597 articles were reviewed, 426 did not comply with the exclusion criteria and were rejected. 171 articles were accepted as evidence. The results show an emerging evidence base for CAMBRA in support for the viability of assessing the risk factors: Saliva flow; Salivary counts of S. mutans and Lactobacilli; Frequency of fermentable carbohydrate intake; past caries experience and for the use of Dental chewing gum; Chlorhexidine; Topical fluoride; Glass ionomers; CPP/ACP for caries management.
There is good evidence that supports the use of sugarless dental chewing gum, containing Xylitol and/or Sorbitol, for caries reduction, particularly on the occlusal tooth surface. Gum chewing varied between 2-7x daily after meals for 5-20 min. There seemed to be no difference between Xylitol-, Sorbitol and Xylitol/Sorbitol Chewing Gum. Two trials showed no significant anti- caries effect as compared to the control. However, one trial (in situ) used an intensive chewing regimen of 5x daily...
Zonkizizwe (Zulu; Eng: All Nations) is one of many informal settlements located South East of Johannesburg. Zonkizizwe has been founded in 1989. Today, it has an estimated population of 150 000 people. The majority of its residents are Zulu speaking people who migrated from KwaZulu/Natal to the metropolitan area of Johannesburg. The main forms of housing in Zonkizizwe are informal dwellings. However, people have access to electricity, sewerage system with outside toilets and tap water i...
Objective: To determine the impact of operator knowledge and skills in the Atraumatic Restorative Treatment (ART) approach on the number of rendered tooth extractions and restorations in the Sedibeng district oral health service. Methods: All dentists (3) and dental therapists (4) employed on full time basis in Sedibeng were trained in ART. The training followed standards recommended by the World Health Organisation. One year after training, the treatment ratio number of total restora...
In 2012, the Systematic Review initiative for Evidence-based Minimum Intervention in Dentistry (SYSTEM) has been accepted as research entity with programme status within the Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa. The aim of the initiative is to establish an applicable evidence-based body of clinical knowledge in the field of Minimum Intervention (MI) dentistry. This article provides a brief overview over SYSTEM’s activities during 2012/13.
REVIEW QUESTION: The objective of this quantitative systematic review is to appraise the current clinical literature for evidence whether loss of complete sealant retention is directly associated with caries occurrence on formerly sealed teeth and to apply the appraised evidence as test for the null-hypothesis that the retention/caries ratio between different types of sealant materials is not statistically significant. SYSTEMATIC LITERATURE SEARCH: The following electronic databases will b...
BACKGROUND: Systematic reviews aim to answer clearly formulated questions by using systematic and explicit methods for identifying, selecting, and critically appraising relevant research. However, as research progresses, the content of a systematic review may become obsolete. The modified Ottawa method was developed in order to identify qualitative and quantitative signals indicating the need to update a systematic review. The aim of this study was to investigate how well signals identifi...
OBJECTIVE: To test the null hypothesis that clinical dental trials with adequate random sequence generation together with adequate allocation concealment do not differ in their effect size from trials lacking adequate concealment. STUDY DESIGN AND SETTING: The oral health section of the Cochrane database was searched online until 20 July 2011. All listed entries, except reviews in protocol stage and duplications, were included. Included systematic reviews were accepted for data extraction ...
REVIEW AIM: The aim of this systematic review is to appraise the quality of existing reviews in the English dental literature in regard to general review methodology, as well as specifically to the comparison method applied, during the last 20 years concerning the compared longevity of different types of direct restorations placed in permanent posterior teeth and subsequently the validity of such reviews’ conclusions. SYSTEMATIC LITERATURE SEARCH: Databases: MEDLINE accessed via PubMed; ...
CONTEXT: The dichotomous outcome of a clinical intervention may be defined as success versus failure and subsequently expressed in the number of intervention successes and failures. Success and failure numbers of two clinical interventions may be compared and the resulting effect estimate expressed either as Risk ratio (RR) or Odds ratio (OR) with 95% confidence intervals (CI). The expression of effect estimates in Risk ratio appears to be easier to interpret. Also, Risk ratio of success ...
CONTEXT: Selection bias interferes with the internal validity of clinical trials and leads to favoring one clinical outcome over another. Random sequence generation and allocation concealment of such sequence have been proposed to limit the risk of selection bias. However, selection bias can be introduced based on knowledge of the directly observed random sequence when allocation concealment is subverted. Such subversion may statistically be detected in randomised control trials with dich...
CONTEXT: Systematic review evidence provides best justification for specific beliefs regarding clinical interventions. The degree of such belief depends on the precision and internal validity of the evidence. While precision is often achieved on basis of quantification and statistical analysis, the (internal) validity of the evidence is appraised through judgement of the risk for several known biases. Against the background of the subsequent results, a conclusion is formulated in answer t...
CONTEXT: Clinical knowledge, as any other type of knowledge, can be regarded as justified belief. The justification of belief follows two cognitive strategies: coherence of logic and correspondence of facts. PROBLEM: Coherence strategy has been traditionally favoured in the justification of beliefs concerning medical interventions throughout the centuries and is today still preferred by many clinicians as providing “logical sense” for or against the application of therapies, diagnostic...
BACKGROUND: This 3rd systematic review update includes evidence from further Chinese trials that were identified during reference re-check and regression analysis of the possible influence of split-mouth study design on overall results. REVIEW OBJECTIVE: This systematic review seeks to answer the question as to whether, in patients with carious cavities of any class in primary and permanent teeth, ART restorations with high-viscosity GIC have a higher failure rate than amalgam restorations...
BACKGROUND: This further systematic review update includes evidence from Chinese trials that were initially still under translation, as well as corrections of all identified errata. Atraumatic Restorative Treatment (ART) is a minimally invasive procedure that involves removing markedly softened carious enamel and dentine, using only hand instruments, and then restoring the resulting cavity with an adhesive restorative material. Although developed for use in the less industrialized parts o...