Factors Influencing Adoption of New Technologies into Dental Practice: A Qualitative Study

Determinants of Plasma Alzheimer's Disease Biomarker Use by Primary Care Providers and Dementia Specialists

BACKGROUND

The efficiencies of plasma Alzheimer's disease (AD) biomarkers could facilitate early AD diagnosis. Unfortunately, limited knowledge exists about whether and how they would be used by clinicians.

OBJECTIVE

To identify and compare determinants of plasma AD biomarker use reported by primary care providers and dementia specialists.

DESIGN

Semi-structured interviews with clinicians organized using Rogers' Diffusion of Innovations theory and analyzed using an iterative coding approach.

PARTICIPANTS

The subjects were internal and family medicine, neurology, and geriatrics providers with varying degrees of expertise in dementia diagnosis and care.

MAIN MEASURES

Factors influencing a clinician's decision to use or not use plasma AD biomarkers in clinical practice.

KEY RESULTS

We interviewed 30 clinicians (16 family or internal medicine providers, 8 geriatricians, and 6 neurologists). Fifteen were dementia specialists. Hesitance to use plasma AD biomarkers was due to perceived lack of effective treatments for AD, limited access to supports, and stigma. Plasma AD biomarkers would be more readily adopted by clinicians with dementia expertise.

CONCLUSIONS

Several factors will influence clinical use of plasma AD biomarkers. Some of them may inform the design of interventions to promote the effective and appropriate clinical translation of these tests.

A comparison study: The use of digital and conventional impression techniques in dental hygiene education

PURPOSE/OBJECTIVES

The study aimed to assess the applicability of digital intraoral scanning in dental hygiene education and compare the quality, efficiency, and ease of use to conventional impression techniques.

METHODS

Twenty-eight first-year dental hygiene students (DH1) at UTHealth Houston School of Dentistry (UTSD) participated in this 2022 study. Each student participated in two 4-h lab sessions. Students took traditional alginate impressions and digital intraoral scans using Planmeca Romexis on standardized teeth during the first and second sessions. Both techniques were assessed by faculty for quality and efficiency using a standardized rubric. Participants completed a post-survey providing insight into their perceptions of both techniques and ease of use.

RESULTS

The study had 100% participation in the lab sessions and survey responses (N = 28). The results showed digital scanning produced a statistically higher quality product than conventional alginate impressions (p = 0.023). The study found no statistical difference in the efficiency between the two methods. The majority of students (82%) agreed that digital intraoral scanning was easy to use (p = 0.001), and 89% agreed they would use digital intraoral scanning in clinical courses to help with patient care (p = 0.03).

CONCLUSION

In this study, dental hygiene students with limited clinical experience learned new technology and used it to produce quality impressions compared to the conventional technique, indicating the value of introducing digital dentistry early in dental hygiene education.

Digital technologies in dentistry in Saudi Arabia: Perceptions, practices and challenges

Background

The aim of this study was to assess practicing dentists' characteristics and professional aspects that influence users to adopt Digital Technologies in Dentistry (DTD) in Saudi Arabia (SA). Moreover, we aimed to identify dentists' perceived barriers and challenges and to anticipate future potential developments towards implementing DTDs in their practices in SA.

Methods

This analytical cross-sectional study based on a validated questionnaire was conducted using a snowball sampling technique to include a conveniently selected sample of dentists from all dental specialties currently working in SA.

Results

The response rate was 64% completed and returned. A statistically significantly large share of Gen X (10.1%) used digital technologies (DTs) in dental practice compared with non-digital users. 40% received sufficient postgraduate education on DT, 92% agreed that DT should be included in the undergraduate dental curriculum. However, 79% actually gained skills or knowledge on DT through workshops and formal courses. 'Lack of practitioners' awareness', 'lack of education and pioneers' and 'lack of clinical evidence' were highlighted as the foremost barriers. Lower-frequency DT users believed that treating patients with DT makes treatment more predictable. Together, clinical trials and hands-on training courses can help overcome the barriers to the adoption of new dental technologies.

Conclusions

Exploring technology adoption and usage amongst practicing dentists allows healthcare stakeholders and policymakers to set a clear direction towards the digitalisation of the healthcare system and within healthcare organisations. The study also highlighted the foremost barriers, challenges and actions towards the adoption of DTDs.

Crossing the Innovation Chasm: Identifying Facilitators and Barriers to Early Adoption of the Global Health Starter Kit Curriculum

Purpose:

The Global Health Starter Kit (GHSK) is an interdisciplinary, competency-based, open access global health curriculum covering global disease and demographic trends, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), the connection between oral health and overall health, social determinants of health, and concepts of sustainable and ethical global health programs. In this study, we evaluate and describe barriers to and facilitators for using and implementing the GHSK curriculum across a variety of new users.

Methods:

This two-phase study uses the Roger’s Adoption Curve concept to standardize this evaluation and inform a strategic plan for continuing to move the curriculum across the chasm from early adopters to an early majority of global oral health educators and learners. We utilized a theoretical adoption framework to identify facilitators and barriers under the domains of innovation and curricular, educator and learner, and institutional and structural factors. Under qualitative Phase 1, five early adopter institutions were interviewed to elicit understanding of factors that contribute to adoption of the GHSK curriculum. Common themes identified were next used to create a Phase 2 quantitative survey for early majority subscribers of the GHSK (N = 27).

Results:

These qualitative and quantitative results showed an overall high satisfaction with the quality of the GHSK materials, but also effectively identified barriers to its adoption, including inexperience of faculty in teaching global oral health, a lack of awareness and marketing, and absence of global health accrediting requirements.

Conclusions:

By identifying the barriers and facilitators of GHSK curriculum integration, this study provides concrete and specific opportunities to improve its format, relevance, content, and delivery. This study outlines next steps to creating a standardized approach to successfully adopting competency-based global oral health teaching and learning.

Cell-Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review

Current regenerative strategies for alveolar bone and periodontal tissues are effective and well adopted. These are mainly based on the use of a combination of synthetic/natural scaffolds and bioactive agents, obviating the incorporation of cells. However, there are some inherent limitations associated with traditional techniques, and we hypothesized that the use of cell-based therapies as part of comprehensive regenerative protocols may help overcome these hurdles to enhance clinical outcomes. We conducted a systematic review of human controlled clinical trials investigating the clinical and/or histological effect of the use of cell-based therapies for alveolar bone and periodontal regeneration and explored the translational potential of the different cell-based strategies identified in the included trials. A total of 16 studies (11 randomized controlled trials, 5 controlled clinical trials) were included for data synthesis and qualitative analysis with meta-analyses performed when appropriate. The results suggest a clinical benefit from the use of cell therapy. Improved outcomes were shown for alveolar ridge preservation, lateral ridge augmentation, and periodontal regeneration. However, there was insufficient evidence to identify best-performing treatment modalities amongst the different cell-based techniques. In light of the clinical and histological outcomes, we identify extraction socket and challenging lateral and vertical bone defects requiring bone block grafts as strong candidates for the adjuvant application of mesenchymal stem cells. Given the complexity, invasiveness, and costs associated with techniques that include "substantial manipulation" of tissues and cells, their additional clinical benefit when compared with "minimal manipulation" must be elucidated in future trials. Stem Cells Translational Medicine 2019;8:1286&1295.

Assessing the Translation of Research and Innovation into Dental Practice

INTRODUCTION

Over the past 100 y, there have been an unprecedented number of innovations that have improved oral health and functioning. Variations in lag times between discovery and clinical adoption are related to dentist education, the clinical availability of technology, and the perceived value of an innovation.

OBJECTIVES

The purposes of this cross-sectional study were 1) catalogue research discoveries and innovations over the past 30 y and 2) from that list identify those which practicing dentists believe have maximally affected patient care.

METHODS

Thirty International Association for Dental Research leaders identified innovations over the past 30 y that have significantly affected dental care. The 30 most cited innovations were included in a questionnaire that was sent to a random sample of US dentists who graduated dental school during or before 1995 (before the recency of identified discoveries) and devoted ≥50% of their time to patient care. Eighty-two percent of respondents identified as general dentists and 18% as specialists. Respondents were asked to identify 5 to 7 items whose loss would have the most adverse effects on patient care.

RESULTS

The most cited advances were adhesive dental materials (74.5%), dental implants (71.9%), direct bonding systems (71.2%), dental loupes (54.7%), universal precautions for infection control (48.6%), and digital imaging (46.0%). There were differences in the ranking of responses between generalists and specialists. For the oral surgeons and periodontists (OMSPER, n = 51), top choices were dental implants (82%), cone beam computed tomography (CBCT) imaging (74%), regenerative dentistry and tissue engineering (68%), universal precautions (58%), digital imaging (56%), and dental loupes (48%).

CONCLUSIONS

There was agreement among generalists and specialists about the importance of dental implants, digital imaging, use of dental loupes, and universal precautions in improving patient care. However, generalists also cited the importance of adhesive dental materials and bonding, and OMSPER cited CBCT and biological-based tissue restoration as major advances.

KNOWLEDGE TRANSFER STATEMENT

Many advances in dental patient care capitalize on innovations and technologies that have emerged after dentists graduate from dental school. Adoption of new technologies is influenced by information acquired from professional journals, continuing education, industry marketing activities, and interactions with colleagues. The results of this study suggest that innovations that are directly related to clinical procedures were rated most impactful. Future research should consider cost-effectiveness and patient perceptions on the impact of innovations and technologies.

Comparison of Efficiency and Image Quality of Photostimulable Phosphor Plate and Charge-Coupled Device Receptors in Dental Radiography

The photostimulable phosphor (PSP) plate and charge-coupled device (CCD) are receptors commonly used for intraoral radiography in U.S. dental schools. However, it is unclear which receptor is more beneficial for radiology education and patient care in an academic setting. The aim of this study was to compare the time efficiency, image quality, and operator performance for student-operated PSP plate and CCD receptors. At one U.S. dental school in 2018, 20 dental hygiene and dental students (n=10 each) were recruited as operators. They each exposed anterior and posterior periapical and bitewing radiographs on dental radiograph teaching and training replica using the PSP plate and CCD as receptors. The time taken to expose the radiographs was recorded. Image sharpness/definition, brightness/contrast, and technical errors, including placement, angulation, and cone cut errors, were evaluated on a three-point scale with 0=non-diagnostic, 1=diagnostic acceptable with minor errors, and 2=perfect diagnostic quality. The results showed that it was generally faster for the students to expose intraoral radiographs with CCDs than with PSP plates, although the difference was not significant (p>0.05). Image quality and technical accuracy, especially angulation, were significantly superior for PSP relative to CCD (p<0.05). This study found that PSP imaging was of higher quality and accuracy than CCD, whereas CCD was more efficient. Dental and dental hygiene students would benefit from being trained on both receptors to be able to adapt to a diversified workplace.

Understanding technology adoption by orthodontists: A qualitative study

INTRODUCTION

Orthodontics is evolving with advances in 3D imaging, additive fabrication, digital scanning, and treatment planning. With digital tools, orthodontic treatment may become more predictable, efficient, and effective while reducing side-effects. These technologies are affecting patient care, but knowledge of their adoption patterns and influence is incomplete. We aimed to identify adoption decision makers, information sources, perspectives, incentives, and barriers.

METHODS

Twenty-four privately practicing orthodontists were interviewed in a semistructured format following a topic guide. Interview transcripts were analyzed to identify factors in technology adoption and its perceived influence on practice. Thematic patterns were established through iterative systematic analysis, and qualitative validity was ensured with researcher triangulation.

RESULTS

Qualitative interviews revealed that orthodontists make purchasing decisions independently from staff, after consulting other dentists and company representatives. Meetings, residency training, and continuing education courses are influential information sources, whereas research literature is not. Early and middle adopters are integrating digital imaging, planning, and fabrication technologies into practice and view enhanced ease of use, capabilities, performance, and procedural efficiency as primary incentives to adoption. Improving outcomes and patient comfort are not frequently cited as incentives, and all interviewees view cost as the largest barrier. Orthodontists positively perceive the influence of technology on their practices, but are concerned that further innovation and direct-to-consumer products will cause loss of market share.

CONCLUSIONS

CAD/CAM appliances, 3D imaging, and digital treatment planning are viewed as future standards of care and are increasingly being incorporated into the orthodontic office. Understanding the technology adoption process can guide innovation to improve treatment and ease the transition into a digital workflow.

Dentists' opinions on using digital technologies in dental practice

OBJECTIVES

To investigate which opinions among dentists are associated with level of technology use, when characteristics of the dentist and dental practice, as well as motivating work aspects are taken into account.

METHODS

A total of 1000 general dental practitioners in the Netherlands received a questionnaire on digital technologies they use, opinions on using technologies and related motivating work aspects. Questions were derived from expert interviews, the Dentists' Experienced Job Resources Scale and literature on technology implementation. Technology use was measured as the number of technologies used, and divided into three technology user groups: low (using 0-4 technologies, mostly administrative and radiographic technologies), intermediate (using 5-7, more varied technologies) and high technology users (using 8-12, including more innovative diagnostic technologies). Opinions on technology use and motivating work aspects were analysed using principal components analysis (PCA) and exploratory factor analysis. Scores on all components and factors were calculated for each respondent by computing the mean of all valid responses on the underlying items. Differences in these scale scores on opinions among the technology user groups were assessed using one-way analysis of variance and Kruskal-Wallis tests. A multiple linear regression analysis assessed the association of scale scores about opinions on technology use with the sum of technologies used, taking into account motivating work aspects and characteristics of the dentist and dental practice.

RESULTS

The response rate was 31%. Dentists who were high technology users perceived technologies as yielding more improvements in quality of care, adding more value to the dental practice and being easier to use, than low technology users. High technology users thought technologies added more value to their work and they reported higher skills and resources. They also focused more on technologies and thought these are more ready to use than low technology users. High technology users derived more motivation from "Immediate results" and "Craftsmanship" than low technology users. Personal and practice characteristics, motivating work aspects, and the opinion scales "Focus" and "Added value to dentist" explained 50% of the variance in the number of technologies a dentist uses.

CONCLUSION

Opinions on digital technologies among dentists and motivating work aspects vary with level of technology use. Being more focused on technologies and perceiving a higher added value from using them are associated with using more digital dental technologies, when taking into account motivating work aspects and characteristics of the dentist and dental practice.

Innovation, productivity, and pricing: Capturing value from precision medicine technology in Canada

For new technology and innovation such as precision medicine to become part of the solution for the fiscal sustainability of Canadian Medicare, decision-makers need to change how services are priced rather than trying to restrain emerging technologies like precision medicine for short-term cost savings. If provincial public payers shift their thinking to be public purchasers, value considerations would direct reform of the reimbursement system to have prices that adjust with technologically driven productivity gains. This strategic shift in thinking is necessary if Canadians are to benefit from the promised benefits of innovations like precision medicine.