Evidence-based dentistry
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Evidence-based dentistry · Jun 2020
Coronavirus disease 2019 (COVID-19): challenges and management of aerosol-generating procedures in dentistry.
Data sources Experimental investigation. Study design A retrospective review to evaluate the use of a negative-pressure otolaryngology viral isolation drape (NOVID) system to reduce cross-infection through aerosol. The apparatus consists of a plastic drape suspended over the surgical field in the head and neck region with a smoke evacuator suction placed inside the chamber with an ultra-low penetrating air (ULPA) efficiency rating and a fluid suction high-efficiency particulate air (HEPA) filter compartment. ⋯ The sample size is limited to four patients and variations in the magnitude and extent of aerosol contamination needs to be investigated further before drawing any conclusions. Although unlikely, this study design did not capture the presence of aerosol/droplets in the air within the operating room which may follow removal of the isolation drape system or from exposed surgical instruments. Notwithstanding the limitations of the design, negative-pressure aspiration of air under a chamber barrier is likely to minimise the contamination from aerosol and droplet during endonasal and transoral surgery.
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Evidence-based dentistry · Mar 2020
CommentExploring the cost-effectiveness of child dental caries prevention programmes. Are we comparing apples and oranges?
Data sources The following seven databases were searched: PubMed, EMBASE, DARE, NHSEED, HTA, Cost-Effectiveness Analysis Registry and Paediatric Economic Database Evaluation (PEDE). Study selection The review included trial and model-based economic evaluation studies and the participants included children aged from 0 to 12 years old who were healthy except for having dental caries. Studies of mixed populations of parents and children were included where the data for children were presented separately. ⋯ Conclusions A comprehensive analysis of the OHPPs confirmed that DMFT could be reduced, hence, lowering the financial burden of dental-care treatment. More effort is needed to manage the allocation of scarce resources, taking into account the economic impact of dental caries on healthcare systems. More studies on caries-prevention programmes among young children in high-, middle- and low-income countries are needed, in order to assess the clinical and financial effectiveness.
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Evidence-based dentistry · Dec 2019
CommentHome use of interdental cleaning devices and toothbrushing and their role in disease prevention.
Objectives The primary objective of this review was to determine the effectiveness of interdental cleaning per se as a stand-alone treatment, and then with the addition of tooth-brushing or a brushing device as a comparator. The ecological plaque model within which biofilm modification is key to stabilisation of periodontal inflammation. Thus, the control of plaque biofilms has a positive impact on reducing periodontal diseases and caries in the population.1 A secondary objective of the review was to carry out cross-sectional analysis of the effectiveness of different interdental cleaning aid groups (ICA) to ascertain which ICA emerged as the most effective in removing bacterial plaque. ⋯ However, the bleeding site and plaque score information was difficult to interpret. An oral irrigator showed no real benefit over brushing alone at three months. Rubber/elastomer sticks reduced plaque scores but not gingivitis at one month (very low certainty evidence.) Safety: None of the studies included in the review tested compared the degree of gingival irritation caused by the ICAs.
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Evidence-based dentistry · Sep 2019
ReviewOne phase or two phase orthodontic treatment for Class II division 1 malocclusion ?
Data sources Numerous online databases were searched including:, the Cochrane Central Register of Controlled Trials, the Cochrane Library, MEDLINE Ovid and Embase Ovid). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials. No restrictions were placed on the language or date of publication when searching the electronic databases. ⋯ Conclusions Evidence classified as low to moderate quality suggests that providing early orthodontic treatment/two stages for children with prominent upper front teeth is more effective for reducing the incidence of upper front teeth trauma ( incisal trauma) than providing one course of orthodontic treatment in adolescence. However, it appears that there is no other benefit of providing early treatment when compared to late treatment. Low-quality evidence proposes that, compared to no treatment, late treatment in adolescence with functional appliances, is effective for reducing the prominence of upper front teeth.
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Evidence-based dentistry · Jun 2019
CommentOne phase or two phases orthodontic treatment for Class II division 1 malocclusion?
Data sources Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 27 September 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 8), MEDLINE Ovid (1946 to 27 September 2017), and Embase Ovid (1980 to 27 September 2017). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. ⋯ Conclusions Evidence of low to moderate quality suggests that providing early orthodontic treatment for children with prominent upper front teeth is more effective for reducing the incidence of incisal trauma than providing one course of orthodontic treatment in adolescence. There appear to be no other advantages of providing early treatment when compared to late treatment. Low-quality evidence suggests that, compared to no treatment, late treatment in adolescence with functional appliances, is effective for reducing the prominence of upper front teeth.