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The Journal of Prosthetic Dentistry Sep 2023Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome.
PURPOSE
The purpose of this systematic review and meta-analysis was to investigate the treatment outcome in terms of the implant survival rate and success parameters of immediate implant placement in compromised extraction sockets.
MATERIAL AND METHODS
An electronic search was conducted in PubMed, Embase, Cochrane Library, and ISI Web of Science up to January 2021. Studies evaluating implant survival rate and main success parameters were included for a qualitative and quantitative analysis (risk ratio and mean difference).
RESULTS
In total, 43 studies with analysis of 4825 sockets were included. Compared with the noncompromised sockets, the compromised group showed no significant differences in implant survival rates (risk ratio=0.992; 95% confidence interval (CI)=0.979 to 1.005; P=.246). No significant statistical differences were found in marginal bone level at ≤12 months (mean difference [MD]=0.033; 95% CI=-0.012 to 0.078; P=.154) or esthetic parameters.
CONCLUSIONS
Immediate implant placement in compromised sites does not appear to decrease the survival and success rates. However, randomized clinical trials with large sample sizes should be conducted to draw a definite conclusion about the efficacy and safety of this treatment protocol in compromised sockets.
Topics: Dental Implantation, Endosseous; Dental Implants; Tooth Socket; Esthetics, Dental; Immediate Dental Implant Loading
PubMed: 34772483
DOI: 10.1016/j.prosdent.2021.09.025 -
Clinical Oral Investigations Dec 2023This scoping review aimed to systematically identify evidence-based interventions to stimulate healing or protect the harvested palate of patients undergoing gingival... (Review)
Review
OBJECTIVE
This scoping review aimed to systematically identify evidence-based interventions to stimulate healing or protect the harvested palate of patients undergoing gingival grafting.
MATERIAL AND METHODS
The study followed guidelines from the Joanna Briggs Institute and PRISMA-ScR (protocol available at osf.io/zhafn). PubMed, Embase, and seven other databases were searched on November 2022, with additional monitoring until April 2023. The inclusion criteria focused on studies evaluating outcomes related to the donor area (palate) and interventions for healing or protecting it, regardless of publication year and language. Data from the included publications was extracted and presented through narrative text, tables, and figures.
RESULTS
Eighty-one studies (including 64 clinical trials, four case series, five theses, and eight systematic reviews) and 37 clinical trial records were included. The number of studies on this topic has significantly increased, reflecting a growing interest in the field. Thirty-six interventions with published results and 12 interventions with unpublished results from clinical trial registers were identified. Some promising interventions that showed potential for improving patient-reported outcomes include cyanoacrylate adhesive, platelet-rich fibrin (PRF), and the combination of palatal stents and healing agents.
CONCLUSIONS
Thirty-six interventions with published results were identified for postoperative use on the harvested palate, showing varying levels of evidence and conflicting effectiveness for specific outcomes.
CLINICAL RELEVANCE
Postoperative discomfort and pain in the palate are commonly experienced by patients undergoing grafting procedures using this region as the donor area. Awareness of the available options and their levels of evidence is crucial for informed decision-making.
Topics: Humans; Gingiva; Wound Healing; Palate; Platelet-Rich Fibrin; Pain
PubMed: 37851129
DOI: 10.1007/s00784-023-05296-5 -
The Journal of Contemporary Dental... Dec 2023The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental...
AIMS
The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry.
BACKGROUND
The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols.
REVIEW RESULTS
Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials.
CONCLUSION
The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice.
CLINICAL SIGNIFICANCE
Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, . Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.
Topics: Child; Humans; Cost-Benefit Analysis; Dental Atraumatic Restorative Treatment; Tooth, Deciduous; Dental Restoration, Permanent; Esthetics, Dental; Dental Caries; Dental Materials; Pain; Parents
PubMed: 38317401
DOI: 10.5005/jp-journals-10024-3607 -
Progress in Orthodontics Nov 2023To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of... (Review)
Review
AIMS
To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events.
METHODS
A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal.
RESULTS
A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low.
CONCLUSIONS
Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.
Topics: Humans; Maxilla; Root Resorption; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Malocclusion; Open Bite; Molar
PubMed: 37953383
DOI: 10.1186/s40510-023-00490-3 -
Cureus Jul 2023Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective... (Review)
Review
Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective treatment and preventive measures. Teledentistry, which involves remote dental assessment using digital technologies, has shown promise as a potential tool for caries screening. This systematic review and meta-analysis aims to compare the dental caries scores obtained from clinical examinations and teledentistry assessments. Literature searches were conducted across databases such as PubMed, Embase, the Cochrane Library, Scopus, the Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO by using predefined search terms and inclusion criteria. Two reviewers separately extracted the data. The study designs, evaluation techniques, dentition types, mean scores, and follow-up times of the included studies were examined. The New Castle-Ottawa Scale was used to assess the risk of bias. Review Manager (RevMan) (computer program) Version 5.4, The Cochrane Collaboration 2020, was used for the quantitative assessment of the data. Eight studies met the inclusion criteria and were included in the review. The findings revealed that teledentistry assessments (based on intraoral photographs captured using smartphones or intraoral cameras) demonstrated comparable accuracy to traditional clinical examinations in detecting and assessing dental caries. Among the four studies that were quantitatively analysed, no significant difference was noted at p = 0.09. A mean difference of 0.64 (95% confidence interval (CI): -0.10; 1.38) suggested that clinical examination and teledentistry-based checkup were on par with each other for the detection of dental caries. The New Castle-Ottawa scale (NOS) grading indicated that the studies were of good quality. Teledentistry may be an effective approach for identifying and evaluating dental caries. However, further research is required to substantiate the findings observed in the present review.
PubMed: 37637546
DOI: 10.7759/cureus.42414 -
BMC Oral Health Dec 2023The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The...
BACKGROUND
The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration.
METHODS
The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle-Ottawa Scale quality assessment tool was used to assess the studies' quality.
RESULTS
After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127.
CONCLUSIONS
Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration.
Topics: Humans; Prevalence; Mandible; Tooth, Impacted; Treatment Outcome; Cuspid
PubMed: 38062382
DOI: 10.1186/s12903-023-03717-1 -
The Science of the Total Environment Jun 2024Children's heightened susceptibility to environmental exposure arises from their underdeveloped detoxification mechanisms and augmented per-unit body-weight absorption... (Review)
Review
Children's heightened susceptibility to environmental exposure arises from their underdeveloped detoxification mechanisms and augmented per-unit body-weight absorption capacity for chemical compounds. Primary teeth are an emerging biomatrix, which aid in storing crucial data on early exposure to harmful substances and developmental illnesses. This systematic review aimed to evaluate the association between environmental chemical exposure and health outcomes in children and adolescents using primary teeth as a matrix. The study protocol was registered with PROSPERO (CRD42023428013). The review spanned studies published between 1974 and 2023, identified through an extensive literature search on databases like MEDLINE, EMBASE, LILACS, CINAHL, the Cochrane Oral Health Group Specialized Register, Scopus, and Web of Science. Distiller SR software was used to assess study quality and extract the outcome data. The NTP-OHAT scale assessed evidence quality, and case-control, cross-sectional, and cohort studies in English were included. Comprehensively reviewing 5287 articles resulted in 29 studies being included in the final analysis, comprising 15 cross-sectional, seven case-control, and seven cohort studies. All 29 studies qualified for qualitative analysis. Eleven studies analyzed lead (Pb) effects on health outcomes, four analyzed manganese (Mn), and 14 investigated other element groups. Primary teeth biomatrix assessed various health outcomes: neurobehavior, childhood behaviour, ADHD, birth outcomes, fetal alcohol syndrome disease, inflammatory bowel disease, and dental caries. This study contributes to existing evidence, reinforcing a link between environmental metal exposure and health consequences. The evidence extends to prenatal and postnatal periods, substantiated by primary teeth biomatrix analysis. Lead level fluctuations can influence neuropsychological functioning, potentially causing cognitive impairments. Altered manganese levels correlate with behavioral issues, adverse effects on visuospatial development, and birth weight changes. Primary teeth biomatrices aid fetal alcohol spectrum disorders diagnosis, and correlations between organo-chemical exposure and autism were observed.
Topics: Adolescent; Child; Child, Preschool; Humans; Environmental Exposure; Environmental Pollutants; Tooth, Deciduous; Manganese; Neurodevelopmental Disorders
PubMed: 38554965
DOI: 10.1016/j.scitotenv.2024.172032 -
Operative Dentistry Jul 2023To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies through a systematic review and meta-analysis.
METHODS
Systematic electronic searches were performed by two independent reviewers into the following databases: PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library until December of 2021. Only randomized clinical trials were selected, comparing etch-and-rinse and self-etch strategies and using universal adhesive systems in NCCLs. This systematic review was conducted according to the PRISMA guidelines and registered into PROSPERO.
RESULTS
After the removal of duplicates, 170 articles were identified. In an initial screening of titles and abstracts, 146 records did not satisfy the inclusion criteria and were, therefore, excluded. Twenty-four studies were eligible for evaluation of the full text, and four were excluded after this step. Finally, 20 randomized clinical trials were included in this systematic review and meta-analysis.
CONCLUSION
This systematic review and meta-analysis revealed that applying universal adhesive systems in the etch-and-rinse strategy could lead to better medium-term (>12 to 36 months) retention of NCCL restorations than the self-etch strategy, as well as resulting in lower percentages of marginal discoloration, marginal adaptation, and secondary caries. However, the use of a self-etching strategy can lead to lower postoperative sensitivity.
Topics: Humans; Dental Cements; Dentin-Bonding Agents; Resin Cements; Composite Resins; Tooth Cervix; Dental Restoration, Permanent; Dental Marginal Adaptation
PubMed: 37352462
DOI: 10.2341/22-067-LIT -
Clinical Oral Investigations May 2024This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and regions based on cone-beam computed tomography (CBCT) studies.
MATERIALS AND METHODS
PubMed, Scopus, Embase, Web of Science, and Open-Grey were searched up to October 2023 according to specific keywords. A hand search was conducted on the references of the included studies and articles from three peer-reviewed journals in endodontics. The main variable of interest was the prevalence of MMC. Additional data such as the total number of included cases, age and country of the population, CBCT device information, voxel size, and field of view details were also extracted. Extracted data were analyzed qualitatively with the JBI quality assessment checklist and quantitatively with STATA software.
RESULTS
Of 32,793 studied teeth, the cumulative prevalence of MMC in both mandibular 1 and 2 molars was 3.11% (95% CI: 2.00-4.44%). The subgroup analysis reveals a prevalence of 4.15% (95% CI: 2.69-5.89%) for mandibular 1 molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2 molars. The highest prevalence of MMC in 1 molar was attributed to South Asia (11.24%) and Africa (6.61%).
CONCLUSIONS
The prevalence of MMC varies among regions. Clinicians should be aware of the potential prevalence of MMC, particularly in mandibular first molars, as a missed MMC could result in endodontic failure.
CLINICAL RELEVANCE
The presence of MMCs varies in different geographic regions (0% to 29.7%). Clinicians should always look for MMC when doing an endodontic treatment on mandibular molars, as the presence of this canal is not uncommon. We suggest searching for this canal as if searching for the second mesiobuccal canal of maxillary 1st molars.
Topics: Humans; Cone-Beam Computed Tomography; Mandible; Molar; Prevalence; Dental Pulp Cavity; Global Health
PubMed: 38743355
DOI: 10.1007/s00784-024-05660-z -
Journal of the American Dental... Aug 2023Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis. The authors searched the Epistemonikos database, including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the US clinical trials registry (ClinicalTrials.gov) from inception until April 2023. Pairs of reviewers independently screened titles and abstracts, then full texts of trials were identified as potentially eligible. After duplicate data abstraction, the authors conducted random-effects meta-analyses. Risk of bias was assessed using Version 2 of the Cochrane Risk of Bias tool and certainty of the evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Forty randomized controlled trials proved eligible. The evidence suggested that corticosteroids compared with a placebo provided a trivial reduction in pain intensity measured 6 hours (mean difference, 8.79 points lower; 95% CI, 14.8 to 2.77 points lower; low certainty) and 24 hours after surgical tooth extraction (mean difference, 8.89 points lower; 95% CI, 10.71 to 7.06 points lower; very low certainty). The authors found no important difference between corticosteroids and a placebo with regard to incidence of postoperative infection (risk difference, 0%; 95% CI, -1% to 1%; low certainty) and alveolar osteitis (risk difference, 0%; 95% CI, -3% to 4%; very low certainty).
PRACTICAL IMPLICATIONS
Low and very low certainty evidence suggests that there is a trivial difference regarding postoperative pain intensity and adverse effects of corticosteroids administered orally, submucosally, or intramuscularly compared with a placebo in patients undergoing third-molar extractions.
Topics: Humans; Molar, Third; Acute Pain; Adrenal Cortex Hormones; Dry Socket; Postoperative Complications; Pain, Postoperative
PubMed: 37500235
DOI: 10.1016/j.adaj.2023.04.018