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Study Results

Conducted between 2012-2019

Funded by NIH grant U19-DE-022516.

Study PI: Dr. Greg Huang, University of Washington

Brief Study Description

Key study publications:

Huang G, Baltuck C, Funkhouser E, Wang HF, Todoki L, Finkleman S, Shapiro P, Khosravi R, Ko HC, Greenlee G, DeJesus-Vinas J, Vermette M, Larson M, Dolce C, Kau CH, Hamick D, National Dental PBRN Collaborative Group. The National Dental Practice-Based Research Network adult anterior openbite study: treatment recommendations and their association with patient and practitioner characteristicsAmerican Journal of Orthodontics & Dentofacial Orthopedics 2019; 156(3):312-325.

Choi KW, Ko HC, Todoki LS, Finkleman SA, Khosravi R, Wang HF, Funkhouser E, Baltuck C, Raj V, Allareddy V, Matunas JC, Vermette ME, Harrell WE Jr, Coro JC, Greenlee GM, Huang GJ, National Dental PBRN Collaborative Group. The National Dental PBRN adult anterior openbite study: a description of the practitioners and patientsAngle Orthodontist 2018; 88(6): 675-683.

Study protocol

Study data dictionary

Data set 1 (Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Data set 4 (Data set link is best downloaded through Internet Explorer)

Data set 5 (Data set link is best downloaded through Internet Explorer)

Data set 6 (Data set link is best downloaded through Internet Explorer)

Data set 7 (Data set link is best downloaded through Internet Explorer)

Data set 8 (Data set link is best downloaded through Internet Explorer)

Data set 9 (Data set link is best downloaded through Internet Explorer)

Listed below were the forms for the study:

Practitioner characteristics form

Practitioner’s enrollment visit form

Patient’s enrollment visit form

Patient contact form

Practitioner’s end of active treatment form

Patient’s end of active treatment form

Practitioner’s retainer use form

Patient’s retainer use form

Practitioner’s final visit form

Patient’s final visit form

Study PI: Dr. Tom Hilton, Oregon Health Sciences University

Brief Study Description

Key study publications:

Hilton TJ, Funkhouser E, Ferracane JL, Gilbert GH, Gordan VV, Bennett S, Bone J, Richardson PA, Malmstrom H, National Dental PBRN Collaborative Group. Symptom changes and crack progression in untreated cracked teeth: One-year findings from the National Dental Practice-Based Research NetworkJournal of Dentistry 2020; accepted.

Hilton TJ, Funkhouser E, Ferracane JL, Schultz-Robins M, Gordan VV, Bramblett BJ, Snead RM, Manning W, Remakel JR, National Dental PBRN Collaborative Group. Recommended treatment of cracked teeth: results from the National Dental PBRN. Journal of Prosthetic Dentistry 2020; 123(1): 71-78.

Ferracane JL, Funkhouser E, Hilton TJ, Gordan VV, Graves C, Giese KA, SHea W, Pihlstrom DJ, Gilbert GH, National Dental PBRN Collaborative Group. Observable characteristics coincident with internal cracks in teeth: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2018; 149(10):885-892.

Hilton TJ, Funkhouser E, Ferracane JL, Gordan VV, Huff KD, Barna J, Mungia R, Marker T, Gilbert GH, National Dental PBRN Collaborative Group. Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: findings from the National Dental Practice-Based Research NetworkJournal of Dentistry 2018; 70(1): 67-73.

Hilton TJ, Funkhouser E, Ferracane JL, Gilbert GH, Baltuck C, Benjamin PL, Louis D, Mungia R, Meyerowitz, National Dental PBRN Collaborative Group. Correlation between symptoms and external cracked tooth characteristics: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2017; 148(4):246-256.

Study protocol

Study data dictionary

Data set 1 (Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Abstracts of study results presented at the 2016 American Association for Dental Research meeting.

This was an observational study examining the natural history of posterior cracked teeth, in which initial screening, patient enrollment, informed consent, initial data collection, and treatment (if indicated) were completed at baseline. Subsequent annual recalls are completed and follow-up data recorded. Treatment on a study tooth was always documented.

At the initial baseline visit, the following forms were used: patient characteristicsbaseline: exam and treatment form, and reference worksheet.

For recall visits, the reference worksheet and appropriate (year 1, 2, 3) annual follow-up exam and treatment forms are completed.

For treatment accomplished other than at baseline or annual recalls, the treatment visit form was used.

If a patient will no longer participated in the study, a discontinuation form is filled out.

If a patient moved from the study practice, and was unwilling or unable to see a network dentist to continue data collection, a patient telephone interview guide and form was used to obtain information.

Appendix E for the subject retention plan

Study PI: Dr. Sonia Makhija, University of Alabama at Birmingham

Brief Study Description

Key study publications:

Makhija SK, Bader JD, Shugars DA, Litaker MS, Nagarkar S, Gordan VV, Rindal DB, Pihlstrom DJ, Mungia R, Meyerowitz C, Gilbert GH, National Dental PBRN Collaborative Group. Influence of 2 caries-detecting devices on clinical decision making and lesion depth for suspicious occlusal lesions: a randomized trial from the National Dental Practice-Based Research NetworkJournal of American Dental Association 2018; 149(4): 299-307.

Makhija SK, Robinson ME, Bader JD, Shugars DA, Litaker MS, Im HR, Rindal DB, Pihlstrom DJ, Meyerowitz C, Gordan VV, Buchberg M, Gilbert GH, National Dental PBRN Collaborative Group. Dentists’ decision strategies for suspicious occlusal caries lesions in a National Dental PBRN StudyJournal of Dentistry 2018; 69(2):83-87.

Makhija SK, Shugars DA, Gilbert GH, Litaker MS, Bader JD, Schaffer R, Gordan VV, Rindal DB, Pihlstrom DJ, Mungia R, Meyerowitz C, National Dental PBRN Collaborative Group. Surface characteristics and lesion status of suspicious occlusal carious lesions: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2017; 148(12):922-929.

Study protocol

Study data dictionary

Data set 1 (Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Data set 4 (Data set link is best downloaded through Internet Explorer)

Data set 5 (Data set link is best downloaded through Internet Explorer)

This study consisted of two phases: pre-intervention and intervention.

For the pre-intervention phase, the following forms were used: pre-study vignettesconsecutive eligible patient logpatient characteristics form, and dentist assessments form.

For the intervention phase, the following forms were used: consecutive eligible patient logpatient characteristics form, dentist assessments form for those assigned to a device and no device, and post-study vignettes for those assigned to the SpectraDIAGNOdent, and no device.

Abstracts of study results presented at the 2016 and 2017 American Association for Dental Research.

Summary of study results for the pre-intervention and intervention phases.

Appendix A

Study PI: Dr. Michael McCracken, University of Alabama at Birmingham

Brief Study Description

Key study publications:

Lawson NC, Litaker MS, Sowell E, Gordan VV, Mungia R, Ronzo KR, Lam BT, Gilbert GH, McCracken MS, National Dental PBRN Collaborative Group. Clinical acceptance of single-unit crowns and its association with impression and tissue displacement techniques: findings from the National Dental Practice-Based Research NetworkJournal of Prosthetic Dentistry 2020; in press.

McCracken MS, Litaker MS, Thomson AES, Slootsky A, Gilbert GH, National Dental PBRN Collaborative Group. Laboratory technician assessment of the quality of single-unit crown preparations and impressions as predictors of clinical acceptability of crowns as determined by the treating dentist: findings from the National Dental Practice-Based Research NetworkJournal of Prosthodontics 2020; 29(2):114-123.

Lawson NC, Litaker MS, Ferracane JL, Gordan VV, Atlas AM, Rios T, Gilbert GH, McCracken MS, National Dental PBRN Collaborative Group. Choice of cement for single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2019; 150(6):522-530.

McCracken MS, Litaker MS, Gordan VV, Karr T, Sowell E, Gilbert GH, National Dental PBRN Collaborative Group. Remake rates for single-unit crowns in clinical practice: findings from the National Dental Practice-Based Research NetworkJournal of Prosthodontics 2019; 28(2):122-130.

Study protocol

Study data dictionary

Data set 1 (Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Data set 4 (Data set link is best downloaded through Internet Explorer)

Data set 5 (Data set link is best downloaded through Internet Explorer)

The clinical study involved the following forms:

Enrollment/Baseline: consecutive eligible patient logpatient characteristics formcrown preparation form; and laboratory checklist

Final Study Visit: crown insertion form

The laboratory completed the laboratory questionnaire to evaluate technical aspects of the impression and preparation.

If a patient no longer participated in the study, a discontinuation form is completed.

Study PI: Dr. Michael McCracken, University of Alabama at Birmingham

Brief Study Description

Key study publications:

Minye HM, Gilbert GH, Litaker MS, Mungia R, Meyerowitz C, Louis D, Slootsky A, Gordan VV, McCracken MS, National Dental PBRN Collaborative Group. Preparation techniques used to make single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of Prosthodontics 2018; 27(9):813-820.

McCracken MS, Louis DR, Litaker MS, Minye HM, Oates T, Gordan VV, Marshall DG, Meyerowitz C, Gilbert GH, National Dental PBRN Collaborative Group. Impression techniques used for single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of Prosthodontics 2018; 27(8): 722-732.

McCracken MS, Litaker MS, George AJ, Durand S, Malekpour S, Marshall DG, Meyerowitz C, Carter L, Gordan VV, Gilbert GH, National Dental PBRN Collaborative Group. Impression evaluation and laboratory use for single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2017; 148(11):788-796.

Makhija SK, Lawson NC, Gilbert GH, Litaker MS, McClelland J, Louis DR, Gordan VV, Pihlstrom DJ, Meyerowitz C, Mungia R, McCracken M, National Dental PBRN Collaborative Group. Dentist material selection for single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of Dentistry 2016; 55:40-47.

McCracken MS, Louis DR, Litaker MS, Minye HM, Mungia R, Gordan VV, Marshall D, Gilbert GH, National Dental PBRN Collaborative Group. Treatment recommendations for single-unit crowns: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2016; 147(11):882-890.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

Stage 1 Full questionnaire

Supplemental table A1 includes the distribution of respondents’ likelihood of recommending a single-unit crown based on four scenarios in Figure 1 of the main manuscript, by dentist and practice characteristics.

Appendix Table 1A included the distribution of the responses to accept or reject an impression

Abstracts of study results presented at the American Association for Dental Research

Network enrollment questionnaire

Appendix Table 3 included the association of practitioner and practice characteristics with agreement on the practitioners’ top three treatment recommendations

Study PI: Dr. Gregg Gilbert, University of Alabama at Birmingham

Brief Study Description

Objectives:

The primary objective of the study was:

  • To quantify the self-reported use or non-use of rubber dams when performing RCT.

The secondary objective was:

  • To identify factors associated with use or non-use of rubber dams for RCT.

Key study publications:

Funkhouser E, Vellala K, Baltuck C, Cacciato R, Durand E, McEdward D, Sowell E, Theisen SE, Gilbert GH, National Dental PBRN Collaborative Group. Survey methods used to optimize response rate in the National Dental Practice-Based Research NetworkEvaluation and the Health Professions 2017; 40(3):332-358.2-358.

Eleazer PD, Gilbert GH, Funkhouser E, Reams GJ, Law AS, Benjamin PL, National Dental PBRN Collaborative Group. Techniques and materials used by general dentists during endodontic treatment procedures: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2016; 147(1):19-27.

Gilbert GH, Riley JL III, Eleazer PD, Benjamin PL, Funkhouser E, National Dental PBRN Collaborative Group. Discordance between presumed standard of care and actual clinical practice: the example rubber dam use during root canal treatment in the National Dental Practice-Based Research NetworkBMJ Open 2015; 5(12):e009779.

Lawson NC, Gilbert GH, Funkhouser E, Eleazer PD, Benjamin PL, Worley DC, National Dental PBRN Collaborative Group. General dentists’ use of isolation techniques during root canal treatment: from the National Dental Practice-Based Research NetworkJournal of Endodontics 2015; 41(8):1219-1225.

Study protocol

Study data dictionary

Data set (Data set is best downloaded through Internet Explorer)

View the full questionnaire.

Annotated version

Supplemental tables 1-6 include the distribution of the characteristics of eligible practitioners and their association with participation in the study; practitioners by tooth type for which they do root canal treatment; type and frequency of isolation method used; practitioner/practice characteristics by rubber dam use; stratified by frequency whether they perform root canal treatment on molars; as associations with using a rubber dam all the time.

Supplemental tables A1-A2 include frequency distribution for each attitude question item and a multivariable logistic regression of dentists’ attitudes about rubber dam use and whether or not they use a rubber dam 90% of the time or more often.

Supplemental table 3A includes logistic regressions of practitioner characteristics associated with use of endodontic methods characterized as ‘inappropriate’ by the endodontist authors.

View a pdf version of the National Dental PBRN Enrollment Questionnaire.

Study PI: Dr. Thankam Thyvalikakath, Indiana University

Key study publication:

Thyvalikakath T, Duncan W, Siddiqui Z, Michelle L, Eckert G, Schleyer T, Rindal D, Jurkovich M, Shea T, Gilbert G, National Dental PBRN Collaborative Group. Leveraging electronic dental record data for clinical research in the National Dental PBRN practices. Applied Clinical Informatics 2020; accepted.

Study protocol

Study data dictionary

Data set [this data set is too large to store on this web site.  If you would like access, please email Gregg Gilbert at ghg@uab.edu]

As part of the recruitment process, practitioners were provided  background information and a FAQ page.

Study PI: Dr. Dorota Kopycka-Kedzierawski, University of Rochester

Brief Study Description

Key study publications:

Kopycka-Kedzierawski DT, Cacciato R, Hennessey R, Meyerowitz C, Litaker MS, Heft MW, Johnson KS, Reyes SC, Johnson JD, Baltuck CT, Gilbert GH, National Dental PBRN Collaborative Group. Electronic and paper mode of data capture when assessing patient-reported outcomes in the National Dental Practice-Based Research NetworkJournal of Investigative and Clinical Dentistry 2019; 10(4): e12427.

Heft MW, Litaker MS, Kopycka-Kedzierawski DT, Meyerowitz C, Chonowski S, Yardic RL, Gordan VV, Mungia R, Gilbert GH, National Dental PBRN Collaborative Group. Patient-centered dentinal hypersensitivity treatment outcomes: results from the National Dental PBRNJDR Clinical & Translational Research 2018; 3(1):76-82.

Kopycka-Kedzierawski DT, Meyerowitz C , Litaker MS, Heft MW, Tasgaonkar N, Day MR, Porter-Williams A, Gordan VV, Yardic RL, Lawhorn TM,  Gilbert GH, National Dental PBRN Collaborative Group. Management of dentin hypersensitivity by practitioners in the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2017; 148(10):728-736.

Kopycka-Kedzierawski DT, Meyerowitz C, Litaker MS, Chonowski S, Heft MW, Gordan VV, Yardic RL, Madden TE, Reyes SC, Gilbert GH, National Dental PBRN Collaborative Group.  Management of dentin hypersensitivity by National Dental PBRN practitioners: results from a questionnaire administered prior to initiation of a clinical study on this topicBMC Oral Health 2017; 17(1):41.

Study protocol

Study data dictionary

Data set 1(Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Data set 4 (Data set link is best downloaded through Internet Explorer)

Appendix Table 1 showing the association of practitioner and patient characteristics with agreement on the practitioners’ top three treatment recommendations.

Abstract of study results presented at the American and International Association for Dental Research meetings.

Region-specific study results for the baseline and follow-up phases.

The primary aims of this study were to ascertain practitioners’ preferred methods of diagnosing and treating dentin hypersensitivity by completing a practitioner online questionnaire upon study enrollment.

To characterize diagnosis and treatment of dentin hypersensitivity in the practice setting, the following forms were used at baseline:

Patient eligibility checklist

Patient contact form

Baseline exam form

Patient demographic form

Patient history form

Patient pain assessment baseline (1st line of treatment)

Forms were used at 1 week, 4 weeks, and 8 weeks.

1 week

Patient pain assessment (1st line of treatment);Patient pain assessment (2nd line of treatment);Patient pain assessment (3rd line of treatment)

4 weeks

Patient pain assessment (1st line of treatment);Patient pain assessment (2nd line of treatment);Patient pain assessment (3rd line of treatment)

8 weeks

Patient pain assessment (1st line of treatment);Patient pain assessment (2nd line of treatment);Patient pain assessment (3rd line of treatment)

Other forms used include the following:

Symptomatic exam form (2nd line treatment)

Symptomatic exam form (3rd line treatment)

-Patient pain assessment (2nd line treatment)

-Patient pain assessment (3rd line treatment)

Appendix Table 3 includes the association of practitioner and practice characteristics with agreement on the practitioners’ top three treatment recommendations

Study PI: Dr. Eric Schiffman, University of Minnesota

Brief Study Description

Key study publications [none yet]

Study protocol

Study data dictionary [not available until the main findings from the study have been accepted for publication]

Data set [not available until the main findings from the study have been accepted for publication]

Prior to beginning the study, doctors completed a doctor demographics form. At baseline, the patient completed a demographic formcontact form and a baseline questionnaire. The doctor completed a doctor initial questionnaire.

The patient completed follow-up questionnaires at 1-month,  3-months and 6-months. The doctor also completed a follow-up questionnaire at 6-months.

Study PI: Dr. Jeffrey Fellows, Kaiser Permanente Center for Health Research

Brief Study Description

Key study publications [none yet]

Study protocol

Study data dictionary [not available until the main findings from the study have been accepted for publication]

Data set [not available until the main findings from the study have been accepted for publication]

At the baseline enrollment visit, patients completed tablet-based enrollmentcontact information, and two surveys (before and after treatment) at the baseline enrollment visit.

Patient-reported follow-up data were collected by web-based or phone survey at 1 week6 months, and 12 months following the RCT completion visit date.

Practitioners completed web-based weekly recruitment logs during the recruitment period, a before treatment survey at the enrollment visit, an after RCT completion survey on the obturation date (some patients required multiple visits), and uploaded pre- and post-RCT radiographs to a study site.

Practitioners completed a 12-month survey and radiograph upload during a patient recal visit approximately one year after the RCT completion visit.

Study PI: Dr. Peter Lockhart, Charlotte Medical Center

Brief Study Description

Key study publications [none yet]

Study protocol

Study data dictionary [not available until the main findings from the study have been accepted for publication]

Data set [not available until the main findings from the study have been accepted for publication]

Participants completed a questionnaire about their AP use.

Participating dentists also completed the network’s Enrollment Questionnaire.

Study PI: Dr. Jamie Studts, University of Kentucky

Brief Study Description

Key study publication:

Stoops WW, Johnson MF, Strickland JC, Knudsen HK, Gilbert GH, Massingale SD, Ray MN, Studts CR, Atchley L, Reynolds G, Studts JL, National Dental PBRN Collaborative Group. Feasibility of collecting saliva for biological verification of tobacco use status in dental practices and patients’ homes: results from the National Dental PBRNCommunity Dental Health 2019; 36(3):187-189.

This study received primary funding by R44-DE-021327.  Consequently, the responsibility for public access to data from this study lies with that grant.

SBIR Website

ClincalTrials.gov website

NIHreporter

Study PI: Dr. Julia Melkers, Georgia Technical University

Brief Study Description

Key study publications:

Hicks D, Melkers J, Isett KR. A characterization of professional media and its links to research. Scientometrics 2019; 119(2):827-843.

Melkers J, Hicks D, Isett KR, Kopycka-Kedzierawski DT, Gilbert GH, Rosenblum S, Burton V, Mungia R, Melkers MJ, Ford G, National Dental PBRN Collaborative Group. Preferences for peer-reviewed versus other publication sources: a survey of general dentists in the National Dental PBRNImplementation Science 2019; 14(1):19.

Isett KR, Rosenblum S, Barna J, Hicks D, Fellows JL, Cochran D, Wiedner H, Gordan VV, Gilbert GH, Melkers J, National Dental PBRN Collaborative Group. Missed opportunities for detecting alternative nicotine product use in youth: data from the National Dental PBRNJournal of Adolescent Health 2018; 63(5): 587-593.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

Study Questionnaire

Network Enrollment Questionnaire

Study PI: Dr. Jenna McCauley, Medical University of South Carolina

Brief Study Description

Key study publications:

McCauley JL, Nelson JD, Gilbert GH, Gordan VV, Durand SH, Mungia R, Meyerowitz C], Leite RS, Fillingim RB, Brady KT, National Dental PBRN Collaborative Group. Prescription drug abuse among patients in rural dental practices reported by members of the National Dental PBRNJournal of Rural Health 2020; 36(2):145-151.

McCauley JL, Gilbert GH, Cochran D, Gordan VV, Leite RS, Fillingim RB, Brady KT, National Dental PBRN Collaborative Group. Prescription drug monitoring program use: National Dental PBRN resultsJDR Clinical & Translational Research 2019; 4(2):178-186.

McCauley JL, Reyes S, Meyerowitz C, Gordan VV, Rindal DB, Gilbert GH, Leite RS, Fillingim RB, Brady KT, National Dental PBRN Collaborative Group. Training experiences regarding pain management, addiction, and drug diversion of dentists enrolled in the National Dental Practice Based Research NetworkSubstance Abuse 2019; 4:1-6.

McCauley JL, Leite RS, Gordan VV, Fillingim RB, Gilbert GH, Meyerowitz C, Cochran D, Rindal DB, Brady KT, National Dental PBRN Collaborative Group. Opioid prescribing and risk mitigation implementation in the management of acute pain: results from the National Dental PBRNJournal of the American Dental Association 2018; 149(5): 353-362.

Study protocol

Study data dictionary

Data set (Data set link is best viewed in Internet Explorer)

Questionnaire

Network Enrollment Questionnaire

Study PI: Dr. Maura Gillison, The Ohio State University

Brief Study Description

Key study publication:

Rindal DB, Gilbert GH, Carcelen C, Funkhouser E, Durand E, Uppgaard DA, Fellows JL, Ikeda J, Kerr AR, Brar B, Gordan VV, Agarwal S, Barnett P, Pickard RK, Gillison M, National Dental PBRN Collaborative Group. Feasibility and acceptance of oral HPV detection in the dental office: results from the National Dental PBRNJournal of the American Dental Association 2019; 150(2):130-139.

Study protocol

Study data dictionary

Data set-patients (Data set link is best downloaded through Internet Explorer)

Data set-practitioners (Data set link is best downloaded through Internet Explorer)

Study PI: Dr. Elizabeth Shenkman, University of Florida

Brief Study Description

Key study publications [none yet]

Study protocol

Study data dictionary [not available until the main findings from the study have been accepted for publication]

See here for the data collection forms used in this study.

Participating dentists and hygienists also completed the network’s Enrollment Questionnaire.

Study PI: Dr. Walter Psoter, University of Rochester

Brief Study Description

Key study publication:

Psoter WJ, Morse DE, Kerr AR, Tomar SL, Aguilar ML, Harris DR, Stone LH, Makhija SK, Kaste LM, Strumwasser B, Pihlstrom DJ, Masterson EE, Meyerowitz C, National Dental PBRN Collaborative Group. Oral cancer examinations and lesion discovery as reported by U.S. general dentists: findings from the National Dental Practice-Based Research NetworkPreventive Medicine 2019; 124:117-123.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Inernet Explorer)

This study consisted of 2 components:

1) a questionnaire survey

2) a clinical case-vignette presentation questionnaire

Conducted between 2005-2012

Funded by NIH grants U01-DE-16746 and U01-DE-16747.

Study PI: Dr. Valeria Gordan, University of Florida

The purpose of this project was to identify methods that DPBRN dentists used to diagnose and treat caries lesions. The aims of this study were to: (a) quantify the percentages of DPBRN dentists who report using selected methods for caries diagnosis; (b) quantify the percentage of DPBRN dentists who report using a caries-risk assessment protocol of any variety; (c) quantify the percentages of DPBRN dentists who report intervening surgically at caries stages E1, E2, D1, D2, or D3. The aims were met by enrolling more than 500 DPBRN practitioner-investigators, each of whom completed a 10-page questionnaire about caries diagnosis and treatment assessment. Findings from this study were compared to treatment that was actually delivered as determined in DPBRN studies of primary and replacement restorations.

Key study publications:

Riley JL III, Rindal DB, Fellows JL, Gilbert GH, Ajmo CT, Amundson C, Anderson GA, Gordan VV for The DPBRN Collaborative Group. Preferences for caries prevention agents in adult patients: findings from The Dental PBRNCommunity Dentistry and Oral Epidemiology 2010; 38(4): 360-370.

Riley III JL, Gordan VV, Rindal DB, Fellows JL, Williams OD, Ritchie LK Jr, Gilbert GH for The DPBRN Collaborative Group. General practitioners’ use of caries-preventive agents in adult patients versus pediatric patients: findings from The Dental Practice-Based Research NetworkJournal of the American Dental Association 2010; 141(6): 679-687.

Gordan VV, Bader JD, Garvan CW, Richman JS, Qvist V, Fellows JL, Rindal DB, Gilbert GH for The DPBRN Collaborative Group. Restorative treatment thresholds for occlusal primary caries by dentists in The Dental PBRNJournal of the American Dental Association 2010; 141(2):171-184.

Gordan VV, Garvan CW, Richman JS, Fellows JL, Rindal DB, Qvist V, Heft MW, Williams OD, Gilbert GH for The DPBRN Collaborative Group. How dentists diagnose and treat defective restorations: evidence from The Dental PBRNOperative Dentistry 2009; 34(6): 664-673.

Study Protocol

Study data dictionary

Data set (The data set is best downloaded through Internet Explorer)

Annotated version

View the questionnaire

View an article from the May 2012 issue of Dr. Biscupid

Study PI: Dr. Andrei Barasch, University of Alabama at Birmingham

The incidence of diabetes mellitus has been increasing at epidemic proportions, making this chronic disease the most common medical condition in dental patients. Hyperglycemia has been identified as a potential risk factor for periodontal disease, disease infection, and poor response to treatment. Additionally, an estimated 4% of Americans are undiagnosed diabetics, and more than 80% of the diagnosed patients are not well-controlled. Early diagnosis and intervention have been shown to improve outcomes and reduce morbid medical complications in diabetic patients. Thus, identifying hyperglycemia in dental practice could lead to significant improvement in both the dental and medical outcomes.

This study investigated the prevalence of hyperglycemia in dental patients of DPBRN practitioner-investigators. The global aim of this study was to determine the feasibility of blood sugar testing and diabetes screening in dental practice. The specific aims of this study were to quantify the: 1) percentage of DPBRN patients who meet the American Diabetes Association screening criteria and describe the characteristics of these patients; and 2) acceptability of conducting blood sugar testing in the dental office and barriers to regular screening, as reported by DPBRN patients and practices.

*the terms ‘blood sugar’ , ‘blood glucose’, and ‘hyperglycemia’ are related and interchangeable in some contexts. DPBRN adopted the term ‘blood sugar’ for the title of this study to tailor its communication to a lay, non-dental, non-medical audience. This helps facilitate explaining the study to dental patients.

Key study publications:

Barasch A, Gilbert GH, Spurlock N, Funkhouser EM, Persson LL, Safford MM; DPBRN Collaborative Group. Random plasma glucose values measured in community dental practice: findings from The Dental Practice-Based Research NetworkClinical Oral Investigations 2013;17(5):1383-1388.

Barasch A, Safford MM, Palmore R, Gesko D, Gilbert GH for The DPBRN Collaborative Group. Random blood glucose testing in dental practice: a community-based feasibility study from The Dental Practice-Based Research NetworkJournal of the American Dental Association2012; 143(3):262-269.

Study Protocol

Study data dictionary

Annotated dentist survey

Annotated end of survey dentist form

Annotated patient survey

Annotated screening form

Data set-dentist (The data set link is best downloaded through Internet Explorer)

Data set-patient (The data set link is best downloaded through Internet Explorer)

Data set-screening (The data set link is best downloaded through Internet Explorer)

This study used several data forms. The first one was the “Screening and Testing” form, which provided patient information and risk for diabetes mellitus.

If the patient qualified and agreed, this form also collected the glucose test result. Another form was a questionnaire answered by the patient.

Participants received a Physician Referral Letter and an information brochure about diabetes from the American Diabetes Association.

We also used a questionnaire completed by the practice’s dentist and staff ; it provided insights regarding the feasibility of and possible barriers to glucose testing in dental practice. Each Regional Coordinator also conducted an end-of-study interview of the participating practitioners. Finally, we used a “Consecutive Patient Log” and a “Master Participant List”.

Detailed report, overall and by region

Graphical presentation of study findings, overall and by region

Study PI: Dr. Andrei Barasch, University of Alabama at Birmingham

Osteonecrosis of the jaws (ONJ) is a potentially morbid and costly oral condition. In the recent past more than 200 cases of ONJ have been described in patients treated with bisphosphonates (BPs) for osseous cancer lesions or osteoporosis. The number of BP prescriptions has been steadily increasing, creating concerns about this potential side effect. The causes and risk factors for ONJ are not known. In this study we investigated these issues making use of the research infrastructure from the three dental practice-based research networks (PBRNs) funded by NIDCR.

The specific aims of this study were to test the hypotheses that: (1) BP treatment is a risk factor for ONJ; and (2) dental diseases, particularly periodontal disease and invasive dental procedures such as dental extractions are true risk factors for ONJ, or whether these procedures are a consequence of the necrotic disease process. This study quantified the impact that BP exposure had on the risk of developing ONJ, relative to comparable control patients, using a case-control study design. The risk factors studied included BPs, dental risk factors, and other factors, such as radiation and steroid therapy. All the patients with ONJ identified from the PBRNs were recruited for the study. Cases were identified by a dentist in the PBRN and were diagnosed by the dentist or a specialist as having ONJ with an onset between January 2005 and January 2007. Each case had three controls from the practice that identified the case. The dentist summarized the relevant dental treatment history and provided a dental disease diagnosis history from January 2000 until diagnosis of ONJ for cases, and until recruitment for controls. A professional centralized interviewer within each PBRN administered the same standardized questionnaire to cases and controls over the telephone.

Relevance to public health: This study was a unique and timely opportunity to investigate risk factors for ONJ, results from which may have a substantial impact on dental health and oral-related quality of life in an increasing number of patients.

Key study publications:

Barasch A, Cunha-Cruz J, Curro FA, DeRouen T, Gilbert GH, Hujoel P, Safford MM, Vena DA, Voinea-Griffin AE, Wu H for the CONDOR Collaborative Group. Dental risk factors for osteonecrosis of the jaws: a CONDOR case-control studyClinical Oral Investigations 2013; 17(8): 1839-1845.

Barasch A, Cunha-Cruz J, Curro FA, Hujoel P, Sung AH, Vena D, Voinea-Griffin AE for the CONDOR Collaborative Group. Risk factors for osteonecrosis of the jaws: case-control study from the CONDOR Dental PBRNJournal of Dental Research 2011; 90(4):439-444.

Study Protocol

Study data dictionary

Data set-history (The data set link is best downloaded through Internet Explorer)

Data set-MDs (The data set link is best downloaded though Internet Explorer)

Main dental history form

Annotated form for MDs

Annotated history form

Patient interview questionnaire

Study PI: Dr. Thomas Houston, University of Alabama at Birmingham

This was an internet-based clinical trial of oral cancer prevention. Eligibility required having internet access in the dental practice. The project was directed at prevention of oral cancer in dentistry by offering internet education and tools for the practice and support for all members of the practice. The project was not very time consuming, did not require training beforehand, and enhanced preventive care and risk management in the practice. To participate, you must have: (a) completed a series of internet continuing education modules; (b) encouraged your staff to support the project by also completing the modules; (c) designated a staff member to distribute 100 postcard surveys to patients at four different times for total of 400 postcards; (d) used the educational tools to enhance the preventive care in your practice. In addition to other benefits, the practice was paid an honorarium for its participation. Due to the success of the recruitment of this study, we increased the number of participants from 140 to 190. The goal of 190 practitioners was met. Any information that was provided is confidential and only reported in the aggregate. This project was funded by an R01 grant from NIDA and NIDCR (R01-DA-17971).

Key study publications:

Houston TK, DeLaughter KL, Ray MN, Gilbert GH, Allison JJ, Kiefe CI, Volkman JE for the National Dental PBRN Collaborative Group. Cluster-randomized trial of a web-assisted tobacco quality improvement intervention of subsequent patient tobacco product use: A national dental PBRN studyBMC Oral Health 2013; 13(1):13.

This study received primary funding by R01-DA-017971.  Consequently, the responsibility for public access to data from this study lies with that grant.

Several instruments were used for data collection in this study. Initially, the patients at each dental practice were queried about whether the dentist asked or advised about tobacco use, the patient’s smoking status and willingness to participate in a telephone interview.

Each dental practice completed a baseline survey about the demographics and characteristics of its practice.

After participating in the web intervention directed at increasing tobacco control practices in dentistry, the practices were re-assessed.

At the end of the study, patients who agreed to participate were contacted about the status of their tobacco use and attempts to quit.

Dental practices completed a final survey that assessed how their dental practice changed tobacco cessation practices.

Study PI: Dr. Andreea Voinea-Griffin, University of Alabama at Birmingham (deceased)

There is great variation in caries diagnosis and management, with many dentists choosing a surgical approach rather than non-invasive treatment methods (“watchful monitoring” combined with prevention) for early caries. Approaches that delay placement of the first restoration may be a key source of improving the long-term effectiveness of dental care. This project focused on improving the quality of dental care by fostering movement of the latest scientific advances into daily clinical practice in the area of early caries treatment.

The aims of this project were to: (1) develop a patient handout to encourage patient acceptance of non-invasive treatment for early caries in permanent teeth and to increase dentists” use of non-invasive treatment; (2) quantify patient satisfaction with treatment options for early caries to quantify patient acceptance; and (3) quantify pre- and post-intervention caries stage at which dentists place the first restoration to determine the feasibility of the intervention.

This project entailed instrument development as well as a feasibility study that informed the design of a subsequent clinical trial in dental private practices. Semi-structured qualitative interviews with 30 patients and 10 dentists were conducted to develop the patient handout. Specific factors from pre-existing patient satisfaction surveys were used as quantitative tools. The handout was tested for readability and content structure. The study design was factorial, with patient satisfaction and handout assessment data from 300 surveyed patients diagnosed with early caries by participating dentists. The feasibility study design was longitudinal with pre- and post-intervention caries stage data from each participating DPBRN dentist collected from the practice assessment questionnaires. The 10 practitioners were recruited to participate in the study, based on their early caries treatment pattern and a stratified convenience sampling scheme that encouraged representation of minority dentists and patients.

Key study publications:

Mitchell ST, Funkhouser E, Gordan VV, Riley JL III, Makhija SK, Litaker MS, Gilbert GH, National Dental PBRN Collaborative Group. Satisfaction with dental care among patients who receive invasive or non-invasive treatment for non-cavitated early dental caries: findings from one region of the National Dental Practice-Based Research NetworkBMC Oral Health 2017; 17(1):70.

This study was primarily funded by F32-DE-18592.  Because of the small number of practitioners and patients in this study and the fact that they were all from a limited geographic area, it is not possible to provide a de-identified data set that does not risk being identifiable.  Therefore, no public use data set is available.

In Phase I, practitioners were interviewed about their opinions on non-invasive caries treatment and patients’ preferences by using an interview script .

Non-invasive treatment patients were offered the opportunity to provide feedback during a telephone interview.

Based on information collected from patients and providers in Phase I, we designed a patient education brochure and “patient satisfaction with treatment for early caries” survey in Phase II. These two forms were handed to the patients who participated in the Phase III study.

Each practitioner kept track of how many patients received non-invasive treatment for early caries during the data collection period, along with how many of these agreed to participate in the study.

Before the final data collection in Phase III, practitioners participated in an individual training session.

For each patient, practitioners completed a data collection form and a caries risk assessment form.

Study PI: Dr. Donald Nixdorf, University of Minnesota

This was a nested case-control study in which DPBRN Study 17 patients who still had pain at 6 months and were seen by endodontic and orofacial pain experts. The primary goal of this study was to determine the proportion of patients with pain who would best be managed with traditional dental care compared to those who had a non-odontogenic source for their pain, so that treatment directed at the etiology of their pain would occur.

Key study publications:

Daline IH, Nixdorf DR, Law AS, Pileggi R, McEdward D, Massingale S, Sowell E, National Dental PBRN Collaborative Group. 3-year outcome of patients with persistent pain after root canal treatment: the National Dental Practice-Based Research NetworkJournal of Endodontics 2020; accepted.

Nixdorf DR, Law AS, Lindquist K, Reams GJ, Cole E, Kanter K, Nguyen RHN, Harris DR, National Dental PBRN Collaborative Group. Frequency, impact and predictors of persistent pain following root canal treatment: a National Dental PBRN studyPain 2016; 157(1):159-165.

Nixdorf DR, Law AL, John MT, Sobieh RM, Kohli R, Nguyen RH, National Dental PBRN Collaborative Group. Differential diagnoses for persistent pain after root canal treatment: a study in the National Dental Practice-Based Research NetworkJournal of Endodontics 2015; 41(4):457-463.

Study protocol

Study Data dictionary

Data set (The data set link is best downloaded through Internet Explorer. The data set contains both the baseline and follow-up studies)

Questionnaires completed by the patients.

Forms completed by the practitioner.

Study PI: Dr. Thomas Houston, University of Alabama at Birmingham

Dental practices have advanced tobacco cessation by adopting a model of brief advice similar to that used by medical providers. DPBRN will do a randomized clinical trial designed to allow dental hygienists to provide additional tobacco cessation counseling with little additional marginal effort. This would be done using an internet-based referral to external resources. This system, termed “Refer2Quit”, will allow hygienists to refer patients to a patient education website and accompanying Quitline, while the patient is still in the dental office. Our overall goal is to advance science related to internet use in health services delivery by targeting dental hygienists. The intervention will also support subsequent brief counseling by providing feedback on the activities of patients to the practice through a secure server.

We had these specific aims:

  1. Test the hypothesis that the proportion of patients REFERRED to self-management resource websites would be larger in intervention practices compared to control practices.
  2. To test the hypothesis that the proportion of patients referred who GO to the patient self-management website would be larger in intervention practices compared to control practices.
  3. To test the hypothesis that the proportion of smokers who are referred who QUIT at six months would be larger among intervention compared to control because of the additional connectivity of the intervention.

This was done by randomizing 80 community-based dental practices into a clinical trial that contrasts the intervention with a paper-based “information prescription”.

Key study publication:

Ray MN, Funkhouser E, Williams JH, Sadasivam RS, Gilbert GH, Coley HL, Houston TK for the National Dental PBRN Collaborative Group. Smoking cessation e-referrals: a National Dental Practice-Based Research Network randomized controlled trial. American Journal of Preventive Medicine 2014; 46(2):158-165.

Study protocol

Study data dictionary

Data set 1 (Data set link is best downloaded through Internet Explorer)

Data set 2 (Data set link is best downloaded through Internet Explorer)

Data set 3 (Data set link is best downloaded through Internet Explorer)

Data set 4 (Data set link is best downloaded through Internet Explorer)

Data set 5 (Data set link is best downloaded through Internet Explorer)

To determine study eligibility practices returned the interest survey.

Annotated version of interest survey

Each dental practice completed a baseline survey on the demographics and characteristics of its practice.

After randomization, providers completed a qualitative survey and an online survey.

Annotated version of online survey

Patients who were referred and logged-on to the patient intervention site completed an online survey.

Annotated version of patient online survey

The dental practices completed a final survey to reassess their tobacco control practices and the patients completed a follow-up survey to assess their smoking status six months after registering on the quit smoking website.

Annotated version of final survey

Annotated version of follow-up survey

Study PI: Dr. Gregg Gilbert, University of Alabama at Birmingham

The overarching goal of DPBRN is to impact the practice of dentistry and improve patient care. A critical issue is assessing whether the research conducted is achieving this goal. The three NIDCR-funded PBRNs (DPBRN, NWPRECEDENT, and PEARL), collectively known as the “Collaboration on Networked Dental and Oral Health Research” (CONDOR), have developed a strategy for assessing the impact of practice-based dental research on the PBRN practices and on the practice of dentistry in general. The strategy involves the development and use of a core questionnaire that includes several questions from each PBRN that have been extracted from questionnaires previously administered as part of their initial research program activities.

This project comprised the first administration of this Core Questionnaire with the purpose of assessing dental practice changes that may have occurred since the earlier administration of the individual questions within the separate networks. It also collected baseline information for the others. The Core Questionnaire were re-administered at later points in time. In this manner changes in practice over time and concurrent with research results dissemination were measured.

Key study publications:

McBride R, Lindblad A, Williams OD, Leroux B, Lemann M, Rindal DB, Botello-Harbaum M, Gilbert GH, Gillette J, Demko C for the CONDOR Collaborative Group. Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research, CONDOR. Journal of Dentistry 2013; 41(5):393-403.

Botello-Harbaum MT, Curro FA, Rindal DB, Gilbert GH, Hilton TJ, Collie D, Craig RG, Lehman M, McBride R, Vena DA, Thompson V, Lindblad A for the CONDOR Collaborative Group. Information-seeking behaviors of dental practitioners in three practice-based research networksJournal of Dental Education 2013; 77(2):152-160.

Study Protocol

Study data dictionary

Annotated form

Data set (Data set link is best downloaded through Internet Explorer)

View the questionnaire.

Detailed report, overall and by region.

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Gregg Gilbert, University of Alabama at Birmingham

The purpose of this study was to update the status of practices in the network with regard to these items: practice type (solo, group, public health, academic, other); percent of patients who are regular care seekers versus problem-oriented; whether the practice shares facilities or organizational structure with medical providers; percent of patients with certain chronic diseases; how commonly patients are referred to physicians for medical evaluations; electronic dental record usage and type of software; preferences for how to have study results communicated; rubber dam usage for endodontic procedures; utilization of dental staff for specific dental procedures; opinions about dental therapists and other expanded-function dental staff.

Key study publications:

Funkhouser E, Fellows JL, Gordan VV, Rindal DB, Foy PJ, Gilbert GH for the National Dental PBRN Collaborative Group. Supplementing online surveys with a mailed option to reduce bias and improve response rate: the National Dental PBRNJournal of Public Health Dentistry 2014; 74(4):276-282.

Anabtawi MF, Gilbert GH, Bauer MR, Reams G, Makhija SK, Benjamin PL, Williams OD for the National Dental PBRN Collaborative Group. Rubber dam use during root canal treatment: findings from The Dental Practice-Based Research NetworkJournal of the American Dental Association 2013; 144(2):179-186.

Blue CM, Funkhouser DE, Riggs S, Rindal DB, Worley D, Pihlstrom DJ, Benjamin PL, Gilbert GH for the National Dental PBRN Collaborative Group. Utilization of non-dentist providers and attitudes toward new provider models: findings from the National Dental Practice-Based Research NetworkJournal of Public Health Dentistry 2013; 73(3):237-244.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

View the questionnaire.

Annotated version of the questionnaire

Detailed report, overall and by region.

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Valeria Gordan, University of Florida

The purpose of this project was to use data from “primary” restorations to assess how defects that may lead to failure develop over time, and to follow restorations placed in a practice-based setting for up to three years. The specific aims were to:

  1. quantify the annual and 3-year incidence of defects and replacement rates on restorations inserted as primary restorations;
  2. test the hypothesis that directly-placed composite restorations have a significantly higher 3-year incidence of defects and significantly higher replacement rate after 3 years compared to amalgam restorations;
  3. test the hypothesis that the 3-year replacement rate of restorations in permanent teeth of adolescents is significantly higher than that of restorations in adults. Criteria used to evaluate restorations over time will be the same as those employed in the DPBRN study of replacement restorations. Recall frequency was according to the schedule used in the practice where the restoration was placed. Patients were informed about the follow-up study as part of the informed consent procedure. If a patient sought treatment in a different practice, informed consent included permission to contact that practice for information related to restoration(s) in this longitudinal study.

Key study publications:

McCracken MS, Gordan VV, Litaker MS, Funkhouser E, Fellows JL, Shamp DG, Qvist V, Meral J, Gilbert GH for the National Dental PBRN Collaborative Group. A 24-month evaluation of amalgam and resin-based composite restorations: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2013; 144(6): 583-593.

Study Protocol

Data Dictionary

Data set (The data set link is best downloaded through Internet Explorer)

Main data collection form

Annotated data form for year 1

Annotated form for year 2

Annotated form for year 3

Detailed report, overall and by region

Graphical presentation of study findings, also overall and by region

Study PI: Dr. Sonia Makhija, University of Alabama at Birmingham

Although the progression of cavitated dental caries has slowed dramatically over the years, the prevalence of precavitated lesions has significantly increased; therefore, diagnosing and following these lesions has become an important part of daily clinical practice. There has been some debate on the best way to manage and treat these small lesions long-term. Some clinicians believe it is best to perform operative treatment and conserve tooth structure; whereas, other clinicians believe in managing it with preventive treatment, allowing the lesion the potential to remineralize or arrest over time. Limited literature is available for these “questionable” lesions and the reasons behind why clinicians are having difficulty diagnosing and treating them.

The aims of this study were to (1a) for unopened questionable occlusal carious lesions, test the hypothesis that the baseline clinical characteristics are significantly associated with change in caries status; and (1b) for opened questionable occlusal carious lesions, test the hypothesis that the clinical characteristics at baseline are significantly associated with caries depth.

These aims were met by performing a follow-up on the consecutive questionable occlusal carious lesions enrolled in “Prevalence of Occlusal Carious Lesions”. The study recorded the status of these lesions, if treatment changed,and the condition of the restoration or sealant, if applicable.

This study about occlusal carious lesions provided the opportunity to compare these results to “Assessment of Caries Diagnosis and Caries Treatment”, and “Prevalence of Occlusal Carious Lesions”.

Key study publication:

Makhija SK, Gilbert GH, Funkhouser E, Bader JD, Gordan VV, Rindal DB, Qvist V for the National Dental PBRN Collaborative Group. Twenty-month follow-up of occlusal caries lesions deemed questionable at baseline: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2014; 145(11):1112-1118.

Study Protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

Follow-up data collection form. Lesions were followed for 24 months.

Annotated follow-up data collection form

Detailed report, overall and by region

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Valeria Gordan, University of Florida

The purpose of this project was to use data from the DPBRN study of replacement restorations to assess how defects that lead to failure develop over time, and follow restorations placed in a practice-based setting for up to three years.

The specific aims were to:

  1. quantify the annual and 3-year incidence of defects and replacement rates on restorations inserted as replaced restorations;
  2. test the hypothesis that directly-placed composite restorations have a significantly higher 3-year incidence of defects and significantly higher replacement rate after 3 years compared to amalgam restorations;
  3. test the hypothesis that there is no significant difference in 3-year replacement rates between restorations inserted that were partially replaced as compared to restorations that were completely replaced during DPBRN study of replaced restorations; and
  4. test the hypothesis that the 3-year replacement rate of restorations in permanent teeth of adolescents is significantly higher than that of restorations in adults.

Recall frequency was according to the schedule used in the practice where the restoration was placed. Patients were informed about the follow-up study as part of the informed consent procedure. If a patient sought treatment in a different practice, informed consent included permission to contact that practice for information related to restoration(s) in DPBRN longitudinal study.

Key study publication:

Gordan VV, Riley JL III, Geraldeli S, Williams OD, Spoto JC 3rd, Gilbert GH, National Dental PBRN Collaborative Group. The decision to repair or replace a defective restoration is affected by who placed the original restoration: findings from the National Dental PBRNJournal of Dentistry 2014; 42(12):1528-1534.

Study Protocol

Data Dictionary

Annotated baseline form

Annotated year 1 form

Annotated year 2 form

Annotated year 3 form

Data set (The data set link is best downloaded through Internet Explorer)

Main data collection form

Study PI: Dr. Joseph Riley, III, University of Florida

Patient satisfaction is important to practicing dentists because of links to regular return visits, caregiver trust, perception of technical competence, and treatment outcome.  However, little is known about the satisfaction of dental patients, particularly as related to specific dental procedures.  Dental restorations are one of the most commonly performed dental procedures, yet no study has documented patient satisfaction with a restoration-specific dental visit.  There are many unique characteristics to a dental restoration visit such as dentist-patient communication about the restoration material, comfort during and following the procedure, and the patient’s view of the quality of the restoration.  How patients prioritize these characteristics or use them in decisions about satisfaction are unknown.  It is known that patients make judgments of the technical competence of dentists, but whether these judgments have any association with immediate or long-term restoration quality and therefore the extent to which they are valid is undetermined.

The aims of the study were to determine the relative contribution and importance of characteristics of a restoration and restoration visit with overall patient satisfaction following a dental visit that involved a restoration replacement or repair; and to link patient’s satisfaction and perception of the dentist’s technical expertise with long-term objective outcomes of the dental restoration.

This study involved approximately 6,000 patients that received at least one dental restoration repair/replacement.  Patients were recruited from practices participating in the DPBRN study of replacement restorations, most of whom were enrolled in a DPBRN longitudinal study. Participants completed and mailed the survey questionnaire the day following the dental visit to allow them to evaluate and respond to the short-term outcomes, such as comfort and function, as well as to the immediate aspects of the visit.

Key study publications:

Riley JL III, Gordan VV, Hudak-Boss S, Fellows JL, Rindal DB, Gilbert GH for the National Dental PBRN Collaborative Group. Concordance between patient satisfaction and the dentist’s view: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2014; 145(4):355-362.

Riley JL III, Gordan VV, Rindal DB, Fellows JL, Qvist V, Patel S, Foy P, Williams OD, Gilbert GH for the National Dental PBRN Collaborative Group. Components of patient satisfaction with a dental restorative visit: results from The Dental Practice-Based Research NetworkJournal of the American Dental Association 2012; 143(9):1002-1010.

Study Protocol

Data Dictionary

Annotated dentist survey

Annotated patient survey

Data set-dentist (The data set link is best downloaded through Internet Explorer)

Data set-patients (The data set link is best downloaded through Internet Explorer)

View the patient questionnaire.

The dentists who did the dental restoration at this visit also completed a questionnaire for each patient visit.

Detailed report, overall and by region.

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Donald Nixdorf, University of Minnesota

Pain following root canal therapy occurs commonly, with an incidence range of 3% to 58% depending on the definition. The majority of this post-endodontic pain is well controlled using current treatment modalities, but a small subset of patients seems to be resistant to treatment and experiences severe pain. Significant post-endodontic pain is commonly referred to as an endodontic flare-up and has been defined as severe pain that precipitates a patient-dentist interaction within one week of treatment initiation. Such pain, when associated with local soft tissue swelling, is known to occur in 3% of all cases of root canal therapy. Given that >16.4 million root canal therapies are performed every year within the US, about half a million patients experience severe pain that is resistant to treatment. This pain is known to cause significant amounts of dental anxiety and fear, which in turn is a major barrier to receiving dental care and can have other negative psychosocial consequences. For these reasons, it is important to understand the factors related to the development of endodontic flare-up pain in efforts to better treat this pain. Research on endodontic-related pain has suggested that (a) the intensity of pre-operative pain and (b) the experience of intra-operative pain are significant factors related to the subsequent development of persistent tooth pain. Therefore, the primary goal of this study was to assess the presence and magnitude of pre-operative and intra-operative tooth pain, and determined how these factors were associated with the outcome of intense post-endodontic flare-up pain. The overall goal was to better understand how the experience of peri-operative pains relate to each other. The long-term goal of this line of research was to identify the modifiable pre-operative factors that put patients at greater risk of developing persistent tooth pain following root canal therapy, thereby providing evidence that will allow dentists to act preventively to mitigate this risk, improve pain control, increase their patients’ quality of life, and decrease the number of dental emergency interactions. Since future studies within the network are required to achieve this long-term goal, the secondary goal of this study was to assess the feasibility of recruiting patients using the DPBRN and to pilot test a more detailed data collection procedure from both patients and practitioners using a small subset of practitioners and within the DPBRN.

Key study publications:

Law AS, Nixdorf DR, Rabinowitz I, Reams GJ, Smith JA Jr., Torres AV, Harris DR, for the National Dental PBRN Collaborative Group. Root canal therapy reduces multiple dimensions of pain: a National Dental PBRN StudyJournal of Endodontics 2014; 40(11):1738-1745.

Study protocol

Study data dictionary

Data set (The data set link is best downloaded through Internet Explorer. The data set contains both the baseline and longitudinal studies)

Practitioner completed a data form before beginning the root canal, and a different one after obturation.

Annotated forms for before beginning the root canal and after obturation.

Each practitioner also kept track of how many eligible patients presented for treatment during the data collection period, along with how many of these agreed to participate in the study.

Patients who were receiving root canal treatment completed a questionnaire immediately before treatment , another one immediately after treatment, and another form one week after treatment.

Annotated forms for immediately before treatment, immediately after treatment, and one week after treatment.

Patients also completed a form with contact information. When the root canal treatment required more than one visit, comparable forms were again completed by the dentist practitioner and the patient.

An additional form was completed by the dentist regarding pain and anxiety management for the treated tooth.

Annotated form

Detailed report, overall and by region.

Graphical presentation of study findings, also overall and by region.

Study PI: Dr. Donald Nixdorf, University of Minnesota

Dentists perform over 16.4 million root canal therapies every year in the United States (American Dental Association, 2002). Persistent tooth pain, which is pain present 6 months after root canal therapy, is known to occur following root canal therapy in a fashion similar to other post-surgical pains, such as phantom limb pain. Research in this area is limited, but suggests a frequency of occurrence of 3% to 12% for persistent post-root canal pain. Despite the commonality of root canal treatment, the occurrence and severity of persistent tooth pain and extent of interference with daily life from this condition has not been well studied in dental care populations. Adequate treatments for some of these pains are emerging, and early identification and treatment may improve prognosis, but the first step is to determine how widespread the problem is and how severely it affects dental patients. This knowledge is expected to influence patient and provider decisions about dental treatment and to facilitate the development of preventative treatment strategies, such as pre-emptive analgesia, aimed at reducing patients’ modifiable peri-operative risk factors. The long-term goal of this line of research is to identify pre-operative factors that put patients at greater risk for developing persistent tooth pain following root canal therapy, thereby providing evidence that will allow dentists to act preventively to mitigate this risk, improve pain control, and increase their patients’ quality of life. For this long-term goal to be realized, future externally funded research using the DPBRN is anticipated; hence, there is a need for pilot data to support the feasibility of such research. Even though this research proposal is focused on understanding the outcomes of root canal therapy, with the long-term goal of improving care, the resultant data may have ramifications for surgical procedures performed elsewhere in the body. Undoubtedly aspects of this research will be specific to root canal therapy, but since pain is a centrally derived phenomenon that affects the whole individual, aspects of the involved pain mechanisms are likely shared with other surgical procedures. Thus, this line of research could have an impact on healthcare in general.

Key study publications:

Law AS, Nixdorf DR, Aguirre AM, Reams GJ, Tortomasi AJ, Manne BD, Harris DR, National Dental PBRN Collaborative Group. Predicting severe pain after root canal therapy in the National Dental PBRNJournal of Dental Research 2015; 94(3 Suppl) 37S-43S.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

Patients were followed for six months after they completed treatment in the study ”Peri-operative pain and root canal therapy”, and were asked to return a three-month form and a six-month form.

Annoted three-month and six-month forms

Detailed report, overall and by region

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Gregg Gilbert, University of Alabama at Birmingham

The overarching goal of DPBRN is to impact the practice of dentistry and improve patient care. A critical issue is assessing whether the research conducted is achieving this goal. The three NIDCR-funded PBRNs (DPBRN, NWPRECEDENT, and PEARL), collectively known as the “Collaboration on Networked Dental and Oral Health Research” (CONDOR), developed a strategy for assessing the impact of practice-based dental research on the PBRN practices and on the practice of dentistry in general. The strategy involved the development and use of a core questionnaire that included several questions from each PBRN that have been extracted from questionnaires previously administered as part of their initial research program activities. This project comprised the pre-planned second administration of this Core Questionnaire with the purpose of assessing dental practice changes that may have occurred since the first administration (DPBRN Study 16).

Key study publications:

Norton WE, Funkhouser E, Makhija SK, Gordan VV, Bader JD, Rindal DB, Pihlstrom DJ, Hilton TJ, Frantsve-Hawley J, Gilbert GH for the National Dental PBRN Collaborative Group. Concordance between clinical practice and published evidence: findings from the National Dental Practice-Based Research NetworkJournal of the American Dental Association 2014; 145(1):22-31.

Study protocol

Study data dictionary

Annotated form

Data set (The data set link is best downloaded through Internet Explorer)

View the questionnaire.

Detailed report, overall and by region.

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Gregg Gilbert, University of Alabama at Birmingham

Brief study description:

We have an innovative opportunity to develop the nation’s only dental practice-based research network, which is called the Alabama Dental Practice Research Network.

Specific Aim 1 was to enhance the infrastructure and research capacity of the network. This aim was accomplished by enhancing the administrative structure of the network, by providing fundamental training in clinical research and human subjects precautions to network dentists, and by providing a communication infrastructure for network practices and the network administration, which will include an internet-based system.

Specific Aim 2 was to conduct a feasibility study to test data collection methods for a retrospective cohort study that tested the hypothesis that endodontic treatment (root canal) failure was significantly higher among dental patients with diabetes mellitus type 2 when compared to non-diabetic controls.

This feasibility study provided a sound scientific foundation for an R01 application to investigate the potentially bi-directional relationship between diabetes mellitus type 2 and endodontic treatment failure, allowing us to determine whether diabetes contributes to poor endodontic healing, and whether inadequate endodontic healing can itself contribute to poor diabetic control.

Key study publications:

None.

This study received primary funding by R21-DE-016033 (Alabama Dental Practice-Based Research Network Development).  Consequently, the responsibility for public access to data from this study lies with that grant.

Study PI: Dr. Sonia Makhija, University of Alabama at Birmingham

Although the progression of cavitated dental caries has slowed dramatically over the years, the prevalence of precavitated lesions has significantly increased; therefore, diagnosing these lesions has become an important part of daily clinical practice. Due to the size of these lesions, the ability to correctly diagnose and treat them can be difficult. There has been some debate on the best way to manage and treat these small lesions. Some clinicians believe it is best to perform operative treatment and conserve tooth structure; whereas, other clinicians believe in managing it with preventive treatment, allowing the lesion the potential to remineralize or arrest. Limited literature is available for these “questionable” lesions and the reasons behind why clinicians are having difficulty diagnosing and treating them.

The aims of this study were to (1) quantify the prevalence of questionable occlusal carious lesions in permanent teeth in the first 100 consecutive eligible patients of DPBRN practitioners; (2a) for unopened questionable occlusal carious lesions, test the hypothesis that the patient’s baseline caries risk is significantly associated with lesion description (i.e., perceived caries status); and (2b) for opened questionable occlusal carious lesions, test the hypothesis that the patient’s baseline caries risk is significantly associated with caries depth.

These aims were met by enrolling 80-100 practitioner-investigators, each of whom recorded information about 100 consecutive patients and 25-50 consecutive questionable early occlusal caries lesions on a 2-page questionnaire. The study recorded the reason why these occlusal lesions were questionable, the tools used to diagnose the lesions, the reason why a certain treatment was rendered, and the depth of the lesions when treated operatively.

This study about early occlusal caries lesions provided the opportunity to compare these results to DPBRN study entitled “Assessment of Caries Diagnosis and Caries Treatment”, a questionnaire wherein practitioners’ caries diagnosis, caries treatment, and preventive dentistry practices were quantified as well as compare these results to the DPBRN study entitled “Longitudinal Study of Questionable Occlusal Carious Lesions”.

Key study publication:

Makhija SK, Gilbert GH, Funkhouser E, Bader JD, Gordan VV, Rindal DB, Pihlstrom DJ, Qvist V for the National Dental PBRN Collaborative Group. Characteristics, detection methods, and treatment of questionable occlusal caries lesions: findings from the National Dental Practice-Based Research NetworkCaries Research 2014; 48(3):200-207.

Makhija SK, Gilbert GH, Funkhouser E, Bader JD, Gordan VV, Rindal DB, Bauer M, Pihlstrom DJ, Qvist V for the National Dental PBRN Collaborative Group. The prevalence of questionable occlusal caries lesions: findings from The Dental PBRNJournal of the American Dental Association 2012; 143(12):1343-1350.

Study Protocol

Study data dictionary

Data set (The data set link is best downloaded through Internet Explorer. The data set contains both the baseline and follow-up studies)

Baseline data collection form

Annotated baseline form

Change of treatment form

Annotated change of treatment form

Consecutive patient log

Participant list form

Detailed report, overall and by region

Graphical presentation of study findings, overall and by region

Patient characteristics, by region

Study PI: Dr. Eric Schiffman, University of Minnesota

The overall goal of this project was to collect data to be used in preparing an application for a Clinical Trial Planning Grant and then in designing a subsequent Phase III clinical trial. The ultimate goal was to determine the most practical approach to conduct a randomized clinical trial to evaluate initial interventions for patients with painful temporomandibular muscle and joint disorders (TMJD) in primary care clinics. This project characterized by surveying the feasibility of recruiting dentists in primary care dental clinics in The Dental Practice-Based Research Network and document their current initial care for their TMJD pain patients.

Key study publication:

Velly AM, Schiffman EL, Rindal DB, Cuhna-Cruz J, Gilbert GH, Lehmann M, Horowitz A, Fricton J, McBride R for the CONDOR Collaborative Group. The feasibility of clinical trial of pain related to temporomandibular muscle and joint disorders: The results of a survey from the Collaboration on Networked Dental and Oral Research dental practice-based research networksJournal of the American Dental Association 2013; 144(1):e01-e10.

Study protocol

Study data dictionary

Data set (Data set link is best downloaded through Internet Explorer)

View the questionnaire.

Annotated form

Detailed report, overall and by region.

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Valeria Gordan, University of Florida

This study of previously-untreated permanent tooth surfaces was the second of the restorative dentistry studies planned for the Dental Practice-Based Research Network (DPBRN). The aims for this study were to: (a) quantify DPBRN practitioner-investigators’ pre-operative and post-operative assessments of the depth of the caries lesion being treated and (b) quantify the prevalence of dental material types used to restore the first restoration in a permanent tooth surface. These aims were met by enrolling 229 DPBRN practitioner-investigators in this study, each of whom recorded information about an average of 50 consecutive restorations that they placed on unrestored permanent tooth surfaces. The study recorded the main reason that the restoration was placed, the preoperative and postoperative depth of the caries lesion on the previously unrestored surface, and the type of dental restorative material that was used. This study about restorative treatment received by DPBRN patients provided the opportunity to record not only the diversity in the treatment provided, but also to generate information for subsequent hypothesis testing and for the design of future studies.

Key study publications:

Nascimento MM, Bader JD, Qvist V, Litaker MS, Williams OD, Rindal DB, Fellows JL, Gilbert GH, Gordan VV for The DPBRN Collaborative Group. Concordance between pre-operative and post-operative assessments of primary caries lesion depths: results from The Dental PBRNOperative Dentistry 2010; 35(4): 391-398.

Nascimento MM, Gordan VV, Qvist V, Litaker MS, Rindal DB, Williams OD, Fellows JL, Ritchie LK Jr, Mjör IA McClelland J, Gilbert GH for The DPBRN Collaborative Group. Reasons for placement of restorations on previously un-restored tooth surfaces by dentists in The Dental Practice-Based Research NetworkJournal of the American Dental Association 2010; 141(4): 441-448.

Study Protocol

Study data dictionary

Data set (The data set link is best downloaded in Internet Explorer. The data set consists of the baseline and follow-up studies)

Annotated form

Main data collection form

Consecutive patient log

Master participant list

Detailed report, overall and by region

Graphical presentation of study findings, overall and by region.

Study PI: Dr. Valeria Gordan, University of Florida

This study recorded the reason(s) for replacement or repair of 50 consecutive restorations as diagnosed by 200 DPBRN clinicians. This constituted baseline data which was used for analysis of factors that affect the diagnoses.

Factors that affected the number of replaced or repaired restorations was analyzed using baseline data, e. g., how they vary among clinicians, the practice setting, the gender of the patients and the clinicians, and the clinicians” attitudes towards caries lesion development and caries risk assessment. These data was also a source for monitoring treatment changes in restorative dentistry that may occur over time. A better understanding of the reasons why restorations needed to be replaced or repaired led to improvements in the longevity of restorations.

Key study publications:

Gordan VV, Riley JL III, Worley DC, Gilbert GH for The DPBRN Collaborative Group. Restorative material and other tooth-specific variables associated with the decision to repair or replace defective restorations: findings from The Dental PBRNJournal of Dentistry 2012; 40(5):397-405.

Gordan VV, Riley JL III, Geraldeli S, Rindal DB, Qvist V, Fellows JL, Kellum HP, Gilbert GH for the National Dental PBRN Collaborative Group. Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research NetworkJournal of the American Dental Association 2012; 143(6):593-601.

Study Protocol

Study data dictionary

Data set (The data set link is best downloaded through Internet Explorer. The data set consists of the baselind and follow-up studies)

Annotated form

Main data collection form

Each practitioner kept track of how many eligible patients presented for treatment during the data collection period, along with how many of these agreed to participate in the study.

Each practice kept track of the names of each participant because the network tracked these restorations longitudinally. This information was kept at the dental practice and at the regional office, but was not passed on to the Coordinating Center.

Detailed report, overall and by region.

Graphical presentation of study findings, also overall and by region.

Study PI: Dr. Jeffrey Fellows, Kaiser Permanente Center for Health Research

In the past two years, the literature has described more than 200 cases of osteonecrosis of the jaws (ONJ) among patients treated with bisphosphonates (BPs). About 3 million patients have been treated with BPs and another 7-8 million osteoporotic or cancer-afflicted persons in the U.S. may take BPs in the near future. To date, the prevalence of ONJ has not been quantified, nor is it known whether exposure to BPs actually increases ONJ prevalence. We investigated these issues using data from a large cohort of patients from the Kaiser Permanente Northwest and HealthPartners medical and dental plans. Both health maintenance organizations are part of DPBRN, allowing us to take advantage of an already-functioning interdisciplinary collaborative infrastructure.

This study addressed three specific aims. Aim 1 quantified the annual, consecutive prevalence of confirmed ONJ cases in a large cohort of adults 40 years of age and older from 1994 to 2005. Aim 2 tested the hypothesis that BP treatment is a risk factor for ONJ. We quantified the impact of BP exposure on the risk of developing ONJ, relative to comparable patients not exposed to BP, using a retrospective cohort design and time-to-event analysis. Finally, Aim 3 tested the hypothesis that ONJ develops only in patients treated with BPs who have additional risk factors. These health maintenance organizations provided a unique, unprecedented opportunity to investigate ONJ by including thousands of patients through their electronic medical and dental records.

Relevance to public health: In light of the substantial morbidity due to ONJ, this study provided important information about this growing health concern.

Key study publication:

Fellows JL, Rindal DB, Barasch A, Gullion CM, Rush W, Pihlstrom DJ, Richman J for The DPBRN Collaborative Group. ONJ in two Dental Practice-Based Research Network regions. Journal of Dental Research 2011; 90(4):433-438.

Study Protocol

Study data dictionary

Data set  (Data set link is best downloaded through Internet Explorer)

Read about the the following study highlights from the Practice-Based Research Network:

  • Assessing Outcomes of Cracked Teeth
  • Remineralization of White Spot Lesions after Removal of Orthodontic Brackets
  • Single Tooth Endodontic and Restorative Treatment Outcomes: PEARL Interim Findings
  • PEARL Non-Carious Cervical Lesion RCT Baseline and Sleep Bruxism Findings
  • Lessons Learned During the Conduct of Clinical Studies in the Dental PBRN
  • Repair or Replacement of Defective Restorations by Dentists in the Dental PBRN