Improvement and enhancement of students’ diagnostic abilities is one of the main goals of medical education. On the one hand, classical clinical training of students of the School of Dentistry is based in the recognition and diagnosis of conditions affecting real clinical patients. Direct examination of the clinical patients is still a fundamental part of the formation of undergraduate University students (clinical method). This classical clinical teaching strategy has been proved for long time as a useful tool for an efficient odontological diagnosis formation in dentistry students. On the other hand, one of the currently most used methods for the training of University students is the use of photographic records using Microsoft Power Point software (virtual method or PPP). This method offers a highly available large number of diagnostic cases, including rare conditions, and allows the teacher and students to select for specific diagnostic areas in a short time. PPP method is considered to be a good complement for the clinical method. However, PPP method is based on archive pictures and lacks the advantages of in vivo clinical diagnosis of actual odontological patients.
In this work, we have carried out a comparative study to determine the usefulness of the virtual method (PPP) as a training strategy for dental diagnosis in dentistry students in comparison with the clinical method. With that purpose, a total of one hundred and fifty dentistry students from a Faculty of Odontology were selected. Then, students were asked to make a diagnosis related to the extent of incisal dental wear in maxillary central incisors using PPP. In short, students were provided with twenty eight standardized and digitalized photographs with PPP of mouths showing incisive teeth, where the patients corresponded to different ages and had different levels of dental wear. The obtained results were compared to those obtained by two oral rehabilitator specialists using the method of Hugoson on actual clinical patients (clinical method).
The results of this study showed that 65% of the cases shown to the students using PPP method were correctly diagnosed (65% agreement between PPP and clinical method), with a 35% of misdiagnosis. In general, most of the misdiagnoses corresponded to overestimations made by the students, who tended to diagnose many of the normal cases as dental wears.
These results suggest that PPP method could lead to misdiagnosis of morphological patterns on teeth by student’s eyes. Although virtual diagnosis based on the use of PPP images is a good training tool, there are specific drawbacks that must be taken into account, especially the trend to overestimate pathological conditions. For that reason, PPP training should always be combined with clinical methods whenever that is possible.