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Community Dentistry and Oral... Dec 2023There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate... (Review)
Review
BACKGROUND
There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate outcomes used in randomized clinical trials for caries prevention, pit and fissure sealants and fluoridated dentifrices, according to the Prentice criteria.
METHODS
A systematic review was conducted in MEDLINE (PubMed), LILACS and Scopus databases up to 05 October 2022. The grey literature and the list of eligible studies' references were also screened. The search was conducted, selecting randomized clinical trials focussed on dental caries prevention using pit and fissure sealants or fluoridated dentifrices and with at least one surrogate endpoint for cavitated caries lesions. The risk of each surrogate endpoint and for the occurrence of cavitated caries lesions was calculated and compared. The association between each surrogate and the presence of cavitation was quantified, and each outcome was assessed graphically for validity according to the Prentice criteria.
RESULTS
For pit and fissure sealants, from 1696 potentially eligible studies, 51 were included; while for fluoridated dentifrices, of 3887 potentially eligible studies, four were included. Possible surrogates assessed were retention of sealants, presence of white spot lesions, presence of plaque or marginal discoloration around the sealants, oral hygiene index, radiographic and fluorescence caries lesion assessments. However, only the retention of sealants and the presence of white spot lesions could be evaluated for their validity according to the Prentice criteria.
CONCLUSION
Loss of retention of sealants and the presence of white spot lesions do not fulfil all of the Prentice criteria. Therefore, they cannot be considered valid surrogates for caries prevention.
Topics: Humans; Dental Caries; Pit and Fissure Sealants; Dental Caries Susceptibility; Dentifrices; Biomarkers; Randomized Controlled Trials as Topic
PubMed: 37246464
DOI: 10.1111/cdoe.12861 -
Journal of Investigative and Clinical... Feb 2017The aim of the present study was to evaluate the relationship between pit and fissure sealants and the prevention of dental caries in permanent molars of children in... (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of the present study was to evaluate the relationship between pit and fissure sealants and the prevention of dental caries in permanent molars of children in China.
METHODS
The Cochrane Handbook for Systematic Reviews of Interventions was followed. Articles published in English and Chinese from 2002 to 2013 were selected. All these studies were randomized clinical trials related to pit and fissure sealants on caries prevention. Data were analyzed using Software Review Manager 5.1.
RESULTS
A search of the four largest Chinese medical literature databases and the PubMed/Medline database yielded a total of 397 clinical research studies about the effects of pit and fissure sealants on the prevention of dental caries; 20 original research studies were selected. In this meta-analysis, a total of 12 187 participants were included. Statistical analyses demonstrated a significant association between pit and fissure sealants and dental caries prevention for a 6-month follow-up period (combined odds ratio = 0.06, 95% CI: 0.01, 0.32, P < 0.0001). For other follow ups, there was a trend in pit and fissure sealants preventing the occurrence of dental caries.
CONCLUSION
Current clinical evidence suggests that pit and fissure sealants are effective for dental caries prevention. Sealants should be placed as part of an overall caries prevention approach. Further research with larger sample sizes and rigorously-designed clinical trials are required to corroborate the current results.
Topics: Child; Humans; China; Dental Caries; Molar; Pit and Fissure Sealants; Treatment Outcome
PubMed: 26272130
DOI: 10.1111/jicd.12183 -
Ophthalmic Genetics Oct 2022Nicolaides-Baraitser syndrome (NCBRS), first described in 1993, is a rare autosomal dominant disease caused by pathogenic variants in the SMARCA2 gene on chromosome...
BACKGROUND
Nicolaides-Baraitser syndrome (NCBRS), first described in 1993, is a rare autosomal dominant disease caused by pathogenic variants in the SMARCA2 gene on chromosome 9p24.3. NCBRS typically presents with dysmorphic facial features, seizures, intellectual disability, and developmental delays. Abnormal findings of the eye and ocular adnexa associated with NCBRS have not been systematically evaluated and summarized in literature. This report presents the case of a 4-year-old male with NCBRS along with a systematic review of literature of the abnormal ophthalmologic and facial features of NCBRS cases.
METHODS
A systematic review of literature of published cases of molecularly confirmed NCBRS was performed and the frequencies of eye, ocular adnexa, and facial abnormalities were calculated.
RESULTS
Our patient's abnormal eye features include myopia, down slanting palpebral fissures, sagging inferior periorbital skin, hypertelorism, and long eyelashes. From the systemic review of literature, the most common abnormal eye and ocular adnexa features include prominent/long eyelashes, thick eyebrows, sagging periorbital skin, down slanting palpebral fissures, and ptosis. The most common facial dysmorphic features include thick/everted lower lip, coarse facial features, wide/large mouth, and thin upper lip. Dental abnormalities are also commonly reported.
CONCLUSIONS
NCBRS frequently presents with well-defined ophthalmic and facial abnormalities. Prompt ophthalmologic evaluation following NCBRS diagnosis may be recommended to screen for several eye disorders. Surgical correction of ptosis may be indicated for NCBRS patients. This report may help further delineate the phenotype of this condition, which may allow for more rapid identification of those affected and provide incentive for additional studies.
Topics: Abnormalities, Multiple; Facies; Foot Deformities, Congenital; Humans; Hypotrichosis; Intellectual Disability; Male; Transcription Factors
PubMed: 35762114
DOI: 10.1080/13816810.2022.2089358 -
The European Journal of Prosthodontics... Nov 2023Pit and fissure sealants are effective in preventing caries disease, however, they may present flaws that damage the physical barrier leading to treatment failure.
INTRODUCTION
Pit and fissure sealants are effective in preventing caries disease, however, they may present flaws that damage the physical barrier leading to treatment failure.
OBJECTIVE
To answer the question ''Do pit and fissure sealants present good adhering to the dental structure when analyzed by their resistance to shear/microshear?".
METHODS
This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and was recorded in Open Science Framework. Embase, PubMed, SCOPUS, and Web of Science databases were used for the search strategy. The articles were selected according to the eligibility criteria. The risk of bias was performed with the adaptation of the quasi-experimental studies tool by Joanna Briggs Institute (JBI).
RESULTS
1245 studies were found in the databases when applying the search strategy, after removal of duplicates 881 were evaluated and 44 were selected. After applying the JBI tool, 30 studies presented low risk and 15 moderate risk of bias. Meta-analysis was not possible to performed due to the heterogeneity of the studies.
CONCLUSION
The adhesion is dependent on the application protocol, and among the protocols evaluated, conditioning with 37% phosphoric acid for 60 seconds and contamination of the substrate, as these can affect sealant adhesion.
Topics: Humans; Dental Caries; Pit and Fissure Sealants; Shear Strength
PubMed: 37721539
DOI: 10.1922/EJPRD_2503Ferreira14 -
PloS One 2016Glass-ionomers are traditionally regarded to be inferior to resin as fissure sealants in protecting teeth from dental caries, due to their comparatively lower retention... (Review)
Review
BACKGROUND
Glass-ionomers are traditionally regarded to be inferior to resin as fissure sealants in protecting teeth from dental caries, due to their comparatively lower retention rate. Unlike low-viscosity glass-ionomers, high-viscosity glass-ionomer cements (HVGIC) are placed as sealants by pressing the material into pits and fissures with a petroleum-jelly-coated index finger. Hence, HVGIC sealants are assumed to penetrate pits and fissures deeper, resulting in a higher material retention rate, which may increase its caries-preventive effect.
METHODS
The aim of this review was to answer the question as to whether, in patients with fully erupted permanent molar teeth, HVGIC based fissure sealants are less effective to protect against dental carious lesions in occlusal pits and fissures than resin-based fissure sealants? A systematic literature search in eight databases was conducted. Heterogeneity of accepted trials and imprecision of the established evidence were assessed. Extracted sufficiently homogenous datasets were pooled by use of a random-effects meta-analysis. Internal trial validity was evaluated. The protocol of this systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO / Nr.: CRD42015016007).
RESULTS
Seven clinical trials were provisionally included for further review. Of these, one was excluded. Seven trial reports reporting on six trials were accepted. From these, 11 datasets were extracted and pooled in four meta-analyses. The results suggest no statistically significant differences after up to 48 months and borderline significant differences in favour of HVGIC sealants after 60 months (RR 0.29; 95% CI: 0.09-0.95; p = 0.04 / RD -0.07; 95% CI: -0.14, -0.01). The point estimates and upper confidence levels after 24, 36, 48 and 60 months of RR 1.36; RR 0.90; RR 0.62; RR 0.29 and 2.78; 1.67; 1.21; 0.95, respectively, further suggest a chronological trend in favour of HVGIC above resin-based sealants. The internal trial validity was judged to be low and the bias risk high for all trials. Imprecision of results was considered too high for clinical guidance.
CONCLUSION
It can be concluded that: (i) Inferiority claims against HVGIC in comparison to resin-based sealants as current gold-standard are not supported by the clinical evidence; (ii) The clinical evidence suggests similar caries-preventive efficacy of HVGIC and resin-based sealants after a period of 48 months in permanent molar teeth but remains challenged by high bias risk; (iii) Evidence concerning a possible superiority of HVGIC above resin-based sealants after 60 months is poor (even if the high bias risk is disregarded) due to imprecision and requires corroboration through future research.
Topics: Acrylic Resins; Child; Dental Caries; Female; Glass Ionomer Cements; Humans; Male; Outcome Assessment, Health Care; Pit and Fissure Sealants; Resin Cements; Silicon Dioxide; Tooth
PubMed: 26799812
DOI: 10.1371/journal.pone.0146512 -
International Journal of Paediatric... Sep 2023Fluoride varnish (FV) is a convenient way of professionally applying fluoride in preschoolers. However, its modest anticaries effect highlights the need for economic... (Review)
Review
BACKGROUND
Fluoride varnish (FV) is a convenient way of professionally applying fluoride in preschoolers. However, its modest anticaries effect highlights the need for economic evaluations.
AIM
To assess economic evaluations reporting applications of FV to reduce caries incidence in preschoolers.
DESIGN
We included full economic evaluations with preschool participants, in which the intervention was FV and the outcome was related to dentin caries. We searched in CENTRAL; MEDLINE via PubMed; WEB OF SCIENCE; EMBASE; SCOPUS; LILACS; BBO; and BVS Economia em saúde, OpenGrey, and EconoLit. Clinical trial registers, thesis and dissertations, and meeting abstracts were hand searched, as well as 11 dental journals. Risk of bias in the included studies was assessed using the Philips' and Drummond's (full and simplified) tools.
RESULTS
Titles and abstracts of 2871 articles were evaluated, and 200 were read in full. Eight cost-effectiveness studies were included: five modeling and three within-trial evaluations. None of the studies gave sufficient information to allow a thorough assessment using the bias tools. We did not combine the results of the studies due to the great heterogeneity among them. Four studies reported that FV in preschool children was a cost-effective measure, but in one of these studies, sealants and fluoride toothpaste were more cost-effective measures than the varnish, and three studies used limited data that compromised the generalizability of their results. The other four studies showed a large increase in costs due to the application of varnish and/or low cost-effectiveness.
CONCLUSION
We did not find convincing overall evidence that applying FV in preschoolers is an anticaries cost-effective measure. The protocol of this systematic review is available at Open Science Framework (https://osf.io/xw5va/).
Topics: Humans; Child, Preschool; Fluorides; Cariostatic Agents; Fluorides, Topical; Cost-Benefit Analysis; Dental Caries; Pit and Fissure Sealants
PubMed: 36695007
DOI: 10.1111/ipd.13049 -
The Cochrane Database of Systematic... Sep 2016Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one... (Review)
Review
BACKGROUND
Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method.
OBJECTIVES
To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.
SEARCH METHODS
We searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 17 August 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library (searched 17 August 2016), MEDLINE Ovid (1946 to 17 August 2016), Embase Ovid (1980 to 17 August 2016), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 17 August 2016), SciELO BIREME Virtual Health Library (1998 to 17 August 2016), Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 30 August 2016), VIP (in Chinese) (1989 to 30 August 2016), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 30 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (including split-mouth trials) assessing the effects of rubber dam isolation for restorative treatments in dental patients.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion.
MAIN RESULTS
We included four studies that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.
AUTHORS' CONCLUSIONS
We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
PubMed: 27648846
DOI: 10.1002/14651858.CD009858.pub2 -
BMC Oral Health Apr 2015Untreated dentin caries in primary teeth is commonly found in preschool children worldwide. Recently, the use of simple non-surgical approaches to manage the situation... (Review)
Review
BACKGROUND
Untreated dentin caries in primary teeth is commonly found in preschool children worldwide. Recently, the use of simple non-surgical approaches to manage the situation has been advocated. The aim of the study was to systematically review and evaluate the literature on effectiveness of non-surgical methods in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children.
METHODS
A systematic search of the main electronic databases (Pubmed, Cochrane Collaboration, EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947-2014. Keywords and MeSH terms used in the search were "dental caries", "primary dentition" and various non-surgical treatments (fluoride, sealant, resin infiltration, xylitol, chlorhexidine, CPP-ACP, ozone, etc.). The inclusion criteria were clinical studies conducted in children under 6 years old, and reported findings on caries arrest or caries progression in primary teeth. Retrieved papers were read by two reviewers independently to assess suitability for inclusion, and the final decision was made by consensus. Quality of the included studies was assessed and data were extracted for analysis.
RESULTS
The search identified 323 papers for screening. Among these, 290 papers did not satisfy the study inclusion criteria. Consequently, 33 full papers were retrieved and reviewed. Finally, 4 studies were included. Three studies reported that topical applications of silver diammine fluoride (SDF) solution could arrest dentin caries in preschool children. One study supported that having a daily toothbrushing exercise in kindergarten using toothpaste with 1000 ppm fluoride could stabilize the caries situation in young children.
CONCLUSIONS
There is limited evidence to support the effectiveness of SDF applications or daily toothbrushing with fluoride toothpaste in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. More well-designed randomized controlled trials are required to confirm these findings.
Topics: Anti-Infective Agents, Local; Cariostatic Agents; Child, Preschool; Dental Caries; Dentin; Humans; Pit and Fissure Sealants; Tooth Remineralization; Tooth, Deciduous
PubMed: 25888484
DOI: 10.1186/s12903-015-0033-7 -
Dentistry Journal Sep 2019This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water... (Review)
Review
This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water purification in removing excess fluoride in drinking water and drug delivery. It has great potential for controlled fluoride release in dentistry, e.g., varnishes, fissure sealants and muco-adhesive strips, etc. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed with two reviewers performing a literature search using four databases: PubMed, Web of Science, Science Direct and Ovid Medline with no date restrictions. Studies including any LDH for ion/drug release in dentistry were included, while assessing the application of LDH and the value of the methodology, e.g., ion release protocol and the LDH production process. Results: A total of 258 articles were identified and four met the inclusion criteria. Based on two in vitro studies and one clinical study, LDH was previously studied in dental materials, such as dental composites and buccal muco-adhesive strips for fluoride release, with the latter studied in a clinical environment. The fourth study analysed LDH powder alone (without being incorporated into dental materials). It demonstrated fluoride release and the uptake of volatile sulphur compounds (VSC), which may reduce halitosis (malodour). Conclusion: LDHs incorporated in dental materials have been previously evaluated for fluoride release and proven to be clinically safe. LDHs have the potential to sustain a controlled release of fluoride (or other cariostatic ions) in the oral environment to prevent caries. However, further analyses of LDH compositions, and clinical research investigating any other cariostatic effects, are required.
PubMed: 31480648
DOI: 10.3390/dj7030087 -
General Dentistry 2020Despite the worldwide decline in dental caries, pit and fissure caries remains a cause of concern, and application of pit and fissure sealants is an important preventive... (Meta-Analysis)
Meta-Analysis
Despite the worldwide decline in dental caries, pit and fissure caries remains a cause of concern, and application of pit and fissure sealants is an important preventive measure. Due to the high wear rate of conventional unfilled sealants, various other materials have been tested for fissure sealing. The present meta-analysis was conducted to compare the effectiveness of flowable composite resins as a fissure sealant to that of conventional pit and fissure sealants. A literature search was performed in MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar. Clinical trials comparing the efficacy of flowable composite resins as fissure sealants to that of conventional pit and fissure sealants on permanent teeth with a follow-up of 12 or 24 months were included in this meta-analysis. The retention rates of the 2 groups were evaluated with a random-effects model using Cochrane Reviews software (Cochrane RevMan, version 5.3). Seven studies were included in the final review. Flowable composite resins proved to be a significantly better fissure-sealing material after 1 year of follow-up (odds ratio = 0.47; 95% CI = 0.22-1.01; P = 0.05; degree of inconsistency [I] = 59%). The retention rates of flowable composite resins at the end of 2 years were similar to those of conventional pit and fissure sealants (odds ratio = 0.71; 95% CI = 0.13-3.95; P = 0.70; I = 85%). Flowable composite resins proved to be a superior alternative to conventional sealants after 1 year of follow-up; however, no such difference between the 2 groups was observed after 2 years of follow-up. Further longitudinal studies should be conducted to evaluate the long-term retention and efficacy of flowable composite resins in fissure sealing.
Topics: Composite Resins; Dental Caries; Dentition, Permanent; Humans; Pit and Fissure Sealants
PubMed: 32597778
DOI: No ID Found