title: Restoring the fractured root-canal-treated maxillary lateral incisor: in search of an evidence-based approach.
abstract: OBJECTIVE
  To demonstrate the existing difficulties and variability in the application of evidence-based dentistry by comparing the recommendations made by 4 dental experts for the treatment of a fractured tooth.
  
  
  METHODS
  A case presentation was given to 4 specialists, who were asked to independently develop and explain their personal favorite treatment strategy, based on the best available external evidence and their clinical expertise. The entire case was then reviewed by an expert in evidence-based medicine and discussed with the first author.
  
  
  RESULTS
  Each of the 4 experts relied on different articles in justifying their clinical decisions. The minimal overlap in the literature they cited largely explains the different treatment suggestions: While the endodontist preferred a metal post-and-core and a porcelain-fused-to-metal (PFM) crown, both the operative dentist and the prosthodontist opted for a glass-fiber post/fiber-reinforced resin composite post. The perio-prosthodontist recommended a PFM crown with either a direct or indirect post and core. The citation analysis revealed that little high-quality information is available about what would be the best therapy for horizontal fractures of root-canal-treated anterior teeth.
  
  
  CONCLUSIONS
  This article illustrates that, although it is now common practice in dentistry to base clinical decision making on external evidence from the literature, search strategies and the resulting clinical recommendations still vary greatly.
authors.affiliation: Clinic for Reconstructive Dentistry and Temporomandibular Disorders, Dental School, University of Basel, Basel, Switzerland. jens.tuerp@unibas.ch
authors.forename: Jens C
authors.initials: JC
authors.lastname: Türp
authors.forename: Guido
authors.initials: G
authors.lastname: Heydecke
authors.forename: Gabriel
authors.initials: G
authors.lastname: Krastl
authors.forename: Oliver
authors.initials: O
authors.lastname: Pontius
authors.forename: Gerd
authors.initials: G
authors.lastname: Antes
authors.forename: Nicola U
authors.initials: NU
authors.lastname: Zitzmann
mesh_terms: D004708:Endodontics; D019317:Evidence-Based Medicine; D006801:Humans; D007180:Incisor / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011176:Post and Core Technique; D014082:Tooth Fractures / Q000209:etiology / Q000628:therapy*; D014092:Tooth Root / Q000293:injuries; D019553:Tooth, Nonvital / Q000150:complications*