Dental Tribune South African Edition

3InterviewsDental Tribune South African Edition - March 2014 Chris Jenkins DTSA: With your findings challenging the supremacy of silver amalgams in dentistry, how do you see this affecting the dental trade from the dentist’s point of view and from the dental manufacturer’s point of view? Dr Mickenautsch: This is an interesting question and may best be answered by members of the dental industry. What is the typical length of time it takes to complete a research project that you and your team commit to? Our projects may take between 6 months and 2 years until completion. What other research projects are you currently working on? We have just completed a systematic review regarding the failure rate of high-viscosity (reinforced) glass-ionomers in comparison to composite resin for load-bearing posterior tooth restorations. We are further investigating, in collaboration with colleagues in the United States, the accuracy of a novel statistical test for routine detection of selection bias in randomised control trials (RCT) and during the past year, SYSTEM’s research work focused on the appraisal of clinical merits for Chlorhexidine in the prevention of infection after tooth extraction; the use of the alcohol-sugar Xylitol in preventing tooth caries and the clinical failure rate of using resin-based glass-ionomer cements (RM-GIC) for orthodontic bracket bonding. The later relates to the lower incidence of carious decay associated with orthodontic treatment when RM-GICs are used instead of resin-based adhesives. However, common belief considers the use of RM-GIC as less effective for bracket bonding. In contrast, our systematic review found no difference in the failure rate between RM-GICs and resin-based adhesives after up to 14 months. Xylitol products are increasingly presented as being equal to fluoride in their caries preventive effect. Our systematic reviews show that such optimism may be premature. Chlorhexidine as an antibacterial agent may, when used under certain application regimes, prevent infection after tooth extraction. Through another systematic search of the dental literature, we found 95 clinical studies that investigated the retention rate of resin-based fissure sealants and subsequent caries occurrence on resin-sealed teeth. Based on the combined data of these trials we compared the caries predictive power of losing resin sealant material in pit and fissures to the predictive power of mere random guesses. To our surprise, no significant difference beyond the play of chance was found, thus sealant retention loss appears not to be a valid predictor for developing tooth caries. While these results do not question sealant retention as a beneficial factor for caries prevention, they shed grave doubts on the justification of its status as ruling quality criterion for pits and fissure sealants. The conclusions of these findings suggest the need for adopting clinical outcomes, such as the caries occurrence rate in formerly sealed teeth as ruling quality criterion for pit and fissure sealants, instead of the commonly used sealant material retention rate. Having conducted a vast number of reviews, updates and evidence reviews on a number of topics, how influential is SYSTEM in the dental world? We hope that our systematic reviews and their regular updates by us assist health care providers in finding answers to clinical questions in daily dental practice. Do Wits Dental students get to contribute and participate in your research? Yes, we had the collaboration of post-graduate/master students in the past and are currently preparing aspects of our work for future student input and training. Have you got any other interesting information about SYSTEM that the dental world might not be party to that you could share with us? We regularly share news of our research- output online on http://www.system-initiative.info/ DT Dr Steffen Mickenautsch, Research programme leader: SYSTEM Initiative/Department of Community Dentistry, Faculty of Health. Interview: Research with the SYSTEM Initiative “ ” We hope that our systematic reviews and their regular updates by us assist health care providers in finding answers to clinical questions in daily dental practice