Research Articles (Dental Management Sciences)

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Learning from data in dentistry : summary of the third annual OpenWide conference
(Wiley, 2024-10) Kalenderian, Elsbeth; Zouaidi, Kawtar; Yeager, Jan; Urata, Janelle; Yansane, Alfa; Tokede, Bunmi; Rindal, D. Brad; Spallek, Heiko; White, Joel; Walji, Muhammad
The overarching goal of the third scientific oral health symposium was to introduce the concept of a learning health system to the dental community and to identify and discuss cutting‐edge research and strategies using data for improving the quality of dental care and patient safety. Conference participants included clinically active dentists, dental researchers, quality improvement experts, informaticians, insurers, EHR vendors/developers, and members of dental professional organizations and dental service organizations. This report summarizes the main outputs of the third annual OpenWide conference held in Houston, Texas, on October 12, 2022, as an affiliated meeting of the American Dental Association (ADA) 2022 annual conference.
Buccal and palatal alveolar bone dimensions in the anterior maxilla
(Wiley, 2023-04) Todorovic, Vladimir S.; Postma, Thomas Corne; Hoffman, Jakobus; Van Zyl, Andre W.
OBJECTIVE : Anterior maxillary immediate implant placement has become a popular procedure. It has aesthetic and functional risks. A prerequisite for success is sufficient alveolar bone for primary stability. Many cone-beam computed tomography (CBCT) studies have assessed alveolar bone dimensions in the anterior maxilla, with varying results. More accurate information on the alveolar bone dimensions in the anterior maxilla is required. The objective of the present study was to evaluate bone dimensions in the anterior maxilla using micro-CT, a high-resolution imaging tool. MATERIALS AND METHODS : Seventy-two human skulls were scanned using micro-CT at the South African Nuclear Energy Corporation. Specialized software was used for 3-D rendering, segmentation, and visualization of the reconstructed volume data. Axial planes were created over each alveolus/tooth from canine to canine. Buccal and palatal bone dimensions were measured at crestal, 3 mm, 6 mm, and 9 mm levels. RESULTS : Buccal bone rarely exceeded 0.5 mm, consisting of bundle bone only for all investigated teeth at all levels. Up to a third of teeth showed buccal fenestrations. Alveolar bone on the palatal side was thicker than buccal and increased from <1 mm at crestal level up to 3.77 mm, 4.56 mm, and 5.43 mm for centrals, laterals, and canines at the 9 mm level, respectively. CONCLUSIONS : Immediate implants in the anterior maxillae has anatomical risks. Alveolar bone on the buccal aspect is very thin, with fenestrations in certain positions. Therefore, a thorough planning and individual approach are needed to avoid possible complications and achieve stable aesthetic and functional results in the long-term.
Evaluating and improving the usability of a mHealth platform to assess postoperative dental pain
(Oxford University Press, 2024-03) Ibarra Noriega, Ana M.; Yansane, Alfa; Mullins, Joanna; Simmons, Kristen; Skourtes, Nicholas; Holmes, David; White, Joel; Kalenderian, Elsbeth; Walji, Muhammad F.
OBJECTIVES : The use of interactive mobile health (mHealth) applications to monitor patient-reported postoperative pain outcomes is an emerging area in dentistry that requires further exploration. This study aimed to evaluate and improve the usability of an existing mHealth application. MATERIALS AND METHODS : The usability of the application was assessed iteratively using a 3-phase approach, including a rapid cognitive walkthrough (Phase I), lab-based usability testing (Phase II), and in situ pilot testing (Phase III). The study team conducted Phase I, while providers and patients participated in Phase II and III. RESULTS : The rapid cognitive walkthrough identified 23 potential issues that could negatively impact user experience, with the majority classified as system issues. The lab-based usability testing yielded 141 usability issues.; 43% encountered by patients and 57% by dentists. Usability problems encountered during pilot testing included undelivered messages due to mobile phone carrier and service-related issues, errors in patients’ phone number data entry, and problems in provider training. DISCUSSION : Through collaborative and iterative work with the vendor, usability issues were addressed before launching a trial to assess its efficacy. CONCLUSION : The usability of the mHealth application for postoperative dental pain was remarkably improved by the iterative analysis and interdisciplinary collaboration.
Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN
(BMC, 2024-02) Kalenderian, Elsbeth; Tungare, Sayali; Mehta, Urvi; Hamid, Sharmeen; Mungia, Rahma; Yansane, Alfa-Ibrahim; Holmes, David; Funkhouser, Kim; Ibarra-Noriega, Ana M.; Urata, Janelle; Rindal, D. Brad; Spallek, Heiko; White, Joel M.; Walji, Muhammad F.
BACKGROUND : Dental Patient Reported Outcomes (PROs) relate to a dental patient’s subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. METHODS : Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mHealth) platform to collect the pain experience after dental procedures. A themes analysis was conducted to identify implementation barriers and facilitators. RESULTS : Five themes were uncovered: (1) Sense of Better Care. (2) Tailored Follow-up based on the dental procedure and patient’s pain experience. (3) Effective Messaging and Alerts. (4) Usable Digital Platform. (5) Routine mHealth Integration. CONCLUSION : Frequent automated and preferably tailored follow-up messages using an mHealth platform provided a positive care experience for patients, while providers felt it saved them time and effort. Patients thought that the mHealth questionnaires were well-developed and of appropriate length. The mHealth platform itself was perceived as user-friendly by users, and most would like to continue using it. PRACTICAL IMPLICATIONS : Patients are prepared to use mobile phones to report their pain experience after dental procedures. Practitioners will be able to close the post-operative communication gap with their patients, with little interruption of their workflow.
Translating periodontal data to knowledge in a learning health system
(Elsevier, 2022-10) Tokede, Bunmi; Yansane, Alfa; White, Joel; Bangar, Suhasini; Mullins, Joanna; Brandon, Ryan; Gantela, Swaroop; Kookal, Krishna; Rindal, Donald; Lee, Chun-Teh; Lin, Guo-Hao; Spallek, Heiko; Kalenderian, Elsbeth; Walji, Muhammad
BACKGROUND : A learning health system (LHS) is a health system in which patients and clinicians work together to choose care on the basis of best evidence and to drive discovery as a natural outgrowth of every clinical encounter to ensure the right care at the right time. An LHS for dentistry is now feasible, as an increased number of oral health care encounters are captured in electronic health records (EHRs). METHODS : The authors used EHRs data to track periodontal health outcomes at 3 large dental institutions. The 2 outcomes of interest were a new periodontitis case (for patients who had not received a diagnosis of periodontitis previously) and tooth loss due to progression of periodontal disease. RESULTS : The authors assessed a total of 494,272 examinations (new periodontitis outcome: n = 168,442; new tooth loss outcome: n = 325,830), representing a total of 194,984 patients. Dynamic dashboards displaying performance on both measures over time allow users to compare demographic and risk factors for patients. The incidence of new periodontitis and tooth loss was 4.3% and 1.2%, respectively. CONCLUSIONS: Periodontal disease, diagnosis, prevention, and treatment are particularly well suited for an LHS model. The results showed the feasibility of automated extraction and interpretation of critical data elements from the EHRs. The 2 outcome measures are being implemented as part of a dental LHS. The authors are using this knowledge to target the main drivers of poorer periodontal outcomes in a specific patient population, and they continue to use clinical health data for the purpose of learning and improvement. PRACTICAL IMPLICATIONS : Dental institutions of any size can conduct contemporaneous self-evaluation and immediately implement targeted strategies to improve oral health outcomes.
BigMouth : development and maintenance of a successful dental data repository
(Oxford University Press, 2022-03) Walji, Muhammad F.; Spallek, Heiko; Kookal, Krishna Kumar; Barrow, Jane; Magnuson, Britta; Tiwari, Tamanna; Oyoyo, Udochukwu; Brandt, Michael; Howe, Brian J.; Anderson, Gary C.; White, Joel; Kalenderian, Elsbeth
Few clinical datasets exist in dentistry to conduct secondary research. Hence, a novel dental data repository called BigMouth was developed, which has grown to include 11 academic institutions contributing Electronic Health Record data on over 4.5 million patients. The primary purpose for BigMouth is to serve as a high-quality resource for rapidly conducting oral health-related research. BigMouth allows for assessing the oral health status of a diverse US patient population; provides rationale and evidence for new oral health care delivery modes; and embraces the specific oral health research education mission. A data governance framework that encouraged data sharing while controlling contributed data was initially developed. This transformed over time into a mature framework, including a fee schedule for data requests and allowing access to researchers from noncontributing institutions. Adoption of BigMouth helps to foster new collaborations between clinical, epidemiological, statistical, and informatics experts and provides an additional venue for professional development.
Measuring final-year dental students’ ability to remove teeth independently using independence ratios
(Health and Medical Publishing Group, 2022-09) Merbold, Karl-Heinz; Postma, Thomas Corne; corne.postma@up.ac.za
BACKGROUND. Universities are obliged to ensure that dental graduates possess the necessary skills to render safe and effective treatment. Empirical evidence regarding the development of safe and effective independent practice at undergraduate level is unfortunately lacking. OBJECTIVES. To measure final-year students' abilities to correctly perform exodontia (tooth removal/extraction) skills independently, based on the applied postgraduate progressive independence theory. METHODS. Fourteen clinical teachers systematically assessed 13 263 tooth extractions completed by final-year dental students (2014 - 2016). An independence ratio (extractions performed without assistance/total number of extractions) was used as the key performance indicator to provide feedback on the ability to complete procedures independently over time. A customised index was used for controlling the level of difficulty. RESULTS. Final-year students (n=146) achieved independence ratios ranging between 90% and 94% (standard deviation 3.3%) by the end of their clinical training. Logical gradients of increased independence were illustrated with time, as well as variable performance among students. The level of difficulty index scores remained similar within cohorts per year of study. Acceptable assessment differences existed between clinical teachers, which could largely be explained by complex operational circumstances. CONCLUSIONS. As far as we are aware, this is the first study that quantified progressive independence in exodontia for undergraduate students. The measure was sensitive enough to show logical independence gradients and variance among students. Final-year students demonstrated that they could remove >8/10 teeth independently by the time of their graduation. The measure shows promise as a proxy of competence for skills that are often practised. It is recommended that factors that influence these measurements be examined in more detail.
Development of an inventory of dental harms : methods and rationale
(Lippincott Williams and Wilkins, 2022-09) Kalenderian, Elsbeth; Lee, Joo Hyun; Obadan-Udoh, Enihomo M.; Yansane, Alfa; White, Joel; Walji, Muhammad F.
OBJECTIVES : While adverse events (AEs) are all too prevalent, their underlying causes are difficult to assess because they are often multifactorial. Standardizing the language of dental AEs is an important first step toward increasing patient safety for the dental patient. METHODS : We followed a multimodal approach building a dental AE inventory, which included a literature review; review of the MAUDE database; a cross-sectional, self-administered patient survey; focus groups; interviews with providers and domain experts; and chart reviews. RESULTS : One hundred eight unique allergy/toxicity/foreign body response, 70 aspiration/ingestion of foreign body, 70 infection, 52 wrong site/wrong patient/wrong procedure, 23 bleeding, 48 pain, 149 hard tissue injury, 127 soft tissue injury, 91 nerve injury, 171 other systemic complication, and 177 other orofacial complication were identified. Subtype AEs within the categories revealed that allergic reaction, aspiration, pain, and wrong procedure were the most common AEs identified among known (i.e., chart reviews) and hypothetical (i.e., interviews) sources. CONCLUSIONS : Using a multimodal approach, a broad list of dental AEs was developed, in which the AEs were classed into 12 categories. Hard tissue injury was noted frequently during interviews and in actuality. Pain was the unexpected AE that was consistently identified with every modality used. PRACTICAL IMPLICATIONS : Most AEs result in temporary harm with hard tissue injury being a common AE identified through interviews and in actuality through chart reviews. Acknowledging that AEs happen is an important step toward mitigating them and assuring quality of care for our patients.
Study protocol : understanding pain after dental procedures, an observational study within the National Dental PBRN
(BMC, 2022-12-09) Kalenderian, Elsbeth; White, Joel; Yansane, Alfa‑Ibrahim; Urata, Janelle; Holmes, David; Funkhouser, Kimberly; Mungia, Rahma; Xiao, Jin; Rauschenberger, Cindy; Ibarra‑Noriega, Ana; Tran, Duong; Rindal, D. Brad; Spallek, Heiko; Walji, Muhammad
BACKGROUND : Patient-reported outcome measures provide an essential perspective on the quality of health care provided. However, how data are collected, how providers value and make sense of the data, and, ultimately, use the data to create meaningful impact all influence the success of using patient-reported outcomes. OBJECTIVES : The primary objective is to assess post-operative pain experiences by dental procedure type through 21 days post-procedure as reported by patients following dental procedures and assess patients’ satisfaction with pain management following dental surgical procedures. Secondary objectives are to: 1) assess post-operative pain management strategies 1 week following dental surgical procedures, as recommended by practitioners and reported by patients, and 2) evaluate practitioner and patient acceptance of the FollowApp.Care post visit patient monitoring technology (FollowApp.Care). We will evaluate FollowApp.Care usage, perceived usefulness, ease of use, and impact on clinical workload. DESIGN AND METHODS : We describe the protocol for an observational study involving the use of the FollowApp. Care platform, an innovative mobile application that collects dental patients’ assessments of their post-operative symptoms (e.g., pain). The study will be conducted in collaboration with the National Dental Practice-based Research Network, a collective Network of dental practices that include private and group practices, public health clinics, community health centers and Federal Qualified Health Centers, academic institutional settings, and special patient populations. We will recruit a minimum of 150 and up to 215 dental providers and up to 3147 patients who will receive push notifications through text messages FollowApp.Care on their mobile phones at designated time intervals following dental procedures. This innovative approach of implementing an existing and tested mobile health system technology into the real-world dental office setting will actively track pain and other complications following dental procedures. Through patients’ use of their mobile phones, we expect to promptly and precisely identify specific pain levels and other issues after surgical dental procedures. The study’s primary outcome will be the patients’ reported pain experiences. Secondary outcomes include pain management strategies and medications implemented by the patient and provider and perceptions of usefulness and ease of use by patients and providers.
Presence of management, entrepreneurship, leadership and marketing topics in the dental school curriculum in Brazil
(Wiley, 2022-05) Cunha D'Assuncao, Fabio Luiz; Kalenderian, Elsbeth; Carneiro, Davi Clementino; Fragoso Vercosa, Maria Vitoria; Santos, Jozemar Pereira; Yansane, Alfa-Ibrahim; Cunha D'Assuncao, Veronica Cabral dos Santos; Felinto, Arturo Rodrigues
INTRODUCTION : To analyse the presence and characteristics of curricular components related to management, entrepreneurship, leadership and marketing as part of the structure and teaching methods of undergraduate courses in dentistry in Brazil. MATERIALS AND METHODS : This is an observational study that used the Ministry of Education's Undergraduate Course Accreditation Platform, which included 424 undergraduate courses in Dentistry on the last date of collection (August 31 2019). The following items were analysed as follows: the existence of curricular components in relation to the proposed themes, the most recurring denominations of curricular components, minimum and maximum workload, mandatory/optional classification, theoretical/practical teaching condition and in which year the curricular components were inserted. RESULTS : 367/424 (86.6%) of dentistry courses in Brazil included at least one of the topics: management, entrepreneurship, leadership and marketing curricular components in their curriculum, whilst 57/424 (13.4%) did not have these curricular components in their curricular structure. The most frequent names were "Management" 99 (45.21%) and "Entrepreneurship" 80 (36.5%). There was a predominance of the “theoretical method” and the number of hours varied considerably, with the most common course hours between 40 and 60 h. The majority of curricular components were inserted in the third to fifth year and offered on a compulsory basis. CONCLUSION : Most curricular matrices of dentistry courses in Brazil had components related to the topics studied. However, due to the variety of curricular components' names, hours, periods of courses and different teaching methodologies, there is a need to redesign the teaching and learning process, defining educational and evaluation models with common curricular components.
Development of a quality improvement dental chart review training program
(Lippincott Williams and Wilkins, 2022-08) Kalenderian, Elsbeth; Hebballi, Nutan B.; Franklin, Amy; Yansane, Alfa; Ibarra Noriega, Ana M.; White, Joel; Walji, Muhammad F.
INTRODUCTION : Chart review is central to understanding adverse events (AEs) in medicine. In this article, we describe the process and results of educating chart reviewers assigned to evaluate dental AEs. METHODS : We developed a Web-based training program, “Dental Patient Safety Training,” which uses both independent and consensus-based curricula, for identifying AEs recorded in electronic health records in the dental setting. Training included (1) didactic education, (2) skills training using videos and guided walkthroughs, (3) quizzes with feedback, and (4) hands-on learning exercises. In addition, novice reviewers were coached weekly during consensus review discussions. TeamExpert was composed of 2 experienced reviewers, and TeamNovice included 2 chart reviewers in training. McNemar test, interrater reliability, sensitivity, specificity, positive predictive value, and negative predictive value were calculated to compare accuracy rates on the identification of charts containing AEs at the start of training and 7 months after consensus building discussions between the 2 teams. RESULTS : TeamNovice completed independent and consensus development training. Initial chart reviews were conducted on a shared set of charts (n = 51) followed by additional training including consensus building discussions. There was a marked improvement in overall percent agreement, prevalence and bias-adjusted κ correlation, and diagnostic measures (sensitivity, specificity, positive predictive value, and negative predictive value) of reviewed charts between both teams from the phase I training program to phase II consensus building. CONCLUSIONS : This study detailed the process of training new chart reviewers and evaluating their performance. Our results suggest that standardized training and continuous coaching improves calibration between experts and trained chart reviewers.
The burnout construct with reference to healthcare providers : a narrative review
(Sage, 2022-03) Khammissa, Razia Abdool Gafaar; Nemutandani, Simon; Shangase, Sindisiwe Londiwe; Feller, Gal; Lemmer, Johan; Feller, Liviu; razia.khammissa@up.ac.za
Burnout syndrome is a psychological response to long-term exposure to occupational stressors. It is characterized by emotional exhaustion, cognitive weariness and physical fatigue, and it may occur in association with any occupation, but is most frequently observed among professionals who work directly with people, particularly in institutional settings. Healthcare professionals who work directly with patients and are frequently exposed to work overload and excessive clinical demands, to ethical dilemmas, to pressing occupational schedules and to managerial challenges; who have to make complex judgements and difficult decisions; and who have relatively little autonomy over their job-related tasks are at risk of developing clinical burnout. In turn, clinical burnout among clinicians has a negative impact on the quality and safety of treatment, and on the overall professional performance of healthcare systems. Healthcare workers with burnout are more likely to make mistakes and to be subjected to medical malpractice claims, than do those who are burnout-naïve. Experiencing the emotional values of autonomy, competence and relatedness are essential work-related psychological needs, which have to be satisfied to promote feelings of self-realization and meaningfulness in relation to work activities, thus reducing burnout risk. Importantly, an autonomy-supportive rather than a controlling style of management decreases burnout risk and promotes self-actualization, self-esteem and a general feeling of well-being in both those in charge and in their subordinates. The purpose of this article is to discuss some of the elements constituting the burnout construct with the view of gaining a better understanding of the complex multifactorial nature of burnout. This may facilitate the development and implementation of both personal, behavioural and organizational interventions to deal with the burnout syndrome and its ramifications.
A preliminary inquiry on the association between pre-admission assessments and academic performance of first year dental technology students’ within a South African university of technology
(South African Dental Association, 2021-05) Vahed, Anisa; Naidoo, Subhadranalene; Singh, Deepak
INTRODUCTION : The use of selection, diagnostic, proficiency, placement, admission, manual dexterity and aptitude tests can reportedly predict students' academic success. Predictive admission procedures help to reduce dropout rates, improve academic performance, increase success rates, and selectively exclude applicants who are unlikely to be successful in the course. There is an absence of research, however, in this area of work in Dental Technology. AIM : To examine the association between pre-admission assessments and Dental Technology students' academic performance in a South African University of Technology. DESIGN : A quantitative and cross-sectional study design was used. METHODS : The target populations were the 2018 and 2019 first-year Dental Technology students. Retrospective data extracted from academic records and programme files were statistically analysed to measure the correlations against students' academic performance RESULTS : Despite there being no significant differences between pre-admission tests and students' academic performance, there were significant positive correlations between first-year university subjects. CONCLUSIONS : There are indications of horizontal coherence between the discipline-specific subjects in the first-year Dental Technology curriculum. Examining the association between pre-admission tests and students' academic results through to graduation, together with the horizontal and vertical alignments of all subjects in the undergraduate Dental Technology curriculum, can facilitate the learning pathways for students to succeed academically at universities.
Caries risk documentation and prevention : eMeasures for dental electronic health records
(Thieme Gruppe, 2022-01) Bangar, Suhasini; Neumann, Ana; White, Joel M.; Yansane, Alfa; Johnson, Todd R.; Olson, Gregory W.; Kumar, Shwetha V.; Kookal, Krishna K.; Kim, Aram; Obadan-Udoh, Enihomo; Mertz, Elizabeth; Simmons, Kristen; Mullins, Joanna; Brandon, Ryan; Walji, Muhammad F.; Kalenderian, Elsbeth
BACKGROUND: Longitudinal patient level dataavailable in the electronic health record (EHR)allows for the development, implementation, and validations of dental quality measures (eMeasures). Objective We report the feasibility and validity of implementing two eMeasures. The eMeasures determined the proportion of patients receiving a caries risk assessment (eCRA) and corresponding appropriate risk-based preventative treatments for patients at elevated risk of caries (appropriateness of care [eAoC]) in two academic institutions and one accountable care organization, in the 2019 reporting year. METHODS: Both eMeasures define the numerator and denominator beginning at the patient level, populations’ specifications, and validated the automated queries. For eCRA, patients who completed a comprehensive or periodic oral evaluation formed the denominator, and patients of any age who received a CRA formed the numerator. The eAoC evaluated the proportion of patients at elevated caries risk who received the corresponding appropriate risk-based preventative treatments. RESULTS: EHR automated queries identified in three sites 269,536 patients who met the inclusion criteria for receiving a CRA. The overall proportion of patients who received a CRA was 94.4% (eCRA). In eAoC, patients at elevated caries risk levels (moderate, high, or extreme) received fluoride preventive treatment ranging from 56 to 93.8%. For patients at high and extreme risk, antimicrobials were prescribed more frequently site 3 (80.6%) than sites 2 (16.7%) and 1 (2.9%). CONCLUSION: Patient-level data available in the EHRs can be used to implement process-ofcare dental eCRA and AoC, eAoC measures identify gaps in clinical practice. EHR-based measures can be useful in improving delivery of evidence-based preventative treatments to reduce risk, prevent tooth decay, and improve oral health.
Assessing the completeness of periodontal disease documentation in the EHR : a first step in measuring the quality of care
(BMC, 2021-05-29) Mullins, Joanna; Yansane, Alfa; Kumar, Shwetha V.; Bangar, Suhasini; Neumann, Ana; Johnson, Todd; Olson, Gregory W.; Kookal, Krishna Kumar; Sedlock, Emily; Kim, Aram; Mertz, Elizabeth; Brandon, Ryan; Simmons, Kristen; White, Joel M.; Kalenderian, Elsbeth; Walji, Muhammad F.
BACKGROUND : Our objective was to measure the proportion of patients for which comprehensive periodontal charting, periodontal disease risk factors (diabetes status, tobacco use, and oral home care compliance), and periodontal diagnoses were documented in the electronic health record (EHR). We developed an EHR-based quality measure to assess how well four dental institutions documented periodontal disease-related information. An automated database script was developed and implemented in the EHR at each institution. The measure was validated by comparing the findings from the measure with a manual review of charts. RESULTS : The overall measure scores varied significantly across the four institutions (institution 1 = 20.47%, institution 2 = 0.97%, institution 3 = 22.27% institution 4 = 99.49%, p-value < 0.0001). The largest gaps in documentation were related to periodontal diagnoses and capturing oral homecare compliance. A random sample of 1224 charts were manually reviewed and showed excellent validity when compared with the data generated from the EHR-based measure (Sensitivity, Specificity, PPV, and NPV > 80%). CONCLUSION : Our results demonstrate the feasibility of developing automated data extraction scripts using structured data from EHRs, and successfully implementing these to identify and measure the periodontal documentation completeness within and across different dental institutions.
Treatment of psoriasis
(Medpharm Publications, 2020-12) Jacobs, T.; Kgokolo, Mahlatse C.M.
Psoriasis is a prevalent chronic inflammatory disease. Beyond skin and joint manifestations, psoriasis has numerous associated comorbidities, including metabolic and cardiovascular disease. There are many treatment options available, from topical treatment for mild psoriasis, phototherapy for moderate disease, to systemic therapy or biological agents for severe disease. This article aims to focus on the treatment for the majority of patients where topical agents alone are generally appropriate.
Dental students’ self-perceived competency and usage of the internet for learning and evaluation purposes - Part 2
(South African Dental Association, 2020-08) Sykes, Leanne M.; Postma, Thomas Corne; Uys, Andre; Brandt, Paul Dieter; Crafford, Elmine; leanne.sykes@up.ac.za
Many dental lecturers are moving away from providing hand-out notes to their students and are rather opting for posting lecture material and tutorials on the internet using the various university platforms such as clickUP. At the same time a number of students have queried the need to purchase the prescribed text books due to their high costs, and dated content. The presumption is that all students have unrestricted and equal access to this material, and are competent using digital technology for learning and assessment, however there has been no formal investigation into whether this is so. Student access and usage was reported on in Part I of this study. The present paper investigated students’ preferences with regards to the mode of learning material, and their self-perceived competencies in using the internet for various academic purposes. The project took the form of an anonymous, structured questionnaire that was given to all dental students from the second to the fifth year of study.
The ‘digital access divide’ at a South African dental school – a cross-sectional study - Part 1
(South African Dental Association, 2020-08) Postma, Thomas Corne; Sykes, Leanne M.; Uys, Andre; Brandt, Paul Dieter; Crafford, Elmine; leanne.sykes@up.ac.za
This study sought to investigate the digital divide, from an access perspective, of dental students at the University of Pretoria. Second to final year students (n= 218 (87.2% response rate) completed a custom-designed survey at the end of 2017. The investigation enquired about the digital devices and infra-structure they owned and used for study purposes. They were also asked to reveal the networks and resources they used to access online platforms and to comment on any other related access issues such as the quality of the Internet, speed and reliability, as well as cost and personal implications related to usage. A clear divide could be detected for a minority of students (±1/7). Individually targeted interventions will be required to ensure an equitable and fair online learning experience.
Reasons why South African dentists chose a career in Dentistry, and later opted to enter an academic environment
(South African Dental Association, 2018-04) Mostert, Vanessa C.; vanessa.mostert@up.ac.za
OBJECTIVES : This study aimed to investigate the reasons why South African dentists chose to study Dentistry, later opting for an academic career. METHODS : A cross sectional survey using an anonymous 12-point questionnaire that was sent out to a cohort of dentists and specialists holding positions at the four South African universities which offer a dental degree. Descriptive statistics were calculated using STATA Release 14. RESULTS : Of 160 questionnaires distributed, 66 were completed. Popular reasons dentists cited for choosing this career were job security, a desire to help people, the degree is recognised, love working with their hands, and regular but flexible working hours. The main reasons the respondents chose an academic career were a need for intellectual stimulation, desiring a broad spectrum of work, having a love for teaching, wanting to influence or shape the profession, to pursue postgraduate studies and to do research. More than half (55%) of respondents would not choose Dentistry as a career again. CONCLUSION : This study revealed that the career motivations of this cohort of SA dentists was far less related to the socioeconomic aspects of Dentistry than it was to their desire for more mental stimulation, in contrast to many findings elsewhere.
The prevalence of second canals in the mesiobuccal root of maxillary molars : a cone beam computed tomography study
(Wiley, 2019-04) Fernandes, N.A. (Nelson Alexander); Herbst, Dirk; Postma, Thomas Corne; Bunn, Belinda Kathleen
The aim of this study was to determine the prevalence of MB2 canals in permanent maxillary molars utilising CBCT; in patients attending a university hospital. A total of 200 patient scans, (100 female and 100 male patients), were enrolled in the study. In total, 800 teeth were analysed, and teeth with additional canals in their MB roots (MB2) were identified. First maxillary molar teeth exhibited the highest prevalence of MB2 canals, 92% and 87%, for teeth 16 and 26, respectively. Second maxillary molar teeth showed a lower prevalence of MB2 canals, 69% and 65%, for the 17 and 27, respectively. There were no associations of significance between the prevalence of MB2 canals and patient age or gender. Root morphology and anatomy of permanent maxillary first and second molar teeth was found to be highly variable. The prevalence of additional canals in the MB roots is a frequent finding which has previously been underreported.

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