Evaluating the patient sociodemographic factors affecting dental students' clinical communication skills using a three-perspective approach.

OBJECTIVE: This study aimed to assess undergraduate dental students' communication skills in relation to patient sociodemographic factors using a three-perspective approach; the student, the patient, and the clinical instructor perspective. MATERIALS AND METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI), and Clinical Communication Assessment Instruments (CCAI). Moreover, 176 undergraduate clinical year students were recruited in this study whereby each student was assessed by a clinical instructor, a patient, and self-evaluation. RESULTS: The clinical communication skills domains were not significantly influenced by patient sociodemographic factors, including sex, educational background, and the number of visits (p > .05). However, this study revealed a statistically significant difference in the domain of "caring and respectful" of the SCAI between the low- and middle-income groups. CONCLUSIONS: Overall, most of the patient sociodemographic factors did not affect clinical communication skills. However, patient income groups played a significant role in one of the communication domains.

Evaluation of dental students' clinical communication skills from three perspective approaches: A cross-sectional study.

INTRODUCTION: The communication skills of clinicians are very crucial in providing better health outcomes for patients. Therefore, this study aimed to assess undergraduate dental students' communication skills in relation to their demographics and clinical setting using a three-perspective approach; the student, the patient and the clinical instructor perspective. METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI) and Clinical Communication Assessment Instruments (CCAI) which included four communication domains. One hundred and seventy-six undergraduate clinical year students were recruited in this study whereby each of them was assessed by a clinical instructor and a randomly selected patient in two settings: Dental Health Education (DHE) and Comprehensive Care (CC) clinic. RESULTS: Comparing the three perspectives, PCAI yielded the highest scores across all domains, followed by SCAI and CCAI (p < .001). SCAI exhibited a better score in Year 5 compared to Year 3 and Year 4 (p = .027). The male students perceived they performed better than females in all domains (p < .05). Patients rated the students higher in the DHE clinic as compared to the CC clinic for the team interaction domain. CONCLUSION: There was an upward pattern of the communication skills score rated from the clinical instructor perspective to the student and patient perspectives. The use of PCAI, SCAI and CCAI collectively gave a complementary view of students' communication performance in all the domains assessed.

Porous NiTi Dental Implant Fabricated by a Metal Injection Molding: An in Vivo Biocompatibility Evaluation in an Animal Model.

This study assessed the corrosion resistance, intracutaneous reactivity, acute systemic toxicity, and in situ tissue effect of the implantation of porous NiTi fabricated by metal injection molding in animal models. For the intracutaneous reactivity study, five intracutaneous injections were administered per site with and without the tested extract in polar and nonpolar solutions. The extract was also delivered via intravenous and intraperitoneal routes for acute systemic toxicity. TiAl6 V4 (control) and porous NiTi were implanted in rabbit femora for a period of 13 weeks to evaluate the in situ tissue response. Corrosion was evaluated through open and cyclic polarization in PBS, while biocompatibility was investigated by assessing the general conditions, skin irritation score (edema and erythema), and histopathology. No active dissolution or hysteresis loop was observed in the corrosion study. None of the animals exhibited death, moribundity, impending death, severe pain, self-mutilation, or overgrooming. No edema was observed at injection sites. Only the positive control showed an erythematous reaction at 24, 48, and 72 h observations (p < 0.001). Porous NiTi showed a low in situ biological response for inflammation, neovascularization, and fibrosis in comparison to the control implant (p = 0.247, 0.005, and 0.011, respectively). Porous NiTi also demonstrated high pitting corrosion resistance while causing no acute hypersensitivity or acute systemic toxicity. The study concludes that porous NiTi implants were unlikely to cause local sensitization, acute systemic toxicity, or chronic inflammatory reactions in an animal model. Porous NiTi also exhibited osseointegration equivalent to Ti6AI4 V of known biocompatibility.

Structural Integrity of Anterior Ceramic Resin-Bonded Fixed Partial Denture: A Finite Element Analysis Study.

This study was conducted as a means to evaluate the stress distribution patterns of anterior ceramic resin-bonded fixed partial dentures derived from different materials and numerous connector designs that had various loading conditions imposed onto them through the utilization of the finite element method. A finite element model was established on the basis of the cone beam computed tomography image of a cantilevered resin-bonded fixed partial denture with a central incisor as an abutment and a lateral incisor as a pontic. Sixteen finite element models representing different conditions were simulated with lithium disilicate and zirconia. Connector height, width, and shape were set as the geometric parameters. Static loads of 100 N, 150 N, and 200 N were applied at 45 degrees to the pontic. The maximum equivalent stress values obtained for all finite element models were compared with the ultimate strengths of their materials. Higher load exhibited greater maximum equivalent stress in both materials, regardless of the connector width and shape. Loadings of 200 N and 150 N that were correspondingly simulated on lithium disilicate prostheses of all shapes and dimensions resulted in connector fractures. On the contrary, loadings of 200 N, 150 N, and 100 N with rectangular-shaped connectors correspondingly simulated on zirconia were able to withstand the loads. However, two of the trapezoidal-shaped zirconia connectors were unable to withstand the loads and resulted in fractures. It can be deduced that material type, shape, and connector dimensions concurrently influenced the integrity of the bridge.

Occlusal re-establishment and clinical complications of resin-bonded fixed partial dental prostheses cemented at an increased occlusal vertical dimension: A retrospective study.

STATEMENT OF PROBLEM: Resin-bonded fixed partial dental prostheses (RBFPDPs) cemented at an increased occlusal vertical dimension (OVD) (the Dahl concept) to create space for a metal retainer remain controversial because of the lack of reported clinical studies. This study evaluated RBFPDPs by applying the Dahl concept. PURPOSE: The purpose of this retrospective study was to investigate the clinical factors affecting the occlusal re-establishment and short-term complications of RBFPDPs cemented at an increased OVD. MATERIAL AND METHODS: Occlusal re-establishment and clinical complications were reviewed in 109 participants (155 RBFPDPs) treated at the Faculty of Dentistry, Universiti Teknologi MARA from January 2013 to May 2018. Types of complications and risk factors were assessed from clinical data. Demographic factors, clinical factors, and prosthesis factors were distinguished and their association with occlusal re-establishment analyzed by using multiple regression analysis. RESULTS: A total of 155 RBFPDPs (42 anterior, 113 posterior) were placed in 109 participants. All achieved occlusal re-establishment, 89.9% complete occlusal re-establishment and 10.1% partial occlusal re-establishment, a minimum of 4 months after the RBFPDPs had been placed at an increased OVD. The design of the metal retainer coverage was found to be a significant factor affecting occlusal re-establishment and decementation (P<.05). Widening of the periodontal ligament space was the most common complication (29.2%). CONCLUSIONS: RBFPDPs cemented at an increased OVD can be clinically recommended. The design of the retainer coverage was a significant factor influencing occlusal re-establishment and clinical complications.

Comparison between conventional teaching and blended learning in preclinical fixed prosthodontic training: A cross-sectional study.

INTRODUCTION: Blended learning utilizes technology with reduced face-to-face time and promotes a student-centred learning environment that excites the learning process. However, studies on blended learning in fixed prosthodontics is still lacking. This study aimed to compare students' performance in easy and difficult level of fixed prosthodontic preclinical projects given by either blended learning or conventional teaching. METHODS: A cross-sectional study was conducted on 72 s-year dental students, who attended preclinical fixed prosthodontic training. Participants were randomly segregated into conventional teaching (n = 36) and blended learning (n = 36). All participants were evaluated for learning preferences using Visual-Aural-Read/Write-Kinesthetic (VARK) questionnaire and performed a project as their baseline skill assessment. They performed another two preclinical projects (easy and difficult level) after the allocated teaching approach. Learning preferences were analysed using Fisher's exact test and performance in preclinical projects were analysed with an independent t test (significant at p < .05). RESULTS: The highest prevalence of learning preferences was the quad-modal preferences (50.7%), which were visual, auditory, reading/writing and kinesthetic. There were no significant differences in baseline skills and learning preferences (p > .05) between groups. No significant differences found between both teaching approaches for easy (p = .319) and difficult projects (p = .339). In the blended learning group, no significant difference was found in both difficulty level of projects (p = .064). CONCLUSION: The participants performed equally on both teaching approaches. However, blended learning for preclinical fixed prosthodontics is anticipated as the new norm of learning, especially in the current pandemic with reduced face-to-face time.

Crestal bone loss and periimplant inflammatory parameters around zirconia implants: A systematic review.

STATEMENT OF PROBLEM: Zirconia implants have been used for oral rehabilitation; however, evidence of their ability to maintain crestal bone and periimplant soft tissue health is not clear. PURPOSE: The purpose of this systematic review was to evaluate crestal bone loss (CBL) around zirconia dental implants and clinical periimplant inflammatory parameters. MATERIAL AND METHODS: The focus question addressed was, "Do zirconia implants maintain crestal bone levels and periimplant soft tissue health?" Databases were searched for articles from 1977 through September 2014 with different combinations of the following MeSH terms: "dental implants," "zirconium," "alveolar bone loss," "periodontal attachment loss," "periodontal pocket," "periodontal index." Letters to the editor, case reports, commentaries, review articles, and articles published in languages other than English were excluded. RESULTS: Thirteen clinical studies were included. In 8 of the studies, the CBL around zirconia implants was comparable between baseline and follow-up. In the other 5 studies, the CBL around zirconia implants was significantly higher at follow-up. Among the studies that used titanium implants as controls, 2 studies showed significantly higher CBL around zirconia implants, and in 1 study, the CBL around zirconia and titanium implants was comparable. The reported implant survival rates for zirconia implants ranged between 67.6% and 100%. Eleven studies selectively reported the periimplant inflammatory parameters. CONCLUSIONS: Because of the variations in study design and methodology, it was difficult to reach a consensus regarding the efficacy of zirconia implants in maintaining crestal bone levels and periimplant soft tissue health.