Bespoke video vignettes - an approach to enhancing reflective learning developed by dental undergraduates and their clinical teachers.

This study explores the selective use of video as a medium to support reflective processes as related to dental undergraduate learning. With the objective of developing and enhancing high-quality adult dental care, the use of compiled video materials created in an undergraduate clinical setting was investigated. Video cameras were used to capture elements of reflection-in-action and reflection-on-action typically found during everyday clinical practice. 'Gold standard' or 'textbook outcomes' are rarely, if ever, fully achieved in dental practice. Real-life clinical experiences offer challenges and opportunities for both teachers and students to engage with reflective learning processes. The materials generated allowed for an experience of individual reflective learning and the creation of a data bank or archive with potential use for the benefit of a wider student cohort. Various aspects of the students' views and comments on the process of reflection were reported and explored by means of a semi-structured focus group moderated by a linked educational advisor.

The management of defective resin composite restorations: current trends in dental school teaching in Japan.

AIM: The aim of this article is to investigate the contemporary teaching of the management of defective direct resin composite restorations in dental schools in Japan. METHODS: A questionnaire relating to the teaching of the management of defective resin composite restorations was developed and e-mailed to 29 dental schools in Japan in 2010. RESULTS: Completed responses were received from 19 of the 29 invited schools (response rate = 66%). Eighteen schools (95%) report that they included the teaching of repair of direct defective resin composite restorations in their dental school programs. Thirteen schools reported that they included both clinical and didactic instruction on the repair of direct resin composite restorations. Fourteen schools did not teach any mechanical roughening of the exposed resin composite restoration surface before undertaking a repair. The most commonly reported treatment was acid etching with phosphoric acid (12 schools). The most commonly taught material for completing repairs was a flowable resin composite (16 schools). CONCLUSION: The teaching of repair of defective resin composite restorations is well established within many Japanese dental schools, to a greater extent than in some other regions of the world. The impact of this teaching on subsequent clinical practices in Japan should be investigated. Furthermore, it is concluded that there is a need for much stronger leadership in operative and conservative dentistry, ideally at the global level, to resolve differences in key aspects of operative procedures such as repairs.

Teaching of direct composite restoration repair in undergraduate dental schools in the United Kingdom and Ireland.

AIM: To investigate aspects of the teaching of restoration repair as a minimally invasive alternative to the replacement of defective direct composite restorations in teaching programmes in undergraduate curricula in dental schools in the United Kingdom and Ireland. METHODS: An online questionnaire which sought information in relation to the current teaching of composite restoration repair was developed and distributed to the 17 established UK and Irish dental schools with undergraduate teaching programmes in Spring 2010. RESULTS: Completed responses were received from all 17 schools (response rate= 100%). Fifteen schools reported that they included teaching of repair techniques for defective direct composite restorations in their programme. Of the two remaining schools, one indicated that it would introduce teaching of repair techniques during the next five years. The most common indication for a composite repair was that of 'tooth substance preservation' (15 schools). The defects in restorations considered appropriate for repair rather than replacement by the largest number of schools included partial loss of restoration (13 schools) and marginal defects (12 schools). The most commonly taught surface treatment when performing a repair was mechanical roughening of the existing composite with removal of the surface layer (14 schools). Thirteen schools taught etching and the application of an adhesive bonding agent to the prepared surfaces, while the most commonly taught material for completing the repair was a hybrid composite resin (12 schools). Popular finishing implements included diamond finishing instruments (13 schools) and finishing discs (11 schools). CONCLUSION: Not withstanding reluctance amongst general dental practitioners, the teaching of repair of a defective composite restoration, rather than total restoration replacement, is firmly established within UK and Irish dental school programmes. Repair techniques have clear advantages for patients, not least including a minimally invasive approach to treatment and avoidance of unnecessary loss of tooth tissue and pulpal damage. Dental practitioners should look more to repair techniques when managing defective composite restorations and clinical dental teachers should continue to research and refine composite repair techniques.

Teaching of the repair of defective composite restorations in Scandinavian dental schools.

Given increased tooth retention into later years of life, dentists face increasing challenges in maintaining teeth with extensive composite restorations. Accompanying the increase in placement of composite restorations in general practice, there has also been increased evidence that repair, rather than replacement, of composite restorations is being increasingly considered as a treatment option. Previous work has demonstrated that such techniques are often underutilised in practice. The aim of this study was to examine contemporary teaching of composite repair techniques in Scandinavian dental schools. A questionnaire was distributed by email to each of the 12 Scandinavian dental schools in late 2010/early 2011. This questionnaire sought information on the undergraduate teaching of composite repair techniques as well as indications and materials utilised for this technique. A 100% response rate was achieved (12 schools). Eleven of the 12 respondent schools indicated that they included the teaching of composite repair techniques within their dental school programme. The most commonly reported indications for the teaching of the repair of direct composite restorations were tooth substance preservation (11 schools) and reduced risk of harmful effects on the pulp (10 schools). The most commonly taught surface treatment was mechanical roughening of the existing composite restoration, including the removal of the surface layer of material, prior to application of fresh composite (11 schools). Overall, the results of this study showed that the teaching of composite repair techniques is established within Scandinavian dental schools. This may influence the practising habits of dentists graduating from these schools when considering treatment options for defective composite restorations.

Defective dental restorations: to repair or not to repair? Part 1: direct composite restorations.

The presentation of patients with failing dental restorations that exhibit minor defects is a common clinical situation in everyday dental practice. The repair of such restorations, rather than replacement, is increasingly considered to be a viable alternative to the replacement of the defective restoration. This first of two papers considers indications and techniques for the repair of defective direct composite restorations. It is possible that some dental practitioners are unaware of the option of repair rather than replacement of composite restorations. This article provides an overview of contemporary knowledge and understanding of restoration repair in the clinical management of defective composite restorations.

Defective dental restorations: to repair or not to repair? Part 2: all-ceramics and porcelain fused to metal systems.

With the increasing use of ceramics in restorative dentistry, and trends to extend restoration longevity through the use of minimal interventive techniques, dental practitioners should be familiar with the factors that may influence the decision either to repair or replace fractured metal-ceramic and all-ceramic restorations and, also, the materials and techniques available to repair these restorations. This second of two papers addresses the possible modes of failure of ceramic restorations and outlines indications and techniques in this developing aspect of restoration repair in clinical practice.

State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools.

AIM: Advances of composite systems and their application have revolutionised the management of posterior teeth affected by caries, facilitating a minimally invasive approach. Previous surveys have indicated that the teaching of posterior composites within dental schools was developing, albeit not keeping pace with clinical evidence and the development of increasingly predictable techniques and materials. Concurrently, surveys of dental practice indicate that dental amalgam still predominates as the 'material of choice' for the restoration of posterior teeth within UK general dental practice. In light of such considerations, the aim of this study was to investigate current teaching of posterior composites in Irish and UK dental schools. METHODS: An online questionnaire which sought information in relation to the current teaching of posterior composites was developed and distributed to the 17 established Irish and UK dental schools with undergraduate teaching programmes in late 2009. RESULTS: Completed responses were received from all 17 schools (response rate = 100%). All 17 schools taught the placement of occlusal and two-surface occlusoproximal composites in premolar and permanent molar teeth. Two schools did not teach placement of three-surface occlusoproximal composites in either premolars or molars. In their preclinical courses, ten schools taught posterior composites before teaching dental amalgams. Fifty-five percent of posterior restorations placed by dental students were of composite (range = 10-90%) and 44% amalgam (range = 10-90%), indicating an increase of 180% in the numbers of posterior composites placed over the past five years. Diversity was noted in the teaching of clinical techniques and students at different schools are trained with different composites and bonding systems. Some cause for concern was noted in the teaching of certain techniques that were not in keeping with existing best evidence, such as the teaching of transparent matrix bands and light-transmitting wedges for occluso-proximal composites (eight schools) and the teaching of bevels on the cavosurface enamel margins of both the occlusal and proximal box margins (three schools). CONCLUSION: The teaching of posterior composites in the Irish and UK dental schools has substantially increased over the last five years. Dental students in these schools often gain more experience in the placement of posterior composites than amalgam. However, practice trends indicate that a majority of GDPs continue to place amalgam in preference to composite, thereby suggesting a source of tension as current dental students emerge into the dental workforce over the coming years. There is, as a consequence, a challenge to the dental profession and its funding agencies in the UK to encourage more of a shift towards the minimally interventive use of composite systems in the restoration of posterior teeth, in particular among established practitioners.

A survey of undergraduate education in dental implantology in UK dental schools.

The aim of this study was to ascertain knowledge on current teaching of implant dentistry in the undergraduate curriculum of Dental Schools in the UK. Information on the teaching modalities, including year of introduction of implant dentistry into undergraduate curriculum, departments involved in teaching, format of teaching, use of adjunctive teaching aids, and types of implant systems used in undergraduate teaching was collected by means of a questionnaire, which was sent to all undergraduate dental schools in the UK. Based on a 100% response rate, the findings indicate that all dental schools in the UK reported that they included dental implantology in their undergraduate curriculum; however there were marked variations in the content and delivery of the teaching.

A cohort investigation of the changes in vocational dental practitioners' views on repairing defective direct composite restorations.

OBJECTIVE: To investigate changes in vocational dental practitioners (VDPs) views on repairing direct composite restorations (DCRs) during the vocational training (VT) year 2002-2003. DESIGN: A questionnaire-based cohort study. METHOD: Data on the repair of DCRs, including indications and details of operative techniques were collected by a questionnaire sent at the beginning of the VT year (September 2002) to all 12 Postgraduate Dental Deans in England. A follow-up questionnaire was sent to the Deans near the end of the VT year (May 2003). They were asked, on both occasions, to distribute the questionnaires among their VDPs and to return the completed questionnaires. RESULTS: Ten deaneries participated in the study. The September 2002 and May 2003 findings (306 respondents [66%] and 313 respondents [67%] respectively) were analysed using Chi-square statistic and t-test to identify any significant differences (P<0.05). Significant changes in the attitudes of the VDPs during the VT year included a shift to viewing reduction in treatment time (30% to 48%), cost to patient (12% to 20%) and the management of the partial loss of a restoration (57% to 70%) as indications for repairs. In contrast, there was a significant change in viewing secondary caries as an indication for repair (46% to 29%). In addition, there was a significant, worrisome shift in relation to the use of bonding systems and finishing instruments, together with a reduction in the anticipated longevity of composite repairs. CONCLUSION: Aspects of VDPs' attitudes to the repair of DCRs were found to change significantly during the VT year. Not all aspects of the changes observed were considered to be positive. Knowledge and understanding of repairs to DCRs need to be strengthened.

The repair of direct composite restorations: an international survey of the teaching of operative techniques and materials.

This article reports the findings of a study on the aspects of the teaching of repair as a conservative alternative to the replacement of failing direct composite restorations (DCRs) in primary dental degree curricula in the UK and Ireland, Germany and Scandinavia. Data on teaching, including operative techniques applied in the repair of DCRs, were collected by means of a questionnaire sent to 58 dental schools in the surveyed countries. Based on the overall response rate of 83%, the findings indicate that the majority (59%) of the schools in the countries surveyed may be found to teach the repair of DCRs. However, marked variations were observed in respect of this teaching and the expected longevity of repaired DCRs. Where the repair of DCRs was not taught, views differed as to the intentions, if any, to include this teaching in the curriculum. It is concluded that the teaching of DCRs may be found to be widespread in dental schools in the UK and Ireland, Germany and Scandinavia, with this teaching being subjected to considerable variation within and between countries.

A quick and simple method to obtain a radiographic evaluation of remaining alveolar bone height before implant placement.

This article describes a method for making a diagnostic radiographic evaluation of remaining alveolar bone height in the bounded-saddle patient without the previous fabrication of a study model and radiographic ball-bearing template. The method presented is simple, enabling the busy practitioner to perform immediate radiographic diagnosis and inform the patient at the first visit about the available alveolar bone height at the site of planned implant insertion. This method is therefore time saving for both the dentist and the patient.

Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review.

The objective of this article is to harmonize descriptive definitions for the condition known as alveolar osteitis and to critically review and discuss the aetiology and pathogenesis of alveolar osteitis. In addition, the need for the identification and elimination of risk factors as well as the preventive and symptomatic management of the condition are discussed. The aim of this critical review is to provide a better basis for clinical management of the condition. A meta-analysis of data was not done.