Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study.

OBJECTIVES: To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan. METHODS: A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05. RESULTS: Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group. CONCLUSIONS: The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

Electrical stimulation to clinically identify position of the lingual nerve: results of 50 subjects with reliability and correlation with MRI.

PURPOSE: Recently we described mapping of the lingual nerve clinically in patients using electrical nerve stimulation. This paper reports results of a larger study with inter- and intra-observer reliability and comparison with positional measurements from magnetic resonance imaging (MRI). METHODS: In 50 healthy participants, measurements were taken when subjects felt a tingling sensation in the tongue induced by a stimulation probe over the lingual nerve. Three positions were measured in relation to the third molar. Measurement reliability was tested for both inter-observer and intra-observer agreement and positional data of the lingual nerve measured clinically was also compared with nerve position as measured from MRI scans. RESULTS: Out of 50 participants, 96 nerves (49 = left/47 = right) were included in the study. The lingual nerve was identified in 90% (87) of this sample. The mean of height of the nerve in points A, B and C were 9.64 mm, 10.77 mm and 12.34 respectively. Inter-and intra-observer agreement was considered to be good to excellent (ICC = 0.8-0.96). Agreement between nerve mapping measured values and MRI measured values was good (ICC < 0.6). CONCLUSION: This technique may prove useful for the clinical determination of lingual nerve position prior to procedures in the third molar region.

The Surgical Management of External Cervical Resorption: A Retrospective Observational Study of Treatment Outcomes and Classifications.

INTRODUCTION: The aims of this study were to assess the survival and clinical success of patients with teeth with external cervical resorption (ECR) who underwent surgical repair, to assess the reliability of using 2 different classification systems for ECR (Heithersay 2-dimensional classification and Patel 3-dimensional classification), and to identify if a 3-dimensional classification is a viable alternative. METHODS: A retrospective study was performed in a teaching dental hospital in England. The inclusion criteria were limited to patients who underwent surgical management of ECR between 2015 and 2018. Both periapical radiographs and cone-beam computed tomographic scans of 13 patients were assessed by 2 independent dental practitioners using the Heithersay and Patel classifications. The same radiographic assessment of those records was then repeated 3 weeks later by 1 operator. These data were tested using the Cohen kappa analysis to determine inter- and intraobserver agreement. RESULTS: A total of 14 teeth affected with ECR were identified in 13 patients (6 women and 7 men) with a mean age of 41 years. The mean follow-up was 20 months. At follow-up, survival was noted in all cases; however, clinical success describing endodontic success, comprehensive restorative integrity, and arrest of the resorptive process was only met in 11 cases. Although helpful in describing the lesions, both classification systems displayed considerable limitations in predicting treatment outcome. A measure of Cohen kappa regarding interobserver reliability found the Heithersay classification to provide a moderate level of agreement (0.69), whereas the Patel classification provided a weak level of agreement (0.40). CONCLUSIONS: ECR is a complex, aggressive, and uncommon form of external resorption. The long-term success of the treatment is predictable but strictly related to careful case selection and operative skill. In reference to ECR classifications, ambiguity still exists between their distinctive categories, leading to moderate and weak levels of interobserver agreement. Further improvement is required to enhance their use in future research.