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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Flap or flapless surgery for immediate implant placement?

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This review comparing immediate implant placement using flap or flapless surgery included 5 small RCTs involving a total of 140 patients. The findings suggested a benefit for flapless srugery but in addition to being small the studies were short term and 3 of the 5 studies were considered to be at high risk of bias.

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Prenatal vitamin D and enamel defects

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This review of the the potential impact of prenatal Vitamin D levels on enamel defects and tooth erosion included 7 studies. While the findings suggest an association between Vitamin D and emamel defects the studies varied in relation to the study designs, Vitamin D assessment methods, enamel defect assessment, and demographic characteristics of the populations studied so the findings should be interpreted very cautiously.

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Prevalence of maxillofacial trauma in children and adolescents

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This review of the prevalence of maxillofacial trauma by different causes in children and adolescents included 58 studies. The findings indicated that road traffic accidents and falls were the commonest causes. However rates do vary across difference geographic regions.

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Mouthguard wearing and athletic performance

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This review assessing the impact of wearing a mouthguard on athletic performance included 41 studies involving 852 athletes. While the findings suggest some potential benefits for athletic performance the included studies are small, very hetrogeneous with only 7 studies being at low risk of bias. Consequently the findings should be interpreted very cautiously.

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Music, audio-visuals or virtual reality for dental anxiety?

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This review of the effectiveness of relaxing music, audio-visuals (AV), and virtual reality (VR) in reducing dental anxiety associated with tooth extraction included 11 RCTs. The findings suggest that music performed better than VR and AV . However the limited number of studies and variation in anxiety scales, musical and visual interventions used means that the findings should be interpreted cautiously.

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Acupuncture for temporomandibular joint disorder?

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This review of the effectiveness and safety of acupuncture in treating temporomandibular joint disorders (TMD) included 32 RCTs. The findings suggest potential benefits for acupuncture compared with both active and inactive controls. However none of the studies were at low risk of bias and the certainty of the evidence was rated as very low to low. Consequently the findings should be interpreted cautiously.

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High-fluoride toothpaste or high fluoride mouthrinse to prevent white spot lesions in adolescent orthodontic patients – trial

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270 pateints were randomised in this trial to compare high-fluoride toothpaste and high-fluoride mouth rinse for preventing white spot lesions during orthodontic treatment. The findings suggest a benefit for high fluoride toothpaste and fluoride mouth rinse in preventing white spot lesions.

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Manual v powered toothbrushing in adolescent orthodontic patients – trial

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The aim of this randomised trial was to compare the efficacy of a powered versus manual toothbrush in controlling plaque and gingival health in participants undergoing fixed orthodontic treatment in respect of both the short term and long term. The findings showed no differences between the brush types at any time points ( 1, 6 or 12 months).

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CAD/CAM versus conventional fixed retainers in orthodontic patients

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This review comparing the effect of CAD/CAM-based and conventional fixed retainers on the stability of treatment outcomes and periodontal health in patients undergoing orthodontic retention using fixed retainers includeds 7 RCTs. The studies are of moderate size and relatively short duration (6 to 12months) and there are quality concerns so the findings should be viewed cautiously.

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Supportive care to prevent recurrence or progression of peri-implantitis

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This review of whether supportive care is effective in preventing recurrence or progression of peri-implantitis included 15 studies. However none of the included studies was specifically designed to test supportive care regimens so there is a need for new well conducted and reported randomised trials of appropraite size and duration to provide better quality evidence.

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