Medical & Health Sciences

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Medical & Health Sciences Research Papers/Topics

ERRATUM: Failure rate of atraumatic restorative treatment using high-viscosity glass-ionomer cement

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...

SYSTEM Research note on: Initial observations of diagnostic accuracy concerning quantitative testing for selection bias in RCTs

CONTEXT: Selection bias interferes with the internal validity of clinical trials and leads to favouring one clinical outcome over another. In order to limit the influence of selection bias on clinical trials, the methodological interventions: random sequence generation and allocation concealment of such sequence have been proposed. Subsequently, authors of systematic reviews judge risk of selection bias in trials according to the reported details concerning how random sequence generation ...

Failure rate of atraumatic restorative treatment using highviscosity glass-ionomer cement: systematic review update

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...

SYSTEM Research note on: A simulation method to test for potential accuracy of a selection bias test for RCTs

CONTEXT: Selection bias interferes with the internal validity of clinical trials and leads to favoring one clinical outcome over another. Risk of selection bias is introduced when knowledge of certain patient characteristics, known to be conducive to the success of one particular intervention, is applied together with foreknowledge regarding the allocation of such patients in a specific sequence of interventions. PROBLEM: Selection bias testing has been proposed and recommended on basis of...

Failure rate of atraumatic restorative treatment using highviscosity glass-ionomer cement compared to conventional amalgam restorative treatment in primary and permanent teeth

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...

SYSTEM Research note on: Assessing attrition bias risk

CONTEXT: Systematic reviews of clinical trials need to assess the risk of attrition bias as part of its appraisal of the currently available evidence to a particular review question. PROBLEM: Notwithstanding the possible merits of different approaches to estimate the potential intervention outcomes of lost trial participants as the main reason for attrition bias, most remain arbitrary. SUGGESTED SOLUTION: Assuming a worst- and best-case scenario of intervention outcomes provides the certain...

SYSTEM Research note on: Assessing publication bias

CONTEXT: Systematic reviews aim to assess precision and internal validity of the current clinical evidence. The precision and internal validity of clinical evidence is limited by the risk of biases, one of which is publication bias. Publication bias is created when trials, often with small sample size that have found negative or non-significant results are not being published and thus are not identified during systematic reviews as part of the of current clinical evidence. In that way, publ...

SYSTEM Research note on: Recognizing statistical in-between-trials heterogeneity

CONTEXT: Quantitative systematic reviews need to consider clinical, methodological and statistical heterogeneity of trials or datasets from trials before combining their results in meta-analyses, as combining results from heterogeneous datasets and/or trials will lead to meaningless results and thus should be avoided. Potential statistical heterogeneity between trials/datasets that have been considered as being clinically/methodologically homogeneous is usually investigated using I2 – t...

ATRAUMATIC RESTORATIVE TREATMENT (ART) – FACTORS AFFECTING SUCCESS

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...

FACTORS INHIBITING THE IMPLEMENTATION OF THE ATRAUMATIC RESTORATIVE TREATMENT APPROACH IN PUBLIC ORAL HEALTH SERVICES IN GAUTENG PROVINCE, SOUTH AFRICA

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...

SUGAR-FREE CHEWING GUM AND DENTAL CARIES – A SYSTEMATIC REVIEW

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...

Utilization of the ART approach in a group of public oral health operators in South Africa: a 5-year longitudinal study

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...

Systematic reviews, systematic error and the acquisition of clinical knowledge.

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...

Demineralization of hard tooth tissue adjacent to resin-modified glass-ionomers and composite resins: a quantitative systematic review

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...

Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: An update of systematic review evidence

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...


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