Advanced Prosthodontic Education Research Articles

Survey of Advanced Education in Prosthodontics Directors and Residents on Practices in Esthetic Dentistry

The aim of this study was to determine the difference between the intended education by advanced education in prosthodontics (AEP) program directors and the perceived education received by AEP residents with respect to concepts of esthetic dentistry. Residents' confidence levels and current practices were also determined based on program level, with first- and second-year residents combined into "junior residents" and third- and fourth-year residents combined into "senior residents." Surveys were distributed to all U.S. and Canadian AEP program directors (N=52) in 2014 and residents (N=393) in 2015. The seven questions asked of directors and 20 asked of residents assessed resident training. The response rate for directors was 59.6% and for residents was 27.3%. Statistically significant results were found between the responding program directors' perceived education on esthetic principles and the responding residents' perceived education. The senior-level residents were more confident in each of the categories than residents at the junior level, although the difference was only significant for selecting porcelain systems to match inherent translucency, transfer of information to the laboratory, and surface staining or characterization. There was a difference between the program directors' intended teaching and the residents' perceptions with regards to bleaching, shade matching, selection of porcelain systems, transfer of information to the laboratory, and surface staining or characterization. The residents' confidence levels were higher at the senior level than those at the junior level in selecting porcelain systems, transfer of information to the laboratory, and staining/characterization. Faculty members in advanced prosthodontics programs may be able to use these findings to improve their residents' education in these areas.

A 10‐Year Survey of US Deans: Trends, Challenges, and Mentoring in Prosthodontics. Part 2

Part 2 of this survey reports on the 2009 survey findings distributed to the deans of US dental schools. A national, electronic survey of 58 dental school deans was distributed by e-mail to evaluate an interest in specialty training, an interest in specialty training in prosthodontics, faculty shortage issues, predoctoral curriculum in prosthodontics, ideology regarding dental specialties, and the administrative position of prosthodontics within the schools. The survey data were transferred to an online spreadsheet program for statistical analysis (Key Survey, Inc. http://www.keysurvey.com, Braintree, MA). The opinions of dental school deans were viewed as legitimate indicators of change within predoctoral and postdoctoral prosthodontic education. Statistical analysis was carried out using Statistica Version 9.1 (Statsoft, Tulsa, OK). Of the 58 deans, 42 deans responded, for a 72.4% response rate. Twenty-three deans reported an increase in the number of students seeking specialty training after dental school. Only three deans reported a decrease in those seeking specialty training. In the 2009 survey, 45% the deans responded that there was an increased interest in prosthodontics. One or more open faculty positions in prosthodontics existed at 24 (59%) of the dental schools, and 30 (71%) offered at least one incentive or a variety of incentives to recruit faculty. The 2009 respondents to the deans' survey revealed predoctoral student exposure to prosthodontists was high, and exposure to advanced education in prosthodontics students was low. A survey of internal school programs that might have an impact on an increased interest in prosthodontics revealed the presence of a predoctoral mentoring program for prosthodontics in 36 (88%) of the institutions. The clinical curriculum included treatment of a variety of cases including complex cases as defined by a diagnostic classification system. The 2009 survey respondents reported an increase in the number of schools where prosthodontics is a separate entity or department. Deans reported an increased interest in prosthodontics in the 2009 survey. Open faculty positions in prosthodontics existed in the majority of dental schools, and most schools offered incentives to recruit faculty. The survey of deans found a very high level of exposure of dental students to full-time prosthodontists and a very low exposure level to students enrolled in advanced education in prosthodontics. The establishment of mentoring programs in prosthodontics was reported by most deans, and the predoctoral curriculum included treating complex cases. Most deans stated that dual-specialty training in prosthodontics and periodontics would be beneficial. The 2009 survey reported an increase in the number of departments of prosthodontics in US schools.

Foreign-Trained Dentists in Advanced Education in Prosthodontics Programs in the United States: Demographics, Perspectives on Current Training, and Future Goals

This study investigated the perspectives of foreign-trained dentists (FTDs) in comparison with US-trained Dentists (USTDs) in Advanced Education in Prosthodontics (AEP) programs on their current clinical training and future goals. This study was conducted by analyzing data from previously published literature. When appropriate, Chi-square statistical analysis was conducted to determine the influence of where the AEP residents earned their DMD/DDS degree (FTDs/USTDs) on all variables. Only results that yielded significant differences were discussed. A majority of both FTDs and USTDs were male. Most USTDs were married, while most FTDs were single. Most FTDs were not US citizens and most originated from Asia, followed by the Middle East, South America, and Europe. Significantly more FTDs had higher ranks in their dental schools, had more advanced degrees, and spent more time practicing before entering the AEP programs. In selecting AEP programs, FTDs placed significantly higher values on a program's reputation and research opportunities. During their AEP training, FTDs paid significantly higher tuition and received lower stipends, but obtained more financial support from families. On the other hand, USTDs received significantly more financial aid and earned income from part-time work, but had significantly higher total educational debts. USTDs showed a significantly higher interest in becoming a student member of the American College of Prosthodontists and participated actively in prosthodontics organizations. USTDs were more interested in becoming maxillofacial prosthodontists, while FTDs were more interested in pursuing academic careers. FTDs differed from USTDs in several ways. Because of their interests in academics and research, FTDs may potentially have a positive impact on the development of the prosthodontics discipline. This information may be beneficial for AEP program directors in accommodating the needs of FTDs, and for FTDs in better preparing for their AEP training.

Advanced Education in Prosthodontics: Residents’ Perspectives on Their Current Training and Future Goals

The purposes of this study were to identify current prosthodontic residents' demographics and to document prosthodontic residents' perspectives on their clinical training and future goals. A 52-item survey was created and distributed to prosthodontic residents in the United States on February 8, 2007. The data collected were analyzed; the means and standard deviations were calculated and ranked. Statistical analysis was conducted using Chi-square and Mann-Whitney analysis (p = 0.05). A 43% response rate was achieved, representing approximately 48% of the total population of prosthodontic residents in the United States. The majority of residents ranked clinical education as the most important factor in selecting their programs, were satisfied with their training, and planned to pursue the certification of the American Board of Prosthodontics. When asked how often they planned to work, 4 days a week was the most common answer. This is the first report identifying current prosthodontic residents' demographics and their perspectives on their clinical training and future goals. Several trends were identified, indicating a bright future for the specialty. By knowing the students' perceptions regarding their training and future goals, the American College of Prosthodontists and/or program directors will be able to use this information to improve residency programs and the specialty.

P.253 Combination of segmental osteotomy & prosthodontic therapy

Guidelines for advanced education in prosthodontics describe specific competency levels. The complex nature of temporomandibular disorders (TMD) and oral facial pain requires a multidisciplinary team. However, the multifactorial nature of this malady places some aspects of this disease beyond the traditional education of a prosthodontist. The management goals for the prosthodontist as a member of a TMD team are patient comfort, occlusal stability, and/or the complex restoration of teeth.

A Survey of Deans: Trends, Challenges, and Mentoring in Prosthodontics. Part 2

This study consists of two parts. Part 1, a survey of program directors, was conducted to examine current trends in advanced education in prosthodontics in the United States. Part 2 reports on the findings of a survey distributed to the deans of US dental schools to evaluate their observations of trends in prosthodontic education. A national, electronic survey of 55 dental school deans was distributed by e-mail to evaluate an interest in specialty training, an interest in specialization in prosthodontics, faculty shortages, programs to address faculty shortages, predoctoral curriculum in prosthodontics, opinions regarding dental specialties, and the administrative position of prosthodontics within the schools. Of the 55 deans, 44 deans responded, an 80% response rate. Only five deans reported a decrease in the number of students seeking specialty training after dental school. The remaining 39 deans reported a large increase, slight increase, or no change in those seeking specialty training. In 29.6% of the deans' responses, an increased interest in prosthodontics was reported, whereas 16 deans reported no change in the level of interest. One or more open faculty positions in prosthodontics existed at 29 dental schools, and 28 schools offered at least one incentive or a variety of incentives to recruit faculty. The respondents to the deans' survey revealed predoctoral student exposure to prosthodontists was high, and exposure to postgraduate prosthodontics students was low. A survey of internal school programs that might have an impact on an increased interest in prosthodontics revealed the presence of a predoctoral mentoring program for prosthodontics in 80% of the institutions. The clinical curriculum included treatment of a variety of cases, including complex cases as defined by a diagnostic classification system. The response to whether dental specialties should be combined or remain individual provided some interesting data. Only 40.9% of the deans responded that prosthodontics was a separate department. Dental school deans reported an increased interest in specialty training. Predoctoral student exposure to prosthodontics was high due to the nature of their clinical experience and due to the exposure to full-time prosthodontics faculty. Many dental schools have programs, such as mentoring and new technology, which might have an impact on predoctoral students' increased interest in prosthodontics.

A Survey of Program Directors: Trends, Challenges, and Mentoring in Prosthodontics. Part 1

This study consisted of two parts. Part 1, a survey of program directors, was conducted to examine current trends in advanced education in prosthodontics in the United States. Part 2 will report on the survey results distributed to the deans of US dental schools to evaluate their observations of trends in prosthodontics. A national e-mail survey of 45 program directors was used to collect enrollment data for years 1 to 3 of prosthodontics training for US and international dental school graduates, the total number of applicants and applications considered, and the trends over time of applicants to prosthodontic programs for US dental school graduates and for international graduates. In addition, the program directors were asked to rank 13 key factors that may have contributed to any changes in the prosthodontic applicant pool. Comments were accepted on why more or less US- or internationally trained applicants have applied. Program directors were also asked for information on student financial incentives, whether their programs were state or federally funded, and whether their sponsoring institution was a dental school. Of the 45 program directors, 39 responded, for an 86.7% response rate. Respondents reported that 64% of their enrollments were graduates of US dental schools. Between 2000 and 2004 the applicant pool in prosthodontics increased by 23%, with 41% of program directors reporting an increase in US-trained applicants, 46.2% reporting no change, and only 12.8% reporting a decrease. Using the Spearman correlation, there was a moderate, positive statistically significant correlation that the following factors contributed to an increase in the number of US dental graduates applying to prosthodontic programs: (1) mentoring by prosthodontists at the predoctoral level, (2) interest in prosthodontics among US dental students, and (3) society's demand for a higher level of training and credentialing, (4) data depicting current and projected income for dental specialists, and (5) number of trained prosthodontists full- or part-time faculty at the predoctoral level. Only five programs offered no financial packages to offset tuition. The remaining 34 respondents reported some financial package. Among the respondents, there were 25 state-sponsored programs, 9 sponsored by private universities, and 5 sponsored by hospitals or federal agencies. An increased applicant pool and more US-trained applicants to prosthodontics programs create a more competitive applicant pool for our specialty. Program directors reported that factors such as mentoring, society's demand for a higher level of training and credentialing, data depicting current and projected income for prosthodontists, exposure to prosthodontic faculty at the predoctoral level, the dollar value of prosthodontic training, and advances in implant, aesthetic, and reconstructive dentistry have all had some impact on increasing the applicant pool to prosthodontic training in the United States.

Private practice and the economic rate of return for residency training as a prosthodontist

The authors used survey data to estimate the economic rate of return from undertaking an investment in residency training to become a practicing prosthodontist. The authors estimated earnings of practicing prosthodontists using results from a survey of 2500 U.S. prosthodontists. Survey data were used to assess the total costs of prosthodontic residency and earnings of practicing general practitioners. The authors applied statistical methods to estimate the internal rate of return (IRR) for prosthodontic residency training. The estimated IRR ranged from 8.23 percent for private practitioners with no financial assistance during residency training to 12.18 percent for full-time private practitioners with stipends and loans. Total costs of residency ranged from 271,835 dollars to 441,321 dollars, depending on the amount of forgone earnings, time in practice and how soon practice began after the residency. All of the estimates of IRR in this study were positive, indicating that prosthodontic residency is a financially attractive investment. The positive IRR for prosthodontic residency indicates that the demand for advanced education in prosthodontics will continue, and that the amount of time spent in practice increases the rate of return.

Prosthodontic management of temporomandibular disorders and orofacial pain

Guidelines for advanced education in prosthodontics describe specific competency levels. The complex nature of temporomandibular disorders (TMD) and oral facial pain requires a multidisciplinary team. However, the multifactorial nature of this malady places some aspects of this disease beyond the traditional education of a prosthodontist. The management goals for the prosthodontist as a member of a TMD team are patient comfort, occlusal stability, and/or the complex restoration of teeth.

The mandibular subperiosteal implant denture: A fourteen-year study

A n analysis of 74 of the 80 patients undergoing or having experienced mandibular subperiosteal implant denture (MSID) therapy at the University of Southern California, School of Dentistry was conducted to evaluate the 1Cyear follow-up results. The design and prosthodontic procedures used have been reported by Bodine et al’s2 and the initial report on the MSID was given at 5 years by Bodine et al3 The fabrication of the mandibular subperiosteal implant framework and superstructure attachment was performed by Buttress and Associates Laboratory of Los Angeles, California. All implant frameworks were cast by using Vitallium (Austenal Dental, Inc., Chicago, Ill.) alloy. The MSID therapy was administered by dentists receiving instruction in the Advanced Prosthodontic Education Program and the Oral and Maxillofacial Surgery Program at the University of Southern California. Recalls are performed at the sixth month after insertion of the MSID and annually thereafter for evaluation with treatment as needed for problems that are noted. As the study continues these problems deal with normal denture wear and various difficulties with the implant itself. This study evaluated the clinical manifestations of paresthesia, incision line separation, implant framework exposure, inflammation, and reaction to vertical force along the abutments. The responses were subjected to analysis by number of occurrences and frequency on an IBM 3081 computer system for each category, recall, and specific post.

Background information: Requirements for advanced specialty education programs in prosthodontics

The proposed revisions have been developed to address problems of fragmentation, inconsistency, and lack of balance in advanced prosthodontic education. Minimum didactic and clinical requirements for each subdiscipline are clearly indicated in the proposed “Requirements, ” and programs will no longer be directed to provide speical emphasis in one subdiscipline. It should be noted that the proposed “Requirements” do not prevent or preclude programs from emphasizing one subdiscipline. This option is left up to the sponsoring institutions. The proposed “Requirements, ” however, do underscore the fact that the primary responsibility of accredited prosthodontic programs is to provide students with the opportunity to achieve competence in the full scope of prosthodontic procedures.

Advanced prosthodontic education: A rationale for a curriculum which integrates fixed and removable prosthodontic education

E ducators in advanced prosthodontics have traditionally emphasized differing disciplines in achieving clinical competence for their students. However, there is general acceptance of the didactic requirements in the clinical and basic sciences related to prosthodontics. These have been described specifically by the ADA Council on Dental Education in its “Guidelines for Advanced Specialty Education Programs.“’

The making of a prosthodontist: Advanced prosthodontic education at the University of Southern California

F or a system of education to be successful, it must be appropriate to the needs of that civilization. A superb example is the era from 1860 to 1917 which has been termed the “creative” period in higher education-a period in which great progress was made because the development of new patterns and processes in education proceeded at the same pace as the civilization and was appropriate to the new social order. We, as educators, must be cognizant of today’s realities and tomorrow’s needs so that we may provide an enlightened and progressive environment for learning. If we become stagnant and teach the concept of “what was good enough for our fathers, is good enough for us,” we are holding back the clock. Prepaid health insurance programs are here, group practice is on the rise, the use of expanded-duties auxiliaries seems certain, and peer review and quality control committees are already functioning in some states. l Some educators believe that as a result of these changes, the dentist who engages in general practice will assume more of the responsibility that previously has been delegated to the specialist and, in the future, the number of dental specialists will decrease.2 We are all aware of the hazards of overspecialization. One needs only to be reminded of the overspecialized group of engineers who were involved in our space program in the 1960’s. Some of these people are today pumping gasoline or driving taxicabs. Still others are sitting unproductively on their front porches remembering “the good old days.” For prosthodontics to survive as a specialty, I believe that it should not be fragmented into areas such as fixed prosthodontics or removable prosthodontics. In 1969, the Federation of Prosthodontic Organizations3 published its “Guidelines for Advanced Prosthodontic Education.” It was stated that a program should include instruction in all branches of prosthodontics-complete and removable partial denture prosthodontics, fixed prosthodontics, and maxillofacial prosthodontics. The

Minimum clinical requirements for advanced education in prosthodontics

Minimum clinical requirements for advanced education in prosthodontics

Advanced education in prosthodontics—Curriculum content

Advanced education in prosthodontics—Curriculum content

Advanced prosthodontic education: Survey of graduate students

Advanced prosthodontic education: Survey of graduate students

Advanced prosthodontic education

Advanced prosthodontic education

Minimal clinical requirements for advanced prosthodontic education

Minimal clinical requirements for advanced prosthodontic education

Advanced prosthodontic education—1998

Advanced prosthodontic education—1998

Guidelines for advanced prosthodontic education—1969

Guidelines for advanced prosthodontic education—1969