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J Evid Based Dent Pract. 2016 Mar;16(1):7-18. doi: 10.1016/j.jebdp.2015.12.001. Epub 2016 Feb 23.

Practical Implementation of Evidence-Based Dentistry Into Daily Dental Practice Through a Short Time Dependent Searching Method.

Author information

DDS, PhD, Department of Operative Dentistry, Faculty of Medicine, University of Coimbra, Portugal. Electronic address:
DDS, PhD, Department of Orthodontics, Medical Faculty, Slovak Medical University, Bratislava, Slovakia.
DDS, PhD, Department of Periodontology, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey.
DDS, PhD, Department of Prosthodontics, Faculty of Dentistry, University of Gazi, Ankara, Turkey.
DDS, PhD, Restorative Dentistry, Faculty of Dentistry, University of Porto, Portugal; DDS, PhD, Department of Oral Public Health, Institute of Public Health, University of Porto, Portugal.



Despite the fact that the benefits of implementation of Evidence-Based Dentistry (EBD) into clinical practice is increasingly being highlighted, there are still clear limitations in its implementation into daily dental practice. One potentially important barrier to effective implementation into practice is the perception of EBD as a time-consuming process. The aim of the present study is to increase the familiarity of dental practitioners with the benefits of different time-dependent 'practical' search strategies important to EBD using a clinical question from the field of dental implantology as an example.


The PICO (population, intervention, comparison, outcome) question used in this study was: "In young adults with anterior single-tooth implant what is the effect of immediate or delayed loading on success?" A bibliographic search according to the Haynes 5S pyramid, together with 3 different time-dependent strategies (5-min, 30-min and more than 60-min), were applied.


Both the Haynes 5S Pyramid and time-dependent search strategies revealed promising results for enhancing decision-making for determining the feasibility of immediate or conventional loading of anterior single dental implants. Results clearly showed that selection of the loading protocol would be case (patient)-specific and also indicated high primary implant stability and bone quality as the most important prerequisites for a successful immediate/early loading. From among the 3 different time-dependent strategies (5 min, 30 min and more than 60 min), the 60+ min search results were quite comparable with the Haynes pyramid search results.


It is likely that the different time-dependent search strategies may have the potential to support the clinical decision making process and may improve the implementation of EBD into daily dental practice. Increased time spent searching naturally seems to increase the extent of this support. However, even with short time-dependent searches, busy dental clinicians may get an improved idea/opinion regarding a clinical question.


Clinical guidelines; Decision making; Implant loading protocol

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