Predictors of clinical performance in comprehensive care cases in undergraduate dentists.

INTRODUCTION: Achieving a high grade in the final-year comprehensive clinical care (CCC) course is not only important for the individual candidate but also to ensure competency of students as they transition from dental school into independent practice. Here, we aimed to identify predictors of success in the CCC that might prove useful to identify which, if any, students need focused intervention to improve their performance in the CCC. MATERIALS AND METHODS: This was a cross-sectional study of two consecutive cohorts (2017-2018 and 2018-2019) of final-year (Year six) dental students (n = 180 females and n = 150 males) attending [King Abdulaziz University], Saudi Arabia. Age, gender, cumulative GPA to the start of Year six and assessment results were tabulated and analysed as independent variables in binary logistic regression to identify predictors of the final case grade (≤69% or >70%). RESULTS: Year five GPA (OR 1.07, 95% CI 1.02-1.12; p = .004) and female gender (OR 2.21, 95% CI 1.12-4.36; p = .02) were significantly associated with an increased odds of achieving a final case grade >70%. In particular, female students were over twice as likely as male students to achieve a higher score in their final case assessment. DISCUSSION: This study suggests that gender may influence final performance in the CCC. The better performance of females in the final CCC course than their male counterparts suggests that there may be a narrowing or even reversal of the historical gender gap in dental school performance. CONCLUSIONS: Both cognitive (GPA) and other (i.e. gender) factors influence clinical dental performance. Further work is required to establish what instructional modifications are required to accommodate these gender differences in CCC courses to pave the way for personalised teaching approaches to optimise educational outcomes.

Cross-cultural adaptation of oral health-related quality of life measures used to assess the impacts of malocclusion and dentofacial deformities in Saudi Arabia: A literature review.

Since the World Health Organization broadened its definition of health, beyond biological boundaries, to include physical, emotional, and social wellbeing. Oral health-related quality of life (OHRQoL) became common outcome measure in clinical trials and epidemiological studies in Dentistry and Medicine. It is not surprising, therefore, to see quality of life as one of the programs of the Saudi 2030 vision. That said, it can be difficult to interpret the findings of OHRQoL research if the measures used were not appropriately adapted and validated in the population being studied. In this review article, the concept of cross-cultural adaptation of OHRQoL and its use in the Saudi context, as applied to orthodontic research, was discussed. An electronic search in PubMed and MEDLINE databases was conducted. A second search was conducted to locate methodological papers discussing cross-cultural adaptation and translations. Appraisal of relevant research was conducted to provide a better understanding of the process of adapting OHRQoL measures to assess the impact of malocclusion and dentofacial abnormalities on quality of life. This review pointed out important methodological concerns that warrant considerations during the translation and adaptation of OHRQoL measures.

Development of a novel integrated educational relative-unit value system to assess dental students' clinical performance.

PURPOSE: The use of relative unit values (RUVs) to assess students' clinical productivity is common in dental education. However, there are large variations on how RUVs are defined, developed, validated, and reported across institutions. This study described the development of a novel educational RUV system. METHODS: A preparatory phase of literature review and methodological gap analysis, followed by initial conception, pilot testing, and a 2-round modified Delphi process were conducted. Panelists reviewed the procedure list, nomenclature, purpose of development, basis of calculation of RUVs, and the relative weights of different dental procedures. Also, their perception of the usefulness, fairness, and practicality of the system was assessed. Agreement was set at 80%. RESULTS: Eight published educational RUV systems were identified. These data guided the initial conception of the novel Integrated Educational RUVs (IERUVs). Five experts reviewed the system and it was piloted for a full educational cycle. Feedback from faculty and students was used to adjust over- or under-estimated RUVs, with deconstruction of multi-step procedures. Fifteen experts participated in the second Delphi round (71% response rate). Consensus was reached for 105 procedural RUVs. A total of 93% of the panelists agreed the system was useful, while 71% perceived it as fair and practical. CONCLUSION(S): Content validity of the new educational RUV was established. The system provides a promising tool for assessing dental students' clinical performance, as it provides a unified base unit to assess clinical productivity, clinical competence, and comprehensive care cases. Longitudinal evaluations in different contexts are needed to confirm IERUVs validity.

Management of internal derangement of temporomandibular joint disc displacement with reduction using two different lines of treatment / Manejo do desarranjo interno do deslocamento de disco temporomandibular com redução utilizando dois tipos diferentes de tratamento

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)

Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)

Comparison of Digital and Paper Assessment of Smile Aesthetics Perception.

OBJECTIVES: Despite the widespread of assessment of smile aesthetic perception in many areas, there has yet to be a direct comparison of digital and paper-based photographs for the assessment of smile aesthetics. Here we compared digital and paper-based photographs representing different smile aesthetic features using visual analog scale (VAS) scoring. MATERIALS AND METHODS: One hundred students were randomly recruited from a university campus. Participants were asked to record their perception of smile aesthetics via paper and digital-based platforms. The minimum clinically important difference between platforms was set at 15 mm. The percentage of participants who rated smile attractiveness worse on digital images was recorded. The paired one-tailed Student's t test was used to determine differences between digital and paper platforms, and Bland-Altman analysis and intraclass correlations (ICCs) were used to test for agreement between paper and digital photographs. RESULTS: Ninety-nine subjects participated, 55 men (mean age = 22.05, standard deviation [SD] = 1.91) and 44 women (mean age 22.05, SD = 1.84). There were statistically significant differences between paper-based and digital photographs for all images except one (paired t test; P < 0.05). Digital ratings were lower than paper-based ratings for all images, and differences were clinically significant in four out of eight images. A high percentage of participants (50.5%-85.9%) rated smile attractiveness worse on digital images than on paper for all images. There was poor agreement between the two methods as assessed by ICCs and Bland-Altman analysis. CONCLUSION: Equivalence between paper and digital images for smile aesthetics cannot be assumed, and paper-based photographs may lead to clinically relevant overestimations of perceived attractiveness. As academic dentistry increasingly relies on digital imaging and sharing in the post-COVID-19 world, further validation of digital platforms for smile aesthetics assessment is warranted, and care should be taken when interpreting the results of studies assessing smile perception based on different platforms.

Dimensions of Maxillary Lateral Incisor on the Esthetic Perception of Smile: A Comparative Study of Dental Professionals and the General Population.

AIM: To evaluate the effect of the differences in the dimensions of maxillary lateral incisor on the esthetic perception of smile among dental professionals and the general population. MATERIALS AND METHODS: Two sets of photographs where the maxillary incisor dimensions were modified using computer software (Adobe Photoshop) were created. In the first set, six images were included where the maxillary lateral incisor width was modified. The second set included five images where only the maxillary lateral incisor length was modified keeping the gingival margins same. Three groups of participants formed the sample. Hypodontia patients formed the first group, non-hypodontia patients formed the control group, while the dentists constituted to the third group. A total of 156 participants were recruited, 36 patients with radiographically confirmed hypodontia out of which 22 were female and 14 were male, 54 non-hypodontia "control" patients out of which 29 were female and 24 were male, and 66 dentists out of which 39 were female and 27 were male. Every participant had 15 seconds to view each photograph along with 30 seconds at the end for confirmation. RESULTS: The "most attractive smile" was the ones with 77% lateral incisor to central incisor width proportion according to 25.0% of the hypodontia group and 40.8% of the dentist's group, while only 4.2% of the control group agreed that it was the most attractive. However, the "least popular" was the 52% lateral incisor to central incisor width proportion according to 40.0% of patients who are hypodontic, 20.8% of participants from control group, and 49.0% of dentists. CONCLUSION: The golden proportion was not considered as the most attractive among all groups. The esthetic perceptions of the patients might not be same as that of the dentists. In general, reductions in the maxillary lateral incisor width were not all acceptable. CLINICAL SIGNIFICANCE: This study will help us understand the different perceptions of the patients and the dentists on esthetics, which would further help us in planning the treatment accordingly.