Dental students' self-reported confidence level in restorative crown and bridge procedures: A UK quantitative study

INTRODUCTION

Graduating confident students who can flourish and develop in their future career is an important outcome of dental education. The aim of the study was to gain an insight into students' self-reported level of confidence in restorative crown and bridge procedures, highlighting in which stage of the process students have the highest and lowest confidence, depending on the level of supervision required.

MATERIALS AND METHODS

Fourth and final year students (n = 85) were invited to complete a 71-item closed questionnaire specific to self-reported confidence based on the level of supervision required in stages of crown and bridge procedures. Clinical activity for each student from their portfolio system was collected. Non-parametric tests, specifically the Mann-Whitney U-test was used to analyse the continuous non-normal data.

RESULTS

A response rate of 65% was obtained. Final year students were more confident in crown and bridge procedures than fourth year students. Fourth year students were more confident in bridges, whilst final year students were more confident with crowns. Majority of students expressed "average confidence requiring minimal supervision" in crown and bridge procedures. An association between clinical activity, confidence and year of study was noted. Gender was not strongly associated with confidence. Stages in crown and bridge procedures were noted where students lacked confidence.

CONCLUSION

The study highlighted areas in which students were most and least confident in crown and bridge procedures. A positive relationship between clinical activity in crown and bridge procedures and student self-confidence has been noted for both years, though slightly higher in the bridge procedure for fourth year students. We attribute this to the fact that fourth year students had recently completed their bridge competency assessment. Upon graduating, final year students still require supervision and reported average confidence in certain aspects of crown and bridge procedures, namely occlusal, bevel and axial reduction.

Dental students' experience and perceived confidence level in different restorative procedures

PURPOSE

Graduating confident students who are able to flourish and develop in their future careers is an importance outcome of the dental education. This study aims to evaluate self-perceived level of confidence of fifth-year dental students in different restorative-related tasks and the relationship between their clinical training and its corresponding confidence.

METHODS

Fifth-year graduate dental students (n = 202) were asked to fill a questionnaire that rated their level of confidence in different clinical restorative dentistry tasks. Additionally, they were asked about the number of times they performed tasks prior to attempting the equivalent competency and in which sub-specialty they felt the most confident.

RESULTS

Completed responses were received from 120 students giving a response rate of 59%. Students felt the most prepared and confident in direct restorations and simple endodontic treatment, and they seemed less confident in indirect restorations and complex endodontic treatment. Regarding the steps of indirect restorations, students expressed least confidence in crown preparation compared to impression making and try-in procedures (P < .05). Students rated their confidence highest in operative dentistry, followed by endodontics and lastly fixed prosthodontics.

CONCLUSION

The results highlight the areas in which students exhibit the least confidence. Enhancement of student clinical skills and directed exposure is necessary to raise the level of perceived confidence which will reflect positively on their current and future professional performance.

The Success of Dental Veneers According To Preparation Design and Material Type

BACKGROUND:

Due to their high aesthetic outcome and long-term predictability, laminate veneers have become a common restorative procedure for anterior teeth. However, because of the variety in the preparation designs and the material types, the clinician faces a dilemma of which approach to use.

AIM:

To compare the survival rate of dental veneers according to different preparation designs and different material types. The sub-aim is to reach a favourable preparation design and material based on scientific evidence.

METHODS:

Comprehensive electronic search of the dental literature via PUBMED, MEDLINE and Scopus databases was performed using the following keywords: “porcelain veneers”, “composite veneers”, “all-ceramic veneers”, “success of porcelain veneers”, “preparation design”, “preparation geometry”, “patient’s satisfaction”. Additionally, references from the selected studies and reviews were searched for more information.

RESULTS:

Under the limitations of the available literature, the clinician preference is the decisive factor for choosing the preparation design. Nonetheless, incisal overlap preparation seems to have the most predictable outcome from all the preparation designs.

CONCLUSION:

Porcelain veneers show excellent aesthetic results and predictable longevity of the treatment, while composite veneers can be considered as a good conservative option, but with less durability.

Minimally-invasive dental anesthesia: Patients' preferences and analysis of the willingness-to-pay index

AIM

The aim of the present prospective study was to evaluate the impact of a computer-controlled anesthesia on patients' comfort and to investigate, through the willingness-to-pay (WTP) index, and patients' acceptance of this new technology.

METHODS

Fifty patients undergoing a class I or II restorative procedure were enrolled. A computer-controlled device for anesthetic delivery was utilized, and a questionnaire on the level of discomfort and WTP was given to all patients.

RESULTS

A total of 86% of participants declared less discomfort than that perceived during their last traditional procedure for pain control; 58% of patients were willing to pay an additional fee for a modern anesthesia technique, with a median WTP value of 20$.

CONCLUSIONS

Computer-controlled systems for local anesthesia represent a relevant tool for reducing patients' discomfort during dental treatment. The WTP index helps to quantify its relevance.

The Use of Glass-fibers Ribbon and Composite for Prosthetic Restoration of Missing Primary Teeth-Laboratory and Clinical Research

Very few modalities can be used for restoring missing primary anterior teeth, although the impact of missing anterior teeth during early childhood can be harmful. In the permanent dentition the use of glass-fibers ribbon and composite materials are frequently used for restoring missing teeth with no or minimal preparation. The purpose of this study was to examine the possibility to use the glass-fibers ribbon (ever-Stick from GC Corporation, Japan) together with esthetic composite materials (G-aenial A1 from GC Corporation, Japan) for restoring anterior primary teeth and to determine the best methodology and bonding system to be used. The effect of etching time was analyzed using 20-80 sec on primary buccal enamel with SEM and the results showed that at least 60 second is necessary in order to remove the prismless layer and to affect the prismatic layer similar (as observed by SEM) to the 20 sec etching time on permanent enamel. Three bonding systems (SE Bond by Kurary, Japan, Scotchbond Universal by 3M/ESPE, Germany and G-aenial bond by GC Company, Japan) were compared for bonding the glass-fibers ribbon to the primary enamel and microtensile strength analyses were performed. Mean tensile strength ranged from 10.9 to 13 MPa with no statistically significant differences between all three systems. Based on the laboratory results it can be concluded that the glass-fibers ribbon together with the composite material can be used clinically to restore missing primary teeth for esthetic and functional reasons. Two clinical cases are presented that show favorable results.

Effect of oral-transmucosal midazolam sedation on anxiety levels of 3-4 years old children during a Class II restorative procedure

AIM

A double-blind randomized control trial was conducted to assess the effect of oral-transmucosal midazolam sedation on changes in anxiety levels of precooperative children during a Class II amalgam restorative procedure.

METHODOLOGY

A sample of 40 healthy, American Society of Anesthesiologists I, children aged 3-4 years having at least one carious primary mandibular molar requiring a Class II amalgam restoration with no previous dental history were randomly divided into experimental and control groups comprising of 20 children each. The children in the experimental group (Group I) received 0.5 mg/kg body weight of midazolam mixed in strawberry syrup and those in the control group (Group II) received the same syrup mixed in saline, 15 min prior to the restorative procedure. Routine nonpharmacological behavior management techniques were used in both groups. The anxiety levels were recorded using Venham's anxiety scale at the start and end of each procedural step.

RESULTS

There was a significant (P < 0.001) reduction in the anxiety levels of children in the experimental group on entry into the operatory compared with the control group. Introduction of each fear evoking stimuli showed a somewhat similar increase in anxiety levels in the two groups. In spite of a similar trend, the anxiety levels remained much lower in Group I than in Group II.

CONCLUSION

Midazolam in conjunction with behavior management is more helpful in relaxing the child initially than behavior management alone, thus increasing the chances of successful and easy accomplishment of further treatment steps.