Should undergraduate lectures be compulsory? The views of dental and medical students from a UK university

Formal lectures have been a traditional part of medical and dental education, but there is debate as to their compulsory status. This study was designed to explore dental and medical students’ views on compulsory lectures and the use of Video-Recorded Lectures (VRL). A cross-sectional study of University of Bristol students in Years 2 to 4 was conducted using an online questionnaire. The majority of both dental (76%) and medical (66%) students felt lectures should be non-compulsory. The most common learning resources used by both dental and medical students were live lectures, lecture handouts and VRL. The majority of both dental (84%) and medical (88%) students used VRL. Most students attended lectures all of the time both before and after the introduction of VRL, even though most dental and medical students believe lectures should be non-compulsory. VRL is a popular learning resource. These findings tie-in with General Dental Council and General Medical Council recommendations that encourage self-directed learning. Dental and Medical schools should offer a range of learning resources and make use of current technology, including the use of VRL

A randomised controlled study on the use of finishing and polishing systems on different resin composites using 3D contact optical profilometry and scanning electron microscopy

Objectives: The aim of this study was to evaluate theeffects of different finishing and polishing techniques on the surface roughness of microhybrid and nanofilled resin composites. Methods: The resin composites included were Filtek Z250 (a universal microhybrid resin composite) and Filtek Supreme XTE (a universal nanofill resin composite). Ninety cylindrical-shaped specimens were prepared for each composite resin material. The polishing methods used included tungsten carbide bur (TC); diamond bur (Db); Sof-Lex discs (S); Enhance PoGo discs (PG); TC + S; Db + S; TC + PG; Db + PG. Polymerisation against a Mylar strip without finishing and polishing acted as the control group. Surface roughness was measured using a 3D contact optical profilometer and surface morphology was examined by scanning electron microscope examination. Results: The results showed that the Mylar-formed surfaces were smoothest for both composites. Finishing with the 20 μm diamond finishing bur caused significantly greater surface irregularity (P < 0.0001) and damage than finishing with the tungsten carbide finishing bur. The Enhance PoGo polishing system produced smoother surfaces than the Sof-Lex disc polishing system; this difference was statistically highly significant (P < 0.0001). Conclusion: For both composites, the Mylar-formed surfaces were smoothest. Where indicated clinically, finishing is better conducted using a tungsten carbide bur- rather than a diamond finishing bur. The Enhance PoGo system was found to produce a smoother surface finish than the Sof-Lex system. Clinical Significance: If finishing and polishing is required the use a tungsten carbide finishing bur followed by Enhance PoGo polishing may be found to result in the smoothest surface finish

Root and canal morphology of third molar teeth

Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch. However, the anatomy of third molars has been described as unpredictable. To date, there has been little published work on root and canal morphology of third molars, with an adequate sample size. The aim of this study was to investigate root and canal morphology of third molars. Maxillary and mandibular third molars were gathered from dental surgeries within north Jordan. Following access cavity preparation, pulp tissue was removed and root canals stained. Teeth were subject to examination after rendering them clear by immersion in methyl salicylate, and the following features evaluated: (1) number of roots; (2) number and type of root canals; (3) number and position of lateral canals; and (4) presence of inter-canal communications. Out of the examined 592 maxillary third molars, 69.9% had three roots, 10.81% had one, 9.79% had two, 9.12% had four, and 0.34% had five roots. Most had three (52.36%) and four canals (28.2%) with less frequency of two (11.48%), one (5.91%) and five canals (2.03%). Of the 639 mandibular third molars, 89.76% had two roots, 7.35% had three, 2.5% had one, and 0.47% had four roots. Most had three (55.71%) and two canals (29.42%) with less frequency of four (13.61%), one (1.09%) and five canals (0.15%). The majority of maxillary third molars had 3 roots, while the majority of mandibular third molars had two. Overall, nearly half of the maxillary and mandibular third molars had three canals. New canal configurations, not previously described in the literature nor included in Vertucci's classifications, were identified in both maxillary and mandibular third molars. 2023, The Author(s).The authors wish to thank Jordan University of Science & Technology for supporting this project.Scopu

Co-Blend Application Mode of Bulk Fill Composite Resin

Objective: To evaluate the effect of a new application method of bulk-fill flowable composite resin material on bond-strength, nanoleakage, and mechanical properties of dentine bonding agents. Materials and methods: Sound extracted human molars were randomly divided into: manufacturer&rsquo;s instructions (MI), manual blend 2 mm (MB2), and manual blend 4 mm (MB4). Occlusal enamel was removed and flattened, dentin surfaces were bonded by Prime &amp; Bond universal (Dentsply and Optibond FL, Kerr). For the MI group, adhesives were applied following the manufacturer&rsquo;s instructions then light-cured. For MB groups, SDR flow+ bulk-fill flowable composite resin was applied in 2- or 4-mm increment then manually rubbed by a micro brush for 15 s with uncured dentine bonding agents and the mixture was light-cured. Composite buildup was fabricated incrementally using Ceram.X One, Dentsply nanohybrid composite resin restorative material. After 24-h water storage, the teeth were sectioned to obtain beams of about 0.8 mm2 for 24-h and thermocycled micro-tensile bond strength at 0.5 mm/min crosshead speed. Degree of conversion was evaluated with micro-Raman spectroscopy. Contraction gaps at 24 h after polymerization were evaluated and atomic force microscopy (AFM) nano-indentation processes were undertaken for measuring the hardness across the interface. Depth of resin penetration was studied using a scanning electron microscope (SEM). Bond strength data was expressed using two-way ANOVA followed by Tukey&rsquo;s test. Nanoindentation hardness was separately analyzed using one-way ANOVA. Results: Factors &ldquo;storage F = 6.3&rdquo; and &ldquo;application F = 30.11&rdquo; significantly affected the bond strength to dentine. For Optibond FL, no significant difference in nanoleakage was found in MI/MB4 groups between baseline and aged specimens; significant difference in nanoleakage score was observed in MB2 groups. Confocal microscopy analysis showed MB2 Optibond FL and Prime &amp; Bond universal specimens diffusing within the dentine. Contraction gap was significantly reduced in MB2 specimens in both adhesive systems. Degree of conversion (DC) of the MB2 specimens were numerically more compared to MS1 in both adhesive systems. Conclusion: Present study suggests that the new co-blend technique might have a positive effect on bond strengths of etch-and-rinse adhesives to dentine

Development of Self-Regulation amongst Dental Students in Problem-based Learning Curricula: A Qualitative Study

To explore the value of problem-based learning in the development of self-regulation amongst undergraduate dental students. A qualitative approach using focus groups was used to explore the perceptions and experiences of the participants regarding the role of problem-based learning (PBL) in promoting self-regulation in undergraduate dental education. The study was carried out at a newly established dental institution in Qatar. Purposive sampling technique was used to recruit the participants. Invitations to potential participants were sent by e-mail through appropriate professional channels. All focus groups were transcribed verbatim, and data were imported into NVivo 12 and analysed thematically. A total of five focus groups were conducted with 37 participants which included 27 females and 7 males from two different cohorts. Participants expressed their views on a range of issues related to the self-regulation in problem-based learning and also provided recommendations to enhance the learning experiences of students. PBL was perceived to be an appropriate and effective strategy to support student autonomy in construction of knowledge and developing problem solving and interpersonal skills. However, the workload of the students can impact adversely on their motivation and time management skills. This study provides useful insights into the concept of self-regulation in problem-based learning environments as perceived by the stakeholders at a newly established dental institution. The findings of this study may offer clarity on how problem-based learning can be best utilised to promote self-regulation in undergraduate dental education.Open Access funding provided by the Qatar National Library

Clip placement to prevent delayed bleeding after colonic endoscopic mucosal resection (CLIPPER): study protocol for a randomized controlled trial

Background: Endoscopic mucosal resection (EMR) for large colorectal polyps is in most cases the preferred treatment to prevent progression to colorectal carcinoma. The most common complication after EMR is delayed bleeding, occurring in 7% overall and in approximately 10% of polyps ≥ 2 cm in the proximal colon. Previous research has suggested that prophylactic clipping of the mucosal defect after EMR may reduce the incidence of delayed bleeding in polyps with a high bleeding risk. Methods: The CLIPPER trial is a multicenter, parallel-group, single blinded, randomized controlled superiority study. A total of 356 patients undergoing EMR for large (≥ 2 cm) non-pedunculated polyps in the proximal colon will be included and randomized to the clip group or the control group. Prophylactic clipping will be performed in the intervention group to close the resection defect after the EMR with a distance of < 1 cm between the clips. Primary outcome is delayed bleeding within 30 days after EMR. Secondary outcomes are recurrent or residual polyps and clip artifacts during surveillance colonoscopy after 6 months, as well as cost-effectiveness of prophylactic clipping and severity of delayed bleeding. Discussion: The CLIPPER trial is a pragmatic study performed in the Netherlands and is powered to determine the real-time efficacy and cost-effectiveness of prophylactic clipping after EMR of proximal colon polyps ≥ 2 cm in the Netherlands. This study will also generate new data on the achievability of complete closure and the effects of clip placement on scar surveillance after EMR, in order to further promote the debate on the role of prophylactic clipping in everyday clinical practice. Trial registration: ClinicalTrials.gov NCT03309683. Registered on 13 October 2017. Start recruitment: 05 March 2018. Planned completion of recruitment: 31 August 2021

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely