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Dental operative microscope has been wildly used in endodontics and operative dentistry for many years. Many progresses have been made by using operative microscope in improving the outcomes of root canal therapy, endodontic surgery and operative dentistry. However, in clinical practice, improper use of the dental operative microscope is not uncommon, the reason related to which is the operator's lack of understanding and mastering not only the properties but also the standard operative procedure of the dental operative microscope. To this end, in October 2019, the vice chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, professor Liang Jingping, organized a group of professional experts in this field, convened a meeting about the standard operative procedure of dental operative microscope. Experts at the meeting had a very heated discussion and the consensuses were reached.

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Objective: The acquisition of motor skills is a key competency for the practice of dentistry, and innate abilities have been shown to influence motor performance. Thus, finding the most efficient manual dexterity tests may predict performance of dental students. The current study used the Bruininks-Oseretsky Test of Motor Proficiency, to assess motor skills of first year (D1) and second year (D2) dental students. Materials and methods: Three fine motor subsets of the BOT-2-fine motor precision, fine motor integration, and manual dexterity-were administered to D1 and D2 dental students in 2017 and 2018. The BOT-2 subset scores of D1 students were compared with those of D2 students, who had preclinical dental experiences. For D2 students, we tested for correlations between BOT-2 subset scores and performance scores in a preclinical operative dentistry course. Results: No differences were found between D1 and D2 students for any BOT-2 subtest scores (all Ps > .09). No correlations were found between total scores of each BOT-2 subtest and the operative dentistry course for D2 students (all Ps > .20). Conclusions: Our results suggested the BOT-2 was not predictive of manual skills of dental applicants or preclinical dental students. Although we assumed students would perform well with instruction, practice, and feedback, we were unable to determine whether innate abilities influenced acquisition of manual dexterity skills. More research about the acquisition of technical clinical skills in dentistry is required.

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This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society. The residency program was cost-beneficial to trainees, realizing an estimated return of SR 4.07 per SR 1 invested. The overall societal return was SR 0.98 per SR 1 invested, slightly shy of a bang for the buck, in part because the public sector largely runs the training. Benefits included increased earnings and enhanced restorative dentistry skills accruing to trainees; increased charitable contributions and programming-related payments accruing to programs and the public; and practice-related payments accruing to governmental, professional, and insurance agencies. Rest of society, notably government underwrote much of the cost of programming. A sensitivity analysis revealed the results were robust to uncertainties in the data and estimation. Our findings offer evidence to evaluate whether continued residency training is cost-beneficial to trainees and potentially to overall society.

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INTRODUCTION: This paper conducted standard setting (SS) (Angoff and Hofstee methods) to determine cutoff scores for summative examinations and to compare the derived passing levels to the existing fixed passing score of 60% in the Faculty of Dentistry at King Abdulaziz University. METHODS: Historic performance data for final examinations in preclinical Operative Dentistry course were used by four raters to conduct both Angoff and Hofstee methods to determine the cut off scores for three academic years (2012, 2013, and 2014). RESULTS: Both methods yielded higher than 60% cut off scores for each year. For the first examination of academic year 2012, the cutoff score was 64.75, while it was 63.5 for year 2013, and 66.75 for the last academic year of 2014. Hofstee scores were 64.5, 65.25, and 62.25 consecutively for years 2012 through 2014. CONCLUSIONS: Using Angoff or Hofstee methods, yielded higher than the fixed 60% passing score currently used by the dental school. The use of Angoff method alone is encouraged as there were limitations to using the Hofstee method to determine the cut off score. This finding provides preliminary support to use evidence-based SS methods to determine the cutoff score for the whole Dentistry program.

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INTRODUCTION: Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. OBJECTIVE: This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. MATERIALS AND METHODS: A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. RESULTS: Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. CONCLUSIONS: Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge.

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The aims of this study were to identify the level of interexaminer agreement among preclinical operative dentistry faculty members when grading Class II preparations performed by first-year dental students; to develop discrimination exercises for specific preparation components where interexaminer agreement was poor; and to evaluate if the discrimination exercises were able to improve inter- and intraexaminer agreement. In the preliminary phase of this study, 13 components of 32 Class II cavity preparations were assessed by eight course faculty members at one U.S. dental school. Analysis of average interexaminer agreement on these components revealed that six were below 60%. These were proximal contact clearance, retention groove placement, retention groove depth, preparation walls, preparation margins, and preparation toilet/debris. A 30-minute calibration session was subsequently developed to provide discrimination exercises utilizing 3-D models and digital images of various levels of student performance for five of the six components. Immediately following calibration, the course faculty assessed the same 32 preparations (Phase I) followed by a delayed assessment without calibration (Phase II) approximately six months later. The results showed that overall interexaminer reliability improved after calibration. Although there was a decline in interexaminer reliability after an interval of six months (Phase II), the degree of variation among examiners was lower than in the preliminary assessment. These findings support the use of discrimination exercises for preclinical operative dentistry course faculty to increase interexaminer agreement and thereby improve the consistency of faculty-student communication.

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PURPOSE: To establish a standard system of composite resins restoration in dental undergraduate education. METHODS: The modern phantom system was improved. A step-by-step operating manual with large amount of photographs and contents was set up, and multimedia tools were used simultaneously. A set of standardized operative procedures and detailed score evaluation system were established. Questionnaires were used to assess students' satisfaction in the reform. Then the survey results were statistically analyzed by Fisher exact test with SPSS 18.0 software package. RESULTS: The students' satisfaction about the education of composite resin restoration were improved (P<0.001). This reform helped to deepen students' comprehension of the theories and standardize their manipulation. CONCLUSIONS: The establishment of a standardized teaching procedure is beneficial to improve the quality of dental undergraduate education in composite resin restoration.

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A reliable test of manual dexterity could potentially have utility in dental education. Recently, haptic technologies have emerged that may offer a means of testing manual dexterity in the preclinical setting. The purpose of this study was to determine whether performance on a complex haptic simulator exercise was associated with preclinical operative dentistry practical examination scores or the Perceptual Ability Test (PAT) scores of the Dental Admission Test. All thirty-nine first-year dental students enrolled in the Operative Dentistry preclinical course at the Stony Brook University School of Dental Medicine completed a haptic exercise consisting of a single manual dexterity test (D-circle), repeated eight times in succession during a single session at midterm. A score reflecting accuracy and time to completion of each trial was calculated automatically and resulted in a success or failure for each trial. Preclinical operative dentistry practical examinations consisting of plastic tooth preparations given at three time points during the course were scored by four calibrated and masked course faculty members. Examination scores were compared with students' performance on the haptic test using linear regression. Number of failures during a single session on a complex haptic exercise was found to be a significant predictor of examination performance in the preclinical setting. These results suggest a role for haptics in identifying students with potential learning challenges in the preclinical stages of dental education. Identification of students with manual dexterity problems at an early stage may allow for early intervention to prevent failure.

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Pascal Magne, lecturer in adhesive and aesthetic dentistry at the University of Southern California in the USA, on biomimetics, mentorship and the future for the profession.

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BACKGROUND: The authors conducted a literature review to determine how dentofacial esthetics can be evaluated in restorative dentistry and which quantifiable clinical parameters can be used for this assessment of dentofacial esthetics. TYPES OF STUDIES REVIEWED: The authors selected 35 studies that focused on assessment strategies for dental professionals. The primary inclusion criteria were intraoral and extraoral esthetic assessment methods and indexes or rating scales evaluating esthetics in restorative dentistry. RESULTS: The studies' protocols and assessment methods were heterogeneous. The authors grouped the studies into six categories according to topic: golden proportion, soft-tissue measurement, smile and smile line assessment, orofacial indexes and scales, incisor proportion and angulation, and facial esthetics. These categories included various esthetic parameters, including the smile line, lip line, incisal offset, location of dental and facial midline, incisor angulations and width to height ratios of the maxillary anterior teeth, gingival contour, and root coverage and papilla height. These parameters should be considered when providing dental treatment in the anterior area, as they allow for quantification and objective judgment. CLINICAL IMPLICATIONS: The findings of this review might increase interest in a comprehensive dental esthetic index that allows for objective quantification and intrastudy and interstudy comparison of dental treatment outcomes.

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The aim of this study was to assess the literature on microleakage of direct restorations in operative dentistry indexed in the ISI Web of Science, in order to assess the robustness of the statistical methodology used. Our database included 226 scientific papers (published between 2001 and 2009 in 22 journals) from the journal citation report categories 'Dentistry, Oral Surgery and Medicine' and 'Materials Science, Biomaterials'. We reviewed all articles to find potential mistakes that are commonly made at different stages in the scientific research process. Microleakage was assessed quantitatively in 50 (22.2%) studies and qualitatively in 176 (77.8%) studies. In all studies reviewed the statistical methods used were appropriate for the category attributed to the outcome variable, but in 13% of the total, the chi-square test or parametric methods were inappropriately used afterwards. When the appropriate statistical methods were applied in studies that had originally employed inappropriate methods to analyse their data, and in which the authors provided raw data, an alteration of the conclusions was necessary in 15.4% of these re-analysed studies. This survey also showed that the statistical methodology applied varies considerably for similar experimental designs. This could have an effect on statistical results; hence, a more standardized methodology should be implemented.

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