Introduction to EBD & Research for Dental Specialists

When and where?

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BBCE Meeting Room, Institute of Stomatology RSU (meet me office 248)

Basic Concepts of EBD & Research for Dental Specialities

Aim

This module aims to give dental residents the basic concepts and terminology about clinical research.

Lecturer

Sergio Uribe, PhD, MSc, DDS, Assoc Professor, Lead Researcher.

Methodology of the Classes:

Residents will receive one or two 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.

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.

This approach aims to strengthen residents' understanding of evidence-based practice and equip them to incorporate it into their clinical practice.

The goal of your presentation should be to communicate your understanding of the paper rather than simply reading pre-written slides. Hence, we will not use Powerpoint, instead residents will utilize hand-drawn diagrams or other visual aids

Practical Activity (for the entire course)

Residents will be expected to identify a case from their specialty, 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 & Research in Dental Specialties

Introduction to clinical problems in dental specialties
Overview of Evidence-Based Practice (EBP)
Understanding the importance of EBP in diagnosing and treating patients
Steps in the EBP process
Formulating answerable clinical questions (PICO)
Overview of Research Study Designs
Practical Activity: Create a PICO question based on a clinical case from your specialty

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, OpenEvidence 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 Dental Practice

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

Website to locate reporting guidelines: https://www.equator-network.org/

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

The systems is broken

F. Schwendicke, S.E. Uribe, N.S. Jakubovics, The Science System at the Limit: A Call to Action for Considerate Publishing, J. Dent. Res. https://doi.org/10.1177/00220345251349804.

Chalmers, I., Bracken, M.B., Djulbegovic, B., Garattini, S., Grant, J., Gülmezoglu, A.M., Howells, D.W., Ioannidis, J.P.A., Oliver, S., 2014. How to increase value and reduce waste Research: increasing value, reducing waste 1: when research priorities are set. Lancet 383, 156–165.

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

TMD Readings

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).

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