This review paper analyzed 1300 publications in the Journal of Maxillofacial Oral Surgery from 2009 to 2020 to evaluate trends in levels of evidence. The analysis found that case reports and narrative reviews with a level D evidence accounted for 36% of publications. The majority (35%) of articles fell under maxillofacial pathology. The percentage of higher levels of evidence (A and B) increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, indicating improving research quality over time. Categorizing publications by level of evidence and topic can help refine research quality in the journal going forward.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
Radiographic Evaluation of the MB2 Canal in Permanent Maxillary Molars- An Or...DrHeena tiwari
This study evaluated the presence and location of the MB2 canal in maxillary first molars using CBCT scans. The scans of 296 patients were analyzed, showing MB2 canals in 43.8% of teeth. No significant gender difference was found. The angle between the mesiobuccal, distobuccal and palatal canals (ƒMDP) was greater in teeth with MB2 canals. A moderate positive correlation was found between ƒMDP and the angle between mesiobuccal, distobuccal and MB2 canals (ƒMDMB2). If ƒMDP was over 90.95 degrees, there was a 78% probability of finding an
The document discusses a survey of 56 endodontists on their preferences for root canal obturation materials and techniques. Most endodontists still prefer traditional techniques like lateral compaction (34%) and single cone (15%) due to their simplicity. However, thermoplasticized techniques like Thermafil were also popular (28%) for their ability to provide a three-dimensional seal. Gutta percha remained the most commonly used material (65%) due to its biocompatibility and easy manipulation. Resilon was also widely used (22%) for its similar properties to gutta percha. The study aimed to understand best practices for achieving a tight seal during root canal obturation.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
Radiographic Evaluation of the MB2 Canal in Permanent Maxillary Molars- An Or...DrHeena tiwari
This study evaluated the presence and location of the MB2 canal in maxillary first molars using CBCT scans. The scans of 296 patients were analyzed, showing MB2 canals in 43.8% of teeth. No significant gender difference was found. The angle between the mesiobuccal, distobuccal and palatal canals (ƒMDP) was greater in teeth with MB2 canals. A moderate positive correlation was found between ƒMDP and the angle between mesiobuccal, distobuccal and MB2 canals (ƒMDMB2). If ƒMDP was over 90.95 degrees, there was a 78% probability of finding an
The document discusses a survey of 56 endodontists on their preferences for root canal obturation materials and techniques. Most endodontists still prefer traditional techniques like lateral compaction (34%) and single cone (15%) due to their simplicity. However, thermoplasticized techniques like Thermafil were also popular (28%) for their ability to provide a three-dimensional seal. Gutta percha remained the most commonly used material (65%) due to its biocompatibility and easy manipulation. Resilon was also widely used (22%) for its similar properties to gutta percha. The study aimed to understand best practices for achieving a tight seal during root canal obturation.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
This document discusses suction and retractors used in oral and maxillofacial surgery. It describes the objective of suction as removing fluids, blood, debris, and air from the surgical site to maintain a clear field of view. It outlines different types of suction instruments including tips, tubing, and devices. It also discusses various surgical retractors, their importance for providing exposure and separation of tissues during surgery, materials used, and types including self-retaining retractors. The document serves as a reference for suction and retraction tools in oral and maxillofacial surgery.
This study compared the antifungal efficacy of various endodontic irrigants, with and without the antifungal agent clotrimazole, against Candida albicans in extracted human teeth. Teeth were inoculated with C. albicans and irrigated with sodium hypochlorite, chlorhexidine gluconate, doxycycline hydrochloride, or combinations of these with 1% clotrimazole. Colony forming units were significantly lower for sodium hypochlorite and chlorhexidine alone compared to doxycycline or the control. Adding clotrimazole increased the efficacy of all irrigants, with no significant difference between sodium hypochlorite with
Longevity of teeth and implants a systematic reviewdroliv
SUMMARY
This systematic review analyzed 11 publications on teeth with 3,015 subjects and follow-up periods ranging from 10-30 years. The incidence of tooth loss was 1.3-5% in most studies but 14-20% in two studies of rural Chinese populations. The percentage of subjects experiencing tooth loss varied from 25-75%, highest in Chinese populations and untreated periodontitis patients. Bone loss appeared small (<1mm) in well-maintained patients. Nine implant studies with 476 subjects and follow-up up to 20 years found implant loss varied between 1-18%. Bone loss around implants was 0.7-1.3mm in most studies. Comparisons of longevity are difficult due to heterogeneity.
Marginal and Internal Fit of Different Fixed Dental Prostheses: A Comparative...DrHeena tiwari
This study compared five methods for assessing the marginal and internal fit of fixed dental prostheses: the cross-sectional method, silicone replica technique, triple scan method, micro-computed tomography, and optical coherence tomography. Measurements of the marginal gap, axial gap, angle gap, and occlusal gap found statistically significant differences between the methods. The cross-sectional method and silicone replica technique showed the lowest mean values and were the most similar, while the triple scan method and optical coherence tomography also showed similarities. The study concluded that while fit values may fall within clinically acceptable ranges, differences between assessment methods should be considered.
MB2 In Maxillary Second Molar – Two Case ReportsQUESTJOURNAL
This document presents two case reports of maxillary second molars that each had an extra canal (MB2) identified in the mesiobuccal root. In the first case, careful visualization with magnifying loupes revealed a groove indicating the presence of an MB2 canal, which was located using an ultrasonic tip. In the second case, an incomplete access cavity was modified and exploration uncovered an extra mesiobuccal canal. Both cases were treated with biomechanical preparation and obturation of all canals. Failure to locate and treat extra canals such as MB2 is a common reason for endodontic treatment failure.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
The document discusses denture stomatitis (DS), an inflammatory condition affecting the oral mucosa of individuals wearing complete or partial removable dental prostheses. It reports that DS prevalence varies widely between studies but can be as high as 75% in some populations. The document conducts a systematic review of eight studies on the association between partial removable dental prostheses (RDPs) and DS. The review finds that DS prevalence in partial RDP wearers ranges from 1.1% to 36.7% across the studies. Several factors are proposed as potential risks for DS, but the evidence is inconsistent. The review concludes that there is some evidence linking DS to partial RDP use, but higher quality studies are needed to establish causality.
This document discusses mixed dentition space analysis, which is used to predict space requirements for unerupted permanent teeth during the mixed dentition period from ages 6 to 12 years. Accurate prediction is important for orthodontic diagnosis and treatment planning. The document outlines three main methods for mixed dentition space analysis: 1) using measurements of erupted permanent teeth on dental casts to predict sizes of unerupted teeth, 2) measuring unerupted teeth directly on radiographs, and 3) combining the first two methods. It provides details on several commonly used techniques within each category to facilitate space prediction and assessment of crowding or spacing in the dental arches.
This case report describes an adult patient who presented with an anterior open bite that was associated with breathing problems. Clinical and radiographic examination revealed the open bite was due to skeletal factors including an increased lower anterior facial height and hyperdivergent skeletal planes. The patient's breathing problems acted synergistically with her skeletal pattern to cause and worsen the open bite over time as her mandible rotated counterclockwise to open and facilitate breathing. Treatment of the open bite would need to address both the skeletal and respiratory etiological factors.
This study investigated the craniofacial morphology and growth of cleft palate patients. Common findings among patients included anterior crossbite, a reduced and posteriorly positioned maxilla. Frequent orthodontic issues were deviations of the upper incisors, missing teeth in the cleft area, and asymmetries of the upper dental arch. Regarding growth, some patients had normal facial development while others exhibited a hypoplastic maxilla and middle third of the face. The study aimed to characterize the morphological features and growth patterns of cleft palate patients' craniofacial complexes to help establish appropriate treatment protocols.
EFFICACY OF FIXED VERSUS REMOVAL RETAINER POST ORTHODONTIC TREATMENT: A COMP...DrHeena tiwari
This study compared the efficacy of fixed versus removable retainers for maintaining orthodontic treatment outcomes over 4 years. 48 participants from an original randomized controlled trial were evaluated. Those with fixed retainers had lower irregularity scores on average (0.85mm increase) compared to removable retainers (1.47mm increase). After adjusting for confounding factors, the difference in irregularity between groups was statistically significant, with removable retainers having 1.64mm more irregularity on average. No other significant differences were found between groups for other metrics like inter-canine width. Compliance with removable retainers decreased over time. Fixed retainers maintained their position better, though some required repair. In conclusion, fixed retainers appeared to
8-9 powerpoint slide not including title, intro or conclusion-usitroutmanboris
8-9 powerpoint slide not including title, intro or conclusion-using attached template-rubric attached as well
o Reflect on the four peer-reviewed articles you critically appraised in Module 4. (last weeks articles)
o Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, including its culture and readiness for change. The organization is a Hospice company-
o
o The Assignment: (Evidence-Based Project): Part 5: Recommending an Evidence-Based Practice Change
o
o Create an 8- to 9-slide PowerPoint presentation in which you do the following:(USE ATTACHED POWERPONT TEMPLATE
o Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)(ORGANIZATION IS A HOSPICE COMPANY)
o Describe the current problem or opportunity for change. (PREVENTING PRESSURE ULCERS/INJURIES IN HOSPICE PATIENT OR AT THE END OF LIFE)Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
A bullet in powerpoint states : There are also concerns about the professionalism and ethical considerations of health care givers.
What are the concerns?
o Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Should be customized to a hospice setting -how would it be customized
o Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
o Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Possibly give examples? It is asking for measurable outcomes
o Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
o Add a lessons learned section that includes the following:
· A summary of the critical appraisal of the peer-reviewed articles you previously submitted
· An explanation about what you learned from completing the evaluation table (1 slide)-ATTACHED
· An explanation about what you learned from completing the levels of evidence table (1 slide)-ATTACHED
· An explanation about what you learned from completing the outcomes synthesis table (ATTACHED) (1 slide)
Use this order for the Assignment:
Title Page: 1 slide
Introduction paragraph and purpose statement: 1 slide
PPT Presentation: 8- to 9-slides
Conclusion: 1 slide
References
Note: The PPT title page, introduction paragraph and purpose statement, conclusion, and references do not count toward the 8- to 9-slide PPT presentation slide requirement. References can be single spaced but make sure that there is enough space between the refe ...
Central mucoepidermoid carcinoma an up to-date analysis of 147 casesMNTan1
1. The study analyzed 147 cases of central mucoepidermoid carcinoma (CMC) reported in 36 publications to understand clinical aspects, histology, treatment and prognostic factors.
2. It found that CMC was more common in females than males, most often in the mandible, and usually low grade histologically. The main treatment was surgical resection.
3. Significant prognostic factors associated with worse survival in multivariate analysis included male sex, high histological grade, conservative rather than radical treatment, and lymph node metastasis.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
This document discusses suction and retractors used in oral and maxillofacial surgery. It describes the objective of suction as removing fluids, blood, debris, and air from the surgical site to maintain a clear field of view. It outlines different types of suction instruments including tips, tubing, and devices. It also discusses various surgical retractors, their importance for providing exposure and separation of tissues during surgery, materials used, and types including self-retaining retractors. The document serves as a reference for suction and retraction tools in oral and maxillofacial surgery.
This study compared the antifungal efficacy of various endodontic irrigants, with and without the antifungal agent clotrimazole, against Candida albicans in extracted human teeth. Teeth were inoculated with C. albicans and irrigated with sodium hypochlorite, chlorhexidine gluconate, doxycycline hydrochloride, or combinations of these with 1% clotrimazole. Colony forming units were significantly lower for sodium hypochlorite and chlorhexidine alone compared to doxycycline or the control. Adding clotrimazole increased the efficacy of all irrigants, with no significant difference between sodium hypochlorite with
Longevity of teeth and implants a systematic reviewdroliv
SUMMARY
This systematic review analyzed 11 publications on teeth with 3,015 subjects and follow-up periods ranging from 10-30 years. The incidence of tooth loss was 1.3-5% in most studies but 14-20% in two studies of rural Chinese populations. The percentage of subjects experiencing tooth loss varied from 25-75%, highest in Chinese populations and untreated periodontitis patients. Bone loss appeared small (<1mm) in well-maintained patients. Nine implant studies with 476 subjects and follow-up up to 20 years found implant loss varied between 1-18%. Bone loss around implants was 0.7-1.3mm in most studies. Comparisons of longevity are difficult due to heterogeneity.
Marginal and Internal Fit of Different Fixed Dental Prostheses: A Comparative...DrHeena tiwari
This study compared five methods for assessing the marginal and internal fit of fixed dental prostheses: the cross-sectional method, silicone replica technique, triple scan method, micro-computed tomography, and optical coherence tomography. Measurements of the marginal gap, axial gap, angle gap, and occlusal gap found statistically significant differences between the methods. The cross-sectional method and silicone replica technique showed the lowest mean values and were the most similar, while the triple scan method and optical coherence tomography also showed similarities. The study concluded that while fit values may fall within clinically acceptable ranges, differences between assessment methods should be considered.
MB2 In Maxillary Second Molar – Two Case ReportsQUESTJOURNAL
This document presents two case reports of maxillary second molars that each had an extra canal (MB2) identified in the mesiobuccal root. In the first case, careful visualization with magnifying loupes revealed a groove indicating the presence of an MB2 canal, which was located using an ultrasonic tip. In the second case, an incomplete access cavity was modified and exploration uncovered an extra mesiobuccal canal. Both cases were treated with biomechanical preparation and obturation of all canals. Failure to locate and treat extra canals such as MB2 is a common reason for endodontic treatment failure.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
The document discusses denture stomatitis (DS), an inflammatory condition affecting the oral mucosa of individuals wearing complete or partial removable dental prostheses. It reports that DS prevalence varies widely between studies but can be as high as 75% in some populations. The document conducts a systematic review of eight studies on the association between partial removable dental prostheses (RDPs) and DS. The review finds that DS prevalence in partial RDP wearers ranges from 1.1% to 36.7% across the studies. Several factors are proposed as potential risks for DS, but the evidence is inconsistent. The review concludes that there is some evidence linking DS to partial RDP use, but higher quality studies are needed to establish causality.
This document discusses mixed dentition space analysis, which is used to predict space requirements for unerupted permanent teeth during the mixed dentition period from ages 6 to 12 years. Accurate prediction is important for orthodontic diagnosis and treatment planning. The document outlines three main methods for mixed dentition space analysis: 1) using measurements of erupted permanent teeth on dental casts to predict sizes of unerupted teeth, 2) measuring unerupted teeth directly on radiographs, and 3) combining the first two methods. It provides details on several commonly used techniques within each category to facilitate space prediction and assessment of crowding or spacing in the dental arches.
This case report describes an adult patient who presented with an anterior open bite that was associated with breathing problems. Clinical and radiographic examination revealed the open bite was due to skeletal factors including an increased lower anterior facial height and hyperdivergent skeletal planes. The patient's breathing problems acted synergistically with her skeletal pattern to cause and worsen the open bite over time as her mandible rotated counterclockwise to open and facilitate breathing. Treatment of the open bite would need to address both the skeletal and respiratory etiological factors.
This study investigated the craniofacial morphology and growth of cleft palate patients. Common findings among patients included anterior crossbite, a reduced and posteriorly positioned maxilla. Frequent orthodontic issues were deviations of the upper incisors, missing teeth in the cleft area, and asymmetries of the upper dental arch. Regarding growth, some patients had normal facial development while others exhibited a hypoplastic maxilla and middle third of the face. The study aimed to characterize the morphological features and growth patterns of cleft palate patients' craniofacial complexes to help establish appropriate treatment protocols.
EFFICACY OF FIXED VERSUS REMOVAL RETAINER POST ORTHODONTIC TREATMENT: A COMP...DrHeena tiwari
This study compared the efficacy of fixed versus removable retainers for maintaining orthodontic treatment outcomes over 4 years. 48 participants from an original randomized controlled trial were evaluated. Those with fixed retainers had lower irregularity scores on average (0.85mm increase) compared to removable retainers (1.47mm increase). After adjusting for confounding factors, the difference in irregularity between groups was statistically significant, with removable retainers having 1.64mm more irregularity on average. No other significant differences were found between groups for other metrics like inter-canine width. Compliance with removable retainers decreased over time. Fixed retainers maintained their position better, though some required repair. In conclusion, fixed retainers appeared to
8-9 powerpoint slide not including title, intro or conclusion-usitroutmanboris
8-9 powerpoint slide not including title, intro or conclusion-using attached template-rubric attached as well
o Reflect on the four peer-reviewed articles you critically appraised in Module 4. (last weeks articles)
o Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, including its culture and readiness for change. The organization is a Hospice company-
o
o The Assignment: (Evidence-Based Project): Part 5: Recommending an Evidence-Based Practice Change
o
o Create an 8- to 9-slide PowerPoint presentation in which you do the following:(USE ATTACHED POWERPONT TEMPLATE
o Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)(ORGANIZATION IS A HOSPICE COMPANY)
o Describe the current problem or opportunity for change. (PREVENTING PRESSURE ULCERS/INJURIES IN HOSPICE PATIENT OR AT THE END OF LIFE)Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
A bullet in powerpoint states : There are also concerns about the professionalism and ethical considerations of health care givers.
What are the concerns?
o Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Should be customized to a hospice setting -how would it be customized
o Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
o Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Possibly give examples? It is asking for measurable outcomes
o Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
o Add a lessons learned section that includes the following:
· A summary of the critical appraisal of the peer-reviewed articles you previously submitted
· An explanation about what you learned from completing the evaluation table (1 slide)-ATTACHED
· An explanation about what you learned from completing the levels of evidence table (1 slide)-ATTACHED
· An explanation about what you learned from completing the outcomes synthesis table (ATTACHED) (1 slide)
Use this order for the Assignment:
Title Page: 1 slide
Introduction paragraph and purpose statement: 1 slide
PPT Presentation: 8- to 9-slides
Conclusion: 1 slide
References
Note: The PPT title page, introduction paragraph and purpose statement, conclusion, and references do not count toward the 8- to 9-slide PPT presentation slide requirement. References can be single spaced but make sure that there is enough space between the refe ...
Central mucoepidermoid carcinoma an up to-date analysis of 147 casesMNTan1
1. The study analyzed 147 cases of central mucoepidermoid carcinoma (CMC) reported in 36 publications to understand clinical aspects, histology, treatment and prognostic factors.
2. It found that CMC was more common in females than males, most often in the mandible, and usually low grade histologically. The main treatment was surgical resection.
3. Significant prognostic factors associated with worse survival in multivariate analysis included male sex, high histological grade, conservative rather than radical treatment, and lymph node metastasis.
A Systematic Literature Review On Supply Chain Risk Management Is Healthcare...Cynthia King
This document presents a systematic literature review on supply chain risk management in healthcare. The review aimed to investigate how supply chain risk management is applied to healthcare supply chains and identify opportunities for improvement. It addressed three research questions: (1) What are the main gaps in healthcare supply chain risk management? (2) What is the definition of healthcare supply chain risk management? (3) What risk management techniques and approaches are used in healthcare supply chains? The review found that healthcare supply chain risk management is an under-researched area and proposed a formal definition. It also identified common risks in healthcare supply chains and generated a list of relevant risk management studies in the healthcare sector.
This document provides guidelines for evaluating patients with pulmonary nodules from the American College of Chest Physicians. It summarizes the guideline objectives, target population, diagnostic and management interventions considered, major outcomes, methodology, recommendations, and validation process. The guideline was developed through a systematic review of literature and expert consensus to provide evidence-based recommendations. It defines solitary pulmonary nodules and provides 12 major recommendations on pre-test probability assessment, imaging tests, PET scanning, discussion of risks/benefits with patients, and tissue diagnosis.
Systematic reviews of topical fluorides for dental caries: a review of report...cathykr
This document summarizes a systematic review of 38 published systematic reviews and meta-analyses on the caries-preventive effects of topical fluoride therapies. It finds that while many reviews focused on fluoride toothpastes and children/adolescents, reporting of eligibility criteria, search methods, and risk of bias assessment was often inadequate. Future reviews should follow guidelines like PRISMA to improve validity and relevance through complete reporting of methods and results.
This document analyzes the top 100 most cited publications in dentistry based on citation counts from Scopus and Google Scholar. It finds that the most productive decade was the 2000s, with 40 of the top 100 articles published then. Nearly half of the articles came from the United States. The most cited article had over 4,700 citations and focused on the relationship between oral hygiene and periodontal health during pregnancy. Overall, the top 100 articles received over 110,000 citations in Scopus and over 214,000 in Google Scholar, demonstrating the significant impact of this research in the field of dentistry.
The document discusses various methods and data sources for performing citation analysis and research evaluation, including using citation data from Web of Science, Scopus, and Google Scholar. It also covers benchmarking research groups using metrics like the h-index and Essential Science Indicators, evaluating researchers based on citation metrics and journal impact factors, and limitations of using citation data and journal impact factors for research assessment.
This document provides guidance on writing effective abstracts. It discusses what abstracts are, why they are important, and different types of abstracts such as unstructured and structured. Key elements that should be included in abstracts are background, objectives, methods, results, and conclusions. Tips are provided such as explaining abbreviations, using synonyms, and refraining from citations. The importance of keywords for searchability is covered, including reviewing similar articles and MeSH terms. Overall, the document aims to help authors write abstracts that accurately summarize their work and allow other researchers to easily find the information.
Appraisal of weekly conducted clinical pathologic case conference (CPC).pdfLeslie Schulte
- The document discusses a survey evaluating a weekly clinical pathologic case conference (CPC) conducted at the School of Medical Sciences, Universiti Sains Malaysia.
- The survey found that the majority of faculty were unaware of the original/formal CPC format and that many presentations deviated from this format by lacking differential diagnosis discussion.
- However, most faculty expressed willingness to follow guidelines to adapt presentations to the formal CPC format and recognized CPC as an important continuing medical education opportunity.
A Graduate Critical Appraisal Assignment for Athletic TrainingJohn Parsons
1) The document discusses a graduated critical appraisal assignment used to teach athletic training students how to critically analyze research studies. 2) It involves having students start with annotating articles and working up to crafting clinical questions, analyzing levels of evidence, and fully critically appraising studies. 3) The assignment is meant to help students develop skills in evidence-based practice and preparing them for real-world clinical decision making.
This document provides guidelines for publishing manuscripts in medical/dental journals. It discusses various types of manuscripts like case reports, case series, research articles, and systematic reviews. It explains guidelines for each type like CARE guidelines for case reports and CONSORT guidelines for clinical trials. It also discusses the peer review process, impact factor, indexing/abstracting of journals, and tips for manuscript acceptance. Overall, the document serves as a useful reference for authors to understand the publishing process and guidelines for improving the quality of their manuscripts.
Cancer Treatment and Research Communications 27 (2021) 100316TawnaDelatorrejs
This document summarizes a scoping review of 161 articles published between 2015-2020 about adolescents and young adults (AYAs) with cancer. The review found that 46% of articles discussed health systems/treatment, 39.1% discussed quality of life, 8.7% discussed sexual health, and 6.2% discussed social issues. Most studies were qualitative (134) and conducted in the US (70). The majority of studies (73.3%) investigated variables related to AYAs to increase understanding of their needs, 11.2% intervened through pilot studies, and 13.7% evaluated interventions. There is still much to research around developing and evaluating interventions for AYAs with cancer.
The document summarizes a study that assessed the quality of reports of randomized clinical trials (RCTs) in plastic surgery published from 2004 to 2008. The study aimed to verify changes from an earlier analysis of RCTs published from 1966 to 2003. Key findings include:
1) 29% of identified RCTs appropriately described allocation concealment, an improvement from 17% in the earlier period.
2) When evaluated using the Delphi List, RCTs showed improved reporting of baseline group similarity but no other significant changes.
3) When evaluated using the Jadad scale, the percentage of low-quality RCTs decreased from 59% to 14%, indicating improved overall quality of reporting.
Guide for conducting meta analysis in health researchYogitha P
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Frictional resistance in self ligating orthodontic brackets and conventionall...VARADARAJU MAGESH
This document summarizes a systematic review that compares the frictional resistance between self-ligating brackets and conventionally ligated brackets based on in vitro studies. A total of 19 studies met the selection criteria for inclusion in the review. The review found that self-ligating brackets produce lower friction than conventional brackets when used with small round archwires in the absence of tipping or torque in an ideally aligned arch. However, the evidence was insufficient to claim that self-ligating brackets produce lower friction than conventional brackets when used with large rectangular wires that involve tipping and/or torque or in arches with malocclusion. The variability in experimental methods among the selected studies may explain the inconsistent results.
Ana Marusic - MedicReS World Congress 2011MedicReS
Four clinical trials (Trials A-D) tested active treatments against placebo for about 5 years. Trial A reported survival rates, Trial B reported risk reduction, Trial C reported mortality reduction, and Trial D reported number needed to treat. Clinicians considered Trials B and D most useful for practice based on how the results were reported. Reporting guidelines recommend presenting numbers of events, absolute risk reductions, relative risks with confidence intervals, and number needed to treat to improve interpretation and clinical applicability of trial results. Adopting reporting standards can enhance transparency and reliability of research literature.
The purpose of this initial paper is to briefly describe your sear.docxhelen23456789
The purpose of this initial paper is to briefly describe your search strategies when identifying two articles that pertain to an evidence-based practice topic of interest. Mine is on Avoiding Hospital Readmissions. I will be focusing as an individual on examining the sources of knowledge that contribute to professional nursing practice qualitative or quantitative design? Apply research principles to the interpretation of the content of published research studies. "What is the number of trends in 30-day post-discharge mortality among beneficiaries after the implementation of HRRP -- period 3 and 4, for mortality rate in myocardial infarctions?" (Wadhera, et al., 2018)
Clinical Question:
A. Describe problem
b. Significance of problem in terms of outcomes or statistics
c. Your PICOT question in support of the group topic
d. Purpose of your paper
B. Levels of Evidence
a. Type of question asked
b. Best evidence found to answer question
C. Search Strategy
a. Search terms
b. Databases used (you may use Google Scholar in addition to the library databases; start with the Library)
c. Refinement decisions made
d. Identification of two most relevant articles
D. Format
a. Correct grammar and spelling
b. Use of headings for each section
c. Use of APA format (sixth edition)
d. Page length: three to four pages
Clinical Question
45 points 28%1. Problem is described. What is the focus of your group’s work? 2. Significance of the problem is described. What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations. 3. What is your PICOT question? 4. Purpose of your paper. What will your paper do or describe? This is similar to a problem statement. “The purpose of this paper is to . . .”
Levels of Evidence
20 points 13% 1. What type of question are you asking (therapy, prognosis, meaning, etc.)? 2. What is the best type of evidence to be found to answer that question (e.g., RCT, cohort study, qualitative study)?
Search Strategy
65 points 41% 1. Search topic(s) provided. What did you use for search terms? 2. What database(s) did you use? Link your search with the PICOT question described above. 3. As you did your search, what decisions did you make in refinement to get your required articles down to a reasonable number for review? Were any limits used? If so, what? 4. Identify the two most relevant and helpful articles that will provide guidance for your next paper and the group’s work. Why were these two selected?
Format
30 points 18% 1. Correct grammar and spelling 2. Use of headings for each section: Clinical Question, Level of Evidence, Search Strategy, Conclusion 3. APA format (sixth ed.) 4. Paper length: three to four pages
Total worth 160 points
DIRECTIONS AND ASSIGNMENT CRITERIA Assign ment Criteria Points % Description Clinical Question 45
28 1. Problem is described. What is the focus of your group’s work.
This document provides a 24-item checklist for reporting qualitative studies submitted to the Canada Communicable Disease Report (CCDR). The checklist outlines key elements that should be included in a qualitative study such as the objective, methods, findings, and conclusion. It also provides examples of what should be described such as the study setting, sampling strategies, data collection tools, data analysis process, and key findings. Following the checklist guidelines will help ensure qualitative studies submitted to the CCDR clearly describe the research context and process to aid readers' assessment and understanding of the findings.
This document provides an overview of the history and process of systematic reviews. It discusses how Karl Pearson was one of the first to synthesize data from multiple studies in 1904. It also discusses how Archie Cochrane advocated for systematic reviews in 1979. The number of systematic reviews has grown significantly from 1990 to 2007. The document then outlines the steps involved in conducting a systematic review, including developing a focused question, searching multiple databases, appraising evidence, and documenting methods. It emphasizes starting organized with tools like spreadsheets and citation managers.
This case report describes an unusual case of pseudo-ankylosis in an 8-year-old child with a history of trauma. Imaging revealed an old fractured right condyle that had been anteriorly displaced and dislocated into the sigmoid notch, where it had fused to the zygomatic arch. Computed tomography with 3D reconstruction clearly showed the displaced condylar fragment. The child underwent surgery to release the ankylotic mass and perform a coronoidectomy to improve mouth opening. Post-operatively, aggressive physiotherapy helped increase the child's maximum interincisal opening. This unique case highlights the importance of accurate imaging and diagnosis for successful treatment of complex facial injuries.
This document provides information about the editors and contributors of the book "Oral and Maxillofacial Surgery for the Clinician". It begins with an introduction by the editors explaining the motivation and scope of the book. It aims to be a comprehensive textbook on oral and maxillofacial surgery for clinicians and trainees. The book has contributions from AOMSI members in India as well as 41 international authors to represent global expertise. It contains 22 sections and 88 chapters covering all aspects of cranio-maxillofacial surgery, along with 68 video demonstrations. The editors thank the contributors and AOMSI for their support in producing this open access textbook.
Here are the key points about suction:
- The objective of suction is to maintain a clear airway by removing secretions like saliva, blood or vomit from the mouth or surgical site.
- It prevents aspiration which can lead to infections. Suction also helps surgeons see clearly during procedures.
- Safety considerations include using proper technique to avoid injury, knowing which patients are at risk of aspiration, monitoring for respiratory distress, and addressing other potential causes of distress beyond just secretions.
This document provides an introduction to mixed dentition space analysis. It discusses that during the mixed dentition period, there may be discrepancies between the space available in the dental arches and the size of the teeth. Accurate mixed dentition space analysis is important for orthodontic diagnosis and treatment planning. The document outlines that mixed dentition typically lasts from ages 6 to 12 years and is when maximum orthodontic problems can develop due to inadequate space for permanent teeth. It also categorizes different methods for mixed dentition space analysis, including those based on regression equations using measurements of erupted permanent teeth and those using radiographs.
This study compared the antifungal efficacy of various endodontic irrigants, with and without the antifungal agent clotrimazole, against Candida albicans in extracted human teeth. Teeth were inoculated with C. albicans and irrigated with sodium hypochlorite, chlorhexidine gluconate, doxycycline hydrochloride, or combinations of these with 1% clotrimazole. Colony forming units were significantly lower for sodium hypochlorite and chlorhexidine alone compared to doxycycline or the control. Adding clotrimazole increased the efficacy of all irrigants, with sodium hypochlorite with clotrimaz
This document discusses the importance of adult immunization and provides guidelines for vaccination against various diseases. It begins by noting that while childhood immunization is well-known, adult immunization is less understood but still important. It then reviews literature on vaccination protocols for adults, including for travel, communicable diseases, hepatitis B, shingles, and more. The document focuses in depth on recommended vaccination for human papillomavirus (HPV), hepatitis, and human immunodeficiency virus (HIV). It provides vaccination schedules, target groups, and notes the need to increase awareness of adult immunization among healthcare professionals and the public.
Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
Sahu S, Patley A, Kharsan V, Madan RS, Manjula V, Tiwari RVC. Comparative evaluation of efficacy and latency of twin mix vs 2% lignocaine HCL with 1:80000 epinephrine in surgical removal of impacted mandibular third molar. J Family Med Prim Care. 2020 Feb;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb. PubMed PMID: 32318443; PubMed Central PMCID: PMC7113948.
- The document discusses animal models that are being used to test vaccines for COVID-19. It conducted a systematic review of studies published between January and August 2020.
- The review identified 20 relevant studies examining nonhuman primates, mice, hamsters, ferrets, cats and dogs. These animal models show some similar responses to SARS-CoV-2 infection as humans such as respiratory symptoms.
- However, the models do not fully mimic the severe complications seen in human COVID-19 patients such as acute respiratory distress syndrome and coagulopathy. While the models provide useful information, they have limitations in replicating the full disease severity in humans.
This study aimed to evaluate the knowledge and concerns of 124 dental health professionals in southern India regarding COVID-19. A survey was administered to assess understanding of COVID-19 transmission, oral manifestations, appropriate testing and emergency procedures. The results found good knowledge of COVID-19 and precautions, but some lack of awareness regarding appropriate testing and managing contaminated air. While most respondents understood transmission risks and emergency protocols, there was uncertainty around testing patients and using mouthwashes as prevention. This highlights gaps in knowledge that could be addressed with further education for dental professionals on COVID-19 clinical guidelines.
Vohra P, Belkhode V, Nimonkar S, Potdar S, Bhanot R, Izna, Tiwari RVC. Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study. J Family Med Prim Care. 2020 May;9(5):2437-2441. doi: 10.4103/jfmpc.jfmpc_138_20. eCollection 2020 May. PubMed PMID: 32754516; PubMed Central PMCID: PMC7380795
A 34-year-old male presented with pain and pus discharge from a recently extracted tooth. Radiographs showed two distinct radiolucencies - a large cyst in the left mandible and a smaller cyst in the right mandible. Histological examination found the left cyst to be a radicular cyst and the right cyst to be a dentigerous cyst. This presented a diagnostic dilemma as it is uncommon to have multiple cyst types occurring bilaterally in the mandible without an associated syndrome. Careful radiographic and histological analysis was needed to arrive at the accurate diagnosis and appropriate treatment.
Mittal S, Hussain SA, Tiwari RVC, Poovathingal AB, Priya BP, Bhanot R, Tiwari H. Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report. J Family Med Prim Care. 2020 Feb;9(2):1215-1218. doi: 10.4103/jfmpc.jfmpc_1125_19. eCollection 2020 Feb. PubMed PMID: 32318498; PubMed Central PMCID: PMC7113973.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
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1. REVIEW PAPER
Level of Evidence Analysis in Journal of Maxillofacial Oral
Surgery: A Twelve-Year Bibliometric Analysis of 1300
Publications (2009–2020)
Kirti Chaudhry1 • Rishi Kumar Bali2 • Amanjot Kaur1 • Rahul V. C. Tiwari3 •
Arun K. Patnana1
Received: 26 June 2020 / Accepted: 19 April 2021
Ó The Association of Oral and Maxillofacial Surgeons of India 2021
Abstract
Aim Analysing Level of Evidence (LOE) provides an
insight to evidence-based medicine (EBM). The aim of our
study was to evaluate and analyse trends in Levels of
Evidence (LOE) in Journal of Maxillofacial and Oral
Surgery (MAOS) since inception, i.e. December 2009
along with categorization into subtopics.
Methodology LOE for each article was determined
according to modified American Society of Plastic Sur-
geons (ASPS) scale and National Health and Medical
Research Council (NHMRC) Evidence Hierarchy.
Results A total of 1264 articles were included in the final
analysis, out of which high-quality evidence (Level A)
accounted for 7% of the journal. The percentage of Level
I/II (Level A) has increased from 2.09% in 2009/2010 to
12.74% in 2019/2020, representing a promising trend
toward higher-quality research in just 10 years. Case
reports and narrative reviews with Level of Evidence value
‘‘D’’ account the highest number (36%) of all the published
articles. The majority of articles fell under Class 2 (Max-
illofacial pathology) classification (35%) highlighting
myriad of articles covering pathologies and various
reconstruction methods, followed by trauma (16%).
Conclusion The status of LOE and categorizing of pub-
lished articles are the first step to audit and quantify the
nature of literature published by JMOS and may further
help in refining the quality of research jointly by the
researchers and the editorial board.
Keywords Level of Evidence (LOE) Journal of
Maxillofacial and Oral Surgery (MAOS) Evidence-based
medicine (EBM)
Introduction
Bibliometrics is the discipline where quantitative approa-
ches are applied mainly to scientific fields and are based
principally on various aspects of written articles like sub-
ject, author, citation, title, etc. [1]. It is beneficial for
monitoring growth of the literature and pattern of research
in a journal [2] .
Evidence-based Medical practice (EBM) is the mainstay
for any diagnostic, therapeutics, prognostic, medical or
surgical decision making for the patient care. Predominant
backbone of EBM is the ability to codify any study based
on Level of Evidence (LOE). Oral and Maxillofacial Sur-
gery (OMFS) is an evolving speciality requiring training in
both medicine and dentistry and is specially rooted in
experimentation and innovation. Scientific journals are
excellent platforms for two-way communication of
research findings, latest discoveries and developments, and
Amanjot Kaur
amanjotkaur1992@yahoo.com
Kirti Chaudhry
chaudhry_kirti@yahoo.com
Rishi Kumar Bali
rshbali@yahoo.co.in
Rahul V. C. Tiwari
drrahulvctiwari@gmail.com
Arun K. Patnana
arun0550@gmail.com
1
Department of Dentistry, All India Institute of Medical
Sciences, Jodhpur, India
2
DAV Dental College and MDM General Hospital,
Yamunanagar, India
3
Vizag, Andhra Pradesh, India
123
J. Maxillofac. Oral Surg.
https://doi.org/10.1007/s12663-021-01575-4
Author Personal Copy
2. future research prospects, thus having a pivotal role in
amalgamating EBM in any clinical speciality.
Randomized controlled trials (RCTs), which have been
the gold standard for unbiased evidence, have found a
limited role in surgical specialities, due to lack of under-
standing of RCTs, epidemiological and statistical training
in the surgical community. Ethical considerations like
Sham surgeries (placebo surgeries), lack of funding, sur-
gical learning curve and lack of feasibility of blinding of
surgeons, lack of long-term follow-ups of outcomes are
few of the other major challenges in conducting high-level
RCTs. In defiance of all these odds, OMFS as a speciality
is trying to evolve leaps and bounds from a field driven by
anecdotal evidence and expert opinions to embrace evi-
dence-based medicine.
Journal of Maxillofacial and Oral Surgery (MAOS) is a
quarterly, official peer-reviewed publication of the Asso-
ciation of Oral and Maxillofacial Surgeons of India
(AOMSI). MAOS got PubMed indexed in December 2009,
since then it has played a very crucial role in complete
spectrum of academics, disseminative, contemporary,
scholarly, technical, cutting-edge innovations, diagnostic
works and future trends related to extensive field of OMFS.
It focuses on publishing original articles, review articles,
editorials, letter to the editor, case reports, technical notes,
mini reviews and commentaries.
Refining of research quality published in OMFS journals
is an uphill task where assessing the trends of LOEs in a
journal is the first and critical step. The aim of our study
was to evaluate and analyse trends in Levels of Evidence
(LOE) in Journal of Maxillofacial and Oral Surger-
y(MAOS) since inception, i.e. December 2009. A sec-
ondary purpose was to describe the current publication
pattern in terms of LOE and sub-categories.
Methodology
A search team including three authors (AK, AP and RT)
screened and reviewed all the articles of MAOS since
December 2009–April 2020. The team worked in pairs so
that two authors separately screen each article and any
discord was settled by consulting senior author KC and RB.
An explicit data extraction sheet was prepared categorizing
all the articles based on LOE and themes and all the articles
published in MAOS from 2009 (Volume 8 Issue 1) to 2020
(Volume 19 Issue 2). Cataloguing the LOE was done as per
Table 1 that was prepared, objectified and simplified
according to modified American Society of Plastic Sur-
geons (ASPS) scale [3] and National Health and Medical
Research Council (NHMRC) Evidence Hierarchy [4].
Articles were further classified by reviewers according to
the study design: (1) systematic review, (2) RCT, (3)
prospective cohort studies, (4) meta-analysis, (5) case–
control study, (6) retrospective study, (7) analytical cross-
sectional study, (8) descriptive cross-sectional study, (9)
case series, (10) case reports, (11) narrative reviews, (12)
expert opinions, (13) editorials/letter to editor, (14) per-
spectives, (15) technical notes. Published articles on basic
sciences, in vitro studies, animal studies, cadaveric studies,
instructional course lectures and conference proceedings
were excluded from the analysis. Additionally, each article
was assigned an LOE by the reviewers according to
Table 1 with any discrepancy settled by consensus. Highest
quality evidence is produced from randomized controlled
trails or systemic reviews/meta-analysis of the RCTs, thus
given Level A. The lowest Level of Evidence (Level E)
was given to articles of limited study designs like
Table 1 Level of Evidence (LOE) distribution according to modified
American Society of Plastic Surgeons (ASPS) scale [3] and National
Health and Medical Research Council (NHMRC) Evidence Hierarchy
[4]
LOE name LOE value
Level I/II
Prospective RCT’s A
Prospective cohort studies
Systematic review of RCT’s,
Cohort studies
Meta-analysis
Level III
Case–control study B
Retrospective study
Systematic review of case control
Studies
Analytical cross-sectional studies
Level IV
Case series C
Descriptive cross sectional
Systematic review of cross
Sectional or case series
Level V
Case reports D
Narrative reviews
Expert opinion
Editorials/letter to editor E
Perspectives
Technical notes
Excluded
Animal studies, cadaveric studies, X
In vitro studies, erratum,
Conference proceedings
J. Maxillofac. Oral Surg.
123
3. editorials, expert opinions or technical notes. Smaller LOE
values (i.e. closer to A) indicate research that presents
higher-quality evidence. The articles were simultaneously
categorized according to the subspeciality as shown in
Tables 1 and 2. The flowchart of methodology was as
depicted in Fig. 1.
Statistical Analysis
The descriptive statistics of the number of articles pub-
lished according to the year, Level of Evidence and cate-
gory of the topic were done to evaluate the percentages of
each variable. Chi-square test was done to evaluate the
distribution of number of articles according to the year,
Level of Evidence and category of the topic. The variations
in the publication of different levels of evidence were
analysed using the bar charts. All statistical tests were done
using the SPSS software version 21, and the P value of less
than 0.05 was considered statistically significant.
Results
The descriptive statistics of the number of articles pub-
lished according to the year, Level of Evidence and cate-
gory of the topic are presented in Figs. 2, 3 and 4,
respectively. Maximum of the articles (20%) were pub-
lished during the year 2015. Case reports and narrative
reviews with Level of Evidence value ‘‘D’’ account the
highest number (36%) of all the published articles from
2009 to 2020. Maxillofacial pathology category ranks the
highest number of publications (35%) from 2009 to 2020.
The distribution of year of publication and Level of
Evidence of the published articles from 2009 to 2020 are
presented in Fig. 5. The Chi-square test showed significant
difference (P = 0.000) in the distribution of articles from
2009 to 2020 according to different Level of Evidence
values (Table 3). The distribution of year of publication
and category of the topic of the published articles are
shown in Fig. 4. The Chi-square test showed significant
difference (P = 0.009) in the distribution of articles from
2009 to 2020 according to categories of the topics pub-
lished (Table 4). The distribution of articles published
according to different levels of evidence and category of
the topics are presented in Fig. 5. The Chi-square test
showed significant difference (P = 0.000) in the distribu-
tion of articles according to different levels of evidence and
different categories of the topics published (Table 5). The
variations in the publication of articles with different levels
of evidence are presented in Fig. 5.
Discussion
Bibliometrics is a set of statistical methods to analyse
academic literature quantitatively and its changes over
time. However, subfield of bibliometric, i.e. restricted to
analysis of scientific publications, is called scientometrics.
The term ‘‘bibliometrie’’ was coined by Paul Otlet in 1934
[5]. Peer-reviewed publication is primary mode of com-
munication and recorded for scientific research which
forms the basis of LOE and EBM. Individual studies can be
judged for its quality if it is peer-reviewed publication, if it
has followed reporting guidelines and its citation indices
for healthcare stimulation research.
Different study designs based on the research questions
have found use in different conditions. For therapeutic,
RCTs are the best form of study and for prognostics well-
designed cohorts are the best form of study. Former is the
highest form in interventional studies and later being in
observational study. Depending on the quality of study
conducted and type of research question sometimes LOE
may vary. For example, cigarette smoking association with
oral cancer cannot be assessed with RCT; here, depending
on this research question, well-designed cohort will form
the Level 1 evidence. Levels I and II were combined in our
study to minimize subjectivity in high- and low-quality
RCT. In vitro, animal studies and pilot studies are the
building blocks and finally pave way for future clinical
research formed 3% of the journal publications. The animal
studies may not necessarily be able to reliably predict the
safety and efficacy of an intervention when trailed in
humans [6]. They were excluded from the LOE as guide-
lines and were given Level X [3].
There has been a growth in levels A, B and C evidence,
with a reduction in the publication in lower-quality evi-
dence. In total, high-quality evidence (Level A) accounted
for 7% of the journal which is much lower than orthopaedic
literature (21.6%) [7], neurosurgical (10.3%) [8] but higher
than the previously published maxillofacial research in
2007 showing 0% articles in Level I evidence and 2% for
Level II evidence [9] and plastic surgery having 2% Level I
evidence in 2018 [10]. This finding corresponds well to the
field of surgery, because it is difficult to conduct a standard
RCT in a surgery. The major difficulties include the fea-
sibility of randomization and compliance with random
allocations. Moreover, it is difficult to persuade a patient to
comply with newer drugs or surgery based on hypothesis of
animal studies.
However, there has been rapid expansion in technology
and heightened awareness of RCTs, and the quality of the
articles is improving with time. In this study, evaluating
LOE of over 1264 articles over the last decade, analysis
showed that the percentage of Level I/II (Level A) has
J. Maxillofac. Oral Surg.
123
4. Table 2 Categorical distribution of the articles
Category name Category value Category name Category value
Minor oral surgery
Exodontia
Impaction
Endodontic surgery
Pre-prosthetic surgery
Orthodontic/paediatric
Tooth exposure
1 Trauma
Dentoalveolar fracture
Maxillary fracture
Mandibular fracture
NOE fracture
Orbito-zygomatic fracture
Naso-orbito-ethmoid fracture
Frontal fracture
Pan facial fracture
Soft tissue injuries
Ballistic injuries
5
Maxillofacial pathology
Cysts of the oral cavity
Odontogenic and
Nonodontogenic tumours
Oral cancer
Head and neck tumours
Salivary gland pathologies
Maxillary sinus pathologies
Premalignant lesions
Vascular lesions
Reconstructive surgery and
Tissue engineering
2 Dental implants 6
Dentofacial deformity and aesthetics
Orthognathic surgery
Distraction Osteogenesis
Aesthetic Surgery/Procedures
Hair Transplant
Sleep Apnoea procedures
Orofacial cleft
3 Space infection and systemic infectious
Diseases
Head Neck Space Infections
Osteomyelitis, Osteoradionecrosis,
Osteochemonecrosis
Systemic manifestations of infectious
diseases
7
TMJ and orofacial pain
Orofacial neuropathy and
Neurological disorders
TMJ disorders, TMD
Myofascial pain
All neuralgias
4 Miscellaneous
Armamentarium
Diagnostics
Sterilization and disinfection
Suturing materials and techniques
Haemorrhage and shock
Wound care
Local anaesthesia
General anaesthesia
Medically compromised patients
Medical emergencies and their
Management
Burns
8
J. Maxillofac. Oral Surg.
123
5. increased from 2% in 2009/2010 to 12.74% in 2019/2020,
representing a significant and promising trend toward
higher-quality research in just 10 years.
Case series are the backbone of surgical research as they
comprise of similar group of patients with a common
intervention. No doubt, the absence of control group has
shifted its value to quite a lower level, but its value is
special in surgery. Level C which includes case series
forms 16% of the literature. Case reports are important
although they cannot be regarded as clinical evidence and
forms the bulk of the journal (36%). Further, there were
two supplemental issues in the year 2015 and 2016 of case
reports only; lower Level of Evidence was seen in these
two years. As it is said never judge a book by its cover, and
Fig. 1 Flowchart of the
methodology of the study
Fig. 2 Pie chart showing % distribution of the article’s yearwise from 2009 to 2020
J. Maxillofac. Oral Surg.
123
6. the same is true for case reports. Most of the time, the
large-scale and extensive clinical trials are planned on the
basis of results of a single case report. Editorials, expert
opinions and technical notes form a total of 13% of all
articles, having similar advantage as of a case report. They
were excluded from the LOE as guidelines in spite of that
we computed and were found as capitulations/submissions
in Level E [3].
Also, the majority of articles fell under Class 2 (Max-
illofacial pathology) classification (35%) highlighting
myriad of articles covering pathologies and various
reconstruction methods, followed by trauma (16%). Both
Fig. 3 Pie chart showing % distribution of the article’s Level of Evidence (LOE) from 2009 to 2020 with major contribution by Level D studies
Fig. 4 Pie chart showing % distribution of the article’s sub-topic categorization from 2009 to 2020 with major contribution by Category 2 studies
J. Maxillofac. Oral Surg.
123
7. these categories form major bulk due to emphasis placed
during training in these aspects. However, there is still long
way to go in the field of dental implants forming only 3%
of the literature.
Even though bibliographic studies are a hefty job, still
our analysis has several limitations. Mostly bibliometric
analysis is computing citation index which was not calcu-
lated in our study. Citation index though important may be
erroneous as usually narrative reviews, and case reports
which form lowest step in LOE pyramid usually have high
citation. It has been found many articles downloaded,
discussed but not cited, thus skewing citation index as a
wide criterion for evaluating a study. This bibliometric
study has just quantified all the articles based on type of
study. No attempt was made to assess the quality of each
article using any tool or software. Our results lack critical
Fig. 5 Histogram showing yearly distribution of the article’s Level of Evidence (LOE) from 2009 to 2020
Table 3 Distribution of year of publication and Level of Evidence of the published articles
Number of articles published in each Level of
Evidence (percentages)
Total number of articles
published
Chi-square
value
P value
A B C D E
Year of
publication
2009 3 (3) 43 (46) 3 (3) 35 (38) 9 (10) 93 (100) 198.345a
0.000*
2010 1 (1) 33 (34) 3 (3) 48 (49) 13 (13) 98 (100)
2011 4 (5) 20 (27) 6 (8) 34 (45) 11 (15) 75 (100)
2012 2 (2) 41 (43) 10 (11) 35 (37) 7 (7) 95 (100)
2013 11 (12) 22 (25) 17 (20) 24 (27) 14 (16) 88 (100)
2014 12 (12) 20 (20) 34 (35) 21 (22) 11 (11) 98 (100)
2015 25 (10) 35 (14) 41 (16) 32 (51) 24 (9) 257 (100)
2016 7 (6) 30 (25) 12 (10) 52 (43) 20 (16) 121 (100)
2017 6 (7) 37 (32) 24 (22) 15 (18) 17 (21) 83 (100)
2018 6 (6) 37 (38) 24 (24) 18 (18) 14 (14) 99 (100)
2019 11 (10) 34 (32) 24 (22) 23 (21) 16 (15) 108 (100)
2020 5 (10) 12 (25) 13 (26) 12 (25) 7 (14) 49 (100)
Total 93 (7) 354
(28)
205
(16)
449
(36)
163
(13)
1264 (100)
The values in the tables were presented as percentages of total number of articles published
Chi-square test was used to analyse the significant difference between the year and Level of Evidence values of the published articles
*
P value of less than 0.05 was considered significant
J. Maxillofac. Oral Surg.
123
8. appraisal of each article’s methodology, bias and power
[3]. There is a critical distinction between a study LOE and
its inherent quality, exemplified by the fact that even RCTs
are susceptible to flaws in design and may suffer from poor
Jadad scores, which are used to quantify the strength of the
trial design [11]. Thus, in this study articles have been
quantified for the LOE; individual articles have not been
assessed for their quality.
Last few decades have shown a surge in publications of
various qualities which may be attributed to multitude of
reasons including widespread use of Internet facility, faster
dissemination, current publish and perish culture in aca-
demia. All of this has led to an explosion of scientific
publications that has overwhelmed the publication system
and has made it impossible either for the traditional, and
generally effective, peer-reviewed system to work or for
the scientific community to evaluate a lot of scientific
research. Efforts to improve the reproducibility and integ-
rity of science are needed as the published results are
unreliable due to growing problems with research and
publication practices [12].
To improve the quality of research, we should invest
sufficient time for strategic research and should be able to
identify the barriers in the implementation of the methods.
Also, research methodology courses should be made
mandatory for the trainees to fill the lacunae left behind in
the undergraduate days and to avoid research misconduct.
Plan-Do-Study-Act (PDSA) should be the motto for every
thesis topic or project allotted to postgraduate students and
researchers [13] .
Conclusion
Seglenonce said, ‘‘Science deserves to be judged by its
contents, not by its wrapping,’’ which remains true for
characterization of individual papers and scientists [14].
The LOE of MAOS literature has increased over time, as
Table 4 Distribution of year of publication and category of the topic of the published articles
Number of articles in each category of the topic (percentage) Total number of articles
published
Chi-square
value
P value
1 2 3 4 5 6 7 8
Year of
publication
2009 8 (9) 34
(37)
11
(12)
4 (4) 18
(19)
3 (3) 2 (2) 13
(14)
93 (100) 109.584a
0.009*
2010 4 (4) 42
(43)
11
(11)
5 (5) 20
(21)
1 (1) 3 (3) 12
(12)
98 (100)
2011 8 (11) 29
(39)
9 (12) 1 (1) 14
(19)
0 (0) 1 (1) 13
(17)
75 (100)
2012 7 (7) 35
(37)
11
(12)
4 (4) 20
(21)
2 (2) 2 (2) 14
(15)
95 (100)
2013 14
(16)
22
(25)
13
(15)
6 (7) 9 (10) 2 (2) 6 (7) 16
(18)
88 (100)
2014 5 (5) 28
(29)
15
(16)
8 (8) 12
(12)
6 (6) 8 (8) 16
(16)
98 (100)
2015 20 (8) 110
(43)
24 (9) 18
(7)
42
(16)
7 (3) 18
(7)
18 (7) 257 (100)
2016 11 (9) 41
(34)
21
(17)
6 (5) 19
(16)
5 (4) 4 (3) 14
(12)
121 (100)
2017 10
(12)
28
(34)
10
(12)
9
(11)
9 (11) 2 (2) 4 (5) 11
(13)
83 (100)
2018 10
(10)
25
(26)
13
(13)
9 (9) 23
(23)
2 (2) 4 (4) 13
(13)
99 (100)
2019 12
(13)
33
(31)
14
(13)
10
(9)
11
(10)
3 (3) 9 (8) 15
(14)
108 (100)
2020 0 (0) 13
(26)
4 (8) 6
(13)
6 (12) 5
(10)
5
(10)
10
(21)
49 (100)
Total 110
(9)
440
(35)
156
(12)
86
(7)
203
(16)
38
(3)
66
(5)
165
(13)
1264 (100)
The values in the tables were presented as percentages of total number of articles published
Chi-square test was used to analyse the significant difference between the year and Level of Evidence values of the published articles
*
P value of less than 0.05 was considered significant
J. Maxillofac. Oral Surg.
123
9. demonstrated by increased proportion of Level I/II evi-
dence. The main critic remains the readers which should
judge on the basis of quality. Thus, a bibliometric study
like this would help us to gauze the status of LOE of
published MAOS articles, thus paving way for improving
the quality of research conduction by researchers and
acceptance by the editors.
Authors’ Contributions Dr. Rishi Bali (RB) and Dr. Kirti Chaudhry
(KC) helped in study conception and design. Dr. Amanjot Kaur (AK),
Dr. Arun K. Patnana (AP) and Dr. Rahul VC Tiwari (RT) acquired the
data. AP and AK analysed and interpreted the data. KC and AK
drafted the manuscript. KC and RB critically revised.
Funding No funding was taken for this study.
Declarations
Conflict of interest The authors have no conflict of interest to
disclose.
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Table 5 Distribution of Level of Evidence and category of the topic of the published articles
Number of articles in each category of the topic (Percentage) Total number of articles
published
Chi-square
value
P value
1 2 3 4 5 6 7 8
Level of
Evidence
A 34
(36)
7 (7) 8 (9) 8 (9) 21
(23)
2 (2) 1 (1) 12
(13)
93 (100) 387.019a
0.000*
B 49
(14)
87
(25)
54
(15)
27
(8)
83
(23)
14
(4)
11
(3)
29 (8) 354 (100)
C 11
(5)
47
(23)
33
(16)
22
(11)
36
(18)
9 (4) 16
(8)
31
(15)
205 (100)
D 9 (2) 260
(58)
44
(10)
18
(4)
43
(10)
6 (1) 34
(7)
35 (8) 449 (100)
E 7 (4) 39
(24)
17
(11)
11
(7)
20
(12)
7 (4) 4 (2) 58
(36)
163 (100)
Total 110
(9)
440
(35)
156
(12)
86
(7)
203
(16)
38
(3)
66
(5)
165
(13)
1264 (100)
The values in the tables were presented as percentages of total number of articles published
Chi-square test was used to analyse the significant difference between the year and Level of Evidence values of the published articles
*
P value of less than 0.05 was considered significant
J. Maxillofac. Oral Surg.
123