Errors and complications in clinical periodontal practice due to methodologic bias and bad interpretation of the evidence

Abstract

Different types of errors and complications may arise during and after the execution of periodontal or implant‐related procedures. Some of the most relevant, although also controversial, and less commented, causative agents of errors and complications are methodological biases and bad interpretation of the evidence. Proper assessment of the literature requires of solid clinical knowledge combined with a systematic approach built on the recognition of common methodological biases and the avoidance of interpretive errors to critically retrieve, dissect, and judiciously apply available information for the promotion of periodontal and peri‐implant health. This review addresses common types of methodological bias and interpretive errors that can alter the reader's perceptions on the real effect and potential ramifications of the reported outcomes of a given therapeutic approach due to bad interpretation of the available evidence: (1) types of methodological biases; (2) spin and interpretive bias; (3) interpretation pitfalls when assessing the evidence (4) choice of relevant endpoints to answer the question(s) of interest; and (5) balance between statistical significance and clinical relevance.

Diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects and Gingival Phenotype: A multicenter inter‐ and intra‐examiner agreement study

“…It is important to highlight that the proper assessment and analysis of GRD characteristics is one of three essential pillars for the effective management of these clinical entities, 8,10 together with a proper identification of the etiologic agent(s) associated with the onset and progression of the defect and the selection of the most appropriate treatment option(s) 8 . The use of proper diagnostic and classification tools may reduce the occurrence of errors and the introduction of ‘treatment biases’ (i.e., errors that lead to a deviation from the true intervention effect) which may lead to a ‘downhill’ cascade of events (e.g., an inaccurate diagnosis that might lead to an incorrect interpretation of the evidence, inadequate formulation of a treatment plan, and erroneous treatment) 17 …”