Evidence and the Practice of Prosthodontics: 20 Years after EBD Introduction

Prosthodontics has a rich history related to the principles embedded in evidence-based health care. This paper reviews the evidence-based prosthodontics activity over the past 3 decades. It also discusses the impact of health care reform on evidence-based medicine as it relates to broader context of care outcomes. Finally, the value associated with an Evidence Stewardship emphasis in prosthodontics is presented. This emphasis suggests that combining evidence from clinical trials with evidence from clinical practice environments best equips clinicians for the management of patients in the future. Adoption of a strategic Evidence Stewardship direction is an extended commitment to change that recognizes health care reform aims and seeks to be an accountable provider group in the broader health care arena. The vision to form a representative network of prosthodontic practitioners that augments a commitment to Cochrane “clinical trial” data demonstrates a responsibility to professional transparency about who we are, adds value for patients and oral health care providers, impacts teachers and students in dental education, and provides a measure of care accountability unique in dentistry. The history of prosthodontic involvement in evidence-based dentistry (EBD) spans three decades. 1 The importance for recognizing and appreciating this history relates to the utility it brings to future knowledge creation; a challenging process in light of knowledge and technology expansion, the speed of change, and the complexity associated with identifying information important to integrate with patient care. 2 This paper will review the prosthodontic EB activity since 1993. Additionally, the health care reform impact on evidencebased medicine (EBM) will be discussed as it relates to broader context of care outcomes. Finally, the value associated with an Evidence Stewardship emphasis in prosthodontics will be presented. This emphasis suggests that combining evidence from clinical trials with evidence from clinical practice environments best equips clinicians for the management of patients in the future. 3