Assessing graduating dental students' competencies: the impact of classroom, clinic and externships learning experiences.

OBJECTIVES: The present study assessed recent dental graduates' educational experiences with regard to competency development in different learning contexts and preparedness for independent professional performance. METHODS: The present study employed a questionnaire examining University of Manitoba graduating dental students' confidence and perceived importance of 47 competencies expected by the ACFD/CDA by requiring students to rate each competency on a five-point Likert scale. In addition, contribution of each of the three learning environments (classroom, clinic, and externship) towards competency development was assessed. RESULTS: Recent graduates reported most confidence in areas of basic clinical procedures involving radiographic, pharmacologic and caries management, with least confidence in implantology, orofacial pain, trauma and surgical management. Most importance was attributed to interpersonal-communication and basic clinical skills, with least importance in scientific research, implantology and prosthetic laboratory aspects. Overall, graduates felt that clinical setting contributed the most to competency development, followed by classroom and then externship contexts. CONCLUSION: Graduating students' professional preparedness can reflect the quality of dental programme. However, the amount of importance that graduates place on each competency might impact their confidence in the associated competencies and vice versa. In addition, learning settings must be effectively utilised for particular competencies' development.

Pantographic clutch fabrication using implant components.

Obtaining accurate pantographic recordings is problematic when insufficient teeth remain to intraorally stabilize the pantographic clutches. Implant fixtures can provide the retention required to obtain pantographic recordings. Clutch fabrication is accomplished indirectly on mounted master casts.

Longevity of partial, complete and fixed prostheses: a literature review.

A review of the dental literature reveals a lack of consensus as to the longevity of conventional prosthodontic therapy. The reasons for this are suggested and best estimates of the longevity of partial, complete and fixed prostheses are presented based on the available literature. A renewed interest in survival studies, hopefully based on sound parameters that outline the reasons for failure, as well as replacement indicators, is required to update our knowledge of survival rates.

The marginal-ridge rest seat.

Natural canine crowns are preferred as abutments for removable partial dentures because of their root morphology and bony support. However, preparing the rest seat on the lingual surface of a mandibular canine risks perforating the enamel. An alternative rest-seat preparation, on the marginal ridge of the canine crown, conserves tooth structure and provides a rest seat of adequate length and depth to ensure support for a cast framework. To illustrate why this little-discussed rest-seat preparation has endured locally, the rationale and preparation of the marginal-ridge rest seat is discussed from both historical and clinical perspectives.

Direct assembly of implant suprastructures.

The technique described uses innovative technology and conventional prosthodontic techniques to directly assemble a cast framework to implant abutments with a resin luting agent. This technique has been used to restore multiple implants with a fixed restoration and for implant connecting bars to support overdentures. Brånemark and Calcitek implant systems have been used successfully.

Bond strength of acrylic resin to cobalt-chromium alloy treated with the Silicoater MD and Kevloc systems.

BACKGROUND: An optimum bond strength at the resin-metal interface of a prosthesis is essential to the success of that prosthesis. Silicoater MD and Kevloc are two systems used to increase bond strength at the resin-metal interface. This study investigated the effect that surface pretreatment and chemical shelf life had on the bond strength of silicoated samples and compared the shear bond strength of the two systems. METHODS: Test samples consisted of autocure denture resin attached to cylinders of chrome cobalt that had been treated either with the Silicoater MD or the Kevloc bonding system. The shear strength of the resin-metal interface was tested using a universal testing machine. The following variables were tested: various silicoating pretreatments; shelf-life period of the silanating chemicals; the method of silicoating. The shear strength of repairs using the Kevloc system were also tested. RESULTS: Surface pretreatment using aluminium oxide and sandblasting significantly enhanced the shear bond strength. The shelf life of the chemicals used in the silicoating process did not affect the bond strength over a six-week testing period. Samples treated with the Kevloc system showed significantly higher bond-strength values (17.3 +/- 1.7 MPa) and less variability than samples treated with the Silicoater MD system (11 +/- 3.6 MPa). In addition, all the samples repaired with the Kevloc system had bond strengths comparable to the original Kevloc-treated samples. CONCLUSION: The Kevloc system has the potential to provide a more optimal resin-metal bonding system, a stronger and more consistent bond and a simpler laboratory technique.

Resin-metal bonding systems: a review of the Silicoating and Kevloc systems.

The Silicoating and Kevloc systems are resin-metal attachment devices that are designed to improve bond strength and decrease microleakage at the resin-metal interface. Clinically, these systems can be used to place resin pontics and veneers, enhance cementation with resin cements, and bond the resin matrix to metal implant substructures. To provide practitioners contemplating the use of either modality with background information, a concise summary of the potential advantages of resin-metal bonding, the procedures required to establish the chemical bond, and the methods of evaluating laboratory studies are presented. Chemical bonding with these systems is technique sensitive. How the system is used may be as important to the final clinical results as is the choice of system.

Online educational resources - will more information make us wiser?

Although the Internet is still primarily an information resource, there is increasing emphasis on its instructional potential. Practitioners can receive Internet-based information and education from a variety of sources around the world. However, they must learn to assess this information and to assimilate it into knowledge that will help them in their practices. They must also be given the opportunity to interact with colleagues to discuss issues pertinent to practice. This article describes the advantages of online education and provides resources to help practitioners evaluate the quality of online information and courses.

The role of the restorative dentist in the diagnostic and maintenance phases of implant therapy--Part I: Patient selection.

The objective of patient selection is to ensure that the patient's need and desire for dental treatment is consistent with the clinical findings and the clinician's ability to provide treatment. Considerable effort is required to gather and analyze the data necessary to determine whether implant therapy is feasible. Additional planning is required to determine if this is the best treatment modality. All aspects of dental treatment need to be considered and planned before the implant phase of treatment is contemplated. Our experience indicates that the potential need, and indeed necessity, for conventional dental treatment in patients seeking implant therapy is high. The general practitioner is the logical resource to fulfil the dental needs of the majority of these patients.

The role of the restorative dentist in the diagnosis and maintenance phases of implant therapy--Part II: Prosthetic planning.

Prosthetic planning is critical to the success of the diagnostic phase of implant therapy and is used to establish fixture numbers, position and the optimal occlusal scheme, based on the design of the definitive prosthesis. The prosthetic needs of the patient, anticipated functional and parafunctional forces, restoration fabrication and serviceability are all considered. A clear picture of the intended rehabilitation is provided to the surgical team and expedites the consultation between implant team members. Comprehensive diagnostic planning using mounted diagnostic casts and diagnostic wax-ups will provide definite parameters for fixture number, position and alignment, and permit the fabrication of radiographic and surgical templates as the treatment sequence progresses. Patients need to be informed of the time and expense involved in the diagnostic phase of implant therapy prior to the initiation of the planning process. The practitioner conducting the selection and planning phase is entitled and should expect financial remuneration commensurate with the time and effort required to achieve the objectives of this phase of implant therapy. The Planning Process Using mounted diagnostic casts and diagnostic wax-ups: 1. Establish fixture numbers and position; 2. Establish the optimal occlusal scheme; 3. Design the definitive prosthesis; 4. Fabricate a surgical template. Design Principles--Summary 1. The location and number of fixtures dictates the prosthetic design and influences restorative success. 2. A restoration must be designed to distribute forces to the fixtures without overloading the bone, and therefore be able to withstand anticipated functional and parafunctional loading. 3. Design for optimal function and esthetics with a regard for patient comfort and maintenance.

The role of the restorative dentist in the diagnosis and maintenance phases of implant therapy--Part III: The restoration and maintenance of oral health prior to the provision of the implant prosthesis.

Establishing and maintaining the patient's oral health prior to provision of the definitive implant restoration is the responsibility of the restorative dentist and is an important aspect of comprehensive treatment. The additional time and expense required to provide oral hygiene and conventional dental treatment needs to be acknowledged by the implant team and the patient. An anticipated three to five treatment hours are often required to provide maintenance and hygiene care, with additional time needed to provide individualized conventional dental treatment to each patient. The provision of implant therapy is a rewarding experience when all aspects of treatment are properly planned and competently performed. The general practitioner is the logical resource to provide much of the necessary treatment that is directly and indirectly related to the provision of implant restorative dentistry.