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Future Science OA Dec 2023This meta-analysis was performed to assess the efficacy and safety of mavacamten in patients with hypertrophic cardiomyopathy.
AIM
This meta-analysis was performed to assess the efficacy and safety of mavacamten in patients with hypertrophic cardiomyopathy.
METHODS & MATERIALS
A search was conducted using PubMed, Cochrane, and Scopus up to August 2022 for randomized studies reporting our pre-specified outcomes.
RESULTS
It was observed that mavacamten significantly improved New York Heart Association class (p < 0.009), Clinical Summary Score of the Kansas City Cardiomyopathy Questionnaire (p = 0.02), post-exercise left ventricular outflow tract gradient (p < 0.00001), functional end point (p = 0.05), and lowered septal reduction therapy rates (p < 0.00001). However, there were no significant differences in the ≥1 severe adverse events, ≥1 treatment-emergent adverse events, left ventricular volume index, left ventricular filling pressure, left ventricular end-diastolic volume index, and peak oxygen uptake (pVO).
CONCLUSION
Future large-scale trials are required to confirm our results and determine the long-term benefits and risks of mavacamten use in these patients.
PubMed: 37753355
DOI: 10.2144/fsoa-2023-0059 -
Clinical Oral Implants Research Sep 2023For the present review, the following focused question was addressed: In patients with root-analog dental implants, what is the effect of implants made of other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
For the present review, the following focused question was addressed: In patients with root-analog dental implants, what is the effect of implants made of other materials than titanium (alloy) on implant survival, marginal bone loss (MBL), and technical and biological complications after at least 5 years.
MATERIALS AND METHODS
An electronic (Medline, Embase, Web of Science) search was performed to identify observational clinical studies published from January 2000 investigating a minimum of 20 commercially available zirconia implants with a mean follow-up of at least 60 months. Primary outcome was implant survival, secondary outcomes included peri-implant MBL, probing depths (PDs), and technical and biological complications. Meta-analyses were performed to evaluate implant survival, MBL, and PD.
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 4 prospective and 2 retrospective observational clinical cohort studies were included for data extraction. Meta-analyses estimated after 5 years of loading mean values of 97.2% (95% CI 94.7-99.1) for survival (277 implants, 221 patients), 1.1 mm (95% CI: 0.9-1.3) for MBL (229 implants, 173 patients), and 3.0 mm (95% CI 2.5-3.4) for PDs (231 implants, 175 patients).
CONCLUSIONS
After 5 years, commercially available zirconia implants showed reliable clinical performance based on survival rates, MBL, and PD values. However, more well-designed prospective clinical studies and randomized clinical trials investigating titanium and zirconia implants are needed to confirm the presently evaluated promising outcomes.
Topics: Humans; Dental Implants; Prospective Studies; Retrospective Studies; Titanium; Bone Diseases, Metabolic
PubMed: 37750521
DOI: 10.1111/clr.14133 -
Clinical and Experimental Dental... Aug 2023The aim of this article is to establish a comprehensive nationwide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this article is to establish a comprehensive nationwide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in the Turkish population.
MATERIAL AND METHODS
A systematic search of PubMed, Scopus, and Web of Science was supplemented by manual searches of Google Scholar and the reference lists of included studies. Original Turkish health studies of any age were included. Strengthening the Reporting of Observational Studies in Epidemiology assessed study quality and bias (STROBE). Sagittal, vertical, and transverse malocclusion features were retrieved and gathered.
RESULTS
Eleven studies were selected from 434 titles. Two studies showed a high risk of bias, eight low and one moderate. Thirteen thousand two hundred seventy-one individuals were investigated from early childhood to late adulthood. Most studies were sampled from universities and dental (nonorthodontic) clinics. The pooled malocclusion prevalence was 56% for Class I (95% confidence interval (CI): 44-68%), 31% for Class II (CI: 6-42%), and 11% for Class III (CI: 21-37%). The other common types of malocclusions were crowding (41%, CI: 18-65%), overjet (34%, CI: 21-50%), negative overjet (13%, CI: 7-20%), and crossbite (11%, CI: 7-15%). Additionally, there was no significant difference in Class I (relative risk [RR] = 1.00, [0.96-1.05]), Class II ([RR] = 0.97, [0.92-1.03]), and Class III ([RR] = 1.08, [0.96-1.225]) malocclusion by gender.
CONCLUSIONS
This study showed Class I malocclusion has a high prevalence among the Turkish population followed by Class II and Class III malocclusions. In addition, crowding and overjet were the most prevalent malocclusions among Turkish individuals. There were no significant differences in the prevalence of malocclusions between males and females.
Topics: Child, Preschool; Male; Female; Humans; Child; Adolescent; Adult; Malocclusion, Angle Class II; Prevalence; Malocclusion; Malocclusion, Angle Class III; Overbite
PubMed: 37574975
DOI: 10.1002/cre2.771 -
Medicina (Kaunas, Lithuania) Aug 2023: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving... (Meta-Analysis)
Meta-Analysis Review
: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving functional outcomes with good compliance rates. Herein, we aimed to perform a meta-analysis comparing clinical outcomes between OSA children treated with dental appliances versus controls. : The study was registered with PROSPERO. A systematic search was performed for all comparative studies examining outcomes in pediatric patients who underwent treatment of OSA with oral appliances versus controls. Data was extracted and analyzed using a random effects model via Rev Man 5.3. : Six studies including 180 patients were analyzed split into two groups: patients treated with dental appliances (n = 123) and the controls (n = 119). Therapy with dental appliances was shown to significantly improve the apnea-hypopnea index ( = 0.009) and enlarge the superior posterior airway space ( = 0.02). Maxilla-to-mandible measurements were not significantly different between the two groups, nor was the mean SO ( = 0.80). : This is the most updated meta-analysis assessing the role of dental appliances for OSA in children; it shows that such devices can improve functional outcomes by decreasing the apnea-hypopnea index.
Topics: Humans; Child; Patient Compliance; Sleep Apnea, Obstructive
PubMed: 37629737
DOI: 10.3390/medicina59081447 -
Pharmaceuticals (Basel, Switzerland) Sep 2023: Probiotic microorganisms, commonly used to bolster gut health, might also have benefits for dental health, according to certain studies. Probiotics (PBs) are... (Review)
Review
: Probiotic microorganisms, commonly used to bolster gut health, might also have benefits for dental health, according to certain studies. Probiotics (PBs) are associated with reducing cariogenic pathogens and protecting against periodontal diseases, although the exact way they function in the mouth is not fully clear. Our study aimed to explore the use of PBs to improve oral health, focusing on issues such as cavities, gum disease, bad breath, mucositis, and periimplantitis. : We utilized the Boolean keywords "Probiotics" AND "Oral health" to search the databases of PubMed, Scopus, and Web of Science. The search was restricted to English-language papers published from 1 January 2019 to 13 April 2023. : A total of 3460 articles were found through our computerized search. After removing duplicates, reviewing the papers, and determining their relevance, 12 were selected for inclusion. : Assessing how bacteria in food or dietary supplements might alter the stable oral microbiota is a complex task. Although probiotic microorganisms have been found to have proven therapeutic benefits, their application in dental health is not yet solidly backed by evidence. Further research is necessary to thoroughly understand the long-term effects of probiotic bacteria on the oral environment, including their ability to colonize and form biofilms.
PubMed: 37765121
DOI: 10.3390/ph16091313 -
Acta Bio-medica : Atenei Parmensis Aug 2023the COVID-19 infection, caused by severe Coronavirus 2 syndrome (Sars-Cov-2), immediately appeared to be the most tragic global pandemic event of the twentieth century.... (Meta-Analysis)
Meta-Analysis
the COVID-19 infection, caused by severe Coronavirus 2 syndrome (Sars-Cov-2), immediately appeared to be the most tragic global pandemic event of the twentieth century. Right from the start of the pandemic, diabetic patients treated with metformin experienced a reduction in mortality and complications from COVID-19 compared to those with different treatments or no treatment. Objective The main objective of the study was to observe the effects of metformin in hospitalized subjects infected with COVID-19. Specifically, the outcomes of hospitalization in Intensive Care Units or death were examined. Materials and Methods A specific research PICOS was developed and the Pubmed, Embase and Scopus databases were consulted down to April 30, 2022. To estimate the extent of the metformin effect and risk of severity in SARS-CoV-2 infection, the Odd Ratio (OR) with 95% Confidence Interval (CI) published by the authors of the selected systematic reviews was used. Results from five systematic reviews 36 studies were selected. The final meta-analysis showed that thanks to treatment with metformin, DM2 patients affected by COVID-19 had protection against risk of disease severity, complications (ES 0.80; 95% CI) and mortality (ES 0.69; 95% CI). Conclusions More in-depth studies on the use of metformin, compared to other molecules, may be required to understand the real protective potential of the drug against negative outcomes caused by COVID-19 infection in DM2 patients.
Topics: Humans; COVID-19; SARS-CoV-2; Systematic Reviews as Topic; Databases, Factual; Metformin
PubMed: 37695186
DOI: 10.23750/abm.v94iS3.14405 -
International Journal of Implant... Jul 2023The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.
RESULTS
Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs.
CONCLUSIONS
ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Prosthesis Failure; Titanium; Treatment Outcome; Alloys
PubMed: 37405545
DOI: 10.1186/s40729-023-00479-x -
Clinical Oral Implants Research Sep 2023In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year?
MATERIALS AND METHODS
This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487).
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material.
CONCLUSIONS
Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.
Topics: Humans; Titanium; Dental Implants; Alloys; Aluminum Oxide
PubMed: 37750527
DOI: 10.1111/clr.14159 -
Journal of Conservative Dentistry and... 2023This systematic review investigates the crucial need for solvent use in root canal retreatment, as it effectively removes filling materials, reduces apical debris... (Review)
Review
INTRODUCTION
This systematic review investigates the crucial need for solvent use in root canal retreatment, as it effectively removes filling materials, reduces apical debris extrusion, and alleviates postoperative pain, ultimately enhancing treatment success. The review aims to assess the success rates, compare outcomes, explore benefits and drawbacks, and identify subgroups where solvent use may be more effective during root canal retreatment.
MATERIALS AND METHODS
The search was performed in PubMed Central, Scopus, Cochrane, LILAC, ScienceDirect, Google Search, Web of Science, and manually using the search items alone and in combination by means of PUBMED search builder. The studies were assessed for eligibility according to the eligibility criteria by two independent reviewers. Groups containing solvent with nonsolvent groups and randomized control trials were included and in vitro studies, retrospective studies, and animal studies were excluded from the study. Quality assessment was performed using the risk of bias (RoB) 2.0 tool.
RESULTS
Out of the 596 articles obtained, 14 were shortlisted for full-text reading and finally two articles were included in the study. The studies were assessed for quality, and data were extracted in a tabulated form. Overall RoB is low, but due to the lack of homogeneity, meta-analysis could not be conducted.
CONCLUSION
The use of solvent does not cause any significant difference in the postoperative pain levels or analgesic intake for retrieval of gutta-percha in cases of root canal retreatment. Due to the limited number of studies available and the lack of clinician-related outcomes such as time taken to retrieve the gutta-percha, these results should be taken into consideration with caution.
PubMed: 38292751
DOI: 10.4103/JCDE.JCDE_86_23 -
Clinical Oral Investigations Dec 2023To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review.
METHODS
An electronic search was performed in three databases, last updated in June 2023, supplemented by hand searching. The eligibility criteria were clinical studies reporting patients rehabilitated with zirconia implants. The cumulative survival rate (CSR) of implants was calculated. A meta-analysis for marginal bone loss (MBL) under different follow-up times and a meta-regression assessing the relationship between mean MBL and follow-up were done.
RESULTS
Twenty-five studies were included (4017 implants, 2083 patients). Seven studies had follow-up longer than 60 months. 172 implants failed, after a mean of 12.0 ± 16.1 months (min-max 0.3-86.0), of which 47 early failures, and 26 due to implant fracture, the majority in narrow-diameter implants. The 10-year CSR was 95.1%. Implants with coronal part prepared by drills presented statistically significant lower survival than non-prepared implants (p < 0.001). Two-piece implants presented lower survival than one-piece implants (p = 0.017). Implants discontinued from the market presented lower survival than the commercially available ones (p < 0.001). The difference in survival was not significant between implants in maxilla and mandible (p = 0.637). The mean MBL fluctuated between 0.632 and 2.060 mm over long periods of observation (up until 132 months). There was an estimated MBL increase of 0.005 mm per additional month of follow-up.
CONCLUSION
Zirconia implants present high 10-year CSR and short-term low MBL. The review was registered in PROSPERO (CRD42022342055).
CLINICAL RELEVANCE
The clinical outcomes observed for zirconia dental implants are very promising, although these have not yet been extensively studied as titanium alloy implants.
Topics: Humans; Dental Implants; Treatment Outcome; Dental Restoration Failure; Zirconium; Titanium; Dental Prosthesis Design
PubMed: 38135804
DOI: 10.1007/s00784-023-05401-8