Evidence-Based Decision Making in Dentistry (eBook)

Dr. Eyal Rosen received his DMD degree, and completed an advanced specialty graduate program in endodontics, at Tel Aviv University School of Dental Medicine. He is an Israeli board-certified endodontic specialist and maintains a private practice limited to endodontics. Dr. Rosen is a faculty member at Tel Aviv university school of dental medicine, and he was a faculty member at Tufts University School of Dental Medicine in Boston, USA. Dr. Rosen completed a postdoctoral fellowship at Harvard Medical School and the Orthopedic Biomechanics Laboratory at Beth Israel Deaconess Medical Center in Boston, USA (2005–7). His endodontic research interests focus on endodontic surgery, endodontic complications, risk management in endodontics, and evidence-based endodontics. Dr. Rosen has presented his research findings in numerous peer-reviewed articles and international scientific congresses. He is co-editor (with Drs. Aviad Tamse and Igor Tsesis) of the Springer book Vertical Root Fractures in Dentistry (2015).Dr. Carlos E. Nemcovsky graduated from the Dental School in Montevideo, Uruguay in 1979 and subsequently undertook postgraduate studies in Periodontology at TelAviv University, Israel. He has been a Specialist in Periodontology since 1997 and is currently Full Professor in the Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, TelAviv University. He is a former President of the Israel Periodontal and Osseointegration Society. Dr. Nemcovsky is involved in basic and clinical research, his main interest being tissue regeneration. He is the author or co-author of more than 100 extensively quoted scientific publications (including over 90 listed in Pubmed.org) in the leading international journals in the fields of Dental Research, Occlusion, Oral Rehabilitation, Periodontology, and Dental Implants, as well as a number of book chapters. He is a member of the editorial board of Clinical Implant Dentistry and Related Research and is a reviewer for several scientific journals. He is also a renowned international speaker, having delivered more than 120 invited lectures.Dr. Igor Tsesis received his DMD degree from Moscow Medical Stomatological Institute, Russia, in 1990 and in 2003 graduated cum laude from the Post-Graduate Endodontic Program at the Dental School of Tel Aviv University, Israel. He currently serves as Director of Graduate Endodontics in Tel Aviv University. Dr. Tsesis is President of the Israeli Endodontic Society and a member of the Scientific Council of the Israeli Dental Association. He is a member of the Scientific Advisory Board of the Journal of Endodontics and also a member of the International Editorial Board of the journal Italian Oral Surgery. His research is in the area of diagnosis and treatment of complications following root canal therapy and endodontic surgery. Most of his research has been published in the leading endodontic journals. Dr. Tsesis is editor of the Springer book Complications in Endodontic Surgery (2014) and co-editor (with Drs. Aviad Tamse and Eyal Rosen) of the publication Vertical Root Fractures in Dentistry (Springer, 2015).

Contents 6
Contributors 7
1: Introduction to Evidence-Based Decision-Making in the Multidisciplinary Management of the Natural Dentition 9
References 12
2: Principles of Evidence-Based Decision-Making 14
2.1 Introduction: Treatment Choices in Modern Dentistry 14
2.2 Algorithms for Decision-­Making in Patient Management: Historical Perspectives and Evolution 15
2.3 Evidence-Based Medicine and Its Application into Clinical Practice 16
2.4 Types of Research Design: Advantages and Shortcomings 17
2.4.1 Preclinical Research 17
2.4.2 Primary Clinical Research 18
2.4.3 Secondary Research 19
2.5 Bias 20
2.6 Level of the Evidence 21
2.7 The Journal’s Impact Factor (IF) 22
2.8 The PICO Question: How to Start Well a Systematic Review 22
2.9 Scientific Information: How to Find It (the Literature Databases) 23
References 25
Links 25
3: Evidence-Based Decision Making in Dentistry: The Endodontic Perspective 26
3.1 Introduction 26
3.2 Case Selection, Treatment Planning, and Long-Term Prognosis as the Basis for Clinical Decision Making 27
3.3 Contemporary Endodontic Technologies 29
3.3.1 Electronic Apex Locators 29
3.3.2 Magnification and Illumination Systems 30
3.3.3 Digital Radiography 31
3.3.4 Cone Beam Computed Tomography 31
3.4 Contemporary Endodontic Treatment Modalities 31
3.4.1 Nonsurgical Endodontic Treatments 32
3.4.2 Surgical Endodontic Treatment 32
3.5 Decision Making Regarding the Diagnosis and Management of Endodontic Complications 34
3.5.1 Vertical Root Fractures 34
3.5.2 Iatrogenic Root Perforations 35
3.5.3 Separated Endodontic Instruments 36
3.5.4 Root Resorption 37
3.6 Conclusions and Key Learning Point 38
References 38
4: Evidence-Based Decision Making in Periodontal Tooth Prognosis and Maintenance of the Natural Dentition 45
4.1 Introduction 46
4.2 Patient-Related Factors 47
4.3 Tooth-Related Factors 49
References 61
5: Evidence-Based Decision-Making in Restoration of the Natural Dentition 66
5.1 Introduction 66
5.2 Restoration Type and Timing 66
5.3 Post Type, Size, and Cementation 68
5.4 Core Materials 70
5.5 Ferrule Effect and Cementation 71
5.6 Conclusion and Clinical Recommendations 73
5.6.1 Vital Teeth Full Crown Coverage Restoration 74
References 75
6: Preserving the Natural Tooth Versus Extraction and Implant Placement: An Evidence-Based Approach 77
6.1 Introduction 78
6.2 Outcome Assessment of Implants and Teeth 78
6.2.1 Outcome Assessment of Dental Implants 79
6.2.2 Periodontal Factors Related to the Outcome of Teeth 81
6.2.3 Endodontic Prognosis 82
6.2.4 Restorative Aspects 83
6.3 Comparison of Endodontically Treated Teeth and Dental Implants 88
6.4 Dental Implant Complications 89
6.5 Operator Training and Skills 92
References 94
7: Case Selection for the Use of Cone Beam Computed Tomography in Dentistry Based on Diagnostic Efficacy and Risk Assessment 100
7.1 Introduction 100
7.2 The Potential Benefits 101
7.3 The Potential Risks 105
7.4 Case Selection Algorithm for the Use of CBCT in Dental Practice: Benefit Versus Risk 107
References 108
8: Evolving New Strategies for Periodontal, Endodontic, and Alveolar Bone Regeneration 112
8.1 Tooth-Associated and Implant-Associated Loss of Support 112
8.2 Current and Future Periodontal and Bone Regenerative Treatments 112
8.3 Tissue Engineering 113
8.3.1 Scaffolds (Matrices), Signaling Molecules (Biologics), and Cells [1] 113
8.4 Periodontal Regeneration Using Tissue Engineering 114
8.5 Protein/Peptide Therapy in Periodontal Regeneration 115
8.6 Gene Therapy 115
8.7 Gene Therapy in Periodontal Regeneration 116
8.8 Cell Therapy 118
8.9 Cell Therapy in Periodontal Regeneration 118
8.10 Combined Cell + Gene Therapy 120
8.10.1 3-D Bioprinting 122
8.11 Enamel Matrix Proteins in Periodontal Regeneration 122
8.11.1 Future Trends in Bone Regeneration 124
8.11.2 Future Trends in Endodontic Regenerative Therapy 128
8.12 Regenerative Endodontic Procedures 129
8.13 Guided Tissue Regeneration During Surgical Endodontic Treatments 131
References 131
Index 141