AARD 2010

It is critical for the dental profession, and for patients, that dentists practice evidence-based dentistry. However, in a contemporary product-driven world, it is becoming increasingly difficult for many clinicians to practice at this level. One of the primary reasons for this is that there is a paucity of evidence available in the upper levels of the evidence-based hierarchy (meta-analyses or systematic reviews of properly conducted, randomized, controlled clinical trials, or RCTs). Additionally, with the large number of journals currently available, there are expanding numbers of scientific articles for clinicians to read and analyze. There are also many more commercialized sources of information, and dentists are deluged with information from trade journals, advertisements, and brochures. Sources for continuing dental education abound, and information, good, bad, and indifferent, is obtained from both lectures and Internet sites.

These facts are further complicated by the relatively poor quality of the science conducted in some of the studies. Many of these studies suf- fer from deficiencies related to small sample sizes, investigator bias, lack of controls or adequate randomization, failure to account for obvious confounding variables, nonstandardized means of data collection and measurement, and failure to blind the evaluators. Often these deficiencies result in authors deriving conclusions that, on further review, are not sup- ported by the data generated by the investigation.
However, it is apparent that many investigators are making honest ef- forts to design and conduct RCTs that will yield important data and help answer many of the important questions that remain in the provision of optimal oral health care to patients. The primary function of this review is to assist practicing dentists in clinical decision making and to guide them to the best scientific evidence published in 2009. The Committee on Scientific Investigation has carefully reviewed and selected articles published in 2009, because they believe the resultant data contribute to the advancement of the practice of evidence-based dentistry. Comments on study design, statistical analysis, and the relative strengths of the findings are included to aid the reader in inter- pretation of the results.

Analysis of the scientific literature published in 2009 is divided into 6 sections: (1) pulp pathology; (2) den- tal materials; (3) prosthodontics; (4) occlusion, temporomandibular dis- orders, and sleep-disordered breath- ing; (5) periodontics; and (6) implant dentistry.

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