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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Evidence based orthodontics /certified fixed orthodontic courses by Indian d...Indian dental academy
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.
Evidence based orthodontics /certified fixed orthodontic courses by Indian de...Indian dental academy
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
This document provides an overview of evidence-based orthodontics. It defines evidence-based orthodontics as integrating the best available research evidence with clinical expertise and patient values. The need for evidence-based orthodontics is that it allows practitioners to provide the currently best care available to patients. Evidence-based orthodontic practice differs from traditional practice by regularly accessing new evidence, identifying risk factors, and providing continuous, patient-centered, and efficient care. Systematic reviews are used to summarize research evidence in an unbiased manner to inform clinical decision making.
Evidence based orthodontics litesh /certified fixed orthodontic courses by In...Indian dental academy
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
The document discusses evidence-based orthodontics. It begins with definitions of evidence and evidence-based dentistry. It then discusses the history and evolution of evidence-based practice from the 19th century to present day. The need for evidence-based orthodontics is described as providing patients with the currently best available care. Clinical scenarios are presented and critically appraised based on evidence from the literature. Different study designs and hierarchies of evidence are reviewed. The importance of evidence-based decision making in orthodontics is emphasized.
Evidence based medicine (frequently asked DNB theory question)Raghavendra Babu
This document summarizes evidence-based medicine (EBM) and its application in pediatrics. EBM involves systematically searching medical literature, critically appraising evidence, and applying results to practice. While EBM is growing in pediatrics, more adoption is still needed. The key steps of EBM are asking answerable clinical questions, searching efficiently using databases like PubMed and limiting to clinical trials, critically appraising evidence, and applying to practice. Resources like Cochrane Library provide high-quality systematic reviews and evidence syntheses to help pediatricians practice EBM.
Evidence based decision making in periodonticsHardi Gandhi
INTRODUCTION TO EVIDENCE BASED DENTISTRY
EVIDENCE BASED PERIODONTOLOGY
NEED, PRINCIPLES, GOALS AND ADVANTAGES OF EBDM
SKILLS NEEDED FOR EBDM
ASSESING THE EVIDENCE
INCORPORATING INTO THE PRACTICE
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.for more details please visit
www.indiandentalacademy.com
Evidence based orthodontics /certified fixed orthodontic courses by Indian d...Indian dental academy
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.
Evidence based orthodontics /certified fixed orthodontic courses by Indian de...Indian dental academy
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
This document provides an overview of evidence-based orthodontics. It defines evidence-based orthodontics as integrating the best available research evidence with clinical expertise and patient values. The need for evidence-based orthodontics is that it allows practitioners to provide the currently best care available to patients. Evidence-based orthodontic practice differs from traditional practice by regularly accessing new evidence, identifying risk factors, and providing continuous, patient-centered, and efficient care. Systematic reviews are used to summarize research evidence in an unbiased manner to inform clinical decision making.
Evidence based orthodontics litesh /certified fixed orthodontic courses by In...Indian dental academy
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
The document discusses evidence-based orthodontics. It begins with definitions of evidence and evidence-based dentistry. It then discusses the history and evolution of evidence-based practice from the 19th century to present day. The need for evidence-based orthodontics is described as providing patients with the currently best available care. Clinical scenarios are presented and critically appraised based on evidence from the literature. Different study designs and hierarchies of evidence are reviewed. The importance of evidence-based decision making in orthodontics is emphasized.
Evidence based medicine (frequently asked DNB theory question)Raghavendra Babu
This document summarizes evidence-based medicine (EBM) and its application in pediatrics. EBM involves systematically searching medical literature, critically appraising evidence, and applying results to practice. While EBM is growing in pediatrics, more adoption is still needed. The key steps of EBM are asking answerable clinical questions, searching efficiently using databases like PubMed and limiting to clinical trials, critically appraising evidence, and applying to practice. Resources like Cochrane Library provide high-quality systematic reviews and evidence syntheses to help pediatricians practice EBM.
Evidence based decision making in periodonticsHardi Gandhi
INTRODUCTION TO EVIDENCE BASED DENTISTRY
EVIDENCE BASED PERIODONTOLOGY
NEED, PRINCIPLES, GOALS AND ADVANTAGES OF EBDM
SKILLS NEEDED FOR EBDM
ASSESING THE EVIDENCE
INCORPORATING INTO THE PRACTICE
Introduction to Evidence Based DentistryRasha Adel
The document discusses evidence-based dentistry (EBD), which involves integrating the best available research evidence with a dentist's expertise and their patient's values and circumstances. It outlines the five steps of EBD: asking a focused question, acquiring evidence by searching databases, appraising the evidence by evaluating its validity and reliability, applying the evidence to patient care, and assessing how effective the process was. It provides details on critically appraising research studies, such as looking for biases, and defines key terms like systematic reviews, meta-analyses, internal and external validity.
This document discusses evidence-based periodontology. It begins by defining evidence-based practice as integrating clinical expertise with the best available research evidence from systematic research. It then discusses the key components of evidence-based periodontology, including systematic reviews, meta-analyses, and critically appraising studies for bias and confounding. The document contrasts evidence-based and traditional approaches to periodontology, noting evidence-based periodontology is more objective and transparent. It emphasizes the importance of evidence-based practice in providing the best patient care.
This document discusses evidence-based surgery and how surgeons evaluate the strength of evidence for surgical practices. It covers:
1) Guidelines and secondary sources that surgeons can use to inform evidence-based practice, but notes individual surgeons must also evaluate primary studies.
2) Factors used to evaluate the validity of scientific studies, including internal validity (study quality), external validity (generalizability), and the influence of chance, bias, and confounding.
3) Hierarchies of evidence that rank study designs, with randomized controlled trials considered the strongest, but these systems have limitations and surgeons must make judgments.
This document provides an overview of evidence-based periodontics. It discusses the need for evidence-based decision making to reduce variations in clinical practice. The advantages of an evidence-based approach are that it is objective, scientifically sound, patient-focused, and incorporates clinical expertise. The process of evidence-based decision making involves framing questions, searching for and appraising evidence from various sources and levels, evaluating outcomes, and implementing decisions. Key aspects include assessing evidence critically and avoiding changes to pre-established hypotheses.
This document discusses evidence-based dentistry and randomized controlled trials (RCTs) in orthodontics. It defines evidence-based dentistry as integrating systematic assessments of scientific evidence with clinical expertise and patient preferences. RCTs are described as the gold standard for testing hypotheses as they minimize bias through randomization and blinding. However, RCTs can be challenging to conduct in orthodontics due to long treatment times and variability between patients. Recommendations for improving RCT quality include clearly defining the research question, proper randomization, sufficient sample sizes, and using valid and reliable methods.
Abstract
To address the growing need for information on a therapeutic, besides information on safety and efficacy, and the increasing trend to extrapolate data from traditional randomized control trials (RCT’s) to influence clinical practice; an in-depth evaluation of the utility and practicability of RCT’s in influencing real-world clinical practice is evaluated. The pragmatic clinical trial (PCT) is discussed and introduced as a potentially viable means to influence clinical practice. The regulatory impact of this new adaptation is also explored. Concepts of study design, including concepts such as validity, generalizability, efficacy and effectiveness are discussed for both RCT’s and PCT’s.
This document provides an overview and introduction to evidence-based decision making (EBDM) for dental professionals. It defines key terms like evidence-based practice and discusses the need for EBDM to improve patient care and address variations in practice. The document outlines the 5 steps of EBDM and emphasizes that evidence alone is not sufficient, and a hierarchy of evidence exists. It also discusses forming answerable clinical questions as the first step using the PICO framework.
This document defines key terms used in evidence-based medicine including those related to validity, therapy, diagnosis, bias and statistics. It provides definitions for internal and external validity, randomization, concealment, blindness, intention-to-treat analysis, sensitivity, specificity, likelihood ratios, absolute risk reduction, relative risk reduction, number needed to treat, confidence intervals, and biases such as detection and publication bias. An example is also given to calculate and interpret results including relative risk, absolute risk reduction, relative risk reduction and number needed to treat from a randomized controlled trial.
This document provides an overview of evidence-based medicine (EBM). It defines EBM as integrating the best research evidence with clinical expertise and patient values. The history and obstacles of EBM are discussed. The document outlines how to practice EBM using the 5 A's framework: Ask, Acquire, Appraise, Apply, and Assess. A case example is provided to demonstrate how to formulate a focused clinical question using the PICO format.
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.for more details please visit
www.indiandentalacademy.com
Critically appraise evidence based findingsBarryCRNA
The document discusses critical appraisal of evidence-based findings. It defines critical appraisal as assessing the strength and quality of scientific evidence to evaluate its applicability to healthcare decision making. Strength of evidence depends on factors like quality, quantity, and consistency of research. Evidence is ranked in levels based on research design, with systematic reviews and randomized controlled trials having the highest levels of evidence. Evaluating the quality and applicability of evidence involves assessing the validity of results and whether results can be applied to target populations. Statistical evaluation through effect sizes can also aid in appraising evidence.
Levels of evidence, recommendations & phases ofsanyal1981
This document discusses levels of evidence and phases of clinical trials. It defines evidence-based medicine as using current best evidence from systematic research to make decisions about patient care. Levels of evidence are ranked from 1A to 5 based on study design, with systematic reviews and randomized controlled trials ranked highest. Clinical trials progress through four phases to test safety, efficacy, and optimal use of new drugs or devices. Phase 1 assesses safety, phase 2 establishes efficacy, phase 3 confirms safety and efficacy in larger groups, and phase 4 studies monitor risks and benefits after marketing.
The document discusses evidence-based periodontology. It defines evidence-based practice and outlines the stages in evidence-based practice, including framing clinical questions and searching for evidence through systematic reviews. Critical appraisal of evidence is important to determine internal and external validity. The best available evidence was searched for various periodontal therapies and procedures, finding that mechanical debridement remains the foundation treatment, while some adjunctive therapies provide modest benefits. A review found reduced pocket depth reduction in smokers compared to non-smokers following nonsurgical periodontal therapy.
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
Evidence based dentistry strategies for new diagnostic and treatment methodol...devicharan11
Evidence-based dentistry is an approach that requires integrating systematic assessments of scientific evidence about a patient's oral and medical condition with the dentist's expertise and the patient's needs. It follows five steps - asking a question, acquiring evidence, appraising the evidence, analyzing it, and applying it to patient care. Higher levels of evidence come from systematic reviews, meta-analyses, and randomized controlled trials, while lower levels include retrospective cohort studies and case-control studies. The goal is to use the strongest available scientific evidence to guide clinical decision making.
Improving Biomedical Literature Search Skills within Evidence-Based Dentistryvmarnova
This document provides an overview of conducting literature searches to support evidence-based dentistry. It discusses different types of biomedical databases including bibliographic databases like PubMed and evidence-based practice databases like Cochrane. It also outlines the process of developing a focused clinical question, performing a systematic search of the relevant literature, and evaluating the levels of evidence found. The goal is to effectively apply the growing body of dental knowledge to clinical practice and improve patient outcomes.
Evidence-based medicine involves integrating clinical expertise with the best available external clinical evidence from systematic research. It includes formulating clinical questions, searching literature, evaluating evidence, and applying evidence to individual patient care. The highest levels of evidence come from randomized controlled trials, while lower levels include observational studies and expert opinion. Clinical trials progress through phases to evaluate safety, efficacy, and effectiveness of interventions. Statistical analysis of trial results provides measures of significance, risk, and accuracy to guide clinical decision-making.
. Evidence-based dentistry (EBD) is the integration and interpretation of the available current research evidence, combined with personal experience. It allows dentists, as well as academics researchers, to keep update of the new developments and to make decisions that should improve their clinical practice.
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
Classifi mo 1 /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
The document discusses the development of the concept of normal occlusion from three periods - fictional, hypothetical, and factual. It provides definitions for key terms like occlusion, normal occlusion, and ideal occlusion. It also describes compensatory curves like the curve of Spee, curve of Wilson, and curve of Monson which help the dental arches function during mastication.
Introduction to Evidence Based DentistryRasha Adel
The document discusses evidence-based dentistry (EBD), which involves integrating the best available research evidence with a dentist's expertise and their patient's values and circumstances. It outlines the five steps of EBD: asking a focused question, acquiring evidence by searching databases, appraising the evidence by evaluating its validity and reliability, applying the evidence to patient care, and assessing how effective the process was. It provides details on critically appraising research studies, such as looking for biases, and defines key terms like systematic reviews, meta-analyses, internal and external validity.
This document discusses evidence-based periodontology. It begins by defining evidence-based practice as integrating clinical expertise with the best available research evidence from systematic research. It then discusses the key components of evidence-based periodontology, including systematic reviews, meta-analyses, and critically appraising studies for bias and confounding. The document contrasts evidence-based and traditional approaches to periodontology, noting evidence-based periodontology is more objective and transparent. It emphasizes the importance of evidence-based practice in providing the best patient care.
This document discusses evidence-based surgery and how surgeons evaluate the strength of evidence for surgical practices. It covers:
1) Guidelines and secondary sources that surgeons can use to inform evidence-based practice, but notes individual surgeons must also evaluate primary studies.
2) Factors used to evaluate the validity of scientific studies, including internal validity (study quality), external validity (generalizability), and the influence of chance, bias, and confounding.
3) Hierarchies of evidence that rank study designs, with randomized controlled trials considered the strongest, but these systems have limitations and surgeons must make judgments.
This document provides an overview of evidence-based periodontics. It discusses the need for evidence-based decision making to reduce variations in clinical practice. The advantages of an evidence-based approach are that it is objective, scientifically sound, patient-focused, and incorporates clinical expertise. The process of evidence-based decision making involves framing questions, searching for and appraising evidence from various sources and levels, evaluating outcomes, and implementing decisions. Key aspects include assessing evidence critically and avoiding changes to pre-established hypotheses.
This document discusses evidence-based dentistry and randomized controlled trials (RCTs) in orthodontics. It defines evidence-based dentistry as integrating systematic assessments of scientific evidence with clinical expertise and patient preferences. RCTs are described as the gold standard for testing hypotheses as they minimize bias through randomization and blinding. However, RCTs can be challenging to conduct in orthodontics due to long treatment times and variability between patients. Recommendations for improving RCT quality include clearly defining the research question, proper randomization, sufficient sample sizes, and using valid and reliable methods.
Abstract
To address the growing need for information on a therapeutic, besides information on safety and efficacy, and the increasing trend to extrapolate data from traditional randomized control trials (RCT’s) to influence clinical practice; an in-depth evaluation of the utility and practicability of RCT’s in influencing real-world clinical practice is evaluated. The pragmatic clinical trial (PCT) is discussed and introduced as a potentially viable means to influence clinical practice. The regulatory impact of this new adaptation is also explored. Concepts of study design, including concepts such as validity, generalizability, efficacy and effectiveness are discussed for both RCT’s and PCT’s.
This document provides an overview and introduction to evidence-based decision making (EBDM) for dental professionals. It defines key terms like evidence-based practice and discusses the need for EBDM to improve patient care and address variations in practice. The document outlines the 5 steps of EBDM and emphasizes that evidence alone is not sufficient, and a hierarchy of evidence exists. It also discusses forming answerable clinical questions as the first step using the PICO framework.
This document defines key terms used in evidence-based medicine including those related to validity, therapy, diagnosis, bias and statistics. It provides definitions for internal and external validity, randomization, concealment, blindness, intention-to-treat analysis, sensitivity, specificity, likelihood ratios, absolute risk reduction, relative risk reduction, number needed to treat, confidence intervals, and biases such as detection and publication bias. An example is also given to calculate and interpret results including relative risk, absolute risk reduction, relative risk reduction and number needed to treat from a randomized controlled trial.
This document provides an overview of evidence-based medicine (EBM). It defines EBM as integrating the best research evidence with clinical expertise and patient values. The history and obstacles of EBM are discussed. The document outlines how to practice EBM using the 5 A's framework: Ask, Acquire, Appraise, Apply, and Assess. A case example is provided to demonstrate how to formulate a focused clinical question using the PICO format.
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.for more details please visit
www.indiandentalacademy.com
Critically appraise evidence based findingsBarryCRNA
The document discusses critical appraisal of evidence-based findings. It defines critical appraisal as assessing the strength and quality of scientific evidence to evaluate its applicability to healthcare decision making. Strength of evidence depends on factors like quality, quantity, and consistency of research. Evidence is ranked in levels based on research design, with systematic reviews and randomized controlled trials having the highest levels of evidence. Evaluating the quality and applicability of evidence involves assessing the validity of results and whether results can be applied to target populations. Statistical evaluation through effect sizes can also aid in appraising evidence.
Levels of evidence, recommendations & phases ofsanyal1981
This document discusses levels of evidence and phases of clinical trials. It defines evidence-based medicine as using current best evidence from systematic research to make decisions about patient care. Levels of evidence are ranked from 1A to 5 based on study design, with systematic reviews and randomized controlled trials ranked highest. Clinical trials progress through four phases to test safety, efficacy, and optimal use of new drugs or devices. Phase 1 assesses safety, phase 2 establishes efficacy, phase 3 confirms safety and efficacy in larger groups, and phase 4 studies monitor risks and benefits after marketing.
The document discusses evidence-based periodontology. It defines evidence-based practice and outlines the stages in evidence-based practice, including framing clinical questions and searching for evidence through systematic reviews. Critical appraisal of evidence is important to determine internal and external validity. The best available evidence was searched for various periodontal therapies and procedures, finding that mechanical debridement remains the foundation treatment, while some adjunctive therapies provide modest benefits. A review found reduced pocket depth reduction in smokers compared to non-smokers following nonsurgical periodontal therapy.
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
Evidence based dentistry strategies for new diagnostic and treatment methodol...devicharan11
Evidence-based dentistry is an approach that requires integrating systematic assessments of scientific evidence about a patient's oral and medical condition with the dentist's expertise and the patient's needs. It follows five steps - asking a question, acquiring evidence, appraising the evidence, analyzing it, and applying it to patient care. Higher levels of evidence come from systematic reviews, meta-analyses, and randomized controlled trials, while lower levels include retrospective cohort studies and case-control studies. The goal is to use the strongest available scientific evidence to guide clinical decision making.
Improving Biomedical Literature Search Skills within Evidence-Based Dentistryvmarnova
This document provides an overview of conducting literature searches to support evidence-based dentistry. It discusses different types of biomedical databases including bibliographic databases like PubMed and evidence-based practice databases like Cochrane. It also outlines the process of developing a focused clinical question, performing a systematic search of the relevant literature, and evaluating the levels of evidence found. The goal is to effectively apply the growing body of dental knowledge to clinical practice and improve patient outcomes.
Evidence-based medicine involves integrating clinical expertise with the best available external clinical evidence from systematic research. It includes formulating clinical questions, searching literature, evaluating evidence, and applying evidence to individual patient care. The highest levels of evidence come from randomized controlled trials, while lower levels include observational studies and expert opinion. Clinical trials progress through phases to evaluate safety, efficacy, and effectiveness of interventions. Statistical analysis of trial results provides measures of significance, risk, and accuracy to guide clinical decision-making.
. Evidence-based dentistry (EBD) is the integration and interpretation of the available current research evidence, combined with personal experience. It allows dentists, as well as academics researchers, to keep update of the new developments and to make decisions that should improve their clinical practice.
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
Classifi mo 1 /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
The document discusses the development of the concept of normal occlusion from three periods - fictional, hypothetical, and factual. It provides definitions for key terms like occlusion, normal occlusion, and ideal occlusion. It also describes compensatory curves like the curve of Spee, curve of Wilson, and curve of Monson which help the dental arches function during mastication.
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.for more details please visit
www.indiandentalacademy.com
The document discusses early vs late orthodontic treatment. It provides definitions and discusses the advantages and disadvantages of early treatment. It describes different types of early treatment including growth modification devices, open bite correction, arch length discrepancy correction, eruption disturbances, and phase I treatment. It discusses how devices like headgears and functional appliances can be used for growth modification and provides examples of studies that have examined the effects of these appliances on craniofacial growth.
The predentate period refers to the time from birth until the eruption of the first primary teeth. During this period, the oral cavity contains gum pads instead of teeth. The gum pads are divided into segments by grooves and develop in labial and lingual portions. Growth of the gum pads is rapid in the first year. Parents should clean the gum pads daily with a toothbrush or wipe to remove film. Certain soft tissue lesions, like congenital epulis and Epstein pearls, may occur on the gum pads. The relationship between the upper and lower gum pads allows only molar contact initially. Some transient malocclusions, like an open bite and retrognathic mandible, are present and corrected
Class 3 malocclusions /certified fixed orthodontic courses by Indian dental a...Indian dental academy
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
Class III malocclusion by sooraj s pillaiSooraj Pillai
This document provides an overview of class III malocclusions, including definition, etiology, classification, clinical examination, and treatment approaches. It discusses pseudo and skeletal class III malocclusions. Treatment options covered include functional appliances like Frankel III regulator, chin cup, and face mask therapy. It also discusses camouflage treatment approaches like non-extraction and extraction methods. The goal of early interceptive treatment is preventing worsening and providing favorable growth. Functional appliances aim to redirect mandibular growth. Camouflage treatments disguise the underlying skeletal deformity through dental movements.
Class iii malocclusion /certified fixed orthodontic courses by Indian denta...Indian dental academy
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
Protraction face mask /certified fixed orthodontic courses by Indian dental a...Indian dental academy
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
Transient malocclusions are self-correcting developmental variations that occur during dental development. In the pre-dentate period, infants have a retrognathic mandible that corrects over time. In the primary dentition, children commonly have an anterior open bite, deep anterior bite, spacing between teeth, and an edge-to-edge anterior bite that self-correct. In the mixed dentition, a deep bite and crowding are common but resolve with time. The permanent dentition may show increased overjet and overbite during transition that lessen without treatment.
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.for more details please visit
www.indiandentalacademy.com
Early vs late orthodontic treatment /certified fixed orthodontic courses by I...Indian dental academy
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.
This document discusses occlusal development from birth through adulthood. It begins by describing the gum pads present at birth, noting their segmentation and relationships. It then outlines the four periods of occlusal development: neonatal, primary dentition, mixed dentition, and permanent dentition. For each period, it details the typical eruption sequence and characteristics. The mixed dentition period is subdivided into three phases focusing on molar relationships and shifts. Factors that facilitate the transition between primary and permanent incisors are also explained.
This ppt will help dentists in taking Evidence Based decision in daily practice and will also help researchers to categorized result of research on the basis of hierarchy of Evidence Based Dentistry
Module 2 of the Oral Health Tutorial, a production of UT HSC Libraries.
This module focuses on evidence-based dental health. View this tutorial to learn how to define evidence-based dental public health, learn effective retrieval strategy, be able to critique the literature and apply it to public health dental practice.
This tutorial is copyright Lara Sapp and Julie Gaines.
This document provides an introduction to evidence-based medicine (EBM). It begins with a test to assess the reader's understanding of EBM principles. It then discusses the key components of EBM, including the patient, physician, and best available medical evidence. It emphasizes that EBM involves actively searching scientific literature for the highest levels of evidence, like randomized controlled trials and systematic reviews, to inform medical decisions for individual patients. The document outlines the five basic steps of EBM: developing a focused clinical question, finding the best evidence, critically appraising the evidence, applying useful findings to patient care, and evaluating the process. It stresses that developing a clear clinical question is the first and most important step.
Are Most Positive Findings False? Confirmatory Bias in the Evaluation of Psyc...James Coyne
I was tired of this 2007 presentation being plagiarized and so i am making it available. The time stamp for the file on a hard drive for it is 3.20.2007. An old cv I retrieved indicates that I gave a talk at Catholic University of America and at University of Gronigen with this title in 2007. I recycled some of the slides since and slides 48-50 have been quite popular as seen in some persons using them in publications without appropriate attribution.
Regardless, you should be amazed how prescient this presentation now seems, over a decade later, and how much things have not changed.
The document discusses various factors that can reduce the validity of clinical interpretations and predictions. It describes common cognitive biases clinicians may fall prey to, such as oversimplifying complex patients, over-interpreting limited data, relying on stereotypes, and discounting evidence that does not conform to preconceived notions. It emphasizes the importance of considering all available data, including strengths, validating interpretations with others involved in the patient's care, using structured assessment methods, and avoiding vague concepts in clinical analysis and decision-making.
Evidence based medicine what it is and what it is notDr. Jiri Pazdirek
This document discusses evidence-based medicine and related concepts. It defines evidence-based medicine as the conscientious, explicit and judicious use of current best evidence in making decisions about patient care. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. Medicine draws on both scientific knowledge and clinical expertise. While randomized controlled trials provide the strongest evidence, not all clinical questions can be answered through RCTs alone.
Introduction to Evidence Based Medicine (EBM)Elsayed Salih
This document provides an overview of evidence-based medicine (EBM), including its definition, importance, and process. It defines EBM as the conscientious use of the best available evidence in making decisions about patient care. The key steps in EBM are asking a clear clinical question using the PICO framework, acquiring evidence through a literature search, appraising the evidence for validity and applicability, and applying the evidence to the individual patient. Examples of question types and appropriate study designs are also discussed.
Research plays an important role in clinical psychology by establishing an evidence base to guide practice and interventions. It provides a foundation of knowledge and tests the reliability and validity of psychological assessments. There are four main research designs: descriptive research defines the prevalence of issues; correlational research examines relationships between variables but cannot prove causation; experimental research manipulates variables to determine causation but can lack realism; and single-case designs study individuals over time. The goal is to establish cause-and-effect while eliminating threats to validity and alternative hypotheses. No single design is best and constraints may limit design options.
Introduce IUON students to evidence-based nursing literature and effective strategies for searching for and accessing evidence-based research in nursing.
The document discusses a proposed study to validate a pain assessment tool for critically ill patients who cannot communicate verbally. Two nurse researchers plan to assess patients using the tool after a painful procedure (tracheal suctioning) and a nonpainful one (oral care) to determine if it can differentiate pain responses.
Peer reviewers discuss whether the study requires exempt, expedited or full IRB review. One argues full review is needed since patients cannot consent. The other argues it is exempt since the assessment tool itself poses minimal risk, though the procedures being assessed are part of routine care. Both agree the study would not be considered ethical since patients cannot provide informed consent to participate.
This document discusses evidence-based practice and provides examples of how it is implemented in nursing. It begins by defining evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and preferences. It emphasizes using scientific evidence to inform decision-making and eliminate outdated practices. Several examples are then given of evidence-based practices in nursing related to infection control, oxygen use for COPD patients, measuring blood pressure in children, and intravenous catheter size. The document stresses the importance of following evidence-based protocols for patient health and safety.
This document provides an overview of evidence-based periodontology. It defines evidence-based periodontology as the application of evidence-based healthcare to the field of periodontology. The document discusses the development of evidence-based periodontology and its key components, advantages over traditional periodontology, and terminology used in evidence-based approaches. It also addresses searching for evidence, levels of evidence, systematic reviews, meta-analyses, and evidence-based decision making in periodontal therapy.
Comparing research designs fw 2013 handout versionPat Barlow
This is an updated version of my Comparing Research Designs lecture, which now includes discussions on: (1) common considerations with research design such as bias, reliability, validity, and confounding; and (2) expanded discussion of RCT designs including factorial and cross-over designs.
This document provides an overview of important concepts in inferential statistics, including definitions of key terms like population, sample, variable, and statistic. It explains the two main branches of statistics - descriptive statistics, which describes sample data using measures like mean and standard deviation, and inferential statistics, which uses sample statistics to make inferences about population parameters. The document discusses important considerations for planning a study, like choosing a sampling method and addressing issues of validity. It also covers hypothesis testing, which determines whether a treatment has no effect, and point estimation, which estimates the size of a treatment effect using confidence intervals. Finally, it provides guidance on choosing the appropriate statistical test based on the study design and outcome variable.
Good Regulators of Pharmaceuticals (GRP) 22 October 2014Ajaz Hussain
Sharing thoughts on what makes a Good Regulator of Pharmaceuticals with pharmacy students at the Universities of Minnesota and Iowa. A point of emphasis on "we all are regulators" is explained and three areas for learning - (a) Systems and Integrative Thinking, (b) Argumentation and (c) Behavioral Economics described.
I hope you, the viewers, will also find some value in reviewing these slides. If you are a student and have some questions please feel free to drop me a email (a2zpharmsci@msn.com).
This document provides an overview of essentials for manuscript review, including how to organize a manuscript, use statistics, identify types of studies and levels of evidence, address bias, interpret results, and write an abstract, introduction, methods, discussion, and conclusion. It discusses key aspects of each section and how to effectively review a submitted manuscript.
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
How evidence affects clinical practice in egyptWafaa Benjamin
Evidence based medicine is the gold standard for clinical care.
It implies the integration of best research evidence with clinical expertise and patient values.
There is still a wide gap between availability of evidence and its incorporation into routine practice in our country.
Barriers to implementation could be personal, social, institutional, financial and legal barriers.
True practice of evidence based care can only occur where evidence based decisions coincide with patients’ beliefs and clinicians’ preferences.
Continuing medical education programs should be set with integrating evidence based medicine teaching and learning within clinical training.
The importance of presence of local national guidelines which need to take into account variation in expertise, resources and patient preferences across our geographical and cultural contexts .
Customisation of a guideline to meet the local needs of a target patient population is critical to successful implementation.
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
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3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
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1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
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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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
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.for more details please visit
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Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
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.for more details please visit
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Properties of Denture base materials /rotary endodontic coursesIndian dental academy
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.for more details please visit
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
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.for more details please visit
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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.for more details please visit
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This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
MATATAG CURRICULUM: ASSESSING THE READINESS OF ELEM. PUBLIC SCHOOL TEACHERS I...NelTorrente
In this research, it concludes that while the readiness of teachers in Caloocan City to implement the MATATAG Curriculum is generally positive, targeted efforts in professional development, resource distribution, support networks, and comprehensive preparation can address the existing gaps and ensure successful curriculum implementation.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
2. Fasten your seatFasten your seat
belts for thebelts for the
bumpy ride tobumpy ride to
evidence basedevidence based
practice.practice.
3. Never discuss divergentNever discuss divergent
views concerning religionviews concerning religion
and politics with friends,and politics with friends,
you could lose a friend andyou could lose a friend and
create an enemy.create an enemy.
4.
5. Generally, an article published in aGenerally, an article published in a
scientific journal- reporting resultsscientific journal- reporting results
of a clinical trial- is considered asof a clinical trial- is considered as
evidence.evidence.
EVIDENCEEVIDENCE
6. EVIDENCE BASED DENTISTRYEVIDENCE BASED DENTISTRY
Webster’s dictionary:Webster’s dictionary: judicious asjudicious as
exercising sound judgment.exercising sound judgment.
DefinedDefined : “ a conscientious explicit ,: “ a conscientious explicit ,
and judicious use of current bestand judicious use of current best
evidence in conjunction with clinicalevidence in conjunction with clinical
experience to make decisions regardingexperience to make decisions regarding
patient care.”patient care.”
In other words, it is using evidence toIn other words, it is using evidence to
base one’s therapeutic decision –base one’s therapeutic decision –
making, rather than whim, instinct , ormaking, rather than whim, instinct , or
hearsay.hearsay.
7. ADAADA: “ an approach to oral health care: “ an approach to oral health care
that requires the judicious integrationthat requires the judicious integration
of systematic assessments of clinicallyof systematic assessments of clinically
relevant scientific evidence , relating torelevant scientific evidence , relating to
patient’s oral and medical conditionpatient’s oral and medical condition
and history, with the dentist’s clinicaland history, with the dentist’s clinical
expertise and patient’s treatmentexpertise and patient’s treatment
needs and preferences.needs and preferences.
8. Our literature is oftenOur literature is often
inconclusive, inconsistent orinconclusive, inconsistent or
even contradictory. This leaveseven contradictory. This leaves
clinicians frustrated, confusedclinicians frustrated, confused
and skeptical of all researchand skeptical of all research
EBO is not a cook book approachEBO is not a cook book approach
to orthodontics.to orthodontics.
9. An approach to oral health care thatAn approach to oral health care that
requires the judicious integration ofrequires the judicious integration of
systemic assessments of clinicallysystemic assessments of clinically
relevant scientific evidence, relatingrelevant scientific evidence, relating
to the patients oral and medicalto the patients oral and medical
condition and history, with thecondition and history, with the
dentist’s treatment needs anddentist’s treatment needs and
preferencespreferences
EVIDENCE BASEDEVIDENCE BASED
DENTISTRYDENTISTRY
10. PROCESS INTEGRATESPROCESS INTEGRATES
1.1. Clinical expertiseClinical expertise
2.2. Best research evidenceBest research evidence
3.3. Patient treatment needsPatient treatment needs
11. HISTORY OF EBDHISTORY OF EBD
Origin in the middle of 19Origin in the middle of 19 thth
century in Paris,century in Paris,
when young graduates started challengingwhen young graduates started challenging
the validity of clinical decisions based solelythe validity of clinical decisions based solely
upon personal experience.upon personal experience.
Mc Master University in Canada in 1985 ,Mc Master University in Canada in 1985 ,
introduced some concepts in its curriculum.introduced some concepts in its curriculum.
American College of Physicians followed.American College of Physicians followed.
Establishment of Center for Evidence- basedEstablishment of Center for Evidence- based
Medicine in Oxford, UK in 1995.Medicine in Oxford, UK in 1995.
The litigious nature of society further fueledThe litigious nature of society further fueled
the need for practicing evidence basedthe need for practicing evidence based
health carehealth care
12. Faulty arguments against evidenceFaulty arguments against evidence
based decision makingbased decision making
Dogmatic approachDogmatic approach
Influence of drug companiesInfluence of drug companies
Academics Vs clinical researchAcademics Vs clinical research
““Galileo ploy”Galileo ploy”
15. CONFOUNDINGCONFOUNDING
EFFECTSEFFECTS A goal of sound experimental research andA goal of sound experimental research and
design is the control of confoundingdesign is the control of confounding
factors.factors.
When factors are not controlled, theWhen factors are not controlled, the
effects of treatment are clouded with theeffects of treatment are clouded with the
outside influence of extrinsic factors andoutside influence of extrinsic factors and
the treatment effects cannot be isolatedthe treatment effects cannot be isolated
and analyzed.and analyzed.
If the findings of confounded studies areIf the findings of confounded studies are
accepted ,there is a strong possibility thataccepted ,there is a strong possibility that
this will negatively impact patientthis will negatively impact patient
care.i.e.beneficial treatment will becare.i.e.beneficial treatment will be
ignored and useless treatment adopted.ignored and useless treatment adopted.
16. CONTROLLING GROUPCONTROLLING GROUP
Research does lend itself to the use of a control.Research does lend itself to the use of a control.
nonetheless ,when controls are required andnonetheless ,when controls are required and
used, the liability and validity of a study areused, the liability and validity of a study are
improved. with observational research vis-à-visimproved. with observational research vis-à-vis
experimental research, the group not havingexperimental research, the group not having
treatment is often called the comparison ortreatment is often called the comparison or
matched group rather than the control group.matched group rather than the control group.
Through the use of a control group inThrough the use of a control group in
experimentally designed studies, a researcherexperimentally designed studies, a researcher
can assert with confidence that the treatment orcan assert with confidence that the treatment or
condition introduced is directly responsible for thecondition introduced is directly responsible for the
findings obtained, instead of due to chance orfindings obtained, instead of due to chance or
some other extraneous variable.some other extraneous variable.
17. HAWTHORNE EFFECTHAWTHORNE EFFECT
Despite the effectiveness of experimentDespite the effectiveness of experiment
design, potential threats can directlydesign, potential threats can directly
impact validity ,a time management studyimpact validity ,a time management study
in 1930 at western electrics Chicago basedin 1930 at western electrics Chicago based
Hawthorne plant desired to improveHawthorne plant desired to improve
employee morale and particularlyemployee morale and particularly
productivity.productivity.
Reverse Hawthorne effect- resentment orReverse Hawthorne effect- resentment or
apathy developing in control group whichapathy developing in control group which
does not receive treatment. This producesdoes not receive treatment. This produces
poor behavior or improvement in controlpoor behavior or improvement in control
groups.groups.
18. TYPES OF STUDIESTYPES OF STUDIES
STUDIES
EXPERIMENTAL OBSERVATIONAL
RCT COHORT CASE
CONTROL
CASE
REPORT
19. LEVELS OF EVIDENCELEVELS OF EVIDENCE
To judge the quality of studies a “hierarchy ofTo judge the quality of studies a “hierarchy of
evidence” exists the relative strength ofevidence” exists the relative strength of
various studies.various studies.
The evidence that is most likely to be useful forThe evidence that is most likely to be useful for
making decisions regarding patientmaking decisions regarding patient
management:management:
1.Systematic Review (Meta-analysis)
2.Randomized Controlled Trials (RCTs)
3.Cohort Studies
4.Case-control Studies
5.Cross-sectional Surveys
6.Case Series/ Report
21. SYSTEMATIC REVIEWSSYSTEMATIC REVIEWS
Systematic reviews are a synopsis of theSystematic reviews are a synopsis of the
existing evidence on a specific topic.existing evidence on a specific topic.
Provides means to keep up with numerousProvides means to keep up with numerous
articles published annually in every field.articles published annually in every field.
Concentrates on a very specific andConcentrates on a very specific and
narrow, clinically relevant question.narrow, clinically relevant question.
Team of expertsTeam of experts
Inclusion and exclusion criteria is usedInclusion and exclusion criteria is used
Bias unlikely to happenBias unlikely to happen
22. STEPS IN PERFORMINGSTEPS IN PERFORMING
SYSTEMATIC REVIEWSYSTEMATIC REVIEW
FIRST STEPFIRST STEP : framing an important and: framing an important and
well defined question that is relevant towell defined question that is relevant to
patient care.patient care.
Framing a question in a proper formatFraming a question in a proper format
and identifies four crucial “ PICO”and identifies four crucial “ PICO”
elements. These elements are:elements. These elements are:
1.1. PPopulation or patient typeopulation or patient type
2.2. IInterventionntervention
3.3. CComparisonomparison
4.4. OOutcomeutcome
23. SECOND STEP:SECOND STEP: determining inclusion anddetermining inclusion and
exclusion to select the eligible studies.exclusion to select the eligible studies.
Subcategory of outcome, exposure,Subcategory of outcome, exposure,
confounder, effect modifiers, intermediates,confounder, effect modifiers, intermediates,
type of control as well as type of study designtype of control as well as type of study design
and other consideration.and other consideration.
24. THIRD STEP:THIRD STEP: design a searchdesign a search
strategy.strategy.
Employed to search available studiesEmployed to search available studies
include both electronic databasesinclude both electronic databases
such as MEDLINE, EMBASE, Web ofsuch as MEDLINE, EMBASE, Web of
science and Cochrane, databasesscience and Cochrane, databases
and manual searches.and manual searches.
25. FOURTH STEP:FOURTH STEP: involves applicationinvolves application
of the selection criteria identified inof the selection criteria identified in
step Two to the potential studiesstep Two to the potential studies
retrieved from both electronic andretrieved from both electronic and
manual search strategies determinedmanual search strategies determined
in step Three.in step Three.
This action will result in selection ofThis action will result in selection of
the eligible studies for the reviewthe eligible studies for the review
and appraising these studies.and appraising these studies.
26. FIFTH STEP:FIFTH STEP: Performing a statisticalPerforming a statistical
summary of the abstracted data, orsummary of the abstracted data, or
Meta- analysis.Meta- analysis.
Data from different study designs areData from different study designs are
summarized with the purpose of thesummarized with the purpose of the
followingfollowing six taskssix tasks::
1.1. Deciding whether to combine the data orDeciding whether to combine the data or
defining what to combinedefining what to combine
2.2. Evaluating the statistically heterogeneityEvaluating the statistically heterogeneity
of the dataof the data
3.3. Estimating a common effectEstimating a common effect
4.4. Exploring and explained heterogeneityExploring and explained heterogeneity
5.5. Assessing the potential for biasAssessing the potential for bias
6.6. Presenting the results in the form of aPresenting the results in the form of a
tabletable
27. FINAL STEP:FINAL STEP: INTERPRET THEINTERPRET THE
EVIDENCE TO ANSWER THEEVIDENCE TO ANSWER THE
RESEARCH QUESTIONRESEARCH QUESTION
28. META ANALYSISMETA ANALYSIS
It identifies the major varying factorsIt identifies the major varying factors
for their significance, and reportsfor their significance, and reports
that studies match their definedthat studies match their defined
standardization criteriastandardization criteria
29. RANDOMISED CONTROLRANDOMISED CONTROL
TRIALSTRIALS
An experimental study on patients with aAn experimental study on patients with a
particular disease or disease –freeparticular disease or disease –free
subjects in which the individuals aresubjects in which the individuals are
randomly assigned to either anrandomly assigned to either an
experimental intervention or a controlexperimental intervention or a control
group to determine the ability of an agentgroup to determine the ability of an agent
or a procedure to diminish symptoms, toor a procedure to diminish symptoms, to
decrease risk of death from disease duringdecrease risk of death from disease during
follow up period.follow up period.
Provide strongest evidence causation ofProvide strongest evidence causation of
evidence.evidence.
30. DrawbacksDrawbacks::
Raise ethical concerns in controlRaise ethical concerns in control
groupsgroups
Costly and time consuming toCostly and time consuming to
implementimplement
Because of the strict eligibilityBecause of the strict eligibility
criteria and loss to follow-up, RCTcriteria and loss to follow-up, RCT
sample size requirements are difficultsample size requirements are difficult
to attain and maintain,to attain and maintain,
Result becomes in limited externalResult becomes in limited external
validity of results for the generalvalidity of results for the general
populationpopulation
31. COHORT STUDIESCOHORT STUDIES
An observational study that follows anAn observational study that follows an
exposed cohort compared to anexposed cohort compared to an
unexposed cohort to determine theunexposed cohort to determine the
incidence of given outcome.incidence of given outcome.
Well designed cohort study providesWell designed cohort study provides
strong support for causationstrong support for causation
Non concurrent cohort studies areNon concurrent cohort studies are
relatively weaker because they rely onrelatively weaker because they rely on
existing records.existing records.
Disadvantages : require large sample sizeDisadvantages : require large sample size
Length of the studies result inLength of the studies result in
misclassification in outcome statusmisclassification in outcome status
Continuous assessment of the exposureContinuous assessment of the exposure
and outcome results.and outcome results.
32. CASE CONTROLCASE CONTROL
STUDIESSTUDIES These are observational studies whereThese are observational studies where
in cases with a particular outcome andin cases with a particular outcome and
controls that donot have the samecontrols that donot have the same
outcome are first selected andoutcome are first selected and
exposure assessment is doneexposure assessment is done
retrospectively.retrospectively.
Quick, relatively inexpensiveQuick, relatively inexpensive
Appropriate in studying rare diseasesAppropriate in studying rare diseases
Assessment of multiple risk factors forAssessment of multiple risk factors for
a particular disease within the samea particular disease within the same
studystudy
33. CASE REPORT ANDCASE REPORT AND
CASE SERIESCASE SERIES
Document unusual occurrences ofDocument unusual occurrences of
outcomesoutcomes
First clues of a new diseases orFirst clues of a new diseases or
adverse effects of exposureadverse effects of exposure
Case series are an extension of caseCase series are an extension of case
reportsreports
34.
35. HISTORYHISTORY Early part of 19 century ushered inEarly part of 19 century ushered in
evidence based decision making forevidence based decision making for
health care.health care.
1920 Geis1920 Geis report- Medical and Dentalreport- Medical and Dental
schools to be scientific in their teaching.schools to be scientific in their teaching.
Dentistry and Orthodontics have laggedDentistry and Orthodontics have lagged
behind medicine in the quest tobehind medicine in the quest to
incorporate science in to clinical practice.incorporate science in to clinical practice.
Perhaps, the art in the practice ofPerhaps, the art in the practice of
dentistry has overshadowed the need fordentistry has overshadowed the need for
science.science.
36. Making sense of EvidenceMaking sense of Evidence
The evidence gathered is checked forThe evidence gathered is checked for
its scientific validity, and applicabilityits scientific validity, and applicability
in patients.in patients.
Why article not published inWhy article not published in
prestigious journal ?prestigious journal ?
The RCT is considered to be ‘deThe RCT is considered to be ‘de
rigueur’ for arriving at a scientificallyrigueur’ for arriving at a scientifically
valid conclusion.valid conclusion.
37. Necessary to know the type ofNecessary to know the type of
randomization done, by goingrandomization done, by going
through the methodology of study.through the methodology of study.
Element of blinding too should beElement of blinding too should be
apparent in the study.apparent in the study.
Even though the study is determinedEven though the study is determined
to be valid , still may not beto be valid , still may not be
applicable to one’s patient.applicable to one’s patient.
1.1. Different characteristics of patientDifferent characteristics of patient
2.2. Results may be weakResults may be weak
3.3. Statistical analysis may not beStatistical analysis may not be
adequateadequate
38.
39. Face mask protraction therapy in earlyFace mask protraction therapy in early
skeletal Class IIIskeletal Class III
AJO DO 2005 128; 299-309AJO DO 2005 128; 299-309
Does RME enhance the efficiency ofDoes RME enhance the efficiency of
maxillary protraction with face mask inmaxillary protraction with face mask in
developing Class III malocclusion?developing Class III malocclusion?
Results: Face mask therapy effective inResults: Face mask therapy effective in
early Class III MOearly Class III MO
The need for palatal expansion in theThe need for palatal expansion in the
absence of a transverse discrepancy or aabsence of a transverse discrepancy or a
skeletal/ dental cross bite is not supported.skeletal/ dental cross bite is not supported.
Correction due to combined skeletal andCorrection due to combined skeletal and
dental change.dental change.
40. Critical appraisalCritical appraisal
EBD 2006:7,16-17.EBD 2006:7,16-17.
First prospective RCT of the subjectFirst prospective RCT of the subject
Inclusion of control group to quantifyInclusion of control group to quantify
growth before recruiting participants.growth before recruiting participants.
Results are conclusive.Results are conclusive.
The skeletal change followingThe skeletal change following
protraction is significant, but has noprotraction is significant, but has no
correlation with expansion.correlation with expansion.
41. Skeletal and dental changes with fixed slowSkeletal and dental changes with fixed slow
maxillary expansion treatment. Systematicmaxillary expansion treatment. Systematic
reviewreview..
JADA Feb 2005JADA Feb 2005
Eight studies were selected, eachEight studies were selected, each
lacked a control group, and four alsolacked a control group, and four also
did not have a measurement errordid not have a measurement error
treatment.treatment.
A control group is necessary to factorA control group is necessary to factor
out normal growth changes in theout normal growth changes in the
dental arch and cranio facial structure.dental arch and cranio facial structure.
No strong conclusion could be made onNo strong conclusion could be made on
dental and skeletal changes after SME.dental and skeletal changes after SME.
42. Meta analysis of immediate changesMeta analysis of immediate changes
with RME treatmentwith RME treatment
JADA Jan 2006JADA Jan 2006
Results: Of the 31 selected abstracts, 12Results: Of the 31 selected abstracts, 12
were rejected b coz they failed to reportwere rejected b coz they failed to report
immediate changes after the activationimmediate changes after the activation
phase of RME and instead reportedphase of RME and instead reported
changes only after the retention phase.changes only after the retention phase.
The greatest changes were in theThe greatest changes were in the
maxillary transverse plane in which themaxillary transverse plane in which the
width gained was caused more by dentalwidth gained was caused more by dental
expansion than true skeletal expansion.expansion than true skeletal expansion.
Few vertical and anteroposterior changesFew vertical and anteroposterior changes
were statistically significant, and none waswere statistically significant, and none was
clinically significant.clinically significant.
43. A systematic review concerning earlyA systematic review concerning early
orthodontic treatment of unilateralorthodontic treatment of unilateral
posterior cross biteposterior cross bite
Angle Orthod 2003;73:588-596Angle Orthod 2003;73:588-596
The aim of this study was to assess theThe aim of this study was to assess the
orthodontic treatment effects on unilateralorthodontic treatment effects on unilateral
posterior cross bite in primary and earlyposterior cross bite in primary and early
mixed dentition by systematically reviewingmixed dentition by systematically reviewing
the literature. Two RCT’s of early treatment ofthe literature. Two RCT’s of early treatment of
cross bite have been found and these twocross bite have been found and these two
studies support grinding as treatment in thestudies support grinding as treatment in the
primary dentition. There is no scientificprimary dentition. There is no scientific
evidence to show which of the treatmentevidence to show which of the treatment
modalities, grinding, quad helix, expansionmodalities, grinding, quad helix, expansion
plates or RME is most effectiveplates or RME is most effective
44. Orthodontics and Temporo-mandibularOrthodontics and Temporo-mandibular
Disorders – A meta-analysisDisorders – A meta-analysis
AJO DO 2002;121:438-446AJO DO 2002;121:438-446
Orthodontists are blamed for causing TMD.Orthodontists are blamed for causing TMD.
Epedemiologic studies show that TMDEpedemiologic studies show that TMD
symptoms are most prevalent amongsymptoms are most prevalent among
patients between 15-25 years of age.patients between 15-25 years of age.
Orthodontists may encounter patients whoOrthodontists may encounter patients who
complain about TMD during or aftercomplain about TMD during or after
treatment.treatment.
Does traditional orthodontic treatmentDoes traditional orthodontic treatment
change the prevalence of TMD?change the prevalence of TMD?
No study indicated that traditional applianceNo study indicated that traditional appliance
increased the prevalence of TMD, exceptincreased the prevalence of TMD, except
for mild or transient signsfor mild or transient signs
45. The effect of topical fluorides onThe effect of topical fluorides on
decalcification in patients with fixeddecalcification in patients with fixed
orthodontic appliances: A systematic revieworthodontic appliances: A systematic review
AJO DO 2005; 128: 601-606AJO DO 2005; 128: 601-606
Decalcification is a significant problem duringDecalcification is a significant problem during
fixed orthodontic treatment. Topical fluoridesfixed orthodontic treatment. Topical fluorides
can reduce or eliminate the problem, but thecan reduce or eliminate the problem, but the
relative effectiveness of different orrelative effectiveness of different or
combinations of topical fluoride preparations iscombinations of topical fluoride preparations is
unknown.unknown.
Results:Results: The use of topical fluorides in addition toThe use of topical fluorides in addition to
fluoride toothpaste reduced the incidence offluoride toothpaste reduced the incidence of
decalcification in populations with bothdecalcification in populations with both
fluoridated and non fluoridated water supplies.fluoridated and non fluoridated water supplies.
Different preparations and formats appear toDifferent preparations and formats appear to
decrease decalcification but there was nodecrease decalcification but there was no
evidence that any one method was superior.evidence that any one method was superior.
46. Incremental versus maximum biteIncremental versus maximum bite
advancement during Twin block therapy:advancement during Twin block therapy:
A randomized controlled clinicalA randomized controlled clinical trialtrial..
AJO-DO 2004;126:583-8AJO-DO 2004;126:583-8
•Experimental patients had 2mm initial bite advancement and
subsequent 2mm advancements at 6 weekly intervals with a Twin
block appliance incorporating advancement screws.
•The aim of this study was to evaluate the effectiveness of
incremental and maximum bite advancement during treatment of
class II div 1 malocclusion with the Twin-block appliance in the
permanent dentition.
•The use of incremental advancement of the twin block did not
confer any advantage in terms of process and outcome of the
treatment.
47. Outcomes in a 2-phase RCT of earlyOutcomes in a 2-phase RCT of early
class II treatmentclass II treatment
AJO DO 2004;125:657-667AJO DO 2004;125:657-667
This study was a randomized control trial designed to examine the
2 major strategies used to treat class II malocclusion:early
treatment in mixed dentition before adolescence,followed by a
second phase of comprehensive treatment in permanent
dentition;and 1-phase treatment during the adolescent growth
spurt and early permanent dentition.
Results: there was no differences in the findings between the
‘intent to treat’(ITT) sample,who had completed phase 1,and an
‘efficacy analyzable’(EA)sample(n=137),which comprised only
patients who completed phase 2.During phase 2 of the trial,the
advantage created during phase 1 treatment in the 2 early
treatment group was lost,and by the end of fixed appliance
treatment,there was no significant difference between any of the 3
groups for all anteroposterior and vertical skeletal and dental
measures.
48. CONCLUSIONCONCLUSION
Currently, researchers and facilitatingCurrently, researchers and facilitating
organizations disseminate best evidence inorganizations disseminate best evidence in
the forms perceived logical for clinicalthe forms perceived logical for clinical
practice .These forms are standard topractice .These forms are standard to
research reporting. Once reported,research reporting. Once reported,
evidence must be read,analyzed,andevidence must be read,analyzed,and
accepted for its statisticalaccepted for its statistical
significance.Then,findings need to besignificance.Then,findings need to be
integrated with other types of evidence tointegrated with other types of evidence to
provide statistically componentprovide statistically component
comparisons and measures of decisioncomparisons and measures of decision
making.making.
49. REFRENCESREFRENCES
1. Incremental versus maximum bite advancement during twin
block therapy : A randomized controlled clinical trail- Phil
Banks, Jean Wright & Kevin O’Brein (AJODO 2004; 126: 583-8)
2. Outcomes in a 2-phase randomized clinical trail of early Class
II treatment- J.F.Camilla Tulloch, William R. Proffit & Ceib
Phillips (AJODO 2004; 125: 657-67)
3. Essential elements of evidenced- based endodontics: Steps
involved in conducting clinical research- Mahmoud Torabinejad
& Khaled Babjri (JOE 2005; 35: 563-8)
4. The effect of topical fluorides on decalcification in patients with
fixed orthodontic appliances: A systematic review- Barbara L
Chadwick, Jayne Roy, Jeremy Knox & Elizabeth T Treasure
(AJODO 2005; 128: 601-6)
5. Orthodontics & temporomandibular disorder: A meta- analysis-
Myung- Rip Kim, Thomas M Graber & Marlos A Viana (AJODO
2002; 121: 438-46)
50. 6. Making the case for evidence- based orthodontics- Greg J
Huang (AJODO 2004; 125: 405-6)
7. Putting the evidence first- David L Turpin (AJODO 2005; 128:
415)
8. Effect of Herbst treatment on temporomandibular joint
morphology: A systematic literature review- Kurt Popowich,
Brain Nebbe & Paul w Major (AJODO 2003;123: 388-94)
9. Evidence - based versus experience- based views on occlusion
& TMD- Donald J Rinchuse, Daniel J Rinchuse & Sanjivan
Kandasamy(AJODO February 2005,Volume 127,Number 2)
10. Fasten your seat belts for the bumpy ride to evidence-based
practice.Greg J.Huang(AJODO,Volume 127,Number 1)
11. Understanding science and evidence-based decision making
in orthodontics-Donald J Rinchuse,Emily M.Sweitzer,Daniel
J.Rinchuse,Dara L.Rinchuse,AJODO,Volume 127,Number 5)
12. Model of Evidence-Based Dental Decision Making,Janet
Baeuer,Sue Spackman,Francesco Chiappelli,Paolo Prolo(Journal
of Evidence-Based Dental Practice 2005;5:189-97)
51. 14.A Systematic Review Concerning Early Orthodontic Treatment
Of Unilateral Posterior Crossbite-Sofia Petren,Lars
Bondemark,Bjorn Soderfeldt,Med Sc(Angle Orthodontist,Volume
73, Number 5,2003)
15. Face mask protraction therapy in early skeletal class III
malocclusion-Anmol S Kalha(EBD 2006:7.1)
16.Skeletal and dental changes with fixed slow maxillary
expansion treatment-Manuel Lagravere,Paul Major,Carlos Flores-
mir(JADA,Volume-136,February 2005)
17. Meta-analysis of immediate changes with rapid maxillary
expansion treatment-Manuel Lagravere,Giseon Heo,Paul Major,Carlos
Flores Mir(JADA,Vol.137,January 2006)
13.Evidence-Based therapy:An Orthodontic dilemma-
Anthony Gianelly(AJODO,Volume 129,Number 5)