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Introduction: Shortage of medicines in Peruvian healthcare facilities is a significant public health issue that may affect patient satisfaction., Objective: To estimate the association between access to medicines and the level of satisfaction with the received care from users of healthcare facilities in Peru during 2016., Methods: An analytical cross-sectional study was conducted using data from the 2016 National Survey of User Satisfaction in Health (ENSUSALUD). Access to medicines at the healthcare facilities' pharmacy and patient satisfaction were measured using self-report questions. Crude and adjusted ordinal logistic regression models were used to estimate Odds ratios with 95% confidence intervals. The complex sample design of the 2016 National Health User Satisfaction Survey was considered in all calculations., Results: Data from 10 386 healthcare facility users were included. After receiving medical care, 19.6% had partial access to medications, 6.8% had no access, and 6% were dissatisfied with the care received. Users with partial access to drugs had 87% higher odds of dissatisfaction (Odds ratio: 1.87; 95% confidence interval: 1.56 to 2.23), while users without access to medications had 51% higher odds of dissatisfaction (OR: 1.51; 95% CI: 1.06 to 2.16), compared to users with full access to drugs, adjusted for confounding variables., Conclusions: Patients with limited access to medicine at pharmacies in Peruvian healthcare facilities reported higher dissatisfaction with the care received., Competing Interests: The authors declare that they have no conflicts of interest in the publication of this study., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Aim: The purpose of this study was to evaluate if the use of intraoral scanner analysis could help students to optimise their performance and their self-assessment abilities in prosthetic preparation without the teacher's assistance in the preclinical course., Materials and Methods: Ninety-five second-year dental students were randomly divided into three groups: Control group (C), CeRec group (CR) and PrepCheck group (PC). Group C only use silicon keys to control the preparation thickness. The students in Group CR analysed their work with Cerec™ software. The Group PC use a pedagogic software (PrepCheck™) which allowed comparison with the "master" preparation. They used control tools preparations for three consecutive training sessions. Then a final assessment session without control tool to evaluate their performance was organised. All preparations were objectively evaluated thanks to stl. analysis software (Geomagic® Control X). Each preparation was compared with the master preparation by defining tolerance ranges. An objective overall score out of 20 was assigned to each preparation according to their degree of correspondence. In addition, a questionnaire was performed to analyse the students' perceptions regarding the use of intraoral camera., Results: During the assessment session, no significant difference was revealed between the different groups with respect to the students' performance. The comparative analysis between the self-assessment scores and the objective scores using Geomagic® software showed that digital control tools did not help the student to improve their self-assessment abilities without the teacher's assistance., Conclusions: The intraoral cameras and specific pedagogic software in autonomy could not improve students' performance for teeth preparation and self-assessment abilities in second year. These digital tools facilitate objective feedback on preparation defects, but constructive criticism needs human reflection. The teacher's opinions and advice remain essential to develop their students' performance and self-assessment skills. The use of digital tools must be integrated in dentistry course to develop the interpret of the results and optimise feedback., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The purpose of this article was to analyze the effect of an instructional video on practical tutorial and to ascertain whether an instructional video improves students' performance on practical performance and reduces the stress associated with learning., Materials and Methods: A randomized controlled trial was conducted on a group of 78 first-year students. A pretest was conducted by administering questionnaires to evaluate the interest in the use of videos as well as the level of stress. Students were randomly assigned into two groups: control and test. Students assigned to the control group received conventional teaching, while the experimental group received both conventional teaching and watched a video. Thereafter, a satisfaction questionnaire was distributed to each of the groups, and they were awarded a grade., Results: A total of 98.7% of students wished to learn fixed prosthodontics through instructional videos, as they believed that the videos could reduce their worry and stress levels. At the end of the first tutorial, the total grade was significantly lower for the test group ( p = 0.003). However, the subjective value of stress was significantly lower in the test group ( p = 0.0007) as well as the subjective value of tutorial difficulty ( p = 0.0004). Students felt that they better understood the objectives of the tutorial "thanks to the video" ( p = 0.0001)., Conclusion: This study did not reveal any improvement in terms of performance when an instructional video was used for tutorials in comparison with the conventional teaching method. However, the results show a reduction in the level of stress., Competing Interests: None declared., (European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objectives: Ceramic veneers restorations may undergo damages, such as cracks, fractures, or debonding. Full-field measurements must be carried out in order to visualize and analyze the strain fields. This paper demonstrates that digital holography permits to investigate the mechanical behavior under stress of a natural incisor and a natural incisor reconstructed with CAD/CAM ceramic veneer., Methods: The facial surface of a maxillary central incisor is prepared to receive a monolithic ceramic reconstruction manufactured using a chairside computer-aided design and computer aided manufacturing (CAD/CAM) system (Cerec AC® system, Sirona Dental System®, Bensheim, Germany). One incisor is kept intact for comparison. The samples are sectioned longitudinally to obtain a planar observation of the region of interest. A mechanical indentation head and digital holographic set-ups permit a full-field, contact-less and single-shot measurement of the three-dimensional displacement fields at the surface of the tooth sample when subjected to load. Stain fields are then estimated and comparison of the results between two samples can be carried out., Results: 3D displacement, fields and strain fields are measured and highlight the behavior of the region of interest in three directions of space for the ceramic veneer and the natural incisor. The strain maps reveal the local behavior, especially the concentration or the sudden change in strain. The transition zones are clearly observed, particularly for the veneered sample., Conclusion: Digital holography highlights the localization of stress concentration zones in regions of interest and yields comparative analysis between samples with different tooth preparations., Significance: holography permits to visualize and compare the mechanical response of the ceramic veneer and natural tooth. This helps choosing the mechanical properties of the bonding interface., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Immediate-loaded implants with a fixed prosthesis are a viable option for the restoration of edentulous ridges. Several procedures now allow for the fabrication of immediate-loading provisional and definitive prostheses. However, this complex treatment is not accessible to all patients with budget restrictions. By using a unique master model with a single titanium framework prosthesis can simplify and shorten the treatment, as well as reduce costs. After surgical placement of implant fixtures, an interim prosthesis was fabricated using a laser-welded definitive titanium framework. The prosthesis was fitted intraorally following the immediate loading protocols. The master cast model used to fabricate interim prosthesis was conserved and subsequently used in modifying the final prosthesis. After the healing process and complete soft tissue stability, an impression was made to register the clearance between the gingiva and resin. The light silicone material was directly injected under the prosthesis screwed in the mouth. In the master cast model, the stone was eliminated between the implants and a new plaster was poured to modify the crest profile with the posthealing new shape. With this modified model, it is possible to rehabilitate the denture to the new gingival anatomy in 3 to 4 hours and, if necessary, the tooth rearrangement. This "one shot" concept combines the single definitive titanium welded framework and limited laboratory work with a unique master model thereby decreasing the cost and the time of treatment., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this article., (Copyright © 2021 Philippe Bousquet et al.)

Objectives: CAD/CAM ceramic occlusal veneers are increasingly used as therapeutic options. However, little is known about their mechanical behavior under stress, as the response of the prepared tooth that supports it. The aim of this article is to use for the first time 3D color holography to evaluate the behavior of a molar occlusal veneer under stress and the response of the prepared tooth., Methods: The occlusal surface of a lower molar is prepared to receive a specific monolithic ceramic reconstruction manufactured with a chairside CAD/CAM system. Longitudinally cut samples are used to get a planar object observation and to "look inside" the tooth. A digital holographic set-up permits to obtain the contact-less and one-shot measurement of the three-dimensional displacement field at the surface of the tooth sample; stain fields are evaluated with low noise-sensitive computation., Results: Figures show the strain fields with micro-strain units and highlight the behavior of the ROI (region of interest) in the three directions of space. The ROI are: the ceramic, the glue junction, the dentin enamel junction, dentin and enamel. The results show an excellent behavior of the restored tooth without areas of excessive stress concentrations, but also a significant involvement of the dentin enamel junction., Significance: The ceramic occlusal veneer seems to behave in accordance with the biomechanical concepts ensuring the longevity of the reconstituted tooth. 3D holography is a highly recommended method for studying dental biomechanics., (Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

The wide use of chairside CAD/CAM restorations has increased the diversity of the restorative material. For the practitioner, the selection of the appropriate material is difficult amongst the variety offered by the market. Information on the characteristics of the products can be difficult to assess due to the lack of up-to-date classification and the lack of reliability of manufacturer's advertising. The purpose of this article is to structure the data on restorative materials provided by various sources in order for the practitioner to choose the product most suited to the clinical situation. The objective is to classify chairside CAD/CAM materials and to define their characteristics and indications.

Purpose: The objective of the present study was to analyze the clinical outcomes of 447 monoblock ceramic chairside computer-aided design/computer-aided manufacture (CAD/CAM) reconstructions over a 7-year functional period. Of these reconstructions, 212 were peripheral crowns and 235 were endocrowns., Materials and Methods: The restorations were placed between 2003 and 2008 in a total of 323 patients. They were created using a chairside CAD/CAM method and the same materials in all cases. All of the crowns were manufactured and glued during the same clinical session by the same practitioner. Data were descriptively analyzed and survival probabilities were calculated using Kaplan-Meier statistics., Results: Of the 447 restorations, only 6 failures occurred, resulting in a success rate of 98.66%. All of the failures were the result of a partial ceramic fracture. Of the six ceramic fractures, five appeared on peripheral crowns and one on an endocrown. All fractures appeared in the first 24 months, including two in the first month. Log-rank test comparing incidence rates between crowns and endocrowns showed no significant differences (P = .08)., Conclusion: This survival rate study reinforced the use of CAD/CAM full ceramic crowns and endocrowns on molars, showing a much more favorable survival rate for endocrowns.

For many practitioners, longevity of full glass ceramic crowns in the posterior area, molars and premolars, remains a real challenge. The purpose of this article is to identify and evaluate the parameters that can significantly influence their resistance when preparing a tooth. The analysis proposed in this article relies on interrelated studies conducted at three levels: in vitro (mechanical tests), in silico (finite elements simulations) and in vivo (clinical survival rates). The in vitro and the in silico studies proved that an appropriate variation of the geometric design of the preparations enables to increase up to 80% the mechanical strength of ceramic reconstructions. The in vivo clinical study of CAD/CAM full ceramic crowns was performed in accordance with the principles stated within the in vitro and the in silico studies and provided a 98.97% success rate over a 6 years period. The variations of geometric design parameters for dental preparation allows for reconstructions with a mechanical breaking up to 80% higher than that of a non-appropriate combination. These results are confirmed in clinical practice.