Derek Richards

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Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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Orthodontic ligation methods and biofilm formation

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This review comparing elastomeric ligation with self-ligation and steel wire ligation for orthodontic appliances and their effect on clinical outcomes included 11 RCTs. The findings suggest no significant differences although the trials were small with a majority at high risk of bias.

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Third molar extraction– effect of preoperative oral corticosteroids on pain, swelling and trismus

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Four RCTs involving a total of 212 patients were included in this review of a single pre-operative dose of oral corticosteroids in reducing pain,swelling & trismus after surgical removal of lower third molars. While the findings suggested there was little benefit to the patients none of the studies were small and none of them were at low risk of bias.

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Titanium or biodegradable osteosyntheses in orthognathic surgery?

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This review assessing the efficacy and morbidity of biodegradable vs. titanium osteosyntheses in orthognathic surgery included 33 studies 11 of which were RCTs. The findings suggest that biodegradable osteosyntheses is a valid alternative to titanium osteosyntheses for orthognathic surgery, but the quality of evidence is low.

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Oral cancer – adjunctive diagnostic tests

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OLYMPUS DIGITAL CAMERA

This Cochrane review update was to estimate the diagnostic accuracy of index tests for the detection of oral cancer and oral potentially malignant disorders, in people presenting with clinically evident suspicious and innocuous lesions.

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Treatments for cavitated or dentine carious lesions

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This Cochrane review of interventions to treat carious lesions conventionally considered to require restorations in primary or permanent teeth with vital pulps included 27 RCTs. Compared with conventional treatment there were lower numbers of failures with the Hall technique and selective excavation (SE) in primary teeth and with SE and stepwise removal in permanent teeth.

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Lasers for treatment of dentine hypersensitivity?

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This Cochrane review of the effectiveness of lasers in the treatment of dentine hypersensitivity included 23 RCTs. The findings suggest that lasers may reduce pain intensity at short, medium, or long term when compared to placebo/no treatment. However the evidence is limited and of low to very low certainty.

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Oral proliferative verrucous leukoplakia and the rate of malignant transformation

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This review of the evidence on the malignant transformation of oral proliferative verrucous leukoplakia included 17 mainly retrospective observational studies. The overall estimate for malignant transformation was 43.87% (95% CI; 31.93 to 56.13) but only 4 studies were at low risk of bias.

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Tooth loss during long-term periodontal maintenance

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This review evaluating risk factors / predictors of tooth loss in patients with periodontitis having periodontal therapy and long-term periodontal maintenance (PM) included 33 studies only 3 of which were prospective. There findings suggest that patients having long-term PM suffer the loss of 1 tooth per patient every 10 years.

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Orthodontic retainers and periodontal health

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This review comparing the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health included 6 RCTs. While the findings suggests a statistical benefit in favour of HR in the short term the studies are small, short-term and most ( 5) were considered to be at high risk of bias.

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Sinus lift for implants in maxilla – graft or not?

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This review of the efficacy of graftless maxillary sinus membrane elevation using the lateral window approach for implantation in the atrophic maxilla included 9 RCTs. While some difference between grafted and graftless sinus lifts were shown at 6 months only a limited number of small short term trials were available.

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