Advantages of the dental practice-based research network initiative and its role in dental education.

Practice-based research networks (PBRNs) provide a novel venue in which providers can increase their knowledge base and improve delivery of care through participation in clinical studies. This article describes some aspects of our experience with a National Institute of Dental and Craniofacial Research-supported PBRN and discusses the role it can play in dental education. PBRNs create a structured pathway for providers to advance their professional development by participating in the process of collecting data through clinical research. This process allows practitioners to contribute to the goals of evidence-based dentistry by helping to provide a foundation of evidence on which to base clinical decisions as opposed to relying on anecdotal evidence. PBRNs strengthen the professional knowledge base by applying the principles of good clinical practice, creating a resource for future dental faculty, training practitioners on best practices, and increasing the responsibility, accountability, and scope of care. PBRNs can be the future pivotal instruments of change in dental education, the use of electronic health record systems, diagnostic codes, and the role of comparative effectiveness research, which can create an unprecedented opportunity for the dental profession to advance and be integrated into the health care system.

Defective amalgams - repair or replace?

DATA SOURCES: Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, ISI Web of Science, ISI Web of Science Conference Proceedings, BIOSIS, OpenSIGLE. Reference lists of all eligible trials and review articles, and their reference lists were searched. STUDY SELECTION: Trials were selected if they met the following criteria: randomised or quasi-randomised controlled trial, involving replacement and repair of amalgam restorations. DATA EXTRACTION AND SYNTHESIS: Titles and abstracts were assessed independently by two authors. Full papers were obtained for relevant articles. Data synthesis was to follow Cochrane Collaboration statistical guidelines. RESULTS: 145 potentially eligible studies were identified. Only three studies were analysed further but none of these met the inclusion criteria and all were excluded from this review. CONCLUSIONS: There are no published randomised controlled clinical trials (RCTs) relevant to this review question. There is a need for methodologically sound RCTs reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/). Further research needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, distress and anxiety, time and costs.

Defective resin composite - repair or replace?

DATA SOURCES: Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, ISI Web of Science, ISI Web of Science Conference Proceedings, BIOSIS, OpenSIGLE. Reference lists of all eligible trials and review articles and their reference lists were searched. STUDY SELECTION: Trials were selected if they met the following criteria: randomised or quasi-randomised controlled trial, involving replacement and repair of resin composite restorations. DATA EXTRACTION AND SYNTHESIS: Titles and abstracts were assessed independently by two review authors for relevance . Full papers were obtained for relevant articles and both review authors studied these. Data synthesis was to follow Cochrane Collaboration statistical guidelines. RESULTS: 279 potentially eligible studies were identified. Only four studies were analysed further but none of these met the inclusion criteria and all were excluded from this review. CONCLUSIONS: There are no published randomised controlled clinical trials relevant to this review question. There is therefore a need for methodologically sound randomised controlled clinical trials that are reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/). Further research also needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, distress and anxiety, time and costs.

Midpalatal implants for orthodontic anchorage.

DESIGN: Randomised controlled trial. INTERVENTION: Patients with various malocclusions in which any forward movement of the molars would prevent achievement of an ideal Class I canine relationship were randomly allocated to either the headgear or the implant group. Randomisation was carried out by using a block design and computer-generated random numbers. The allocations were concealed in consecutively numbered, sealed envelopes. OUTCOME MEASURE: The outcomes were; surgical and orthodontic success rates of the implants, the number of visits, the length of treatment time and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients' attitudes to implant placement. RESULTS: The surgical success rate of the implants was 75% and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage. CONCLUSIONS: The use of palatal implants to reinforce anchorage was as effective as extraoral anchorage with headgear.