Preliminary Performance of the Advanced Dental Admission Test (ADAT): Association Between ADAT Scores and Other Variables for Applicants to Residency Programs at a U.S. Dental School

Historically, dental residency programs have used numerical assessment criteria to evaluate and identify qualified candidates for admission. Recent elimination of such assessment tools has undermined many programs’ holistic evaluation process. The Advanced Dental Admission Test (ADAT) was developed and recently piloted in hopes of addressing this issue. The aim of this study was to evaluate the preliminary performance and validity of the ADAT by exploring the association between ADAT scores and other variables for a sample of applicants to residency programs. The WebAdMIT admissions database was used to identify the test scores and educational and demographic information of 92 individuals who completed the pilot ADAT and were seeking a 2017 postgraduate specialty position at Indiana University School of Dentistry. The results showed that the ADAT had strong to weak correlations with certain applicant variables (p<0.05). No significant differences were found for age, race, school location, or country of origin. However, males performed better than females (p<0.05), and non-Hispanics performed better than Hispanics (p<0.01). ADAT component scores were also higher for individuals with a history of research activity (p<0.05). This study found that significant associations existed between the ADAT and indices typically associated with competitive applicants. These findings suggest that the ADAT may serve as a useful numerical assessment instrument, with the potential to identify high-performing candidates. Furthermore, the ADAT seemed to be a plausible option for programs seeking to incorporate a quantitative assessment instrument as part of a holistic candidate selection process

Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion

Objectives: To compare changes in upper airway volume after maxillary expansion with bone- and tooth-borne appliances in adolescents and to evaluate the dentoskeletal effects of each expansion modality. Materials and Methods: This retrospective study included 36 adolescents who had bilateral maxillary crossbite and received bone-borne maxillary expansion (average age: 14.7 years) or tooth-borne maxillary expansion (average age: 14.4 years). Subjects had two cone beam computed tomography images acquired, one before expansion (T1) and a second after a 3-month retention period (T2). Images were oriented, and three-dimensional airway volume and dentoskeletal expansion were measured. Analysis of variance was used to test for differences between the two expansion methods for pretreatment, posttreatment, and prepost changes. Paired t-tests were used to test for significance of prepost changes within each method. Results: Both groups showed significant increase only in nasal cavity and nasopharynx volume (P < .05), but not oropharynx and maxillary sinus volumes. Intermolar and maxillary width increased significantly in both groups (P < .05); however, the buccal inclination of maxillary molars increased significantly only in the tooth-borne group (P < .05). There was no significant difference between tooth- and bone-borne expansion groups, except for the significantly larger increase in buccal inclination of the maxillary right first molar after tooth-borne expansion. Conclusions: In adolescents, both tooth- and bone-borne RME resulted in an increase in nasal cavity and nasopharynx volume, as well as expansion in maxillary intermolar and skeletal widths. However, only tooth-borne expanders caused significant buccal tipping of maxillary molars

Three-Dimensional Computed Tomography Analysis of Airway Volume Changes Between Open and Closed Jaw Positions

Introduction Airway dimensions are closely linked to the bone and soft-tissue craniofacial anatomy. Reduction of the airway is seen with airway disorders and can impair function. The purpose of this retrospective study was to determine whether changing from open to closed jaw position affects the volume of the nasal cavity, nasopharynx, and oropharynx; the soft palate; the soft-tissue thickness of the airway; and the most constricted area of the airway. Methods Following reliability studies, in this retrospective study, we analyzed cone-beam computed tomography scans taken in both closed and open jaw positions of 60 subjects who were undergoing diagnosis and treatment of temporomandibular disorders. On each scan, condyle-fossa measurements, volumes of airway segments (nasal cavity, nasopharynx, oropharynx), soft palate areas, soft tissue thicknesses of the airway, and the most constricted area of the airway and its location were measured using Dolphin imaging software (version 11.5; Patterson Dental Supply, Chatsworth, Calif). Differences between the 2 jaw positions were analyzed with paired t tests, accepting P ≤0.05 as significant. Results Significant changes in airway dimensions were found between the closed and open jaw positions. With jaw opening, the nasopharynx volume increased, whereas the oropharynx volume decreased. Significant decreases were also found for measurements of basion to posterior airway wall, cervical vertebrae to posterior airway wall, most constricted area, nasal cavity volume, and soft palate area when the jaw was open. Conclusions Changing jaw position significantly affects airway dimensions

Dental Professionals’ Perspective on Direct-To-Consumer Clear Aligners

Background: Technology continues to drastically change the practice of orthodontics. One recent change includes direct-to-consumer (DTC) clear aligners, a model that omits a clinical exam by a licensed dentist and radiographic evaluation prior to initiating treatment. The purpose of this study was to collect quantitative data about dental professionals’ perspectives of the DTC treatment model. Materials and Methods: The Qualtrics-based survey was disseminated to dental professionals using several email lists. The survey included 26 questions, containing four domains: basic demographic information, perceptions of the direct-to-consumer clear aligner model, standards of orthodontic care, and patient experiences. Responses were summarized with descriptive statistics. Associations between respondent demographics and their perceptions about DTC clear aligner treatment and standards of orthodontic care were evaluated using Mantel- Haenszel Chi-squared tests. Results: There were 334 completed surveys, with 155 orthodontists (46.4%), 154 general dentists (46.1%), and 25 other dental specialties (7.5%) participants. More than 95% of respondents had a generally negative view of the DTC treatment model, with most respondents citing “suboptimal orthodontic care” and “misleading the public about orthodontic treatment” as the biggest influence in their view. Over 94% of respondents agreed that it is not within the standard of care to initiate orthodontic treatment without an in-person clinical exam or radiographs. Conclusion: Results suggest that dental professionals regard treatment rendered by DTC modalities not in the best interest of the public. Practical Implications: Dentists should be more active with educating patients about the impact of different dental treatment modalities.Indiana University School of Dentistr

Accuracy of 3D Reconstructed Orthodontic Models

Objective: To evaluate the accuracy of 3D reconstructed orthodontic models, derived by various digitization methods, as compared to conventional orthodontic plaster models. Materials and Methods: Twenty-five maxillary orthodontic plaster models were randomly selected from the Indiana University School of Dentistry Department of Orthodontics. Each plaster model was scanned with the Cadent iOC scanner and the digital data was used to print 3D reconstructed orthodontic models. The same 25 plaster models were duplicated using alginate and poured in plaster after two days. These duplicated plaster models were also scanned with the iOC scanner and 3D reconstructed. Next, the duplicate plaster models were sent to a lab, scanned with a 3Shape R700 scanner, and the digital data was 3D reconstructed. Digital calipers were used to obtain ten linear dimensional measurements on all plaster and 3D reconstructed models for comparisons. Equivalence testing was performed using 2 one-sided paired t-tests with a significance level of P <0.05. Results: Nine of the 10 linear measurements were statistically equivalent in all groups. Clinically insignificant, but statistically significant, measurement differences in maxillary central incisor height (P <0.05) were found on 3D reconstructed models derived from the 3Shape R700 desktop scanner. Conclusion: 3D reconstructed orthodontic models derived from alginate impressions, iOC scanners, and 3Shape R700 scanners are an accurate and reliable substitute for orthodontic plaster models.Indiana University School of Dentistr

EFFECTS OF ORTHODONTIC MINI-IMPLANT DIAMETER ON MICRODAMAGE.

POSTER ABSTRACTMicrodamage reduces bone mechanical properties and thus could possi-bly contribute to implant failure. The objective of this study was to investi-gate whether the diameter of mini-implants (MI) affects microdamage gen-eration and whether this differs between the mandible and maxilla due to their contrasting cortical thicknesses. Methods: Maxillary and mandibular quadrants of 5 dogs were randomly assigned to receive, in situ, no interven-tion (control), pilot drilling only, or pilot drilling plus one of three diameters of MI: 1.4 (n=18), 1.6 (n=18), and 2.0 mm (n=18). Microdamage was as-sessed on basic fuchsin stained sections using epifluorescence microscopy. Results: No microdamage was found in the non-drilling controls. Pilot drill-ing produced only minimal microdamage in the maxilla but more microdamage in the mandible. There was significantly higher microdamage generated in the mandible, compared to the maxilla (p<0.05). In the maxil-la, although insertion of all implants produced higher microdamage than the control and pilot drilling, there were no differences between the 3 MI diame-ters. In the mandible, insertion of implants generated significantly higher microdamage than the control, but it did not produce higher microdamage than pilot drilling. Similarly, no differences in microdamage were found be-tween 3 MI diameters. Conclusion: Insertion of MIs in the mandible pro-duced higher microdamage than in the maxilla, which may explain that the higher MI failure rate in the mandible. Implant diameter did not affect over-all microdamage burden in either jaw. Microdamage was mostly generated by pilot drilling through the cortex in the mandible, while microdamage in the maxilla was mainly produced when manual inserting MIs after pilot drill-ing

Microdamage generation by tapered and cylindrical mini-screw implants after pilot drilling

Objective:  To investigate the relationship between mini-screw implant (MSI) diameter (1.6 vs 2.0 mm) and shape (tapered vs cylindrical) and the amount of microdamage generated during insertion. Materials and Methods:  Thirty-six cylindrical and 36 tapered MSIs, 6 mm long, were used in this study. Half of each shape was 1.6 mm in diameter, while the other half was 2.0 mm. After pilot drilling, four and five MSIs were inserted, respectively, into fresh cadaveric maxillae and mandibles of dogs. Bone blocks containing the MSIs were sectioned and ground parallel to the MSI axis. Epifluorescent microscopy was used to measure overall cortical thickness, crack length, and crack number adjacent to the MSI. Crack density and total microdamage burden per surface length were calculated. Three-way analysis of variance (ANOVA) was used to test the effects of jaw, and MSI shape and diameter. Pairwise comparisons were made to control the overall significance level at 5%. Results:  The larger (2.0 vs 1.6 mm) cylindrical MSIs increased the numbers, lengths, and densities of microcracks, and the total microdamage burden. The same diameter cylindrical and tapered MSIs generated a similar number of cracks and crack lengths. More total microdamage burden was created by the 2.0-mm cylindrical than the 2.0-mm tapered MSIs. Although higher crack densities were produced by the insertion of 1.6-mm tapered MSIs, there was no difference in total microdamage burden induced by 1.6-mm tapered and 1.6-mm cylindrical MSIs. Conclusions:  Pilot drilling is effective in reducing microdamage during insertion of tapered MSIs. To prevent excessive microdamage, large diameter and cylindrical MSIs should be avoided

Correlation between Advanced Dental Admission Test performance and dental MATCH success

Purpose/Objectives The Advanced Dental Admissions Test was developed in 2016 to aid residency programs evaluate qualified applicants. Since its conception, however, there have been no studies seeking to evaluate the usefulness of the exam regarding an applicants’ ability to match with a residency program through the Postdoctoral Dental Matching Program (MATCH). The aim of this study was to evaluate the impact of the Advanced Dental Admission Test performance on student MATCH success into a post-doctoral pediatric residency program. Methods This retrospective study evaluated the academic records of pediatric residency applicants using the ADEA PASS and MATCH program between 2017 and 2019. Five scholastic and 7 demographic variables were extracted from student ADEA PASS applications. Applicant MATCH status and preference was obtained from the Postdoctoral Dental Matching Program. Descriptive statistics for each application cycle was calculated and used to evaluate applicant demographic and scholastic data. Correlation coefficients assessed for associations between scholastic/demographic factors and MATCH status/preference. Logistic regression models estimated the probability of MATCH status/preference. Significance was set at 5%. Results An association was found between ADAT scores and MATCH status, but the influence was minimal (odds ratio: 1.004, 95% confidence interval: 1.001-1.008). Applicant age (P < 0.0216) and dental schools that ranked students (P < 0.0002) were the most significant factors for MATCH status and preference, respectively. Conclusions ADAT scores played a minimal role in applicants matching to pediatric residency programs. Applicant age and schools that provide class ranks were found to be significant predictors when considering MATCH status and preference to pediatric residency programs

Accuracy of Orthodontic Soft Tissue Prediction Software between Different Ethnicities

Objective: The objective of this study was to assess the accuracy of the soft tissue prediction module of Dolphin Imaging Software (DIS) in patients requiring extractions as part of the orthodontic treatment plan and compare its accuracy between different ethnicities. Materials and Methods: Initial and final records of 57 patients from three ethnic groups (African Americans, Caucasians, and Hispanics) who completed orthodontic treatment were included for assessment. The identified cases were managed non-surgically with dental extractions. A predictive profile was generated using DIS and compared to post-treatment lateral photographs. Actual and predictive profile photographs were compared using five designated parameters. The assessment parameters were evaluated using a manual protractor. ANOVA was used to compare differences between actual and predicted parameters between the specified groups and ICC was used to assess correlations between the data. Results: Neither ethnicity nor gender had a significant effect on the difference between predicted and final values. No significant difference was noted between the predicted and final images for the nasolabial angle. Significant differences were observed for the mentolabial fold, upper lip to E-line, and lower lip to E-line between predicted and actual images. Additionally, soft tissue convexity was significantly different (p=0.019). Additionally, a clinically significant difference was found for the mentolabial fold. Conclusion: Ethnicity and gender had no impact on the accuracy of predicted and actual image parameters. Overall, DIS demonstrated acceptable accuracy when simulating soft tissue changes after extraction therapy. Additional research on the accuracy of the software is warranted

Predictors of orthodontic residency performance: An assessment of scholastic and demographic selection parameters

Objective: To evaluate the association between resident selection criteria, including Graduate Record Examination (GRE) scores, and student performance in an orthodontic residency program. Materials and methods: This retrospective study evaluated the academic records of 70 orthodontic residency graduates from the Indiana University School of Dentistry. The following demographic and scholastic data were extracted from the student academic records: applicant age, gender, ethnicity, race, country of origin, dental school graduation year, GRE score, and graduate orthodontic grade point average (GPA). In addition, student American Board of Orthodontics (ABO) written examination quintiles were obtained from the ABO. Scatterplots, analysis of variance, and correlation coefficients were used to analyze the data. Statistical significance was established at .05 for the study. Results: No associations were found with any component of the GRE, except with the quantitative GRE section, which displayed a weak association with ABO module 2 scores. Dental school GPA demonstrated weak correlations with all ABO modules and moderate correlations with overall and didactic orthodontic GPAs. When assessing demographic factors, significant differences (P < .05) were observed, with the following groups demonstrating higher performance on certain ABO modules: age (younger), race (whites), and country of origin (US citizens). Conclusions: Findings suggest the GRE has no association with student performance in an orthodontic residency. However, dental school GPA and/or class rank appear to be the strongest scholastic predictors of residency performance