Journal of Oral Implantology December 2013 - (Page 655)

RESEARCH Evidence-Based Techniques to Assess the Performance of Dental Implants Ajay Kashi, BDS (DDS), MS, PhD1* Subrata Saha, PhD2 The clinical use of evidence-based medicine has been regarded as one of the most significant medical advancements of the last century. As the costs of medical care escalate, clinical decisions have to be made prudently and with a high degree of efficacy. One of the most expensive treatments in dentistry includes the use of dental implants to rehabilitate partial and fully edentulous patients. Due to the high costs of treatments and the ever increasing varieties of dental implants becoming available, the clinician is often faced with a challenging situation to decide the best prostheses for their patients. Furthermore, navigating through the vast database of literature pertaining to dental implants and their related research can be very time consuming and challenging to a dental surgeon before they can make appropriate clinical decisions. Similar to other orthopedic implants, dental implants need to be evaluated for their long-term efficacy in vivo before they are clinically acceptable. In order to help clinician(s) make patient oriented decisions, evidence-based techniques are becoming increasingly popular. This can be a very useful tool in translating research findings into clinical practice, thus narrowing the gap between research and clinical dentistry. This article discusses ways in which evidence-based techniques can help dental surgeons analyze and make informed clinical decisions about dental implant treatments. Key Words: evidence based dentistry, evidence based medicine, dental implants, dentistry, in vivo, single in vitro, long-term performance INTRODUCTION E vidence-based medicine (EBM) is used to analyze clinical data objectively in terms of quality from different studies. It is defined as ''the process of systematically finding, appraising and using contemporaneous research findings as the basis for clinical decisions.''1(p236) Evidence-based medicine is currently recognized as a well-established principle that forms a critical decision-making tool of many clinical specialties. However, compared with traditional medical specialties, EBM is yet to be widely recognized in dentistry and specifically in assessing the performance of dental implants. The application of evidence-based principles in dentistry has led to the 1 Division of General Dentistry, University of Rochester, Eastman Institute for Oral Health, Rochester, NY 2 Biomedical Engineering Program, School of Graduate Studies, Department of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, NY * Corresponding author, e-mail: ajay.kashi@gmail.com DOI: 10.1563/AAID-JOI-D-10-00084 term evidence-based dentistry (EBD). However, EBD is not well recognized in comparison with EBM, albeit both follow similar principles. This article attempts to emphasize the need for using EBD in general and in assessing the clinical performance and survival of dental implants, specifically. The terms EBM and EBD will be used interchangeably in this article. Various authors have proposed definitions for EBD. Some of these include the following. ''EBD is the integration and interpretation of the available current research evidence, combined with personal experience''2(p1) and ''the practice of evidence based medicine is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and the integration of patients' values and expectations.''3(p151) The American Dental Association has formulated the following definition for EBD based on the concepts of EBM: ''an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition Journal of Oral Implantology 655

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2013

Blade-Form Dental Implants: FDA Reclassification as a Class II Dental Implant Device
Effect of Different Storage Media on the Regenerative Potential of Autogenous Bone Grafts: A Histomorphometrical Analysis in Rabbits
Tensile Resistance of Mineralized and Demineralized Rat Bones in Different Regions (Calvarial and Femur)
Microbial Diversity of Peri-Implant Biofilms on Implant Fixed Bar and Telescopic Double Crown Attachments
Evidence-Based Techniques to Assess the Performance of Dental Implants
Influence of Platform and Abutment Angulation on Peri-Implant Bone. A Three- Dimensional Finite Element Stress Analysis
Direct Current Electric Stimulation in Implant Osseointegration: An Experimental Animal Study With Sheep
Prevalence of Sinus Augmentation Associated With Maxillary Posterior Implants
The Bactericidal Effects of an Acidified Sodium Chlorite-Containing Oral Moisturizing Gel: A Pilot Study
Influence of Fine Threads and Platform-Switching on Crestal Bone Stress Around Implant— A Three-Dimensional Finite Element Analysis
An Evaluation of the Resonance Frequency Analysis Device: Examiner Reliability and Repeatability of Readings
Histologic and Histomorphometric Assessment of Implants and Periapical Tissues When Placed in the Sockets of Extracted Teeth, Teeth With Periapical Lesions, and Healed Lesions: A Canine Study
Microbiological Aspects of Human Mandibular Subperiosteal Dental Implants
A Technique for Removal of a Fractured Implant Abutment Screw
Eight-Year Results of Site Retention of Anorganic Bovine Bone and Anorganic Bovine Matrix
A Reactive Lesion (Pyogenic Granuloma) Associated With Dental Implant: A Case Report
Twelve-Year Clinical and Radiological Results of Maxillary and Mandibular Implant- Retained Bar Overdentures Carried out on Oxidized (TiUnite) Replace Select Implants: A Clinical Case
PEEK Dental Implants: A Review of the Literature

Journal of Oral Implantology December 2013