Impact of class II and class III skeletal malocclusion on pharyngeal airway dimensions: A systematic literature review and meta-analysis.

Background: This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods: An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion: Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.

Exploring Professionalism among Final Year Dental Students and New Graduates: Translating Knowledge to Practice.

OBJECTIVES: The aim of this study was to evaluate senior students' and dental graduates' perception of professionalism as defined by international regulatory bodies and to assess students' ability to apply such knowledge in clinical-based scenarios. MATERIALS AND METHODS: Knowledge of professional competencies was conducted using a survey based on domains of professionalism for a newly qualified general dental practitioner as defined by international regulatory bodies. This survey consists of 32 items addressing participants' perception of three domains of professionalism. Application of the perceived professional competencies was tested by asking participants to answer questions following the observation of a clinical-based scenario video where participants needed to identify issues related to professional, ethical, and communication skills, which were embedded in the scenarios. STATISTICAL ANALYSIS: Differences were analyzed using ANOVA and t-tests (p<0.05). RESULTS: Data from 146 participants showed no significant differences in the survey scores between the participants' professional levels, place of practice, age groups, and genders. Analyses of correlation between the different domains of professionalism showed significant relationships between pair-wise comparisons of the total domain scores. Paired t-tests revealed that the mean score percentage for each of the three domains of professionalism was significantly higher than the responses reported in the relevant clinical-based scenario questions. CONCLUSIONS: This indicates that all domains of professionalism contributed in a similar way to their overall assessment. Furthermore, our findings show that dental practitioners may not be able to apply their knowledge of professionalism in real-life scenarios. This suggests that teaching professionalism at the early stages of the dental curriculum should incorporate innovative approaches to mimic real-life scenarios.

Impact of Guidance and Multitasking on Manual Dexterity Skills in Dentistry.

OBJECTIVES: This study investigated the effect of learning by observation on the development of fine motor skills related to endodontic manual instrumentation. We evaluated if learning by observation with guidance had any influence upon operator performance under tense or taxing conditions. MATERIALS AND METHODS: Dental students prepared standardized simulated root canals of varying morphology. Learning involved silent video with hand guidance (n = 23), audiovisual combined with oral instructions (n = 23), or silent video (n = 13). Undergraduates who previously completed conventional preclinical endodontics provided comparative data as a control group (n = 16). During investigations, a root canal of a lower molar plastic tooth was shaped, beginning with a primary task, and followed by multitasking conditions. The performance of the students was assessed by evaluating the accuracy of dental canal shaping and time taken to complete the task. STATISTICAL ANALYSIS: Differences were analyzed using ANOVA (p < 0.05). RESULTS: Performance was similar during learning between the three experimental groups. Accuracy of the performance did not differ within each group for the two tests nor between the groups at each test (p > 0.05). CONCLUSIONS: These findings demonstrated that performance subsequent to learning by observation without instructions was comparable to learning with instructed observation. The results also identified that the performance of the experimental group (1.5- to 2-hour practice) was comparable with the conventional control group (15- to 20-hour practice). Alternative approaches to learning dexterity skills in dentistry may provide improved outcomes, especially in demanding situations.

Genetic, Epigenetic and Environmental Factors Influence the Phenotype of Tooth Number, Size and Shape: Anterior Maxillary Supernumeraries and the Morphology of Mandibular Incisors.

The aim of this study is to investigate whether the genetic, epigenetic and environmental factors that give rise to supernumeraries in the maxillary incisor region and larger dimensions of the adjacent maxillary incisors are also associated with variations in the morphology of the mandibular incisors. If so, this would contribute to understanding the distribution and interactions of factors during dental development and how these can be modelled. The sample consisted of 34 patients with supernumerary teeth in the maxillary anterior region, matched for gender, age and White Caucasian ethnicity with 34 control subjects. The average ages of the supernumerary and control groups were 12.8 and 12.2 years, respectively. Study models of all subjects were constructed and imaged using a previously validated system. Using custom software, each of the mandibular incisor teeth were measured to obtain 17 parameters from the labial view and 17 from the occlusal view. Principal component analysis (PCA) was used to summarize the measurements into a smaller set representing distinct features of the clinical crowns, followed by a comparison between the supernumerary and control groups using 2-way ANOVA. Seven factors of tooth size of the mandibular central incisors and six factors of the mandibular lateral incisors were identified as major features of the clinical crowns. All parameters of both mandibular incisors were greater in the supernumerary group than in the control, with three of these, located in the incisal and cervical regions of the mandibular lateral incisors, being statistically significantly larger. The findings of this study indicate that the aetiological factors associated with supernumerary teeth in the maxillary anterior region also affect tooth crown dimensions of mandibular incisors. This new evidence enhances several models of the interactions of genetic, epigenetic and environmental components of dental development and supports a multi-model approach to increase understanding of this process and its variations.

The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt.

The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals.

The educational use of social networking sites among medical and health sciences students: a cross campus interventional study.

BACKGROUND: In recent years, social networking sites (SNSs) have evolved beyond connection and networking to become a powerful instructional tool. There is still a dearth of knowledge on the professional use of SNSs for education particularly among students from diverse backgrounds. This study examined the extent and pattern of SNSs usage for education across six institutions and then conducted an interventional workshop to fortify and regulate the educational use of SNSs. METHODS: This multicenter study was done in two phases. In the first phase, an online cross-sectional survey using a validated inventory was administered to determine the prevalence, extent, and preferences of SNSs usage by undergraduate students in medicine, health sciences and dentistry across five centers. Later, the second phase of the study was undertaken in a 75-min guided live workshop about the appropriate use of SNSs in academia. Additionally, pre- and post-test surveys were conducted to assess the impact and outcome of workshop. RESULTS: Of the 1722 respondents, 1553 (90%) reported using SNSs with the frequency of once a month to three to five times per day for education and to stay in touch with others. Most students agreed with the benefits of SNSs for education mainly in terms of information gathering, networking and collaboration. Twitter, Instagram, and Pinterest were noted as the most preferred SNSs for education. Nevertheless, 63% perceived that proper instruction was required for the efficient use of SNSs. Following the guided workshop, there was a significant improvement in web technology understanding, digital professionalism, skills and knowledge on the productive use of SNSs. Students rated the efficient for conceptual learning, connection to community practice, e-portfolio, and collaborative learning as the top four major teaching and learning strategies, respectively, in the post-workshop survey. CONCLUSION: Our study demonstrates that SNSs can be used as learning tools in medical education. However, SNSs usage should be regulated and guided for a more collegial and coherent learning climate in the digital realm. We urge medical educators to integrate SNSs into their courses for a technologically advanced and impactful curriculum.

Clinical effectiveness of space maintainers and space regainers in the mixed dentition: A systematic review.

BACKGROUND: The aim of this systematic review was to address the clinical effectiveness of space maintainers and space regainers in the prevention and correction of dental arch decreases in mixed dentition. METHODS: An electronic search was conducted using five databases: the Cochrane Database for Systematic Reviews, EBSCO Host, ScienceDirect, PubMed, and Scopus (until February 2021) and 6 relevant journals. Inclusion criteria were: Randomized Controlled Clinical Trials (RCTs), Controlled Clinical Trials (CCTs), cohort studies and case-control studies of children in the mixed dentition requiring a space maintainer or a space regainer, children with mild to moderate crowding, and with Class I and mild Class II or Class III skeletal pattern. All articles included in this review were examined independently by three teams of investigators to assess the level of bias using the Cochrane risk of bias tools RoB 2.0 (for RCTs) and ROBINS-I (for non-RCTs). RESULTS: Following the three phases of a systematic search, 11 studies were included for the final analysis, of which nine used space maintainers (a lower lingual arch) and two used space regainers (one lip bumper and one transpalatal arch) with contradicting results. Four of the former and one of the latter devices showed a significant increase in arch length. Out of the 11 articles, one was found to be of critical risk, two of serious risk and eight of moderate risk of bias. CONCLUSIONS: There is very low evidence to suggest that space maintainers and regainers are effective in preserving arch length and preventing mild to moderate crowding in children during the mixed dentition stage at the expense of lower incisor proclination. However, considering the low evidence provided by this systematic review, high-quality studies are needed.

Is Orthodontic Treatment a Risk Factor of Cervical Root Resorption? A Systematic Review.

Cervical root resorption is an uncommon, aggressive form of external resorption that occurs on the root surface of a permanent tooth and presents clinically as a characteristic pinkish discoloration of the tooth. The cause of cervical root resorption is poorly understood, and it has been suggested that orthodontic treatment may play a role in causing this pathological condition. The aim of this systematic review was to investigate whether orthodontic treatment could be considered as a risk factor of cervical root resorption in patients who had undergone fixed appliances therapy. A comprehensive electronic and manual search was conducted in four databases and six journals without any limitations on year of publication. A customized data extraction form was used to retrieve relevant information from each eligible study. Risk of bias was assessed using the Cochrane risk of bias tool (RoB 2) and the risk of bias in nonrandomized studies of interventions tool (ROBINS-I). The quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. Two randomized clinical trials (RCTs) and one cohort study were included in the review. Risk of bias was assessed as high for both RCTs and critical for the cohort study. Conflicting results were reported by the studies included in this review. Both RCTs reported significant differences between orthodontically moved teeth and teeth that were not moved, while the cohort study reported a lack of association between fixed orthodontic treatment and cervical root resorption. Quality of evidence provided by this review was judged to be of very low quality. Orthodontic treatment may have potential in inducing cervical root resorption; however, due to the high risk of bias of the included studies and their conflicting findings, better-quality studies are needed to make definitive conclusions.

Determining the impact of stressors on students' clinical performance in endodontics.

OBJECTIVES: This study aims to evaluate the impact of stress on the clinical performance of endodontics dental students. METHOD: The study sample consists of 16 randomly selected fourth-year dental students who had completed pre-clinical activities stipulated in their curriculum. The distal canal of a plastic mandibular first molar is prepared on two separate occasions, first under normal conditions and then under stressful conditions. The preparation accuracy of the root canal and the time taken to complete the task area measured. Stress is assessed using subjective (State-Trait Anxiety Inventory and Perceived Stress Scale) and objective (heart rate) measures. RESULTS: While the accuracy of the root canal preparation did not differ significantly between the normal and stressful conditions (p > 0.05, paired t-test), the completion time for the root canal preparation decreased significantly under stressful conditions (p < 0.05, paired t-test). CONCLUSION: The findings of this study suggest that there is no association between the high levels of stress and the performance breakdown of root canal hand instrumentation skills. Students develop an adaptive response to stress, enabling them to improve their completion times and maintain their performance under stressful conditions. Future research should focus on learning methods that can contribute toward better outcomes, especially in stressful environments.

Valproate-induced Periorbital Edema.

INTRODUCTION: Valproate is an antiepileptic medication that can be used to manage behavioral symptoms associated with Alzheimer's dementia. We present a rare case of valproate-induced periorbital edema. CASE: A 76-year-old man came to the emergency room with agitation and aggression. He was medically cleared and referred to a psychiatric facility where he was treated with haloperidol. When he developed drug-induced parkinsonism, the haloperidol was stopped, and the patient was started on valproate 250 mg twice daily. The day after valproate administration, the patient developed periorbital edema. After ruling out other causes of periorbital edema, adverse drug reaction was suspected. Valproate was discontinued, and the edema rapidly resolved within five days. CONCLUSION: Periorbital edema is a rare side effect of valproate. It can occur in patients who are being treated with valproate for behavioral changes in Alzheimer's disease. The edema resolves with discontinuation of the medication.

Impact of tribocorrosion and titanium particles release on dental implant complications - A narrative review.

Titanium particles as a product of degradation have been detected in periimplant oral tissues and it has been assumed that implants were the source of these particles. Periimplantitis sites had higher concentrations of particles in comparison to healthy implant sites. Several factors have been identified in the degradation of dental implant surface, such as mechanical wear, contact with chemical agents, and the effects of biofilm adhesion. Titanium particles silently prompt the immune-system activation and generate a pro-inflammatory response in macrophages, T lymphocytes and monocytes. During the activation, inflammatory cytokines are released including, granulocyte-macrophage colony-stimulating factor (GM-CSF), prostaglandin, and TNF-α, IL-1ß, IL-6. The nanoparticles depict unique features such as high level of biological reactivity and potentially harmful compared to microparticles since they have a relatively greater surface area to volume ratio. Allergic response to titanium as a cause of implant failure has not been well documented. Evidence demonstrating biological complication due to titanium particles release includes peri-implant tissue inflammation that lead terminally to implant loss. There is a biological probability for a relation between the presence of titanium particles and ions, biological complication, and corrosion, but there is no justifiable evidence for unidirectional series of causative actions.

Hepatitis E Virus Persistence and/or Replication in the Peripheral Blood Mononuclear Cells of Acute HEV-Infected Patients.

BACKGROUND: Hepatitis E virus (HEV) causes about 14 million infections with 300,000 deaths and 5,200 stillbirths worldwide annually. Extrahepatic manifestations are reported with HEV infections, such as renal, neurological, and hematological disorders. Recently, we reported that stool-derived HEV-1 replicates efficiently in human monocytes and macrophages in vitro. However, another study reports the presence of viral RNA but no evidence of replication in the PBMCs of acute hepatitis E (AHE) patients. Therefore, the replication of HEV in PBMCs during AHE infection is not completely understood. METHODS: PBMCs were isolated from AHE patients (n = 17) enrolled in Assiut University Hospitals, Egypt. The viral load, positive (+) and negative (-) HEV RNA strands and viral protein were assessed. The gene expression profile of PBMCs from AHE patients was assessed. In addition, the level of cytokines was measured in the plasma of the patients. RESULTS: HEV RNA was detected in the PBMCs of AHE patients. The median HEV load in the PBMCs was 1.34 × 103 IU/ml. A negative HEV RNA strand and HEV open reading frame 2 protein were recorded in 4/17 (23.5%) of the PBMCs. Upregulation of inflammatory transcripts and increased plasma cytokines were recorded in the AHE patients compared with healthy individuals with significantly elevated transcripts and plasma cytokines in the AHE with detectable (+) and (-) RNA strands compared with the AHE with the detectable (+) RNA strand only. There was no significant difference in terms of age, sex, and liver function tests between AHE patients with detectable (+) and (-) RNA strands in the PBMCs and AHE patients with the (+) RNA strand only. CONCLUSION: Our study shows evidence for in vivo HEV persistence and replication in the PBMCs of AHE patients. The replication of HEV in the PBMCs was associated with an enhanced immune response, which could affect the pathogenesis of HEV.

Understanding Motor Skill Learning as Related to Dentistry.

Learning dental procedures is a complex task involving the development of fine motor skills. The reported use of theories and/or evidence for designing learning activities to develop the fine motor skills needed for dental practice is limited. The aim of this review is to explore the available body of knowledge related to learning motor skills relevant to dentistry. Evidence from studies investigating motor skill learning highlights the negative impact of self-focus and self-regulation on learning outcomes, particularly during the early stages of learning. The development of activities and schedules that enable novices to demonstrate characteristics similar to experts, without the reported long period of 'deliberate practice', is clearly of value. Outcomes of learning implicitly are important in dentistry because working under stressful conditions is common, either during undergraduate study or in practice. It is suggested that learning implicitly in the simulation stage can reduce disrupted performance when transitioning to clinical settings. Therefore, further investigation of effective methods for learning dental fine motor skills is indicated, using approaches that result in robust performance, even under stressful conditions.

Rapid Maxillary Expansion and Nocturnal Enuresis in Children and Adolescents: A Systematic Review of Controlled Clinical Trials.

OBJECTIVES: To evaluate the effectiveness of rapid palatal expansion in the treatment of nocturnal enuresis among 6-18-year-old children and adolescents. METHODS: Comprehensive searches were carried out in 6 electronic databases (EBSCO, ProQuest, Clinical Key, Science Direct, SCOPUS, and OVID) and supplemented by additional manual searches in 4 orthodontic journals until June 2020. Randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) of children and adolescents aged 6-18 years old of both genders who underwent rapid palatal expansion and were considered unresponsive to previous conventional nocturnal enuresis treatment were included in this review. Risk of bias of individual trials was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) assessment tool for CCTs and the revised Cochrane Risk-of-Bias tool for RCTs (RoB 2). RESULTS: Four studies met all inclusion criteria and were finally included in this systematic review, of which one was an RCT and three were CCTs. Reduction in nocturnal enuresis frequency was reported in all included studies with varying rates and methods of reporting, but most studies reported a statistically significant reduction in the number of wet nights per week. The average range of becoming completely dry 1 year after treatment with an RME was 0%-60%. Also, there was a statistically significant correlation between an improvement in bedwetting and an increase in nasal volume after the use of RME. CONCLUSION: A rapid palatal expansion device may be considered as an alternative treatment option of the nocturnal enuresis condition with guarded prognosis when other treatment modalities have failed.

Evaluation of hepatitis E antigen kinetics and its diagnostic utility for prediction of the outcomes of hepatitis E virus genotype 1 infection.

HEV-Ag ELISA assay is a reliable diagnostic test in resource-limited areas. HEV genotype 1 (HEV-1) infections are either self-limited or progress to fulminant hepatic failure (FHF) and death if anti-HEV therapy is delayed. Limited data is available about the diagnostic utility of HEV Ag on HEV-1 infections. Herein wWe aimed to study the kinetics of HEV Ag during HEV-1 infections at different stages, i.e., acute HEV infection, recovery, and progression to FHF. Also, we evaluated the diagnostic utility of this marker to predict the outcomes of HEV-1 infections. Plasma of acute hepatitis E (AHE) patients were assessed for HEV RNA by RT-qPCR, HEV Ag, and anti-HEV IgM by ELISA. The kinetics of HEV Ag was monitored at different time points; acute phase of infection, recovery, FHF stage, and post-recovery. Our results showed that the level of HEV Ag was elevated in AHE patients with a significantly higher level in FHF patients than recovered patients. We identified a plasma HEV Ag threshold that can differentiate between self-limiting infection and FHF progression with 100% sensitivity and 88.89% specificity. HEV Ag and HEV RNA have similar kinetics during the acute phase and self-limiting infection. In the FHF stage, HEV Ag and anti-HEV IgM have similar patterns of kinetics which could be the cause of liver damage. In conclusion, the HEV Ag assay can be used as a biomarker for predicting the consequences of HEV-1 infections which could be diagnostically useful for taking the appropriate measures to reduce the complications, especially for high-risk groups.

The role of prosthetic, orthodontic and implant-supported rehabilitation in the management of secondary malocclusion to maxillofacial trauma- A systematic review.

PURPOSE: Different approaches have been proposed to treat malocclusion secondary to the treatment of maxillofacial trauma. This study aimed to investigate the efficacy of prosthodontic treatment, orthodontic treatment, and implant-supported rehabilitation for the management of secondary malocclusion after maxillofacial trauma. STUDY SELECTION: We searched five electronic databases and hand searched eight journals. The types of studies included were randomized controlled trials, cohorts, case-controls, and case series with at least eight patients with maxillofacial trauma and postoperative malocclusion. These studies used prosthetic treatment and implant-supported rehabilitation for secondary malocclusion after maxillofacial trauma. Risk of bias of eligible studies to be included in the final analysis was assessed independently by two authors using a tool for methodological quality assessment and synthesis of case series and case reports. RESULTS: After initial screening and identification of titles and abstracts, full text of 44 articles were found and evaluated against inclusion criteria. Of these 42 articles were excluded and remaining two were included in the review. Both the studies were case series with moderate to high risk of bias. CONCLUSIONS: Both prosthetic treatment and implant-supported rehabilitation have the potential to restore secondary malocclusion after maxillofacial trauma. However, because less number of well-designed studies with high risk of bias were included in this systematic review, the findings should be interpreted with caution. Well-designed high-quality studies are required to draw definitive conclusions.

Evaluation of Conscious Monitoring and Movement Control Efforts Among Dental Students.

Prior research has demonstrated that motor skill learning is often disrupted by self-focus and attempts to control movement. The propensity for reinvestment (i.e., self-focus and movement control) has been associated with poor motor skill learning in sport and surgery, but it has not yet been examined in dental education. Therefore, the aim of this study was to evaluate the propensity for disruptive reinvestment among dental students so as to optimize their learning needs. Volunteer dental students (210) completed three reinvestment surveys to investigate their self-reported propensity to engage in conscious self-monitoring and control of their movements and decisions. We used analysis of variance (ANOVA), with post-hoc analyses as appropriate, to assess the effect of various participant demographics on their reinvestment scores. Male participants had a lower mean reinvestment scale score than females (p < .05). Older participants were found to have a lower mean movement reinvestment score, compared to younger reinvesters (p < .05). On the other hand, younger reinvesters had a lower mean decision reinvestment score compared to the older age group (p < .05). When compared with participants in previous studies our participants obtained a significantly higher reinvestment score (p < .05). In conclusion, gender and age may be related to dental students' self-reported propensity to reinvest. Moreover, dental students were found to be more self-conscious when compared with individuals who perform gross motor skill tasks. These results provide insight into the acquisition of dental skills that may assist in designing pre-clinical training curriculum in dental education.

How to Improve Fine Motor Skill Learning in Dentistry.

INTRODUCTION: Restorative dental treatment is a complex task involving various procedures which require the development and integration of both theoretical knowledge and fine motor skills. It aims to provide the theoretical background and role of key factors in learning these skills. MATERIALS AND METHODS: The following electronic databases were searched to identify relevant articles to our topic: PubMed, Medline, Google Scholar, and Scopus. Generic keywords, that is, factors, fine, performance, and dentistry, and MeSH terms, that is, "learning," "instruction," "patient simulation," "motor skills," "perception," "tactile," "neurophysiology," and "working memory" were used to conduct our comprehensive search. Results and Conclusions. Several techniques are used in performing different restorative procedures in dentistry, that is, root canal preparation, root planning, and minor oral surgery procedures. Mastering these techniques requires a good understanding of the underpinning cognitive, sensory, and neuromuscular processes. Factors including the amount and timing of instructions provided, cognitive abilities, and practice schedule of learning trials may have significant implications on the design of fine motor skill learning exercises.

Effect of errorless learning on the acquisition of fine motor skills in pre-clinical endodontics.

This study aimed to evaluate the impact of errorless and errorful learning, on acquisition of root canal hand-instrumentation skills. Dental students prepared standardised canals of different diameters and curvatures. Learning involved minimising (errorless: n = 21) or maximising errors (errorful: n = 21). Students who had completed accredited pre-clinical activities provided comparative data (n = 17). During testing, the distal canal of a plastic mandibular molar was prepared, first as a single task and then under multi-tasking conditions. Performance was assessed by preparation accuracy and time. Differences were assessed using anova (P < 0.05). Performance in the experimental groups was similar during learning. When multi-tasking, errorful learners showed a deterioration in preparation accuracy (P < 0.05). In contrast, preparation accuracy and completion times for the errorless and comparative groups remained stable when multi-tasking. Errorless learning resulted in stable performance under multi-tasking conditions. Investigation of alternative approaches to learning motor skills in dentistry is warranted as such approaches may provide better outcomes, especially under demanding conditions.

Perception of Smile Aesthetics of Patients with Anterior Malocclusions and Lips Influence: A Comparison of Dental Professionals', Dental Students,' and Laypersons' Opinions.

OBJECTIVES: The aim of the study was to evaluate the perception of smile aesthetics in patients with varying degrees of anterior crowding and spacing among dental specialists, dentists, dental students, and laypersons and to assess the effect of the lips position. MATERIALS AND METHODS: Clinical photos of cases of anterior crowding (mild, moderate, and severe) and spacing (mild, moderate, and severe) with and without the associated lips were used. The images were evaluated by 250 persons including dental specialists, dentists, dental students, and laypersons using the rating scale method, (extremely unaesthetic to extremely aesthetic, 1 to 5, respectively). Nonparametric tests were used to analyse the data on SPSS version 24. RESULTS: According to the 250 responses, the aesthetic perception of all severities of anterior crowding and mild and moderate spacing was found to be more aesthetic when displayed with the lips (p < 0.05). Additionally, the higher the level of dental education, the lower the aesthetic perception with and without the lips (p < 0.05). CONCLUSIONS: The lips play a significant role in improving the aesthetics of crowded anterior teeth and spaced anterior teeth. Dental educational level influences the aesthetic perception of anterior crowding and spacing. This may have an impact on treatment planning and need for orthodontic intervention.