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Clinical Oral Implants Research Jun 2022In systematically healthy patients with an implant-supported fixed restoration (P), what is the influence of thin (E) as compared to thick (C) peri-implant soft tissues... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In systematically healthy patients with an implant-supported fixed restoration (P), what is the influence of thin (E) as compared to thick (C) peri-implant soft tissues on aesthetic outcomes (O)?
METHODS
Following an a priori protocol, a literature search of six databases was conducted up to August 2020 to identify prospective/retrospective clinical studies on healthy patients with an implant-supported fixed reconstruction. Measurement of the buccal soft tissue thickness and an aesthetic outcome was a prerequisite, and sites presenting with a buccal soft tissue thickness of <2 mm or shimmering of a periodontal probe were categorized as a thin phenotype. After study selection, data extraction, and risk of bias assessment, random-effects meta-analysis of Mean Differences (MD) or Odds Ratios (OR) with their corresponding 95% Confidence Intervals (CI) were conducted, followed by sensitivity analyses and assessment of the quality of evidence.
RESULTS
Thirty-four unique studies reporting on 1508 patients with 1606 sites were included (9 randomized controlled trials, one controlled trial, 10 prospective cohort studies, 8 cross-sectional studies, and 6 retrospective cohort studies). The mean difference of the pink aesthetic score (PES) after the follow-up was not significantly different between thin (<2.0 mm) or thick soft tissues (≥2.0 mm) or phenotypes (12 studies; MD = 0.15; [95% CI = -0.24, 0.53]; p = .46). PES changes during the follow-up, however, were significantly in favour of thick soft tissues (≥2.0 mm) or phenotypes (p = .05). An increased mean mucosal thickness was associated with an increased papilla index (5 studies; MD = 0.5; [95% CI = 0.1, 0.3]; p = .002) and an increase in papilla presence (5 studies; OR = 1.6; [95% CI = 1.0, 2.3]; p = .03). Thin soft tissues were associated with more recession, -0.62 mm (4 studies; [95% CI = -1.06, -0.18]; p = .006). Patient-reported outcome measures (patient satisfaction) were in favour of thick soft tissues -2.33 (6 studies; [95% CI = -4.70, 0.04]; p = .05). However, the quality of evidence was very low in all instances due to the inclusion of non-randomized studies, high risk of bias and residual confounding.
CONCLUSION
Within the limitations of the present study (weak study designs and various soft tissue measurements or time-points), it can be concluded that increased soft tissue thickness at implant sites was associated with more favourable aesthetic outcomes.
Topics: Cross-Sectional Studies; Dental Implants; Esthetics; Humans; Prospective Studies; Retrospective Studies
PubMed: 35763024
DOI: 10.1111/clr.13789 -
Clinical and Experimental Dental... Aug 2021Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on...
OBJECTIVE
Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on plaque formation, gingivitis, and oral microbial growth in subjects with or without periodontal disease.
MATERIALS AND METHODS
PubMed/MEDLINE, ScienceDirect, Google Scholar, and Cochrane Library were searched for relevant studies. The review was conducted per PRISMA guidelines. Only randomized controlled trials and observational studies comparing octenidine with placebo or other mouthwashes in healthy subjects with or without periodontal disease, were considered for this review. The endpoints included percentage reduction in plaque index (PI), gingival index (GI), absolute reduction in the mean number of colony-forming units (CFU/ml [log ]) and adverse effects (AEs; tooth staining/mucosal tolerance).
RESULTS
Ten randomized controlled and six observational studies fulfilled the selection criteria. Twice or thrice daily rinsing with 0.1% octenidine for 30-60 s produced significant reduction in plaque, gingivitis and oral microbial growth. Compared to control mouthwash or baseline, 0.1% octenidine inhibited plaque formation by ~38.7%-92.9%, which was either equal or greater than that of chlorhexidine gluconate. 0.1% octenidine reduced gingivitis by ~36.4%-68.37% versus control mouthwash or baseline and microbial growth by 0.37-5.3 colony-forming units (vs. chlorhexidine: 0.4-4.23 colony-forming units). Additional benefits of 0.1% octenidine were significant reduction in the number of bleeding sites, papilla bleeding index, sulcus bleeding index, and gingival fluid flow.
CONCLUSION
Within the limitations of this study, there exists moderate evidence that 0.1% OCT was found to be an effective antiplaque agent. Octenidine inhibited plaque formation upto 93% and gingivitis upto 68% versus placebo and was either superior or comparable to chlorhexidine. Octenidine was well-tolerated and safe and can be an effective alternative to CHX and other contemporary mouthwashes.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Imines; Mouthwashes; Periodontal Diseases; Pyridines
PubMed: 34227746
DOI: 10.1002/cre2.386 -
Frontiers in Dentistry 2023The focused question of this systematic review was "does hyaluronic acid (HA) injection in areas of interdental papillary deficiency reduce black triangles?" A...
The focused question of this systematic review was "does hyaluronic acid (HA) injection in areas of interdental papillary deficiency reduce black triangles?" A systematic literature search was performed to find clinical studies on human patients with a minimum of 6-month follow-up, published in English from 2005 to May 2020. There were two outcome variables: black triangle area (BTA) change after treatment at different measurement time points compared with baseline, and patient reported outcome measures (PROMs), when available. Of eight eligible articles (2 randomized clinical trials (RCTs) and 6 non-randomized, non-placebo controlled clinical studies), seven reported that HA injections had a positive impact on reduction of BTA and subsequent papillary augmentation. Six studies were included in meta-analysis and showed that the intervention led to a pooled reduction percentage of 57.7% in BTA after 6 months. Although there were clinical diversities between the studies, all the studies applied the same concentration of HA (approximately 2%), 2-3 mm apical to the papilla tip in several intervals. Some degrees of relapse were reported in some studies. Within the limits of this study, this systematic review and meta-analysis showed that HA injection can serve as an efficient minimally-invasive treatment for small interdental papillary deficiencies. It is essential to conduct further randomized clinical studies with prolonged follow-ups in order to support this conclusion.
PubMed: 37701648
DOI: 10.18502/fid.v20i19.12867 -
Contemporary Clinical Dentistry 2022Minimally invasive therapeutic approaches have become the standard of care for many medical procedures. Conventional periodontal surgical therapies involve extensive... (Review)
Review
BACKGROUND
Minimally invasive therapeutic approaches have become the standard of care for many medical procedures. Conventional periodontal surgical therapies involve extensive tissue reflection, resulting in increased morbidity which stands to reason out that Minimally invasive surgery (MIS) approach for periodontal therapy would result in less morbidity and better esthetics for the patient. Thus, the aim of this review is to assess the clinical efficacy of MIS periodontal therapy compared to conventional access flap surgery for the treatment of intrabony periodontal defects.
MATERIALS AND METHODS
An electronic and manual search was done to identify and collect studies evaluating MIS periodontal therapy for the treatment of intrabony periodontal defects in terms of periodontal probing depth (PPD) reduction, clinical attachment level (CAL) gain, and gingival recession (REC) with a minimum of 6 month follow-up published in English. Six studies which satisfied the inclusion criteria were included for the review and the data extracted.
RESULTS
The six included studies contributed to a total of 193 patients who underwent 93 MIS therapies for treating intrabony defects with at least a 6-month follow-up. Clinical evaluation showed a PPD reduction ranging from 3.55 ± 0.88 mm to 5.2 ± 1.6 mm, while CAL gain ranged from 2.82 ± 1.19 mm to 4.5 ± 1.1 mm, while the change in gingival margin level ranged from 0.06 mm to 0.5 mm. Only one study directly compared single flap approach (SFA) (a type of MIS) to double flap approach (papilla preservation flap) which reported PPD reduction and CAL gain to be better in SFA.
CONCLUSION
Even though the above evidence compels us to believe that minimally invasive periodontal surgery is less invasive, less time consuming, and less morbid, the lack of enough studies directly comparing MIS with conventional access flap surgeries suggest that these conclusions are arbitrary. Thus, there is currently an absence of adequate evidence to substantiate the beneficial effect of minimally invasive periodontal surgical approach compared to a conventional access flap surgery for the treatment of intrabony periodontal defects.
PubMed: 35846580
DOI: 10.4103/ccd.ccd_1046_20 -
European Endodontic Journal Oct 2022This systematic review aimed to evaluate the cytotoxicity of intracanal medicaments used for root canal disinfection and assess their effect on the proliferation and...
This systematic review aimed to evaluate the cytotoxicity of intracanal medicaments used for root canal disinfection and assess their effect on the proliferation and differentiation potential of stem cells from apical papilla (SCAP). The PubMed/Medline, Cochrane, Scopus, EMBASE, CINAHL and Web of Science databases were searched. Studies evaluating the effect of intracanal medicament on human SCAP (in-vitro primary cell culture experiment) were included in this systematic review. The risk of bias analysis of included studies was carried out using the Toxicological data Reliability Assessment tool. The data was analysed for qualitative characteristics. A meta-analysis was not carried out considering the heterogeneity of selected studies in terms of cell culture experiments, methods of analysis and the interpretation of results. Four studies fulfilled the desired inclusion criteria. The different antibiotic pastes and their intracanal concentrations lead to reduction in the SCAP survival compared to calcium hydroxide medicament. The findings were insufficient to make a clear distinction between different antibiotic pastes regarding their cytotoxicity. Within the limitations of the present systematic review, it can be concluded that calcium hydroxide is a relatively better intracanal medicament than antibiotic paste mixtures in terms of their cytotoxicity and effect on proliferation of SCAP.
Topics: Anti-Bacterial Agents; Calcium Hydroxide; Cell Proliferation; Humans; Reproducibility of Results; Stem Cells
PubMed: 36217639
DOI: 10.14744/eej.2022.63835 -
European Journal of Orthodontics Nov 2020Superimposition of three-dimensional (3D) digital models offers great opportunities to assess tooth movement during time. In the literature, several superimposition...
BACKGROUND
Superimposition of three-dimensional (3D) digital models offers great opportunities to assess tooth movement during time. In the literature, several superimposition techniques are described.
OBJECTIVES
To summarize and critically assess the available evidence from studies on serial digital 3D dental model superimposition.
SEARCH METHODS
MEDLINE via Ovid and PubMed, EMBASE via Ovid, Cochrane Register of Diagnostic Test Accuracy Studies, and Google Scholar were searched with no time limit (last update: December 2018). Hand and unpublished literature searches were also performed.
SELECTION CRITERIA
Studies of any design that had a sample size ≥5 and tested superimposition of serial 3D digital dental models to assess tooth movement were included.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment were performed independently by the authors.
RESULTS
Twelve studies met the eligibility criteria. The total risk of bias (QUADAS-2 tool) of 10 studies was high, whereas only 2 studies had unclear bias. Ten studies had high and two studies low overall applicability concerns. From these, one study tested the mandibular alveolar bone area, three studies the rugae area, nine studies a larger palatal area, and two studies the incisive papilla area. The high heterogeneity in samples, outcomes, and methods did not allow for synthesis of a considerable amount of studies in any case.
LIMITATIONS
The high heterogeneity among studies and the limited evidence did not allow for solid conclusions.
CONCLUSIONS AND IMPLICATIONS
The following areas of the maxilla could provide reliable outcomes: (1) the medial two-thirds of the third rugae and the area 5 mm dorsal to them and (2) an area including all rugae, with the lateral margins located at least 5 mm from the gingival margins and a distal margin that does not extend beyond the first molars. No recommendation is possible for other regions of the mouth. There is an urgent need for further research in the field.
REGISTRATION
PROSPERO (CRD42019124365).
Topics: Humans; Mandible; Maxilla; Molar; Palate; Tooth Movement Techniques
PubMed: 31742598
DOI: 10.1093/ejo/cjz075 -
Restorative Dentistry & Endodontics Nov 2023This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.
OBJECTIVES
This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.
MATERIALS AND METHODS
Electronic searches were performed in July 2023. and studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed.
RESULTS
Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment ( = 3). However, orally administered drugs did not reduce pulp inflammation ( = 4). Cytotoxicity ( = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies.
CONCLUSIONS
Few studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings.
TRIAL REGISTRATION
PROSPERO Identifier: CRD42022337192.
PubMed: 38053785
DOI: 10.5395/rde.2023.48.e39