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Cureus Sep 2023Blockchain technology has gained attention as a potential solution for improving data security, privacy, and interoperability in various industries, including... (Review)
Review
Blockchain technology has gained attention as a potential solution for improving data security, privacy, and interoperability in various industries, including healthcare. In the field of dentistry, the implementation of blockchain holds promise for transforming dental practice and management. However, a comprehensive evaluation of the existing literature regarding the implementation of blockchain technology in dental practice is lacking. This systematic review aimed to assess the current evidence on the implementation of blockchain technology in dental practice and management. A systematic literature search was conducted using major databases to identify relevant studies. The search strategy included keywords related to blockchain technology and dentistry. The investigation was performed as per the PRISMA guidelines. Studies reporting on the implementation, adoption, and outcomes of blockchain technology in dental practice and management were included. Quality assessment and data extraction were performed following predefined criteria. The initial search yielded a multitude of articles, and after applying the inclusion and exclusion criteria, six studies were included in the systematic review. The studies explored various aspects of blockchain technology implementation in dental practice, including data security, interoperability, supply chain management, and patient consent management. Furthermore, the use of blockchain-based systems showed potential benefits in enhancing supply chain management efficiency and patient consent authentication. This systematic review provided insights into the current state of blockchain technology implementation in dental practice and management. The findings suggested that blockchain technology has the potential to enhance data security, privacy, and interoperability in dental practices. However, further research and real-world implementation studies are needed to fully understand the impact of blockchain technology on dental practice and to address the existing challenges.
PubMed: 37868487
DOI: 10.7759/cureus.45512 -
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 -
Clinical Medicine & Research Dec 2023Lichen planus (LP) is a chronic autoimmune disease of skin and mucous membranes. World Health Organization has announced oral lichen planus (OLP) as a premalignant... (Review)
Review
Lichen planus (LP) is a chronic autoimmune disease of skin and mucous membranes. World Health Organization has announced oral lichen planus (OLP) as a premalignant lesion. The exact etiology of OLP remains unknown; however, different mechanisms may be involved in its immunopathogenesis. The upregulation of cytokines, chemokines, and adhesion molecules is consistent with a persistent and erratic immunological response to OLP-mediated antigens generated by oral keratinocytes and innate immune cells. These molecules attract T cells, and mast cells to the disease site and regulate complex interactions among cells that lead to death of keratinocytes, degradation of basement membrane, and chronicity of the disease. It is believed that CD8+ and CD4+ T helper 1 (Th1) cells are the main lymphocytes involved in this process, although recent evidence suggests implication of other T helper subgroups, such as Th23, Th17, and regulatory T cells (Tregs), proposing a more complex cellular immunity process to be involved in its pathogenesis. The emphasis of this research review is on the function of IL-17 in the pathophysiology of OLP and how current discoveries may point to future treatment strategies. This research protocol will follow Preferred Reporting Items for Systematic Reviews (PRISMA 2020) checklist. An electronic search was conducted in PubMed, Scopus, Google Scholar, Embase, and Cochrane databases for articles published from 1960 to June 2022. Based on the eligibility criteria, 21 articles were enrolled. In comparison to healthy controls, the findings of this review demonstrated greater expression of IL-17 and Th-17 in the blood, saliva, and tissues of OLP and LP patients. Additionally, there was a strong link between the relative levels of IL-17 and IL-23 expression. Treatment with monoclonal antibodies against Th-17/Tc-17, IL-12/IL-23, and IL-23 would result in significant long-term improvement of LP symptoms.
Topics: Humans; Lichen Planus, Oral; Interleukin-17; Cytokines; Lichen Planus; Interleukin-23
PubMed: 38296640
DOI: 10.3121/cmr.2023.1822 -
Clinical Oral Investigations Dec 2023Rheumatoid arthritis (RA) is a debilitating disease where numerous pro-inflammatory cytokines have a proven role in its pathology. These cytokines are also involved in... (Review)
Review
OBJECTIVES
Rheumatoid arthritis (RA) is a debilitating disease where numerous pro-inflammatory cytokines have a proven role in its pathology. These cytokines are also involved in the pathogenesis of apical periodontitis (AP) where they have a pro-inflammatory role and induce bone resorption. Patients with RA may therefore be more prone to develop pulpal-periapical pathology (PPP). This study systematically reviewed the existing literature evaluating the association between RA and PPP.
MATERIALS AND METHODS
Studies including human participants with both RA and PPP were included. The search was performed in PubMed, Web of Science, and The Cochrane Library databases using keywords and Medical Subject Headings (MeSH) search terms. The risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. The following parameters were extracted and analyzed by the reviewers; author, journal, year, design of the study, diagnostic criteria for periapical pathology, the association between rheumatoid arthritis and periapical pathology, and the evidence level.
RESULTS
The search identified 142 records. Inclusion criteria were as follows; studies in the English language, including human participants only, including patients with RA and PPP, cohort studies, cross-sectional studies, clinical trials, and case-control studies. According to the inclusion criteria, 5 studies were included in this systematic review. Three of the five studies reported significant association between RA and PPP.
CONCLUSIONS
Existing evidence suggests there may be an association between RA and PPP.
CLINICAL RELEVANCE
Clinicians should be aware that RA patients can be more prone to develop PPP which may result in a reduced quality of life.
Topics: Humans; Quality of Life; Cross-Sectional Studies; Arthritis, Rheumatoid; Periapical Periodontitis; Cytokines
PubMed: 37828236
DOI: 10.1007/s00784-023-05305-7 -
BMC Oral Health Oct 2023Statins are a category of medications widely used to reduce plasma LDL-cholesterol levels, that also possess antibacterial, anti-inflammatory, and immunomodulatory...
OBJECTIVES
Statins are a category of medications widely used to reduce plasma LDL-cholesterol levels, that also possess antibacterial, anti-inflammatory, and immunomodulatory action. The aim of this systematic review was to explore the effects of systemic statins therapy on the development and treatment of apical periodontitis (AP) on humans and animals.
MATERIAL AND METHODS
Three electronic databases (PubMed, Web of Science, and Scopus) and grey literature were searched from their inception until February, 20 2023 (PROSPERO CRD42021246231). For the quality assessment and risk of bias, different guidelines were used according to the typology of the studies considered (Animal Research Reporting of In Vivo Experiments, Newcastle-Ottawa Quality Assessment Form for Cohort Studies, Systematic Review Centre for Laboratory animal Experimentation Risk of Bias tool and Tool to assess risk of bias in cohort studies of CLARITY Group).
RESULTS
Seven hundred eleven records were screened, and six articles were included for this qualitative review. The eligible studies showed a moderate overall quality and risk of bias. Human patients in treatment with statins exhibited a higher healing rate of AP following root canal treatment. In experimental animal models, statins had a beneficial effect on the development of AP.
CONCLUSIONS
Despite the limited number of studies and considering that most of them are on animals, our findings suggest that systemically administered statins make a positive contribution to prevent the development and help healing of AP.
CLINICAL RELEVANCE
There is an increased evidence that a pharmacologic adjunct to endodontic treatment may be considered to enhance healing of AP. Among other medications, statins seem to have a positive impact on the disease.
Topics: Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Periapical Periodontitis; Root Canal Therapy; Anti-Bacterial Agents; Wound Healing
PubMed: 37805447
DOI: 10.1186/s12903-023-03472-3 -
Journal of Pain Research 2024The prevalence of orofacial pain continues to increase. Additionally, the rising number has been accompanied by reduced quality of life of its sufferers. An assumed... (Review)
Review
The prevalence of orofacial pain continues to increase. Additionally, the rising number has been accompanied by reduced quality of life of its sufferers. An assumed association between orofacial pain and anxiety has surfaced due to the results of several studies that show higher occurrence of anxiety in people experiencing orofacial pain, compared to those who are orofacial-pain-free. The aim of this systematic review was to discover past research on orofacial pain and its relationship to anxiety, and to understand the relationship between acute and chronic orofacial pain and anxiety. The current systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) rules. Study searches were carried out using three databases, namely PubMed, ScienceDirect, and Scopus. Article selection was carried out in several stages and was based on inclusion and exclusion criteria and continued by assessing the methodological quality and risk of bias of each article. The risk of bias was analyzed by using the critical review tool for cross-sectional studies from the Joanna Briggs Institute (JBI). The selection process led to a review process of 13 cross-sectional research articles. The systematic review showed a positive relationship between orofacial pain and anxiety, with variations in the strength of the relationship (weak to moderate). Most articles revealed that anxiety is a risk factor for orofacial pain. A correlation between chronic orofacial pain and anxiety was mentioned in several studies. It can be concluded that there is an existing relationship between orofacial pain and anxiety, especially chronic orofacial pain. Prospero registration number: CRD42023385409.
PubMed: 38192368
DOI: 10.2147/JPR.S432031 -
The Journal of Prosthetic Dentistry Sep 2023Digital workflows for digital complete denture fabrication have a variety of clinical and laboratory procedures, but their outcomes and associated complications are... (Review)
Review
STATEMENT OF PROBLEM
Digital workflows for digital complete denture fabrication have a variety of clinical and laboratory procedures, but their outcomes and associated complications are currently unknown.
PURPOSE
The purpose of this systematic review was to evaluate the clinical and laboratory procedures for digital complete dentures, their outcomes, and associated complications.
MATERIAL AND METHODS
Electronic literature searches were conducted on PubMed/Medline, Embase, and Web of Science for studies published from January 2000 to September 2022 and screened by 2 independent reviewers. Information on digital complete denture procedures, materials, their outcomes, and associated complications was extracted.
RESULTS
Of 266 screened studies, 39 studies were included. While 26 assessed definitive complete dentures, 7 studies assessed denture bases, 2 assessed trial dentures, and 4 assessed the digital images only. Twenty-four studies used border molded impression technique, 3 studies used a facebow record, and 7 studies used gothic arch tracing. Only 13 studies performed trial denture placement. Twenty-one studies used milling, and 17 studies used 3D printing for denture fabrication. One study reported that the retention of maxillary denture bases fabricated from a border-molded impression (14.5 to 16.1 N) was statistically higher than the retention of those fabricated from intraoral scanning (6.2 to 6.6 N). The maximum occlusal force of digital complete denture wearers was similar across different fabrication procedures. When compared with the conventional workflow, digital complete dentures required statistically shorter clinical time with 205 to 233 minutes saved. Up to 37.5% of participants reported loss of retention and up to 31.3% required a denture remake. In general, ≥1 extra visit and 1 to 4 unscheduled follow-up visits were needed. The outcomes for patient satisfaction and oral health-related quality of life were similar between conventional, milled, and 3D-printed complete dentures.
CONCLUSIONS
Making a border-molded impression is still preferred for better retention, and trial denture placement is still recommended to optimize the fabrication of definitive digital complete dentures.
PubMed: 37689573
DOI: 10.1016/j.prosdent.2023.07.027 -
Journal of Taibah University Medical... Aug 2023Molar incisor hypomineralization (MIH) is a growing global concern. Herein, we conducted a systematic review and meta-analysis of the prevalence and associated... (Review)
Review
OBJECTIVES
Molar incisor hypomineralization (MIH) is a growing global concern. Herein, we conducted a systematic review and meta-analysis of the prevalence and associated factors/risk factors of MIH in the Middle East (ME).
METHODS
This systematic review and meta-analysis included studies on children with at least one first permanent molar affected by MIH, aged 5-18 years, without syndromes or congenital anomalies, and residing in the ME and included cross-sectional, case-control, and cohort studies. Keywords related to MIH and ME countries were systematically searched until January 10, 2021 in four databases, PubMed, Google Scholar, Science Direct, and the Cochrane Library, following the specified eligibility criteria. The Joanna Briggs Institute quality assessment tool was used to evaluate all included studies. Meta-analyses were conducted to assess the effect of risk factors. The study protocol was registered on the PROSPERO International Prospective Register of Systematic Reviews (Registration No. 247391).
RESULTS
After screening 4,373 documents, 29 eligible studies with a total of 32,636 children aged 7-12 years were included from 11 countries. The frequency of MIH reported in the ME ranged from 2.3% to 40.7%, with a mean prevalence of 15.05%. Pregnancy and early childhood illnesses (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 1.91-2.68; P < 0.001) and factors related to delivery (OR: 2.4, 95% CI: 1.55-3.72; P < 0.001) were statically significantly associated with MIH.
CONCLUSION
The mean prevalence of MIH in ME aligns with the global MIH prevalence rate. Illnesses and delivery complications are risk factors that could be controlled to prevent MIH. As included studies showed high heterogeneity in the meta-analyses, further evidence from the ME is needed to assess the prevalence and other associated environmental risk factors for MIH.
PubMed: 36852253
DOI: 10.1016/j.jtumed.2022.12.011 -
Dental Materials : Official Publication... Dec 2023To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth? (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth?
DATA
Randomized controlled clinical trials (RCTs) investigating direct and indirect resin composite restorations in posterior permanent teeth were considered.
SOURCES
Several electronic databases were searched, with no language or date restrictions. The revised Cochrane Collaboration's tool for assessing risk of bias (RoB-2) was used to analyze the studies; meta-analyses were run and the certainty of evidence was assessed by the GRADE tool. A subgroup meta-analysis was performed for resin composite restorations placed on posterior worn dentition.
STUDY SELECTION
Twenty-three articles were included in qualitative synthesis, while 8 studies were used for meta-analyses. According to the RoB-2 tool, 5 studies were ranked as "low risk", 7 had "some concerns", while 11 papers were rated as "high risk" of bias. There were no statistically significant differences in short-term (p = 0.27; RR=1.54, 95% CI [0.72, 3.33]), medium-term (p = 0.27; RR=1.87, 95% CI [0.61, 5.72]) and long-term longevity (p = 0.86; RR=0.95, 95% CI [0.57, 1.59]). The choice of restorative technique had no influence on short-term survival of resin composite restorations placed on worn dentition (p = 0.13; RR=0.46, 95% CI [0.17, 1.25]). The certainty of evidence was rated as "very low".
CONCLUSIONS
Direct and indirect resin composite restorations may show similar clinical longevity in posterior region, regardless of the observation period or substrate (wear-affected and non-affected dentition). The very low quality of evidence suggests that more long-term RCTs are needed to confirm our results.
Topics: Dental Restoration, Permanent; Composite Resins; Molar
PubMed: 37827872
DOI: 10.1016/j.dental.2023.10.009 -
Journal of Prosthodontic Research Jan 2024This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. (Review)
Review
PURPOSE
This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.
STUDY SELECTION
Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.
RESULTS
One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.
CONCLUSIONS
Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Patient Satisfaction; Quality of Life; Tooth
PubMed: 37164658
DOI: 10.2186/jpr.JPR_D_22_00252