title: Rehabilitation of children with ectodermal dysplasia. Part 1: an international Delphi study.
abstract: OBJECTIVE
  An international Delphi study was undertaken to determine by consensus an agreed approach to the management of children with dental manifestations of ectodermal dysplasia, including the use of dental implants. This was done using a questionnaire developed by an interdisciplinary team.
  
  
  METHODS
  The Delphi study questionnaire was built around 19 areas of clinical relevance and included 90 items. Topic areas included dental disability; initial diagnosis; global disability; oral health aspects of dental treatment (orthodontics, hypodontia, anodontia, implants); and case studies of selected treatment options. Eleven teams from six countries contributed to three iterations of the questionnaire. An algorithm was designed to standardize analysis of the questionnaire answers, all of which were blinded to ensure anonymity. The second and third rounds of the questionnaire excluded previously agreed-upon items but included the responses to the questions from the earlier rounds. The nonconsensus items inquired about the use of radiographs at initial diagnosis; sedation of an uncooperative child; use of a pretreatment questionnaire; the age range for specific treatments (eg, dentures, orthodontics, implants); specific uses of implants (eg, partial prostheses, overdentures, cantilevered prostheses); and case study 2. The residual nonconsensus questions were subsequently discussed at a 2-day meeting.
  
  
  RESULTS
  Among the 90 questions and partial questions, there was progressive consensus, with agreements in rounds 1, 2, and 3 of 61%, 21%, and 8%, respectively. At the conclusion of round 3, there was 90% agreement and it was considered that the nonconsensus items required in-depth face-to-face discussion at a consensus meeting, which is described in part 2 of the study.
  
  
  CONCLUSIONS
  The Delphi study provided an opportunity to engage specialist teams in recognized centers to integrate their clinical knowledge and draw on published data to develop a consensus of evidence-based responses.
authors.affiliation: The University of Sydney, Westmead Hospital Center for Oral Health, Westmead, New South Wales, Australia. iven.klineberg@sydney.edu.au
authors.forename: Iven
authors.initials: I
authors.lastname: Klineberg
authors.forename: Angus
authors.initials: A
authors.lastname: Cameron
authors.forename: Terry
authors.initials: T
authors.lastname: Whittle
authors.forename: John
authors.initials: J
authors.lastname: Hobkirk
authors.forename: Birgitta
authors.initials: B
authors.lastname: Bergendal
authors.forename: Marie-Cecile
authors.initials: MC
authors.lastname: Maniere
authors.forename: Nigel
authors.initials: N
authors.lastname: King
authors.forename: Richard
authors.initials: R
authors.lastname: Palmer
authors.forename: Ross
authors.initials: R
authors.lastname: Hobson
authors.forename: Clark
authors.initials: C
authors.lastname: Stanford
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kurtz
authors.forename: Arun
authors.initials: A
authors.lastname: Sharma
authors.forename: Albert
authors.initials: A
authors.lastname: Guckes
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003697:Delphi Technique; D015921:Dental Implants / Q000009:adverse effects; D004476:Ectodermal Dysplasia / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D005147:Facial Bones / Q000254:growth & development; D005260:Female; D006801:Humans; D008297:Male; D012886:Skull / Q000254:growth & development; D009057:Stomatognathic Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D055815:Young Adult
chemical_list: D015921:Dental Implants