A removable partial denture using an esthetically designed round-rest distal clasp on maxillary anterior abutment teeth: a clinical report.

A round-rest, distal depression clasp is suggested as an esthetic alternative to a conventional clasp for maxillary anterior teeth serving as abutments for a removable partial denture. A lingual round rest provides support for the prosthesis, and a mesiolingual reciprocating plate is present. A split minor connector engages a distal depression for retention. The facial surface of the abutment displays no metal and provides an esthetic result.

Fabrication of a caliper device for interalveolar dimension measurement in the complete denture patient.

A method is presented for measuring interalveolar dimension (IAD) of existing dentures using a caliper. Directions for construction of an IAD gauge are included. This device is easy to construct and "zeroes out" in the closed position. The measurement is useful for determining occlusal vertical dimension (OVD) in new dentures and for monitoring changes over time. Its dimension is entered in the patient record for future reference.

Narrow diameter implants for mandibular denture retention.

Narrow diameter implants are a lower cost alternative to conventional implants and are used to retain mandibular dentures. The experiences at a dental school predoctoral clinic are reviewed. The cumulative success rate for 626 fixtures placed in a six-year period is 92.6 percent with high patient satisfaction. Narrow diameter implants are a useful adjunct in the long-term management of edentulous patients.

Addressing problems in complete dentures.

The authors have compiled a set of solutions to the most common issues influencing the success of complete denture cases. A brief review and discussion of occlusal vertical dimension is presented, followed by a troubleshooting guide to problems such as inadequate retention and stability, discomfort, and other problems affecting treatment outcome.

Perspectives on dental practice in Eqypt.

The dynamics of modernization that characterize developing countries are reflected in the oral healthcare structure of Egypt. An extensive system of free and government-subsidized care exists along side modern, Western-style care for the affluent. The rapid population expansion has doubled the number of students accepted in dental schools (almost twice the number in the U.S.), but uneven economic growth makes the viability of the profession uncertain. Dental education follows the European model of five years after graduation from high school, with a mandatory sixth year of residency training. Dental school faculty members are expected to earn a masters or PhD degree in addition to their dental training.

A predoctoral clinical geriatric dentistry rotation at the University of the Pacific School of Dentistry.

Predoctoral dental students from University of the Pacific School of Dentistry provide initial and yearly dental evaluations for participants of On Lok Senior Health Services on site at On Lok centers. Student dentists also complete some dental procedures including denture fabrication, adjustments and repairs, hard and soft relines, scaling/root planing, polishing, and limited restorative treatments. A wide range of age-prevalent oral conditions such as candidiasis and xerostomia are identified and treated or managed. Students may also be called upon to present patient needs weekly to a member of the interdisciplinary team for discussion. Students periodically review instructions and devices for oral health care with the On Lok staff. The program is intended to be mutually beneficial to the participants of On Lok and Pacific student dentists. While the majority of comprehensive and emergency services are provided by On Lok staff dentists and contract specialists, the student dentist program has broadened the scope of the oral health program at On Lok and has been well integrated with the other day services. Meanwhile, Pacific students gain experience identifying and managing the complex social, economic, and health needs of frail elders in San Francisco.

The effects of student self-assessment on learning in removable prosthodontics laboratory.

It has been consistently shown that there is a weak association between student self-assessment and faculty member assessment of student projects in preclinical technique laboratory settings and that students overestimate their performance. Greater overestimation is observed among students judged by faculty to be the weakest, and these students also use a wider range of scores. This study hypothesized that student self-assessment is a function of capacity to perform, accuracy of understanding grading standards, and psychological factors. Further it hypothesized that learning, defined as change in performance, is a function of ability and self-assessment. Dental students at one U.S. dental school self-assessed their performance on two projects in a removable prosthodontics laboratory course separated by a six-month period. Faculty evaluations of these projects were used to determine students' understanding of the criteria for the projects, and a standardized psychological test was used to assess the learning orientation of the students. A statistical correction was made for the artifact of regression toward the mean. The study found that self-assessment was a better predictor of future learning under these circumstances than was evaluation by faculty members.

Why professional judgment is better than objective description in dental faculty evaluations of student performance.

Practices intended to increase the appearance of objectivity in grading may work at cross purposes with professional judgment. In this study, an analysis of two removable prosthodontics technique projects in one U.S. dental school found that the use of component criteria (checklist) grading was less consistent than overall judgments of the same work and less predictive of dental students' future learning. A factor analysis revealed latent structures in both projects that would make it inappropriate to use a component criteria approach for grading. Common defenses of objectivity-such as scientific foundation, the relationship between reliability and validity, and legal requirements-are questioned in this article, and it is shown how simple adjustments to judgment scores can be made more effective than checklists, faculty calibration, or deselecting faculty members and with better measurement and teaching features.

Pre- and postdoctoral dental education compared to practice patterns in special care dentistry.

There has been limited research into the impact of predoctoral experiences and postdoctoral general dentistry residencies on the practice patterns of dentists in the care of patients with special or complex needs. This study was undertaken to determine if educational experiences with special populations had a relationship to practice patterns after graduation or residency. University of the Pacific alumni who graduated between 1997 and 2007 were surveyed regarding their pre- and postdoctoral dental education and their practice patterns for the care of patients categorized as medically compromised, frail elders, and developmentally disabled. Definitions for each patient category were provided. Alumni were asked about their practice setting and postdoctoral education. Thirty-one percent (n=526) of those surveyed responded. Regression analyses showed respondents not in private practice were more likely to have completed a postdoctoral general dentistry program (Advanced Education in General Dentistry or General Practice Residency) after dental school compared to respondents in private practice (p<0.001). Across all age groups, respondents not in private practice treated significantly more patients with developmental disabilities than those in private practice (p<0.001). Respondents not in private practice treated more medically compromised patients younger than age sixty-five compared to respondents in private practice (p<0.01). Interestingly, those in private practice treated significantly more patients over sixty-five who were also classified as medically compromised (p<0.05). Pacific alumni who completed postdoctoral training in general dentistry were found to practice more often in non-private practice settings. Alumni in non-private practice settings reported treating a higher percentage of medically compromised patients below age sixty-five than their counterparts in a typical private practice. The pre- and postdoctoral experiences of treating special needs populations appear to have a relationship to graduates' practice setting and patient population.

Perceptions of predoctoral dental education and practice patterns in special care dentistry.

The objective of this research project was to compare alumni perceptions of predoctoral dental education in the care and management of patients with complex needs to alumni practice patterns. Alumni from the University of the Pacific Arthur A. Dugoni School of Dentistry who graduated from 1997 to 2007 were surveyed regarding perceptions of their predoctoral education in the care of patients categorized and defined as medically compromised, frail elders, and developmentally disabled, as well as their practice patterns. Perceptions were rated on a Likert scale. Regression analyses were utilized. Three primary relationships were identified: 1) positive relationships emerged between perceptions of educational value, as students and practitioners, of the training they received compared to percentages of medically compromised patients they currently treat (p≤0.05); 2) after practice experience, 2003-07 graduates reported significantly higher value of their education in this area compared to 1997-2002 graduates; and 3) alumni who reported treating more patients with complex needs during school reported treating significantly more of these patients in practice (p≤0.05). We conclude that alumni who reported educational experiences as more valuable treat more patients with complex needs compared to those who valued them less. Alumni who reported having more opportunities to treat patients with complex needs as students treat a higher percentage of those patients than those reporting fewer. Even positive perceptions may underestimate the value of educational experiences as they relate to future practice.

Comprehensive dental services for an underserved and medically compromised population provided through a community partnership and service learning.

The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.