DENTAL PATIENT-REPORTED OUTCOMES UPDATE 2023.

The emergence and rapid development of disruptive innovations are quickly turning our profession into personalized dentistry, built upon evidence-based, data-oriented, and patient-centered research. In order to help improve the quality and quantity of patient-centered evidence in dentistry, further promote the wide and standard use of dental patient-reported outcomes (dPROs) and dental patient-reported outcome measures (dPROMs), the Journal of Evidence-Based Dental Practice has put together this special issue, the third of a series entitled Dental Patient-Reported Outcomes Update. A total of 7 solicited articles are collected in this issue. To put them into a broader perspective, this review provides a concise summary of key, selected PRO and dPRO articles published during 2023. A brief introduction to those articles included in this Special Issue follows. Four main domains are covered in this Special Issue: (1) dPROs and digital dentistry, (2) standardization of dPRO-related methodology, (3) current usage of dPROs and dPROMs in published research, and (iv) the significance and relevance of dPRO usage.

New dental graduates transition into UK professional practice; a longitudinal study of changes in perceptions and behaviours through the lens of evidence-based dentistry.

BACKGROUND: This longitudinal study using qualitative methodology aims to investigate the perceptions, and implementation, of evidence-based guidelines into practice among new dental graduates (NDGs) during their transition from university into professional practice, by identifying factors that influence the adoption of evidence-based practice (EBP) in dental practice. METHODS: The study invited NDGs from one UK dental school (N = 66) and employed longitudinal, multiple qualitative methodologies for data collection, throughout the participants' Vocational Dental Training (VDT) year. Initial interviews (Interview 1) conducted upon graduation and follow-up interviews (Interview 2) carried out between six and nine months into professional practice were combined with participants longitudinal audio diaries (LADs) recorded between the interviews. RESULTS: A total of 12 NDGs agreed to participate. For Interview 1, twelve participants were interviewed, seven of whom agreed to participate in Interview 2 and six recorded the LADs. Interview 1 exposed diverse views among NDGs about EBP, acknowledging its significance but facing obstacles in implementation due to time and financial constraints. They intended to use evidence selectively, often aligning with trainers' or NHS treatment options, while hesitating to fully embrace EBP in a busy dental practice. During VDT, LAD entries showed initial enthusiasm for EBP, but integrating evidence-based guidelines within the NHS system led to pragmatic treatment decisions, balancing gold-standard and cost-effective options. Over time, NDGs became more comfortable with alternative treatments, considering patients' financial constraints, yet they expressed frustration with external pressures limiting their clinical decision-making autonomy. In Interview 2, after six to nine months in practice, NDGs exhibited mixed attitudes towards EBP. Some actively used dental guidelines like SDCEP, others associated EBP with hi-tech or expensive materials, while others would thought to rely on colleagues' recommendations. None consistently sought direct evidence for treatment decisions. CONCLUSION: NDGs' attitudes towards EBP changed and became more negative over their first year in professional practice, leading to challenges in their applying it. It questions the assumption that teaching EBP during undergraduate education ensures its implementation. Further understanding the influences on the development of attitudinal challenges will help to devise effective strategies for fostering lifelong learning and supporting evidence-based practice in dentistry.

THE 3P MODEL AND ORAL HEALTH IMPACT: DEMONSTRATING THE IMPORTANCE OF BEHAVIORAL AND SOCIAL SCIENCES IN THE FUTURE OF EVIDENCE-BASED DENTISTRY.

Oral health impact or oral health related quality of life is an increasingly important and well-known metric in dental care and research. There have been recent calls for greater integration of the behavioral and social sciences into oral health research and practice, including the need for frameworks and theories to guide this work. One such framework for understanding the role of predisposing, precipitating, and perpetuating biopsychosocial mechanisms in health and disease is the "3P" model. Here, the 3P model is described and applied to case examples to help understand the development and maintenance of oral health impact. Additionally, this paper outlines how this conceptualization using the 3P model and oral health impact makes way for greater integration of behavioral interventions to prevent, mitigate, or treat the negative impact that oral, craniofacial, or dental disease may have on individuals. Doing this allows for a broadening of what evidence-based dentistry means for the future and provides a roadmap going forward.

Effectiveness of educational strategies to teach evidence-based dentistry to undergraduate dental students: a systematic review.

OBJECTIVES: Evidence-based dentistry (EBD) training has been widely promoted in dental schools around the world and policymakers ask for suitable strategies to teach EBD within undergraduate dental education. The present study aims to evaluate the effectiveness of these strategies on dental students' knowledge, attitude, and skills. METHODS: PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, and Eric databases were searched using search terms obtained from Medical Subject Headings (MeSH) terms and free text method without time restrictions, up to November 2022. The identified articles were screened based on titles and abstracts for inclusion criteria. Subsequently, relevant articles underwent data extraction. Finally, the risk of bias was assessed through Joanna Briggs Institute critical appraisal checklists. RESULTS: Twelve of 439 studies were included: nine quasi-experimental studies, two cross-sectional, and one randomized controlled trial study. Regarding the overlap among categories, six studies assessed knowledge, seven assessed attitude, and eight focused on skills or performance in EBD. Due to the heterogeneity of the interventions and results of included studies, a meta-analysis was not performed. EBD was mostly taught in small group collaborations. Interventions included lectures, workshops, seminars, small group sessions, journal clubs, online sessions, or a combination of them in various frequencies and duration. CONCLUSIONS: EBD implementation into dental curricula is improving through strategies including designing continuing and frequent dental education courses, establishing collaborative student research groups, utilizing online tools for EBD education, and dividing EBD courses into shorter modules. The systematic review protocol was registered in PROSPERO (ID: CRD42022350238).

Methodological quality of evidence-based clinical practice guidelines in cariology.

OBJECTIVE: The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS: A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS: Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION: The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE: Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.

Evaluation of the Performance of Generative AI Large Language Models ChatGPT, Google Bard, and Microsoft Bing Chat in Supporting Evidence-Based Dentistry: Comparative Mixed Methods Study.

BACKGROUND: The increasing application of generative artificial intelligence large language models (LLMs) in various fields, including dentistry, raises questions about their accuracy. OBJECTIVE: This study aims to comparatively evaluate the answers provided by 4 LLMs, namely Bard (Google LLC), ChatGPT-3.5 and ChatGPT-4 (OpenAI), and Bing Chat (Microsoft Corp), to clinically relevant questions from the field of dentistry. METHODS: The LLMs were queried with 20 open-type, clinical dentistry-related questions from different disciplines, developed by the respective faculty of the School of Dentistry, European University Cyprus. The LLMs' answers were graded 0 (minimum) to 10 (maximum) points against strong, traditionally collected scientific evidence, such as guidelines and consensus statements, using a rubric, as if they were examination questions posed to students, by 2 experienced faculty members. The scores were statistically compared to identify the best-performing model using the Friedman and Wilcoxon tests. Moreover, the evaluators were asked to provide a qualitative evaluation of the comprehensiveness, scientific accuracy, clarity, and relevance of the LLMs' answers. RESULTS: Overall, no statistically significant difference was detected between the scores given by the 2 evaluators; therefore, an average score was computed for every LLM. Although ChatGPT-4 statistically outperformed ChatGPT-3.5 (P=.008), Bing Chat (P=.049), and Bard (P=.045), all models occasionally exhibited inaccuracies, generality, outdated content, and a lack of source references. The evaluators noted instances where the LLMs delivered irrelevant information, vague answers, or information that was not fully accurate. CONCLUSIONS: This study demonstrates that although LLMs hold promising potential as an aid in the implementation of evidence-based dentistry, their current limitations can lead to potentially harmful health care decisions if not used judiciously. Therefore, these tools should not replace the dentist's critical thinking and in-depth understanding of the subject matter. Further research, clinical validation, and model improvements are necessary for these tools to be fully integrated into dental practice. Dental practitioners must be aware of the limitations of LLMs, as their imprudent use could potentially impact patient care. Regulatory measures should be established to oversee the use of these evolving technologies.

THE CONTENTS, METHODS, AND ASSESSMENT OF EVIDENCE-BASED DENTISTRY EDUCATION: A SCOPING REVIEW.

OBJECTIVE: With evidence-based dentistry (EBD) having a far-reaching influence on oral healthcare, dental educators worldwide have made joint efforts to integrate EBD-related knowledge and skills into dental education. The present scoping review aims to identify and summarize the existing teaching contents, teaching methods, and assessment strategies of EBD education. METHODS: Electronic (PubMed and Embase) and manual searches were performed to identify articles related to both "dental education" and "evidence-based practice." Based on predetermined eligibility criteria, articles were selected by 2 reviewers, independently and in duplicate. Data synthesis was conducted based on teaching contents, teaching strategies, and teaching assessment. RESULTS: Of the 1758 articles found in the literature searches, 74 were deemed eligible and included in this review. A total of 4 basic skills (problem formulation, literature searching, critical appraisal, and research methodology), 5 teaching methods, and 6 assessment strategies were identified. In most of the articles, 2, or more skills were taught, and a combination of traditional strategies for teaching and its assessment (eg, courses and questionnaire survey) was involved. Other teaching methods, such as journal clubs and workshops, were seldom used, and validated assessment tools accounted for a relatively small proportion of the assessment strategies involved. CONCLUSIONS: The contents, methods and assessment of EBD education have been widely studied and discussed. However, the current literature focuses mainly on teaching of critical appraisal skills, traditional teaching methods, and short-term outcome assessments. Future research in this area can be aimed at integrating all EBD-related skills into educational models, studying multifaceted teaching approaches, and developing comprehensive teaching outcome assessment methods based on validated tools and dental patient-reported outcomes.

Knowledge changes after applying evidence-based dentistry educational interventions to dental students: A systematic review.

PURPOSE: To critically evaluate the evidence on knowledge changes observed after the application of evidence-based dentistry (EBD) educational interventions to dental students. METHODS: We included studies that assessed EBD knowledge after applying educational interventions to undergraduates. Studies that evaluated post-graduate students or professionals, that exclusively described educational interventions, programs, or the application of curriculum revisions were excluded. Electronic databases (PubMed, Embase, Scopus, and Web of Science), unpublished gray literature, and manual searches were performed. Data concerning "perceived" and "actual knowledge" was extracted. The quality of the studies was appraised according to the Mixed Methods Appraisal Tool. RESULTS: The 21 selected studies enrolled students at different stages, and the intervention formats were diverse. The educational interventions could be categorized into three modalities, that is, regular, EBD-focused disciplines or courses, and other educational interventions including one or more of the EBD principles, methods, and/or practices. Despite the format, knowledge was generally improved after the implementation of educational interventions. Overall, perceived and actual levels of knowledge increased considering EBD general concepts, principles, and/or practices, and concerning the "acquire" and "appraise" skills. Among the selected studies, two were randomized controlled trials, while most were non-randomized or descriptive studies. CONCLUSIONS: EBD-related educational interventions seem to improve dental students' perceived and actual knowledge, according to literature with a high risk of bias. Therefore, more complete, methodologically rigorous, and longer-term studies are still recommended to confirm and expand the current knowledge.

Fatores que influenciam o perfil de conhecimento dos cirurgiões-dentistas brasileiros sobre sistemas adesivos / Factores que influyen en el perfil de conocimiento de los odontólogos brasileños sobre los sistemas adhesivos / Factors that influence the knowledge profile of Brazilian dental professionals about dental adhesive systems

Os sistemas adesivos estão diretamente envolvidos nos procedimentos mais corriqueiros da prática clínica odontológica, o que torna o seu conhecimentoindispensável para os profissionais. O objetivo do presente estudo foi avaliar o perfil de conhecimento sobre sistemas adesivos e verificar os fatores que influenciam nesse desfecho, com ênfase na formação profissional. A coleta de dados foi realizada pormeio de um questionário levando em consideração: I. Perfil do profissional; II. Conhecimento, uso e preferências sobre os sistemas adesivos. A amostra foi composta por 501 cirurgiões-dentistas brasileiros e os dados foram analisados no programa Sigma Stat5.0 (p<0,05). O percentual mínimo de acertos das questões considerado adequado foi definido como 80%. Os resultados mostraram que apenas 46,3% dos profissionais demonstraram conhecimento adequado sobre o assunto. Além disso, verificou-se associação estatisticamente significativa entre o baixo nível de acertos e profissionais com preferência por sistemas adesivos simplificados (p=0,046), especialistas em ortodontia [OR=0,24 (0,08-0,67)] e cirurgiões-dentistas graduados em instituições privadas [OR=1,58 (1,03-2,42)]. Esse cenário alerta para a necessidade iminente de sanar essa fragilidade por meio de melhorias nas matrizes curriculares, além da educação continuada de docentes e constante atualização dos profissionais (AU).

Los sistemas adhesivos están directamente involucrados en los procedimientos más comunes de la práctica clínica dental, lo que hace que su conocimiento sea fundamental para los profesionales. El objetivo del presente estudio fue evaluar el perfil de conocimiento sobre sistemas adhesivos y verificar los factores que influyen en ese resultado, con énfasis en la formación profesional. La recolección de datos se realizó a través de un cuestionario teniendo en cuenta: I. Perfil del profesional; II. Conocimiento,uso y preferencias sobre los sistemas adhesivos. La muestra estuvo compuesta por 501 dentistas brasileños y los datos fueron analizados mediante el programa Sigma Stat 5.0 (p<0,05). El porcentaje mínimo de respuestas correctas a las preguntas considerado adecuado se definió en el 80%. Los resultados mostraron que sólo el 46,3% de los profesionales demostraron conocimientos adecuados sobre el tema. Además, hubo una asociación estadísticamente significativa entre el bajo nivel de aciertos y los profesionalescon preferencia por los sistemas adhesivos simplificados (p=0,046), especialistas en ortodoncia [OR=0,24 (0,08-0,67)] y odontólogos egresados de instituciones privadas [OR=1,58 (1,03-2,42)]. Este escenario advierte de la inminente necesidad de subsanar esta debilidad a través de mejoras en las matrices curriculares, además de la formación continua de los docentes y la constante actualización de los profesionales (AU).

Dental adhesive systems are directly involved in common procedures of clinical dentistry, which makes knowledge about this topic indispensable for professionals. The objectives of the current study are to analyze the knowledge profile of dental professionals about dental adhesive systems and verify factors that influence this closure, with emphasis on professional education. The data was collected using a list of questions that consider: I) Professional profile and II) Knowledge, use, and preferences of adhesive systems. The sample considers 501 Brazilian dentists and the data was analyzed using the software Sigma Stat 5.0 (p<0.05). The minimum percentual of correct questions considered adequate was defined as 80%. The results show that only 46.3% of the professionals demonstrated satisfactory knowledge on the subject. In addition, it verified relevant statistical association between low level of correct questions and professionals with preferences for simplified adhesive systems (p=0.046), orthodontic specialists [OR=0.24 (0.08­0.67)], and dentists with private education degrees [OR=1.58 (1.03­2.42)]. This context indicates the imminent necessity to resolve this weakness through improvements in the educational curriculum, as well as continuing education of faculty and constant updating of professionals (AU).

Oclusión basada en evidencia: rompiendo paradigmas / Occlusion based on evidence: breaking paradigms

La odontología basada en evidencias es una metodología que busca que las decisiones clínicas diarias que toman los profesionales en estomatología se encuentren fundamentadas en la evidencia científica, en ella se integran las experiencias clínicas, las necesidades, las preferencias del paciente y la evidencia clínicamente relevante más actual analizada por pares. Estos pilares son parte del proceso en la toma de decisiones para la atención al paciente. La odontología basada en evidencias surge de las exitosas experiencias obtenidas con el desarrollo e implementación de la medicina fundamentada en pruebas, al aplicar el método científico en la evaluación, planificación y toma de decisiones de las prestaciones sanitarias, sobre todo a través de los estudios controlados. En general, toda la práctica odontológica ha tenido grandes avances basados en evidencias, con hechos verídicos comprobados, pero los conceptos fundamentales de oclusión no han tenido una mejora cimentada en el conocimiento científico, prueba de ello es que se siguen ocupando teorías y conceptos de las filosofías de oclusión en la rehabilitación de muchos pacientes, seguimos creyendo en mitos y sofismas que no han podido ser demostrados. En esta revisión, demostramos los grandes avances en los conceptos de oclusión e invitamos a todos los odontólogos a romper los paradigmas de la oclusión antigua sin evidencias científicas y a utilizar las herramientas del método científico en la práctica clínica odontológica (AU)

Evidence-based dentistry is a strategy that seeks to ensure that the daily clinical decisions made by the dental professional are based on scientific evidence. It integrates the clinical experience of the dentist, the needs and preferences of the patient, and the most current relevant clinical evidence. All three are part of the decision-making process for patient care. Evidence-based dentistry arises from the successful experiences obtained with the development and implementation of evidence-based medicine, applying the scientific method in the evaluation, planning and decision-making of health benefits, especially through controlled studies. In general, all dental practice has had great advances based on evidence, with proven true facts, but the fundamental concepts of occlusion have not had an improvement based on scientific knowledge, proof of this is that theories and concepts continue to be used. of the philosophies of occlusion in patient rehabilitation, we follow myths and sophisms that have not been demonstrated, in this review, we demonstrate the great advances in the concepts of occlusion and we know all dentists to break the paradigms of the old occlusion without scientific evidence (AU)

Evidence-based dentistry: Knowledge, Practice, Confidence and Attitude amongst Malaysian dental undergraduate students: A Multi-institutional study.

INTRODUCTION: Evidence-based dental practice provides patient-centred, compatible and efficient interventions and forms the basis for health profession education. So far, there is a paucity of data about Malaysian undergraduate dental education and the role of evidence-based dentistry in it. The current research aimed to study the level of knowledge, attitude, practice and confidence of dental undergraduate students in Malaysia towards evidence-based dental practice. METHODS: This cross-sectional study included final-year undergraduate dental students (N = 645) who completed a pre-tested self-administered questionnaire that analysed the domains of perceived knowledge, practice, critical appraisal and attitude towards evidence-based dentistry. We further explored the association between these domains with the type of curriculum, sex, prior research experience and EBD training. RESULTS: A total of (n = 526) students participated (response rate of 81.55%). About 92% knew about evidence-based dentistry. Whilst 58% had undergone formal training in evidence-based dentistry, 90% of the respondents showed an overall positive attitude towards evidence-based dentistry. However, only 45% of them practised it most of the time. Schools with an integrated curriculum showed more willingness and practised evidence-based dentistry more frequently (p < 0.001). More than 50% of the participants rated their confidence in appraisal as moderate. CONCLUSION: Our findings revealed that Malaysian dental undergraduate students who are well aware of evidence-based dentistry displayed a positive attitude towards it. The type of dental curriculum had a significant association with practice and attitude towards evidence-based dental knowledge and practice.

Dental hygiene students' participation as subjects in a randomized controlled trial: A full evidence-based dentistry experience.

PURPOSE: Demonstrate that dental hygiene students' participation in a randomized controlled trial comparing the plaque-removing capability of two toothbrushes provides a fuller understanding of the factors affecting the potential application of research to practice. METHODS: All students (N = 18) in a baccalaureate dental hygiene class were engaged in the design of a randomized controlled trial using the Consolidated Standards of Reporting Trials (CONSORT) standard and then participated as subjects in a staggered, repeated measures trial using plaque removal as the dependent variable and brush type, brush head wear, and time in study as independent variables. A debriefing of student participation and lessons learned from analyzing the results was conducted. RESULTS: The study found statistically significant differences in plaque removal capability. Brush type accounted for only 4% of the variance, while measures of brush head wear were inconsistent, and time in the study ("experimental fatigue") accounted for the most variance (9%). Students recognized and confirmed by their personal experiences that research that fails to focus on variance can create an overly optimistic impression of research effectiveness. There was strong agreement that subjects/patients vary widely and that performance depends on multiple factors. CONCLUSIONS: Dental hygiene students who participated as subjects in a randomized controlled trial comparing toothbrushes for plaque removal capacity felt that full analysis to account for all sources of variance and estimate the magnitude of measures of effect add to the value of reported research. Variation across patients is important in practice, if often overlooked as an "error" in the literature.

¿La Entrevista Motivacional puede ser utilizada en la prevención de las caries en preescolares? Una revisión integradora / A Entrevista Motivacional pode ser utilizada na prevenção da cárie em pré-escolares? Uma revisão integrativa / Can Motivational Interviewing be used in caries prevention in preschoolers? An integrative review

El objetivo fue realizar una revisión a partir de una duda clínica: "¿La práctica de la entrevista motivacional (EM) puede ser utilizada en la prevención de las caries en preescolares?" Materiales y métodos: se realizó una revisión integradora de la literatura en abril de 2021 utilizándose una adaptación del "Sistema 6S". Se evaluó la calidad de las revisiones sistemáticas (RS). Fueron realizadas búsquedas en las revistas periódicas Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice y en el sitio del Centro de Odontología Basada en Evidencias de American Dental Associaton, Biblioteca Cochrane y PubMed/Medline. Las palabras para la búsqueda fueron "motivational interviewing" y "dental caries". Resultados: Se hallaron 2 RS sobre el tema. Una RS de 2020 mostró reducción de caries a través del meta-análisis, pero sin diferencia estadísticamente significativa; los autores destacan que las evidencias limitadas se deben a la presencia de estudios heterogéneos basados en diferentes metodologías. Otra RS de 2021 concluyó que la EM posee el potencial de modificar el comportamiento y reducir significativamente lesiones cariosas principalmente en niños con elevada experiencia de caries. Fue también evaluada la calidad metodológica de las RS incluidas en esta revisión a través de los protocolos PRISMA y AMSTAR-2. Ambas presentaron bajo riesgo de sesgo y alta calidad. Conclusión: la práctica de la EM contribuyó en la prevención de la caries en preescolares, principalmente en los niños de alto riesgo. Sin embargo, las evidencias son moderadas, obtenidas a partir de meta-análisis poco robustos y de un número limitado de estudios aleatorios de buena calidad metodológica

Objetivou-se realizar uma revisão integrativa a partir de uma dúvida clínica: "A prática da entrevista motivacional (EM) pode ser utilizada na prevenção da cárie dentária em pré-escolares?". Materiais e métodos: foi realizada uma revisão integrativa da literatura em abril de 2021 utilizando-se uma adaptação do "Sistema 6S". Avaliou-se a qualidade das revisões sistemáticas (RS) encontradas através de duas ferramentas para avaliação metodológica. Foram realizadas buscas nos periódicos Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice e no site do Centro de Odontologia Baseada em Evidências da American Dental Associaton. Buscou-se RS nas bases da Biblioteca Cochrane e PubMed/Medline. As palavras selecionas para as buscas foram "motivational interviewing" e "dental caries". Resultados: a busca final resultou em 2 RS sobre o tema. Uma RS de 2020 mostrou redução de cárie através da meta-análise, porém sem diferença estatisticamente significativa; os autores destacam que as evidências limitadas se devem a presença de estudos heterogêneos baseados em diferentes metodologias. Outra RS de 2021 concluiu que a EM possui o potencial de modificar o comportamento e reduzir significativamente lesões cariosas principalmente em crianças com elevada experiência de cárie. Foi ainda avaliada a qualidade metodológica das RS incluídas nesta revisão através dos protocolos PRISMA e AMSTAR-2. Ambas apresentaram baixo risco de viés e alta qualidade. Conclusão: a prática da EM contribui na prevenção da cárie em pré-escolares, principalmente nas crianças de alto risco. Entretanto, as evidências são moderadas, obtidas a partir de meta-análises pouco robustas e de um número limitado de estudos randomizados de boa qualidade metodológica

Aim: to perform an integrative review based on a clinical question: "Can motivational interviewing (MI) be used to prevent dental caries in preschool children?". Materials and methods: an integrative literature review was conducted in April 2021 using an adaptation of the "6S System". We also evaluated the quality of the systematic reviews (SR) found through two tools for methodological assessment. Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice and on the website of the Center for Evidence-Based Dentistry of the American Dental Association. SRs were searched in the Cochrane Library and PubMed/Medline databases were searched. The selected search words were "motivational interviewing" and "dental caries". Results: the final search resulted in 2 SR on the topic. One SR from 2020 showed a reduction in dental caries through meta-analysis, but with no statistically significant difference; the authors point out that the limited evidence is due to the presence of heterogeneous studies based on different methodologies. Another SR from 2021 concluded that MI has the potential to modify behavior and significantly reduce carious lesions, mainly in children with high caries experience. The methodological quality of the SR included in this review was also assessed using the PRISMA and AMSTAR-2 protocols. Both showed high quality and low risk of bias. Conclusion: the practice of MI contributes to the prevention of dental caries in preschoolers, especially in high-risk children. However, the evidence is moderate, obtained from poor meta-analyses and a limited number of randomized studies of good methodological quality.

Reframing perceptions in operative dentistry relating evidence-based dentistry and clinical decision making: a cross-sectional study among Jordanian dentists.

BACKGROUND: The aim of the current study was to investigate current dental practice in operative dentistry in Jordan, and the relationship between evidence-based dentistry in caries research and decision making in clinical practice in operative dentistry. MATERIALS AND METHODS: This cross-sectional study was conducted through a survey of dentists in Jordan. The survey aimed to explore the degree of knowledge and practice of evidence-based dentistry in caries research the dentists possess regarding clinical decision making in operative dentistry. The sample size was composed of (5811) dentists whom registered in Jordan Dental Association database. Descriptive statistics were generated and Chi-square test was used to examine associations between the different variables and the significance level was set at P < 0.05. RESULTS: 4000 responses were collected from the web-survey, response rate (68.83%). Nearly half of the surveyed dentists focus on the chief complaint of their patients (n = 2032, 50.8%) rather than doing full mouth assessment. Nearly two-thirds of dentists (n = 2608, 65.2%) treat lesions confined to enamel with operative treatment. Half of dentists use operative treatment when asked about the routine management of radiographically detected proximal caries confined to enamel. When treating incipient lesions, the majority (n = 3220, 80.5%) use preventive treatment. Three-quarters of dentists (n = 2992, 74.8%) treat deep dentinal caries by removing just the soft infected carious dentin, and treated old failed restorations with replacement. CONCLUSION: In operative dentistry, the evidence-based research is not implemented clinically. To optimize relationship between evidence-based dentistry and clinical decision-making, dental curriculum has to be updated and modified constantly.

Dientes supernumerarios: reporte de un caso / Supernumerary teeth: report of a case

Los dientes supernumerarios son unidades dentales que numéricamente exceden la cantidad de dientes normal, un fenómeno también conocida como hiperdontia, los dientes supernumerarios más comunes son mesiodens, que ocurren entre los incisivos centrales. El presente artículo tiene como objetivo describir un reporte de caso de una paciente de género femenino, de 21 años de edad, que presenta 13 dientes incluidos, de los cuales 6 son supernumerarios, los mismos que fueron extraídos en dos tiempos quirúrgicos. (AU)

Supernumerary teeth are dental units that numerically exceed the normal number of teeth, a phenomenon also known as hiperdontia. The most common supernumerary teeth are mesiodens, which occur between the central incisors. This article aims to describe a case report of a female patient, 21 yearsold, who has 13 included teeth, of which 6 are supernumerary, thesameones that were extracted in two surgical times. (AU)

Alterações na clínica odontológica decorrentes da Pandemia: a mínima intervenção como a primeira opção em Odontopediatria / Changes in the dental clinic resulting from the Pandemic: minimal intervention as the first option in Pediatric Dentistry

A pandemia pelo novo coronavírus impactou a prática clínica odontológica, trazendo a necessidade de consultas mais rápidas, por vezes remotas, e com diminuição na produção de aerossóis, com o intuito de diminuir a disseminação do vírus Sars-CoV-2. Desta maneira, as técnicas abrangidas pela filosofia da Mínima Intervenção (MI) ganharam destaque pois, além dos benefícios para o momento pandêmico atual, são técnicas pautadas em evidências científicas e que podem ser oferecidas com segurança e de maneira integral à saúde bucal dos pacientes. Neste comentário, nós retomamos como o odontopediatra pode agir de maneira minimamente invasiva desde o diagnóstico ao tratamento mais complexo, além de educar o paciente e envolver a família na mudança comportamental, compreendendo seu papel na conquista da saúde bucal. A odontologia de Mínima Intervenção oferece ao paciente, em qualquer idade ou etapa de desenvolvimento, uma abordagem na qual sua família compreende os riscos e benefícios do plano de tratamento e participa das decisões para a construção de uma nova realidade em saúde.

The pandemic caused by the new coronavirus has impacted clinical dental practice, bringing the need for faster consultations, sometimes remote, and with a decrease in the production of aerosols, in order to reduce the spread of the Sars-CoV-2 virus. In this way, the techniques covered by the philosophy of Minimum Intervention (MI) gained prominence because, in addition to the benefits for the current pandemic moment, they are techniques based on scientific evidence and that can be offered safely and in an integral way to the oral health of patients. In this commentary, we revisit how pediatric dentists can act in a minimally invasive way from diagnosis to more complex treatment, in addition to educating the patient and involving the family in behavioral change, understanding their role in achieving oral health. Minimal Intervention Dentistry offers patients, at any age or stage of development, an approach in which their family understands the risks and benefits of the treatment plan and participates in decisions to build a new health reality.