Preclinical Prosthodontics Research Articles

Introduction and Effectiveness of Early Clinical Exposure Among Dental Students in Pre-clinical Prosthodontics.

Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students.Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.

Objective quantitative digital evaluation of crown preparation using intraoral optical scanner: Novel preclinical teaching method.

Adequate preclinical training in dentistry is crucial for students before engaging in patient treatment. Constructive feedback from the instructors plays a pivotal role in guiding the students to master skills, boost confidence, and above all ensure patient safety. This manuscript introduces a new method employing intraoral scanners as digital tools to provide objective and quantitative feedback for crown preparation evaluation in preclinical prosthodontics. Initial reference scan before preparation on typodont and preparation scan after crown preparation was obtained. Utilizing the patient monitoring feature in Trios 3 scanner (3Shape, Copenhagen, Denmark) superimposition of two scans was performed. The method enabled a comprehensive quantitative preparation assessment compared to the tooth pre-preparation. This includes tooth reduction in any axis, abutment height measurement, evaluation of the status of adjacent teeth after preparation, and proposed capability for estimating the convergence angle. The method enabled a subjective quantitative evaluation of crown preparation in phantom model. This method requires no additional hardware or software beyond the basic functions embedded in the intraoral scanner. Implementation of this function not only facilitates feedback and self-evaluation for students during preclinical teaching but also enhances their proficiency in using intraoral scanners in clinical practice in perspective. Key words:Dental education, prosthodontics, intraoral scanner, feedback, self-assessment.

Assessment and evaluation of a serious game for teaching factual knowledge in dental education

ObjectivesA serious game application was developed to train factual knowledge and for self-assessment. The aim of the present study was to compare the effects of a game application (intervention group) or paper scripts (control group) on knowledge acquisition and to evaluate the acceptance of the new application among dental students.MethodsThe 4th semester students of the second preclinical prosthodontics course were randomly assigned to one of the two groups (n = 58/51) for two consecutive years. The study was conducted in two phases: First, all participants took a pretest, with the intervention group using the game application and the control group receiving the same set of questions in a paper script. In the second phase, all participants took a post-test. After the post-test, both groups had access to the application for another three weeks. After that, all participants completed standardized questionnaires and a scale to evaluate the usability of the system. Usage statistics were also tracked. Differences between groups were evaluated together and for both years separately in terms of pretest and posttest scores and learning success.ResultsThere was no significant difference between the groups with regard to the posttest and learning success. A significant improvement in knowledge between pretest and posttest (p < 0.05) was demonstrated in both groups. Each student played approximately 350 questions. Participants rated the application with the German school grade "good". Participants appreciated the application and rated it positively. They stated that the game motivated them to learn and that they spent more time with the learning content.ConclusionDue to the positive perception achieved through the game, this application is able to motivate students to learn. The learning effect achieved is similar to learning on paper.

Experience of the Students after Transition from Preclinical Fixed Prosthodontic Training to Clinical Phase Survey

Introduction: Accurate preclinical prosthodontics training is a part of curriculum monitored so that the preclinical students perform the operation with much attention and care enabling the educators to improve the preclinical training. The aim of the study is to assess the students’ preclinical knowledge and skills of fixed prosthodontic training after transition to clinical training. Materials and Methods: A questionnaire survey is conducted among the students involved in clinical practice of the fixed partial dentures. Results: All 100% of the students were aware of the importance of the abutment evaluation before tooth preparation. Hundred percent of the students performed radiograph evaluation of the tooth and 47% of them expressed difficulty in correlating pulp size and position of the tooth radiographically. The majority of the students (84, 84%) thought that there is much difference in the tactile sense between natural teeth and typodont teeth. Pulp health preservation is vital for all restorative procedures; hence, this response from the students should be considered more carefully. More than half of the respondents, 74 students (74%), thought that clinical variation of tooth position is a difficult challenge during the transition stage. Tooth position variations such as supra-eruption, tilting, and drifting are common in the clinical situation which cannot be simulated in the preclinical training. However, most of the students feel that it was a formidable challenge in the initial stage of clinical training. Conclusion: Preclinical training is the most challenging for the educationist. Managing the transition for students from preclinical learning to providing patient care in the clinic is an important issue for oral health-care educators

Variability in Assessment of Preclinical Prosthodontics Work of Undergraduate Student

Background and objective. Clinical professions are often concerned not just on the knowledge acquisition, but achievement of skills and their application. Assessment tools employed in preclinical prosthodontic training vary widely, the two most common being used are the glance and grading method and the objective check list criteria, and any assessment procedure employed should be transparent in manner with both the staff and students informed of the purpose and the process adopted. This study was undertaken to examine whether introduction of an objective scoring criteria can improve the validity of scoring in assessment of preclinical prosthodontics (bite block) that done by students. Methods. The study evaluated 240 undergraduate students who were in second year of study at dental school Tripoli University, performing a bite block (trial denture base with wax rim) performed on ideal stone cast. The preclinical work (bite block) were evaluated and allotted marks by four blinded independent examiners using two methods of scoring, glance and grade method and objective checklist scoring method. Results. The data were parametric and met the normal distribution. Therefore, the scores were presented by mean and standard deviation. There was a significant difference (p value less than 0.005) between two scoring methods of preclinical prosthodontics work (glance and grade and objective checklist methods). Conclusion. This study concludes by recommending that preclinical prosthodontics work of students be assessed by objective checklist criteria scoring and it should be introduced after sufficient training and calibration sessions to induce examiner reliability.

Self-assessment and peer-assessment of the psychomotor skills in preclinical prosthodontics: A prospective study.

Students' self-assessment and peer assessments are essential to understand the rubrics criteria and improve their psychomotor skills. The purpose of this study was to assess the impact of self-assessment score (SAS), peer-assessment score (PAS) and teacher assessment score (TAS) on the final scores of the psychomotor skills of dental students in a preclinical fixed prosthodontics course. A prospective study included D2 students in a preclinical fixed prosthodontics course for two consecutive academic years from September 2017 to May 2019. Students' performance of various procedures over 14 sessions was assessed by SAS, PAS and TAS. Repeated-measures ANOVA was used to assess differences between the three scores and control charts showed their change over time. Multivariable linear regression was used to assess the association between two outcome variables: TAS and the total preclinical score and the explanatory variables: SAS, PAS, TAS, gender and GPA. The significance level was set at 5%. SAS had a significantly higher mean (80.21) than TAS (79.32) and PAS (78.58). SAS reached higher levels earlier than TAS and PAS. PAS had a stronger association with TAS than SAS (partial eta squared, η2=0.17 and 0.13), whereas SAS significantly predicted total preclinical score (p < .0001). PAS helped develop the skills of dental students during training, while SAS had an impact on their total preclinical score. Different student-centred activities are needed to support students' preclinical training in fixed prosthodontics courses.

Postgraduate student’s perception on preclinical prosthodontics curricula: A web-based survey

This study aimed to determine the current background of teaching pre-clinical prosthodontics for post graduate students. It describes the perception of post graduate students regarding the effectiveness of the preclinical prosthodontic curriculum in preparing them to operate efficiently in the clinical setting.: To assess student’s knowledge and perception of preclinical postgraduate prosthodontics course in different dental colleges of India.: The study sample was obtained from 148 postgraduate student, both male and female, an anonymous questionnaire consisting of 15 questions regarding knowledge, attitude and practice of the preclinical curriculum. This research was conducted after getting permission from the respective authority and consent from all respondents. Data acquired from structured questionnaires were analysed and compared by simple percentage method.After careful assessment and graphical representation of responses acquired from participants, results were formulated. Participants expressed through open ended and closed ended questionnaire that exercises conducted for complete denture prostheses and fixed partial denture prostheses were adequate and preclinical curriculum for implantology and maxillofacial prostheses needs to be streamlined.This paper has found that, while all schools make efforts to ensure that their postgraduate dental students are best prepared for subsequent independent practices, prosthodontic education varies among schools. Although some trends in curricular formats and content are evident. This survey indicated that active and passive learning for preclinical prosthodontics and frequent feedback from students plays a vital role.

Complete denture processing errors – A proposed classification system and its incidence in Preclinical Prosthodontics training of second year undergraduate dental students

Complete denture processing errors – A proposed classification system and its incidence in Preclinical Prosthodontics training of second year undergraduate dental students

Dental Students’ Perceptions of Digital Assessment Software for Preclinical Tooth Preparation Exercises

Objective self-assessment is essential to learning and continued competence in dentistry. A computer-assisted design/computer-assisted manufacturing (CAD/CAM) learning software (prepCheck, Sirona) allows students to objectively assess their performance in preclinical prosthodontics. The aim of this study was to evaluate students' perceptions of CAD/CAM learning software for preclinical prosthodontics exercises. In 2014, all third-year dental students at Harvard School of Dental Medicine (n=36) were individually instructed by a trained faculty member in using prepCheck. Each student completed a preclinical formative exercise (#18) and summative examination (#30) for ceramometal crown preparation and evaluated the preparation using five assessment tools (reduction, margin width, surface finish, taper, and undercut) in prepCheck. The students then rated each of the five tools for usefulness, user-friendliness, and frequency of use on a scale from 1=lowest to 5=highest. Faculty members graded the tooth preparations as pass (P), marginal-pass (MP), or fail (F). The survey response rate was 100%. The tools for undercut and taper had the highest scores for usefulness, user-friendliness, and frequency of use. The reduction tool score was significantly lower in all categories (p<0.01). There were significant differences in usefulness (p<0.05) and user-friendliness (p<0.05) scores among the P, MP, and F groups. These results suggest that the prepCheck taper and undercut tools were useful for the students' learning process in a preclinical exercise. The students' perceptions of prepCheck and their preclinical performance were related, and those students who performed poorest rated the software as significantly more useful.

Challenges in Learning Preclinical Prosthodontics: A Survey of Perceptions of Dental Undergraduates and Teaching Faculty at an Indian Dental School.

Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student's and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. The students and faculty expressed a "need" for early clinical exposure to enhance the learner's understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India.

MCQ-construction improves Quality of Essay Assessment among undergraduate dental students

A well-constructed essay is indicative of deep strategic understanding and is considered a valid assessment tool in many dental schools. It has been suggested that constructing MCQs could be an effective learning tool for students while at the same time contribute towards a pool of well-constructed MCQs that could stand up to scrutiny at high-stakes examinations. This study aimed to compare the quality of essays written by students trained and untrained in MCQ construction. The null hypothesis was that construction of MCQs did not result in higher grades achieved in “closed-book” time-limited assessment conditions. A Test cohort (n=48) of undergraduate dental students were taught and constructed MCQs during their preclinical prosthodontics course. The Control cohort (n=48) consisted of students who underwent the same course 1 year prior. The same question was administered to both cohorts without the students׳ knowledge. Answers were de-identified and randomized for grading by a blinded expert prosthodontic examiner not involved in the teaching of the students. Based on a passing grade of 50 and a maximum grade of 100, the Test cohort exhibited significantly improved essay quality, scoring a mean grade of 73.0±8.0, compared to a mean grade of 63.6±11.8 achieved by the control cohort (p<0.001). The null hypothesis was rejected. Under the conditions of this double-blind study, MCQ-construction resulted in better essays written by students under examination conditions.

Effect of Dental Students as Instructors on Preclinical Performance in Prosthodontics

Dental schools continue to have difficulty recruiting and retaining faculty. One approach to augment student learning would be to train and utilize senior dental students as instructors in preclinical courses. This study was undertaken to evaluate the effect of using senior dental students as instructors on the performance of second-year students in two preclinical prosthodontic courses. In the spring term of 2007, four senior dental students and four or five full-time faculty were assigned as instructors for the fixed prosthodontics and complete denture prosthodontics preclinical courses. Each course has previously been conducted with a total of seven to nine faculty instructors. The performance of two groups of second-year students on preclinical projects was compared based upon their source of instruction for the project. The scores for the two groups were compared using the Wilcoxon rank sum tests and the corresponding 95 percent confidence intervals for the median difference in scores for the two instructor types. This study found no significant difference in performance between sophomore students instructed by full-time faculty or those instructed by senior dental students in either the fixed or removable prosthodontics preclinical courses (p>.05). The use of senior dental students as instructors in the preclinical prosthodontics courses may be one option to partially address the shortage of full-time dental faculty.

Students' Perceptions of Prosthodontics in a PBL Hybrid Curriculum

A survey was distributed to the Harvard School of Dental Medicine (HSDM) predoctoral student classes of 2005 and 2006 to assess their perceptions regarding preclinical prosthodontics laboratory exercises. Prosthodontics curriculum clock hours, prosthodontics teaching participation, and plans for specialization were also analyzed. We hypothesized that reduced hours and perceived stress in the prosthodontics curriculum might impact students' choice of specialty at HSDM. HSDM preclinical prosthodontics clock hours were compared with national means from published data. A survey was distributed to the HSDM classes of 2005 and 2006 (n = 70) at the end of their preclinical prosthodontics laboratory exercises, prior to students seeing their first patient in the clinics. A 100% response rate was achieved. Results from this study show that HSDM preclinical prosthodontics clock hours are on average shorter than other schools. The majority of the students felt stressed during the laboratory exercises, and they felt they did not gain adequate knowledge from the lectures, resulting in low self-esteem (confidence) in treating patients in the clinic. Despite this perception, HSDM students do just as well, if not better, than other students, as judged by external and internal outcome measures. Graduate prosthodontics specialization is still a specialty of choice among the graduates when compared to national data. The shortened preclinical didactic and laboratory exercises in prosthodontics at HSDM affect student anxiety, but not their didactic and clinical performances or their decisions in choosing their graduate program. Problem-based learning (PBL) tutorials help the students to integrate preclinical and clinical knowledge and skills in prosthodontics.

Evaluation of Dental Students as Instructors in Preclinical Prosthodontics and Occlusion Courses

While facing a shortage of faculty members, dental schools need to be innovative in their educational methodologies. One approach to augment student learning would be to mentor dental students as participating faculty in current courses. A study was undertaken to evaluate dental students as instructors in preclinical prosthodontics and occlusion courses. In spring term 2003, three senior dental students (4DN) and four full-time faculty were assigned as faculty for each of two preclinical courses: fixed prosthodontics and complete denture prosthodontics. In the summer term 2003, two junior dental students (3DN) and five full-time faculty were assigned to teach in the occlusion preclinical course. Each course had previously been conducted with a total of seven full-time faculty. Three types of outcome assessment were accomplished: (1) evaluation by the 2DN students of full-time faculty and student instructors at the end of the course using a standardized university scale of 1 (poor) to 5 (excellent); (2) a survey of student instructors about their experience; and (3) a course debriefing with selected 2DN students. The overall mean instructor-quality score assigned to the student instructors, 4.5 (SD, 0.7), was slightly higher than that of faculty instructors, 4.2 (SD, 0.9). Student instructors were rated higher than or equal to full-time faculty based on the mean response scores for all ten evaluation questions. The greatest difference between faculty and student ratings was in the category of "respect and concern for the students" in all courses. In addition, information gathered from eight student instructors indicated that the experience was a very positive one overall with an increased interest in an academic career noted. Comments from the 2DN students in the debriefing sessions were positive about having student instructors. This study demonstrated that from the perspective of second year dental students, senior and junior dental students were accepted as preclinical instructors in prosthodontics and occlusion preclinical courses. Additionally, senior and junior students who participated in student teaching had a positive experience. The use of dental students as preclinical faculty in prosthodontics and occlusion appears to be a viable approach for mentoring students in careers in academics, providing student instructors with higher learning experiences, and supplementing the efforts of full-time faculty.

Effective taper criterion for the full veneer crown preparation in preclinical prosthodontics.

Effective taper criteria must define a realistic, measurable goal that the student can visualize and achieve. Six degrees is widely accepted as the taper criterion for the full veneer crown preparation. However, studies show the actual taper of most preparations to be greater than 12 degrees. The purpose of this study was to determine whether 12 degrees is an effective taper criterion for the full veneer crown preparation in preclinical prosthodontics instruction. A group of 191 full veneer crown preparations with 6 degrees as the taper criterion, and a group of 130 full veneer crown preparations with 12 degrees as the taper criterion were evaluated. All preparations were accomplished by preclinical dental students working on typodonts under examination conditions. The overall mean taper for each group exceeded the targeted criterion. The overall mean taper for the 6 degrees group was 14,490. When 12 degrees was the criterion, the overall mean taper was 15,580. The t test results indicate significant differences (p < .0001) between the targeted criterion and the actual preparation mean taper in all samples except one: the faciolingual measurements in the 12 degrees group. The faciolingual measurement of 12,920 was not statistically significantly different (.0542) from the targeted criterion of 12 degrees. The use of a 12 degrees taper criterion did not result in preclinical students achieving the goal of a 12 degrees taper. However, a 12 degrees criterion is more realistic than a 6 degrees criterion for full veneer crown preparations.