Effectiveness of face-to-face, blended and e-learning in teaching the application of local anaesthesia: a randomised study.

BACKGROUND: Local anaesthesia plays a key role in many aspects of a dentist's work. The required skills to perform anaesthesia successfully are acquired at university. To take advantage of the possibilities for new teaching formats, a blended learning concept for the local anaesthesia course was developed. The aim of the study was to compare the effectiveness of face-to-face, blended and e-learning in teaching in local anaesthesia by assessing students' knowledge gain, performance of practical skills and satisfaction with the course. METHODS: All participants (n = 37) were randomly allocated into three groups. After acquiring the theoretical background in the blended learning, e-learning or lecture groups, a test to assess knowledge gain was performed. The performance of the practical skills was assessed in a small-group seminar. Student attitudes were evaluated with a questionnaire. RESULTS: The blended group showed significantly better results (mean = 17, SD =1.5) in theoretical knowledge gain than the other two groups (e-learning group: mean = 14.7, SD = 2.2; lecture group: mean = 14.8, SD =2.3). When comparing the results of the clinical skills assessment, there was no significant difference among all three groups (p > 0.017). The participants confirmed a high overall satisfaction with the course, in particular with the blended learning approach. CONCLUSION: This study indicates that blended learning improves the learning outcome for theoretical knowledge in teaching local anaesthesia more than either face-to-face learning or e-learning alone. Furthermore, the blended learning approach is highly appreciated by the students. For acquiring practical skills, this study shows that blended learning is as effective as other teaching methods.

Anatomy meets dentistry! Linking anatomy and clinical practice in the preclinical dental curriculum.

BACKGROUND: Establishing a strong link early on between preclinical coursework and the clinical context is necessary for students to be able to recognize the practical relevance of the curriculum during their preclinical anatomical courses and to transfer knowledge more easily. Our objective was to enhance the clinical relevance of a preclinical anatomy course for second-year medical students of dentistry by implementing an interdisciplinary skills training course on "Palpation of the Head and Neck Muscles" and to measure the learning outcomes. METHODS: For the curricular development of the expanded course module, Kern's 6-step approach was applied including subjective evaluation. We used a peer-teaching format supported by an e-learning application. A randomized control study measured effects of the two components (skills training, e-module) on learning outcomes. Four learning methods were compared: (1) lecture, (2) lecture + e-module, (3) lecture + skills training, (4) lecture + skills training + e-module. An objective structured clinical examination (OSCE) was used to measure and compare learning outcomes. RESULTS: The two-way variance analysis demonstrated that participation in the skills training had a statistically significant effect on the OSCE results (p = 0.0007). Students who participated in the skills training did better (φ 107.4 ± 14.4 points) than students who only attended the lecture (φ 88.8 ± 26.2 points). Students who used the e-module but did not attend the skills training earned a slightly but not significantly higher average number of points (φ 91.8 ± 31.3 points) than those who only attended the lecture. The learning outcomes of the skills training were again significantly increased when the training was combined with the e-module (φ 121.8 ± 21.8 points), thus making it the ideal method for achieving the learning objectives defined in this study. CONCLUSIONS: The "Palpation of the Head and Neck Muscles" interdisciplinary skills training course linking basic anatomical knowledge and clinical skills led to clearly improved learning outcomes for both, anatomical knowledge and clinical skills. The additional use of an e-learning tool (e-module) improved the learning effect.

Three-unit CAD/CAM-generated lithium disilicate FDPs after a mean observation time of 46 months.

OBJECTIVES: Lithium disilicate can easily be machined by CAM techniques in its metasilicate status. Due to slightly inferior material properties, the material is not yet recommended for three-unit fixed dental prosthesis (FDP) as it is the case for the press material up to the second bicuspid. Therefore, the aim of this clinical study was to evaluate the performance of CAD/CAM-fabricated lithium disilicate FDPs. MATERIALS AND METHODS: A total of 32 anterior and posterior FDPs were provided for 32 patients. Twelve FDPs were fabricated chair-side. The first recall took place 6 months after insertion and then annually. The FDPs were rated according to biological and technical complications. As failure, those events were defined, which led to the removal of a FDP. The failure-free (survival) rate and the complication-free rate were calculated according to Kaplan-Meier. RESULTS: After a mean observation time of 46 months (SD ± 8.4 months), three endodontic complications in two FDPs, two minor chippings, and one catastrophic fracture occurred. One FDP had to be removed due to persisting undefined complaints. Thus, the failure-free rate and the complication-free rate were revealed as 93 and 83 %, respectively. CONCLUSIONS: Despite the limited observation period, the results are promising, especially due to the fact that the fractured FDP did not fulfill the recommended connector dimensions. CLINICAL RELEVANCE: Inserted as a full-contour three-unit FDP within its indications, the CAD/CAM lithium disilicate ceramic offers an appropriate alternative to layered restorations.

Clinical results of lithium-disilicate crowns after up to 9 years of service.

OBJECTIVES: The purpose of this prospective study was to evaluate the clinical outcome of anterior and posterior crowns made of a lithium-disilicate glass-ceramic framework material (IPS e.max Press, Ivoclar Vivadent). MATERIALS AND METHODS: A total of 104 single crowns were placed in 41 patients (mean age, 34 ± 9.6 years; 15 male, 26 female). Eighty-two anterior and 22 posterior crowns were inserted. All teeth received a 1-mm-wide chamfer or rounded shoulder preparation with an occlusal/incisal reduction of 1.5-2.0 mm. The minimum framework thickness was 0.8 mm. Frameworks were laminated by a prototype of a veneering material combined with an experimental glaze. Considering the individual abutment preconditions, the examined crowns were either adhesively luted (69.2 %) or inserted with glass-ionomer cement (30.8 %). Follow-up appointments were performed 6 months after insertion, then annually. Replacement of a restoration was defined as failure. RESULTS: Four patients (10 crowns) were defined as dropouts. For the remaining 94 crowns, the mean observation time was 79.5 months (range, 34-109.7 months). The cumulative survival rate according to Kaplan-Meier was 97.4 % after 5 years and 94.8 % after 8 years. Applying log rank test, it was shown that the location of the crown did not significantly have an impact on the survival rate (p = 0.74) and that the cementation mode did not significantly influence the occurrence of complications (p = 0.17). CONCLUSIONS: The application of lithium-disilicate framework material for single crowns seems to be a reliable treatment option. CLINICAL RELEVANCE: Crowns made of a lithium-disilicate framework material can be used clinically in the anterior and posterior region irrespective of an adhesive or conventional cementation when considering abutment preconditions.