Simodont虚拟仿真系统在口腔住院医师规范化培训中的应用

目的    探讨Simodont虚拟仿真系统在口腔住院医师规范化培训中的应用效果。方法    选取于湖南中南大学湘雅口腔医院进行住院医师规范化培训的2020级住院医师20名，采用随机数字表法分为研究组和对照组，每组各10名。研究组和对照组住院医师分别使用Simodont虚拟仿真系统和传统仿头模培训系统进行G.V.Black Ⅱ类洞的制备训练。采用专业化评分和数字化评级比较两组训练效果，并对研究组住院医师进行Simodont虚拟仿真系统使用情况调查。结果    两组住院医师分组训练前的专业化评分及数字化评级比较，差异均无统计学意义（均P > 0.05）。研究组住院医师分组训练后的专业化评分和数字化评级均显著提高，且优于对照组，差异均有统计学意义（均P < 0.05）。研究组10名住院医师均完全认同使用Simodont虚拟仿真系统进行口腔科操作训练是未来的发展趋势，且认为Simodont虚拟仿真系统比传统仿头模更容易操作；但大部分住院医师也同样认为Simodont虚拟仿真系统对操作者的操作精度要求更高。结论    Simodont虚拟仿真系统的应用有助于提高口腔住院医师的操作水平。建议在充足的Simodont虚拟仿真系统专业培训前提下，将其广泛应用于口腔科临床操作训练。     

Simodont虚拟仿真系统在口腔修复牙体预备教学中的应用

目的    分析Simodont虚拟仿真系统应用于全冠修复牙体预备的教学效果和特点。方法    选取第四军医大学口腔医学专业四年级学生22名,随机分为2组,每组11名,分别在传统仿真头模上（N组）和Simodont虚拟仿真系统上（S组）完成两阶段的全冠修复牙体预备操作训练,并分别进行操作考核,记录牙体预备操作时间。按照金属烤瓷全冠牙体预备的要求,分别就轴面聚合度、修复空间、点线角、肩台质量、体位姿势5个方面进行评分,并计算总分。第二次考核结束后,S组所有学生填写对Simodont虚拟仿真系统评价的调查问卷。结果    两组学生第二次考核的总分相较于第一次考核均显著提高,操作时间均明显减少,差异均有统计学意义（均P < 0.05）。在第一次考核中,两组学生总分比较,差异无统计学意义（P > 0.05）;仅在体位姿势方面,S组学生评分高于N组（P < 0.05）。在第二次考核中,S组学生总分高于N组,差异有统计学意义（P < 0.05）;在肩台质量、体位姿势方面,S组学生评分高于N组（P < 0.05）。其他方面两组学生评分比较,差异均无统计学意义（均P > 0.05）。S组学生对Simodont虚拟仿真系统评价的调查问卷结果显示,各项评分均较高,为3.6～4.9分。结论　Simodont虚拟仿真系统能够有效提高学生的全冠修复牙体预备水平,在牙体预备教学中具有潜在优势。     

虚拟仿真系统在口腔局部麻醉教学中应用效果评价

目的评价虚拟仿真系统应用于口腔局部麻醉教学的效果。 方法于2019年7月选择兰州大学口腔医学院2017级口腔医学专业五年制本科生60人为研究对象，采用随机数字表法将学生分为对照组（C组）、仿头模组（F组）和虚拟仿真组（V组），每组20人。全部学生统一接受理论知识培训及观看操作演示，结束后进行理论考试。将C组学生两两分组互相进行下牙槽神经阻滞麻醉，由专业教师进行评分；F组和V组分别在仿头模和虚拟仿真系统上进行练习，结束后进行麻醉操作考核。操作考核后三组统一进行第二次理论考试，额外再对F组和V组进行问卷调查。采用SPSS 22.0软件对数据进行统计学处理，各分组前后两次理论成绩的比较采用配对样本t检验，三组操作成绩和麻醉效果评分的比较采用单因素方差分析，组间操作成绩和麻醉效果评分的比较则采用独立样本t检验。 结果麻醉理论知识考核结果显示，V组学生经过练习后，第二次理论成绩明显提高，与第一次理论成绩相比差异具有统计学意义（t = 3.768，P = 0.001），而F组和C组学生的第二次理论成绩与第一次理论成绩相比，差异无统计学意义（t_F = 2.079，P_F = 0.051；t_C = 0.538，P_C = 0.597）。在操作考核中，三组的考核成绩分别为C组（82.1 ± 2.6）分、F组（83.9 ± 1.5）分、V组（85.7 ± 2.5）分，差异具有统计学意义（F = 12.629，P<0.001）。麻醉效果考核成绩分别为C组（63.5 ± 6.7）分、F组（68.5 ± 5.9）分、V组（74.0 ± 6.8）分，差异具有统计学意义（F = 13.157，P<0.001）。调查问卷结果显示，大多数学生认为虚拟仿真系统更能够提高操作技能、理论知识水平及学习兴趣。 结论在口腔外科麻醉的临床前教学过程中，虚拟仿真系统更有利于提高口腔医学生的操作技能和理论知识的掌握，值得推广。     

Simodont虚拟仿真系统和KaVo仿真头模在龋病学实验课教学中的联合应用

目的探讨在龋病学实验课中联合运用Simodont虚拟仿真系统和KaVo仿真头模的教学效果。 方法在中山大学光华口腔医学院口腔临床医学专业2009级五年制本科生的龋病学实验课中联合应用Simodont系统和KaVo仿真头模。教学步骤如下：（1）将学生随机分入两组,每组28人;（2）学生完成龋病临床知识考核表;（3）指导学生学习龋病临床技能考核表和Simodont操作手册;（4）第一组学生使用Simodont系统培训,第二组学生使用KaVo仿真头模培训,制备改良型Ⅱ类和Ⅴ类龋洞洞型,进行评分;（5）两组学生互换培训系统,再次制备改良型Ⅱ类和Ⅴ类龋洞洞型,并评分;（6）学生填写教学问卷;（7）收集数据、统计学分析。 结果两组学生龋病临床知识的考核成绩差异无统计学意义（P > 0.05）。学生经过Simodont系统和KaVo仿真头模联合培训后,制备改良型Ⅱ类和Ⅴ类龋洞洞型的评分比较仅使用单一培训系统的学生更高（P < 0.05）。问卷结果表明,学生高度认同"Simodont系统安全性好,节约培训时间,可反复练习。Simodont系统与KaVo仿真头模联合应用能获得更理想的教学效果" 。 结论在龋病学实验课中联合应用Simodont系统和KaVo仿真头模可较单一培训系统更好地提升学生龋洞制备的考核成绩,是一种值得推广的教学模式。     

微种植体支抗植入患者牙科焦虑的调查分析

目的研究微种植体支抗（MIA）植入患者牙科焦虑症的影响因素及术前焦虑程度高对术后疼痛的影响。 方法采用改良牙科焦虑量表（MDAS）和视觉模拟量表（VAS）对2016年8月至2018年5月在佛山市口腔医院进行MIA植入的患者进行焦虑情况及术后疼痛程度的调查，共发出问卷553份，回收有效问卷509份，有效率为92.04%。采用成组设计t检验分别统计不同性别、年龄、文化程度、婚姻状况及收入水平间MDAS值差异是否显著，并采用两因素重复测量方差分析评估不同焦虑程度术后疼痛程度VAS评分差异是否显著。 结果接受MIA植入的患者术前MDAS平均值为（11.24 ± 3.05）分，其中，大于11分占58.9%。男性患者的MDAS值为（9.85 ± 2.12）分，女性患者的MDAS值为（12.41 ± 2.56）分，差异有统计学意义（t = -12.18，P<0.001）；12 ~ 18岁患者的MDAS值为（13.27 ± 3.12）分，18岁以上患者的MDAS值为（10.53 ± 2.36）分，差异有统计学意义（t = 10.51，P<0.001）；未婚患者的MDAS值为（11.06 ± 2.96）分，已婚患者的MDAS值为（11.63 ± 2.75）分，差异有统计学意义（t = -2.07，P = 0.039）；文化程度为专科及以下患者的MDAS值为（11.95 ± 2.37）分，文化程度为本科及以上患者的MDAS值为（10.46 ± 3.01）分，差异有统计学意义（t = 6.23，P<0.001）；收入低于2万/月的患者的MDAS值为（11.13 ± 2.14）分，收入2万/月及以上患者的MDAS值为（11.58 ± 3.02）分，差异无统计学意义（t = -1.82，P = 0.068）。低焦虑组患者及高焦虑组患者在术后2、6、24和48 h的VAS值差异均有统计学意义（P<0.001）。 结论MIA植入患者牙科焦虑症患病率较高，与性别、年龄、文化程度及婚姻状况有密切关系，术前焦虑程度高患者术后疼痛的强度高。     

雷帕霉素通过促进细胞自噬抑制大鼠血管平滑肌细胞增殖活性效应

目的探讨雷帕霉素（RAP）抑制表现异常增殖活性的大鼠血管平滑肌细胞（VSMC）增殖活性的作用及其分子机制。 方法使用不同质量浓度的血小板衍生生长因子（PDGF）作为诱导剂处理大鼠主动脉VSMC，构建模拟脉管畸形的体外模型。实验分为对照组、PDGF组、PDGF+RAP组和PDGF+VEC（血管内皮细胞）组，观察对VSMC增殖活性的改变，检测不同处理方式对VSMC自噬水平的影响。两组间比较应用独立样本t检验，多组间比较应用重复测量方差分析，多组mRNA表达量、蛋白表达量比较应用单因素方差分析。 结果细胞增殖检测（CCK-8）和EdU实验结果显示：PDGF处理的VSMC活性呈时间依赖性上升。与PDGF组相比，在48和72 h，PDGF+RAP组细胞增殖活性分别降低了24.8%（0.129 ± 0.010比0.172 ± 0.012，t = 4.787，P = 0.009）和45.1%（0.170 ± 0.012比0.292 ± 0.046，t = 4.431，P = 0.011）；PDGF+VEC组细胞增殖活性分别降低了10.0%（0.155 ± 0.013比0.172 ± 0.012，t = 2.357，P = 0.076）和8.9%（0.266 ± 0.022比0.292 ± 0.046，t = 1.718，P = 0.161）。实时荧光定量PCR和蛋白免疫印迹（Western blot）结果显示，与对照组比较，PDGF可抑制平滑肌蛋白抗体-B（Smoothelin-B）表达（0.486 ± 0.057比1.005 ± 0.067，t = 10.192，P = 0.001），促进细胞视黄醇结合蛋白-1（CRBP-1）表达（3.185 ± 0.091比0.991 ± 0.056，t = 35.461，P<0.001）；而在PDGF+RAP组和PDGF+VEC组，Smoothelin-B表达增加（0.857 ± 0.091比0.486 ± 0.057，t = 5.943，P = 0.004；0.563 ± 0.067比0.486 ± 0.057，t = 1.501，P = 0.208），CRBP-1表达减少（1.579 ± 0.042比3.185 ± 0.091，t = 27.707，P<0.001；2.951 ± 0.144比3.185 ± 0.091，t = 2.382，P = 0.076）。与对照组比较，PDGF组LC3B（LC3-Ⅱ/Ⅰ比值）明显下降（0.175 ± 0.003比1.020 ± 0.020，t = 72.263，P<0.001），p62表达显著上升（2.632 ± 0.098比1.005 ± 0.007，t = 28.562，P = 0.001）。与PDGF组比较，PDGF+RAP组的LC3B明显升高（0.316 ± 0.037比0.175 ± 0.003，t = 6.529，P = 0.022），p62蛋白显著降低（1.396 ± 0.070比2.632 ± 0.098，t = 17.771，P<0.001）；PDGF+VEC组LC3B稍有上升（0.206 ± 0.014比0.175 ± 0.003，t = 3.687，P = 0.021），而p62蛋白表达降低（2.400 ± 0.076比2.632 ± 0.098，t = 3.220，P = 0.032）。透射电镜观察发现，PDGF+RAP组、PDGF+VEC组自噬小体较PDGF组上升。 结论高质量浓度PDGF可使VSMC增殖活性上升；雷帕霉素或VEC可通过激活自噬，抑制PI3K/AKT信号通路使细胞活性降低，并促使VSMC向收缩型转变，逆转PDGF的效应。     

牙科发光二极管光固化灯和普通卤光灯临床应用效果评价

目的：了解牙科发光二极管光固化灯应用于患牙备洞树脂充填固化后的临床效果.方法：按纳入标准选择门诊就诊患者患牙160颗,龋损和楔状缺损各80颗.随机分为试验组和对照组,使用牙科树脂材料充填后,实验组应用发光二极管光固化灯固化20sec,对照组应用普通卤光灯固化40sec,打磨抛光;12个月后复诊,评价.结果：楔状缺损实验组有1颗充填物脱落,1颗边缘密合度缺陷,1颗边缘着色,成功率92.1%;对照组有1颗充填物脱落,1颗边缘着色,成功率94.4%;无统计学意义上的差异（P＞0.05）.龋损实验组有3例边缘密合度缺陷,2颗边缘着色,成功率87.5%;对照组有2颗边缘密合度缺陷,1颗边缘着色,成功率91.7%;无统计学意义上的差异（P＞0.05）.结论：发光二极管光固化灯与普通卤光灯临床效果没有区别,但操作时间更短,使用更为轻巧.     

两种材料在拔牙后引导骨组织再生位点保存术中的应用效果

目的探讨富血小板纤维蛋白（PRF）与口腔胶原膜应用于拔牙后引导骨组织再生（GBR）位点保存术中的效果。 方法从2016年6月至2018年9月期间收治的拔牙后GBR位点保存患者中选取84例进行研究，采用随机数字表法分组，观察组与对照组各42例，两组微创拔牙后均植入Bio-Oss骨替代材料，观察组表面覆盖PRF膜，对照组表面覆盖口腔胶原膜（海奥），对两组创面愈合率、牙槽骨宽度及高度、美学评分进行观察，采用独立样本t检验进行比较。 结果观察组术后2周创面愈合率为（77.1 ± 6.1）%，与同期对照组（65.8 ± 3.7）%对比，差异有统计学意义（t = 10.188，P<0.001）；观察组术后4周创面愈合率为（98.8 ± 12.5）%，与同期对照组（78.7 ± 7.1）%对比，差异有统计学意义（t = 9.084，P<0.001）。拔牙前，两组牙槽骨高度差异无统计学意义（t = 0.022，P = 0.982）；拔牙后1个月，观察组牙槽骨高度为（15.1 ± 1.9）mm，与同期对照组（14.2 ± 1.8）mm对比，差异有统计学意义（t = 2.091，P = 0.039）；拔牙后3个月，观察组牙槽骨高度为（14.2 ± 1.8）mm，与同期对照组（14.0 ± 1.3）mm，差异有统计学意义（t = 2.608，P = 0.010）。拔牙前，两组牙槽骨宽度差异无统计学意义（t=0.062，P=0.950）；拔牙后1个月，观察组牙槽骨宽度为（7.1 ± 0.6）mm，与同期对照组（6.8 ± 0.7）mm对比，差异有统计学意义（t=2.392，P=0.019）；拔牙后3个月，观察组牙槽骨宽度为（6.9 ± 0.4）mm，与同期对照组（6.4 ± 0.5）mm对比，差异有统计学意义（t = 5.748，P<0.001）。修复后即刻，两组PES评分差异无统计学意义（t = 0.142，P = 0.887）；修复后3个月，观察组PES评分为（12.4 ± 4.0）分，与同期对照组（10.5 ± 2.0）分对比，差异有统计学意义（t = 2.644，P = 0.009）；修复后6个月，两组PES评分差异无统计学意义（t = 0.617，P = 0.538）。修复后即刻，两组WES评分差异无统计学意义（t = 0.261，P = 0.794）；修复后3个月，观察组WES评分为（9.1 ± 1.0）分，与同期对照组（8.1 ± 0.7）分对比，差异有统计学意义（t = 5.176，P<0.001）；修复后6个月，两组WES差异无统计学意义（t = 1.318，P = 0.191）。 结论PRF用于拔牙后GBR位点保存术中的效果优于口腔胶原膜，可提高创面愈合率，也能保持牙槽骨宽度与高度，取得满意的短期美学效果，更值得推广。     

低氧增强自噬促进舌鳞状细胞癌细胞迁移和侵袭

目的探讨低氧条件下对舌鳞状细胞癌（TSCC）自噬活性和迁移能力的影响。 方法应用含1% O₂的低氧培养箱培养TSCC UM1细胞,Western blot检测低氧诱导3、6、9、12、24 h后低氧诱导因子1α（HIF-1α）和自噬标记蛋白Beclin-1、自噬相关蛋白5（ATG5）和微管相关蛋白轻链3（LC3）的表达变化;细胞划痕实验检测低氧诱导后细胞迁移能力的改变;Transwell侵袭小室实验检测低氧诱导后细胞的侵袭能力;SPSS 13.0统计软件进行数据分析。 结果低氧条件下,与对照组（0.527 ± 0.055）相比,TSCC UM1细胞自噬体双层膜标记蛋白LC3Ⅱ的表达（1.206 ± 0.053）增加（t= 12.96,P<0.001）,同时自噬相关蛋白Beclin-1表达量（1.151 ± 0.078）较对照组（0.775 ± 0.062）明显提高（t= 6.736,P= 0.001）,ATG5的表达（1.231 ± 0.06）较对照组（0.711 ± 0.052）也明显上升（t= 7.834,P= 0.001）。与对照组相比,低氧诱导后细胞迁移能力（0.349 ± 0.024）较对照组（0.788 ± 0.037）明显增加（t= 9.918,P= 0.001）,细胞侵袭能力（23 ± 2）较对照组（71 ± 4）明显增强（t= 9.528,P= 0.001）。 结论低氧条件下可以增强TSCC细胞自噬活性,促进其迁移和侵袭。     

两种微动力系统在上颌埋伏多生牙拔除术中应用的比较

目的通过对比超声骨刀与涡轮手机去骨法拔除上颌埋伏多生牙的手术效果,探讨更为方便、安全、有效的拔牙方法。 方法选取2013—2017年中山市人民医院口腔颌面外科拔除上颌埋伏多生牙且符合纳入标准的患者150例（共计190颗多生牙）,通过抽签的方法随机分两组。术前均完善锥形束CT（CBCT）检查以定位埋伏多生牙,采用局部浸润麻醉方式,选择合适的切口入路,实验组采取超声骨刀去骨法拔牙,对照组采取涡轮反角手机去骨法拔牙。采用视觉模拟评分法（VAS）量化患者术后疼痛情况,采用SPSS 20.0软件以独立样本的t检验法对两组患者以及年满12周岁以上患者的手术时间、术后疼痛值进行对比分析。 结果患者术后疼痛的VAS值范围为0 ~ 10（0为完全无痛,10为最为剧烈的疼痛）,实验组VAS均值为4.2 ± 1.5,低于对照组的5.2 ± 1.6,差异有统计学意义（t=-4.072,P<0.001）。而对于12岁以上患者的疼痛VAS值分析,实验组均值为4.2 ± 1.5,亦低于对照组的5.1 ± 1.6,差异有统计学意义（t=-2.866,P= 0.005）。手术时间平均值,实验组为（48 ± 6）min,低于对照组的（51±8）min,差异有统计学意义（t=-3.014,P= 0.003）。而对于12岁以上患者的手术平均时间分析,实验组均值为（46 ± 6）min,亦低于对照组的（49 ± 7）min,但差异无统计学意义（t=-0.901,P= 0.060）。 结论采用CBCT引导下超声骨刀拔牙法拔除上颌埋伏多生牙,疼痛少、时间短、舒适性好,是一种值得推广的拔牙方法。     

The Simodont in dental education

The Simodont is a virtual learning environment for students of dentistry which is intended to expand and optimize the preparation ofstudents for the treatment ofpatients so that the transition in education from pre-clinic to clinic is reduced. The Simodont makes it possible to offer students more realistic clinical problems. In that way, students can practice much more extensively than they can in the pre-clinic on phantom heads. The Simodont also provides a safe learning environment in which unlimited mistakes can be made without unfortunate consequencesfor the student and patient. The simulator is coordinated with reading material on a computer, which makes it possible to integrate techniques and theory in dental education. Virtual teeth, with and without pathology, have been created for application in the Simodont, to allow unlimited possibilities for practice. The future possibilities for the Simodont offer many opportunities for students in dental education, for supplementary and post-graduate education andfor the re-integration of dentists in their profession.     

Virtual reality and haptics in dental education: Implementation progress and lessons learned after a decade

Introduction

The search for alternative training environments in dentistry responded mainly to scarcity and lack of standardisation of training material and non-availability of specific clinical procedures. The development of haptic virtual reality (VR) dental trainers provides a platform where irreversible procedures can be safely and unlimitedly practised. The aim of this study was to assess the educational implementation of these devices and evaluate schools' satisfaction.

Methods

Dental schools that were using haptic VR dental trainers, were approached. The Dental Trainer User Inventory (DTUI), addressing the educational implementation and users' satisfaction, was developed and distributed.

Results

Twenty-seven schools completed the DTUI. The total number of VR dental trainers available varied from one to 42 devices with a mean of 7 devices. The dental trainer was mostly made available from the first year (63.0%) of the undergraduate program, but it was mostly integrated into the curriculum by the third year (70.4%). Curricular integration was reported by 18 schools (66.7%), while nine schools (33.3%) indicated that they had not yet achieved integration. Twenty-one schools (69.4%) were ‘satisfied’ or ‘very satisfied’ with the devices, while two schools (7.4%) were dissatisfied and six schools (22.2%) were neither satisfied nor dissatisfied.

Conclusion

VR haptic dental trainers are implemented in multiple dental programs and are also being used for educational research and clinical training. Even though curricular changes and teachers' acceptance remain a challenge, most schools are satisfied with VR haptic dental trainers and would recommend the device to other schools.     

Capturing differences in dental training using a virtual reality simulator

Virtual reality simulators are becoming increasingly popular in dental schools across the world. But to what extent do these systems reflect actual dental ability? Addressing this question of construct validity is a fundamental step that is necessary before these systems can be fully integrated into a dental school's curriculum. In this study, we examined the sensitivity of the Simodont (a haptic virtual reality dental simulator) to differences in dental training experience. Two hundred and eighty‐nine participants, with 1 (n = 92), 3 (n = 79), 4 (n = 57) and 5 (n = 61) years of dental training, performed a series of tasks upon their first exposure to the simulator. We found statistically significant differences between novice (Year 1) and experienced dental trainees (operationalised as 3 or more years of training), but no differences between performance of experienced trainees with varying levels of experience. This work represents a crucial first step in understanding the value of haptic virtual reality simulators in dental education.     

复合树脂嵌体经离体光照固化后修复牙体严重缺损的临床研究

目的：探讨一种适宜的修复牙体严重缺损的方法。方法:复合树脂嵌体经离体光固化后再黏结修复，并与其它传统修复方法比较。结果：1－1．5年临床效果显示：离体光照优于在体光照、银汞合金充填或离子充填。结论：光固化复合树脂嵌体离体固化黏结修复牙体严重缺损是一种值得临床推广的好方法。     

Reliability and validity of a faces version of the Modified Child Dental Anxiety Scale

BACKGROUND: A new version of the Modified Child Dental Anxiety Scale (MCDAS) was formed by adding a faces rating scale to the original numeric form. AIMS: To describe the psychometric properties of the faces version of the Modified Child Dental Anxiety Scale (MCDAS(f)), and to provide normative data for dental anxiety for children using the MCDAS(f). DESIGN: To determine the test-retest reliability, 287 schoolchildren aged 8-10 years completed the MCDAS(f) on two separate occasions 17 weeks apart. To determine the criterion validity, 207 schoolchildren aged 10-12 years completed the MCDAS(f) and the CFSS-DS at the same sitting. Construct validity was assessed using a cohort of 206 consecutive child dental patients and their parents. RESULTS: The MCDAS(f) showed good test-retest reliability (intraclass correlation coefficient = 0.80) and internal consistency (Cronbach's alpha = 0.82). The MCDAS(f) significantly correlated with the CFSS-DS (r = 0.80, P < 0.001). Dental anxiety assessed using the MCDAS(f) was related to the dmft (t = -2.17, P = 0.03), DMFT (t = -4.19, P < 0.001), and dental general anaesthetic experience (t = -4.46, P < 0.01). The mean MCDAS(f) score for the normative sample (n = 475) was 19.81 (95% CI: 19.20, 20.43). CONCLUSIONS: The MCDAS(f) is a reliable and valid measure of dental anxiety in children aged 8-12 years.     

Psychological well-being and perceptions of stress amongst Japanese dental students

The purpose of this study was to investigate the relationship between Psychological General Well Being (PGWB) and perceived sources of stress amongst dental students in Japan. Second to sixth year dental students of Tokyo Medical and Dental University were invited to participate in the questionnaire survey. The questionnaire collected information on demographic and social background, lifestyle behaviours, the PGWB index and the Dental Environment Stress (DES) questionnaire. A total of 320 students (56% male) participated, with a response rate of 91%. Male students had significantly higher PGWB scores and lower DES scores than female students (P < 0.05). There were no significant differences in the year of study for DES mean score and PGWB total score. Students whose first choice of admission was dentistry experienced less stress than those whose first choice was another discipline (P < 0.05). Students who regularly exercised showed significantly lower stress levels and higher well-being status than those students who did not exercise (P < 0.01). Correlational analysis showed an inverse relationship between PGWB and DES scores (r = -0.544, P < 0.001). Multiple regression analysis revealed that DES mean score was significantly related to gender, first choice of admission and PGWB total score. It is suggested that perception of stress amongst Japanese dental students is influenced by gender, dentistry as first choice for admission and students' general well-being.     

Relative esthetic importance of orthodontic and color abnormalities

OBJECTIVE: To assess the relative importance of an orthodontic esthetic index, dental fluorosis and nonfluoride opacities, with respect to parents' satisfaction with their children's dental esthetics. MATERIALS AND METHODS: Dental examinations of Iowa Fluoride Study participants assessed fluorosis and nonfluoride opacities in the mixed dentition. Dental casts of 200 randomly selected subjects were scored using the Dental Aesthetic Index (DAI) criteria. Parent satisfaction was assessed via multiple items on a questionnaire. Associations were evaluated using logistic regression. RESULTS: Nineteen percent of parents were somewhat or very dissatisfied with their children's dental esthetics. Overall DAI score was positively associated with dissatisfaction (P < .001), as was fluorosis (P = .003). CONCLUSIONS: In addition to changes related to DAI scores, parent esthetic satisfaction decreased with the presence of fluorosis. Dental professionals should address both the issues of tooth positioning and color aberration with respect to dental esthetics.