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da Silva Tagliaferro EP, Riley JL, Gilbert GH, da Silva SRC, Rosell FL, Junior AV, Gordan VV. EVIDENCE-PRACTICE GAP IN TREATMENT DECISIONS ABOUT DEFECTIVE COMPOSITE AND AMALGAM RESTORATIONS AMONG BRAZILIAN DENTISTS. Braz J Oral Sci 2023; 22:e231640. [PMID: 38077621 PMCID: PMC10702847 DOI: 10.20396/bjos.v22i00.8671640] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Better understanding of dentists' decision-making about defective restorations is needed to close the evidence-practice gap (EPG). Aim: this study aimed to quantify the EPG about defective restorations and identify dentist factors associated with this EPG. Methods: 216 dentists from São Paulo State, Brazil, completed a questionnaire about three clinical case scenarios involving defective composite restorations with cementum-dentin margins (case 1) and enamel margins (case 2), and an amalgam (case 3) restoration. Dentists were asked what treatment, if any, they would recommend, including preventive treatment, polishing, re-surfacing, or repairing the restoration, or replacing the entire restoration. Replacing the entire restoration in any of these three scenarios was classified as inconsistent with the evidence, comprising an EPG. Bivariate analyses using Chi-square, ANOVA, or multiple comparison tests were performed (p<.05). Results: for defective composite restorations, 49% and 55% of dentists chose to replace the entire restoration for cases 1 and 2, respectively. Twenty-nine percent of dentists chose to replace the entire amalgam restoration. Dentists were significantly more likely to choose to replace the defective amalgam restoration than the composite restoration with a defect at the cementum-dentin margins or the enamel margins (both at p < .001). Female dentists were more likely to choose a conservative treatment than male dentists for cases 1 (p=.034) and 2 (p=.009). Dentists with a higher percentage of patients interested in individualized caries prevention were also more conservative in case 1 (p=.045). Conclusion: a substantial EPG regarding treatment decisions for defective restorations exists, especially for composite restorations. This study adds to the international evidence that an EPG exists in this clinical area and that global strategies need to be developed to close the gap.
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Affiliation(s)
- Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Joseph L Riley
- University of Florida College of Dentistry, Director, Pain Clinical Research Unit, UF CTSI, South Atlantic Region, Dental Practice-based Research Network, Clinical and Translational Research Building (CTRB), Room 2227, 2004 Mowry Road, Box 100404, Gainesville, FL 32610-0404, The United States of America
| | - Gregg H Gilbert
- Department of Clinical & Community Sciences, Room SDB 109, School of Dentistry, University of Alabama at Birmingham, 1720 Second Avenue South, Birmingham, AL 35294-0007, The United States of America
| | - Silvio Rocha Correa da Silva
- Department of Community Dentistry, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Aylton Valsecki Junior
- Department of Community Dentistry, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Valeria Veiga Gordan
- University of Florida, College of Dentistry, Room D9-6 P.O. Box 100415, Gainesville, FL 32610-0415, The United States of America
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Canceill T, Monsarrat P, Faure-Clement E, Tohme M, Vergnes JN, Grosgogeat B. Dental practice-based research networks (D-PBRN) worldwide: A scoping review. J Dent 2020; 104:103523. [PMID: 33186627 DOI: 10.1016/j.jdent.2020.103523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/02/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES For more than twenty years, dental practice-based research networks (D-PBRN) have helped to structure clinical research in private practice. They bring together practitioners working in several structures and may include a greater number of subjects. The aims of this study were thus to systematically explore the scientific production from dental private practices in general and to map and describe the D-PBRN activity worldwide. DATA SOURCES Two research procedures were carried out in parallel. The first was conducted as a scoping review to examine peer-reviewed literature indexed in the PubMed database and the second was performed on the World Wide Web to identify the main characteristics of the networks (location, scientific production…). STUDY SELECTION 368 publications were identified among which 202 were published by PBRN members and the others by private practitioners not affiliated to any network. 210 (57 % of the included articles) were produced in the USA. A higher number of diverse centers are involved in each study when it is conducted by a PBRN (59.06 ± 66.59 vs. 13.51 ± 31.58 for networks and independent teams, respectively; p < 0.01). 24 D-PBRN were identified, a majority being based in the USA and 8 in Europe. CONCLUSIONS Although dental practice-based research has grown over the years, the number of D-PBRN worldwide remains low. Even if it requires some investment to produce research in dental offices, this type of networks helps to fill the gap between private practice and research and to improve knowledge on oral health. RELEVANCE The mapping of all the dental PBRN together with the research topics studied throughout the world make the relevance of this article. The ways to improve practice-based research in dentistry are also discussed in the paper.
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Affiliation(s)
- Thibault Canceill
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; CIRIMAT, University of Toulouse, CNRS, INPT, Université Paul Sabatier, Faculté de Pharmacie, 35 Chemin des Maraichers, Toulouse cedex 9, 31062, France.
| | - Paul Monsarrat
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; Toulouse Institute of Artificial Intelligence ANITI, Toulouse, France; STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm, UPS, France
| | - Edouard Faure-Clement
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France
| | - Marie Tohme
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France
| | - Jean-Noël Vergnes
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; Division of Oral Health and Society, Faculty of dentistry, McGill University, Montreal, Quebec, Canada
| | - Brigitte Grosgogeat
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France; Université Lyon 1, LMI UMR CNRS 5615, 11 rue Guillaume Paradin, Lyon, 69008, France
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