Objective: In June 2008, a survey of freshly graduated dental students of King Abdula¬ziz University Jeddah was conducted to evaluate the extent of their exposure to oral implantology and their knowledge of some basic principles of dental implant treatment.

Materials and methods: Multiple-choice questionnaires were given to the fresh graduate dental students of King Abdulaziz University Jeddah to answer. Sixty-six students responded out of 86, yielding a response rate of 76.7%.

Results: Majority of the students (78.8%) thought that they did not have enough lectures about dental implants and all of them thought that they did not have enough training in dental implant. Most of the students were not familiar with different dental implant systems (61.1%), designs (60.6%) or sizes (74.2%). Majority of the students were lacking the knowledge about basic princi¬ples of dental implant treatment. At King Abdulaziz University, Faculty of Dentistry, implant den¬tistry is taught to the students in the form of implant-related lectures incorporated into their periodontic, oral surgery and prosthodontic courses with one or two lectures given on dental implant in each course.

Conclusion: There is an urgent need to develop a well-structured implant course that includes didactic, laboratory, preclinical and clinical components at the undergraduate curriculum of King Abdulaziz University Faculty of Dentistry.

A 21 multiple-choice questionnaire was given to the fresh grad¬uate dental students of King Abdulaziz University to answer. Sixty-six students out of 86 returned the questionnaire, yield¬ing a response rate of 76.6%. The questions were about the ex¬tent of exposure to oral implantology and some basic knowledge about dental implants.

The results are reported by summarizing responses to each of the 21 questions in the survey.

Question 1: How many lectures did you have about dental implants'? Twenty-eight students (42.4%) reported that they had more than four lectures, 21 students (31.8%) reported that they had four lectures and 17 students (25.8%) reported that they had three lectures.

Question 2: Do you think you had enough lectures about den¬tal implants? Majority of the students (52 students = 78.8%) thought they did not have enough lectures about dental im¬plants while 21.2% thought they did.

Question 3: Do you think you had enough training in dental implants? All the students thought they did not have enough training in dental implant.

Question 4: Did you attend any implant surgery? Most of the students (50 students = 75.8%) did not attend any implant surgery while 16 students (24.2%) reported that they attended implant surgery.

Question 5: Are you familiar with different dental implant systems? Forty-one students (62.1%) reported that they were not familiar with different implant systems, 25 students (37.9%) reported they were.

Question 6: Are you familiar with different dental implant designs? Forty students (60.6%) reported that they were not familiar with different implant designs, 26 students (39.4%) re¬ported they were familiar.

Question 7: Are you familiar with different dental implant sizes? Forty-nine students (74.2%) reported that they were not familiar with different implant sizes, 17 students (25.8%) reported they were.

Question 8: Can dental implant be placed for smoking pa¬tients? Most of the students (56 students = 84.8%) reported that dental implants could be placed for smoking patients, 10 students (15.2%) reported it could not be placed.

Question 9: Can dental implant be placed for diabetic pa¬tients?? Most of the students (58 students = 87.9%) reported that dental implants could be placed for diabetic patients, eight students (12.1%) reported it could not be placed.

Question 10: Can dental implant be placed for osteoporotic patients? Majority of the students (47 students = 71.2%) re¬ported that dental implants could not be placed for osteopo-rotic patients, 19 students (28.8%) reported it could be placed.

Question 11: Can dental implant be placed for periodontally compromised patients? Forty-two students (63.6%) reported that dental implants could not be placed for periodontally compromised patients, 24 students (36.4%) reported it could be placed.

Question 12: Can dental implant be placed for patients with advanced carious lesions? Forty students (60.6%) reported that dental implants could be placed for patients with advanced carious lesions, 26 students (39.4%) reported it could not be placed.

Question 13: Can dental implant be placed for patients with poor oral hygiene? Forty-two students (63.6%) reported that dental implants could not be placed for patients with poor oral hygiene, 24 students (36.4%) reported it could be placed.

Question 14: Resorption of bone after extraction is more in mandible or maxilla? Forty-two students (63.6%) reported that resorption was more in the mandible than the maxilla, 23 stu¬dents (34.8%) reported that resorption was more in the maxilla than the mandible.

Question 15: Did you hear about immediate implant place¬ment? Most of the students (65 students = 98.5%) reported they heard about immediate implant placement, one student (1.5%) reported he did not hear about it.

Question 16: If the answer for question 15 is yes, what is immediate implant placement? Sixty students (92.3%) reported that it was implant placement at the time of extraction, 5 stu¬dents (7.7%) reported that it was implant placement and resto¬ration at the same time.

Question 17: In immediate loading ofdental implant, the prosthesis delivered should be temporary or final or any of the previous? Twenty-nine students (43.9%) reported that the pros¬thesis delivered in immediate loading should be temporary, 20 students (30.3%) reported that it should be final, 16 students (24.2%) reported that it could be temporary or final, one stu¬dent did not answer this question.

Questions 18-21: The last four questions are about some ba¬sic knowledge in implant dentistry like the safe distance be¬tween the apical part of implant osteotomy and the inferior alveolar nerve, the minimum distance between distal part of dental implant and mental foramen, the minimum distance be¬tween dental implant and natural tooth, and the minimum dis¬tance between two implants. The average percentage of students who answered the four questions correctly was 32.5%, the average percentage of students who answered the four questions wrongly was 67.5%.

Learning in academic settings is strongly related to the way the students are tested or examined. Assessment therefore must be integrated in the curriculum design, coordinated and should reflect the learning outcomes of the education. Assessment within the field of implant dentistry must fulfil four major objectives: complete and direct the learning process with feed¬back (formative), ensure that students are adequately prepared (summative), assess attitudes and skills such as critical think¬ing, reflection and self-assessment ability, and supply continu¬ous feedback to teachers on curricular content and impact (Mattheos et al., 2009b).

At the present time, every university dental school provides predoctoral dental implant courses (Young et al., 1999). How¬ever, the precise nature of these courses is different from one school to another. Some schools provide separate dental im¬plant courses which include didactic part and may or may not have laboratory or clinical training. Other schools provide implant-related lectures incorporated in the curriculum of re¬lated subject such as prosthodontics, periodontics and oral sur¬gery (Petropoulos et al., 2006).

With rapidly expanding use of dental implants, dental grad¬uates may encounter more patients with dental implants. The monitoring and maintenance of those implants may then fall upon general dental practitioner (Young et al., 1999). General practitioner should have the ability to maintain these implants and recognize associated pathology if present. They should also be able to know when to refer the patient to specialists. Many schools in United Stated allow their senior predoctoral students to restore single implants and implant overdenture (Maalhagh-Fard et al., 2002; Bavitz, 1990; Lim et al., 2005; Afsharzand et al., 2005; Huebner, 2002).
Studies have shown that recent graduates were more in¬clined to offer and restore implants in their practice when their dental school curricula include implant courses (Maalhagh-Fard et al., 2002; Afsharzand et al., 2005). Therefore, schools need to incorporate a combination of didactic, laboratory, as well as clinical training in dental implants within their predoc-toral programs in order to prepare students well for viable use of dental implants in their practice (Afsharzand et al., 2005).

Implant therapy has evolved into an important part of to¬day's daily dental practice. Appropriate knowledge of diagnos¬tic and therapeutic options with dental implant therapy is, therefore, mandatory for dental students. Students need a solid basic knowledge about biological prerequisites and clinical procedures leading to successful implant treatment and, in par¬ticular, an understanding of the importance of embedding im¬plants into the overall treatment concept. The students should also be able to differentiate between low, medium and high-risk situations. Furthermore, the dentist needs to be competent in evaluating clinical situations and in advising patients about the suitability of the different options. In cases of peri-implan-titis the student should be knowledgeable regarding suitable interventions (Hicklin et al., 2009).

At King Abdulaziz University Faculty ofDentistry, implant dentistry is taught to the students in the form ofimplant-related lectures incorporated into their periodontic, oral surgery, and prosthodontic courses with one or two lectures given on dental implant in each course. The school does not have predoctoral clinical competency requirement for both surgical placement and/or restoration of dental implants. This is due to (1) limited number of dental implant patients in the school, (2) the high cost of dental implant treatment and, (3) inadequate time in an already crowded dental school curriculum, so student were not having enough lectures or training in dental implants. This explains the poor level of knowledge about some basic princi¬ples of oral implantology as seen in the responses to the survey questions.

There is generalized feeling from the student that they did not have enough didactic or clinical training in dental implant. Most of the students did not attend any implant surgery, those who attended (16 students = 24.2%) were lucky because one of their comprehensive care cases needed implant and their instructor(s) allowed them to attend the surgery. Majority of the students were not familiar with different dental implant systems (61.1%), designs (60.6%) or sizes (74.2%).

A proposal was given to the Curriculum Development Committee at the Faculty of Dentistry in King Abdulaziz Uni-versity to include a full dental implant course in the final year of predoctoral training. This course should include lectures about surgical and prosthetic aspects of dental implants, labo¬ratory training, preclinical training and clinical training. This proposal was approved by the committee, School of Dentistry Board and King Abdulaziz University Board. The curriculum of the school was modified by decongestion, eliminating redun¬dancy and conflict between different courses to create a space for the implant course. Starting at fall of 2010, the dental school at King Abdulaziz University, having the qualified well-trained faculty, will incorporate dental implant program in the predoctoral curriculum which will not only include didactic and laboratory components, but actual student participation in the placement and restoration of dental implants, as well as the recall of implant patients.