Critical Thinking in Dental Students and Experienced Practitioners Assessed by the Health Sciences Reasoning Test.

To date, there has been a lack of published studies examining the validity of the Health Sciences Reasoning Test (HSRT) to assess critical thinking among dental students. The aim of this study was to examine the construct validity of the HSRT using a novice-expert model consisting of first-year dental students as novices and experienced general dentists as experts. Novice cohort subjects were recruited from all 105 students in the first-year dental school class at the University of Texas Health Science Center at San Antonio during a regularly scheduled course in August 2015. A total of 83 students participated, for a 79% response rate. Thirty individuals personally recruited from the same school's faculty and from private practitioners made up the expert cohort. The results showed that the adjusted mean overall score for the expert cohort (25.31) was significantly higher than that of the novice cohort (22.64) (p=0.04). The expert cohort achieved higher adjusted mean scores in all scales (Induction, Deduction, Analysis, Inference, and Evaluation), with the difference in the Analysis scale being significant (p=0.02). In this study, experienced general dentists achieved significantly better overall scores on the HSRT as compared to first-year dental students, suggesting the instrument was able to measure differences between novice and expert. Further efforts to validate the instrument in a dental education setting and to understand its correlation with strategies and practices aimed at developing critical thinking in dental students are warranted.

Evaluation of a novel device for measuring patient compliance with oral appliances in the treatment of obstructive sleep apnea.

PURPOSE: The purpose of this study was to evaluate a novel intraoral monitor for measuring patient compliance of oral appliances for the treatment of obstructive sleep apnea. MATERIALS AND METHODS: A clinical trial was conducted to compare objective recording by an intraoral compliance monitor and self-reporting by participants using a mandibular repositioning device (MRD). Ten participants were fitted with a Thornton Adjustable Positioner (TAP III) with an embedded compliance monitor. The participants were asked to wear the test appliance for seven nights and to record their usage of the appliance and any adverse effects in a treatment journal. The data were downloaded to a dedicated computer using radio-frequency identification (RFID) technology, and the information was compared to the data in the participant's journal. RESULTS: The mean objective wearing time, as detected by the compliance monitor, was found to be 6.6 ± 1.6 hours/night. The mean subjective wearing time, as recorded by the participants, was 6.5 ± 1.5 hours/night. The correlation between subjective and objective times was 0.9985. The use of the test appliance by this sample population was 68.7% with a range of 24% to 100%. Participants reported a range of adverse outcomes related to the MRD consistent with those reported in the literature and were found to be transient in nature. CONCLUSIONS: This study supports previously reported usage times and adverse outcomes. The compliance monitor showed a very high linear correlation between subjective and objective data, validating its use in future compliance studies.

Relationship between clinical periodontal biotype and labial plate thickness: an in vivo study.

The primary aim of this study was to evaluate the differences in labial plate thickness in patients identified as having thin versus thick/average periodontal biotypes. The association between biotype and labial plate thickness was evaluated by correlating information obtained from cone beam computed tomographs, diagnostic impressions, and clinical examinations of the maxillary anterior teeth (canine to canine) in 60 patients. Compared to a thick/average biotype, a thin biotype was associated with thinner labial plate thickness (P < .001), narrower keratinized tissue width (P < .001), greater distance from the cementoenamel junction to the initial alveolar crest (P = .02), and probe visibility through the sulcus. There was no relationship between biotype and tooth height-to-width ratio or facial recession. Periodontal biotype is significantly related to labial plate thickness, alveolar crest position, keratinized tissue width, gingival architecture, and probe visibility but unrelated to facial recession.

Customizing a nasal CPAP mask using a silicone elastomer.

Nasal continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA). Airway obstruction is prevented by delivering air at a constant pressure via a nasal mask worn during sleep. Small nares may cause difficulty in wearing even the smallest standard nasal mask, with wear resulting in discomfort and air leaks. This article describes a method for fabricating a custom nasal CPAP mask using maxillofacial prosthodontic laboratory techniques.

Microabrasion of cast metal margins--a warning.

Plastic test patterns were milled to simulate casting margins and were cast in a variety of dental alloys. The cast specimens were exposed to horizontal and vertical streams of low-pressure microabrasion with 50 microm aluminum oxide particles. Post-exposure measurements show all specimens were affected by microabrasion. Dentists and laboratory technicians who use microabrasion must be aware of the potential damage to casting margins.

Fabrication of a stable surgical template using staged tooth extraction for immediate implant placement.

When a patient with a nonrestorable dentition desires an immediate restoration, fabrication and use of a stable surgical template can be challenging. Conventionally made surgical templates may lack stability and may, therefore, be less predictable. This article describes the fabrication of a surgical template that permitted the use of staged tooth extraction to facilitate predictable immediate implant placement in a patient with a nonrestorable dentition.

Fracture of a fixed partial denture abutment: a clinical report.

Commonly observed complications associated with a conventional fixed partial denture (FPD) include loss of retention and tooth fracture. This report describes the occurrence of an unusual FPD abutment fracture and subsequent treatment. The distal abutment of an FPD developed severe periodontal disease with mobility. The anterior abutment fractured in the middle of the clinical crown and experienced cement failure.

Removal of a metal-ceramic fixed partial denture with a loose retainer.

In clinical practice, it is necessary to remove a ceramic-veneered fixed partial denture when an abutment becomes loose. When possible, the fixed partial denture is removed in a single piece, allowing recementation when appropriate. A 1-piece removal is challenging, often putting the veneer and abutment teeth at risk for damage. This article describes a technique for fabricating and using a 2-piece matrix that both protects the prosthesis and better directs removal forces along the long axis of the abutments.

The single-unit crown: factors for clinical success.

Application of the crown preparation guidelines obtained through theoretical models, laboratory testing and clinical studies provide an evidence-based rationale for clinical practice procedures. The evidence-based rationale has been presented to support basic day-to-day techniques in clinical practice. As new techniques and materials are developed, each should be evaluated carefully prior to clinical use and acceptance.