Focusing on outcomes and methods in removable prosthodontics trials: a systematic review

Objectives: The aim of this study was to systematically examine the outcomes of interest of trials in removable prosthodontics and to assess their overall quality. Material and methods: Electronic databases were searched up to August 2011 and complemented by hand searching for published randomized controlled trials (RCTs) in the field of removable prosthodontics in the six major prosthodontic and implant journals. The primary outcome of RCTs was considered as the outcome of interest of this review, and only manuscripts in which the study's primary outcome was reported in the abstract were included. Outcomes were classified according to the Strength of Recommendation Taxonomy (SORT) classification. The quality of individual reports of RCTs was assessed following the Cochrane Handbook for Systematic Reviews of Interventions (Higgins & Green, www.cochrane-handbook.org). Results: The search retrieved 86 reports of RCTs. Among these publications, 43% reported a patient-oriented primary outcome. Most of the publications did not present a clear description of sequence generation (54%) or allocation concealment (65%). Blinding of participants, clinicians, and outcomes assessors was not applicable or reported in most trials. Handling of withdrawals and losses was adequate in 52% of trials. Conclusions: Although published RCTs in removable prosthodontics have increased over time, efforts should be made to increase patient-reported outcomes and the methodological quality of these reports. Such improvement will lead to a better body of evidence in the field, thus providing increased support for clinical decision-making.