Evidence based medicine - MBD
Evidence based medicine is a form of medicine that aims to optimise the decision-making through the use of proofs from the researches. Modern medicine is based on science, but there is and a certain empirical component. MBD classify the proofs by their power by assessing their validity and their real applicability. Only the strongest of the evidences (coming from meta-analyzes, systematic reviews and randomized controlled trials) may lead to strong recommendations into practice.
MBD protects to the greatest possible extent that decisions should be based on a strong evidence, not only on the beliefs and personal experience of the practitioners.
Modern dentistry is constantly introducing newer and newer technologies and materials. Some will prove reliable, others will fail in years. Not every innovation will prove to be successful, but in the other hand we should not stop to develop and utilise the new methods. MBD allows us to make decisions which methods we can use safely and in the best interests of patients.
- The Lasers are a new and modern segment in the contemporary medicine, but in the terms of the specific treatment of the dental caries there is no evidence to show advantages over conventional treatment, our policy is to use lasers only when they definitely prove to be better or at least equal method for treating dental caries, although we are well aware about the great marketing force of using this modern method.
Best results occur when the minimally invasive approach and the MBD work in one direction. Sometimes, though rarely minimally invasive philosophy is not supported by MBD. Then we trust the evidence of the scientific approach (MBD).
- Although drilling the teeth for crowns can not be considered as a minimally invasive approach, MBD by several studies suggested that the teeth that are devitalised should be covered by crowns, because such teeth are fragile and could easily break.
Controlled studies show that devitalized teeth under the action of chewing forces break significantly more often when they are not protected by a crown.
In these cases, as a minimally invasive approach could be considered manufacturing of an ultrathin cad-cam zirconia crown which needs significantly less grinding, instead of drilling for metal-ceramic crown.