Use of evidence-based decision-making in private practice for emergency treatment of dental trauma: EB case report.
Identifieur interne : 000334 ( Main/Exploration ); précédent : 000333; suivant : 000335Use of evidence-based decision-making in private practice for emergency treatment of dental trauma: EB case report.
Auteurs : Syrene A. Miller [États-Unis] ; Greg MillerSource :
- The journal of evidence-based dental practice [ 1532-3390 ] ; 2010.
Descripteurs français
- KwdFr :
- Attelles parodontales (MeSH), Cicatrisation de plaie (MeSH), Extrusion dentaire (MeSH), Humains (MeSH), Incisive (traumatismes), Maxillaire (traumatismes), Médecine d'urgence factuelle (MeSH), Odontologie factuelle (MeSH), Pratique professionnelle privée (MeSH), Processus alvéolaire (traumatismes), Réimplantation dentaire (MeSH), Techniques d'aide à la décision (MeSH), Traitement de canal radiculaire (MeSH).
- MESH :
- traumatismes : Incisive, Maxillaire, Processus alvéolaire.
- Attelles parodontales, Cicatrisation de plaie, Extrusion dentaire, Humains, Médecine d'urgence factuelle, Odontologie factuelle, Pratique professionnelle privée, Réimplantation dentaire, Techniques d'aide à la décision, Traitement de canal radiculaire.
English descriptors
- KwdEn :
- Alveolar Process (injuries), Decision Support Techniques (MeSH), Evidence-Based Dentistry (MeSH), Evidence-Based Emergency Medicine (MeSH), Humans (MeSH), Incisor (injuries), Maxilla (injuries), Periodontal Splints (MeSH), Private Practice (MeSH), Root Canal Therapy (MeSH), Tooth Avulsion (MeSH), Tooth Replantation (MeSH), Wound Healing (MeSH).
- MESH :
Abstract
OBJECTIVE
This article illustrates the use of the evidence-based process in clinical practice to answer questions that arose when a patient presented with dental trauma.
BACKGROUND
The patient had avulsion of the maxillary right central incisor and lateral luxation and alveolar bone fracture partially encasing the roots of the maxillary left central and lateral incisors. At the emergency treatment the dentist replanted the teeth but had 2 questions regarding the impending treatment for the patient regarding the optimal timing of root canal therapy and splint duration that would result in the best outcome and prognosis for healing.
METHOD
The evidence-based process was used to help answer the clinical queries. Two focused clinical (PICO) questions were written, and 2 separate searches were conducted for each PICO question. Four databases were searched for systematic reviews, meta-analyses, critical summaries and practice guidelines.
RESULTS
A total of 3 systematic reviews, 8 practice guidelines, 1 critical summary, and 1 Cochrane protocol were found.
CONCLUSION
For replanted avulsed teeth, with closed apices, successful periodontal healing is improved when elective extirpation of the pulps occurs within 14 days. Second, guidelines recommend a flexible splint for up to 2 weeks for avulsed teeth with an extension of 2 to 4 weeks possibly needed for lateral luxation and with breakdown of marginal bone. However, evidence shows that an association between short-term splinting and an increased likelihood of functional periodontal healing, acceptable healing, or decreased development of replacement resorption, appears inconclusive and that the types of splint and the fixation period are not significant variables when related to healing outcomes. The evidence-based method was efficient, and very helpful in optimizing the management of the emergency dental treatment.
DOI: 10.1016/j.jebdp.2009.12.004
PubMed: 20797655
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Miller</name><affiliation wicri:level="2"><nlm:affiliation>The Center for Oral Health in Deer Park, WA, USA. syrene@ebdlibrary.com</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Center for Oral Health in Deer Park, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Miller, Greg" sort="Miller, Greg" uniqKey="Miller G" first="Greg" last="Miller">Greg Miller</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="RBID">pubmed:20797655</idno><idno type="pmid">20797655</idno><idno type="doi">10.1016/j.jebdp.2009.12.004</idno><idno type="wicri:Area/Main/Corpus">000334</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000334</idno><idno type="wicri:Area/Main/Curation">000334</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000334</idno><idno type="wicri:Area/Main/Exploration">000334</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Use of evidence-based decision-making in private practice for emergency treatment of dental trauma: EB case report.</title><author><name sortKey="Miller, Syrene A" sort="Miller, Syrene A" uniqKey="Miller S" first="Syrene A" last="Miller">Syrene A. Miller</name><affiliation wicri:level="2"><nlm:affiliation>The Center for Oral Health in Deer Park, WA, USA. syrene@ebdlibrary.com</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Center for Oral Health in Deer Park, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Miller, Greg" sort="Miller, Greg" uniqKey="Miller G" first="Greg" last="Miller">Greg Miller</name></author></analytic><series><title level="j">The journal of evidence-based dental practice</title><idno type="eISSN">1532-3390</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Alveolar Process (injuries)</term><term>Decision Support Techniques (MeSH)</term><term>Evidence-Based Dentistry (MeSH)</term><term>Evidence-Based Emergency Medicine (MeSH)</term><term>Humans (MeSH)</term><term>Incisor (injuries)</term><term>Maxilla (injuries)</term><term>Periodontal Splints (MeSH)</term><term>Private Practice (MeSH)</term><term>Root Canal Therapy (MeSH)</term><term>Tooth Avulsion (MeSH)</term><term>Tooth Replantation (MeSH)</term><term>Wound Healing (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Attelles parodontales (MeSH)</term><term>Cicatrisation de plaie (MeSH)</term><term>Extrusion dentaire (MeSH)</term><term>Humains (MeSH)</term><term>Incisive (traumatismes)</term><term>Maxillaire (traumatismes)</term><term>Médecine d'urgence factuelle (MeSH)</term><term>Odontologie factuelle (MeSH)</term><term>Pratique professionnelle privée (MeSH)</term><term>Processus alvéolaire (traumatismes)</term><term>Réimplantation dentaire (MeSH)</term><term>Techniques d'aide à la décision (MeSH)</term><term>Traitement de canal radiculaire (MeSH)</term></keywords><keywords scheme="MESH" qualifier="injuries" xml:lang="en"><term>Alveolar Process</term><term>Incisor</term><term>Maxilla</term></keywords><keywords scheme="MESH" qualifier="traumatismes" xml:lang="fr"><term>Incisive</term><term>Maxillaire</term><term>Processus alvéolaire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Decision Support Techniques</term><term>Evidence-Based Dentistry</term><term>Evidence-Based Emergency Medicine</term><term>Humans</term><term>Periodontal Splints</term><term>Private Practice</term><term>Root Canal Therapy</term><term>Tooth Avulsion</term><term>Tooth Replantation</term><term>Wound Healing</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Attelles parodontales</term><term>Cicatrisation de plaie</term><term>Extrusion dentaire</term><term>Humains</term><term>Médecine d'urgence factuelle</term><term>Odontologie factuelle</term><term>Pratique professionnelle privée</term><term>Réimplantation dentaire</term><term>Techniques d'aide à la décision</term><term>Traitement de canal radiculaire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>This article illustrates the use of the evidence-based process in clinical practice to answer questions that arose when a patient presented with dental trauma.</p></div><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The patient had avulsion of the maxillary right central incisor and lateral luxation and alveolar bone fracture partially encasing the roots of the maxillary left central and lateral incisors. At the emergency treatment the dentist replanted the teeth but had 2 questions regarding the impending treatment for the patient regarding the optimal timing of root canal therapy and splint duration that would result in the best outcome and prognosis for healing.</p></div><div type="abstract" xml:lang="en"><p><b>METHOD</b></p><p>The evidence-based process was used to help answer the clinical queries. Two focused clinical (PICO) questions were written, and 2 separate searches were conducted for each PICO question. Four databases were searched for systematic reviews, meta-analyses, critical summaries and practice guidelines.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>A total of 3 systematic reviews, 8 practice guidelines, 1 critical summary, and 1 Cochrane protocol were found.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>For replanted avulsed teeth, with closed apices, successful periodontal healing is improved when elective extirpation of the pulps occurs within 14 days. Second, guidelines recommend a flexible splint for up to 2 weeks for avulsed teeth with an extension of 2 to 4 weeks possibly needed for lateral luxation and with breakdown of marginal bone. However, evidence shows that an association between short-term splinting and an increased likelihood of functional periodontal healing, acceptable healing, or decreased development of replacement resorption, appears inconclusive and that the types of splint and the fixation period are not significant variables when related to healing outcomes. The evidence-based method was efficient, and very helpful in optimizing the management of the emergency dental treatment.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20797655</PMID><DateCompleted><Year>2010</Year><Month>11</Month><Day>08</Day></DateCompleted><DateRevised><Year>2010</Year><Month>08</Month><Day>27</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1532-3390</ISSN><JournalIssue CitedMedium="Internet"><Volume>10</Volume><Issue>3</Issue><PubDate><Year>2010</Year><Month>Sep</Month></PubDate></JournalIssue><Title>The journal of evidence-based dental practice</Title><ISOAbbreviation>J Evid Based Dent Pract</ISOAbbreviation></Journal><ArticleTitle>Use of evidence-based decision-making in private practice for emergency treatment of dental trauma: EB case report.</ArticleTitle><Pagination><MedlinePgn>135-46</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jebdp.2009.12.004</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">This article illustrates the use of the evidence-based process in clinical practice to answer questions that arose when a patient presented with dental trauma.</AbstractText><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The patient had avulsion of the maxillary right central incisor and lateral luxation and alveolar bone fracture partially encasing the roots of the maxillary left central and lateral incisors. At the emergency treatment the dentist replanted the teeth but had 2 questions regarding the impending treatment for the patient regarding the optimal timing of root canal therapy and splint duration that would result in the best outcome and prognosis for healing.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">The evidence-based process was used to help answer the clinical queries. Two focused clinical (PICO) questions were written, and 2 separate searches were conducted for each PICO question. Four databases were searched for systematic reviews, meta-analyses, critical summaries and practice guidelines.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 3 systematic reviews, 8 practice guidelines, 1 critical summary, and 1 Cochrane protocol were found.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">For replanted avulsed teeth, with closed apices, successful periodontal healing is improved when elective extirpation of the pulps occurs within 14 days. Second, guidelines recommend a flexible splint for up to 2 weeks for avulsed teeth with an extension of 2 to 4 weeks possibly needed for lateral luxation and with breakdown of marginal bone. However, evidence shows that an association between short-term splinting and an increased likelihood of functional periodontal healing, acceptable healing, or decreased development of replacement resorption, appears inconclusive and that the types of splint and the fixation period are not significant variables when related to healing outcomes. The evidence-based method was efficient, and very helpful in optimizing the management of the emergency dental treatment.</AbstractText><CopyrightInformation>Copyright 2010 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Syrene A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>The Center for Oral Health in Deer Park, WA, USA. syrene@ebdlibrary.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Greg</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Evid Based Dent Pract</MedlineTA><NlmUniqueID>101083101</NlmUniqueID><ISSNLinking>1532-3382</ISSNLinking></MedlineJournalInfo><CitationSubset>D</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000539" MajorTopicYN="N">Alveolar Process</DescriptorName><QualifierName UI="Q000293" MajorTopicYN="N">injuries</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003661" MajorTopicYN="Y">Decision Support Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055094" MajorTopicYN="Y">Evidence-Based Dentistry</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055416" MajorTopicYN="Y">Evidence-Based Emergency Medicine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007180" MajorTopicYN="N">Incisor</DescriptorName><QualifierName UI="Q000293" MajorTopicYN="N">injuries</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008437" MajorTopicYN="N">Maxilla</DescriptorName><QualifierName UI="Q000293" MajorTopicYN="Y">injuries</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010516" MajorTopicYN="Y">Periodontal Splints</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011331" MajorTopicYN="N">Private Practice</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012390" MajorTopicYN="Y">Root Canal Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014084" MajorTopicYN="N">Tooth Avulsion</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014090" MajorTopicYN="Y">Tooth Replantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014945" MajorTopicYN="N">Wound Healing</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>11</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">20797655</ArticleId><ArticleId IdType="pii">S1532-3382(09)00222-X</ArticleId><ArticleId IdType="doi">10.1016/j.jebdp.2009.12.004</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Washington (État)</li></region></list><tree><noCountry><name sortKey="Miller, Greg" sort="Miller, Greg" uniqKey="Miller G" first="Greg" last="Miller">Greg Miller</name></noCountry><country name="États-Unis"><region name="Washington (État)"><name sortKey="Miller, Syrene A" sort="Miller, Syrene A" uniqKey="Miller S" first="Syrene A" last="Miller">Syrene A. 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