The teaching of removable partial dentures in dental schools in Oceania

Current and future trends in the teaching of removable partial dentures in dental schools in Malaysia: A cross sectional study

AIMS

To investigate, using a validated questionnaire, the teaching of removable partial dentures (RPDs) in dental schools of Malaysia.

MATERIALS AND METHODS

A validated questionnaire to investigating trends in the teaching of RPDs in dental schools in Oceania was emailed (in English version form) to Heads of Restorative/Prosthodontics/course coordinators in the 13 dental schools in Malaysia. Follow-up reminders were sent and participants were given six weeks to complete and return the questionnaire. Data was entered into an Excel spreadsheet and results compiled and analyzed.

RESULTS

Completed questionnaires were received from 13 dental school - a 100% response rate. All schools (n = 13) provided a preclinical technical course in RPD design. In most schools (n = 9, 69.2%), course work was supervised by senior lecturers while rest of the institutions made use of associate professor/professors. There were significant differences (p<0.05) between dental schools in terms of the contact hours dedicated to preclinical teaching. Students received an average of 62 h of instruction. Didactic instruction was the primary focus with practical (78 h) and didactic teaching (32 h). All dental schools (n = 13) provided practical surveyor design teaching (8 h). The staff student ratio for formal lectures (1:61), tutorials (1:29) and lab demonstrations (1:12) were recorded. Majority of the schools (n = 11, 84.6%) employed paired teaching in clinical sessions. All schools (n = 13, 100%) emphasized on increased teaching of RPD design and prescription writing in future clinical RPD courses.

CONCLUSION

Teaching of RPDs in Malaysia may be considered sufficient and comparable to the teaching in other parts of the world.

CLINICAL SIGNIFICANCE

Whilst the teaching of partial dentures at Dental Schools in Malaysia provides the core competencies involved in partial denture design and construction based on sound fundamental, scientific principles they should address the challenges of teaching partial dentures and other areas of dental education including improving working conditions for dental professionals.

Undergraduate Teaching and Assessment Methods in Prosthodontics Curriculum: An International Delphi Survey

OBJECTIVES

To achieve consensus amongst an expert panel of prosthodontics/restorative dentistry academics on the best undergraduate teaching and assessments, and to develop recommendations regarding teaching and assessment of undergraduate prosthodontics.

METHODS

Semi-structured electronic questionnaires were used to collect data from senior clinical academics involved in the teaching of prosthodontics on three consecutive occasions (Delphi method). The questionnaires asked the experts' opinion on best teaching and assessment methods in the undergraduate prosthodontics curriculum. Invitation emails, with a hyperlink to the Round 1 questionnaire, were sent to 36 international dental academic experts. In later rounds, panellists were invited to consider their previous responses in light of the overall group response in attempt to bring the panel to a consensus. The group response was summarized using simple descriptive statistics, and the target level of consensus for each question was set at ≥ 70%. A response rate of at least 70% between rounds was deemed appropriate to maintain rigour.

RESULTS

Twenty-three senior academic experts from eleven countries agreed to participate. Eighteen (representing nine different countries) completed the questionnaires in its entirety (response rate 78.3%). The number of statements that attained consensus agreement was much higher than the number of non-consensus statements-92.6%, 175 statements out of 189 over three iterative rounds. Only 14 statements did not obtain a consensus during this Delphi study.

CONCLUSIONS

A total of 175 consensus statements represent the agreement expert views of participated senior academics in prosthodontics from nine different countries and across four continents. These consensus statements could be considered detailed guidelines and recommendations to improve future undergraduates' curriculum in prosthodontics.

CLINICAL SIGNIFICANCE

This Delphi study achieved a high consensus among a panel of senior academics in the teaching and assessment of undergraduate prosthodontics. This consensus could help minimise the current international and national divergence in dental schools' prosthodontics curricula, which could benefit future dentists and, subsequently, the patients.

Preparing guiding planes for removable partial dentures: comparison between assisted CAD-CAM template procedure and freehand preparation: An in vitro study

OBJECTIVES

To compare the trueness of computer-aided design and computer-aided manufacturing (CAD-CAM) assisted procedure and freehand procedure for preparing guiding planes for removable partial dentures (RPDs).

METHODS

Forty identical mandibular resin casts were divided into two groups in which the guiding planes of two abutment teeth were prepared freehand (control group, n = 20) and using rigidly constrained templates (test group, n = 20). The template was designed on a digital cast of virtually prepared guiding planes and fabricated by selective laser melting using cobalt-chromium alloy. To assess the 3D trueness, all prepared guiding planes (Test data) were digitized using a laboratory scanner and compared to the virtually designed guiding planes (Reference data). The angle deviation between the Test data and the designed direction of the path of placement was measured for assessing the direction trueness of guiding plane preparation.

RESULTS

The 3D trueness of guiding plane preparation was significantly better in the test group (48.4 ± 12.9 μm) than in the control group (128.5 ± 37.6 μm, p < 0.01). The direction trueness of guiding plane preparation was also significantly better in the test group (1.20 ± 0.55°) than in the control group (7.68 ± 3.00°, p < 0.01).

CONCLUSIONS

The CAD-CAM template assisted procedure can significantly improve tooth preparation of the guiding planes compared to the freehand preparation. The CAD-CAM template could help clinicians prepare parallel guiding planes in a predictable manner.

Current trends in removable partial prosthodontics education in dental colleges of Pakistan

OBJECTIVE

The objective of this study was to investigate the current trends in undergraduate teaching of removable partial prosthodontics in various dental colleges of Pakistan.

METHODOLOGY

A cross-sectional study was conducted in which a questionnaire was sent by email to head of Prosthodontics department of thirty-one dental institutes of Pakistan. The survey included multiple questions regarding current trends in removable partial prosthodontics education in undergraduate dental colleges.

RESULTS

Out of thirty-one questionnaires, twenty-six were completely filled and returned. In 19 (73%) dental colleges, removable partial denture is taught over a period of at least two years of undergraduate education. Students of only six dental colleges fabricate 10-12 removable partial dentures during their Prosthodontic rotation. Lectures and live clinical demonstration for construction of removable acrylic dentures are reported to be carried out in all the dental schools. Simple hinge articulator is the articulator of choice in 22 (84.6%) colleges. Even though twenty-four out of twenty-six colleges (92.3%) teach fabrication of cast partial dentures in lectures, none of the student fabricate these dentures during their Prosthodontic rotation.

CONCLUSION

This survey is the first to comprehensively report the teaching practices of removable denture Prosthodontics in undergraduate dental colleges of Pakistan. Faculty of all twenty-six colleges give clinical demonstrations of acrylic partial denture construction before students start working in the dental OPD. Most of the dental colleges report use of similar impression materials and techniques in removable partial denture fabrication. More than 90% of dental colleges teach cast partial dentures theoretically, but their construction is grossly neglected in all the dental colleges. It is important that this skill is taught and practised by students in order to have the necessary skill set, so they can provide comprehensive treatment to partially dentate patients once they graduate.

Association of fit of partial denture metal framework with various framework design features using alginate as a final impression material: A prospective clinical study

OBJECTIVES

To assess the fit of PRDP frameworks fabricated using alginate as a final impression material in metal stock trays, in terms of number of fabricated frameworks needed until realization of clinically adequate fit. Also, any association of framework fit achieved with its design features, namely major connector design, and numbers of guide plates and occlusal/incisal rests was investigated.

METHODS

147 partially dentate patients were provided with Co-Cr PRDPs, in single or both arches, by undergraduate dental students. Final impressions were made with alginate in metal stock trays. At metal framework try-in, clinical examinations were carried out by two prosthodontists and relevant information noted with regard to proper fit. The relationship between three PRDP design features and number of frameworks that needed to be made in each case to achieve satisfactory fit was determined using factorial analysis of variance (ANOVA) (α = 0.05).

RESULTS

86% (148) of the 173 frameworks fabricated were found to be clinically satisfactory at the first try-in visit (with or without any chairside adjustment). The remaining 14% (25) required new impressions for re-fabrication and passed at the second attempt. None of the examined design features were significantly associated with the number of construction attempts needed, for all 173 arches, or when maxillary and mandibular arches were considered independently (p >  0.05).

CONCLUSIONS

PRDP design features were not associated with the level of accuracy of fit achieved.

CLINICAL SIGNIFICANCE

Alginate in metal stock trays seems to be acceptable for final impressions of all types of Co-Cr PRDP designs with just 1 in 7 castings not fitting after chairside adjustment.

Students' self-confidence and perceived quality of prosthodontics education: A study in the Faculty of Dental Medicine of the University of Porto

INTRODUCTION

Oral rehabilitation with removable dentures (RDs) is still a viable choice for the edentulous population. Fostering students' confidence in prosthodontic procedures should be a major concern in dental schools. This study has three purposes: (a) to measure the self-reported confidence levels of undergraduate dental students when performing removable prosthodontic treatments; (b) to evaluate the students' perceived quality of removable prosthodontics education; and (c) to assess the students' suggestions to improve removable prosthodontics education.

MATERIALS AND METHODS

An anonymous questionnaire was delivered to third-, fourth- and fifth-year students of the Faculty of Dental Medicine of the University of Porto (FMDUP) (n = 176). Data from quantitative questions were statistically analysed with IBM SPSS Statistics for Windows (V.24.0), whilst qualitative data were clustered into topics and analysed in Excel.

RESULTS

With a 100% response rate, most students felt "confident" and "very confident" in RD clinical procedures. Overall, the 5th-year students had higher confidence than 4th-year ones, except when surveying diagnostic casts. Our findings also revealed that students considered the removable prosthodontics education "Good" and "Very good," and their main suggestions were related to increasing the time allocated to clinical practice.

CONCLUSIONS

Students' confidence in carrying out removable prosthodontic procedures grew as they progressed through the course. Overall, the students' evaluation of the quality of prosthodontics education was positive, and their main suggestion to improve their confidence levels was increasing the clinical experience.