Cited by 20Health Sciences Research and EducationDental Education, Practice, ResearchDental materials and restorations

Translating research into everyday clinical practice: Lessons learned from a USA dental practice-based research network

Open access
Gordan, Valeria V.·2013·Dental Materials

Abstract

Clinical studies are of paramount importance for testing and translation of the research findings to the community. Despite the existence of clinical studies, a significant delay exists between the generation of new knowledge and its application into the medical/dental community and their patients. One example is the repair of defective dental restorations. About 75% of practitioners in general dental practices do not consider the repair of dental restorations as a viable alternative to the replacement of defective restorations. Engaging and partnering with health practitioners in the field on studies addressing everyday clinical research questions may offer a solution to speed up the translation of the research findings. Practice-based research (PBR) offers a unique opportunity for practitioners to be involved in the research process, formulating clinical research questions. Additionally, PBR generates evidence-based knowledge with a broader spectrum that can be more readily generalized to the public. With PBR, clinicians are involved in the entire research process from its inception to its dissemination. Early practitioner interaction in the research process may result in ideas being more readily incorporated into practice. This paper discusses PBR as a mean to speed up the translation of research findings to clinical practice. It also reviews repair versus replacement of defective restorations as one example of the delay in the application of research findings to clinical...

Integrity signals

Registry

Crossref · 10.1016/j.dental.2012.07.159

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

18 of 88 cited sources checked · 5 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    Choice of repair over replacement differs among dentists according to dentist characteristics: those who placed the original restoration, graduated within the last 15 years, and work in large group practices repaired more often.

    “Dentists who placed the original restoration, dentists who graduated from dental school within the last 15 years, and dentists who work in large group practices (3 or more practitioners) repaired defective restorations more often than they replaced the restorations [43].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [43] source

      The Results report relative associations with repair, but the cited sentence says these dentists repaired restorations more often than they replaced them. The Results table shows the opposite for each named group: the same dentist repaired 32% and replaced 68%; the most recent graduates repaired 29% and replaced 71%; large-group dentists repaired 30% and replaced 70%. The Methods also do not define large groups as practices with three or more dentists; they define solo or small groups as having three or fewer. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    Enhancing the delivery of established therapies would save more lives than pursuing additional innovations in therapy.

    “Enhancing the delivery of established therapies would save more lives than pursuing additional innovations in therapy [6,3].”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [6] source
    • cites [3] source

      The Concepts and Attitudes section treats improving the implementation of care as important. It does not say that better delivery of established therapies would save more lives than developing new therapies; instead, it cautions that knowledge is also lacking for many patient-care decisions. No page number is available in our copy. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • Premisecitation

    A substantial difference exists between the health care patients may be eligible for and the health care they actually receive.

    “Therefore, a substantial difference exists between the health care that patients may be eligible for and the health care that they actually receive [3-5].”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [3] source
      Experimental — accuracy not yet measured
    • cites [4] source
      Experimental — accuracy not yet measured
    • cites [5] source
  • Premisecitation

    A significant delay exists between the generation of new knowledge and its application into the medical/dental community and patients.

    “A significant delay exists between the generation of breakthroughs and their transfer through applications serving individual patients when science is not efficiently translated to daily clinical practice.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [3] source

      The Abstract and Introduction describe a substantial chasm between knowledge and patient care, and Practical Barriers says researchers rarely have support to implement findings in practice. But Concepts and Attitudes cautions that the problem is not simply delayed translation of existing breakthroughs: relevant evidence is often lacking. The paper addresses primary care, not the dental community. Page numbers are unavailable in our copy. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [4] source
    • cites [5] source
  • Premisecitation

    Studies report a decline in use of dental amalgam due to inferior esthetic appearance, alleged adverse health effects, and environmental concerns.

    “studies report a decline in the use of dental amalgam, because of its inferior esthetic appearance, alleged adverse health effects, and environmental concerns [65-69]”
    Quote in the paperNot a substantial claim3 of 5 sources checked
    • cites [65] source

      The sections “No adverse effects through dental amalgam?” and “Amalgam for mercury pollution” discuss health effects and environmental mercury pollution. The paper does not establish that amalgam use has declined or attribute a decline to its appearance or those concerns; the section on organized dentistry says worldwide use may increase. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [66] source

      The Introduction (page not provided) describes widespread concern about possible health effects of mercury exposure among dentists. It does not report a decline in dental amalgam use or attribute such a decline to appearance, health concerns, or environmental concerns. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [67] source

      The Predictions for future use of restorative materials (p. 6) reports that many surveyed students expected amalgam use to decrease, while the choice-of-material findings (p. 6) identify aesthetics and environmental concerns as reasons some preferred composite. Current clinical practices (p. 6) also reports that patient safety concerns influenced some students’ decisions. The paper does not establish an observed decline in amalgam use or show that these three concerns caused such a decline. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [68] source
    • cites [69] source
  • May combine two claims. 11
  • Classified as probably not a substantial claim. 9
  • May combine two claims.

    Premisecitation

    Clinical diagnosis of secondary caries is ill-defined and marginal staining is often mistakenly diagnosed as caries lesions.

    “The clinical diagnosis of secondary caries is ill-defined [51-56] and marginal staining is often mistakenly diagnosed by clinicians as caries lesions [11,12,57,58].”
    Quote in the paperSubstantial claim1 of 10 sources checked
    • cites [51] source
    • cites [52] source
    • cites [53]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [54] source
    • cites [55] source
    • cites [56] source
    • cites [11]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] source

      The citation group attached to this source concerns the claim that clinicians often mistake marginal staining for caries. The Materials and methods section distinguishes marginal discolouration from secondary caries, and the Results report their recorded frequencies, but neither establishes that staining was often misdiagnosed. The Discussion says secondary-caries diagnosis is ill-defined, but that is the separately cited first clause. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [57] source
    • cites [58] source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Replacement of defective restorations is one of the most frequent problems encountered by general practitioners and accounts for over 50% of work in general dental practice.

    “Replacement of defective restorations is one of the most frequent problems encountered by general practitioners today and accounts for over 50% of the work performed in general dental practice [11-13].”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [11]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] source

      The Materials and methods section (page unavailable) reports that 49% of restorations placed in permanent teeth by surveyed Norwegian general dentists were replacements, supporting that replacement is common. It does not establish that replacement accounts for over 50% of all work in general dental practice; the percentage is below 50% and has a narrower denominator. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [13] source
  • May combine two claims.

    Premisecitation

    Patient characteristics associated with greater likelihood of repair versus replacement include older age, original material different than amalgam, restorations in molar teeth, and fewer surfaces.

    “Some patients’ characteristics were also associated with a greater likelihood of repair versus replacement, such as older patient age, original restorative material different than amalgam, restorations in molar teeth, and fewer surfaces in the original restoration [43].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    PBR generates evidence-based knowledge with a broader spectrum that can be more readily generalized to the public.

    “Additionally, PBR generates evidence-based knowledge with a broader spectrum that can be more readily generalized to the public.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Engaging and partnering with health practitioners on studies addressing everyday clinical questions may offer a solution to speed up translation.

    “Engaging and partnering with health practitioners in the field on studies addressing everyday clinical research questions may offer a solution to speed up the translation of the research findings.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Passive absorption of knowledge usually either does not work or is very slow.

    “passive absorption of knowledge usually either does not work or is very slow.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [77] source
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Early practitioner interaction in the research process may result in ideas being more readily incorporated into practice.

    “Early practitioner interaction in the research process may result in ideas being more readily incorporated into practice.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    Repair of defective restorations offers a less invasive and more conservative approach and has the potential to delay the re-restoration cycle.

    “Repair of defective restorations offers a less invasive and more conservative approach to restoration replacement and has the potential to delay the re-restoration cycle.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Traditional federally-funded or corporate-funded research in academic institutions has significant value that can complement PBRN studies.

    “Traditional federally-funded or corporate-funded research in academic institution has significant value that can complement the studies that are conducted in PBRNs.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Results of these studies serve as a basis to obtain IRB approval for conducting randomized controlled trials, which provide the highest level of evidence.

    “The results of the studies serve now as basis to obtain institutional review board approval for conducting randomized, controlled clinical trials which provide the highest level of evidence.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Academic research addresses different questions that can provide more rapid answers to clinicians' questions and lead to follow-up by PBRNs.

    “Academic research addresses different questions that can provide more rapid answers to clinician's questions and lead to follow-up by PBRNs.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    For these studies to be generalizable to most patients, they would be conducted in a general practice setting.

    “in order for these studies to be generalizable to most patients, they would be conducted in a general practice setting.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    In a PBR study, most treated restorations were amalgam (56%), replaced primarily (56% of cases) with direct tooth-colored materials.

    “The PBR study showed that most of the restorations that were treated in the study were amalgam (56%), which were replaced primarily (56% of cases) with direct tooth-colored restorative materials.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] source
  • May combine two claims.

    Premisecitation

    Acquiring new information is necessary but not enough for a change in behavior.

    “Acquiring new information is necessary, but not enough for a change in behavior [76].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [76] source
  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    Results from PBR can be more generalizable to the public at large, therefore facilitating application of findings for policy changes and establishment of standard of care.

    “The results from PBR can be more generalizable to the public at large, therefore it facilitates the application of the findings for policy changes and the establishment of standard of care.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Participating in PBRN activities may create openness to change, and practitioner-investigators act as agents for change.

    “Participating in PBRN activities may create openness to change and the practitioner-investigators act as agents for change [73].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [73]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Several long-term prospective studies have supported repair versus replacement of restorations, but these studies did not randomly assign treatment.

    “Even though several long-term prospective studies have supported the repair versus replacement of restorations, these studies did not randomly assign the treatment ([81-83].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [81] source
    • cites [82] source
    • cites [83]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

17 of 17
  • The authors state this as an assumption.

    The life-cycle model assumes that the first restoration is placed around age six and that replacements every eight to twelve years lead to tooth loss by age 56.

    “In this model the first restoration placed on a tooth is when the patient is around age six, and subsequent restoration replacements every eight to twelve years lead to progressively larger restorations and, ultimately, to tooth loss when patient reaches age 56.”
  • The paper relies on this without support.

    Most research is conducted in academic and industry settings rather than by the end users.

    “Part of the problem lies in the fact that most research is done in academic and industry environments and not directly by the end users.”
  • The paper relies on this without support.

    Academic studies are often narrowly focused and apply to a limited subset of patients or circumstances.

    “Whereas studies in academia are often narrowly focused and may apply to a limited subset of patients or circumstances”
  • The paper relies on this without support.

    Practice-based research involves a broad spectrum of patients and practitioners.

    “practice-based research involves a broad spectrum of patients and practitioners.”
4 of 4

Cites

Flagged first, then by citations

6 of the 85 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Gordan, 2003, Letter to the Editor of the Journal of the American Dental Association, The Journal of the American Dental Association, 134, 1170
  2. Gordan, 2009, Letter to the Editor of the Journal of the American Dental Association, The Journal of the American Dental Association, 140, 1078
  3. Gordan, 2010, Letter to the Editor of the Journal of the American Dental Association, The Journal of the American Dental Association, 141, 248
  4. Ozer L. The relationship between gap size, microbial accumulation and structural features of natural caries in extracted teeth with Class II amalgam restorations. Based on a thesis submitted to the graduate faculty. Copenhagen, Denmark: University of Copenhagen, in partial fulfillment of the requirements for the M.S. degree; 1997.

Cited by

Sorted by citations

Authors
Gordan, V. V.
Affiliations
University of Florida Health (US)
Corresponding author
Gordan, Valeria V.
Venue
Dental Materials
Publisher
Elsevier BV
Published
2013-01
Volume
29
Issue
1
Pages
3-9
ISSN
0109-5641 (ISSN-L)
OpenAlex
W2081568213
Cited by
20
References
85
Citations by year
2026: 2 · 2025: 3 · 2023: 1 · 2022: 3 · 2021: 1 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 2
FWCI
3.98
Type
journal article
Language
en
Open access
Locations
  • Dental Materials (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Dental and Craniofacial Research (DE-22516, DE16746, U01DE016746, DE16747, U01DE016747, U19DE022516)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Health Professions › General Health Professions › Dental Education, Practice, Research
  • Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
Keywords
practice-based research, research translation, dental restorations, restoration replacement, clinician involvement in research, evidence-based dentistry, general dental practice, research dissemination
MeSH terms
Cooperative Behavior, General Practice, Dental, Humans, United States, Practice Patterns, Dentists', Evidence-Based Dentistry, Translational Research, Biomedical, Dental Restoration Repair

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