Influence of decision-making algorithms on the diagnostic accuracy using the current classification of periodontal diseases-a randomized controlled trial.

OBJECTIVES: To examine the influence of the decision-making algorithms published by Tonetti and Sanz in 2019 on the diagnostic accuracy in two differently experienced groups of dental students using the current classification of periodontal diseases. MATERIALS AND METHODS: Eighty-three students of two different clinical experience levels were randomly allocated to control and study group, receiving the staging and grading matrix, resulting in four subgroups. All diagnosed two patient cases with corresponding periodontal charts, panoramic radiographs, and intraoral photographs. Both presented severe periodontal disease (stage III, grade C) but considerably differed in complexity and phenotype according to the current classification of periodontal diseases. Controls received the staging and grading matrix published within the classification, while study groups were additionally provided with decision-trees published by Tonetti and Sanz. Obtained data was analyzed using chi-square test, Spearman's rank correlation, and logistic regression. RESULTS: Using the algorithms significantly enhanced the diagnostic accuracy in staging (p = 0.001*, OR = 4.425) and grading (p < 0.001**, OR = 30.303) regardless of the clinical experience. In addition, even compared to the more experienced control, less experienced students using algorithms showed significantly higher accuracy in grading (p = 0.020*). No influence on the criteria extent could be observed comparing study groups to controls. CONCLUSION: The decision-making algorithms may enhance diagnostic accuracy in dental students using the current classification of periodontal diseases. CLINICAL RELEVANCE: The investigated decision-making algorithms significantly increased the diagnostic accuracy of differently experienced under graduated dental students and might be beneficial in periodontal education.

The Objective Structured Clinical Examination (OSCE) in Periodontology with Simulated Patient: The Most Realistic Approach to Clinical Practice in Dentistry.

The objective structured clinical examination (OSCE) is becoming an increasingly established assessment test in dental schools. The use of simulated patients in the OSCE makes the stations more similar to clinical practice. Therefore, the student can show their technical and clinical knowledge, and certainly, their ability to manage the patient. These sorts of tests, in which simulated patients can be included, would be used before the student started clinical practice with patients and/or at the end of the degree. The objective of this work was to describe how the periodontology station was developed using a simulated patient for students of a fifth year dentistry degree taking an OSCE test. Furthermore, a questionnaire was created to learn the perception of the students about this station and its characteristics. The fifth year students at the European University of Madrid positively evaluated this station in their examination. In addition, it was recorded that they preferred a simulated patient in their tests, rather than stations with clinical cases, images, X-rays, and presentations. It is essential that once the OSCE has been completed, the student receives a feedback to learn where they have failed and, therefore, be able to improve any of the aspects evaluated in the station.

Diagnosis and treatment planning using the 2017 classification of periodontal diseases among three dental schools.

OBJECTIVES: The American Academy of Periodontology and the European Federation of Periodontology developed a new classification system for periodontal diseases in 2017. The next step in its widespread implementation involves training dental students to improve consistency in clinical decisions. This study conducted in 2020-2021 aimed to evaluate knowledge in periodontal diagnosis and treatment planning using the new classification, among first, second, third- and fourth-year dental students at Indiana University School of Dentistry (IUSD), University of Texas School of Dentistry at Houston (UTSD), and University of Louisville School of Dentistry (ULSD). METHODS: A minimum of 20 dental students per class year from each of the three schools participated. Ten HIPPA de-identified case records and a questionnaire with a fixed list of answer options, comprising two demographic questions and two questions on diagnosis and treatment planning of each case, were presented to the participants. A group of three board-certified periodontists established the answers for all cases which were used to score the appropriateness of diagnosis and treatment planning among the participants. RESULTS: A total of 263 students participated. Overall, 22.6% of IUSD responses, 25.2% of UTSD, and 27.6% of ULSD responses were correct for diagnosis (no statistically significant differences). For the treatment plan, 64.9% of IUSD responses, 66.2% of UTSD, and 68.9% of ULSD responses were correct (no statistically significant differences). CONCLUSION: Based on the findings from our study, we suggest that additional training be considered to improve the understanding of the 2017 classification of periodontal and peri-implant diseases among dental students.

Dental laser training and education in postgraduate periodontics programs in North America.

INTRODUCTION: The application of various lasers to treat periodontal and peri-implant diseases is gaining momentum. While laser-related dental research is ongoing, it is important to determine if current periodontal training programs are keeping pace with these new treatment modalities and actively incorporating them into their training. MATERIALS AND METHODS: An electronic survey was created to evaluate the extent to which lasers are currently being used in North American periodontal programs. A brief explanation of the study and a link to the 15-question survey was emailed to 61 periodontal program directors requesting participation in the survey. The data regarding the prevalence of laser training in all the programs, which types of laser devices are used, and which surgical procedures are performed were collected and analyzed. RESULTS: The response rate was 49.1% (n = 30). Among those responding to the survey, 76.7% (n = 23) of these programs reported providing clinical training in lasers, with the diode laser being the most frequently used (65.2%), followed by carbon dioxide (39.1%), neodymium-doped yttrium aluminum garnet (26.1%), and erbium:yttrium aluminum garnet lasers (26.1%). Two major reasons for not utilizing lasers as part of regular patient care were cost and lack of evidence to support laser efficacy. Three out of seven programs that do not currently use lasers plan to provide laser training in the future. Over half (56.7%) of program directors did not think that lasers would become the standard of periodontal/implant care within the next 10 years, while 20% of them believed that they would. CONCLUSIONS: Laser training and education in postgraduate periodontal programs is still limited, and the majority of periodontal residents are not exposed to many types of laser devices.

Valoración del método de estudio de caso virtual en el posgrado académico / Assessment of the virtual case study method in the academic postgraduate

Introducción: El método de estudio de caso por vía virtual es una herramienta didáctica de gran valor en el proceso pedagógico del posgrado. Este método, promueve el aprendizaje activo de los residentes, y posee inestimable valor como instrumento del posgrado que se imparte, su ejecución favorece el perfeccionamiento del programa de formación académica de la especialidad. Objetivo: Valorar la satisfacción de los residentes y profesores de la especialidad de Periodoncia con el método de estudio de caso virtual como herramienta didáctica. Métodos: Se realizó una investigación descriptiva, con enfoque cualitativo, desarrollada de enero a abril del 2020, en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara y en la Universidad de Ciencias Médicas de las FAR. La población estuvo compuesta por 6 profesores y 7 residentes de la especialidad de Periodoncia y 3 profesores de otras especialidades estomatológicas. Satisfacción con la utilización del caso clínico, residentes y profesores, constituyeron variables del estudio. Resultados: Los casos clínicos preparados por cada profesor, incluían dificultades que no tenían una única solución, para favorecer la comprensión de problemas divergentes y la adopción de soluciones mediante la reflexión. En el análisis de la satisfacción, la mayoría de las respuestas seleccionadas por los residentes y profesores fue siempre. Conclusiones: La satisfacción de residentes y profesores con el uso del estudio de caso virtual fue alta(AU)

Introduction: The virtual case study method is a valuable teaching tool in the postgraduate pedagogical process that can be used for the development of meaningful and autonomous learning. The case study by virtual means, promotes the active learning of the residents, and has invaluable value as an instrument of the postgraduate course that is taught, its execution favors the improvement of the academic training program of the specialty. Objective: To assess the satisfaction of residents and teachers of the periodontics specialty with the virtual case study method as a teaching tool. Method: A descriptive research, with a qualitative approach, was carried out from January to April 2020, at the Faculty of Stomatology of Villa Clara and at the University of Medical Sciences of the FAR. The population was made up of 6 professors and 7 residents of the periodontology specialty and 3 professors from other dental specialties. Satisfaction with the use of the clinical case, residents and teachers, were study variables. Results: The clinical cases prepared by each teacher included difficulties that did not have a single solution, to favor the understanding of divergent problems and the adoption of solutions through reflection. In the analysis of satisfaction; Most of the responses selected by residents and teachers were always. Conclusions: The satisfaction of residents and teachers of the Periodontics specialty with the use of the virtual case study method was high(AU)

Fundamentos teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal / Theoretical foundations of the dentistry students preparation in terms of education for the periodontal oral health

RESUMEN Introducción: La aspiración de egresar un estomatólogo general suficientemente preparado para resolver los problemas de salud bucal periodontal más generales y prevalentes es una exigencia social que se revela en el actual plan de estudio de la carrera de Estomatología. Objetivo: Elaborar unos referentes teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Método: De enero a julio de 2020, en la Facultad de Estomatología de la Universidad de Ciencias Médicas Guantánamo se realizó una revisión narrativa sobre el tema a través de una búsqueda en bases de datos electrónicas (Biblioteca Virtual en Salud, LILACS, PubMed, SciELO, REDALYC, Scopus). Se sistematizaron referentes teóricos que sustentan la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Conclusiones: Se evidencia la necesidad de esta preparación dada su implicación en el modo de actuación profesional para una Atención Bucal Periodontal Integral. Las bases para esta finalidad emergen de la conjugación armoniosa de referentes filosóficos, sociológicos, legales, psicológicos, pedagógicos y didácticos en función de la práctica de la profesión.

ABSTRACT Introduction: The aim to graduate a general dentist with a high standard in knowledge to solve the most general and prevalent periodontal oral health issues is a social demand that is revealed in the current study program of dentistry major. Objective: To elaborate some theoretical references concerning dentistry student preparation in terms of education for periodontal oral health. Method: From January to July 2020, at the Facultad de Estomatología in the Universidad de Ciencias Médicas Guantanamo, a narrative review on the subject was carried out through a search in electronic databases (Virtual Health Library, LILACS, PubMed, SciELO, REDALYC, Scopus). It was systematized all the theoretical references that support the preparation of the dentistry students in terms of education for periodontal oral health. Conclusions: It is evident the necessity of this type of training due to its implication in the way to the best professional performance for an integral oral care. The foundations for achieving this goal emerge from the harmonious conjugation of philosophical, sociological, legal, psychological, pedagogical and didactic referents, in accordance to the practice of the profession.

Dental Students' Exposure to Periodontal and Implant Placement Surgeries in U.S. Dental Schools.

The aim of this study was to assess nationwide trends in the exposure of dental students to periodontal and implant surgical procedures and to evaluate the potential factors that influence these clinical experiences. A 19-item questionnaire was sent to all 64 directors of predoctoral periodontics in U.S. dental schools. In addition to gathering information on the percentage of students who perform surgical periodontics or implant placement procedures in each program, data on student research groups, periodontics residency programs, and periodontics faculty practices were collected. A total of 33 responses were received, for a response rate of 51.5%. Among the responding institutions, 97% and 45.5% allowed dental students to perform periodontal and dental implant placement surgeries, respectively, although only 26.4% and 15.2% of the dental class ended up performing periodontal and dental implant placement surgeries, respectively. Crown lengthening was the most commonly reported (84.8%) periodontal surgical procedure performed by dental students. A negative correlation was found between the presence of a periodontics residency program and dental students' placing dental implants, while the size of the residency program positively correlated with dental students' placing dental implants. Overall, a wide variation in the exposure of dental students to periodontal and dental implant placement surgical experiences was found. Future surveys should assess clinical procedures performed in other special-ties to gain a broader picture of the experience students are gaining in these areas.

[Comparison of two training protocols in periodontal surgery teaching for undergraduate students].

Objective: To compare the efficacies of two training protocols, i.e. the multimedia instruction and the conventional method, in periodontal surgery teaching for undergraduate students. Methods: One hundred and twenty-three dental undergraduates in their pre-clinical training course were recruited and divided into two groups according to the learning grade matching principle: the experimental group (multimedia instruction, 60 students) and the control group (conventional method, 63 students). The teaching aim was to train the students gingivectomy and periodontal flap surgery by using the pig jaws. The conventional teaching method of teacher-demonstrating and student-practicing was used in the control group, and the practice time of the students' for each surgery was 45 minutes. A standardized teaching video combined with the teachers' explanations of the key steps was used in the experimental group. The students' practice time for each surgery was 60 minutes. The efficacy of teaching protocol was evaluated by the teachers according to the scoring criteria set by the teaching group. Results: In gingivectomy training, accuracy of fixed points, angle of postoperative gingival margin and morphology of gingiva of the experimental group were better than those of the control group. The experimental group also had more complete and continuous excised gingivae and more thorough adjacent gingival removal. The total scores of the experimental group were significantly higher than those of the control group (92.8±2.6 vs. 89.9±3.7, P<0.05). In periodontal flap surgery training, the experimental group operated the blade around the shape of the tooth better in internal bevel incision than the control group. Additionally, the incision position of internal bevel incision, periosteal integrity after flapping and flap depth of the experimental group were better than those of the control group. Besides, the experimental group had smoother flap edge and more thorough debridement. The total scores of the experimental group were significantly higher than those of the control group (92.2±4.1 vs. 89.2±4.4, P<0.05). Conclusions: The teaching efficacy of multimedia instruction was better than that of the conventional method. Its value needs to be further tested in future teaching practice.

Assessing Effectiveness of an Audiovisual Educational Tool for Improving Dental Students' Probing Depth Consistency.

Dental students often underestimate their probing depth (PD) measurements, which emphasizes the need for effective and novel methods for teaching proper probing technique. The aim of this study was to evaluate the efficacy of audiovisual learning aids, recorded from the point of view of examiners, for improvement in PD agreement in dental students. In 2017-18, 22 third-year dental students were randomized into test and control groups. Each student and a single blinded faculty examiner performed PD measurements on a minimum of three patients. The test group viewed a video demonstrating proper probing technique, while the control group received only probing technique instruction from prior lectures. All measurements, the periodontal diagnoses, and the total time taken to complete PD measurements were recorded. A survey of student attitudes about the audiovisual tool was conducted after the intervention; all 22 students completed the survey. A total of 11,426 PD sites were measured. The test group had 10% greater accuracy in PD sites=4 mm. The control group had a minor but statistically significant increase in accuracy for 2 mm PD sites. For all incorrect measurements at sites PD≥4, the students tended to underestimate the PD. Tooth type, site location around tooth, and diagnosis had no significant effect on PD measurement agreement. No significant difference between groups was found for the proportions of gingivitis and periodontitis patients or for examination time. This study found that use of the audiovisual learning aid "Calibrated Periodontal Training Video" improved the students' probing depth accuracy for sites with PD of 4 mm.

Influence of Self-Assessment on Dental Students' Performance on Technical Assessments in Periodontics.

Self-assessments were introduced into a third-year clinical periodontics course to enable dental students to self-assess and receive faculty feedback prior to technical assessment. The aims of this study were to determine if there was an improvement in the pass rate and average grade on the technical assessments following implementation of self-assessments and to analyze the accuracy of the student self-assessments by comparing them with faculty assessments. Scores from 106 third-year dental students for four periodontal procedures were included in the analysis. Faculty and student self-assessment scores, along with self-assessment and final technical assessments scores, were compared, as were the average number of self-assessment attempts for the various procedures and the pass rates. The average number of self-assessments per student was 6.5 compared to 4.2 for the technical assessments. There was no significant difference between students' self-assessment scores and faculty scores (average difference=0.005; p=0.7894). However, there was a significant increase in overall scores between students' self-assessments and technical assessments (average difference: 0.30 out of 5; p=0.0001). There was also a significant difference in pass rate between self-assessments and technical assessments (92.3% and 99.7%, respectively). The individual technical assessment with the greatest improvement was for scaling and root planing (average difference=0.47; p=0.0001), which also had significantly more self-assessments (2.3 vs. 1.2-1.7, p=0.0001). These results suggest that self-assessment and the subsequent faculty feedback provided students with information that enabled them to improve their performance on technical assessments.

Comparative effectiveness of hand scaling by undergraduate dental students following a two-week pre-clinical training course.

BACKGROUND: The Bologna reform resulted in a drastic restructuring of pre-clinical training courses at the University of Zurich. The aim of this study was to assess student pre-clinical scaling/root planning skills after just 8.5 hours of manual training. MATERIAL AND METHODS: Three consecutive classes of dental students (n = 41; n = 34; n = 48) were tasked with removing lacquer concrement from the maxillary left canine on a typodont using Gracey and universal (Deppeler M23A) curettes. At baseline (prior to instruction), a timed five-minute session of scaling/root planning was undertaken. The second scaling/root planning session was held immediately following training. Eight experienced dental hygienists and eight lay people served as positive and negative controls, using the same instruments and time limit, respectively. Instrumented teeth were collected, scanned and planimetrically analysed for the percentage of tooth surface cleaned. Statistical analyses were performed to assess the dental students' improvement after the training (Wilcoxon signed-rank test) and to compare it to that of laypeople and dental hygienists (Kruskal-Wallis rank sum test followed by Conover's post hoc test). RESULTS: At baseline, the dental students' mean scaling scores of the cleaned surfaces were not significantly different than those of laypeople (29.8%, 31.0%, 42% vs 27.9%). However, after 8.5 hours of manual training, the students' ability to clean the maxillary tooth improved significantly and they achieved mean removal values of 61.7%, 79.5% and 76% compared to the 67.4% (P < .001) of the experienced dental hygienists (Tables Tables  and ). There were no statistically significant differences between the scores achieved by students after training and those achieved by experienced dental hygienists. CONCLUSION: A shortened pre-clinical training time was sufficient for students to acquire the basic scaling/root planning skills needed in preparation for clinical training. Further research is needed to identify ways to help students consistently reach highest skill levels.

[A glance at the American training mode of the clinical postgraduate students of periodontology through postdoctoral program in periodontics of University of Washington School of Dentistry].

To provide references and recommendations about periodontal professionals training for our country by introducing American training mode of clinical postgraduate students of periodontology. Based on ground visits and surveys of University of Washington School of Dentistry's postdoctoral program in periodontics, the professional training mode and its characteristics which adapt to the development trend of American periodontology were summarized and concluded. The discussion is in the following three parts: the overall status of postgraduate education of periodontology in the United States, the training mode of the clinical postgraduate students of periodontology at University of Washington School of Dentistry, and the observation of the American Academy of Periodontology's annual conferences. This kind of training mode supervised by the American Dental Association, giving priority to clinical practice and emphasizing cultivating the multidisciplinary comprehensive ability are worth learning. Meanwhile, the development trend of periodontology in the United States which pay increasing attention to carry out implant therapy with periodontal features and the adaptive training mode of clinical postgraduate students of periodontology also deserves our deep reflection and can be used for reference.

Effectiveness of a Flipped Classroom in Learning Periodontal Diagnosis and Treatment Planning.

The aim of this study was to assess whether a flipped classroom was an effective model for dental students to learn periodontal diagnosis and treatment planning (DTP). Participants were all third-year students in three academic years (2015-17) at Harvard School of Dental Medicine: two groups that experienced the flipped classroom (Classes of 2017 and 2018), and a control group (Class of 2019) that received the same content in traditional lecture format. All three groups completed a DTP knowledge quiz before and after the educational experience; the flipped classroom groups also completed pre and post surveys of their opinions about flipped classrooms. The flipped classroom group received a 23-minute video and corresponding PowerPoint presentation to view on their own time. In class, these students were divided into groups to diagnosis and treatment plan cases and discuss them with the instructor. Of 71 students in the two flipped classroom groups, 69 pre and post quizzes were returned (response rate 97%), and 61 pre and post surveys were returned (response rate 86%). Of 35 students in the lecture group, 34 completed pre and post quizzes (response rate 97%). The mean pre scores on the knowledge quiz in the flipped classroom groups and the conventional lecture group were 64% and 54%, respectively. After the DTP education, students' quiz scores improved in all three groups, but only the difference in the flipped classroom groups was statistically significant (p<0.01). After the flipped classroom session, 84% of the students agreed or strongly agreed that this methodology was effective for learning periodontal DTP, and 90% agreed or strongly agreed they understood the fundamentals of periodontal DTP-both increases over their pre survey scores. Overall, this flipped classroom model was effective in educating students on periodontal DTP and was well received by the students.

Psychosocial impact, perceived stress and learning effect in undergraduate dental students during transition from pre-clinical to clinical education.

INTRODUCTION: This study aimed to develop a suitable instrument for a comprehensive quantitative and qualitative assessment of perceived psychosocial impact, levels of stress and learning effect in undergraduate dental students during the transition from pre-clinical to clinical education. These findings might improve curricular structures and didactic organisation during this period. MATERIALS AND METHODS: At the beginning of their first clinical year, undergraduate dental students were asked to complete an anonymous forty-item questionnaire. Two hundred and seventy-six undergraduate dental students were willing to participate and completed the questionnaire and participated during the years 2011-2016. RESULTS: The response rate was between 45% and 96%. Correlational analysis (Spearman-Rho) in the field of psychosocial impact showed the dental teacher to be the most important multiplier of students' feelings. If the students feel that their teacher acts cooperatively, positive items increase and negative items decrease significantly (P < .0001). Also, students who report high levels of stress are affected significantly in their psychosocial interaction (P < .0001). Wilcoxon test yielded highest levels of stress in endodontology during the first weeks (P < .0001). During the same period, the greatest learning increment was seen for diagnostics and caries excavation. CONCLUSION: In conclusion, teaching of undergraduate dental students during the transition period from pre-clinical to clinical education can be positively influenced by a supportive learning environment and by specific chronological modifications in the curriculum. Students should start their clinical training with diagnostics, preventive dentistry and initial periodontal treatment. Due to high levels of perceived stress, endodontology should be introduced later in the clinical curriculum.

Periodontal education and assessment in the undergraduate dental curriculum-A questionnaire-based survey in European countries.

OBJECTIVES: This survey aimed to evaluate whether periodontal education and assessment in undergraduate dental curricula amongst the member countries of the European Federation of Periodontology (EFP) follow the competency-based curricular guidelines and recommendations developed by the Association for Dental Education in Europe. MATERIALS AND METHODS: A multiple-choice questionnaire was emailed to 244 dental institutes amongst the 24 EFP member countries between November 2014 and July 2015. RESULTS: Data were received from 16 (66.7%) EFP member countries. Out of 117 responding dental institutes, 76 (64.95%) were included as valid responders. In most of the institutes (86.3%), a minimum set of competencies in periodontology was taken into account when constructing their dental education programmes. Out of 76 responders, 98.1% included lecture-based, 74.1% case-based and 57.1% problem-based teaching in their periodontal curricula, whilst a minority (15.9%) also used other methods. A similar pattern was also seen in the time allocation for these four educational methods, that is, the highest proportion (51.8%) was dedicated to lecture-based teaching and only a small proportion (5.7%) to other methods. Periodontal competencies and skills were most frequently assessed by clinical grading on clinic, multiple-choice examination (written examination) and oral examination, whereas competency tests and self-assessment were rarely used. Only in 11 (14.5%) cases, access flap procedures were performed by students. CONCLUSION: Great diversity in teaching methodology amongst the surveyed schools was demonstrated, and thus, to harmonise undergraduate periodontal education and assessment across Europe, a minimum set of recommendations could be developed and disseminated by the EFP.