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Advancing Pre-Doctoral Research: Engaging in Patient-Based Studies

This initiative invites pre-doctoral students to partake in meaningful patient-based research, transforming it into case presentations suitable for Clinic and Research Day. Students will explore treatment plans, health concerns, and therapeutic challenges based on unique patient cases, emphasizing critical questions and the significance of their findings. The goal is to foster scientific inquiry among future dentists while ensuring an in-depth understanding of patient complexities. This program also provides guidance on case identification, documentation, and evaluation while promoting collaboration with faculty and peers.

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Advancing Pre-Doctoral Research: Engaging in Patient-Based Studies

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  1. UICClinic&ResearchDay2014 CriticallyAppraisedTopics Anapproachtopre-doctoralresearchopportunities FifthAnnualCompetition

  2. L&LAgenda Objectives Parameters Howtofindcases CaseCATPosterTemplate CaseCATWorksheet CaseCATLiteratureWorksheet JudgingCriteria Onceyouhaveidentifiedacase Contactinformation         

  3. Objectives Toprovideanopportunityforpre-doctoral studentstoengageinapatientbasedstudyto thelevelofscientificinquiry Tofacilitatethetransformationofapatient basedstudytoacasepresentationthatcanbe presentedatClinicandResearchDay  

  4. Parameters Howweretreatmentplansoroutcomesforyour patientaffectedby: Treatmentprocedure Patienthealthconcerns Therapeuticproblemsconcerningpatient Unusualmedications Treatmentconsiderationformedically compromisedorpatientswithdisabilities Example:Bloodpressuremedicationthat causesxerostomia What arecauses,howdoyouevaluate,howdoyoutreat?

  5. WheredoIfindcases? Portfolio 1. Onmedicallycompromisedpatientsi.e.diabetes, hypertension Patientson3ormoremedicallysignificanttherapeutic medications   ScreeningClinic/UrgentCare 2. Diagnosisofaninterestingpatientissue  Rotationswithspecialtyclinics 3. Workingwithresidents Examplesinclude:Ortho(craniofacialanomaly),Perio (diabetes),Endo(implants)  

  6. ImportantElements toConsider Patientissueexemplifiesproblem Thoughtfuldescriptionofcase AdequateDocumentation(mustbede-identified)    Photosandradiographs Axiumpagewithcharting Patientmedical,dentalhistory,chiefcomplaint    DifferentialDiagnosis  Inmanycasesalreadypreexistingdiagnosis  DevelopcasetolevelofCAT  Faculty,journalsandinternetasresources  IRBIssues  Mustbesinglecase,caseseriesnotacceptable 

  7. CaseCAT Worksheet

  8. CaseCATWorksheet

  9. Should I use CavitTM, IRMTM, or KetacFillTM? Student: Michael P. Munaretto Advisor: Bradford Johnson, DDS MHPE, UIC Department of Endodontics CASE SCENARIO CAT (1) CAT (2) CAT (3) CRITICAL QUESTION CASE SIGNIFICANCE 29 y/o healthy female has full mouth radiographs taken as part of comprehensive oral examination. PeriapicalRadiolucencies are seen on teeth #4 and #5. Exam: EOE WNL. IOE reveals large DO amalgam restorations present on both teeth. The following clinical tests were performed: Tooth Cold EPT PercPalp Probing Mobility 3 WNL 31/80 WNL WNL 323B 323L 0 4 NR 80/80 WNL WNL 323B 323L 0 5 NR 80/80 WNL WNL 323B 323L 0 6 WNL 26/80 WNL WNL 323B 323L 0 P- Patients receiving root canal therapy I- Temporary restorative material (Cavit, IRM, or KetacFill [GI]) C- Definitive restoration O- Durability and resistance to coronal microleakage Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.

  10. CaseCATWorksheet

  11. CaseCATWorksheet

  12. DirectPulpCapping:MineralTrioxideAggregate(MTA)or CalciumHydroxide(Dycal)? Student:AndreaVenizelos Advisors:SatishAlapati,BDS,MS,PhD;BradfordJohnson,DDS,MHPE,UICDepartmentofEndodontics CASESCENARIO Duringcariesexcavationonamatureadulttoothapinpointpulpexposureisnoticedandpulp cappingisindicated. P…Adultwithpinpointpulpexposure(<1mm) I…Directpulpcapping C…Material((MineralTrioxideAggregate(MTA)or CalciumHydroxide(Dycal)) O…Increasedsurvivaloftooth Exam:EOEWNL.IOErevealslargeDBILcariouslesion. Diagnosis:#8NormalPulpwithNormalPeriapical TreatmentPlan:Excavatecariesandrestore.RCTnotindicated MESHTerms: DentalPulpCapping;Pulpal Response;MineralTrioxide Aggregate;Calcium Hydroxide CRITICALQUESTION Duringcariesexcavationonamatureadulttoothapinpointpulpexposure(<1mm)isnoticed,for increasedsurvivalofthetooth,whichmaterialshouldbeusedforpulpcapping:MTA(Mineral TrioxideAggregate)orCalciumHydroxide(Dycal)? CASESIGNIFICANCE StudentSummary Fewinvivostudiesareavailableonthistopic. However,fromtheavailableevidencethe followingconclusionscanbedrawn: 1.Calciumhydroxidedoesnotadheretothe dentinandlackstheabilitytoseal.Seepageof materialintothepulpisprobable.Hardtissue bridgesthatformareincompleteandpresent withtunneldefectsthatactasapathwayfor microleakage. 2.PulpdefectstreatedwithMTAhaveless inflammation,lesshyperemia,morestablehard tissuebridgeswithincreasedthickness,andare freefromtunneldefects.MTAshowsgreater abilitytoprovideafluid-tightseal. 3.MTAhasamuchgreatercostthancalcium hydroxide. 4.Thereisaneedformorehigh-qualitystudies forMTAtodefinitivelybethematerialofchoice fordirectpulpcapping. CAT2 Aeinehchietal.“MineralTrioxideAggregate (MTA)andCalciumHydroxideasPulp-Capping AgentsinHumanTeeth:APreliminaryReport.” InternationalEndodonticJournal36pp225-231. 2003. Methods:22maxillarythirdmolarswere subjectedtomechanicalpulpexposure.Pulp cappingmaterialwaseitherMTAorcalcium hydroxide,coveredwithZOEandrestoredwith amalgam.Extractionswereafterperiodsof1 week,2months,and6months. Results/Conclusion:Lessinflammation, hyperemiaandnecrosisplusthickerdentinal bridgeandmorecommonodontoblastlayer formationwithMTAwasfoundthanwith calciumhydroxide. Validity:Directpulpcappingmaterialwas randomlyassigned.Smallsamplesize,large drop-outofpatients. LOE:2(RandomizedControlledTrial) CAT1 Olssonetal.“FormationofaHardTissue BarrierAfterPulpCappinginHumans.A SystematicReview.”InternationalEndodontic Journal36pp429-442.2006. Methods:APubMedandCentralliterature searchwithspecifictermsweremade.Levelof evidenceofthepublicationswasassessed. Results/Conclusion:21publicationsremained afterinterpretation.Nonehadahighlevelof evidence,onehadmoderatelevelofevidence, and20hadalowlevelofevidence.Evidence gradewasdeterminedtobeinsufficient.Does notimplythatthereisnoeffectofapulp cappingprocedure,butratheraneedforhigh- qualitystudies.Cappingmaterialincluded calciumhydroxide,bondingmaterials, Vitrebond,synthetichydroxyapatite,isobutyl cyanoacrylate,andMTA. Validity:Hadvalidinclusioncriteria,and evaluatedLOE. LOE:1(SystematicReview) CAT3 Nairetal.“Histological,Ultrastructuraland QuantitativeInvestigationsontheResponseof HealthyHumanPulpstoexperimentalCapping withMineralTrioxideAggregate:A RandomizedControlledTrial.”International EndodonticJournal42pp422-444.2009. Methods:Apulpalexposurewasmadein35 healthymaxillarythirdmolarsfrom23 patients.PulpcappingmaterialwaseitherMTA orDycal.33oftheseteethwerehisto- morphologicallyprocessed.Cavitieswere restoredwithIRM.Extractionswereafter periodsof1week,1month,and3months. Results/Conclusion:Pulpexposurestreated withMTAwereessentiallyfreefrom inflammationandcoveredwithhardtissue bridges.TeethtreatedwithDycalhadlesshard tissueformation,morepulpalinflammation, andseepageofmaterialintothepulp. Validity:Directpulpcappingmaterialwas randomlyassigned.Followupwas100% LOE:2(RandomizedControlledTrial)

  13. IdealLutingAgentforaZirconiaAbutment Student:ShivamPatel Advisor:Dr.SatishAlapati CASESCENARIO P–Patientreceivingazirconiaimplantabutment I–Resinbasedlutingcement 24y/ohispanicfemalepresentsaftertraumaticavulsion#25.Shewouldliketohaveafixedrestoration, preferablyadentalimplant.Estheticsandfunctionareherprimaryconcern.IOErevealsathinsofttissue biotypewhichmayhaveanadverseoutcomeifstock/titaniumabutmentisutilized. Mean(standarddeviation)ofdislodginingforcesofthe studiedcement(N)groups. C–Conventionalcement O–Adequatebondstrengthbetweenfinalrestorationandabutment Meanmicrotensilebondstrengthsforceramicbondedto compositegroups. CRITICALQUESTION ForapatientreceivinganimlpantinanestheticzonewithaZirconiabasedabutment, whatistheideallutingagentthatwillprovideadequateretentiontopreventdislodgement? MESHTerms: Zirconiaabutment LutingAgent CASESIGNIFICANCE StudentSummary Implant Bonding CAT3 EkfeldtA,FürstB,CarlssonGE.“Zirconia abutmentsforsingle-toothimplantrestorations: aretrospectiveandclinicalfollow-upstudy.” ClinOralImplantsRes.2011Nov;22(11):1308-14. Methods:Part1–Retrospectiveevaluationof 130patientsw/185STIrestorationsw/ZrO2 abutments.Part2–Clinicalexamof25patients w/40restorationsplaced>3yrsago.93 cementedw/zincphosphate,1w/resincement, 1w/TempBond Results/Conclusion:ZrO2abutmentshadlow rateoftechnicalandbiologicalcomplications, softtissuerespondedwell. Validity/Applicability:Multiplefocus parametersw/shortfollowupbutvastdata collection.Protocolforsurgeryandrestoration standardizedandpositive3-5yearsuccess. LevelofEvidence:LowLevel3–Retrospecitve analysisandclinicalfollowupstudy ManystudieshavebeenconductedonZrO2 plates/discsandthevastmajorityofsearch resultswereinvitrostudies.Systematicreviews werenotavailableasthematerialinquestionis stillfairlynewinthescopeofdentalpractice. Thetopichashelpedmerealizetheimportance ofmaterialscienceanditsplaceindentistry. Bondingconcepts,biocompatibility,and physical/chemicalpropertiesarefactorsthat contributeagreatdealtosuccesswithinthe oralcavity. Basedonmyresearchresinbasedlutingagents arethebestcandidatesforcementationontoa ZrO2substratesuchasanimplantabutment.Air abrasion,priming,andtrebochemical treatmentsareallareasforfutureresearchto determinethebestalternativetoincreasebond strengthsinthezirconiamaterialwithout compromisingitsphysical/chemicalintegrity. CAT1 NejatidaneshF,SavabiO,ShahtoosiM. “Retentionofimplant-supportedzirconium oxideceramicrestorationsusingdifferent lutingagents.”ClinOralImplantsRes.2011Nov 14. Methods:20ITIabutments(5.5mmheight)and ITIimplantanalogsmountedtoacrylicblocks. 90ZrO2copings(Al2O3abraded).Copings conditionedinartificialsalivaandthermocycled andcementedw/variouscements. Results/Conclusion:ResinbasedandRMGI lutingagentsaremostretentive.Cement selectionshouldbebaseduponsiteaswellas optionforretrievability. Validity/Applicability:Studylimitationswere monotonicstaticload,invivoforceshave dynamicloading.Fatigueofcementsunderload notanalyzedbutdatapresentedandeach specimenonlysubjectedtoonevariable(luting agent). LevelofEvidence:Level5–Benchtopresearch CAT2 Kim,Min-Jeong,etal."ShearBondStrengthsof variousLutingCementstoZirconiaCeramic: SurfaceChemicalAspects."Journalofdentistry 39.11(2011):795-803.. Methods:Mutiplecementtypeswerebonded tosandblastedZrO2(Lava).Specimenswere storedinwaterat37degreesCandother½ thermocycled.Shearbondstrengthsand surfaceenergyparameterswererecorded. Results/Conclusion:PanaviaF2.0andPrinciple producedhigherbondstrengthsthanother cementsw/nosignificantdifferencesbeforeor afterthermocycling. Validity/Applicability:Thestudysuggeststhat surfaceenergyparametersshouldbe importantconsiderationsindeterminingwhich lutingagentshouldbeutilizedforproper adhesion.Varioussurfacetreatmentsshould beincorporatedforcomparison LevelofEvidence:Level5–Benchtopresearch

  14. CaseCAT Literature Worksheet

  15. EvaluationSheet

  16. Onceyouhaveidentifiedacase: Identifyamentor PrimaryContact:GroupPracticeManager AllprojectTitlesshouldturnedinto KatherineLongatlongka@uic.edu ASAP Talktopreviousparticipants    

  17. Questions? CaseCATcontacts: Dr.Crowe Dr.Knight Elizabeth Razdolsky dlcrowe@uic.edu gwknight@uic.edu erazdo2@uic.edu

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