Implant dentistry education in Europe: 5 years after the Association for Dental Education in Europe consensus report

Introducing a novel educational training programme in dental implantology for pregraduate dental students

INTRODUCTION

This study aimed to determine whether implant surgery procedures can be implemented in the dental curriculum by designing novel courses for students. Additionally, this study assesses the perception of these courses and how they can be established in the future.

MATERIALS AND METHODS

Students from the third to fifth years participated in a programme consisting of 4 modules according to their academic year. The modules taught theoretical and practical content as well as clinical references. After participating, the students completed two questionnaires with research questions (RQ1 = evaluation of the relevance and effects; RQ2 = impact of modules 3 and 4) to evaluate the programme. The questionnaires consisted of 52 statements, each rated on a 6-point scale (1 'totally disagree' to 6 'totally agree'). Cronbach's alpha analysis was used, and median values, interquartile ranges and Pearson correlations (p-value) were statistically calculated.

RESULTS

In total, 94 students completed the questionnaires. Cronbach's alpha exceeded 0.7 for all constructs except for one (skills training). The highest evaluated median was 6, and the lowest was 4.75. Pearson correlations were significant (<0.05) for perceived importance/lectures, perceived importance/tutor performance, lectures/skills training, skills training/tutor performance and tutor performance/lectures. Seventeen analysed free comments expressed strong interest in implantology courses for the curriculum. 88% of the students wished for more practical exercises in dental implantology during the curriculum or suggested expanding the programme in the future.

CONCLUSION

The programme was highly accepted among dental students. The students wished for more practice in the future to perform supervised procedures on patients.

Periodontists and oral surgeons' peri-implantitis-related education, knowledge, attitudes, and professional behavior: A national survey

OBJECTIVES

Each year, approximately 5 million dental implants are placed in the United States and one out of three patients is likely to experience peri-implantitis (PI). The objectives were to compare the PI-related education, knowledge, attitudes, and professional behavior of periodontists and oral maxillofacial surgeons (OMS), and to explore relationships between these constructs of interest.

METHODS

A total of 389 periodontists and 161 OMS responded to a web-based survey. Descriptive and inferential statistical analyses (independent sample t-tests, chi-square tests, and correlational analyses) were conducted.

RESULTS

On average, periodontists reported a higher percentage of time spent in residency on implant surgery (21.02% vs. 7.27%; p < 0.001), better education about PI (5-point scale with 1 = not at all well: means: 2.86 vs. 2.59; p < 0.001), and better knowledge of risk factors (4.07 vs. 3.86; p < 0.001) than OMS. Periodontists argued that oral hygiene-related treatment (4.45 vs. 4.22; p = 0.001) and regeneration-focused treatments such as guided tissue regeneration (3.62 vs. 3.20; p < 0.001) contributed more to successfully treating PI and used these treatments more in their practices (4.86 vs. 4.56; p < 0.001/3.06 vs. 2.68; p < 0.001) than OMS. They also considered PI as a more serious problem than OMS (4.55 vs. 3.80; p < 0.001). The better the respondents' PI-related knowledge was, the more they considered PI as a serious problem (r = 0.19; p < 0.001). The more cases they treated per month, the more they considered PI as a serious problem (r = 0.19; p < 0.001).

CONCLUSIONS

The results of the present study highlight the lack of standardization in the specialty training of periodontists and OMS. Best practice guidelines for the diagnosis and treatment of PI are needed to optimize graduate education about this important topic.

Interdisciplinary all-on-four® concept for mandibular jaw in dental education - do students benefit from individual 3d printed models from real patient cases?

PURPOSE

Digitalization is assuming increasing significance in dental education, as dental students are increasingly exposed to digital implant planning and contemporary technologies such as 3D printing. In this study, we present a cohort analysis aimed at assessing the potential benefits derived from the utilization of 3D prints to seamlessly translate planned procedures into real-life applications.

METHODS

21 dental students participated in a virtual planning and hands-on course across two cohorts (C1: n = 10, C2: n = 11). The virtual implant planning phase involved the placement of four implants on an atrophic lower jaw model. Subsequently, Cohort 1 (C1) executed the implantation procedure on a prefabricated hands-on model, while Cohort 2 (C2) engaged with 3D prints representing their individual implant planning during the hands-on session. Subjective assessments of knowledge, skills, and the perceived utility of 3D prints were conducted through pre- and post-course questionnaires, utilizing a 5-point scale.

RESULTS

In the subjective evaluation, 17 out of 21 participants expressed a positive appraisal of the use of personalized models. Notably, there was no statistically significant improvement in overall knowledge scores; however, there was a discernible increase of 0.5 points in the ratings related to perceived expertise and procedural abilities.

CONCLUSION

While there was a notable increase in the subjective ratings of knowledge and abilities, no statistically significant difference was observed between the two groups. The consensus among dental students is that individually planned and printed implant models serve as a valuable and effective tool in hands-on courses.

Dental Students' Perception and Self-Perceived Confidence Level in Key Dental Procedures for General Practice and the Impact of Competency Implementation on Their Confidence Level, Part I (Prosthodontics and Conservative Dentistry)

Background

Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort).

Materials and Methods

An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, n = 153), and the other in 2019 after the implementation of this system (group 2, n = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and t-test for Equality of Means calculated.

Results

Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied.

Conclusions

This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date.

Knowledge and attitude in implant dentistry training courses amongst undergraduate dental students at Tehran University of Medical Sciences

INTRODUCTION

Due to the increase of implant treatments in daily practice, graduates should be well acquainted with appropriate diagnostic and therapeutic knowledge in implantology. This study sought to assess the knowledge and attitude of undergraduate students towards the benefits of their courses in the implant dentistry curriculum.

MATERIALS AND METHODS

This survey study was performed on all senior dental students at Pardis International Campus, School of Dentistry of Tehran University of Medical Sciences. Data collection was carried out through a questionnaire containing various items on knowledge and attitude. The validity and reliability of the questionnaire were already approved. Collected data were coded, entered in Microsoft Excel 2019, and analysed by t-test (α = .05).

RESULTS

Forty questionnaires were filled out by 28 female and 12 male students. Only 7.5% and 12.5% of students reported that they had adequate knowledge to conduct the surgical and prosthetic steps of dental implant treatment, respectively. The majority of students had a positive attitude towards the quality of theoretical education. However, less than 50% of them perceived the same about their practical education. No significant difference existed between male and female students regarding their responses to the knowledge and attitude questions (p = .458 and p = .288, respectively). Ninety percent of the students felt the need for further education regarding dental implant treatment in the undergraduate curriculum.

CONCLUSION

Despite the satisfaction of the theoretical knowledge, most senior students believed that they did not achieve adequate expertise to practice after graduation and were willing to receive further practical training in implantology.

Progress and challenges in the harmonisation of European undergraduate dental education: A systematic literature review with narrative synthesis

INTRODUCTION

Harmonising education to support workforce mobility has been a policy objective for the European Union. However, alignment across varied national contexts presents challenges in dental education.

METHODS

A systematic literature review with narrative synthesis. Searches of the electronic databases Embase [Ovid]; MEDLINE [Ovid]; Scopus; CINAHL; AMED and PsycINFO were conducted for relevant material published between 2000 and 2019 on undergraduate curricula, quality standards and learning outcomes in dentistry.

RESULTS

Seventy-six papers met the inclusion criteria. Fifty-three papers were commentaries or editorials, twenty-one were research studies, and two were literature reviews on specific dental subfields. Eighteen of the research studies reported surveys. The literature contains extensive proposals for undergraduate curricula or learning outcomes, either broadly or for subfields of dentistry. Included papers demonstrated the importance of EU policy and educator-led initiatives as drivers for harmonisation. There is limited evidence on the extent to which proposed pan-European curricula or learning outcomes have been implemented. The nature and extent of dental students' clinical experience with patients is an area of variance across European Union member states. Arrangements for the quality assurance of dental education differ between countries.

DISCUSSION

Harmonisation of European dental education has engaged educators, as seen in the publication of proposed curricula and learning outcomes. However, differences remain in key areas such as clinical experience with patients, which has serious implications if graduate dentists migrate to countries where different expectations exist. Mutual recognition of professional qualifications between countries relies on education which meets certain standards, but institutional autonomy makes drawing national comparisons problematic.

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.

Virtual aids and students' performance with haptic simulation in implantology

OBJETIVES

This study aims to validate that haptic simulator assistance could improve drilling ability in implantology and that the repetition of training session could highlight a learning curve.

METHODS

This work was carried out with 88 first-year dental students. After randomization, students were divided into two groups. Group 1 was assigned to prepare an implant site for a left first mandibular molar (36) on haptic simulator with assistance provided by simulator. Group 2 had to perform the same exercise without assistance. Whatever the group, the maximum time for each reparation was restricted to 5 min. An interval of 1 week was done between each session. For each test, different objective parameters provided by the simulator were recorded and analyzed.

RESULTS

This study showed that the presence of virtual aids led to quickly obtain better results, and the training led to gradually acquire sufficient competence to do without virtual aids.

CONCLUSION

By associating virtual assistance and repetition, the student will acquire more quickly the skills allowing to carry out his clinical gestures in real conditions.

Dentists' Attitudes Toward Dental Implant Maintenance in Thailand

INTRODUCTION

As implant therapy is a widely applied treatment modality, general dentists are in the frontline of maintaining health in patients with implants. It is however unknown to what extent general dentists are competent and feel prepared to deliver maintenance of implants to patients.

OBJECTIVES

The aim of this study was to investigate the attitudes and self-reported and objectively assessed competences of general dentists with maintenance of dental implants in patients.

METHODS

A questionnaire designed and validated for the purpose of the study, including attitudes and self-reported and objectively assessed competences, was distributed by means of an online platform.

RESULTS

Data from 429 questionnaires were included in the study. Half of the participants were 28 to 33 y old and 78% had been working <10 y. Seventy-eight percent believed that dental implant maintenance should be performed by general dentists, but only 51% were prepared to do this, citing obstacles such as insufficient knowledge and limitations of their working environment. The mean ± SD objectively assessed competence score was 8.97 ± 2.74 of 17. There were significant differences (P < 0.001, 1-way analysis of variance) in the scores among dentists who offered the full range of maintenance and management of complications (10.83 ± 2.45) with those willing to provide comprehensive oral examination and implant maintenance only (9.31 ± 2.73), those offering comprehensive examination but unwilling to conduct maintenance (8.22 ± 2.28), and those who refer all dental implant patients elsewhere (7.2 ± 2.66). Around half of the dentists believed that implants last for life.

CONCLUSIONS

While general dentists appeared to largely acknowledge the importance of providing implant maintenance care and present with positive attitudes, a large portion was unwilling to engage with maintenance of implants in patients and appeared to lack essential competences to this end. The main obstacles for providing implant maintenance care included insufficient knowledge and lack of a properly equipped clinical environment.

KNOWLEDGE TRANSFER STATEMENT

The results of this study can identify deficiencies in the currently available maintenance competences and schemes for patients with implants. These results can also help dental professionals, scientific bodies, and associations to design appropriate education and professional development strategies that can strengthen the confidence and competences of general dentists, thus offering better service to the public.

O-HEALTH-EDU: A scoping review on the reporting of oral health professional education in Europe

INTRODUCTION

The variability in oral health professional education is likely to impact on the management of oral health needs across Europe. This scoping review forms the initial part of a larger EU-funded collaborative Erasmus + project, 'O-Health-Edu'. The aim of this scoping review is to investigate how oral health professional education in Europe is reported.

METHODS

The PRISMA and Arksey & O'Malley methodological frameworks for scoping reviews were used to guide reviewers in answering the research question "How is oral health professional education reported in Europe?". The search strategy encompassed published literature searches, internet searches and further searching of relevant documents from educational organisations, regulators and professional bodies. Once the search strategy was developed, it was sent to key stakeholders for consultation. Sources were reviewed by two authors (JD, JF) and included in the review if they reported on oral health professional education in Europe.

RESULTS

A total of 508 sources were retrieved from all of the searches. A total of 405 sources were excluded as they did not report on the topic of interest, leaving 103 sources that reported on oral health professional education in Europe. Handsearching the references of published sources lead to a further 41 sources being screened, of which, 15 were included. In total, 33 duplications were removed and the final number of included sources was 85. The average year of publication for the included sources was 2007, with sources most commonly published in journals dedicated to dental education. Surveys represented the most common form of reporting. From the data obtained, four broad themes of reporting were evident: dental education at a programme level, dental education at a discipline level, other oral health professional education, and postgraduate education and continuous professional development.

CONCLUSION

The reporting of dental and oral health professional education in Europe is limited. Whilst there are many useful documents that provide guidelines on dental education, there is limited knowledge on how education is implemented and delivered. There is a greater need for comprehensive educationally driven programme-level data on oral health professional education across Europe.

A cross-sectional survey of attitudes towards education in implant dentistry in the undergraduate dental curriculum

BACKGROUND

An ongoing debate in dental education is whether implant dentistry, as a multidisciplinary domain, should be integrated into the undergraduate curriculum. The aim of the present study was to evaluate the perspectives of novices, clinical educators, and experienced dentists with regard to the importance of theoretical and practical implant dentistry teaching content in undergraduate dental education. The specific objective was to determine whether a consensus could be found concerning aspects of theoretical knowledge, implant position planning, implantation, prosthetic treatment procedures, postoperative care, and prerequisite experiences that should be provided in undergraduate dental education.

RESULTS

A positive consensus existed in terms of theoretical education, assistance in surgical and prosthodontic procedures, implant planning and restoration in straightforward cases (i.e., posterior single crowns and bridges, overdentures on nonconnected implants), and postoperative care. A negative consensus existed for bone augmentation. Implantation was supported by novices (i.e., students and graduates). In addition, more experienced dentists were more likely to oppose implantation performed by undergraduates. The most preferred implantation method was implant insertion using a digitally fabricated drilling template, after surgical flap elevation.

CONCLUSIONS

Students and graduates preferred a comprehensive undergraduate education that included implant dentistry. Dentists working in private practice, and especially dentists working as university educators, were critical towards the integration of implant-related learning content into undergraduate education. The intention of medical education is to impart knowledge to students and to prepare them for life-long learning and continual professional development after graduation. Thus, an undergraduate dental curriculum that provides students a solid introduction and knowledge foundation in implant dentistry is recommended.

Dental implant maintenance teaching in Australia-A survey of education providers

INTRODUCTION

Implant treatments and peri-implant maintenance continue apace, while the evidence for implant maintenance and home hygiene continues to be developed. Information sources for dental practitioners and patients in peri-implant health maintenance and disease management are generally not known. This study investigated the implant maintenance topics taught, the discipline backgrounds of convenors and presenters and information delivery methods within implant dentistry teaching in Australia.

MATERIALS AND METHODS

An online survey was distributed to 56 convenors of implant dentistry and maintenance education programmes in Australia, garnering responses from 24 individuals which outlined 43 different education programmes.

RESULTS

Lectures were the main delivery method for implant maintenance information across the different course types. Peri-implant diagnostics were generally taught according to current literature recommendations, but coverage varied in topics where the evidence is yet to be established (eg home hygiene, professional maintenance and implant review). Some educators reported awareness of limitations in their programmes.

CONCLUSION

Implant dentistry education programmes in Australia vary widely in teaching implant maintenance, coverage of which should be current and evidence-based at all education levels. The structure of implant dentistry teaching at the continuing professional development level requires further development.

Self-regulated learning strategies in world's first MOOC in implant dentistry

BACKGROUND

Massive Open Online Courses (MOOCs) have been often described as a major innovation Higher Education, but their application in the teaching of clinical disciplines is still very limited, while there is a lack of scientific evaluations in this domain. The aim of this study was to investigate learners' behaviours and correlate patterns of Self-Regulated Learning (SRL) with performance and achievement during a MOOC in Implant Dentistry.

METHODS

The clickstream data of learners from the first run of the MOOC Implant dentistry by The University of Hong Kong were modelled and quantified based on Zimmerman's SRL model. The data were quantitatively analysed by means of k-means clustering for evidence of five SRL behavioural indicators of student activity. The clusters identified were then correlated with student engagement and learning performance.

RESULTS

A total of 7608 individuals enrolled, 5014 engaged (active learners 65.90%), 1277 of them (25.47%) completed the course and 1232 purchased a certificate. Two major groups of learners emerged: Attentive (n = 1433) who were more likely to follow the prescribed pathway in the MOOC and Auditors (n = 3581) who accessed content selectively. There was significantly higher engagement, achievement and completion rates among Attentive than Auditors. Both groups included subcategories (Browser, Digger, Test-driven, Sampler, Persistent) which might reflect different SRL strategies.

CONCLUSION

A MOOC in a clinical discipline can achieve high enrolment and completion rates as compared to current benchmarks. There appears to be a wide diversity of learning behaviours among learners, with two however dominant patterns. Learners with a linear learning pathway achieved significantly higher grades and completion rates than those who accessed content irregularly and selectively. Such differences however might be influenced by the demographic and professional background of the learner, as well as their motivation to attending the MOOC. Certain learning behaviours, in particular how learners access content in relation to assessments might be closer related to SRL.

Knowledge and management of temporomandibular joint disorders by general dentists in Spain

Background

Given the importance of temporomandibular disorders (TMD), we tried to assess general dentists' knowledge regarding etiology, diagnosis, and treatment in order to understand their attitude.

Material and Methods

A sample of 130 general dentists answered a 16-item questionnaire on three areas - etiology, diagnosis, and management of common temporomandibular disorders - as well as a question on the need for continuous education regarding TMD management in common clinical practice in Spain. Given that the descriptive statistics achieved reflect significantly different values among means in each area, a variance analysis for repeated measurements was applied in order to contrast differences among etiology, diagnosis, and management knowledge levels.

Results

The contrast test was based on Wilks' Lambda, which assumed a value of 0.120 (F = 467.28; p<.001), demonstrating statistically significant differences among knowledge levels in the three dimensions. The effect size for these differences, measured by partial eta squared, was very high (η2p = 0.88). Such parameters were also analyzed to search for potential differences according to professional experience, with differences being exposed as non-significant at the 0.05 level: etiology (T = 1.60; p = 0.113), diagnosis (T = - 0.17; p = 0.868), and treatment (T = 1.10; p = 0.273).

Conclusions

Our study found that, even though clinicians are generally skilled regarding the knowledge of the etiologic that explain the diagnosis of TMD, they have room for improvement in terms of TMD management compared to the other two areas studied. General dentists could benefit from specific educational programs enhancing TMD management skills. Key words:Temporomandibular disorders (TMD), knowledge and management. Clinical competence, postgraduate, continuing professional development. Surveys, education,orofacial pain.

A global perspective on implant education: Cluster analysis of the "first dental implant experience" of dentists from 84 nationalities

OBJECTIVES

The aim of this cross-sectional study was to explore the demographic and educational patterns related to the dentists' first implant dental experience.

MATERIAL AND METHODS

Participants of a Massive Open Online Course in implant dentistry who have placed and restored implants completed a 25-item online questionnaire investigating their pathway of education and assessing their experience with the "first implant placement." Exploratory analysis included hierarchical clustering using 9 demographic categorical factors.

RESULTS

A total of 1015 respondents from 84 countries formed 5 distinct clusters. Age and work experience were dominant clustering traits, decreasing from Cluster 1 to Cluster 5. Clusters 1 and 3 represented "senior" and "younger" general dental practitioners, respectively, whilst Clusters 2 and 4 represented post-graduate educated clinicians. Cluster 5 represented recent graduates. Asia, South America and Africa were over-represented in "younger" clusters. Time in practice was a significant determinant of attitudes, followed by completion of post-graduate education. There were significant differences in reported patterns of challenges and complications depending on dentists' time in practice, age and post-graduate education. Challenge in implant positioning was more frequently identified by "young post-graduate" educated dentists. Recent graduates reported having the fewest complications of all clusters. Obtaining implant education in University settings was most frequently recommended by clusters of dentists with post-graduate education.

CONCLUSIONS

Time in practice is a parameter to be considered when designing implant education. The absence of structured education and mentorship might lead to inability to properly assess treatment outcomes and identify complications. Quality-assured and practice-directed education is needed at a global level, to support in particular, recent graduates who now seem to engage with implant dentistry early in their career.

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.

Are UK graduates equipped with the skill set required to meet the demands of the UK's edentulous population?

As the UK witnesses a decline in the number of edentulous adults, there is a simultaneous reduction in the number of cases available to undergraduate dental students for the teaching of complete dentures. When edentulous adults are unable to function with conventional complete dentures, particularly pertaining to the mandibular denture, an implant-supported mandibular overdenture has been evidenced as the gold standard for edentulous patients. The evidence in favour of mandibular implant-supported overdentures is one of the most robust evidence bases for any clinical treatment and similarly it has been shown that undergraduate students are equally as capable in the provision of implant-supported overdentures as experienced prosthodontists. Yet there appears to be a disparity in the General Dental Council's undergraduate learning outcomes pertaining to care for edentulous adults. Furthermore, the UK seems to be falling behind in this respect in comparison to our European, American and Australian colleagues. This review looks at the evidence for the provision of implant-supported overdentures in the setting of the undergraduate dental curriculum, the potential barriers within this teaching forum and how well prepared UK undergraduates are for the clinical management of edentulous patients in the future.

The Graduating European Dentist-Domain III: Patient-Centred Care

This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to patient-centred care. This approach is becoming increasingly prominent within the literature and within policy documents. Whilst working to an evidence base is critical, dentists must also be aware of the scientific basis that underpins the treatment they provide. The evaluation process, which supports treatment planning, also requires dentists to be able to listen, collate, and record pertinent information effectively. In addition, the ability to account for a patient's social, cultural and linguistic needs (cultural competence) will result in a practitioner who is able to treatment plan for patient-centred care.

Competence profiles in undergraduate dental education: a comparison between theory and reality

Background

Competence profiles are purposed to provide a blueprint in support to develop and/or benchmark the learning outcomes of undergraduate dental curricula. This study aims to investigate whether a competence profile as proposed by academic- and clinical experts is able to represent the real clinical reality.

Methods

A questionnaire was developed including questions about gender and age, perception about required competences, and educational organisation and was distributed among Flemish dentists via email and on paper during a symposium. The data was analysed using descriptive statistics, Chi-square and non-parametric Mann-Whitney U-tests.

Results

A total of 312 questionnaires were completed (=6.5% of dentist population, with similar gender and age characteristics). All competences in the European competence profile were rated between 7.2 and 9.4 on a 10-point scale. In dentists under 50 years, females rated the importance of identifying/managing anxiety and abnormal patient behaviour; and promoting/improving oral health as significantly higher than males. In dentists of 50 years and above, females rated 8 competences significantly higher than males, including obtaining/recording a complete history; identifying/managing anxiety and abnormal patient behaviour; obtaining/interpreting radiography; identifying temporomandibular and associated disorders; identifying orthodontic needs; awareness of own limitations/when to refer; managing dental urgencies; and basic-life-support/defibrillation. Clinical practice management was most frequently reported as additional competence to address in dental education. Furthermore, the respondents suggested an undergraduate dental curriculum based on 34% theoretical education, 26% preclinical skills training, and 40% clinical education and 86% agreed with a duration of 5 years. Finally, the respondents also illustrated the dynamic nature of dentistry including a reduction of amalgam fillings, a shift from individual practice to group practices, an increased administrative load, and more assertive patients.

Conclusion

Findings in the present study suggest the validation of the proposed competences for graduating European dentists within the clinical reality of dental professionals in daily practice. Nevertheless, the results have also demonstrated heterogeneity regarding gender and age within the dentist population and emphasised a continuously evolving dental profession and required competences. Hence, to maintain high quality of dental care, a strategy should be developed in which dental curricula are continuously benchmarked against an evolving clinical reality.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0403-4) contains supplementary material, which is available to authorized users.

The opinions and attitudes of dental school academic staff towards oral healthcare education for older adults

The term 'oral health care for older adults' has various interpretations, and its meaning is not clear among dental school academic staff. Additionally, there are no theoretical or practical stand-alone courses on oral health care for older adults in Japanese dental schools. To improve oral health care education, we investigated the opinions and attitudes toward oral health care education for older adults among academic staff in dental schools. Data were collected in seven dental schools from May to September 2013 via an online questionnaire survey. Five-hundred-fifty-eight academics (428 male, 130 female) participated (response rate 57%). The average number of years since they had completed a university degree was 20.2 (SD 10.2) years. The majority (Over 90%) of participants perceived that oral health care should be provided in nursing facilities, hospitals, and at home. Its treatments and instructions should include, not only methods of keeping good oral hygiene, but also improvement of oral function such as swallowing training and salivary glands massage. The majority (84.2%) suggested oral health care education should be combined as a one-credit, stand-alone course. Findings indicate that dental academics have an understanding the need for a course in oral health care for older adults. Participants supported the need for further development of education in oral health care for older adults' in Japan, as a separate course on its own right. However there were some different views about content by teaching field. The need for a national core program for teaching oral health care education was suggested.

Oral implant placement and restoration by undergraduate students: clinical outcomes and student perceptions

INTRODUCTION

Universities are developing and implementing implant dentistry training to prepare dental professionals for the growing treatment needs. This study describes how implant dentistry is taught at the KU Leuven and focuses on implant-related clinical outcomes. Perspectives of participating undergraduate students are analysed with a view to improve oral implant dentistry training.

MATERIALS AND METHODS

Implant dentistry training at the KU Leuven consists of theoretical lectures, pre-clinical hands-on workshops and clinical (surgical/prosthetic) experience. Questionnaires were used to investigate the perceptions of students on the educational programme. Radiographs were taken at implant insertion, at healing abutment connection, at restoration/prosthesis insertion and after 1 and 2 years of functional loading. The marginal bone level was measured from the implant-abutment connection to the first visible bone-to-implant contact.

RESULTS

One hundred and twelve implants were placed by 56 undergraduate students (61.5% of the total students) in 56 patients. After a follow-up time of 3 years, the cumulative implant survival rate, at implant level, was 97.1%. The mean marginal bone loss after 1 and 2 years in function was 0.35 mm and 0.39 mm, respectively. Eighty percentage of students were satisfied with the training, and they considered this sufficient preparation to perform implant placement under close supervision.

CONCLUSIONS

The clinical outcome of implant treatment performed by undergraduate students under close supervision is similar to that reported by experienced clinicians/research teams. Clinical, surgical as well as restorative experience in addition to theoretical and pre-clinical training seems beneficial when implementing implant dentistry in the undergraduate programmes.

Evaluation of the implant-related restorative undergraduate programme at ACTA, the Netherlands. Part I: students' satisfaction

INTRODUCTION

Due to the increasing use of dental implants, many future dentists will encounter implant-related procedures in general practice. Over the past decade, implant dentistry is more and more often included in undergraduate curricula. Very little is known about students' satisfaction regarding implant-related undergraduate programmes, as minimal analyses are performed. In particular, a lack of information exists regarding programmes where undergraduates restore implants. This study describes an evaluation of the students' satisfaction regarding the implant-related restorative undergraduate programme at ACTA, the Netherlands.

MATERIAL AND METHODS

After clinical examination and establishment of the treatment plan, undergraduates were required to assist postgraduate implantology students during surgery. All patients received Straumann (Basel, Switzerland) implants. The restorative phase of the treatment was subsequently performed by the undergraduates. A students' questionnaire was developed. All questions were exclusively on the restorative part of the implant-related programme.

RESULTS

In total, 90 patients were treated by 78 undergraduates. 146 Straumann implants were restored with 121 restorations. The most common restoration was a single crown (80.2%), followed by three-unit fixed partial dentures (12.4%). The questionnaires showed a high rate of students' satisfaction concerning the restorative implant programme. Students replied they think they can manufacture an implant-supported crown or FDP without supervision after following the programme. In their opinion, the existence of the restorative programme should definitely be continued.

CONCLUSION

According to positive student perceptions, an implant-related restorative programme should be recommended for implementation in undergraduate dental curricula. The programme at ACTA could be used as a template for other universities.

Using discussion groups as a strategy for postgraduate implant dentistry students to reflect

INTRODUCTION

More than undergraduates, postgraduate students have the day-to-day clinical experience to reflect upon. Nevertheless, reflection in postgraduate dental education is less well studied. Hence, the purpose was to investigate the attitude towards reflection and the content of reflections in postgraduate implant dentistry education in the UK and Belgium.

MATERIALS AND METHODS

To investigate the attitude towards reflection, a questionnaire was administered to the 10 postgraduates at UCL Eastman Dental Institute (EDI) and 6 postgraduates at Ghent University (UGent). Additionally, students were invited to attend two reflective sessions (60-90 minutes). The sessions' audio recordings were transcribed and analysed using a thematic approach.

RESULTS

In total, 16 postgraduate implant dentistry students participated. Although the majority reported prior experience with reflection, there was variation in the provided definitions of reflection. EDI students agreed with reflection being beneficial for professional development/clinical reasoning and were positive about discussing clinical experiences in groups, but were divided about individual/group reflections. Their UGent counterparts were more indecisive (=neutral), but were positive about discussing clinical experiences. Thematic analysis identified recurring themes as individual learning process, learning and clinical experiences, attitude towards implant dentistry and course programme. EDI postgraduates' reflections focussed on specific clinical situations, while UGent postgraduates' reflections described general considerations.

CONCLUSION

Although students/professionals often report to reflect, it is not clear whether/how they actually reflect, due to the all-purpose word reflection has become. A strategy, using group discussions along with supervision/guidance in how to reflect, demonstrated to expand clinical reasoning into reflections about postgraduate students' clinical actions and professional growth.

Current State of Undergraduate Education in Oral Implantology in Japan

An anonymous questionnaire-based survey was used to determine the current state of and issues involved in undergraduate education in oral implantology at Tokyo Dental College. The participants comprised 139 students who had received lectures on and practical training in oral implantology in 2013. The results indicate that the overall level of student comprehension was high for both lectures and practical training content; the level of difficulty was appropriate for practical training, but the amount of practice time given requires reconsideration. Over 80% of the students gave positive responses in their overall evaluation of lectures and practical training, and the number of students who had an interest in oral implantology after finishing the course and who wanted to be involved in oral implantology as dentists increased. These results indicate that this undergraduate education program is effective in improving understanding of oral implantology. Improvement is required, however, in lecture methodology and practical training content. It is also suggested that the curriculum should be evaluated by students regularly and that the courses be subject to updating as required.

Developing implant dentistry education in Europe: the continuum from undergraduate to postgraduate education and continuing professional development

INTRODUCTION

Implant dentistry is a treatment modality which has mainstream clinical practice of comprehensive care, which however is not adequately represented in the undergraduate dental curricula. A consensus workshop organised by ADEE in 2008, set the benchmarks for the knowledge and competences a modern dental practitioner must possess with regard to implant dentistry, as well as defined undergraduate and postgraduate pathways for the acquisition of these competences. Today, 5 years later, there exist several challenges for the implementation of these benchmarks in both undergraduate curricula but also post-graduation educational pathways.

METHODS

A consensus workshop was organised by ADEE, bringing together 48 opinion leaders, including academic teachers of all disciplines related to implant dentistry, specialists, representatives of relevant scientific and professional associations, as well as industry delegates. The objectives of the workshop were to evaluate the existing scientific literature, reported experience and best practices in order to identify potential and limitations for the implementation of implant dentistry in the undergraduate curriculum, as well produce recommendations for the optimal educational structures for postgraduate programmes and continuing professional development.

RESULTS

The scientific committee conducted two European-wide questionnaire surveys to better document the current state of education in implant dentistry. Upon completion of the surveys, reviewers were appointed to produce three scientific review papers, identifying current achievements and future challenges. Finally, during the 3 days of the workshop, all the evidence was reviewed and the main conclusions and recommendations that were adopted by all participants are reported in the present Consensus Paper.

CONCLUSIONS

Implementation of implant dentistry in the undergraduate curriculum has improved significantly, but still lags behind the benchmarks set in 2008 and the diversity between institutions remains big. At the post-graduation level, there is currently a wide diversity of courses and pathways towards competences related to implant dentistry and there is at present a great need for quality assurance, as well as standardisation and transparency of the learning outcomes.

Continuing professional development in implant dentistry in Europe

INTRODUCTION

Training for dental practitioners in implant dentistry ranges from 1- or 2-day short Continuing Professional Development (CPD) courses to certificate/diploma programmes run by universities. In general, the teaching of implant dentistry in Europe lacks structure and standardisation. This paper aims to: (i) identify the current trends in CPD in implant dentistry in Europe; (ii) identify potential and limitations with regards to the design and implementation of CPD activities in implant dentistry; (iii) provide recommendations on the future structure and development of CPD activities in implant dentistry.

METHODS

A search of the literature was undertaken in PubMed for manuscripts published in English after 2000 reporting on CPD in dentistry and in implant dentistry in particular. In addition, an electronic survey was conducted, investigating the attitudes towards CPD among a wide group of stakeholders in implant dentistry education.

CONCLUSIONS

There is a wide diversity of educational pathways towards achieving competences in implant dentistry through CPD. At present, there is a need for improving the CPD structures in implant dentistry, strengthening the quality assurance and encouraging standardisation and transparency of the learning outcomes. Development of a structured CPD system with clearly defined educational objectives mapped against specific levels of competence is recommended.

Current trends and status of continuing professional development in implant dentistry in Europe

INTRODUCTION

Previous surveys have shown that newly graduated dentists, in most European countries, do not obtain adequate theoretical knowledge and, especially, clinical skills in implant dentistry (ID) through their undergraduate education and must therefore acquire knowledge and develop competencies through further postgraduate study. Moreover, clinicians, in general, need to continue to maintain the currency of their competence by undertaking ongoing continuing professional development (CPD). This seems particularly important in ID as techniques, and materials develop rapidly due to advances in biomedical technology. Despite recent developments, CPD in ID remains poorly organised with little standardisation or harmonisation across Europe. The objective of this survey was to explore the current status and trends within CPD education in ID in Europe.

MATERIALS AND METHODS

Stakeholders and opinion leaders associated with ID education were invited by email to fill an online questionnaire (closing date: 30th April 2013). Two hundred and forty-seven questionnaires were distributed, and two separate reminders were sent to participants in 38 European countries. The survey contained 14 multiple-choice questions, and the data were collected using SurveyMonkey© software, exported in SPSS (Inc, Chicago, IL, USA) format and analysed using descriptive statistics.

RESULTS

Two hundred respondents working in 24 countries replied to the survey (response rate of 81% of invitees and 63% of countries surveyed). The results demonstrated a wide divergence in the content and structure of CPD in ID in Europe.

CONCLUSIONS

Dentists need CPD to develop their skills and to maintain their competence in ID. There is an urgent need for structured and accredited CPD, which should be readily available to all dentists practising ID. It should have pre-determined learning objectives, delivered by accredited CPD providers and educators, and have assessable outcome measures to ensure the best possible impact on clinical practice and patient safety.