1. # 999 ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS Conclusions REFERENCES ACKNOWLEDGEMENTS Objectives: This pilot study sought to examine the effectiveness of using digital impressions as an educational and assessment tool in preclinical fixed prosthodontics. Methods: Fifteen second-year dental students at UNC School of Dentistry completed a PFM crown preparations for a mandibular molar followed by self-assessment and faculty evaluation of the preparations using the UNC evaluation criteria for tooth preparations. After completing conventional evaluations, all preparations were randomly scanned using two different digital impression systems. The digitally impressed tooth preparations were evaluated and assessed by both faculty and students using the same assessment criteria. Students and faculty completed pre- and post- digital impression surveys respectively on their understanding and teaching of tooth preparations concepts and on how it was influenced by the digital impression experience. Results: Responses from the surveys were tabulated and analyzed. 67-93% of the participants felt that their understanding of various concepts of crown preparations improved when using the digital impression technologies for evaluation. The other 7-40% reported that their understanding of the tooth preparation parameters did not change. When comparing the results of the assessment criteria before and after the use of digital impressions, agreement between faculty and students improved by at least 33%. Conclusions: Within the limitations of this pilot study, we can conclude that digital impression technologies: 1) Can be a valuable educational and assessment tool in preclinical Fixed Prosthodontics. 2) More studies with larger sample size are needed for further evaluation of this educational methodology. For all dental students at the University of North Carolina School of Dentistry, the Preclinical Fixed Prosthodontic courses establish the foundation of their understanding and execution of the basic concepts of crown preparations. The courses follow a traditional conventional educational process involving lectures alongside simulated laboratory sessions for application of concepts and techniques learned during lecture. To assess knowledge and competence, students completes written and practical evaluations. The advancements of Computer Aided Technology has positively impacted the practice of dentistry from diagnostics to treatment. In addition, this technology can have an impact on teaching and learning methods in dental education, especially in the field of restorative dentistry. This study sought to examine the effectiveness of digital impressions, a key component of Computer Aided Technology, as a teaching and assessment tool in facilitating the learning process of novice dental students. After using the digital impression systems : Majority of students reported some to significant improvement in their understanding of occlusal reduction, margin design and location, path of draw, axial reduction and functional cusp bevel A split majority of students reported that their understanding of taper either improved somewhat or was not affected at all. One student reported that his or her understanding decreased somewhat with the concept of margin design and location. The use of Computer Aided Technology, through digital impressions, in preclinical fixed prosthodontics can have possible benefits : Students and faculty have better visual aspect of a crown preparation because they view their work in different aspects and outside of the intraoral environment. Students and faculty actively engage in technological advances of dentistry. The digital impression can improve objectivity in the assessment experience. Features that measure taper, clearance, and reduction commonly accompany the computer programs and can be employed to objectively evaluate a crown preparation’s parameters. A previous study using the Kavo PrepAssistant described its usefulness in guaranteeing students an objective assessment, enhanced visualization of errors, and minimizing subjectivity arising from issues in faculty calibration. 1 This technology presents some limitations: Scanning crown preparations can be a lengthy procedure due to unfamiliarity with the digital impression system, occasional malfunctioning of equipment, or while loading information into the computer programs. To be realistically used, more and updated equipment is required. Additional training for both faculty and students in this technology is needed. Other significant alternative uses of Computer Aided Technology, when thoroughly integrated, can be considered: Studies on Virtual Reality-Based Technology simulation found that students felt that they were more independent and able to learn faster. 2,3 1. Cardoso JA, Barbosa C, Fernandes S, Silva CL, Pinho A. Reducing subjectivity in the evaluation of pre-clinical dental preparations for fixed prosthodontics using the Kavo PrepAssistant. Eur J Dent Educ 2006l 10: 149-156 2. Buchanan JA. Experience with virtual reality-based technology in teaching restorative dental procedures. J Dent Educ 2004; 68(12): 1258-1265 3. Quinn F, Keogh P, Mcdonald A, Hussey D. A study comparing the effectiveness of conventional training and virtual reality simulation in the skills acquisition of junior dental students. Eur J Dent Educ 2003; 7: 164-169 This study was a part of my experience as a 2012 fellow of the The ADEAGies Foundation/AADR Academic Dental Careers Fellowship Program (ADEAGies/AADR ADCFP). My mentor was Dr. Ibrahim Duqum. RESULTS Comparisons of the students and faculty evaluations when using both the conventional assessment methods and digital impressions yielded the following results: Conventionally: Faculty and students had the greatest agreement on the finish of wall and margin definition (86.6% agreement) Faculty and students had the most disagreement on internal form (40% agreement). With digital impressions: Faculty and students had the highest agreement on external outline and taper (93.3% agreement). No significant difference in agreement between the faculty and student on the finish of wall and margin definition (86.7% agreement). The most disagreement was on internal form at 80% agreement between faculty and students. RESULTS Assessment Comparison: Conventional (in the manikin)External OutlineInternal FormTaper Finish of Walls+Margin Definition Same Grade8 (53.3%)6 (40%) 11 (73.3%)13 (86.6%) Student Grade Better than Faculty Grade1 (6.7%)5 (33.3%)1 (6.7%) Faculty Grade Better than Student Grade6 (40%)4 (26.7%)3 (20%)1 (6.7%) Assessment Comparison: Digital ImpressionExternal OutlineInternal FormTaper Finish of Walls+Margin Definition Same Grade14 (93.3%)12 (80%) 14 (93.3%)13 (86.7%) Student Grade Better than Faculty Grade0 (0%)2 (13.3%)0 (0%) Faculty Grade Better than Student Grade1 (6.7%) 2 (13.3%) Faculty consistently agreed that the digital impressions were very effective in teaching occlusal reduction, functional cusp bevel, margin design and location, and path of draw. Faculty opinion varied between very to somewhat effective in teaching axial reduction and taper. Both students and faculty almost unanimously reported that after using the digital impression, further modification of the original crown preparation was needed. RESULTS 1.Digital impressions show potential to improve the understanding of crown preparation concepts and thereby, the quality of the educational experience for both faculty and students 2.Students noted improvement to their understanding of crown preparation basics when visualized in the digital setting. 3. Faculty felt that digital impressions were effective in their teaching of crown preparation concepts. 4.The students’ ability to directly visualize preparations on a screen simultaneously with faculty during assessments was advantageous. 5.A thorough and expansive investigation should be conducted to better understand the potential significance of digital technology as an educational tool. Discussion A B C D E A. Pre-digital impression Student Survey B. Pre-digital impression Faculty Survey C. Post-digital impression Student Survey D. Post-digital impression Faculty Survey E. UNC Self Evaluation Form for Fixed Prosthodontics Single Unit Restorations Crown Preparation