Objective: To investigate potential barriers to the utilisation of the ART approach in a South African public oral health service. Method: 7 barriers were identified: patient load/work load, operator opinion, patient opinion, service management, material supply, clinical ART skill, chair-side assistance. Operators were asked to answer a questionnaire one year after completing the ART training. Responses ranged from 1 = no barrier to 5 = highest barrier. Treatment data per operator were co...
Objective: To appraise existing evidence for a therapeutic / anti-cariogenic effect of sugar-free chewing gum for patients. Method: 9 English and 2 Portuguese databases were searched using English and Portuguese keywords. Relevant articles in English, German, Portuguese and Spanish were included for review. Trials were excluded on lack of randomisation, control group, blinding and baseline data, drop out rate >33%, no statistical adjustment of baseline differences and no assessment of clin...
Background: A significant increase in the proportion of restorations to the number of tooth extractions was reported after the introduction of ART in an academic mobile dental service in South Africa. The changes were ascribed to its less threatening procedure. Based on these findings, ART was subsequently introduced into the public oral health service of Ekurhuleni district in the South African province of Gauteng. This article reports on the 5-year restorative treatment pattern of oper...
Background: Since its inception, evidence-based medicine and its application through systematic reviews, has been widely accepted. However, it has also been strongly criticised and resisted by some academic groups and clinicians. One of the main criticisms of evidence-based medicine is that it appears to claim to have unique access to absolute scientific truth and thus devalues and replaces other types of knowledge sources. Discussion: The various types of clinical knowledge sources are cat...
Abstract: The purpose of this systematic review was to quantitatively find out whether resin-modified glass-ionomers (RM-GIC), in comparison to fluoride containing composite resin and composite resin without fluoride, are associated with a more effective reduction of demineralization in hard tooth tissues under caries challenge. Five databases were systematically searched on clinical trials up to 6 April 2009. Article inclusion criteria: titles/abstracts relevant in answering the rev...
Background: This article constitutes a partial update of the original systematic review evidence by Yengopal et al. from 15 January 2008 (published in the Journal of Oral Science in 2009) with primary focus on research quality in regard to bias risk in trials. Its aim is to update the existing systematic review evidence from the English literature as to whether caries occurrence on pits and fissures of teeth sealed with either GIC or resin is the same. Methods: In addition to the 12 trials...
Background: This article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009) and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam. Methods: The systematic literature search was extended beyond th...
Background: This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods: A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC) are beneficial in tooth caries therapy. The case study illustrates how princ...
Background: To report the results of an audit concerning research gaps in clinical trials that were accepted for appraisal in authored and published systematic reviews regarding the application of glass-ionomer cements (GIC) in dental practice Methods: Information concerning research gaps in trial precision was extracted, following a framework that included classification of the research gap reasons: ‘imprecision of information (results)’, ‘biased information’, ‘inconsistency or...
Purpose: The null-hypothesis that retention loss of resin fissure sealants predicts caries manifestation no more accurately than random values was tested. Methods: Systematic reviews were checked and electronic databases searched for clinical trials. Trials reporting on the retention of resin sealants and caries occurrence in permanent molar teeth, with minimum 24-month follow-up period, were included. Extracted data: number of sealed teeth, number of teeth without completely retained seal...
Objective: To demonstrate the application of the modified Ottawa method by establishing the update need of a systematic review with focus on the caries preventive effect of GIC versus resin pit and fissure sealants; to answer the question as to whether the existing conclusions of this systematic review are still current; to establish whether a new update of this systematic review was needed. Methods: Application of the Modified Ottawa method. Application date: April/May 2012. Results: Fo...
Introduction/Aim: To appraise the clinical literature in determining whether loss of complete sealant retention as surrogate endpoint is directly associated with caries occurrence on sealed teeth as its clinical endpoint and to apply the appraised evidence in testing the null-hypothesis that the retention/caries ratio between different types of sealant materials (resin and glass-ionomer cement) is not statistically significant ( = Prentice criterion for surrogate endpoint validity). Method...
Background: Naı¨ve-indirect comparisons are comparisons between competing clinical interventions’ evidence from separate (uncontrolled) trials. Direct comparisons are comparisons within randomised control trials (RCTs). The objective of this empirical study is to test the null-hypothesis that trends and performance differences inferred from naı¨ve-indirect comparisons and from direct comparisons/RCTs regarding the failure rates of amalgam and direct high-viscosity glassionomer cemen...
Background: Randomised controlled trials (RCT) are highly influential upon medical decisions. Thus RCTs must not distort the truth. One threat to internal trial validity is the correct prediction of future allocations (selection bias). The Berger-Exner test detects such bias but has not been widely utilized in practice. One reason for this non-utilisation may be a lack of information regarding its test accuracy. The objective of this study is to assess the accuracy of the Berger-Exner test...
BACKGROUND: A large percentage of evidence concerning dental interventions is based on laboratory research. The apparent wealth of laboratory evidence is sometimes used as basis for clinical inference and recommendations for daily dental practice. In this study two null-hypotheses are tested: whether trial results from laboratory and controlled clinical trials concerning the comparison of high-viscosity glass-ionomer cements (HVGIC) to amalgam for restorations placed in permanent posterior te...