E-learning readiness among dental students and faculty: a comparative study before and after the COVID-19 pandemic.

Background: The COVID-19 pandemic accelerated the global adoption of e-learning, even in institutions that had previous reservations. Nevertheless, the impact of this transformation on dental education remains unclear. This study aimed to assess the e-learning readiness of dental students and faculty before and after COVID-19. It also explored their post-pandemic e-learning preferences for dental education. Methods: Cross-sectional surveys were conducted at King Abdulaziz University's Faculty of Dentistry (KAUFD) in Jeddah, Saudi Arabia both before and after COVID-19. Faculty and students from two distinct cohorts were recruited at two time points. Participants completed a detailed questionnaire on e-learning readiness across multiple domains. Statistical analysis was performed using R v 3.6.3. Descriptive and group comparisons were conducted using chi-squared test, unpaired t-test, and Spearman's correlation. Results: 1,057 responses (response rate = 99.8%) were analyzed: 2015 (n = 400) and 2021 (n = 657). Both faculty and students demonstrated significant improvements in e-learning readiness across all domains from 2015 to 2021. In 2021, faculty members scored significantly higher than students in almost all readiness domains, except for e-learning experience (p < 0.001 for all domains). After the pandemic, both groups preferred a blended learning model: 75% traditional and 25% online education. A significant increase in typing and editing training requests by faculty and students was observed in 2021. Students showed a decline in training needs for web and online tool usage. Conclusion: The COVID-19 pandemic pushed the rapid adoption of e-learning in dental education. In this study, faculty showed greater e-learning readiness, but students voiced concerns about missed in-person interactions, social isolation, and screen fatigue. Further multi-institutional studies are required for more comprehensive insights.

Is motor-driven insertion of orthodontic miniscrews more advantageous than manual insertion? A micro-CT evaluation of bone miniscrew contact surface area and cortical microcracks in rabbits.

AIM: This in vitro study aimed to evaluate and compare the bone-miniscrew contact surface area (BMC) and the cortical bone microcracks (CM) resulting from manual (hand-driven) and automated (motor-driven) orthodontic miniscrew (OM) insertion methods. METHODS: Thirty-three OM were inserted in the femurs of nine New Zealand rabbits using manual (n = 16) and automated (n = 17) insertions. After euthanizing the rabbits, bone blocks, each including one OM, were sawed. Micro-CT scanning was performed, and data analysis included reconstruction, binarization and quantification of morphometric parameters of BMC and the number and length of CM. Means and standard deviations for complete BMC, complete BMC proportion, cortical BMC, cortical BMC proportion, and length and number of CM were calculated. Mixed model analysis was used to adjust for more than one sample/CM per animal. A paired t-test was used to compare the number of CM between the two groups. RESULTS: Compared to the automated insertion, manually inserted miniscrews had significantly lower complete BMC (7.54 ± 1.80 mm2 vs. 11.99 ± 3.64 mm2), cortical BMC (5.91 ± 1.48 mm2 vs. 8.48 ± 1.90 mm2) and cortical BMC proportion (79.44 ± 5.84% vs. 87.94 ± 3.66%). However, it was not statistically significant in complete BMC proportion (p = .052). The automated insertion also resulted in a significantly lower mean number of CM than the manual method (p = .012). However, the length of the cracks was shorter in the manual group but with no significant difference (p = 0.256). CONCLUSION: Motor-driven OM insertion results in superior BMC and reduction in the number of CM, which may lead to better miniscrew stability.

Social Anxiety and Orthognathic Surgery Effect on Oral Health-Related Quality of Life.

OBJECTIVES: This study aimed to investigate the impact of patients' social anxiety on oral health-related quality of life (OHRQoL) in the context of orthognathic surgery. METHODS: The study involved a cohort of 70 patients who were tasked with completing a comprehensive questionnaire aimed at assessing various facets of their OHRQoL at distinct stages of treatment: pre-surgery, within one month post surgery, and more than one month post surgery. Statistical analyses were conducted in the form of t-test. RESULTS: Out of the 70 participants, 27 were male (38.57%) and 43 were female (61.43%). The sample distribution comprised 30 (43%) subjects in the pre-surgical stage, two (3%) at one month post surgery, and 38 (54%) more than one month post surgery. In relation to the t-test results, we found variations in the significance of the results for each question, with multiple results showing patients who reported experiencing discomfort significantly outnumbering those who did not (p < 0.05). CONCLUSION: Social anxiety and orthognathic surgery both demonstrate significant influences on OHRQoL. Subsequent research should delve into specific areas where patients experience the greatest impact.

Evaluation of Moral Reasoning Skills among Dental Students in the Makkah Region, Saudi Arabia.

Introduction: One of the main roles of healthcare educators is to prepare students to make the right ethical decisions. This study evaluated the moral reasoning levels of dental students according to Kohlberg's six-stage moral development system. Materials and Methods: This cross-sectional study was conducted in three dental schools in the Makkah region. Senior-year students completed the self-administered Socio-moral Reflection Objective Measure (SROM), which consists of hypothetical moral dilemmas and options that mirror individual reasoning possibilities. SROM results were matched to Kohlberg's six-stage moral development system and associations with demographic variables and perceptions of educational context variables assessed. Results: One hundred and eighty-eight senior students (mean age 23 ± 1.1 years) completed the SROM. Only 34.6% (n = 44) students reached stage four (morality of law and duty to the social order), while most students (63.8%; n = 81) were at stage three (morality of mutual interpersonal expectations); 1.6% (n = 2) were at stage two (the instrumental relativist orientation). No subject achieved stage 5. Attainment of moral reasoning was not associated with demographic or perception of educational context variables. Conclusion: Students demonstrated a relatively low level of moral reasoning. Healthcare educators must review curricula to provide focused training for students to cultivate their moral reasoning skills. Further studies are also needed to confirm and explain this low moral reasoning level in dental students.

Predictors of clinical performance in comprehensive care cases in undergraduate dentists.

INTRODUCTION: Achieving a high grade in the final-year comprehensive clinical care (CCC) course is not only important for the individual candidate but also to ensure competency of students as they transition from dental school into independent practice. Here, we aimed to identify predictors of success in the CCC that might prove useful to identify which, if any, students need focused intervention to improve their performance in the CCC. MATERIALS AND METHODS: This was a cross-sectional study of two consecutive cohorts (2017-2018 and 2018-2019) of final-year (Year six) dental students (n = 180 females and n = 150 males) attending [King Abdulaziz University], Saudi Arabia. Age, gender, cumulative GPA to the start of Year six and assessment results were tabulated and analysed as independent variables in binary logistic regression to identify predictors of the final case grade (≤69% or >70%). RESULTS: Year five GPA (OR 1.07, 95% CI 1.02-1.12; p = .004) and female gender (OR 2.21, 95% CI 1.12-4.36; p = .02) were significantly associated with an increased odds of achieving a final case grade >70%. In particular, female students were over twice as likely as male students to achieve a higher score in their final case assessment. DISCUSSION: This study suggests that gender may influence final performance in the CCC. The better performance of females in the final CCC course than their male counterparts suggests that there may be a narrowing or even reversal of the historical gender gap in dental school performance. CONCLUSIONS: Both cognitive (GPA) and other (i.e. gender) factors influence clinical dental performance. Further work is required to establish what instructional modifications are required to accommodate these gender differences in CCC courses to pave the way for personalised teaching approaches to optimise educational outcomes.

The Impact of COVID-19 on Dental Research in Educational Settings: What are the Opportunities?

The COVID-19 pandemic has significantly impacted dental education and research activities, creating challenges for students, educators, and health-care professionals. The unfolding crisis has shed the light on how technology can facilitate not only the delivery of dental education and improving access to dental care but also new and ongoing research. While dental schools worldwide have re-structured their policies and curricula in terms of incorporating appropriate methods of distance learning, this now needs to be applied to dental research where appropriate. By conducting a "strengths, weaknesses, opportunities, and threats" analysis and describing the authors' experiences, here we discuss the impact of the pandemic on various aspects of dental research to provide a timely perspective on dental research activity in academic institutions to help achieve research outcomes despite the pandemic's impact.

Cross-cultural adaptation and validation of the malocclusion impact questionnaire for patients seeking orthodontic treatment.

OBJECTIVES: To assess the adaptability and validity of the Arabic version of the Malocclusion Impact Questionnaire (MIQ-AR) in patients seeking orthodontic treatment. MATERIALS AND METHODS: This cross-sectional survey was conducted on a convenience sample of 77 Arabic speaking, healthy, 10-16-year-old children, selected based on their personal perception of "needing braces.". The participants completed the MIQ-AR and the Child Perceptions Questionnaire for children aged 11-14 (CPQ11-14), answered two global questions, and had their Index of Orthodontic Treatment Need, Dental Health Component (IOTN.DHC) scores recorded. Construct validity was examined by measuring the correlation between the MIQ-AR score and the responses to the two global questions. Criterion validity was examined by measuring the correlation between the MIQ-AR and both the IOTN.DHC and CPQ11-14 scores. RESULTS: Moderate positive correlations were observed between the MIQ-AR scores and the first (ρ = 0.320, P < 0.001) and second global questions (ρ = 0.388, P < 0.001). A strong positive correlation was found between the total CPQ11-14 and MIQ-AR scores (ρ = 0.597, P < 0.001). A positive gradient was observed between the MIQ-AR scores and IOTN.DHC scores. CONCLUSION: Our results indicate that the MIQ-AR is a valid tool for measuring oral health-related quality of life in patients with malocclusion, with good psychometric parameters. These preliminary findings require further testing in various settings involving a larger and more diverse sample.

Cross-cultural adaptation of oral health-related quality of life measures used to assess the impacts of malocclusion and dentofacial deformities in Saudi Arabia: A literature review.

Since the World Health Organization broadened its definition of health, beyond biological boundaries, to include physical, emotional, and social wellbeing. Oral health-related quality of life (OHRQoL) became common outcome measure in clinical trials and epidemiological studies in Dentistry and Medicine. It is not surprising, therefore, to see quality of life as one of the programs of the Saudi 2030 vision. That said, it can be difficult to interpret the findings of OHRQoL research if the measures used were not appropriately adapted and validated in the population being studied. In this review article, the concept of cross-cultural adaptation of OHRQoL and its use in the Saudi context, as applied to orthodontic research, was discussed. An electronic search in PubMed and MEDLINE databases was conducted. A second search was conducted to locate methodological papers discussing cross-cultural adaptation and translations. Appraisal of relevant research was conducted to provide a better understanding of the process of adapting OHRQoL measures to assess the impact of malocclusion and dentofacial abnormalities on quality of life. This review pointed out important methodological concerns that warrant considerations during the translation and adaptation of OHRQoL measures.

Development of a novel integrated educational relative-unit value system to assess dental students' clinical performance.

PURPOSE: The use of relative unit values (RUVs) to assess students' clinical productivity is common in dental education. However, there are large variations on how RUVs are defined, developed, validated, and reported across institutions. This study described the development of a novel educational RUV system. METHODS: A preparatory phase of literature review and methodological gap analysis, followed by initial conception, pilot testing, and a 2-round modified Delphi process were conducted. Panelists reviewed the procedure list, nomenclature, purpose of development, basis of calculation of RUVs, and the relative weights of different dental procedures. Also, their perception of the usefulness, fairness, and practicality of the system was assessed. Agreement was set at 80%. RESULTS: Eight published educational RUV systems were identified. These data guided the initial conception of the novel Integrated Educational RUVs (IERUVs). Five experts reviewed the system and it was piloted for a full educational cycle. Feedback from faculty and students was used to adjust over- or under-estimated RUVs, with deconstruction of multi-step procedures. Fifteen experts participated in the second Delphi round (71% response rate). Consensus was reached for 105 procedural RUVs. A total of 93% of the panelists agreed the system was useful, while 71% perceived it as fair and practical. CONCLUSION(S): Content validity of the new educational RUV was established. The system provides a promising tool for assessing dental students' clinical performance, as it provides a unified base unit to assess clinical productivity, clinical competence, and comprehensive care cases. Longitudinal evaluations in different contexts are needed to confirm IERUVs validity.

Management of internal derangement of temporomandibular joint disc displacement with reduction using two different lines of treatment / Manejo do desarranjo interno do deslocamento de disco temporomandibular com redução utilizando dois tipos diferentes de tratamento

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)

Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)

Comparison of Digital and Paper Assessment of Smile Aesthetics Perception.

OBJECTIVES: Despite the widespread of assessment of smile aesthetic perception in many areas, there has yet to be a direct comparison of digital and paper-based photographs for the assessment of smile aesthetics. Here we compared digital and paper-based photographs representing different smile aesthetic features using visual analog scale (VAS) scoring. MATERIALS AND METHODS: One hundred students were randomly recruited from a university campus. Participants were asked to record their perception of smile aesthetics via paper and digital-based platforms. The minimum clinically important difference between platforms was set at 15 mm. The percentage of participants who rated smile attractiveness worse on digital images was recorded. The paired one-tailed Student's t test was used to determine differences between digital and paper platforms, and Bland-Altman analysis and intraclass correlations (ICCs) were used to test for agreement between paper and digital photographs. RESULTS: Ninety-nine subjects participated, 55 men (mean age = 22.05, standard deviation [SD] = 1.91) and 44 women (mean age 22.05, SD = 1.84). There were statistically significant differences between paper-based and digital photographs for all images except one (paired t test; P < 0.05). Digital ratings were lower than paper-based ratings for all images, and differences were clinically significant in four out of eight images. A high percentage of participants (50.5%-85.9%) rated smile attractiveness worse on digital images than on paper for all images. There was poor agreement between the two methods as assessed by ICCs and Bland-Altman analysis. CONCLUSION: Equivalence between paper and digital images for smile aesthetics cannot be assumed, and paper-based photographs may lead to clinically relevant overestimations of perceived attractiveness. As academic dentistry increasingly relies on digital imaging and sharing in the post-COVID-19 world, further validation of digital platforms for smile aesthetics assessment is warranted, and care should be taken when interpreting the results of studies assessing smile perception based on different platforms.

Dimensions of Maxillary Lateral Incisor on the Esthetic Perception of Smile: A Comparative Study of Dental Professionals and the General Population.

AIM: To evaluate the effect of the differences in the dimensions of maxillary lateral incisor on the esthetic perception of smile among dental professionals and the general population. MATERIALS AND METHODS: Two sets of photographs where the maxillary incisor dimensions were modified using computer software (Adobe Photoshop) were created. In the first set, six images were included where the maxillary lateral incisor width was modified. The second set included five images where only the maxillary lateral incisor length was modified keeping the gingival margins same. Three groups of participants formed the sample. Hypodontia patients formed the first group, non-hypodontia patients formed the control group, while the dentists constituted to the third group. A total of 156 participants were recruited, 36 patients with radiographically confirmed hypodontia out of which 22 were female and 14 were male, 54 non-hypodontia "control" patients out of which 29 were female and 24 were male, and 66 dentists out of which 39 were female and 27 were male. Every participant had 15 seconds to view each photograph along with 30 seconds at the end for confirmation. RESULTS: The "most attractive smile" was the ones with 77% lateral incisor to central incisor width proportion according to 25.0% of the hypodontia group and 40.8% of the dentist's group, while only 4.2% of the control group agreed that it was the most attractive. However, the "least popular" was the 52% lateral incisor to central incisor width proportion according to 40.0% of patients who are hypodontic, 20.8% of participants from control group, and 49.0% of dentists. CONCLUSION: The golden proportion was not considered as the most attractive among all groups. The esthetic perceptions of the patients might not be same as that of the dentists. In general, reductions in the maxillary lateral incisor width were not all acceptable. CLINICAL SIGNIFICANCE: This study will help us understand the different perceptions of the patients and the dentists on esthetics, which would further help us in planning the treatment accordingly.

E-learning Readiness among Dental Students and Faculty Members Pre-COVID-19 Pandemic.

PURPOSE: The purpose was to assess students' and faculty readiness toward online dental education in Saudi Arabia. MATERIALS AND METHODS: This is a cross-sectional study using a 5-point Likert scale questionnaire distributed to students (undergraduates and postgraduates) and faculty at King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, in 2018. It assessed individual characteristics, system competency needs, social influence, institutional support, overall readiness, and the needed technical support in using e-learning for personal as well as teaching and learning (T&L) purposes. The readiness response scale for each domain was categorized as follows: low (mean value = 1-<3), acceptable/moderate (mean value = 3-<4), and high readiness level (mean value = 4-5). Descriptive and group comparisons were conducted using Pearson's Chi-square test, paired sample t-test, independent sample t-test, one-way ANOVA, and Tukey's post hoc test. The statistical significance level was set at P < 0.05. RESULTS: the total completed response rate was 400/550 (72.7%) comprising undergraduates (n = 312), postgraduates (n = 38), and faculty (n = 50). The results showed an acceptable level of online skills with no statistically significant difference between the groups (P > 0.05). A statistically significant difference between the two categories of uses, personal and T&L, was found (P < 0.05). The undergraduate students reported statistically significantly lower readiness level in online English literacy, perceived impact of online technology on education, technology accessibility, importance of institutional support, overall readiness, and the need for technical support (P < 0.05). CONCLUSION: Significant differences between students' and faculty readiness for e-learning adoption in dental education were reported. The current study captured the prepandemic e-readiness of students and faculty as a baseline for future assessment of pandemic effect on education.

Does psychological well-being influence oral-health-related quality of life reports in children receiving orthodontic treatment?

INTRODUCTION: Although the associations between oral biologic variables such as malocclusion and oral-health-related quality of life (OHRQOL) have been explored, little research has been done to address the influence of psychological characteristics on perceived OHRQOL. The aim of this study was to assess OHRQOL outcomes in orthodontics while controlling for individual psychological characteristics. We postulated that children with better psychological well-being (PWB) would experience fewer negative OHRQOL impacts, regardless of their orthodontic treatment status. METHODS: One hundred eighteen children (74 treatment and 44 on the waiting list), aged 11 to 14 years, seeking treatment at the orthodontic clinics at the University of Toronto, participated in this study. The child perception questionnaire (CPQ11-14) and the PWB subscale of the child health questionnaire were administered at baseline and follow-up. Occlusal changes were assessed by using the dental aesthetic index. A waiting-list comparison group was used to account for age-related effects. RESULTS: Although the treatment subjects had significantly better OHRQOL scores at follow-up, the results were significantly modified by each subject's PWB status (P <0.01). Furthermore, multivariate analysis showed that PWB contributed significantly to the variance in CPQ11-14 scores (26%). In contrast, the amount of variance explained by the treatment status alone was relatively small (9%). CONCLUSIONS: The results of this study support the postulated mediator role of PWB when evaluating OHRQOL outcomes in children undergoing orthodontic treatment. Children with better PWB are, in general, more likely to report better OHRQOL regardless of their orthodontic treatment status. On the other hand, children with low PWB, who did not receive orthodontic treatment, experienced worse OHRQOL compared with those who received treatment. This suggests that children with low PWB can benefit from orthodontic treatment. Nonetheless, further work, with larger samples and longer follow-ups, is needed to confirm this finding and to improve our understanding of how other psychological factors relate to patients' OHRQOL.

Impact of self-esteem on the oral-health-related quality of life of children with malocclusion.

INTRODUCTION: The purpose of this study was to examine the relationship between self-esteem and oral-health-related quality of life (OHRQoL) in a sample of children seeking orthodontic treatment in Toronto, Ontario, Canada. METHODS: This was a cross-sectional study of children aged 11 to 14 years, evaluating the associations among the child perception questionnaire (CPQ11-14), the self-esteem subscale of the child health questionnaire, and the dental aesthetic index (DAI). RESULTS: The CPQ11-14 scores were significantly related to the self-esteem scores and the DAI ratings. Regression analysis showed that self-esteem contributed significantly to the variance in CPQ11-14 scores. However, the amount of variance explained by normative measures of malocclusion was relatively small. CONCLUSIONS: The impact of malocclusion on quality of life is substantial in children with low self-esteem. Compared with normative measures of malocclusion, self-esteem is a more salient determinant of OHRQoL in children seeking orthodontic treatment. Longitudinal data will be of value to confirm this finding.

Is the child oral health quality of life questionnaire sensitive to change in the context of orthodontic treatment? A brief communication.

OBJECTIVE: This study aimed to assess the ability of the Child Oral Health Quality of Life Questionnaire (COHQoL) to detect change following provision of orthodontic treatment. METHODS: Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the Child Perception Questionnaire, while their parents completed a copy of the Parents Perception Questionnaire and the Family Impact Scale. Normative outcomes were assessed using the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index. Change scores and effect sizes were calculated for all scales. RESULTS: Complete data were collected for 45 children and 26 parents. The mean age was 12.6 years (standard deviation = 1.4). There were significant pre-/posttreatment changes in DAI and PAR scores and significant changes in scores on all three questionnaires (P < 0.05). Effect sizes for the latter were moderate. Global transition judgments also confirmed pre-/posttreatment improvements in oral health and wellbeing. CONCLUSION: The results provide preliminary evidence of the sensitivity to change of the COHQoL questionnaires when used with children receiving orthodontic treatment. However, the study needs to be repeated in different treatment settings and with a larger sample size in order to confirm the utility of the measure.