Resources for a Novel Laboratory Quality Assurance Program: Operating Procedures

Publication ID Published Volume
9865 August 6, 2014 10


The purpose of this resource is to provide dental school faculty with accessible documentation for implementation of a laboratory quality assurance program. The primary goal of a laboratory quality assurance program would be to review and evaluate all laboratory cases departing from and arriving to the dental school. The laboratory quality assurance program can be implemented to evaluate and enforce all pre-clinic techniques being used on clinical cases, critique incoming laboratory clinical cases and to ensure appropriate treatment planning progression for patients of record. These resources were designed to prepare and familiarize dental students to the expectations of quality and precision of indirect laboratory techniques performed on patients of record. The resources were developed and deployed to reduce unnecessary costs associated with indirect laboratory remakes. They were created from daily forms used in pre-clinical techniques courses and brainstorming ideas from several advanced restorative and prosthodontic faculty. It is recommended that two full time staff members be available to monitor paperwork and log cases to and from the dental school, as well as a team of 8-10 calibrated reviewers extremely familiar with pre-clinical technique courses for fixed and removable indirect prostheses. Reviewer calibration is a key component to pre-implementation preparedness and recommended to be done routinely (quarterly) thereafter. Once reviewer calibration is achieved, clinical faculty should be calibrated as a pre-implementation exercise in a one or two day sessional continuing education forum. Resources were utilized for the first time in December of 2010 and have been successfully used to date. The program has significantly (statistically) reduced costs associated with expensive laboratory remakes. Resources are limited in that they monitor only one aspect of clinical care. Resources do not improve clinical decision making on the treatment floor; only that what is being fabricated follows pre-clinical technique, the student and laboratory products are acceptable and documentation of outcomes. A future goal of the QA program is to provide additional continuing education through case presentations for the dental laboratories, clinical faculty, dental students and QA team members to further strengthen this dynamic relationship.

Metz MJ, Abdel-Azim T, Miller CJ, Lin WS, ZandiNejad A, Oliveira GM, Morton D.

Implementation of a laboratory quality assurance program: the Louisville experience. J Dent Educ. 2014 Feb;78(2):195-205.

Within the scope of the current report, both internal and external remake percentage rates demonstrate a decreasing trend from the inception of the program in December 2010 until December 2012.

  • Calendar year 2010 (pre-quality assurance program) out of 2910 total laboratory cases, 419 remakes were identified (14.4%), of which 182 (6.3%) were considered internal and 237 (8.1%) were considered external.
  • Calendar year 2011 (active quality assurance program) out of 2729 total laboratory cases, 255 remakes were identified (9.3%), of these 91 (3.3%) were considered internal and 164 (6.0%) were considered external.
  • Calendar year 2012 (active quality assurance program) out of 2422 total laboratory cases, 138 remakes were identified (5.7%), of these 57 (2.4%) were considered internal and 83 (3.4%) were considered external.
  • Please see the aforementioned publication in the JDE for further details on outcome data and statistical analyses.


Metz M, Lin W, Miller C, ZandiNejad A, Abdel-Azim T, Morton D. Resources for a novel laboratory quality assurance program: operating procedures. MedEdPORTAL Publications. 2014;10:9865.

Educational Objectives

  1. Provide compassionate and ethical care to a diverse population of patients.
  2. Communicate effectively with peers, other professionals, staff, patients and guardians and the public at large.
  3. Comply with federal, state and local regulations as related to infection control, radiation and environmental safety measures on all clinical procedures.
  4. Identify a patient’s chief complaint, general needs, past dental history, and treatment expectations.
  5. Recognize the normal range of clinical and radiographic findings and conditions that require monitoring or management.
  6. Recognize predisposing and etiologic factors that require intervention to prevent disease.
  7. Interpret findings from the history, clinical and radiographic examinations, and other diagnostic procedures.
  8. Integrate subjective and objective clinical findings in the formulation of the diagnosis.
  9. Evaluate the prognoses of various treatment options.
  10. Restore missing or defective tooth structure to proper form, function, and esthetics.
  11. Select and administer/prescribe appropriate pharmacological agents in the treatment of patients with dental disease.
  12. Anticipate, prevent and manage complications of dental treatment.


  • Laboratory Quality Assurance, Laboratory Fabrication, Prosthodontics, Dental Prosthesis, Laboratory Remakes, Dental Education, Clinical Education, Clinic  Management


Metz MJ, Abdel-Azim T, Miller CJ, Lin WS, ZandiNejad A, Oliveira GM, Morton D.

Implementation of a laboratory quality assurance program: the Louisville experience. J Dent Educ. 2014 Feb;78(2):195-205.

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