0.089 for short questions). Based on the results of the native speaking students neither test method nor question length had an influence on overall performance. CONCLUSION: Interactive multiple choice tests may provide an alternative to written tests, especially when considering time expenditure. Language skills and question length should be taken into account when setting time limits for examination.

Dental anxiety--an epidemiological study on its clinical correlation and effects on oral health.

Pronounced dental anxiety could lead to avoidance strategies to evade dental visits. The aim of the present epidemiological study was to investigate the prevalence and related oral disease patterns of dental anxiety in young adult male soldiers. Therefore, the intensity and frequency of dental anxiety are presented and the correlation with oral clinical findings are evaluated. Three hundred seventy-four soldiers who underwent a compulsory dental check-up were randomly assigned to this study. Psychological parameters were collected based on a protocol integrating the Dental Anxiety Scale (DAS) and the Gatchell Fear Scale (GaFS). Patient-based measures included D3,4MF-scores for dental status and the Community Periodontal Index of Treatment Need (CPITN) for periodontal status. Thirty-two individuals (8.6%) showed DAS-scores of 13 or 14 (anxious), while 4.6% had a DAS-score > or = 15 (highly anxious/phobic). Highest DAS-values were measured among patients' aged 19-29 (n = 262). DMFS-values of anxious and less anxious patients showed only minor differences. However, anxious patients had significantly more carious lesions (P < 0.001). CPITN periodontal values showed no significant differences between both groups. 89.2% of less anxious individuals and 79.6% of anxious patients went for regular dental check-ups. Thus, every tenth patient was considered to have high dental anxiety. Anxiety results in avoidance behaviour, which can only be discovered upon compulsory examinations and which is associated with higher caries morbidity and need for oral rehabilitation. As anxiety has a direct influence on oral health, it should be detected and accounted for in a treatment concept integrating dental and cognitive-behavioural therapeutic approaches.

Changes in neurophysiologic parameters in a patient with dental anxiety by hypnosis during surgical treatment.

It was hypothesized that dental anxiety, which leads to neurophysiologic alterations in heart rate, respiratory rate and blood pressure prior, during and subsequent to dental treatment, can be influenced by medical hypnosis. We report the positive impact from non-invasive hypno-sedation during dental implant surgery on a 54-year-old female patient who experienced neurophysiologic reactions as a result of the psychosomatic process of dental anxiety (dental anxiety scale value = 13). The neurophysiologic changes during dental surgery performed with and without hypnosis were compared after the patient underwent the same surgical treatment protocol. This case report was part of a study designed to evaluate hypnosis as a non-invasive therapy for dental-anxious patients over six sessions using subjective experience and objective parameters, which included electroencephalogram, electrocardiogram, heart rate, blood pressure, oxygen saturation of the blood, respiration rate, salivary cortisol concentration and body temperature.

How do elder people live in the GDR?

The improvement of housing conditions for all citizens including the elder population is the gist of the socio-political programme of the Party of the Working Class, the Council of Ministers and the Confederation of Free German Trade Unions (FDGB). Their activities establish the necessity of starting from the differentiated needs of the population in realizing the complex housing programme. The main substance of geriatrics and gerohygiene makes it imperative to preferably care for those citizens who are in the greatest want of a satisfactory solution of the housing problem. The preferred persons are among others: from the pensioners' 6-8% persons needing care, 10-15% persons who should live in small flats being adequate to elder people, and 6% persons accomplishing the evening of life in apartment houses. The remaining groups should live in their hitherto existing rooms. But this requires services rendered such as neighbourhood assistance, informative advice, medical, social and cultural attendance. The basic principles of a solution of the housing problem until the year 2,000 are as follows. Realization of the fundamental requirements of elder people respecting health, safety, shelter as well as full integration, participation and appreciation of the forming of life of the individual on behalf of the society.

[30 years GDR--30 years of social policy for the benefit of aging and aged citizens]. / 30 Jahre DDR--30 Jahre Sozialpolitik zum Wohle der Bürger im höheren und hohen Lebensalter.

The author gives a survey of current problems regarding the realisation of the socio-political programms in the GDR for the benefit of elderly persons. This requirement is reflected in decisions and regulations issued by central state authorities. Public organization also contribute to the development of health-promoting living conditions and patterns of behaviour.

[A healthy and active ageing by preparation and complex care (author's transl)]. / Ein gesundes und aktives Alter durch Vorbereitung und komplexe Betreuung.

Today it is possible and necessary to show the way for a healthy and active ageing under our social conditions. This way means the preparation for the age and the pension. This is only possible by the unit of positive personal attitudes, motivations and behaviour with adequate social planning. There are many examples of the macrobiotic, gerohygiene, geropsychology and sports medicine. There are also results and experiences of the whole life and the effects of extreme situations of the life to take into consideration for the indication for the preparation and complex care. Some methodical theses and postulates for training-programmes for the preparation on age and pension are worked out. Such programmes should be carried out for groups, which are especially endangered by their work: workers and leading works.

[Preparation for old age as a problem of planning working and living conditions (author's transl)]. / Die Vorbereitung auf das Alter als Problem der Gestaltung der Arbeits- und Lebensbedingungen

It was shown that preparation for old age is also a problem of planning social processes and consequently a major problem of health and social policy which must be tackled by the society as a whole. Its solution calls for a wide range of activities in the field of organization of work, housing design, nutrition and reproduction of the working capacity. Ways are shown to supplement preparation training programmes.

[Aspects of health education connected with the process of preparing for old age (author's transl)]. / Gesundheitserziehung im Rahmen der Vorbereitung auf das Alter

The essential principles and content of health education and health propaganda connected with preparing production workers for an active old age were sketched. Certain conclusions were drawn for integrating this complex into general health education and health propaganda, which, in the future, must embrace people of all ages in order to prepare them for old age. On the other hand it is important at this point to give priority to health education and health propaganda for factory workers doing relatively hard work or exposed to environments prejudicial to health. The special purpose of our contribution was to deal with some specific aspects the problems considered here.

[Preparing for old age. (II) (author's transl)]. / Vorbereitung auf das Alter (II).

Looking back on the beginning of the efforts for preparing of working pensioners for activity and creative life in the pensionary there is demonstrated the present state of the request of research for social preparing on age in the socialism. Our new labour law and some results of research of gerohygienic studies show which way for preparing on an active age is further to go.

[Living condition of aging working women in family, marriage, and profession (author's transl)]. / Zur Lebenssituation alternder werktätiger Frauen in Familie, Ehe und Beruf.

Our research has elucidated the important role of family life and intimate sphere for the way of living of women in the conversion phase (40-60 years). It is shown that negative factors lie in too hard housework, in deficiency of help by husband, in familiar conflicts and conflicts of married life, and in unfavourable conditions of employment. The necessity of integrating gerosexualhygiene in measures for preparing for an active and harmonious old age was deduced from our results.

[Theoretical basis for preparation for an active old age (author's transl)]. / Theoretische Grundlagen der Vorbereitung auf ein aktives Alter.

To theoretically substantiate the preparation for an active old age, as regards gerontological hygiene and social gerontology, we can refer to the four crucial points of our research results. 1. The basic mechanisms of aging are biological-genetically controlled; speed, type and forms of manifestation, however, can be essentially influenced by the environment 2. Regarding the factors of influence we must differentiate between negative and positive features to ensure the desired course of the aging process in accordance with the basic needs by controlling and regulating it 3. For working women and men of pre-pensionable and pensionable age, from the present state of the motivation structure the complex of material and ideological contents of preparatory measures can be derived relating both to the transition to pensionable age and to organizing a creative and active old age 4. Geropsychohygiene and health education rank high in the structure of all-social health protection; for they are suited to improve health, capability, and joy of living, and to help prevent losses and decompositions in the psychophysical field.

[Partnership and sexuality in the latter half of life. The partnership situation and sexual behavior of the working woman in the change of life]. / Zum Problem von Partnerschaft und Sexualität in der zweiten Lebenshälfte. Eine Untersuchung zur Partnersituation und zum Sexualverhalten werktätiger Frauen in der Umstellphase.

The problem of partnership and sexuality is of great importance also in the second half of life. It is necessary for the consultation centres on marriage and sexuality to take these facts into account, both with respect to organisation and content.

[Industrial medicine focal points in the preparation for old age]. / Arbeitsmedizinische Schwerpunkte der Vorbereitung auf das dritte Alter.

Occupational medicine takes a certain key position at preparation for an active and healthy old age. Focal points are in this sight: --the active integration of the elder workers into the system of medical investigations of fitness --the dispensary care for elder workers --the shaping of working conditions and claims --health education and --geropsychohygiene.

[Rehabilitation and gerontology (author's transl)]. / Rehabilitation und Gerontologie.

The 9th congress of the GDR Society for Rehabilitation was organized jointly with the GDR Society for Gerontology and held from 4 to 6 January 1977. The article outlines observations made at and conclusions derived from this important scientific event. Three major problems were discussed: rehabilitation of chronically ill and handicapped persons of advanced age within the working process as a task for society as a whole; the combination between gerontology and rehabilitation as a result of the change in the age and morbidity structures of economically advanced countries; beginnings and first experience in the field of gerontology-oriented rehabilitation in the GDR and recommendations made by WHO on the planning and organization of geriatric services with special consideration for rehabilitation in advanced age.