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Sartori CHM, Mazzetti T, Júnior FAV, Daneris ÂP, Cenci MS, van de Sande FH, Montagner AF. Methodological quality of evidence-based clinical practice guidelines in cariology. Clin Oral Investig 2023; 28:66. [PMID: 38159154 DOI: 10.1007/s00784-023-05429-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.
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Affiliation(s)
| | - Thais Mazzetti
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | | | | | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
| | - Anelise Fernandes Montagner
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil.
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Girotto LPDS, Chisini LA, Lynch CD, Blum IR, Wilson NH, Sarkis-Onofre R, Carvalho RVD, van de Sande FH. Teaching of composite restoration repair in Brazilian dental schools. J Dent 2023; 130:104410. [PMID: 36626975 DOI: 10.1016/j.jdent.2023.104410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The aim was to investigate aspects of the teaching of restoration repair as a minimally invasive alternative to replacing defective direct composite restorations in undergraduate curricula teaching programs in Brazilian dental schools. METHODS A 14-item validated survey questionnaire was mailed to directors/coordinators of operative/restorative dentistry teachers of Brazilian Dental Schools. Data were collected on demographic characteristics of the teachers and institutions, together with questions on the teaching of the repair of defective resin-based composite restorations as part of the school curriculum; the rationale behind the teaching; the nature of the teaching (preclinical and/or clinical); how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability and expected longevity of completed repairs. RESULTS Two hundred and twenty-two (94%) directors/ coordinators of dental curricula in Brazil were contacted. One hundred and thirty-one directors/coordinators (59%) replied, providing the e-mail address from the teacher responsible for the operative/restorative dentistry program in their school. Of these, 104 responded to the questionnaire (79% response rate). Ninety-three (89%) of the participating schools reported teaching composite repairs as an alternative to replacing restorations. Of the theoretical content, 43% was taught at preclinical and clinical levels, whereas most practical experience (53%) was acquired at clinical levels. Eighty-eight schools (95%) reported tooth substance preservation being the main reason for teaching repair techniques. All schools that taught repairs reported high patient acceptability. CONCLUSIONS The teaching of composite restoration repair as an alternative to restoration replacement is established in undergraduate programs in most of the Brazilian dental schools surveyed. CLINICAL SIGNIFICANCE The reasons for teaching restoration repair in Brazil were found to be quite unanimous among teachers, especially regarding the preservation of tooth structure. Variations were found in the clinical indications for repair, suggesting the need for further investigations. Monitoring repaired restorations should be encouraged and could contribute to future studies.
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Affiliation(s)
| | - Luiz Alexandre Chisini
- Department of Dentistry, Institute of Health Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
| | - Christopher D Lynch
- Cork University Dental School & Hospital, University College Cork, Cork, Ireland.
| | - Igor R Blum
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
| | - Nairn Hf Wilson
- College of General Dentistry, 124 City Road, London, EC1V2NX United Kingdom.
| | - Rafael Sarkis-Onofre
- Graduate Program in Dentistry, Atitus Educação, Passo Fundo, Rio Grande do Sul, Brazil.
| | - Rodrigo Varella de Carvalho
- Department of Dentistry, Institute of Health Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
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Mazzetti T, Sergio da Silva Santos P, Spindola Antunes H, Fernandes Montagner A, Hélène van de Sande F, Timm Maske T. Reply to "Comment on: Required time for pre-oncological dental management - A rapid review of the literature". Oral Oncol 2023; 136:106265. [PMID: 36444800 DOI: 10.1016/j.oraloncology.2022.106265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Thais Mazzetti
- Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas-RS, Brazil.
| | - Paulo Sergio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil.
| | | | | | | | - Tamires Timm Maske
- Department of Preventive and Community Dentistry, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil.
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Mazzetti T, Sergio da Silva Santos P, Spindola Antunes H, Fernandes Montagner A, Hélène van de Sande F, Timm Maske T. Required time for pre-oncological dental management - A rapid review of the literature. Oral Oncol 2022; 134:106116. [PMID: 36115328 DOI: 10.1016/j.oraloncology.2022.106116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 10/31/2022]
Abstract
This study identified the scientific literature comparing the influence of different times in which dental procedures were performed before the oncological treatments (radiotherapy and/or chemotherapy) on the risk of oral complications development. MEDLINE/PubMed and Embase databases were searched, and articles were selected by title, abstract and full-text assessment. The search identified 2,356 articles and three retrospective observational studies were included. Data were collected and analyzed according to the dental procedure, the time before oncological treatment, and oral complications. Risk of bias (ROBINS) and certainty of evidence (GRADE) were evaluated. Pairwise meta-analyses were performed from dental extractions (Exo) data according to the time which were performed and ORN development using a random-effect model (RR and 95 % CI, p < 0.05). meta-analyses showed a higher risk of ORN development in patients with Exo performed < 2 weeks before oncological treatment than in those who Exo was performed > 2 weeks ≤ 1 month before oncological therapy (RR 1.29; 95 % CI 1.12-1.48; p < 0.01). There was a higher prevalence of oral mucositis (OM) in patients who received periodontal treatment ≤ 3 weeks before oncological therapy than those who received dental procedures > 3 weeks ≤ 6 months before. Although the risk of bias ranged from serious to critical, with very low certainty of evidence, the findings suggest that dental extractions should be performed within > 2 weeks before oncological treatment to avoid ORN complications. More studies are needed to conclude the appropriate time to perform dental procedures to decrease other associated oral complications. (CRD42021272652).
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Affiliation(s)
- Thais Mazzetti
- Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
| | - Paulo Sergio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | | | | | | | - Tamires Timm Maske
- Department of Preventive and Community Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Sande FHVD, Silva AFD, Michelon D, Piva E, Cenci MS, Demarco FF. Surface roughness of orthodontic band cements with different compositions. J Appl Oral Sci 2011; 19:223-7. [PMID: 21625737 PMCID: PMC4234333 DOI: 10.1590/s1678-77572011000300008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 04/29/2010] [Indexed: 12/03/2022] Open
Abstract
Objectives The present study evaluated comparatively the surface roughness of four
orthodontic band cements after storage in various solutions. Material and Methods eight standardized cylinders were made from 4 materials: zinc phosphate cement
(ZP), compomer (C), resin-modified glass ionomer cement (RMGIC) and resin cement
(RC). Specimens were stored for 24 h in deionized water and immersed in saline (pH
7.0) or 0.1 M lactic acid solution (pH 4.0) for 15 days. Surface roughness
readings were taken with a profilometer (Surfcorder SE1200) before and after the
storage period. Data were analyzed by two-way ANOVA and Tukey's test (comparison
among cements and storage solutions) or paired t-test (comparison
before and after the storage period) at 5% significance level. Results The values for average surface roughness were statistically different (p<0.001)
among cements at both baseline and after storage. The roughness values of cements
in a decreasing order were ZP>RMGIC>C>R (p<0.001). After 15 days,
immersion in lactic acid solution resulted in the highest surface roughness for
all cements (p<0.05), except for the RC group (p>0.05). Compared to the
current threshold (0.2 µm) related to biofilm accumulation, both RC and C remained
below the threshold, even after acidic challenge by immersion in lactic acid
solution. Conclusions Storage time and immersion in lactic acid solution increased the surface roughness
of the majority of the tested cements. RC presented the smoothest surface and it
was not influenced by storage conditions.
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