Enhancing learning in an online oral epidemiology and statistics course.

Background: Students in the Faculty of Dentistry at the University of British Columbia have articulated challenges in understanding learning objectives in their oral epidemiology and statistics course. This study aimed to measure the impact of a course renewal intended to enhance student learning. Examples of educational interventions included providing more time for activities, increasing student interactivity, and integrating more hands-on applicable exercises using statistical software. Methods: An online mixed-methods survey using a 5-point Likert scale and open-ended questions was distributed to 43 dental hygiene students before the course renewal and again to a second cohort of 43 students after course revisions. The survey asked students to rank their levels of challenge and self-confidence in learning 23 of the course objectives throughout each academic year. Four semi-structured interviews were also conducted with faculty and staff members involved in teaching or coordinating this course to understand their experiences after the course revisions. Results: Response rates were 32% to 57%. After the course renewal, the extent to which students in the entry-to-practice cohort felt extremely challenged to learn each objective was significantly reduced (25% vs. 3%, p < 0.001), and students' self-confidence scores significantly increased (12% vs. 30%, p < 0.001).The changes on the challenge and confidence scores in the degree-completion cohort were not statistically significant (23% vs. 24% and 31% vs. 36%, respectively). Student satisfaction levels increased in all 6 categories measured. Conclusion: Providing students with more time to absorb their learning, increasing interactivity, offering timely feedback, and integrating applicable exercises using statistical software resulted in an enhanced learning environment.

Contexte: Les étudiants de la Faculté de dentisterie de l'Université de la Colombie-Britannique ont exprimé les difficultés à comprendre les objectifs d'apprentissage de leur cours d'épidémiologie et de statistiques buccodentaires. La présente étude vise à mesurer l'effet du renouvellement d'un cours afin d'améliorer l'apprentissage des étudiants. Les exemples d'interventions éducatives comprennent : accorder plus de temps aux activités, augmenter l'interactivité étudiante, et intégrer plus d'exercices pratiques, applicables au moyen de logiciels statistiques. Méthodologie: Un sondage en ligne, effectué au moyen d'une méthodologie mixte qui utilise l'échelle de Likert en 5 points et des questions ouvertes a été distribué à 43 étudiants en hygiène dentaire avant le renouvellement du cours et une fois de plus à une deuxième cohorte de 43 étudiants après les révisions du cours. Au sondage, les étudiants devaient classer leurs niveaux de difficulté et de confiance en soi relativement à l'apprentissage de 23 des objectifs de cours, tout au long de chaque année universitaire. Quatre entrevues semi-structurées ont aussi été menées auprès du corps professoral et des membres du personnel qui participent à l'apprentissage ou à la coordination de ce cours en vue de comprendre leurs expériences à la suite des révisions du cours. Résultats: Le taux de réponse était de 32 % à 57 %. Après le renouvellement du cours, la mesure dans laquelle les étudiants de la cohorte d'entrée en pratique ont éprouvé de la difficulté à apprendre chaque objectif a été réduite de manière significative (25 % par rapport à 3 %, p < 0,001), et les cotes de confiance en soi des étudiants ont augmenté de manière significative (12 % par rapport à 30 %, p < 0,001). Les changements de cotes de difficulté et de confiance en soi de la cohorte qui termine son diplôme n'étaient pas statistiquement significatifs (23 % par rapport à 24 % et 31 % par rapport à 36 %, respectivement). Les niveaux de satisfaction des étudiants ont augmenté dans les 6 catégories mesurées. Conclusion: Offrir plus de temps aux étudiants pour assimiler leur apprentissage, augmenter l'interactivité, offrir de la rétroaction ponctuelle, et intégrer des exercices applicables à l'aide de logiciels statistiques ont créé un meilleur environnement d'apprentissage.

Fit of tooth-supported zirconia single crowns-A systematic review of the literature.

PURPOSE: The purpose of this study is to systematically map all the factors that influence the fit and adaptation of zirconia crowns and/or copings. MATERIALS AND METHODS: The investigational strategy involved carrying out an electronic search between December 1, 2009 and September 1, 2019 through the Embase and Medline databases using Boolean operators to locate appropriate articles. RESULTS: A total of 637 articles were discovered after the removal of duplicates, and 46 of these were selected for evaluation. Further, a quality assessment was performed using GRADE evaluation criteria. CONCLUSIONS: Shoulder finish line preparations had slightly better marginal fit compared to chamfer finish lines. Crowns obtained from digital impressions had comparable to superior marginal adaptation compared to conventional impressions. Increasing cement space showed to improve zirconia crown adaptation. Cementation and veneering zirconia frameworks found to increase the marginal and internal gaps. Limited information is available on the effect of the alteration of sintering time/Temperature and/or sintering techniques on the adaptation of zirconia crowns. Most of the selected studies had a moderate quality assessment evaluation. Future studies could investigate the chair-side, ultra-fast sintering effect on the marginal gap of zirconia crowns.

Out of the loupe: The prevalence of coaxial misalignment of surgical loupes among dental professionals.

BACKGROUND: Surgical loupes have been increasingly popular among dental professionals for their visual and postural benefits. However, dental professionals will receive the full benefit of surgical loupes only if the loupes are adjusted fully to fit the individual needs of each clinician. In this study, the authors examine coaxial alignment of surgical loupes, a critical criterion for the proper adjustment of these optical systems. METHODS: The authors conducted an in-person survey by using a simple, quantitative visual tool to assess the coaxial alignment of surgical loupes among 97 dental professionals in British Columbia, Canada. RESULTS: Findings indicated that 82% of dental professionals surveyed experienced coaxial misalignment with their surgical loupes. Dental professionals wearing front-lens-mounted (flip-up) surgical loupes with full vertical adjustability, front-lens-mounted surgical loupes with limited vertical adjustability, and through-the-lens surgical loupes were equally likely to be practicing with coaxial misalignment of their surgical loupes. Front-lens-mounted surgical loupes with full vertical adjustability were the only type of surgical loupe that can be adjusted to achieve full coaxial alignment reliably (P < .05). CONCLUSIONS: There was a high prevalence of coaxial misalignment among dental professionals in this cohort. Not all surgical loupes on the market satisfy the criteria for optimal postural and visual support of clinicians. PRACTICAL IMPLICATIONS: The visual tool developed in this study enabled dental professionals to identify coaxial misalignment effectively and efficiently. Findings from this study will assist dental professionals in making informed decisions when choosing their magnification equipment and prompt surgical loupe manufacturers to develop more evidence-based products.

Clinical retrospective study of self-reported penicillin allergy on dental implant failures and infections.

OBJECTIVE: The aim of this retrospective study was to investigate whether self-reported allergy to penicillin may contribute to a higher rate of postsurgical infection and implant failure. METHOD AND MATERIALS: This retrospective, non-interventional, open cohort study reports on implant survival and infection complications of 5,576 implants placed in private practice by one periodontist, and includes 4,132 implants that were followed for at least 1 year. Logistic regression was applied to examine the relationship between self-reported allergy to penicillin and implant survival, while controlling for potential confounders such as smoking, implant site, bone augmentation, loading protocol, immediate implantation, and bone level at baseline. The cumulative survival rate (CSR) was calculated according to the life table method and the Cox proportional hazard model was fitted to data. RESULTS: Out of 5,106 implants placed in patients taking penicillin it was found that 0.8% failed, while 2.1% failed of the 470 implants placed for patients with self-reported allergy to penicillin (P = .002). Odds of failure for implants placed in penicillin-allergic patients were 3.1 times higher than in non-allergic patients. For immediate implant placement, penicillin-allergic patients had a failure rate 10-times higher than the non-allergic cohort. Timing of implant failure occurring within 6 months following implantation was 80% in the penicillin-allergic group versus 54% in the non-allergic group. From the 48 implant sites showing postoperative infection: penicillin-allergic patients had an infection rate of 3.4% (n = 16/470) versus 0.6% in the non-allergic group (n = 32/5,106) (P < .05). CONCLUSION: Self-reported penicillin allergy was associated with a higher rate of infection, and primarily affected early implant failure.

Survival and Success Rates of Dental Implants Placed Using Osteotome Sinus Floor Elevation Without Added Bone Grafting: A Retrospective Study with a Follow-up of up to 10 Years.

This retrospective study with a follow-up period of 4 months to 10 years evaluated survival, success, and complication rates of implants placed using osteotome sinus floor elevation (OSFE) without added bone grafting. A total of 926 implants were placed, including 530 short implants (6 mm to 8.5 mm) and 209 implants in low residual bone height (RBH) (< 5 mm). Bone levels were evaluated at approximately 3 months and at 1, 3, and 5 years, and in some cases up to 10 years after implants were placed. The implant survival rate was 98.3% at the 5-year follow-up. Twelve of the 926 implants failed (6 preprosthetic, 6 postprosthetic). The success rate was 95.4% at a threshold of less than 1 mm of bone loss for combined systems (Straumann; Nobel Biocare). Short implant survival and success rates were statistically comparable to conventional-length implants. Low-RBH implants had a lower but acceptable survival rate of 95.7%. Adverse events were rare, with one case of infection and zero cases of vertigo reported. The findings of this study indicate that implant placement with OSFE without added bone graft is highly successful, even when short implants are used in low RBH.

The economics of dentistry: a neglected concern.

BACKGROUND: Demand for economic evaluations in health care is growing with expectations that they will help to develop regional and national policies on health and social programmes. We present here the scope, quality and content of systematic reviews and meta-analyses relating to the economics of dentistry published over the last 15 years. OBJECTIVES: To review the quality and outcome of systematic reviews and meta-analyses relating to the economics of dental treatments, preventions and services. METHODS: A systematic search was conducted in 14 electronic databases for systematic reviews and meta-analyses published between January 1997 and July 2011 on the economics of oral disorders and oral health care. Review papers were extracted by two independent investigators to identify the characteristics, results and quality of the reviews and to highlight gaps in knowledge about the economics of dentistry. RESULTS: From 3150 unique references, we found 73 systematic reviews or meta-analyses of dental economics as primary or secondary outcomes. The focus of 12 of them was on the cost or cost-effectiveness of dental prevention, 54 on treatment, five on prevention and treatment and two on delivery of dental services. However, only 12 of the systematic reviews drew conclusions from economic data, and four of them constructed an economic model from synthesized data. Overall, the quality was good in the 12 systematic reviews but poor in the original studies. CONCLUSIONS: There is very little helpful data published on the economics of dentistry.

Four-year incidence of sick leave because of neck and shoulder pain and its association with work and lifestyle.

STUDY DESIGN: Four-year prospective cohort study. OBJECTIVE: To find the incidence of sick leave because of neck and shoulder pain (NSP) in industrial workers, and its association with work and lifestyle risk factors. SUMMARY OF BACKGROUND DATA: Longitudinal studies to investigate NSP incidence and risk factors are rare, and even fewer have been conducted in middle- and low-income countries. METHODS: After inviting all full-time employees of an Iranian car manufacturing company with 18,031 employees to participate in a baseline study, they were followed for 4 years. New episodes of sick leave because of NSP have been calculated based on sickness absence registration between the years 2003 and 2007. The incidence was compared for participants and nonparticipants. The association between sick leave, physical, and psychosocial risk factors at work, and previous self-reported NSP, was calculated for the remaining population of baseline participants (12,184 employees) during a 4-year follow-up. RESULTS: During a 4-year follow-up of study subjects for the remaining participants of the baseline study, the incidence of sick leave was 0.8% (98 sick leave cases in 12,184 employees). For nonparticipants this incidence was 4.2% (130 cases in 3127 employees). In the final regression model for sick leave cases, the remaining factors for potential physical risk factors were repetitive work and sitting positions at work; for psychosocial factors unattractive work was the only significant remaining factor. CONCLUSION: The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.

Occupational neck and shoulder pain among automobile manufacturing workers in Iran.

BACKGROUND: Work-related musculoskeletal disorders (MSDs) of the upper extremities are a major problem globally, though most relevant studies have been reported from high income countries. AIMS AND METHODS: The prevalence of neck and shoulder pain and its association with work-related physical and psychosocial factors and life style was determined by a cross-sectional survey using the Nordic Musculoskeletal Questionnaire (NMQ) in the largest Iranian car manufacturing company, with more than 18,000 employees. RESULTS: A total of 14,384 (79.8%) of all employees completed the questionnaire. Depending on the questions used to measure neck and shoulder symptoms, the prevalence varied widely (from 20.5% to 3.9%). In the multiple logistic regression model, limited to employees with at least 1 year of work experience, risk indicators for disabling pain of the neck and/or shoulder that remained for male were: duration of employment, high visual demands, repetitive work, sitting position at work, awkward working position, no regular exercise, monotonous work, lack of encouraging organizational culture, and anxiety concerning change. For female repetitive work, sitting position at work and no support if there is trouble at work were the only remaining factors. CONCLUSIONS: The study confirms the effects of physical and psychosocial factors on neck and shoulder symptoms among automobile manufacturing workers in a low to middle income country in spite of the relative youth and job insecurity of the population.

Reliability and validity study of Persian modified version of MUSIC (musculoskeletal intervention center) - Norrtalje questionnaire.

BACKGROUND: Musculoskeletal disorders (MSDs) are a major health problem in the world. Self-reported questionnaires are a known method for estimating the prevalence of MSDs among the population. One of the studies concerning MSDs and their relation to work-related physical and psychosocial factors, as well as non-work-related factors, is the MUSIC-Norrtalje study in Sweden. In this study, the research group developed a questionnaire, which has been validated during its development process and is now considered a well-known instrument. The aim of this study is to validate the Persian version of this questionnaire. METHODS: The first step was to establish two expert panel groups in Iran and Sweden. The Focus Group Discussion (FGD) method was used to detect questionnaire face and content validity. To detect questionnaire reliability, we used the test-retest method. RESULTS: Except for two items, all other questions that respondents had problems with in the focus group (20 of 297), had unclear translations; the ambiguity was related to the stem of the questions and the predicted answers were clear for the participants. The concepts of 'household/spare time' and 'physical activity in the workplace' were not understood by the participants of FGD; this has been solved by adding further descriptions to these phrases in the translation. In the test-retest study, the reliability coefficient was relatively high in most items (only 5 items out of 297 had an ICC or kappa below 0.7). CONCLUSION: The findings from the present study provide evidence that the Persian version of the MUSIC questionnaire is a reliable and valid instrument.

Accidental exposure to blood in medical interns of Tehran University of Medical Sciences.

Healthcare workers and medical students are at risk of exposure to blood-borne viruses such as HBV, HCV HIV, etc. Here we report the results of a survey of the frequency and causes of cutaneous blood exposure accidents (CBEA) among medical students. Anonymous questionnaires were randomly distributed to 200 interns in their second year of internship in hospitals affiliated to Tehran University of Medical Sciences. A definite exposure was defined as injury by a sharp object causing obvious bleeding, whereas a possible exposure was defined as subtle or superficial injury due to contact with a contaminated instrument or needle but without bleeding, or contamination of an existing wound with blood or other body fluids. One hundred eighty-four subjects (92% of the original sample) responded to the questionnaire. We recorded 121 definite exposures and 259 possible exposures over a mean time interval of 14 months. Needles were the most common objects (41% of exposure episodes) causing CBEAs, while phlebotomy and suturing were the hospital procedures that accounted for the highest percentage of exposure episodes (30 and 28 percent, respectively). Only a minority of students regularly observed basic safety measures (wearing gloves, not recapping used needles and proper disposal of sharp objects). Considering the high incidence of blood exposure in medical interns at Tehran University of Medical Sciences and the ensuing risk of blood-borne infections, the subjects are likely to develop such infections during their internship period.

Do traditional techniques produce better conventional complete dentures than simplified techniques?

OBJECTIVES: To compare the quality of conventional complete dentures fabricated with two different techniques. A randomized controlled clinical trial was conducted to compare traditional (T) and simplified (S) methods of making complete conventional dentures on patients' ratings of satisfaction, comfort and function at 3 and 6 months following delivery. The quality of the prostheses was rated by prosthodontists at 6 months. MATERIALS AND METHODS: One hundred twenty-two male and female edentulous individuals, aged 45-75 years, were randomly allocated into groups that received dentures made with either T or S methods. Following delivery, patients' ratings of several denture-related factors were measured using 100mm visual analogue scales, and denture quality was assessed by blinded prosthodontists using ratings on a validated quantitative scale. RESULTS: There were no significant differences between the two groups in patient ratings for overall satisfaction (3 months: mean T = 83 mm, mean S = 83 mm, P = 0.97; 6 months: mean T = 79 mm, mean S = 79 mm, P = 0.96) or in prosthodontists' ratings of denture quality (T = 66, S = 63; P = 0.38). CONCLUSION: These results show that the quality of complete dentures does not suffer when manufacturing techniques are simplified to save time and materials. Dental educators should consider these findings when re-designing prosthodontic training programs.