Objective: To determine the impact of operator knowledge and skills in the Atraumatic Restorative Treatment (ART) approach on the number of rendered tooth extractions and restorations in the Sedibeng district oral health service. Methods: All dentists (3) and dental therapists (4) employed on full time basis in Sedibeng were trained in ART. The training followed standards recommended by the World Health Organisation. One year after training, the treatment ratio number of total restora...
In 2012, the Systematic Review initiative for Evidence-based Minimum Intervention in Dentistry (SYSTEM) has been accepted as research entity with programme status within the Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa. The aim of the initiative is to establish an applicable evidence-based body of clinical knowledge in the field of Minimum Intervention (MI) dentistry. This article provides a brief overview over SYSTEM’s activities during 2012/13.
REVIEW QUESTION: The objective of this quantitative systematic review is to appraise the current clinical literature for evidence whether loss of complete sealant retention is directly associated with caries occurrence on formerly sealed teeth and to apply the appraised evidence as test for the null-hypothesis that the retention/caries ratio between different types of sealant materials is not statistically significant. SYSTEMATIC LITERATURE SEARCH: The following electronic databases will b...
BACKGROUND: Systematic reviews aim to answer clearly formulated questions by using systematic and explicit methods for identifying, selecting, and critically appraising relevant research. However, as research progresses, the content of a systematic review may become obsolete. The modified Ottawa method was developed in order to identify qualitative and quantitative signals indicating the need to update a systematic review. The aim of this study was to investigate how well signals identifi...
REVIEW AIM: The aim of this systematic review is to appraise the quality of existing reviews in the English dental literature in regard to general review methodology, as well as specifically to the comparison method applied, during the last 20 years concerning the compared longevity of different types of direct restorations placed in permanent posterior teeth and subsequently the validity of such reviews’ conclusions. SYSTEMATIC LITERATURE SEARCH: Databases: MEDLINE accessed via PubMed; ...
BACKGROUND: This 3rd systematic review update includes evidence from further Chinese trials that were identified during reference re-check and regression analysis of the possible influence of split-mouth study design on overall results. REVIEW OBJECTIVE: This systematic review seeks to answer the question as to whether, in patients with carious cavities of any class in primary and permanent teeth, ART restorations with high-viscosity GIC have a higher failure rate than amalgam restorations...
BACKGROUND: This further systematic review update includes evidence from Chinese trials that were initially still under translation, as well as corrections of all identified errata. Atraumatic Restorative Treatment (ART) is a minimally invasive procedure that involves removing markedly softened carious enamel and dentine, using only hand instruments, and then restoring the resulting cavity with an adhesive restorative material. Although developed for use in the less industrialized parts o...
The following errors have been identified for: Mickenautsch S, Yengopal V. Failure rate of atraumatic restorative treatment using high-viscosity glass-ionomer cement compared to conventional amalgam restorative treatment in primary and permanent teeth: a systematic review update. J Minim Interv Dent 2012; 5: 63 – 124. These errors do not change its overall conclusion. Nonetheless, the corrections listed below should be taken into considerations when reading this particular systematic re...
BACKGROUND: Atraumatic restorative treatment (ART) is a minimally invasive procedure that involves removing markedly softened carious enamel and dentine, using only hand instruments, and then restoring the resulting cavity with an adhesive restorative material. Although developed for use in the less industrialized parts of the world ART has now been accepted as part of the minimum intervention (MI) dentistry philosophy in developed countries. Currently the restorative material of choice f...
This protocol has been registered with the International Prospective Register for Systematic Reviews (PROSPERO) on the 05 January 2012 under registration number CRD42012001887 (Available online from http://www.crd.york.ac.uk/PROSPERO/full_doc.asp?ID=CRD42012001887). This protocol comprises an update of an existing systematic review report by the authors as part of the SYSTEM initiative: Mickenautsch S, Yengopal V, Banerjee A. Atraumatic restorative treatment versus amalgam restoration lon...
The success of tooth restorations rendered according to principles of the Atraumatic Restorative Treatment (ART) approach is dependant on various clinical factors. The most common failures, due to these factors, are partial material loss; complete material loss; caries related to restoration margin and material wear > 0.5mm. The main reason for clinical ART failures are related to operator skills and performance. The prevention and management of ART failures includes emphasis on correct cl...
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...