To assess the quality of clinical trials comparing different interventions for shortened dental arches versus restoring complete dental arches in partially dentate adults
Method:
All relevant databases (Medline, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Science Direct, ProQuest, Science Journals, Scopus, PsycINFO, WHO ICTRP,ClinicalTrials.gov and PACTR) were searched to identify appropriate randomized and non-randomized clinical trials . Clinical trial researchers were contacted for missing details. Study pre-specified outcomes were: functioning, patient satisfaction, survival of intervention and negative effects on oral structures. Trial quality was assessed independently by authors using the Cochrane's risk of bias tool and the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach to grade the evidence and strength of recommendations.
Result:
Clinical trials that met our eligibility criteria were included. After completing the GRADE assessments it was observed that some studies had not followed the exact guidelines for randomized controlled trials but had the features thereof. These were downgraded because they did not use randomization, allocation concealment or blinding, and failed to specify the outcomes as primary or secondary. The small sample sizes seriously affected the imprecision, and the risk of bias was very serious with studies where no blinding and selective reporting was observed. From the combined effects, the overall quality of the clinical trials was assessed as being low. This implies that further studies are likely to have an important impact on our confidence in the estimate of effect, and may change the estimate.
Conclusion:
Clinical trials assessing interventions for treating shortened dental arches are of low quality. Higher quality randomized controlled clinical trials assessing this comparison are urgently required to supply the evidence regarding their effectiveness.