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  1. Belayutham S, Wan Hassan WN, Razak FA, Mohd Tahir NNZ
    Clin Oral Investig, 2023 Jun;27(6):3245-3259.
    PMID: 36947263 DOI: 10.1007/s00784-023-04940-4
    OBJECTIVE: This single center parallel, randomized controlled trial aimed to determine the propensity of microbial adherence on vacuum-formed retainers (VFRs) with different surface roughness imprints.

    MATERIALS AND METHODS: Thirty-six patients debonded from fixed appliances at a teaching institution were allocated by block randomization stratified for gender to three groups [VFRs fabricated on conventional, fused deposition modeling (FDM) or stereolithography apparatus (SLA) working models]. Participants wore the VFRs for three months full-time followed by three months part-time. VFRs were collected after each follow-up for Streptococcus and yeast counts. Surface roughness was measured indirectly on the working models using a 3D optical surface texture analyzer. Blinding was not feasible due to appliance appearance. The trial was registered [NCT03844425 ( ClinicalTrials.gov )] and funded by the Universiti Malaya Dental Postgraduate Research Grant (DPRG/14/19).

    RESULTS: Thirty participants (eleven conventional, ten FDM, and nine SLA) were analyzed after six dropped out. No harms were reported. Microbial counts between the groups were not significantly different. There were more microbes in the lower VFRs than upper VFRs (total count: p<0.05; effect size, 0.5 during full-time wear and 0.4 during part-time wear). SLA had significantly (p<0.05) smoother surface than FDM (effect size, 0.3) and conventional models (effect size, 0.5). Microbial adherence was not associated with working model surface roughness.

    CONCLUSION: Microbial adherence on VFRs was not influenced by degree of surface roughness imprints from working models.

    CLINICAL RELEVANCE: 3D printed models can be used to make VFRs. Lower VFRs tended to accumulate oral microbes, potentially increasing the oral health risk in the lower arch.

  2. Lau MN, Kamarudin Y, Zakaria NN, Sivarajan S, Mohd Tahir NNZ, Bahar AD, et al.
    PLoS One, 2021;16(7):e0254478.
    PMID: 34243187 DOI: 10.1371/journal.pone.0254478
    Flipped classroom may overcome weaknesses of live demonstration in teaching orthodontic wire-bending. This study aims to compare the effectiveness between flipped classroom and live demonstration in transferring skills for fabricating Adams clasp. Forty third-year undergraduate dental students were assigned to two groups. The students in group LD (n = 20) attended a live demonstration while students in group FC (n = 20) attended a flipped classroom. Both groups were taught on skills to fabricate Adams clasp in a standardised way. Each student from both groups were asked to submit an Adams clasp for a blinded quality assessment by two trained and calibrated assessors using a 18-item rubric, followed by validated students' satisfaction questionnaires to evaluate their perceived satisfaction on the teaching method received. A crossover study was then conducted three weeks later where LD attended a flipped classroom while FC attended a live demonstration. Students' satisfaction questionnaires were again collected from each student for blinded analysis. Mean scores for the quality of Adams clasp were 9.775 and 9.125 for LD and FC, respectively. No significant difference was detected between the two groups. Statistically significant association was found for one statement on the questionnaire, "I found the classroom arrangements conducive for the wire-bending activity" (p = 0.010). No significant differences were found between the two groups for other statements (p > 0.05). In conclusion, within the limitations of the study, flipped classroom is equally effective as conventional live demonstration in transferring orthodontic wire-bending skills for fabrication of Adams clasp. However, students perceived the classroom arrangements during the flipped classroom significantly more conducive for teaching orthodontic wire-bending.
  3. Lau MN, Sivarajan S, Kamarudin Y, Othman SA, Wan Hassan WN, Soh EX, et al.
    J Dent Educ, 2022 Nov;86(11):1477-1487.
    PMID: 35650663 DOI: 10.1002/jdd.12954
    OBJECTIVE: This study aimed to explore students' perceptions of flipped classroom (FC) compared to live demonstration (LD) in transferring skills of fabricating orthodontic wire components for orthodontic removable appliances.

    METHODS: Forty third-year undergraduate dental students were randomly assigned to two groups: FC (n = 20) and LD (n = 20). Students in group FC attended FC, while students in group LD attended LD. Both groups underwent a series of standardized teaching sessions to acquire skills in fabricating six types of orthodontic wire components. Eight students (four high achievers and four low achievers) from each group were randomly selected to attend separate focus group discussion (FGD) sessions. Students' perceptions on the strengths, weaknesses, and suggestions for improvement on each teaching method were explored. Audio and video recordings of FGD were transcribed and thematically analyzed using NVivo version 12 software.

    RESULTS: Promoting personalized learning, improvement in teaching efficacy, inaccuracy of three-dimensional demonstration from online video, and lack of standardization among instructors and video demonstration were among the themes identified. Similarly, lack of standardization among instructors was one of the themes identified for LD, in addition to other themes such as enabling immediate clarification and vantage point affected by seating arrangement and class size.

    CONCLUSIONS: In conclusion, FC outperformed LD in fostering personalized learning and improving the efficacy of physical class time. LD was more advantageous than FC in allowing immediate question and answer. However, seating arrangement and class size affected LD in contrast to FC.

  4. Othman SA, Kamarudin Y, Sivarajan S, Soh EX, Lau MN, Zakaria NN, et al.
    Eur J Dent Educ, 2023 Aug;27(3):419-427.
    PMID: 35579042 DOI: 10.1111/eje.12823
    OBJECTIVE: To explore students' perception on the implementation of flipped classroom (FC) combined with formative assessment during the undergraduate teaching of orthodontic wire-bending skills.

    METHODS: Third-year undergraduate dental students were taught wire-bending skills via FC teaching method using a series of pre-recorded online video demonstrations. As part of the formative assessment, the students were given the results and assessment rubrics of their prior wire-bending assessment before every subsequent session. Purposive sampling method for focus group discussion was used to recruit eight students comprising four high achievers and four low achievers. Strengths, weaknesses and suggestions for improvement of the FC with formative assessment were explored. Data were transcribed and thematically analysed.

    RESULTS: Students perceived that FC allowed for a more convenient and flexible learning experience with personalised learning and improved in-class teaching efficiency. The pre-recorded online videos were useful to aid in teaching wire-bending skills but lacked three-dimensional representation of the wire-bending process. Students suggested better standardisation of instructions and access to the marking rubric before and after assessment.

    CONCLUSIONS: FC teaching with continuous formative assessment and constructive feedback as a form of personalised learning was viewed favourably by students. The implementation of periodic individual feedback can further enhance their learning experience.

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