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Cochrane Oral Health Group eNewsletter | November 2013

Cochrane Oral Health Group

New title registrations for The Cochrane Library

After Cochrane Oral Health Group changed the policy on the registration of new systematic review titles in Spring 2013 (due to the necessary prioritisation of topic areas), new review proposals are now considered by a meeting of the Editorial Team twice a year (in October and April). A maximum of four titles per year will be registered at these meetings.

COHG‘s editorial board met in October to consider which new titles to register, after receipt of 28 new review proposal submissions over the last six months. As a result of the clinical discussions with Editors and advisors, three titles have now been registered by the Group.

The Editors identified these titles as priority topics, and agreed that they did not significantly overlap with any existing reviews:

- Interventions for the prevention of osteoradionecrosis of the jaws in patients receiving head and neck radiotherapy
This review will be led by Dr. Amir Azarpazhooh from the University of Toronto in Canada.

- Management of gag reflex for patients undergoing dental treatment
Dr. Prashanti Eachempati from Melaka-Manipal Medical College in Malaysia will lead this new review.

- Autologous platelet concentrates for regeneration of periodontal defects
This review will be a collaboration between authors based in Italy and India. Dr. Massimo Del Fabbro from Università degli Studi di Milano leads the team.

We look forward to publishing these protocols in the near future.

If you would like to submit a new title proposal for consideration at the next consideration meeting in April 2014, please follow the instructions on our website.

COHG welcomes two new Editors

We're delighted to welcome two new Editors on to Cochrane Oral Health Group's Editorial Board: Paul Brocklehurst and Giovanni Lodi.

Dr Brocklehurst is an NIHR Clinician Scientist and Honorary Specialist Registrar in dental public health in the School of Dentistry at The University of Manchester, and is an experienced Cochrane author on 9 titles, across COHG and the Cochrane Effective Practice and Organisation of Care Group also.

Dr Lodi is a specialist researcher in oral medicine in the Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche at the Università degli Studi di Milano, and is an experienced Cochrane author on 5 titles.

Congratulations to them both on their recent appointments.

Recent publications on The Cochrane Library

Cochrane Oral Health Group publishes its reviews, updates and protocols within The Cochrane Library.

In June 2013, The Cochrane Library moved from a monthly publication cycle for the Cochrane Database of Systematic Reviews (CDSR) to a Publish-When-Ready format.

In the past five months, since Publish-When-Ready was introduced, COHG has published: 4 new protocols, 4 new reviews, and 6 updated reviews.

The most recent issue of The Cochrane Library was Issue 10, released in October 2013. Within it, COHG published:
New reviews
- Orthodontic treatment for distalising upper first molars in children and adolescents
Jambi S, Thiruvenkatachari B, O'Brien KD, Walsh T.    
Updated reviews
- Antibiotics for the prophylaxis of bacterial endocarditis in dentistry     
Glenny A-M, Oliver R, Roberts GJ, Hooper L, Worthington HV.

In Issue 9, released in September 2013, COHG published:
New reviews
- Interventions for managing relapse of the lower front teeth after orthodontic treatment
Yu Y, Sun J, Lai W, Wu T, Koshy S, Shi Z.
Updated reviews
- Interventions for replacing missing teeth: dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla
Esposito M, Worthington HV.
- Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants
Esposito M, Worthington HV.
New protocols
- Xylitol-containing products for preventing dental caries in children and adolescents
Sharif MO, Ahmed F, Worthington HV.

In Issue 8, released in August 2013, COHG published:
New reviews
- Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia
Shi Z, Xie H, Wang P, Zhang Q, Wu Y, Chen E, et al.
(Also included as part of The Cochrane Library's Special Collection on Hospital-acquired infections)
New protocols
- Hypnosis for alleviation of anxiety in adults undergoing dental treatment
Potter C, Coulthard P, Brown R, Walsh T.

In Issue 7, released in July 2013, COHG published:
Updated reviews
- Fluoride varnishes for preventing dental caries in children and adolescents
(Additional products:Podcast; Cochrane Journal Club entry
Marinho VCC, Worthington HV, Walsh T, Clarkson JE.
- Interventions for the management of mandibular fractures
Nasser M, Pandis N, Fleming PS, Fedorowicz Z, Ellis E, Ali K.
- Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications
Esposito M, Grusovin MG, Worthington HV.

In Issue 6, released in June 2013, COHG published:
New reviews
- Interventions for the restorative care of amelogenesis imperfecta in children and adolescents
Dashash M, Yeung CA, Jamous I, Blinkhorn A.
New protocols
- Adjunctive surgical procedures for accelerating tooth movement in patients undergoing orthodontic treatment
Fleming PS, Pandis N, Johal A, El-Angbawi A, Fedorowicz Z.
- Topical herbal interventions for gingivitis
Leach MJ, Thoms L.

A full list of all published oral health review titles to date can be found here.


Assessing the quality of the body of evidence – Summary of Findings tables

An important part of the Cochrane systematic review process is assessing risk of bias of the included studies. Each study is typically assessed on six aspects (domains) which enable the review author to judge the internal validity of the study and answer the question: “Has this study been conducted and reported in such a way that I can be confident that the estimates of effect reported are true?

A Summary of Findings (SoF) table assesses the body of evidence (i.e. all the included studies making the same comparison and reporting the same outcome), and provides an indication of the generalisability of the findings of the review.

The body of evidence for each main finding of the review is graded as either, high, moderate, low or very low.  The body of evidence is downgraded by one step if review authors consider that there is a risk of bias, imprecision, inconsistency, indirectness or publication bias.

The footnotes under the SoF clearly describe the reason for downgrading; i.e. the review authors judgment of the reasons why the overall risk of bias, levels of imprecision, inconsistency, indirectness and/or possible publication bias in the body of evidence for each of the main outcomes is likely to influence the applicability of the estimate of effect.
  • For example, where the confidence intervals are wide, ranging from a possible harm to a possible benefit, the quality of the body of evidence should be downgraded.
  • Likewise, inconsistency (measured by substantial heterogeneity) within the body of evidence would result in further down grading of the quality of the body of evidence.
  • Indirectness is an indicator of whether the participants in the trials are likely to be similar to the people who will require the intervention in usual practice.
  • The effect of publication bias, if present, may be to reduce the magnitude of the benefit.
For further (free full text) reading on the appropriate preparation of SoF tables, please see:

International Oral Health Care Guideline Repository

As part of COHG's prioritisation of paediatric titles, discussions took place about the potential development of joint paediatric guidelines.

Subsequently, to support national guideline development and assist guideline developers to avoid duplication of effort, COHG established a guideline repository to include all guidelines (proposed and in development) covering issues related to oral health.

The International Oral Health Guideline Repository is located at: http://ohg.cochrane.org/international-oral-health-guideline-repository

We encourage you to notify the repository administrator of unlisted guidelines (currently in development) via email to cohg@manchester.ac.uk


Global Alliance contributors

The following organisations have generously provided funding for the Cochrane Oral Health Group Global Alliance to enable COHG to deliver important/priority reviews in a more timely manner by increasing methodological capacity at the editorial base:

We are immensely grateful to them for their contributions.
Cochrane OHG's blog
If you would like to send any comments, suggestions or a contribution, please contact the COHG Newsletter Editor.

The 2014 Cochrane UK & Ireland Annual Symposium will be held in Manchester on 23/24 April 2014, at the Renold Building on The University of Manchester's campus and close to Manchester Piccadilly station. The Symposium Gala Dinner will be held at Manchester Town Hall on the evening of 23 April.

The theme is of the Symposium is: "Cochrane Evidence: Useful, useable and used", and attendees will make use of the  #CE3U hashtag. So if you can't join us there, keep your eyes peeled on Twitter for updates and outcomes of the sessions.

Global Alliance AGM 2013

COHG held the second GA AGM on 25 July 2013, with representation from the following organisations:
  • British Society of Paediatric Dentistry (BSPD), UK
  • Canadian Dental Hygienists Association (CDHA), Canada
  • National Center for Dental Hygiene Research (NCDHR), USA
  • New York University College of Dentistry (NYUCD), USA
  • COHG Consumer Network
  • American Dental Association (ADA), USA
  • International Association for Dental Research (IADR), USA
The core outcome of the AGM was COHG's commitment to identify all titles considered clinical priorities by end of 2014, through similar expert panels (to the prioritisation exercises already undertaken within the orthodontic and paediatric specialties).

It was suggested that the next prioritisation should consider periodontal, oral surgery, oral medicine, or restorative titles.This process will identify a core portfolio of clinically important titles for COHG to maintain and schedule for regular updates. To read the minutes from the 2013 Global Alliance AGM, please click here.

20 years of  The Cochrane Collaboration
Throughout 2013, The Cochrane Collaboration is celebrating twenty years of its existence. To celebrate, a collaborative wall-hanging has been produced from submissions by Cochrane Review Groups, Fields and Networks from across the globe.

COHG submitted an appropriately oral health-related contribution which makes reference to the worker bee emblem adopted by Manchester (where COHG's editorial team is based) due to the city's industrial heritage.
COHG celebrates 20 years of The Cochrane Collaboration
COHG has had celebratory pieces published in Journal of Dental Research (JDR), American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), and in Public Service Review: UK Science and Technology.

Visit the anniversary site to find out more and watch the short video series, updated every fortnight.


Want to update your skills?
Cochrane Training

There are always plenty of Cochrane training opportunities being organised to take place around the world. To stay updated with what's happening, take a look at the workshop list. The Canadian Cochrane Centre also organizes online webinars that you can participate in or watch the recorded video of them.

Summary of Findings (SOF) table guidance has been developed by the Cochrane Applicability and Recommendation Methods Group (ARMG) and the GRADE working group. Besides the training material that you find on the Cochrane website on this topic, there are other training opportunities to learn about the SOF tables and how it fits into the GRADE system.


Get people talking about your Cochrane Review

The UK Cochrane Centre offers training and support to UK-based Cochrane Review Groups and Cochrane authors to help them use social media to promote their work and activities and be part of a global community discussing healthcare evidence.

Pick up some hints and tips about how you can share your research effectively online, or contact Sarah Chapman, Information Specialist at the UK Cochrane Centre for further information.


New translations available

Cochrane Summaries is a website which abridges Cochrane systematic reviews, giving key messages from the scientific evidence. The aim is to help people make the right healthcare choices for themselves and their families.

Translations in French and Spanish have been available on The Cochrane Library and on Cochrane Summaries for a while, and more recently Croatian and Portuguese have been added. More languages will be coming soon. Cochrane Summaries are now available in five languages. Follow the links to search in the language of your choice:

If you are interested in knowing more about translations or contributing yourself, please contact Juliane Ried, Project Officer at Cochrane Innovations


Have you signed the All Trials petition yet?

The Cochrane Collaboration is one of the supporters of the All Trials campaign, the aim of which is to get the results of all clinical trials (past and present) registered and published. Cochrane cannot produce accurate and rigorous systematic reviews unless the results of all trials are published and openly available.

The founder of the Cochrane Collaboration, Dr Iain Chalmers, comments: “[...] under-reporting of research has led to harm to patients from exaggerated estimates of treatment benefits and safety, and built-in inefficiency in efforts to discover useful and safer treatments.

Hundreds of organisations have now committed to the aim of getting all clinical trials registered and their results reported. Show your support today by signing the AllTrials petition.

Download the GA information pack here. Please contact Jo Leese for further information.


COHG receives NIHR support. Please click for further information
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