Derek Richards

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Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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Presence of mandibular third molars during sagittal split osteotomies did not increase complications

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The sagittal split osteotomy (SSO) is a common procedure  for the correction of mandibular deformities.  It  was first introduced Schuchardt in 1942  the current technique which has been refined an popularised in subsequent years.   Overall it is a safe procedure the  an important intra-operative complication being  an unfavourable fracture with incidences  varying between  0.7-20% being [read the full story…]

Glass fibre-reinforced posts performed better at 5 years in endodontically treated teeth

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Post systems are used in the restoration of endodontically treated teeth where there has been significant loss of the clinical crown. A post provides a method to secure filing material to the tooth.  The aim of this trial was to  assess the survival rate of two different post systems after 5 years of service. Patients [read the full story…]

No difference in marginal bone loss around implants retaining/supporting mandibular overdentures relative to implant type

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This 2010  review by Cehreli et al of marginal bone loss around implants has now been critically reviewed by the American Dental Association Center for Evidence-Based Dentistry. The review found that Marginal bone loss around implants supporting or retaining mandibular overdentures is not significantly affected by the implant system or attachment design However the reviewer [read the full story…]

Good pulpotomy success rates in permanent molars with calcium enriched mixture cement or mineral trioxide aggregate

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This large clinical trial compares the outcomes using two materials for pulpotomies in permanent teeth demonstrating good success at 12 months.

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Periodontal treatment may improve metabolic control in diabetic patients.

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There have been a number of studies including a recent Cochrane review which have looked at the impact of periodontal treatment on glycaemic control in diabetics. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on metabolic control in Type 2 diabetes mellitus (DM2) Forty patients with DM2 and chronic [read the full story…]

Do I need orthodontic treatment – professionals and patient opinions vary

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The number of orthodontic treatments carried out has risen steadily. The reasons patients and parents seek treatment may well differ  from that of the professional who is likely to prioritise function and occlusion. There are systems that have been used to quantify the severity of malocclusions and orthodontic need in an objective manner one of [read the full story…]

Adding mannitol improved the effectiveness of local anaesthesia

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Modern local anaesthetics have transformed the practice of dentistry. However  a proportion of  injections fail to achieve pulpal anaesthesia.   This trial set out to find if  the addition of mannitol to lidocaine with epinephrine improved its efficacy. Forty patients were randomised to receive  an inferior alveolar nerve (IAN) block  in 3 separate appointments spaced at [read the full story…]

Insufficient evidence for recommendations on best adhesive system or bonding strategy for non-carious cervical lesions

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Tooth coloured adhesive filling materials are in common use in dentistry providing good results. However, their success relies on the adhesive systems that provide this bond which has allowed a more conservative approach to cavity preparation.  The aim of this review was to assess the effectiveness of these systems in non-carious cervical lesions (NCCLs).   The [read the full story…]

Limited weak evidence suggesting that flapless dental implant placement is feasible

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Dental implants are usually placed after raising a flap to visualise the bone where they are to be placed. Several flap designs have been proposed but in some instances, they can also be placed flapless reducing patient discomfort.     The aim of this Cochrane review was to evaluate whether:- flapless procedures are beneficial for [read the full story…]

Amoxycillin not helpful for acute sinusitis

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Acute sinusitis (rhinosinusitis) is a common disease with 1 in 5 antibiotic prescriptions for adults in the United States being for sinusitis.  US Centers for Disease Control  and Prevention (CDC) guidelines recommend using clinical criteria for diagnosis and  reserving antibiotic treatment for patients with moderately severe or severe symptoms.  The aim of this study was [read the full story…]