Periodontal Literature Review - American Academy of Periodontology

Report
Update on the Electronic Periodontal Literature Review
Dr. Michael B. Goldberg, MSc DDS
Assistant Professor
University of Toronto
Thank-you
 American Academy
 Shana
of Periodontology Education Committee
Berezin
 Faculty and Post-Graduate Students of the University of Toronto, Faculty of
Dentistry, Division of Periodontics
 Faculty members of the University of Rochester and Indiana University
Periodontal Literature Review— Update
 “Wikipedia”-type
 Electronic
 Paperless
 “Greenshift”
 Instant updating available
 Direct links to specific articles
 Presenting
formatting
 Internal search engine
 Cross-chapter linking
not Critiquing Content
Periodontal Literature Review— Topics
Examination
Microbiology
Diagnosis
Pharmacology
Maintenance
Regenerative Therapy
Epidemiology
Mucogingival Therapy*
Risk Factors
Implantology*
Periodontal Literature Review--Keywords
 Article Accumulation
 identifying
keyword using
PICO:
P- patient, population
I - intervention
C- comparison
O- outcomes
Microbiology and….
•Diagnosis
•Periodontitis
•Chronic Periodontitis
•Aggressive Periodontitis
•Gingivitis
•Periodontal Abscess
•Necrotizing Ulcerative
Lesions
•Cardiovascular Disease
•Diabetes
•Smoking
•Specific Plaque Hypothesis
•Non-Specific Plaque hypothesis
•Supragingival plaque/calculus
•Subgingival plaque/calculus
•Infection
•Inflammation
•Bleeding
•suppuration
Methodology Checklist 2: Randomised Controlled Trials
S I G N
Study identification
(Include author, title, year of publication, journal title, pages)
Guideline topic:
Key Question No:
Checklist completed by:
SECTION 1:
INTERNAL VALIDITY
In a well conducted RCT study…..
In this study this criterion is::
1.1
The study addresses an appropriate and clearly
focused question.
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.2
The assignment of subjects to treatment groups is
randomised
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.3
An adequate concealment method is used
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.4
Subjects and investigators are kept ‘blind’ about
treatment allocation
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.5
The treatment and control groups are similar at the
start of the trial
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.6
The only difference between groups is the treatment
under investigation
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.7
All relevant outcomes are measured in a standard,
valid and reliable way
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.8
What percentage of the individuals or clusters recruited
into each treatment arm of the study dropped out
before the study was completed?
1.9
All the subjects are analysed in the groups to which
they were randomly allocated (often referred to as
intention to treat analysis)
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
1.10
Where the study is carried out at more than one site,
results are comparable for all sites
Well covered
Adequately addressed
Poorly addressed
Not addressed
Not reported
Not applicable
SECTION 2:
OVERALL ASSESSMENT OF THE STUDY
2.1
How well was the study done to minimise bias?
Code ++, +, or 
2.2
If coded as +, or  what is the likely direction in which
bias might affect the study results?
2.3
Taking into account clinical considerations, your
evaluation of the methodology used, and the statistical
AAP Literature Review
Article Check-list
Randomized Control Trials
Citation:
1. The study addresses an appropriate and
clearly focused question?(1)
5. The only difference between groups is the
Treatment under investigation (1 point)
YES
NO
6. Were study drop-outs reported? (1 point)
YES NO
2. The assignment of subjects to treatment
groups is randomized?(1)
YES
7. Were results comparable in all sites for a
Multicentre study? (1 point)
YES NO
3. Subjects and investigators are kept “blind”
about treatment allocation?(1)
YES
YES NO
4. The treatment and control groups are similar
at the start of the trial?(1)
Score
YES NO
NO
NO
8. The study was useful overall (3 points)
/10
AAP Literature Review
Article Summary Sheet
Reviewer’s Name: Goldberg
Section: Exam/Diagnosis
Author: Araujo MWB et al
Title: Reproducibility of Probing Depth Measurements Using a Constant-Force Electronic Probe: Analysis of Inter-and Intraexaminer variability
Journal: J Perio 2003;74:1736-1740
Study Design:
RCT
Cohort/Cross-sectional/Longitudinal Prospective/Retrospective
Observational
Article Summary:
Main objective was to evaluate the inter- and intraexaminer variability of PD using a constant force electronic probe. Compare variability between quadrant means and tooth means.
3 examiners (one DDS, two hygienists) measured 20 patients. Measured one quadrant only, excluded 8’s. Usually quad 1,.
Inclusion criteria…35-79 y.o.; either gender/any ethnic background; > 6 teeth per quadrant; PD< 3 mm.
Examinations done at baseline, 7 days, 14 days by two of 3 examiners each day. Therefore each examiner did 2 exams. 6 sites per tooth measured.
Results:
For quadrant probing data, standard error ranged from 0.38 mm to 0.42 mm.
Tooth level variability was greater compared to quadrant level with incisors showing least variability and first molars showing most variability.
Overall measurement error was always under 0.5 mm, regardless of tooth/quadrant measurement.
Limited periodontal disease may keep information “tighter”…more disease severity and variability in PD may influence results in future studies.
Also need to replicate study using manual probes in future.
Clinical Relevance Ranking: Top 10%
50%
Bottom 50%
Why?:
Top 25%
Top
Periodontal Literature Review—Update
www.periolitreview.com
Where do we go from here?
 Is
this website (conceptually) something
that will be useful to your program?
 “Integrated Dental Education”—utility for
pre-doctoral/post-doctoral programs
 If so, what modifications would you like
to see?
 If not, why not?
 If
this website is to continue, how would your
program be able to contribute to its upkeep and
continued relevance ?
○ Co-ordinator—MG? Other?
○ Graduate Program Yearly rotations to update
literature
○ Assistance from AAP web designers
○ In-Service Exam co-ordination
Contact Information
Dr. Michael B. Goldberg
Assistant Professor, Discipline of Periodontology, University of Toronto
124 Edward Street
Toronto, Ontario
416-979-4928 ext. 4502
[email protected]

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