Reframing Perceptions in Restorative Dentistry: Evidence-Based Dentistry and Clinical Decision-Making.

Ayah A Al-Asmar,Waed Almadani,Motasum Abu-Awwad,Nigel B Pitts,Furat Rihan,Ahmad S Al-Hiyasat,Faleh A Sawair,Nesreen A Salim,Hakam N Mousa,Mario Dioguardi

doi:10.1155/2021/4871385

Abstract

Objectives The worldwide interest of both dentists and patients in esthetic dentistry has affected decision-making in dental practice. The aim of this study was to investigate contemporary dental practice in restorative dentistry and the relationship between evidence-based dentistry in caries research and decision-making in clinical practice in restorative dentistry. Methods The study was conducted through a structured questionnaire distributed randomly at the Jordanian Dental Association registered dentists in Jordan. The questionnaire aimed to clarify the degree of knowledge and practice of evidence-based dentistry in caries research the dentists hold regarding clinical decision-making in restorative dentistry. Results The majority of the surveyed dentists (77%) treat teeth with irreversible pulpitis with root canal treatment rather than vital pulp therapy. 13.8% routinely insert a post and 23% routinely crown the tooth after root canal treatment regardless of the remaining tooth structure. Badly damaged teeth are treated with full crowns in 72% of the cases. Regarding Hollywood smile or smile makeover, the majority of dentists choose conservative approaches, and implants were the first choice to replace missing teeth for 93.8% of the surveyed dentists. Conclusion A higher degree of implementation of evidence-based dentistry in clinical decision-making was found in Prosthetic Dentistry than in Endodontics. Yet, the gap between evidence-based data and clinical practice needs bridging. More emphasis on communicating these data to educators to integrate them into the dental curriculum is a must.

Highlights

Worldwide, there has been an intensive interest in esthetic profile in general, and in esthetic dentistry in particular
We discussed previously the ethical and the scientific philosophies that lie behind the key concept of Minimal Invasive/Intervention Dentistry (MID), and we emphasized the need for updating dentists’ practice dictionary with a new set of terms and norms [3]. e main goal of MID is to increase the life of the International Journal of Dentistry teeth, which was restored with less intervention conveying the concept “prevention of extension” rather than “extension for prevention” [4]. e scientific advances in the knowledge of the caries process combined with developments both technological and technique related, impose that the sole rational pertinent therapeutic model is one that is based on prevention and treatment using the least invasive approaches and MID [5]
This concept was evolved over decades, the answer for the question: ‘Are we ready to move from operative to nonoperative/preventive treatment of dental caries in clinical practice?’ [6] remained over decades ‘No’ due to the disconnection between accepted international evidence-based dentistry (EBD) on how best to prevent and manage caries and the care delivered in dental practice [7]. is miscommunication and the big gulf between research findings and clinical practice led to the wasting of evidence-based practice in patient dental care

Summary

Introduction

There has been an intensive interest in esthetic profile in general, and in esthetic dentistry in particular. Traditional orthodontic treatment to align teeth using the option of whitening procedure could be enough to reach functional and esthetic results without changing the integrity of the enamel surface: the development of tooth whitening and advanced restorative and prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal and oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3dimensional planning and realization of truly natural, individual, and esthetic smiles [38]. Modifying the use of mockups as a preparation guide for dentists or as a surgical guide for periodontists will ensure more conservative soft and hard tissue manipulation with minimally invasive approach

Materials and Methods

Discussion

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Conclusion