Evidence-based Dentistry Research Articles

COVID-19, infordemic, and evidence-based dentistry

COVID-19, infordemic, and evidence-based dentistry

ETHICAL CONSTRAINTS FOR CONDUCTING RESEARCH IN PEDIATRIC AGE GROUP – A REVIEW

Ethical aspect in pediatric dentistry starts when we as a dentist meet a child patient in the clinic, to whom we should provide a dental treatment & oral health needs with taking the patient's point of view into consideration. Thus, with professional ethical codes it is very much concern how we look upon children as individuals and as patients. Clinical Research in pediatric dentistry is incorporated to increase and revise the current knowledge.The aim of this review is improve the concept of clinical research in pediatric dentistry with pertinent ethical concern.In the current times where evidence-based dentistry is known for expertise studies with ethical papers without plagiarism, stress is been emphasized.Proper Knowledge about ethics while conducting a clinical research in pediatric dentistry is propitious to the researcher and also the dental community

RESEARCH IN CLINICAL PERIODONTOLOGY: CURRENT APPROACHES AND FUTURE PERSPECTIVES

Research in the eld of periodontology has observed a huge upheaval in the last two decades unveiling newer alterations in techniques, methodologies, and material science. The recent centre of attention in periodontal research is an evidence-based approach which offers a bridge from science to clinical practice. Research inculcates scientic and inductive thinking and it promotes the development of logical habits of thinking and organization. In terms of research methodology, the article aim to inform the reader on topics relating to randomized controlled trials in periodontal research, evidence-based dentistry, calibration of clinical examiners and statistics relevant to periodontal research.

Dentist’s Knowledge of Evidence-based Dentistry and Digital Applications Resources in Saudi Arabia

Dentist’s Knowledge of Evidence-based Dentistry and Digital Applications Resources in Saudi Arabia

Spotlight on Evidence-Based Dentistry

Spotlight on Evidence-Based Dentistry

Prevalence of root canal system configurations in the brazilian population analyzed by cone-beam computed tomography – a systematic review

Objectives: This study performed a systematic review of anatomy prevalence studies using cone-beam computed tomography to comprehend the root and root canal configuration types in Brazilian sub-populations. Methods: This systematic review followed PRISMA’s statements. Four electronic databases (PubMed, ScienceDirect, Lilacs, and Cochrane Collaboration) were accessed using MeSH terms and free-text keywords. The studies were selected according to predefined criteria. References of the collected studies, three peer-reviewed endodontic journals, and two peer-reviewed evidence-based dentistry journals were hand searched. The authors were contacted for additional information, if necessary. Eligible studies were submitted to a scientific merit assessment by two evaluators independently, who reached a final consensus for each study score using the Joanna Briggs Institute Critical Appraisal tool for prevalence studies. Results: A total of 2266 studies were identified. After analysis, 20 full-text articles were accessed for eligibility and 17 were included for qualitative synthesis. A high prevalence of mandibular incisors presenting two root canals was noted (~35.0% – 40.0). Moreover, a high proportion of two-rooted (17.0% – 28.4%) and two root canals (50.1% – 75.0%) morphologies were identified in maxillary second premolars. A wide range and a high percentage of a second mesiobuccal canal were detected for both maxillary first (37.1% – 88.5%) and second molars (21.8% – 83.4%). A second root canal prevalence ranging from 12.4% to 23.4% was observed in the distal root of mandibular first molars. Conclusions: In conclusion, different Brazilian sub-populations may present divergent characteristics regarding the root and root canal configurations. Clinicians should be aware of these variations for proper planning of endodontic treatment.

Outcome measures to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of European Society of Endodontology (ESE) S3 level clinical practice guidelines: a protocol.

The European Society of Endodontology (ESE) is in the process of developing S3Level Clinical Practice Guidelines for the treatment of pulpal and apical disease for the benefit of clinicians and patients. In order to ensure a homogenous review process in the development of the clinical practice guidelines, it is essential that the core outcomes for all endodontic treatments are standardized and recommendations are made regarding minimum follow-up time specific to each outcome measure. In the absence of a recognized core outcome set in Endodontics, the current project aimed to follow an established consensus process to define the most appropriate clinician and patient-reported outcomes. As part of the project, recommendations will also be agreed regarding an acceptable minimum follow-up period for studies by literature review and group discussion. The selected outcome measures and follow-up periods will be used in subsequent systematic analyses of the literature to investigate the effectiveness of endodontic treatment to alleviate pulpitis and apical periodontitis. In this paper, previous reviews, ESE Guidelines and Position Statements were searched in order to compile a list of potentially important outcome measures for the treatment of pulpitis (working group 1), the nonsurgical treatment of apical periodontitis (working group 2), the surgical treatment of apical periodontitis (working group 3) and the regenerative treatment of apical periodontitis (working group 4). Initially, the two S3 guideline leads selected two independent senior clinical academics with experience of evidence-based dentistry to lead each of the four working groups forming a 10-member steering group. The working group leads in turn selected 32 academics with experience of evidence-based dentistry to lead the individual systematic reviews contained within the respective working groups. These 42 individuals make up the Guideline Development Group (GDG). Prior to the selected systematic reviewers commencing writing and submitting the review protocol, the complete list of outcome variables identified in this document will be ranked by the 42 members of the GDG in their importance to the individual patient using a 9-point Likert scale. A summary of the survey scores will thereafter be shared with the members of the group and the final list of clinician and patient-reported outcome measures rated as critical for decision making (7-9 on Likert scale by majority of survey participants) to guide systematic reviews will be consented and confirmed during an online meeting of the steering group. In this online meeting, another aspect with regard to meaningfulness of clinical trial results to be addressed in systematic reviews will be consented: length of follow-up. In order to develop high quality guidelines, it is suggested that the follow-up period after treatment should be related to the specific outcome measure being addressed; however, a minimum of one year for assessing the effectiveness of treatments for pulpitis and apical periodontitis should be considered. It is accepted, that selected research questions that focus on pain, swelling, medication taken or investigating diagnostic accuracy are likely to have shorter follow-up periods. As a result of the GDG consensus process, the outcome measures and length of follow-up will, alongside the use of standard instruments to assess the methodological quality of clinical trials and other comparative studies, be applied to all the commissioned systematic reviews that will inform the subsequent process when developing the ESE S3 Level Clinical Practice Guidelines.

Mapping oral disease impact with a single metric - Special Issue introduction.

Dental patient-reported outcomes (dPROs) describe how dental patients suffer from oral diseases.1 Thus, dPROs are fundamental for evidence-based dentistry across dental disciplines.2 They are essential to evaluate treatment efficacy and to reduce research waste by addressing questions relevant to clinicians and capturing what matters most to patients.3 Doctor-patient communication centers around them,4 and they are necessary components for value-based oral health care, a concept that relates outcomes to costs.5 Oral health-related quality of life (OHRQoL) is the most important dPRO. Recent studies have demonstrated that OHRQoL has four main components, so called dimensions - Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact.6-8 These four dimensions, characterized by four scores, would allow to "map" all 1,323 oral diseases1 with one, single metric, thus describing oral disease impact with a standardized impact metric across all conditions in all settings. Meta-analytic statistical techniques are available to synthesize these multiple outcomes from differences sources.

Development and Implementation of Evidence-based Dentistry Teaching Module at Saudi Arabian University

Aim: to describe the module followed to help undergraduate students in applying the EBD-related skills to develop an evidence-based report at Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia (KAUFD). Method: The paper explains the procedures undertaken to teach the students at the last year of the dental program at KAUFD. A brief description of the module was provided, starting for the preparation and including all steps required to produce the evidence-based report to answer certain clinically relevant questions. At the end of the module, students were invited to anonymously fill out a questionnaire to evaluate the module. Responses to the questionnaire from 2015-16 and 2019-20 were summarized using descriptive statistics. Chi-square or Fisher’s exact tests were used to compare the students’ responses from the two academic years at significant level of 0.05. Results: Majority of students found the module objectives and expectations clear, were satisfied with the module organization and felt that it was intellectually challenging. More than 80% of respondents stated that they are confidents in applying the EBD concept to answer any clinical question. Overall, majority of the students found the topics were clinically relevant, the assignment were useful, and deadlines were reasonable. Students were highly satisfied with their experience with the assigned tutor in regard to all evaluated aspects. Conclusion: This study supports the effectiveness of the EBD module that was incorporated into the undergraduate curriculum in improving the EBD-related knowledge and skills.

Patient's perspective and awareness of materials used in dentistry.

To assess patients' knowledge and attitude towards different dental materials used in private and public dental facilities in an urban setting. The cross-sectional study was conducted at the Islamabad Dental and Medical College, Islamabad, Pakistan, from February to July 2019, and comprised individuals at private dental clinics and teaching hospitals. Data was collected using a pre-validated structured questionnaire that recorded socio-demographic information as well as patients' perception on evidence-based dentistry using visual analogue, trust on the dentist, quality of materials and the source of information. Data was analysed using SPSS 21. Of the 269 participants, 151(56.1%) were females with a mean age of 33.87±12.63 years, and 118(43.9%) were males with a mean age of 33.28±13.71 years. Overall, 208(77.3%) respondents were in favour of using materials with long-term scientific data; 201(74.7%) recognised a difference in quality of materials used at private clinics and teaching hospitals; 128(63.7%) believed that poor quality materials were used in teaching hospitals; 229(85%) trusted their dentists for using high-quality materials; and 108(40%) identified dentists as the source of information. There was a significant relationship between patient's education level and realising the importance of using dental materials supported by scientific evidence (p≤0.01). Majority of subjects believed that poor quality materials were used in teaching hospitals compared to private dental facilities.

Real-time collaborative question-making activity to enhance students' knowledge of evidence-based dentistry.

Journal of Dental EducationVolume 85, Issue S1 p. 952-954 ADVANCING THROUGH INNOVATION Real-time collaborative question-making activity to enhance students' knowledge of evidence-based dentistry Hanan Omar BDS, MSc, PhD, Corresponding Author Hanan Omar BDS, MSc, PhD [email protected] orcid.org/0000-0002-4144-7170 Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USA Correspondence Dr Hanan Omar, BDS, MSc, PhD, Associate Professor, Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, 800 West Jefferson Street, Kirksville, Missouri 63501, USA. Email: [email protected]Search for more papers by this authorJoan Davis PhD, Joan Davis PhD orcid.org/0000-0003-4007-0129 Research, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USASearch for more papers by this authorHamid Nurrohman DDS, PhD, Hamid Nurrohman DDS, PhD Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USASearch for more papers by this author Hanan Omar BDS, MSc, PhD, Corresponding Author Hanan Omar BDS, MSc, PhD [email protected] orcid.org/0000-0002-4144-7170 Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USA Correspondence Dr Hanan Omar, BDS, MSc, PhD, Associate Professor, Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, 800 West Jefferson Street, Kirksville, Missouri 63501, USA. Email: [email protected]Search for more papers by this authorJoan Davis PhD, Joan Davis PhD orcid.org/0000-0003-4007-0129 Research, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USASearch for more papers by this authorHamid Nurrohman DDS, PhD, Hamid Nurrohman DDS, PhD Restorative Dentistry, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, Missouri, USASearch for more papers by this author First published: 26 October 2020 https://doi.org/10.1002/jdd.12474Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume85, IssueS1Supplement: Advancing Through Innovation in a Challenging TimeJune 2021Pages 952-954 This article also appears in:Advancing Through Innovation in a Challenging Time RelatedInformation

Knowledge of Postgraduate Dental Students on Evidence-based Dentistry and Research Methodology. An International Survey.

To assess the knowledge of postgraduate dental students about evidence-based methodology pertaining to the design, conduct, and critical appraisal of clinical trials. Senior postgraduate students were surveyed from the dental schools of three universities in Athens (Greece), Boston (USA), and Zürich (Switzerland). The proportion of students correctly answering each of the 10 questions of the survey, as well as the cumulative scores, were analysed statistically with descriptive statistics and logistic/linear regression analysis at α = 5%. A total of 96 students with a mean age of 30.0 years attained an overall correct score of 45.6% ± 15.0%, with correct answers to each question ranging from 13.5% to 86.5%. The questions most frequently answered incorrectly pertained to characterising sensitivity/specificity (13.5%), the number needed to treat (14.0%), the credibility of trial synthesis in meta-analysis (23.7%), and publication bias (29.5%). The vast majority of postgraduate students could correctly identify the role of statistical power of a trial (63.8%), random allocation sequence in a randomised trial (76.0%), and blinding in a randomised trial (86.5%). Paediatric dentistry postgraduate students scored better than students from other departments (+15.1%; 95% CI: 3.0% to 27.1%; p = 0.02). Postgraduate students in orthodontics and other dental specialties possessed moderate knowledge on evidence-based methodology and clinical trials. Efforts should be made to integrate such subjects in university postgraduate curricula, so that future dental specialists can critically appraise such research papers.

The Seychelles Dental Service

The Seychelles Dental Service dates back to the 1920s, growing from rudimentary dentistry to the evidence-based dentistry of today. Until the 1970s, dental care was provided by a small number of dentists. However, since the establishment of the School Dental Service (SDS) in the 1980s, child oral health has been the responsibility of Dental Therapists (DTs). Today Seychelles has a well organised oral health care system in place with modern infrastructure and equipment and trained personnel. Locally trained DTs constitute 85% of the SDS workforce. A national oral health plan serves as a guide to ensure that programmes are developed in accordance with WHO global oral health goals, guided by periodic reviews. We present a resume of the major strengths and challenges of the Seychelles Dental Service, concluding with recommendations for staff development. Findings and recommendations of reviews and assessments of various dental health issues conducted in the country between 1977 and 1999 are summarised in the appendix.

The Association between Sex, Knowledge, and Education Level of Evidence-Based Dentistry Behavior among Dentistry Students

The Association between Sex, Knowledge, and Education Level of Evidence-Based Dentistry Behavior among Dentistry Students

Making sense of the literature: an introduction to critical appraisal for the primary care practitioner.

With an abundance of published literature, it is essential that primary care practitioners have the basic skills to determine which studies should impact their clinical decisions and which ones should not. This ability comes from having the skills required to critically appraise the literature. Critical appraisal is a fundamental part of being able to practice evidence-based dentistry, which is a General Dental Council requirement. This article will aim to provide practitioners with the key concepts of critical appraisal and introduce simple methods which can be adopted to aid in the reading of a research paper from a critical viewpoint.

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Background: The use of evidence-based dentistry (EBD) as the integration of investigations and clinical decisions has been a focus of attention in recent years. Objectives: The present study aimed to evaluate the knowledge, attitude, and practice of EBD among Iranian dentists in 2019. Methods: A total of 140 self-administered questionnaires with 57 items were distributed among dentists in the 2019 exhibition of Iranian dentists. Moreover, 60 self- administered questionnaires were sent to five different dentistry schools in Iran. The analyses were carried out using the Chi-square test, independent samples t-test, and Pearson correlation. Results: A total of 119 fully-responded self-administered questionnaires were analyzed in this study. The dentists attending EBD workshops obtained significantly higher scores of knowledge. The Cochrane Library, manufacturer’s brochures, and evidence-based guidelines were used the least for clinical decisions. Consultation with colleagues, use of textbooks, and personal judgment were mostly utilized for clinical decisions. In addition, 93.3% of the participants stated sensible uncertainties in their clinical decisions. The most important barriers to EBD were the need for long discussions with patients, lack of skills in the critical appraisal of articles, and lack of motivation in dentists with the incidence rates of 62.2%, 62.2%, and 39.5%, respectively. Conclusions: Due to the low levels of EBD knowledge among Iranian dentists, it is recommended to give further close attention to increasing the knowledge in this regard. However, their high enthusiasm for participation in EBD workshops and enhancement of EBD skills is promising.

Information Retrieval and Awareness about Evidence-Based Dentistry among Dental Undergraduate Students-A Comparative Study between Students from Malaysia and Finland.

Background: A fundamental skill in education includes the ability to search for, evaluate, and synthesize information, and this cannot be underestimated in dental education. The aim of this study was to assess how dental students from Malaysia and Finland acquire scientific information and to compare their information retrieval skills. Methods: Fourth and fifth-year dental students from Malaysia and Finland were invited to participate. A self-administered structured questionnaire including items about the use of information sources, subjective assessment of literature retrieval skills and knowledge was used. Results: A total of 226 dental students participated in the survey: 131 from Malaysia and 95 from Finland. In both countries, the highest interest for data retrieval among students was found in the oral surgery specialty. The three most used sources of information among Malaysian students were personal lecture notes, dental textbooks, and colleagues; while Finnish students used colleagues, lecture notes, and current clinical guidelines. Students’ knowledge of evidence-based practice was inadequate in both student groups. Though the majority of participants reported that they had good or passable skills in literature retrieval, more students from Finland judged themselves to have at least good skills compared to those from Malaysia. Conclusion: Dental education in both countries includes information retrieval studies and mandatory research projects. However, students did not often use those sources that are considered essential in evidence-based dentistry. Universities should further develop educational and training interventions that guide students to use knowledge resources more effectively for critically appraising scientific evidence.

Methodological considerations when measuring oral health-related quality of life.

Dental patient-reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence-based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results. In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed. Oral disease-generic and dimension-generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5-item version being the one with the lowest burden for the patient. Responses are given on a 5-point ordinal rating scale, the recommended response scale for dPROMs. A 7-day recall period allows for assessment of short-term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument. OHIP-5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions.

The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps.

BackgroundPoor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches.ObjectiveThe primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene.MethodsWe searched six online app stores using four search terms (“oral hygiene game,” “oral hygiene gamification,” “oral hygiene brush game,” and “oral hygiene brush gamification”). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change.ResultsOf 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94%), virtual characters (14/17, 82%), and fantasy (13/17, 76%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app.ConclusionsThe majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement.

How evidence-based is dentistry anyway? From evidence-based dentistry to evidence-based practice.

Since its beginnings in the mid-1990s, evidence-based dentistry (EBD) has gradually gained acceptance into the understanding of dental practitioners. Despite this, most treatment provided by dentists cannot truly be described as being based on experimental evidence. The aim of this paper is to explore the reasons why EBD has not yet reached its full potential. The weakness of evidence produced, as well as the attitude of dentists towards EBD, will be examined. The role of the trusted source in disseminating information will be discussed and examples are given of how this concept could be used to further integrate evidence into everyday practice. Suggestions will be made regarding how research waste can be cut by producing less but more relevant research. Furthermore, realistic ideas on how EBD can be utilised in practice will be provided with the aim to shift towards the concept of evidence-based practice (EBP).