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European Journal of Dental Education :... May 2024Assessment ensures that undergraduate students and postgraduate trainees are providing optimal patient care. Numerous assessment methods are currently being used within...
INTRODUCTION
Assessment ensures that undergraduate students and postgraduate trainees are providing optimal patient care. Numerous assessment methods are currently being used within the United Kingdom. Therefore, the purpose of this review was to provide an overview of the methods used to assess competency in exodontia and compare methods against criteria defined for good assessment.
MATERIALS AND METHODS
A systematic narrative review was carried out. Databases were electronically searched for published studies assessing the competence of undergraduate students and postgraduate trainees in exodontia up to October 2023.The validity, reproducibility, equivalence, feasibility, educational impact, catalytic effect and acceptability of each assessment method was considered.
RESULTS
In this review, 591 undergraduate students (n = 529) and postgraduate dental trainees (n = 62) had their competence in exodontia assessed. Undergraduate students were assessed on simple exodontia with forceps and elevators, whereas postgraduate trainees were assessed on the surgical removal of mandibular third molars. Only one study took place in a simulated dental environment, the remaining (n = 7) took place in a clinical environment. A range of formative and summative assessment methods were identified including structured clinical objective tests (SCOT), self-assessment, peer assessment and logbooks. Common marking criteria such as global rating and checklist scales were also highlighted.
CONCLUSION
This review highlights the lack of evidence to support one form of assessment and the lack of consensus on assessment within the United Kingdom. Further research related to this topic, alongside the opinion of trainees and trainers is required to improve assessments. This will maximise learning opportunities for trainees and translate to better patient care.
Topics: Humans; Clinical Competence; Reproducibility of Results; Education, Dental; Tooth Extraction; United Kingdom
PubMed: 37961850
DOI: 10.1111/eje.12976 -
Acta Stomatologica Croatica Dec 2023The aim of this systematic review and meta-analysis is to assess the association between the MIH presence as well as the severity and OHRQoL in children.
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the association between the MIH presence as well as the severity and OHRQoL in children.
MATERIAL AND METHODS
Relevant studies were identified in PubMed, Embase, Cochrane and Google Scholar. Studies involving MIH and OHRQoL in children were included. A methodological quality assessment of included studies was performed using the Newcastle-Ottawa Scale (NOS) and its adapted version for cross-sectional studies. Random effects models were used to estimate summary effect measures for the association between MIH presence (presence vs. absence) as well as severity (moderate/severe MIH vs. no MIH) and OHRQoL using generic inverse variance meta-analyses. Tests for heterogeneity, publication bias and sensitivity of results were also performed.
RESULTS
Out of 1696 identified publications 11 studies reporting on 5,017 children were included in the meta-analysis assessing the impact of MIH presence. There was no statistically significant association between the presence of MIH and lower OHRQoL in affected children (OR = 1.72, 95% CI = 0.99-2.98). Concerning MIH severity and its impact on OHRQoL, a sum of 6 studies were included in the meta-analysis involving a total of 2,595 children. There was a significant association between moderate/severe MIH and lower OHRQoL in affected children (OR = 3.43, 95% CI = 1.69-6.98).
CONCLUSION
Moderate/Severe MIH has a significant and clinically relevant negative impact on OHRQoL, and it should therefore be addressed adequately. Future research should also consider the impact of a uniform MIH diagnosis and precise severity criteria.
PubMed: 38283314
DOI: 10.15644/asc57/4/8 -
Nutrition Reviews Jul 2023The Food and Agriculture Organization of the United Nations and the World Health Organization are updating their dietary zinc recommendations for children aged 0 to... (Meta-Analysis)
Meta-Analysis
Toward revising dietary zinc recommendations for children aged 0 to 3 years: a systematic review and meta-analysis of zinc absorption, excretion, and requirements for growth.
CONTEXT
The Food and Agriculture Organization of the United Nations and the World Health Organization are updating their dietary zinc recommendations for children aged 0 to 3 years.
OBJECTIVE
The aim of this review was to retrieve and synthesize evidence regarding zinc needs for growth as well as zinc losses, absorption, and bioavailability from the diet.
DATA SOURCES
MEDLINE, Embase, and Cochrane Library databases were searched electronically from inception to August 2020. Studies assessing the above factors in healthy children aged 0 to 9 years were included, with no limits on study design or language.
DATA EXTRACTION
Ninety-four studies reporting on zinc content in tissue (n = 27); zinc absorption (n = 47); factors affecting zinc bioavailability (n = 30); and endogenous zinc losses via urine, feces, or integument (n = 40) met the inclusion criteria. Four reviewers extracted data and two reviewers checked for accuracy.
DATA ANALYSES
Studies were synthesized narratively, and meta-analyses of zinc losses and gains as well the subgroups of age, type of feeding, country's income, and molar ratio of phytate to zinc were conducted. Meta-analysis revealed an overall mean (95%CI) urinary and endogenous fecal zinc excretion of 17.48 µg/kg/d (11.80-23.15; I2 = 94%) and 0.07 mg/kg/d (0.06-0.08; I2 = 82%), respectively, with a mean fractional zinc absorption of 26.75% (23.69-29.81; I2 = 99%). Subgrouping by age revealed differences in mean values associated with the transition from milk-based diets to solid food during the first 3 years of life.
CONCLUSION
This review synthesizes data that may be used to formulate zinc requirements in young children. Results should be interpreted with caution because of considerable heterogeneity in the evidence.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number CRD42020215236.
Topics: Child; Child, Preschool; Humans; Biological Availability; Diet; Feces; Food; Zinc
PubMed: 36478064
DOI: 10.1093/nutrit/nuac098 -
Folia Morphologica Jun 2024Knowledge of the root canals configuration is essential for the success of endodontic treatment. The main aim of the systematic review is to determine the number of...
Knowledge of the root canals configuration is essential for the success of endodontic treatment. The main aim of the systematic review is to determine the number of roots and the number of root canals in maxillary third molars, in addition, where possible, to determine the Vertucci classification. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. The study protocol was registered and approved on the International Prospective Register of Systematic Reviews PROSPERO (Reg. No: CRD42022366444) before the start of the study. Twelve studies were included in the analysis, differing in sample origin and methodology. The combined studies were analyzed based on the number of roots, number of canals, and root canal configurations, and the findings were compared with those of other international studies. Analyzing the available research results regarding the root anatomy and canal configuration of the third maxillary molar, the most commonly maxillary third molars had 3 roots (59.00%). Single-rooted teeth (24.20%) or double-rooted teeth (13.80%) were less common. In addition, it was observed that maxillary third molars typically possessed three root canals (47.28%) and the MB (mesiobuccal), DB (distobuccal), and P (palatal) canals most often showed Vertucci Type I (59.53%, 95.83% and 98.61%, respectively) in three-rooted form. Due to the small number of available studies, it is necessary to conduct further analyses taking into account demographic and ethnic differences that may affect the anatomical and morphological structure of the teeth.
PubMed: 38895751
DOI: 10.5603/fm.98475 -
Journal of Clinical and Experimental... Nov 2023The aim of the present study was to seek scientific evidence through a systematic review and meta-analysis for the choice of articaine over lidocaine in the removal of... (Review)
Review
BACKGROUND
The aim of the present study was to seek scientific evidence through a systematic review and meta-analysis for the choice of articaine over lidocaine in the removal of third molars.
MATERIAL AND METHODS
Searches were performed of the MEDLINE/PubMed, EMBASE, Cochrane Library (CENTRAL), Web of Science, and SCOPUS databases as well as the grey literature.
RESULTS
Four hundred three articles were found, only 14 of which met the eligibility criteria. A total of 1114 third molars were removed: 557 with articaine and 557 with lidocaine. Articaine had a higher success rate than lidocaine (RR = 1.09, 95% CI: 1.03 to 1.15; < 0.05), shorter subjective latency time (MD = -15.10, 95% CI: -21.57 to -8.63; < 0.05), less intraoperative pain (MD = -6; < 0.05), longer duration (MD = 68.86; < 0.05), and less postoperative pain (MD = -3.05; < 0.05).
CONCLUSIONS
Based on the findings, articaine is superior to lidocaine for use in lower third molar surgeries due to the higher success rate, shorter time until the onset of action, greater control of intraoperative and postoperative pain, and longer duration of the anesthetic effect. Articaine, lidocaine, third molar, impacted teeth.
PubMed: 38074170
DOI: 10.4317/jced.60682 -
Journal of Dentistry Jun 2024To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH have greater likelihood of presenting DH/toothache than controls.
DATA
Studies evaluating DH/toothache in patients with MIH were included. Studies focusing on other enamel defects were excluded.
SOURCES
Eight databases, including grey literature, were searched in January 2024.
STUDY SELECTION
The methodological quality of studies was assessed using the Joanna Briggs Institute checklist for Cross-sectional studies. Proportion and association meta-analyses, subgrouped by diagnostic methods, were conducted. The certainty of evidence was assessed using GRADE approach.
RESULTS
Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses. Two studies fulfilled all items of the methodological quality checklist. The overall prevalence of DH/toothache among patients with MIH was 45 %. Prevalence rates of 30 %, 47 %, and 55 % were estimated based on proxy reports, self-reports, and air stimulation, respectively. The overall prevalence of DH/toothache per tooth was 22 %, ranging from 16 % to 29 % according to the diagnostic method. Patients with MIH demonstrated higher likelihood of presenting proxy reports of DH/toothache compared to those without MIH (OR: 1.51, 95 % CI [1.23-1.85], P < 0.01, I: 0 %). The certainty of evidence was very low, mainly due to the low methodological quality of included studies and high inconsistency.
CONCLUSIONS
The global prevalence of DH/toothache was 22 %, per tooth, and 45 % per patient. Estimates vary according to diagnostic methods. Patients with MIH showed higher likelihood of presenting proxy reports of DH/toothache than controls.
CLINICAL SIGNIFICANCE
This systematic review contributes valuable information to the dental literature by assessing the prevalence and associated factors of DH/toothache in patients with MIH. The findings can guide future research, inform clinical practices and public policy makers, and ultimately improve the management of oral health of patients with MIH.
REGISTRATION
PROSPERO CRD42023432805.
Topics: Humans; Dentin Sensitivity; Dental Enamel Hypoplasia; Toothache; Prevalence; Cross-Sectional Studies; Molar Hypomineralization
PubMed: 38582436
DOI: 10.1016/j.jdent.2024.104981 -
Pediatric Dentistry Jul 2023Using a systematic review to answer the following question: What are the treatment patterns for mild and severe molar hypomineralization in permanent teeth? Electronic...
Using a systematic review to answer the following question: What are the treatment patterns for mild and severe molar hypomineralization in permanent teeth? Electronic searches were conducted to identify randomized clinical trials (RCT) that related treatment to molar hypomineralization- (MH) affected permanent molars in children from five to 16 years old. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool, were performed for all included studies. Studies were selected according to PICOS criteria. RCTs relating mild and severe MH to treatments on permanent molars were included. Studies analyzing clinical techniques, whether single or any association of tech- niques for restorative and desensitizing treatments, were included. Studies involving another disease or comparing different types of enamel defects related to trauma and hereditary were excluded. The certainty of the evidence was evaluated using the GRADE approach. The electronic search was performed on MEDLINE via PubMed, Embase, Cochrane Library, and Grey literature up to May 9, 2022. Of the 5,201 studies initially identified, 88 were fully assessed and 14 RCTs were included. A total of 2,399 interventions were analyzed in 576 patients. Certainty of evidence was found to be of low quality for the outcomes remineralization, structural integrity maintenance, and decay prevention, and very low quality for hypersensitivity decrease and retention. Mild molar hypomineralization needs remineralization, desensitization, sealants, and close follow-up. Severe MH requires restoration both to treat hypersensitivity and reconstruct the affected teeth. Yellow-brown defects have a poor prognosis.
Topics: Child; Humans; Child, Preschool; Adolescent; Molar Hypomineralization; Molar; Dental Care; Dental Materials; Hypersensitivity
PubMed: 37605354
DOI: No ID Found -
Odontology Dec 2023Despite the success of monolithic zirconia restorations (MZ), metal-ceramic restorations (MC) are still considered the gold standard for fixed prosthetics in the...
Despite the success of monolithic zirconia restorations (MZ), metal-ceramic restorations (MC) are still considered the gold standard for fixed prosthetics in the posterior region. This systematic review and meta-analysis aimed to compare the fracture strengths of single-unit MC and MZ in the molar region. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, 2020) statement. All articles were searched from the PubMed and Web of Science databases until November 18, 2022. All in vitro studies evaluating the fracture strengths of MC and MZ were also included. Statistical analysis was performed with the Comprehensive Meta-Analysis program, with a significance level of 0.05. Out of 753 studies, five were selected. The fracture strengths of MZ and MC did not show any statistically significant difference for both tooth (95% CI - 1.589: 2.118, p = 0.779, z = 0.280) and implant (95% CI - 2.215: 2.191, p = 0.992 z = - 0.010) supported restorations. However, different abutment materials (p < 0.001) and aging treatments (p < 0.001) in tooth-supported restorations displayed a significant statistical difference. Additionally, a significant difference was also observed in subgroup analysis considering different cements (p = 0.001) and load speeds (p = 0.001) in implant-supported restorations. Fracture strengths of MZ and MC did not show a significant statistical difference in implant or tooth-supported single-unit posterior restorations. MZ may be a suitable alternative to MC in single-unit posterior restorations. The results should be interpreted with caution, as the included studies were in vitro.
PubMed: 38103151
DOI: 10.1007/s10266-023-00878-x -
Inflammopharmacology Aug 2023This study aimed to evaluate the scientific evidence on the effect of preemptive drug coadministration (PDC) for relieving inflammatory events (pain, swelling, and... (Review)
Review
Is coadministration of preemptive medications an effective strategy for reducing inflammatory clinical events and the need for rescue medication after mandibular third molar surgery? A systematic review of randomized clinical trials.
This study aimed to evaluate the scientific evidence on the effect of preemptive drug coadministration (PDC) for relieving inflammatory events (pain, swelling, and trismus) in mandibular third molar surgery. A PROSPERO-registered systematic review (CRD42022314546) was conducted according to the PRISMA guide. The searches were carried out in six primary databases and the gray literature. Studies not written in languages with the Latin alphabet (Roman) were excluded. Potential randomized controlled trials (RCTs) were screened for eligibility. Cochrane's Risk of Bias-2.0 (RoB) tool was assessed. A synthesis without meta-analysis (SWiM) based on a vote counting and an effect direction plot. Nine studies (low RoB) fulfilled the eligibility criteria and were included for data analysis, with a total of 484 patients. PDC mostly involved corticosteroids (Cort) and non-steroidal anti-inflammatory drugs (NSAIDs). PDC of Cort and other drugs mainly reduced pain scores (6 and 12 h postoperatively) and swelling (48 h postoperatively). PDC of NSAIDs and other drugs mainly reduced pain scores at 6, 8, and 24 h follow-up; swelling and trismus intensity ameliorated at 48 h postoperatively. The most frequently prescribed rescue medication was paracetamol, dipyrone, and paracetamol plus codeine. Results from individual studies have shown reduced consumption of ingested rescue analgesics. In summary, the available evidence from clinical trials included in this SWiM suggests that PDC may provide benefits in reducing the severity of inflammatory outcomes related to mandibular third molar surgery, especially the pain scores in the first hours after surgery, and the rescue analgesic consumption during the postoperative period.
Topics: Humans; Acetaminophen; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Molar, Third; Pain; Randomized Controlled Trials as Topic; Trismus
PubMed: 37306939
DOI: 10.1007/s10787-023-01258-1