Cai He, Yang Shuying, Pei Xibo, Qing Hai, Wang Jian
Graduate student, Graduate Prosthodontics, Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu, China.
Lecturer, Department of General Dentistry and Emergency, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China.
J Prosthet Dent. 2017 Mar;117(3):405-409. doi: 10.1016/j.prosdent.2016.07.020. Epub 2016 Sep 24.
Gingival displacement is recognized as a substantive and difficult procedure in fixed prosthodontics. However, a realistic simulation of gingival displacement is unavailable for preclinical dental students.
The purpose of this study was to evaluate whether practice-based preclinical instruction of gingival displacement with animal models could improve students' skill in patient care.
Isolated bovine mandibles (calves were younger than 6 months of age) and isolated porcine hemimandibles were prepared for this study. Twenty-two general dental practitioners with at least 5 years of experience were randomly selected and assigned to perform gingival displacement on both bovine and porcine jaws. Those practitioners were then asked to assess the clinical similarity of gingival displacement between human teeth and animal teeth. The data were analyzed with the paired t test (α=.05). Upon confirmation that the animal jaw provided a similar gingival displacement environment to that of human teeth, 80 predoctoral dental students were enrolled and randomized into 2 groups. Half of them underwent the new practice-based instruction, while the others underwent traditional preclinical teaching only (lectures, online video, or live demonstration). After preclinical learning, clinical performance in gingival displacement was evaluated for all students in terms of the effect of gingival displacement and quality of impression. The data were analyzed with the chi-square test (α=.05).
The dentogingival environments of porcine and bovine jaws were similar to those of human jaws, and no significant difference was detected between these 2 animal models (P=.178). A significant increase occurred in the acceptable rate of the effect of gingival displacement (P<.001) and the quality of impression (P<.001) among students who received the practice-based instruction compared with those who received traditional teaching.
These findings suggest that this practice-based instruction of gingival displacement with animal models is an effective method of promoting dental students' learning of gingival displacement.
牙龈退缩在固定义齿修复中是一个重要且困难的操作。然而，对于牙科临床前学生而言，目前尚无法对牙龈退缩进行逼真的模拟。
本研究旨在评估基于动物模型的牙龈退缩临床前实践教学是否能提高学生的患者护理技能。
本研究准备了分离的牛下颌骨（犊牛年龄小于6个月）和分离的猪半下颌骨。随机挑选22名至少有5年经验的普通牙科医生，让他们在牛和猪的颌骨上进行牙龈退缩操作。然后要求这些医生评估人牙和动物牙之间牙龈退缩的临床相似性。数据采用配对t检验进行分析（α = 0.05）。在确认动物颌骨能提供与人牙相似的牙龈退缩环境后，招募了80名牙科博士前学生并随机分为2组。其中一半接受新的基于实践的教学，另一半仅接受传统的临床前教学（讲座、在线视频或现场演示）。临床前学习后，根据牙龈退缩效果和印模质量对所有学生的牙龈退缩临床操作表现进行评估。数据采用卡方检验进行分析（α = 0.05）。
猪和牛颌骨的牙-牙龈环境与人颌骨相似，这两种动物模型之间未检测到显著差异（P = 0.178）。与接受传统教学的学生相比，接受基于实践教学的学生在牙龈退缩效果的可接受率（P < 0.001）和印模质量（P < 0.001）方面有显著提高。
这些发现表明，这种基于动物模型的牙龈退缩实践教学是促进牙科学生学习牙龈退缩的有效方法。
