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Caries preventive measures in orthodontic practice: the development of a clinical practice guideline
Author(s) -
Oosterkamp B. C. M.,
Sanden W. J. M.,
Frencken J. E. F. M.,
KuijpersJagtman A. M.
Publication year - 2016
Publication title -
orthodontics and craniofacial research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.664
H-Index - 55
eISSN - 1601-6343
pISSN - 1601-6335
DOI - 10.1111/ocr.12107
Subject(s) - delphi method , guideline , medicine , delphi , expert opinion , medline , systematic review , statement (logic) , multidisciplinary approach , dentistry , medical physics , computer science , intensive care medicine , pathology , social science , sociology , artificial intelligence , political science , law , operating system
Structured Abstract Objectives White spot lesions ( WSL s) 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 WSL s, 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 WSL s. 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 WSL s 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 WSL s before and during orthodontic treatment.