Prosthodontic Programs Research Articles

A survey on utilization and barriers of digital removable prostheses in the US dental education.

Gaining knowledge on the extent of digital technology implementation in dental education and the barriers to it will help inform future directions to promote the use of such technology and will enhance dental education. This study aimed to investigate the utilization of digitally fabricated removable prostheses and the potential obstacles to implementing such technology in US dental schools. A survey was developed and distributed to the restorative dentistry department chairs and postdoctoral prosthodontic program directors. The survey delivery protocol included follow-up emails 1 week, 3 weeks, and 4 weeks after the initial email. The collected data were analyzed descriptively. The response rate was 85% and 45% for predoctoral and postdoctoral prosthodontic programs, respectively. The results showed that 88.06% of the predoctoral programs and 95.65% of the postdoctoral prosthodontic programs implement digital complete dentures in the curriculum; however, the digital removable partial dentures implementation rate was recorded at 70.77% in predoctoral programs and 61.9% in postdoctoral prosthodontic programs. Dental schools are challenged by cost, design software limitations, IT and laboratory support, and faculty training. Multifaceted support is instrumental in further implementing digital removable prosthodontics into dental education.

An 8-year retrospective study of fixed prosthodontics clinical unit completions in a postgraduate prosthodontics program.

The range of aesthetic fixed prosthodontics materials utilizing digital manufacturing techniques has expanded in recent years ostensibly replacing traditional laboratory techniques and materials. This retrospective study conducted over eight consecutive years aimed to analyze the types of laboratory fabricated fixed prosthodontics clinical units completed in a postgraduate prosthodontics specialist training program and determine meaningful trends. The logbooks of eight postgraduate prosthodontics completions from 2014 to 2021 were reviewed and the different types of laboratory fabricated fixed prosthodontics units and total number of fixed prosthodontics units completed were recorded. The data was categorized and presented in tabulated and chart form using Microsoft Excel software (version 2016). Paired t-tests and Mann-Kendall trend tests were performed to analyze for statistical significance between the different restoration types across the program completions. Porcelain bonded to metal (PBM) crowns represented 42.05% of all fixed prosthodontics units completed over all study years followed by all-ceramic crowns (ACC) (18.14%) and full gold crowns (FGC) (10.70%). Jointly, PBM, ACC and FGC's encompassed 70.88% of all fixed prosthodontics units. Over the 8-year study period, there were observed trends of reduced use of PBM's, increased use of ACC's, statistically significant reduced use of FGC's (p = 0.035) and a statistically significant difference in the use of complete and partial coverage restorations (p < 0.001). PBM crowns were the dominant laboratory fabricated fixed prosthodontic clinical unit across postgraduate prosthodontics program completions. The trend in later years indicating ACC as the dominant crown type warrants further investigation.

Profile of prosthodontics program directors in North America.

To develop a current profile of prosthodontics program directors in United States dental schools and describe the current challenges and responsibilities of those serving in the position and assess the professional needs of the program directors to better support them in their roles. A survey was sent to 51 participants who were identified as prosthodontics program directors in North America via Qualtrics in 2019 to assess the professional needs of program directors to better support their roles. The survey consisted of 29 items organized into six sections: 1) demographic information; 2) hours and time spent in various areas of the job; 3) greatest challenges; 4) perceived importance of specific competencies; 5) opinions on the greatest rewards of the position, and 6) their needs for support from the American College of Prosthodontists and advice for the future program director. The response rate for this survey was 88.3%. Of the 45 respondents, the majority were white/non-Hispanic, followed by Asian/Pacific Islanders. The two largest and equal numbers of participants who worked for more than 10 years and between 1 to 3 years were observed with approximately 29% each, and program directors who worked less than a year occupied the least amount. 34% of program directors are on the tenure track and 80% of those are tenured. Teaching and clinical services took away the greatest time with approximately 42% and 22.1% respectively. Thirty-five (78%) program directors listed the greatest challenge they encountered was the workload of the role. Skills listed in leadership and personnel competencies were all rated more important than most of the skills listed in management. There is a wide gender gap and a lack of racial diversity among the prosthodontics program directors. The biggest challenge faced by them is the amount of workload followed by budget and fiscal constraints. And for their improved efficiency, they gave emphasis on learning time management and continuous clinical training of newer advances. This article is protected by copyright. All rights reserved.

The future of maxillofacial prosthodontics in North America: Part II – A survey

Statement of problemHead and neck care has been transformed by the introduction of advanced digital technologies that will continue to be important change drivers for maxillofacial prosthodontics. Insight into these changes is important in answering the question of whether maxillofacial prosthodontics is appropriately prepared to contribute effectively to future multidisciplinary care of the head and neck. PurposeThe purpose of this survey was to gain insight into the perception of changes experienced by maxillofacial prosthodontists in relation to clinical practice. The findings of this survey may assist the future development of the subspecialty. Material and methodsAn exploratory cross-sectional survey was conducted by using a convenience sample of members of the American Academy of Maxillofacial Prosthetics. The survey considered 10 domains and 31 questions. Fully completed surveys (164) provided a 59% response. Descriptive statistics used percentage responses to reduce and characterize perceptions across respondents. ResultsEighty-four percent of the respondents were from the United States. Results should be interpreted based on this cohort. Respondents reported a change in care delivered over the past 10 years (72%), with the most important causes of change attributed to surgery (60%) and advanced digital technologies (56%). Respondents perceived advanced digital technologies as being central to the future of maxillofacial prosthodontics (89%) and important in attracting younger colleagues (88%). Sixty-three percent believed training programs were not providing adequate education and training in the use of advanced digital technology. ConclusionsThe perception of maxillofacial prosthodontists regarding changes taking place in care delivery was that the most important changes in the past 10 years were attributed to surgery and advanced digital technologies, that persisting pressures related to few institutional positions, that the subspecialty was poorly visible, that remuneration for care was inadequate and referring disciplines did not understand the subspecialty, that advanced digital technologies were considered central to the future of maxillofacial prosthodontics and important to attract younger colleagues to the subspecialty, that barriers to advanced digital technology use included funding for equipment acquisition, institutional funding support, and remuneration for their use in care delivery, and that maxillofacial prosthodontic programs were not providing adequate education and training in advanced digital technologies.

Audience and Presenter Comparison of Live Web‐Based Lectures and Traditional Classroom Lectures During the COVID‐19 Pandemic

The purpose of the study was to assess participants' and presenters' perceptions of a live web-based lecture series in comparison to traditional in-person lectures. A virtual lecture series was organized by the---from March 25th until June 3rd of 2020. Twenty-five postgraduate prosthodontics programs and 81 presenters participated. Two surveys were developed and distributed to the audience (N = 330) and the presenters (N = 81). Follow-up emails were sent one week, three weeks, and four weeks after the initial email survey to encourage its completion. The data were analyzed descriptively. One-way ANOVA (p = 0.05), followed by a post hoc test, were used to compare the response percentages among the different generations of presenters and participants. Fifty-two percent of participants, and 65% of presenters, completed the survey. More than 96% of participants and presenters were satisfied with the lecture series. Seventy-nine percent of audience members felt that the live web-based lectures were as effective as traditional classroom lectures, or more effective; 32% of presenters agreed. Millennial audience members had significantly (p = 0.0028) more negative responses than the other generations. Participants have more positive perceptions of web-based lectures than presenters.

The use of artificial teeth for post-core techniques in a pre-clinical fixed prosthodontics undergraduate teaching program: an evaluation of student experience

Aim: The use of artificial teeth in pre-clinical simulation clinic teaching of post-core techniques has clear educational benefits for students and staff. This study explored the reasons for selection and direct student experiences with artificial teeth in a recently conducted pre-clinical fixed prosthodontics post-core technique teaching program. Materials and Methods: An online anonymous survey was delivered to fourth year undergraduate dental students who had completed the fixed prosthodontics pre-clinical program seeking information on the choice of artificial or natural teeth and direct experiences. Quantitative data was summarized and qualitative data was clustered into topics. Results: A 100% response rate was received. Twenty-five (36%) of 70 respondents chose to use one or more artificial teeth for the post-core exercises which was predominantly driven by difficulty in sourcing appropriate natural teeth (59%) rather than educational benefit (13%). Forty-five (64%) chose not to use artificial teeth largely due to the cost of the teeth (49%). Direct student experiences in using the artificial teeth for post-core exercises were generally positive. Conclusions: As the first known research of its kind, within the limitations of this study, artificial teeth provided an appropriate and realistic simulation compared with extracted natural teeth and were easier to source for the post-core exercises of the pre-clinical fixed prosthodontics program. More widespread use of artificial teeth was limited by cost.

Teaching the Design and Fabrication of RPD Frameworks With a Digital Workflow: A Preclinical Dental Exercise.

IntroductionThe conventional method for teaching removable partial denture (RPD) design using a pencil drawing on a solid cast has always been the basis for teaching RPD design in most dental schools at both the undergraduate and graduate levels. This does not apply to RPD fabrication technology, as more laboratories have recently adopted more efficient and versatile digital techniques to design and fabricate RPD frameworks.MethodsAt the University of Iowa College of Dentistry, we created a pilot workshop to assess the efficiency of a new approach to teaching RPD design utilizing this new digital RPD technology as a teaching tool for graduate prosthodontics residents. Three first-year prosthodontics residents were enrolled in the workshop, which involved learning the new digital workflow of designing RPD.ResultsThis new teaching approach very successfully achieved its educational goals. The residents reported that the digital RPD teaching approach enriched their knowledge and deepened their understanding of RPD design.DiscussionThe technique garnered significant interest from the students and seemed to also increase their understanding of the steps involved in RPD fabrication as well as the different components of the RPD.

Status of Sleep Apnea and Snoring Disorder Curriculum in U.S. Advanced Education Prosthodontic Programs.

To assess the management of sleep apnea and snoring disorders in Advanced Education Programs in Prosthodontics (AEPP) in the United States. A 51 item, online survey was sent to program directors at 48 AEPPs in the United States in 2015. Data results were analyzed descriptively. Thirty-five program directors responded to the survey. Twenty-four (68.6%, N = 35) programs report not having a dedicated course for the treatment of sleep apnea and snoring disorders. The majority (94.3%) of programs chose to treat sleep disordered breathing with oral appliance therapy and 80.0% (N = 35) of programs utilize customized sleep apnea oral devices. However, only 48.6% (N = 35) and 51.4% (N = 35) of programs regularly address sleep apnea and snoring disorders at initial examination during the comprehensive exam and medical history questionnaire, respectively. The confidence interval for this survey is 8.71 at a confidence level of 95% due to a response rate of 72.9%. This confidence interval suggests there is responder bias in the survey results. Therefore, the results of this survey provide a suggestion of how sleep disorders are managed in AEPPs. Programs appear to be consistent among each other with regards to treatment modalities for sleep disordered breathing. The results suggest that patients are not screened enough to receive treatment addressing sleep disorders.

Prosthodontic Resident Selection by Postdoctoral Dental Matching Program: A National Survey by Participating Program Director.

The purpose of this study was to obtain information about the resident selection and Match process that occurred for the Commission on Dental Accreditation (CODA)-accredited Advanced Education in Prosthodontics program in North America from the program directors' perspective, after the first year of implementation. The list of Advanced Education in Prosthodontics program in CODA-accredited North American institutions was obtained from the ACP central office, and the directors of each program were identified. The surveys were distributed to 48 program directors online and results were compiled. Out of 48 programs, 43 directors responded to and completed the survey (90.0%), where 35 programs participated in the Match process, 5 did not, and 3 were omitted due to incomplete surveys. While the majority of programs did not see any changes in their applicant pool or their quality, 10 programs (25.0%) observed a number of increases in the application and 13 programs (32.5%) observed an increase in the quality of the applications. Among the 35 programs that participated in the Match process, the main reasons for their participation were "fairness" (48.2%), "did not want to keep moving up interview dates" (23.2%), and "have applicants come to interview as planned" (21.4%). Thirty-three programs reported that 75% to 100% of the invited applicants came to the interview (76.7%). The majority of programs that participated in Match expressed satisfaction with the process (29/33, 80.6%). Sixteen programs (45.7%) reported that they matched with 100% of their first selections. Overall response of reintroduction of the Match process for advanced prosthodontic resident selection was very positive for majority of the program directors.

Patient-Specific, Risk-Based Prevention, Maintenance, and Supportive Care: A Need for Action and Innovation in Education.

To develop a competency-based curriculum framework for prevention, supportive care, and maintenance for use in educational and patient care programs and to seek consensus on an overarching competency statement that embraces these critical learning and patient care concepts. A preliminary survey of current preventive and maintenance practices in U.S. dental and prosthodontic programs was completed and summarized with quantitative analysis. The American College of Prosthodontists organized a one-day consensus workshop with 14 participants from various U.S. dental schools with diverse backgrounds to develop a curriculum framework. The curriculum framework was used in the development of a joint competency statement using an iterative, online consensus process of debate and feedback. The preliminary survey helped frame the initiative and identify potential educational needs and gaps. Consensus was achieved for a recommended competency statement: "Graduates must be competent in promoting oral health through risk assessment, diagnosis, prevention, and management of the hard tissue, soft tissue, and prostheses, and as part of professional recall and home maintenance."This competency statement complements the proposed curriculum framework designed around 3 domains-caries prevention, periodontal supportive care, and prosthesis supportive care-with a set of recommended learning objectives. Commission on Dental Accreditation (CODA) learning standards do not outline patient-customized, evidence-based recall and home maintenance programs that highlight prevention of dental caries, periodontal supportive care, prosthesis maintenance, and patient education.The proposed competency-based curricular framework serves as an initial step in addressing student learning and patient care within the context of a recall system and home maintenance program while offering schools the needed flexibility for implementation within their curriculum.

Implementation of a surgical safety checklist for dental implant surgeries in a prosthodontics residency program

Statement of problemSurgical safety checklists are commonly used in medical surgery to reduce errors, yet they are rarely used in the dental office. Presently, research on the implementation of surgical safety checklists in implant dentistry and user adherence is lacking. PurposeThe primary purpose of this quality assessment study was to evaluate user compliance by using a surgical safety checklist for dental implant surgeries in a postgraduate prosthodontics program at the University of Connecticut School of Dental Medicine. The secondary purpose was to identify and analyze the nature, number, and frequency of omitted items on the surgical safety checklist. Material and methodsAll surgical safety checklists completed by 8 prosthodontic residents from 120 dental implant surgeries over the course of 1 academic year were collected as part of the program's quality assessment. Each surgical safety checklist contained 12 preoperative items and 14 postoperative items, giving a total of 26 items to be analyzed for each dental implant surgery. The collected data were then analyzed for user compliance, as well as the nature, number, and frequency of omitted items. ResultsSurgical safety checklists from 120 dental implant surgeries encompassing 262 implants were accessed for the academic year cycle from July 2017 to June 2018. There were 6 additional dental implant surgeries whose checklists were inaccessible. There was a 100% compliance rate for surgical safety checklist completion by all 8 prosthodontic residents across 120 dental implant surgeries. Within the checklists, the rate of incomplete responses or omissions was 2.4% (n=77). The 5 most commonly omitted items on the checklist by residents were preoperative photographs (0.29%), postoperative analgesics or steroids (0.26%), preoperative oral antiseptic rinse (0.22%), postoperative prescriptions (0.19%), and signed prosthodontic treatment plan forms (0.16%). ConclusionsThere was excellent compliance with the implemented dental implant surgical safety checklist across 8 prosthodontic residents, and the number of omitted items was small. Surgical safety checklists appear to be a straightforward method of helping prosthodontic residents in their dental implant surgical training to provide consistent and high-quality safe treatment for patients.

Research Productivity of Directors of U.S. Advanced Education in Prosthodontics Programs.

The aims of this study were to measure the research productivity of directors of U.S. advanced education in prosthodontics programs (AEPP) and to identify associations between the directors' publication metrics and professional characteristics. A list of AEPP directors was obtained from the American College of Prosthodontists website in December 2015. Information on gender, academic rank, and highest degree was collected from the institutional website for each individual. Citation databases (Scopus and Google Scholar) were searched for each director's h-index and i10-index (both indexes are based on numbers of citations of the author's articles) and total numbers of publications and citations. The search identified 50 AEPP directors. The majority were male and had a primary appointment at a university. Most held the rank of associate professor or professor and held both DDS and MS degrees. The mean h-index and i10-index of all directors were 6.32±6.97 and 6.84±10.77, respectively. Their mean numbers of publications and citations were 24.60±31.21 and 288.40±625.97, respectively. The analysis showed that the program directors affiliated with a university had significantly higher mean values for all indexes than those of non-university-affiliated program directors. Professors had productivity metrics significantly higher than those of other ranks in all measures of research productivity.

U.S. Maxillofacial Prosthetics Programs: Fellows' and Directors' Perspectives.

Maxillofacial prosthetics (MFP) programs in the U.S. select only a limited number of applicants for fellowship positions. The aims of this study were to survey MFP fellows about which factors influenced their choice of programs and to survey MFP directors about what they considered critical factors in the selection process. Surveys were sent to all eight directors and 13 fellows at all eight U.S. MFP programs in June 2015. The directors' questions asked about general information, resident selection process, letters of recommendation, interview process, and decision process. The fellows' questions addressed their demographics, program-related factors, and future goals. The directors' surveys were sent directly to the directors, and the fellows' surveys were sent to the directors for distribution. The survey response rate for the directors was 87.5% (N=7), and that of the fellows was 53.8% (N=7). In selecting fellows for programs, responding directors reported the interview process was most important, followed by letters of recommendation, personal statement, and prosthodontic program grades. Responding fellows reported that location, variety of treatment, patient volume provided, and clinical education were crucial components in their choice of program. This information may be useful to MFP programs and fellows in the continuing development of this specialty.

Overdentures borne on less than four abutments with telescopic crowns: 5-year results of a retrospective clinical study.

Retrospective evaluation of the clinical performance of tooth-supported overdentures retained by resilient telescopic crowns with occlusal clearance fit (ODRTC) in severely reduced dentition (1-3 remaining teeth). A total of 313 ODRTCs were inserted in an undergraduate prosthodontic program (University Medical Center, Goettingen, Germany) between 2000 und 2012. Data regarding 263 ODRTCs in 221 patients were reevaluated (observational period: 64.5 ± 34.8months), and time-dependent survival and success rates (Kaplan-Meier-Estimator) were calculated. The number of the abutment teeth was analyzed as an influencing factor (Cox regression model (p < 0.05)). The 5- and 8-year overdenture survival rates were 62% [CI: 0.55; 0.69] and 38% [CI: 0.30; 0.45]. The 5- and 8-year success-rates (biologically and technically event-free restorations) were 13% [CI: 0.09; 0.17] and 3% [CI: 0.01; 0.05]. On the abutment level, the 5- and 8-year survival rates were 55% [CI: 0.48; 0.62], and 34% [CI: 0.27; 0.42]. The number of abutment teeth significantly influenced the overdenture and abutment survival rates. Restorations with 1 or 2 abutments were significantly associated with an increased number of technical and biological complications (decementation of the primary crown, abutment fracture) compared to ODRTCs with 3 abutments. The survival and success rates of ODRTCs are significantly influenced by the number of abutments. For ODRTCs, reduced survival and success rates are expected, especially when only 1 or 2 abutment teeth are included.

Prosthodontic specialty training in the United States: what can we learn

Prosthodontics is one of the nine recognized specialties by American Dental Association. The postgraduate prosthodontic program used to train prosthodontic specialists in U S A started about 70 years ago. Compared to China which just launched the dental residency programs, the programs in U S A have more developed and relatively more mature education system. It is worthwhile for China to study and learn the U S A prosthodontic residency education program. Prosthodontics is a specialty to diagnose and treat complex dental problems, and is often considered as the 'orchestrator' directing and coordinating all the other dental specialists to manage complex situations. This specialty plays an important role in a nation's oral health system. The present article is aimed to introduce the history of US prosthodontic residency program, initial accreditation, curriculum, education standards and mechanisms of the residency program, and how the program is monitored and managed post initial accreditation, with the hope that this system can serve as a reference for China's developing its own residency program.

Dentists’ Attitudes Regarding Shortened Dental Arch Concept in Senior Dental Patients

Objective: A complete dental arch is usually wanted though not affordable nor always achievable especially in old age dental patients with compromised general health. This study investigated dentists’ knowledge and attitude regarding the shortened dental arch (SDA) concept. Methods: A cross-sectional study was conducted over a nine months period, during which 200 self-designed structured questionnaires were distributed to general dentists, restorative consultants and prosthodontists from 47 governmental hospitals and private dental clinics. General information about the SDA concept was included in the questionnaire. The questionnaire was divided into four main sections including knowledge, use of SDA concept, its application and the common treatment options selected. Results: There is a significant relationship between higher level of education and the selection of SDA concept as an option for treatment. Governmental institutions are more aware of the selection of the Concept compared to Private, p-value = 0.044. Out of the responding154 dentists, 34.4% were aware of the SDA concept. However, 81% always replaced missing molars. Moreover, 69% did not apply the concept in their treatment plan and did not use it as a treatment option; in fact, 54% of cases potentially suitable for SDA would be restored with cobalt chrome removable partial dental prosthesis (RPDP). 52.6% believed that they would lose income if they applied the concept. 63% of the sample only became aware of the SDA concept when we introduced it. Conclusions: Most dentists agreed that the concept offers some benefits and may be considered as a method for old patients’ prosthodontic treatment. Nevertheless, most of the dentists in Jeddah did not apply the SDA concept. There is a need to rise the SDA awareness, approval as well as its implementation clinically. Moreover, RPDPs teaching and practicing should continue to be an integral part of Prosthodontics programs.

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.

Preface to the First Edition

These are exciting times in dentistry. Advanced digital technology is changing what is possible in oral health, function, and beauty. Prosthodontists incorporating digital solutions into their practices are finding significantly improved workflow efficiency and ease of collaboration with laboratories. Patients treated with digital solutions are benefitting from the combination of efficient processes, accurate high-strength materials, and beautiful esthetics. However, technology alone does not determine the quality of care. Instead, talented and trained practitioners applying their expertise to design and control the outcome are paramount. The quality of our tools will never substitute for the quality of our training. Practitioners must be prepared to identify the best plan––and technology––for each patient's specific situation and needs. Computer-aided design/computer-aided manufacturing technology was introduced to dentistry decades ago, but only a small minority of dental practices use this technology. A 2014 survey of prosthodontic program directors by the American College of Prosthodontists (ACP) indicated that the underlying cause of the slow adoption of digital dentistry may not be the technology itself or its ability to deliver better patient care, but rather a relative lack of available education and training about its applications and benefits among clinicians. As the organization that represents the specialty of prosthodontics, the ACP is working to ensure that prosthodontists are prepared to lead the emergence of digital dentistry in clinical practice. The Glossary of Digital Dental Terms is intended to provide a convenient reference for the many devices, file formats, and concepts involved in the use of digital technology in dentistry. With the benefit of a common vocabulary, practitioners can communicate more effectively with suppliers, dental laboratories, and each other. With the support of an educational grant from Henry Schein, the College is also engaged in development of a groundbreaking new curriculum that will incorporate advanced digital technology into dental education. We are at a critical juncture in the evolution of digital dental technology, and prosthodontists and trained practitioners have an opportunity to help guide what happens next. Together, these efforts will lay the foundation for the way dentistry is practiced for many years to come. On behalf of the College, I would like to thank the members of the ACP Digital Dentistry Glossary Development Task Force for their work on this first edition, including Dr. Gerald T. Grant, chair, with Dr. Michael R. Andersen, Dr. Peter R. Barndt, Dr. Stephen D. Campbell, Dr. Radi Masri, and Dr. Naif Sinada. Contributions to the text were also made by Scott Keating, Gene Peterson, and Tim Thompson of AvaDent; Dr. George W. Tysowsky of Ivoclar Vivadent; and Mark Heiden of the American College of Prosthodontists. Special recognition is due to Henry Schein for its vision and support of these efforts to advance the use of digital dental technology. This first edition was made possible in part from an unrestricted educational grant from Henry Schein.

Evaluation of second year dental students’ perceptions on preclinical prosthodontic program

SUMMARY Aim: The aim of this study was to obtain information among 2 dental schools in Turkey regarding preclinical students’ perception, stress levels and preparedness for their future clinical studies. Materials and methods: This study was conducted on the second year students in one foundation and one state dental school in Istanbul. The questionnaire consisted of questions about students’ opinions about their stress levels in preclinical exercises of prosthodontics, as well as adequacy of knowledge they received from their preclinical training. Data were analyzed using the chi-square test. Results: The students of the foundation school considered that feedback received from the instructors during laboratory exercises was highly satisfactory with statistically significant differences. In addition they regarded didactic knowledge received for preclinical exercises as highly satisfactory. In general, students of the foundation school felt themselves more prepared for treating patients with statistical significance. Conclusions: Student’s perceptions on preclinical prosthodontic educational program were different in foundation and state dental school. Dental school instructors must provide a well-established program for the students and educational curriculum must be regularly evaluated and updated to be beneficial for the dental student who is expected to start serving the public in the near future.

Success and complications of implant-retained prostheses provided by the Post-Doctoral Prosthodontics Program, University of Puerto Rico: A cross-sectional study

Statement of problemThe success rate of implant-retained prostheses in a postdoctoral prosthodontics program was unknown and could not be related to any set of potential clinical issues or patient characteristics. PurposeThe purpose of this study was to determine the success rate of implant-retained prostheses placed by prosthodontic residents between 1997 and 2012 and to evaluate the associations between patient classifications and specific restoration characteristics as related to prosthesis success or failure. Material and methodsA total of 272 prostheses in 119 patients were clinically evaluated. Success was defined as the absence of prosthetic complications or any implant-related complication that affected prosthesis survival. Logistic regression was used to evaluate associations between prosthesis success/failure and a wide array of study variables, adjusting for patient age, sex, and prosthesis longevity. ResultsThe overall success rate was 71%, with a mean prosthesis age of 4.5 years (range: 4 months to 16.8 years). Implant single crowns were the most successful prosthesis type (81% success). The most common complications observed were porcelain fractures in fixed dental prostheses (15%) and lack of stability (31%) and retention (29%) in removable dental prostheses. Having a removable prosthesis (versus natural dentition) in the opposing occlusion significantly decreased the odds of success (OR=0.26, 95% CI: 0.11-0.64). Definitively cemented fixed prostheses were more successful than those cemented with an interim cement (OR=4.56, 95% CI: 1.37-15.22). ConclusionsThe overall success rate of the implant-retained prostheses placed in the program was low compared with previously published studies. This study revealed the need for an efficient, comprehensive recall system for patients receiving implant-retained prostheses, either fixed or removable.