Research in Clinical Setting

This study focuses on the critical review of literature for identifying effective treatment for relieving symptoms of third molar pericoronitis by focusing on two main types of methods: Saline irrigation and systematic antibiotic.

RESEARCH IN CLINICAL
SETTING

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
RESEARCH METHODOLOGY....................................................................................................1
RESULT ACTION..........................................................................................................................3
DISCUSSION..................................................................................................................................5
LIMITATION AND RECOMMENDATIONS..............................................................................6
CONCLUSION................................................................................................................................7
REREFENCES................................................................................................................................8

INTRODUCTION
Overview
Pericoronitis is a kind of inflammation of tissue which is surrounding a third molar. It is
also known as wisdom tooth (Xiao and Watson, 2019). This condition mainly occurs when a
molar is partially impacted or is not completely visible. This condition is mostly common in
upper or lower molars. This study will focus upon critical review of literature for identification
of effective treatment for relieving symptoms of third moral pericoronitis by focusing upon two
main type of methods that are Saline irrigation and systematic
Aim
To clinically review an article using CASP tool for identifying effectiveness of Saline
irrigation and systematic antibiotic in relieving symptoms of third molar pericoronitis.
Research Questions
Research question of this study will be designed with the help of PICO framework. It is
used for breaking research topic in such a manner that search terms for data base can be
identified and research question which is required to be answered can also be framed. In this
framework PICO stans for:
P: Describing population and condition
I: Intervention or indicator which is being searched for
C: Comparison of intervention with another intervention
O: Does not of the intervention change desired outcome
P: population People having third molar pericoronitis
I: Intervention systematic antibiotic
C: Comparison Saline irrigation
O: Outcome Relieve in painful symptoms of third molar pericoronitis
According to PICO framework research question required to be focused upon is: Which
is more effective treatment in relieving symptoms of third molar pericoronitis Saline irrigation or
systematic antibiotic?
RESEARCH METHODOLOGY
Search strategy
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For critical review and analysis of research articles it is extremely important to develop a
search strategy (Xiao and Watson, 2019). Search strategy chosen for searching articles from
database is as follows:
 All the search terms identified for and used for searching literature from database so that
critical review of articles hosen can be done. All the identified key words helped in searching
40 articles from database.
 Then screening of selected articles were done as per the title and abstract of articles 30
articles were segregated and remining 10 were excluded.
 Then eligibility of all the articles were checked by reading full text of all the articles and
from those 30 articles only 20 articles were segregated.
 As per the inclusion and exclusion criteria only out of 20 10 studies were excluded. Lastly
out of 10 only 7 studies were selected and rest of the 3 were excluded as they were more
than 7 years old.
 Lastly only 7 studies were selected for systematic review out of which 3 studies were
selected from reference list of selected articles.
Inclusion and exclusion criteria
Inclusion criteria: selected studies must consist of 2 or more than two key words, studies that
include feedback provided by patients or their experience will also be include
Exclusion criteria: studies that are more than 7 years old will not be included. Studies that are in
language other than English will also not be included.
Data analysis
Data Analysis is one of the most important part of a study as it helps in analysis of data
collected so that main aim of the research study can be achieved and desired research question
can be answered appropriately (Mohajan, 2018). Data analysis methods are of various types data
analysis methods but they are categorised into two categories: qualitative and quantitative data
analysis (Xiao and Watson, 2019). As it is a qualitative study in which critical analysis of articles
related to research topic is required to done. So, for this matrix method has been chosen for
analysis of data collected for this qualitative study. This method focuses upon representing
logically consistent and structured approach for analysis of qualitative data. Using this method
systematic literature review of chosen articles will be done as it is one of the most suitable
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methods that can be used for critical analysis. Critical analysis of chosen articles will be done
with the help of CASP tool
Key search terms
Main key terms used for identification of articles or research papers for critical review are:
treatment, third molar pericoronitis, Saline irrigation, systematic antibiotic, patients.
RESULT ACTION
CASP Tool
CASP tool can be defined as a kind of tool which is also known as critical Appraisal skill
program tool which is basically used for randomized control traits so that clear sense of clinical
trials can be gained (James, Randall and Haddaway, 2016). This tool is used for analysing
articles or studies so that literature review can be assessed clearly. Selected study is evaluated on
the basis of 10 questions that are:
1. Did the tile of the paper clearly describe the study?
2. Did the study address clear focused issue?
3. Was the recruitment strategy appropriate for the aim of the study?
4. Were appropriate number and quality of participants recruited for the study or not?
5. Is methodology appropriate?
6. Was research design appropriate to address aim of the research?
7. Was data collection done in the way that addressed the research issue?
8. Was the selected study biased or limitation were clearly addressed?
9. Did discussion link available literature to current study clearly?
10. Have ethical issues been clearly taken into consideration or not?
Studies 1 2 3 4 5 6 7 8 9 10
(Eroglu and et.
al., 2018)
+ + + + - - + - + +
(Ramos and et.
al., 2016)
+ + + + - + + - - +
(Yurttutan and
et. al., 2020)
- + - + + - + - + -
(Cope and et.
al., 2016)
+ + - + + - + + + +
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(Huang and et.
al., 2020)
- - + + - + + + + -
(AlHindi,
2017)
+ + - + + - + - + +
(Oyri and et.
al., 2016)
- + + + + - + - + +
(Bhujbal and
et. al., 2019)
+ - - + + + - + + -
(Azemi and et.
al., 2019)
+ + + + - + + - + +
Literature Flow chart
Figure 1 Literature Flow chart
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DISCUSSION
The rationale for conducting the study is to verify the possibility of treating pericoronitis
with consideration of low risk alternative. Another important reason is that when reduce the
quantity of antibiotics medication. In order to test of new oral formulation with MB. Through
this research study, it has been identified the symptoms of third molar pericoronitis Saline
irrigation and systematic antibiotic in relieving symptoms of third molar pericoronitis Saline
irrigation (Pepper and et. al., 2016). However, the specific treatment of pericoronitis varies
among different health professionals but they have no specific evidence- based on the standard of
care. In order to establish the better way to reduce the length period of oral pain and also
associated with the complication.
This study has been described about the certain condition of patient and also preferred the
effective treatment for patient by using acute pericoronitis. As per analysis, it has identified the
significant impact of pericoronitis towards patient. Moreover, medical health professionals, their
clinical practice and background which always support for giving better option in term of
treatment (Compain and et. al., 2018). However, it has determined the best treatment option
which is mainly include prescribing antibiotic, root planning of affected area or place. It became
useful for resection of inflamed soft tissues over reducing the pain. Furthermore, there are wide
range of technique or method which provided as option in survey to signify lack of standard
approach in term of treatment. In some situation, it has been considered the standard method to
performance action against pain relief.
This study has been identified the most commonly affected teeth such as third Molars. By
using surgical process, it can be removed the wisdom teeth. Generally, it can be done by
maxillofacial surgeons and other dentists. The affected wisdom teeth can cause ulceration and
swelling around. Sometimes, it also damaged the root of second molars. General agreement has
been exists that removal of non-restorable third molars which become appropriate if occurred
sign or symptoms of disease related to the wisdom teeth.
Through this study, it has been collected large amount of information on the basis of
evidence and underlying the message of lack of consistent protocol in term of care within acute
pericoronitis. As per result, it has found that 41% of oral professionals had never performed third
moral extraction process (Xiao and Watson, 2019). On the other hand, 77% preferred to choose
antibiotic treatment procedure to reduce pain (Noroozi and Philbert, 2019). Sometimes, it refers
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to the great specialist related the acute pericoronitis. It can be identified the positive response of
medical professional through clinical practices. Study has been shown the accurate result or
outcome, giving the better treatment for patient. Based on the response by health professional, it
has been shown the most preferred treatment which is known as antibiotic treatment with follow-
up.
According to study, it has been prescribing the antibiotic and also scheduling to follow-
up on timely manner (Campbell, 2016). However, timeline may be varied between the service
provider but also require to follow immediate action against the pain of molar pericoronitis. In
order to consider the more effective antibiotic treatment in relieving symptoms, pain.
As per the critical review of articles it can be said that both the interventions has their
own effectiveness in providing relief in symptoms of third molar pericoronitis. It has also bee
observed that saline irrigation is a simple hygiene practise that can provide small amount of
relief in pericoronitis symptoms but systematic antibiotics is one of the most effective way
though which all the symptoms of pericoronitis can be relieved.
LIMITATION AND RECOMMENDATIONS
There were various kinds of limitations that were present in literature review, that created
some gap in this literature review that can be focused upon in future for further studies. One of
the main limitations of this literature review was that it only focused upon qualitative studies in
which interview, survey, focus group etc. were focused upon. No quantitative studies were
focused upon in this study. Due to which effectiveness of both the treatment were measured
observationally only. Value analysis of both the studies was not done. This limitation has
created a gap in this literature review. another limitation of this study is that it only focuses upon
two interventions that can be used for relieving symptoms of third molar pericoronitis. There are
many other methods that can be used for relieving symptoms of third molar pericoronitis.
Another limitation of this literature review was authenticity of data of all the selected articles for
critical review. In this critical review data and findings of selected articles were only reviewed
and solely based upon this review. It can also be said that no primary data was collected for
answering the main research questions. So, in future primary data analysis can be done in which
data from patients having third molar pericoronitis will be collected and analysed using
quantitative method so that different kinds of methods that can be used for this condition can be
focused upon and measured quantitatively.
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CONCLUSION
From the above critical review, it has been concluded that there are two main types of
treatments that are used for relieving symptoms of third molar pericoronitis. But out of both the
interventions mostly systematic antibiotics is the mostly used treatment which is opted for
relieving from symptoms of third molar pericoronitis. Critical review of chosen articles clearly
explains that most of the professionals choose antibiotics treatment. There is no doubt that the
other treatment i.e. Saline irrigation is also used as a pain reliever of symptoms of this problem
faced by peoples. But this critical review has various kinds of gaps in critical review of literature.
One of the main gap in literature review was that there are many other treatment methods such as
surgery etc. that were not focused upon in this study. This study only focused upon two
interventions and their effectiveness in reviving symptoms of pericoronitis that mostly occurs
either at surroundings of lower or upper molar.
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REREFENCES
Books and Journals
AlHindi, M., 2017. Dry socket following teeth extraction: Effect of excessive socket saline
irrigation. J Oral Health Dent Sci. 1(1). pp.2-5.
Azemi, A.L., and et. al., 2019. Identification of the Predominant Oral Microbiome in
Pericoronitis. Journal of International Dental and Medical Research. 12(4). pp.1522-1526.
Bhujbal, R., and et. al., 2019. Effect of oral contraceptives in the incidence of dry socket after
mandibular 3rd molar extraction: A prospective clinical study.
Campbell, J.H., 2016. Third Molar Pericoronitis. Journal of Oral and Maxillofacial
Surgery, 74(11), p.2122.
Compain, H., Berquet, A., Loison-Robert, L.S. and Ahossi, V., 2018. Complication of facial
cellulitis: muscle hematoma after surgical treatment of complicated
pericoronitis. Journal of Oral Medicine and Oral Surgery, 24(3), pp.122-124.
Cope, A.L., and et. al., 2016. Antibiotic prescribing in UK general dental practice: a cross‐
sectional study. Community dentistry and oral epidemiology. 44(2). pp.145-153.
Eroglu, C.N., and et. al., 2018. Clinical and histological evaluation of the efficacy of
antimicrobial photodynamic therapy used in addition to antibiotic therapy in pericoronitis
treatment. Photodiagnosis and photodynamic therapy. 21. pp.416-420.
Huang, X., and et. al., 2020. Microbial Profile During Pericoronitis and Microbiota Shift After
Treatment. Frontiers in Microbiology. 11. p.1888.
James, K.L., Randall, N.P. and Haddaway, N.R., 2016. A methodology for systematic mapping
in environmental sciences. Environmental evidence, 5(1), p.7.
Mohajan, H.K., 2018. Qualitative research methodology in social sciences and related
subjects. Journal of Economic Development, Environment and People, 7(1), pp.23-48.
Noroozi, A.R. and Philbert, R.F., 2019. Modern concepts in understanding and management of
the “dry socket” syndrome: comprehensive review of the literature. Oral Surgery, Oral
Medicine, Oral Pathology, Oral Radiology, and Endodontology. 107(1). pp.30-35.
Oyri, H., and et. al., 2016. Mandibular third molar surgery in 396 patients at a Norwegian
university clinic: Morbidity recorded after 1 week utilizing an e-infrastructure for clinical
research. Acta odontologica Scandinavica. 74(2). pp.148-154.
Pepper, T., Konarzewski, T., Grimshaw, P. and Combes, J., 2016. Treatment of mandibular third
molars and pericoronitis in British military personnel: influence of guidelines from the
National Institute for Health and Clinical Excellence. British Journal of Oral and
Maxillofacial Surgery, 54(10), pp.1111-1115.
Ramos, E., and et. al., 2016. Do systemic antibiotics prevent dry socket and infection after third
molar extraction? A systematic review and meta-analysis. Oral surgery, oral medicine, oral
pathology and oral radiology. 122(4). pp.403-425.
Wadia, R. and Ide, M., 2017. Periodontal Emergencies in General Practice. Primary Dental
Journal. 6(2). pp.46-51.
Xiao, Y. and Watson, M., 2019. Guidance on conducting a systematic literature review. Journal
of Planning Education and Research, 39(1), pp.93-112.
Yurttutan, M.E., and et. al., 2020. Comparison of the quality of life of patients with mandibular
third molars and mild pericoronitis treated by extraction or by a periodontal
approach. British Journal of Oral and Maxillofacial Surgery. 58(2). pp.179-184.
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Mohajan, H.K., 2018. Qualitative research methodology in social sciences and related
subjects. Journal of Economic Development, Environment and People, 7(1), pp.23-48.
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