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Journal of Clinical and Experimental... Nov 2023The indicated treatment in cases of apical periodontitis (AP), a disease very prevalent in diabetic patients, is root canal treatment (RCT). This study aims to conduct a... (Review)
Review
BACKGROUND
The indicated treatment in cases of apical periodontitis (AP), a disease very prevalent in diabetic patients, is root canal treatment (RCT). This study aims to conduct a systematic review with meta-analysis to answer the following PICO question: In adult patients, does the absence or presence of diabetes affect the prevalence of root filled teeth (RFT)"?
MATERIAL AND METHODS
PRISMA Guidelines have been followed to carry out this systematic review. A literature search was undertaken in PubMed-MEDLINE, Embase and Scielo. All studies reporting the prevalence of RFT in diabetic patients and control subjects using radiographic examination were included. Study characteristics and risk ratios with 95% CIs were extracted. Random-effects meta-analyses were performed.
RESULTS
Five studies fulfilled the inclusion criteria. Prevalence of RFT were estimated with 701 people and 15,882 teeth. Among diabetic patients, 6.1% of teeth had undergone RCT, while in controls this percentage was 3% (OR = 1.7; 95% CI = 1.0 - 2.9; p = 0.065). Among diabetic patients, 65% had at least one RFT, while in controls this percentage dropped to 55% (OR = 1.4; 95% CI = 0.5 - 3.7; > 0.05). The certainty of evidence was low.
CONCLUSIONS
The prevalence of RFT in diabetic patients is almost double that in the control population, however this result is only marginally significant. Dentists must take into account the high prevalence of RFT in diabetic patients, investigating the presence of diabetes in those patients in whom a high frequency of RCT is observed. Diabetes, endodontics, epidemiology, root canal treatment, root filled teeth, prevalence, survey, population-based study.
PubMed: 38074167
DOI: 10.4317/jced.61011 -
The Japanese Dental Science Review Dec 2024The accuracy of artificial intelligence-aided (AI) caries diagnosis can vary considerably depending on numerous factors. This review aimed to assess the diagnostic... (Review)
Review
The accuracy of artificial intelligence-aided (AI) caries diagnosis can vary considerably depending on numerous factors. This review aimed to assess the diagnostic accuracy of AI models for caries detection and classification on bitewing radiographs. Publications after 2010 were screened in five databases. A customized risk of bias (RoB) assessment tool was developed and applied to the 14 articles that met the inclusion criteria out of 935 references. Dataset sizes ranged from 112 to 3686 radiographs. While 86 % of the studies reported a model with an accuracy of ≥80 %, most exhibited unclear or high risk of bias. Three studies compared the model's diagnostic performance to dentists, in which the models consistently showed higher average sensitivity. Five studies were included in a bivariate diagnostic random-effects meta-analysis for overall caries detection. The diagnostic odds ratio was 55.8 (95 % CI= 28.8 - 108.3), and the summary sensitivity and specificity were 0.87 (0.76 - 0.94) and 0.89 (0.75 - 0.960), respectively. Independent meta-analyses for dentin and enamel caries detection were conducted and showed sensitivities of 0.84 (0.80 - 0.87) and 0.71 (0.66 - 0.75), respectively. Despite the promising diagnostic performance of AI models, the lack of high-quality, adequately reported, and externally validated studies highlight current challenges and future research needs.
PubMed: 38450159
DOI: 10.1016/j.jdsr.2024.02.001 -
Diagnostics (Basel, Switzerland) Apr 2024: The availability of multiple dental implant systems makes it difficult for the treating dentist to identify and classify the implant in case of inaccessibility or loss... (Review)
Review
: The availability of multiple dental implant systems makes it difficult for the treating dentist to identify and classify the implant in case of inaccessibility or loss of previous records. Artificial intelligence (AI) is reported to have a high success rate in medical image classification and is effectively used in this area. Studies have reported improved implant classification and identification accuracy when AI is used with trained dental professionals. This systematic review aims to analyze various studies discussing the accuracy of AI tools in implant identification and classification. : The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The focused PICO question for the current study was "What is the accuracy (outcome) of artificial intelligence tools (Intervention) in detecting and/or classifying the type of dental implant (Participant/population) using X-ray images?" Web of Science, Scopus, MEDLINE-PubMed, and Cochrane were searched systematically to collect the relevant published literature. The search strings were based on the formulated PICO question. The article search was conducted in January 2024 using the Boolean operators and truncation. The search was limited to articles published in English in the last 15 years (January 2008 to December 2023). The quality of all the selected articles was critically analyzed using the Quality Assessment and Diagnostic Accuracy Tool (QUADAS-2). : Twenty-one articles were selected for qualitative analysis based on predetermined selection criteria. Study characteristics were tabulated in a self-designed table. Out of the 21 studies evaluated, 14 were found to be at risk of bias, with high or unclear risk in one or more domains. The remaining seven studies, however, had a low risk of bias. The overall accuracy of AI models in implant detection and identification ranged from a low of 67% to as high as 98.5%. Most included studies reported mean accuracy levels above 90%. : The articles in the present review provide considerable evidence to validate that AI tools have high accuracy in identifying and classifying dental implant systems using 2-dimensional X-ray images. These outcomes are vital for clinical diagnosis and treatment planning by trained dental professionals to enhance patient treatment outcomes.
PubMed: 38667452
DOI: 10.3390/diagnostics14080806 -
F1000Research 2023To estimate the prevalence of carpal tunnel syndrome (CTS) among dental surgeons and the effect of possible moderators on it. A systematic literature search (Medline... (Meta-Analysis)
Meta-Analysis
To estimate the prevalence of carpal tunnel syndrome (CTS) among dental surgeons and the effect of possible moderators on it. A systematic literature search (Medline and Scopus databases) was conducted independently by two reviewers. Only observational studies that examined specifically the prevalence rates of CTS among dentists were included. Quality assessment was performed. The pooled prevalence with 95% confidence intervals (CI) was estimated. Outlier and influential analysis were conducted. Moderator analysis was performed in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. In total, ten eligible studies (3,547 participants) were finally included in this meta-analysis. Two of them were estimated as high quality (low risk of bias) and the remaining ones as moderate quality (moderate risk of bias). The overall prevalence of CTS among dental surgeons was estimated as 9.87% (95%CI 6.84%-14.03%) with significant heterogeneity between studies. No study was identified as influential. Potential sources of heterogeneity were not identified through meta-regression analysis. In the subgroup analysis the prevalence was 12.47% (95%CI 6.38%-22.95%) for the group identified as having CTS through medical history and at least clinical examination or electrodiagnostic testing and 8.56% (95%CI 5.53%-13.01%) among those who identified solely through questionnaire. Our findings are important to provide the pooled prevalence of CTS among dentists. Our results were based on highly heterogeneous studies. Our study reports a considerable prevalence, consequently, significance of awareness among dental surgeons regarding the etiology of this issue is more than necessary. More studies need to be conducted that could guide researchers in order this issue to be fully investigated.
Topics: Humans; Carpal Tunnel Syndrome; Databases, Factual; Dentists; MEDLINE; Prevalence
PubMed: 37614565
DOI: 10.12688/f1000research.131173.3 -
F1000Research 2023Carpal Tunnel Syndrome (CTS) is one such common disorder among dental health care personnel caused due to the entrapment neuropathy of the median nerve in the carpal... (Meta-Analysis)
Meta-Analysis
Carpal Tunnel Syndrome (CTS) is one such common disorder among dental health care personnel caused due to the entrapment neuropathy of the median nerve in the carpal tunnel. We aimed to evaluate the pooled estimates of the CTS among dental healthcare personnel. We systematically reviewed the existing literature from six databases till January 1 , 2022. Studies reported in English along with the prevalence of CTS or where prevalence could be calculated were included. Independent screening of title and abstracts, and the full text was done by two examiners. Information collected was authors, year of publication, geographic location, type of dental healthcare personnel, sample size, distribution of age, sex, CTS, method of diagnosis, and risk of bias. The random effect model was used to estimate the pooled estimates. Thirty-seven studies yielded 38 estimates. A total of 17,152 dental health care personnel were included of which 2717 had CTS. The overall pooled prevalence of CTS among the included studies was 15%, with a high heterogeneity. Meta-analysis showed no significant difference in the pooled estimates of CTS between male and female dental healthcare personnel (OR: 0.73; 95% CI: 0.52 -1.02; I = 69.71). The pooled estimates among the dentist and dental auxiliaries were 20% and 10%, respectively. The pooled prevalence of CTS with self-reported measures, clinical examination and NCS were 21%, 13% and 8% respectively. Meta-regression showed that the prevalence estimates were significantly associated with publication year (coefficient: 0.006; 95% CI= 0.002-0.01). One out of seven dental health care personnel may be affected by CTS. No significant difference was seen in the prevalence of CTS between male and female dental healthcare personnel.
Topics: Humans; Male; Female; Carpal Tunnel Syndrome; Prevalence; Health Personnel; Wrist
PubMed: 37521768
DOI: 10.12688/f1000research.131659.1 -
Journal of Dentistry Jun 2024Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated... (Review)
Review
OBJECTIVES
Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated by beliefs, attitudes, preferences, and behaviors, it is essential to evidence-based practice. Cross-sectional studies uniformly demonstrate that community NSRCT is of sub-optimal quality worldwide, is lack of knowledge a problem? Our purpose was to measure dentists' knowledge of root canal treatment (NSRCT).
DATA
Quantitative and qualitative data were extracted: purpose, topics assessed, authors cited knowledge sources, number of dentists studied, number of questions, authors descriptors of knowledge level,% correct answers by question, authors recommendations.
SOURCES
OVID Medline, EMBASE, Web of Science, and hand-searching.
STUDY SELECTION
Studies which had measured dentists' knowledge of non-surgical root canal treatment that was valuable, reliable, and had practical implications which could be implemented. A total of 51 papers from 19 countries measured the knowledge of 15,580 dentists using 445 questions on 29 root canal treatment topics.
CONCLUSIONS
'Gold standards' were from literature, external bodies, or expert consensus in 47, 31, and 2 papers respectively. Levels of knowledge by percentage correct answers among studies were poor to moderate and varied considerably. The mean, for the 50 studies where overall study percentages could be calculated, was 57 %, standard deviation 17 %, and a range of 16 % to 82 %. Authors' adjectives describing knowledge levels were generally negative. Additional education was advised in 49 papers, but without evidence that education was inadequate; 6 papers recommended increased use of protocols; only 5 papers advocated research on the cause of lack of knowledge.
CLINICAL SIGNIFICANCE
Dentists' root canal treatment knowledge was found to be poor to moderate, as well variable. This may constrain quality of care. However, provision of information without attention to dentists' cognitions and motivations may not be successful. Educational strategies and goals should be re-evaluated. Evidence-based practice faces many barriers.
Topics: Humans; Root Canal Therapy; Dentists; Health Knowledge, Attitudes, Practice; Clinical Competence; Evidence-Based Dentistry; Practice Patterns, Dentists'
PubMed: 38580057
DOI: 10.1016/j.jdent.2024.104975 -
JPMA. the Journal of the Pakistan... Oct 2023To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
OBJECTIVE
To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
METHODS
The systematic review was conducted after registration with the International prospective register of systematic reviews at the University of York, the United Kingdom, and comprised search on Medline, PubMed, Cochrane and CINAHAL Plus databases for studies published up to December 2021. The Population-Intervention-Comparison- Outcomes-Study criteria was used to search for studies involving patients diagnosed with oral squamous cell carcinoma receiving referrals by dentist or by other healthcare providers. Disease-free survival of patients was taken as the main outcome. Customized data collection proforma was used to record data in line with the Preferred Reporting Items in Systematic Reviews and Meta- Analysis guidelines. Data was subjected to systematic, qualitative review.
RESULTS
Of the 344 studies found, 8(2.3%) were analysed in detail. Patients referred by dentists ranged from 22.6% to 54%. Males comprised 53% to 70.3% of the sample. The highest number of referrals was made by primary physicians, ranging from 27.4% to 71.6%. Upto 67.6% cases were diagnosed with stage 1 and 2 oral cancer. The highest 5-year survival rate was 75% in a study where 59% patients were diagnosed at an early stage of disease.
CONCLUSION
The relative scarcity of studies makes it impossible to draw an association between oral cancer survival rate and type of referral.
Topics: Male; Humans; Female; Carcinoma, Squamous Cell; Mouth Neoplasms; Disease-Free Survival; Squamous Cell Carcinoma of Head and Neck; Systematic Reviews as Topic; Physicians; Head and Neck Neoplasms; Dentists
PubMed: 37876066
DOI: 10.47391/JPMA.7308 -
Antibiotics (Basel, Switzerland) Mar 2024After pulp infection and necrosis, the passage of microbial antigens into the periapical space causes apical periodontitis (AP). Most of the clinical forms of AP can be... (Review)
Review
UNLABELLED
After pulp infection and necrosis, the passage of microbial antigens into the periapical space causes apical periodontitis (AP). Most of the clinical forms of AP can be managed without prescribing antibiotics, only with root canal treatment and abscess drainage or, where appropriate, tooth extraction. However, the scientific literature provides evidence of inappropriate antibiotic prescriptions by dentists in the management of apical disease.
OBJECTIVES
The aim of this systematic review and meta-analysis was to analyze the global pattern of antibiotic prescription in the treatment of apical disease.
METHODS
PRISMA Guidelines were followed to carry out this systematic review. The research question was as follows: What is the pattern of antibiotic prescription by dentists in the treatment of the different clinical forms of apical periodontitis? A systematic search was conducted on MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. All studies reporting data about the pattern of antibiotic prescription by dentists in the treatment of apical disease were included. The meta-analyses were calculated using the Open Meta Analyst version 10.10 software. Random-effects meta-analyses were performed. The risk of bias was assessed using the Newcastle-Ottawa Scale. The certainty of evidence was assessed using GRADE.
RESULTS
The search strategy identified 96 articles and thirty-nine cross-sectional studies fulfilled the inclusion criteria. The overall percentage of antibiotic prescriptions by dentists in cases of symptomatic AP was 25.8%, and 31.5% in cases of asymptomatic AP with sinus tract present. The percentage of dentists prescribing antibiotics in cases of acute apical abscess with no/mild symptoms was 47.7%, whereas, in cases of acute apical abscess with moderate/severe symptoms, 88.8% of dentists would prescribe antibiotics. Endodontists prescribe antibiotics at a lower rate than general practitioners. The total risk of bias was considered moderate, and the final rating for the certainty of the evidence was low.
CONCLUSIONS
Dentists worldwide are over-prescribing antibiotics in the management of apical disease. It is necessary to improve antibiotic prescribing habits in the treatment of endodontic infections, as well as educational initiatives to encourage the rational and appropriate prescription of antibiotics in periapical diseases.
PubMed: 38666965
DOI: 10.3390/antibiotics13040289 -
Cureus Dec 2023When restoring proximal surfaces in posterior teeth, dentists frequently encounter the difficulty of reproducing the proximal contact that is naturally present in... (Review)
Review
When restoring proximal surfaces in posterior teeth, dentists frequently encounter the difficulty of reproducing the proximal contact that is naturally present in unrestored teeth. In order to guarantee the durability of restorations made from class II composite resin, it is imperative that both functional and aesthetic requirements are met. This entails the choice of the matrix system that replicates the optimal proximal contact subsequent to the insertion of restorations made of class II composite resin. The objective of this systematic review is to assemble current research conducted on the various matrix systems utilized in class II composite restorations and assess their impact on the pre-existing composite proximal contact. Three examiners conducted an independent electronic search utilizing the subsequent databases: Web of Science, Cochrane Library, Scopus, PubMed, and Embase. Publications on proximal contact in class II composite restorations were compiled from the time of their inception until August 2022, in accordance with predetermined inclusion and exclusion criteria. The methodological quality assessment was conducted utilizing the Effective Public Health Practice Project (EPHPP) instrument. Among the six studies that were included, it was observed that the sectional matrix system generated greater proximal contact tightness than the circumferential matrix system (Tofflemire). However, no significant distinction was found between the metal and polyester matrix systems. In contrast to alternative circumferential matrix systems, the utilization of a sectional matrix system yields a statistically significant improvement in the optimum proximal contact of class II composite restorations, according to the studies.
PubMed: 38259361
DOI: 10.7759/cureus.50835 -
Journal of Infection and Public Health Dec 2023Antibiotics are gradually becoming less effective against bacteria worldwide, and this issue is of particular concern in economically-developing nations like Pakistan....
Antibiotics are gradually becoming less effective against bacteria worldwide, and this issue is of particular concern in economically-developing nations like Pakistan. We undertook a scoping review in order to review the literature on antimicrobial use, prescribing, dispensing and the challenges associated with antimicrobial resistance in primary care (PC) settings in Pakistan. Furthermore, this review aims to identify potential solutions to promote appropriate use of antimicrobials in Pakistan. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist, a comprehensive scoping review was conducted to review the literature of antimicrobials used, prescribed and dispensed in PC settings in Pakistan. Google Scholar and Pub-Med were searched for the period 2000-2023. Papers were analyzed on the basis of eligibility i.e., included antimicrobial use, prescribing and dispensing practices by general population at homes, by prescribers in outpatient departments of hospitals and by pharmacists/dispensers in community pharmacies, respectively. Two researchers analyzed the articles thoroughly and disagreements were resolved through discussion with a third reviewer. Both quantitative and qualitative research studies were eligible for inclusion. Additionally, the selected papers were grouped into different themes. We identified 4070 papers out of which 46 studies satisfied our eligibility criteria. The findings revealed limited understanding of antimicrobial resistance (AMR) by physicians and community pharmacists along with inappropriate practices in prescribing and dispensing antibiotics. Moreover, a notable prevalence of self-medication with antibiotics was observed among the general population, underscoring a lack of awareness and knowledge concerning proper antibiotic usage. Given the clinical and public health implications of AMR, Pakistan must prioritize its policies in PC settings. Healthcare professionals (HCPs) need to reduce inappropriate antibiotic prescribing and dispensing, improve their understanding of the AWaRe (access, watch and reserve antibiotics) classification and guidance, monitor current usage and resistance trends, as well as implement antimicrobial stewardship (ASP) activities starting in targeted locations.
Topics: Humans; Anti-Bacterial Agents; Pakistan; Drug Resistance, Bacterial; Anti-Infective Agents; Primary Health Care
PubMed: 37973496
DOI: 10.1016/j.jiph.2023.10.046