The impact of clinical competency test on dental students' clinical skills learning and patient care

Clinical Competency Test (CCT) has been regarded as the contemporary method to assess dental students' clinical skills in integrated dental curriculum in dental schools worldwide. It is an independent test for students to carry out specific clinical procedures on patients in the clinic. Each year, students are required to undertake CCTs on different clinical procedures based on the levels of clinical skills relevant to that year (Year 111 -V) . As dentistry Is a clinical profession, students are required to pass all CCTs In the respective year before they are eligible to sit for final examinations. Otherwise, they will be required to repeat the year. In UM, students sit for five CCTs In Year Ill, four CCTs In Year IV, and six CCTs In Year V

Pairing as an instructional strategy to promote soft skills amongst clinical dental students

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students’ feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills

Push-Out Bond Strength of Experimental Apatite Calcium Phosphate Based Coated Gutta-Percha

Objectives. To evaluate the push-out bond strength of experimental apatite calcium phosphate coated gutta-percha (HAGP) compared to different commercially available coated gutta-percha root obturation points. Methods. Extracted teeth were selected and instrumented using ProTaper rotary files. The canals were assigned into five equal groups and obturated using matching single cone technique as follows: EndoREZ cones and EndoREZ sealer, Bioceramic Endosequence gutta-percha (BCGP) with Endosequence BC sealer, Active GP with Endosequence BC sealer (ActiV GP), conventional GP with Endosequence BC sealer, and HAGP with Endosequence BC sealer. Each root was sectioned transversally at the thickness of 1±0.1 mm to obtain 5 sections (n=25 per group). The specimens were subjected to push-out test using a Universal Test Machine at a loading speed of 0.5 mm/ min. Failure modes after push-out test was examined under stereomicroscope and the push-out data were analyzed using ANOVA and the post hoc Dunnett T3 test (p = 0.05). Results. The highest mean bond strength was yielded by HAGP followed by BCGP, ActiV GP, conventional GP, and EndoREZ. There were significant differences between EndoREZ and all other groups (p<0.001). The prominent failure mode of HAGP was mixed mode, whereas EndoREZ exhibited adhesive failure mode. Conventional GP, ActiV GP, and BCGP showed cohesive failure mode. Conclusion. HAGP showed promising results to be used as root canal filling material in combination with bioceramic sealer

The effect of moisture conditions on the constitution of two bioceramic-based root canal sealers

Background/purpose Intraradicular moisture is not standardized and alters the sealing properties and adhesion of root sealers. The aim of this work was to evaluate the effect of different moisture on the constitution of bioceramic sealers. Materials and methods The sealers were evaluated before mixing, and after setting using X-ray diffraction (XRD), Energy Dispersive Analysis (EDX) and Scanning Electron Microscope (SEM) techniques. Twenty four extracted teeth were prepared and assigned to four groups according to the moisture conditions: (1) dry: using ethanol as final irrigation, (2) normal: using paper points until the last one appeared dry, (3) moist: using a Luer adapter for 5 s followed by 1 paper point, and (4) wet: the canals remained totally flooded. The roots were filled with MTA Fillapex® and Endosequence® BC and kept in phosphate buffer solution at 37 °C for 10 days. Each root was sectioned transversally and longitudinally. The sealers harvested from longitudinal sections were analysed using XRD. Whilst the transverse sections were analysed using SEM/EDX. Results The XRD analysis showed MTA Fillapex composed of Bismuth trioxide, calcium silicate and tricalcium aluminate. The intensity of peaks in the wet condition was reduced. Endosequence BC contained mainly calcium silicate, calcium silicate hydrate, zirconia and calcium hydroxide. The wet condition showed a small increase in hydrated calcium silicate. The EDX analysis showed changes in the elemental concentrations with different moisture conditions. The surface morphology differed with different moisture conditions. Conclusion Tested sealers have different constitution that not affected by the degree of moisture. However, it changed their relative quantity

An in vitro Comparison of Bond Strength of Different Sealers/Obturation Systems to Root Dentin Using the Push-Out Test at 2 Weeks and 3 Months after Obturation

Objective: To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha. Materials and Methods: A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation. Results: The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p < 0.05) at both 2 weeks (G1: 1.46 ± 0.29 MPa, G2: 1.74 ± 0.43 MPa, G3: 1.74 ± 0.43 MPa, G4: 0.66 ± 0.31 MPa, G5: 0.74 ± 0.47 MPa) and 3 months after obturation (G1: 1.70 ± 1.05 MPa, G2: 3.69 ± 1.20 MPa, G3: 2.84 ± 0.83 MPa, G4: 0.14 ± 0.05 MPa, G5: 0.24 ± 0.10 MPa). The mean push-out bond strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa). Conclusion: The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time

Physicochemical Properties of Calcium Phosphate Based Coating on Gutta-Percha Root Canal Filling

Dental Gutta-percha (GP) is a polymer based standard root canal filling material that has been widely used in dentistry. However, it has an inadequate sealing ability and adhesion to root dentin. The aim of this study is to coat GP with a bioactive material to enhance its sealing ability and adhesion to the root sealer and subsequently to the root dentin. The choice of coating method is limited by the nature of GP as it requires a technique that is not governed by high temperatures or uses organic solvents. In this study, biomimetic coating technique using 1.5 Tas-simulated body fluids (SBF) was employed to coat the treated GP cones. The coated samples were characterized using Fourier transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), and field emission scanning electron microscope (FESEM). The presence of hydroxyl, carbonate, and phosphate groups was detected by FTIR while the formation of hydroxyapatite (HA)/calcium phosphate was confirmed with XRD. FESEM revealed uniform, thin, and crystalline HA calcium phosphate coating. The adhesion of the coating to the GP substrate was assessed with microscratch technique. It was viable with cohesive failure mode. In conclusion, Tas-SBF is able to coat pretreated GP cones with a crystalline apatitic calcium phosphate layer

Inherent differential propensity of dental pulp stem cells derived from human deciduous and permanent teeth

Introduction: Lately, several new stem cell sources and their effective isolation have been reported that claim to have potential for therapeutic applications. However, it is not yet clear which type of stem cell sources are most potent and best for targeted therapy. Lack of understanding of nature of these cells and their lineagespecific propensity might hinder their full potential. Therefore, understanding the gene expression profile that indicates their lineage-specific proclivity is fundamental to the development of successful cell-based therapies. Methods: We compared proliferation rate, gene expression profile, and lineage-specific propensity of stem cells derived from human deciduous (SCD) and permanent teeth (DPSCs) over 5 passages. Results: The proliferation rate of SCD was higher (cell number, 25 × 106 cells/mL; percent colony-forming units [CFUs], 151.67 ± 10.5; percent cells in S/G2 phase, 12.4 ± 1.48) than that of DPSCs (cell number, 21 × 106 cells/mL; percent CFUs, 133 ± 17.62; percent cells in S/G2 phase, 10.4 ± 1.18). It was observed that fold expression of several pluripotent markers such as OCT4, SOX2, NANOG, and REX1 were higher (&gt;2) in SCD as compared with DPSCs. However, DPSCs showed higher expression of neuroectodermal markers PAX6, GBX2, and nestin (fold expression &gt;100). Similarly, higher neurosphere formation and neuronal marker expression (NF, GFAP) were found in the differentiated DPSCs into neuron-like cells as compared with SCD. Conclusions: This study thus demonstrates that both SCD and DPSCs exhibit specific gene expression profile, with clear-cut inclination of DPSCs toward neuronal lineage. Copyright © 2010 American Association of Endodontists