Biomechanical aspects of oral implants. Consensus report of Working Group 1

The method used by the working group was an iterative process based upon a structured review of the relevant literature by a group of reporters. The review papers were circulated to the members of the group before the conference and formed the basis for subsequent discussions. Each paper was subject to detailed collective analysis and subsequently modified on the basis of the panel's discussions and referenced to additional relevant literature where appropriate. The group assessed the levels of evidence for the statements made in the supporting documentation and recognized that it was necessary to adopt a compromise between acceptance of the lowest level, resulting in the largest body of material, and the highest level, which, in some cases, produced little evidence. While this approach does not represent endorsement of lower evidence levels per se, it was designed to provide conclusions of clinical utility within the existing knowledge base. The consensus statements were prepared after a detailed consideration of the papers submitted to the workshop by the working group. The papers were scrutinized, amended and approved by the group. The basis of each paper is described in the section on 'search strategy' and defines the parameters within which the consensus statements were prepared.     

Biomechanical aspects of oral implants

Abstract: The method used by the working group was an iterative process based upon a structured review of the relevant literature by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for subsequent discussions. Each paper was subject to detailed collective analysis and subsequently modified on the basis of the panel's discussions and referenced to additional relevant literature where appropriate. The group assessed the levels of evidence for the statements made in the supporting documentation and recognized that it was necessary to adopt a compromise between acceptance of the lowest level, resulting in the largest body of material, and the highest level, which, in some cases, produced little evidence. While this approach does not represent endorsement of lower evidence levels per se , it was designed to provide conclusions of clinical utility within the existing knowledge base. The consensus statements were prepared after a detailed consideration of the papers submitted to the workshop by the working group. The papers were scrutinized, amended and approved by the group. The basis of each paper is described in the section on 'search strategy' and defines the parameters within which the consensus statements were prepared.     

Materials. Consensus report of Working Group 4

Abstract: The method used by the working group was an iterative process based upon a structured review of the relevant literature by a group of rapporteurs. The literature was searched using common databanks (e.g., Medline, Pubmed, Cochrane Library etc.), and also by performing manual searches in the non-indexed literature. The review papers were circulated to the members of the group before and during a conference that served as the basis for subsequent discussions. Each paper was subject to detailed collective analysis and subsequently modified on the basis of panel's discussion and referred to additional relevant literature where appropriate. The consensus statements were prepared after a detailed consideration of the papers submitted to the workshop by the working group. The papers were scrutinized, amended and approved by the group.     

Epidemiology and oral function associated with tooth loss and prosthetic dental restorations. Consensus report of Working Group 1

Abstract: The method used by the working group was an iterative process based upon literature reviews of relevant publications by a working group of rapporteurs. The review papers were written and circulated before the conference and served as basis of discussion. Each paper was subject to a detailed collective analysis and modified and amended on the basis of the work group's discussions and referenced to additional relevant literature where appropriate. The group assessed the levels of evidence for the statements made in the supporting documentation and recognised that it was necessary to adopt a compromise between acceptance of the lowest level of evidence, resulting in the largest body of material, and the highest level which produced valuable but limited evidence. Where the objectives were not concerning an intervention, an RCT study design was not applicable and no focussed question could be formulated. Rather cross-sectional and repeated cross-sectional, as well as longitudinal cohort studies, were usually the evidence available.     

Epidemiology and oral function associated with tooth loss and prosthetic dental restorations. Consensus report of Working Group I

The method used by the working group was an iterative process based upon literature reviews of relevant publications by a working group of rapporteurs. The review papers were written and circulated before the conference and served as basis of discussion. Each paper was subject to a detailed collective analysis and modified and amended on the basis of the work group's discussions and referenced to additional relevant literature where appropriate. The group assessed the levels of evidence for the statements made in the supporting documentation and recognised that it was necessary to adopt a compromise between acceptance of the lowest level of evidence, resulting in the largest body of material, and the highest level which produced valuable but limited evidence. Where the objectives were not concerning an intervention, an RCT study design was not applicable and no focussed question could be formulated. Rather cross-sectional and repeated cross-sectional, as well as longitudinal cohort studies, were usually the evidence available.     

Factors influencing survival of reconstructions. Consensus report of Working Group 2

Abstract: In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition

Traumatic injuries to the primary dentition present special problems that often require far different management when compared to that used for the permanent dentition. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The primary goal of these Guidelines is to provide clinicians with an approach for the immediate or urgent care of primary teeth injuries based on the best evidence provided by the literature and expert opinions. The IADT cannot, and does not, guarantee favorable outcomes from strict adherence to the Guidelines; however, the IADT believes their application can maximize the probability of favorable outcomes.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

Avulsion of permanent teeth is one of the most serious dental injuries. Prompt and correct emergency management is essential for attaining the best outcome after this injury. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. It represents the current best evidence and practice based on that literature search and expert opinions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The purpose of these Guidelines is to provide clinicians with the most widely accepted and scientifically plausible approaches for the immediate or urgent care of avulsed permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.     

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning, and follow up are important for achieving a favorable outcome. Guidelines should assist dentists and patients in decision making and in providing the best care possible, both effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. These Guidelines represent the best current evidence based on literature search and expert opinion. The primary goal of these Guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines cover the management of fractures and luxations of permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.     

1950-2005年我国龋病临床研究文献的质量评价

目的了解我国龋病临床研究的质量水平。方法通过电子和手工检索1950-2005年我国龋病临床研究文献，采用Jadad量表进行质量评价。结果我国1950-2005年公开发表的龋病临床研究文献共有3 201篇，其中高质量研究文献为46篇，仅占1.44%。3 201篇文献中，142篇（4.44%）提到了具体的随机分配方法，26篇（0.81%）对双盲的措施进行了描述，256篇（8.00%）对治疗期退出与失访的病例进行了描述。结论我国龋病临床研究文献质量有待进一步提高。     

Association between Orthopedic and Dental Findings: What Level of Evidence is Available?

OBJECTIVE: The aim of this systematic review was to provide comprehensive access to and an analysis of the specialist literature published through December 2005 describing a correlation between orthopedic (leg-length inequality, pelvis obliquity, column diseases and head posture) and dental findings (occlusion, mandibular position, temporomandibular joints, masticatory muscles). METHOD: Four medical and dental internet sources (PubMed; Medpilot.de; databases of the Deutsche Arzte-Verlag and Quintessenz-Verlag) were screened for relevant articles using carefully selected retrieval strategies and keywords. Bibliographies of relevant articles were examined for further pertinent publications. All relevant articles were tabulated according to their year of publication, the subject area discussed, and the levels of scientific evidence. RESULTS: Our electronic inquiry yielded 359 relevant articles (electronic search: 195, search in bibliographies: 164), 355 of which could be analyzed. A correlation between dental findings and spinal column diseases was described in 266 articles, head posture in 216, pelvis obliquity in 53, and leg-length inequality in 35 papers. In 131 publications, conclusions were drawn from dental to orthopedic findings, whereas they were drawn from orthopedic to dental findings in 171 articles. The number of relevant articles rose significantly, particularly since the 1980's. Classification in levels of evidence reveals three publications (0.8%) with level II (randomized controlled trials), 63 (17.7%) with level III (experimental studies with no randomization, cohort studies, or case-control studies), 178 (50.1%) with level IV (non-experimental studies, such as cross-sectional trials, case series, case reports), and 111 (31.3%) with level V (narrative review or expert opinion without explicit critical appraisal). CONCLUSIONS: 1) While there is great interest in possible correlations between orthopedic and dental findings in the specialist literature, most publications fail to provide the hard facts and solid evidence characteristic of high-quality research. 2) This literature analysis attests to the importance of searching electronic databases while making the inherent weaknesses of such searches obvious. Manual literature searches remain essential.     

Burning mouth syndrome and psychological disorders

Burning mouth syndrome (BMS) is an oral dysaesthesia that causes chronic orofacial pain in the absence of a detectable organic cause. The aetiology of BMS is complex and multifactorial, and has been associated in the literature with menopause, trigger events and even genetic polymorphisms. Other studies have found evidence for mechanisms such as central and peripheral nervous system changes, with clinical and laboratory investigations supporting a neuropathologic cause. These physiological explanations notwithstanding, there is still much evidence that BMS aetiology has at least some psychological elements. Somatoform pain disorder has been suggested as a mechanism and factors such as personality, stress, anxiety, depression and other psychological, psychosocial and even psychiatric disorders play a demonstrable role in BMS aetiology and symptomatology. In order to treat BMS patients, both physiological and psychological factors must be managed, but patient acceptance of possible components of psychological disease basis is a major hurdle. Clinical signs of patient stress, anxiety or depression are a useful reinforcement of clinical discussions. The current paper proposes a number of clinical signs that may be useful for both clinical assessment and subsequent patient discussions by providing visible supportive evidence of the diagnosis.     

Aetiology of molar–incisor hypomineralization: a critical review

Objective.  The objective of this study was to assess the strength of evidence for the aetiology of molar–incisor hypomineralization (MIH), often as approximated by demarcated defects.
Method.  A systematic search of online medical databases was conducted with assessment of titles, abstracts, and finally full articles for selection purposes. The level and quality of evidence were then assessed for each article according to Australian national guidelines.
Results.  Of 1123 articles identified by the database search, 53 were selected for review. These covered a variety of potential aetiological factors, some of which were grouped together for convenience. The level of evidence provided by the majority of papers was low and most did not specifically investigate MIH. There was moderate evidence that polychlorinated biphenyl/dioxin exposure is involved in the aetiology of MIH; weak evidence for the role of nutrition, birth and neonatal factors, and acute or chronic childhood illness/treatment; and very weak evidence to implicate fluoride or breastfeeding.
Conclusion.  There is currently insufficient evidence in the literature to establish aetiological factor/s relevant for MIH. Improvements in study design, as well as standardization of diagnostic and examination protocols, would improve the level and strength of evidence.     

Validity of 2D lateral cephalometry in orthodontics: a systematic review

Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.     

Problem-based learning in academic health education. A systematic literature review

Problem based learning (PBL) arguably represents the most significant development in education over the past five decades. It has been promoted as the curriculum of choice, and since its introduction in the 1960's, has been widely adopted by many medical and dental schools. PBL has been the subject of much published literature but ironically, very little high quality evidence exists to advocate its efficacy and subsequently justify the widespread curriculum change. The purpose of this review is to classify and interpret the available evidence and extract relevant conclusions. In addition, it is the intent to propose recommendations regarding the relative benefits of PBL compared with conventional teaching. The literature was searched using PubMed, ERIC and PsycLIT. Further articles were retrieved from the reference lists of selected papers. Articles were chosen and included according to specific selection criteria. Studies were further classified as randomised controlled trials (RCTs) or comparative studies. These studies were then analysed according to intervention type: whole curricula comparisons and single educational interventions of shorter duration. At the level of RCTs and comparative studies (whole curricula), no clear difference was observed between PBL and conventional teaching. Paradoxically, it was only comparative studies of single PBL intervention in a traditional curriculum that yielded results that were consistently in favour of PBL. Further research is needed to investigate the possibility that multiple PBL interventions in a traditional curriculum could be more effective than an exclusively PBL programme. In addition, it is important to address the potential benefits of PBL in relation to life-long learning of health care professionals.     

Periodontal regeneration in aggressive periodontitis patients: A systematic review of the literature

The aim of the present study was to systematically review the existing literature on periodontal regenerative procedures in individuals affected by aggressive periodontitis (AgP). An electronic and manual search was performed using an ad hoc prepared search string. All types of study designs were considered acceptable for inclusion. Data about treated patients, baseline clinical parameters, type of surgery, and outcomes were extracted and recorded. A narrative evaluation of the results was performed. After the article‐selection process, a total of 22 full‐texts were included in the qualitative synthesis. Twelve papers were case reports; one was a retrospective study; six were non‐randomized, comparative studies; and three papers were published on two randomized, controlled trials (RCT). Various biomaterials and surgical techniques were described in the included papers. Based on the existing literature, even considering the relatively low level of evidence, periodontal regenerative surgery could be successfully performed in patients affected by AgP. There is a substantial need of high‐quality RCT to support this.     

Localization of impacted maxillary canines using cone beam computed tomography. Review of the literature

This review analyzed the literature focused on Cone- Beam Computed Tomography (CBCT) diagnostic accuracy and efficacy in detecting impacted maxillary canines, and evaluated the possible advantages in using CBCT technique compared with traditional radiographs. PubMed and Embase searches were performed selecting papers since 1998 up to September 2011, moreover reference lists were hand searched. Two reviewers selected relevant publications on the basis of predetermined inclusion criteria. The literature search yielded 94 titles, of which 5 were included in the review. Three studies used CBCT technique to 3D localize maxillary impacted canines and assess root resorption of adjacent teeth. Other two publications compared traditional radiographs with CBCT images in the diagnosis of maxillary impacted canines. Only three studies presented the results using statistical analysis. The present review highlighted that the use of CBCT has a potential diagnostic effect and may influence the outcome of treatment when compared with traditional panoramic radiography for the assessment of impacted maxillary canines. Furthermore it underlines the need of future studies performed according with high level methodological standards, investigating diagnostic accuracy and effectiveness of CBCT in the diagnosis of maxillary impacted teeth.     

The association between generalized joint hypermobility and temporomandibular joint disorders: a systematic review

To analyze conflicting evidence in the literature for the association between temporomandibular joint disorders (TMD) and generalized joint hypermobility (GJH), we performed a bibliographic search. The methodological quality of the 14 papers found was assessed according to 14 criteria. Papers were included in the analysis if the study population was clinically relevant, if range of motion of 2 or more joints was assessed on the left and right sides, and if cases had a TMD. Four studies fulfilled these selection criteria. Data from 3 studies, 113, cases and 95 controls, were available for analysis. Twenty-six cases and five controls were hypermobile (odds ratio, 5.4). In a sensitivity analysis, the odds ratio changed from significant to non-significant in 2 of 5 scenarios. As a result, it is not clear whether GJH is associated with TMD, and more rigorous studies are needed.