2. Lunch and Learn Agenda
• Objectives
• Parameters
• How to find cases
• CaseCAT Worksheet
• CaseCAT Literature Worksheet
• CaseCAT Poster Template
• Judging Criteria
3. Objectives
• To provide an opportunity for students to engage
in a patient based study to the level of scientific
inquiry
• To facilitate the transformation of a patient
based study to a case presentation that can be
presented at Clinic and Research Day
4. Parameters
How were treatment plans or outcomes for your
patient affected by:
• Treatment procedure
• Patient health concerns
• Therapeutic problems concerning patient
• Unusual medications
• Treatment consideration for medically
compromised or patients with disabilities
• Example: Blood pressure medication that
causes xerostomia
▫ What are causes, how do you evaluate? how do you
treat?
5. Where do I find cases?
1. Portfolio
On medically compromised patients i.e. diabetes,
hypertension
Patients on 3 or more medically significant
therapeutic medications
1. Screening Clinic/Urgent Care
Diagnosis of an interesting patient issue
1. Rotations with specialty clinics
Working with residents
Examples include: Ortho-craniofacial anomaly,
Perio-diabetes, Endo-implants
6. Important Elements to Consider
• Patient issue exemplifies problem
• Thoughtful description of case
• Adequate Documentation (must be de-identified)
▫ Photos and radiographs
▫ Axium page with charting
▫ Patient medical, dental history, chief complaint
• Differential Diagnosis
▫ In many cases already preexisting diagnosis
• Develop case to level of CAT
▫ Faculty, journals and internet as resources
• IRB Issues
▫ Must be single case, case series not acceptable
7. Situation of Concern (Calibri font size 60)
Student Name
Advisor
CASE
Place the critical elements of your case here… e.g., Chief Complaint, Hx, AXIUM data, photos, etc.
SCENARIO (preferably in font Calibri - minimum size 20)
P: P…
I: I…
C: C…
O: O…
Place the critical elements of your case here… e.g., Chief Complaint, Hx, AXIUM data, photos, etc.
(preferably in font Calibri - minimum size 20)
CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCE
Type your searchable question here… (preferably in font Calibri - minimum size 20) Terms…
Student Summary
Type your bottom line here… (preferably in font
Calibri - minimum size 20)
CAT 1 CAT 2 CAT 3
Type your CAT here… (preferably in font Calibri - Type your CAT here… (preferably in font Calibri - Type your CAT here… (preferably in font Calibri -
minimum size 20) minimum size 20) minimum size 20)
FUTURE DIRECTIONS
Write future directions here… (preferably in font
Calibri - minimum size 20)
10. Should I use Cavit , IRM , or KetacFill ? TM TM TM
Student: Michael P. Munaretto
Advisor: Bradford Johnson, DDS MHPE, UIC Department of Endodontics
CASE SCENARIO
29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on both
oral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:
arrows below).
Tooth Cold EPT Perc Palp Probing Mobility
P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0
4 NR 80/80 WNL WNL 323B 323L 0
I- Temporary restorative material
(Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0
6 WNL 26/80 WNL WNL 323B 323L 0
C- Definitive restoration
O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis
microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.
CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCE
For patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, or
KetacFill GI) compares most favorably to the properties of the definitive restoration as measured
by durability and resistance to coronal microleakage?
CAT (1) CAT (2) CAT (3)
FUTURE DIRECTIONS
Write future directions here… (preferably in font
Calibri - minimum size 20)
12. Should I use Cavit , IRM , or KetacFill ? TM TM TM
Student: Michael P. Munaretto
Advisor: Bradford Johnson, DDS MHPE, UIC Department of Endodontics
CASE SCENARIO
29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on both
oral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:
arrows below).
Tooth Cold EPT Perc Palp Probing Mobility
P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0
4 NR 80/80 WNL WNL 323B 323L 0
I- Temporary restorative material
(Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0
6 WNL 26/80 WNL WNL 323B 323L 0
C- Definitive restoration
O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis
microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.
CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCE
For patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, or Root Canal Therapy;
KetacFill GI) compares most favorably to the properties of the definitive restoration as measured Dental Restoration,
by durability and resistance to coronal microleakage? Temporary; Leakage
CAT (1) CAT (2) CAT (3)
Beach et al. “Clinical Evaluation of Bacterial Barthel et al. “Leakage in Roots Coronally
Naoum & Chandler. “Temporization for
Leakage of Endodontic Temporary Filling Sealed with Different Temporary Fillings.”
Endodontics.” International Endodontic Journal
Materials.” Journal of Endodontics 22:9 pp459- Journal of Endodontics 25:11 pp 731-734. 1999.
35:pp 964-978. 2002.
462. 1996.
Methods: 103 extracted single-rooted teeth
Methods: A literature review was performed
Methods: 51 human teeth received RCT in vivo. received RCT and were then filled with either
using MEDLINE and contemporary textbooks to
After obturation a sterile paper disk was placed Cavit, IRM, GI, Cavit/GI, or IRM/GI. Teeth were
assess various endodontic temporary filling
below a 4 mm filling of Cavit, IRM, or TERM. then immersed into a two-chamber system
materials and to make clinical recommendations.
Three weeks later the patients were recalled, the which was inspected daily over a 30-day period
Results/Conclusion: Cavit possesses favorable
fillings were removed, and the paper disks were for bacterial microleakage.
marginal seal but inferior mechanical properties
analyzed for bacterial growth. Results/Conclusion: GI gave the best seal
compared to IRM. Studies have shown that IRM
Results/Conclusion: 1/18 IRM samples showed against bacteria (1/20 samples leaked),
also provides a favorable marginal seal,
bacterial growth, whereas 0/19 Cavit samples whereas Cavit gave the poorest seal (13/20
especially when the powder: liquid ratio is
samples leaked). 11 out of 20 IRM samples
showed growth. No significant difference was
found between IRM and Cavit. leaked.
decreased. GI is more costly, but has been found
to be antibacterial and to have a superior seal;
FUTURE DIRECTIONS
Validity/Applicability: Restoration type was Validity/Applicability: Results of in vitro studies Write future directions here… (preferably in font
thus it may be used for cases of long-term Calibri - minimum size 20)
randomly assigned. Follow up was 100%. in vivo cannot directly be applied to clinical practice.
temporization.
study. 3 week follow-up realistic at UIC COD. However, all available filling materials to UIC
Validity/Applicability: Authors did not provide a
Level of Evidence: 2 (Randomized Controlled COD students were tested.
detailed selection criteria for articles reviewed.
Trial) Level of Evidence: 6 (Preclinical study)
Level of Evidence: 5 (Expert Opinion)
.
14. Should I use Cavit , IRM , or KetacFill ? TM TM TM
Student: Michael P. Munaretto
Advisor: Bradford Johnson, DDS MHPE, UIC Department of Endodontics
CASE SCENARIO
29 y/o healthy female has full mouth radiographs taken as part of comprehensive Exam: EOE WNL. IOE reveals large DO amalgam restorations present on both
oral examination. Periapical Radiolucencies are seen on teeth #4 and #5 (see teeth. The following clinical tests were performed:
arrows below).
Tooth Cold EPT Perc Palp Probing Mobility
P- Patients receiving root canal therapy 3 WNL 31/80 WNL WNL 323B 323L 0
4 NR 80/80 WNL WNL 323B 323L 0
I- Temporary restorative material
(Cavit, IRM, or KetacFill [GI]) 5 NR 80/80 WNL WNL 323B 323L 0
6 WNL 26/80 WNL WNL 323B 323L 0
C- Definitive restoration
O- Durability and resistance to coronal Diagnosis: #4 and #5 Necrotic Pulp, Asymptomatic (Chronic) Apical Periodontitis
microleakage Treatment Plan: Non-surgical RCT #4 and #5. Multiple visits will be required.
CRITICAL QUESTION MESH Terms: CASE SIGNIFICANCE
For patients receiving root canal therapy, which temporary restorative material (Cavit, IRM, or Root Canal Therapy; Few in vivo studies and no systematic reviews
KetacFill GI) compares most favorably to the properties of the definitive restoration as measured Dental Restoration, exist studying this topic. However, from the
by durability and resistance to coronal microleakage? Temporary; Leakage available evidence the following conclusions can
be drawn:
CAT (1) CAT (2) CAT (3) 1. Cavit provides an adequate seal over at least 3
Beach et al. “Clinical Evaluation of Bacterial Barthel et al. “Leakage in Roots Coronally weeks as revealed by an in vivo study (1).
Naoum & Chandler. “Temporization for
Leakage of Endodontic Temporary Filling Sealed with Different Temporary Fillings.” However, due to its poor mechanical properties,
Endodontics.” International Endodontic Journal
Materials.” Journal of Endodontics 22:9 pp459- Journal of Endodontics 25:11 pp 731-734. 1999. its use should be reserved only for conservative
35:pp 964-978. 2002.
462. 1996. accesses where occlusal forces are minimal (3).
Methods: 103 extracted single-rooted teeth 2. IRM provides an adequate seal over at least 3
Methods: A literature review was performed
Methods: 51 human teeth received RCT in vivo. received RCT and were then filled with either weeks as revealed by an in vivo study (1). Its
using MEDLINE and contemporary textbooks to
After obturation a sterile paper disk was placed Cavit, IRM, GI, Cavit/GI, or IRM/GI. Teeth were mechanical properties are superior to Cavit and it
assess various endodontic temporary filling
below a 4 mm filling of Cavit, IRM, or TERM. then immersed into a two-chamber system is therefore indicated for whenever the tooth will
materials and to make clinical recommendations.
Three weeks later the patients were recalled, the which was inspected daily over a 30-day period be regularly subjected to occlusal forces. As the
Results/Conclusion: Cavit possesses favorable
fillings were removed, and the paper disks were for bacterial microleakage. powder: liquid ratio is decreased, the seal
marginal seal but inferior mechanical properties
analyzed for bacterial growth. Results/Conclusion: GI gave the best seal improves (at the expense of mechanical
compared to IRM. Studies have shown that IRM
Results/Conclusion: 1/18 IRM samples showed against bacteria (1/20 samples leaked), properties). (3)
also provides a favorable marginal seal,
bacterial growth, whereas 0/19 Cavit samples whereas Cavit gave the poorest seal (13/20
especially when the powder: liquid ratio is
showed growth. No significant difference was samples leaked). 11 out of 20 IRM samples 3. GI has been found in an in vitro study to have a
decreased. GI is more costly, but has been found
found between IRM and Cavit. leaked. superior seal to Cavit and IRM (2). Because of
to be antibacterial and to have a superior seal;
Validity/Applicability: Restoration type was Validity/Applicability: Results of in vitro studies this, GI has been recommended for longer term
thus it may be used for cases of long-term
randomly assigned. Follow up was 100%. in vivo cannot directly be applied to clinical practice. temporization (3).
temporization.
study. 3 week follow-up realistic at UIC COD. However, all available filling materials to UIC
Validity/Applicability: Authors did not provide a 4. Studies have recommended that a definitive
Level of Evidence: 2 (Randomized Controlled COD students were tested.
detailed selection criteria for articles reviewed. restoration be placed as soon as possible
Trial) Level of Evidence: 6 (Preclinical study)
Level of Evidence: 5 (Expert Opinion) following obturation (2, 3).
.
17. Once you have identified a case:
• Identify a mentor
• Primary Contact: Group Practice Manager
• All project Titles should be emailed or turned
into Katherine Long at longka@uic.edu by
January 9th 2012
• Talk to previous participants
