Study of the use in autonomy of intraoral scanning systems to optimise dental students' performances in fixed prosthodontics practical learning in second year

AIM

The purpose of this study was to evaluate if the use of intraoral scanner analysis could help students to optimise their performance and their self-assessment abilities in prosthetic preparation without the teacher's assistance in the preclinical course.

MATERIALS AND METHODS

Ninety-five second-year dental students were randomly divided into three groups: Control group (C), CeRec group (CR) and PrepCheck group (PC). Group C only use silicon keys to control the preparation thickness. The students in Group CR analysed their work with Cerec™ software. The Group PC use a pedagogic software (PrepCheck™) which allowed comparison with the "master" preparation. They used control tools preparations for three consecutive training sessions. Then a final assessment session without control tool to evaluate their performance was organised. All preparations were objectively evaluated thanks to stl. analysis software (Geomagic® Control X). Each preparation was compared with the master preparation by defining tolerance ranges. An objective overall score out of 20 was assigned to each preparation according to their degree of correspondence. In addition, a questionnaire was performed to analyse the students' perceptions regarding the use of intraoral camera.

RESULTS

During the assessment session, no significant difference was revealed between the different groups with respect to the students' performance. The comparative analysis between the self-assessment scores and the objective scores using Geomagic® software showed that digital control tools did not help the student to improve their self-assessment abilities without the teacher's assistance.

CONCLUSIONS

The intraoral cameras and specific pedagogic software in autonomy could not improve students' performance for teeth preparation and self-assessment abilities in second year. These digital tools facilitate objective feedback on preparation defects, but constructive criticism needs human reflection. The teacher's opinions and advice remain essential to develop their students' performance and self-assessment skills. The use of digital tools must be integrated in dentistry course to develop the interpret of the results and optimise feedback.

An Objective Structured Clinical Examination (OSCE) for French Dental Students: Feedback after 2 Years

The Objective Structured Clinical Examination (OSCE) is a practical examination that provides a standardized assessment of clinical competence. The aim of this study is to evaluate the objectivity and the reliability of an OSCE in dentistry. To this end, a retrospective monocentric observational study was conducted at the Faculty of Dentistry of Nancy by analyzing the exam results of 81 students. The study population consisted of the fifth-year students. The examination was broken down into six stations which were doubled, and different juries of examiners were constituted (installed in different rooms) according to the same composition. The p-value was set at 0.05. We found an equivalence of the results between the different rooms on the global mean score obtained at the six stations (p = 0.021). In terms of gender, women have statistically significantly higher overall scores than men (p = 0.001). The evaluation of a difference in the scores between full-time and part-time teachers does not find any statistically significant difference or equivalence in the station where it was possible to realize the comparison. However, the students’ waiting time before the exam seems to negatively influence the results. Compared with other international OSCE studies, the results presented seemed sufficiently objective and reliable, although some adjustments are still necessary.

[On the stability and modifiability of the sense of coherence in active seniors]

According to Antonovsky, the sense of coherence (SOC) determines health and wellbeing. This life orientation is shaped up to the age of 30 and is supposed to remain constant up to senior age. In a field study, in which the SOC, psycho-social resources and subjective health were assessed at three points in time, it could be shown for the first time that the SOC in old age can be malleable and expanding. The master sample (time t(1)) consisted of N = 58 active and "healthy" seniors at the mean age of 66.3 years (65.5% female), who decided to take part in a 14-week program focusing on physical activity and/or self-reflection (endurance training, strength training, yoga, or meditation), respectively. One year before, 90% of them had participated in the Greifswald Aging Study (t0). The intervention study was attended regularly by n = 42 persons (t1 and t2). The SOC and associated health appraisals remained constant over a period of one year (t0-t1); re-test reliabilities varied from satisfactory to very good. Overall, the current SOC (t1) was more important than the past SOC (t0) in accounting for current well-being (t1). The intervention (t1-t2) revealed that the elderly's SOC was significantly strengthened-independently of the program they took part in. Correspondingly, participants' wellbeing, subjective health and psycho-social resources were enhanced. Taking part in a systematic, age-based and group-oriented program that encourages an active and productive every-day life brings about coherence-promoting and health-promoting life experiences in old age.

Motorische Handlungskompetenz und Lebensqualit�t �lterer aktiver Menschen

Physical activity is a vital pre-condition for healthy aging and well-being. While the association between objective and subjective health in old age has extensively been investigated, the relationship between objective motor competence-the capability of mastering motor demands in everyday life adequately by using motor resources optimally-and subjective health-related quality of life has not been studied yet. In an interdisciplinary study, 168 active seniors (36 men) at the mean age of 67 (range: 59-89) underwent a test battery assessing motor resources and two objective domains of everyday life motor competence-"Perceiving and Reacting" and "Mastering Complex Situations". Subsequently, participants rated their mental, physical, social, functional health and life satisfaction by questionnaire. Motor competence domains were age-dependent; the strongest decrease was found for "Mastering Complex Situations". Only "Mastering Complex Situations" was predicted by motor resources: competent seniors in this domain were faster in motor activity, simple reactions, body movements following acoustic and optic signals, and showed a stronger handcraft and a higher mobility. Overall, health-related quality of life was contingent upon motor competence: physical and functional health and-to a lesser extent-mental health and life satisfaction showed a systematic but moderate relationship to both motor competence domains. The results emphasize the significance of age-compatible and everyday life-adjusted physical activity for the well-being of elderly persons. Even active elderly persons show deficits in motor competence and should be trained, taking into account individual resources and flaws.

[Serology of anti-Pseudomonas aeruginosa and mucoviscidosis: diagnostic aid in the differentiation between colonization and infection]

Serologic test for Pseudomonas aeruginosa have been found useful for differentiating colonization from infection, especially in chronic disease. A Western blot method was compared with the ELISA used routinely. The Western blot detected serum IgGs against P. aeruginosa outer membrane proteins, whereas the ELISA reacted with IgGs against soluble P. aeruginosa antigens. Among the 103 sera from 58 cystic fibrosis patients studied, all those with ELISA reactivity were positive by Western blot. The antibody response was detected earlier by Western blot than by ELISA, suggesting that the former technique may be useful for the early diagnosis of infection.

[Pseudomonas aeruginosa and imipenem: correlation between membrane protein D2 and resistance in fifteen strains isolated from patients with mucoviscidosis]

A characteristic feature of imipenem-resistant strains of Pseudomonas aeruginosa is loss or decreased expression of the outer membrane protein (OMP) D2, whose molecular weight is 45 to 49 kDa. D2 was studied in 15 strains of P. aeruginosa with intermediate susceptibility or resistance to imipenem recovered from the sputum of 15 patients with cystic fibrosis. The OMP was extracted using Sarkosyl and separated by SDS-PAGE electrophoresis. Electrophoresis patterns were compared to those of reference strains 3B and 3C which are resistant and susceptible to imipenem, respectively. Expression of D2 was normal in three strains, weak or very weak in 11 strains and absent in one strain. For 12 strains, the alteration of the D2 protein was consistent with previous reports. However, the finding of normal D2 production in three strains is unusual and suggests the possible presence of another mechanism of resistance.

[Listeria monocytogenes nosocomial infection in the maternity ward]

Nosocomial infection with Listeria monocytogenes 4b occurred in January 1990 in a maternity hospital in Grenoble. The 3 patients involved were born within a 24 hour-interval. The premature newborn responsible for contamination was asymptomatic. Two other newborns without any perinatal infectious risk presented with meningitis, one on the 5th day of life in the maternity hospital, the other one on the 11th day while already at home. The 3 strains of Listeria had the same serovar and lysovar. Epidemiologic investigations led to suspect a contamination in the delivery room and during the care of the children. Strict respect of hygiene orders is imperative to avoid nosocomial infections.

[Evaluation of a DNA probe test for the detection of Legionella SPP]

Seventeen suspension of Legionella pneumophila and ten of Legionella bozemanii in saline or bronchoalveolar lavage (BAL) fluid were tested using the Gen Probe technique. The detection threshold was found to be 10(3)-10(4) CFU/ml. Specificity and sensitivity were evaluated by using the probe on 8 suspensions of bacteria other than Legionella and by performing a comparative study of the probe test, direct immunofluorescence and culture with 103 specimens (BAL fluid in most instances) from 92 patients with possible legionellosis. Sensitivity was found to be acceptable (3 of the 4 culture-positive specimens were positive by the probe test) and specificity was 100% despite the fact that most (80/99) BAL specimens were not sterile and regardless of the cutoff level used to define positivity. The advantages of the DNA probe test, including rapidity, simplicity and objectivity, should be weighed against its disadvantage, i.e., only acceptable sensitivity and use of radioactivity.

[Maternal-child transmission of Chlamydia trachomatis. A prospective inquiry in 168 pregnant women]

A prospective study was performed in 168 pregnant women in order to evaluate the frequency of perinatal transmission of Chlamydia trachomatis and to measure its effects on the child's health during his first 3 months of life. The micro-organism was detected by an immunoenzymatic method specific to Chlamydia antigens, and microimmunofluorescence was used for serological testing. Cervical smears taken at the end of pregnancy were positive in 3 women (1.7 per cent), while the sera of 37 women were positive for Chlamydia trachomatis. Altogether, 26.8 per cent of the women explored had had a contact with the micro-organism. Conjunctival smears taken from 1 month old infants were all negative, but 4 infants (out of 126) had positive nasal smears. The mothers of 2 of these had been exposed to the bacterium, but all 4 mothers had negative cervical smears. Antibody titres in 3-month old infants were 1.2 dilution on average below those found in the mothers. Women exposed to Chlamydia trachomatis are frequently unmarried; their pregnancies tend to shorter than normally, and their infants have more frequent episodes of rhinitis. These peculiarities are insufficiently pronounced to single out a population at risk that might benefit from detection of the bacterium.