Gudray, Kiran; Walmsley, Anthony Damien
This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.
Small, B W
Separating hype from the truth in dental marketing can be frustrating and it is difficult at best for the average dentist to evaluate the safety and efficacy of new products and techniques. Keynote clinicians are presenting information and influencing other dentists without the scientific evidence to support their claims. For the benefit of our patients, the system needs to change. It will not come soon, but until more evidence-based testing is commonplace and made readily available to the practicing dentist, most dentists will continue tradition-based practices.
Sarani, Arezoo; Sarani, Melika; Abdar, Mohammad Esmaeli; Abdar, Zahra Esmaeili
Introduction Evidence-based care helps dentists provide quality dental services to patients, and such care is based on the use of reliable information about treatment and patient care from a large number of papers, books, and published textbooks. This study aimed to determine the knowledge, awareness, and attitude of dentistry students towards evidence-based dentistry. Methods In this cross-sectional study, all dentistry students who were studying in their sixth semester and higher in the Kerman School of Dentistry (n = 73) were studied. The data were analyzed using SPSS version 17 and the independent-samples t-tests and the ANOVA test. Results The means of the students’ knowledge, awareness, and attitude scores were 29.2 ± 10.8, 29.9 ± 8.12 and 44.5 ± 5.3, respectively. Among demographic variables, only the number of semesters showed a significant difference with knowledge, awareness, and attitude of dentistry students toward evidence-based dentistry (p = 0.001). Conclusion According to the results of this study, knowledge and awareness of dentistry students at Kerman University of Medical Sciences towards evidence-based dentistry were average and have a neutral attitude. Thus, providing necessary training in this regard will cause promoting the knowledge, awareness, and improved attitudes of dentistry students. PMID:27382446
Mehta, Nikisha; Marshman, Zoe
BackgroundThis systematic appraisal was conducted to determine if the Evidence-Based Dentistry Journal (EBDJ) acts as a reliable and contemporary source of knowledge for practitioners across all disciplines within dentistry.ObjectivesThe main objectives were to determine i) the year the articles were published and included in the EBDJ; ii) if the articles published covered all fields equally within dentistry; iii) the type of study design of the articles reported in the journal and; iv) the level of expertise of the writers of the commentaries.MethodsThis study used a systematic approach to assess the articles included in the journal. Data were extracted on the difference in the year the article was originally published and the year the article was included in the EBDJ, the number of articles in each dental discipline, the type of study designs included in the journal and the expertise of the commentators of each article. The information provided by the journal was validated by accessing the original articles through electronic databases.ResultsThe appraisal considered the 582 articles that met the inclusion criteria. Overall, 45.3% of the articles were included in the EBDJ in the same year and 44.8% of the articles were included a year after they were originally published. The number of articles varied across disciplines within dentistry: 23.7% from dental public health, 18.4% from periodontology and 11.8% from orthodontics, with only 4.6% from prosthodontics, 1% from oral pathology and 0.5% from dental materials. Most of the articles were systematic reviews and randomised controlled trials at 72% and 22.3% respectively. The writers of the commentaries were mostly academics and hospital consultants (71.2% and 13.6% commentators).ConclusionsOn the whole, it can be concluded that the journal acts as a reliable and contemporary source of knowledge/evidence for dentists, however, not all specialities within dentistry had equal coverage.
Aravamudhan, K; Frantsve-Hawley, Julie
Time and access have often been cited as barriers to implementing Evidence-Based Dentistry (EBD). This paper describes a new web-based resource launched by the American Dental Association to enable practitioners to incorporate evidence into treatment planning. The website offers a database of systematic reviews, critical summaries of systematic reviews, evidence-based clinical recommendations and links to external resources to enable practitioners to access evidence at the point of care. In addition the site offers an online space for clinicians to suggest clinical scenarios where evidence is lacking. This could potentially be a source of topics to drive future research. With the explosion in the use of information technology within a dental office, this web-site will serve as the one-stop resource for credible scientific information for practitioners.
Marshall, T A; Straub-Morarend, C L; Guzmán-Armstrong, S; Handoo, N
The integration of evidence-based dentistry (EBD) into pre-doctoral dental curricula requires the identification of desired outcomes, development of curricular content and design of assessment strategies which guide student performance whilst documenting achievement of desired curricular outcomes. Models for developing EBD curriculums have been described in the literature; however, the logistics of designing assessment instruments to progressively document student performance have received less attention. The objective of this article is to describe the University of Iowa's College of Dentistry's development and implementation of assessment strategies to guide student learning of EBD knowledge, application and assimilation to serve as a model for other institutions developing EBD assessment protocols. Desired EBD knowledge and behaviour outcomes guided the development of curricular content and progressive formative and summative assessment strategies. Vertically and horizontally integrated educational activities enabling students to demonstrate EBD knowledge whilst modelling desired behaviours were identified, whilst assessment principles guided development of learning guides and assessment instruments to document achievement of desired outcomes. Consistent EBD language and educational activities are utilised throughout the 4-year interdisciplinary curriculum with stepwise assessment protocols matched to the curriculum. Examples of student learning guides and assessment instruments are provided. Curricular design guides development of assessment strategies. Assessment protocols provide consistent formative and summative feedback to enable continuous student growth to become proficient EBD practitioners. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hinton, Robert J.; Dechow, Paul C.; Abdellatif, Hoda; Jones, Daniel L.; McCann, Ann L.; Schneiderman, Emet D.; D’Souza, Rena
In the early years of the new millennium, the National Institute of Dental and Craniofacial Research of the National Institutes of Health began funding Oral Health Research Education Grants using the R25 mechanism to promote the application of basic and clinical research findings to clinical training and to encourage students to pursue careers in oral health research. This report describes the impact of an R25 grant awarded to the Texas A&M Health Science Center’s Baylor College of Dentistry (BCD) on its curriculum and faculty development efforts. At BCD, the R25 grant supports a multipronged initiative that employs clinical research as a vehicle for acquainting both students and faculty with the tools of evidence-based dentistry (EBD). New coursework and experiences in all four years of the curriculum plus a variety of faculty development offerings are being used to achieve this goal. Progress on these fronts is reflected in a nascent EBD culture characterized by increasing participation and buy-in by students and faculty. The production of a new generation of dental graduates equipped with the EBD skill set as well as a growing nucleus of faculty members who can model the importance of evidence-based practice is of paramount importance for the future of dentistry. PMID:21368252
Chang, Zhong-Fu; Zhu, Ce; Tao, Dan-Ying; Feng, Xi-Ping; Lu, Hai-Xia
To investigate the knowledge, attitude and practice related to evidence-based dentistry among dental students, and to provide a reference for targeted evidence-based dentistry teaching and practice evidence-based dentistry in dental students. Dental students who attended the internship in Shanghai Ninth People's Hospital and Pudong People's Hospital were invited to attend this survey. Information on knowledge, attitude and practices related evidence-based dentistry was collected through questionnaires. SPSS 21.0 software package was used for data analysis. A total of 62 dental students attended this survey. Evidence-based dentistry related knowledge and attitude scores were 5.5±1.9 and 5.1±1.0, respectively. Over three quarters of students took courses on evidence-based medicine, while around half of students (56.5%) self-reported that they knew little about evidence-based medicine. 70.5% students practiced evidence-based dentistry less than once in the process of clinical decision making per week. The majority of students (80.3%) used MEDLINE or other databases to search for practice-related literature less than once per week. 63.9% students used practice guideline. The top three barriers to practice evidence-based dentistry were lack of information resources, insufficient time and lack of search skills. Evidence-based dentistry related knowledge and practice among dental students is deficient, whereas they hold positive attitude on practice. The top three barriers to practice evidence-based dentistry are lack of information resources, insufficient time and lack of search skills.
Marshall, T A; Straub-Morarend, C L; Guzman-Armstrong, S; McKernan, S C; Marchini, L; Handoo, N Q; Cunningham, M A
Assessment of evidence-based dentistry (EBD) knowledge and behaviour is hampered by lack of explicit competency criteria. This void impedes instructional design and assessment of student growth during the educational process. Knowledge and cognitive domains supporting educational objectives in a pre-doctoral dental programme were identified for each level of the EBD five-step process. We articulated educational objectives with behavioural expectations for each level of skill acquisition at each step of the EBD process. Outcome evaluation criteria identify students' progressive level of skill acquisition from novice to expert. The educational objectives, type of knowledge, and nature of the cognitive process supporting these objectives are presented for each step of the EBD process. For example, educational objectives of the "Ask" step include (i) to construct a question from the patient presentation and knowledge limitations that addresses the clinical problem and (ii) to articulate the Problem, Intervention/Exposure, Comparison, Outcome (PICO) components. Achievement of these objectives requires both factual information regarding the PICO format and the cognitive process of understanding. Educational outcome criteria consistent with a competent clinician include clear articulation of the PICO with identifiable pieces that relate to the clinical situation. Assessment strategies for progression towards EBD competency are limited due to the complexity associated with evaluating EBD knowledge and behaviours. To evaluate performance, the EBD academic community must define competency expectations for entry into unsupervised general dental practice. This framework offers measurable outcome evaluation criteria to initiate a conversation with academic peers regarding current gaps in EBD assessment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Fox, C; Kay, E J; Anderson, R
This paper describes the historical origins and purpose of 'evidence-based practice' and describes the barriers to the growth of evidence-based practice within dentistry. It describes a new research agenda-setting process for dentistry, which includes identifying and prioritising the topics of most relevance to the work of primary dental care practitioners. By undertaking the work described in this paper we were striving to make research more relevant to the day to day decisions made by dentists in practice by introducing a new process, the intention being to promote and promulgate the practice of evidence-based dentistry.
Olivi, G; Genovese, M D; Caprioglio, C
The goal of paediatric dentistry is to provide preventive education to parents and patients as well as interception and therapy of dental diseases in a minimally invasive way using a stress-free approach. Different laser wavelengths are used for different applications following these minimally invasive concepts: argon, KTP, diode, Nd:YAG, and CO2 lasers are used for soft tissue applications and the erbium family is used for both soft and hard tissue procedures. This paper offers a revision and a discussion of the international literature, showing also some clinical procedures. related to these scientific studies. Soft tissues laser applications in Pediatric Dentistry include application in oral surgery as well as in periodontics and orthodontics. Laser applications on hard tissues include caries prevention and detection and application for sealing of pits and fissures. Also application for cavity preparation, carious removal and pulp therapy are discussed.
Afrashtehfar, K I; Eimar, H; Yassine, R; Abi-Nader, S; Tamimi, F
Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Afrashtehfar, Kelvin I; Assery, Mansour K
It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.
Iacono, Vincent J; Cochran, David L
This overview was prepared to describe how an evidence-based approach was used to develop an Academy of Osseointegration (AO) Workshop on the State of the Science on Implant Dentistry (SSID). An AO SSID Workshop Planning Committee was appointed in 2001 to follow an evidence-based approach for reviewing published clinical data using strict inclusion and exclusion criteria in order to answer 8 closed-end 4-part clinical questions. A systematic approach was employed to assure coherent data management and analysis. Reviewers, co-reviewers, and a biostatistician were appointed. The workshop agenda was developed to include participants who had the primary responsibility for each of the 8 workshop sections to answer 5 consensus questions for the section's systematic review. The planned outcomes of the SSID Workshop included publication of the 8 consensus reports with their respective systematic reviews in The International Journal of Oral & Maxillofacial Implants (supplemental issue), 2007; the development of clinical guidelines responding to each of the 8 focused questions; and the identification and prioritization of questions or topics requiring further research. The evidence-based approach was utilized successfully in planning and carrying out the AO SSID Workshop held on August 3-6, 2006, in Oak Brook, Illinois, and the subsequent publication of its proceedings. Although successful in its objectives, the outcome of systematic reviews is only as good as the published data. Significant deficiencies in published implant studies were identified, including, but not limited to, a lack of randomized controlled prospective clinical trials, universal acceptance and publication of defined implant survival and success criteria, and clear questions with well-defined research design. The evidence-based approach can be used to systematically review the literature for a workshop on important questions related to implant dentistry. A major limitation is the lack of common outcome
Li, Chun-jie; Hua, Cheng-ge; Chen, E; Li, Sha; Shi, Zong-dao
To explore the effects of peer-assisted learning (PAL) for evidence-based dentistry (EBD) teaching. Four hundred and eleven students who attended EBD class were randomly classified into PAL group (n=75) and traditional teaching group (n=326) via a ratio of 1:5. Students in traditional teaching group received traditional theoretical teaching; while PAL group received traditional theoretical teaching and group study with tutors introduced and finished study protocols given by the teachers. Teaching effects were evaluated by final examinations, questionnaires and published articles via bibliographic searching. Statistical analysis was carried out with STATA 11.0 software package. In the final examination, students in PAL group had 6.9 higher scores than traditional teaching group (Pgroup had higher interests and contentments in EBD class (Ppositive effects on their usage of EBD methodology and involvement in EBD research (Pgroup were significantly higher than the traditional group (Ppositive effects on EBD teaching.
Hannes, Karin; Norré, David; Goedhuys, Jo; Naert, Ignace; Aertgeerts, Bert
In many countries, questions have been raised about the use of evidence-based practice (EBP) in oral health care. The call for an increase in EBP seems to face many obstacles. Only limited empirical studies address these obstacles. We present a qualitative study that explores the obstacles that Flemish (Belgian, Dutch-speaking) dentists experience in the implementation of EBP in routine clinical work. We collected data from discussions in focus groups. Seventy-nine dentists participated. The data were analyzed using constant comparative analysis. Three major categories of obstacles were identified. These categories relate to obstacles in 1) evidence, 2) partners in health care (medical doctors, patients, and government), and 3) the field of dentistry. Our findings suggest that educators should provide communication skills to aid decision making, address the technical dimensions of dentistry, promote lifelong learning, and close the gap between academics and general practitioners (dentists) in order to create mutual understanding. The obstacles identified are considered useful to support future quantitative research that can be generalized to a broader group.
Zheng, Meixun; Bender, Daniel; Reid, Laura; Milani, Jim
At many dental schools, evidence-based dentistry (EBD) is taught in a traditional lecture format. To avoid the constraints of lectures, in 2012 the EBD unit was redesigned for online delivery at the Arthur A. Dugoni School of Dentistry at the University of the Pacific with a Web 2.0 tool called Voicethread. The aim of this study was to assess the impact of Voicethread-based online learning on students' perceptions of learning EBD, their participation and engagement, and their acceptance of this new online delivery approach. Students' perceptions were collected from two sources: a self-assessment quiz and a question on their self-reported preparedness in EBD from the 2014 American Dental Education Association (ADEA) Survey of Dental School Seniors. The Voicethread analytics tool provided data on students' participation and engagement. Students' responses to the survey questions on the self-assessment quiz provided data on their acceptance of Voicethread-based learning. The average score of the 124 students (91% of total) taking the quiz was 7.3 out of 8. The percentage of students who reported in the 2014 ADEA survey that they were "well prepared" in EBD was 45.2%, compared with the national average of 31.2%. Responses to this question for the Classes of 2013 and 2015, who received instruction in the traditional lecture format, were 35.2% and 34.6%, respectively. With Voicethread, students actively participated and interacted with their peers through questions and answers. They perceived Voicethread to be more effective than other delivery approaches and reported that it made learning more active and engaging. These findings suggest that Voicethread may be an effective tool for students to learn EBD since it adds interactivity to online learning.
Hinton, Robert J.; McCann, Ann L.; Schneiderman, Emet D.; Dechow, Paul C.
In 2008, Texas A&M University Baylor College of Dentistry launched a comprehensive four-year curriculum in evidence-based dentistry (EBD) along with a series of faculty development initiatives to create an EBD culture. The aim of this study was to determine the institution's success in achieving this goal. The assessment tool used was the PEAK instrument, which measures respondents’ EBD Practices, Experience, Attitudes, and Knowledge. Two EBD-trained classes of students and one class untrained in EBD (approximately 100 students in each class) were assessed annually. The faculty were assessed before and after completion of the initiative. Nearly all students responded, with samples ranging from 87 to 102; the faculty response rates were 53% (62/117) in 2009 and 66% in 2013 (81/123). In the results, the trained students scored significantly higher in knowledge than the untrained students at each of the first three PEAK administrations (p≤0.001). Regarding confidence in appraising a research report, the first trained group significantly gained in appropriate use of statistical tests (pdentistry (p<0.001). Faculty comfort level with reading peer-reviewed articles increased significantly from 2009 to 2013 (p=0.039). Faculty members who participated in the summer EBD Fundamentals course (n=28) had significantly higher EBD knowledge scores than those who did not participate (p=0.013), and their EBD attitudes and practices were more positive (p<0.05). Students and faculty trained in EBD were more knowledgeable and exhibited more positive attitudes, supporting a conclusion that the college has made substantial progress towards achieving an EBD culture. PMID:25941143
Sabounchi, S S; Nouri, M; Erfani, N; Houshmand, B; Khoshnevisan, M H
Educating dental practitioners is a major component in obtaining evidence-based approach to oral health care, but there is no evidence about knowledge and attitude of dental faculty members towards evidence-based dentistry (EBD) in Iran. A cross-sectional study was conducted using self-administered questionnaires on dental school faculties in Iran to assess their knowledge and attitude towards basic principles and methods of EBD. A total of eight dental schools were randomly selected of 17 public and two existing private schools. Validated questionnaire with an appropriate reliability (Cronbach's alpha 0.67 - 0.87) was conducted on (n = 505) available dental instructors. The covered dimensions were perceived knowledge on critical appraisal, actual knowledge of EBD concepts, evidence-accessing methods and attitudes about EBD. Correlations were assessed between background characteristics and four main parts of the questionnaire, and multiple linear regression analysis was also used. A total of 377 of 505 dental instructors returned completed questionnaires (response rate 74.65%). The mean perceived knowledge score was 15.32 ± 4.69 on a range of 6-36, and mean actual knowledge was 7.98 ± 2.0 on a range of 0-11 for all respondents with an overall positive attitude towards EBD. This study suggests that the level of actual knowledge of dental faculties about basic principles of EBD was moderate in Iran. However, faculties' overall interest and positive attitude towards learning EBD is encouraging. Therefore, it is highly recommended that degree/certificate continuing educational programmes be planned by the organising committees. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available This study aimed to characterize the knowledge of evidence-based dentistry (EBD among dental faculty members in the city of Bhopal in central India. A cross-sectional questionnaire was administered at two dental colleges in Bhopal City. All dental faculty members who were present on the day of the study and who agreed to participate were included in the study. A total of 50 dental faculty members returned the questionnaire. Six Likert-type questions were asked, and the percentages of various responses were used for analysis. Sixteen faculty members (32.0% strongly agreed that EBD is a process of making decisions based on scientifically proven evidence. Fifteen faculty members (30.0% strongly disagreed or disagreed with the item stating that the best and quickest way to find evidence is by reading textbooks or asking experienced colleagues. Thirteen faculty members (26.0% strongly agreed that EBD allows dentists to improve their scientific knowledge and clinical skills. It is recommended that EBD be included in undergraduate and postgraduate curricula and in intensive continuing dental education programs that are conducted for dental faculty members.
Bosch-Aranda, María Louisa; Vázquez-Delgado, Eduardo; Gay-Escoda, Cosme
Atypical odontalgia (AO) is a severe and persistent pain involving controversial pathophysiological mechanisms and clinical management. Presented here is a systematic review of the literature on AO, using the SORT criteria (Strength of Recommendation Taxonomy) to assess the level of evidence and the quality of randomized clinical trials (RCT). A total of 54 articles were obtained of which 34 belonged to level 3 evidence, 17 to level 2, and 3 to level 1. Of these, only 8 RCT had an average quality of four points. The main finding of this systematic review is that only a few studies have systematically evaluated AO. It also determines a strength recommendation of level B to the theory of neuropathic origin of pain in AO and strength of recommendation level C for the pharmacological management of this condition. The aim of this study was to carry out a systematic review of the published literature on AO in order to determine the physiopathology and treatment based on the level of scientific evidence and following the evidence-based principles of dentistry.
Clarkson, J E; Bonetti, D; Worthington, H
The Cochrane Collaboration was founded in 1993 as an international, non-profit and independent organisation dedicated to making up-to-date, accurate and reliable information about healthcare readily available. This paper discusses how the Cochrane Oral Health Group reviews have contributed to the oral health evidence base used in the development of many international and U.K. dental guidance documents, particularly in the field of paediatric dentistry.
This study describes the current roles of dental librarians in Evidence-based Dentistry (EBD) education including their perceptions of EBD and barriers to their involvement. A Web-based survey was distributed to the dental librarians in North America, with a 71% response rate. The results showed that the majority of dental librarians are playing multiple and diverse roles in EBD education. The most frequently cited barrier to their involvement is the low level of interest from the dental faculty/student/school. Most dental librarians felt competent in supporting EBD, although continuing education needs in both EBD and teaching skills were pointed out.
Marshall, Teresa A; Straub-Morarend, Cheryl L; Handoo, Nidhi; Solow, Catherine M; Cunningham-Ford, Marsha A; Finkelstein, Michael W
Introducing critical thinking and evidence-based dentistry (EBD) content into an established dental curriculum can be a difficult and challenging process. Over the past three years, the University of Iowa College of Dentistry has developed and implemented a progressive four-year integrated critical thinking and EBD curriculum. The objective of this article is to describe the development and implementation process to make it available as a model for other dental schools contemplating introduction of critical thinking and EBD into their curricula. The newly designed curriculum built upon an existing problem-based learning foundation, which introduces critical thinking and the scientific literature in the D1 year, in order to expose students to the rationale and resources for practicing EBD in the D2 and D3 years and provide opportunities to practice critical thinking and apply the EBD five-step process in the D2, D3, and D4 years. All curricular content is online, and D3 and D4 EBD activities are integrated within existing clinical responsibilities. The curricular content, student resources, and student activities are described.
Ciancio, Mae J; Lee, Michelle M; Krumdick, Nathaniel D; Lencioni, Catherine; Kanjirath, Preetha P
Dental practitioners transitioning to dental educators (PTEs) have an integral role in dental education. While PTEs intrinsically apply some form of evidence-based dentistry (EBD) in patient care, it may not be a standardized, systematic approach. The aims of this study were to determine the self-perceived knowledge, skills, attitudes, and behaviors of PTEs regarding EBD at one U.S. dental school and to identify areas where formal calibration may be warranted to facilitate their competence and confidence as dental educators. Participants voluntarily completed a 32-question survey regarding their EBD training and self-perceived EBD skills in several areas: use of the clinical evidence pyramid; systematic, objective, and critical appraisal of the evidence; application of the evidence to patient care; and integrating clinical expertise, scientific evidence, and patient's preferences to formulate a treatment plan. The PTEs were invited to participate in the anonymous survey during regularly scheduled calibration sessions held between May and July 2014. After study information was distributed, 100% of the attendees (n=43) completed the survey. The percentage of total PTEs at the school could not be calculated. Of the responding PTEs, 69% rated themselves better than satisfactory (70% proficiency) in their knowledge, skills, and attitudes regarding EBD skills application. However, only 33-42% of the respondents indicated that they frequently used the evidence pyramid and systematically, objectively, and critically appraised the evidence, even though 65% indicated they applied the evidence to improve patient care over 70% of the time. In addition, the participating PTEs identified a need for more frequent use of formal EBD skills. Providing case-based EBD projects involving PTEs as mentors may provide more opportunities for the judicious and effective use of these important skills and may improve PTEs' self-perceived confidence.
Yamalik, Nermin; Nemli, Secil Karakoca; Carrilho, Eunice; Dianiskova, Simona; Melo, Paulo; Lella, Anna; Trouillet, Joel; Margvelashvili, Vladimer
Based on evidence-based dentistry (EBD) being a relatively new concept in dentistry, the attitudes, perceptions and level of awareness of dentists regarding EBD, and perceived barriers to its implementation into daily practice, were comparatively analysed in six countries of the FDI (World Dental Federation-Federation Dentaire Internationale)-European Regional Organization (ERO) zone (France, Georgia, Poland, Portugal, Slovakia and Turkey). For this purpose, a questionnaire, 'The Relationship Between Dental Practitioners and Universities', was developed by the FDI-ERO Working Group and applied by National Dental Associations (NDAs). A total of 850 valid responses were received, and cumulative data, comparisons between countries and potential impact of demographic variables were analysed. Regarding EBD, similar percentages of respondents reported that they 'know what it is' (32.8%) and 'they practice' (32.1%). Most respondents believed that 'EBD is beneficial' (89.1%); however, they had different thoughts regarding 'who actually benefited from EBD'. Of the participants, 60% believed that 'dentists experience difficulties in implementing EBD'. Although lack of time, lack of education and limited availability of evidence-based clinical guidelines were among the major barriers, there were differences among countries (Pdifferences were also observed between countries regarding certain questions such as 'where EBD needed to be taught' (Ppractice mode and years of practice significantly affected many of the responses (Pattitude toward EBD; however, there was also a clear demand for more information and support to enhance dentists' knowledge and use of EBD in everyday practice and a specific role for the NDAs. © 2015 FDI World Dental Federation.
Eslamipour, Faezeh; Ghaiour, Marzieh
Aim: Evidence-based dentistry (EBD) is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral health and his priorities. The aim of this study was to assess knowledge, attitude, and practice of dental students of Isfahan about EBD. Materials and Methods: In this descriptive study, 168 dental students in 3 final years of their education who engaged in clinical practice by consensus sampling were recruited. For data collection, a validated questionnaire was used. The questionnaire was consisted of demographic questions and some questions about four issues: Knowledge of self-assess (KSA), evidence-based practice, actual knowledge and attitude about EBD. Data were analyzed with t-test, one-way ANOVA, Chi-square, and linear regression with SPSS 16. Results: One hundred and thirty-six students from 168 students were filled the questionnaire. The mean of KSA was 13 ± 4.3, mean of usage of useful references in EBD was 16.9 ± 7.6. One-third of students were studied their last article in last 6 months before. The mean of actual knowledge and attitude was 7.4 ± 2.3 and 24 ± 3.8, respectively. The relation between 4 main issues was significant (P < 0.05). Conclusion: By considering overall interest and positive attitude toward learning EBD in dental students, it is highly recommended that practical educational courses about EBD be planned by dental faculties. PMID:27500165
Eslamipour, Faezeh; Ghaiour, Marzieh
Evidence-based dentistry (EBD) is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral health and his priorities. The aim of this study was to assess knowledge, attitude, and practice of dental students of Isfahan about EBD. In this descriptive study, 168 dental students in 3 final years of their education who engaged in clinical practice by consensus sampling were recruited. For data collection, a validated questionnaire was used. The questionnaire was consisted of demographic questions and some questions about four issues: Knowledge of self-assess (KSA), evidence-based practice, actual knowledge and attitude about EBD. Data were analyzed with t-test, one-way ANOVA, Chi-square, and linear regression with SPSS 16. One hundred and thirty-six students from 168 students were filled the questionnaire. The mean of KSA was 13 ± 4.3, mean of usage of useful references in EBD was 16.9 ± 7.6. One-third of students were studied their last article in last 6 months before. The mean of actual knowledge and attitude was 7.4 ± 2.3 and 24 ± 3.8, respectively. The relation between 4 main issues was significant (P attitude toward learning EBD in dental students, it is highly recommended that practical educational courses about EBD be planned by dental faculties.
Horst, Orapin V; Cunha-Cruz, Joana; Zhou, Lingmei; Manning, Walter; Mancl, Lloyd; DeRouen, Timothy A
This study aimed to measure prevalence of pain in the orofacial regions and determine association with demographics, treatment history, and oral health conditions in dental patients visiting clinics in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) research network. Data were recorded in a survey with systematic random sampling of patients (n = 1,668, 18 to 93 years old, 56% female) visiting 100 general dentists in the Northwest PRECEDENT research network. Prevalence ratios (PR) of orofacial pain by each variable were estimated by generalized estimating equations for Poisson regression. The prevalence of orofacial pain during the past year was 16.1% (95% confidence interval [CI], 13.4-18.9), of which the most prevalent pain locations were dentoalveolar (9.1%; 95% CI, 7.0-11.2) and musculoligamentous tissues (6.6%; 95% CI, 4.5-8.7). Other locations included soft tissues (0.5%; 95% CI, 0.2-0.8) and nonspecific areas (0.6%; 95% CI, 0.2-1.0). The prevalence of dentoalveolar but not musculoligamentous pain decreased with age. When comparing the 18- to 29-year-old patients, dentoalveolar pain decreased significantly in 45- to 64-year-old patients (PR, 0.59; 95% CI, 0.4-0.9) and in those 65 years or older (PR, 0.5; 95% CI, 0.3-0.9). Sex significantly affected the prevalence of musculoligamentous but not dentoalveolar pain. Women (PR, 3.2; 95% CI, 2.0-5.1) were more likely to have musculoligamentous pain. The prevalence of dentoalveolar and musculoligamentous pain did not vary significantly by ethnicity. Dentoalveolar pain was reported more frequently in patients who did not receive dental maintenance (PR, 2.9; 95% CI, 2.1-4.2) and those visiting community-based public health clinics (PR, 2.2; 95% CI, 1.2-3.7). One in 6 patients visiting a general dentist had experienced orofacial pain during the past year. Dentoalveolar and musculoligamentous pains were the most prevalent types of pain. Pain in the muscles and
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Full Text Available Introduction: Comparative effectiveness and efficacy research for analysis and practice (CEERAP was performed to assess the effects of penicillin-based versus erythromycin-based antibiotic treatments in patients with skin and soft tissue infections (SSTIs including cellulitis, impetigo, and erysipelas. Because SSTIs, especially orofacial cellulitis, are volatile infectious diseases of a life-threatening nature, research on the most efficacious remedies is necessary. Methods: The stringent bibliome yielded three systematic reviews, which were examined for quality of research synthesis protocol and clinical relevance. Results: The sample size of three, rendered the statistical analyses and cumulative meta-analysis problematic. Conclusion: The systematic review outlined here should aid in increasing clinical awareness, improving patient health literacy, and promoting consensus of the best evidence base (BEB to mitigate the threat of sepsis and potential death caused by cellulitis infections.
Wright, John T; Crall, James J; Fontana, Margherita; Gillette, E Jane; Nový, Brian B; Dhar, Vineet; Donly, Kevin; Hewlett, Edmond R; Quinonez, Rocio B; Chaffin, Jeffrey; Crespin, Matt; Iafolla, Timothy; Siegal, Mark D; Tampi, Malavika P; Graham, Laurel; Estrich, Cameron; Carrasco-Labra, Alonso
This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces. This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. These
This first of three articles on evidence-based dental practice discusses the historical background of evidence-based medicine/evidence-based dentistry, how to formulate clear clinical questions and how to track down (search) the available evidence in the literature databases. Nigerian Quarterly Journal of Hospital Medicine ...
If you have stained, broken or uneven teeth, cosmetic dentistry can help. Cosmetic dentistry is different from orthodontic treatment, which can straighten your teeth with braces or other devices. Cosmetic dental procedures include Bleaching to make teeth whiter ...
Abdellatif, Hoda; Dechow, Paul C; Jones, Daniel L
In an effort to improve patient care, there has been a growing trend across the nation and the world to embed the principles of evidence-based dentistry into mainstream care delivery by private practicing dentists. Evidence-based dentistry is an essential tool that is used to improve the quality of care and to reduce the gap between what we know, what is possible, and what we do. An evidence-based health care practice is one that includes the decision maker's ability to find, assess, and incorporate high-quality, valid information in diagnosis and treatment. The evidence is considered in conjunction with the clinician's experience and judgment, and the patient's preferences, values, and circumstances. This article introduces the basic skills of evidence-based dentistry. Their practice requires a discipline of lifelong learning in which recent and relevant scientific evidence are translated into practical clinical applications.
Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma
Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947
Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...
Sports dentistry is one of the most recent and upcoming field in dentistry. It mainly includes the prevention and management of athletics-related orofacial injuries and associated oral diseases. The sports or team dentist assists athletes in the prevention, treatment, and diagnosis of oral injuries. The most significant aspect in preventing sports-related orofacial injuries is wearing basic protective devices such as properly-fitting helmets, face masks and/or mouth guards. Dental injuries ar...
Full Text Available Evidence-based medicine (EBM has become a hot topic in medical practice, education, and research. However, a large number of senior doctors did not have an opportunity to learn EBM in medical schools. Firstly, this article addresses the history of EBM and the principle of practicing EBM, i.e., asking, acquiring, appraisal, application, and auditing. Secondly, this article also provides a brief introduction to evidence-based dermatology and compares the introduction of clinical practice guidelines between Europe, the UK, and the US. Finally, this article addresses the present condition and future perspective of evidence-based dermatology in Taiwan.
Hertzum, Morten; Simonsen, Jesper
Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... and electronic patient records for diabetes patients, this paper reports research in progress regarding the prospects and pitfalls of evidence-based development....
Saleha Shah, B.D.S, MClinDent Paediatric Dentistry (UK
Full Text Available Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry. The skills apply to the ever-changing stages of dental, physical, and psychosocial development for treating conditions and diseases distinctive to growing individuals. Hence with the changing scope of practice it is imperative that the clinician stays updated with the current evidence based trends in practice, collaborates with other disciplines and Imparts quality oral health care tailored to the specific needs of every child.
Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry. The skills apply to the ever-changing stages of dental, physical, and psychosocial development for treating conditions and diseases distinctive to growing individuals. Hence with the changing scope of practice it is imperative that the clinician stays updated with the current evidence based trends in practice, collaborates with other disciplines and Imparts quality oral health care tailored to the specific needs of every child.
Sports dentistry is one of the most recent and upcoming field in dentistry. It mainly includes the prevention and management of athletics-related orofacial injuries and associated oral diseases. The sports or team dentist assists athletes in the prevention, treatment, and diagnosis of oral injuries. The most significant aspect in preventing sports-related orofacial injuries is wearing basic protective devices such as properly-fitting helmets, face masks and/or mouth guards. Dental injuries are the most common type of orofacial injury sustained during participation in sports. Many athletes are not aware of the health implications of a traumatic injury to the mouth or of the potential for incurring severe head and orofacial injuries while playing. The dentist can play an imperative role in informing athletes, coaches and patients about the importance of preventing orofacial injuries in sports. The aim of this paper is to increase professional awareness and interest for orientation toward sports dentistry.
Hafslund, Bjorg [Institute of Radiography, Faculty of Health and Social Sciences, Bergen University College, P.O. Box 7030, N-5020 Bergen (Norway)], E-mail: firstname.lastname@example.org; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica [Centre for Evidence Based Practice, Faculty of Health and Social Sciences, Bergen University College, Bergen (Norway)
Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain.
Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin
Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.
Evidence-based dentistry (EBD) concept has caused great impact and interest in the field of dentistry. For its development is important to use research protocols and study designs according to the research problem. The aim of this review is to present basic aspects for the start of a quantitative research in dentistry.It presents the topics necessary to transform a research problem to a question with clinical approach. Then, concepts about finding relevant scientific articles in the electroni...
Rushton, Vivian E; Horner, Keith
Since 1988, thirteen dental schools have provided dental undergraduate programmes within the United Kingdom (UK). In 2006, two new dental schools were created supporting dental education in the community. A further new dental school in Scotland will be accepting students in autumn 2008. In the past 25 years, extensive reorganisation of the NHS has resulted in long-term implications for the training of medical and dental academic staff. The number of academic clinicians is below the minimum viable level and external constraints, combined with a lack of suitable applicants, have led to a moratorium on academic recruitment within some Dental Schools. A detailed review of the historical and associated factors which have led to the problems presently besetting academic dentistry are discussed along with the initiatives introduced in the last 10 years to revitalise the speciality. Also, the present and future outlook for academic dentistry in other countries are discussed. Opinion is divided as to the appropriate setting for the training of undergraduate students between those who support community-based dental education and those who believe dental education should remain within research led dental establishments. External factors are moulding an unsatisfactory situation that is proving increasingly unattractive to the potential dental academic and the case for reform is obvious.
Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....
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Mans, R..S.; H. A. REIJERS; van Genuchten, M.; Wismeijer, D
Business processes in dentistry are quickly evolving towards "digital dentistry". This means that many steps in the dental process will increasingly deal with computerized information or computerized half products. A complicating factor in the improvement of process performance in dentistry, however, is the large number of independent dental professionals that are involved in the entire process. In order to reap the benefits of digital dentistry, it is essential to obtain an accurate view on ...
Lee, Matthew K; Most, Sam P
Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.
Shinagare, Atul B.; Khorasani, Ramin [Dept. of Radiology, Brigham and Women' s Hospital, Boston (Korea, Republic of)
With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.
Smith, Tony [Senior Lecturer in Medical Radiation Science, University Department of Rural Health, School of Health Sciences, Faculty of Health, University of Newcastle, Locked Bag 9783 NEMSC, Tamworth, NSW 2348 (Australia)], E-mail: email@example.com
Background: The evidence based paradigm was first described about a decade ago. Previous authors have described a framework for the application of evidence based medicine which can be readily adapted to medical imaging practice. Purpose: This paper promotes the application of the evidence based framework in both the justification of the choice of examination type and the optimisation of the imaging technique used. Methods: The framework includes five integrated steps: framing a concise clinical question; searching for evidence to answer that question; critically appraising the evidence; applying the evidence in clinical practice; and, evaluating the use of revised practices. Results: This paper illustrates the use of the evidence based framework in medical imaging (that is, evidence based medical imaging) using the examples of two clinically relevant case studies. In doing so, a range of information technology and other resources available to medical imaging practitioners are identified with the intention of encouraging the application of the evidence based paradigm in radiography and radiology. Conclusion: There is a perceived need for radiographers and radiologists to make greater use of valid research evidence from the literature to inform their clinical practice and thus provide better quality services.
BACKGROUND: The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. METHODS: A mapping of systematic reviews (SR) of literature was carried out in Pub...... and preventive dentistry that must be addressed and bridged through clinical research of good quality....... review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic...
Ramachandran Sudarshan; G Sree Vijayabala
With the advancements in the field of dentistry, new treatment protocols are budding day by day to combat human ailments in a much natural better and simpler way. One such advancement is the application of ozone in dentistry. Ozone is a natural element protects us from ultraviolet rays. It has several properties including analgesics, immunostimulant and antimicrobial properties. In Dentistry its uses are abundance from gingival diseases, infection control, temporomandibular disorders, radiati...
Kovner, Anthony R; Rundall, Thomas G
Reports of medical mistakes have splashed across newspapers and magazines in the United States. At the same time, instances of overuse, underuse, and misuse of management tactics and strategies receive far less attention. The sense of urgency associated with improving the quality of medical care does not exist with respect to improving the quality of management decision making. A more evidence-based approach would improve the competence of the decision-makers and their motivation to use more scientific methods when making a decision. The authors of this article consider a study of 68 U.S. health services managers that found a low level of evidence-based management behaviors. From the findings, four strategies are suggested to increase health systems managers' use of research evidence to improve decision making: focusing evidence-based decision making on strategically important issues, developing committees and other structures to diffuse management research throughout the organization, building a management culture that values research, and training managers in the competencies required to apply research evidence to health services management decisions. To aid the manager in understanding and applying an evidenced-based approach to decision making, the article provides practical tools, techniques, and resources for immediate use.
Full Text Available Today laser has a lot of usage in medicine and dentistry. In the field of dentistry, laser is used in soft tissue surgery, sterilization of canals (in root canal therapy and in restorative dentistry laser is used for cavity preparation, caries removal, sealing the grooves (in preventive dentistry, etching enamel and dentin, composite polymerization and removal of tooth sensitivity. The use of Co2 lasers and Nd: YAG for cavity preparation, due to creating high heat causes darkness and cracks around the region of laser radiation. Also due to high temperature of these lasers, pulp damage is inevitable. So today, by using the Excimer laser especially the argon floride type with a wavelength of 193 nm, the problem of heat stress have been solved, but the use of lasers in dentistry, especially for cavity preparation needs more researches and evaluations.
Full Text Available Evidence-based dentistry (EBD concept has caused great impact and interest in the field of dentistry. For its development is important to use research protocols and study designs according to the research problem. The aim of this review is to present basic aspects for the start of a quantitative research in dentistry.It presents the topics necessary to transform a research problem to a question with clinical approach. Then, concepts about finding relevant scientific articles in the electronic databases available on the Internet. It also presents observational and experimental research designs, their classification and topics for your choice. These elements represents simple and clear recommendations for research in dentistry.
Williams, D. R. R. (David Robert Rhys)
... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix 1. The Evidence Base for Diabetes Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rhys Williams, William Herman, Ann-Louise Kinmonth...
Refshauge, Anne Dahl; Stigsdotter, Ulrika K.; Lamm, Bettina
This paper develops, explores and evaluates an evidence-based approach to playground design, with a public park playground (playlab Cph) in Copenhagen as a case study. In the increasingly urbanised world, park playgrounds are valuable places that support healthy child development by providing...... opportunities for play, nature exploration and sensory stimulation. As it is increasingly expected that designers base their decisions on research evidence, there is a need to develop approaches to facilitate this, which also applies to playground design. The design of PlayLab Cph was based on relevant evidence...
Full Text Available Technological and scientific innovations have increased exponentially over the past years in the dentistry profession. In this article, these developments are evaluated both in terms of clinical practice and their place in the educational program. The effect of the biologic and digital revolutions on dental education and daily clinical practice are also reviewed. Biomimetics, personalized dental medicine regenerative dentistry, nanotechnology, high-end simulations providing virtual reality, genomic information, and stem cell studies will gain more importance in the coming years, moving dentistry to a different dimension.
Graskemper, Joseph P
Advertising in dentistry has steadily increased since the 1970s to become a leading choice of many dentists to promote their practices. The manner in which advertising progresses within the profession affects all dentists and how patients perceive dentistry as a profession. This paper presents ethical concepts that should be followed when dentists are pursuing practice promotion through advertising. It also raises questions that, hopefully, will increase attention and discussion on dental advertising. The paper concludes that ethical advertising is easily achieved by promoting patient education while not placing the dentist's self-interests ahead of the patient's. With this approach, dentistry may continue to be one of the most trusted professions.
Full Text Available Evidence-based dental practice requires the developmment and evaluation of protocols that en-sure translational effectiveness: that is, the efficient incorporation of the best available efficacy and effec-tiveness findings in specific clinical dentistry settings and environments. Evidence-based dentistry predi-cates the synthesis of research for obtaining the best available evidence in a validated, stringent, systematic and unbiased fashion. Research synthesis is now established as a science in its own right, precisely because it adheres to the scientific process that is driven by a research question and a hypothesis, follows through clearly defined methodology and design, yielding quantifiable data that are analyzed statistically, and from which stringent statistical inferences are drawn. The conclusions from the protocol of research synthesis define the best available evidence, which is used in the process of evidence-based revision of clinical practice guidelines. One important hurdle of the process of applying research synthesis in evidence-based dentistry lies in the fact that the statistical inferences produced by research must be translated into clinical relevance. Here, we present a model to circumvent this limitation by means of text analysis/mining protocols, which could lead the path toward a novel, valid and reliable ap-proach for the inferential analysis of clinical relevance.
Vergnes, Jean-Noel; Apelian, Nareg; Bedos, Christophe
Narrative medicine strives toward a humanized form of medicine in which empathy and the ability to listen are developed with the same emphasis as scientific rigor. We hypothesize that the adoption of narrative medicine in dentistry would be an excellent method to cultivate the philosophy behind the emerging clinical concept of patient-centered dentistry. Reading literary works, reflective writing, and creative writing would sensitize practitioners to the daily lives of people, human uniqueness, and alterity. Narrative dentistry could lead to more empathic and self-aware practices, and improve dental professionals' observational abilities by making them more perceptive and more attentive to image, metaphor, and meaning. The introduction of narrative dentistry would enrich the clinical clerkship of dentists by bringing the often-missing humanities to the dental professional, academic, and scientific environment. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Barnes, Douglas M.; And Others
A description of the University of Maryland at Baltimore's one-year postdoctoral program in advanced general dentistry focuses on its goals and objectives, curriculum design, patient population, faculty and staff, finances, and program evaluation measures. (MSE)
Full Text Available With the advancements in the field of dentistry, new treatment protocols are budding day by day to combat human ailments in a much natural better and simpler way. One such advancement is the application of ozone in dentistry. Ozone is a natural element protects us from ultraviolet rays. It has several properties including analgesics, immunostimulant and antimicrobial properties. In Dentistry its uses are abundance from gingival diseases, infection control, temporomandibular disorders, radiation and chemotherapy induced mucositis, lichen planus etc. Researchers believe that this therapy is in state of equilibrium with benefit and drawback. This review throws light on the history, properties, methods of administration, uses in the field of medicine and dentistry, toxicity, contraindications of ozone. [Archives Medical Review Journal 2013; 22(1.000: 45-54
Depalma, D A
The author presents, after a long and minute research, the pieces of music, tango composers dedicated to dentistry, in its maximum symbols: the teeth. He contributes as well with some references to tangos dedicated to some dentists.
Full Text Available Steroids are one of the widely used drugs in dentistry. These are immunosuppressive agents. The reason for its use is its anti-inflammatory as well as immunosuppressive properties. Corticosteroids have revolutionized the management of several disabling conditions, but its use in term of dosage is inappropriate. The current review highlights its uses, contraindications, side-effects as well as a guideline for its use in dentistry.
Kotlow, Lawrence A
Pediatric dentistry's mission in delivering care to our young patients is simple: provide optimal preventive, interceptive, and restorative dental care in a stress-free environment. Lasers such as argon, diode, Nd:YAG, CO2, and now the erbium family enable minimally invasive dentistry for hard- and soft-tissue procedures. This article offers an understanding of treatment planning in the pediatric practice and demonstrates the procedures that dental lasers can perform on younger patients.
Dargahi H; Saraji J; Sadr J; Sadri G
Background and Aims: There are several risk factors in dentistry professional environment. Carelessness about occupational health regulation endangers dentist's life. Erconomics in dentistry is a scientific approach which introduces the latest ergonomic principles in dental profession. It discusses about physical and mental stresses. Ergonomic programs eliminate dentist physical and mental challenges and provide practical solution to establish efficient and comforting environment. Materi...
Proponents of evidence-based medicine (EBM) have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. © 2014 John Wiley & Sons, Ltd.
This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.
American Psychologist, 2006
The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…
Full Text Available Introduction: Evidence-based education has been introduced to dentistry as a new educational tool. However, its effectiveness should be evaluated in different educational topics. The aim of this study was to compare the effects of evidence-based and conventional education on radiography assessment before endodontic treatment. Methods: In this semi-experimental study 75 senior dental students of Kermanshah Dentistry School were enrolled. Demographic information and the results of evaluation were collected using a weblog designed for this purpose. 20 questions were prepared to be answered in 30 minutes. 12 topics were covered in the questionnaire. To analyze the data, the paired sample t-test, Wilcoxon, and Whitney U tests were used. Results: The finding of the present study showed that total scores of the test in both conventional and evidence-based groups significantly improved after education (P=0.005 and P=0.001, respectively. There was a significant difference between the two groups (P=0.047 and evidence-based education showed better results in comparison with conventional one. Conclusion: The present study asserts that evidence-based education can lead to better diagnostic performance of senior dental students and thus can be used as an efficient alternative for conventional education methods in dental schools.
Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D
In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.
The guidelines of all international hernia societies recommend as procedures of choice the laparoendoscopic techniques total extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) as well as the open Lichtenstein operation for elective inguinal hernia repair. The learning curve associated with the laparoendoscopic techniques, in particular TEP, is longer than that for the open Lichtenstein technique due to the complexity of the procedures. Accordingly, for laparoendoscopic techniques it is particularly important that the operations are conducted in a standardized manner in compliance with the evidence-based recommendations given for the technical details. When procedures are carried out in strict compliance with the guidelines of the international hernia societies, low rates of perioperative complications, complication-related reoperations, recurrences and chronic pain can be expected for TEP. Compliance with the guidelines can also positively impact mastery of the learning curve for TEP. The technical guidelines on TEP are based on study results and on the experiences of numerous experts; therefore, it is imperative that they are implemented in routine surgical practice.
Dheeraj D Kalra
Full Text Available Since past few years, there have been many strategies to combat dental caries, erosion, hypersensitivity, and many other oral conditions. The last decade has seen many advanced researches in the field of dentistry. The scope of dentistry has evolved from only a curative one to a largely preventive one. There have been technologies available for the minimal invasive cure of dental caries, early diagnosis and early reversal of the initial carious lesion using nonoperative techniques. There has also more focus being made to treat dental caries as a process rather than curing the lesion only. The role of saliva, demineralization and remineralization has been better understood. The aim of this paper is to review the contemporary nonfluoridated systems available for remineralization therapy and ideas for their implementation into clinical practice. A search of articles from "PubMed" and "Medline" and databases like Google and Google scholar, ScienceDirect and Wiley with the keywords remineralization, demineralization, nonfluoridated demineralizing agents was conducted in the month of August 2012 out of a total 114 articles, 86 articles have been used in the present evidence-based review.
Gordon, M; Gorfil, C; Segal, S; Mass, E
This was to evaluate some suggested diagnostic procedures, treatment policies and professional attitudes of specialists in paediatric dentistry, in light of the periodically published guidelines by The American Academy of Pediatric Dentistry, The European Academy of Paediatric Dentistry and The British Society of Paediatric Dentistry. Using a structured questionnaire, 67% of the Israeli specialists in paediatric dentistry, who agreed to participate in this study, were personally interviewed. Only 7.5% of the participants reported that they carry out pulp capping of primary teeth in cases of pulp exposure. Over 50% reported restoring teeth after pulpotomy with preformed crowns. Most indicated sealing pit and fissures after considering depth and morphology of the fissures and correlation with the patient's risk to caries. Cleaning teeth after eruption of the first tooth was suggested by 75.5% of the participants. A striking majority (96%) claimed that they restored permanent anterior teeth with composite resins and most used these materials for occlusal restoration in both primary and permanent posterior teeth. Most specialists advocated the use of amalgam in proximal posterior restorations. The presence of a parent in the operatory/surgery was preferred by 85% of the dentists. Israeli specialists in paediatric dentistry mostly comply with the mentioned guidelines. Further studies of this nature should also be encouraged in other countries to emphasize the importance of monitoring compliance with established and evidence based guidelines.
Schaefer, Jessica D; Welton, John M
To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.
Reid, Kevin I
A review of literature regarding informed consent in dentistry reveals a paucity of information and minimal scholarship devoted to this subject. But this begs the question about informed consent somehow being different for dentistry than for medicine or other healthcare delivery. My account draws distinctions where appropriate but is rooted in the premise that informed consent is an ethical construct applicable to vulnerable people as patients independent of what type of treatment or body part being considered. This paper highlights the crucial importance of the process of informed consent and refusal in dentistry, underscoring its important place in oral healthcare. This paper will not address the unique circumstances involving consent in those without capacity or focus on informed consent in the research setting; our focus will be on those patients with full decisionmaking capacity in the clinical setting. I will emphasize the importance of disclosure of treatment options and highlight the benefits of shared-decision-making in the informed consent process.
Adams, Timothy C; Pang, Peter K
This article focuses on lasers and aesthetic dentistry and their unique parallel in history from their early development to their present day usage and application. The demand for aesthetic dentistry has had a major impact not only on treatment planning but also on the choice of materials, techniques, and equipment. It is this demand that has married the use of lasers with aesthetic dentistry. A short literature review on the five basic laser types precedes the basic premise of smile design and its critical importance in attaining the desirable aesthetic end result. A short review on biologic width and biologic zone reinforces their importance when manipulating gingival tissue. Four case reports highlight the use of diode, erbium, and carbon dioxide lasers. The end results show the power of proper treatment planning and the use of a smile design guide when using these instruments and confirm a conservative, aesthetic treatment without compromising the health and function of the patients.
... Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral Health Policies & Recommendations News Room Latest News Releases & Studies Press ...
Largent, Beverly A
Founded in 1947, the American Academy of Pediatric Dentistry (AAPD) is a not-for-profit membership association representing the specialty of pediatric dentistry. The AAPD's 7,500 members are primary oral health care providers who offer comprehensive specialty treatment for millions of infants, children, adolescents, and individuals with special healthcare needs. The AAPD also represents general dentists who treat a significant number of children in their practices. As advocates for children's oral health, the AAPD develops and promotes evidence-based policies and guidelines, fosters research, contributes to scholarly work concerning pediatric oral health, and educates healthcare providers, policymakers, and the public on ways to improve children's oral health. The academy's philanthropic arm, Healthy Smiles, Healthy Children: The Foundation of the AAPD, advances the AAPD mission through the support and promotion of education, research, service, and policy development.
Ghorayeb, Sleiman R; Bertoncini, Crystal A; Hinders, Mark K
This paper reviews diagnostic applications of ultrasound to dentistry, or dental ultrasonography, beginning with pioneering work of the 1960s up through present lines of research. Clinical, in vivo applications that are of direct interest to dental practice are reviewed here, including measurements of enamel thickness and periodontal pocket depth. In vitro research that involves destructive tooth preparation or procedures, such as sound speed measurements or scanning acoustic microscopy, also are included. Although dental ultrasonography has been studied for over 40 years, most methods are not quite ready for routine clinical use, and there remains much opportunity for diagnostic ultrasonography to significantly impact the practice of dentistry.
Hannig, Matthias; Hannig, Christian
The prevention of tooth decay and the treatment of lesions and cavities are ongoing challenges in dentistry. In recent years, biomimetic approaches have been used to develop nanomaterials for inclusion in a variety of oral health-care products. Examples include liquids and pastes that contain nano-apatites for biofilm management at the tooth surface, and products that contain nanomaterials for the remineralization of early submicrometre-sized enamel lesions. However, the treatment of larger visible cavities with nanomaterials is still at the research stage. Here, we review progress in the development of nanomaterials for different applications in preventive dentistry and research, including clinical trials.
Full Text Available Research being an investigative process is employed to increase or revise the current knowledge. Scientific research involves the conduct of a methodical study to prove a hypothesis or give an answer to a specific question with the main aim of finding definitive answer. This paper aims to advance knowledge of research and develop interest in the postgraduate students. It also throws light on the existing and emerging research strengths within a “high-performance culture.” The trends in dental research worldwide are looked at, in particular, a comparison between the publication status in two countries, namely India and Australia. The current themes in dental research are also discussed to facilitate future projects for the aspiring pediatric dentists. Stress is given to the importance of evidence-based dentistry as the current times call for high-quality and ethical papers which are devoid of plagiarism. The common reasons for failure of a research are explored and the strengthening factors are highlighted. Proper planning of a pertinent research project is beneficial to the researcher as well as the dental community.
... AACD AACD 2018: A Masterpiece of Comprehensive Cosmetic Dentistry Education 34th Annual Scientific Session | April 18-21 ... 222.9540 Contact Us © 2017American Academy of Cosmetic Dentistry American Academy of Cosmetic Dentistry (AACD) © 2017American Academy ...
... upon achieving adequate local anesthesia. Research has shown that the fear of pain associated with dentistry is closely associated with the most common method for blocking pain during dental procedures-intraoral administration of local anesthetics. This is considered aversive due to the pain associated with the injection and the perceived threat ...
Dorozhkin, Sergey V
Dental caries, also known as tooth decay or a cavity, remains a major public health problem in the most communities even though the prevalence of disease has decreased since the introduction of fluorides for dental care. Therefore, biomaterials to fill dental defects appear to be necessary to fulfill customers' needs regarding the properties and the processing of the products. Bioceramics and glass-ceramics are widely used for these purposes, as dental inlays, onlays, veneers, crowns or bridges. Calcium orthophosphates belong to bioceramics but they have some specific advantages over other types of bioceramics due to a chemical similarity to the inorganic part of both human and mammalian bones and teeth. Therefore, calcium orthophosphates (both alone and as components of various formulations) are used in dentistry as both dental fillers and implantable scaffolds. This review provides brief information on calcium orthophosphates and describes in details current state-of-the-art on their applications in dentistry and dentistry-related fields. Among the recognized dental specialties, calcium orthophosphates are most frequently used in periodontics; however, the majority of the publications on calcium orthophosphates in dentistry are devoted to unspecified "dental" fields.
Hernández F., Luis J.
Evidence based Public Health is the execution and evaluation of the efficiency of interventions, plans, programs, projects and politics in public health through the application of the scientific principles of reasoning, including the systematic use of information and information systems. Evidence based public health involves the use of methodologies similar to those applied in evidence-based clinical medicine, but differs in its contents. In public health two types of evidence are described. ...
Hotelling, Barbara A.
Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided.
Adams, Susan; McCarthy, Ann Marie
School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…
Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.
In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still
Kumar, G Senthil; Muruganandan, J; Prasad, T Srinivasa
Aloe vera is a medicinal plant which has been used for thousands of years. The health benefits of aloe vera is well known and the dental uses of this plant is multiple. Interest is gathering among researchers regarding the use of this plant. Studies have proved the antiseptic, anti inflammatory, antiviral and antifungal properties of aloe vera and the use of this plant is proved beneficial. This plant is proved to be non allergic and very good in building up the immune system. Aloe vera is gaining popularity in dentistry as it is completely natural and there is no side effects being reported with its use. This paper gives an overview of the uses of this miracle plant and its uses in dentistry. PMID:25478478
Pushpa S Pudakalkatti
Full Text Available Personalized medicine is a branch of medicine that proposes customization of healthcare in which decisions and treatment are tailored according to individual patient needs. The field of personalized medicine relies on genetic information, proteomic information and clinical patient characteristics to individualize treatment. With advances in genetics, proteomics, pharmacogenetics and knowledgeable patient population, the opportunity exists to deliver never before levels of personalized care. Although general dentists may consider personalized medicine a concept for the future, the reality is that its direct application to everyday dentistry is closer than one might think. Use of personalized medicine in dentistry, especially in periodontology is progressing rapidly, and dentist should consider this approach while treating patients. Google and PubMed search was done to select articles for present review. Total 17 articles were used to compile information.
Although many regulations and standards relating to laser safety are in effect, there continue to be an average of 35 laser injuries per year. Laser safety professionals believe that this number under-represents the actual number of injuries and that many more accidents per year occur that are not documented with federal agencies. A review of these accidents has determined that failing to wear available eye protection is one of the most frequent contributing factors to laser injuries. As the purchase and use of lasers in dentistry continues to grow, so must concern for laser safety. This article provides basic information to advance the safe use of lasers in dentistry and to help establish laser safety protocols for the dental office.
Sujatha, G; Kumar, G Senthil; Muruganandan, J; Prasad, T Srinivasa
Aloe vera is a medicinal plant which has been used for thousands of years. The health benefits of aloe vera is well known and the dental uses of this plant is multiple. Interest is gathering among researchers regarding the use of this plant. Studies have proved the antiseptic, anti inflammatory, antiviral and antifungal properties of aloe vera and the use of this plant is proved beneficial. This plant is proved to be non allergic and very good in building up the immune system. Aloe vera is gaining popularity in dentistry as it is completely natural and there is no side effects being reported with its use. This paper gives an overview of the uses of this miracle plant and its uses in dentistry.
Lovelock, D.J. [Dental Hospital and School, Newcastle upon Tyne (United Kingdom). Dept. of Radiology
Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author).
Donly, Kevin J
This article discusses contemporary pediatric restorative dentistry. Indications and contraindications for the choice of different restorative materials in different clinical situations, including the risk assessment of the patient, are presented. The specific use of glass ionomer cement or resin-modified glass ionomer cement, resin-based composite, and stainless steel crowns is discussed so that preparation design and restoration placement is understood. Copyright © 2013 Elsevier Inc. All rights reserved.
Abou Neel, Ensanya Ali; Chrzanowski, Wojciech; Salih, Vehid M; Kim, Hae-Won; Knowles, Jonathan C
of this review is to inform practitioners with the most updated information on tissue engineering and its potential applications in dentistry. The authors used "PUBMED" to find relevant literature written in English and published from the beginning of tissue engineering until today. A combination of keywords was used as the search terms e.g., "tissue engineering", "approaches", "strategies" "dentistry", "dental stem cells", "dentino-pulp complex", "guided tissue regeneration", "whole tooth", "TMJ", "condyle", "salivary glands", and "oral mucosa". Abstracts and full text articles were used to identify causes of craniofacial tissue loss, different approaches for craniofacial reconstructions, how the tissue engineering emerges, different strategies of tissue engineering, biomaterials employed for this purpose, the major attempts to engineer different dental structures, finally challenges and future of tissue engineering in dentistry. Only those articles that dealt with the tissue engineering in dentistry were selected. There have been a recent surge in guided tissue engineering methods to manage periodontal diseases beyond the traditional approaches. However, the predictable reconstruction of the innate organisation and function of whole teeth as well as their periodontal structures remains challenging. Despite some limited progress and minor successes, there remain distinct and important challenges in the development of reproducible and clinically safe approaches for oral tissue repair and regeneration. Clearly, there is a convincing body of evidence which confirms the need for this type of treatment, and public health data worldwide indicates a more than adequate patient resource. The future of these therapies involving more biological approaches and the use of dental tissue stem cells is promising and advancing. Also there may be a significant interest of their application and wider potential to treat disorders beyond the craniofacial region. Considering the
Saleha Shah, B.D.S, MClinDent Paediatric Dentistry (UK)
Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of ...
This month's feature article offers a review of analgesics commonly used in implant dentistry. While the placement of an implant is certainly of the utmost importance to the practitioner, ensuring adequate pain control during and after the procedure is one of the more important aspects to the patient. Selecting the most effective and appropriate agent to control swelling, pain, and anxiety requires a broad knowledge of these classes of medication.
Lamas Lara, César; Cirujano Dentista, Diplomado en Odontología Restauradora y Estética de la Facultad de Odontología de la UNMSM. Docente del Curso de Operatoria Dental I y II ULADECH Católica.; Paz Fernández, Juan José; Cirujano Dentista, Especialista en Rehabilitación Oral, Docente del Área de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Paredes Coz, Gerson; Cirujano Dentista, Especialista en Rehabilitación Oral, Docente del Área de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Angulo de la Vega, Giselle; Cirujano Dentista, Estudios de Especialidad de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Cardoso Hernández, Sully; Estudiante de internado de la Facultad de Odontología de la UNMSM.
Nowadays is fundamental the interrelationship of the diverse specialities of dentistry for the resolution of the treatments realized in the patients who come to the odontologic consultation, since the vision slanted of some area can deprive to offer a better possibility of treatment. Working with specialists in different areas carries to orientating adequately the treatments and to optimizing results. In the present article the integral rehabilitation of a patient is detailed by the participa...
Full Text Available Prevention in prosthetic dentistry is not just a regular oral hygiene and the prevention of caries in the early stages of its development. The initial goal of orthopedic and dental should be the ability to convey to the patient's sense of pros-thetics that proteziruya one saved more. An example is included prosthetic dental arch defects with bridges or single artificial crowns on implants that will prevent movement of teeth and the continuity of the dentition
MM., Jingarwar; NK., Bajwa; A, Pathak
Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgic...
Sinha, Dakshita J; Sinha, Ashish A
The major objective in root canal treatment is to disinfect the entire root canal system. Cleaning, shaping, and use of antimicrobial medicaments are effective in reducing the bacterial load to some extent, but some bacteria do remain behind and multiply, causing reinfection. Taking into consideration the ineffectiveness, potential side-effects and safety concerns of synthetic drugs, the herbal alternatives for endodontic usage might prove to be advantageous. Over the past decade, interest in drugs derived from medicinal plants has markedly increased. Phytomedicine has been used in dentistry as anti-inflammatory, antibiotic, analgesic, sedative and also as endodontic irrigant. Herbal preparations can be derived from the root, leaves, seeds, stem, and flowers. The PubMed database search revealed that the reference list for natural medicaments featured 1480 articles and in dentistry 173 articles. A forward search was undertaken on the selected articles and author names. This review focuses on various natural drugs and products as well as their therapeutic applications when used as phytomedicine in dentistry.
Bridges, Susan; Drew, Paul; Zayts, Olga; McGrath, Colman; Yiu, Cynthia K Y; Wong, H M; Au, T K F
The global movements of healthcare professionals and patient populations have increased the complexities of medical interactions at the point of service. This study examines interpreter mediated talk in cross-cultural general dentistry in Hong Kong where assisting para-professionals, in this case bilingual or multilingual Dental Surgery Assistants (DSAs), perform the dual capabilities of clinical assistant and interpreter. An initial language use survey was conducted with Polyclinic DSAs (n = 41) using a logbook approach to provide self-report data on language use in clinics. Frequencies of mean scores using a 10-point visual analogue scale (VAS) indicated that the majority of DSAs spoke mainly Cantonese in clinics and interpreted for postgraduates and professors. Conversation Analysis (CA) examined recipient design across a corpus (n = 23) of video-recorded review consultations between non-Cantonese speaking expatriate dentists and their Cantonese L1 patients. Three patterns of mediated interpreting indicated were: dentist designated expansions; dentist initiated interpretations; and assistant initiated interpretations to both the dentist and patient. The third, rather than being perceived as negative, was found to be framed either in response to patient difficulties or within the specific task routines of general dentistry. The findings illustrate trends in dentistry towards personalized care and patient empowerment as a reaction to product delivery approaches to patient management. Implications are indicated for both treatment adherence and the education of dental professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.
One disadvantage of the rapid advances in modern dentistry is that treatment options have never been more varied or confusing. Compounded by a more educated population greatly assisted by online information in an increasingly litigious society, a major concern in recent times is increased litigation against health practitioners. The manner in which courts handle disputes is ambiguous and what is considered fair or just may not be reflected in the judicial process. Although legal decisions in Australia follow a doctrine of precedent, the law is not static and is often reflected by community sentiment. In medical litigation, this has seen the rejection of the Bolam principle with a preference towards greater patient rights. Recent court decisions may change the practice of dentistry and it is important that the clinician is not caught unaware. The aim of this article is to discuss legal issues that are pertinent to the practice of modern dentistry through an analysis of legal cases that have shaped health law. Through these discussions, the importance of continuing professional development, professional association and informed consent will be realized as a means to limit the legal complications of dental practice. © 2014 Australian Dental Association.
Asha, M L; Chatterjee, Ingita; Patil, Preeti; Naveen, S
The purpose of this paper was to review various dosimeters used in dentistry and the cumulative results of various studies done with various dosimeters. Several relevant PubMed indexed articles from 1999 to 2013 were electronically searched by typing "dosimeters", "dosimeters in dentistry", "properties of dosimeters", "thermoluminescent and optically stimulated dosimeters", "recent advancements in dosimetry in dentistry." The searches were limited to articles in English to prepare a concise review on dental dosimetry. Titles and abstracts were screened, and articles that fulfilled the criteria of use of dosimeters in dental applications were selected for a full-text reading. Article was divided into four groups: (1) Biological effects of radiation, (2) properties of dosimeters, (3) types of dosimeters and (4) results of various studies using different dosimeters. The present review on dosimetry based on various studies done with dosimeters revealed that, with the advent of radiographic technique the effective dose delivered is low. Therefore, selection of radiological technique plays an important role in dental dose delivery.
Mm, Jingarwar; Nk, Bajwa; A, Pathak
Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.
NK., Bajwa; A, Pathak
Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry. PMID:25177659
The oral examination is performed in equids to assess and monitor oral health status, provide diagnoses, and determine efficacy of treatments. While there is currently insufficient scientific material of adequate quality to enable evidence-based medicine in equine dentistry, this by no means negates the clinician's responsibility to provide oral health care in a scientific and ethical manner. To do so requires that the clinician be knowledgable and skilled in dentistry and general medicine, that each case upholds the principles of scientific method, and that data is gathered and appraised in an objective, precise, consistent, uniform, and reliable manner. Copyright © 2013 Elsevier Inc. All rights reserved.
R.A. Bal (Roland)
textabstractThe call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more
Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.
Al-Namankany, A; de Souza, M; Ashley, P
To review paediatric dental anxiety measures (DAMs) and assess the statistical methods used for validation and their clinical implications. A search of four computerised databases between 1960 and January 2011 associated with DAMs, using pre-specified search terms, to assess the method of validation including the reliability as intra-observer agreement 'repeatability or stability' and inter-observer agreement 'reproducibility' and all types of validity. Fourteen paediatric DAMs were predominantly validated in schools and not in the clinical setting while five of the DAMs were not validated at all. The DAMs that were validated were done so against other paediatric DAMs which may not have been validated previously. Reliability was not assessed in four of the DAMs. However, all of the validated studies assessed reliability which was usually 'good' or 'acceptable'. None of the current DAMs used a formal sample size technique. Diversity was seen between the studies ranging from a few simple pictograms to lists of questions reported by either the individual or an observer. To date there is no scale that can be considered as a gold standard, and there is a need to further develop an anxiety scale with a cognitive component for children and adolescents.
Niederman, Richard; Richards, Derek
From Celsus' first reports of rubor, calor, dolor, tumor, and functio laesa, has come an understanding of inflammation's manifestations at the organ, tissue, vascular, cellular, genetic, and molecular levels. Molecular medicine now raises the opposite question: can local oral infections and their inflammatory mediators increase systemic morbidity or mortality? From these perspectives we examine the clinical evidence relating caries, periodontal disease, and pericoronitis to systemic disease. Widespread affirmation of an oral-systemic linkage remains elusive, raising sobering cautions. Copyright © 2011 Elsevier Inc. All rights reserved.
Roger L Sur
Full Text Available This essay reviews the historical circumstances surrounding the introduction and evolution of evidence-based medicine. Criticisms of the approach are also considered. Weaknesses of existing standards of clinical practice and efforts to bring more certainty to clinical decision making were the foundation for evidence-based medicine, which integrates epidemiology and medical research. Because of its utility in designing randomized clinical trials, assessing the quality of the literature, and applying medical research at the bedside, evidence-based medicine will continue to have a strong influence on everyday clinical practice.
Williams, D. R. R. (David Robert Rhys)
... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3. Evidence-Based Deﬁnition and Classiﬁcation: A Commentary . . . . . . Steve O'Rahilly 37 PART II: PREVENTION OF DIABETES 4. Prevention of Type 1 Diabetes...
Full Text Available the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised....
Ozak, Sule Tugba; Ozkan, Pelin
Nanotechnology deals with the physical, chemical, and biological properties of structures and their components at nanoscale dimensions. Nanotechnology is based on the concept of creating functional structures by controlling atoms and molecules on a one-by-one basis. The use of this technology will allow many developments in the health sciences as well as in materials science, bio-technology, electronic and computer technology, aviation, and space exploration. With developments in materials science and biotechnology, nanotechnology is especially anticipated to provide advances in dentistry and innovations in oral health-related diagnostic and therapeutic methods.
Unthank, M; True, G
In the increasingly complex, competitive and stressful field of dentistry, effectively designed dental offices can offer significant benefits. Esthetic, functional and life-cycle cost issues to be considered when developing your interior design scheme include color, finishes, lighting, furnishings, art and accessories. An appropriately designed dental office serves as a valuable marketing tool for your practice, as well as a safe and enjoyable work environment. Qualified interior design professionals can help you make design decisions that can yield optimum results within your budget.
Full Text Available Glucocorticosteroids are used extensively in dentistry for their anti-inflammatory and immunosuppressive effects. Most of the diseases for which steroids are used are characterized by inflammation, which appears secondary to a hypersensitivity reaction against auto components. Glucocorticoids do not interfere with the primary disease mechanisms but they are used because of their anti-inflammatory and immunosuppressive effects. It seems reasonable to profit from steroids as palliatives in acute phases of the diseases and/or as long-term suppressors of the general host defense. The article deals with the use of corticosteroids in the treatment of the various conditions and diseases affecting oral cavity.
This is a clinician's view of the current state of veterinary dentistry at the level of the general practitioner across the different species. An indication of the work done and the hazards commonly encountered are covered. To increase awareness within the dental profession of the current state of veterinary dentistry.
Murray, J J
The objective of the British Society of Paediatric Dentistry is to promote the oral health of children. This objective is discussed from four different aspects. First, it is necessary to quantify the dental needs of children and to appreciate how these needs have changed over the last 20 years. Using information from national dental surveys, changes between 1973 and 1993 in the prevalence of dental caries, periodontal disease, accidental damage to anterior teeth and occlusal problems, are summarized. Secondly, the development in consultant posts and the specialty of paediatric dentistry are discussed. The impact of research gradings given to Dental Schools in Britain is the third aspect to be considered and its possible effect on research topics directly relevant to improving the oral health of children. Lastly the effect of public perceptions on our specialty must be considered. Although paediatric dentists may not hit the headlines, the public must be convinced that good oral health is the birthright of every child and that we are dedicated to preventing and treating oral disease in children.
Melanie Sadono Djamil
Full Text Available Technology has continuously improved along with the complexity of devices. Nowadays, it is widely accepted that micro-technology, which is defined as a further reduction in the size of interconnections and components, is achieved by a conventional “top-down” method. We have now moved to a new concept and approach for fabrication from small to bigger building-block elements, which is called nanotechnology. Nanotechnology is the fabrication technology of tiny parts that is achieved by a “bottom-up” method. Nanotechnology has been developed in many areas of life sciences, such as in dentistry. This presentation provides some examples that illustrate the progress in technological growth, especially in the nanoscale. In the developments of nanotechnology, we are also concerned in many ways about its ethics and the laws of physics. The expansion in nanotechnology shows that much multidisciplinary research is being done in the nanoscale area. In dentistry, one of the examples is research in dental materials such as nanoleakage types in the use of various adhesives with resin composition. Nanodiagnostics are nanotechnology in applied molecular diagnostics. All these fields have applications in diagnostics and in point-of-care hand-held devices.
Straub-Morarend, Cheryl L; Marshall, Teresa A; Holmes, David C; Finkelstein, Michael W
Academic dental institutions today seek to provide curricular content and learning opportunities for students to develop an essential skill set for evidence-based practice. To support that effort, studies that explore current practice patterns are valuable in identifying factors that influence the evidence-based habits and behaviors of dental school graduates. The purpose of this study was to explore the knowledge, perceptions, and behavior of private practice dentists in the state of Iowa with respect to evidence-based dentistry and to determine the influence of the dentist's education and the scope of his or her practice on those opinions and habits. A questionnaire addressing practitioners' familiarity with, understanding of, and adoption of an evidence-based philosophy of practice was mailed in September 2009 to all dentists licensed and practicing in Iowa. Questionnaires were returned by 518 practitioners, for an overall response rate of 38.4 percent. The majority of respondents reported awareness, understanding, and adoption of an evidence-based approach to their practice of dentistry. Recent graduates were more likely to report insufficient time as the primary obstacle to practicing evidence-based dentistry. Dental specialists indicated a higher level of comfort in assessing scientific information, as well as implementing current reliable, valid published research in practice, than did general practitioners.
The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.
McEvoy, Maureen P; Crilly, Mike; Young, Taryn; Farrelly, Jane; Lewis, Lucy Kate
PHENONENON: In many developed countries, accreditation documents, which reflect the practice standards of health professions, form the basis for evaluation of education programs for meeting the requirements for registration. The 2005 Sicily statement proposed a 5-step model of training in evidence-based practice (ask, access, appraise, apply, and assess). A key recommendation was that evidence-based practice should be incorporated into entry-level health professional training and registration. No previous research has assessed the extent to which this has occurred. We undertook a systematic audit of the accreditation documents for the registered health professions in Australia. The 11 health professional disciplines included in the audit were medicine, nursing and midwifery, pharmacy, physiotherapy, dentistry, psychology, occupational therapy, optometry, podiatry, osteopathy, and chiropractic. Two investigators independently identified the occurrence of the term evidence that related to "evidence-based practice" and the occurrences of terms related to the 5 steps in the accreditation documents. Occurrence of the term evidence as it relates specifically to "evidence-based practice" ranged from 0 (pharmacy, dentistry and occupational therapy) to 8 (physiotherapy) in the accreditation documents. Overall, there were 77 occasions when terms relating to any of the 5 steps of evidence-based practice were used across all 11 accreditation documents. All 5 steps were included in the physiotherapy and psychology documents; 4 steps in medicine and optometry; 3 steps in pharmacy; 2 steps each in documents for chiropractic, osteopathy, and podiatry; and 1 step for nursing. There was no inclusion of terms relating to any of the 5 steps in the dentistry and occupational therapy documents. Insights: Terminology relating explicitly to evidence-based practice and to the 5 steps of evidence-based practice appears to be lacking in the accreditation documents for health professions
Wigram, Tony; Gold, Christian
This chapter begins by outlining the challenges of preparing a chapter on evidence-based practice (EBP) to underpin the use of music as a therapeutic tool in treatment, in the overall frame of music, health, and wellbeing. It then reviews the terminology of EBP and evidence-based medicine...... practice as health, education, and social services tighten their belts and the demand on their resources grows, there is increasing interest in the value of music for health and wellbeing, despite even less ‘hard’ evidence that it is effective against illness and disability....
McCallum, C A
Specialization in dentistry is appropriate for any country, in order to serve its primary functions--to provide a sound dental educational base, to meet the needs of special patients, to react to the complex needs of society on behalf of the dental profession, and to meet the growth needs of individual dentists. Each country must determine for itself the types and numbers of dental specialties it needs to meet the demands of its people. However, as specialties develop, attention should be directed toward preventing an unnecessary over commitment of resources to the education and training of more specialists than are needed. Such an excess of specialists would dilute or compromise the concept of the general practitioner, which must be maintained to insure for the public ready access into the dental health care system.
Khoury, B S; Khoury, J N
Criminal law in dentistry, as shaped and moulded by the prevailing views of society, defines what is or is not socially acceptable. It applies in both personal and professional contexts with the intended consequence of protecting the public from unacceptable conduct and potential imbalances of power. At its centre, a patient's consent plays a pivotal role in transforming unlawful conduct into lawful conduct. This literature review considers the current law and the trend of utilizing criminal law in addition to non-criminal law alternatives of reprimanding clinicians for failure to achieve consent in the course of dental practice. Dentists must appreciate this change and the prosecuting authority's increasing willingness to resort to criminal law. © 2017 Australian Dental Association.
Wigdor, Harvey A.
One of the major causes of anxiety in the dental clinic is the dental handpiece. Because dentists wish to provide a method which can replace the drill there has often been a premature use of the laser in dentistry. Various lasers have been introduced into the clinic before research has shown the laser used is of clinical benefit. Any new treatment method must not compromise the health of the patient being treated. Thus a method of evaluating the clinical abilities of dentists and their understanding the limitations of the laser used must be developed. Dentist must be trained in the basic interaction of the laser on oral tissues. The training has to concentrate on the variation of the laser wavelength absorption in the different tissues of the oral cavity. Because of the differences in the optical properties of these tissues great care must be exercised by practitioners using lasers on patients.
Domb, William C
Summary The 21st century dental practice is quite dynamic. New treatment protocols and new materials are being developed at a rapid pace. Ozone dental therapy falls into the category of new treatment protocols in dentistry, yet ozone is not new at all. Ozone therapy is already a major treatment modality in Europe, South America and a number of other countries. What is provided here will not be an exhaustive scientific treatise so much as a brief general introduction into what dentists are now doing with ozone therapies and the numerous oral/systemic links that make this subject so important for physicians so that, ultimately, they may serve their patients more effectively and productively. PMID:25363268
Full Text Available The successful practice of dentistry involves a good combination of technical skills and soft skills. Soft skills or communication skills are not taught extensively in dental schools and it can be challenging to learn and at times in treating dental patients. Guiding the child′s behavior in the dental operatory is one of the preliminary steps to be taken by the pediatric dentist and one who can successfully modify the behavior can definitely pave the way for a life time comprehensive oral care. This article is an attempt to revisit a simple behavior guidance technique, reframing and explain the possible psychological perspectives behind it for better use in the clinical practice.
Kamalbekova, G; Kalieva, M
Understanding principles of evidence-based medicine is of vital importance for improving quality of care, promoting public health and health system development. Understanding principles of evidence-based medicine allows using the most powerful information source, which have ever existed in medicine. To evaluate the effectiveness of teaching Evidence-Based Medicine, including long-term outcomes of training. The study was conducted at the Medical University of Astana, where the Scientific and Educational Center of Evidence-Based Medicine was established in 2010 with the help of the corresponding project of the World Bank. The participants of the study were the faculty trained in Evidence-Based Medicine at the workshop "Introduction to Evidence-Based Medicine" for the period of 2010-2015 years. There were a total of 16 workshops during the period, and 323 employees were trained. All participants were asked to complete our questionnaire two times: before the training - pre-training (to determine the initial level of a listener) and after the training - post-training (to determine the acquired level and get the feedback). Questionnaires were prepared in such a way, that the majority of questions before and after training were identical. Thus, it provided a clear picture of the effectiveness of training. Questions in the survey were open-ended so that the respondents had the opportunity to freely and fully express their views. The main part of the questionnaires included the following questions: "Do you understand what evidence-based medicine is", "how do you understand what the study design means", "what is randomization", "how research is classified", "do you know the steps of decision-making according to Evidence-Based Medicine, list them", "what literature do you prefer to use when searching for information (print, electronic, etc.)", "what resources on the Internet do you prefer to use". Only 30-35% of respondents gave correct answers to the questions on
Wolf, Fredric M.
Presents statistics of deaths caused by medical errors and argues the effects of misconceptions in diagnosis and treatment. Suggests evidence-based medicine to enhance the quality of practice and minimize error rates. Presents 10 evidence-based lessons and discusses the possible benefits of evidence-based medicine to evidence-based education and…
Noronha, Victor T; Paula, Amauri J; Durán, Gabriela; Galembeck, Andre; Cogo-Müller, Karina; Franz-Montan, Michelle; Durán, Nelson
Silver nanoparticles (AgNPs) have been extensively studied for their antimicrobial properties, which provide an extensive applicability in dentistry. Because of this increasing interest in AgNPs, the objective of this paper was to review their use in nanocomposites; implant coatings; pre-formulation with antimicrobial activity against cariogenic pathogens, periodontal biofilm, fungal pathogens and endodontic bacteria; and other applications such as treatment of oral cancer and local anesthesia. Recent achievements in the study of the mechanism of action and the most important toxicological aspects are also presented. Systematic searches were carried out in Web of Science (ISI), Google, PubMed, SciFinder and EspaceNet databases with the keywords "silver nano* or AgNP*" and "dentist* or dental* or odontol*". A total of 155 peer-reviewed articles were reviewed. Most of them were published in the period of 2012-2017, demonstrating that this topic currently represents an important trend in dentistry research. In vitro studies reveal the excellent antimicrobial activity of AgNPs when associated with dental materials such as nanocomposites, acrylic resins, resin co-monomers, adhesives, intracanal medication, and implant coatings. Moreover, AgNPs were demonstrated to be interesting tools in the treatment of oral cancers due to their antitumor properties. The literature indicates that AgNPs are a promising system with important features such as antimicrobial, anti-inflammatory and antitumor activity, and a potential carrier in sustained drug delivery. However, there are some aspects of the mechanisms of action of AgNPs, and some important toxicological aspects arising from the use of this system that must be completely elucidated. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Khatoon, B; Hill, K B; Walmsley, A D
Dentistry-related applications for mobile phones are becoming a popular way of accessing information for students, practitioners and patients. The aim of this article is to review the use of mobile technology, such as 'apps', within dentistry. Over time, there has been a change from desktop learning (D-learning) to mobile learning (M-learning) and this has only been possible with the aid of electronic media and the growth of the Internet. In spite of the increase in mobile applications, there is a need for any information to have a strong underlying evidence base. Several good examples of dental applications which take full advantage of this electronic medium are available. However, developers of mobile applications should provide good quality, peer-reviewed evidence to validate their material.
Martens, L C
The aim of this introduction to this special laser issue is to describe some basic laser physics and to delineate the potential of laser-assisted dentistry in children. A brief review of the available laser literature was performed within the scope of paediatric dentistry. Attention was paid to soft tissue surgery, caries prevention and diagnosis, cavity preparation, comfort of the patient, effect on bacteria, long term pulpal vitality, endodontics in primary teeth, dental traumatology and low level laser therapy. Although there is a lack of sufficient evidence taking into account the highest standards for evidence-based dentistry, it is clear that laser application in a number of different aetiologies for soft tissue surgery in children has proven to be successful. Lasers provide a refined diagnosis of caries combined with the appropriate preventive adhesive dentistry after cavity preparation. This will further lead to a new wave of micro-dentistry based on 'filling without drilling'. It has become clear from a review of the literature that specific laser applications in paediatric dentistry have gained increasing importance. It can be concluded that children should be considered as amongst the first patients for receiving laser-assisted dentistry.
Liu, F; Dang, Y H
Forensic dentistry is an interdiscipline of forensic medicine and stomatology, which provides legal information by collecting, testing and assessing the dental evidence scientifically. In this review, the present application of forensic dentistry has been described, such as the estimation of age, sex, species, occupation and living habit, as well as the identification of individual, domestic violence or abuse, which aims to enrich and improve forensic dentistry for making it be more useful in forensic medicine even in juridical practice. Copyright© by the Editorial Department of Journal of Forensic Medicine.
van Foreest, Andries
Rooted in human dentistry, veterinary dentistry has developed steadily in the Netherlands since the 1980s and is now recognized as an essential discipline of veterinary medicine. The availability of specialized tools and techniques has led to improved treatment outcomes and results, with the choice of treatment being largely determined by the functionality of the dentition and the costs involved. Domestic animals and horses with dental problems should be referred to dental veterinarians. The Working Group Veterinary Dentistry in the Netherlands is an association for skilled veterinarians with professional dental equipment at their disposal.
Winning, T.; Needleman, I.; Rohlin, M.; Carrassi, A.; Chadwick, B.; Eaton, K.; Hardwick, K.; Ivancakova, R.; Jallaludin, R.L.; Johnsen, D.; Kim, J.G.; Lekkas, D.; Li, D.; Onisei, D.; Pissiotis, A.; Reynolds, P.; Tonni, I.; Vanobbergen, J.; Vassileva, R.; Virtanen, J.; Wesselink, P.R.; Wilson, N.
An evidence-based (EB) approach has been a significant driver in reforming healthcare over the past two decades. This change has extended across a broad range of health professions, including oral healthcare. A key element in achieving an EB approach to oral healthcare is educating our
B. Spek; M. Wieringa-de Waard; C. Lucas; N. van Dijk
BACKGROUND: Worldwide speech-language therapy (SLT) students are educated in evidence-based practice (EBP). For students to use EBP in their future day-to-day clinical practice, they must value EBP as positive and must feel confident in using it. For curricula developers it is therefore important to
In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence-based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning which includes recognition...
Mesibov, Gary B.; Shea, Victoria
Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…
Hajebrahimi, Sakineh; Sadeghi-Ghyassi, Fatemeh; Olfati, Nahid; Dastgiri, Saeed; Maghbouli, Leili
To determine the attitudes and beliefs of Iranian urologists toward Evidence Based Medicine (EBM) and investigation of the barriers of evidence based practice (EBP). A self- administrated, Likert scale questionnaire designed in Persian and filled up by censuses selected urologist from Iranian Urology Association (IUA). Data were entered to Predictive Analytics Soft Ware version 18.0 and descriptive statistics were obtained for all parts of the questionnaire. A total of 111 out of 500 Iranian urologists who attended in IUA annual meeting, responded to the questionnaires. Mean attitude score of respondents was 30.4 (SD: 5.7, range 16-40). Attitude score showed statistically significant association to previous participation in EBM workshops (P = .01). Of participants 96% believed EBP will improve patient care and 76.2% of them appreciated the impact of use of research utilization and application of evidence based guidelines on clinical decision making and the outcome of surgery. The main barriers to EBP stated as lack of time (64.8%), facilities (53.4%), and training in EBM (29.4%). The urologists have positive attitudes towards EBP. However, regarding lack of time, pre-appraised databases or EBP guidelines can be helpful. Evidence based workshops and familiarity with evidence databases is recommended for Iranian urologists. In addition, health care system and policy makers could play a major role to provide a culture of EBP.
Hoerle, S; Kroll, P
Evidence-based medicine is often misunderstood as 'cookbook medicine with standard recipes' that does not take clinical experience into account. It is, however, supposed to be a basis for decision making in caring for individual patients under consideration of patients' preferences. This seems to be very important, since diabetic retinopathy continues to be the most frequent cause of vision loss in working age adults with negative consequences for patients' quality of life and for health economics. The most important evidence-based therapy for diabetic retinopathy and maculopathy is laser coagulation. Vitrectomy for proliferative stages has also been proven effective by clinical studies. For more recent treatment options like triamcinolone injection and vitrectomy for diabetic macular edema there is a lower level of evidence so far. The Diabetic Retinopathy Study was the first to show the effectiveness of panfundus laser coagulation for a larger group of patients. The Early Treatment Diabetic Retinopathy Study in turn serves as a basis for laser coagulation of retinopathy and maculopathy. The Diabetic Retinopathy Vitrectomy Study could show the advantages of timely vitrectomy. Both the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study could show the value of intensive blood glucose control. Evidence-based medicine on the basis of the studies mentioned above is practiced quite self-evidently in ophthalmo-diabetology. It should be regarded as a helpful tool for special therapeutic situations which still leaves room for one's personal clinical experience to be included. It is somewhat problematic that the term evidence-based medicine seems to be restricted to the results of large randomized studies, because even special problems and very individual, difficult therapeutic questions can be placed on an evidence-based foundation, although at a lower level of evidence, using today's modern means of literature research. Copyright (c
Full Text Available Aesthetic dentistry is a branch of dentistry which aims primarily at improving patient’s physical appearance and, to a lesser extent, the functionality of teeth. This field raises particular ethical dilemmas and requires a careful evaluation of patient’s needs and wishes versus his/her clinical best interests. In this article, the authors discuss the main ethical challenges in the field of aesthetic dentistry in the light of the four “classical” principles of bioethics: autonomy, beneficence, non-maleficence and justice. The authors conclude that the principles of medical ethics should be at the very foundation of the field of aesthetic dentistry, for establishing a patient-physician relationship which could lead to optimum clinical outcomes, while respecting the wishes of the patient and promoting his/her best interests.
Groppo, Francisco Carlos; Bergamaschi, Cristiane de Cássia; Cogo, Karina; Franz-Montan, Michelle; Motta, Rogério Heládio Lopes; de Andrade, Eduardo Dias
Over the past decade, interest in drugs derived from medicinal plants has markedly increased. This study was aimed at a literature review focusing on studies investigating herbal drugs and other natural products, as well as their therapeutic application, side effects and possible drug interactions. Few studies were found to support their rational use in dentistry. Since there is an increasing use of phytotherapeutic agents in dentistry, further studies are needed to evaluate their safety and effectiveness for clinical use.
Mon-Williams, M A; Mushtaq, F; Wilkie, R M; Khambay, B; Keeling, A; Manogue, M
Stereopsis and its role in dental practice has been a topic of debate in recent editions of this Journal. These discussions are particularly timely as they come at a point when virtual reality simulators are becoming increasingly popular in the education of tomorrow's dentists. The aim of this article is to discuss the lack of robust empirical evidence to ascertain the relationship (if any) between stereopsis and dentistry and to build a case for the need for further research to build a strong evidence base on the topic.
Full Text Available Nel corso dell’ultimo decennio, nel pensiero pedagogico anglosassone, si è affermata una cultura dell’evidenza cui ci si riferisce con l’espressione “evidence based education” (EBE. Secondo tale prospettiva, le decisioni in ambito educativo dovrebbero essere assunte sulla base delle conoscenze che la ricerca empirica offre in merito alla minore o maggiore efficacia delle differenti opzioni didattiche. Si tratta di un approccio (denominato “evidence based practice” che ha origine in ambito medico e che in seguito ha trovato applicazione in differenti domini delle scienze sociali. L’autore presenta un quadro introduttivo all’EBE, dando conto delle sue origini e dei differenti significati di cui è portatrice.
This book contains an evidence-based pedagogic guide to enable any motivated teaching/training professional to be able to teach effectively and creatively. It firstly summarises the extensive research field on human psychological functioning relating to learning and how this can be fully utilised in the design and facilitation of quality learning experiences. It then demonstrates what creativity actually 'looks like' in terms of teaching practices, modelling the underpinning processes of creative learning design and how to apply these in lesson planning. The book, having established an evidence-based and pedagogically driven approach to creative learning design, extensively focuses on key challenges facing teaching professionals today. These include utilising information technologies in blended learning formats, differentiating instruction, and developing self-directed learners who can think well. The main purpose of the book is to demystify what it means to teach creatively, explicitly demonstrating the pr...
The use of science for policy is at the core of a perfect storm generated by the insurgence of several concurrent crises: of science, of trust, of sustainability. The modern positivistic model of science for policy, known as evidence based policy, is based on dramatic simplifications and compressions of available perceptions of the state of affairs and possible explanations (hypocognition). This model can result in flawed prescriptions. The flaws become more evident when dealing with complex issues characterized by concomitant uncertainties in the normative, descriptive and ethical domains. In this situation evidence-based policy may concur to the fragility of the social system. Science plays an important role in reducing the feeling of vulnerability of humans by projecting a promise of protection against uncertainties. In many applications quantitative science is used to remove uncertainty by transforming it into probability, so that mathematical modelling can play the ritual role of haruspices. This epistem...
Gale, Barbara Van Patter; Schaffer, Marjorie A
This study explored factors that affect the adoption or rejection of evidence-based practice (EBP) changes and differences in nurse manager and staff nurse perceptions about those factors. Roger's Diffusion of Innovations Theory explains relevant organizational strategies for guiding practice change. The primary author developed the Evidence-Based Practice Changes Survey consisting of 12 items, completed by 92 nurses at a level 1 trauma center. Top barriers to EBP were insufficient time, lack of staff, and not having the right equipment and supplies. Top reasons to adopt EBP were having personal interest in the practice change, avoiding risk of negative consequences to the patient, and personally valuing the evidence. Several statistically significant differences emerged for demographic variables. Planning for EBP change must address barriers and facilitators to practice change and emphasize the benefit for patients and value of the practice change to nurses.
The idea of evidence- based practice is influential in public welfare services, including education. The idea is controversial, however, not least because it involves a poten tial redefinition of the relation ship between knowledge, authority and professionalism. This is discussed based on a study...... of evidence- based methods in Danish pre-school education and care. The management sees the use of these methods as strengthening pre- school teacher professionalism, but the actual practices in the day-careinstitutions are ambiguous. In some cases, using the methods becomes an end in itself and tends...... to displace important educational objectives. In other cases, the methods are reflectively adjusted to a given context. Used in this way only, evid ence-based practice and methodology is a valuable resource for professional practice in education. From such a perspective, at least some types of research based...
e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work.
Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.
Fins, Joseph J
Medicine in the last decades of the twentieth century was ripe for a data sweep that would bring systematic analysis to treatment strategies that seemingly had stood the test of time but were actually unvalidated. Coalescing under the banner of evidence-based medicine, this process has helped to standardize care, minimize error, and promote patient safety. But with this advancement, something of the art of medicine has been lost. © 2016 The Hastings Center.
Wahlqvist, Mark L
The clinical nutrition case study is a neglected area of activity and publication. This may be in part because it is not regarded as a serious contributor to evidence-based nutrition (EBN). Yet it can play a valuable part in hypothesis formulation and in the cross-checking of evidence. Most of all, it is usually a point at which the operationalisation of nutrition evidence is granted best current practice status.
Jan Klusáček; Marie Klusáčková
The article deals with the evidence base of health policy in the Czech Republic. It focuses on articles published in peer-reviewed scholarly journals. It builds on a quantitative analysis of articles published between 2005 and 2010 in scholarly journals in the fields of social science, management and administration, public health and other relevant fields. The main finding is that almost half of the 161 articles with potential use for health policy were published in a single journal, Zdravotn...
Sardanelli, Francesco; Di Leo, Giovanni [Universita degli Studi di Milano, Dipartimento di Scienze Medico-Chirurgiche, Unita di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, Milan (Italy); Hunink, Myriam G. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Epidemiology, Rotterdam (Netherlands); Harvard School of Public Health, Program for Health Decision Science, Boston, MA (United States); Gilbert, Fiona J. [University of Aberdeen, Aberdeen Biomedical Imaging Centre, Aberdeen (United Kingdom); Krestin, Gabriel P. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands)
To provide an overview of evidence-based medicine (EBM) in relation to radiology and to define a policy for adoption of this principle in the European radiological community. Starting from Sackett's definition of EBM we illustrate the top-down and bottom-up approaches to EBM as well as EBM's limitations. Delayed diffusion and peculiar features of evidence-based radiology (EBR) are defined with emphasis on the need to shift from the demonstration of the increasing ability to see more and better, to the demonstration of a significant change in treatment planning or, at best, of a significant gain in patient outcome. The ''as low as reasonably achievable'' (ALARA) principle is thought as a dimension of EBR while EBR is proposed as part of the core curriculum of radiology residency. Moreover, we describe the process of health technology assessment in radiology with reference to the six-level scale of hierarchy of studies on diagnostic tests, the main sources of bias in studies on diagnostic performance, and levels of evidence and degrees of recommendations according to the Centre for Evidence-Based Medicine (Oxford, UK) as well as the approach proposed by the GRADE working group. Problems and opportunities offered by evidence-based guidelines in radiology are considered. Finally, we suggest nine points to be actioned by the ESR in order to promote EBR. Radiology will benefit greatly from the improvement in practice that will result from adopting this more rigorous approach to all aspects of our work. (orig.)
Full Text Available Stefan Stübinger,1 Andres Stricker,2 Britt-Isabelle Berg3,4 1Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland; 2Private Practice, Konstanz, Germany; 3Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland; 4Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA Abstract: Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. Keywords: implantology, piezoelectric device, piezosurgery, maxillary sinus elevation, bone grafting, osteotomy, edentulous ridge splitting
Professional risk factors in dentistry may harm the dentist and the dental team. It is essential for the dentist to recognize these risk factors and protect against them. Among the various organs that are vulnerable in the dental situation are (in a nut-shell): The eyes, the ears, the respiratory system, the palm of the hand, and the back and the vertebrae. In addition, the dentist and the dental team must recognizes the potential for Hepatitis (A, B, C, D, E), and for the acquired immune deficiency syndrome due to the HIV virus. The primary means for protecting against these potential hazardous factors is meticulously keeping proper working conditions such as good ventilation of the operating room, using face masks which are capable of blocking even small particles, using eye protection and gloves, and proper seating at the chair. It is reasonable to adopt a routine of taking a vaccine against Influenza and Hepatitis B, and to routinely check the level of antibodies for Hepatitis B. Personal accidents- and severe-diseases-insurances, as well as insurance against losing the ability to work are advised for every dentist.
Taheri, Jamile B; Azimi, Somayyeh; Rafieian, Nasrin; Zanjani, Hosein Akhavan
Herbs have been used for centuries to prevent and control disease. Herbal extracts are effective because they interact with specific chemical receptors within the body and are in a pharmacodynamic sense, drugs themselves. By using herbal medicines, patients have averted the many side effects that generally come with traditional medicines, but this does not mean that side effects do not occur. Only knowledgeable practitioners can prescribe the right herb and its proper dosage. Herbal medicines had been considered in every culture, however, pharmaceutical companies overturned this type of thinking. Now, pharmaceuticals are called traditional and herbs are libeled as the 'alternative'. The biggest challenge and problem is lack of information about the effect of herbs in oral tissues, mechanism of effect, and side effects. Several popular conventional drugs on the market are derived from herbs. These include aspirin (from white willow bark), digitalis (from foxglove), and sudafed (modelled after a component in the plant ephedra). Herbal products can vary in their potency. Therefore, care must be taken in selecting herbs, even so, herbal medicines have dramatically fewer side effects and are safer to use than conventional medications. The herbs described in this article are Bloodroot, Caraway, Chamomile, Echinacea, Myrrh, Peppermint, Rosemary, Sage, Thyme, Aloe Vera, Propolis, and a summary of other herbs that are useful in dentistry. Herbs may be good alternatives to current treatments for oral health problems but it is clear that we need more research. © 2011 FDI World Dental Federation.
Welk, Alexander; Immenroth, Marc; Sakic, Petar; Bernhardt, Olaf; Eberspächer, Hans; Meyer, Georg
Since fine-motor movements and complex procedures, which are often necessary in dental practice, can be compared to those used by professional athletes, the purpose of this study was to determine the impact of the mental training technique, established in sport science, on dentistry. In a randomized, controlled study, 2 groups of 20 and 21 dental students in their second semester (experimental group with mental training, and control group with conventional training, respectively), were evaluated at 2 time points (pre- and posttest) by measuring the effect of training by the criteria "knowledge," "process," and "quality" of a crown preparation on the computer-assisted Dental-Simulator (DenX). The improvements of the experimental group and of the control group from pre- to posttest could be distinguished for all criteria in favor of the experimental group, in which improvements of knowledge (F1,39 = 72.674, P mental training is detectable in dental education, especially with regard to cognitive aspects of dental procedures.
Walmsley, A. D.
Ultrasonic instruments have been used in dentistry since the 1950's. Initially they were used to cut teeth but very quickly they became established as an ultrasonic scaler which was used to remove deposits from the hard tissues of the tooth. This enabled the soft tissues around the tooth to return to health. The ultrasonic vibrations are generated in a thin metal probe and it is the working tip that is the active component of the instrument. Scanning laser vibrometry has shown that there is much variability in their movement which is related to the shape and cross sectional shape of the probe. The working instrument will also generate cavitation and microstreaming in the associated cooling water. This can be mapped out along the length of the instrument indicating which are the active areas. Ultrasonics has also found use for cleaning often inaccessible or different surfaces including root canal treatment and dental titanium implants. The use of ultrasonics to cut bone during different surgical techniques shows considerable promise. More research is indicated to determine how to maximize the efficiency of such instruments so that they are more clinically effective.
Eldredge, J D
To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.
Khong, T Y
The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.
Full Text Available This issue of Evidence Based Library and Information Practice includes three papers from the Evidence Based Scholarly Communication Conference (EBSCC that took place in March 2010i. Kroth, Philips and Eldredge have written a commentary that gives an overview of the conference, and introduces us to the research papers that were presented. As well, two research presentations from the conference appear in this issue, an article by Donahue about a potential new method of communicating between scholars, and a paper by Gilliland in our Using Evidence in Practice section, detailing a library’s Open Access Day preparations.Kroth, Philips and Eldredge note that “The EBSCC brought together librarians and information specialists to share evidence-based strategies for developing effective local scholarly communication support and training and, hopefully, form new coalitions to address this topic at a local and national level.” (p 108. This conference focused on translational medicine, and looked at how to promote new methods of scholarly communication, partially through the inclusion of research papers at the conference.The inclusion of these articles and the evidence based focus of the EBSCC conference, made me ask myself, can scholarly communication be evidence based? At its core, scholarly communication is anything but a scientific issue. It is charged with emotion; from authors, publishers, librarians and others involved in the business of publishing. The recent shift to look at new models of scholarly communication has been a threat to many of the established models and sparked much debate in the academic world, especially in relation to open access. In her 2006 EBLIP commentary on evidence based practice and open access, Morrison notes, “Open Access and evidence based librarianship are a natural combination” (p. 49, and outlines her perspective on many of the reasons why. Debate continues to rage, however, regarding how authors should
Full Text Available Evidence based library and information practice (EBLIP is a strategy to bridge research and practice. Generally EBLIP is seen as a movement to encourage and give practitioners the means to incorporate research into their practice, where it previously may have been lacking. The widely accepted definition of EBLIP (Booth, 2000 stresses three aspects that contribute to a practice that is evidence based: 1 "the best available evidence;" 2 "moderated by user needs and preferences;" 3 "applied to improve the quality of professional judgements." The area that the EBLIP movement has focused on is how to create and understand the best available research evidence. CE courses, critical appraisal checklists, and many articles have been written to address a need for librarian education in this area, and it seems that strides have been made.But very little in the EBLIP literature talks about how we make professional judgements, or moderate evidence based on our user needs and preferences. Likewise, how do we make good evidence based decisions when our evidence base is weak. These things seem to be elements we just take for granted or can’t translate into words. It is in keeping with tacit knowledge that librarians just seem to have or acquire skills with education and on the job experience. Tacit knowledge is "knowledge that is not easily articulated, and frequently involves knowledge of how to do things. We can infer its existence only by observing behaviour and determining that this sort of knowledge is a precondition for effective performance" (Patel, Arocha, & Kaufman, 1999, p.78. It is something that is difficult to translate into an article or guideline for how we work. I think of this area as the "art" of evidence based practice. And the art is crucial to being an evidence based practitioner.Science = systematized knowledge, explicit research, methodological examination, investigation, dataArt = professional knowledge of your craft, intuition
Zeeman, Laetitia; Aranda, Kay; Grant, Alec
This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley
Lewis, Brennan; Allen, Stephanie
The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders
Jekl, Vladimir; Hauptman, Karel; Knotek, Zdenek
The number of exotic companion pet rodents seen in veterinary practices is growing very rapidly. According to the American Veterinary Medical Association's surveys, more than 2,093,000 pet rodents were kept in US households in 2007 and in 2012 it was more than 2,349,000 animals. This article summarizes the most important evidence-based knowledge in exotic pet rodents (diagnostics of the hyperadrenocorticism in guinea pigs, pituitary tumors in rats, urolithiasis in guinea pigs, use of itopride as prokinetics, use of deslorelin acetate in rodents, cause of dental disease, and prevention of mammary gland tumors in rats). Copyright © 2017 Elsevier Inc. All rights reserved.
Dougherty, William M; Christophel, John Jared; Park, Stephen S
This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors. Copyright © 2017 Elsevier Inc. All rights reserved.
Sir Arthur Conan Doyle, the creator of the fictional detective Sherlock Holmes, studied medicine at the University of Edinburgh between 1876 and 1881 under Doctor Joseph Bell who emphasised in his teaching the importance of observation, deduction and evidence. Sherlock Holmes was modelled on Joseph Bell. The modern notions of Evidence Based Medicine (EBM) are not new. A very brief indication of some of the history of EBM is presented including a discussion of the important and usually overlooked contribution of statisticians to the Popperian philosophy of EBM.
Laville, Martine; Segrestin, Berenice; Alligier, Maud
BACKGROUND: Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities...... as patient-centred outcomes may occur decennia into the future. The methodologies and regulations for drug trials are, however, applicable to nutrition trials. CONCLUSIONS: Research on clinical nutrition should start by collecting clinical data systematically in databases and registries. Measurable patient...
Schwartz, Michael R
After reading this article, the participant should be able to: 1. Understand the key decisions in patient evaluation for cosmetic breast augmentation. 2. Cite key decisions in preoperative planning. 3. Discuss the risks and complications, and key patient education points in breast augmentation. Breast augmentation remains one of the most popular procedures in plastic surgery. The integral information necessary for proper patient selection, preoperative assessment, and surgical approaches are discussed. Current data regarding long term safety and complications are presented to guide the plastic surgeon to an evidence-based approach to the patient seeking breast enhancement to obtain optimal results.
Summa, Noémie M; Guzman, David Sanchez-Migallon
This article presents relevant advances in avian medicine and surgery over the past 5 years. New information has been published to improve clinical diagnosis in avian diseases. This article also describes new pharmacokinetic studies. Advances in the understanding and treatment of common avian disorders are presented in this article, as well. Although important progress has been made over the past years, there is still much research that needs to be done regarding the etiology, pathophysiology, diagnosis, and treatment of avian diseases and evidence-based information is still sparse in the literature. Copyright © 2017 Elsevier Inc. All rights reserved.
Summa, Noémie M; Brandão, João
Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine. Copyright © 2017 Elsevier Inc. All rights reserved.
Vitale, M. C.
Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.
Pemberton, M N
Patient safety has always been important and is a source of public concern. Recent high profile scandals and subsequent reports, such as the Francis report into the failings at Mid Staffordshire, have raised those concerns even higher. Mortality and significant morbidity associated with the practice of medicine has led to many strategies to help improve patient safety, however, with its lack of associated mortality and lower associated morbidity, dentistry has been slower at systematically considering how patient safety can be improved. Recently, several organisations, researchers and clinicians have discussed the need for a patient safety culture in dentistry. Strategies are available to help improve patient safety in healthcare and deserve further consideration in dentistry.
Dawood, A; Marti Marti, B; Sauret-Jackson, V; Darwood, A
3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.
DeForge, Donald H
Ergonomics is the application of a body of knowledge addressing the interactions between man and the total working environment, such as atmosphere, heat, light and sound, as well as all tools and equipment of the workplace. Work related musculoskeletal injuries, caused by poor posture, have been discussed in human dentistry for several years. Veterinary dentistry, as a relatively new specialty within veterinary medicine, should address the ergonomics of poor posture without further delay to prevent work-related injuries. The generalist, as well as the specialist and their technicians, are subject to various neck and back disorders if proper ergonomic recommendations are not followed. This review article highlights basic ergonomic design principles for illumination and posture in veterinary dentistry.
Chen, Li-Li; Lin, Jun-Dai
Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.
Lasers have been used in human dentistry since the 1960's. Lasers can provide a veterinary dentist access to difficult to reach areas with a relatively bloodless surgical field. Due to vaporization of nerve endings, human patients undergoing laser dental treatment reveal less pain compared to scalpel driven procedures. Dental applications for the commonly used lasers are discussed, as are special safety precautions. Many dental procedures enhanced by a carbon dioxide laser are covered. Future applications for the laser in veterinary dentistry are also discussed.
Su, Y C
It is a digital age today. Exposed to all kinds of digital products in many fields. Certainly, implant dentistry is not exception. Digitalization could improve the outcomes and could decrease the complications of implant dentistry. This paper introduces the concepts, definitions, advantages, disadvantages, limitations and errors of digital implant dentistry.
The first book focused solely on dentistry was published in Germany in 1530. Former scientific publications on dentistry were collected by an unknown author. The book presents 44 pages on the main issues of dentistry divided into 13 chapters. It was made by the Guttenberg method of printing.
Chin-Yee, Benjamin H
This article explores the philosophical implications of evidence-based medicine's (EBM's) epistemology in terms of the problem of underdetermination of theory by evidence as expounded by the Duhem-Quine thesis. EBM hierarchies of evidence privilege clinical research over basic science, exacerbating the problem of underdetermination. Because of severe underdetermination, EBM is unable to meaningfully test core medical beliefs that form the basis of our understanding of disease and therapeutics. As a result, EBM adopts an epistemic attitude that is sceptical of explanations from the basic biological sciences, and is relegated to a view of disease at a population level. EBM's epistemic attitude provides a limited research heuristic by preventing the development of a theoretical framework required for understanding disease mechanism and integrating knowledge to develop new therapies. Medical epistemology should remain pluralistic and include complementary approaches of basic science and clinical research, thus avoiding the limited epistemic attitude entailed by EBM hierarchies. © 2014 John Wiley & Sons, Ltd.
Pickrell, Brent B; Hollier, Larry H
After reading this article, the participant should be able to: 1. Explain the epidemiology of mandible fractures. 2. Discuss preoperative evaluation of the patient with a mandible fracture. 3. Compare the various modalities of fracture fixation. 4. Identify common complications after fracture repair. In this Maintenance of Certification/Continuing Medical Education article, the reader is provided with a review of the epidemiology, preoperative evaluation, perioperative management, and surgical outcomes of mandible fractures. The objective of this series is to present a review of the literature so that the practicing physician can remain up-to-date on key evidence-based guidelines to enhance management and improve outcomes. The physician can also seek further in-depth study of the topic through the references provided.
Duran-Vega, Héctor César
Evidence-based surgery is a tool that has been adopted worldwide by surgeons. As all decisions must be current and have a scientific basis, the approach for performing it must be standardised. Five important steps are required to perform surgery based on evidence. Convert the need for information into a question that can be answered, finding the best information to answer that question, critical evaluation of the evidence, and its validity, impact and applicability, integrating the evidence with your own experience, and with the evaluation of the patients. This should take into account their biology, values and specific circumstances, as well as to evaluate the effectiveness and efficiency of the execution of steps 1-4 and propose how to improve them. This article presents the main tools to perform surgery properly based on evidence. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence it more effectively. Similarly, policymakers need to understand the complexities of the scientific process to improve their interaction with the scientific sphere. This literature review addresses those factors that influence the uptake of scientific evidence into policymaking, the barriers to using science in policymaking, as well as recommendations for improved science–policymaking interaction. A visual diagram of the gears of a car is used to convey the message of the complexities around the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised.
From a humanistic, social scientific perspective, the most complex task in evidence-based medicine lies in the communication of specialized medical knowledge to non-professionals. Information is never simply the neutral transmission of facts, not even when dealing with scientific knowledge and research. It is always interpreted and evaluated from a particular perspective in a specific context. That information can be neutral is thus a myth. In all medical consultations the process of communication is not just a matter of transmitting information from one who knows to one who does not. Knowledge created and formulated in a scientific context is thus recontextualised first in a clinical situation and then as an interpreted version in people's real lives. Furthermore there are difficulties when practice must be based on current research, in a situation in which no prior clinical experience exists and in which results are interpreted and used regardless of the relative certainty of current evidence.
Yadava B Jeve
Full Text Available Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based.
Hayes, Martina; Allen, Edith; da Mata, Cristiane; McKenna, Gerald; Burke, Francis
Ten million people in the UK today are aged over 65. The latest projections estimate that there will be 5 1/2 million more people aged 65 and older in the next 20 years. This projected pattern of population ageing will have profound consequences for dentistry. Minimal intervention dentistry (MID) is a modern evidence-based approach to caries management in dentate patients that uses the 'medical model' whereby disease is controlled by the 'oral physician'. This approach offers considerable benefits over conventional dentistry for older patients. It encourages patients to be responsible for their oral health through the provision of both knowledge and motivation. MID encompasses risk assessment for dental disease, early detection and control of disease processes, and minimally invasive treatment. Clinical Relevance: Risk assessment tools can aid the general dental practitioner and the patient to develop a suitable caries prevention programme for that individual and reduce the need for future operative intervention.
Smith, Tristram; Iadarola, Suzannah
This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008 ). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers.
Almost the entire human creativity today, from the standpoint of its efficiency and expediency, is conditioned with the existence of information systems. Most information systems are oriented to the management and decision-making, including health information system. System of health and health insurance together form one of the most important segments of society and its functioning as a compact unit. Increasing requirements for reducing health care costs while preserving or improving the quality of services provided represent a difficult task for the health system. Using descriptive metods by retreiiving literature we analyzed the latest solutions in information and telecommunications technology is the basis for building an effective and efficient health system. Computerization does not have the primary objective of saving, but the rationalization of spending in health care. It is estimated that at least 20-30% of money spent in health care can be rationally utilized. Computerization should give the necessary data and indicators for this rationalization. Very important are the goals of this project and the achievement of other uses and benefits, improving overall care for patients and policyholders, increasing the speed and accuracy of diagnosis in determining treatment using electronic diagnostic and therapeutic guidelines. Computerization in dentistry began similarly as in other human activities-recording large amounts of data on digital media, and by replacing manual data processing to machine one. But specifics of the dental profession have led to the specifics of the application of information technology (IT), and continue to require special development of dental oriented and applied IT. Harmonization of dental software with global standards will enable doctors and dentists to with a few mouse clicks via the internet reach the general medical information about their patients from the central national health database. Standardization will also allow access to
Journal of Dental Education, 1990
The American Association of Dental Schools' guidelines for curriculum design explain the scope of forensic dentistry and interrelationships with other fields, give an overview of the curriculum, and outline suggested primary educational goals, prerequisites, core content, specific behavioral objectives, sequencing, faculty and facility…
Schnitman, Paul A
Computer-guided minimally invasive implant treatment promises to revolutionize the way we practice implant dentistry. This new technology allows implants and associated restorations to be precisely placed at the same procedure directly through the gingiva in an hour or less. Since there is no incision, there is minimal postoperative discomfort or swelling and no sutures.
New York State Education Dept., Albany. Office of the Professions.
The handbook contains laws, rules, and regulations of the New York State Education Department that govern dentistry and dental hygiene practice in the state. It describes licensure requirements and includes complete application forms and instructions for obtaining license and first registration as a dentist and dental hygienist. Applicants are…
Hinton, Stephanie; Beyari, Mohammed M; Madden, Kim; Lamfon, Hanadi A
The use of a randomized controlled trial (RCT) research design is considered the gold standard for conducting evidence-based clinical research. In this present study, we aimed to assess the quality of RCTs in dentistry and create a general foundation for evidence-based dentistry on which to perform subsequent RCTs. We conducted a systematic assessment of bias of RCTs in seven general dentistry journals published between January 2011 and March 2012. We extracted study characteristics in duplicate and assessed each trial's quality using the Cochrane Risk of Bias tool. We compared risk of bias across studies graphically. Among 1,755 studies across seven journals, we identified 67 RCTs. Many included studies were conducted in Europe (39%), with an average sample size of 358 participants. These studies included 52% female participants and the maximum follow-up period was 13 years. Overall, we found a high percentage of unclear risk of bias among included RCTs, indicating poor quality of reporting within the included studies. An overall high proportion of trials with an "unclear risk of bias" suggests the need for better quality of reporting in dentistry. As such, key concepts in dental research and future trials should focus on high-quality reporting.
religious acts of the prehistoric era to empirical-rational decisions of the Egyptian civilization, to modern day evidence-based medicine. Evidence-based medicine requires that clinical decisions and health policies on the prevention, diagnosis and ...
Full Text Available Objective To evaluate the current treatments and possible adverse reactions of metabolic myopathy, and to develop the best solution for evidence-based treatment. Methods Taking metabolic myopathy, mitochondrial myopathy, lipid storage myopathy, glycogen storage diseases, endocrine myopathy, drug toxicity myopathy and treatment as search terms, retrieve in databases such as PubMed, Cochrane Library, ClinicalKey database, National Science and Technology Library (NSTL, in order to collect the relevant literature database including clinical guidelines, systematic reviews (SR, randomized controlled trials (RCT, controlled clinical trials, retrospective case analysis and case study. Jadad Scale was used to evaluate the quality of literature. Results Twenty-eight related articles were selected, including 6 clinical guidelines, 5 systematic reviews, 10 randomized controlled trials and 7 clinical controlled trials. According to Jadad Scale, 23 articles were evaluated as high-quality literature (≥ 4, and the remaining 5 were evaluated as low-quality literature (< 4. Treatment principles of these clinical trials, efficacy of different therapies and drug safety evaluation suggest that: 1 Acid α-glycosidase (GAA enzyme replacement therapy (ERT is the main treatment for glycogen storage diseases, with taking a high-protein diet, exercising before taking a small amount of fructose orally and reducing the patient's physical activity gradually. 2 Carnitine supplementation is used in the treatment of lipid storage myopathy, with carbohydrate and low fat diet provided before exercise or sports. 3 Patients with mitochondrial myopathy can take coenzyme Q10, vitamin B, vitamin K, vitamin C, etc. Proper aerobic exercise combined with strength training is safe, and it can also enhance the exercise tolerance of patients effectively. 4 The first choice to treat the endocrine myopathy is treating primary affection. 5 Myopathies due to drugs and toxins should
van Enst, W.A.
Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. Systematic reviews have become the cornerstone of evidence-based medicine, which is reflected in the position systematic reviews have in the pyramid of evidence-based medicine. Systematic
Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…
Objective: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. Methods: The author develops a broader conception of clinical…
JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…
The paper examined information provision in special libraries such as medical libraries. It provides an overview of evidence based practice as a concept for information provision by librarians. It specifically proffers meaning to the term evidence as used in evidence based practice and to evidence based medicine from where ...
Aio’s huisartsgeneeskunde hebben adequate kennis ten aanzien van evidence-based medicine (geneeskunde op basis van bewijs). In de huisartspraktijk is evidence-based gedrag vaak niet direct zichtbaar, maar artsen kunnen wel aangeven op welk aspect van evidence-based medicine de voorgeschreven
More, Frederick G.; Sasson, Lisa M.; Godfrey, Emilie M.; Sehl, Rima B.
The American Dietetic Association and the American Dental Association share a common interest in improving the health and quality of life of the population. Dental visits present an opportunity to identify nutrition-related issues for both the pediatric and adult population. Traditionally, dental and nutrition students have had little opportunity to learn and work together since little time was spent on nutrition in the dental curriculum. The purpose of this article is to describe the development of a new collaborative training experience for dietetic interns and pediatric dentistry residents. The oral health rotation for dietetic interns also has several objectives, including experience interacting with a culturally diverse population and participating in community nutrition education (Head Start). In its first 18 months, the collaborative program has been viewed as a success by the pediatric dentistry faculty and residents and the nutrition faculty and interns. PMID:16639470
The fundamentals of Evidence-Based Medicine (EBM) are the clinical experience, the application of best evidences from research and the consideration of patient expectations. It enabled significant progresses in the management of diseases with a low or multifactorial causality. But it has also led to unintended negative consequences, partly related to conflicts of interest. The objective of this article is to bring the attention back to the scientific rigor that must sustain the medical practice, namely in the occurrence : 1) formulating a question that addresses all the elements of an individual clinical situation; 2) exploring the literature systematically; 3) estimating the degree of confidence in the conclusions of clinical trials. EBM provides intuitive tools to address some uncomfortable concepts of biostatistics and to identify the biases and the embellished data that invalidate many studies. However, it is difficult to decide of the care of a single patient from observations issued from the comparison of'heterogeneous groups. Personalized medicine should help to overcome this difficulty and should facilitate clinical decision making by targeting the patients who are most likely to benefit from an intervention without much inconvenience.
Full Text Available Evidence-based interactive management of change means hands-on experience of modified work processes, given evidence of change. For this kind of pro-active organizational development support we use an organisational process memory and a communication-based representation technique for role-specific and task-oriented process execution. Both are effective means for organizations becoming agile through interactively modelling the business at the process level and re-constructing or re-arranging process representations according to various needs. The tool allows experiencing role-specific workflows, as the communication-based refinement of work models allows for executable process specifications. When presenting the interactive processes to individuals involved in the business processes, changes can be explored interactively in a context-sensitive way before re-implementing business processes and information systems. The tool is based on a service-oriented architecture and a flexible representation scheme comprising the exchange of message between actors, business objects and actors (roles. The interactive execution of workflows does not only enable the individual reorganization of work but also changes at the level of the entire organization due to the represented interactions.
Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman
Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.
Full Text Available I love food. I love cooking, baking, testing, and eating. I read about food preparation, food facts, and food service. Over the years I’ve developed my fair share of knowledge about cooking and I’m a decent cook, but I’m no chef. I guess I’m what you’d call a “foodie”. However, I have the good fortune to have a friend who is a chef and owns one of the best, and certainly the most innovative, restaurants in town. During this summer I hosted a cooking class in my home for my family with my chef friend as instructor. The Tex-Mex barbecue theme was a big hit (you can contact me for recipes, if you like, but much more fascinating was the explanation of the science behind the cooking. It turns out that there is a term for this: molecular gastronomy. Another term, and hence the genesis of my “Eureka!” moment of the summer, is evidence based cooking. Good cooking is not just following a recipe (not all of which are evidence based but at its best is the culmination of heaps of tested information regarding why and how chemical and environmental factors work together to result in a gastronomical delight. For example, will brining or marinating a pork chop make it moister? And, if brining, what temperature should the water be, how long should it soak, and how much salt is needed? Why does pounding meat increase its tenderness? What will keep guacamole from browning better – the pit or lime juice? What does baking soda do in a chocolate cake? Eggs or no eggs in fresh pasta? Like most librarians, I tend not to take information at face value. I want to know where information comes from and whether or not it is valid, based on specific factors. I’ve come to notice that evidence based, or evidence informed, practice is everywhere and has a tremendous impact on our lives. Why do you rotate the tires on your car? Evidence shows that the front tires wear more quickly (think about all those 3-pointturns, the braking, etc and therefore
Full Text Available Hale Zerrin Toklu Department of Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive “medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.” Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs. Keywords: pharmacist, rational use of medicine, pharmacotherapy, pharmaceutical, outcome
Sharma, A; Hasan, K; Carter, A; Zaidi, R; Cro, S; Briggs, T; Goldberg, A
Evidence driven orthopaedics is gaining prominence. It enables better management decisions and therefore better patient care. The aim of our study was to review a selection of the leading publications pertaining to knee surgery to assess changes in levels of evidence over a decade. Articles from the years 2000 and 2010 in The Knee, the Journal of Arthroplasty, Knee Surgery, Sports Traumatology, Arthroscopy, the Journal of Bone and Joint Surgery (American Volume) and the Bone and Joint Journal were analysed and ranked according to guidelines from the Centre for Evidence-Based Medicine. The intervening years (2003, 2005 and 2007) were also analysed to further define the trend. The percentage of high level evidence (level I and II) studies increased albeit without reaching statistical significance. Following a significant downward trend, the latter part of the decade saw a major rise in levels of published evidence. The most frequent type of study was therapeutic. Although the rise in levels of evidence across the decade was not statistically significant, there was a significant drop and then rise in these levels in the interim. It is therefore important that a further study is performed to assess longer-term trends. Recent developments have made clear that high quality evidence will be having an ever increasing influence on future orthopaedic practice. We suggest that journals implement compulsory declaration of a published study's level of evidence and that authors consider their study designs carefully to enhance the quality of available evidence.
Dufour, J-C; Mancini, J; Fieschi, M
The foundation of evidence-based medicine is critical analysis and synthesis of the best data available concerning a given health problem. These factual data are accessible because of the availability on the Internet of web tools specialized in research for scientific publications. A bibliographic database is a collection of bibliographic references describing the documents indexed. Such a reference includes at least the title, summary (or abstract), a set of keywords, and the type of publication. To conduct a strategically effective search, it is necessary to formulate the question - clinical, diagnostic, prognostic, or related to treatment or prevention - in a form understandable by the research engine. Moreover, it is necessary to choose the specific database or databases, which may have particular specificity, and to analyze the results rapidly to refine the strategy. The search for information is facilitated by the knowledge of the standardized terms commonly used to describe the desired information. These come from a specific thesaurus devoted to document indexing. The most frequently used is MeSH (Medical Subject Heading). The principal bibliographic database whose references include a set of describers from the MeSH thesaurus is Medical Literature Analysis and Retrieval System Online (Medline), which has in turn become a subpart of a still more vast bibliography called PubMed, which indexes an additional 1.4 million references. Numerous other databases are maintained by national or international entities. These include the Cochrane Library, Embase, and the PASCAL and FRANCIS databases.
Straus, Sharon E.; McAlister, Finlay A.
Discussions about evidence-based medicine engender both negative and positive reactions from clinicians and academics. Ways to achieve evidence-based practice are reviewed here and the most common criticisms described. The latter can be classified as ”limitations universal to the practice of medicine,” ”limitations unique to evidence-based medicine” and ”misperceptions of evidence-based medicine.” Potential solutions to the true limitations of evidence-based medicine are discussed and areas f...
Doughty, J; Lala, R; Marshman, Z
The popularity of cosmetic surgery has seen a rapid increase recently, with the trend mirrored in dentistry. The Department of Health expressed concerns about the potential for biological and psychosocial harm of these cosmetic procedures. Furthermore, the dental public health implications (DPH) of the growing uptake of cosmetic dental procedures have not been explored. Conduct a scoping review to explore the DPH implications of cosmetic dentistry and identify gaps for future research. A fivestage scoping review was conducted of studies identified using the search terms cosmetic AND dentistry. Data from the studies meeting the inclusion criteria were extracted, collated and summarised into themes. Fifty-seven papers met the inclusion criteria (11 cross-sectional studies, 10 literature reviews and 36 opinion pieces). The DPH implications were summarised into five emergent themes: dento-legal and ethical, marketing, psychosocial, biological and workforce. These themes revealed patients' increased expectations, expanding commercialisation of the profession, psychological risks to vulnerable patients, the iatrogenic consequences of invasive cosmetic dental procedures and workforce implications of the current trends. The scoping review found that existing literature on cosmetic dentistry is predominately anecdotal - professional opinions and discussions. Despite this, our findings demonstrated workforce training and governance implications due to increased demand for cosmetic dentistry. Further empirical research is needed to understand the DPH implications of the increasing demand and uptake of cosmetic dental procedures to guide evidence-based policy to safeguard patients and improve the quality of dental services.
Full Text Available Nanofibrous structures exhibit many interesting features, such as high surface area and surface functionalization and porosity in the range from submicron to nanoscale, which mimics the natural extracellular matrix. In particular, electrospun nanofibers have gained great attention in the field of tissue engineering due to the ease of fabrication and tailorability in pore size, scaffold shape, and fiber alignment. For the reasons, recently, polymeric nanofibers or bioceramic nanoparticle-incorporated nanofibers have been used in dentistry, and their nanostructure and flexibility have contributed to highly promotive cell homing behaviors, resulting in expecting improved dental regeneration. Here, this paper focuses on recently applied electrospun nanofibers in dentistry in the range from the process to the applications.
Deb, Sanjukta; Chana, Simran
Dental caries remains a challenge in the improvement of oral health. It is the most common and widespread biofilm-dependent oral disease, resulting in the destruction of tooth structure by the acidic attack from cariogenic bacteria. The tooth is a heavily mineralised tissue, and both enamel and dentine can undergo demineralisation due to trauma or dietary conditions. The adult population worldwide affected by dental caries is enormous and despite significant advances in caries prevention and tooth restoration, treatments continue to pose a substantial burden to healthcare. Biomaterials play a vital role in the restoration of the diseased or damaged tooth structure and, despite providing reasonable outcomes, there are some concerns with clinical performance. Amalgam, the silver grey biomaterial that has been widely used as a restorative material in dentistry, is currently in throes of being phased out, especially with the Minimata convention and treaty being signed by a number of countries (January 2013; http://mercuryconvention.org/Convention/) that aims to control the anthropogenic release of mercury in the environment, which naturally impacts the use of amalgam, where mercury is a component. Thus, the development of alternative restoratives and restoration methods that are inexpensive, can be used under different climatic conditions, withstand storage and allow easy handling, the main prerequisites of dental biomaterials, is important. The potential for using biologically engineered tissue and consequent research to replace damaged tissues has also seen a quantum leap in the last decade. Ongoing research in regenerative treatments in dentistry includes alveolar ridge augmentation, bone tissue engineering and periodontal ligament replacement, and a future aim is bioengineering of the whole tooth. Research towards developing bioengineered teeth is well underway and identification of adult stem cell sources to make this a viable treatment is advancing; however, this
Recent development of the ultrasonography (US) equipments enables the visualization of fine detail of the surface structure of the face and neck soft tissue. In this article, some studies referring to the clinical usefulness of the US in dentistry in the diagnosis of lymph node metastases, tongue carcinomas, periapical lesions and temporomandibular joint disorders are reviewed. For the early detection of lymph node metastases, follow-up US is recommended at an interval of no more than 1 month...
Nash, D A
Esthetic dentistry has assumed an integral position in the provision of oral health care for society. Esthetics is a branch of philosophy dealing with beauty. Beauty is both enjoyable (subjective and cosmetic), and admirable (objective and definable). Ethics is a branch of philosophy dealing with morality. Morality relates humans to one another in a responsible way using rationality. Dentists assume unique moral duties in presenting themselves to society as being uniquely qualified to care for their oral health. Three principles of ethics relate directly to professional duties in esthetic dentistry: beneficence, autonomy, and justice. These principles have moral force in committing dentists to gain informed consent and to execute therapy in keeping with professional standards of care. Practical application of issues deriving from esthetics and ethics suggests that dentists must be sensitive to esthetics in their diagnosis and treatment planning and that a structured, formal consultation with a patient must be conducted to educate the patient regarding the goals of treatment, alternative therapies, prognosis, and costs. Only through such an effort can dentists gain informed consent. The goal of esthetic dentistry is the achievement of admirable (objective) and enjoyable (subjective) beauty, which is possible only through patient participation in decision making and excellence in technical performance.
Full Text Available Introduction: Dentistry in particular and biomedicine in general have undergone a fundamental transformation over the recent decades, which have been formalized by the Affordable Care Act, 2010. In brief, modern contemporary health care has evolved from procedure-driven and intervention-centered care based on research evidence to the administration and delivery of care that is patient-centered, effectiveness-focused, and that utilizes the best evidence base generated by systematic research synthesis (i.e., evidence-based. The present conceptualization of health care integrates translational research and translational effectiveness, and allows convergence of the multiple specialization fields of biomedicine (e.g., dentistry, internal medicine, and psychiatry as well as the various medical traditions globally (i.e., Western, Ayurvedic, and Chinese medical traditions, etc.. The Hypothesis: Here, we propose the hypothesis that increased literacy of the best evidence base optimizes patient-clinician communication in the current convergent translational health care model including dental care. Evaluation of the Hypothesis: We discuss the salient points of this proposition, and outline the relevance of certain salient convergent patient-centered modalities of health care that intimately intertwine medicine and dentistry.
Frencken, J E
Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.
Flaer, Paul J; Younis, Mustafa Z; Benjamin, Paul L; Al Hajeri, Maha
Dentistry for the underserved is more than an egalitarian social issue--it is a key factor in the health and social progress of our nation. The first signs or manifestations of several diseases such as varicella (i.e., chicken pox and shingles), STDs, and influenza become apparent in the oral cavity. The value of access to quality dentistry is an immeasurable factor in maintaining general medical health of people and fulfilling their psychosocial needs of pain reduction and enhanced cosmetics. In the United States, for the most part, only the middle and upper classes receive non-extraction, restorative, and prosthetic dentistry that is economically within their ability to pay. In addition, uninsured and poverty-level individuals often must face overwhelming long waiting lists, unnecessary referrals, lack of choice, and bureaucratic hurdles when seeking primary dental care. Therefore, it seems pertinent to put forth the question: What are the critical values and beliefs of psychosocial theory that can underscore the practice of dentistry for underserved populations in the United States? The widely employed public health theory, the health belief model (HBM), is applied to evaluate psychosocial factors in dental care for the underserved. The HBM is used to predict and explain behavioral changes in dental health and associated belief patterns. The HBM as applied to dentistry for the underserved predicts self-perceptions of susceptibility and seriousness of dental disease, health status, cues to action, and self-efficacy. Furthermore, patients can make judgments about benefits, costs, and risks of dental treatment. A theoretical approach to dentistry employing the HBM, mediated by values and culture, can provide significant insights into patient thinking, beliefs, and perceptions. These insights can mediate access to and use of primary care dental services by underserved populations. Evidence-based practice (i.e., based on research using the scientific method) has been
This paper reviews Minimally Invasive Dentistry (MID) from a day-to-day dentistry perspective, focusing mostly on cariology and restorative dentistry, even though it embraces many aspects of dentistry. The concept of MID supports a systematic respect for the original tissue, including diagnosis, risk assessment, preventive treatment, and minimal tissue removal upon restoration. The motivation for MID emerges from the fact that fillings are not permanent and that the main reasons for failure are secondary caries and filling fracture. To address these flaws, there is a need for economical re-routing so that practices can survive on maintaining dental health and not only by operative procedures.
Azam, Aftab; Manchanda, Sunny; Thotapalli, Suman; Kotha, Sunil Babu
There are many medical and dental conditions which do not have complete treatment modalities in conventional ways. The botulinum toxin can be used as an alternative treatment modality working through chemo denervation method in many medical and dental conditions. An internet research was done for botulinum toxin used in dentistry and all articles and studies were selected, articles related to dentistry were extracted and summarized. This article explains the basic of botulinum toxin and some of its uses in dentistry. In next parts, the extensive details of its use in dentistry will be dealt with.
Klem, Mary L; Weiss, Patricia M
The implementation of evidence-based practice (EBP) requires acquisition and use of a complex set of skills, including the ability to locate and critically evaluate clinically relevant research literature. In this article, we discuss information resources and tools that may be of value to educators faced with the task of teaching students to search for and evaluate research-based evidence. In addition, we discuss how health sciences librarians, with the use of new models of information instruction and delivery, can work with nursing faculty in developing curricula for training students in EBP.
Spallek, Heiko; Song, Mei; Polk, Deborah E; Bekhuis, Tanja; Frantsve-Hawley, Julie; Aravamudhan, Krishna
Objective The purpose of this study is to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines. Method This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges. Results The most common barriers to implementation are difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems have to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature. Conclusions Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists’ fears need to be addressed. PMID:21093800
Dhar, V; Hsu, K L; Coll, J A; Ginsberg, E; Ball, B M; Chhibber, S; Johnson, M; Kim, M; Modaresi, N; Tinanoff, N
The science of dental materials and restorative care in children and adolescent is constantly evolving, and the ongoing search for ideal restorative materials has led to plethora of research. To provide an evidence base to assist dental practitioners choose appropriate restorative care for children and adolescents. This evidence-based review appraises this literature, primarily between the years 1995-2013, for efficacy of dental amalgam, composites, glass ionomer cements, compomers, preformed metal crowns and anterior esthetic restorations. The assessment of evidence for each dental material was based on a strong evidence, evidence in favor, expert opinion, and evidence against by consensus of the authors. There is varying level of evidence for the use of restorative materials like amalgam, composites, glass ionomers, resin-modified glass-ionomers, compomers, stainless steel crowns and anterior crowns for both primary and permanent teeth. A substantial amount data is available on restorative materials used in pediatric dentistry; however, there exists substantial evidence from systematic reviews and randomized clinical trials and clinicians need to examine and understand the available literature evidence carefully to aid them in clinical decision making.
Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.
Evidence based medicine provides independent, validated advice about treatment options, but does it take sufficient account of individual patients' values to provide them with an optimal health outcome?
Chen, Yu-Chih; Tang, Lee-Chun; Chou, Shin-Shang
Evidence-based practice has been demonstrated to improve quality of care, increase patients' satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice.
Abdelkarim, Ahmad; Sullivan, Donna
The study aimed at evaluating attitudes and perceptions of dental students and faculty toward evidence-based practice, integration of technology and social media, general practitioners' and specialists' scope of practice, and dental practice rewards and disadvantages. A survey instrument was designed with 10 statements rated on a five-point Likert scale (strongly agree to strongly disagree) and an optional comment section. The survey instrument was delivered through SurveyMonkey, whereby 401 students and 182 faculty members from ten U.S. dental schools participated (16% estimated response rate). Null hypotheses regarding the equality between the responses of the two groups were statistically tested using Mann-Whitney U test. Statistical significance was set at .05. Evidence-based practice is positively perceived by both groups, but with significantly higher support by faculty than students (P = 0.002). Both groups agreed that technological advancements are advantageous (P = 0.95), but do not constitute good dentistry and cannot mask poor clinical skills. Students showed higher support for social media than faculty (P = 0.000). Both groups perceived group practices positively. Faculty members showed higher agreement than students toward limitation of dental specialists' practices to their specialties (P = 0.000). Both groups are aware of practice disadvantages, such as increased litigation, health risks, and detriment to the dentist's posture. However, they both perceive dental practice positively despite all these challenges. Students and faculty share generally comparable perspectives toward dental practice. They are both in agreement with evidence-based practice and adoption of technology. They both acknowledge practice limitations. Copyright © 2014 Elsevier Inc. All rights reserved.
Roudebush, Philip; Logan, Ellen; Hale, Fraser A
Successful treatment and prevention of periodontal disease in pet animals requires a multidimensional approach to identify and eliminate exacerbating factors, provide scheduled professional examinations and care, and plan and implement a dental homecare program. Over the years, many therapeutic and preventive interventions have been developed or advocated for periodontal disease, but evidence of efficacy or effectiveness is highly variable. Accordingly, the main objective of this systematic review is to identify and critically appraise the evidence supporting various aspects of homecare for prevention of canine and feline periodontal disease.
Sale, Joanna E M; Amin, Maryam; Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir
Because of qualitative researchers' abilities to explore social problems and to understand the perspective of patients, qualitative research studies are useful to provide insight about patients' fears, worries, goals, and expectations related to dental care. To benefit fully from such studies, clinicians should be aware of some relevant principles of critical appraisal. In this article, the authors present one approach to critically appraise the evidence from a qualitative research study. Critical appraisal involves assessing whether the results are credible (the selection of participants, research ethics, data collection, data analysis), what are these results, and how they can be applied in clinical practice. The authors also examined how the results could be applied to patient care in terms of offering theory, understanding the context of clinical practice, and helping clinicians understand social interactions in clinical care. By applying these principles, clinicians can consider qualitative studies when trying to achieve the best possible results for their own practices. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Abrahamyan, Lusine; Pechlivanoglou, Petros; Krahn, Murray; Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir
In everyday practice, dentists face clinical decisions for which they need to consider both treatment consequences (that is, benefits and harms) and costs. Economic analysis is a study design in which investigators evaluate and compare the costs and consequences of different treatment alternatives within a defined period. A critical appraisal of such studies includes an assessment of the risk of bias, results, and applicability of the study. The authors provide the concepts and guidelines that dentists can apply to critically appraise economic analyses. Dentists who wish to inform their clinical decisions regarding questions that involve both treatment consequences and costs can use these guidelines to understand the different types of economic analyses and to decide what type of economic analyses to search for, as well as to critically appraise any economic analyses identified. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Brignardello-Petersen, Romina; Carrasco-Labra, Alonso; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir
Dental practitioners spend most of their time administering treatments. To ensure that their clinical decisions are informed by the best available evidence, dental practitioners need to be skilled in critically appraising studies addressing therapy issues. Randomized controlled trials offer the optimal study design to inform decisions regarding therapy. The critical appraisal of randomized controlled trials involves assessing the risk of bias, results, and applicability. In this article, the authors present these concepts and provide guidance for this type of appraisal. Dentists who wish to inform their clinical decisions regarding therapy and prevention questions can use these guidelines to decide what type of studies to search, define the specific question of interest to search efficiently for these studies, and critically appraise an article about therapy or prevention. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Brignardello-Petersen, Romina; Carrasco-Labra, Alonso; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir
Questions regarding diagnosis are common in dental practice. Studies in which investigators apply a diagnostic test and a reference standard to all patients and compare their results represent the best type of design to answer these questions. The critical appraisal of these studies includes an assessment of the risk of bias, results, and applicability of the study. The authors provide the concepts and guidelines that dentists can apply to most effectively use articles regarding diagnosis to guide their clinical practice. Dentists who wish to inform their clinical decisions regarding questions related to diagnostic test properties can use these guidelines to decide what type of studies to search, define the specific question of interest to search efficiently for these studies, and critically appraise studies addressing diagnosis. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Duffy, Rosemary; Weaver, Richard G.; Hayes, Kathy L.
The federal general dentistry grant program supports development of new programs and first-year positions in postdoctoral general dentistry education. Since inception, 115 institutions have participated, establishing 59 new programs (88% remain in operation) and 560 new positions (69% of which are still being filled), representing 72% and 77%,…
Undergoing trial are nanoparticle-coated, radioactive sources placed close to or within the tumor to destroy it.. Tissue engineering and dentistry. Potential applications of tissue engineering and stem cell research in dentistry include the treatment of orofacial fractures, bone augmentation, cartilage regeneration of the.
Mihnea Ioan Nicolescu
Full Text Available This review aims to trace the contour lines of regenerative dentistry, to offer an introductory overview on this emerging field to both dental students and practitioners. The crystallized depiction of the concept is a translational approach, connecting dental academics to scientific research and clinical utility. Therefore, this review begins by presenting the general features of regenerative medicine, and then gradually introduces the specific aspects of major dental subdomains, highlighting the progress achieved during the last years by scientific research and, in some cases, which has already been translated into clinical results. The distinct characteristics of stem cells and their microenvironment, together with their diversity in the oral cavity, are put into the context of research and clinical use. Examples of regenerative studies regarding endodontic and periodontal compartments, as well as hard (alveolar bone and soft (salivary glands related tissues, are presented to make the reader further acquainted with the topic. Instead of providing a conclusion, we will emphasize the importance for all dental community members, from young students to experienced dentists, of an early awareness rising regarding biomedical research progress in general and regenerative dentistry in particular.
Saha, R; Malik, P
A number of conditions can lead to aesthetically unacceptable dentitions like dental caries, discoloration, trauma, early loss of teeth, misalignment and any abnormality of shape and size. Today we have a large number of solutions available for aesthetic problems in paediatric dentistry. But the biggest dilemma is: How to choose what is best for a particular patient and that situation? Through this review we try to precisely highlight the various options for aesthetic restorations along with their indications, advantages and disadvantages. A search and analysis of international works on aesthetics in paediatric dentistry is presented. A considerable number of studies have shown that people are more concerned about missing anterior teeth and their replacement than about posterior ones as aesthetics seems to be more important than function. Dental caries, although not life threatening, causes nagging pain and physical as well as psychological discomfort. Nevertheless, it is clear that the condition is complex and multifactorial and hence it is important to review the various approaches available to restore the lost aesthetics.
Lijnen, I; Willems, G
DNA analysis has recently been introduced to forensic dentistry and is now frequently used in identifying individuals or determining the origin of certain tissues. This review reports on teeth and saliva as a source of DNA. Not only the quantity of DNA available for the laboratory is important, but also the quality and purity. Teeth are resistant against extreme circumstances such as temperature, humidity and acidity, which is an important advantage in DNA analysis. Furthermore, an abundance of DNA can be extracted from teeth. Saliva can be obtained in a simple, painless and non-radical way. The double swab method is very effective; DNA recovery is significantly higher with the double swab method compared to the single swab or filter paper method. This review reports on the different techniques used to extract DNA from teeth and saliva, as well as DNA analysis of these samples. The usefulness and advantages of the double swab method for saliva, cryogenic grinding for teeth and the chelex extraction and polymerase chain reaction for both types of samples is also described. DNA analysis has proven its value in forensic dentistry, but ethical and juridical considerations are still a matter of debate and criticism.
Creugers, N H J
This article describes the mutual relations between three important dental concepts. 'Minimal invasive dentistry', 'adhesive dentistry' and the 'dynamic treatment concept' are concepts which have changed restorative dentistry substantially during the last decade. The ultimate goal of restorative dental care, which is the maintenance of a healthy and functional dentition for life, is unchanged and as applicable as ever. To achieve maximal results from applying minimal invasive dentistry, a clear understanding of adhesive dentistry as well as the implications and goals of the dynamic treatment concept is needed. Dentists must realize that as invasiveness of interventions is decreasing, the need for monitoring and aftercare of restorative work is increasing. It is important to involve the patient in this process by providing sufficient information and achieving informed consent.
Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette
Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric...... dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric...... Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out...
Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette
Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out case reports), the publication rate is less than 1 percent--completely out of proportion to the size of the problem dental trauma impose in children.
Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette
dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric...... Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out......Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric...
Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier…
Adams, Susan; McCarthy, Ann Marie
The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…
Prins, David; Ingham, Roger J.
Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…
School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…
Hilbert, Anja; Hoek, Hans W.; Schmidt, Ricarda
Purpose of review: The current systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders. Recent findings: Nine evidence-based clinical treatment guidelines for eating disorders were located through a systematic search. The
Pring, Richard; Thomas, Gary
The book begins with an explication of evidence-based practice. Some of the ideas of its proponents are discussed, including the Campbell Collaboration, and the application to education of Cochrane-style reviews and meta-analyses. The thinking behind evidence-based practice has been the subject of much criticism, particularly in education, and…
Stuart, Richard B.; Lilienfeld, Scott O.
Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. Regrettably, the task force report was largely silent on three critical issues. As a consequence, it omitted much of the evidence necessary for a complete picture of evidence-based…
Background: The principles of evidence-based medicine places case reports in the lower level of the hierarchy of scientific evidence. With the increased advocacy of evidence-based medicine, the survival of the case report has been threatened, prompting several authors to call for its preservation. Materials and methods: ...
To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Obesity is defined as a body mass index (BMI) of at last 30 kg/m(2).() Morbid obesity is defined as a BMI of at least 40 kg/m(2) or at least 35 kg/m(2) with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m(2) has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m(2). An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999-2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25-29.9 kg/m(2)) or obese (BMI ≥ 30 kg/m(2)). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the "normal" range may begin at slightly above 18.5 kg/m(2) and extend into the "overweight" range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their height and under-report their weight
Qiu, Yun-Liang; Peng, Ming-Qi
As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks.
Full Text Available Psychosocial interventions are an essential part of the treatment for people with severe mental illness such as schizophrenia. The criteria regarding what makes an intervention “evidence-based” along with a current list of evidence-based interventions are presented. Although many evidence-based interventions exist, implementation studies reveal that few, if any, are ever implemented in a given setting. Various theories and approaches have been developed to better understand and overcome implementation obstacles. Among these, merging two evidence-based interventions, or offering an evidence-based intervention within an evidence-based service, are increasingly being reported and studied in the literature. Five such merges are presented, along with their empirical support: cognitive behavior therapy (CBT with skills training; CBT and family psychoeducation; supported employment (SE and skills training; SE and cognitive remediation; and SE and CBT.
Ross J. Todd
Full Text Available Objective – This paper provides an overview of progress and developments surrounding evidence based practice in school librarianship, and seeks to provide a picture of current thinking about evidence based practice as it relates to the field. It addresses current issues and challenges facing the adoption of evidence based practice in school librarianship.Methods – The paper is based on a narrative review of a small but growing body of literature on evidence based practice in school librarianship, set within a broader perspective of evidence based education. In addition, it presents the outcomes of a collaborative process of input from 200 school libraries leaders collected at a School Library summit in 2007 specifically to address the emerging arena of evidence based practice in this field.Results – A holistic model of evidence based practice for school libraries is presented, centering on three integrated dimensions of evidence: evidence for practice, evidence in practice, and evidence of practice.Conclusion – The paper identifies key challenges ahead if evidence based school librarianship is to develop further. These include: building research credibility within the broader educational environment; the need for ongoing review and evaluation of the diverse body of research in education, librarianship and allied fields to make quality evidence available in ways that can enable practicing school librarians to build a culture of evidence based practice; development of tools, strategies, and exemplars to use to facilitate evidence based decision-making; and, ensuring that the many and diverse advances in education and librarianship become part of the practice of school librarianship.
Hayashi, Mikako; Haapasalo, Markus; Imazato, Satoshi; Lee, Jae Il; Momoi, Yasuko; Murakami, Shinya; Whelton, Helen; Wilson, Nairn
Oral health is - literally - vital to good general health, not least because the mouth is the sentinel of the body. Dentistry, the Cinderella of health care, faces immense challenges of globalisation. Governments, having spent freely on everything from defence to social security, face mountains of debts which make budget cutbacks essential. Simultaneously, most developed countries have to pay increasing costs of caring for rapidly ageing populations. Dentistry is being pulled two ways: wealthy members of society demand high-end expensive treatment, much of it cosmetic rather than necessary to deal with disease, whereas many millions of poor people in developing countries cannot afford basic dental treatment and may never see a dentist. Too many governments and dentists persist with the expensive and destructive regime of 'drill and fill (and bill)'. International advances in care may not reach the clinician's chair because treatment guidelines and payments are set locally. An international symposium to celebrate Mikako Hayashi becoming Professor of Restorative Dentistry and Endodontology at Osaka University concluded that dentistry should move from an increasingly un-affordable curative model to a cost-effective evidence-based preventive model. The goal is to help people retain healthy natural teeth throughout their lives, as an essential part of enhancing their general health. © 2014 FDI World Dental Federation.
Gupta, Roopali; Ingle, Navin Anand; Kaur, Navpreet; Yadav, Pramod; Ingle, Ekta; Charania, Zohara
Ayurvedic medicine was considered to be world's oldest medical system, which was originated in India dating back over thousands of years. There was a long history regarding plants for the improvement of dental health and oral hygiene. To study various plants and their products as effective medicines in the treatment of various ailments since ancient times. Data were performed in PubMed Central and Cochrane library using MeSH Terms - Dentistry, Herbal Medicine, Periodontitis. A total of 142 relevant articles were found in 2013 and 2014 followed by case reports. Various studies have mentioned the uses of herbs, which are found to be statistically significant in treatment and management of oral diseases. Current researches showed that herbal extracts are effective because of the interaction with specific chemical receptors within the body. Nowadays, there has been a sudden increase in the use of herbal extracts or plant products as an alternative approach to modern day medicines.
Full Text Available Ayurveda is considered as the "science of life," because the ancient Indian system of health care focused views of man and his illness. India has an age-old heritage of traditional herbal medicine. Conventional drugs usually provide effective antibiotic therapy for bacterial infections, but there is an increasing problem of antibiotic resistance and a continuing need for new solutions. Hence, now herbal drugs are being preferred to synthetic antibiotics. ′Triphala′ is a well-known powdered preparation in the Indian system of medicine (ISM. It consists of equal parts of the Emblica officinalis, Terminalia chebula, and Terminalia belerica. Currently, Triphala is being extensively researched for its various therapeutic effects including its anti-caries, antioxidant, anti-collagenase, and anti-microbial activities. The present review will focus on the comprehensive appraisal of Triphala and its several applications in dentistry.
Packard, Thomas; Shih, Amber
Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.
Full Text Available Evidence-based health care informs clinicians of choices regarding the most effective care based on the best available research evidence. However, concepts or instruments of evidence-based medicine are still fragmented for most clinicians. Substantial gaps between evidence and clinical practice remain. A knowledge translation roadmap may help clinicians to improve the quality of care by integration of various concepts in evidence-based health care. Improving research transparency and accuracy, conducting an updated systematic review, and shared decision making are the key points to diminish the gaps between research and practice.
Kessel, Line; Erngaard, Ditte; Flesner, Per
In 2013, the Danish Health and Medicines Authorities published a National Clinical Guideline on the treatment of age-related cataracts. The guideline provided evidence-based recommendations on the indication for cataract surgery, cataract surgery in patients with age-related macular degeneration...... medicine. Thus, evidence-based guidelines do change practice patterns unless they are counteracted by the reimbursement system....... likely to prescribe non-steroidal anti-inflammatory eye drops and to not prescribe topical antibiotic eye drops after the guideline was published. Other parameters, most notably the use of toric IOLs and use of postoperative examinations were more guided by reimbursement standards than by evidence-based...
Kowalski, Evan.; Chung, Kevin C.
Synopsis Evidence based medicine is analyzed from its inception. The authors take the reader through the early formation of ‘scientific medicine’ that has evolved into the multi-purpose tool it has become today. Early proponents and their intentions that sparked evidence base and outcomes are presented: the work of David Sackett, Brian Haynes, Peter Tugwell, and Victor Neufeld is discussed - how they perceived the need for better clinical outcomes that led to a more formalized evidence based practice. The fundamentals are discussed objectively in detail and potential flaws are presented that guide the reader to deeper comprehension. PMID:23506764
Garrocho-Rangel, J A; Ruiz-Rodríguez, M S; Pozos-Guillén, A J
The purpose of this report was to provide the reader with some basic concepts in order to better understand the significance and reliability of the results of any article on Pediatric Dentistry. Currently, Pediatric Dentists need the best evidence available in the literature on which to base their diagnoses and treatment decisions for the children's oral care. Basic understanding of Biostatistics plays an important role during the entire Evidence-Based Dentistry (EBD) process. This report describes Biostatistics fundamentals in order to introduce the basic concepts used in statistics, such as summary measures, estimation, hypothesis testing, effect size, level of significance, p value, confidence intervals, etc., which are available to Pediatric Dentists interested in reading or designing original clinical or epidemiological studies.
Khurshid, Zohaib; Zohaib, Sana; Najeeb, Shariq; Zafar, Muhammad Sohail; Rehman, Rabia; Rehman, Ihtesham Ur
Applications of proteomics tools revolutionized various biomedical disciplines such as genetics, molecular biology, medicine, and dentistry. The aim of this review is to highlight the major milestones in proteomics in dentistry during the last fifteen years. Human oral cavity contains hard and soft tissues and various biofluids including saliva and crevicular fluid. Proteomics has brought revolution in dentistry by helping in the early diagnosis of various diseases identified by the detection of numerous biomarkers present in the oral fluids. This paper covers the role of proteomics tools for the analysis of oral tissues. In addition, dental materials proteomics and their future directions are discussed.
Kwon, Ho-Beom; Park, Young-Seok; Han, Jung-Suk
Augmentation reality technology offers virtual information in addition to that of the real environment and thus opens new possibilities in various fields. The medical applications of augmentation reality are generally concentrated on surgery types, including neurosurgery, laparoscopic surgery and plastic surgery. Augmentation reality technology is also widely used in medical education and training. In dentistry, oral and maxillofacial surgery is the primary area of use, where dental implant placement and orthognathic surgery are the most frequent applications. Recent technological advancements are enabling new applications of restorative dentistry, orthodontics and endodontics. This review briefly summarizes the history, definitions, features, and components of augmented reality technology and discusses its applications and future perspectives in dentistry.
Green, James; Weiss, Adam; Stern, Avichai
Advances in technology are changing the ways that patients experience dental treatment. Technology helps to decrease treatment time and makes the treatment more comfortable for the patient. One technological advance is the use of lasers in dentistry. Lasers are providing more efficient, more comfortable, and more predictable outcomes for patients. Lasers are used in all aspects of dentistry, including operative, periodontal, endodontic, orthodontic, and oral and maxillofacial surgery. Lasers are used for soft and hard tissue procedures in the treatment of pathologic conditions and for esthetic procedures. This article discusses how lasers work and their application in the various specialties within dentistry. Copyright © 2011 Elsevier Inc. All rights reserved.
Michael, O S
The book appraised in this edition of Chronicles of Medical History, History of Dentistry in Nigeria, is a product of many years of painstaking research. The Author, Professor Eyitope Ogunbodede, has put together an excellent book that is a great work of art. Dentistry is one of the first specialties in medicine with a very long history; evidence of periodontal disease has been traced back to at least 100, 000 years in human remains. However, the book by Professor Ogunbodede is the first comprehensive record of the History of dentistry in Nigeria. It is a must-read for every medical professional practicing in Nigeria and a worthy addition to every library.
Dworkin, Robert H.; O'Connor, Alec B.; Backonja, Miroslav
Patients with neuropathic pain (NP) are challenging to manage and evidence-based clinical recommendations for pharmacologic management are needed. Systematic literature reviews, randomized clinical trials, and existing guidelines were evaluated at a consensus meeting. Medications were considered...
”. No evidence provided. Not evidence-based and impractical for a resource .... European Federation of. Neurological Sciences. Task Force. Non-acute headache. EEG is not routinely indicated in the diagnostic evaluation of headache.
Bracke, Paul J; Howse, David K; Keim, Samuel M
...) health sciences programs and to the University Medical Center. Librarians at AHSL collaborated with UA College of Medicine faculty to create an innovative search engine, Evidence-based Medicine (EBM...
Johannsen, Carl Gustav
The article examines problems concerning the introduction and future implementation of evidence-based practice (EBP) in libraries. It includes important conceptual distinctions and definitions, and it reviews the more controversial aspects of EBP, primarely based on experiences from Denmark...
Abstract. This paper will explore the role of evidence-based medicine in ethical practice of health care professionals. It will also address some of its limitations and potential for negative impact on health care.
Ubbink, Dirk T.; Brölmann, Fleur E.; Go, Peter M. N. Y. H.; Vermeulen, Hester
Significance: Large variation and many controversies exist regarding the treatment of, and care for, acute wounds, especially regarding wound cleansing, pain relief, dressing choice, patient instructions, and organizational aspects. Recent Advances: A multidisciplinary team developed evidence-based
Falzon, Louise; Davidson, Karina W.; Bruns, Daniel
There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down questions into searchable statements, and adapting statements to suit both the question being asked and the resource being searched. A number of free, evidence-based resources are listed. Knowing how and where to access this information will enable practitioners to more easily use an evidence-based approach to their practice. PMID:21503266
Christina Ouzouni; Konstantinos Nakakis
Despite the fact that nursing research has been developed in Greece, nevertheless the provision of nursing care is not based on current research findings, but rather on the knowledge gained by nurses during their undergraduate education. The transition of medicine in the last decade towards evidence based practice had definitely an impact on the nursing profession.The aim of this article is to briefly present evidence based nursing as a process and perspective to Greek nurses.Method: A litera...
Joshi, G P; Neugebauer, E A M; Kehlet, Henrik
Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidence-based pain therapy has not been described. The aim of this systematic review was to evaluate the available literature on the management of pain after haemorrhoidal surgery.......Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidence-based pain therapy has not been described. The aim of this systematic review was to evaluate the available literature on the management of pain after haemorrhoidal surgery....
Newhouse, Robin P; Dearholt, Sandi; Poe, Stephanie; Pugh, Linda C; White, Kathleen M
Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university.
Kehlet, Henrik; Wilkinson, Roseanne C; Fischer, H Barrie J; Camu, Frederic
Existing general guidelines for perioperative pain management do not consider procedure-specific differences in analgesic efficacy or applicability of a given analgesic technique. For the clinician, an evidence-based, procedure-specific guideline for perioperative pain management is therefore desirable. This chapter reviews the methodology and results of a public web site (www.postoppain.org) which provides information and recommendations for evidence-based procedure-specific postoperative pain management.
Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin
Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715
Oude Rengerink, K
This thesis presents a number of research projects centred on ‘evidence-based medicine’. It consists of two parts. Part 1 focuses on improving recruitment of the necessary number of patients in clinical trials, as this is the major problem while evaluating the effectiveness of interventions in health care. To improve our understanding of patient recruitment we tried to identify obstacles and facilitators for successful recruitment. Part 2 focuses on improving integration of evidence-based dec...
Falzon, Louise; Davidson, Karina W.; Bruns, Daniel
There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down q...
Wampold, Bruce E.; Goodheart, Carol D.; Levant, Ronald F.
Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in…
Mihalic, Sharon F; Elliott, Delbert S
There is a growing demand for evidence-based programs to promote healthy youth development, but this growth has been accompanied by confusion related to varying definitions of evidence-based and mixed messages regarding which programs can claim this designation. The registries that identify evidence-based programs, while intended to help users sift through the findings and claims regarding programs, has oftentimes led to more confusion with their differing standards and program ratings. The advantages of using evidence-based programs and the importance of adopting a high standard of evidence, especially when taking programs to scale,are described. One evidence-based registry is highlighted--Blueprints for Healthy Youth Development hosted at the University of Colorado Boulder. Unlike any previous initiative of its kind, Blueprints established unmatched standards for identifying evidence-based programs and has acted in a way similar to the FDA--evaluating evidence, data and research to determine which programs meet their high standard of proven efficacy. Published by Elsevier Ltd.
Olivi, G; Genovese, M D
The idea of substituting a drill with a laser light, has led to its introduction in dentistry. Besides being more accepted to patients, in paediatric dentistry the laser has demonstrated safety compared with rotating instruments. A review of the past 20 years of the dental literature concerning laser use in dentistry, including paediatric dentistry was completed. The findings of that review are presented. The various types of lasers and their uses for caries detection, tooth sealing and caries removal are described. Laser caries detection demonstrated a good reproducibility, reliability and predictability to monitor the caries process over time. Erbium lasers have been found to be efficient for caries removal, tooth cleaning and decontamination. The laser erbium technology represents a safe device to effectively and selectively remove carious tissues from decayed teeth. For children, all the recognized advantages of this technique play a decisive role in the successful day-to-day treatment of dental caries.
Malamed, S F
One hundred and fifty years ago, Horace Wells opened the door to local anesthetics. Since then, many advances have been made in pain control. The development of dentistry's most important drugs is highlighted here.
Karumuri, Sunil Kumar; Rastogi, Trisha; Beeraka, Kartheeki; Penumatcha, Mohan Raju; Olepu, Sanjeeva Rao
An ultrasound (US) gives a visible image of the organs that are present inside the body. In medicine it serves for diagnosing and also its therapeutic benefits are well established for bone healing, osteointegration and soft tissue healing. In dentistry it is widely used for diagnostic purposes. When it was discovered it was introduced for therapeutic purposes, but due to lack of clinical studies its use as therapy was remittent in dentistry. The aim of the present paper was to establish the ...
Guzmán-Álvarez, R; Medeiros, M; Lagunes, LI Reyes; Campos-Sepúlveda, AE
R Guzmán-Álvarezv,1 M Medeiros,2,3 LI Reyes Lagunes,4 AE Campos-Sepúlveda11Pharmacology Department, UNAM School of Medicine and Dentistry, Mexico City, 2Pharmacology Clinical Seminar, UNAM School of Medicine, Mexico City, 3Medical Sciences Department, Mexico Federico Gómez Children's Hospital, Mexico City, 4Measuring and Evaluation Unit, UNAM School of Psychology, Mexico City, MexicoBackground: Students in schools of dentistry attend to pati...
Hamed Mortazavi; Maryam Baharvand; Maede Mokhber-Dezfuli; Niloofar Rostami-Fishomi; Maryam Doost-Hoseini; Orkideh Alavi-Chafi; Shalaleh Nourshad
Introduction: Lasers are used in various disciplines in dentistry such as restorative dentistry, endodontics, periodontics, pedodontics, and oral and maxillofacial surgery. Despite many advantages of dental lasers, this method might have some adverse effects. The aim of this review article is to debate about the impacts of lasers on orodental tissues. Methods: An electronic search was accomplished using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and ...
Paradella, Thaís Cachuté; Unesp-FOSJC; Bottino, Marco Antonio; Unesp-FOSJC
The purpose of this article was to review the usage of Scanning Electron Microscopy (SEM) in dentistry research nowadays, through a careful and updated literature review. By using the key-words Scanning Electron Microscopy and one of the following areas of research in dentistry (Endodontics, Periodontics and Implant), in international database (PubMed), in the year of 2012 (from January to September), a total of 112 articles were found. This data was tabled and the articles were classified ac...
Azam, Aftab; Manchanda, Sunny; Thotapalli, Suman; Kotha, Sunil Babu
There are many medical and dental conditions which do not have complete treatment modalities in conventional ways. The botulinum toxin can be used as an alternative treatment modality working through chemo denervation method in many medical and dental conditions. An internet research was done for botulinum toxin used in dentistry and all articles and studies were selected, articles related to dentistry were extracted and summarized. This article explains the basic of botulinum toxin and some ...
Shah, Naseem; Bansal, Nikhil; Logani, Ajay
Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools, specially imaging methods, have become mandatory. From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the proce...
Rodríguez Lozano, Francisco Javier; Insausti, Carmen Luisa; Iniesta, Francisca; Blanquer, Miguel; Ramírez, María del Carmen; Meseguer, Luis; Meseguer Henarejos, Ana Belén; Marín Atucha, Noemi Teresa; Martínez, Salvador; Moraleda Jiménez, José María
In the last decade, tissue engineering is a field that has been suffering an enormous expansion in the regenerative medicine and dentistry. The use of cells as mesenchymal dental stem cells of easy access for dentist and oral surgeon, immunosuppressive properties, high proliferation and capacity to differentiate into odontoblasts, cementoblasts, osteoblasts and other cells implicated in the teeth, suppose a good perspective of future in the clinical dentistry. However, is necessary advance in...
Kyriakoulis, Konstantinos; Patelarou, Athina; Laliotis, Aggelos; Wan, Andrew C; Matalliotakis, Michail; Tsiou, Chrysoula; Patelarou, Evridiki
The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was
Paravina, Rade D; Ghinea, Razvan; Herrera, Luis J; Bona, Alvaro D; Igiel, Christopher; Linninger, Mercedes; Sakai, Maiko; Takahashi, Hidekazu; Tashkandi, Esam; Perez, Maria del Mar
interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization. The importance of quality control in dentistry is reinforced by increased esthetic demands of patients and dental professionals. © 2015 Wiley Periodicals, Inc.
Rees, Eliot; Sinha, Yashashwi; Chitnis, Abhishek; Archer, James; Fotheringham, Victoria; Renwick, Stephen
Many medical schools teach the principles of evidence-based medicine (EBM) as part of their undergraduate curriculum. Medical students perceive that EBM is valuable to their undergraduate and postgraduate career. Students may experience barriers to applying EBM principles, especially when searching for evidence or identifying high-quality resources. The UK National Institute for Health and Care Excellence (NICE) Evidence Search is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal. Evidence-based medicine workshops were organised and delivered by fourth-year medical students, having first received training from NICE to become NICE student champions. The workshops covered the basic principles of EBM and focused on retrieving EBM resources for study through the NICE Evidence Search portal. The scheme was evaluated using a pre-workshop survey and an 8-12 week post-workshop survey. Self-reported confidence in searching for evidence-based resources increased from 29 per cent before the workshop to 87 per cent after the workshop. Only 1 per cent of students rated evidence-based resources as their first preference pre-workshop, compared with 31 per cent post-workshop. The results show that although many students were aware of evidence-based resources, they tended not to use them as their preferred resource. Despite appreciating the value of evidence-based resources, few students were confident in accessing and using such resources for pre-clinical study. A peer-taught workshop in EBM improved students' confidence with, and use of, evidence-based resources. © 2014 John Wiley & Sons Ltd.
Full Text Available Recent development of the ultrasonography (US equipments enables the visualization of fine detail of the surface structure of the face and neck soft tissue. In this article, some studies referring to the clinical usefulness of the US in dentistry in the diagnosis of lymph node metastases, tongue carcinomas, periapical lesions and temporomandibular joint disorders are reviewed. For the early detection of lymph node metastases, follow-up US is recommended at an interval of no more than 1 month if a “wait-and-see” policy is adopted. US-elastography has a potential to be a promising method offering complementary information to conventional US. In order to determine the appropriate treatment planning of tongue carcinoma (including the prediction of subsequent lymph node metastases, intraoral US should be routinely used as one of the standard technique for the evaluation of the depth of tumor invasion. In the diagnosis of periapical lesions, US can provide useful information about the extent of the lesions and the location of the tooth root apices once the surface cortical bone around the lesion is eroded. Moreover, US is reported to be useful as an alternative imaging technique for visualization of disk position, joint effusion and bone abnormalities for the evaluation of temporomandibular joint disorders.
Bellini, M; Maltoni, O; Gatto, M R; Pelliccioni, G; Checchi, V; Checchi, L
This study evaluated the presence of current and general phobia and anxiety symptoms in periodontology patients just before treatment in relation to specific dental fears and to general health status and quality of life. The study population was all consecutive outpatients attending the Periodontics and Implantology Services, School of Dentistry, University of Bologna, over a 12-month period in 2007. Data collection instruments were psychological questionnaires (State-Trait Anxiety Inventory [STAI]-Y1, Marks-Sheehan Phobia Scale [MSPS], World Health Organization Quality of Life [WHOQOL] short form) plus supplementary items investigating specific dental fears, patient's dental history, and the dentist's clinical assessment of the patient. In all, 250 consecutive patients were recruited. Most (86%) presented with very mild anxiety and phobia symptoms; 13.2% and 13% presented with psychological symptoms of anxiety and phobia, respectively, independently of those subjects with specific dental fears who were significantly younger. The most common dental fears were fear of pain (48.8%) and of receiving an injection (29.9%). The patients' quality of life did not appear to be affected by these fears. In the dental outpatients seeking treatment for moderate-to-severe dental pathology at a university periodontics and implantology clinic and referring good general health and psychosocial functioning, levels of anxiety and phobia were usually low or absent; but when present, they were independent of ascertained specific dental fears.
AlSarheed, Maha A
To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year. Exclusion criteria were articles that did not focus on pediatric dentistry. Twenty studies were included. The most commonly used sedatives were midazolam, followed by ketamine and sufentanil. Onset of action for IN midazolam was 5-15 minutes (min), however, IN ketamine was faster (mean 5.74 min), while both IN sufentanil (mean 20 min) and IN dexmedetomidine (mean 25 min) were slow in comparison. Midazolam was effective for modifying behavior in mild to moderately anxious children, however, for more invasive or prolonged procedures, stronger sedatives, such as IN ketamine, IN sufentanil were recommended. In addition, ketamine fared better in overall success rate (89%) when compared with IN midazolam (69%). Intranasal dexmedetomidine was only used as pre-medication amongst children. While its' onset of action is longer when compared with IN midazolam, it produced deeper sedation at the time of separation from the parent and at the time of anesthesia induction. Intranasal midazolam, ketamine, and sufentanil are effective and safe for conscious sedation, while intranasal midazolam, dexmedetomidine, and sufentanil have proven to be effective premedications.
Patricia da Silva Barbosa
Full Text Available Conservation of deciduous teeth with pulp alterations caused by caries and trauma is a major therapeutic challenge in pediatric dentistry as a result of the internal anatomy and life cycle characteristic. It is essential that the root canal procedures sanitizers have a performance in eliminating bacterial. In this context, antimicrobial photodynamic therapy (PAT is promising and emerging as adjuvant therapy in an attempt to eliminate the microorganisms persistent to chemi-mechanical preparation. Since there is presence of oxygen in cells, photosensitizer activated by light can react with molecules in its vicinity by electrons’ or hydrogen’s transfer, leading to microorganism death. This paper reports the case of 4-year-old patient, female, with early childhood caries. The proposed endodontic treatment incuded chemomechanical treatment allied to PAT in the decontamination of root canals using methylene blue dye 50 μg/mL during 3–5 minutes and 40 J/cm2 as energy density, taking into account the need for tissue penetration and effectiveness of PAT inside the dentinal tubules.
Schwendicke, Falk; Opdam, Niek
Clinical studies should be one main aspect underlying dentists' decision-making towards dental materials. Study design, conduct, analysis and reporting impact on the usefulness of studies. We discuss problems with current studies and highlight areas where improvement might be possible. Based on systematically and non-systematically collected data, we demonstrate where and why current studies in clinical dentistry deliver less-than-optimal results. Lending from general medicine, we suggest ways forward for clinical dental material science. Randomized controlled (efficacy) trials remain a major pillar in dental material science, as they reduce selection bias and, if well-designed and conducted, have high internal validity. Given their costs and limited external validity, alternatives like practice-based or pragmatic controlled trials or observational studies can complement the evidence-base. Prior to conduct, researchers should focus on study comparators and setting (answering questions with relevance to clinical dentistry), and pay attention to statistical power, considering the study aim (superiority or non-inferiority trial), the expected event rate, and attrition. Study outcomes should be chosen on the basis of a core outcome set or, if not available, involving patients and other stakeholders. Studies should be registered a priori, and reporting should adhere to standards. Possible clustering should be accounted for during statistical analysis. Many clinical studies in dental material science are underpowered, and of limited validity and usefulness for daily decision-making. Dental researchers should mirror existing efforts in other medical fields in making clinical studies more valid and applicable, thus contributing to better dental care. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Tinanoff, N; Coll, J A; Dhar, V; Maas, W R; Chhibber, S; Zokaei, L
There has been significant advances in the understanding of preventive restorative procedures regarding the advantages and disadvantages for restorative procedures; the evidence for conservative techniques for deep carious lesions; the effectiveness of pit and fissure sealants; and the evidence for use of resin infiltration techniques. The intent of this review is to help practitioners use evidence to make decisions regarding preventive restorative dentistry in children and young adolescents. This evidence-based review appraises the literature, primarily between the years 1995-2013, on preventive restorative strategies. The evidence was graded as to strong evidence, evidence in favor, or expert opinion by consensus of authors Results: The preventive strategy for dental caries includes individualized assessment of disease progression and management with appropriate preventive and restorative therapy. There is strong evidence that restoration of teeth with incomplete caries excavation results in fewer signs and symptoms of pulpal disease than complete excavation. There is strong evidence that sealants should be placed on pit and fissure surfaces judged to be at risk for dental caries, and surfaces that already exhibit incipient, non-cavitated carious lesions. There is evidence in favor for resin infiltration to improve the clinical appearance of white spot lesions. Substantial evidence exists in the literature regarding the value of preventive dental restorative procedures.
Schaub, R.M.; de Baat, C.
In recent years, a specialization in geriatric dentistry has been established and along with it an educational programme. A specialist in geriatric dentistry is a dentist general practitioner with special knowledge and skills for delivering oral care to frail elderly people. The educational
Schaub, R.M.; Baat, C. de
In recent years, a specialization in geriatric dentistry has been established and along with it an educational programme. A specialist in geriatric dentistry is a dentist general practitioner with special knowledge and skills for delivering oral care to frail elderly people. The educational
Sadeghi-Bazargani, Homayoun; Tabrizi, Jafar Sadegh; Azami-Aghdash, Saber
Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Different database searching methods and also manual search were employed in this study using the search words ('evidence-based' or 'evidence-based medicine' or 'evidence-based practice' or 'evidence-based guidelines' or 'research utilization') and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled. © 2014 John Wiley & Sons, Ltd.
Greenroyd, Fraser L; Hayward, Rebecca; Price, Andrew; Demian, Peter; Sharma, Shrikant
Using a case study of a pharmacy department rebuild in the South West of England, this article examines the use of evidence-based design to improve the efficiency and staff well-being with a new design. This article compares three designs, the current design, an anecdotal design, and an evidence-based design, to identify how evidence-based design can improve efficiency and staff well-being by reducing walking time and distance. Data were collected from the existing building and used to measure the efficiency of the department in its current state. These data were then mapped onto an anecdotal design, produced by architects from interviews and workshops with the end users, and an evidence-based design, produced by highlighting functions with high adjacencies. This changed the view on the working processes within the department, shifting away from a focus on the existing robotic dispensing system. Using evidence-based design was found to decrease the walking time and distance for staff by 24%, as opposed to the anecdotal design, which increased these parameters by 9%, and is predicted to save the department 248 min across 2 days in staff time spent walking. © The Author(s) 2016.
Nguyen, Thi Ngoc Minh; Wilson, Anne
Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association. © 2016 John Wiley & Sons Australia, Ltd.
Full Text Available Global acknowledgement of ecological restoration, as an important tool to complement conservation efforts, requires an effort to increase the effectiveness of restoration interventions. Evidence-based practice is purported to promote effectiveness. A central tenet of this approach is decision making that is based on evidence, not intuition. Evidence can be generated experimentally and in practice but needs to be linked to baseline information collection, clear goals and monitoring of impact. In this paper, we report on a survey conducted to assess practitioners’ perceptions of the evidence generated in restoration practice in South Africa, as well as challenges encountered in building this evidence base. Contrary to a recent assessment of this evidence base which found weaknesses, respondents viewed it as adequate and cited few obstacles to its development. Obstacles cited were mostly associated with planning and resource availability. We suggest that the disparity between practitioners’ perceptions and observed weaknesses in the evidence base could be a challenge in advancing evidence-based restoration. We explore opportunities to overcome this disparity as well as the obstacles listed by practitioners. These opportunities involve a shift from practitioners as users of scientific knowledge and evidence, to practitioners involved in the co-production of evidence needed to increase the effectiveness of restoration interventions.
Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.
Kathleen Packard, PharmD, MS, BCPS
Full Text Available AbstractPurpose: The objective of the study was to compare a traditionally structured journal club with an evidence based structured journal club during an advanced clinical pharmacy rotation and to determine the best utilization that aligns with recent changes to the pharmacy school accreditation standards.Methods: The study included 21 students who completed journal club utilizing the traditional journal club format and 24 students who utilized an evidence based journal club format. Background characteristics, student reported beliefs, and mean critical evaluation skills scores were evaluated and compared in each group.Results: There were no statistically significant differences between the two cohorts in mean overall percentage grade for the activity. Students in the traditional cohort received significantly higher grades for the Study Analysis and Critique section (90.97 + 12.18 versus 81.25 + 11.18, P=0.01 as well as for the Preparedness section (96.11 + 8.03 versus 85.0 + 17.13, P=0.002. Students in the evidence based cohort received statistically superior grades for the Presentation Skills section (96.43 + 6.39 versus 82.47 + 14.12, P=0.0004.Conclusion: An evidence based journal club is a reasonable and effective alternative to the traditionally structured journal club when the primary objective is to assist students in understanding evidence based concepts and to apply current literature to clinical practice.
Gowri, S; Kannan, Sridharan
Evidence-based practice requires clinical trials to be performed. In India, if any clinical trial has to be performed, it has to be registered with clinical trial registry of India. Studies have shown that the report of clinical trials is poor in dentistry. Hence, the present study has been conducted to assess the type and trends of clinical trials being undertaken in dentistry in India over a span of 6 years. All the clinical trials which were registered with the Central Trial Registry of India (CTRI) (www.ctri.nic.in) from January 1, 2007 to March 3, 2014 were evaluated using the keyword "dental." Following information were collected for each of the clinical trials obtained from the search; number of centres (single center/multicentric), type of the institution undertaking the research (government/private/combined), study (observational/interventional), study design (randomized/single blinded/double-blinded), type of health condition, type of participants (healthy/patients), sponsors (academia/commercial), phase of clinical trial (Phase 1/2/3/4), publication details (published/not published), whether it was a postgraduate thesis or not and prospective or retrospective registration of clinical trials, methodological quality (method of randomization, allocation concealment). Descriptive statistics was used for analysis of various categories. Trend analysis was done to assess the changes over a period of time. The search yielded a total of 84 trials of which majority of them were single centered. Considering the study design more than half of the registered clinical trials were double-blinded (47/84 [56%]). With regard to the place of conducting a trial, most of the trials were planned to be performed in private hospitals (56/84 [66.7%]). Most (79/84, 94.1%) of the clinical trials were interventional while only 5/84 (5.9%) were observational. Majority (65/84, 77.4%) of the registered clinical trials were recruiting patients while the rest were being done in healthy
Full Text Available Dimensional changes in the alveolar ridge after extraction often compromises on achieving optimal implant stability and placement of implants in the right prosthodontic positions. These situations demand augmentation of the residual ridge to achieve successful implant placement and long-term survival. Although the available literature speaks of an overabundance of techniques and agents for ridge augmentation, there is a relative paucity of quality evidence to guide the selection of suitable techniques and material. Henceforth, this paper is an endeavor to develop and describe an evidence-based decision pathway for the selection of suitable techniques for various clinical situations. Additionally, a descriptive overview of various techniques and materials is presented.
Mashlah, A M
This cross-sectional questionnaire survey assessed the motives for choosing dentist as a profession among dentistry students at Damascus University, Syrian Arab Republic. A total of 408 undergraduate students (233 males and 175 females) aged 18-23 years were selected randomly from students in the second, third and fourth years of dentistry study. They completed a questionnaire that enquired about their reasons for studying dentistry as well as their sociodemographic characteristics. The number of admissions in females had increased over the 3 years. Most parents of the students were university-educated. The main motivation for choosing dentistry was as a means to achieve personal goals, including getting a good job abroad, having financial independence, and attaining a good reputation. There were significant differences between the sexes with regard to the reasons for choosing dentistry.
Kahler, Bill; Heithersay, Geoffrey S
design of animal experimentation to correctly simulate some dental injuries. Some of the studies employed rigid splinting techniques, which are not representative of current recommendations. Recommended splinting treatment protocols for teeth that have been luxated, avulsed or root-fractured teeth are formulated on the strength of research evidence. Despite the ranking of these studies in this appraisal as low levels of evidence, these recommendations should be considered 'best practice', a core philosophy of evidence-based dentistry.
Schoemaker, Casper G; Smulders, Yvo M
In 1992, the Canadian physician Gordon Guyatt wrote an article that is generally regarded as the starting point of evidence-based medicine (EBM). He described the ideas behind the McMaster residency programme for 'evidence-based practitioners', founded by David Sackett. Eight years later, in 2000, Guyatt concluded that this programme was too ambitious. In a new publication he described most doctors as 'evidence-users'. This editorial marks the transition from an individual to a collective form of EBM, emphasizing the use of evidence-based guidelines. The starting point of this collective form of EBM is not the well-known 1992 paper, but the forgotten editorial in 2000, which was described by Guyatt's colleagues as the capitulation of EBM.
Lee, Catherine M; Hunsley, John
Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills.
Lee, Catherine M; Hunsley, John
Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821
Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the
Määttä, Sylvia; Wallmyr, Gudrun
The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.
Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li
To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor
Schleyer, Titus K L; Thyvalikakath, Thankam P; Spallek, Heiko; Torres-Urquidy, Miguel H; Hernandez, Pedro; Yuhaniak, Jeannie
Measure the adoption and utilization of, opinions about, and attitudes toward clinical computing among general dentists in the United States. Telephone survey of a random sample of 256 general dentists in active practice in the United States. A 39-item telephone interview measuring practice characteristics and information technology infrastructure; clinical information storage; data entry and access; attitudes toward and opinions about clinical computing (features of practice management systems, barriers, advantages, disadvantages, and potential improvements); clinical Internet use; and attitudes toward the National Health Information Infrastructure. The authors successfully screened 1,039 of 1,159 randomly sampled U.S. general dentists in active practice (89.6% response rate). Two hundred fifty-six (24.6%) respondents had computers at chairside and thus were eligible for this study. The authors successfully interviewed 102 respondents (39.8%). Clinical information associated with administration and billing, such as appointments and treatment plans, was stored predominantly on the computer; other information, such as the medical history and progress notes, primarily resided on paper. Nineteen respondents, or 1.8% of all general dentists, were completely paperless. Auxiliary personnel, such as dental assistants and hygienists, entered most data. Respondents adopted clinical computing to improve office efficiency and operations, support diagnosis and treatment, and enhance patient communication and perception. Barriers included insufficient operational reliability, program limitations, a steep learning curve, cost, and infection control issues. Clinical computing is being increasingly adopted in general dentistry. However, future research must address usefulness and ease of use, workflow support, infection control, integration, and implementation issues.
The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education.
Lindoerfer, Doris; Mansmann, Ulrich
This paper discusses an evidence-based approach to software requirements engineering. The approach is called evidence-based, since it uses publications on the specific problem as a surrogate for stakeholder interests, to formulate risks and testing experiences. This complements the idea that agile software development models are more relevant, in which requirements and solutions evolve through collaboration between self-organizing cross-functional teams. The strategy is exemplified and applied to the development of a Software Requirements list used to develop software systems for patient registries.
Eldredge, J D
This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).
Stichler, Jaynelle F
The Evidence-Based Design Accreditation and Certification (EDAC) is a professional certification that validates that individuals have a core body of knowledge and experience necessary to lead and engage in an evidence-based design process for healthcare facilities. This bimonthly department expands nurse leaders' knowledge and competencies in health facility design and enables them to lead in design efforts. In this article, the vision and mission of EDAC and specific content are shared to increase nurse leaders' awareness of the certification when interviewing prospective architectural firms or for nurse leaders who aspire to have a career in the healthcare design field.
Evidence-based medicine's (EBM) quantitative methodologies reflect medical science's long-standing mistrust of the imprecision and subjectivity of ordinary descriptive language. However, EBM's attempts to replace subjectivity with precise empirical methods are problematic when clinicians must negotiate between scientific medicine and patients' experience. This problem is evident in the case of bibliotherapy (patient reading as treatment modality), a practice widespread despite its reliance on anecdotal evidence. While EBM purports to replace such flawed practice with reliable evidence-based methods, this essay argues that its aversion to subjective language prevents EBM from effectively evaluating bibliotherapy or making it amenable to clinical and research governance.
Full Text Available History of dentistry in the Central Serbian District of Jagodina has been influenced by traditional medicine for centuries. Development of dentistry in the region of Jagodina was slow, the level of oral and general hygiene was low and the sanitary prevention was absent. Trained physicians started to practice medicine and dentistry in the first half of the nineteenth century and they were educated in abroad universities. However, common people used to address to these physicians only when the traditional medicine were unable to help. Until the end of the World War II, common, mostly rural people, with the urgent dental treatment need were usually referred to the barbers, healers or empirics in the nearby villages rather than the dentists. Medications used for the urgent dental treatment were balsams and solutions made of herbs. After the World War II, the dental technicians who finished special courses started to practice dentistry. In 1947 the Regional Dental Office in Jagodina was opened and in 1955 the first Doctor of Dental Medicine who graduated from the School of Dental Medicine of University of Belgrade was employed. Nowadays, the Department of Dentistry represents is an important and independent part of the Health Care Centre in Jagodina.
Gursoy, Hare; Ozcakir-Tomruk, Ceyda; Tanalp, Jale; Yilmaz, Selçuk
The purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry. A review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords "photodynamic therapy", "dentistry", "periodontology", "oral surgery", and "endodontics". It is anticipated that this overview will create a specific picture in the practitioner's mind regarding the current status and use of PDT. In spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry. PDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.
Paulo Vinícius Soares
Full Text Available Sports Dentistry (SD acts in the prevention, maintenance and treatment of oral and facial injuries, as well as the collection and dissemination of information on dental trauma, beyond stimulus to research. Establishes as a duty for the dentist detect problems related to the athlete’s stomatognathic system. This essay is based on the provided data from the literature related to SD, including definition, practice areas and research fields. To discuss the data, six areas were categorized: shares in sports dentistry; oral health of athlete; sports-related dental implications; dental-facial trauma; face shields; and mouthguards. The analyzed data show that the SD is still an underexplored field of action by dentists, but it is expanding, despite not being recognized specialty by the Federal Council of Dentistry, but the Brazilian Academy of Sports Dentistry has been created with a mission to show the real importance of Dentistry in sport. The dentist should be part of the group of professionals associated with the athlete to perform periodic checks in order to ensure oral health which may contribute to athletes´performance. When impact occurs, however, it would be possible reduce the severity of the impact related to injuries, by using helmets, masks, goggles, face shields and mouthguard. Additionally, it is imperative that dentists, sports coaching, athletes, and professional who work with athletes be aware of the benefits of incorporating SD as an important academic and professional subject.
Embry, Dennis D.; Biglan, Anthony
This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior-influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of…
Cychosz, Chris C.; Phisitkul, Phinit; Barg, Alexej; Nickisch, Florian; van Dijk, C. Niek; Glazebrook, Mark A.
The purpose of this study was to provide a comprehensive review of the current literature on tendoscopy of the foot and ankle and assign an evidence-based grade of recommendation for or against intervention. A comprehensive review of the literature was performed on May 26, 2013, using the PubMed,
Kortekaas, Marlous|info:eu-repo/dai/nl/357299817; Bartelink, Marie Louise|info:eu-repo/dai/nl/100449069
Aan de praktijk van evidence-based medicine (EBM) besteden we in de huisartsopleiding te weinig aandacht. Iedere huisarts die de adviezen uit een NHG-Standaard volgt, of ervan afwijkt, doet aan EBM: het wegen van beschikbare evidence met de eigen ervaring en met de voorkeuren van de patiënt.
Forrest, Jane L.; Miller, Syrene A.
Evidence-based decision making (EBDM) was incorporated into an institute for 42 dental hygiene, occupational therapy, and physical therapy faculty. The 4-day sessions addressed active teaching techniques, formulation of good questions, critical appraisal of evidence, and application, feedback, and evaluation. Most participants felt prepared to…
Evidence-Based Nursing (EBN) permits the highest quality of care in meeting the multifaceted needs of clients using the best available evidence from research findings, expert ideas from specialists in the various health care sectors and feedback from clients. However, in many instances, various challenges need to be ...
Methadone maintenance therapy as evidence based drug abuse planning in developed countries: Can developing countries afford and learn from this experience? ... However, various studies and preventive approaches have been tried in the US on drug abusers in order to prevent the associated adverse health outcomes.
Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 2, 2015. Making Evidence Based Changes on the Labor Ward of Muhima Hospital: Staff Teaching Staff. Jossette Umucyo1, Rondi Anderson1. 1Muhima Hospital, Kigali, Rwanda. Background. In January 2014 it was noted that Muhima hospital was lagging ...
Concept and practice of evidence-based psychiatry and its application in Nigerian psychiatry: a critical review. PO Onifade, LO Oluwole. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 15(1) 2006: 16-19. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny
Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…
The project's three components include: -Build capacity for evidence-based public policy-making and analysis in all three countries through the university's Institute of Public Policy and Administration; -Support a group of regional researchers on issues of mountain economies and natural resource management through the ...
Evidence-based medicine has had a major impact on health care in the last 30 years. This approach has lead to the critical appraisal of therapeutic knowledge. Archie Cochrane, an epidemiologist, gave a series of lectures in 1972 regarding his reflections on the effectiveness and efficiency of health services.1 He ...
Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry
Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.
LIRNEasia seeks to build the capacity of local researchers and policymakers for evidence-based ICT-related interventions in the public policy process. To this end, it undertakes action research on institutional constraints to the effective use of ICTs. The first phase of LIRNEasia was funded under project 103017. The current ...
Evidence-based ICT Policy for Development and Innovation. The cost of access to information and communication technologies (ITCs) in Africa remains the major impediment to the participation of Africans in the networked society. While Africa is the region with the fastest growing number of mobile phone subscribers in the ...
Bates, Joanne; McClure, Janelle; Spinks, Andy
Evidence-based practice is the collection, interpretation, and use of data, such as collection statistics or assessment results, that measure the effectiveness of a library media program. In this article, the authors will present various forms of evidence and show that any library media specialist can use data to make informed decisions that…
Leipzig, Rosanne M.; Wallace, Eleanor Z.; Smith, Lawrence G.; Sullivant, Jean; Dunn, Kathel; McGinn, Thomas
Described and evaluated an interactive course designed to create a cadre of medical school faculty in New York who could integrate evidence-based medicine into their training programs. Findings for representatives of 30 internal medicine residency programs show the usefulness of the regional dissemination model used. (SLD)
Mottonen, Merja; Tapanainen, Paivi; Nuutinen, Matti; Rantala, Heikki; Vainionpaa, Leena; Uhari, Matti
Evidence-based medicine--the process of using research findings systematically as the basis for clinical decisions--can be taught using problem-solving teaching methods. Evaluates whether it was possible to motivate students to use the original literature by giving them selected patient problems to solve. (Author/ASK)
Dean, R; Brennan, M; Ewers, R; Hudson, C; Daly, J M; Baillie, S; Eisler, M C; Place, E J; Brearley, J; Holmes, M; Handel, I; Shaw, D; McLauchlan, G; McBrearty, A; Cripps, P; Jones, P; Smith, R; Verheyen, K
The Royal College of Veterinary Surgeons now lists 'How to evaluate evidence' as a day one competence for newly qualified vets. In this article, representatives from each of the veterinary schools in the UK discuss how the challenge of delivering and assessing the concepts of evidence-based veterinary medicine in a crowded undergraduate curriculum can be met. British Veterinary Association.
Veugelers, R.; van der Ploeg, F.; Dewatripont, M.; Thys-Clément, F.; Wilkin, L.
Universities are key players in the successful transition to a knowledge-based economy and society. However, this crucial sector of society needs restructuring if Europe is not to lose out in the global competition in education, research and innovation. To allow a more evidence based process of
Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.
The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…
Grote, F.K.; Dommelen, P. van; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Verkerk, P.H.; Wit, J.M.; Buuren, S. van
Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population.
David-Ferdon, Corinne; Kaslow, Nadine J.
The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and…
Book Review: Deployment Psychology: Evidence-based strategies to promote mental health in the Military. AB Adler, PD Bliese, CA Castro. Abstract. Washington, DC: American Psychological Association 2011 294 pages ISBN-13: 978-1-4338-0881-4. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
The checklist included the evidence-based clinical practice guidelines for the HD vascular access, HD adequacy, anemia of chronic kidney disease (CKD), nutrition, cardiovascular risk assessment, and hepatitis B and C virus infection control. Implementation of these guidelines was evaluated, and further graded using a ...
Acute otitis externa (AOE), or diffuse inflammation of the external ear canal, causes a range of symptoms, including otalgia, otorrhoea, hearing loss and itching. Despite AOE being common, with a 12-month prevalence of approximately 1%, there is a paucity of evidence-based treatment guidelines. This contributes to a wide ...
Evidence-based medicine - searching the medical literature. Part 1. ... psychological literature, but these are only available on payment of a subscription. Most of ... 2. Component terms (keywords/phrases) children drug resistant malaria treatment. 3. Alternative terms (synonyms) child drug-resistant resistance multidrug.
Examines to what extent the skills and techniques of evidence-based practice are transferable to the areas of professional practice of librarians and information professionals? Is it desirable for information professionals to integrate research findings into their day-to-day decision making?
Schaffner, Angela D.; Buchanan, Linda Paulk
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…
Schroeder, Torben Veith
Evidence-based medicine (EBM) is not a randomised controlled trial (RCT), but EBM seeks to apply evidence gained from scientific methods - which could be RCT - to daily medical practice. Any surgical treatment reflects a certain development technically as well as skills based. The procedure may...
Objectives: The aim of this cross-sectional study was to determine the awareness and attitude of hospital resident doctors towards evidence-based medicine (EBM) and their related educational needs. Methods: A cross-sectional descriptive study was performed on a randomly selected sample of 141 hospital resident ...
Evidence-based medicine (EBM) is a rapidly expanding subject. The aim of this editorial is to give an overview and address some of the practical issues relevant to the developing world. EBM may be defined as the conscientious, explicit and judicious use of current best evidence in making decisions about the care of ...
Regional Educational Laboratory Southeast, 2011
Over the past decade, research on dropout prevention has become focused on using evidence-based practice, and data-driven decisions, to mitigate students' dropping out of high school and instead, support and prepare students for career and college. Early warning systems or on-track indicators, in which readily available student-level data are used…
into the evidence base. Data contributes to develop- ment. Health outcomes can be improved by investing in: □ 17,506 households. □ 203 health facilities. □ 15,606 pregnant women. Data on child health and immunization was gathered from: □ 13,220 households. □ 214 health facilities. □ 22,589 children under the.
This paper is an extension of the author's earlier work on developing management information services and creating a culture of assessment in libraries. The author will focus observations on the use of data in decision-making in libraries, specifically on the role of leadership in making evidence-based decision a reality, and will review new…
Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the ...
Morrow, Michael T.; Lee, Hsin-Hua; Bartoli, Eleonora; Gillem, Angela R.
Evidence-based practice (EBP) is a core priority in counselor education. This paper details one United States' counselor education program's self-assessment of its EBP curriculum. Faculty members collaborated to identify challenges and generate solutions to strengthen the EBP emphasis within the program. This paper is intended as a resource for…
The need to integrate the accrued scientific evidence into clinical orthodontic practice is amongst the challenges facing orthodontists in the 21st century. The evidence-based health care approach aims to improve patient care based upon informed decision-making. This article therefore highlights the importance and ...
This article aims to summarise the available evidence in the wound management of diabetic foot ulcers to promote cost-effective evidence-based practice. Diabetic foot ulcers have a significant impact on the individual patient's quality of life, potential morbidity and even mortality. Diabetic foot ulcers also consume a.
This article aims to summarise the available evidence in the wound management of diabetic foot ulcers to promote cost-effective evidence-based practice. Diabetic foot ulcers have a significant impact on the individual patient's quality of life, potential morbidity and even mortality. Diabetic foot ulcers also consume a ...
Jun 1, 2012 ... Since limited resources are available for life-saving health services in Nigeria, those who plan health programs need to know which interventions are most effective and how to prioritise them. An important objective of the Nigeria Evidence-based Health. System Initiative (NEHSI) is to build the capacity of.
Oude Rengerink, K.
This thesis presents a number of research projects centred on ‘evidence-based medicine’. It consists of two parts. Part 1 focuses on improving recruitment of the necessary number of patients in clinical trials, as this is the major problem while evaluating the effectiveness of interventions in
While research is needed and necessary, promoting the value of evidence-based practice (EBP), quality improvement (QI) and project evaluation (PE) initiatives could rapidly and economically further the development of nursing and midwifery disciplines globally, perhaps especially in resource constrained settings.
Bates, Stacey L.
Fifteen studies of family-school interventions with preschool children conducted between 1980 and 2002, and published in peer-reviewed journals, were reviewed and evaluated according to the criteria developed by the Task Force on Evidence-Based Intervention in School Psychology (Division 16 and Society for the Study of School Psychology Task…
Cook, Bryan G.; Tankersley, Melody; Landrum, Timothy J.
Determining evidence-based practices is a complicated enterprise that requires analyzing the methodological quality and magnitude of the available research supporting specific practices. This article reviews criteria and procedures for identifying what works in the fields of clinical psychology, school psychology, and general education; and it…
Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.
Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…
Full Text Available . In this paper, we report on a survey conducted to assess practitioners’ perceptions of the evidence generated in restoration practice in South Africa, as well as challenges encountered in building this evidence base. Contrary to a recent assessment...
Pozos-Guillén, Amaury; Ruiz-Rodríguez, Socorro; Garrocho-Rangel, Arturo
The main purpose of the second part of this series was to provide the reader with some basic aspects of the most common biostatistical methods employed in health sciences, in order to better understand the validity, significance and reliability of the results from any article on Pediatric Dentistry. Currently, as mentioned in the first paper, Pediatric Dentists need basic biostatistical knowledge to be able to apply it when critically appraise a dental article during the Evidence-based Dentistry (EBD) process, or when participating in the development of a clinical study with dental pediatric patients. The EBD process provides a systematic approach of collecting, review and analyze current and relevant published evidence about oral health care in order to answer a particular clinical question; then this evidence should be applied in everyday practice. This second report describes the most commonly used statistical methods for analyzing and interpret collected data, and the methodological criteria to be considered when choosing the most appropriate tests for a specific study. These are available to Pediatric Dentistry practicants interested in reading or designing original clinical or epidemiological studies.
Lynch, Christopher D; Opdam, Niek J; Hickel, Reinhard; Brunton, Paul A; Gurgan, Sevil; Kakaboura, Afrodite; Shearer, Ann C; Vanherle, Guido; Wilson, Nairn H F
There have been many developments in operative dentistry in recent years, including a progressive shift to the use of resin composites, rather than dental amalgam, in the restoration of posterior teeth. This shift allows the adoption of minimal intervention approaches, thereby helping to conserve and preserve remaining tooth tissues and structures. This paper presents the position of the Academy of Operative Dentistry European Section (AODES) in relation to posterior resin composites. The AODES considers adhesively bonded resin composites of suitable composition and properties to be the "material of choice" for use in direct minimal intervention approaches to the restoration of posterior teeth. In so doing, the AODES emphasises the importance of the practice of evidence-based minimal intervention dentistry, including the use of refurbishment and repair techniques to extend the longevity of restorations. Guidance, based on best available evidence, has been made in relation to certain aspects of resin composite placement techniques in posterior teeth. Copyright © 2014 Elsevier Ltd. All rights reserved.
Shah, Naseem; Bansal, Nikhil; Logani, Ajay
Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools, specially imaging methods, have become mandatory. From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the process simpler and faster but also made image storage, manipulation (brightness/contrast, image cropping, etc.) and retrieval easier. The three-dimensional imaging has made the complex cranio-facial structures more accessible for examination and early and accurate diagnosis of deep seated lesions. This paper is to review current advances in imaging technology and their uses in different disciplines of dentistry. PMID:25349663
Khurshid, Zohaib; Zafar, Muhammad; Qasim, Saad; Shahab, Sana; Naseem, Mustafa; AbuReqaiba, Ammar
Rationalizing has become a new trend in the world of science and technology. Nanotechnology has ascended to become one of the most favorable technologies, and one which will change the application of materials in different fields. The quality of dental biomaterials has been improved by the emergence of nanotechnology. This technology manufactures materials with much better properties or by improving the properties of existing materials. The science of nanotechnology has become the most popular area of research, currently covering a broad range of applications in dentistry. This review describes the basic concept of nanomaterials, recent innovations in nanomaterials and their applications in restorative dentistry. Advances in nanotechnologies are paving the future of dentistry, and there are a plenty of hopes placed on nanomaterials in terms of improving the health care of dental patients. PMID:28787967
Caprioglio, C; Olivi, G; Genovese, M D
Knowledge of the physical characteristics of different laser lights and optical and thermal properties of oral tissues is very important to understand the interaction of dental lasers with biological tissues. Choosing the correct dental laser is crucial to match specific wavelengths with target chromophores of different tissues; this affinity makes laser irradiation selective and therefore minimally invasive. Various types of lasers are used in dentistry, offering a viable alternative to low and high-speed handpieces and surgical blades, and also minimising fear and discomfort of the patient. Lasers can provide innovative and minimally invasive therapies in different branches of dentistry including preventive and restorative dentistry, traumatic injury treatments and surgical procedures. Laser has also biostimulating and anti-inflammatory effects, as well as analgesic effect.
Greig, Vicki; Sweeney, Petrina
Although special care dentistry (SCD) is a fairly recent specialty, the principles and practice of SCD have been developed since the 1980s. Shared care of these patients with general dental practitioners remains vital to ensure that comprehensive care is provided. This article aims to discuss some of the patient groups commonly seen in SCD clinics and give an insight into the varied complex medical and social aspects of care which are managed as part of providing appropriate, safe and holistic care. Many patients who currently fall under the remit of special care dentistry could be treated safely in general dental practice. This article acts as an introduction to special care dentistry for general dental practitioners.
Khurshid, Zohaib; Zafar, Muhammad; Qasim, Saad; Shahab, Sana; Naseem, Mustafa; AbuReqaiba, Ammar
Rationalizing has become a new trend in the world of science and technology. Nanotechnology has ascended to become one of the most favorable technologies, and one which will change the application of materials in different fields. The quality of dental biomaterials has been improved by the emergence of nanotechnology. This technology manufactures materials with much better properties or by improving the properties of existing materials. The science of nanotechnology has become the most popular area of research, currently covering a broad range of applications in dentistry. This review describes the basic concept of nanomaterials, recent innovations in nanomaterials and their applications in restorative dentistry. Advances in nanotechnologies are paving the future of dentistry, and there are a plenty of hopes placed on nanomaterials in terms of improving the health care of dental patients.
Full Text Available Rationalizing has become a new trend in the world of science and technology. Nanotechnology has ascended to become one of the most favorable technologies, and one which will change the application of materials in different fields. The quality of dental biomaterials has been improved by the emergence of nanotechnology. This technology manufactures materials with much better properties or by improving the properties of existing materials. The science of nanotechnology has become the most popular area of research, currently covering a broad range of applications in dentistry. This review describes the basic concept of nanomaterials, recent innovations in nanomaterials and their applications in restorative dentistry. Advances in nanotechnologies are paving the future of dentistry, and there are a plenty of hopes placed on nanomaterials in terms of improving the health care of dental patients.
Shah, Naseem; Bansal, Nikhil; Logani, Ajay
Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools, specially imaging methods, have become mandatory. From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the process simpler and faster but also made image storage, manipulation (brightness/contrast, image cropping, etc.) and retrieval easier. The three-dimensional imaging has made the complex cranio-facial structures more accessible for examination and early and accurate diagnosis of deep seated lesions. This paper is to review current advances in imaging technology and their uses in different disciplines of dentistry.
Ntovas, Panagiotis; Doukoudakis, Spyridon; Tzoutzas, John; Lagouvardos, Panagiotis
Oscillating diamond instruments are considered gentle sources for the removal of demineralized tooth hard tissues and the preparation of cavity angles and margins needed in minimally invasive dentistry. However, there is a question if literature provides enough evidence for their efficacy in restorative dentistry procedures. A literature search until May 2016 was conducted, using PubMed, Scopus, and The Cochrane Central Register of Controlled Trials databases. The quality of the studies was assessed using the recommendation of the Oxford Centre for Evidence-based Medicine. Fifty-five studies were finally included in the study. Of which, 78.2% of them were laboratory studies and only 21.8% were clinical studies. The strength of recommendation was 5 for most of them and D their grade of evidence. Bond strength of adhesives on surfaces prepared with these instruments, effective caries removal and cutting characteristics of the oscillating instruments were the main targets of the studies. Conventional diamond, steel, and chemical vapor deposition diamond tips and systems based on abrasive slurry were the oscillating tips, used in different studies. The strength of recommendation and grade of evidence of the studies were low. Although these devices seem to be useful for many clinical situations, there is a need for more well-structured evidence-based studies with more widely accepted procedures and common devices, to have more meaningful results and conclusions of higher strength. PMID:28729806
Andreea Dana Tudose
technical report of treatment ( labor - price, average duration, satisfaction, relative to direct restoration techniques versus indirect techniques . In conclusion, SWOT analysis can be successfully applied to a better targeting of treatments, applying a plan lines for management in dental treatment units. None of direct techniques can not fit the bioeconomy principles (saves time, money, dental tissue in the short term. All maneuvers efficient in terms of functional aesthetics dentistry win at time saving and lost tooth structure chapter to the cost issue. In the long run costs can be amortized, especially since the restoration increases predictability.
This paper explores the entrepreneurial role of dentists in primary care dentistry. It reviews the changing context of dentistry, not least the reforms being introduced by the health and social care bill. It suggests that this new context will reinforce the need to consider the business side of dental practice, in particular, the importance of quality, creativity and innovation, alongside the importance of meeting the needs of patients. An entrepreneurial approach will be required in order to sustain dental practice in an increasingly competitive environment.
da Silva, Ricardo Henrique Alves; Sales-Peres, Arsenio; de Oliveira, Rogério Nogueira; de Oliveira, Fernando Toledo; Sales-Peres, Sílvia Helena de Carvalho
The established importance of Forensic Dentistry for human identification, mainly when there is little remaining material to perform such identification (e.g., in fires, explosions, decomposing bodies or skeletonized bodies), has led dentists working with forensic investigation to become more familiar with the new molecular biology techniques. The currently available DNA tests have high reliability and are accepted as legal proofs in courts. This article presents a literature review referring to the main studies on Forensic Dentistry that involve the use of DNA for human identification, and makes an overview of the evolution of this technology in the last years, highlighting the importance of molecular biology in forensic sciences. PMID:19089123
Ramos-Gomez, Francisco J
Traditional curricula of pediatric dental residency programs have overemphasized restorative dentistry while failing to give adequate attention to early diagnosis, preventive disease management, risk assessment, cultural competency, advocacy, community partnerships and interprofessional education. The University of California, Los Angeles, Community Health and Advocacy Training Program in Pediatric Dentistry emphasizes these lesser-taught areas, integrating them within a structured education in classical restorative techniques and Commission on Dental Accreditation-approved standards, providing a diverse curriculum and preparing residents for practice in increasingly diverse communities.
One of the most controversial areas of restorative dentistry is the subject of liners and bases. Currently, there is no single protocol, with respect to the use of liners and bases, for clinicians to follow. This article is an in-depth literature review that discusses the use of liners and bases and the types of materials that are available to the restorative dentist. The new emerging concept of minimally invasive dentistry will require new restorative techniques. These changes will require the clinician to reevaluate their use of liners and bases. Other clinical considerations and findings from recent research are discussed. © 2011 Australian Dental Association.
The book appraised in this edition of Chronicles of Medical History, History of Dentistry in Nigeria, is a product of many years of painstaking research. The Author, Professor Eyitope Ogunbodede, has put together an excellent book that is a great work of art. Dentistry is one of the first specialties in medicine with a very long history; evidence of periodontal disease has been traced back to at least 100, 000 years in human remains. However, the book by Professor Ogunbodede is the first comp...
S, Vagish Kumar L
Propolis, known as bee glue, is a wax-cum-resin substance, which is created out of a mix of buds from some trees with the substance secreted from the bee's glands. Its diverse chemical content is responsible for many valuable properties. Multiple applications of propolis have been studied and described in detail for centuries. However, currently available information on propolis is scarce. A literature search in the PubMed database was performed for English language articles, using the search terms propolis, oral health, dentistry, and oral cancer; no restrictions were used for publication dates. The aim of the article was to review propolis and its applications in dentistry including oral cancer.
Butani, Yogita; Levy, Steven M; Nowak, Arthur J; Kanellis, Michael J; Heller, Keith; Hartz, Arthur J; Dawson, Deborah V; Watkins, Catherine A
The purpose of this report was to describe the quantity of published literature and types of studies supporting the use of 4 pediatric dentistry procedures: (1) ferric sulfate pulpotomy; (2) stainless steel crowns; (3) space maintainers; and (4) atraumatic restorative technique (ART). When available, titles and abstracts of reports written in English and published over a 36-year period (1966-2002) concerning these procedures were retrieved from MEDLINE. They were classified using a modified classification scheme that, in addition to the study designs, also considered the 4 dimensions of measuring dental outcomes. The quantity of available literature concerning each dental procedure varied considerably. Even though many reports were published on treatments, only a small proportion of the published literature for each procedure was found to evaluate outcomes, regardless of outcome dimension. Besides outcomes evaluations, studies on techniques, material properties, and review articles comprised a large proportion of the literature. Clinical dimension of outcomes was most commonly studied. Case series and case reports were the most frequently used study designs to report outcomes. The outcomes-related literature to support some of the commonly performed treatments is limited both in quantity and study types. More reports are needed to develop the evidence base to support the commonly performed procedures in pediatric dental practice. Additional analyses reporting of the literature are also needed to assess internal and external validity of the studies.
Hoagwood, Kimberly; Johnson, Jacqueline
Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…
Byiers, Breanne J; Reichle, Joe; Symons, Frank J
Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. The authors discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout. SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders.
Lee, M W L; McPhee, R W; Stringer, M D
The dermatome is a fundamental concept in human anatomy and of major importance in clinical practice. There are significant variations in current dermatome maps in standard anatomy texts. The aim of this study was to undertake a systematic literature review of the available evidence for the distribution of human dermatomes. Particular emphasis was placed on the technique of ascertainment, the location and extent of each dermatome, the number of subjects studied, and methodologic limitations. Our findings demonstrate that current dermatome maps are inaccurate and based on flawed studies. After selecting the best available evidence, a novel evidence-based dermatome map was constructed. This represents the most consistent tactile dermatomal areas for each spinal dorsal nerve root found in most individuals. In addition to highlighting the orderly arrangement, areas of consistency and clinical usefulness of dermatomes, their overlap and variability deserve greater emphasis. This review demonstrates the validity of an evidence-based approach to an anatomical concept.
Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh
The major difference between Iranian traditional medicine and allopathic medicine is in the application of evidence and documents. In this study, criteria for evidence-based practice in Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.
Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke
Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions.
Hajebrahimi, Sakineh; Mostafaie, Ali
The goal of this article is to help develop, disseminate, and evaluate resources that can be used to practice and teach EBM for urology residents and continuing education of urologists to reduce the gap between research and clinical practice. Urology departments should build capacity for residents to shape the future of quality and safety in healthcare through translating evidence into practice. Cutting edge approaches require knowing how to teach Evidence-based urology, to make Bio-statistics easy to understanding and how to lead improvement at every level. The authors shared their experience about ‘what works’ in a surgical department to building an Evidence-based environment and high quality of cares. PMID:22279316
Mokhles, Sahar; Takkenberg, Johanna Jm; Treasure, Tom
Good clinical practice is an amalgamation of personalized medicine with evidence-based medicine in the best interests of patient. Hence, our title uses Boolean operators to indicate that it is [AND] not [OR]. This is the syntax of formal searching for systematic reviews, ensuring that all the evidence is found. Comprehensive evidence-based guidance can thus be formulated. Many residents and fellows around the world, and their chiefs, are now exposed to consensus documents, white papers, levels of appropriateness, and guidelines and are in many jurisdictions expected to comply with them. However, they are the summation of many forms of evidence, each of which has its place, and we consider them in turn in this article. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Vratny, Amy; Shriver, Deb
Nursing administration at a small medical center is developing and implementing an evidence-based practice (EBP) model of care to support a culture of quality care, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth. The purpose of this article is to describe a conceptual model for EBP that addresses how to overcome barriers to implementation. Clinician expertise and values, experience, patient preference and expectation, and caring become grounded in a practice environment that must strive to become rooted in clinical research to evolve into a practice that is evidence-based. Education helps to nourish EBP, but leadership, enthusiasm, mentorship, clinical inquiry, and reflective practice make EBP thrive. The EBP ambassadors branch out to each department to grow journal clubs, EBP Web pages, EBP projects, research utilization projects, and staff-led practice reviews. The fruits are quality patient care and outcomes, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth.
Nüssler, Emil Karl; Eskildsen, Jacob Kjær; Håkonsson, Dorthe Døjbak
Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register...... of Gynecological Surgery we examine factors related to decisions to use mesh. Our results indicate that decisions to use mesh are not evidence based, and cannot be explained neither by FDA safety communications, nor by medical conditions usually assumed to predict its usage. Instead, decisions to use mesh...... are highly influenced by the geographical placement of surgeons. Therfore, decisions to use mesh are boundedly rationality, rather than rational....
Mittman, Brian S
Intensive efforts are under way to improve health care quality and safety throughout the United States and abroad. Many of these efforts use the quality improvement collaborative method, an approach emphasizing collaborative learning and exchange of insights and support among a set of health care organizations. Unfortunately, the widespread acceptance and reliance on this approach are based not on solid evidence but on shared beliefs and anecdotal affirmations that may overstate the actual effectiveness of the method. More effective use of the collaborative method will require a commitment by users, researchers, and other stakeholders to rigorous, objective evaluation and the creation of a valid, useful knowledge and evidence base. Development of this evidence base will require improved conceptions of the nature of quality problems, quality improvement processes, and the types of research needed to elucidate these processes. Researchers, journal editors, and funding agencies must also cooperate to ensure that published evaluations are relevant, comprehensive, and cumulative.
Mitchell, Helen L; Aggett, Peter J; Richardson, David P; Stowell, Julian D
The present report summarises a meeting held by the Food & Health Forum at the Royal Society of Medicine, London, on 27 May 2010. The objective of the meeting was to review the problems associated with the use of evidence-based nutrition and to discuss what constitutes the efficacy for foods and food constituents and how the strength and consistency of the evidence can be assessed and adapted to circumstances in which health claims are to be used on food products. The meeting highlighted the limitations with the present evidence-based nutrition models with the prospect that this may have long-term consequences for nutrition science and ultimately the consumer who may not benefit from new science that could have an impact on health.
Rapp, Amy M.; Bergman, R. Lindsay; Piacentini, John; McGuire, Joseph F.
Obsessive–compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793
Amy M. Rapp
Full Text Available Obsessive–compulsive disorder (OCD is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress.
Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.
Evidence-based medicine (EBM) as a health care practice is being incorporated into education programs across the spectrum of medical education to develop lifelong learning skills and to enhance the practice of evidence-based health care. Since improving the quality of patient care is the ultimate goal of EBM, EBM learning must be integrated with clinical application, and resulted outcomes must be reflected in learning transfer (or EBM practice) within the context of solving patient problems. Different factors may constitute the context or environment in which EBM is learned, practiced, and sustained. However, these contextual factors are seldom considered and examined in the development, implementation, and evaluation of EBM instruction for learners at different levels. This article will introduce several contextual factors as tips and strategies that affect EBM learning and transfer. Also included in the article are recommended practices for designing effective EBM instruction that would contribute to a sustainable change in learner behavior.
Ramandeep Singh Gambhir
Full Text Available Nanotechnology offers advances particularly in each and every field of human activity such as electronics, industry, telecommunications, environmental science, etc., The field of nanotechnology has got remarkable potential that can bring considerable improvements to the human health, enhanced use of natural resources, and reduced environmental pollution. Since 1990s, nanotechnology has been exploited for potential medical and dental applications. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. Dentistry is undergoing yet another change to benefit mankind, this time by transforming itself to the nanodentistry. A variety of nanostructures such as nanorobots, nanospheres, nanofibers, nanorods, etc., have been studied for various applications in dentistry and medicine. Preventive dentistry has also utilized nanodentistry to develop the nanomaterials for inclusion in a variety of oral health-care products. However, due to insufficient evidence on potential hazards on human health and environment, nanotechnology has become a controversial issue. It is documented that nanomaterials can enter the human body through several routes and can pose a threat to human health by interacting with the DNA. The present article focuses on the current status and the future implications of nanotechnology in dentistry.
Richards, N. David, Ed.; Cohen Lois K., Ed.
This bibliographic review of social sciences studies in the field of dentistry is a result of the collaboration of dentists and social and behavioral scientists who volunteered manuscripts to the Commission on Dental Practice of the Federation Dentaire Internationale. The manuscript topics include: (1) social science research on the dental…
The relationship between medicine and dentistry in Nigeria from the time of colonial rule to date is highlighted. Records have shown that medical practice is much older than dental practice and this pioneering advantage in health education enhanced the establishment of the first medical school in Ibadan in 1948. Whereas ...
Background: A previous study has shown that dental practitioners in Benghazi believed that the less prevention-oriented education system is one of the barriers to applying preventive dentistry. Objective: To assess attitudes and perceived competence of the dental graduates in Benghazi towards prevention and early ...
Dostálová, T.; Eliášová, H.; Seydlová, M.; Zvárová, Jana
Roč. 19, č. 9 (2008), s. 926-926 ISSN 0905-7161. [EAO Annual Scientific Meeting /17./. 18.09.2008-20.09.2008, Warsaw] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : forensic dentistry * identification * electronic health record Subject RIV: IN - Informatics, Computer Science
Zvárová, Jana; Dostálová, T.; Hanzlíček, Petr; Teuberová, Z.; Nagy, Miroslav; Pieš, Martin; Seydlová, M.; Eliášová, H.; Šimková, H.
Roč. 47, č. 1 (2008), s. 8-13 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * forensic dentistry Subject RIV: IN - Informatics, Computer Science Impact factor: 1.057, year: 2008
Raggio, D.P.; Camargo, L.B.; Naspitz, G.M.C.C.; Politano, G.T.; Bonifacio, C.C.; Mendes, F.M.; Kierstman, F.
Generally natural rubber latex (NRL) allergy is detected after some exposition to the material. As NRL is commonly found in different materials used daily in dental clinic, the allergy can be manifested in the pediatric dentistry clinic. The first clinical manifestation can be smooth but also
Full Text Available Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided or dynamic (navigated systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias, in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry.
Gulati, Minkle; Anand, Vishal; Salaria, Sanjeev Kumar; Jain, Nikil; Gupta, Shilpi
Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM) technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided) or dynamic (navigated) systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias), in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry.
Tanzania Dental Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (1989) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. AIDS in dentistry. RJ Muya. Abstract. No Abstract. Full Text:.
New York State Education Dept., Albany. Office of the Professions.
The laws, rules and regulations of the New York State Education Department governing dentistry and dental hygiene practice in the state are presented. In addition, the requirements and procedures for obtaining licensure and first registration as a dentist and dental hygienist in New York are discussed. The following chapters are provided: (1)…
Background. Evidence-based medicine is a method that helps physicians find and critically evaluate evidences from the medical literature, and apply the evidences in clinical decision-making. In clinical practice the method supplements core medical skills, clinical experience and emphasizes the importance of clinical research evidence. Evidencebased medicine is characterised by two fundamental principles: first, the scientific evidences alone do not suffice for clinical decision-making, second...
Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin
For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.
Sammut, Mario R.
Background In Malta smoking is widespread and associated with significant morbidity and mortality. Family doctors are well-placed to provide smoking cessation advice to their patients. Objective The aim of this review is to assist family doctors in helping their patients quit smoking by informing them of evidence-based therapies. Method The online Cochrane Database of Systematic Reviews within the Cochrane Library was searched for metaanalyses and systematic reviews related to various smoking...
Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z
It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Narra, Lekha; Sahama, Tony; Stapleton, Peta
Large volumes of heterogeneous health data silos pose a big challenge when exploring for information to allow for evidence based decision making and ensuring quality outcomes. In this paper, we present a proof of concept for adopting data warehousing technology to aggregate and analyse disparate health data in order to understand the impact various lifestyle factors on obesity. We present a practical model for data warehousing with detailed explanation which can be adopted similarly for studying various other health issues.
Visser, Claire; Hadley, Gina; Wee, Bee
There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard’ randomised controlled trials (RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves cons...
Reese, Robert J; Slone, Norah C; Soares, Neelkamal; Sprang, Rob
Families with a child diagnosed with attention-deficit hyperactivity disorder completed an 8-session parenting program, the Group Triple P Positive Parenting Program, provided by videoconferencing technology. Families reported improved child behavior (effect size of d = -1.23) and decreased parent distress (d = -0.34). Parent training implemented with videoconferencing technology can be an effective way of delivering evidence-based services to families with specialized needs. (c) 2012 APA, all rights reserved.
Alireza Moayyeri; Akbar Soltani; Hamideh Moosapour; Mohsin Raza
Physicians all through the world visit patients under time limitations. The most important troubled clinical skill under ?time constraint? is the diagnostic approach. In this situation, clinicians need some diagnostic approaches to reduce both diagnostic time and errors. It seems that highly experienced physicians utilize some special tactics in this regard. Evidence-based medicine (EBM) as a relatively new paradigm for clinical practice stresses on using research evidences in diagnostic eval...
Pagoto, Sherry; Schneider, Kristin; Jojic, Mirjana; DeBiasse, Michele; Mann, Devin
Physicians have limited time for weight-loss counseling, and there is a lack of resources to which they can refer patients for assistance with weight loss. Weight-loss mobile applications (apps) have the potential to be a helpful tool, but the extent to which they include the behavioral strategies included in evidence-based interventions is unknown. The primary aims of the study were to determine the degree to which commercial weight-loss mobile apps include the behavioral strategies included in evidence-based weight-loss interventions, and to identify features that enhance behavioral strategies via technology. Thirty weight-loss mobile apps, available on iPhone and/or Android platforms, were coded for whether they included any of 20 behavioral strategies derived from an evidence-based weight-loss program (i.e., Diabetes Prevention Program). Data on available apps were collected in January 2012; data were analyzed in June 2012. The apps included on average 18.83% (SD=13.24; range=0%-65%) of the 20 strategies. Seven of the strategies were not found in any app. The most common technology-enhanced features were barcode scanners (56.7%) and a social network (46.7%). Weight-loss mobile apps typically included only a minority of the behavioral strategies found in evidence-based weight-loss interventions. Behavioral strategies that help improve motivation, reduce stress, and assist with problem solving were missing across apps. Inclusion of additional strategies could make apps more helpful to users who have motivational challenges. © 2013 American Journal of Preventive Medicine.
Brand, Paul L P
A critical step in the development of evidence based guidelines is the interpretation and weighing-up of the epidemiological evidence. According to the model of human dynamic judgement formation, the personal views, convictions, and choices of the experts developing the guidelines play a part in determining this process. If such views, convictions, and choices are stated explicitly (as is recommended in the GRADE methodology for developing guidelines), physicians are more likely to really follow the guidelines.
Evidence-based practice (EBP) is now the dominant model in health care; its aim is to increase the use of research evidence to inform clinical decision making. Clinical practice guidelines are the predominant method by which research is distilled into practice recommendations. Clinical psychology has its own model which promotes the integration of research evidence with clinical expertise, the scientist practitioner model (SPM). Recent developments within the United Kingdom health service, su...
Ollendick, Thomas H.
Evidence-based practice has a long history; however attempts to bridge the gap between science and practice have been only partially effective and much work remains to be done. Part of the problem has been the unilateral approach associated with dissemination of research findings to clinical practitioners. In this special series, Goldfried and colleagues suggest a two-way bridge, in which practitioners are afforded the opportunity to disseminate their rich clinical experiences to researchers ...
Dea, Nicolas; Fisher, Charles G
Treatment modalities for metastatic spine disease have significantly expanded over the last two decades. This expansion occurred in many different fields. Improvement in surgical techniques and instrumentation now allow the oncologic spine surgeons to effectively circumferentially decompress the neural elements without compromising stability. Percutaneous techniques, both vertebral augmentation and pre-operative endovascular embolization procedures, also greatly benefit patients suffering from spinal column metastasis. Imaging technology advances has contributed to better pre-operative planning and the development of highly conformational radiation techniques, thus permitting the delivery of high-dose radiation to tumors, while avoiding radiotoxicity to the spinal cord and other vital structures. These new developments, combined with evidence-based stability and disease-specific quality of life scores now allow not only better treatment, but also a solid foundation for high-quality research. Spine oncology literature currently suffers from a lack of high-quality evidence due to low prevalence of the disease and complex methodological issues. However, when following evidence-based medicine principles, which incorporate best available evidence, clinical expertise and patient preference, sound, evidence-based recommendations can be made regarding the abovementioned treatment modalities.
Perlstein, P H; Kotagal, U R; Bolling, C; Steele, R; Schoettker, P J; Atherton, H D; Farrell, M K
To describe the effect of implementing an evidence-based clinical practice guideline for the inpatient care of infants with bronchiolitis at the Children's Hospital Medical Center in Cincinnati, Ohio. A multidisciplinary team generated the guideline for infants first-time episode of typical bronchiolitis. The guideline was implemented January 15, 1997, and data on all patients admitted with bronchiolitis from that date through March 27, 1997, were compared with data on similar patients admitted in the same periods in the years 1993 through 1996. Data were extracted from hospital charts and clinical and financial databases. They included LOS and use and costs of resources ancillary to bed occupancy. After implementation of the guideline, admissions decreased 29% and mean LOS decreased 17%. Nasopharyngeal washings for respiratory syncytial virus were obtained in 52% fewer patients. Twenty percent fewer chest radiographs were ordered. There were significant reductions in the use of all respiratory therapies, with a 30% decrease in the use of at least 1 beta-agonist inhalation therapy. In addition, 51% fewer repeated inhalations were administered. Mean costs for all resources ancillary to bed occupancy decreased 37%. Mean costs for respiratory care services decreased 77%. An evidence-based clinical practice guideline for managing bronchiolitis was highly successful in modifying care during its first year of implementation.guideline, bronchiolitis, evidence-based medicine, pediatrics, outcome research.
Martinón-Torres, F; Rodríguez Núñez, A; Martinón Sánchez, J M
Bronchiolitis is the leading cause of lower respiratory tract infection in infants and produces significant morbidity. Limited progress has been made in the treatment of this disease and, in many cases, the therapy employed is controversial and mainly based on general recommendations and not on evidence-based strategies. This report uses evidence-based methodology to provide a critical review of the data available on the treatment of acute bronchiolitis (understood as the first episode of respiratory syncytial virus bronchiolitis in a previously healthy infant). After this analysis, we conclude that the only justifiable therapeutic interventions in these patients are supportive treatment, nebulized epinephrine and mechanical ventilation. Other therapies such us physiotherapy, nebulization, heliox, anticholinergics or exogenous surfactant, among others, require further randomized controlled trials to determine their utility. No evidence supports the routine use of corticosteroids, beta-adrenergic drugs, antibiotics, immunoglobulins, interferon, vitamin A or ribavirin in these patients. Finally, we consider that a national consensus review for the implementation of evidence-based clinical practical guidelines on the management of acute bronchiolitis would be of great interest.
ZHANG, QIANG; YANG, JIE; QIAN, QUN
Rectal cancer is a worldwide disease whose incidence has increased significantly. Evidence-based medicine is a category of medicine that optimizes decision making by using evidence from well-designed and conducted research. Evidence-based medicine can be used to formulate a reasonable treatment plan for newly diagnosed rectal cancer patients. The current review focuses on the application of evidence-based treatment on patients with rectal cancer. The relationship between perioperative blood transfusion and recurrence of rectal cancer after surgery, the selection between minimally invasive laparoscopic surgery and traditional laparotomy, choice of chemotherapy for patients with rectal cancer prior to surgery, selection between stapled and hand-sewn methods for colorectal anastomosis during rectal cancer resection, and selection between temporary ileostomy and colostomy during the surgery were addressed. Laparoscopy is considered to have more advantages but is time-consuming and has high medical costs. In addition, laparoscopic rectal cancer radical resection is preferred to open surgery. In radical resection surgery, use of a stapling device for anastomosis can reduce postoperative anastomotic fistula, although patients should be informed of possible anastomotic stenosis. PMID:26998054
Fernanda Carolina Camargo
Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.
Full Text Available Background. Evidence-based medicine employs systematic searching, evaluation and use of current research findings as the basis for clinical decision-making. However, there are some problems and uncertainties hindering introduction and spreading of the use of the method in clinical practice. Physicians often have no time for literature searching and for use of the method in practice. For certain questions in clinical practice there are no answers in medical literature. Most of the evidences in medical literature are only available in English. Introduction of the method is hampered also by the fact that clinical decision-making is complex and does not allow procedures prescribed in advance. Rigidity and universality of decisions resulting from the evidence may appear impersonal and may affect the relationship between the physician and the patient. Trends towards evidence based medicine are followed also by big multinational pharmaceutical corporations. They carry out large and expensive clinical trials using the results for promotional purposes. In this way, they get the competitive advantage and influence the objectivity of physicians’ clinical decision-making.Conclusions. With introduction of evidence based medicine into clinical practice physicians acquire new information and use a new form of continuing education by following new developments in their field. This way, new findings from medical literature get into clinical practice faster and more efficiently. In addition, physicians get more professional satisfaction and quality in clinical practice is higher.
Full Text Available There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.
Dijkzeul, Dennis; Hilhorst, Dorothea; Walker, Peter
This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the need for evidence-based approaches sometimes is viewed in tension with a principled approach, often unnecessarily. Choosing appropriate research methods depends on the objectives of the researcher, in particular whether the research focuses on the intervention and/or the context and the length and complexity of the causal chains involved. The paper concludes by defining some trends in evidence-based approaches in crises: the move away from inputs and outputs of humanitarian action towards outcomes and impacts; the shift towards a higher degree of partnerships in research, and the participation of users and target groups; and the acceptance of a broad array of approaches to establish evidence. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.
Prudhomme, Michael B; Ropp, Lincoln G; Sauer, Samual W; LaVan, Joseph T
Using concepts from evidence-based medicine, systems theory, and risk assessment, a standardized model was developed to accept or reject medications for use in flight. The model calculates the risk scores of medications, which can then be compared to an organization's acceptable risk tolerance. Risk scores for each medication were established by summing the products of incidence rates and severity scores for all published side effects. The incidence of each side effect was obtained in an evidence-based manner and each assigned a severity multiplier. Using statistical analysis of the calculated risk scores of approved medications, an acceptance control chart was generated. Range of calculated risk scores of historically approved medications was 10-9140. Six Sigma Acceptance Control Line was calculated at 1.5 SDs above the mean and was 9822. Risk score range of medications generally felt unsafe was 27,010-41,294. Risk score range of medications under consideration for approval was 986-6863. This novel approach to medication approval is the first in aerospace medicine to attempt to combine evidence-based medicine, risk analysis, and control charts to standardize and streamline the medication approval process within an organization. The model was validated by testing against medications generally accepted to be unsafe for use in flight. These medications fell several deviations above the control line. Other medications not yet authorized fall well below the acceptance line and could be considered for approval.
Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro
To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.
Chiang, Li-Chi; Liao, Mei-Nan
As clinical scientists on the interdisciplinary healthcare team, nurses use the art and science of current nursing knowledge to provide evidence-based healthcare to each patient and his/her family. Nurses not only comprise the largest contingent of medical personnel and provide 24-hour patient care but are also professional scientists that develop unique nursing knowledge through reflective practice. Five strategies for expanding the body of current evidence-based nursing scientific knowledge include: (1) reflecting empirically on the practice-service domain, (2) developing nursing knowledge using rigorous methodology, (3) emancipating nursing knowledge using innovative transformation, (4) using collaborative interdisciplinary healthcare that is based in patient-centered care, and (5) initiating innovative transformation in nursing education. Nurses are critical healthcare providers that make important contributions to today's healthcare system. Nursing scientists provide frontline, evidence-based transforming care that deserves to be respected and valued on an equal basis with the care and services that are provided by other medical personnel.
Satterfield, Jason M; Spring, Bonnie; Brownson, Ross C; Mullen, Edward J; Newhouse, Robin P; Walker, Barbara B; Whitlock, Evelyn P
Context This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed. PMID:19523122
Full Text Available The practice of "evidence-based medicine" aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the individualised patient care. The clinical genetics evolved from translational genetics research and contributes to the clinical care of patients and families through evidence-based health care in managing inherited disorders through accurate diagnosis, molecular pathology and assessing phenotypic correlations. Translational genetics and genomics research has led to the development of powerful tools for clinical diagnosis, assessing individual's genomic profile for disease prediction/prevention, high-throughput genome-wide screening for predisposition and/or protection to complex medical conditions, and discovery and development of new drugs and vaccines. Gene mapping and deciphering pathogenic mutations have helped in unravelling the basic biological mechanisms leading to new drug discovery and development. Targeted pharmacotherapy is now possible for managing the highly penetrant multi-system dominantly inherited conditions. Notable examples include rapamycin (sirolimus in suppressing the mTOR pathway associated hamartomas in dominantly inherited cancer family syndromes and angiotensin converting enzyme receptor blockers (ACE-RB in preventing aortic dilatation in Marfan syndrome and related familial arteriopathies. The translational genomic research is the essential prerequisite for developing sound evidence-based diagnostic, therapeutic and prognostic clinical protocols for the practice of personalised clinical medicine.
Fardi, Anastasia; Kodonas, Konstantinos; Lillis, Theodoros; Veis, Alexander
Citation analysis is the field of bibliometrics that uses citation data to evaluate the scientific recognition and the influential performance of a research article in the scientific community. The aim of this study was to conduct a bibliometric analysis of the top-cited articles pertaining to implant dentistry, to analyze the main characteristics, and to display the most interesting topics and evolutionary trends. The 100 top-cited articles published in "Dentistry, Oral Surgery, and Medicine" journals were identified using the Science Citation Index Database. The articles were further reviewed, and basic information was collected, including the number of citations, journals, authors, publication year, study design, level of evidence, and field of study. The highly cited articles in implant dentistry were cited between 199 and 2,229 times. The majority of them were published in four major journals: Clinical Oral Implants Research, International Journal of Oral & Maxillofacial Implants, Journal of Clinical Periodontology, and Journal of Periodontology. The publication year ranged from 1981 to 2009, with 45% published in a nine-year period (2001 to 2009). Publications from the United States (29%) were the most heavily cited, followed by those from Sweden (23%) and Switzerland (17%). The University of Göteborg from Sweden produced the highest number of publications (n = 19), followed by the University of Bern in Switzerland (n = 13). There was a predominance of clinical papers (n = 42), followed by reviews (n = 25), basic science research (n = 21), and proceedings papers (n = 12). Peri-implant tissue healing and health (24%), implant success/failures (19.2%), and biomechanical topics (16.8%) were the most common fields of study. Citation analysis in the field of implant dentistry reveals interesting information about the topics and trends negotiated by researchers and elucidates which characteristics are required for a paper to attain a "classic" status. Clinical
Ostlie, Daniel J; St Peter, Shawn D
The efficiency of medical care in the United States has become intensely scrutinized with expectations from patients, families, payors, lawmakers, and, currently, the President. The most effective vehicle to bring more efficient care is the employment of evidence-based medicine whenever possible. Evidence-based medicine is dependent on best evidence, and best evidence is generated from prospective trials. To evaluate current state of evidence based practice in pediatric surgery we reviewed the literature for trials conducted in our field the past 10 years. All randomized controlled trials from January 1999 through December 2009 published in the English literature were identified through a literature search using PubMed (www.pubmed.com). We included only those in pediatric general surgery excluding transplant, oncology, and the other nongeneral subspecialties. The search criteria produced 56 manuscripts, of which 51 described appropriate randomization techniques. A definitive trial design with a sample size calculation was utilized in only 19 studies (34%). A statistically significant difference between treatment arms was identified in 29 of the 56 (52%) trials. There were 26 different journals of publication, with the Journal of Pediatric Surgery being most common (20) followed by Pediatric Surgery International (7). The combined total publications from January 1999 through December 2009 for the 26 journals these randomized trials represent 0.04% of all publications. Appendicitis was the most common condition that was studied (n = 10) followed by pyloric stenosis (n = 4). Trials originated in 19 different countries led by the United States (28%), United Kingdom (14%), and Turkey (12%). There was a generally progressive increase in published trials from 1999 to 2009, however, the percentage of prospective articles published in pediatric surgery was similar to a previous review published in 1999. The current state of evidence-based surgery in pediatric surgery has
Weaver, Robert R
Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.
Aarons, Gregory A; Cafri, Guy; Lugo, Lindsay; Sawitzky, Angelina
Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61-74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.
Rosen, Raymond C; Ruzek, Josef I; Karlin, Bradley E
There is a pressing global need for trained and competent mental health clinicians to deliver evidence-based psychological therapies to millions of trauma survivors in need of care. Three model, large-scale training programs were initiated a decade ago, one in the United Kingdom (U.K.), and two in the United States (U.S.), to disseminate high-quality, evidence-based psychological care to traumatized children and adults in need of assistance. Milestone contributions to implementation science have been made by each of these training programs, although limitations and challenges remain to be considered. In contrast, culturally adapted and simplified PTSD interventions and therapy training programs have also been developed and tested during the past decade, three of which show particular promise for broader implementation. These simplified but evidence-based interventions have been developed for use by lay counsellors or health technicians with minimal or no prior mental health training. Finally, a growing range of technology-based and technology-assisted training models for PTSD providers have also been developed and disseminated in the past decade. This trend is expected to accelerate as more providers become accustomed to acquiring clinical training in this modality or format, although significant barriers to technology-based training will need to be overcome. Copyright © 2016. Published by Elsevier Ltd.
Shreeve, Michael W.
Evidence-based practice has emerged as a driving factor in current curriculum development in chiropractic education. This commentary discusses educational strategies incorporating evidence-based practices in the doctor of chiropractic curriculum and explores whether all five steps of the evidence-based process and patient outcomes from evidence-based practice are being assessed.
Crawford, James M
Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has been given to testing accuracy and precision. Critical examination of the evidence base supporting the clinical use of specific laboratory tests or technologies is a separate endeavor, to which specific attention must be given. In the case of anatomic pathology and more specifically surgical pathology, the expertise required to render a diagnosis is derived foremost from experience, both personal and literature-based. In the first instance, knowledge of the linkage between one's own diagnoses and individual patient outcomes is required, to validate the role of one's own interpretations in the clinical course of patients. Experience comes from seeing this linkage first hand, from which hopefully comes wisdom and, ultimately, good clinical judgment. In the second instance, reading the literature and learning from experts is required. Only a minority of the relevant literature is published in pathology journals to which one may subscribe. A substantial portion of major papers relevant to the practice of anatomic pathology are published in collateral clinical specialty journals devoted to specific disease areas or organs. Active effort is therefore required to seek out the literature beyond the domain of pathology journals. In examining the published literature, the essential question then becomes: Does the practice of anatomic pathology fulfill the tenets of 'evidence-based medicine' (EBM)? If the pinnacle of EBM is 'systematic review of randomized clinical trials, with or without meta-analysis', then anatomic pathology falls far short. Our published
Mary M. Somerville
Full Text Available Objective – In response to unrelenting disruptions in academic publishing and higher education ecosystems, the Informed Systems approach supports evidence based professional activities to make decisions and take actions. This conceptual paper presents two core models, Informed Systems Leadership Model and Collaborative Evidence-Based Information Process Model, whereby co-workers learn to make informed decisions by identifying the decisions to be made and the information required for those decisions. This is accomplished through collaborative design and iterative evaluation of workplace systems, relationships, and practices. Over time, increasingly effective and efficient structures and processes for using information to learn further organizational renewal and advance nimble responsiveness amidst dynamically changing circumstances. Methods – The integrated Informed Systems approach to fostering persistent workplace inquiry has its genesis in three theories that together activate and enable robust information usage and organizational learning. The information- and learning-intensive theories of Peter Checkland in England, which advance systems design, stimulate participants’ appreciation during the design process of the potential for using information to learn. Within a co-designed environment, intentional social practices continue workplace learning, described by Christine Bruce in Australia as informed learning enacted through information experiences. In addition, in Japan, Ikujiro Nonaka’s theories foster information exchange processes and knowledge creation activities within and across organizational units. In combination, these theories promote the kind of learning made possible through evolving and transferable capacity to use information to learn through design and usage of collaborative communication systems with associated professional practices. Informed Systems therein draws from three antecedent theories to create an original
Glober, Nancy K.; Sporer, Karl A.; Guluma, Kama Z.; Serra, John P.; Barger, Joe A.; Brown, John F.; Gilbert, Gregory H.; Koenig, Kristi L.; Rudnick, Eric M.; Salvucci, Angelo A.
Introduction In the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with a suspected stroke and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods We performed a literature review of the current evidence in the prehospital treatment of a patient with a suspected stroke and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the stroke protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were the use of a stroke scale, blood glucose evaluation, use of supplemental oxygen, patient positioning, 12-lead electrocardiogram (ECG) and cardiac monitoring, fluid assessment and intravenous access, and stroke regionalization. Results Protocols across EMS agencies in California varied widely. Most used some sort of stroke scale with the majority using the Cincinnati Prehospital Stroke Scale (CPSS). All recommended the evaluation of blood glucose with the level for action ranging from 60 to 80mg/dL. Cardiac monitoring was recommended in 58% and 33% recommended an ECG. More than half required the direct transport to a primary stroke center and 88% recommended hospital notification. Conclusion Protocols for a patient with a suspected stroke vary widely across the state of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols. PMID:26973735
Gausche-Hill, Marianne; Brown, Kathleen M; Oliver, Zoë J; Sasson, Comilla; Dayan, Peter S; Eschmann, Nicholas M; Weik, Tasmeen S; Lawner, Benjamin J; Sahni, Ritu; Falck-Ytter, Yngve; Wright, Joseph L; Todd, Knox; Lang, Eddy S
The management of acute traumatic pain is a crucial component of prehospital care and yet the assessment and administration of analgesia is highly variable, frequently suboptimal, and often determined by consensus-based regional protocols. To develop an evidence-based guideline (EBG) for the clinical management of acute traumatic pain in adults and children by advanced life support (ALS) providers in the prehospital setting. Methods. We recruited a multi-stakeholder panel with expertise in acute pain management, guideline development, health informatics, and emergency medical services (EMS) outcomes research. Representatives of the National Highway Traffic Safety Administration (sponsoring agency) and a major children's research center (investigative team) also contributed to the process. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to guide the process of question formulation, evidence retrieval, appraisal/synthesis, and formulation of recommendations. The process also adhered to the National Prehospital Evidence-Based Guideline (EBG) model process approved by the Federal Interagency Council for EMS and the National EMS Advisory Council. Four strong and three weak recommendations emerged from the process; two of the strong recommendations were linked to high- and moderate-quality evidence, respectively. The panel recommended that all patients be considered candidates for analgesia, regardless of transport interval, and that opioid medications should be considered for patients in moderate to severe pain. The panel also recommended that all patients should be reassessed at frequent intervals using a standardized pain scale and that patients should be re-dosed if pain persists. The panel suggested the use of specific age-appropriate pain scales. GRADE methodology was used to develop an evidence-based guideline for prehospital analgesia in trauma. The panel issued four strong recommendations regarding patient
Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli
Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a
I respond to Kamhi's (2011) conclusion in his article "Balancing Certainty and Uncertainty in Clinical Practice" that rational or critical thinking is an essential complement to evidence-based practice (EBP). I expand on Kamhi's conclusion and briefly describe what clinicians might need to know to think critically within an EBP profession. Specifically, I suggest how critical thinking is relevant to EBP, broadly summarize the relevant skills, indicate the importance of thinking dispositions, and outline the various ways our thinking can go wrong. I finish the commentary by suggesting that critical thinking skills should be considered a required outcome of our professional training programs.
The workshop titled, National Library of Medicine: Evidence-based Information At Your Fingertips, is a computer training class designed to meet the needs of nurses who require access to information on specific medical topics and on the adverse health effects of exposure to hazardous substances. The Specialized Information Services Division of the National Library of Medicine (NLM) is sponsoring this workshop for the National Black Nurses Association to increase the awareness of health professionals of the availability and value of the free NLM medical, environmental health, and toxicology databases.
Gennari, Rosella; Marenzi, Ivana; Prieta, Fernando; Rodríguez, Juan
Research on Technology Enhanced Learning (TEL) investigates how information and communication technologies can be designed in order to support pedagogical activities. The workshop proceedings collects contributions concerning evidence based TEL systems, like their design following EBD principles as well as studies or best practices that educators, education stakeholders or psychologists used to diagnose or improve their students' learning skills, including students with specific difficulties. The international ebTEL’12 workshop wants to be a forum in which TEL researchers and practitioners alike can discuss ideas, projects, and lessons related to ebTEL. The workshop takes place in Salamanca, Spain, on March 28th-30th 2012.
Mold, James W; Hamm, Robert; Scheid, Dewey
Evidence-based medicine and goal-directed, patient-centered health care seem, at times, like parallel universes, though, at a conceptual level, they are perfectly compatible. Part of the problem is that many of the kinds of information required for decision making in primary care are often unavailable or difficult to find. Several case examples are used to illustrate this problem, and reasons and solutions are suggested. The goal-directed health care model could be helpful for directing the search for evidence that is relevant to the decisions that patients and their primary care physicians must make on a regular basis.
The Montessori educational method has existed for over 100 years, but evaluations of its effectiveness are scarce. This review paper has three aims, namely to (1) identify some key elements of the method, (2) review existing evaluations of Montessori education, and (3) review studies that do not explicitly evaluate Montessori education but which evaluate the key elements identified in (1). The goal of the paper is therefore to provide a review of the evidence base for Montessori education, with the dual aspirations of stimulating future research and helping teachers to better understand whether and why Montessori education might be effective.
Raditic, Donna M; Bartges, Joseph W
Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology. Published by Elsevier Inc.
Saugel, Bernd; Malbrain, Manu L N G; Perel, Azriel
Hemodynamic instability frequently occurs in critically ill patients. Pathophysiological rationale suggests that hemodynamic monitoring (HM) may identify the presence and causes of hemodynamic instability and therefore may allow targeting therapeutic approaches. However, there is a discrepancy between this pathophysiological rationale to use HM and a paucity of formal evidence (as defined by the strict criteria of evidence-based medicine (EBM)) for its use. In this editorial, we discuss that this paucity of formal evidence that HM can improve patient outcome may be explained by both the shortcomings of the EBM methodology in the field of intensive care medicine and the shortcomings of HM itself.
Bilder, Robert M.
Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift towards evidence-based science and practice can be enabled by innovations, including: (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress towards these goals. PMID:21092355
A single 5-6 hours manualized abreactive ego state therapy session has recently been subjected to two placebo-controlled investigations meeting evidence-based criteria. Ego state therapy was found to be a highly effective and durable treatment for posttraumatic stress disorder. Apparently, ego state therapy works because it is emotion focused, activates sub-cortical structures, and because the supportive, interpretive therapist reconstructs the patient's personality to be resilient and adaptive. In this article the author reviews the treatment procedures and presents the findings of both studies.
Bishop, SueZanne Monique
Little research exists linking interview-appropriate attire to improved employment outcomes for women. Thus, it appears that the professional clothing bank has not been investigated as evidence-based practice. To provide preliminary evidence for clothing banks, in this article the author synthesizes findings from existing research on the provision of a professional clothing bank as a means for offering interview-appropriate attire to poor women in job readiness programming. For context, job readiness programs are explored and a case study of one program operating a professional clothing bank is presented. Finally, preliminary considerations for planning and implementing clothing banks based on this literature review are given.
Thomas, Laurie Endicott
Medical students in the United States are taught little about nutrition and dietetics. Worse yet, their training biases them against the studies that show the power of dietary approaches to managing disease. The current approach to evidence-based medicine encourages physicians to ignore any information that does not come from a double-blind, randomized controlled trial. Yet human beings cannot be blinded to a dietary intervention. As a result, physicians are biased toward drug treatments and against dietary interventions for the management of chronic disease. Copyright © 2013 Elsevier Ltd. All rights reserved.
This work aims to deepen our understanding of the role played by technical guidelines and tools for the design, construction and operation of healthcare facilities, ultimately establishing the impact of the physical environment on staff and patient outcomes. Using case studies largely drawn from the UK, Europe, China and Australasia, design approaches such as sustainability (e.g. targets for energy efficiency, carbon neutrality, reduction of waste), evidence-based design (EBD), and Post-Project Evaluation (PPE) are examined in order to identify policies, mechanisms and strategies that can promote an integrated learning environment that in turn supports innovation in healthcare.
The authoritarian standpoint in medicine has been under challenge by various groups and researchers since the 1980s. The challenges have been ethical, political and medical, with patient movements at the forefront. Over the past decade, however, a deep challenge has been posed by evidence-based...... medicine (EBM), which has challenged the entire strategy of medical treatment from the point of view of a self-critical, anti-authoritarian and hereby also (it has been claimed) a more democratic medical practice. Previously, the challenges arose out of the patient rights perspective. EBM, by contrast...
Lystbæk, Christian Tang
, cost-efficiency and measurable quality. Thus, today, evidence-based practice has become an expectation and fashion, often used to emphasize the grounding of practice in research based knowledge that provides measurable evidence for best practice. But at the same time, there is a growing distrust......“Knowledge” is of the utmost significance for professional practice and learning. Today, though, the established knowledge base is changing in all areas of the labour market (Alvesson, 2004). Work and society are dominated by commitment to demands for high levels of demonstrable accountability...
Christiansen, Ole B; Nybo Andersen, Anne-Marie; Bosch, Ernesto
OBJECTIVE: To give an overview of currently used investigations and treatments offered to women with recurrent pregnancy loss (RPL) and, from an evidence-based point of view, to evaluate the usefulness of these interventions. DESIGN: Ten experts on epidemiologic, genetic, anatomic, endocrinologic......, and an extensive investigation for all major factors should always be undertaken. There is an urgent need for agreement concerning the thresholds for detecting what is normal and abnormal, irrespective of whether laboratory tests or uterine abnormalities are concerned. A series of lifestyle factors should...
Vergneau-Grosset, Claire; Larrat, Sylvain
Fish and aquatic invertebrates deserve evidence-based medicine. Pharmacologic information is available; most pharmacokinetic studies are derived from the aquaculture industry and extrapolated to ornamental fish. Conversely, advanced diagnostics and information regarding diseases affecting only ornamental fish and invertebrates require more peer-reviewed experimental studies; the examples of carp edema virus, sea star wasting disease, seahorse nutrition, and gas bubble disease of fish under human care are discussed. Antinociception is also a controversial topic of growing interest in aquatic animal medicine. This article summarizes information regarding new topics of interest in companion fish and invertebrates and highlights some future avenues for research. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Evidence-based polices have important place for the educational development. Monitoring and reporting activities through national and international reports and surveys provide data sources for a comparable education in Europe and make contribution to a more effective policy making process. It is seen that only almost half of the European countries carry out such surveys and reports by the year of 2010/2011 within the context of teaching methods and low achievement in mathematics education. In order to reach to the common educational objectives, systematic data sources are required both in national and international level.
Ucer, T C; Botticelli, D; Stavropoulos, A; Cowpe, J G
Training for dental practitioners in implant dentistry ranges from 1- or 2-day short Continuing Professional Development (CPD) courses to certificate/diploma programmes run by universities. In general, the teaching of implant dentistry in Europe lacks structure and standardisation. This paper aims to: (i) identify the current trends in CPD in implant dentistry in Europe; (ii) identify potential and limitations with regards to the design and implementation of CPD activities in implant dentistry; (iii) provide recommendations on the future structure and development of CPD activities in implant dentistry. A search of the literature was undertaken in PubMed for manuscripts published in English after 2000 reporting on CPD in dentistry and in implant dentistry in particular. In addition, an electronic survey was conducted, investigating the attitudes towards CPD among a wide group of stakeholders in implant dentistry education. There is a wide diversity of educational pathways towards achieving competences in implant dentistry through CPD. At present, there is a need for improving the CPD structures in implant dentistry, strengthening the quality assurance and encouraging standardisation and transparency of the learning outcomes. Development of a structured CPD system with clearly defined educational objectives mapped against specific levels of competence is recommended. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Siddique, Nida; Raza, Hira; Ahmed, Sehrish; Khurshid, Zohaib; Zafar, Muhammad Sohail
Gene therapy holds a promising future for bridging the gap between the disciplines of medicine and clinical dentistry. The dynamic treatment approaches of gene therapy have been advancing by leaps and bounds. They are transforming the conventional approaches into more precise and preventive ones that may limit the need of using drugs and surgery. The oral cavity is one of the most accessible areas for the clinical applications of gene therapy for various oral tissues. The idea of genetic engineering has become more exciting due to its advantages over other treatment modalities. For instance, the body is neither subjected to an invasive surgery nor deep wounds, nor is it susceptible to systemic effects of drugs. The aim of this article is to review the gene therapy applications in the field of dentistry. In addition, therapeutic benefits in terms of treatment of diseases, minimal invasion and maximum outcomes have been discussed.
Full Text Available Gene therapy holds a promising future for bridging the gap between the disciplines of medicine and clinical dentistry. The dynamic treatment approaches of gene therapy have been advancing by leaps and bounds. They are transforming the conventional approaches into more precise and preventive ones that may limit the need of using drugs and surgery. The oral cavity is one of the most accessible areas for the clinical applications of gene therapy for various oral tissues. The idea of genetic engineering has become more exciting due to its advantages over other treatment modalities. For instance, the body is neither subjected to an invasive surgery nor deep wounds, nor is it susceptible to systemic effects of drugs. The aim of this article is to review the gene therapy applications in the field of dentistry. In addition, therapeutic benefits in terms of treatment of diseases, minimal invasion and maximum outcomes have been discussed.
Jabr S. Al-Sanabani
Full Text Available Calcium phosphate materials are similar to bone in composition and in having bioactive and osteoconductive properties. Calcium phosphate materials in different forms, as cements, composites, and coatings, are used in many medical and dental applications. This paper reviews the applications of these materials in dentistry. It presents a brief history, dental applications, and methods for improving their mechanical properties. Notable research is highlighted regarding (1 application of calcium phosphate into various fields in dentistry; (2 improving mechanical properties of calcium phosphate; (3 biomimetic process and functionally graded materials. This paper deals with most common types of the calcium phosphate materials such as hydroxyapatite and tricalcium phosphate which are currently used in dental and medical fields.
Dederich, Douglas N; Bushick, Ronald D
During the last two decades, much has been written in both the scientific literature and the popular press about lasers and their use in the dental office. Both soft- and hard-tissue applications have been discussed, including frenectomy, gingival contouring, caries removal and bleaching. Almost one-third of patients surveyed by the American Dental Association in the late 1990s thought it was very important that their dentists have lasers, which could put pressure on dentists to invest in this tool to attract patients. The authors describe the different types of dental lasers and examine the science behind their applications in dentistry. Although lasers do have legitimate uses in dentistry, they do not take the place of any of the more conventional tools in the dentist's armamentarium. Before investing in a laser, dentists should fully understand the differences between the various types, including what the scientific literature says about their applications.
The oral cavity appears as an open ecosystem, with a dynamic balance between the entrance of microorganisms, colonization modalities, and host defenses aimed to their removal: To avoid elimination, bacteria need to adhere to either hard dental surfaces or epithelial surfaces. The oral biofilm formation and development, and the inside selection of specific microorganisms have been correlated with the most common oral pathologies, such as dental caries, periodontal disease, and peri-implantitis. The mechanical removal of the biofilm and adjunctive use of antibiotic disinfectants or various antibiotics have been the conventional methods for periodontal therapy. Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms, and its application in medicine and dentistry has been indicated for the treatment of 260 different pathologies. The ozone therapy has been more beneficial than present conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment. The exposition of molecular mechanisms of ozone further benefits practical function in dentistry. PMID:22346227
Ian Matos Vieira
Full Text Available The glass ionomer cement was developed in the past century 70s, after continuous researches about silicate cement. Over the years, glass ionomers have been playing an important role on restorative dentistry. Initially, the material was used for restoration of small cavities, however, its usage has been increased. The main indications at present are: as core buildup restorative, luting cement, liner and base and as a sealant. Recently, glass ionomer cement has been used for ART restorations and in some medicine fields because of the positive biointeraction with bone cells. Although glass ionomer cements exhibit an initial critical solubility and poor aesthetics, great biological properties like fluoride release to oral environment, chemical bonding to tooth tissues and biocompatibility leads this material elective for many purposes. Finally, their inherent antimicrobial properties contributes to the treatment of many situations in dentistry.
Full Text Available Emergence of advanced digital technology has opened up new perspectives for design and production in the field of dentistry. Rapid prototyping (RP is a technique to quickly and automatically construct a three-dimensional (3D model of a part or product using 3D printers or stereolithography machines. RP has various dental applications, such as fabrication of implant surgical guides, zirconia prosthesis and molds for metal castings, maxillofacial prosthesis and frameworks for fixed and removable partial dentures, wax patterns for the dental prosthesis and complete denture. Rapid prototyping presents fascinating opportunities, but the process is difficult as it demands a high level of artistic skill, which means that the dental technicians should be able to work with the models obtained after impression to form a mirror image and achieve good esthetics. This review aims to focus on various RP methods and its application in dentistry.
THE ORAL CAVITY APPEARS AS AN OPEN ECOSYSTEM, WITH A DYNAMIC BALANCE BETWEEN THE ENTRANCE OF MICROORGANISMS, COLONIZATION MODALITIES, AND HOST DEFENSES AIMED TO THEIR REMOVAL: To avoid elimination, bacteria need to adhere to either hard dental surfaces or epithelial surfaces. The oral biofilm formation and development, and the inside selection of specific microorganisms have been correlated with the most common oral pathologies, such as dental caries, periodontal disease, and peri-implantitis. The mechanical removal of the biofilm and adjunctive use of antibiotic disinfectants or various antibiotics have been the conventional methods for periodontal therapy. Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms, and its application in medicine and dentistry has been indicated for the treatment of 260 different pathologies. The ozone therapy has been more beneficial than present conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment. The exposition of molecular mechanisms of ozone further benefits practical function in dentistry.
Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C
Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation. PMID:26504385
Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C
Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation.
Mangaiyarkarasi, S. P.; Manigandan, T.; Elumalai, M.; Cholan, Priyanka K.; Kaur, Roopam Pal
Aloe vera (Aloe barbadensis) is a plant that belongs to Liliaceae family. The name Aloe derives from the Arabic word “Alloeh” meaning shining bitter substance while “vera” in Latin means true. It contains various minerals and vitamins. It has got various properties such as immunomodulatory, antiviral and antiinflammatory in nature. A. vera can play a significant role in dentistry in treatment of lichen planus, oral submucous fibrosis, recurrent aphthous stomatitis, alveolar osteitis, periodontitis, etc. PMID:26015726
Brostek, Andrew M; Bochenek, Andrew J; Walsh, Laurence J
The term "Minimal Invasive (MI) Dentistry" can best be defined as the management of caries with a biological approach, rather than with a traditional (surgical) operative dentistry approach. Where operative dentistry is required, this is now carried out in the most conservative manner with minimal destruction of tooth structure. This new approach to caries management changes the emphasis from diagnosing carious lesions as cavities (and a repeating cycle of restorations), to one of diagnosing the oral ecological imbalance and effecting biological changes in the biofilm. The goal of MI is to stop the disease process and then to restore lost tooth structure and function, maximizing the healing potential of the tooth. The thought process which underpins this new minimal invasive approach can be organized into three main categories: (1) Recognize, which means identify patient caries risk, (2) Remineralize, which means prevent caries and reverse non-cavitated caries, and (3) Repair, which means control caries activity, maximize healing and repair the damage. The disease of dental caries is not just demineralization, but a process of repeated demineralization cycles caused by an imbalance in the ecological and chemical equilibrium of the biofilm /tooth interface (the ecological plaque hypothesis). Dietary and lifestyle patterns, especially carbohydrate frequency, water intake and smoking, play an important role in changing the biofilm ecology and pathogenicity. Tools for chairside assessment of saliva and plaque, allow risk to be assessed and patient compliance monitored. The remineralizing properties of saliva can be enhanced using materials which release biologically available calcium, phosphate and fluoride ions (CPP-ACP and CPP-ACFP). Use of biocides can also alter the pathogenic properties of plaque. Use of these MI treatment protocols, can repair early lesions and improve patient understanding and compliance. This review article introduces some of the key concepts
Nida Siddique; Hira Raza; Sehrish Ahmed; Zohaib Khurshid; Muhammad Sohail Zafar
Gene therapy holds a promising future for bridging the gap between the disciplines of medicine and clinical dentistry. The dynamic treatment approaches of gene therapy have been advancing by leaps and bounds. They are transforming the conventional approaches into more precise and preventive ones that may limit the need of using drugs and surgery. The oral cavity is one of the most accessible areas for the clinical applications of gene therapy for various oral tissues. The idea of genetic engi...
Full Text Available Since the 1950s, dentistry's ultrasonic instruments have developed rapidly. Because of better visualization, operative convenience, and precise cutting ability, ultrasonic instruments are widely and efficiently applied in the dental field. This article describes the development and improvement of ultrasonic instruments in several dental fields. Although some issues still need clarification, the results of previous studies indicate that ultrasonic instruments have a high potential to become convenient and efficient dental tools and deserve further development.
F C Peedikayil
Full Text Available Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Most often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains. Dentists want to make their patients well and to prevent unpleasant complications. These desires, coupled with the belief that many oral problems are infectious, stimulate the prescribing of antibiotics. Good knowledge about the indications of antibiotics is the need of the hour in prescribing antibiotics for dental conditions.
Lasers and radiosurgery frequently used in human dentistry are rapidly entering veterinary dental use. The carbon dioxide, diode, and low-level therapy lasers have features including hemostasis control, access to difficult to reach areas, and decreased pain, that make them useful for oral surgery. Periodontal pocket surgery, gingivectomy, gingivoplasty, gingival hyperplasia, operculectomy, tongue surgery, oropharyngeal inflammation therapy, oral mass surgery, crown, and frenectomy laser surgeries are described, including images. Copyright © 2013 Elsevier Inc. All rights reserved.
Barzè, Franco; Palmieri, Beniamino; Scalise, Lorenzo; Rottigni, Valentina
Laser therapy has achieved an important rule in cosmetic dentistry especially in the treatment of several complications such as leukoplakia, oral lichen planus, glossitis, oral mucositis, labial herpes virus, stomatitis, frenulum and oral hemangioma. In our study we enrolled 40 patients affected by these diseases to treat them with a new infrared dental laser demonstrating that it is extremely safe and effective in pain and postoperative discomforts reduction.
Coppa, A; Bondioli, L; Cucina, A; Frayer, D W; Jarrige, C; Jarrige, J-F; Quivron, G; Rossi, M; Vidale, M; Macchiarelli, R
Prehistoric evidence for the drilling of human teeth in vivo has so far been limited to isolated cases from less than six millennia ago. Here we describe eleven drilled molar crowns from nine adults discovered in a Neolithic graveyard in Pakistan that dates from 7,500-9,000 years ago. These findings provide evidence for a long tradition of a type of proto-dentistry in an early farming culture.
Wang, Ting-Shun; Tsai, Tsen-Fang
Scalp psoriasis is commonly the initial presentation of psoriasis, and almost 80 % of patients with psoriasis will eventually experience it. Although several systematic reviews and guidelines exist, an up-to-date evidence-based review including more recent progress on the use of biologics and new oral small molecules was timely. Of the 475 studies initially retrieved from PubMed and the 845 from Embase (up to May 2016), this review includes 27 clinical trials, four papers reporting pooled analyses of other clinical trials, ten open-label trials, one case series, and two case reports after excluding non-English literature. To our knowledge, few randomized controlled trials (RCTs) are conducted specifically in scalp psoriasis. Topical corticosteroids provide good effects and are usually recommended as first-line treatment. Calcipotriol-betamethasone dipropionate is well tolerated and more effective than either of its individual components. Localized phototherapy is better than generalized phototherapy on hair-bearing areas. Methotrexate, cyclosporine, fumaric acid esters, and acitretin are well-recognized agents in the treatment of psoriasis, but we found no published RCTs evaluating these agents specifically in scalp psoriasis. Biologics and new small-molecule agents show excellent effects on scalp psoriasis, but the high cost of these treatments mean they may be limited to use in extensive scalp psoriasis. More controlled studies are needed for an evidence-based approach to scalp psoriasis.
Bracke, Paul J; Howse, David K; Keim, Samuel M
This paper reports on the development of a tool by the Arizona Health Sciences Library (AHSL) for searching clinical evidence that can be customized for different user groups. The AHSL provides services to the University of Arizona's (UA's) health sciences programs and to the University Medical Center. Librarians at AHSL collaborated with UA College of Medicine faculty to create an innovative search engine, Evidence-based Medicine (EBM) Search, that provides users with a simple search interface to EBM resources and presents results organized according to an evidence pyramid. EBM Search was developed with a web-based configuration component that allows the tool to be customized for different specialties. Informal and anecdotal feedback from physicians indicates that EBM Search is a useful tool with potential in teaching evidence-based decision making. While formal evaluation is still being planned, a tool such as EBM Search, which can be configured for specific user populations, may help lower barriers to information resources in an academic health sciences center.
Full Text Available In everyday clinical practice there is a constant need for valid information about diagnosis, prognosis, therapy and prevention of a variety of diseases. But there could be a disparity between the physician's diagnostic skills and his clinical judgment if he relies only on traditional sources of information. In the 1992, a group of scientists from the McMaster University in Ontario, Canada attempted to integrate individual clinical expertise with the best external evidence. They propose a process in which systematically finding, appraising and using of contemporaneous research were the base for proper clinical decision. They called this integration of personal clinical knowledge with research evidence - Evidence Based Medicine (EBM and since then interest in this field has growing exponentially. But 400 years before this important concept emerged a young physician from Koper, named Santorio Santorio (1561 - 1636 argued that a doctor should first rely on sense experience, then on reasoning, and only lastly on authority. Beside his numerous medical inventions he was the first to search justification to his practice by using some vital connection between measured parameters and a person's health state. He could be therefore credited as one of the beginners of modern concepts of science or evidence based medicine.