-
Indian Journal of Dental Research :... 2020Melatonin is an indolamine that is primarily secreted by the pineal gland. It has immunomodulatory as well as antioxidant properties. It is a potent anti-oxidant that... (Review)
Review
BACKGROUND AND AIMS
Melatonin is an indolamine that is primarily secreted by the pineal gland. It has immunomodulatory as well as antioxidant properties. It is a potent anti-oxidant that protects against inflammation and cellular damage caused by reactive oxygen species, also has potent angiogenic function that adds on to the benefits of melatonin. As a result of these actions, melatonin may be useful as an adjuvant in the treatment of various conditions in the oral cavity. The aim of this study is to systematically evaluate the role of melatonin in periodontal disease.
METHODS
An extensive review of the scientific literature was carried out using PubMed, Science Direct, Google Scholar and the Cochrane base. Research articles were collected upto December 2017.
RESULTS
Melatonin may have beneficial effects in certain inflammatory oral pathologies, mainly periodontal diseases where they inhibit bone resorption destroy reactive oxygen species, stimulates osteoblastic differentiation. Salivary melatonin could also act as a risk indicator for periodontal diseases.
CONCLUSION
Many studies showed that the melatonin levels in GCF, Saliva, Serum of patients suffering from chronic periodontitis is lowered suggesting that may play a pivotal role in protecting the tissue from damage caused by oxidative stress. However, there exists no data on the concentration needed, method of application for potential benefits. Randomized clinical trials in this field are needed to fill the lacunae and better improve our understanding.
Topics: Antioxidants; Humans; Melatonin; Oxidative Stress; Periodontal Diseases; Saliva
PubMed: 33107463
DOI: 10.4103/ijdr.IJDR_227_18 -
The Journal of Prosthetic Dentistry Aug 2020Oral health-related quality of life (OHRQoL) is a subjective measure that assesses a person's perception of oral health. Patients with Alzheimer disease (AD) suffer from...
STATEMENT OF PROBLEM
Oral health-related quality of life (OHRQoL) is a subjective measure that assesses a person's perception of oral health. Patients with Alzheimer disease (AD) suffer from impaired cognitive function and a compromised ability to perform activities of daily living. Further exploration is needed to clarify whether OHRQoL is negatively impacted by cognitive degeneration and oral health conditions among patients with AD.
PURPOSE
The purpose of this systematic review was to increase understanding of OHRQoL among patients with AD and explore factors that may affect OHRQoL.
MATERIAL AND METHODS
Searches were conducted in PubMed, the Cochrane Library database, Medline, EBSCO, ProQuest, and EMBASE until August 30, 2018, with no date restrictions. The initial search targeted quantitative observational studies published in English that included the keywords AD, oral, prosthesis, and OHRQoL. Data extraction was independently conducted by 2 reviewers. OHRQoL was investigated as the outcome. Cognitive status and oral health conditions were treated as exposures. Tools used to measure OHRQoL included the Geriatric Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile. The research adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
Six studies were included. The sample sizes ranged from 30 to 226 participants, 5 studies used cross-sectional designs, and 1 was a nonrandomized controlled trial. Three studies reported higher OHRQoL scores among participants with AD than those among controls, but only 1 study showed a statistically significant difference. A statistical analysis was conducted with 4 studies that reported GOHAI scores, and no significant differences were found in GOHAI scores between participants with AD and controls (standard mean difference: 0.09; 95% confidence interval: -0.66 to 0.85). All studies that explored factors affecting OHRQoL showed different associations between cognitive impairment, oral health conditions, and OHRQoL. One study showed that cognitive impairment was negatively associated with OHRQoL. Three studies found oral health conditions (including periodontitis, gingival bleeding, probing depth >4 mm, and number of natural teeth) impaired the OHRQoL of participants with AD. Three studies reported that prosthetic type and quality positively affected OHRQoL among participants with AD.
CONCLUSIONS
OHRQoL may not fully represent actual oral health problems of patients with AD. Clinical dentists should evaluate oral problems in this population, preferably by using both subjective and objective examinations, including oral and dental conditions. This will ensure oral problems among patients with AD can be detected early and timely treatment provided.
Topics: Activities of Daily Living; Aged; Alzheimer Disease; Cross-Sectional Studies; Humans; Oral Health; Quality of Life
PubMed: 31753458
DOI: 10.1016/j.prosdent.2019.08.015 -
Dental Research Journal 2020Scaling and root planing (SRP) for the treatment of periodontitis may be less effective in some patients. This study evaluated the effectiveness of local doxycycline as... (Review)
Review
Effect of locally delivered doxycycline as an adjunct to scaling and root planing in the treatment of periodontitis in smokers: A systematic review of randomized controlled trials with meta-analysis and trial sequential analysis.
BACKGROUND
Scaling and root planing (SRP) for the treatment of periodontitis may be less effective in some patients. This study evaluated the effectiveness of local doxycycline as an adjunct to SRP among smokers with periodontitis compared to SRP alone in randomized controlled trials (RCTs).
MATERIALS AND METHODS
For this systematic review and meta-analysis, PubMed and Scopus databases were searched till November 2018 for English publications. RCTs that compared the effect of local doxycycline adjunct to SRP among smokers with periodontitis were selected. Patient characteristics, disease characteristics, and outcome data on clinical attachment level (CAL) and periodontal probing depth at 1, 3- and 6-month follow-up was extracted. Quality of selected studies was assessed by the revised Cochrane Risk of Bias 2.0 tool. Random effects model and trial sequential analysis were performed. GRADE approach was used to assess the quality of evidence. > 0.05 was considered as statistically significant.
RESULTS
Five trials were included in the review. Local use of doxycycline as an adjunct to SRP was effective in gain of 1.1 mm (0.47-1.74, = 0.091) in CAL at 6 months calculated from two studies. The evidence was of low quality, and at least a total of 866 patients are required for conclusiveness.
CONCLUSION
Local doxycycline as an adjunct to SRP significantly improved clinical attachment in smokers with periodontitis and can be recommended. Studies are required with long-term follow-up and patient-related outcome data.
PubMed: 33282148
DOI: No ID Found -
Clinical and Experimental Dental... Aug 2023BACKGROUND AND OBJECTIVES: Promoting resolution of inflammation using new classes of lipids mediators has been proposed for the management of inflammatory disease. This... (Meta-Analysis)
Meta-Analysis
UNLABELLED
BACKGROUND AND OBJECTIVES: Promoting resolution of inflammation using new classes of lipids mediators has been proposed for the management of inflammatory disease. This systematic review and meta-analysis aimed to evaluate the benefits of the use of omega-3 fatty acids as an adjuvant in the nonsurgical treatment of periodontitis.
MATERIAL AND METHODS
The data search was conducted into three main databases: PubMed, Embase, and Cochrane. The search equation was built around the PICO framework in which the population was constituted by human adults suffering from chronic periodontitis that had to be treated with conventional SRP with the adjunction of omega-3 fatty acids (I) or without the adjunction of omega-3 fatty acids (C), with, as a first outcome the probing pocket depth reduction (PPD) and as a second outcome the clinical attachment loss reduction (CAL). Risk of bias within studies was evaluated for each included study using the Cochrane collaboration tool for randomized studies (RoB Tool). A meta-analysis was performed using REVMAN 5.3.
RESULTS
After a global search, 117 studies were selected but only seven of them were eligible for the systematic review and meta-analysis. Six out of seven studies showed a significantly better PPD reduction in the omega-3 fatty acids group compared to the control group and five out of seven studies showed a significantly better CAL reduction in the omega-3 fatty acids group compared to the control group. The meta-analysis showed a statistically significant difference for PPD reduction (SMD: -0.78 [95% CI: -1.02, -0.54, p < .0001]) and CAL reduction (SMD: -0.80 [95% CI: -1.04, -0.56, p < .0001]) in favor of the test group.
CONCLUSION
After scaling and root planning, PPD reduction and CAL reduction were observed in both control and test groups, but with statistically significant better values for the omega-3 fatty acids group. Patients suffering from periodontitis could benefit from the use of omega-3 fatty acids to increase the effectiveness of a nonsurgical treatment.
Topics: Adult; Humans; Dental Scaling; Chronic Periodontitis; Fatty Acids, Omega-3; Dental Care
PubMed: 37345207
DOI: 10.1002/cre2.736 -
Clinical Implant Dentistry and Related... Jun 2022Studies have examined the benefit of having keratinized peri-implant mucosa width with mixed results. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Studies have examined the benefit of having keratinized peri-implant mucosa width with mixed results.
PURPOSE
This study examines whether the lack of a prespecified (2 mm) amount of keratinized mucosa width (KMW) is a risk factor for peri-implant diseases.
METHODS
A systematic electronic and manual search of randomized or nonrandomized controlled or noncontrolled clinical trials was conducted. Qualitative review, quantitative meta-analysis, and trial sequence analysis (TSA) of implants inserted at sites with <2 mm or ≥2 mm of KMW were analyzed to compare all the predetermined outcome variables. The level of evidence concerning the role of KMW in peri-implant health was evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system guide.
RESULTS
Nine studies were included in the qualitative analysis and four in the meta-analysis and TSA. No significant inter-group difference (p > 0.05) and a low power of evidence were found for probing depth, soft-tissue recession, and marginal bone loss. A significant difference favoring ≥2 mm KMW had a lower mean plaque index (MD = 0.37, 95% CI: [0.16, 0.58], p = 0.002) (3 studies, 430 implants, low-quality evidence). GRADE system showed very low and low quality of evidence for all other outcome measures.
CONCLUSION
Based on the available studies, the impact of amount of KMW (either <2 mm or ≥ 2 mm) as a risk factor for developing peri-implant disease remains low. Future control studies with proper sample size and longer follow-up are needed to further validate current findings.
Topics: Dental Implants; Dental Plaque Index; Humans; Mucous Membrane; Peri-Implantitis; Risk Factors
PubMed: 35298862
DOI: 10.1111/cid.13080 -
Australian Dental Journal Jun 2022Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa having no clear aetiology or pathogenesis. The influence of psychological disturbances on... (Meta-Analysis)
Meta-Analysis Review
Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa having no clear aetiology or pathogenesis. The influence of psychological disturbances on OLP has been widely discussed but still bears the controversy. This study aimed at assessing scientific evidence between the OLP and psychological alterations of the patient. We searched seven important databases for studies on OLP and psychological factors (anxiety, depression, stress, sleep disorders, etc.) published between 1 January 2000, and 1 October 2020. Case-control and cross-sectional studies were incorporated into this study. The meta-analysis used a random-effects model assessed by using the I statistic. Dichotomous variables used the odds ratio and 95% confidence interval (CI), and continuous variables used the mean difference with 95% CI. Finally, 26 studies were included in the review. A meta-analysis of 13 studies showed there was a significant association of OLP with anxiety, depression and stress compared with healthy controls. Certain personality characteristics and sleep disorders also influence the patient of OLP. Therefore, psychological and psychiatric examinations should be carried out routinely for patients with OLP and improve the prognosis of the disease. © 2022 Australian Dental Association.
Topics: Australia; Cross-Sectional Studies; Humans; Lichen Planus, Oral; Mental Disorders; Sleep Wake Disorders
PubMed: 35067951
DOI: 10.1111/adj.12896 -
Journal of Dental Anesthesia and Pain... Dec 2022Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have... (Review)
Review
Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.
PubMed: 36601134
DOI: 10.17245/jdapm.2022.22.6.405 -
International Journal of Dental Hygiene Feb 2022The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of... (Review)
Review
OBJECTIVE
The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.
METHODS
MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.
RESULTS
Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.
CONCLUSIONS
Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Mouthwashes; Periodontal Diseases; Sodium Hypochlorite
PubMed: 33971082
DOI: 10.1111/idh.12510 -
The Chinese Journal of Dental Research 2016To review the current oral health status and oral health care models in China in an effort to provide recommendations for the future implementation of these models. (Review)
Review
OBJECTIVE
To review the current oral health status and oral health care models in China in an effort to provide recommendations for the future implementation of these models.
METHODS
A systematic literature review was conducted. The Medline, EMBASE, CNKI and Wanfang databases were searched for English and Chinese articles reporting relevant data from 1949 to the present. Data from three national oral health epidemiology surveys, Chinese government reports and national statistics yearbooks from 2011 to 2015 were also included.
RESULTS
The oral health status of preschool children were significantly improved over the past 10 years, while caries experience among 35 to 45-year-old and 65 to 74-year-old groups showed an increase in 2005. The status of poor oral hygiene was observed for both adolescent and elderly groups. The ratio of dentist-to-population in China was reported as 1:10,000 in 2009, which was much lower than that of developed countries. The workforce of the dental service is distributed unevenly and remains insufficient for such a highly populated country. Although the need for dental treatment was perceived as high, the true demand for dental service in China was relatively low and not seen as critical. This situation clearly did not reflect so well with true oral disease conditions. There are several basic social medical insurance systems available in China, which covered most of the population's need for medical attention, but seldom covered dental treatment.
CONCLUSION
National oral health policy in China should emphasise oral health promotion, especially in school education for children and young adults, to further strengthen daily toothbrushing, use of fluoride toothpaste and dental floss, and actively promote annual oral health examination. Oral health management should focus on cost-effective primary and secondary prevention with the long-term goal of maintaining oral health.
Topics: China; Dental Health Services; Health Status; Humans; Models, Theoretical; Oral Health
PubMed: 27995225
DOI: 10.3290/j.cjdr.a37145 -
The Saudi Dental Journal Feb 2021Platelet concentrates have been shown to enhance periodontal regeneration when used as a treatment on their own or in conjunction with bone grafting materials. This... (Review)
Review
OBJECTIVES
Platelet concentrates have been shown to enhance periodontal regeneration when used as a treatment on their own or in conjunction with bone grafting materials. This systematic review aims to assess the effects of using platelet-rich fibrin (PRF), both alone and in combination with other conventionally used materials, on periodontal regeneration in clinical trials.
MATERIALS AND METHODS
A systematic electronic search was performed in the electronic databases MEDLINE (PubMed), Scopus, and Web of Science. Specifically, we searched for English language articles published between 2009 and 2019 that conducted in-human studies and included a summary of the results. Our primary search yielded 220 articles, and of these, 110 were clinical studies. Forty-four articles were then selected for a full reading.
RESULTS
Twenty-six randomized control trials (RCTs) met the inclusion criteria and were included in this review. Despite the differences between the reviewed studies, most revealed the ability of PRF to promote periodontal wound healing. The positive effects of PRF were observed in clinical criteria, such as reductions in pocket probing depth (PD) and increases in clinical attachment level (CAL), as well as in the degree of defect bone fill, which was determined either radiographically or by surgical re-entry.
CONCLUSIONS
Additional studies are needed to compare the clinical outcomes of various PRF application procedures and establish standardized protocols for treating periodontal disease with PRF.
PubMed: 33551617
DOI: 10.1016/j.sdentj.2020.12.002