Update on the Electronic Periodontal Literature Review Dr. Michael B. Goldberg, MSc DDS Assistant Professor University of Toronto Thank-you American Academy Shana of Periodontology Education Committee Berezin Faculty and Post-Graduate Students of the University of Toronto, Faculty of Dentistry, Division of Periodontics Faculty members of the University of Rochester and Indiana University Periodontal Literature Review— Update “Wikipedia”-type Electronic Paperless “Greenshift” Instant updating available Direct links to specific articles Presenting formatting Internal search engine Cross-chapter linking not Critiquing Content Periodontal Literature Review— Topics Examination Microbiology Diagnosis Pharmacology Maintenance Regenerative Therapy Epidemiology Mucogingival Therapy* Risk Factors Implantology* Periodontal Literature Review--Keywords Article Accumulation identifying keyword using PICO: P- patient, population I - intervention C- comparison O- outcomes Microbiology and…. •Diagnosis •Periodontitis •Chronic Periodontitis •Aggressive Periodontitis •Gingivitis •Periodontal Abscess •Necrotizing Ulcerative Lesions •Cardiovascular Disease •Diabetes •Smoking •Specific Plaque Hypothesis •Non-Specific Plaque hypothesis •Supragingival plaque/calculus •Subgingival plaque/calculus •Infection •Inflammation •Bleeding •suppuration Methodology Checklist 2: Randomised Controlled Trials S I G N Study identification (Include author, title, year of publication, journal title, pages) Guideline topic: Key Question No: Checklist completed by: SECTION 1: INTERNAL VALIDITY In a well conducted RCT study….. In this study this criterion is:: 1.1 The study addresses an appropriate and clearly focused question. Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.2 The assignment of subjects to treatment groups is randomised Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.3 An adequate concealment method is used Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.4 Subjects and investigators are kept ‘blind’ about treatment allocation Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.5 The treatment and control groups are similar at the start of the trial Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.6 The only difference between groups is the treatment under investigation Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.7 All relevant outcomes are measured in a standard, valid and reliable way Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.8 What percentage of the individuals or clusters recruited into each treatment arm of the study dropped out before the study was completed? 1.9 All the subjects are analysed in the groups to which they were randomly allocated (often referred to as intention to treat analysis) Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable 1.10 Where the study is carried out at more than one site, results are comparable for all sites Well covered Adequately addressed Poorly addressed Not addressed Not reported Not applicable SECTION 2: OVERALL ASSESSMENT OF THE STUDY 2.1 How well was the study done to minimise bias? Code ++, +, or 2.2 If coded as +, or what is the likely direction in which bias might affect the study results? 2.3 Taking into account clinical considerations, your evaluation of the methodology used, and the statistical AAP Literature Review Article Check-list Randomized Control Trials Citation: 1. The study addresses an appropriate and clearly focused question?(1) 5. The only difference between groups is the Treatment under investigation (1 point) YES NO 6. Were study drop-outs reported? (1 point) YES NO 2. The assignment of subjects to treatment groups is randomized?(1) YES 7. Were results comparable in all sites for a Multicentre study? (1 point) YES NO 3. Subjects and investigators are kept “blind” about treatment allocation?(1) YES YES NO 4. The treatment and control groups are similar at the start of the trial?(1) Score YES NO NO NO 8. The study was useful overall (3 points) /10 AAP Literature Review Article Summary Sheet Reviewer’s Name: Goldberg Section: Exam/Diagnosis Author: Araujo MWB et al Title: Reproducibility of Probing Depth Measurements Using a Constant-Force Electronic Probe: Analysis of Inter-and Intraexaminer variability Journal: J Perio 2003;74:1736-1740 Study Design: RCT Cohort/Cross-sectional/Longitudinal Prospective/Retrospective Observational Article Summary: Main objective was to evaluate the inter- and intraexaminer variability of PD using a constant force electronic probe. Compare variability between quadrant means and tooth means. 3 examiners (one DDS, two hygienists) measured 20 patients. Measured one quadrant only, excluded 8’s. Usually quad 1,. Inclusion criteria…35-79 y.o.; either gender/any ethnic background; > 6 teeth per quadrant; PD< 3 mm. Examinations done at baseline, 7 days, 14 days by two of 3 examiners each day. Therefore each examiner did 2 exams. 6 sites per tooth measured. Results: For quadrant probing data, standard error ranged from 0.38 mm to 0.42 mm. Tooth level variability was greater compared to quadrant level with incisors showing least variability and first molars showing most variability. Overall measurement error was always under 0.5 mm, regardless of tooth/quadrant measurement. Limited periodontal disease may keep information “tighter”…more disease severity and variability in PD may influence results in future studies. Also need to replicate study using manual probes in future. Clinical Relevance Ranking: Top 10% 50% Bottom 50% Why?: Top 25% Top Periodontal Literature Review—Update www.periolitreview.com Where do we go from here? Is this website (conceptually) something that will be useful to your program? “Integrated Dental Education”—utility for pre-doctoral/post-doctoral programs If so, what modifications would you like to see? If not, why not? If this website is to continue, how would your program be able to contribute to its upkeep and continued relevance ? ○ Co-ordinator—MG? Other? ○ Graduate Program Yearly rotations to update literature ○ Assistance from AAP web designers ○ In-Service Exam co-ordination Contact Information Dr. Michael B. Goldberg Assistant Professor, Discipline of Periodontology, University of Toronto 124 Edward Street Toronto, Ontario 416-979-4928 ext. 4502 m.goldberg@dentistry.utoronto.ca