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2.
J Am Dent Assoc ; 151(10): 796-797.e2, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32979959

RESUMEN

BACKGROUND: Bonding crowns and bridges with resin cement can improve retention and reinforcement of the restoration. However, there is variation in the steps taken by different practitioners to achieve this goal. METHODS: The authors developed a survey on bonding dental crowns and bridges with resin cement and distributed it electronically to the American Dental Association Clinical Evaluators (ACE) Panel on May 22, 2020. The survey remained open for 2 weeks. Descriptive data analysis was conducted using SAS Version 9.4. RESULTS: A total of 326 panelists responded to the survey, and 86% of respondents who place crowns or bridges use resin cements for bonding. When placing a lithium disilicate restoration, an almost equal proportion of respondents etch it with hydrofluoric acid in their office or asked the laboratory to do it for them, and more than two-thirds use a silane primer before bonding. For zirconia restorations, 70% reported their restorations are sandblasted in the laboratory, and 39% use a primer containing 10-methacryloyloxydecyl dihydrogen phosphate. One-half of respondents clean their lithium disilicate or zirconia restorations with a cleaning solution. Resin cements used with a primer in the etch-and-rinse mode are the most widely used. The technique used to cure and clean excess resin cement varies among respondents. CONCLUSIONS: The types of resin cements used, tooth preparation, crown or bridge preparation, and bonding technique vary among this sample. PRACTICAL IMPLICATIONS: Although many dentists bond crowns and bridges on the basis of best practices, improvement in the process may be achieved by dentists communicating with their laboratory to confirm the steps performed there, ensuring an effective cleaning technique is used after try-in and verifying that the correct primer is used with their chosen restorative material.


Asunto(s)
Recubrimiento Dental Adhesivo , Cementos de Resina , American Dental Association , Coronas , Cementos Dentales , Materiales Dentales , Porcelana Dental , Análisis del Estrés Dental , Humanos , Ensayo de Materiales , Propiedades de Superficie , Encuestas y Cuestionarios , Estados Unidos
5.
J Am Dent Assoc ; 151(8): 556, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32718482
6.
J Am Dent Assoc ; 151(7): 544-545.e2, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32498964

RESUMEN

BACKGROUND: The ability to polymerize light-activated dental materials with dental light-curing units (DLCUs) has revolutionized dentistry. However, proper DLCU use is essential for ensuring the effectiveness and performance of these materials. METHODS: The authors developed an electronic cross-sectional survey in the American Dental Association Qualtrics Research Core platform. The survey included questions about DLCU use, unit type and selection, training, maintenance, technique, and safety measures. The authors deployed the survey to 809 American Dental Association Clinical Evaluators (ACE) panelists on October 9, 2019, and sent reminder links to nonrespondents 1 week later. They conducted exploratory and descriptive analyses using SAS software Version 9.4. RESULTS: Of the 353 ACE panelists who completed the survey, most used a DLCU in their practices (99%), and light-emitting diode multiwave units were the most common type of DLCU units (55%). Dentists use DLCUs for over one-half of their appointments each day (mean [standard deviation], 59% [22%]). Regarding technique, respondents reported that they modify their curing technique on the basis of material thickness (79%) and material type or light tip-to-target distances (59%). Maintenance practices varied, with two-thirds of respondents reporting that they periodically check their DLCUs' light output. CONCLUSIONS: DLCUs are an integral part of a general dentist's daily practice, but maintenance, ocular safety, and technique varied widely among this sample. PRACTICAL IMPLICATIONS: Because clinical effectiveness requires delivery of an adequate amount of light energy at the appropriate wavelength, variation in DLCU maintenance, safety, and techniques suggest that dentists could benefit from additional guidance and training on DLCU operation.


Asunto(s)
Resinas Compuestas , Luces de Curación Dental , American Dental Association , Estudios Transversales , Encuestas y Cuestionarios , Estados Unidos
9.
J Dent Educ ; 84(3): 279-282, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32115710

RESUMEN

Population demographic shifts in the United States and Canada have led to an increasingly diverse postsecondary student population. However, the largely homogenous dental faculty in the United States and Canada does not reflect the rapidly changing student body and the diverse patient population academic dentistry has been called to serve. Therefore, recruitment and retention of diverse dental faculty in dental education must be a priority. Substantial evidence also indicates improved outcomes for faculty, students, and institutions when faculty diversity on campus is increased. Beyond the positive impact faculty diversity can deliver to the learning and working environments of an academic institution, a variety of regulatory bodies mandate good faith efforts to maintain a diverse faculty, including the Commission on Dental Accreditation (CODA) standards for dental schools and dental therapy education programs. To assist its member institutions with answering the call for improved faculty diversity, the American Dental Education Association (ADEA) worked with its members to develop the ADEA Faculty Diversity Toolkit (ADEA FDT), a landmark evidence-based resource designed to assist dental education with the design and implementation of faculty recruitment and retention initiatives that can be tailored to their unique needs. This article provides an overview of the changing landscape of the United States and Canadian populations, shares the historic homogeneity of dental education faculty, provides an overview of some of the benefits associated with faculty diversity and highlights the challenges and barriers related to recruiting and retaining diverse faculty. Most importantly, it introduces the ADEA FDT and the need for dental schools and allied dental programs to use the Toolkit as a proactive resource in increasing and maintaining faculty diversity. Furthermore, it provides an overview of how to utilize and adapt the highlighted best practices and model programs to improve faculty diversity on their campuses.


Asunto(s)
Educación en Odontología , Docentes de Odontología , American Dental Association , Canadá , Humanos , Facultades de Odontología , Estados Unidos
10.
J Am Dent Assoc ; 151(4): 303-304.e2, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32222178

RESUMEN

BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted oncovirus associated with several malignancies, including oropharyngeal squamous cell carcinoma. The 9-valent HPV vaccine can help protect against the high-risk HPV strains most commonly associated with HPV-related cancers. METHODS: The authors used an electronic survey to assess the roles of dentists and their team members in discussing the HPV vaccine, as well as administering the vaccine in a dental setting. On December 6, 2019, the authors e-mailed a survey link to the American Dental Association Clinical Evaluators (ACE) Panel (n = 813), a sample of American Dental Association member dentists. After 1 e-mail reminder, the survey closed on December 19, 2019, and the authors conducted exploratory and descriptive data analyses using SAS Version 9.4 (SAS). RESULTS: A total of 329 dentists responded to the survey, and 83 (25%) of them reported that they or their team members discuss the implications of the HPV vaccine with age-eligible patients or their parents or guardians. Dentists lead two-thirds (n = 218) of the discussions, and the clinical examination is the most frequent moment during the patient visit in which HPV-related topics are discussed. Some of the top reasons respondents mentioned for not discussing the vaccine in their practice were the perception that these discussions are best left to other health care professionals and not knowing how to address the topic with patients. If the scope of dental practice is expanded to include administering the vaccine, 125 (38%) of respondents would feel uncomfortable administering the vaccine. The most common potential barriers to administering the vaccine in a dental setting include obtaining reimbursement and vaccine management and preservation. CONCLUSIONS: The survey results suggest that dentists' comfort levels and perceived roles in discussing and administering the HPV vaccine vary. PRACTICAL IMPLICATIONS: There is a need to further define the role of dentists and their team members in the promotion and administration of the HPV vaccine. Resources for dentists and dental team members may be helpful to support professional education and communication about the HPV vaccine.


Asunto(s)
Infecciones por Papillomavirus , Vacunas contra Papillomavirus , American Dental Association , Conocimientos, Actitudes y Práctica en Salud , Humanos , Encuestas y Cuestionarios , Estados Unidos
11.
J Am Dent Assoc ; 151(1): 72, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31902404
13.
J Dent Educ ; 84(11): 1314-1320, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33460138

RESUMEN

There is a continuous challenge in academic health education to retain early career faculty members and staff. Attrition rates in the field can be as high as 42% in the first five years of an individual's career and are principally due to a sense that academic careers do not progress at a satisfactory rate. In response to this ongoing issue, the American Dental Education Association launched the Summer Program for Emerging Academic Leaders (ADEA EL) in 2012. The program has supported 301 participants from over 74 academic programs and private practice institutions. This current study describes data collected from program participants in an effort to conduct a thorough review of the program. In all, pre- and post-program data were assessed from faculty members and staff who have participated in the program over its eight-year history. The outcomes of this mixed-methods study describe an assessment of the curriculum (including changes that have occurred over the tenure of the program), the fit of the intended learning outcomes, reasons why a program such as the ADEA EL is needed, and what can be done to provide additional leadership resources and support for faculty members in dental education. This study represents the first time a longitudinal report of a professional development program designed exclusively for early-career faculty and staff has been described in the literature. Its outcomes are intended to be supportive of institutions and other programs focused on support and retention of early faculty and staff.


Asunto(s)
Docentes de Odontología , Liderazgo , American Dental Association , Curriculum , Docentes Médicos , Humanos , Desarrollo de Programa , Desarrollo de Personal , Estados Unidos
14.
J Am Dent Assoc ; 150(11): 906-921.e12, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31668170

RESUMEN

BACKGROUND: An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulp necrosis and symptomatic apical periodontitis, or pulp necrosis and localized acute apical abscess using antibiotics, either alone or as adjuncts to definitive, conservative dental treatment (DCDT) in immunocompetent adults. TYPES OF STUDIES REVIEWED: The authors conducted a search of the literature in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature to retrieve evidence on benefits and harms associated with antibiotic use. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and the Evidence-to-Decision framework. RESULTS: The panel formulated 5 clinical recommendations and 2 good practice statements, each specific to the target conditions, for settings in which DCDT is and is not immediately available. With likely negligible benefits and potentially large harms, the panel recommended against using antibiotics in most clinical scenarios, irrespective of DCDT availability. They recommended antibiotics in patients with systemic involvement (for example, malaise or fever) due to the dental conditions or when the risk of experiencing progression to systemic involvement is high. CONCLUSION AND PRACTICAL IMPLICATIONS: Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate DCDT should be prioritized in all cases.


Asunto(s)
American Dental Association , Absceso Periapical , Adulto , Antibacterianos , Odontología Basada en la Evidencia , Humanos , Odontalgia
16.
J Am Dent Assoc ; 150(12): e179-e216, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31761029

RESUMEN

BACKGROUND: Patients with pulpal and periapical conditions often seek treatment for pain, intraoral swelling, or both. Even when definitive, conservative dental treatment (DCDT) is an option, antibiotics are often prescribed. The purpose of this review was to summarize available evidence regarding the effect of antibiotics, either alone or as adjuncts to DCDT, to treat immunocompetent adults with pulpal and periapical conditions, as well as additional population-level harms associated with antibiotic use. TYPE OF STUDIES REVIEWED: The authors updated 2 preexisting systematic reviews to identify newly published randomized controlled trials. They also searched for systematic reviews to inform additional harm outcomes. They conducted searches in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. Pairs of reviewers independently conducted study selection, data extraction, and assessment of risk of bias and certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: The authors found no new trials via the update of the preexisting reviews. Ultimately, 3 trials and 8 additional reports proved eligible for this review. Trial estimates for all outcomes suggested both a benefit and harm over 7 days (very low to low certainty evidence). The magnitude of additional harms related to antibiotic use for any condition were potentially large (very low to moderate certainty evidence). CONCLUSIONS AND PRACTICAL IMPLICATIONS: Evidence for antibiotics, either alone or as adjuncts to DCDT, showed both a benefit and a harm for outcomes of pain and intraoral swelling and a large potential magnitude of effect in regard to additional harm outcomes. The impact of dental antibiotic prescribing requires further research.


Asunto(s)
Antibacterianos , Periodontitis Periapical , Pulpitis , Absceso , Adulto , American Dental Association , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estados Unidos
19.
J Dent Educ ; 83(7): 770-775, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31262794
20.
Evid Based Dent ; 20(1): 7-8, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30903116

RESUMEN

Scope and purpose This guideline concerns patients with no lesions, innocuous or nonsuspicious lesions, lesions suspected to be potentially malignant as well as malignant lesions of the oral cavity. The audience for this guideline is health care workers who examine the mouth as well as community dental health co-ordinators and policy makers. Methodology The Appraisal of Guidelines Research & Evaluation reporting checklist II and the GIN-McMaster Guideline Development Checklist were followed and the guideline is partly informed by systematic reviews and diagnostic test accuracy meta-analyses. Studies assessing patients' values and preferences were also considered. The process of moving from the evidence to decisions and the formulation was guided by GRADE (Grading of Recommendations Assessment, Development and Evaluation).Review and Updating Updates for this guideline will be conducted every five years or when new emerging evidence indicates a potential change in the recommendation statements from the expert panel. Any updated versions of this guideline will be available at the ADA Center for Evidence-Based Dentistry's website: www.ebd.ada Recommendations The expert panel developed six conditional recommendations, all based on evidence rated as low to very low quality using GRADE. 1. For patients with a clinically evident oral mucosal lesion with an unknown clinical diagnosis considered to be seemingly innocuous or nonsuspicious of malignancy, or other symptoms, clinicians should follow up periodically to determine the need for further evaluation. If the lesion has not resolved and the clinical diagnosis of a potentially malignant disorder cannot be ruled out, then clinicians should perform a biopsy of the lesion or refer the patient to a specialist.2. For patients with a clinically evident oral mucosal lesion considered to be suspicious of a potentially malignant or malignant disorder, or other symptoms, clinicians should perform a biopsy of the lesion or provide immediate referral to a specialist.3. Cytologic adjuncts for the evaluation of potentially malignant disorders among adult patients with clinically evident, seemingly innocuous or suspicious lesions are not recommended. Should a patient decline the clinician's recommendation for performing a biopsy of the lesion or referral to a specialist, the clinician can use a cytologic adjunct to provide additional lesion assessment. A positive or atypical cytologic test result reinforces the need for a biopsy or referral.A negative cytologic test result indicates the need for periodic follow-up of the patient. If the clinician detects persistence or progression of the lesion, immediately performing a biopsy of the lesion or referral to a specialist is indicated.4. The panel does not recommend autofluorescence, tissue reflectance or vital staining adjuncts for the evaluation of potentially malignant disorders among adult patients with clinically evident, seemingly innocuous or suspicious lesions.5. The panel suggests that for patients with no clinically evident lesions or symptoms, no further action is necessary at that time.6. The panel does not recommend commercially available salivary adjuncts for the evaluation of potentially malignant disorders among adult patients with or without clinically evident, seemingly innocuous or suspicious lesions and their use should be considered only in the context of research.Research recommendations There is a need for better estimation of the prevalence of potentially malignant disorders (PMDs) and oral squamous cell carcinoma (OSCC) in populations with different baseline risks. More information on patients' values and preferences is required as well as studies on the diagnostic test accuracy of cytologic and salivary adjuncts.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de la Boca , Adulto , American Dental Association , Humanos , Derivación y Consulta
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