In all three treatment options, the SR of the implants is more than 95%. The studies included reveal that a maxillary overdenture supported by six dental implants, which are connected with a bar, is the most successful treatment regarding survival of both the implants and overdenture. Second in line is the treatment option with four implants and a bar. The treatment option with four or less implants and a ball attachment system is the least successful.

ObjectiveTo compare a four‐ and six‐implant maxillary overdenture after an observation period of 5 years.Material and methodsFifty subjects with functional problems concerning their maxillary denture, who had ample bone volume in the anterior region to place four or six implants, were included and randomly assigned to either group. Implant and overdenture survival, clinical performance, marginal bone loss and patient satisfaction were assessed.ResultsForty‐six patients completed the 5‐year follow‐up. One implant failed in the six implants group (99.2% survival) and none in the four implants group (100% survival). No overdentures had to be replaced during the observation period and the number of complications was limited. Clinical function was good, with no difference in clinical parameters between the groups. Mean marginal bone resorption was 0.50 ± 0.37 and 0.52 ± 0.43 mm in the four and six implant group respectively.ConclusionIn patients with functional complaints of their maxillary denture, bar‐supported overdentures on four implants in the anterior maxillary region were not inferior to overdentures supported by six implants after 5 years of function. Implant survival and patient satisfaction were high, clinical parameters favourable, bone loss and complications to the denture were minor in both groups (Clinical trial registration number: NTR2969).

A bar-supported overdenture on 4 implants in the posterior maxillary region is not inferior to an overdenture supported by 6 bar-connected dental implants.

This experimental study was designed to investigate whether supervision meetings, in which students receive specific advice on how to use a development portfolio to monitor their progress and plan their future learning, helps them to develop self-directed learning skills and improve their learning in the domain. In the first year of a hairdressing program in vocational education, supervision meetings were used to provide students with either specific advice or not. Students in the advice group (n = 21) formulated better learning needs, selected more suitable learning tasks, completed more practical assignments, and acquired more certificates than students in the feedbackonly group (n = 22). Interviews also showed that students in the advice group appreciated the supervision meeting more and perceived them as more effective than students in the feedback-only group. Guidelines are provided for the use of development portfolios and the organization of supervision meetings in on-demand vocational education.

No abstract

Objective To compare clinical and patient‐reported outcomes when providing maxillary overdentures on four bar‐ and six bar‐connected implants placed in the posterior region during a 5‐year follow‐up period. Materials and methods Sixty‐six fully edentulous patients with functional maxillary denture complaints and insufficient bone volume to allow implant placement were scheduled for a maxillary sinus floor elevation procedure with bone from the anterior iliac crest and randomized to receive either four or six implants in the posterior maxilla and four implants in the mandible. After 3 months of osseointegration, a bar‐supported overdenture was constructed. Maxillary implant survival, overdenture survival, clinical scores, peri‐implant bone height changes and patient satisfaction were assessed. Results Sixty patients completed the 5‐year follow‐up. Implant survival was 100% in the four‐implant group and 99.5% in the six‐implant group. No new overdentures had to be made in the four‐implant group, and three new overdentures were made in the six‐implant group due to excessive wear of the denture base and teeth (90.9% overdenture survival). Clinical parameters did not differ significantly between groups. Mean marginal bone loss compared to baseline was 0.58 ± 0.51 mm in the four‐implant group and 0.60 ± 0.58 mm in the six‐implant group, respectively. Overall, patient satisfaction improved significantly, but did not differ between groups. Conclusion Following a bilateral maxillary sinus floor elevation procedure, a bar‐supported overdenture on four implants in the posterior maxillary region is not inferior to an overdenture supported by six implants after a 5‐year evaluation period in patients with functional maxillary denture complaints and marked posterior resorption (Clinical trial registration number: NTR2969).

Objective: To compare a four-and six-implant maxillary overdenture after an observation period of 5 years. Material and methods: Fifty subjects with functional problems concerning their maxillary denture, who had ample bone volume in the anterior region to place four or six implants, were included and randomly assigned to either group. Implant and overdenture survival, clinical performance, marginal bone loss and patient satisfaction were assessed. Results: Forty-six patients completed the 5-year follow-up. One implant failed in the six implants group (99.2% survival) and none in the four implants group (100% survival). No overdentures had to be replaced during the observation period and the number of complications was limited. Clinical function was good, with no difference in clinical parameters between the groups. Mean marginal bone resorption was 0.50 AE 0.37 and 0.52 AE 0.43 mm in the four and six implant group respectively. Conclusion: In patients with functional complaints of their maxillary denture, bar-supported overdentures on four implants in the anterior maxillary region were not inferior to overdentures supported by six implants after 5 years of function. Implant survival and patient satisfaction were high, clinical parameters favourable, bone loss and complications to the denture were minor in both groups (Clinical trial registration number: NTR2969).

In on-demand education, students often experience problems with directing their own learning processes. A Structured Task Evaluation and Planning Portfolio (STEPP) was designed to help students develop three basic self-directed learning skills: Assessing the quality of own performance, formulating learning needs, and selecting future learning tasks. A case study with 10 first-year students in the domain of hairdressing was conducted to evaluate STEPP's use, usability, and perceived effectiveness. Results from student interviews show that usability and use are influenced by several factors. Students with low prior hairdressing skills, a weakly developed personal approach to direct their own learning, and an inclination to update STEPP as part of their weekly routine, use STEPP more frequently than students without these characteristics. Both the supervisor and students who frequently used STEPP perceived its use as a positive contribution to the development of self-directed learning skills. Furthermore, this study provides guidelines for the design of development portfolios in on-demand education. Development portfolio 3Design and Evaluation of a Development Portfolio: How to Improve Students' Self-Directed Learning SkillsIn the Netherlands, on-demand education is becoming increasingly popular in secondary vocational education because it is expected to address the uniqueness of students' learning needs and to better prepare students for lifelong learning in their future profession. It offers students the opportunity to plan their own learning trajectory by providing them a certain amount of freedom to choose what they want to learn (i.e., selecting a topic) and how they want to learn this (i.e., selecting particular learning tasks). For instance, an on-demand educational program at a school for hairdressing offers students the opportunity to decide for themselves which skills, from a predefined set of skills, they prefer to develop first: Washing hair, permanent waving, applying hair-dye, and so forth. After choosing which skill(s) they want to develop, students select from a predefined set of tasks the tasks they want to perform to develop these skill(s), creating their personal learning trajectory. Students can choose from tasks in which they practice on a dummy or a model, in which they learn from studying a book, watching a video, or observing an expert at work, in which they work in groups or individually, in which they practice only one skill (i.e., part-task practice) or more than one skill (i.e., whole-task practice), and so forth.Self-directed learning (SDL) plays an important role in on-demand education. Althought the concept of SDL originally emerged from the field of adult education, with particular relevance to workplace learning, students in secondary vocational education are also more and more required to direct their own learning processes, including assessing their own performance, deducing their learning needs from these assessments, and selecting suitable learning resources (e.g., learn...