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- Volume 5, Issue 2, 2012
Journal of Minimum Intervention in Dentistry - Volume 5, Issue 2, 2012
Volume 5, Issue 2, 2012
Author Steffen MickenautschSource: Journal of Minimum Intervention in Dentistry 5, pp 23 –28 (2012)More Less
Context : Systematic reviews of clinical trials need to assess the risk of attrition bias as part of its appraisal of the currently available evidence to a particular review question.
Problem : Notwithstanding the possible merits of different approaches to estimate the potential intervention outcomes of lost trial participants as the main reason for attrition bias, most remain arbitrary.
Suggested solution : Assuming a worst- and best-case scenario of intervention outcomes provides the certainty that neither lower nor higher values beyond these scenarios, respectively, are possible. Thus, worst- and best-case scenarios provide extreme outcome values that have the same probability to correspond with the true intervention outcome as any other possible scenario in between these extremes. Worst- and best-case scenarios can be calculated for dichotomous and continuous data, if the number of lost trial participants per intervention group is known. The results may then be compared to the intervention outcomes computed for participants available to follow-up and on this basis conclusions concerning attrition bias risk been drawn: i.e. risk of attrition bias may be assumed if the computed outcomes between worst- and best-case scenario and the intervention outcomes computed for participants available to follow-up differ significantly. Care needs to be taken not to accept the results of either worst- or best case-scenario as evidence for clinical considerations. They only provide evidence, if they differ significantly, for reasonable doubt concerning the validity of trial results in light of potential attrition bias risk.
Failure rate of atraumatic restorative treatment using high-viscosity glass-ionomer cement compared to conventional amalgam restorative treatment in primary and permanent teeth : a systematic review update [protocol]Source: Journal of Minimum Intervention in Dentistry 5, pp 29 –42 (2012)More Less
This protocol has been registered with the International Prospective Register for Systematic Reviews (PROSPERO) on the 05 January 2012 under registration number CRD42012001887 (Available online from http://www.crd.york.ac.uk/PROSPERO/full_doc.asp?ID=CRD42012001887). This protocol comprises an update of an existing systematic review report by the authors as part of the SYSTEM initiative: Mickenautsch S, Yengopal V, Banerjee A. Atraumatic restorative treatment versus amalgam restoration longevity: a systematic review. Clin Oral Investig 2010; 14: 233-40. The protocol of this original review was not registered. This update will differ from the original review by changing and adding the following:
PICO question : while the original review focused on the comparative success rate, this update will focus on the comparative failure rate between ART and amalgam restorations;
Systematic literature search : extended to the databases for open access journals (OpenJ-Gate); regional databases (LILACS, BBO, IndMed, SABINET, Scielo); grey literature sources (Scirus/Medicine, OpenSIGLE, GoogleScholar); hand-searching of additional journals that were identified as not been indexed in above databases; searching of reference lists of included articles; Search term development: a detailed search strategy will be added; the search cut-off date will be extended beyond the date of the original systematic review;
Article inclusion criteria : while the original review focused on articles published in English, only, this update will have no restriction on the publication language type;
Article exclusion criteria : while the original review used lack of randomisation/quasi-randomisation as criteria for exclusion, this update will include all clinical controlled trials for data extraction;
Data extraction: The information extracted from trials will be more extensive in terms of general trial information, intervention integrity, methodological quality and bias risk;
Data analysis and reporting: in addition to a computed relative point estimate (RR = Risk ratio), the results will also be converted into an absolute outcome measure (RD = Risk difference), as well as an illustrative comparative risk for both, test- and control intervention, and reported accordingly; a summary of findings table will be added; statistical heterogeneity will be investigated using regression analysis; sensitivity analysis will be added in order to establish whether all findings are robust to the type of data analysis used;
The original quality assessment of studies, including its criteria, will be replaced by a more stricter assessment of selection-, detection-, performance-, attrition bias risk; the assessment of publication- and reporting bias risk in the accepted trials will be added;
Research gaps within accepted trials in terms of imprecision, inconsistency, lack of right information and shortcomings in bias risk control will be identified using a designated worksheet and subsequently more detailed recommendations for further research will be added to the this systematic review update.
Source: Journal of Minimum Intervention in Dentistry 5, pp 43 –51 (2012)More Less
Some ten years after the development of the composite resin family there was another addition to the class of adhesive restorative materials. In the mid 1960s polycarboxylate cements based upon zinc oxide combined with polyalkenoic acid were developed. These demonstrated some level of ion exchange adhesion with tooth structure but they lacked both tensile and compressive strength. Alan Wilson and his team at the London Government Chemist understood the chemistry and combined a polyalkenoic acid with a silica glass, similar to that used in the silicate cements, instead of zinc oxide and developed the glass-ionomer cements. It was a further ten years before these were fully developed as a family with unique and valuable properties for use in clinical dentistry.
Source: Journal of Minimum Intervention in Dentistry 5, pp 52 –57 (2012)More Less
GV Black called the fissure lesion on the occlusal surface of posterior teeth the Class I lesion because he recognized it as the most common lesion. It is still the most common lesion simply because there are often developmental faults within the fissures and bacterial plaque can be forced down into the fissure but it cannot be easily removed. The profession therefore has a responsibility to carefully assess all fissures and be prepared to undertake preventive measures to preserve their integrity. Atraumatic restorative treatment (ART) has proven to be of great value in areas where there are no organized dental services and often no electricity and many patients have been given comfort and relief from pain in a simple relatively inexpensive manner using hand instruments only.