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53 Cards in this Set
- Front
- Back
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5 Skills and abilities needed to apply the EBDM process
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1- convert info needs and problems into clinical questions to enable them to be answered.
2-Conduct a computerized search with maximum efficiency for finding the best external evidence with which to answer the question 3- Critically appraise the evidence for its validity and usefulness (clinical applicability) 4-Apply the results of the appraisal, or evidence, in clinical practice 5- Evaluate the process and performance of the RDH |
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EBDM involves what two fundamental principles
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-Evidence alone is never sufficient to make a clinical decision
-Hierarchies of quality and applicability of evidence exist to guide clinical decision making |
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What are the forces driving the need for EBDM to improve the quality of care?
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-variations in practice patterns
-clinician's difficulty in assimilating scientific evidence into practice |
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variations often occur as a result of what?
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a gap between the time that current research becomes available and its application to care, consequently adopting useful procedures and discontinuing ineffective or harmful ones are delayed
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A well built question should include the following four parts
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P- Patient problem or population
I- Intervention C- Comparison O- Outcome |
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Using PICO to frame the question serves three key purposes
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-forced to focus on single issue
-identify key terms to facilitate the computerized search -identify the problem, results and outcomes related to the specific care provided to that pt |
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outcomes yield better search results when what?
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defined in very specific terms
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What are the main steps in the EBDM process?
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1- ask good questions (PICO)
2- searching for and acquiring the evidence 3- critically appraising the evidence 4- evaluate the outcomes |
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What constitutes clinical evidence?
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comes from studies related to questions about tx, prevention, diagnosis, origin, harm and prognosis of disease
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Levels of Evidence
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1- systemic review (SR) and meta-analysis
2- case-control studies 3- case-control studies 4- case series 5- traditional literature review 6- studies without human participants |
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What does the highest level evidence provide?
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A summary of multiple research studies that investigate the same specific question
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Primary sources
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-original research publications that have not been
-include randomized controlled trials, cohort studies and case studies |
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Secondary sources
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-synthesized publications of the primary literature
-include SRs (systematic reviews) and meta-analysis, evidence based article reviews and clinical practice guidelines and protocols |
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What allows the user to search for publication types such as meta-analyses, RCT's, clinical trials and practice guidelines?
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the "limits"
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What is the key component in critically appraising the evidence?
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determining whether the findings are relevant to the patient, problem, or question
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The final step in the EBDM process is to evaluate?
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-the effectiveness of the intervention
-clinical outcomes of care -determine how effectively the EBDM process was applied |
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T/F: the modified pen grasp is held in the same manner as the grasp used in writing
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False: the modified pen grasp is much more precise than the grasp for writing
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Successful instrumentation technique depends to a great degree on what?
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precise placement of each finger in the modified pen grasp
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The thumb and index finger are ______ at or near the junction of the handle and shank.
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opposite each other (NOT across from each other, NOT overlap)
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The instrument handle ___________ to stabilize the instrument.
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rests against the hand
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How does the middle finger sit on the instrument?
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One side of the pad of the middle finger rests lightly on the shank, the other side rests against-or slightly overlaps- the ring finger
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The index, middle, and ring finger should what?
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be in contact at least at one point
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T/F: the ring finger has no function in the grasp
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true
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Ergonomics step by step
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1-me
2- my patient 3- my equipment (light) 4- my mirror hand 5- my dominant hand 6- my fulcrum 7-pause and self-check fulcrum |
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The most common positioning error when working on the maxillary posterior treatment areas is what?
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failing to maintain neutral wrist position
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What is the solution to when the clinician bends his or her wrist when working on the maxillary posterior treatment areas?
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change where the handle contacts the hand in the grasp. Rest the handle between the 3rd knuckle and the "V" of the hand
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The appearance of an anterior cavity preparation restored with these materials differs from the appearance of interproximal caries and can be identified by what?
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well-defined smooth outline
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what is the wearing away of tooth structures from the friction of a foreign object
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abrasion
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what is the mechanical wearing down of teeth
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attrition
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what us an apparent radiolucency found just below the CE junction on the root due to anatomical variation or gap between the enamel and bone covering the root
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cervical burnout
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Approximately ____% of demineralization is required for radiographic detection of a lesion.
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50%
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Caries detection is improved with a higher or lower kvp setting, which provides a higher contrast.
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lower kvp
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What is up to half the thickness of the enamel?
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Incipient caries
-usually not restored unless patient has high level of caries activity. Tx with FL |
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What is more than halfway through the enamel (up to DEJ)
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Moderate
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What is form DEJ to half-way through dentin?
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Advanced
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What is more than halfway through the dentin?
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Severe
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T/F: incipient occlusal caries are not seen on radiographs
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True
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What must happen for occlusal caries to be visible?
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must have penetrated into dentin
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saucer like cratering on the roots of the teeth, involving the cementum
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root caries
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found around the margins of existing restorations
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recurrent caries
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extensive and rapidly progressing caries usually found in children and teens with poor diet and inadequate OH
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rampant caries
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found in head/neck radiation therapy patients with xerostomia
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radiation caries, FL used for control
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Caries Classification
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I= incipient (stage I)
M=moderate (stage II) A= advanced (stage III) S= severe (stage IV) |
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What is the thin radiopaque border adjacent to the PDL called?
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Lamina Dura
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Width, shape and angle of crest vary according to?
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The convexity of the proximal teeth and the level of their respective CEJs
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What is the most reliable technique for taking radiographs?
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Long cone paralleling with an XCP device
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Four criteria to determine adequate angulation of periapical radiographs
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-should show the tips of the molar cusps with little to none of the occlusal surfaces showing
-enamel caps and pulp chambers should be distinct -interproximal spaces should be open -proximal contacts should not overlap unless teeth are anatomically out of line |
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Radiographs are an ______ method of determining bone loss.
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indirect
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T/F: they show the amount remaining rather than the amount lost
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True
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What is the distance from the CEJ to the alveolar crest in normal healthy bone?
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approximately 2 mm
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Interdental septa changes affect the?
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Lamina dura
crestal radiodensity size and shape of medullary spaces height and contour of the bone |
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What radiographs do NOT reveal
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-internal morphology
-depth of craterlike interdental defects -extent of the involvement on the facial and lingual surfaces |
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What are irregular areas of reduced radiopacity on the alveolar bone crests
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inderdental craters
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