Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students.

INTRODUCTION: COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic. MATERIALS AND METHODS: A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed. RESULTS: The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators. CONCLUSION: The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered.

Lithium disilicate posterior overlays: clinical and biomechanical features.

OBJECTIVES: The aim of this study was to evaluate the survival rate of lithium disilicate overlays in increasing occlusal vertical dimension (OVD) in the setting of minimally invasive techniques and the restoration thicknesses at different tooth sites. MATERIALS AND METHODS: This is an observational study evaluating 43 lithium disilicate overlays (Lithium IPS e.max Press, Ivoclar Vivadent) on 8 patients, prepared with minimally invasive criteria over a follow-up period between 19 to 45 months (mean follow-up of 32 months). Occlusal vertical dimension's increase was planned using occlusal treatment plan and diagnostic wax-up. Prior to adhesive cementation, restoration thicknesses were measured with a caliber. The survival rate was calculated by Kaplan-Meier analysis. RESULTS: Restoration survival rates at 32 months were 97.7%. One infiltration was observed, no cases of fracture occurred. The greatest thickness in monolithic restorations was detected in the cusp sides of teeth, whereas the thinnest was highlighted in the central fossa. The average amount of dental tissue removed during preparation was 0.98 mm in non-functional cusps, 0.88 mm in functional cusps, and 0.57 mm in the central fossa. CONCLUSIONS: Lithium disilicate posterior overlays show an excellent complication-free survival rate, and the material allows for conservative restorations with minimum thickness. CLINICAL RELEVANCE: Monolithic lithium disilicate overlays feature a satisfying 32-month survival rate. The technique allows to perform restorations with a minimal removal of dental tissue, while limiting fractures over time. Its esthetical performance is excellent.