口腔临床综合实习模式的建立

口腔临床实习是口腔医学教育的重要阶段,第四军医大学口腔医院经过5年的实践和探索,以树立整体诊疗观、提高实习生综合素质为目标,改变传统的以内、外、修复分科轮转的"三段式"临床实习模式,实行通科与专科实习相结合,建立了口腔临床综合实习模式,提高了临床实习质量。     

儿童口腔局部麻醉控制疼痛研究进展

 儿童口腔疾病治疗中，患儿的配合度与疼痛控制密切相关，局部麻醉是疼痛控制最常用的方法之一。局部麻醉药物的合理选择、麻醉剂量的准确评估、针对不同类型患儿个性化麻醉方案的制定等为儿童口腔疾病治疗提供了保障。安全有效的局部麻醉既有利于提高治疗质量和远期疗效，又能让患儿获得舒适的就诊体验，有助于其建立积极的口腔保健态度。文章对儿童口腔局部麻醉控制疼痛的研究进展做一综述。     

纳米羟磷灰石在口腔医学领域的应用

纳米羟磷灰石(nano-HA)在整个医学领域应用越来越广,它不但具有羟磷灰石本身的特性,而且因为它是纳米级材料,所以具有比普通羟磷灰石更优质的性能。在口腔医学领域,纳米羟磷灰石也有着广阔的应用前景。本文综述纳米羟磷灰石在口腔医学领域的最新研究进展及应用现状,同时简要分析其发展前景。     

循证医学在口腔医学研究中的应用

循证医学是一门近年来迅速发展起来的新学科,是目前国际医学领城的研究热点之一。循证医学强调,任何医疗卫生决策必须依据当前最好的、可获得的科学研究证据,结合决策者或临床医生自己的专业技能和经验,考虑决策对象或患者的需求和愿望,将三者有机地结合做出科学、合理的决策。本文对循证医学的概念、实施方法、口腔医学领城中循证医学研究存在的问题及如何改进等进行综述。     

Teaching and learning in dental student clinical practice

Clinical learning in restorative dentistry is principally centred around the provision of patient care, yet we know very little about the learning processes occurring within the clinical environment. A study of undergraduate dental student clinical practice used a combination of group interview and questionnaire techniques to explore some of the characteristics of student/teacher interaction that students finds significant, and which they consider to affect their learning of clinical skills. Study data, when analysed, revealed three major categories of teacher or student behaviour which appear to be of importance to students. This paper focuses on one of these, describing a number of behaviours, grouped together under the category of 'teaching/learning behaviours'. The aim of the paper is to report these results and to discuss their application to clinical teaching of restorative dentistry.     

翻转课堂结合OSCE教学方法在口腔本科生教学中的应用

目的：探讨翻转课堂结合客观结构化临床考试（OSCE）培训及考核系统运用于口腔医学教学的可行性。方法选择新疆医科大学口腔医学院2012级本科生,随机分为2组,试验组(28人)进行翻转课堂教学结合OSCE培训及考核,对照组（25人）进行传统教学,比较2组的教学效果。结果从OSCE考核实践成绩来看：试验组（85.39±7.60）分,对照组（80.60±11.64）分,试验组成绩优于对照组,P<0.05;从2组笔试理论成绩来看：试验组（84.11±5.88）分,对照组（85.80±7.76）分,差异无统计学意义（P>0.05）。结论口腔专业教学中通过翻转课堂结合OSCE系统有益于提高学生学习的自主性,显示良好的教学效果,值得进一步推广。     

The influence of providing a clinical practice guideline on dental students'' decision making

The aim of this study was to assess the effect of the provision of a clinical practice guideline (CPG) on dental students' decisions to remove asymptomatic, impacted lower third molars. All dental students, who in 2001 were in the 3rd, 4th or 5th (final) year of their study at the Nijmegen College of Dental Sciences, were invited to participate. A pre-test-post-test control group design was used. Given 36 patient cases, all dental students were asked to assess the need for removal of asymptomatic, impacted lower third molars. All pre-test respondents were randomly allocated to the control or intervention group. After the provision of a CPG to the intervention group, both groups were asked to assess the same cases again. Frequencies of decisions to remove the third molars were calculated. Chi-square tests and anova were used to test the influence of study year and gender on the drop-out rate and on the effect of the provision of a CPG on students' treatment decisions. The decrease in indications to remove third molars by the intervention group was statistically significant (P < 0.05). In the control group, no significant decrease was observed. It was concluded that the provision of a CPG significantly influences dental students' decision making about treatment in a third-molar decision task. Students who used the CPG showed more guideline-conformed decision making.     

口腔医学本科生临床实习阶段口腔数码摄影培训初探

口腔数码摄影是当今高素质口腔专业人才必备的一项技能。本文介绍了在本科生修复临床实习阶段引入口腔数码摄影基础培训的尝试,包括培训内容、培训意义、培训过程中存在的问题等。实践证明,在本科教学中开展这一培训是有必要并切实可行的。但培训内容仍有待系统化、规范化。     

拉曼光谱在口腔医学中的应用

拉曼光谱是根据拉曼散射原理而形成的一项光谱技术,被广泛地应用于医学和生命科学的研究中。拉曼光谱可以检测生物样本中蛋白质、脂质、DNA和其他生物大分子的结构和组成,提供丰富的分子水平信息,被称为“分子指纹”。拉曼光谱可以早期检测出组织中生物大分子结构、成分和含量的改变,灵敏度高且特异性强,方便快速,在疾病的早期诊断中具有较高的优势,被广泛应用于医学研究领域。目前,拉曼光谱技术已经成为临床原位诊断技术的研究热点,在口腔医学领域的应用愈发普及。本文通过复习文献,对拉曼光谱在口腔医学中的应用作一综述。     

Dental practice in Northern Ireland, UK

Abstract A postal survey concerning clinical practice by general practitioners in Northern Ireland U.K. had a response rate of 71.2%. There were little differences in practice between chose who had graduated at the Dental School in Belfast (70%) and those who qualified elsewhere. Older dentists appeal- to undertake less ambitious dentistry and while this might be a reflection of their training, there were some practices of younger dentists such as not using a rubber dam for endodontic treatment which was certainly not taught to them at Dental School.     

Development of a clinical guideline to predict undiagnosed diabetes in dental patients

BackgroundIn 2007, 17.9 million people in the United States had diagnosed diabetes, and 5.7 million had undiagnosed diabetes. The authors developed a clinical guideline to help dentists identify patients with undiagnosed diabetes.MethodsThe authors used classification and regression tree (CART) methods to generate different prediction models using data from the Third National Health and Nutrition Examination Survey (NHANES III) (1988–1994) and data from NHANES 2003–2004 for external validation. They classified participants who answered “No” to the question “Have you ever been told by a physician that you have diabetes?” and who had a fasting plasma glucose level greater than or equal to 126 milligrams per deciliter as having undiagnosed diabetes. The authors used oral examination data regarding the presence or absence of periodontitis and waist circumference, as well as data on participants' self-reported oral health status, weight, age, family history and race or ethnicity. The authors chose the best prediction model by means of 10-fold cross-validation, as well as internal and external validation methods, which evaluated each prediction model by comparing sensitivity, specificity, area under the receiver operating characteristic curve and ease of use criteria (N = 7,545).ResultsThe authors' final clinical guideline for predicting undiagnosed diabetes in dental patients had a sensitivity of 82.4 percent, a specificity of 52.8 percent and a receiver operating characteristic area under the curve of 0.72. They found that waist circumference, age, self-reported oral health status, self-reported race or ethnicity and self-reported weight information could be used to predict the risk of having undiagnosed diabetes (range, 0.1 to 9.1 percent).ConclusionDental care providers should consider using a clinical guideline that includes the following predictors: waist circumference, age, self-reported oral health, self-reported weight and self-reported race or ethnicity, as well as any additional information on periodontal status and family history of diabetes.Clinical ImplicationsThis clinical guideline could help dentists identify patients with undiagnosed diabetes, resulting in the early identification of dental patients who require treatment for diabetes and, thus, reduce morbidity and health care costs.     

The concepts of minimally invasive dentistry and its impact on clinical practice: a survey with a group of Brazilian professionals

This cross‐sectional study aimed to assess the knowledge and attitudes of 123 Brazilian dentists in relation to the concepts and practice of minimally invasive dentistry (MID). Data were collected through a questionnaire developed and validated by experts. Statistical analysis was performed using an spss program and Pearson's chi‐square test. Most participants had up to 10 years experience after graduation (69.9%), were specialised (60.2%) and worked in public and private service (43.1%). Regarding current concepts of dental caries, 87.0% were unaware and 65.9% answered that the treatment involves only the restorative phase. In relation to caries lesion arrest, 39.8% replied that it depended on the total removal of carious tissue. Most of them were aware of MID procedures (82.1%) but 49.6% did not follow them in daily practice. From these participants, 48.4% did not believe in the technique or did not know how to perform it. Decisions on partial or total removal of carious dentine, behaviour in relation to the procedures (permanent or temporary) and the practice of MID were not influenced by how long since the professionals had graduated or become specialised. It can be concluded that scientific evidence reaches most of the professionals, but does not benefit all patients, as many practitioners still follow the principles of total removal of carious tissue. Teaching should include making professionals fully aware of the carious process and encourage them to fully adopt the techniques and attitudes of MID.     

A dental practice placement scheme: benefits for practitioners and undergraduates

OBJECTIVES: To report the feedback from general dental practitioners (GDPs) and dental undergraduates who participated in a general dental practice placement scheme. METHODS: Subjects All 61 students in a year made 2 to 3 full day visits, individually or in pairs, to 44 general dental practices allocated to them. Thirty four GDPs completed and returned the questionnaire, representing a response rate of 77%. Data collection Formal feedback from the students and GDPs were obtained through 6 structured seminar sessions and a postal questionnaire respectively. Analysis Sifting, indexing and charting the data according to key issues and themes. RESULTS: All 61 students attended the feedback sessions, 34 GDPs (response rate 77%) returned the questionnaire. The two most common themes that students reported having gained insight into were personal/professional development and practice management. The common positive aspects reported by the GDPs included exposure to the General Dental Service (GDS), motivation for undergraduate training and benefits for GDPs. These benefits included encouragement for the GDPs to reflect critically on their clinical practice, focus on their practice facilities and management, and stay in touch with developments in dental education. Through their visits and assignments, students gained skills in observation, interviewing, communication, relation-building and report writing. CONCLUSIONS: Placements of dental undergraduates in general dental practices enable students to gain insight into the GDS, develop key transferable skills and undergo professional socialisation. They are also beneficial and enjoyable for the GDPs who participated.     

冷冻异体硬脑膜引导骨组织再生在口腔种植中的临床应用

采用异体硬脑经膜冷冻处理，作为引导种植体周围骨组织再生的膜材料，经临床24例应用观察，未发生伤口愈合不良、形成瘘道等现象，所有病例种植体稳固，骨再生修复良好。其中15例（16区）裂隙状骨缺报引导骨组织修复率达87．8％。临床应用表明，冷冻异体硬脑膜引导骨组织再生，具有来源广、制备贮存简便，不产生排斥反应，引导骨组织生长效果好等特点，是目前较理想的引导骨组织再生膜材料、可广泛应用于各类与种植有关的骨缺损。还讨论了与提高引导骨组织再生效果有关的手术技巧。     

A brief introduction to stomatological education in the Chinese Army

Modern stomatological education in China has developed into its present form over a period of 90 years. The College of Stomatology of the Fourth Military Medical University, as the only one of its kind in the Chinese army, has been playing an essential role in training professionals and guaranteeing the dental health of all officers and soldiers in the army. Its education system and five‐year curricula designed for undergraduates were introduced in relation to those of China's first‐rate stomatological colleges. This paper also examines in detail the problems of the current curriculum and holds up the prospect of a further improved curriculum to meet the ever increasing demand for qualified professionals in the military service.     

五年制口腔医学专业临床实践考核体系的探索

本文详细介绍了针对五年制口腔医学专业本科生临床实践阶段,建立的一套考核体系,从操作、理论、科研和医德4方面考评学生综合实践能力。该考核体系客观、科学,不仅重视学生理论知识的掌握,同时注重临床实际分析问题和实际操作能力的培养,从效果来看,该考评模式可作为保障口腔医学生人才培养的重要手段。     

Effectiveness of clinical practice guideline implementation on lower third molar management in improving clinical decision-making: a randomized controlled trial

The objective of this study was twofold, namely to evaluate the effectiveness of a dental clinical practice guideline on the management of asymptomatic impacted lower third molars (i) on referral rates and (ii) on dentists' change in knowledge. A two-arm cluster randomized controlled trial, with pre- and post-test assessments, was conducted. A guideline was implemented by multifaceted interventions (i.e. feedback, reminders, and an interactive meeting). The effect was evaluated after 1 yr by repeating the baseline questionnaire and by monitoring the number of patients who were referred for removal of their asymptomatic impacted mandibular third molars. Instruments were questionnaires for detecting changes in knowledge, patient records, and panoramic radiographs. The knowledge of dentists regarding asymptomatic mandibular third molar management was found to increase significantly in the intervention group as compared to the control group. There was no statistically significant difference between the groups in guideline-consistent patient referral rates at the post-test assessment. It was concluded that the methodology employed for dissemination and implementation of a clinical practice guideline on asymptomatic mandibular third molar management improves dentists' knowledge on this topic and is effective in improving decision-making in simulated cases; however, no clinical effect was demonstrated.