Teaching of composite restoration repair in Brazilian dental schools.

OBJECTIVES: The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools. METHODS: A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs. RESULTS: Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability. CONCLUSIONS: The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed. CLINICAL SIGNIFICANCE: The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies.

Is there a correlation between students' performance in dental anatomy and performance in operative dentistry? / ¿Existe una correlación entre el rendimiento de los estudiante de anatomía dental y el rendimiento en odontología operativa?

SUMMARY: Manual skills form only a part of the capabilities required for a future dentist. Nevertheless, they are very important components that should be tested. The aim of this study is to investigate if a correlation exists between dental students' grades in the preclinical courses and their clinical performance. Preclinical/clinical grades were collected for first, fourth, and fifth year students who graduated from the Faculty of Dentistry at the University of Jordan, Amman, Jordan, in 2016, and 2017. Two courses (Dental Anatomy and Operative Dentistry) were selected. Corre-lations comparing the practical grades of Dental Anatomy course for first year students, and the practical grades of Operative Dentistry course for the same students in fourth and fifth years. Statistically significant positive correlation was found between the soap carving grades of first-year dental students and their practical grades in Operative Dentistry course during fourth and fifth years. Also, statistically significant strong positive correlation was found between the grades of fourth-year practical Operative Dentistry and the grades of fifth-year practical Operative Dentistry. The clinical performance of dental students in their practical courses in fourth and fifth years can be predicted from their soap carving grades at their first year in Dental School.

RESUMEN: Las habilidades manuales forman solo una parte de las capacidades requeridas para un futuro dentista. Sin embargo, son componentes muy importantes que deben ser probados. El objetivo de este estudio fue investigar si existe una correlación entre las calificaciones de los estudiantes de odontología en los cursos preclínicos y su desempeño clínico. Los grados preclínicos / clínicos se obtuvieron para los estudiantes de primero, cuarto y quinto año, graduados de la Facultad de Odontología, de la Universidad de Jordania, Amman, Jordania, en 2016 y 2017. Se seleccionaron dos cursos (Anatomía Dental y Odontología Operativa). Correlaciones que comparan los grados prácticos del curso de Anatomía Dental para estudiantes de primer año y las notas de calificación prácticas del curso de Odontología Operativa para los mismos estudiantes en cuarto y quinto año. Se encontró una correlación positiva estadísticamente significativa, entre las notas de tallado de jabón de los estudiantes de primer año de odontología y sus notas de calificación prácticas en el curso de Odontología Operativa durante el cuarto y quinto años. Además, se encontró una fuerte correlación positiva estadísticamente significativa entre las notas de calificación en Odontología Operativa práctica de cuarto año y los grados de Odontología Operativa práctica de quinto año. El rendimiento clínico de los estudiantes de odontología en sus cursos prácticos en cuarto y quinto año se puede predecir a partir de las calificaciones en tallado de jabón durante su primer año en la Escuela de Odontología.

A Review of Simulators with Haptic Devices for Medical Training.

Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

Development and Application of a New Learning Object for Teaching Operative Dentistry Using Augmented Reality.

Learning objects (LOs) associated with augmented reality have been used as attractive new technologic tools in the educational process. However, the acceptance of new LOs must be verified with the purpose of using these innovations in the learning process in general. The aim of this study was to develop a new LO and investigate the acceptance of gold onlay in teaching preparation design at a dental school in Brazil. Questionnaires were designed to assess, first, the users' computational ability and knowledge of computers (Q1) and, second, the users' acceptance of the new LO (Q2). For both questionnaires, the internal consistency index was calculated to determine whether the questions were measuring the same construct. The reliability of Q2 was measured with a retest procedure. The LO was tested by dental students (n=28), professors and postgraduate students in dentistry and prosthetics (n=30), and dentists participating in a continuing education or remedial course in dentistry and/or prosthetics (n=19). Analyses of internal consistency (Kappa coefficient and Cronbach's alpha) demonstrated a high degree of confidence in the questionnaires. Tests for simple linear regressions were conducted between the response variable (Q2) and the following explanative variables: the Q1 score, age, gender, and group. The results showed wide acceptance regardless of the subjects' computational ability (p=0.99; R2=0), gender (p=0.27; R2=1.6%), age (p=0.27; R2=0.1%), or group (p=0.53; R2=1.9%). The methodology used enabled the development of an LO with a high index of acceptance for all groups.

Current cariology education in dental schools in Spanish-speaking Latin American countries.

This study sought to provide an overview of current cariology education in Spanish-speaking Latin American dental schools. Data collection was via an eighteen-item survey with questions about curriculum, methods of diagnosis and treatment, and instructors' perceptions about cariology teaching. The response rate was 62.1 percent (n=54), and distribution of participating schools by country was as follows: Bolivia (four), Chile (four), Colombia (twenty-four), Costa Rica (one), Cuba (one), Dominican Republic (two), El Salvador (two), Mexico (six), Panama (two), Peru (four), Puerto Rico (one), Uruguay (two), and Venezuela (one). Forty percent of the responding schools considered cariology the key axis of a course, with a cariology department in 16.7 percent. All schools reported teaching cariology, but with varying hours and at varying times in the curriculum, and 77.8 percent reported having preclinical practices. The majority reported teaching most main teaching topics, except for behavioral sciences, microbiology, saliva and systemic diseases, caries-risk factors, root caries, erosion, and early caries management strategies. The most frequently taught caries detection methods were visual-tactile (96.3 percent), radiographic (92.6 percent), and the International Caries Detection and Assessment System (ICDAS) (61.1 percent). Respondents said their schools' clinics make an operative treatment decision when radiolucency is in the inner half of enamel (42.3 percent) for radiographic criteria and when the lesion is visually non-cavitated (5.8 percent). All respondents reported that their schools teach preventive strategies, but only 43.4 percent said they tie it to risk assessment and 40.7 percent said they implement nonsurgical management regularly.

Rapid prototyping and 3D-virtual models for operative dentistry education in Brazil.

Many dental students struggle for visual recognition when first exposed to the study of tooth cavity preparation in the operative dentistry laboratory. Rapid prototypes and virtual models of different cavity preparations were developed for the incoming first-year class of 2010 at the Dental School of Federal University of Uberlândia, Brazil, to help them to visualize the subtle differences in cavity preparations and are described in this article. Rapid prototyping techniques have been used in dental therapy, mainly for the fabrication of models to ease surgical planning in implantology, orthodontics, and maxillofacial prostheses. On the other hand, the application of these technologies associated with 3D-virtual models in dental education is waiting to be exploited, once they have significant potential to complement conventional training methods in dentistry.

Paediatric dentistry education of atraumatic restorative treatment (ART) in Brazilian dental schools.

AIM: To evaluate the degree of knowledge, use and teaching of atraumatic restorative treatment (ART) of paediatric dentistry lecturers in dental schools throughout Brazil. METHODS: A structured questionnaire was applied, containing questions regarding the use of ART, socio-demographic characteristics and academic degree background. Descriptive analysis and Poisson's regression were conducted in order to verify the association between exploratory variables and ART teaching (α=5%). RESULTS: Of the 721 questionnaires sent to dental schools, approximately 40% were returned (n=285). Some 98.2% of the participants teach ART. STATISTICS: Concerning dental lecturers who teach ART, in multiple regression model, considering ART indication (emergency versus restorative treatment) the lecturers residents of the Mid-West (PR=1.66; CI:1.13-2.45) and Northeast region (PR=1.33; CI:1.02-1.72) and lecturers who use ART regularly (PR=3.73; CI:2.11-5.59) teach ART as restorative treatment. When the question was about reason for using ART (conservative technique versus other techniques failures/fast treatment), lecturers with a longer period of TG (time elapsed since graduation) (PR=1.30; CI:1.08- 1.56) and also lecturers who use ART regularly (PR=2.87; CI:1.95-4.22), teach it as being a conservative technique. Regarding the patients' age covered by ART (versus without limitation), women (PR=1.26; CI:1.06-1.50) and lecturers who use ART regularly (PR=1.28; CI:1.06-1.54), teach that there is no age restriction. CONCLUSIONS: ART has been widely taught in Brazilian dental schools, is regularly used in lecturer's clinical practices and has positively influenced the appropriate teaching of this technique.

E-learning used in a training course on atraumatic restorative treatment (ART) for Brazilian dentists.

The purpose of this study was to assess the benefits of using e-learning resources in a dental training course on Atraumatic Restorative Treatment (ART). This e-course was given in a DVD format, which presented the ART technique and philosophy. The participants were twenty-four dentists from the Brazilian public health system. Prior to receiving the DVD, the dentists answered a questionnaire regarding their personal data, previous knowledge about ART, and general interest in training courses. The dentists also participated in an assessment process consisting of a test applied before and after the course. A single researcher corrected the tests, and intraexaminer reproducibility was calculated (kappa=0.89). Paired t-tests were carried out to compare the means between the assessments, showing a significant improvement in the performance of the subjects on the test taken after the course (p<0.05). A linear regression model was used with the difference between the means as the outcome. A greater improvement on the test results was observed among female dentists (p=0.034), dentists working for a shorter period of time in the public health system (p=0.042), and dentists who used the ART technique only for urgent and/or temporary treatment (p=0.010). In conclusion, e-learning has the potential of improving the knowledge that dentists working in the public health system have about ART, especially those with less clinical experience and less knowledge about the subject.

Three-year clinical performance of composite restorations placed by undergraduate dental students.

This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most restorations placed by dental students were considered satisfactory after long-term evaluation. Failure was more prevalent in larger restorations and was not associated with secondary caries.

Three-year clinical performance of composite restorations placed by undergraduate dental students

This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most restorations placed by dental students were considered satisfactory after long-term evaluation. Failure was more prevalent in larger restorations and was not associated with secondary caries.

Este estudo retrospectivo avaliou o comportamento clínico e as razões de falhas de restaurações de resina composta em dentes anteriores e posteriores, realizadas por alunos de graduação em odontologia, após 3 anos de acompanhamento. Cento e dois pacientes que tiveram restaurações de resina composta colocadas por alunos do terceiro ou quarto ano foram rechamados e examinados para analisar a qualidade das restaurações. Todas as cavidades foram restauradas utilizando Prime & Bond 2.1 e TPH (Dentsply), de acordo com as orientações do fabricante. As restaurações foram avaliadas utilizando o sistema USPHS modificado. Duzentas e cinquenta e seis restaurações de resina composta, 170 em dentes anteriores e 86 em posteriores foram avaliadas. Destas restaurações, 85 por cento foram consideradas satisfatórias após 3 anos. Cavidades de classe II e classe IV apresentaram maior prevalência de falhas. Perda de restaurações e adaptação marginal deficiente foram as maiores causas de falhas. Nenhuma restauração falhou em decorrência de cárie secundária. Em conclusão, restaurações de resina composta feitas por estudantes de odontologia foram na sua maioria consideradas satisfatórias após 3 anos. Falhas das restaurações foram mais prevalentes em restaurações maiores e não esteve associada com cárie secundária.

Crown and crown-root fractures: an evaluation of the treatment plans for management proposed by 154 specialists in restorative dentistry.

Traumatic tooth injuries involve function and aesthetics and cause damage that range from minimal enamel loss to complex fractures involving the pulp tissue and even loss of the tooth crown. Technical knowledge and clinical experience are essential to establish an accurate diagnosis and provide a rational treatment. The purpose of this study was to evaluate the knowledge of Restorative Dentistry specialists about the management of crown and crown-root fractures based on treatment plans proposed by these professionals for these cases. A descriptive questionnaire was mailed to 245 Restorative Dentistry specialists with questions referring to their professional profile and the treatment plans they would propose for the management of crown and crow-root fractures resulting from dental trauma. One hundred and fifty-four questionnaires were returned properly filled. The data were subjected to descriptive statistics and the chi-square test was used to determine the frequency and the level of the significance among the variables. The analysis of data showed that in spite of having a specialist title, all interviewees had great difficulty in planning the treatments. As much as 42.8% of the participants were unable to treat all types of dental trauma. Complicated and uncomplicated crown-root fractures posed the greatest difficulties for the dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis.

Utilização de vídeo como recurso complementar de ensino em dentística operatória / The use of the video as complemental resource of teaching in operative dentistry

A diversificação das práticas pedagógicas tem sido adotada visando o aprimoramento do processo de ensino. Elaborou-se um vídeo sobre a técnica de restauração em amálgama na disciplina de Dentística Operatória da Faculdade de Odontologia de São José dos Campos – UNESP. O vídeo foi apresentado na aula expositiva, ao término da apresentação de slides, visando a melhor fixação do conhecimento e disponibilizado na Internet (http://www.fosjc.unesp.br/dentistica/paginas/ DentisticaI-noturno/paginas/Home.htm) . O objetivo desse estudo foi avaliar a opinião dos alunos sobre a validade do vídeo como facilitador da compreensão do assunto e da execução dos procedimentos laboratoriais. Foi aplicado um questionário aos alunos (n=78), com questões fechadas relativas ao aproveitamento do vídeo. Após a coleta dos resultados, os dados foram submetidos à análise estatística descritiva. Observou-se que 100% dos alunos consideraram o vídeo como um recurso facilitador da compreensão e execução laboratorial da técnica; 94,87% observaram a melhora do processo de aprendizagem decorrente da visão dinâmica apresentada no vídeo em comparação à visão estática proporcionada pelos slides. Apenas 29,49% consideraram o vídeo como substituto adequado à demonstração prática dada pelo professor. Somente 28,20% acessaram o vídeo na internet após a aula e 8,97% o indicaram a outra pessoa. Concluiu-se que a apresentação do vídeo representou um recurso complementar de ensino válido e aprovado pelos alunos, contudo, não substituiu o contato aluno/professor proporcionado durante as demonstrações práticas. Em adição, o acesso do site pela Internet deve ser mais incentivado.

The diversification of the pedagogic practices has been adopted aiming the improvement of the learning process. Avideo about the amalgam restoration technique was produced in the discipline of Operative Dentistry in São José dos Campos School of Dentistry – UNESP. The video was showed in the class, at the end of the slides show, in order to improve the understanding of the knowledge and was available in Internet (http://www.fosjc.unesp.br/dentistica/paginas/ DentisticaI noturno/paginas/Home.html). The aim of this study was to evaluate the student’s opinion about the validity of the video as a facilitator of the restoration technique understanding and of the laboratorial procedures implementation. A questionnaire was applied to the students (n=78), with closed questions related to the use of video. After the collectionof the results, data were submitted to descriptive statistic analyzes. It was observed that 100% of the students consideredthe video as valid resource of helping the understanding and laboratorial execution of the technique; 94.87% observedthe improvement of the learning process due to the dynamic vision presented in the video in comparison with the staticvision from the slides. Only 29.49% considered the video as an appropriate substitute to the practice demonstration given by the teacher. Only 28.20% accessed of the video in the Internet after the class and 8.97% students indicated itto other person. It was concluded that the video represented an additional resource of teaching and it was approved bythe students, however, it does not replace the relation student/teacher provided during the practical demonstrations. Inaddition, the access to the Internet site should be further encouraged.