Literature Watch

The Evidence-Based Dentistry Champions: a Grassroots Approach to the Implementation of EBD
Monday, July 07, 2008

The June 2008 issue of The Journal of Evidence-Based Dental Practice features an article "The Evidence-Based Dentistry Champions: a Grassroots Approach to the Implementation of EBD". The article describes the use of Champions, influential individuals to support thetransfer of knowledge among their peers, as one effective approach used by others in the health care field to successfully implement science research into clinical care. Due to copyright restraints, only the abstract can be viewed. Click here to go to the PubMed website.

January 2008 issue of JADA features 2 articles and editorial regarding bisphosphonate-associated osteonecrosis of the jaws (ONJ)
Friday, January 11, 2008

January 2008 edition of JADA has published two articles, as well as an editorial, that address the issue of bisphosphonate-associated ONJ. The first article, "Bisphosphonate Use and the Risk of Adverse Jaw Outcomes: A medical claims study of 714,217 people", used a retrospective review to identify osteoporosis and specific cancer patients and divide them into bisphosphonate (BP) exposed and non-exposed patients. Results showed that both osteoporosis and cancer patients treated with IVBP had a significantly higher number of inflammatory conditions of the jaws and higher number of surgical procedures. Osteoporosis patients treated with oral BP had a significantly lower number of inflammatory jaw conditions. All other analyses showed no statistical differences. The authors concluded that IVBP constitutes a risk for ONJ while oral BP may be protective.

This study has significant limitations, including a retrospective design and use of surrogate markers for ONJ. The authors also assume that all patients who were prescribed oral BP were compliant with their treatment, which is contrary to other published results. No effort was made in this study to confirm claims data against medical charts. It is also highly unlikely that cancer patients and osteoporosis patients treated with highly different amounts of IVBP will have the same association with ONJ. These findings contradict previous reports. Due to copyright restraints, only the abstract can be viewed. Click here to view the abstract on the PubMed website.

The second article, "Incidence of Osteonecrosis of the Jaw in Women With Postmenopausal Osteoporosis in the Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly Pivotal Fracture Trial", was sponsored by NOVARTIS (the maker of zoledronic acid). These are results of a study previously published elsewhere, which did not have ONJ as one of its studied outcomes. Osteoporosis patients were treated with 5mg zoledronic acid IV yearly or placebo. About half of the patients received two drug administrations while the other half got all three doses during the 3 year study duration. The main study outcome was the number of bone fractures, which was significantly lower in the BP treated group. A review of the adverse effects uncovered one ONJ case in the BP-treated group and one in the control group. The authors concluded that there is no increased risk of ONJ from 5mg zoledronic acid IV administered yearly.

The limitations here are: no information on dental treatment is presented and the patients were followed for a very brief period of time. Given the frequency of ONJ reported in the literature for osteoporosis patients and the average time to development of jaw necrosis in this group, two to three doses of drug would not be expected to produce significant results. These findings contradict results published by Cartsos et al in the article discussed above. Due to copyright restraints, only the abstract can be viewed. Click here to view the abstract on the PubMed website.

The design of these two studies substantially limit their ability to inform daily clinical practice. An editorial, "Closing in on the Puzzle of ONJ", about these two articles by Michael Glick, JADA’s Editor–in-Chief, notes that “these studies do not help clarify the potential adverse effects of dental treatment in patients taking bisphosphonates.” DPBRN has two ONJ studies ongoing (DPBRN Study 7 and 12) that are designed to inform daily clinical practice. Results from these studies should be released in late 2008. Click here to view the editorial on the JADA website.

The Creation and Development of the Dental Practice-Based Research Network
Monday, January 07, 2008

The January 2008 issue of JADA features an article DPBRN entitled "The Creation and Development of the Dental Practice-Based Research Network". The article describes the creation and development of DPBRN, which originally began as the Alabama Dental Practice-Based Research Network in 2002. The article also explains the administrative and study development process within the network. Due to copyright restraints, only the abstract can be viewed. Click here to view the abstract on the PubMed website.

Intravenous Bisphosphonate Therapy and Inflammatory Conditions of the Jaw: A Population-based Analysis
Tuesday, December 04, 2007

This article from the July 2007 issue of The Journal of the National Cancer Institute investigates the association between intravenous bisphosphonate use and ONJ. Click here to view the article.

Economic Impact of Regulating the Use of Amalgam Restorations
Friday, August 10, 2007

An article on the economic impact of regulating the use of amalgams is in the September-October 2007 issue of Public Health Reports. In it, they discuss the financial impact of a ban on amalgam.

Click here to view the article.

Food and Drug Administration Toothpaste Alert
Monday, July 09, 2007

The U.S. Food and Drug Administration issued a warning to consumers to avoid using tubes of toothpaste labeled as made in China. The agency issued alert to prevent toothpaste containing the poisonous chemical diethylene glycol (DEG) from entering the country. DEG is used in antifreeze and as a solvent.

Click here to read this important information.

Study links chronic periodontitis to tongue cancer
Tuesday, May 29, 2007

The ADA recently published an article that links chronic periodontitis to an increased risk in tongue cancer in men.

To read more about the study, click here.

Overview of Osteonecrosis of the Jaw (ONJ)
Thursday, May 17, 2007

The ADA recently published a news article regarding Bisphosphonate medications and their link to ONJ. Included are the list of medications associated with ONJ and treatment guidlines.

Click here to read the overview.

Click here to read the treatment guidelines.

Updated guidelines recommend antibiotic prophylaxis for fewer dental patients
Monday, April 30, 2007

This news story from the ADA news posted April 19, 2007, discusses the revised guidelines for antibiotic prohylaxis in the dental office. The new guidelines include reducing the number of patients who have to be pre-medicated.

Click here to view the news story.

Practice-Based Research-"Blue Highways" on the NIH Roadmap
Wednesday, February 14, 2007

An article on practice-based research is in the January issue of JAMA. In it, they discuss the importance of practice-based research networks. Some of the benefits of PBRNs are: (1) their ability to identify problems that arise in daily clinical practice; (2) their ability to more quickly translate research into daily clinical practice that can improve clinical practice for the benefit of the patients; and (3) their ability to access a large number of patients. Practice-based research is the final common pathway for improving individual patient care and outcomes. Click here to view the article.

The evidence supporting alternative management strategies for early occlusal caries and suspected occlusal dentinal caries
Tuesday, January 09, 2007

This article from the March 2006 issue of The Journal of Evidence-Based Dental Practice assesses the strength of the evidence describing the effectiveness of alternative strategies to the detection and management of early occlusal caries and suspected occlusal dentinal caries. Click here to view the abstract of the article. Due to copyright restraints, only the abstract can be viewed.

Practicing dentistry using findings from clinical research: You are closer than you think
Tuesday, January 09, 2007

The November 2006 issue of JADA features a commentary regarding the 3 Dental Practice-Based Research Networks (DPBRN, PEARL, PRECEDENT) receiving funding from NIH-NIDCR. The commentary focuses on the importance of this research, the benefits of participating in a dental practice-based research network, as well as the knowledge gained from the results of the studies. To view the entire commentary, please visit the JADA website at www.jada.ada.org.

Diagnostic tools for early caries detection
Thursday, December 21, 2006

This article from the December 2006 issue of JADA reviews diagnostic tools for early caries detection. Click here to view the abstract of the article. Due to copyright restraints, only the abstract can be viewed. In order to retrieve the full article, please go to the JADA website (www.ada.org).

Research as a Career Option for Dental Hygienists
Monday, December 04, 2006

The November 2006 issue of Access published an article citing the various options that research has to offer for dental hygienists. Among them are the 3 Dental Practice-Based Research Networks, including DPBRN. Click here to view the article in its entirety.

Charles CH, Cugini M. Research as a career option for dental hygienists.Access 2006; 20(9):27-31. Reprinted by permission of the American Dental Hygienists' Association.

Information on cracked tooth syndrome
Thursday, October 26, 2006

One of the most requested topics of discussion is related to cracked teeth. In the June 2006 issue of Dental Truamatology, the aim of the study was to analyze the cases of tooth cracks in a dental hospital in a year, and to find out the characteristic features of cracks of teeth. Click here to read the abstract.

ADA Evidence-based clinical recommendations
Thursday, July 20, 2006

The ADA recently made available the evidence-based clinical recommendations for professionally-applied topical fluoride. These recommendations were developed through evidence-based assessments. Click here to see the Evidence-based Clinical Recommendations report of the Council on Scientific Affairs. Click here to visit the ADA's website.

Journal of the Canadian Dental Association's "Point of Care" article
Wednesday, April 19, 2006

The Journal of the Canadian Dental Association has begun a “Point of Care” section that is designed to answer “everyday clinical questions by providing practical information that aims to be useful at the point of patient care.” DPBRN practitioner-investigators may find this Point of Care section useful. Click here to access this month's issue.

Making Sense of Evidence-Based Dentistry
Monday, February 20, 2006

One of the practitioner-investigators in the DPBRN, Dr. Brad Rindal, and a colleague at the University of Minnesota, Dr. Gary Anderson, wrote an article entitled "Making Sense of Evidence-Based Dentistry" in Northwest Dentistry, the journal of the Minnesota Dental Association. In it they discuss the role of scientific evidence in daily clinical practice, address concerns that some dentists may have about evidence-based dentistry, and discuss opportunities for the future of dentistry. Click here to read the article.

Clinical diagnosis of recurrent caries
Thursday, November 17, 2005

This article from the October 2005 issue of JADA reviews practice-based literature regarding the diagnosis of recurrent caries. Click here to view the abstract of the article. Due to copyright restraints, only the abstract can be viewed. In order to retrieve the full article, please go to the JADA website (www.ada.org).

Research in general dental practice
Monday, August 15, 2005

This article, by four DPBRN investigators, found in the Feb 2005 issue of Acta Odontologica Scandinavica, presents the need for a change in clinical dental research towards practice-based research. Click here to view the abstract. Click here to view the full paper.

Primary Care Practice-Based Research Networks: Working at the Interface between Research and Quality Improvement
Monday, August 15, 2005

This May/June 2005 issue of Annals of Famliy Medicine describes the emerging role of primary care practice-based research, quality improvement, and translation of research into practice. Click here to view the article.

The National Institute of Dental and Craniofacial Research Research for the practicing dentist
Wednesday, June 01, 2005

This article from the June 2005 issue of JADA discusses the new NIDCR initiative in general dentistry practice-based research. It also highlights research supported by the NIDCR and its implications for dental practices in restorative dentistry. Click here to view the abstract of the article. Due to copyright restraints, only the abstract can be viewed. In order to retrieve the full article, please go to the JADA website (www.ada.org).

"The integration of clinical research into therapeutic research: the role of the astute clinician"
Wednesday, March 30, 2005

This article reviews the strategies needed to engage clinicians in the process of therapeutic intervention through clinical research. Click here to view the abstract of the article, which appeared in the November 2004 edition of the Journal of the American Dental Association. Due to copyright restraints, only the abstract can be viewed. In order to retrieve the full article, please go to the JADA website (www.ada.org).

"The health insurance portability and accountability act privacy rule: a practical guide for researchers"
Wednesday, March 30, 2005

This article reviews the HIPPA guide for researchers. Click here to bring up the abstract of the article, which appeared in the April 2004 edition of Medical Care. Due to copyright restraints, only the abstract can be viewed.

"A primer for the HIPPA privacy rule for practice-based researchers"
Wednesday, March 30, 2005

This article reviews the HIPPA for practice-based researchers. Click here to bring up an Adobe pdf file of the article, which appeared in the November-December 2004 edition of the Journal of the American Board of Family Practice.

"A systematic review of the performance of a laser fluorescence device for detecting dental caries"
Monday, November 08, 2004

This article reviews the diagnostic performance of the DIAGNOdent device. Click here to bring up the abstract of the article, which appeared in the October 2004 edition of the Journal of the American Dental Association. Due to copyright restraints, only the abstract is available. For the full text, please visit the JADA website (www.ada.org).

"Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice?"
Monday, November 08, 2004

This article reviews the current state of patient care for dental caries. Click here to bring up an Adobe pdf file of the article, which appeared in Caries Research in 2004, published by S. Karger AG, Basel.

"Modern Concepts of Caries Measurement"
Monday, November 08, 2004

This article reviews the state of the science on the clinical management of dental caries. Click here to bring up an Adobe pdf file of the article, which appeared in a 2004 Special Issue of the Journal of Dental Research.