Programmatic assessment of a university-based implant training program using patient-reported outcomes.

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

Evidence-based curriculum reform: the Kentucky Experience.

Evidence-based health care seeks to base clinical practice and decision-making on best evidence, while allowing for modifications because of patient preferences and individual clinical situations. Dentistry has been slow to embrace this discipline, but this is changing. In the Graduate Periodontology Program (GPP) of the University of Kentucky, an evidence-based clinical curriculum was implemented in 2004. The tools of evidence-based health care (EBHC) were used to create evidence-based protocols to guide clinical decision-making by faculty and residents. The program was largely successful, although certain challenges were encountered. As a result of the positive experience with the GPP, the college is implementing a wider program in which evidence-based protocols will form the basis for all patient care and clinical education in the predoctoral clinics. A primary component of this is a computerized risk assessment tool that will aid in clinical decision-making. Surveys of alumni of the periodontal graduate program show that the EBHC program has been effective in changing practice patterns, and similar follow-up studies are planned to assess the effectiveness of the predoctoral EBHC program.

Commercial soft drinks: pH and in vitro dissolution of enamel.

Most soft drinks are acidic in nature and exposure to these drinks may result in enamel erosion. This study sought to measure the pH of 20 commercial brands of soft drinks, the dissolution of enamel resulting from immersion in these drinks, and the influence of pH on enamel loss. Comparison of the erosive potential of cola versus non-cola drinks as well as regular sugared and diet versions of the same brands was undertaken. The pH was measured immediately after opening the soft drink can. Enamel slices obtained from freshly extracted teeth were immersed in the soft drinks and weighed at baseline and after 6, 24, and 48 hours of immersion. Non-cola drinks had significantly higher pH values than cola drinks but showed higher mean percent weight loss. By contrast, sugared versions of the cola and non-cola drinks showed significantly lower pH values and higher mean percent weight loss than their diet counterparts. The pH value of the soft drink did not have a significant influence on the mean percent weight loss (r = -0.28). Prolonged exposure to soft drinks can lead to significant enamel loss. Non-cola drinks are more erosive than cola drinks. Sugared versions of cola and non-cola drinks proved to be more erosive than their diet counterparts. The erosive potential of the soft drinks was not related to their pH value.