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.

A Combination of Various Technologies in the Fabrication of a Removable Partial Denture--A Case Study.

Digital dentistry is increasing prevalent throughout general dental practice. Scanned impression systems, CAD/CAM software, milling units, and 3D printers are becoming used with regularity by some private practitioners. This case report describes a combination of multiple technologies including intraoral scanning, 3D printing, and traditional impression and processing techniques used for fabricating a removable partial denture. The patient indicated that he was highly satisfied throughout the course of treatment and especially with the final result. Future technology will continue to evolve and be more widely used in removable prosthodontics and other areas of dentistry.

Case report: immediate dentures in an HIV positive patient.

A 35-year-old patient with a previous history of recreational drug use, mainly cocaine, presented to the UTHSCSA Dental School with grossly carious remaining dentition. The pattern of the wear and caries on the teeth also indicated other recreational drug such as methamphetamine over a long period of time. He was planned for extractions of the remaining teeth and placement of immediate dentures considering the patient's wish for not being edentulous for the healing period.

Alternatives to traditional complete dentures.

Specific alternatives to traditional complete denture therapy have been controversial because of the uncertainties surrounding effectiveness of retention. This article addresses the importance of retention, border molding, diagnosis, and treatment planning, and the meticulous attention to detail required throughout the treatment course of these alternative modalities. Indications, advantages, and limitations are also presented. Although these alternatives are not routinely used in making complete dentures, they have been successfully used for the treatment of the edentulous patient. Alternatives serve as valuable prosthodontic treatment options that greatly enhance denture aesthetics, and should be considered for edentulous patients.

Effects of pretreating preparations with sodium hypochlorite on bonding composite resin restorations.

This study sought to determine whether using sodium hypochlorite (NaOCl) as a pretreatment in bonding composite resins has a detrimental effect on bond strength. Previous studies have addressed pretreating dentin with NaOCl after etching; however, little research is available concerning pretreatment before etching. This study examines pretreating dentin with NaOCl prior to acid etching when fourth generation bonding systems are used. Thirty noncarious teeth were selected and sectioned horizontally at the occlusal third of the clinical crown. The teeth were divided into 3 groups (n = 10). Group 1 was the control group, with composite resin bonded to the dentin surface per manufacturer's instructions. Group 2 was pretreated with 6% NaOCl for 10 seconds; then, composite resin was bonded to the dentin as in Group 1. Group 3 was pretreated with 6% NaOCl for 20 seconds; then composite resin was bonded to the dentin as in Group 1. The specimens were stored in water for 24 hours, then thermocycled for 1000 cycles at temperatures of 5°C and 60°C. The specimens were shear tested until failure. According to the 1-way ANOVA testing (α = 0.05), using NaOCl as a pretreatment prior to etching with a specific fourth generation bonding agent does not affect bond strength.

Long term success of 6 implants supporting a mandibular screw-retained fixed dental prosthesis: a clinical report.

Dental implant therapy has become successful with improved surgical and prosthodontic techniques. However, most clinical trials, even though well controlled, are limited in longevity. There are few clinical reports that show long-term results with dental implants. Although there are many similarities among criteria for success in these studies, these criteria may vary from what the individual patient reports as a success. This clinical report describes the 28-year successful clinical outcome of a 62-year-old woman with dental implants supporting a mandibular screw-retained fixed dental prosthesis.

Dental implants in the older adult.

A need for dental implant treatment in the older population is recognized considering the prevalence of partial and complete edentulism and the positive predictability of implant therapy. Even with a number of barriers to overcome for the older adult seeking implant care, dental implants provide stabilizing support for removable dental appliances and have been shown to be successful in that population. In this paper, we describe quality of life, systemic, surgical, and prosthodontic considerations of this prosthetic treatment along with maintenance challenges.

A 5-year prospective multicenter clinical trial of non-submerged dental implants with a titanium plasma-sprayed surface in 200 patients.

BACKGROUND: Endosseous dental implants are a popular treatment to replace missing teeth. Although many advances have occurred and affected the macrogeometry and surface characteristics of dental implants, among other aspects, it is important to document how the implants perform in patients over time. Such evaluations are helpful not only to document the clinical survival of the implants but also patient satisfaction over an extended period. METHODS: A formal prospective multicenter human clinical was performed at five centers involving 200 patients and 626 implants. Specific inclusion and exclusion criteria were used and detailed data collected at specified times using case report forms. An independent study monitor reviewed all study data before entry into the study database. Two implant designs were used in two different clinical indications. A non-submerged titanium plasma-sprayed (TPS) hollow cylindrical implant with a smooth transgingival collar was evaluated in the maxillary anterior sextant and a non-submerged TPS solid screw implant with similar collar in the mandible. RESULTS: Over the course of the 5-year clinical trial, there was one early failure occurring before definitive prosthesis delivery. Three late failures were documented, one occurring at each of the 6, 12, and 18 months postoperative visits. Life table analysis at 5 years revealed a 99.4% survival rate and a 92.5% success rate. Patient satisfaction was rated as good to excellent for 96.1% of implants in regards to esthetics after 5 years; 98.8% for appearance; and 99.4% for prosthesis comfort, ability to chew and taste, fit, and general satisfaction. No serious adverse events were reported. CONCLUSIONS: Implant success and survival was over 92% and 99%, respectively, in a formal 5-year prospective multicenter clinical trial involving 200 patients and 626 non-submerged TPS implants. These implants included hollow cylinder implants in the anterior maxilla and solid screw implants placed in the mandible. These findings document the predictability and patient satisfaction of tooth replacement using a non-submerged surgical technique involving a tissue-level, rough surfaced endosseous dental implant.

Removable partial dentures--treatment now and for the future.

The use of a removable partial denture (RPD) in clinical practice remains a viable treatment modality. Various advancements have improved the quality of a RPD, subsequently improving the quality of life for the individuals that use them. This article describes four removable partial denture treatment modalities that provide valuable treatment for the partially edentulous patient. These modalities include: the implant supported RPD, attachment use in RPDs, rotational path RPDs, and Titanium and CAD/CAM RPDs. Data on future needs for RPDs indicate that while there is a decline in tooth loss in the U.S., the need for RPDs will actually increase as the population increases and ages. With the growth in the geriatric population, which includes a high percentage of partially edentulous patients, the use of RPDs in clinical treatment will continue to be predictable treatment option in clinical dentistry.

Fabricating a custom earpiece for hand-held radios.

This article describes the fabrication of a custom earpiece for use with hand-held radios. The technique can be used to fabricate custom earpieces, as a public service, for law enforcement personnel, firefighters, emergency medical services (EMS) personnel, and others, improving safety and providing a valuable benefit to the community.

Immediate placement and immediate provisional abutment modeling in anterior single-tooth implant restorations using a CAD/CAM application: a clinical report.

A patient underwent immediate implant placement and immediate provisional restoration with nonocclusal loading in the right central incisor area. A provisional custom abutment and a cemented provisional restoration were fabricated. At the impression appointment, an implant level impression was made and the provisional abutment was scanned for fabrication of the definitive custom abutment. This clinical report describes how CAD/CAM technology can facilitate the definitive restoration of immediately placed and loaded implants by allowing the fabrication of the definitive abutment as an exact duplicate of the provisional abutment.

Soft liners.

The article provides a background for understanding the properties of soft liner materials, describing associated problems, and discussing clinical applications of soft liners in dental practice. Although not a panacea, soft liner materials provide the practitioner with a variable tool in providing excellent clinical care for patients.

Prosthetic management of implants in the esthetic zone.

The purpose of this article is to review and project treatment procedures for areas of esthetic concern. The authors were participants in a consensus conference sponsored by ITI and held in August 2003 in Gstaad, Switzerland. This article deals with the basic prosthetic/restorative aspects in implant esthetics. It is based on a literature review performed by 16 participants from Group 2 (Buser et al) in this section of the Journal.

Proximal contour modifications for fixed partial dentures: a clinical report.

An often-neglected aspect of fixed prosthodontics is the contour of the tooth adjacent to the cast restoration. The adjacent surfaces should be surveyed to reveal compatibility with the path of insertion of the restoration. Adjacent contacts may have to be altered to permit the placement of the fixed partial denture and to ensure proper contact size/shape and embrasure size. The need for guide planes on teeth adjacent to fixed partial denture abutments in fixed prosthodontics is described.

Developing an effective generic prescription drug program.

Pharmacy benefit managers (PBMs) use a variety of pricing strategies. When employers have a thorough knowledge of those strategies, they can use them to their advantage to help manage pharmacy benefits. This article discusses PBM strategies in terms of what employers need to know, the questions employers need to ask and goals employers must keep in mind in order to secure the affordable cost and quality prescription drug management programs that they and their employees need and deserve.