Integration of an Objective Structured Clinical Examination (OSCE) into the Dental Preliminary Exams

Introduction: In the pre-clinical phase of the study of dentistry at the University of Greifswald, the course “Early Patient Contact (EPC)” is conducted within the framework of Community Medicine/Dentistry. The course is based on three pillars: the patient visiting program, special problem-oriented seminars, and communication training for doctors. The essential goal consists of providing students with real patient contact right at the beginning of their study of dentistry, thus making the study of dentistry patient-based very early on. Students are trained in taking comprehensive anamneses and recording clinical findings

Der "Frühe Patientenkontakt" im Studiengang Zahnmedizin [Community Dentistry and early patient contact at the department of dentistry at the University of Greifswald]

[english] The "Early Patient Contact" is a relatively new "Teaching Concept" enabling students to receive an insight early on their studies about patient contact and treatment possibilities. Within the one year visiting program the students had "Hands-on" experience with "real patients". Through accompanying lectures using the "Problem-based learning method" (PBL) students were able to learn about the principles of Community Medicine/Dentistry within the Health Service, and about population relevant illnesses. An evaluation form part of a Questionaire made evident that it is possible to provide considerable improvement of the medical/dental education as regards communication skills and understanding of the patients' perceptions, by letting the student establish contact with patients at the very beginning of the curriculum. The students found that experience of high importance. [german] Das Lehrkonzept "Der Frühe Patientenkontakt" für den Studiengang der Zahnmedizin wird im Rahmen der Community Medicine/Dentistry an der Universität Greifswald durchgeführt. Die Lehreinheit erstreckt sich über die ersten vier vorklinischen Semester. Die wesentliche Zielstellung besteht darin, den Studierenden bereits zu Beginn des Zahnmedizinstudiums einen Patientenkontakt zu ermöglichen und somit das Zahnmedizinstudium frühzeitig patientennah zu gestalten. Sie lernen einen "Echt-Patienten" und dessen Lebenssituation über den Zeitraum von einem Jahr kennen. Anhand von begleitenden Vorlesungen und Seminaren wird das Prinzip der Community Medicine/Dentistry erläutert und die Studierenden werden mit bevölkerungsrelevanten Erkrankungen und Gesundheitsstrukturen bekannt gemacht. Dabei wird unter anderem die Lehrmethode "Problemorientiertes Lernen" angewendet. Das Lehrprojekt wird zu Beginn und zum Abschluss mittels eines speziellen Evaluationsbogens ausgewertet. Die Ergebnisse zeigen, dass die Studierenden den "Frühen Patientenkontakt" zu Beginn des Studiums mehrheitlich positiv bewerten. Das Projekt ermöglicht den Teilnehmern erste Erfahrungen im dialogischen Beziehungsaufbau und einen Einblick in die komplexe Persönlichkeitsstruktur eines "echten Patienten". Die Studierenden halten es für wichtig, bereits frühzeitig reale "Patientenwirklichkeiten" kennen zu lernen

Konzeption postgradualer Masterstudiengänge am Beispiel des Weiterbildungsstudiengangs „Zahnärztliche Funktionsanalyse und -therapie“

[english] Introduction: The decision to consolidate European higher education was reached by the Bologna Conference. Based on the Anglo-American system, a two-cycle degree program (Bachelor and Master) has been introduced. Subjects culminating in a state examination, such as Medicine and Dentistry, were excluded from this reform. Since the state examination is already comparable in its caliber to a Master’s degree in Medicine or Dentistry, only advanced Master’s degree programs with post-graduate specializations come into consideration for these subjects. In the field of dentistry numerous post-graduate study programs are increasingly coming into existence. Many different models and approaches are being pursued.Method: Since the 2004-2005 winter semester, the University of Greifswald has offered the Master’s degree program in Dental Functional Analysis and Therapy. Two and a half years in duration, this program is structured to allow program participation while working and targets licensed dentists who wish to attain certified skills for the future in state-of-the-art functional analysis and therapy.Aim: The design of this post-graduate program and the initial results of the evaluation by alumni are presented here.Conclusion: Our experiences show that the conceptual idea of an advanced Master’s program has proved successful. The program covers a specialty which leads to increased confidence in handling challenging patient cases. The sharing of experiences among colleagues was evaluated as being especially important

New insights in the reproducibility of visual and electronic tooth color assessment for dental practice

Background The aim of the study was to compare a 2D and 3D color system concerning a variety of statistical and graphical methods to assess validity and reliability of color measurements, and provide guidance on when to use which system and how to interpret color distance measures, including Delta E and d(0M1). Methods The color of teeth 14 to 24 of 35 patients undergoing regular bleaching treatment was visually assessed and electronically measured with the spectrophotometer Shade Inspector (TM). Tooth color was recorded before bleaching treatment, after 14 days, and again after 6 months. VITAPAN (R) Classical (2D) and VITA-3D-Master (R) (3D) served as reference systems. Results Concerning repeated measurements, the 2D system was superior to the 3D system, both visually and electronically in terms of Delta E and d(OM1), for statistics of agreement and reliability. All four methods showed strong patterns in Bland-Altman plots. In the 3D system, hue was less reliable than lightness and chroma, which was more pronounced visually than electronically. The smallest detectable color difference varied among the four methods used, and was most favorable in the electronic 2D system. Comparing the methods, the agreement between the 2D and 3D system in terms of Delta E was not good. The reliability of the visual and electronic method was essentially the same in the 2D and 3D systems; this comparability is fair to good

Standard and limit values for the symmetry of articulation parameters in the temporomandibular joint area - evaluations of the associated project of the SHIP study

The articulation parameters, especially the horizontal condylar inclination angle (HCI), the Bennett angle (BA), and the immediate side shift (ISS) were determined in 259 subjects (100 males; 159 females) of the associated project with reference to the population-representative baseline study (Study of Health in Pomerania, SHIP 0). The evaluations were based on a clinical functional status and electronic motion recording with the ultrasonic measuring system Jaw Motion Analyser (JMA, Zebris, Isny, Germany). The reference plane, to which all measured values were represented and the HCI calculated, was the hinge axis infraorbital plane (HA-IOP). The HCI was determined after an excursive movement with a length of 4 mm to the HA-IOP in the sagittal view and the BA after a mediotrusive excursion movement of 6 mm in the horizontal view to the midsagittal plane. For the standard and limit values, the average value in addition to the standard deviation and the 10th and 90th percentile value (10th percentile value, 90th percentile value) were determined: HCI right 52.1 +/- 10.14 degrees (39.4 degrees, 64.0 degrees), HCI left 53.1 +/- 9.67 degrees (42.3 degrees, 67.0 degrees), BA right 15.2 +/- 7.53 degrees (6.7 degrees, 25.0 degrees), BA left 14.2 +/- 7.84 degrees (5.4 degrees, 24.1 degrees). The HCI was approximately 2 to 3 degrees larger in females (males: right 50.5 +/- 9.47 degrees, left 51.9 +/- 8.99 degrees; females: right 53.1 +/- 10.42 degrees, left 53.8 +/- 10.03 degrees). Likewise, the BA in the age group >= 40 years (males: right 14.4 +/- 6.62 degrees, left 13.1 +/- 7.14 degrees; females: right 17.0 +/- 9.02 degrees, left 16.9 +/- 8.72 degrees). The latter proved to be statistically significant in the t test for independent samples, assuming variance equivalence on the right, with P =0.009, and with rejection of the variant equivalence on the left, with P = 0.002. The right and left HCI and BA joint values showed highly significant linear dependence at P = 40 years with assumed variance equality than in the age group < 40 years (P = 0.002 right, P = 0.003 left). The groups relating to the Helkimo index (HI) did not differ significantly in all function-specific parameters. If it is assumed that there is no significant influence on the occlusion if the HCI values differ by 7 to 8 degrees from the average value, only approximately one third of all cases (35.1%) were characterized by a purely average value setting in the articulator. In 41.7% of cases, one joint value was situated outside the average value range; in 23.2% of the cases both values were outside the average value range. Without a measurement of the condylar path inclination, however, it is impossible to decide to what extent the HCI deviates from the average value, and which joint side is larger or smaller than the other and to what extent. These results suggest that in extensive and complex cases, the articulator should be adjusted according to individual, function-specific joint values

Assessing the effect of multibracket appliance treatment on tooth color by using electronic measurement

Abstract Background The purpose of this study was to investigate how tooth color is affected by multibracket appliance (MBA) treatment. Methods The color of teeth #14 to #24 of 15 patients with MBA was measured on body and gingival tooth segments using the spectrophotometer Shade Inspector™. Colors of both segments were recorded before start of MBA treatment (baseline T0), end of MBA treatment (T1; 2 years ±0.3), and 3 months after T1 (T2). A 2D color system and a 3D system served as reference systems. Multilevel models were used to analyze color change within segments and to compare the difference in color change between segments (treatment effect). Results 2D system. Changes within tooth segments from T0 to T2 were at worst 2.0 units (ΔE in the gingival segment), which is less than the threshold of 2.7 units for a clinically meaningful difference. Confidence intervals for the treatment effect indicated no clinically important differences in color change between body and gingival segments. 3D system. Changes within tooth segments from T0 to T2 were at worst 2.3 units (ΔE in the body segment), which is less than the threshold of 2.7 units for a clinically meaningful difference. Confidence intervals for the treatment effect indicated no clinically important differences in color change between body and gingival segments. Thus, MBA treatment did not lead to clinically relevant changes in tooth color. Conclusion Within the limitation of this study the MBA treatment can be seen as a safe method with respect to tooth color