2025 Publication Highlights

• Publications Highlights

2025 was yet another very productive year for our network. We completed additional studies and have two more that will have completed data collection by the end of this calendar year. Recall that we have been funded continuously by NIH since 2005, in three consecutive seven-year funding cycles. By the end of this funding cycle in 2026, we will have completed 18 studies during the 2021-2026 funding period.

2025 has also been very productive with regard to publishing findings from our studies in peer-reviewed scientific journals. These publications demonstrate the National Dental PBRN’s commitment to addressing a very broad range of practical clinical issues – as well as yet another highly successful year! We highlight four articles from this year, but see here if you would like to access all 18.

Factors affecting root canal treatment case difficulty

This article is one of a series of 11 articles and manuscripts so far from the Network’s clinical study of root canal treatment called the “PREDICT” study.

What we learned:

Network dentists (general dentists and endodontists) encountered intra-operative complications in 16% of patients. They used a Case Difficulty Assessment Form (CDAF) developed by the American Association of Endodontists and found that it significantly predicted intra-operative complications (comprising length of obturation > 2 mm from radiographic apex or beyond apex; canals not negotiable within 2 mm of apex; instrument separation; inadvertent filing/file placement past root apex; and perforation).

What you might want to do:

Consider whether predictors from the CDAF match what happens in your practice and whether you should change when you decide to do a root canal yourself or instead refer it to an endodontist.

See an additional recent article from the PREDICT study — one focused on procedural differences between endodontists and general dentists. There are some substantial differences that you might find worth pondering whether you should begin using some of these techniques.

Overview of the National Dental PBRN and its impact on orthodontics

This article is probably the last in a series of seven articles from the Network’s “Adult Anterior Openbite” clinical study.  

What we learned:

This article reports on the impact of orthodontics articles that the Network has published.  Their overall mean citation ratio (a measure of the article’s impact on the field as judged by the number of times other researchers cite the article) was 2.62. This indicates that they were cited 2.62 times more often than other NIH-funded articles after adjusting for the size of the scientific field. One publication was cited above the 90^th percentile.

What you might want to do:

Encourage practitioners you know to enroll in the Network and participate in Network studies. We have objectively demonstrated that Network studies are nationally important and clinically impactful. Encourage them also to participate in other Network activities that keep practitioners up-to-date on the current state of clinical evidence and which keep them highly engaged in their profession in a meaningful and fun way.

Classification of bleeding severity

This article is the first from a planned series of three articles from the Network’s questionnaire study about treatment of patients on anticoagulants.

What we learned:

General dentists in the Network had strong agreement (low variability) for clinical scenarios that were classified as “severe bleeding” and lower agreement (higher variability) for “moderate bleeding”. Agreement was not significantly related to whether they had completed training in a General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD). Only a small percentage of general dentists had experience with “major bleeding” that may lead to hemodynamic emergency or referral to an emergency department.

Intending to foster better communication between dental professionals, and based on the results from this study, the authors propose a new tool to assess severity of oral bleeding. The new tool may standardize documentation and communication with other health care professionals.

What you might want to do

Consider the article’s suggestions when consulting with physicians about dental treatment that may cause bleeding. Also, stay tuned for the next two articles from this study, which have to do with how best to manage treatment on patients who are taking anticoagulants, such as warfarin (coumadin) and direct oral anti-coagulants. These are most commonly patients who have atrial fibrillation, heart valve surgery, history of knee or hip replacement, and others who are at risk for deep vein thrombosis or pulmonary embolism.

Substance use screening among adolescents

This was the first national study of dentists’ substance use disorders (SUDs) screening, counseling and referral practices among adolescent patients.

What we learned:

Fewer than half of dentists (41%) reported screening for adolescent nicotine/tobacco use at least annually, whereas approximately one-third reported screening at least annually for other substances of abuse. Approximately half who screen reported never providing counseling/education regarding adolescents’ positive screens for alcohol (49%), cannabis (53%), and illicit drug use (55%). Rates of referral to specialty care were low.

What you might want to do:

Although current rates are low, a substantial proportion of dentists indicated willingness to screen, counsel and refer adolescents for SUD and endorsed surprisingly low rates of stigma and high ratings of relevance to their practice. Consider whether you should start to do this in your practice – you could improve your patients’ lives as well as make dental care safer.