Evidence-Based Dentistry for Dental Specialists
When and where?
2023 dates: 9.11.23., 16.11.23. and 23.11.23
Thursdays, 9.30am, Room 408, Institute of Stomatology RSU
Evidence-Based Diagnosis and Treatment of Temporomandibular Disorders
Aim
This module aims to give the residents the necessary skills to understand, evaluate and apply the research evidence in the diagnosis, treatment, and prognosis of Temporomandibular Disorders. This should foster more effective, efficient, and quality patient care.
Lecturer
Sergio Uribe, PhD, MSc, DDS, Assoc Professor, Leading Researcher.
Methodology of the Classes:
The methodology for these classes will employ an interactive and practical methodology to promote evidence-based practice. Residents will receive one or two important research papers for each class, study them, and prepare a 15-minute presentation for each paper covering their essence and clinical implications. The presenter is randomly selected to ensure equal engagement.
Following the presentation, we delve into a detailed discussion of the papers, aiming to discuss doubts, understand limitations, and explore their practical applications. We encourage active participation in these discussions. Practical examples will be interspersed throughout the classes to highlight real-clinical applications.
This approach aims to strengthen residents' understanding of evidence-based practice and equip them to incorporate it into their clinical practice.
FOR THE RESIDENTS: The goal of your presentation should be to communicate your understanding of the paper rather than simply reading pre-written slides. Hence, rather than relying heavily on PowerPoint slides, we encourage you to utilize hand-drawn diagrams or other visual aids Engage with the content, analyze it, and distill its essence in your own words. Showcase your interpretation of the paper's contents and its potential clinical applications. Remember, the objective is to spark an insightful discussion and deepen our understanding of the topic.
Practical Activity (for the entire course)
Residents will be expected to identify a TMD case from their practice, apply the principles of EBP learned during the course, and present their case, including a literature search, critical appraisal, and discussion on how the evidence was used in diagnosis, treatment and prognosis at the end of the course.
Assessment
Assessment will be based on participation in class discussions, completion of practical activities, and the final case presentation.
Seminars
Seminar 1: Introduction to Evidence-Based Practice in Temporomandibular Disorders
Introduction to Temporomandibular Disorders (TMD)
Overview of Evidence-Based Practice (EBP)
Understanding the importance of EBP in diagnosing and treating TMD
Steps in the EBP process
Formulating answerable clinical questions (PICO)
Overview of Research Study Designs
Practical Activity: Create a PICO question based on a TMD case study
Readings:
Brignardello-Petersen R, Carrasco-Labra A, Glick M, et al. (2014) A practical approach to evidence-based dentistry: I. The Journal of the American Dental Association 145(11): 1105–1107. Link
Complementary readings:
Levin KA (2005) Study design I. Evidence-based dentistry 6(3): 78–79. Link
Seminar 2: Searching for the Best Evidence
Importance of literature search in EBP
Strategies to search medical literature effectively
Databases and resources for finding evidence (PubMed, Cochrane, TRIP, etc.)
Reading and understanding research articles
Practical Activity: Conduct a literature search based on the PICO question created in the previous class
Readings:
Brignardello-Petersen R, Carrasco-Labra A, Booth HA, et al. (2014) A practical approach to evidence-based dentistry: II: How to search for evidence to inform clinical decisions. Journal of the American Dental Association 145(12): 1262–1267. Link
Complementary readings:
Hill AB (1965) THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proceedings of the Royal Society of Medicine 58(5): 295–300. Link
Seminar 3: Critical Appraisal and Application of Evidence in TMD
Introduction to critical appraisal: What it is and why it's important
Assessing the validity, importance, and applicability of the evidence
Statistical significance vs clinical significance
Tools for critical appraisal (e.g., EQUATOR Network, CASP, PRISMA, STARD, STROBE, CONSORT, GRADE)
Translating Evidence into Practice: individual clinical expertise vs. patient values and expectations
Practical Activity: Critically appraise a research paper on TMD; discuss how the findings could be implemented into practice
Follow-up and evaluation of the evidence-based approach in practice
Readings:
Brignardello-Petersen R, Carrasco-Labra A, Glick M, et al. (2015) A practical approach to evidence-based dentistry: III: how to appraise and use an article about therapy. The Journal of the American Dental Association 146(1): 42–49.e1. Link
Carrasco-Labra A, Brignardello-Petersen R, Glick M, et al. (2015) A practical approach to evidence-based dentistry: VI: How to use a systematic review. The Journal of the American Dental Association 146(4): 255–265.e1. Link
Carrasco-Labra A, Brignardello-Petersen R, Glick M, et al. (2015) A practical approach to evidence-based dentistry: VII: How to use patient management recommendations from clinical practice guidelines. The Journal of the American Dental Association 146(5): 327–336.e1. Link
Complementary readings:
Brignardello-Petersen R, Carrasco-Labra A, Glick M, et al. (2015a) A practical approach to evidence-based dentistry: IV: how to use an article about harm. The Journal of the American Dental Association 146(2): 94–101.e1.
Brignardello-Petersen R, Carrasco-Labra A, Glick M, et al. (2015b) A practical approach to evidence-based dentistry: V: how to appraise and use an article about diagnosis. The Journal of the American Dental Association 146(3): 184–191.e1.
Carrasco-Labra A, Brignardello-Petersen R, Azarpazhooh A, et al. (2015) A practical approach to evidence-based dentistry: X: How to avoid being misled by clinical studies’ results in dentistry. The Journal of the American Dental Association 146(12): 919–924.
Additional Readings
Recommended books
Richards D (2008) Evidence-Based Dentistry : Managing Information for Better Practice. London; Chicago: Quintessence Pub.
Schulz K and Grimes DA (2018) Essential Concepts in Clinical Research: Randomised Controlled Trials and Observational Epidemiology. 2nd ed. London, England: Elsevier Health Sciences.
Moher D, Altman D, Schulz K, et al. (2014) Guidelines for Reporting Health Research: A User’s Manual. John Wiley and Sons Ltd.
Dental Clinics Special issue LINK
Position papers
FDI Evidence-based Dentistry (EBD) https://www.fdiworlddental.org/evidence-based-dentistry-ebd
TMJ Readings
General reviews
Brignardello-Petersen R (2017) No evidence of association between articular status and clinical symptoms in patients with temporomandibular joint disorders. Journal of the American Dental Association .
Delcanho R, Val M, Guarda Nardini L, et al. (2022) Botulinum Toxin for Treating Temporomandibular Disorders: What is the Evidence? Journal of oral & facial pain and headache 36(1): 6–20.
Greene CS and Manfredini D (2020) Treating Temporomandibular Disorders in the 21st Century: Can We Finally Eliminate the “Third Pathway”? Journal of oral & facial pain and headache 34(3): 206–216.
González-González, A.M., Herrero, A.J., 2021. A systematic review of temporomandibular disorder diagnostic methods. Cranio 1–13.
Kandasamy S and Greene CS (2020) The evolution of temporomandibular disorders: A shift from experience to evidence. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology 49(6): 461–469.
Manfredini D, Saracutu OI, Ferrari Cagidiaco E, et al. (2023) EPA Consensus Project Paper: The Relationship Between Prosthodontic Rehabilitations and Temporomandibular Disorders. The European journal of prosthodontics and restorative dentistry. DOI: 10.1922/EJPRD_2484Manfredini05.
Neff A, McLeod N, Spijkervet F, et al. (2021) The ESTMJS (European Society of Temporomandibular Joint Surgeons) Consensus and Evidence-Based Recommendations on Management of Condylar Dislocation. Journal of clinical medicine research 10(21). DOI: 10.3390/jcm10215068.
Patel K, Eley KA, Cascarini L, et al. (2023) Temporomandibular disorders-review of evidence-based management and a proposed multidisciplinary care pathway. Oral surgery, oral medicine, oral pathology and oral radiology 136(1): 54–69.
Ohrbach, R., Greene, C., 2022. Temporomandibular Disorders: Priorities for Research and Care. J. Dent. Res. 220345211062047.
Racich MJ (2018) Occlusion, temporomandibular disorders, and orofacial pain: An evidence-based overview and update with recommendations. The Journal of prosthetic dentistry 120(5): 678–685.
Uribe S (2011) The impact of imaging technologies on temporomandibular joint disorder diagnosis. Evidence-based dentistry 12(4): 113–114.
Zagury JG, Ananthan S, Quek SYP, et al. (2023) Myofascial Temporomandibular Disorders at a Turning Point: Pragmatic or Evidence-Based Management? Dental clinics of North America 67(2): 335–348.
Temporomandibular Disorders (TMD): From Research Discoveries to Clinical Treatment [WWW Document], n.d. URL https://www.nationalacademies.org/our-work/temporomandibular-disorders-tmd-from-research-discoveries-to-clinical-treatment?trk=feed_main-feed-card_feed-article-content (accessed 3.17.23).