School of Dentistry

Practice-based Research in Oral Health Network

SOD Stock Banner PROH

Practice-based Research in Oral Health (PROH) is an infrastructure that facilitates research studies conducted in practice settings outside the university, primarily private practices.

Guidance is provided in the design of research studies, grant proposal submission, and the identification of appropriate practitioners and practices. PROH interfaces with regulatory oversight entities, trains the research practitioners, and manages the implementation of research projects. Clients of PROH are the private practitioners themselves, university researchers, product manufacturers, research organizations, foundations and service providers.

Goal

The goal of PROH is to provide the research infrastructure for generating practical, timely information that can be used by dental practitioners to enhance the quality and effectiveness of oral health care delivered to the general public.

The PROH Network conducts clinical oral health research using practitioners from different regions in Oregon and Washington, operating within their own practices, in their own communities, and on their own diverse patient pools.

This cadre of well-trained dental professionals is capable of undertaking research to answer questions that arise during the every day practice of dentistry and to evaluate products, procedures and behaviors. Virtually any clinical research project can be performed.

Background

Practice-based Research Networks (PBRNs) are an established mechanism to conduct clinical research in medicine. They have been in existence for several decades, and have been successfully employed to investigate a wide variety of relevant medical issues. However, PBRNs have not been a part of oral health clinical research. The Practice-based Research in Oral Health (PROH) network was established to address this deficiency.

Controlled clinical trials are conducted primarily in university settings under very closely managed conditions. This scenario imparts the necessary scientific rigor to ensure that results are attributable to the independent variables. It helps to ensure that the study outcomes provide accurate and precise information about a new treatment, material, or technique. These controlled clinical studies are most useful for determining the maximum potential of the treatment of interest.

However, clinical trials in the university setting do not duplicate how various procedures are performed in routine practice outside of this setting, and therefore do not provide information about the typical outcomes to be expected within a practice-based population of clinicians. This discrepancy can significantly affect conclusions regarding oral health care outcomes. The controlled clinical trials are very expensive, and typically too small to include enough members of varying populations. In addition, controlled clinical trials do not allow assessment of disease progression and treatment effects under the normal “in situ” conditions in which dentistry is routinely practiced.

Therefore, there is a need for practice-based clinical studies that can reach a large and diverse population, while maintaining an adequate level of control of the design and conduct of the study. This is the intent of PROH.

Overview

The Practice-based Research in Oral Health (PROH) Network has the infrastructure to perform a wide variety of oral health research studies in a diversity of practice settings across Oregon and southwest Washington. It is designed to address certain shortcomings of clinical research as it is currently carried out.

The PROH Network is practitioner-centric with the participating practitioners and investigators actively involved in generating project ideas, as well as conducting the studies.

We also have the expertise, not just in the School of Dentistry, but in the university at large, to make this project a success.

The Network provides great flexibility as to future directions for research. The existing infrastructure has sufficient numbers and a variety of practitioners and practice settings to conduct virtually any clinical research project. It also serves as a focus for outreach by the dental school, and provides opportunities for involvement of the dental school with practices in rural and/or underserved communities. To this end, PROH is actively engaged with the Oregon Rural Practice-based Research Network (ORPRN) to investigate projects of mutual interest

Funding

An OHSU Center of Excellence in Clinical Research (COEHR) grant from the Oregon Opportunity fund demonstrates the institutional commitment to the PROH Network and endorses the importance of this approach to clinical research.

Additional support from the Austin Clinical Research Endowment is greatly appreciated and indicative of the excitement generated in the community by the concept of practice-based research.

Funding for future studies is being pursued from the National Institutes of Health, foundations and the dental manufacturing industry.

Organizers

The PROH network is governed by a steering committee. It is comprised of private practitioners, OHSU School of Dentistry faculty and staff, and other OHSU faculty. The members of the steering committee are:

Private practitioners

Sean Benson, D.D.S., Baker City, Oregon
Mark Driver, D.M.D., Roseburg, Oregon
Mark Jensen, D.M.D., Bend, Oregon
Walt Manning, D.M.D., Albany, Oregon
George McCully, D.M.D., Eugene, Oregon
John Shurtz, D.D.S., Salem, Oregon

OHSU faculty

Lyle J. Fagnan, Director of Oregon Rural Practice-based Research Network
Cynthia Morris, Director of Oregon Human Investigations Program

OHSU School of Dentistry Faculty and Staff

Thomas J. Hilton is the Director of PROH. He received his D.M.D. in 1978, two-year A.E.G.D. certificate in 1984, board certification from the American Board of General Dentistry in 1992, and M.S. degree in Biomaterials and Biomechanics in 2003.   He spent 21 years in the U. S. Air Force, and joined the OHSU faculty in 1999.   He currently holds the position of Alumni Centennial Professor in Operative Dentistry and maintains a part time private dental practice. His research interests include laboratory and clinical evaluation regarding restorative dental materials and techniques.

Jack L. Ferracane received his M.S. degree in 1981 and his Ph.D. in 1983, both in biomaterials from Northwestern University. After teaching for five years at Baylor College of Dentistry, Ferracane arrived at OHSU in 1989. He is the chair of the Department of Restorative Dentistry and the division director of the Department of Biomaterials and Biomechanics. His research interests include studies on the structure, function and clinical performance of dental restorative materials.

Cindy G. Barnes is the Program Manager for PROH. She received her R.D.H. in 1979 and an M.B.A. in 1989, both from the University of Colorado. Her dental experience is in general and periodontal practices, a Veteran's Administration Hospital, and as a clinical instructor at Colorado Northwestern Community College. She comes to OHSU after spending four years in development work in Central Europe with the Peace Corps and Junior Achievement International

OHSU School of Dentistry faculty and staff

Thomas J. Hilton is the Director of PROH. He received his D.M.D. in 1978, two-year A.E.G.D. certificate in 1984, board certification from the American Board of General Dentistry in 1992, and M.S. degree in Biomaterials and Biomechanics in 2003.   He spent 21 years in the U. S. Air Force, and joined the OHSU faculty in 1999.   He currently holds the position of Alumni Centennial Professor in Operative Dentistry and maintains a part time private dental practice. His research interests include laboratory and clinical evaluation regarding restorative dental materials and techniques.

Jack L. Ferracane received his M.S. degree in 1981 and his Ph.D. in 1983, both in biomaterials from Northwestern University. After teaching for five years at Baylor College of Dentistry, Ferracane arrived at OHSU in 1989. He is the chair of the Department of Restorative Dentistry and the division director of the Department of Biomaterials and Biomechanics. His research interests include studies on the structure, function and clinical performance of dental restorative materials.

Cindy G. Barnes is the Program Manager for PROH. She received her R.D.H. in 1979 and an M.B.A. in 1989, both from the University of Colorado. Her dental experience is in general and periodontal practices, a Veteran's Administration Hospital, and as a clinical instructor at Colorado Northwestern Community College. She comes to OHSU after spending four years in development work in Central Europe with the Peace Corps and Junior Achievement International

2018 Annual Conference
2017 Annual Conference
2016 Annual Conference
2015 Annual Conference
2014 Annual Conference

The PROH Network is truly multidisciplinary in nature. Over 150 practitioners in 40 communities in Oregon and Southwest Washington have expressed interest in becoming PROH investigators. It is designed to meet the needs of general practitioners as well as specialists and for those living in rural areas and metropolitan settings. The PROH Network is practitioner-centric with the participating practitioners and investigators actively involved in generating project ideas, as well as conducting the studies.

Expertise is committed from the School of Dentistry and OHSU at large to make this project a success. All of the departments within the School of Dentistry can utilize the PROH network. An agreement is in place with our medical counterpart, the Oregon Rural Practice-based Research Network (ORPRN), to share some of their on-site research coordinators. One joint study with ORPRN has been completed and both networks are vigilant to further opportunities for cooperation. The School of Medicine and Medical Informatics has been involved in the design of PROH's infrastructure, and data collection/data management systems for the Network.

The Network has the infrastructure to conduct virtually any clinical dental research project.

PROH Network

Practitioners in the PROH network participate in surveys and clinical trials in their own offices with their own patients. Click on the study titles below to see summaries and results of PROH research projects.

Cracked Tooth Survey
Effects of Eugenol Concentration in ZOE Study
First Online Survey of PROH Members
Posterior Composite Clinical Trial
School of Dentistry Curriculum Survey
Temporary Crown Clinical Trial
Unmet Dental Needs Study

Research involving human subjects is a highly regulated activity. OHSU is committed to meet or exceed all federal requirements to protect the health of patients and the privacy of their health-related information. PROH practitioners need to complete the following training components: 

1. If you are a visiting doctor, scholar, non-OHSU student, non-OHSU trainee, intern, non-research volunteer or other affiliate of OHSU, you will first need to complete and submit the Compass online request form.All dentist research partners are required to complete the online HIPPA training.
Be sure to follow the step-by-step instructions. The training will take 1-1.5 hours. 

2. Responsible Conduct of Research (RCR) Education. All dentist research partners and staff members involved in studies are required to complete one module of the online Responsible Conduct of Research (RCR) Education. The Web site can be found at https://bigbrain.ohsu.edu/. Be sure to follow the step-by-step instructions.
The training will take approximately 20 minutes. 

Resources

Contact us

Thomas J. Hilton, D.M.D., M.S.
Director
hiltont@ohsu.edu

Cindy Gibb Barnes, B.S.D.H., M.B.A.
Program Manager
barnesc@ohsu.edu

Mailing address:

School of Dentistry
Oregon Health & Science University
Mailcode SD-REDE
2730 SW Moody Ave.
Portland, OR 97201-5042