Function Consensus report of Working Group 3 Asbjrn Jokstad Jens C. Tu ¨rp On behalf of Working Group 3 n Authors’ affiliations: Asbjrn Jokstad, Department of Prosthodontics, University of Toronto Faculty of Dentistry, Toronto, Canada Jens C. Tu ¨rp, Clinic for Reconstructive Dentistry and Temporomandibular Disorders, Dental School, University of Basel, Switzerland Correspondence to: Prof. Asbjrn Jokstad Department of Prosthodontics University of Toronto Faculty of Dentistry 124 Edward Street Toronto, ON M5G 1G6 Canada Tel.: þ 1 416 979 4930 Fax: þ 1 416 979 4936 e-mail: a.jokstad@dentistry.utoronto.ca Key words: attrition, biomechanics, bruxism, clinical research, clinical trials, dysfunction, occlusal designs, oral health-related quality of life, temporomandibular disorders, tooth wear, systematic review Abstract: The method used by the working group was an iterative process based upon a structured review of the relevant literature by the four author groups. Review papers were circulated to the members of the group before the conference and formed the basis for subsequent discussions. Each paper was subject to detailed collective analysis and subsequently modified on the basis of the panel’s discussions and referenced to additional relevant literature where appropriate. The group assessed the levels of evidence for the claims and statements made in the supporting documentation. It was recognized that it was often necessary to adopt a compromise between acceptance of the lowest level, resulting in the largest body of material, and the highest level, which in some cases, produced little evidence. While this approach does not represent endorsement of lower evidence levels per se, it was designed to provide conclusions of clinical utility within the existing knowledge base. The papers, following the scrutiny, were amended and approved by the expert group. The consensus report was prepared by the working group after detailed considerations of the five approved papers. The working group was charged with eval- uating the available evidence for dimen- sions of stomatognathic function that influence outcome of prosthetic therapy. Some of these factors were elucidated in five systematic reviews. All reviews addressed clearly focused issues, i.e., (i) How do patients perceive benefit from reconstructive dentistry (Oral health-related quality of life)? (ii) What is the basis for occlusal designs in tooth, denture and implant borne reconstructions? (iii) In patients with temporomandibular disorders, do particular interventions influ- ence oral health-related quality of life? Is there a superiority of multimodal as opposed to simple therapy in patients with tempor- omandibular disorders? and (iv) What is the treatment concept for severe tooth attrition? All author teams reported difficulties in conducting quantitative reviews on these topics for reasons beyond identification difficulties and accessibility to full text papers. The most common problem was the heterogeneity of treatments and man- agement as well as lack of crucial details on how to differentiate between interventions. Moreover, it was recognized that several recommendations from the reviews, as well this consensus report, are based on less than ideal levels of evidence. The use of bibliographic databases varied markedly amongst the five author groups. Medline was the most commonly used database and all five author groups had used this resource. One author group re- ported using only Medline, while another combined Medline with searches on the Premedline, the Cochrane Library and the ISI Web of Science. Checks from the reference lists were also not consistently reported being used. Resources for non- English literature were not searched, e.g. Embase (European, non-English titles) and Bireme (Spanish and Portuguese). The expert group members agreed that the sys- n David Bartlett, Nico Creugers, Dominik A. Ettlin, Guido Heydecke, Iven Klineberg, Ignace Naert, J. Mark Thomason, Arie van’t Spijker, Isabelle Windecker- Ge ´taz. To cite this article: Jokstad A, Tu ¨ rp JC. Function. Consensus report of Working Group 3. Clin. Oral Impl. Res. 18 (Suppl. 3), 2007; 189–192 doi: 10.1111/j.1600-0501.2007.01441.x c  2007 The Authors. Journal compilation c  2007 Blackwell Munksgaard 189