The teaching of fixed partial dentures in undergraduate dental schools in Ireland and the United Kingdom.

All areas of the practice of dentistry are evolving at a considerable pace. One area in particular which has seen a rapid revolution is the oral rehabilitation of partially dentate adults. The aim of this study was to describe the contemporary teaching of fixed partial dentures (FPDs) in dental schools in Ireland and the United Kingdom. An online questionnaire which sought information in relation to the current teaching of FPDs was developed and distributed to 15 Irish and UK dental schools with undergraduate teaching programmes in Spring 2009. Responses were received from 12 schools (response rate=80%). All schools offer teaching programmes in relation to FPDs. The number of hours devoted to pre-clinical/phantom head teaching of FPDs ranged from 3 to 42h (mean: 16h). The staff/student ratio for pre-clinical teaching courses in FPDs ranged from 1:6 to 1:18 (mode: 1:12). Cantilever resin-retained FPDs were the most popular type of FPD provided clinically (average=0·83 per school; range=1-2). Five schools (42%) report that they have requirements (e.g. targets, quotas, competencies) which students must complete prior to graduation in relation to FPDs. Fixed partial dentures form an important part of the undergraduate teaching programme in UK and Irish dental schools. While this teaching is subjected to contemporary pressures such as lack of curriculum time and a lack of available clinical facilities and teachers, there is evidence that teaching programmes in this area are evolving and are sensitive to current clinical practice trends and evidence-based practice.

Crown and bridge disassembly--when, why and how.

Crown and bridgework has a finite life span and fails for a number of reasons. Removal is often by destructive means. There are a number of clinical circumstances, however, in which a conservative disassembly would aid the practitioner in completing restorative/endodontic procedures. The aims of this paper are to provide a classification for crown and bridge removal systems; describe how a number of such systems work; and when and why they might be considered.

The teaching of implant dentistry in undergraduate dental schools in the United Kingdom and Ireland.

OBJECTIVES: The objective of this paper is to describe the contemporary teaching of dental implantology to dental undergraduates in the United Kingdom and Ireland. The paper also aims to assess the attitudes of dental school educators in relation to future trends in dental implant training for dental undergraduates. METHODS: An online questionnaire relating to current and future possible trends in dental implantology education was developed and distributed to Heads of Division/Departments of Restorative Dentistry, or equivalent, in each of the 15 dental schools with undergraduate dental programmes in the United Kingdom and Ireland. The questionnaire included both 'open' and 'closed' style questions. RESULTS: All 15 dental schools invited to participate in this survey responded. Of the 15 schools, two do not provide any training for their undergraduate dental students in relation to implant dentistry. The teaching is mainly delivered in lecture-based or phantom head room settings (eight of the 13 implant-teaching schools). Only four schools allow their students to interact clinically with implant patients. All schools anticipate an increase in dental implant teaching in the next five years, however, there is much variation in the scope and nature of this increase. CONCLUSIONS: The teaching of dental implants in the UK and Ireland has increased since the time of previous surveys. It would seem prudent for this theme of teaching to further increase in order to best prepare graduating students for independent clinical practice.

An in vitro study on the use of circumferential matrix bands in the placement of Class II amalgam restorations.

OBJECTIVE: To compare the effectiveness of a disposable metal matrix band system and the Siqveland matrix system in the restoration of a Class II preparation with amalgam. To assess the difference in amalgam overhang produced between the two systems in vitro. METHODS: A right maxillary first premolar with a Class II cavity preparation was duplicated in acrylic to produce a standardized cavity. Forty acrylic teeth were individually mounted in a hand-held model of an upper right quadrant and restored with amalgam by twenty dentists. Each dentist restored two replica teeth with amalgam; one using the Omni-matrix system and the other using the Siqveland matrix system. All 40 restored teeth were individually mounted on a standardised jig, viewed under a microscope, photographed and overhangs, if present, measured using Image ProPlus 4.0. A comparison of the overhangs produced by the two systems was analysed using a paired sample t-test. RESULTS: An overhang was present in all cases. There was a significant difference in the size of the overhangs produced by the two different matrix systems (p-value 0.036). The Siqveland produced a larger overhang than the Omni-matrix system. CONCLUSION: A commonly used matrix band (Siqveland), when compared to a newer, disposable system (Omni-matrix), was found to result in consistently larger overhangs during the restoration of class II preparations with amalgam. As Omni-matrix is a disposable system, the potential for cross-contamination is removed and it can, therefore, be considered a suitable replacement for the non-disposable Siqveland matrix system.

Attitudes of general dental practitioners in the UK to the use of composite materials in posterior teeth.

OBJECTIVE: To determine the opinions and current methods used in placing posterior composite restorations by general dental practitioners. SETTING: The study was completed by general dental practitioners randomly selected from across the UK. METHOD: A questionnaire was devised to gain this information. It was sent to 500 UK dentists chosen at random from the general dental register, with an explanatory letter and reply-paid envelope. RESULTS: Two hundred and sixty-seven replies were received. Sixty-one percent of dentists felt amalgam use had decreased over the last five years, 75% felt posterior composite use had increased. Regarding choice of posterior material, almost all cited clinical indication as the most influential factor while patient's aesthetic demands (89%),wish for a certain material (78%) and the dentist's confidence using a certain restorative material (76%) were contributing factors. Regarding the techniques used, contemporary techniques were employed although there was confusion regarding the need for rubber dam and the most appropriate method of lining the cavity. A case scenario of a pregnant patient who required treatment found that 66% of respondents would place a restoration other than a temporary dressing, with 16% placing an amalgam restoration. CONCLUSIONS: The majority of dentists surveyed place load bearing posterior composite restorations regularly. Their choice of restorative material is influenced by clinical indications and the patient's aesthetic demands. The techniques used were appropriate, although there was confusion around the need for rubber dam and the most appropriate method to line the cavity. There was also confusion in relation to the most appropriate materials for use in pregnancy.

Clindamycin and dentistry.

Clindamycin is an antimicrobial agent that dentists use in the UK for infective endocarditis prophylaxis but rarely for other clinical situations that require antimicrobial intervention. This has been largely due to its association with acute pseudomembranous colitis. Up to date information on the efficacy and safety of this antimicrobial agent should be known before prescription.

Does your practice website need updating?

The internet is becoming a more and more powerful tool and many dental practitioners use it to advertise their dental service; some dental practices even offer on-line appointment booking! It is not unreasonable to surmise that use of the internet is likely to become increasingly common practice by dentists in the future. This is not surprising as the World Wide Web (WWW) provides an opportunity for dentists to advertise themselves and their practices to a wide audience in a relatively economical manner.

Azithromycin and dentistry - a useful agent?

OBJECTIVES: Azithromycin has recently replaced clindamycin oral suspension for prop hylaxis of infective endocarditis (IE) in children. It is also currently recommended by the American Heart Association as an alternative to penicillin, along with clindamycin for prophylaxis of infective endocarditis in adults. The objectives of this paper were to firstly, review the current literature on the efficacy of azithromycin as a suitable prophylactic agent in the prevention of infective endocarditis; and secondly, to review its pharmacological properties as a suitable therapeutic agent in the management of odontogenic infections. DESIGN: A review of the literature. CONCLUSIONS: The available evidence from animal models on infective endocarditis supports the efficacy of this drug as a prophylactic agent against oral streptococci. The pharmacological properties of this agent would make it a very promising therapeutic adjunct in the management of odontogenic infections. At present there are only a small number of studies available with valuable data on the efficacy of this relatively new drug. Further investigations comparing this compound with other commonly used adjuncts would be of great benefit.

Associated postmortem dental findings as an aid to personal identification.

The use of the unique features of the human dentition to aid in personal identification is well accepted within the forensic field. Indeed, despite advances in DNA and other identification methodologies, comparative dental identifications still play a major role in identifying the victims of violence, disaster or other misfortune. The classic comparative dental identification employs the use of postmortem and antemortem dental records (principally written notes and radiographs) to determine similarities and exclude discrepancies. In many cases the tentative identification of the individual is unknown and therefore antemortem records cannot be located. In such a situation a dental profile of the individual is developed to aid the search for the individual's identity. With such a profile a forensic odontologist can identify and report indicators for age at time of death, race (within the four major ethnic groups) and sex. In addition to these parameters the forensic dentist may be able to give more insight into the individual. This paper outlines, for the non-expert, some of the additional personal information that can be derived from the teeth of the deceased, and which may assist in their ultimate identification.