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Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of studies.Acta Odontologica Scandinavica Nov 2022To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation.
METHOD
Systematic literature review was implemented, using 12 databases. All studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included.
RESULTS
At the apical level, pooling the data in the random-effects model (I=64%, ) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; ). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; ) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; ) of the root canal.
CONCLUSIONS
Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.
Topics: Humans; Smear Layer; Root Canal Irrigants; Root Canal Preparation; Dental Pulp Cavity; Ultrasonics; Sodium Hypochlorite; Therapeutic Irrigation; Edetic Acid; Microscopy, Electron, Scanning
PubMed: 35430959
DOI: 10.1080/00016357.2022.2061591 -
International Journal of Dentistry 2021Resin-dentin bond strength decreases over time. This reduction is related to the loss of hybrid layer integrity. Collagenolytic enzymes, especially matrix... (Review)
Review
OBJECTIVES
Resin-dentin bond strength decreases over time. This reduction is related to the loss of hybrid layer integrity. Collagenolytic enzymes, especially matrix metalloproteinases (MMPs), are responsible for the degradation of the collagen matrix of the hybrid layer. Various MMP inhibitors with the ability to prevent enzymatic degradation have been identified. This study aimed to systematically review the literature for studies which evaluated the effect of MMP inhibitors on the immediate and aged dentin bond strengths. Screening and analysis were carried out by two reviewers. Two databases were searched, and from a total of 740 articles, 43 were accepted for full review. 21 articles with 0.2%-2% chlorhexidine (CHX) treatments were included for meta-analysis. A risk of bias assessment was performed on all studies chosen for meta-analysis. A variety of MMP inhibitors have been studied, CHX being the most widely used.
CONCLUSIONS
A clear trend for a lower loss of dentin bond strength was observed with different MMP inhibitors. In meta-analysis, no significant difference was seen between the CHX and control in the immediate bond strengths. Bond strengths in the CHX group were significantly higher than the control group after aging ( < 0.001). The percentage of fractures occurring at the adhesive interface increased after aging. Five out of 21 studies included in the meta-analysis had high and the rest medium risk of bias. More long-term studies with lower risks of bias should be carried out to increase the reliability of results. The use of MMP inhibition with chlorhexidine can be recommended to increase the longevity of resin-dentin bond strength.
PubMed: 34135969
DOI: 10.1155/2021/9949699 -
JDR Clinical and Translational Research Apr 2023Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not support proper treatment. Previous risk estimates were constructed based on the experience in short-duration space missions and isolated environments on Earth. However, previous estimates did not account for potential changes in dental structures due to space travel, even though bone loss is a known problem for long-duration spaceflights. The objective of this study was to systematically analyze the changes in hard tissues of the craniofacial complex during spaceflights.
METHODS
Comprehensive search of Medline, Embase, Scopus, the NASA Technical Report Server, and other sources identified 1,585 potentially relevant studies. After screening, 32 articles that presented quantitative data for skull in humans (6/32) and for calvariae, mandible, and lower incisors in rats (20/32) and mice (6/32) were selected.
RESULTS
Skull bone mineral density showed a significant increase in spacefaring humans. In spacefaring rodents, calvariae bone volume to tissue volume (BV/TV) demonstrated a trend toward increasing that did not reach statistical significance, while in mandibles, there was a significant decrease in BV/TV. Dentin thickness and incisor volume of rodent incisors were not significantly different between spaceflight and ground controls.
DISCUSSION
Our study demonstrates significant knowledge gaps regarding many structures of the craniofacial complex such as the maxilla, molar, premolar, and canine teeth, as well as small sample sizes for the studies of mandible and incisors. Understanding the effects of microgravity on craniofacial structures is important for estimating risks during long-duration spaceflight and for formulating proper protocols to prevent dental emergencies.
KNOWLEDGE TRANSFER STATEMENT
Avoiding dental emergencies in long-duration spaceflights is critical since this environment does not support proper treatment. Prior risk estimates did not account for changes in dental structures due to space travel. We reviewed and synthesized the literature for changes in craniofacial complex associated with spaceflight. The results of our study will help clinicians and scientists to better prepare to mitigate potential oral health issues in space travelers on long-duration missions.
Topics: Humans; Mice; Rats; Animals; Emergencies; Space Flight; Head; Skull; Incisor
PubMed: 35311413
DOI: 10.1177/23800844221084985 -
Dental Materials : Official Publication... Jul 2022The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not... (Review)
Review
OBJECTIVES
The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not well-understood. This systematic review aimed to collect the recorded effects of therapeutic radiation on tooth chemical, structural and mechanical properties, in relation with their means of investigation.
DATA
Systematic search (January 01 2012 - September 30 2021) terms were "Radiotherapy", "Radiation effects", "Dental enamel", "Dentin", "Human" and "Radiotherapy" NOT "Laser".
SOURCES
PubMed, DOSS and Embase databases were searched.
STUDY SELECTION
Selected studies compared dental enamel, coronal and root dentin properties before and after in vitro or in vivo irradiation up to 80 Gy.
RESULTS
The systematic search identified 353 different articles, with 28 satisfying inclusion criteria. Their reference lists provided two more. Twenty-two studies evaluated dental enamel evolution, nine assessed coronal dentin and eight concerned root dentin. Coronal and root dentin results indicate a major impact of the radiation on their organic matrix. Dental enamel's chemical properties are less modified. Enamel and root dentin's hardness are decreased by therapeutic radiation, but no consensus arises for coronal dentin.
CONCLUSIONS
Our findings revealed some interesting information about enzymatic degradation mechanisms of dentin organic matrix and highlighted that dental hard-tissue characterization requires highly specific expertise in materials science. That scientific knowledge is necessary to design suitable protocols, adequately analyze the obtained data, and, thus, provide relevant conclusions.
CLINICAL SIGNIFICANCE STATEMENT
Better knowledge and understanding of the mechanisms involved in the degradation of enamel and dentin would enable development of new preventive and therapeutic methods for improved medical care of patients undergoing radiotherapy.
Topics: Dental Caries; Dental Enamel; Dentin; Head and Neck Neoplasms; Humans; Radiation Injuries; Tooth
PubMed: 35570008
DOI: 10.1016/j.dental.2022.04.014 -
Journal of the American Dental... Nov 2014Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers... (Review)
Review
BACKGROUND
Hemostatic agents have been used clinically in dentistry for many years to control bleeding. The authors reviewed scientific publications in which researchers investigated the effects of hemostatic agents on dentin and enamel surfaces and on bonding of adhesive systems and resin cements.
TYPES OF STUDIES REVIEWED
The authors screened PubMed and Scopus databases for studies in English published from 1980 to 2013. They read the titles and abstracts to identify literature that fulfilled the inclusion criteria. The authors included studies in which researchers evaluated the hemostatic action on the dentin and enamel surfaces or its influence on the bond strength of adhesive systems or resin cements. They used cross-referencing to identify more articles.
RESULTS
Twenty in vitro studies met the inclusion criteria. Investigators in 12 of these studies evaluated the bond strength to contaminated dentin. Investigators in 10 of these studies reported a significant decrease in bond strength. Those in two studies evaluated the influence of a hemostatic agent on the dental enamel and reported decreases in bond strength. Researchers also reported significant increases in microleakage of self-etching adhesives on contaminated dentin. Scanning electron microscopy revealed partial removal of the smear layer or an etching effect of dentin as a result of the application of hemostatic agents on dentin.
PRACTICAL IMPLICATIONS
Adhesive procedures may be affected adversely when performed on dentin and enamel contaminated by hemostatic agents. Hemostatic agents may induce changes in the dentin surface morphology. The results of this review indicate that the bond strength of self-etching adhesive systems is affected more negatively than is that of etch-and-rinse systems. The authors found that a 60-second application of ethylenediaminetetraacetic acid followed by a water spray restored the bond strength of a self-etching adhesive to dentin; use of phosphoric acid for 15 seconds followed by a water spray also was an effective cleaning method. Direct comparison of selected studies was not possible, however, mainly because of methodological differences hampering definitive conclusions.
Topics: Acid Etching, Dental; Composite Resins; Dental Bonding; Dental Cements; Dental Enamel; Dental Stress Analysis; Dentin; Dentin-Bonding Agents; Hemostatics; Microscopy, Electron, Scanning; Surface Properties
PubMed: 25359643
DOI: 10.14219/jada.2014.84 -
Microorganisms Jun 2021() is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also... (Review)
Review
() is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also triggering intracerebral haemorrhage. The durable and stable bond interface, besides bacteria elimination, is one of the crucial factors influencing the resin composite restoration performance. This study aimed to evaluate universal adhesives (UAs) with regard to in vitro bond strength to dentin, and the inhibition of the growth and compare them with UAs modified with antimicrobial agents through a systematic review and meta-analysis. Two reviewers performed a literature search up to April 2021 in 5 electronic databases: PubMed MedLine, Scielo, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies reporting the effect of modifying UAs with antimicrobial agents on the bond strength to dentin and/or on the inhibition of the were included. Analyses were carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was evaluated following the parameters of a previous systematic review. A total of 1716 potentially relevant publications were recognized. After reviewing the title and abstract, 16 studies remained in the systematic review. From these, a total of 3 studies were included in the meta-analysis. Since data from the studies included in the antimicrobial outcome included zero values, they could not be meta-analysed. Including 0 values in the analysis will lead to several biases in the analysis, so these data were discarded. The antibacterial effect against of UAs modified with antimicrobial agents was higher than the non-modified adhesive systems. Within the limitations of the present study, the bond strength of UAs to dentin could be improved by using antimicrobial agents. The UAs modified with antibacterial agents showed a decrease in the viability of biofilm, among the adhesives tested. However, there are not enough valid data on antibacterial properties of modified UAs; therefore, more well-designed research on these materials is needed.
PubMed: 34204100
DOI: 10.3390/microorganisms9061230 -
Clinical Oral Investigations Jan 2023For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects.
MATERIAL AND METHODS
Databases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p ≤ 0.05. The I value and the Q-test were used to assess the heterogeneity.
RESULTS
A total of 14 in vitro trials were subjected to the meta-analysis. Within the study's limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p = 0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p = 0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p > 0.05). Among the removal methods of temporary cements, the AlO abrasion restored the decreased bond strength (p = 0.07) and performed better than hand instruments alone (p = 0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p = 0.05, 95% CI = - 1.62 to 0).
CONCLUSIONS
The choices of IDS, polycarboxylate and calcium hydroxide temporary cements, AlO abrasion removal method were feasible and efficient to enhance the bond strength.
CLINICAL RELEVANCE
It is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The AlO abrasion of cleaning dentin can minimize the negative effects of temporary cement.
Topics: Resin Cements; Dental Bonding; Dentin-Bonding Agents; Calcium Hydroxide; Dental Cements; Materials Testing; Dentin; Tensile Strength; Dental Stress Analysis
PubMed: 36422719
DOI: 10.1007/s00784-022-04790-6 -
Australian Dental Journal Sep 2015Carious affected dentine (CAD) represents a very common substrate in adhesive dentistry. Despite its ability to interact with adhesive systems, the intrinsic character... (Review)
Review
BACKGROUND
Carious affected dentine (CAD) represents a very common substrate in adhesive dentistry. Despite its ability to interact with adhesive systems, the intrinsic character of CAD leads to lower bonding compared with sound dentine, regardless of the adhesive systems used. This low bonding may be more susceptible to leakage and hydrolysis of the interface by matrix metalloproteinases (MMPs). This systematic review aimed to determine current knowledge of CAD bonding, together with bond strength and MMP inhibitors' ability to prevent hybrid layer instability.
METHODS
MEDLINE/Pubmed, Scopus and The Cochrane Library databases were electronically searched for articles published from 1 January 1960 to 31 August 2014. Two reviewers independently screened and included papers according to predefined selection criteria.
RESULTS
The electronic searches identified 320 studies. After title, abstract and full-text examinations, 139 articles met the inclusion criteria. Data highlighted that a poor resin saturation of the already demineralized collagen matrix in CAD is strictly related to nanoleakage in interdiffusion and is the basis of the progressive decrease in strength with hydrolysis by MMPs. The use of mild self-etching systems seems to be the more accredited method to establish bonding in CAD. Inhibitors of MMPs may ensure better performance of CAD bonding, allowing undisturbed remineralization of the affected matrix.
CONCLUSIONS
CAD bonding needs further understanding and improvement, particularly to enhance the strength and durability of the hybrid layer.
Topics: Dental Bonding; Dental Caries; Dental Cements; Dental Leakage; Dentin; Humans; Matrix Metalloproteinase Inhibitors; Stress, Mechanical
PubMed: 25790344
DOI: 10.1111/adj.12309 -
Photodiagnosis and Photodynamic Therapy Mar 2023The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin.
METHODS
This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05).
RESULTS
Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome.
CONCLUSION
It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
Topics: Root Canal Filling Materials; Photochemotherapy; Dentin; Photosensitizing Agents; Anti-Infective Agents; Materials Testing
PubMed: 36596331
DOI: 10.1016/j.pdpdt.2022.103270 -
Journal of Dentistry Dec 2020To investigate the effectiveness of desensitizing agents (DA) on dentin hypersensitivity (DH) after non-surgical periodontal treatment (NSPT) through a systematic review... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effectiveness of desensitizing agents (DA) on dentin hypersensitivity (DH) after non-surgical periodontal treatment (NSPT) through a systematic review and meta-analysis.
DATA
The PICO strategy was used to include randomized clinical trials in human subjects with DH (P) after NSPT treated with DA (I) compared to those treated with placebo or control (C) to identify DH relief (O). The Cochrane guidelines and GRADE was used to classify the risk of bias and the quality of the evidence, respectively.
SOURCES
PubMed, Web of Science, Scopus, Lilacs, Cochrane Library databases, and OpenGrey were searched on the 20 of May 2020.
STUDY SELECTION
Nine studies were included in the quantitative synthesis. Five meta-analyses were performed. Three meta-analyzes assessed the effectiveness of DA compared to a placebo or control in relation to pain assessment stimuli and two meta-analyzes assessed the mechanism of action of DA. For the mechanical stimulus in overall analysis, the control group presented a higher mean of pain reduction (SMD 1.03 [0.73, 1.32], p < 0.001) with very low certainty of evidence. For water (SMD -0.78 [-1.22, -0.35], p = 0.0009) and evaporative in overall analysis (SMD -1.21 [-1.79, -0.64], p < 0.001) stimuli, the DA decreased DH pain with very low and low certainty of evidence, respectively.
CONCLUSION
Due to the limited quality of evidence, there is no definitive conclusion on the effectiveness of DA on DH after NSPT. Thus, further clinical studies with a low risk of bias and high-quality evidence are encouraged to reinforce the certainty of evidence on that issue.
CLINICAL SIGNIFICANCE
The use of desensitizing agents show promise for relief of dentin hypersensitivity after non-surgical periodontal therapy.
Topics: Dentin Desensitizing Agents; Dentin Sensitivity; Humans; Pain Measurement
PubMed: 33069772
DOI: 10.1016/j.jdent.2020.103498