Rating criteria to evaluate student performance in digital wax-up training using multi-purpose software

PURPOSE

The aim of this study was to introduce rating criteria to evaluate student performance in a newly developed, digital wax-up preclinical program for computer-aided design (CAD) of full-coverage crowns and preliminarily investigate the reliability and internal consistency of the rating system.

MATERIALS AND METHODS

This study, conducted in 2017, enrolled 47 fifth-year dental students of Okayama University Dental School. Digital wax-up training included a fundamental practice using computer graphics (CG), multipurpose CAD software programs, and an advanced practice to execute a digital wax-up of the right mandibular second molar (#47). Each student’s digital wax-up work (stereolithography data) was evaluated by two instructors using seven qualitative criteria. The total qualitative score (0-90) of the criteria was calculated. The total volumetric discrepancy between each student’s digital wax-up work and a reference prepared by an instructor was automatically measured by the CAD software. The inter-rater reliability of each criterion was analyzed using a weighted kappa index. The relationship between the total volume discrepancy and the total qualitative score was analyzed using Spearman’s correlation.

RESULTS

The weighted kappa values for the seven qualitative criteria ranged from 0.62 - 0.93. The total qualitative score and the total volumetric discrepancy were negatively correlated (ρ = -0.27, P = .09, respectively); however, this was not statistically significant.

CONCLUSION

The established qualitative criteria to evaluate students’ work showed sufficiently high inter-rater reliability; however, the digitally measured volumetric discrepancy could not sufficiently predict the total qualitative score.

Antifungal effect of zeolite-incorporated tissue conditioner against Candida albicans growth and/or acid production

A new antimicrobial material, Ag-zeolite (Zeomic), was combined with a commercial tissue conditioner (GC-Soft Liner (GC); 1-5%) and, through monitoring the pH of the growth medium, examined for effects on the in vitro growth and/or acid production of Candida albicans on protein-free and saliva-coated specimens. The effect of incorporation of this agent on the physical property of the lining material was also examined according to the ISO penetration test. Comparison studies were carried out using GC, Coe Comfort (CC) or undecylenate combined GC (1-5%) specimens. Although the pH changes in the media varied depending upon the materials on which the Candida was grown, reverse sigmoidal pH curves were observed with most samples. As compared with GC, the soft lining materials showed, to some extent, an inhibitory effect on the acid production and/or the growth of C. albicans. These inhibitory effects consisted of a delay in the onset of rapid pH decline, decreases in the rate of pH change and increases in minimum pH. In most cases, the inhibitory effects of test specimens were dose-dependent, and zeolite specimens showed a significantly higher antifungal effect, followed by CC and undecylenate-combined GC; GC showed the least antifungal effect. The inhibitory effects of these materials on fungal growth were decreased by the presence of a saliva-coat, particularly with zeolite specimens and CC. However, four of eight 5%-Zeomic specimens still exhibited perfect growth inhibition in the presence of the salivary pellicle. Furthermore, test specimens containing 2-5% Zeomic showed a significantly greater effect on the delay in rapid decline of pH, as compared with the other specimens examined. In addition, the significantly higher minimum pH was observed where the yeasts were grown on 4%- and 5%-Zeomic specimens. The physical properties of all the test specimens conformed with the ISO standard as examined by penetration test. These results taken together suggest that an antimicrobial zeolite-combined tissue conditioner would be a potential aid in denture plaque control.