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Evidence based dentistry/certified fixed orthodontic courses by Indian dental academy
 

Evidence based dentistry/certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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    Evidence based dentistry/certified fixed orthodontic courses by Indian dental academy Evidence based dentistry/certified fixed orthodontic courses by Indian dental academy Presentation Transcript

    • www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
    • Evidence-Based Dentistry A New Initiative In Health Care www.indiandentalacademy.com
    • Presentation brought to you by College of Dental Sciences, Davangere Dr. Anmol S. Kalha, Prof & Head Dept Of Orthodontics Director & Co-ordinator Chief Convenor 1st National Workshop On EBD Centre for Evidence-Based Dentistry & Informatics www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care ©Truths of today, myths of tomorrow… Universally accepted scientific truth that explains a natural phenomenon Foundation for building a scientific structure ideas and concepts are like bricks Paradigms www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © Opinion-based decisions Charismatic leadership Vast array of philosophies Evidence-based decisions Empowerment Accountability Paradigms www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © + Experience • May be out of date • Increasingly difficult to keep up with • New ideas and concepts • Acquisition of new knowledge is slow & haphazard KnowledgeExpertise = Clinical Decision-making www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © • May be limited, subject to personal bias • May outweigh knowledge Clinical Decision-making + Experience • May be out of date • Increasingly difficult to keep up with • New ideas and concepts • Acquisition of new knowledge is slow & haphazard KnowledgeExpertise = www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © CERTAINTY CLINICAL DECISION Clinical Situation Etiology, Diagnosis, Treatment, Prognosis UNCERTAINTY CLINICAL INDECISION www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © CERTAINTY CLINICAL DECISION Clinical Decision 1. Increased awareness 2. Increased access to information 3. Cost of procedure 4. Litigious society Patients may challenge your decision: www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? HOW DO YOU DEFEND YOUR CLINICAL DECISION? www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © UNCERTAINTY CLINICAL INDECISION Clinical Indecision 1. What is the current evidence? 2. Where and how to look for it? 3. Is the evidence valid? 4. Is it applicable to my patient? May challenge your mind: www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © HOW DO YOU REACH A CLINICAL DECISION? How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © HOW DO YOU REACH A CLINICAL DECISION? HOW DO YOU DEFEND YOUR CLINICAL DECISION? www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © If you are a: Undergraduate student Teacher, textbooks www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © If you are a: Practicing Dentist Fellow dentists, product literature, former teachers, old textbooks, CDEs, journals www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © If you are a: Postgraduate Student PG guide, product literature, textbooks, journals www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © How does one arrive at a clinical decision that is valid, current and applicable to one’s patient? Evidence-Based Dentistry (Health Care) www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © DEFINITION “a conscientious, explicit, and judicious use of current best evidence in conjunction with clinical experience to make decisions regarding patient care” www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © HISTORY  Post-revolutionary Paris; around 1850s  China B.C.  Some tools of EBHC can be traced Biblical times  1970s : McMaster University, Canada  1980s : University Harvard, US  1995 : Oxford, UK www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © HISTORY  1970s : McMaster University, Canada  1980s : University Harvard, US  1995 : Oxford, UK • Centre for Evidence-based Medicine • Centre for Evidence-based Dentistry • Centre for Evidence-based Medicine • Centre for Evidence-based Dentistry www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © HISTORY 31st March 2000 Centre for Evidence-Based Dentistry And Informatics College of Dental Sciences Davangere www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Formulating a relevant, focused, clinically important question that is likely to be answered. Gaps in our knowledge about etiology, diagnosis, prognosis or therapy. Problem areas or controversial aspects of health sciences. Introduction of new diagnostic test, therapy (surgical procedure, medicaments, materials) or preventive measure. Research in fundamental sciences suggests clinical application. www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Finding the evidence. Sources: Primary research: articles in journals (& even unpublished research work) Secondary research: systematic reviews (with or without meta-analysis), non-systematic reviews, guidelines, decision analysis, economic analysis www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © Search strategy: Manual search: library, correspondence Electronic search: Medline, Dental Gate, Dentist’s SilverPlatter, Embase, AIDSline, Toxline MeSH, Ovid STEPS Finding the evidence. www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Finding the evidence. M E D L I N E MeSH www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Finding the evidence. Limit Thesaurus S I L V E R P L A T T E R www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © Levels of evidence: • Systematic reviews and meta-analysis • Randomized controlled trials • Cohort studies • Case-control studies • Cross-sectional surveys • Case reports STEPS Finding the evidence. www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Appraising the evidence for validity and its applicability in your patient. Systematic Reviews Meta- analysis Clinical Practice Guidelines NNTs, SpPins & SpNouts Critical Appraisal of a Topic www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Appraising the evidence for validity and its applicability in your patient. ‘CAT’ CRITICALLY APPRAISED TOPIC Practical Approach to EBHC www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS Applying the evidence in one’s own patients, based upon one’s clinical judgement, experience and patient’s expectations and values. Assessing the outcome of applying the evidence in your patients. Summarizing and storing records for future reference. www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © STEPS www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © VALUE Defines the current acceptable standard of health care (medico-legal, health insurance & health administration implications). Immediately applicable clinically : regularly incorporating new concepts and techniques into practice. Improves one’s skills in acquisition and critical assessment of information: fun and exciting part but based on scientific fact and validity. www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © Points out areas for further research. VALUE Educational value: 1. The need to provide the most current and relevant scientific inputs to students 2. Developing and implementing a cadre of clinical faculty capable of bridging the gap between basic research and clinical skills 3. Provide a data base / electronic referral point to analyze research and data and provide ready reference www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © LIMITATIONS Access to information is limited. Suitable evidence (studies) may not be available. Some of the tools of EBHC are time consuming and difficult to master. Evidence-based practice may increase rather than decrease the cost of health care. Authoritarian clinicians & teachers perceive it as a threat !! www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © WHY PRACTICE EBD? “simply because we, as health care professionals, owe it to our patients to provide the currently best care available” WHY TEACH EBD? “to prepare our students with life-long learning skills, so that they continue to evaluate and use information for patients ” www.indiandentalacademy.com
    • WHY PRACTICE EBD? “simply because we, as health care professionals, owe it to our patients to provide the currently best care available” WHY TEACH EBD? “to prepare our students with life-long learning skills, so that they continue to evaluate and use information for patients ” Evidence-Based DentistryA New Initiative In Health Care © “PROFESSIONAL RESPONSIBILITY” “PROFESSIONAL RESPONSIBILITY” www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © IN A NUTSHELL The practice of EBD is the integration of… Individual Clinical Expertise Best Available External Evidence Patient’s Values & Expectations www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © IN A NUTSHELL The practice of EBD is the integration of… …so as to deliver the most valid and current health care.www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © EBD – A GLOBAL EVENT CEBD-i: a Progressive Step Part of a Global Initiative Support the Initiative www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © • A Change in Mindset • Faculty Development • Policy Implementation • Minimum Essential Infrastructure • Sharing of Data and Information • Creation of an Electronic Library EBD – A GLOBAL EVENT CEBD-i: a Progressive Step Part of a Global Initiative Support the Initiative www.indiandentalacademy.com
    • Evidence Based Health Care will segmented archtechnique Patient or Problem Intervention Comparison Intervention Outcomes result in better vertical control by Causing no extrusion of posterior Buccal teeth as compared to continuous leveling wires In overbite correction with fixed appliances… Practice: Critical Appraisal of a Topic (CAT) www.indiandentalacademy.com
    • Evidence Based Health Care Practice: Critical Appraisal of a Topic (CAT) SEARCH “”Evaluation of continuous and segmented Arch leveling techniques in adult patients” Frank J.Weiland et al AJODO, Vol.110 no.6, dec1996, 647-52 www.indiandentalacademy.com
    • Title: Clinical bottom line: In overbite correction with fixed appliances, segmented arch technique provides better vertical control in comparison to continuous leveling wires as it does not cause extrusion of posterior buccal teeth. Citation: Three-part clinical question: The study: The evidence: ARR, RRR, CI, NNT Comments: Appraised by: Dr. Anmol Kalha Date: 21/10/2000 Kill by or update by: 27 oct 2001 Evidence Based Health Care Practice: Critical Appraisal of a Topic (CAT) 1-PAGE CAT www.indiandentalacademy.com
    • CLINICAL EXAMPLE A 14-YEAR OLD BOY AFTER COMPLETION OF ORTHO TREATMENT PRESENTS FOR EVALUATION OF CLINICALLY AND RADIOGRAPHICALLY ASYMPTOMATIC UNERUPTED THIRD MOLARS. EXTRACTIONTRADITIONAL MODEL www.indiandentalacademy.com
    • NEW MODEL SELF-ASSESSMENT ON-LINE LITERATURE DATABASE LITTLE EVIDENCE EXISTS www.indiandentalacademy.com
    • THE MYTH OF ORAL FOCI OF INFECTION • BASED ON THE ASSUMPTION ORAL INFECTION AFFLICTS OTHER ORGANS • CRITICALLY APPRAISED BY EASLICK IN 1951 • NO CORRELLATION!!! • RECOMMENDATIONS BY ADA www.indiandentalacademy.com
    • Center for Evidence-based Dentistry College of Dental Sciences invites you for FIRST NATIONAL WORKSHOP ON EVIDENCE-BASED DENTISTRY 10-11, March 2001 Dr Derek Richards Director, CEBD, Oxford, UK. Dr Asbjorn Jokstad University of Oslo, Norway. YOU CAN REGISTER ONLINE AT: http://www.cods.net/cebd/workshop.htm www.indiandentalacademy.com
    • Evidence-Based DentistryA New Initiative In Health Care © For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com