A Clinically Oriented Complete Denture

Program for Second-Year Dental Students

Ales Obrez, D.M.D., Ph.D.; Damian J. Lee, D.D.S.; Anna Organ-Boshes, D.D.S.;
Judy Chia-Chun Yuan, D.D.S., M.S.; G. William Knight, D.D.S., M.S., M.S.
Abstract: The traditional preclinical complete denture prosthodontic curriculum relies predominantly on the laboratory (e.g.,
bench-type) component of the complete denture fabrication process. In most cases, this involves a passive model of student
knowledge acquisition utilizing lectures and low-fidelity laboratory exercises. A recently implemented program in the College of
Dentistry at the University of Illinois at Chicago challenges this educational paradigm by introducing an active learning environ-
ment for second-year students based on significant clinical exposure with patients. The result is a major shift of emphasis, first,
from a purely technical/laboratory aspect of the discipline to patient-centered education and, second, from mastering individual
phases of denture fabrication to understanding the entire process of edentulous patient care. To compare student outcomes in the
new program with those in the traditional program, their performance overall and in three components of the final examination for
each program were statistically compared. The results of the one-way ANOVA analysis show statistically significant improvement
in the students’ total score in the new program, including their performance on the written, practical, and OSCE portions of the
final examination. This article describes the rationale, logistics, challenges, and advantages of the new educational model of the
complete denture prosthodontics curriculum.
Dr. Obrez is Associate Professor; Dr. Lee is Clinical Assistant Professor; Dr. Organ-Boshes is Clinical Assistant Professor;
Dr. Yuan is Clinical Assistant Professor; and Dr. Knight is Assistant Dean for Clinical Education—all at the Department of
Restorative Dentistry, College of Dentistry, University of Illinois at Chicago. Direct correspondence and requests for reprints
to Dr. Ales Obrez, Department of Restorative Dentistry, College of Dentistry (MC 555), University of Illinois at Chicago,
801 South Paulina Street, Room 204K, Chicago, IL 60612-7211; 312-996-4977 phone; 312-996-3535 fax; aobrez@uic.edu.
Keywords: innovation, dental educational methodology, predoctoral prosthodontics curriculum
Submitted for publication 5/1/09; accepted 7/21/09

A
major teaching and learning objective of the
preclinical curriculum in complete denture
removable prosthodontics is to introduce
students to the fundamental laboratory and clinical
steps involved in the fabrication and delivery of
complete dentures. The subject is traditionally taught
during the second year of dental education, with a
major emphasis on the laboratory component.1-4 This
laboratory emphasis is one of the major deficiencies
of this model.5 Students spend a majority of their
time in the laboratory, with minimal or no patient
contact. Teaching dental students clinical procedures
in the laboratory setting requires that students gain
an abstract understanding of the process of denture
fabrication, rather than creating a process that in-
volves alternating sequences of clinical and labora-
tory procedures found in clinical practice. Though
some schools have introduced manikin heads into
the laboratory setting, a majority of programs still
rely on the edentulous dentoform to simulate the
patient. Alternatively, the clinical and laboratory
procedures are presented by using prerecorded video
demonstrations.2 However, none of these educational
methods adequately replaces live patient demon-
strations and students’ active engagement in both
the laboratory and clinical environments. Only one
school has reported no laboratory component of the
course, instead opting for an entirely patient-based
curriculum.6
If the primary objective of the preclinical
curriculum is to provide dental students with the
knowledge and skills to successfully initiate patient
care, the traditional curriculum in removable com-
plete denture prosthodontics falls short of adequately
preparing students for this transition in their educa-
tion.7 Furthermore, the average lag time between
completion of preclinical education and actual pa-
tient treatment ranges from six to nine months. The
lecture format is still the most widely used didactic
educational method for the transfer of knowledge.
But without purposeful planning, lectures tend to
be passive experiences from a student point of view
and have questionable learning outcomes. All of
these shortcomings of the traditional curriculum
have been previously identified in reports from the
Institute of Medicine8 and the American College of
Prosthodontists.5
As part of a major, ongoing curriculum revi-
sion in the College of Dentistry of the University
of Illinois at Chicago since 2002,9 including course

1194 Journal of Dental Education ■ Volume 73, Number 10

evaluation data collected from students and faculty,
the Department of Restorative Dentistry took a sig-
nificant step forward by introducing a new curriculum
in complete removable prosthodontics. This program
is characterized as a small-group, asynchronous
model of education that introduces a clinical compo-
nent into the traditional bench-type curriculum. The
program is supported with Internet-based transfer
of knowledge that allows substitution of traditional
lectures with grand-rounds-like discussions. This ar-
ticle describes this innovative high-fidelity approach
to prosthodontic curriculum delivery.
The Restructured Program
The overarching objective of this curriculum
revision was to introduce dental students to the
clinical and laboratory aspects of complete denture
prosthodontics as early as possible and in the most
clinically relevant manner. The summer semester of
student transition from the first year to the second was
identified as the place to start the program. The exist-
ing preclinical course had been taught as a traditional
laboratory course in the dental technique laboratories
during the fall semester of the second year.
The specific objectives of the project were to 1)
develop a curriculum in which students would expe-
rience clinical practice as part of their “pre-patient”
curriculum, helping them to transition seamlessly
into clinical practice; 2) provide a way for students
to participate in small-group discussions related to
Figure 1. Schematic of the clinically oriented preclinical complete denture curriculum
October 2009  ■  Journal of Dental Education
the subject of complete removable prosthodontics; 3)
provide background information for students through
the Internet-based educational platform (Blackboard
Academic Suite, 2009); and 4) vertically integrate
this program with the newly implemented predoctoral
implant program.
General Outline of the Program
This twenty-one-week program was introduced
in 2005. It is offered one day per week to the first-
year dental students as they transition into the second
year (summer and second-year fall semesters). The
program is divided into two half-day sessions, split-
ting the class of approximately ninety students in two
groups. Each session consists of a didactic and clini-
cal or laboratory assignment, depending on the step
within the sequence of denture fabrication and care
process (Figure 1). As part of the didactic component,
each student is expected to review the assigned mate-
rial prior to the session (available on the Blackboard
site and in the required reading), answer the review
questions received a week earlier, and attend struc-
tured summary discussions prior to each clinic or
laboratory session (Figure 2). The topics for each
discussion session are narrowly focused and related
to the rationale, technique, sequence of the steps, and
possible difficulties expected during the laboratory
or clinical procedures that immediately follow. This
discussion session is also dedicated to clarifying any
questions students may have regarding any laboratory
or clinic procedure related to their understanding of
1195
 Review Session
0.5 Hour
Figure 2. Example of a typical session (total three hours) in the complete denture curriculum
the material or to their patient care activity. With the
expectation that they will be prepared for the ses-
sion, students are challenged to actively participate
in all aspects of the review of the topic. The faculty
member’s traditional role of lecturer is replaced with
the role of a facilitator of discussions.
In the clinic and the laboratory, each student
is assigned to a team consisting of eight students
working with one edentulous patient and one faculty
member. Each team is responsible for completing
management of the edentulous patient, including
fabrication and delivery of a complete denture with
all the necessary interim and post-delivery care. In
this clinical and laboratory work, each student has
an opportunity to experience the individual steps and
procedures that are necessary during the process of
complete denture therapy/care. Most of the laboratory
work for the patient’s dentures, including processing,
is performed by a commercial laboratory. If the indi-
vidual clinical session requires more time, the team’s
faculty member decides whether to extend the clini-
cal assignment into the following session. For some
teams, this may necessitate lengthening the entire
1196
Clinic/Laboratory Session
2.5 Hours
program. Each team of students, therefore, proceeds
through the clinical component of the program at its
individual pace (asynchronously). However, teams
are required to complete their didactic requirement by
the time of the program’s final examination, usually
given during the final week of the fall semester.
Patients receive complete dentures that are a
combined result of the faculty member’s direct in-
volvement through his or her clinical demonstrations
and supervision, students’ active participation, and
the commercial laboratory’s work. While most of the
laboratory work on patients’ dentures is performed
by a commercial laboratory, the students experience
various aspects of the laboratory steps and procedures
using class-wide standardized maxillary and mandib-
ular edentulous master casts. The casts are mounted
on a semi-adjustable articulator (Hanau WhipMix
articulator, WhipMix Corp., Louisville, KY) in an
ideal maxillo-mandibular relationship using mounting
indices. The laboratory sessions are scheduled during
the time the patient’s prosthesis is in the commercial
laboratory. The student’s simulated complete denture
projects are evaluated at the wax try-in stage.
Journal of Dental Education ■ Volume 73, Number 10
Patient Selection
Patients for the program are recruited from
within the pool of existing edentulous patients who
have already been treated in the College of Dentistry.
They are treatment-planned for denture reline, den-
ture repair, or a remake of their existing dentures.
All prospective patients are carefully screened by
the program director using criteria that follow the
Prosthodontic Diagnostic Index (PDI) classifica-
tion.10 Only those patients classified as Class I (e.g.,
having minimal alveolar ridge resorption, adequate
attached gingival, ideal maxillo-mandibular relation-
ship) are selected to participate in the program.
Patients who agree to participate are given
the detailed schedule of approximately nine clinic
appointments and a letter of understanding stating
that, if they keep all the scheduled appointments,
they will receive the new set of dentures at no cost.
All of the patients accepted into the program are
also encouraged to participate in the predoctoral
implant program. Patients who agree to receive two
mandibular implants to support the newly fabricated
mandibular denture are followed by the same group
of students, further augmenting student learning.
Didactic Material
The background material necessary for the
students to prepare for the individual laboratory and
clinical sessions, as well as for the final examination,
is posted either on the dedicated Blackboard site or
provided in the required reference book11 and the
college-generated program manual. It is mandatory
that each student review the appropriate material be-
fore each didactic and clinical or laboratory session.
Each student answers the review questions received
a week earlier and turns the completed huddle sheet
in before starting the discussion, which ensures
student preparedness for the session. The students
are encouraged to take notes in their manuals on all
comments regarding the discussed material and to
keep it for their future clinical practice. The program
manual thus provides for the students a repository for
information acquired in the program.
In addition to checking the program manuals,
the program director is responsible for maintaining
the Blackboard site by providing content material in
the form of PowerPoint presentations12 and handouts.
The PowerPoint presentations cover all steps involved
in fabrication of complete dentures (evaluation of
edentulous patient, custom tray fabrication, border
molding and final impressions, record base and wax
October 2009  ■  Journal of Dental Education
rim fabrication, maxillo-mandibular records, selec-
tion and setting of denture teeth, concepts of complete
denture occlusion, and complete denture delivery).
The program director also meets with the faculty
mentors to provide course updates and to review each
team’s progress.
Student Evaluation
In the current course, prior to the final examina-
tion the student is to 1) complete team management
of the edentulous patient consisting of all the required
clinical steps in the process of complete denture fabri-
cation; 2) attend and actively participate in the review
sessions; 3) complete and turn in the huddle sheets
prior to each discussion; and 4) complete his or her
laboratory work (custom tray, record base with wax
rims, mounting the casts on semi-adjustable articula-
tor, setting anatomic denture teeth in bilateral balance
articulation, final wax contouring) using standardized
edentulous casts. The final examination consists of a
written part in the form of multiple-choice questions,
a station-to-station problem-based examination (an
objective structured clinical examination, OSCE),
and a practical examination consisting of setting
maxillary denture teeth against a mounted cast of an
existing mandibular denture. The final practical ex-
amination is an open-book type and requires students
to follow accepted criteria of setting the anatomic
teeth in bilateral balanced articulation. Passing this
program is one of the prerequisites for students to
advance into patient care.
Student and Faculty Perceptions of
the Program
Upon completion of the program each year,
each student completes a survey regarding percep-
tions about the content, logistics, and role of faculty
in this program. Comparison of student responses
to the same survey given prior to the introduction of
the new curriculum illustrates their perceptions of its
main strengths and weaknesses. This information is
analyzed by the program director and used for ap-
propriate changes.
Student evaluation from the previously deliv-
ered courses cited excellent organization, informative
and useful lectures, and a supportive course manual
as strengths. Weaknesses noted centered on the
questionable usefulness of the artificial (simulated)
patients. Students identified the use of casts from
unknown patients, the arbitrary articulator mount-
1197
 ings, and the lack of facial characteristics for mold
selection and tooth arrangement.
The major identified strength of the new pro-
gram is its early introduction of the student to the
patient, while the major perceived weakness has
tended to be a desire for more structured discussion
sessions. This concern has been addressed by addi-
tion of a focused review of the topic, presented by
the designated faculty member with the intention of
provoking active discussion among students.
The faculty members who have experience in
both the old and new curricula have expressed their
opinions that students have generally performed bet-
ter and seemed to be working at or above the level
of competence with the new curriculum. They have
also said they felt that students would benefit even
more if the group size was smaller.
Objective Evaluation of the
Program
To assess overall student academic achievement
in the revised curriculum and compare it to that of
students in the old program, their final performance
was analyzed. Since there has not been any change in
the final assessment of students upon completion of
both types, the outcome measures of the study were
the results on individual components of the programs’
final examination. The latter consisted of 1) a written
multiple-choice examination, 2) an OSCE, and 3) a
practical examination consisting of setting denture
teeth. The data used in the study had been originally
collected for educational purposes only, archived and
retained for legal purposes. The use of the data and
the analysis itself were reviewed and approved by the
Institutional Review Board at UIC (Research Pro-
tocol #2009-0645). After removal of the identifiers,
the data were pooled by the type of the curriculum
and statistically compared using one-way ANOVA
(SPSS version 16.0; SPSS, Chicago, IL). The results
of the analysis are presented in Table 1. The results
show significant improvement in students’ overall
performance in the program, including on each of
the components of their final examination.
Discussion
Clinical Exposure in the Preclinical
Curriculum
The traditional pre-patient complete denture
curriculum ������������������������������������
place�������������������������������
s������������������������������
major emphasis on������������
��������������
laboratory
techniques������������������������������������������
, with minimal or no exposure
���������������������
or
������������
relation
to patient care�����������������������������������������
. Due to time constraints in most dental
curricula, even the teaching of technique procedures
has often been reduced to student observations rather
than direct involvement.3 ��������������������������
A�������������������������
������������������������
study published in 2003
examin��������������������������������������������
ed the �������������������������������������
predoctoral �������������������������
complete denture curricu-
lum in forty-three U.S. dental schools. In combination
with other educational approaches, thirty schools (71
percent) reported using an edentulous dentoform
for preclinical laboratory, twenty-one schools (50
percent) were using manikin heads as a substitute for
the patient, and only one dental school (2 percent)
reported having no laboratory component but rather
teaching complete removable prosthodontics in its
entirety in the clinic.2 That school, the University
of Colorado School of Dentistry, and its “transition
clinic” integrated major pre-patient courses and
students’ clinical experiences.6 One of the courses
that was significantly changed and successfully
incorporated into its curriculum was a complete
denture prosthodontics program. Though the program
was entirely clinically based and without significant
student laboratory exposure, the initial report of the
outcomes measured (decreasing lag time between the

Table 1. Results of one-way ANOVA comparing academic achievement of students in the old and new curricula
Total Points
Achieved in the Final Written Final Practical
Program Examination OSCE Examination

Curriculum Old New Old New Old New Old New

Number of students 446 291 446 291 446 291 446 291
Mean score 81.93 85.88 78.15 79.49 85.25 87.38 79.77 84.12
SD 7.34 6.15 8.41 10.02 8.67 8.98 11.13 11.88
F ratio 57.58 3.88 10.35 21.63
Significance 0.000 0.049 0.001 0.000

1198 Journal of Dental Education ■ Volume 73, Number 10

conclusion of the pre-patient course and the students’
first clinical experience, student satisfaction, etc.)
supported continuation of that program.6
Teaching removable prosthodontics with the
complex interaction of the laboratory and clinical
phases requires careful balance.13 Focusing these
early student experiences entirely on one of the two
components of the process (i.e., the laboratory) can
easily translate into ignoring important roles of the
diagnostic process and patient-clinician relation-
ship.14 Another benefit of managing patients in a
curriculum designated as being “pre-patient” or
preparatory to actual patient care is the elimination of
the lag period between the didactic/laboratory portion
of student learning and students’ actual exposure to
clinical care. The students apply the newly acquired
clinical and laboratory concepts promptly and with-
out the need to memorize the procedures in abstract
form.13 �������������������������������������������
Entering the clinical environment early is
also overwhelmingly favored by dental students, as
expressed in their answers to recent surveys, and
objectively supported by the number of completed
clinical procedures during their remaining clinical
training (Table 2); similarly, it has been reported that
dental school graduates rank early clinical exposure
as the factor most important in preparing them for
clinical practice.15-17
Finally, vertically integrating our program with
the predoctoral implant program provides students
an opportunity to follow the same patient through
the entire process of delivering implant-supported
mandibular overdentures, recognized as a first choice
option of care for most edentulous patients.18
Active Learning
Progress in development of information tech-
nology has allowed significant changes with respect
to the structure of curriculum delivery.19,20 Traditional
learning methods in the form of lectures, combined
with self-study by using textbooks and course
manuals, are considered to be passive with respect
to students’ participation in the learning process. Us-
ing information technology as a platform to provide
background information to students not only changes
the role of faculty, but also provides the student with
unlimited access to the needed information. As a
result, students have the opportunity to expand the
scope of inquiry while pacing themselves according
to their individual needs regarding learning facts.21
Instead of maintaining the traditional role of the
lecturers, faculty members become responsible for
ensuring the information is available to students and
for guidance in the learning process.16 In addition,
faculty members maintain student contact as facilita-
tors of small-group discussions and, as shown in our
program, with no need to increase their number.
Although 28 percent of ������������������
North American
dental schools ����������������������������������
have reported
�����������������������������
the expanded use of
instructional technology ������������������������
in their ���������������
core curricula�,2 there
is no report regarding a follow-up with small-group
discussions. Having the pertinent background infor-
mation available in advance and requiring students to
come to discussion sessions prepared and with ques-
tions related to the reviewed material add relevance
to the session. Participation in small groups gives
students an opportunity to actively discuss issues re-

Table 2. Mean number of clinical experiences per student for graduating classes 2004–09 (new program was intro-
duced in 2005)
Graduating Year 2004 2005 2006 2007 2008 2009
n=number of students n=64 n=68 n=67 n=60 n=66 n=62
Total Total Total Total Total Total
(mean per (mean per (mean per (mean per (mean per (mean per
Procedure student) student) student) student) student) student)

Maxillary complete 142 189 165 168 241 212

denture (2.22) (2.78) (2.46) (2.80) (3.65) (3.42)
Mandibular complete 89 118 110 112 175 142
denture (1.39) (1.74) (1.64) (1.87) (2.65) (2.29)
Maxillary immediate 30 30 51 55 67 56
denture (0.47) (0.44) (0.76) (0.92) (1.02) (0.90)
Mandibular immediate 15 17 25 26 47 39
denture (0.23) (0.25) (0.37) (0.43) (0.71) (0.63)
Total procedures 276 354 351 361 530 449
(4.31) (5.21) (5.24) (6.02) (8.03) (7.24)

October 2009  ■  Journal of Dental Education 1199

 lated to the already familiar clinical and/or laboratory
scenario. The student thus assumes the role of active
learner.7 Consequently, this educational model allows
each group facilitator to highlight clinical relevance,
encourage critical thinking, and integrate biomedi-
cal and clinical sciences.5,17 This vertical integration
became part of the newly implemented curriculum at
our dental school, allowing existing knowledge to be
progressively supplemented by new information.8
Active learning has ������������������������
also been
�������������������
shown to have
a positive effect on the student���������������������
with respect to the
quality of the learning process and the learning
environment itself.16,22 Significantly, small-group
learning provides an opportunity for each student
to participate, while eliminating the likelihood of
segregation of the group into smaller subsets of stu-
dents. In addition, this learning environment charges
the student with the responsibility for learning and
checking themselves through self- and peer evalua-
tion. Students participating in early versions of the
program expressed a desire for more organized and
moderated discussions. By presenting an abbreviated
synopsis of the material first, followed by the discus-
sion, a successful compromise between the lecture
and discussion formats was achieved.
Potential Shortcomings of the
Curriculum in U.S. dental schools. J Prosthod 2005;14(3):191–7.
One of the potential shortcomings of this new
method of learning is its heavy dependence on patient
compliance and student motivation. If the patient
fails to make an appointment, the planned clinical
procedure is delayed, and the expected experience for
faculty and students has to be replaced with a didactic
and/or laboratory session. This may impede the flow
of learning. In addition, the new proposed curriculum
places heavy dependence on a student’s personal
motivation to learn the material and to be prepared
in advance of the laboratory or clinical sessions. In
spite of the abbreviated review of the subject, unless
the student comes to the sessions prepared, small-
group discussions may not be productive. To ensure
positive discussion outcomes, contingencies must be
addressed in advance.16
Conclusions
In our dental school, a clinically based “pre-
patient” curriculum in complete removable prosth-
odontics has recently replaced a traditionally taught
1200
laboratory-based course. The revised curriculum
introduces each student to the clinical experience
early in the preclinical curriculum, allowing the stu-
dent to practice high-fidelity “pre-patient” care and
to seamlessly transition to clinical practice. Use of
an Internet-based educational platform as a source
for pertinent clinical and laboratory information has
allowed the introduction of small-group discussions,
in which the student becomes an active participant
while the faculty member has the simultaneous
opportunity to assess and evaluate the student’s un-
derstanding of the required information. Finally, the
new curriculum has not only significantly improved
students’ academic achievement, but has also enabled
vertical and horizontal integration with the rest of our
revised curriculum.
Acknowledgments
We thank Dr. Stephen D. Campbell, Professor
and Chair, Department of Restorative Dentistry, Col-
lege of Dentistry, University of Illinois at Chicago,
for making helpful and very valuable suggestions on
the manuscript.
REFERENCES
1. Petropolous VC, Rashedi B. Complete denture education
2. Rashedi B, Petropolous VC. Preclinical complete denture
survey. J Prosthod 2003;12(1):37–46.
3. Weintraub AM, Weintrub GS. The dental student as
technician: an 18-year follow-up of preclinical laboratory
programs. J Prosthod 1997;6(3):128–13.
4. Huang SP, Brown DT, Goodacre CJ, Cerimele BJ.
Recent graduates’ and current dental students’ evalua-
tion of their prosthodontic curriculum. J Prosthet Dent
1993;70(4):361–71.
5. Diaz-Arnold AM, Langenwalter EM, Andres CJ, Lloyd
PM, Nimmo A, Cronin RJ. The Institute of Medicine
study of dental education: issues affecting prosthodontics.
J Prosthod 1996;5(2):133–41.
6. Lang LA, Holmes DC, Passon C, Trombly RM, Astroth
JD, Tavel AF. Introducing dental students to clinical care:
the Complete Denture Prosthodontics Transition Clinic. J
Prosthod 2003;12(3):206–10.
7. Sukotjo C, Thammasitboon K, Howell H, Karimbux N.
Students’ perceptions of prosthodontics in a PBL hybrid
curriculum. J Prosthod 2008;17(6):495–501.
8. Field MJ, ed. Dental education at the crossroads: chal-
lenges and change. An Institute of Medicine Report.
Washington, DC: National Academy Press, 1995.
9. Crawford JM, Adami G, Johnson BR, Knight GW,
Knoernschild K, Obrez A, et al. Curriculum restructuring
at a North American dental school: rationale for change.
J Dent Educ 2007;71(4):524–31.
Journal of Dental Education ■ Volume 73, Number 10
10. McGarry JT, Nimmo A, Skiba JF, Ahlstrom RH, Smith
CR, Koumjian JH. Classification system for complete
edentulism. J Prosthod 2004;13(2):73–82.
11. Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH,
Mericske-Stern R. Prosthodontic treatment for edentulous
patients: complete dentures and implant-supported pros-
theses. 12th ed. St. Louis: Mosby, 2004.
12. Complete denture educational curriculum. Los Angeles:
UCLA School of Dentistry, American College of Prosth-
odontists, and Ivoclar Vivadent, 2004.
13. Clark RK. The future of teaching of complete denture
construction to undergraduates. Br Dent J 2002;193(1):
13–4.
14. Carlsson GE, Omar R. Trends in prosthodontics. Med
Princ Pract 2006;15(3):167–79.
15. Henzi D, Davis E, Jasinevicius R, Hendricson W. In the
students’ own words: what are the strengths and weak-
nesses of the dental school curriculum? J Dent Educ
2007;71(5):632–45.
16. Henzi D, Davis E, Jasinevicius R, Hendricson W. North
American dental students’ perspectives about their clinical
education. J Dent Educ 2006;70(4):361–77.
October 2009  ■  Journal of Dental Education
17. Ryding HA, Murphy HJ. Assessing outcomes of curricular
change: a view from program graduates. J Dent Educ
2001;65(5):422–6.
18. Feine JS, Carlsson GE. Implant overdentures: the standard
of care for edentulous patients. Chicago: Quintessence
Publishing Co., 2003.
19. Hendricson WD, Panagakos F, Eisenberg E, McDonald
J, Guest G, Jones P, et al. Electronic curriculum imple-
mentation at North American dental schools. J Dent Educ
2004;68(10):1041–57.
20. Kassebaum DK, Hendricson WD, Taft T, Haden NK. The
dental curriculum at North American dental institutions in
2002–03: a survey of current structure, recent innovations,
and planned changes. J Dent Educ 2004;68(9):914–31.
21. Bogacki RE, Best A, Abbey LM. Equivalence study of
a dental anatomy computer-assisted learning program. J
Dent Educ 2004;68(8):867–71.
22. Victoroff KZ, Hogan S. Students’ perceptions of effec-
tive learning experiences in dental school: a qualitative
study using a critical incident technique. J Dent Educ
2006;70(2):124–32.
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