A complex haptic exercise to predict pre-clinic operative dentistry performance: A prospective study.

PURPOSE/OBJECTIVES: The purpose of this study was to determine whether performance on a complex manual dexterity haptic test was associated with preclinical operative dentistry practical examination scores in handpiece naïve students. METHODS: Thirty-nine first-year pre-clinical operative dentistry students completed a 15-min complex manual dexterity exercise "D-circle" repeated eight times in succession before the beginning of the preclinical operative dentistry course. A composite haptic score was compared with students' subsequent preclinical operative examination performance and perceptual ability test scores. RESULTS: Mean accuracy scores on the haptic test increased, and failures decreased across the eight repetitions. Thirty students were successful at least twice in eight attempts, while nine failed all or all but one attempt. The group that failed all or all but one had lower mean scores on the first practical examination (Exam 1) (78.4 vs. 82.2, p = 0.23 Student's t-test), and 7.0 odds of failing the examination (confidence interval 0.95-51.4, p = 0.06). As a diagnostic predictor of pre-clinical operative dentistry performance, failing all, or all but one attempt at the haptic test had 60% sensitivity and 82% specificity as a predictor of failure on Exam 1. This resulted in correct classification of 79%. CONCLUSIONS: These data provide evidence for the first time that a complex manual dexterity test on a haptic simulator given to dental students was predictive of early pre-clinical success. These prospective results confirm previous retrospective studies and if replicated in larger cohorts may lead to improvements in the dental school admissions process.

Antibiotic prescription patterns among US general dentists and periodontists.

BACKGROUND: In the absence of a full spectrum of evidence-based guidelines for the appropriate use of antimicrobial agents, dentists, including periodontists, remain a highly frequent antibiotic prescribing group. With the goal of understanding antibiotic prescribing practices, the authors surveyed a convenience sample of dental practitioners and periodontists to identify differences between the 2 cohorts and assess the factors that affect prescribing practices. METHODS: An institutional review board-approved 15-item survey was developed to capture antibiotic prescribing practices addressing the main research question, factors affecting systemic antibiotic prescription patterns, and prescription timing. The authors collaborated with the American Dental Association (ADA) and the American Academy of Periodontology (AAP) for survey dissemination. Responses were summarized using descriptive statistics. Multivariable models were developed to identify antibiotic prescription predictors. RESULTS: Overall, 32.4% of the participants prescribed systemic antibiotics with scaling and root planing. When comparing the 2 groups, the authors found that 46.4% and 18.7% of the AAP and ADA members, respectively, prescribed systemic antibiotics with scaling and root planing (P = .0001). The authors found a significant difference between the AAP and ADA groups in prescription timing (P = .01). The multivariable model revealed that practitioner sex (P = .03), AAP membership (P = .0001), and years of practitioner experience (P = .04) predicted antibiotic prescription practices. The geographic location, practice setting, and occupation type did not predict antibiotic prescription patterns. CONCLUSION: The authors found a lack of clarity related to prescription timing, factors determining prescription patterns, and selection of patient population who would benefit more from antibiotics. PRACTICAL IMPLICATIONS: This study confirmed a lack of clarity related to antibiotic prescription patterns in combination with nonsurgical periodontal treatment.

Bone Ring Allograft: Digitally Guided Placement in the Anterior Esthetic Area. A Retrospective Case Series.

This case series demonstrates a surgical technique consisting of a digitally planned and guided placement of a bone ring allograft and implant in the anterior esthetic zone. Eight consecutive patients with horizontal and vertical defects in the anterior maxilla underwent augmentation with a commercially available bone ring allograft and simultaneous implant placement using two digital guides. After 6 to 8 months, implants were uncovered and restored with a screw-retained prosthesis. Follow-up periods ranged from 8 to 24 months. All eight implants met predefined success criteria with no adverse events. Radiographic measurements demonstrated stable peri-implant bone levels 1 year after implantation, with bone loss ranging from 0.0 to 1.4 mm. All patients were satisfied with the total treatment time, postsurgical healing, and final esthetic outcome. This case series describes a one-stage procedure in which a bone ring allograft and implant are simultaneously placed for treatment of a severely defective ridge in the anterior maxilla. The technique appears to be reliable for use in the esthetic zone, with minimal first-year loss of peri-implant bone. In combination with a digital guide, accurate implant and bone ring placement can be achieved, resulting in reduced chair time and fewer surgical procedures for the patient.

Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study.

BACKGROUND: The aim of this pilot study was to test whether diagnostic agreement of aggressive and chronic periodontitis amongst Board Certified Periodontists, is influenced by knowledge of a patient's age. In 1999 at the International World Workshop age was removed as a diagnostic criteria for aggressive periodontitis. The impact of this change on the diagnostic reliability amongst clinicians has not yet been assessed. METHODS: Nine periodontal case reports were twice presented to sixteen board certified periodontists, once with age withheld and again with patient age provided. Participants were instructed to choose a diagnosis of Chronic Periodontitis or Aggressive Periodontitis. Diagnostic agreement was calculated using the Fleiss Kappa test. RESULTS: Including the patients' age in case report information increased diagnostic agreement (the kappa statistic) from 0.49 (moderate agreement) to 0.61 (substantial agreement). CONCLUSION: These results suggest that knowledge of a patients' age influenced clinical diagnosis, when distinguishing between aggressive periodontitis and chronic periodontitis, which may in turn impact treatment decision-making.

Changes in diabetes medications in the Diabetes and Periodontal Therapy Trial and their effect on hemoglobin A1c (HbA1c).

OBJECTIVE: Evaluate the effect of medications and medication changes during the Diabetes and Periodontal Therapy Trial (DPTT) on the primary study outcome, namely, change in hemoglobin A1c (HbA1c) at 6months following baseline. METHODS: The DPTT set strict criteria for changes in diabetes medications. Medication change was defined as: change in dose of any 1 oral hypoglycemic agent by more than two-fold, change in dose of insulin of >10% and/or addition or subtraction of an oral hypoglycemic agent, insulin or non-insulin injectable agents. Comparisons between the treatment (non- surgical periodontal therapy) and control (no therapy) groups used t-tests for continuous variables and chi-square tests for categorical variables, including DPTT defined diabetes medication changes between baseline (BL) and 3month visits and 3- and 6-month visits. Changes in HbA1c were compared across the four medication change categories using ANOVA models, overall and for each treatment group separately. RESULTS: Baseline medication use was similar between the treatment groups (p>0.40), as were medication changes between BL- 3month visits and 3 and 6month visits (p=0.58). Participants with higher BL HbA1c (>8%) and those taking insulin at BL were more likely to have a change in medication (p=0.03). CONCLUSIONS: The DPTT had the most rigorous definition of medication changes and medication monitoring of any trial in this field to date. The absence of a significant difference in medication changes between treatment groups may suggest that such changes did not play a role in the negative outcome of the DPTT.

Systemic Inflammatory Biomarkers and Their Association With Periodontal and Diabetes-Related Factors in the Diabetes and Periodontal Therapy Trial, A Randomized Controlled Trial.

BACKGROUND: The present study evaluates effects of non-surgical periodontal treatment on serum biomarkers in patients with type 2 diabetes mellitus (t2DM) and chronic periodontitis who participated in the Diabetes and Periodontal Therapy Trial (DPTT); and associations among diabetes markers, serum biomarkers, and periodontal measures in these patients. METHODS: DPTT participants randomized to receive immediate or delayed non-surgical periodontal therapy were evaluated at baseline and 6 months. Serum samples from 475 participants with 6-month data were analyzed for the following biomarkers: 1) high sensitivity C-reactive protein; 2) E-selectin; 3) tumor necrosis factor (TNF)-α; 4) vascular cell adhesion molecule (VCAM); 5) interleukin (IL)-6; 6) IL-8; 7) intercellular adhesion molecule; and 8) IL-10. Changes in biomarker levels from baseline and correlations among biomarker levels and clinical findings were analyzed. RESULTS: No differences between treatment and control groups were observed for any biomarkers at baseline or 6 months (P >0.05 for all variables). VCAM levels increased by an average (standard deviation) of 17.9 (99.5); ng/mL (P = 0.006) and E-selectin decreased by 2.33 (16.08) ng/mL (P = 0.03) in the treatment group after 6 months. E-selectin levels were significantly correlated with DM-related variables (hemoglobin A1c [HbA1c] and fasting glucose) at baseline and with 6-month change in both groups; no significant correlations were found among periodontal clinical parameters and serum biomarkers or DM-related variables. Neither HbA1c or body mass index varied during the study period in either study group. CONCLUSIONS: Non-surgical periodontal therapy and periodontal disease severity were not associated with significant changes in serum biomarkers in DPTT participants during the 6-month follow-up. Correlations among changes in E-selectin, IL-6, and DM-related variables suggest that t2DM may be the primary driver of systemic inflammation in these patients.

Animal models for peri-implant mucositis and peri-implantitis.

The treatment of infectious diseases affecting osseointegrated implants in function has become a demanding issue in implant dentistry. Since the early 1990s, preclinical data from animal studies have provided important insights into the etiology, pathogenesis and therapy of peri-implant diseases. Established lesions in animals have shown many features in common with those found in human biopsy material. The current review focuses on animal studies, employing different models to induce peri-implant mucositis and peri-implantitis.

Factors associated with the clinical response to nonsurgical periodontal therapy in people with type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. People with T2DM are at risk of experiencing periodontitis and likely require treatment. Using data from the national multicenter Diabetes and Periodontal Therapy Trial (DPTT), the authors assessed patient-based characteristics associated with the clinical response to nonsurgical therapy. METHODS: The DPTT investigators randomly assigned adults with T2DM (hemoglobin A1c [HbA1c] ≥ 7 percent and < 9 percent) and moderate to advanced periodontitis to receive immediate or delayed therapy (scaling and root planing, oral hygiene instruction, chlorhexidine rinse). The investigators assessed probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and medical conditions at baseline, three months and six months. Six-month changes in mean PD, CAL and BOP defined the treatment response. Complete data were available for 473 of 514 DPTT participants. The authors used multiple regression models to evaluate participant-level factors associated with the response. RESULTS: More severe baseline PD, CAL and BOP were associated with greater improvements in these same measurements (P < .0001). Hispanic participants experienced greater improvements in PD and CAL than did non-Hispanic participants (P < .0001). Obese participants (those with a body mass index > 30 kilograms per square meter) experienced greater reductions in PD and BOP than did participants who were not obese (P < .001). Age, sex, HbA1c values, diabetes duration, and smoking were not associated with change in any outcome (P > .1). CONCLUSIONS: In patients with T2DM, baseline disease severity was associated with the clinical response to nonsurgical periodontal therapy. Body mass index and Hispanic ethnicity-but not glycemic control, diabetes duration or smoking-also may be useful in predicting clinical changes in this population.

Periodontal disease and glycemic control in diabetics.

DATA SOURCES: Medline, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). This was supplemented by handsearching of the Journal of Clinical Periodontology, Journal of Periodontology, Journal of Dental Research, Journal of Dentistry, Journal of Periodontal Research, International Journal of Periodontics and Restorative Dentistry, Periodontology 2000, Odontology, Clinical Oral Investigations, Annals of Periodontology, Journal of American Dental Association, British Dental Journal, Community Dentistry and Oral Epidemiology, Diabetes, Diabetes Care, Diabetes & Metabolic Syndrome, Diabetes & Metabolism and Annals of Internal Medicine. There were no language restrictions. STUDY SELECTION: Randomised controlled trials (RCTs) on diabetic patients with periodontal disease that reported glycated haemoglobin (HbA1c) and/or fasting plasma glucose (FPG) modification after treatment, with a minimum of three months follow-up were included. Study quality was assessed independently by two reviewers. DATA EXTRACTION AND SYNTHESIS: Data extraction was carried out independently by two reviewers. Meta-analysis was carried out to evaluate the effect of non-surgical periodontal treatment on HbA1c and FPG levels. The effect of the adjunctive use of antimicrobials was also assessed. RESULTS: Fifteen studies were included, five were considered to be at low risk of bias, three at high risk and the remainder at unclear risk. Seven studies (678 patients) contributed to the meta-analysis for HbA1c. At the three-four months follow-up, the weighted mean difference was -0.38% (95% CI -0.23 to -0.53; P < 0.001) and at six months it was -0.31% (95% CI 0.11 to -0.74; P = 0.15), favouring the treatment groups [three studies contributing to meta-analysis]. There was statistically significant heterogeneity for both comparisons. For FPG, five studies presented data for three-four months and two for six months. At the three-four months follow-up, the weighted mean difference was -9.01 mg/dL (95% CI -2.24 to -15.78; P = 0.009) and at six months it was -13.62 mg/dL (95% CI 0.45 to -27.69; P = 0.06). CONCLUSIONS: Despite the limitations of the present study, it can be concluded that periodontal treatment might be effective in improving metabolic control in terms of reduction of HbA1c and FPG concentrations in patients with diabetes. However, the significance of this improvement is questionable and should be further investigated.

Full-mouth esthetic rehabilitation with acellular dermal matrix.

Treatment of multiple recession defects with the adjunct use of a connective tissue graft (CTG) represents a challenge when diagnosed in several teeth of the mouth. The amount of CTG harvested from the palate may not be adequate to address this condition. In such scenarios, alternative sources such as acellular dermal matrix (ADM) are preferred due to the unlimited availability. A case report is presented, dealing with the treatment of multiple gingival recessions affecting the majority of dentition using ADM, with a 6-month follow-up.

Microradiography and microcomputed tomography comparative analysis in human bone cores harvested after maxillary sinus augmentation: a pilot study.

OBJECTIVES: The aim of this study was to compare microradiography (MR) and microcomputed tomography (µCT) analysis of bone samples following maxillary sinus augmentation at different time periods and determine the relationships between measured area and volume fractions. MATERIALS AND METHODS: Lateral window sinus grafts were performed on 10 patients using a mineralized human bone allograft (MHBA). At implant placement, 5-13 months after surgery, 10 bone core biopsies were harvested. Prior to histologic sectioning, bone samples were evaluated with µCT. The morphometric parameters computed by MR and µCT were compared using Pearson's correlation and Bland and Altman analysis and included hard tissue fraction (HV/TV:%), soft tissue fraction (SV/TV:%), vital bone fraction (BV/TV:%) and residual graft fraction (GV/TV:%). RESULTS: Strong positive correlation between MR and µCT was found for HV/TV and SV/TV and BV/TV [r = 0.84, 0.84 and 0.69, respectively] but weak for GV/TV [r = 0.10]. CONCLUSION: µCT technology shows promising potential as an indicator of bone morphology changes; however, caution should be used in interpreting morphometric parameters, as the different methods reveal important biases.

A novel three-dimensional analysis of standardized bone defects by means of confocal scanner and micro-computed tomography.

OBJECTIVES: The aim of the study was to introduce a novel three-dimensional (3D) method to quantify the relative amount of different tissue components in bone substitute-treated defects by means of integration of confocal laser imaging into micro-computed tomography (µCT) analysis. MATERIALS AND METHODS: One standardized semisaddle intraosseous defect was prepared in the mandibles of six minipigs and scanned by an optical scanner to capture the surface of the fresh defect in a 3D manner. Subsequently, all the defects were filled with a biphasic calcium phosphate material. The animals were divided into two groups of three animals each, which were allowed to heal for 3 and 8 weeks, respectively. µCT analysis followed the two healing periods and was performed on all defect locations. The data from optical scanning and µCT were used for three-dimensional evaluation of bone formation, nonmineralized tissue ratio, and graft degradation. The integration of confocal laser scanning into µCT analysis through a superimposition imaging procedure was conducted using the software Amira (Mercury Computer Systems, Chelmsford, MA, USA). RESULTS: The feasibility of combining the confocal imaging into µCT data with regard to obtaining accurate 3D quantification was demonstrated. The amount of tissue components was identified and quantified in all the investigated samples. Quantitative analysis demonstrated that a significant increase in the amount of bone filling the defect was observed in vivo (p < 0.02) while a significant decrease in the amount of nonmineralized tissue occurred (p < 0.04). No difference in the amount of residual grafting material was detected between 3 and 8 weeks in vivo (p > 0.38). CONCLUSIONS: The combination of confocal imaging and micro-computed tomography techniques allows for analysis of different tissue types over time in vivo. This method has revealed to be a feasible alternative to current bone regeneration quantification methods. CLINICAL RELEVANCE: Assessment of bone formation in a large animal model is a key step in assessing the performance of new bone substitute materials. Reliable and accurate methods are needed for the analysis of the regenerative potential of new materials.

An evaluation of recruitment methods utilized for a clinical trial with periodontal and diabetes enrollment criteria: the Diabetes and Periodontal Therapy Trial.

BACKGROUND: Diabetes and its complications are a major United States public health concern. METHODS: The Diabetes and Periodontal Therapy Trial (DPTT) evaluated whether non-surgical treatment of periodontal disease influenced diabetes management among persons with Type 2 diabetes and periodontitis. The aim of this study was to evaluate DPTT's many recruitment strategies in terms of enrollment success. RESULTS/CONCLUSION: Targeted recruitment strategies were more effective in identifying individuals who met periodontal and diabetes eligibility criteria. Individuals eligible for a baseline visit/enrollment were more often male, had a younger age at diabetes diagnosis, a longer diabetes duration, more often Hispanic and less often African-American. Tracking and evaluating recruitment sources during study enrollment optimized recruitment methods to enroll a diverse participant population based upon gender, race and ethnicity.

The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial.

IMPORTANCE: Chronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control. OBJECTIVE: To determine if nonsurgical periodontal treatment reduces levels of glycated hemoglobin (HbA1c) in persons with type 2 diabetes and moderate to advanced chronic periodontitis. DESIGN, SETTING, AND PARTICIPANTS: The Diabetes and Periodontal Therapy Trial (DPTT), a 6-month, single-masked, multicenter, randomized clinical trial. Participants had type 2 diabetes, were taking stable doses of medications, had HbA1c levels between 7% and less than 9%, and untreated chronic periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with 5 academic medical centers. INTERVENTIONS: The treatment group (n = 257) received scaling and root planing plus chlorhexidine oral rinse at baseline and supportive periodontal therapy at 3 and 6 months. The control group (n = 257) received no treatment for 6 months. MAIN OUTCOMES AND MEASURES: Difference in change in HbA1c level from baseline between groups at 6 months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose level, and Homeostasis Model Assessment (HOMA2) score. RESULTS: Enrollment was stopped early because of futility. At 6 months, mean HbA1c levels in the periodontal therapy group increased 0.17% (SD, 1.0), compared with 0.11% (SD, 1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference, -0.05% [95% CI, -0.23% to 0.12%]; P = .55). Periodontal measures improved in the treatment group compared with the control group at 6 months, with adjusted between-group differences of 0.28 mm (95% CI, 0.18 to 0.37) for probing depth, 0.25 mm (95% CI, 0.14 to 0.36) for clinical attachment loss, 13.1% (95% CI, 8.1% to 18.1%) for bleeding on probing, and 0.27 (95% CI, 0.17 to 0.37) for gingival index (P < .001 for all). CONCLUSIONS AND RELEVANCE: Nonsurgical periodontal therapy did not improve glycemic control in patients with type 2 diabetes and moderate to advanced chronic periodontitis. These findings do not support the use of nonsurgical periodontal treatment in patients with diabetes for the purpose of lowering levels of HbA1c. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00997178.

A complex haptic exercise to predict preclinical operative dentistry performance: a retrospective study.

A reliable test of manual dexterity could potentially have utility in dental education. Recently, haptic technologies have emerged that may offer a means of testing manual dexterity in the preclinical setting. The purpose of this study was to determine whether performance on a complex haptic simulator exercise was associated with preclinical operative dentistry practical examination scores or the Perceptual Ability Test (PAT) scores of the Dental Admission Test. All thirty-nine first-year dental students enrolled in the Operative Dentistry preclinical course at the Stony Brook University School of Dental Medicine completed a haptic exercise consisting of a single manual dexterity test (D-circle), repeated eight times in succession during a single session at midterm. A score reflecting accuracy and time to completion of each trial was calculated automatically and resulted in a success or failure for each trial. Preclinical operative dentistry practical examinations consisting of plastic tooth preparations given at three time points during the course were scored by four calibrated and masked course faculty members. Examination scores were compared with students' performance on the haptic test using linear regression. Number of failures during a single session on a complex haptic exercise was found to be a significant predictor of examination performance in the preclinical setting. These results suggest a role for haptics in identifying students with potential learning challenges in the preclinical stages of dental education. Identification of students with manual dexterity problems at an early stage may allow for early intervention to prevent failure.

Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis.

CONTEXT: The effect of periodontal therapy on diabetes outcomes has not been established. OBJECTIVE: This update examines the effect of periodontal treatment on diabetes outcomes. DATA SOURCES: Literature since October 2009 using MEDLINE. STUDY ELIGIBILITY CRITERIA: Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months. DATA EXTRACTION: Pre-defined data fields, including study quality indicators were used. DATA SYNTHESIS: A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models. RESULTS: A meta-analysis indicated a mean treatment effect of _0.36% HbA1c (CI _0.54, _0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I2 = 9%). LIMITATIONS: Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably. CONCLUSION: The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.

Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis.

CONTEXT: The effect of periodontal therapy on diabetes outcomes has not been established. OBJECTIVE: This update examines the effect of periodontal treatment on diabetes outcomes. DATA SOURCES: Literature since October 2009 using MEDLINE. STUDY ELIGIBILITY CRITERIA: Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months. DATA EXTRACTION: Pre-defined data fields, including study quality indicators were used. DATA SYNTHESIS: A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models. RESULTS: A meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I(2 ) = 9%). LIMITATIONS: Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably. CONCLUSION: The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.

Current status of periodontal risk assessment.

Chronic periodontitis is a destructive chronic inflammatory disease of bacterial etiology. Mounting evidence confirms that not all patients are susceptible to inflammatory periodontal disease, and further, that the extent and severity of its clinical manifestation varies as a function of individual risk. Risk assessment models are needed to target treatment effectively. Contemporary risk assessment, as applied to periodontal disease, represents an innovative approach to managing periodontitis. The central intent of this paper is to review the current view of risk assessment as it relates to the diagnosis and management of chronic periodontitis, as well as to consider a number of such applications that can be incorporated into daily practice.

The use of haptics to predict preclinic operative dentistry performance and perceptual ability.

The aim of this study was to test whether performance on a range of manual dexterity haptic simulator exercises was associated with preclinical operative dentistry examination and Perceptual Ability Test (PAT) scores. Thirty-nine first-year dental students were tested with three haptic exercises--straight line, circle, and mirror line--each performed twice. Haptic exercise outcomes for accuracy, time, and success rate were measured using commercially available computer software. Spearman correlation coefficients and Student's t-test were used to assess the results. PAT and exam scores were not significantly correlated. Significant correlations were observed between exam scores and both time and accuracy scores for the circle and mirror exams. These results suggest that haptic devices have a potential role in predicting performance in preclinical dental education. Further studies are warranted to develop and validate diagnostic testing strategies for dental students and to evaluate implementation of haptics in the dental teaching environment.