Effect of surgical and prosthodontic protocols of distal extension implant-supported removable partial dentures on clinical and patient-reported outcomes: A systematic review.

STATEMENT OF PROBLEM: Standard surgical and prosthodontic protocols for managing partially dentate patients with implant-supported removable partial dentures (ISRPDs) are lacking. PURPOSE: The purpose of this systematic review was to determine clinical and patient-reported outcome measures (PROMs) in patients provided with ISRPDs in distal edentulous arches based on different surgical and prosthodontic protocols. MATERIAL AND METHODS: An electronic and manual literature search was conducted in 3 databases, PubMed/MEDLINE, SCOPUS, and Cochrane Library, for clinical studies on distal extension ISRPDs related to clinical and patient-reported outcomes. Kennedy Class I and II arches described in articles published from January 2000 to December 2023 were included. Clinical parameters regarding implant type, location, loading protocols, and implant survival rate and PROMs including masticatory performance, esthetics, and overall satisfaction were compared. The risk of bias was determined by using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). RESULTS: An initial total of 103 studies were identified, but only 11 articles were selected after implementing the inclusion and exclusion criteria. Ten studies evaluated PROMs, and 6 studies evaluated clinical outcomes (5 studies evaluated both). The implant survival rate ranged from 91.7% to 100%, with no clear differentiation among the studies with immediate or delayed loading protocols. Most studies described implants positioned in the molar region. In general, patient satisfaction and oral health-related quality of life (OHRQoL) improved significantly with ISRPDs compared with conventional removable partial dentures (RPDs) or RPDs with healing abutments. Posttreatment clinical outcomes revealed stable peri-implant health with no significant bone loss or prosthetic complications. No specific implant configuration, including implant type and location or attachment system, appeared to be better than another. Ball attachments were the commonly used attachments. Two studies were of high risk and 3 studies of low risk. The remaining 6 studies were judged to have some concerns based on the RoB 2.0 analysis. CONCLUSIONS: Providing an ISRPD improved patient satisfaction, OHRQoL, and the clinical outcomes in distal extension situations, with most studies positioning the implants in the molar region. The type of attachment did not significantly affect the outcomes, although ball attachments were the most used attachment in ISRPDs.

The effect of transactional analysis training on emotional intelligence in health professions students.

BACKGROUND: Emotional intelligence (EI) is considered to present a significant predictor of work performance whereas Transactional analysis (TA) is the relational perspective in communication in managing emotions. We evaluated the effect of psycho-educational training in EI and TA (TEITA) on EI among health professions undergraduates, with post-training, and at 1-month follow-up. METHODS: A total of 34 participants participated in the study where 17 participants were in the TEITA group and another 17 were in the control group. A quasi-experimental non-randomised, controlled cohort study was conducted, in which participants in the TEITA group were introduced to EI and TA concepts on a weekly basis for four weeks, at 90 min each time, and provided with opportunities for experiential sharing of emotions and coping mechanisms experienced in the previous week. Both TEITA and control groups received weekly EI and TA reading materials. All completed the 16-item Wong and Law EI Scale at baseline and post-training. The training group also completed the questionnaire at a 1-month follow-up. Wilcoxon Signed Ranks and Mann Whitney tests were used to analyse within a group and between group changes in EI scores. RESULTS: Baseline EI scores in the TEITA group were lower than the control group. On completion of TEITA, EI scores in the TEITA group increased, and differences were not detected between groups. Within the TEITA group, paired increases in all domains were statistically significant, whereas, in the control group, the paired increase was only detected in the domain addressing regulations of emotion (ROE). Pre to post-training increases in EI scores were statically significantly greater in TEITA compared to control groups. At the 1-month follow-up, EI scores were sustained. CONCLUSION: The psycho-educational training based on EI and TA is effective in enhancing EI among health professions undergraduates. Future research should investigate the effect of such training on observable inter-personal and socio-economic behaviours.

Does Emotional Intelligence of Dental Undergraduates Influence Their Patient Satisfaction?

OBJECTIVES: The research aimed to investigate if emotional intelligence (EI) scores of dental undergraduates influenced their patients' satisfaction with the treatment received. METHODS: A 33-item EI questionnaire was completed by 46 dental undergraduates in a cross-sectional study. Responses, measured on a five-point Likert scale, were summed to yield EI scores. Patients treated by the same undergraduates were invited to complete a patient satisfaction (PS) questionnaire. EI and PS scores were calculated and compared by undergraduates' gender and the patients' age and education status. The four EI factors (optimism/mood regulation, appraisal of emotions, utilization of emotions, and social skills of students) were correlated with PS using Spearman's correlation test with a significance level set at p < 0.05. RESULTS: EI scores did not differ significantly between male (N = 23) and female (N = 23) undergraduates (p=0.218). PS was not associated with patients' gender, but those educated to the secondary school level were more likely to be satisfied compared to those educated to the college/university level (p=0.022). Of the four EI factors, optimism/mood regulation was positively correlated with PS (p=0.049). CONCLUSION: The results of the study suggest that the EI of the students can influence PS. Practical Implications. Interventions to enhance EI can be developed to improve the patient experience.

Prevalence of Postoperative Infection after Tooth Extraction: A Retrospective Study.

The aim of the study was to identify the postoperative infection rates after tooth extraction in a university dental clinic and to identify the factors associated with an increased risk for postoperative infection. A retrospective study of case records of patients who underwent tooth extractions at the International Medical University's Oral Health Centre (IMU-OHC) over a span of 6 years was conducted. Data on demography, patient-related factors, and treatment-related factors were extracted from the case records. A binary logistic regression analysis was performed to assess the odds ratio of a patient having a postoperative infection or not, comparing it with each variable. A total of 1821 extractions, including simple and complex extractions, were performed over 6 years. Only 25 (1.4%) of the cases were reported to have a postoperative infection. The complexity of the extraction was the only variable that significantly affected the occurrence of postoperative infection after extraction; more complex extractions were reported with higher rates of infection (binary logistic regression, OR = 2.03, p = 0.004). None of the other factors, including antibiotic prescription, had a significant influence on the occurrence of postoperative infection. The prevalence of postoperative infection after dental extractions was low in IMU-OHC, and prescribing antibiotics had no added advantage in the prevention of postoperative infection.

Dental students' compliance with antibiotic prescribing guidelines for dental infections in children.

CONTEXT: To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children. METHODS: This was a cross-sectional study involving final year dentals students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students' responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20. RESULTS: A total of 108 completed responses were received. About 74 (69%) students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05). CONCLUSIONS: Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.

A comparative effect of various surface chemical treatments on the resin composite-composite repair bond strength.

AIM: The aim of this in vitro study was an attempt to investigate the effect of different surface treatments on the bond strength between pre-existing composite and repair composite resin. MATERIALS AND METHODS: Forty acrylic blocks were prepared in a cuboidal mould. In each block, a well of 5 mm diameter and 5 mm depth was prepared to retain the composite resin (Filtek™ Z350, 3M/ESPE). Aging of the composite discs was achieved by storing them in water at 37°C for 1 week, and after that were divided into 5 groups (n = 8) according to surface treatment: Group I- 37% phosphoric acid, Group II-10% hydrofluoric acid, Group III-30% citric acid, Group IV-7% maleic acid and Group V- Adhesive (no etchant). The etched surfaces were rinsed and dried followed by application of bonding agent (Adper™ Single Bond 2. 3M/ESPE). The repair composite was placed on aged composite, light-cured for 40 seconds and stored in water at 37°C for 1 week. Shear bond strength between the aged and the new composite resin was determined with a universal testing machine (crosshead speed of 0.5 mm/min). STATISTICAL ANALYSIS: The compressive shear strengths were compared for differences using ANOVA test followed by Tamhane's T2 post hoc analysis. RESULTS: The surface treatment with 10% hydrofluoric acid showed the maximum bond strength followed by 30% citric acid, 7% maleic acid and 37% phosphoric acid in decreasing order. CONCLUSION: The use of 10% hydrofluoric acid can be a good alternative for surface treatment in repair of composite resin restoration as compared to commonly used 37% orthophosphoric acid.

Indian dental students' preferences regarding lecture courses.

Teaching and learning activities in the dental clinic or hospital are a challenging area for students as well as teachers. With various teaching methodologies being used in dental schools around the world, gaining greater understanding of students' attitudes toward these methodologies would be useful for dental educators. The objective of this study was to explore the preferences of dental students in India about various aspects of lecture courses. A structured survey consisting of ten closed-ended questions was developed, and 2,680 undergraduate students from forty-three dental schools in India were approached via e-mail with a follow-up postal mailing. Of these, 1,980 students responded, for a response rate of 73.8 percent. Most of the students reported preferring lectures with the aid of PowerPoint and chalkboard. They preferred morning lectures from 8 am to 10 am for a maximum of thirty to forty minutes for each lecture, and they preferred to receive information about the lecture topic in advance. The students said that delivery of clinical demonstrations was beneficial after the lectures, and they preferred learning-based rather than exam-oriented education. The respondents also said that attendance should be made compulsory and that numerical marking of examinations should not be replaced by a grading system.

Management of supernumerary teeth.

Supernumerary paramolars are the rare anomalies of the maxillofacial complex. These are more common in the maxilla than in the mandible. This article reviews the etiology, frequency, classification, complications, diagnosis and management of supernumerary teeth (bilateral maxillary paramolars).

Management of dentinal hypersensitivity: a review.

Dentinal hypersensitivity is a very common clinical finding that can cause considerable concern for the patient. Clinicians must understand the various etiological factors, their complexities, and numerous treatment options available. This article reviews the etiology, management, and prevention of dentinal hypersensitivity.

Comparative evaluation of the curve of Spee in two age groups and its relation to posterior teeth disclusion.

OBJECTIVES: This study aims to compare the curve of Spee in human permanent healthy dentitions in two age groups to the disclusion in the premolar and molar region during protrusion. MATERIALS AND METHODS: Sixty subjects were chosen and equally divided into two age groups of 18-25 years and 35-44 years. The left side of the mandibular dental casts was photographed using a digital camera to measure the curve of Spee. The canine cusp, mesiobuccal cusp of the first molar and the distal cusp of the second molar were marked and joined to form an arc. Using AUTOCAD software, the radius for this arc was obtained. A protrusive interocclusal record was made using rigid bite registration material to measure the amount of posterior disclusion during edge to edge protrusion. A dial gauge with an accuracy of 1/100 of a millimeter was used to measure the distance between the cusp tip indentations at the region of the buccal cusp of the mandibular 2nd premolar and distobuccal cusp of mandibular 1st molar. The results obtained were statistically analyzed. RESULTS: The radius of curve of Spee increased nonsignificantly with age. The mean disclusion values measured in premolar and molar region showed a nonsignificant decrease with age. CONCLUSION: As age advances, there is a flattening of the curve of Spee and a concurrent reduction in the disclusion values during protrusion.

Use of a natural tooth crown as a pontic following cervical root fracture: a case report.

The loss of anterior teeth can be psychologically and socially damaging to the patient. Despite a wide range of treatment options available, traumatised teeth may be inevitably lost on certain occasions. This paper describes the immediate replacement of a right central incisor using a fibre-composite resin with the natural tooth crown as a pontic. The abutment teeth can be conserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at chair side thereby avoiding laboratory costs. It can be used as an interim measure or a definitive prosthesis.