INNOVATIONS AND RESOURCE SHARING IN GRADUATE PERIODONTAL EDUCATION

Update on the Electronic Periodontal Literature Review

Dr. Michael B. Goldberg, MSc DDSAssistant Professor

University of Toronto

Thank-you

American Academy of Periodontology Education Committee Shana 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— UpdateElectronic

Paperless “Greenshift” Instant updating available Direct links to specific articles

Presenting not Critiquing Content

“Wikipedia”-type formatting Internal search engine Cross-chapter linking

Periodontal Literature Review— TopicsExaminationDiagnosisMaintenanceEpidemiologyRisk Factors

MicrobiologyPharmacologyRegenerative TherapyMucogingival Therapy*Implantology*

Periodontal Literature Review--Keywords Article Accumulation

identifying keyword using PICO:

P- patient, populationI - interventionC- comparisonO- outcomes

•Cardiovascular Disease•Diabetes•Smoking•Specific Plaque Hypothesis•Non-Specific Plaque hypothesis•Supragingival plaque/calculus•Subgingival plaque/calculus•Infection•Inflammation•Bleeding•suppuration

Microbiology and….

•Diagnosis•Periodontitis•Chronic Periodontitis•Aggressive Periodontitis•Gingivitis•Periodontal Abscess•Necrotizing Ulcerative Lesions

S I G N

Methodology Checklist 2: Randomised Controlled Trials

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)

YES NO 2. The assignment of subjects to treatment

groups is randomized?(1)

YES NO 3. Subjects and investigators are kept “blind”

about treatment allocation?(1)

YES NO 4. The treatment and control groups are similar

at the start of the trial?(1)

YES NO

5. The only difference between groups is theTreatment under investigation (1 point)

YES NO

6. Were study drop-outs reported? (1 point)

YES NO

7. Were results comparable in all sites for aMulticentre study? (1 point)

YES NO

8. The study was useful overall (3 points)

Score /10

AAP Literature Review Article Summary Sheet

Reviewer’s Name: GoldbergSection: Exam/DiagnosisAuthor: Araujo MWB et alTitle: Reproducibility of Probing Depth Measurements Using a Constant-Force Electronic Probe: Analysis of Inter-and Intraexaminer variabilityJournal: J Perio 2003;74:1736-1740Study Design: RCT Cohort/Cross-sectional/Longitudinal Prospective/Retrospective ObservationalArticle 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% Top 25% Top 50% Bottom 50%Why?:

www.periolitreview.com

Periodontal Literature Review—Update

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Contact InformationDr. Michael B. GoldbergAssistant Professor, Discipline of Periodontology, University of Toronto124 Edward StreetToronto, Ontario416-979-4928 ext. 4502

m.goldberg@dentistry.utoronto.ca