Faculty Bibliography

Advancements in digital technologies over the past decade have revolutionized dentistry, particularly with the integration of digital workflows in removable partial dentures (RPDs). Key innovations include digital data capture and computer-aided design and manufacturing, which enhance patient comfort, streamline workflows, and reduce treatment time and costs. Initially embraced by fixed restorations, these technologies are now transforming RPDs, previously reliant on analog methods. The collaboration between dentists, laboratory technologists, and patients is essential for selecting optimal materials and achieving successful RPD treatments.

INTRODUCTION/BACKGROUND:Objective Structured Clinical Examinations (OSCEs) serve as a reliable assessment tool for clinical and competency evaluation. Traditional OSCEs, involving live patients, present logistical challenges and evoke student anxiety. In an effort to create a comprehensive clinical series of examinations, electronic OSCEs (e-OSCEs) were developed for assessing clinical competencies in prosthodontics at a large dental school. This manuscript aims to describe e-OSCEs as a competency assessment. METHODS:The e-OSCEs were implemented for the graduating classes from 2014 to 2023, covering categories of Single-unit Crowns and Fixed Partial Dentures, Implants, Removable Partial Dentures and Complete Dentures. A digital library of clinically relevant questions was developed to simulate chairside scenarios. Competence in any area was defined as scoring a 100% where questions were taken from a pool that represented the full scope of the clinical procedure. RESULTS:Ten-year retrospective data indicate sustained student performance over the years, with the majority achieving competence after three e-OSCE attempts. DISCUSSION/CONCLUSIONS:Advantages of the e-OSCE include standardised assessments, reduced examiner bias and adaptability to external disruptions in addition to fair and relevant evaluations, cost-effectiveness and test security. Evaluation of e-OSCE outcomes allows ease of analysis for curriculum enhancement and modification. CONCLUSION/CONCLUSIONS:The e-OSCE method of clinical assessment offers a standardised, clinically equivalent and efficient process for assessing dental students' competencies. The assessment methodology aligns with US accreditation standards and can be easily adapted by other institutions with different grading parameters for comprehensive clinical assessments. This approach provides a feasible and effective method for assessments in dental education.

Parkinson's disease is a neurodegenerative disease that results in patients exhibiting uncontrolled movements, changes in saliva production, and difficulty in swallowing and speech. Understanding the staging of the disease and the available therapies allows dentists to treat these patients safely and with compassion to meet their oral health care needs for an optimal quality of life. This appraisal discusses Parkinson's disease as it relates to clinically relevant facts to manage and treat the oral health care needs of these patients in the short and long term including general dental care recommendations. Important observations related to Parkinson's disease include disease causation,; stages, pharmacologic treatment, the effects on saliva, mastication, dysphagia, and aspiration pneumonia. Dental recommendations are made for the dentate, the partially edentulous, and the completely edentulous Parkinson's patients with a focus on late-stage concerns. Optimizing dental health will help maintain the quality of life as the disease progresses. In late stages of Parkinson's disease, dental treatment should focus on keeping the patient comfortable and out of pain.  While benign neglect is an often-used term, compassionate therapy in the late stages of Parkinson's disease is a more compelling term for defining the patient's needs.  Since dysphagia in Parkinson's patients has been underdiagnosed, neurologists must be aware of the important part that dentists play in the early diagnosis for these patients.  Early referral to a dentist is vital to mitigate the unfortunate consequence of the need for extensive dental care in late-stage patients.

The purpose of this article is to detail the primary challenges faced by large dental institutions as they incorporate digital dentistry into their mainstream workflow. Integration of digital technology is easier in private practices with smaller patient volumes and fewer trained staff required. Additionally, in private practices, scanning, designing and milling frequently occur in a single location, which does not require an external digital data transfer. However, large dental institutions must overcome several barriers which are uniquely generated by their large-scale operation. Numerous individuals must be comprehensively and efficiently trained to operate the advanced technologies. The digital software must seamlessly integrate with existing software and an internal infrastructure must be established capable of handling massive data inputs. High-volume production in large dental institutions requires the involvement of external laboratories to meet demand. This outsourcing presents a new challenge of safe digital data transfer in accordance with patient privacy and protection regulations set forth by governing agencies. It is vital for large dental institutions to recognise the unique challenges thrust upon them as they attempt to incorporate a digital workflow. With proper forethought and planning an appropriate infrastructure may be established allowing for a smooth and safe transition to the digital era.

The clinician's selection of an implant system is influenced by many variables. Ideally, the decision should be based on scientific evidence, but often these decisions are based on economic considerations or influenced by the experience of a trusted peer. The purpose of this paper is to describe the influence of implant neck features (shape and surface) and abutment connection (diameter that matches or is smaller than the implant's platform) on hard and soft tissues around single-tooth implants placed into healed ridges with adequate hard and soft tissue thickness. In an effort to reduce the number of variables, only two-piece implants fully placed at bone level or beneath were taken into consideration. The goal is to provide additional guidance for clinicians on the decision-making and implant-selection processes.

The oral rehabilitation of adolescent patients with amelogenesis imperfecta (AI) is complex due to the presence of mixed dentition with altered eruption sequence. In this manuscript, the interdisciplinary treatment approach for adolescent patients with AI is discussed. The types and timing of treatments at various stages of growth are described through a literature review on this topic. AI is an inherited condition that disturbs the development of the enamel structure. Because of the presence of mixed dentition, definitive treatment options often have to be delayed until eruption of permanent dentition is complete, requiring careful treatment coordination and proper sequencing between different dental disciplines starting at a young age. Adolescent patients require prosthodontic treatment design that can be adapted to the changes in arch shapes, sizes, interarch relationship, and esthetic needs. AI patients are often challenged with both excessive and limited restorative spaces within the same arch due to the abnormal growth patterns, enamel structure, tooth size, and tooth shape. Therefore, careful determination of the required restorative space is critical to ensure optimal prognosis. This clinical report discusses treatment recommendations, timing of various treatment modalities, and involvement of appropriate interdisciplinary teams for managing adolescent patients. This article is protected by copyright. All rights reserved.

AIM/OBJECTIVE:The aim of this study is to assess the influence of e-learning on dental education as perceived by predoctoral dental students. MATERIALS AND METHODS/METHODS:In an institutional review board (IRB) approved protocol, a 14-question survey was created and electronically distributed to second-, third-, and fourth-year dental students. The participation was considered voluntary and all responses were anonymous. RESULTS:The survey targeted 1,130 predoctoral students, of which 255 (22.6%) responded. Of the respondents, 124 students (48.6%) preferred traditional lecture mixed with online learning, while 46 students (18%) preferred only the traditional lecture style. The top three electronic resources/applications, which students perceived as having the greatest impact on their learning, were: YouTube, Bone Box, and Google. The responses also indicated that 76.5% of the students gave high credibility (scores of 4 and 5) to electronic resources recommended by faculties. Sixty percent of students spent 1 to more than 4 hours per day on electronic resources for academic performance. The most important factor for online applications influencing academic performance was "organization and logic of content" (54%). E-learning had a significant perceived effect (scores of 4/5) on didactic understanding (65.1%) and on clinical understanding (71.4%). Students observed that faculties estimated to be under 50 years of age were more likely to incorporate e-learning into courses (52.6%) and more likely to use social media for communication (41.6%). CONCLUSION/CONCLUSIONS:The results indicate that e-learning may successfully be used in a dental school's curriculum to enhance students' perceptions of fundamental concepts and to enable students to apply this knowledge to clinical cases. CLINICAL SIGNIFICANCE/CONCLUSIONS:E-learning has recently been proposed as a basic supplementary tool to enhance medical and dental education. It is crucial to determine dental students' preferences regarding social media, online applications, and databases in order to incorporate e-learning into dental school courses.

The peri-implant soft tissue seal consists of a connective tissue cuff and a junctional epithelium that is different from the arrangement of periodontium around a natural tooth. However, the peri-implant soft tissue complex lacks Sharpey's fibers, thus offering less resistance to clinical probing and biofilm penetration compared to the natural dentition. Therefore, the proper restorative emergence profile design is essential to facilitate favorable esthetic outcomes and maintain peri-implant health. The aim of this article is to review the currently available evidence related to the design of subgingival (critical and subcritical) and supragingival contours of the implant restorative emergence profile (IREP) as well as provide a flowchart for decision-making in clinical practice. Theoretically, the subgingival contours of the crown/abutment complex should mimic the morphology of the root and the cervical third of the anatomic crown as much and as often as possible. However, this is highly dependent upon the three-dimensional spatial position of the implant relative to the hard and soft tissue complex, in addition to the location of the definitive restoration. Frequently, a convex critical contour is required on the facial aspect of a palatally or incisally positioned implant to support an adequate gingival-margin architecture. Conversely, if the implant is placed too far facially, then a flat or concave contour is recommended. In instances where soft tissue support is not needed, the subcritical area may be undercontoured to increase the thickness, height, and stability of the soft tissue cuff.