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Plastic and Reconstructive Surgery Jul 2016There is conflicting evidence on the effectiveness of the various strategies to prevent postoperative seroma. Many high-quality studies have been performed to evaluate... (Review)
Review
BACKGROUND
There is conflicting evidence on the effectiveness of the various strategies to prevent postoperative seroma. Many high-quality studies have been performed to evaluate those strategies, but the numbers of patients included in those studies have been small. The authors' goal was to perform a systematic review of all Level I and II studies on the prevention of postoperative seroma.
METHODS
A PubMed search was performed of all Level I and II studies that evaluated strategies for the prevention of postoperative seroma. Only English-language comparative studies on humans, defining seroma as a postoperative serous fluid collection detectable on physical examination, were included. Data from all the studies were compiled, and a systematic review was performed to evaluate the effectiveness of each strategy.
RESULTS
Seventy-five studies comprising 7173 patients were included. Effective strategies for seroma prevention included the use of closed-suction drains; keeping the drains until their output volume was minimal; maintaining a high pressure gradient in the drains; using sharp or ultrasonic dissection rather than cautery; dissecting the abdomen in a place superficial to the Scarpa fascia; ligating blood vessels with sutures or clips; using quilting or progressive tension sutures; using fibrin, thrombin, or talc; and immobilizing the surgical site postoperatively. Surgical-site compression did not prevent seroma accumulation. The use of sclerosants at the initial operation actually increased the risk of seroma.
CONCLUSIONS
Seroma is a common and frustrating complication in plastic surgery. This study demonstrates that simple strategies can be used to lower the risk of seroma.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, II.
Topics: Drainage; Fibrin Tissue Adhesive; Humans; Postoperative Complications; Practice Guidelines as Topic; Plastic Surgery Procedures; Seroma
PubMed: 27348657
DOI: 10.1097/PRS.0000000000002245 -
Materials (Basel, Switzerland) Oct 2021Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated.... (Review)
Review
Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated. This study aimed to evaluate the bond strength of rebonded brackets after different residual adhesive removal methods. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, The Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Bond strength comparisons were made considering the method used for removing the residual adhesive on the bracket base. A total of 12 studies were included for the meta-analysis. Four different adhesive removal methods were identified: sandblasting, laser, mechanical grinding, and direct flame. When compared with new orthodontic metallic brackets, bond strength of debonded brackets after air abrasion ( = 0.006), mechanical grinding ( = 0.007), and direct flame ( < 0.001) was significantly lower. The use of an erbium-doped yttrium aluminum garnet (Er:YAG) laser showed similar shear bond strength (SBS) values when compared with those of new orthodontic brackets ( = 0.71). The Er:YAG laser could be considered an optimal method for promoting the bond of debonded orthodontic brackets. Direct flame, mechanical grinding, or sandblasting are also suitable, obtaining clinically acceptable bond strength values.
PubMed: 34683722
DOI: 10.3390/ma14206120 -
Journal of Dentistry Jan 2021Secondary caries is a major long-term complication of dental restorations. Different adhesive strategies and restorative materials may affect secondary caries risk. We... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Secondary caries is a major long-term complication of dental restorations. Different adhesive strategies and restorative materials may affect secondary caries risk. We aimed to systematically review and synthesize the secondary caries risk of different adhesive strategies and restorative materials.
SOURCES
Medline via PubMed 01/2005-10/2019.
STUDY SELECTION
Randomized controlled studies with minimum 2 years follow-up, comparing different adhesive strategies and/or restorative materials in permanent teeth were included. Our outcome was the occurrence of secondary caries. Bayesian pairwise and network-meta-analysis were conducted.
DATA
We included 50 trials; 19 assessing secondary caries depending on different adhesive strategies, 31 on restorative materials. Studies were published between 2005 and 2017, largely of unclear risk of bias, and included a mean of 40 (range: 8-90) participants and 46 (range: 14-200) placed restorations. Mean follow-up was 43 (range: 24-180) months. Secondary caries was a rare event; the majority of studies did not find any lesions. Network meta-analysis found great uncertainty. 3-step etch-and-rinse adhesives showed the lowest risk of secondary caries, 2-step etch-and-rinse the highest. For restorative materials, resin-modified glass ionomer showed the lowest risk of secondary caries. Most resin composites showed similar risks.
CONCLUSION
Data from randomized trials comparing different adhesive strategies or restorative materials are extremely scarce. The differences between materials were limited over the observational period of the included studies. The yielded rankings should be interpreted with caution.
CLINICAL SIGNIFICANCE
Despite often claimed to be a major complication of restorations, there is surprisingly little data on secondary caries from randomized trials. Longer-term studies may be needed to identify differences in secondary caries risk between materials.
Topics: Bayes Theorem; Composite Resins; Dental Caries; Dental Caries Susceptibility; Dental Cements; Dental Restoration, Permanent; Dentition, Permanent; Humans; Network Meta-Analysis
PubMed: 33259888
DOI: 10.1016/j.jdent.2020.103541 -
Clinical and Experimental Dental... Dec 2023The aim of this study was to review the selection criteria of resin cements for different types of partial coverage restorations (PCRs) and investigate if the type of... (Review)
Review
OBJECTIVE
The aim of this study was to review the selection criteria of resin cements for different types of partial coverage restorations (PCRs) and investigate if the type of restorations or restorative materials affect the type of selected resin cement.
MATERIALS AND METHODS
An electronic search (1991-2023) was performed in PubMed, Medline, Scopus, and Google Scholar databases by combinations of related keywords.
RESULTS
A total of 68 articles were included to review the selection criteria based on the advantages, disadvantages, indications, and performance of resin cements for different types of PCRs.
CONCLUSIONS
The survival and success of PCRs are largely affected by appropriate cement selection. Self-curing and dual-curing resin cements have been recommended for the cementation of metallic PCRs. The PCRs fabricated from thin, translucent, and low-strength ceramics could be adhesively bonded by light-cure conventional resin cements. Self-etching and self-adhesive cements, especially dual-cure types, are not generally indicated for laminate veneers.
Topics: Resin Cements; Ceramics; Dental Cements; Cementation
PubMed: 37427500
DOI: 10.1002/cre2.761 -
Evidence-based Complementary and... 2019Acupotomy therapy is widely used for pain management. However, the efficacy of acupotomy on shoulder adhesive capsulitis (SAC) is still uncertain. The aim of this study... (Review)
Review
OBJECTIVE
Acupotomy therapy is widely used for pain management. However, the efficacy of acupotomy on shoulder adhesive capsulitis (SAC) is still uncertain. The aim of this study was to determine the effectiveness and safety of acupotomy therapy for SAC.
METHODS
We searched seven electronic databases to collect randomized controlled trials (RCTs) of acupotomy for SAC published before April 2019. A meta-analysis was performed according to the Cochrane systematic review method by using RevMan 5.3 software.
RESULTS
A total of eight RCTs involving 501 patients were enrolled. Meta-analysis showed that acupotomy was significantly better than the control group in debasing the Visual Analogue Scale (VAS) score (MD = -0.97, 95% CI = [-1.49, -0.45], =0.0003) and improving the Constant-Murley Score (CMS) (MD = 8.46, 95% CI = [1.04, 15.87], =0.03), and there was no significant difference in adverse events (OR = 1.24, 95% CI = [0.34, 4.52], =0.74) between the two groups.
CONCLUSION
Acupotomy therapy is an effective and safe treatment for SAC, and this treatment can be recommended for the management of SAC. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large-scale are recommended in future.
PubMed: 31915443
DOI: 10.1155/2019/2010816 -
The Journal of Prosthetic Dentistry Nov 2022Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations.
PURPOSE
The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations.
MATERIAL AND METHODS
A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020). Data extraction was performed regarding the percentage of restoration failure among dental adhesive materials, including glass ionomer cements, resin-modified glass ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis of statistics assessment and review instrument (MAStARI). Confidence in cumulative evidence was evaluated by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol.
RESULTS
Four studies met the inclusion criteria. All included studies were classified as having a moderate risk of bias and reported results regarding class V restorations. Overall, composite resins presented lower failure rates at 2 years (30%) when compared with resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis showed that the risk of failure with glass ionomer cements was greater than with resin-modified glass ionomer cements (RR: 1.71, P<.001). Composite resins presented lower risk of failure when compared with glass ionomer (RR: 2.29, P<.001) and resin-modified glass ionomer cements (RR: 1.30, P=.03). Three studies reported results regarding fluoride compliance, which had a negative effect on the survival rates of glass ionomer and resin-modified glass ionomer cements and a positive effect on composite resin restorations.
CONCLUSIONS
The results suggest that composite resin restorations associated with fluoride gel compliance seems to be the best alternative for restoring class V lesions in patients after head and neck radiotherapy. However, the results showed moderate certainty of evidence, which justifies the need for more randomized clinical trials regarding this subject.
Topics: Humans; Dental Restoration, Permanent; Dental Marginal Adaptation; Fluorides; Dental Restoration Failure; Glass Ionomer Cements; Composite Resins; Resin Cements
PubMed: 33715834
DOI: 10.1016/j.prosdent.2021.02.002 -
Singapore Medical Journal Dec 2016Adhesive capsulitis is a common cause of shoulder pain and limited movement. The objectives of this review were to assess the efficacy and safety of corticosteroid... (Review)
Review
Adhesive capsulitis is a common cause of shoulder pain and limited movement. The objectives of this review were to assess the efficacy and safety of corticosteroid injections for adhesive capsulitis and to evaluate the optimum dose and anatomical site of injections. PubMed and CENTRAL databases were searched for randomised trials and a total of ten trials were included. Results revealed that corticosteroid injection is superior to placebo and physiotherapy in the short-term (up to 12 weeks). There was no difference in outcomes between corticosteroid injection and oral nonsteroidal anti-inflammatory drugs at 24 weeks. Dosages of intra-articular triamcinolone 20 mg and 40 mg showed identical outcomes, while subacromial and glenohumeral corticosteroid injections had similar efficacy. The use of corticosteroid injections is also generally safe, with infrequent and minor side effects. Physicians may consider corticosteroid injection to treat adhesive capsulitis, especially in the early stages when pain is the predominant presentation.
Topics: Adrenal Cortex Hormones; Bursitis; Female; Humans; Injections; Male; Pain; Physical Therapy Modalities; Primary Health Care; Randomized Controlled Trials as Topic; Shoulder; Shoulder Joint; Treatment Outcome; Visual Analog Scale
PubMed: 27570870
DOI: 10.11622/smedj.2016146 -
Journal of Orthopaedics Jan 2024Adhesive Capsulitis is a common condition of the shoulder with significant morbidity and protracted disease. It is usually characterized by sudden onset with progressive... (Review)
Review
INTRODUCTION
Adhesive Capsulitis is a common condition of the shoulder with significant morbidity and protracted disease. It is usually characterized by sudden onset with progressive symptoms of pain and loss of function. This systematic review compares platelet rich plasma (PRP) intra-articular injections with corticosteroids (CS) injections and physiotherapy.
MATERIAL AND METHODS
A literature search was performed using online databases (Pubmed, Cochrane, EMBASE, Medline and CINAHL) including all the studies performed on humans through April 2023. Prospective comparative studies were included in this review of patients with adhesive capsulitis assessing the use of PRP injections versus corticosteroid injections or physiotherapy. The standardized mean difference (SMD) with 95 % confidence interval in VAS/DASH/SPADI and ROM scores was calculated using a random effects model, comparing PRP to corticosteroids injections and physiotherapy across studies.
RESULTS
A total of 11 studies and 971 patients, with a mean age of 52.1, were included in this analysis with 7 being randomised trials and four cohort studies. The control group was corticosteroid injections in 8 studies and physiotherapy in the other three studies. Overall PRP lead to a statistically significant improved outcome at 3 and 6 months follow up for all outcome parameters. The outcome measures at three months includes VAS 0.73 (0.31, 1.16) SMD, DASH 0.66 (0.36, 0.96) SMD, SPADI 1.50 (0.43, 2.57) SMD, ER 1.47 (0.27, 2.66) SMD and Abduction 1.10 (0.21, 1.98) SMD. Six months assessment similarly favoured PRP with VAS 3.17 (1.26, 5.08) SMD and DASH 2.10 (1.66, 2.55) SMD scores. Furthermore, a subgroup analysis demonstrated that PRP was favourable to corticosteroids as control with significant improvement in pain (VAS) at 3 months 0.65 (0.29, 1.00) and 6 months 3.17 (1.26, 5.08) SMD.
CONCLUSION
This review demonstrated that intra-articular PRP injections for adhesive capsulitis produces favourable outcomes when compared to corticosteroid injections and physiotherapy. PRP produces improved pain and functional scores as well as range of motion, which is statistically significant from 3 to 6 months post intervention. PRP seems to be a safe and effective alternative non-invasive treatment modality for patients with adhesive capsulitis.
PubMed: 38022840
DOI: 10.1016/j.jor.2023.10.015 -
The Journal of Evidence-based Dental... Dec 2018Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was to compare the effectiveness of biomaterials and techniques by means of a systematic review and meta-analysis.
METHODS
The PubMed, Cochrane, and Embase databases were used to search the literature published from January 1, 1980 until August 31, 2017. Studies that met inclusion criteria were screened by 2 authors individually. The meta-analysis was performed on mineral trioxide aggregate (MTA) cement vs calcium hydroxide cement, tricalcium silicate cement vs MTA cement, and adhesive systems vs CaOH cement and evaluated the success rate, inflammatory response, and dentin bridge formation.
RESULTS
Forty-six studies were included in the systematic review, while 22 studies were included in the meta-analysis. There was no significant heterogeneity between the studies. MTA cements showed a significantly higher success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 2.72; 95% confidence interval [CI] = 1.90-3.90; P = 0.000). However, when compared with the tricalcium silicate cements, there were no statistically significant differences (odds ratio = 1.18; 95% CI = 0.53-2.65; P = 0.672). Adhesive systems showed a significantly lower success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 0.062; 95% CI = 0.024-0.157; P = 0.000).
CONCLUSIONS
MTA cements have a higher success rate, with a lower inflammatory response and a more predictable hard dentin barrier formation than calcium hydroxide cements. However, there were no differences, in these parameters, when MTA cement was compared with tricalcium silicate cements. Dental adhesives systems showed the lowest success rates.
Topics: Dental Cements; Dental Pulp Capping; Humans; Root Canal Therapy
PubMed: 30514444
DOI: 10.1016/j.jebdp.2018.02.002 -
Lasers in Medical Science Jan 2023At present, lasers are increasingly used in the oral clinical field, and research and applications in dental hard tissue treatment are also increasing. The effect of... (Meta-Analysis)
Meta-Analysis Review
Effects of Er: YAG, Er,Cr: YSGG, and Nd: YAG laser irradiation and adhesive systems on the immediate and long-term bond strength of dentin: a systematic review and meta-analysis.
At present, lasers are increasingly used in the oral clinical field, and research and applications in dental hard tissue treatment are also increasing. The effect of laser etching dentin on the bonding strength of composite resin reported in the literature is still inconclusive. The purpose of this review was to evaluate whether laser etching can improve the immediate and long-term bonding strength of dentin and investigate the effect of different types of adhesives on the bonding strength of dentin. Two reviewers performed a literature search up from January 2012 to November 2021 in four databases: MEDLINE (PubMed), Web of Science, EMBASE, and the Cochrane Library. A total of 25 studies were included in the meta-analysis. The Cochrane Collaboration Bias Risk Assessment tool was used to evaluate the quality of the included literature, and an analysis was carried out using Review Manager Software version 5.3. The aging bond strength of dentin after erbium (Er): yttrium aluminum garnet (YAG) laser treatment was significantly lower than that of dentin in the bur group (P < 0.00001). At the same time, the bond strength of dentin immediately and aging after (Er), chromium-doped (Cr): yttrium scandium gallium garnet (YSGG) laser treatment was lower than that of dentin in the bur group (P < 0.05). There was no significant difference in the immediate and aging bonding strength among samples in the Er: YAG laser, Er, Cr: YSGG laser, and blank control groups (no laser or bur). The aging bond strength of samples after neodymium-doped (Nd): YAG laser treatment was higher than that of samples in the blank control group (P < 0.05); in addition, the performance of self-etching adhesive was slightly better than that of acid etching adhesive. Regardless of the applied surface treatment and the adhesive employed, dentin after aging showed significant bond degradation (P < 0.05). There was high heterogeneity of bond strength between different groups, and the small number of studies and the contradictory results may be the main reasons for this outcome.
Topics: Lasers, Solid-State; Adhesives; Erbium; Neodymium; Scandium; Yttrium; Dentin; Dental Bonding
PubMed: 36595096
DOI: 10.1007/s10103-022-03699-6