The analysis of residents’ training needs in musculoskeletal disorders of the masticatory system is required in the department, because patients suffering from temporomandibular disorders and referred by general dentists constitute a significant proportion of patients consulting the service. Sufficient skills are thus required to provide appropriate care to these patients. Objective: The aim of our work is to survey residents’ training needs in «Temporomandibular Dysfunction» practicing within the prosthodontics department of the Dental Consultation and Treatment Center of Casablanca. Method: Qualitative descriptive analysis of the initial training requirements in ‘management of temporomandibular dysfunctions« among eleven residents in the department of fixed prosthodontic in Casablanca. Each participant responded to a questionnaire during a brainstorming session and an FGP grid has been done. Results: This work has highlighted a real need for training residents in temporomandibular dysfunction, especially for dysfunction of muscular origin and during the post-occlusal split stabilization period. Conclusion: Knowing the type of dysfunction (muscle or joint) is essential because the effectiveness of the diagnosis is a decisive step in the treatment. Within the context of the analysis of the training requirements for residents of the fixed prosthodontic department Casablanca in temporo-mandibular disorders, our preliminary survey should be regarded as a preliminary study.
Background: Learning clinical reasoning (LCR) sessions were first described by Dr. M. Chamberland in 1998. These sessions are intended to support the development of clinical reasoning in a protected learning context. They are structured to reproduce the processes that clinicians spontaneously use, the generation of hypotheses, the collection of clinical data to develop a correct and seriously considered medical attitude. Objective: To analyze the impact of clinical reasoning learning sessions in dental prosthesis as an active teaching strategy applied to dental interns. Method: A descriptive cross-sectional epidemiological survey was carried out on 12 interns (among 19 invited) from the 2017 and 2018 promotions. The session duration was of two-hours, subdivided into 4 sequences: situation and evaluation before the ARC, strategic approach of the session, discussion of clinical cases aloud and finally the study of the impact of the introduction of the LCR method. Results: After the implementation of our clinical reasoning supervision model, intern’s reasoning improved and became more structured, however our session revealed clinical gaps that interns have in some disciplines. These gaps concerned specialties such as orthodontics, occlusodontics and implantology. This work is part of a set of two parts, the first deals with the evaluation of clinical reasoning in a population of dental interns at the end of their internship, and the second is a satisfaction survey relating to the introduction of LCR as a method of active teaching, within the same population.
A descriptive cross-sectional epidemiological survey was carried out on 12 interns (among 19 invited) from the 2017 and 2018 promotions. Our survey was in the form of a two-hour session, subdivided into 4 sequences: situation and evaluation of clinical reasoning in dental interns before LCR, discussion of clinical cases in groups and finally the study of the impact of the introduction of the LCR method. This satisfaction survey focused on several axes (pedagogical, technical and general appreciation aspects), respondents had to choose between five different degrees of satisfaction according to the LIKERT scale. The overall appreciation was very positive and the experience of introducing LCR as a model of pedagogical supervision was very accepted by all interns and they also demonstrated their preference for group work. This work is part of a set of two parts, the first deals with the evaluation of clinical reasoning in a population of dental interns at the end of their internship, and the second is a satisfaction survey relating to the introduction of LCR as a method of active teaching, within this same population.
Cognitive Behavioral Therapy (CBT), represents today the psychotherapeutic current most widely validated by the methods of Evidence Based Medicine. The aim of this work is to evaluate the clinical efficacy of this therapy in the management of temporomandibular disorders, which are pathologies of multifactorial origin, in which the psychic factor plays an important role.The collection of data from the scientific literature was carried out among the scientific production published during the period from 2004 to 2019 through research on the PubMed database.Articles published and meeting the eligibility criteria were identified after reading their titles and abstracts by 3 readers.A manual search covering the same period was conducted to expand the bibliography.Through this systematic review, we can abstract the following conclusions:- Temporomandibular joint disorders are pathologies with various origins, in which the psychic factor plays an important role in the appearance and maintenance of the disorder, as well as during treatment.-In front of this pathology which is multifactorial, medical care must address all of the elements responsible of the disorder.- The treatment plan must be adapted to each patient, promoting the non-invasive conservative therapeutic means (drug treatments, occlusal splints).-The combination of the standard conservative therapy with Cognitive Behavioral Therapy (CBT), which is a psychotherapy that focuses on the patient's wrong and negative thoughts and beliefs, allows to increases the effectiveness of treatment, accelerates healing and prevents relapse.- Further studies are needed, with a longer observation period and a large sample size. In order to make a better analysis of this effectiveness, not only on temporomandibular joint disorders, but also for the various oral and dental pathologies which are related to the psychology of the patients. In addition, the oral cavity represents an organ with high psychological importance, and the dentist must today know how to approach a patient as a globality for a better care.