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The Journal of Prosthetic Dentistry Sep 2023High-level evidence concerning the restoration of endodontically treated posterior teeth by means of direct composite resin or indirect restorations is lacking. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
High-level evidence concerning the restoration of endodontically treated posterior teeth by means of direct composite resin or indirect restorations is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to analyze the current literature on the direct and indirect restoration of endodontically treated posterior teeth.
MATERIAL AND METHODS
Databases MEDLINE, CENTRAL, and EMBASE were screened. Risk of bias was assessed by using the ROB2 tool for RCTs and the ROBINS-I tool for prospective and retrospective clinical studies. Randomized clinical trials (RCTs) and prospective and retrospective studies comparing direct composite resin and indirect restorations on endodontically treated posterior teeth were included. Outcomes were tooth and restoration survival. A meta-analysis was conducted for tooth retention and restorative success.
RESULTS
Twenty-two studies were included (2 RCTs, 3 prospective, and 17 retrospective). Over the short term (2.5 to 3 years), low-quality evidence suggested no difference in tooth survival. For the prospective and retrospective clinical trials, the overall risk of bias was serious to critical from the risk of confounding because of a difference in restorative indication: Direct restorations were fabricated when one marginal ridge remained or when tooth prognosis was unfavorable. For short-term restorative success, low-quality evidence suggested no difference between the direct and indirect restorations.
CONCLUSIONS
For the short term (2.5 to 3 years), low-quality evidence suggests no difference in tooth survival or restoration quality. To assess the influence of the type of restoration on the survival and restorative success of endodontically treated posterior teeth, clinical trials that control for the amount of coronal tooth tissue and other baseline characteristics are needed.
Topics: Humans; Composite Resins; Dental Restoration, Permanent; Molar; Retrospective Studies; Dental Restoration Failure; Tooth, Nonvital
PubMed: 34980474
DOI: 10.1016/j.prosdent.2021.11.009 -
The Journal of Clinical Pediatric... Jul 2023This scoping review aims to summarize the available evidence on strategies employed in preventing caries in patients with molar incisor hypo-mineralization (MIH). MIH... (Review)
Review
This scoping review aims to summarize the available evidence on strategies employed in preventing caries in patients with molar incisor hypo-mineralization (MIH). MIH refers to an enamel defect involving opacities, and sometimes post-eruptive degradation due to enamel porosity; resulting in outcomes ranging from a mild atypical caries to severe coronary destruction. A systematic review was conducted for literature in PubMed, Cochrane Library, Epistemonikos and Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). The search was aimed at studies published between January 2010 and February 2022. Data were independently selected and extracted. 989 studies were found from the systematic search and 8 studies met the eligibility criteria. Most studies evaluated remineralization and cariogenic risk, both of which are crucial elements in caries prevention, as well as decreased sensitivity. The included studies investigated fluoride varnish, dental sealants, giomers, casein, and Icon as preventative methods for dental caries. Several methods for preventing dental caries in paediatric patients with MIH exist, but more research is needed to determine their effectiveness and safety. Any preventive intervention should consider the etiological aspects of the disease, the risk of caries, the type and extent of lesions, hypersensitivity level and patient's age. Collaboration between patients and carers is critical for disease diagnosis and caries prevention.
Topics: Humans; Child; Dental Caries; Dental Enamel Hypoplasia; Molar Hypomineralization; Dental Enamel; Molar; Prevalence
PubMed: 37408341
DOI: 10.22514/jocpd.2023.030 -
International Journal of Oral and... Jan 2024Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A... (Meta-Analysis)
Meta-Analysis Review
Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A systematic review of randomised clinical trials was conducted to compare the risk of dry socket and surgical site infection after the removal of lower third molars with different prophylactic antibiotics. The occurrence of any antibiotic-related adverse event was also analysed. A pairwise and network meta-analysis was performed to establish direct and indirect comparisons of each outcome variable. Sixteen articles involving 2158 patients (2428 lower third molars) were included, and the following antibiotics were analysed: amoxicillin (with and without clavulanic acid), metronidazole, azithromycin, and clindamycin. Pooled results favoured the use of antibiotics to reduce dry socket and surgical site infection after the removal of a lower third molar, with a number needed to treat of 25 and 18, respectively. Although antibiotic prophylaxis was found to significantly reduce the risk of dry socket and surgical site infection in patients undergoing lower third molar extraction, the number of patients needed to treat was high. Thus, clinicians should evaluate the need to prescribe antibiotics taking into consideration the patient's systemic status and the individual risk of developing a postoperative infection.
Topics: Humans; Dry Socket; Antibiotic Prophylaxis; Surgical Wound Infection; Molar, Third; Network Meta-Analysis; Anti-Bacterial Agents; Tooth Extraction
PubMed: 37612199
DOI: 10.1016/j.ijom.2023.08.001 -
La Tunisie Medicale Jan 2024Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the...
INTRODUCTION
Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the prevalence of ITM, its pattern and associated affections in Tunisian patients.
METHODS
The study reviewed panoramic radiographs of patients consulting the Fattouma Bourguiba University Hospital, Monastir (Tunisia). Orthopantomograms were analyzed to define the prevalence of ITM; its angulation, depth and relation with the anterior border of mandibular ramus. Associated pathologies were also assessed.
RESULTS
Seven hundred and thirty patients were included (286 men and 444 women). The age ranged from 19 to 89 years. Half of the patients (50.3%) showed at least one ITM. The total number of ITM was 881 with a statistical difference between arches (respectively 34.3% and 65.7% in the maxilla and in the mandible). The most common number of ITM was two (35.4%). Level C of impaction was observed more frequently in the maxilla and level A in the mandible. The most common angulation was the vertical one for both arches. Seventy six percent of ITM were presented with class II in relation with the anterior border of mandibular ramus. There was no significant difference in the frequency of impaction between gender and sides. The number of ITM associated with pathological conditions was 199 (22.6%). The most frequently observed pathology was the distal caries on the second molars (11.7%) followed by the caries of the third molars (5.2%).
CONCLUSION
The prevalence of ITM among Tunisian patients was high.
Topics: Male; Humans; Female; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Molar, Third; Prevalence; North African People; Mandible; Tooth, Impacted
PubMed: 38545727
DOI: 10.62438/tunismed.v102i1.4461 -
Dentistry Journal Aug 2023Ectopic permanent molar is a condition in which the permanent tooth deviates from its normal path of eruption. The etiology of this eruption anomaly is multifactorial,... (Review)
Review
Ectopic permanent molar is a condition in which the permanent tooth deviates from its normal path of eruption. The etiology of this eruption anomaly is multifactorial, with both general and local factors. The principal results suggest that a valid indicator of irreversible consequences is the degree of impaction of the first permanent molar. Self-correction is most common between the ages of 7 and 8, after which help may be required. Accordingly, early management can assist in preventing subsequent potential challenges that could interfere with maintaining a balanced occlusion. Several variables, including the degree of mesial tilting, the level of root resorption, and the condition of the second primary molar, may be crucial in choosing the most effective method of treatment. Interproximal wedging and distal tipping are the two basic therapeutic strategies for ectopic permanent molars. Additionally, the use of fixed or removable appliances might also be required. Delaying treatment until a later stage is not recommended because early diagnosis and treatment are essential for optimal management. This review aims to provide a comprehensive overview of ectopic permanent molars, including their prevalence, etiologic factors, self-correction rates, clinical implications for adjacent teeth, and various treatment techniques, that emphasizes the importance of early detection and intervention in the successful management of ectopic permanent molars. In addition, it highlights the importance of future research into the contributing variables of irreversible ectopic molar outcomes.
PubMed: 37754326
DOI: 10.3390/dj11090206 -
Journal of Oral Science Oct 2023This study aimed to evaluate masticatory performance in cases where one molar was missing.
PURPOSE
This study aimed to evaluate masticatory performance in cases where one molar was missing.
METHODS
Participants were 156 adults with one molar missing from their natural teeth, who were divided into group A (without prosthetic treatment) and group B (with prosthetic treatment). The non-missing side was designated as A1 or B1, and the missing side was designated as A2 or B2. The amount of glucose eluted (AG) when the participants chewed a gummy jelly was measured and used as a parameter for masticatory performance. AG was compared between the non-missing side (A1, B1) and missing side (A2, B2), and between the first molar missing group and second molar missing group.
RESULTS
AG was significantly greater on the dentate side (P < 0.001) and was significantly less in the A2 group when the first molar was missing (P = 0.002). The rate of decrease of AG was 11.1%, 14.3%, and 8.4% in groups A+B, A, and B, respectively.
CONCLUSION
Masticatory performance appears to decrease even with only one missing molar. Although improvement is achieved by prosthetic treatment, performance remains inferior to that on the dentate side.
Topics: Adult; Humans; Mastication; Molar; Mouth, Edentulous; Glucose
PubMed: 37558434
DOI: 10.2334/josnusd.23-0212 -
The Japanese Dental Science Review Dec 2023Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and... (Review)
Review
Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and establish their genotype-phenotype correlation. Forty articles were eligible for 178 patients and 61 mutations (26 in frame and 32 null mutations). mutations predominantly affected molars, mostly the second molar, and the mandibular first premolar was the least affected. More missing teeth were found in the maxilla than the mandible, and with null mutations than in-frame mutations. The number of missing teeth was correlated with the locations of the in-frame mutations with the C-terminus mutations demonstrating the fewest missing teeth. The null mutation location did not influence the number of missing teeth. Null mutations in all locations predominantly affected molars. For the in-frame mutations, a missing second molar was commonly associated with mutations in the highly conserved paired DNA-binding domain, particularly the linking peptide (100% prevalence). In contrast, C-terminus mutations were rarely associated with missing second molars and anterior teeth, but were commonly related to an absent second premolar. These finding indicate that the mutation type and position contribute to different degrees of loss of function that further differentially influences the manifestations of TA. This study provides novel information on the correlation of the genotype-phenotype, aiding in the genetic counseling for TA.
PubMed: 37159578
DOI: 10.1016/j.jdsr.2023.04.001 -
Journal of Dentistry Mar 2024To investigate distribution of affected teeth and severity of molar-incisor hypomineralisation (MIH) in 8-9-year-old children. A second aim was to study association...
OBJECTIVES
To investigate distribution of affected teeth and severity of molar-incisor hypomineralisation (MIH) in 8-9-year-old children. A second aim was to study association between severity of MIH and hypersensitivity, caries, and affection of incisors and second primary molars (SPM).
METHODS
A total of 3013 children in one age cohort participated in a cross-sectional study, of which 851 children were diagnosed with MIH. A majority of these children were re-examined and MIH diagnosis based on the European Academy of Paediatric Dentistry criteria was confirmed in 538 children. The re-examinations were undertaken at the local clinics by one calibrated dentist. Data were tested with bivariate logistic regression analysis. Results were reported using frequencies, proportions, odds ratios (OR) and confidence intervals (CI).
RESULTS
Almost half of the children with MIH (46.8 %) had at least one severely affected molar. Incisors were affected in 51.9 % of children with MIH, and the prevalence was higher in children with severe affection (57.4 %, p < 0.01). Among children with MIH, second primary molars were affected in 29.6 %, hypersensitivity in at least one first permanent molar was reported by 25.8 and 30.8 % had caries extending to dentine. Children classified with severe MIH were more likely to suffer from hypersensitivity (OR 5.62, 95 % CI 3.61-8.74) and dentine caries (OR 10.32, 95 % CI 6.46-16.50) than children with mild MIH.
CONCLUSION
Prevalence of hypomineralised incisors and SPM were high in the studied children with MIH. Children with severe MIH had higher probability of incisor affection, dentin caries and hypersensitivity.
CLINICAL SIGNIFICANCE
This study highlights the importance of understanding the association between MIH, caries and hypersensitivity, especially in children with severe MIH. These children need extensive and individualized care in the dental services to prevent caries and pain.
Topics: Child; Humans; Dental Enamel Hypoplasia; Cross-Sectional Studies; Dental Caries Susceptibility; Molar Hypomineralization; Dental Caries; Molar; Prevalence
PubMed: 38331377
DOI: 10.1016/j.jdent.2024.104881 -
Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.The Angle Orthodontist Nov 2023To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion.
MATERIALS AND METHODS
Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis.
RESULTS
After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05).
CONCLUSIONS
Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
Topics: Adult; Humans; Root Resorption; Overbite; Open Bite; Malocclusion, Angle Class II; Molar; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliances, Removable; Maxilla
PubMed: 37922387
DOI: 10.2319/010723-14.1 -
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