Limitations of Surface Mapping Technology in Accurately Identifying Critical Errors in Dental Students' Crown Preparations.

The aim of this study was to evaluate the effectiveness of the Planmeca Compare software in identifying and quantifying a common critical error in dental students' crown preparations. In 2014-17, a study was conducted at one U.S. dental school that evaluated an ideal crown prep made by a faculty member on a dentoform to modified preps. Two types of preparation errors were created by the addition of flowable composite to the occlusal surface of identical dies of the preparations to represent the underreduction of the distolingual cusp. The error was divided into two classes: the minor class allowed for 1 mm of occlusal clearance, and the major class allowed for no occlusal clearance. The preparations were then digitally evaluated against the ideal preparation using Planmeca Compare. Percent comparison values were obtained from each trial and averaged together. False positives and false negatives were also identified and used to determine the accuracy of the evaluation. Critical errors that did not involve a substantial change in the surface area of the preparation were inconsistently identified. Within the limitations of this study, the authors concluded that the Compare software was unable to consistently identify common critical errors within an acceptable degree of error.

The Validity of Using E4D Compare's "% Comparison" to Assess Crown Preparations in Preclinical Dental Education.

When a dental school is deciding which technology to introduce into a curriculum, it is important to identify the educational goals for the system. The authors' primary goal for the use of a computer-aided resource was to offer students another way to assess their performance, to enhance their learning, and to potentially decrease their learning curve in the preclinical environment prior to using the technique in clinical patient care. The aim of this study was to examine the validity of the "% Comparison" numbers derived from the E4D Compare software program. Three practical examinations were administered to a class of 82 students at one U.S. dental school over a six-week period. The grading of the practical examinations was performed with individual faculty members being responsible for evaluating specific aspects of each preparation. A digital image of each student's practical examination tooth was then obtained and compared to the digital image of an ideal preparation. The preparations were compared, and the "% Comparison" was recorded at five tolerance levels. Spearman's correlation coefficient (SCC) was used to measure the agreement in rankings between the faculty scores on practical exams 1-3 and the scores obtained using E4D Compare at the different tolerance levels. The SCC values for practical exams 2 and 3 were all between 0.2 and 0.4; for practical exam 1, the SCC values ranged from 0.47 to 0.56. There was no correlation between the faculty scores and the numbers given by the "% Comparison" of the software.

Fabrication of a definitive obturator from a 3D cast with a chairside digital scanner for a patient with severe gag reflex: a clinical report.

Patient gagging is a common problem during dental procedures such as maxillary impression making. This clinical report describes the use of a chairside intraoral scanner for a patient with a hypersensitive gag reflex. The technique proved to be a more comfortable alternative for the patient and an accurate method for the clinician to capture both hard and soft tissue detail for the fabrication of a definitive obturator.

Effect of Employing Different Typodonts When Using E4D Compare for Dental Student Assessment.

The use of computers to aid in instruction and help decrease the subjective component of assessment is steadily increasing. One of the potential barriers to the effective utilization of CAD/CAM technology for assessment purposes is the efficient scanning of the teeth being used for comparison. The purpose of this pilot study was to determine if the use of different typodonts, of the same make and model, has any significant effect on the percent comparison results when using E4D Compare. Tooth #30 was prepared by a faculty member to represent what dental students at Georgia Regents University are taught as the ideal preparation for a full gold crown. Ten typodonts of the same make and model were selected for comparison. Three different examples of students' preparations were scanned and compared to the ideal preparation. Each of the three student preparations was subjected to ten trials (occasions), one for each typodont, at five tolerance levels: 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm, and 0.5 mm. The intraclass correlation coefficient (ICC) was used to measure the intrarater agreement among the typodonts at the various tolerance levels. The agreement coefficients (0.971-0.984) indicated very little variability attributable to the use of a different typodont. The high agreement coefficients achieved using different typodonts of the same make and model provide evidence for the interchangeability of typodonts when assessing a student's performance in the preclinical simulation environment.

Inter- and Intrarater Reliability Using Different Software Versions of E4D Compare in Dental Education.

The problems associated with intra- and interexaminer reliability when assessing preclinical performance continue to hinder dental educators' ability to provide accurate and meaningful feedback to students. Many studies have been conducted to evaluate the validity of utilizing various technologies to assist educators in achieving that goal. The purpose of this study was to compare two different versions of E4D Compare software to determine if either could be expected to deliver consistent and reliable comparative results, independent of the individual utilizing the technology. Five faculty members obtained E4D digital images of students' attempts (sample model) at ideal gold crown preparations for tooth #30 performed on typodont teeth. These images were compared to an ideal (master model) preparation utilizing two versions of E4D Compare software. The percent correlations between and within these faculty members were recorded and averaged. The intraclass correlation coefficient was used to measure both inter- and intrarater agreement among the examiners. The study found that using the older version of E4D Compare did not result in acceptable intra- or interrater agreement among the examiners. However, the newer version of E4D Compare, when combined with the Nevo scanner, resulted in a remarkable degree of agreement both between and within the examiners. These results suggest that consistent and reliable results can be expected when utilizing this technology under the protocol described in this study.

Effectiveness and feasibility of utilizing E4D technology as a teaching tool in a preclinical dental education environment.

Recent efforts have been directed towards utilizing CAD/CAM technology in the education of future dentists. The purpose of this pilot study was to investigate the feasibility of implementing CAD/CAM technology in instruction on preparing a tooth for restoration. Students at one dental school were assigned access to CAD/CAM technology vs. traditional preparation methods in a randomized, crossover design. In a convenience sample of a second-year class, seventy-six of the seventy-nine students volunteered to participate, for a response rate of 96 percent. Two analyses were performed on this pilot data: a primary effectiveness analysis comparing students' competency exam scores by intervention group (intention-to-treat analysis) and a secondary efficacy analysis comparing competency exam scores among students who reported using CAD/CAM versus those who did not. The effectiveness analysis showed no difference in outcomes by intervention group assignment. While student survey results indicated interest in utilizing the technology, the actual utilization rate was much less than one might anticipate, yielding a sample size that limited statistical power. The secondary analysis demonstrated higher mean competency exam scores for students reporting use of CAD/CAM compared to those who did not use the technology, but these results did not reach statistical significance (p=0.075). Prior research has investigated the efficacy of CAD/CAM in a controlled educational trial, but this study adds to the literature by investigating student use of CAD/CAM in a real-world, self-study fashion. Further studies should investigate ways in which to increase student utilization of CAD/CAM and whether or not increased utilization, with a larger sample size, would yield significant outcomes.