Competency Assessment of Final-Year Dental Students in Tunisia

Introduction. The educational program assessment has always been the main objective of quality improvement in all curricula. The aim of this study was to describe the levels of competency of final-year students of the Faculty of Dental Medicine of Monastir in Tunisia in the major skills needed for a new dentist. Methods. In this cross-sectional descriptive study, 154 students filled out a questionnaire including 53 competencies, rated on a four-point Likert scale, broadly based on the competencies described in the profile and competences for the graduating dentist in Europe. Results. The response rate was 67% (145/230). For twenty items in the questionnaire, over 75% of the students reported being competent. The five items with the highest percentages were “undertaking supragingival and subgingival scaling-Item 22” (97.2%), “evaluating the periodontium, establishing a diagnosis and formulating a treatment plan-Item 2” (96.6%), “identify the location and degree of activity of dental caries-Item 24 (95.9%), “taking and interpreting dental radiographs-Item 12” (94.4%), “restoring damaged teeth-Item 25” (93.8%), and “managing primary oral health care-Item 16” (93.8%). For eighteen skills, more than 75% of students self-rated being not competent, demonstrating a need of more thorough training, notably in periodontal surgery and implantology, among these, five skills were found that demand in-depth acquisition according to the students. Conclusion. The general state of competency of the last-year dental students was described as fairly satisfactory based on the students’ self-reported responses. However, theoretical and practical backgrounds related to some subjects in the school need to be improved.

Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. Results: Ten randomized controlled trials were included out of 1,434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial PPD was 4-6mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.

Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. Results: Ten randomized controlled trials were included out of 1,434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial PPD was 4-6mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.

Clinical evaluation of ultrasonic subgingival debridement versus ultrasonic subgingival scaling combined with manual root planing in the treatment of periodontitis: study protocol for a randomized controlled trial

Background: Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes the obvious growth tendency in the whole world, increased by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and tricky problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes. Root planing, in order to eliminate the “infected cementum”, is an important step in treatment of periodontitis since 1970s. Along with the understanding of endotoxin’s feature on root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments wouldn’t remove the cementum excessively, which are more time-saving and labor-saving compared to hand instruments as well. Hence, an increasing number of dentists prefer to scaling with ultrasonic instruments only. However, the necessity of root planing has still been emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which taking the implementation of root planing as the only variable and more in line with the clinical situation, hoping to provide some reference to dentists. Methods/design: Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. Control group: ultrasonic subgingival debridement. In a 24-weeks follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (visual analog scale for pain and sensitivity) will be observed and documented. Discussion: This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial will potentially contribute to an advanced treatment strategy of periodontitis with ideal clinical outcome. Trial registration: The study has been registered in International Clinical Trials Registry Platform (ICTRP) under the identifier number ChiCTR1800017122. Registered on 12 July 2018. Keywords: Peridontitis, Non-surgical periodontal therapy, Ultrasonic subgingival debridement, Root planing

Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: Public databases were searched. Weighted mean differences in PPD and clinical attachment loss (CAL) reduction were estimated by random effects model. Bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus were analyzed by comparing the results of each study. Results: Ten randomized controlled trials were included out of 1,434 identified. Selected outcomes were PPD and CAL. Initial PPD and follow-up periods formed subgroups. For 3-month follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-month follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial probing pocket depth was 4-6mm, PPD reduction proved manual scaling superior to ultrasonic subgingival scaling, but CAL and GR results showed no statistical differences between the two means. When initial probing pocket depth was ≥6mm, PPD, CAL and BOP reductions suggested that manual subgingival scaling was superior to ultrasonic subgingival scaling, but GR results showed no statistical differences. No conclusion could be drawn about residual dental calculus.

Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and subgingival hand scaling at different pocket probing depths.

Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontitis treatment. The study aims to compare the effectiveness of ultrasonic subgingival scaling and subgingival hand scaling at different initial pocket probing depths in periodontitis treatment. Methods: Public databases were searched. Weighted mean pocket probing depths and clinical attachment loss reduction differences estimated by random effects model. Results: Ten randomized controlled trials were included out of 1,434 identified. Selected outcomes were pocket probing depth and clinical attachment loss. Initial pocket probing depth and follow-up periods formed subgroups. For 3-month follow-up: (1) too few shallow initial pocket studies available; (2) medium depth studies were unmergeable; (3) deep studies were adequate. No statistical differences between pocket probing depth nor clinical attachment loss reduction between ultrasound and hand groups. For 6-month follow-up: (1) too few shallow initial pocket probing depth studies for analysis; (2) medium initial pocket probing depth studies favored hand scaling. No statistical differences observed in clinical attachment loss reduction between the two approaches; (3) deep initial pocket probing depth studies showed hand scaling superior by both measures. Conclusion: When initial pocket probing depths were ≥4mm, pocket probing depth results, clinical attachment loss reduction, and other outcomes indicated subgingival hand scaling was superior. When operation duration and comfort were considered, ultrasonic debridement was.

Clinical evaluation of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planning in patients with periodontitis: study protocol for a randomized controlled trial

Background: Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes the obvious growth tendency in the whole world, increased by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and tricky problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes. Root planning, in order to eliminate the “infected cementum”, is an important step in treatment of periodontitis since 1970s. Along with the understanding of endotoxin’s feature on root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments wouldn’t remove the cementum excessively, which are more time-saving and labor-saving compared to hand instruments as well. Hence, an increasing number of dentists prefer to scaling with ultrasonic instruments only. However, the necessity of root planing has still been emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which taking the implementation of root planing as the only variable and more in line with the clinical situation, hoping to provide some reference to dentists. Methods/design: Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. Control group: ultrasonic subgingival debridement. In a 24-weeks follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (visual analog scale for pain and sensitivity) will be observed and documented. Discussion: This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial will potentially contribute to an advanced treatment strategy of periodontitis with ideal clinical outcome. Trial registration: The study has been registered in International Clinical Trials Registry Platform (ICTRP) under the identifier number ChiCTR1800017122. Registered on 12 July 2018. Keywords: Peridontitis, Non-surgical periodontal therapy, Ultrasonic subgingival debridement, Root planing