B C M Oosterkamp1, W J M van der Sanden2, J E F M Frencken3, A M Kuijpers-Jagtman1. 1. Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands. 2. Department of Global Oral Health, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
OBJECTIVES: White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. MATERIALS AND METHODS: A nominal group technique (RAND-e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice- and evidence-based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3-point section of the 9-point scale regarding a specific statement was accepted as consensus. RESULTS: After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4-h consensus meeting. CONCLUSIONS: Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment.
OBJECTIVES: White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. MATERIALS AND METHODS: A nominal group technique (RAND-e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice- and evidence-based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3-point section of the 9-point scale regarding a specific statement was accepted as consensus. RESULTS: After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4-h consensus meeting. CONCLUSIONS: Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment.
Authors: Barbara C M Oosterkamp; Afzal Wafae; Jan G J H Schols; Wil J M van der Sanden; Michel Wensing Journal: Trials Date: 2016-04-15 Impact factor: 2.279
Authors: Janneke F M Scheerman; Berno van Meijel; Pepijn van Empelen; Gijsbert H W Verrips; Cor van Loveren; Jos W R Twisk; Amir H Pakpour; Matheus C T van den Braak; Gem J C Kramer Journal: Int J Dent Hyg Date: 2019-08-09 Impact factor: 2.477