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Dear group 2,

The grades for the assignments are as follows:

Research project -83%
Flip the classroom- 72%

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Tutorial Three (Diagnostic Accuracy Study 2)

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Tutorial Three (Diagnostic Accuracy Study 2)

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Name of article:

Role of Toluidine Blue Staining in Suspicious Lesions of Oral Cavity and Oropharynx

Link to article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848367/

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Tutorial Three (Diagnostic Accuracy Study 1)

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Tutorial Three (Diagnostic Accuracy Study 1)

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Name of article: Supravital staining: It's role in detecting early malignancies

Link to article: https://pubmed.ncbi.nlm.nih.gov/23120232/

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DIAGNOSTICS (A.F, C.B, C.G, K.L)

Locate two cohort studies or blind comparison to a gold standard studies to answer the diagnosis type question below: Is staining with toluidine blue an effective method of detecting oral cancer?

Step 1: Break your topic into searchable concepts

Keywords included: oral cancer, detection, detecting, toluidine blue, thiazine metachromatic dye, stains, staining, lesion

Step 2: Use Boolean to describe the relationship between the concepts

("oral cancer" OR lesion) AND ("toluidine blue" OR “thiazine metachromatic dye”) AND ("stain" OR "staining") AND (“detect” OR “detecting”)

Step 3&4: Click search and look at the results.

After looking at the results, the articles obtained were as follows:

Role of Toluidine Blue Staining in Suspicious Lesions of Oral Cavity and Oropharynx

Link: https://pubmed.ncbi.nlm.nih.gov/31741949/

Supravital staining: It's role in detecting early malignancies

Link: https://pubmed.ncbi.nlm.nih.gov/23120232/

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CASE STUDY 2

P is a healthy 24-month old healthy girl whom you have seen regularly since birth. Her birth history and past medical history are unremarkable. Her mother is a vice president of a small company. Her physical examination is normal. She has healthy dentition (no signs of early childhood tooth decay). P lives in an area with non-fluoridated municipal drinking water.

a. You need to make a decision whether pit and fissure sealants should be applied. (C.B)

Population: Children under the age of 5 years old from areas with non-fluoridated municipal drinking water

Intervention: Pit and fissure sealants

Comparison: No treatment

Outcome: Reduction in dental caries

Question:  Should pit and fissure sealants be used on children from areas that do not have fluoridated municipal drinking water?

b. You need to unfold the relationship of socioeconomic status and increased risk of dental caries in children in P’s age group (<5 years). (A.F)

Population: Children under the age of 5

Exposure: High economic status

Comparison: Low economic status

Outcome: Reduction in dental caries

Question: What is the correlation between socioeconomic status and increased risk of dental caries in children under the age of 5?

c. What types of studies are recommended to find the answers to the questions formulated in a and b? Arrange these studies in descending order based on the level of evidence they provide (strongest to weakest evidence). (C.G)

The studies recommended are:

1.  Cohort Study - These studies involve selection of study subjects based on the presence or absence of an exposure factor. A comparison is then made between exposed and unexposed on the subsequent development of disease.

2. Case Control - These are conducted when the disease has already occurred and look at the history of exposure.

3. Case Series - This is a descriptive study used when there are interesting or unusual findings. They can identify public health issues or potential diseases. However, they cannot be used for hypothesis testing.

QUESTION 3 (A.F, C.B, C.G)

Evaluation of Treatment Outcome After Impacted Mandibular Third Molar Surgery With the Use of Autologous Platelet-Rich Fibrin

Purpose- To assess the effect of platelet-rich fibrin (PRF) on postoperative pain, swelling, trismus, periodontal healing on the distal aspect of the second molar, and progress of bone regeneration in mandibular third molar extraction sockets. Materials and Methods- Over a 2-year period, 31 patients (mean age, 26.1 yr) who required surgical extraction of a single impacted third molar and met the inclusion criteria were recruited. After surgical extraction of the third molar, only primary closure was performed in the control group, whereas PRF was placed in the socket followed by primary closure in the case group (16 patients). The outcome variables were pain, swelling, maximum mouth opening, periodontal pocket depth, and bone formation, with a follow-up period of 3 months. Quantitative data are presented as mean. Statistical significance was inferred at a P value less than .05. Results -Pain (P = .017), swelling (P = .022), and interincisal distance (P = .040) were less in the case group compared with the control group on the first postoperative day. Periodontal pocket depth decreased at 3 months postoperatively in the case (P < .001) and control (P = .014) groups, and this decrease was statistically significant. Bone density scores at 3 months postoperatively were higher in the case group than in the control group, but this difference was not statistically important. Conclusions -The application of PRF lessens the severity of immediate postoperative sequelae, decreases preoperative pocket depth, and hastens bone formation.

Type of study? Intervention Study (Randomized Clinical Trial)

PICO:

Population: Young adults with impacted mandibular third molars

Intervention: Platelet-rich fibrin (PRF)

Comparison: Primary closure

Outcome: To reduce post-operative pain, swelling and trismus

To increase bone regeneration and periodontal healing

Research question: What is the effect of PRF compared to primary methods of closure on mandibular third molar extraction sockets?

QUESTION 4 (A.F, C.B, C.G)

Non-pharmacological interventions for alleviating pain during orthodontic treatment Pain is usual during orthodontic treatment and may make some people stop treatment early, meaning that planned benefits do not occur. Painkillers are recommended to reduce pain during orthodontic treatment, but an effective non drug solution would lower risks of side effects and help people to continue for the full course of treatment. We included studies published before 6 October 2016.We included 14 studies that involved a total of 931 teenagers and adults. The studies investigated the effects of using laser irradiation provided by the orthodontist, vibratory devices, changing chewing patterns (patients chewing gum or wafers), brain wave music, cognitive behavioural therapy, and text messages to support people after braces were fitted. The main outcome measured was the intensity of pain over the short term as reported by patients. We found insufficient evidence to assess the effectiveness of the interventions, although the available low-quality evidence suggested that laser irradiation may help to control short-term orthodontic pain. None of the studies considered side effects of the treatments. We identified relatively few studies, some of which used flawed methods or were not well reported. More research to look at the possible merits of non-drug methods of pain control would be helpful. Future studies should measure pain over longer time periods and should measure side effects and costs.

Type of study? Systematic Review

PICO:

Population: Teenagers and adults that feel pain during orthodontic treatment

Intervention: Laser irradiation, Vibratory devices, Changing of chewing patterns, Brain wave music, Cognitive behaviour therapy, Text messages of support

Comparison: Pharmacological painkillers

Outcome: To reduce pain during orthodontic treatment?

Research question: What are the effects of non-pharmacological interventions compared to the pharmacological counterparts in reducing orthodontic pain?