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CaseCAT MSRG
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CaseCAT MSRG CaseCAT MSRG Presentation Transcript

  • CaseCATs(Critically Appraised Topics)An approach to pre-doctoralresearch opportunities
  • Lunch and Learn Agenda• Objectives• Parameters• How to find cases• CaseCAT Worksheet• CaseCAT Literature Worksheet• CaseCAT Poster Template• Judging Criteria
  • Objectives • To provide an opportunity for students to engage in a patient based study to the level of scientific inquiry • To facilitate the transformation of a patient based study to a case presentation that can be presented at Clinic and Research Day
  • ParametersHow were treatment plans or outcomes for your patient affected by:• Treatment procedure• Patient health concerns• Therapeutic problems concerning patient• Unusual medications• Treatment consideration for medically compromised or patients with disabilities• Example: Blood pressure medication that causes xerostomia ▫ What are causes, how do you evaluate? how do you treat?
  • Where do I find cases?1. Portfolio  On medically compromised patients i.e. diabetes, hypertension  Patients on 3 or more medically significant therapeutic medications1. Screening Clinic/Urgent Care  Diagnosis of an interesting patient issue1. Rotations with specialty clinics  Working with residents  Examples include: Ortho-craniofacial anomaly, Perio-diabetes, Endo-implants
  • Important Elements to Consider• Patient issue exemplifies problem• Thoughtful description of case• Adequate Documentation (must be de-identified) ▫ Photos and radiographs ▫ Axium page with charting ▫ Patient medical, dental history, chief complaint• Differential Diagnosis ▫ In many cases already preexisting diagnosis• Develop case to level of CAT ▫ Faculty, journals and internet as resources• IRB Issues ▫ Must be single case, case series not acceptable
  • Situation of Concern (Calibri font size 60) Student Name Advisor CASE Place the critical elements of your case here… e.g., Chief Complaint, Hx, AXIUM data, photos, etc. SCENARIO (preferably in font Calibri - minimum size 20)P: P… I: I…C: C…O: O…Place the critical elements of your case here… e.g., Chief Complaint, Hx, AXIUM data, photos, etc.(preferably in font Calibri - minimum size 20) CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCEType your searchable question here… (preferably in font Calibri - minimum size 20) Terms… Student Summary Type your bottom line here… (preferably in font Calibri - minimum size 20) CAT 1 CAT 2 CAT 3Type your CAT here… (preferably in font Calibri - Type your CAT here… (preferably in font Calibri - Type your CAT here… (preferably in font Calibri -minimum size 20) minimum size 20) minimum size 20) FUTURE DIRECTIONS Write future directions here… (preferably in font Calibri - minimum size 20)
  • CaseCATWorksheet
  • CaseCAT Worksheet
  • Should I use Cavit , IRM , or KetacFill ? TM TM TM Student: Michael P. Munaretto Advisor: Bradford Johnson, DDS MHPE, UIC Department of EndodonticsCASE SCENARIO29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on bothoral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:arrows below). Tooth Cold EPT Perc Palp Probing Mobility P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0 4 NR 80/80 WNL WNL 323B 323L 0 I- Temporary restorative material (Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0 6 WNL 26/80 WNL WNL 323B 323L 0 C- Definitive restoration O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCEFor patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, orKetacFill GI) compares most favorably to the properties of the definitive restoration as measuredby durability and resistance to coronal microleakage?CAT (1) CAT (2) CAT (3) FUTURE DIRECTIONS Write future directions here… (preferably in font Calibri - minimum size 20)
  • CaseCAT Worksheet
  • Should I use Cavit , IRM , or KetacFill ? TM TM TM Student: Michael P. Munaretto Advisor: Bradford Johnson, DDS MHPE, UIC Department of EndodonticsCASE SCENARIO29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on bothoral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:arrows below). Tooth Cold EPT Perc Palp Probing Mobility P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0 4 NR 80/80 WNL WNL 323B 323L 0 I- Temporary restorative material (Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0 6 WNL 26/80 WNL WNL 323B 323L 0 C- Definitive restoration O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCEFor patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, or Root Canal Therapy;KetacFill GI) compares most favorably to the properties of the definitive restoration as measured Dental Restoration,by durability and resistance to coronal microleakage? Temporary; LeakageCAT (1) CAT (2) CAT (3)Beach et al. “Clinical Evaluation of Bacterial Barthel et al. “Leakage in Roots Coronally Naoum & Chandler. “Temporization forLeakage of Endodontic Temporary Filling Sealed with Different Temporary Fillings.” Endodontics.” International Endodontic JournalMaterials.” Journal of Endodontics 22:9 pp459- Journal of Endodontics 25:11 pp 731-734. 1999. 35:pp 964-978. 2002.462. 1996. Methods: 103 extracted single-rooted teeth Methods: A literature review was performedMethods: 51 human teeth received RCT in vivo. received RCT and were then filled with either using MEDLINE and contemporary textbooks toAfter obturation a sterile paper disk was placed Cavit, IRM, GI, Cavit/GI, or IRM/GI. Teeth were assess various endodontic temporary fillingbelow a 4 mm filling of Cavit, IRM, or TERM. then immersed into a two-chamber system materials and to make clinical recommendations.Three weeks later the patients were recalled, the which was inspected daily over a 30-day period Results/Conclusion: Cavit possesses favorablefillings were removed, and the paper disks were for bacterial microleakage. marginal seal but inferior mechanical propertiesanalyzed for bacterial growth. Results/Conclusion: GI gave the best seal compared to IRM. Studies have shown that IRMResults/Conclusion: 1/18 IRM samples showed against bacteria (1/20 samples leaked), also provides a favorable marginal seal,bacterial growth, whereas 0/19 Cavit samples whereas Cavit gave the poorest seal (13/20 especially when the powder: liquid ratio is samples leaked). 11 out of 20 IRM samplesshowed growth. No significant difference wasfound between IRM and Cavit. leaked. decreased. GI is more costly, but has been found to be antibacterial and to have a superior seal; FUTURE DIRECTIONSValidity/Applicability: Restoration type was Validity/Applicability: Results of in vitro studies Write future directions here… (preferably in font thus it may be used for cases of long-term Calibri - minimum size 20)randomly assigned. Follow up was 100%. in vivo cannot directly be applied to clinical practice. temporization.study. 3 week follow-up realistic at UIC COD. However, all available filling materials to UIC Validity/Applicability: Authors did not provide aLevel of Evidence: 2 (Randomized Controlled COD students were tested. detailed selection criteria for articles reviewed.Trial) Level of Evidence: 6 (Preclinical study) Level of Evidence: 5 (Expert Opinion) .
  • CaseCAT Worksheet
  • Should I use Cavit , IRM , or KetacFill ? TM TM TM Student: Michael P. Munaretto Advisor: Bradford Johnson, DDS MHPE, UIC Department of EndodonticsCASE SCENARIO29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on bothoral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:arrows below). Tooth Cold EPT Perc Palp Probing Mobility P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0 4 NR 80/80 WNL WNL 323B 323L 0 I- Temporary restorative material (Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0 6 WNL 26/80 WNL WNL 323B 323L 0 C- Definitive restoration O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCEFor patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, or Root Canal Therapy; Few in vivo studies and no systematic reviewsKetacFill GI) compares most favorably to the properties of the definitive restoration as measured Dental Restoration, exist studying this topic. However, from theby durability and resistance to coronal microleakage? Temporary; Leakage available evidence the following conclusions can be drawn:CAT (1) CAT (2) CAT (3) 1. Cavit provides an adequate seal over at least 3Beach et al. “Clinical Evaluation of Bacterial Barthel et al. “Leakage in Roots Coronally weeks as revealed by an in vivo study (1). Naoum & Chandler. “Temporization forLeakage of Endodontic Temporary Filling Sealed with Different Temporary Fillings.” However, due to its poor mechanical properties, Endodontics.” International Endodontic JournalMaterials.” Journal of Endodontics 22:9 pp459- Journal of Endodontics 25:11 pp 731-734. 1999. its use should be reserved only for conservative 35:pp 964-978. 2002.462. 1996. accesses where occlusal forces are minimal (3). Methods: 103 extracted single-rooted teeth 2. IRM provides an adequate seal over at least 3 Methods: A literature review was performedMethods: 51 human teeth received RCT in vivo. received RCT and were then filled with either weeks as revealed by an in vivo study (1). Its using MEDLINE and contemporary textbooks toAfter obturation a sterile paper disk was placed Cavit, IRM, GI, Cavit/GI, or IRM/GI. Teeth were mechanical properties are superior to Cavit and it assess various endodontic temporary fillingbelow a 4 mm filling of Cavit, IRM, or TERM. then immersed into a two-chamber system is therefore indicated for whenever the tooth will materials and to make clinical recommendations.Three weeks later the patients were recalled, the which was inspected daily over a 30-day period be regularly subjected to occlusal forces. As the Results/Conclusion: Cavit possesses favorablefillings were removed, and the paper disks were for bacterial microleakage. powder: liquid ratio is decreased, the seal marginal seal but inferior mechanical propertiesanalyzed for bacterial growth. Results/Conclusion: GI gave the best seal improves (at the expense of mechanical compared to IRM. Studies have shown that IRMResults/Conclusion: 1/18 IRM samples showed against bacteria (1/20 samples leaked), properties). (3) also provides a favorable marginal seal,bacterial growth, whereas 0/19 Cavit samples whereas Cavit gave the poorest seal (13/20 especially when the powder: liquid ratio isshowed growth. No significant difference was samples leaked). 11 out of 20 IRM samples 3. GI has been found in an in vitro study to have a decreased. GI is more costly, but has been foundfound between IRM and Cavit. leaked. superior seal to Cavit and IRM (2). Because of to be antibacterial and to have a superior seal;Validity/Applicability: Restoration type was Validity/Applicability: Results of in vitro studies this, GI has been recommended for longer term thus it may be used for cases of long-termrandomly assigned. Follow up was 100%. in vivo cannot directly be applied to clinical practice. temporization (3). temporization.study. 3 week follow-up realistic at UIC COD. However, all available filling materials to UIC Validity/Applicability: Authors did not provide a 4. Studies have recommended that a definitiveLevel of Evidence: 2 (Randomized Controlled COD students were tested. detailed selection criteria for articles reviewed. restoration be placed as soon as possibleTrial) Level of Evidence: 6 (Preclinical study) Level of Evidence: 5 (Expert Opinion) following obturation (2, 3). .
  • CaseCATLiteratureWorksheet
  • Once you have identified a case:• Identify a mentor• Primary Contact: Group Practice Manager• All project Titles should be emailed or turned into Katherine Long at longka@uic.edu by January 9th 2012• Talk to previous participants
  • Questions?Additional ContactsDr. Marucha- marucha@uic.eduDr. Knight- gwknight@uic.eduKaitrin Baloue kbaloue2@uic.edu