Developing Comprehensive Course Evaluation Guidelines: A Step towards Organizing Program Evaluation Activities in Tehran University of Medical Sciences, Iran

Background & Objective: One of the potential strategies for ensuring the quality of educational programs is adopting a systematic approach to its evaluation. Current evidence indicates the lack of high quality program evaluation activities in the field of medical education. The aim of this study was to review the current status of program evaluation activities in Tehran University of Medical Sciences, Tehran, Iran, and formulate guidelines to promote program evaluation activities at the University level. Methods: A survey was conducted to investigate the current conditions of program evaluation using a questionnaire in 2012. Then, the comprehensive course evaluation guidelines, consisting of 22 items, were developed based on literature review, survey results, and experts’ opinions. Finally, each affiliated school developed its own evaluation plan. The evaluation taskforce reviewed evaluation plans using a checklist. Results: Using one tool or resource, 9 schools (90%) conducted course evaluation at least once. The views of students, faculty, staff or alumni were used occasionally. Moreover, 4 schools (40%) reported the evaluation results. After reviewing 14 submitted course plans based on the checklist, 51 feedbacks were provided. Most and least feedbacks were related to evaluation design and implementation and evaluation infrastructure, respectively. Conclusion: The process of developing guidelines and plans resulted in stakeholders reaching a common understanding of course evaluation, and in turn, creating evaluation capacity and more accountability. Keywords: Program evaluation; Ongoing evaluation; Evaluation system; Comprehensive evaluatio

Patient Confidentiality and Ethical Behaviour as a Professional Commitment in Dentistry: A Case Study in a Genetic Disorder

A professional commitment to patient confidentiality may sometimes contradict other principles of bioethics. Decision-making for doctors and their team can be challenging amidst such conflicting principles, and despite the practitioner’s best intentions, withholding information can result in potential consequences such as harm to others.Un engagement professionnel en faveur de la confidentialité des patients peut parfois être en contradiction avec d’autres principes de bioéthique. La prise de décision pour les médecins et leur équipe peut être difficile au milieu de ces principes contradictoires, et malgré les meilleures intentions du praticien, la rétention d’informations peut avoir des conséquences potentielles telles que le préjudice causé à autrui

Truth Telling as an Element of Ethical Behaviour and Professional Commitment in Dentistry: A Case Study Assessing Non-Disclosure Action

Being truthful with patients is a critical foundation of the doctor-patient relationship and is fundamental to development of trust. A professional commitment to truth telling may sometimes contradict other principles of bioethics, which may challenge decision-making for the doctor and/or the treatment team. Practitioners may fail to address all ethical or legal aspects of a case and therefore make inappropriate decisions.Dire la vérité aux patients est un fondement essentiel de la relation médecin-patient et est indispensable au développement de la confiance. Un engagement professionnel à dire la vérité peut parfois contredire d’autres principes de bioéthique, ce qui peut remettre en question la prise de décision du médecin ou de l’équipe traitant. Les praticiens peuvent ne pas aborder tous les aspects éthiques ou juridiques d’un cas et donc prendre des décisions inappropriées

Management of Limited Interocclusal Distance with the Aid of a Modified Surgical Guide: A Clinical Report

In completely edentulous patients, limited interarch distance can compromise conventional prosthetic fabrication. Bone reduction through various surgical procedures has been recommended to restore an acceptable interarch distance. In such circumstances, a surgical guide built on a mounted cast can be used to minimize and control the amount of bone reduction performed. In the present report, an innovative method of fabrication of surgical guide has been described

Investigation of the effects of arch size and implant angulation on the accuracy of digital impression using two intraoral scanners: An in vitro study

Abstract Objectives The aim of this in vitro study was to evaluate the effect of arch size and implant angulation on the accuracy of digital impression in two intraoral scanners of Trios (3shape) and CEREC (Omnicam). Material and Methods Four acrylic models each including six implants at sites 11, 12, 15, 17, 23, and 27 were used, including large with parallel implants, large with angled implants, small with parallel implants, and small with angled implants. After tightening the scan bodies, distance measurements were done using a coordinate measuring machine. Then, each model was scanned 10 times using each scanner. Trueness and precision measurements were finally computed. Results The trueness values ranged from 20 to 260 μm in CEREC Omnicam, and from 40 to 1030 μm in Trios. The precision values ranged from 30 to 190 μm in CEREC Omnicam, while from 50 to 770 μm in Trios. The multivariate test analysis indicated that the measured distances via two scanners and different models show different behaviors. Pairwise interactions between these three variables were significant (p < .05). Pairwise interactions between these variables were also significant. (p < .0001). Conclusions Arch width could affect the accuracy of digital impression; by rotating toward the second quadrant and end points of the scan, errors have increased. However, the angulation of the implants had no effect on the accuracy of digital impression. The CEREC Omnicam scanner showed higher accuracy (trueness and precision) compared to the Trios (3shape) one

Comparison of Bond Strength in the Different Class of Resin Cements to Cast and CAD/CAM Co-Cr Alloys

Objectives. Despite the widespread use of resin cements in cementing dental restorations, their bond strength to CAD/CAM base metal alloys is not widely studied. This study aimed to evaluate the microshear bond strength (μSBS) between cobalt-chrome (Co-Cr) alloys fabricated using casting or CAD/CAM methods with three types of resin cements. Materials and Methods. Fifty Co-Cr blocks were prepared with CAD/CAM or casting technique. Specimens were divided using primer or not and bonded to three types of resin cements: Panavia F2, RelyX Unicem, and Duo-Link. The differences between the mean μSBS values were analyzed using the two-way ANOVA test and Tukey analysis (α = 0.05). The mode of failure was evaluated using a stereomicroscope. In addition, the specimens were examined by scanning electron microscopy (SEM) based on two received signals: backscattered electrons (SEB) and secondary electrons (SEs). One intact alloy specimen in each group was analyzed by energy-dispersive X-ray spectroscopy (EDX). Results. Most of the specimens in the no-primer group were prematurely debonded. Statistical analyses showed that the interaction between the alloy substrate and cement type was significant (). The bond strength of Panavia F2 was significantly higher than Duo-Link in the CAD/CAM group (). SEM evaluation confirmed the difference in grain structures, while EDX showed no remarkable difference in the chemical composition of the alloy substrates. Conclusion. Alloy fabrication technique may influence the bond strength of resin cements. In the CAD/CAM group, cement containing MDP molecules exhibited higher strength than the etch-and-rinse one.Peer Reviewe

Marginal adaptation of three-unit interim restorations fabricated by the CAD-CA systems and the direct method before and after thermocycling

Limited information is available regarding the marginal adaptation of three-unit interim restorations fabricated by different techniques from different materials. Also, the efficacy of computer-aided design/computer-aided manufacturing (CAD-CAM) systems

Comparison of Marginal Fit and Fracture Strength of a CAD/CAM Zirconia Crown with Two Preparation Designs

Objectives: The purpose of this in vitro study was to compare the marginal adaptation and fracture resistance of a zirconia-based all-ceramic restoration with two preparation designs. Materials and Methods: Twenty-four mandibular premolars were randomly divided into two groups (n=12); the conventional group received a peripheral shoulder preparation and the modified group received a buccal shoulder and proximal/lingual chamfer preparation. The marginal fit of the zirconia crowns (Cercon) was evaluated using a stereomicroscope. After cementation, load was applied to the crowns. The mean fracture load and the mean marginal gap for each group were analyzed using t-test (P=0.05). Results: The mean marginal gap was 71±16µm in the conventional group and 80±10µm in the modified group, with no significant difference (P=0.161). The mean fracture strength was 830±153N for the conventional group and 775±125N for the modified group, with no significant difference (P=0.396). All but one fracture occurred in the veneering ceramic. Conclusion: Less aggressive preparation of proximal and lingual finish lines for the preservation of tooth structure in all-ceramic restorations does not adversely affect the marginal adaptation or fracture strength of the final restoration

Fracture Resistance of Ceramic Laminate Veneers Bonded to Teeth with Class V Composite Fillings after Cyclic Loading

Purpose. Porcelain laminate veneers (PLVs) are sometimes required to be used for teeth with composite fillings. This study examined the fracture strength of PLVs bonded to the teeth restored with different sizes of class V composite fillings. Materials and Methods. Thirty-six maxillary central incisors were divided into three groups (n=12): intact teeth (control) and teeth with class V composite fillings of one-third or two-thirds of the crown height (small or large group, resp.). PLVs were made by using IPS e.max and bonded with a resin cement (RelyX Unicem). Fracture resistance (N) was measured after cyclic loading (1 × 106 cycles, 1.2 Hz). For statistical analyses, one-way ANOVA and Tukey test were used (α=0.05). Results. There was a significant difference between the mean failure loads of the test groups (P=0.004), with the Tukey-HSD test showing lower failure loads in the large-composite group compared to the control (P=0.02) or small group (P=0.05). The control and small-composite groups achieved comparable results (P>0.05). Conclusions. Failure loads of PLVs bonded to intact teeth and to teeth with small class V composite fillings were not significantly different. However, extensive composite fillings could compromise the bonding of PLVs