Influence of dental education on adoption and integration of technological aids in the delivery of endodontic care by dental practitioners: a survey.

OBJECTIVE: To investigate adoption and integration of technological aids during endodontic treatment and where dental practitioners (DPs) learnt to use this technology. MATERIALS AND METHODS: An electronic questionnaire was distributed to all 459 dentists who graduated from University of Bergen between 2008 and 2018. The respondents were divided into two cohorts, older graduates (2008-2013) and newer graduates(2014-2018). RESULTS: A total of 314(68.4%) DPs answered the questionnaire. Magnification in the form of dental operating microscopes (DOM) and dental loupes was used by 180 (59.6%), electronic apex locators (EAL) by 271(89.7%) and motor-driven files by 281 (93.4%) DPs. The most frequent response, as to where they learnt to use them was: during undergraduate dental (UG) education. Significantly more newer graduates (90.7%) performed instrumentation based on what they learnt during UG education (p < .001). Older graduates based their instrumentation method equally on what they learnt during UG education (51.9%) and continuing dental education(42.6%). Rubber dam was used during all treatment procedures by 93% of the DPs. CONCLUSIONS: UG education is a communication channel with long-lasting importance for adoption and integration of technology by DPs. Exposure to innovations (awareness) during UG education is adequate for integration of technology. Continuing dental education is as valuable as UG education for adoption of technology for older graduates.

Radiological evaluation of single implants in maxillary anterior sites with special emphasis on their relation to adjacent teeth: a 3-year follow-up study.

AIM: The aim of this study was to measure, in adults, changes in crest bone level around single dental implants in the anterior maxilla and continuous eruption of adjacent teeth. MATERIAL AND METHODS: In this prospective study, 50 patients received single-implant-supported crowns in the maxillary anterior region. Enrolled patients lacked maxillary anterior teeth as a sequel to trauma or agenesis in the maxillary anterior region. Participants were followed during a 3-year period. Baseline radiographs were taken at the time of loading and then repeated at one- and 3-year recalls. Radiographic parameters were recorded to assess changes in the skeletal bone structure and crest bone level. RESULTS: Twenty-six patients attended for all recalls. Three patients were excluded owing to difficulties related to identifying the same radiographic landmark on the radiographs throughout the recall period. All implants were successfully integrated with no sign of peri-implantitis. The mean crest bone loss was 0.45 mm at the mesial aspect of the implant and 0.56 mm at the distal aspect. In smokers, there was significant bone loss on the distal aspect. Mean change between reference points on implant and adjacent tooth (continuous eruption of adjacent tooth) over the 3-year period was 0.67 mm. In women, mean change (0.79 mm) was statistically insignificantly higher, compared with men (0.59 mm). CONCLUSIONS: Radiographic evaluation of crest bone level showed slight bone loss after 3 years of functional loading. Some changes in the eruption of neighbouring teeth were seen. Being a smoker was associated with significant negative changes related to the crest bone level.

Aesthetics of implant-supported single anterior maxillary crowns evaluated by objective indices and participants' perceptions.

AIM: The objective of this study was to evaluate the aesthetics of implant-supported single crowns in the anterior maxilla using objective indices and patients' perception. METHODS: Fifty participants, former patients (mean age 31.3 years) at the Dental Hospital, University of Bergen, or at Haukeland University Hospital in Bergen, Norway, who had implant-supported single crowns replacing upper anterior teeth lost due to trauma or agenesis during 2006, were included. One year after placement of the crown, an evaluation was carried out using the Pink Aesthetic Score (PES), the Implant Crown Aesthetics Index (ICAI), a modified version of the ICAI (mod-ICAI), and the index of the Californian Dental Association (CDA). The participants rated their satisfaction with the crowns and adjacent soft tissue. RESULTS: The form of the crown was satisfactory for 88% and the colour for 84% of participants, while 72% were satisfied with the adjacent mucosa. A statistically significant bivariate correlation was found between the PES and the ICAI and mod-ICAI. A weaker association was found between the CDA and the ICAI, mod-ICAI and PES. A positive correlation was found between the mod-ICAI index and satisfaction with the form and colour of the crowns and with the sum of ratings of responses to the questions about the form and colour of the crowns and the form and colour of the adjacent mucosa (P<0.05). Although most participants were satisfied, objective evaluation showed that a good aesthetic outcome for single implants was related to the quantity of the peri-implant mucosa. CONCLUSION: The mod-ICAI index correlated with responses to questions about the form and colour of the mucosa. Other significant correlations were found between the participants' aesthetic perceptions and the ICAI and the mod-ICAI. The mod-ICAI combined best objective and subjective assessment of aesthetics related to implant-supported crowns.

Dental auto-transplantation to anterior maxillary sites.

AIM: To investigate the indications for, and the outcome of auto-transplantation of teeth to the anterior maxillary region. MATERIAL AND METHODS: From 1978 to 1994, 41 teeth in 31 subjects were transplanted to anterior maxillary sites at the Department of Oral Surgery, Stavanger University Hospital, Norway. All transplantations were performed by one oral surgeon (B.G.). Relevant information was collected from patients' files, including radiographs of the tooth graft, the recipient site and follow-up radiographs. RESULTS: The mean observation period was 55.1 months (range 1-158 months). The age of the patients at the time of the auto-transplantation ranged from 10 to 30 years (mean 14.8 year). The most common indications for auto-transplantation were aplasia (41.5%), sequelae of trauma (36.6%) and impacted or ectopic teeth (17.1%). Eight teeth were judged to be failures; five had been extracted because of severe root resorptions and periodontal infection and three were judged as failures owing to severe ongoing root resorption but remained in the alveolus. CONCLUSION: Trauma is as common indication as aplasia for transplantation. From a biological point of view, dental auto-transplantation to the anterior maxillary region has a high success rate. Hence, auto-transplantation is an important treatment option for missing or lost maxillary anterior teeth where preservation of the alveolar bone is important during growth and development in adolescents. The major reason for failure was various types of root resorptions, some of which were detected late.