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International Journal of Dental Hygiene Feb 2022This systematic review and network meta-analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review and network meta-analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing action with oscillating-rotating (OR) or high-frequency sonic (HFS) powered toothbrushes (PTB) compared with a manual toothbrush (MTB) as control.
MATERIAL AND METHODS
Databases were searched up to 1 August 2021, for clinical trials that evaluated the efficacy of a PTB with OR or HFS technology compared with an MTB on plaque removal after a single-brushing action and conducted with healthy adult patients. Meta-analysis (MA) and a network meta-analysis (NMA) were performed.
RESULTS
Twenty-eight eligible publications, including 56 relevant comparisons, were retrieved. The overall NMA results for the mean post-brushing score showed a statistically significant difference for the comparison between an OR PTB and an MTB (SMD = -0.43; 95% CI [-0.696;-0.171]). The change in plaque score data showed a significant effect of a PTB over an MTB and OR over HFS. Based on ranking, the OR PTB was highest, followed by the HFS PTB and the MTB.
CONCLUSION
Within the limitations of the present study design, based on the outcome following a single-brushing action, it can be concluded that for dental plaque removal, there is a high certainty for a small effect of a PTB over an MTB. This supports the recommendation to use a powered toothbrush for daily plaque removal. There is moderate certainty for a very small benefit for the use of a powered toothbrush with an OR over an HFS mode of action.
Topics: Adult; Dental Plaque; Dental Plaque Index; Equipment Design; Humans; Network Meta-Analysis; Single-Blind Method; Toothbrushing
PubMed: 34877772
DOI: 10.1111/idh.12563 -
Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of studies.Acta Odontologica Scandinavica Nov 2022To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation.
METHOD
Systematic literature review was implemented, using 12 databases. All studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included.
RESULTS
At the apical level, pooling the data in the random-effects model (I=64%, ) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; ). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; ) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; ) of the root canal.
CONCLUSIONS
Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.
Topics: Humans; Smear Layer; Root Canal Irrigants; Root Canal Preparation; Dental Pulp Cavity; Ultrasonics; Sodium Hypochlorite; Therapeutic Irrigation; Edetic Acid; Microscopy, Electron, Scanning
PubMed: 35430959
DOI: 10.1080/00016357.2022.2061591 -
The Journal of Prosthetic Dentistry Dec 2023Artificial intelligence (AI) models have been developed for periodontal applications, including diagnosing gingivitis and periodontal disease, but their accuracy and... (Review)
Review
STATEMENT OF PROBLEM
Artificial intelligence (AI) models have been developed for periodontal applications, including diagnosing gingivitis and periodontal disease, but their accuracy and maturity of the technology remain unclear.
PURPOSE
The purpose of this systematic review was to evaluate the performance of the AI models for detecting dental plaque and diagnosing gingivitis and periodontal disease.
MATERIAL AND METHODS
A review was performed in 4 databases: MEDLINE/PubMed, World of Science, Cochrane, and Scopus. A manual search was also conducted. Studies were classified into 4 groups: detecting dental plaque, diagnosis of gingivitis, diagnosis of periodontal disease from intraoral images, and diagnosis of alveolar bone loss from periapical, bitewing, and panoramic radiographs. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus.
RESULTS
Twenty-four articles were included: 2 studies developed AI models for detecting plaque, resulting in accuracy ranging from 73.6% to 99%; 7 studies assessed the ability to diagnose gingivitis from intraoral photographs reporting an accuracy between 74% and 78.20%; 1 study used fluorescent intraoral images to diagnose gingivitis reporting 67.7% to 73.72% accuracy; 3 studies assessed the ability to diagnose periodontal disease from intraoral photographs with an accuracy between 47% and 81%, and 11 studies evaluated the performance of AI models for detecting alveolar bone loss from radiographic images reporting an accuracy between 73.4% and 99%.
CONCLUSIONS
AI models for periodontology applications are still in development but might provide a powerful diagnostic tool.
Topics: Humans; Dental Plaque; Alveolar Bone Loss; Artificial Intelligence; Periodontal Diseases; Gingivitis
PubMed: 35300850
DOI: 10.1016/j.prosdent.2022.01.026 -
Oral Health & Preventive Dentistry Oct 2020Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this...
PURPOSE
Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this systematic review is to identify and assess the quality of evidence of the effectiveness of manual toothbrushing techniques in the existing literature.
METHODS
A broad search was conducted on the electronic databases Medline via Ovid, PubMed and EBSCO Dentistry & Oral Sciences. Included studies examined manual toothbrushing technique efficiency. Articles were assessed utilising the Cochrane Collaboration's tool for assessing risk of bias. Thirteen studies met the inclusion criteria and were included in this review. These included five randomised controlled trials (RCT), seven experimental non-randomised control studies and one in vitro study.
RESULTS
Of the 3190 articles identified, 40 were relevant to manual toothbrushing and 13 were included in the final review. Studies indicating statistically significantly superior plaque removal for a given technique were Bass (one), modified Bass (one), Charter's (two), Fones (two), scrub (two), roll (one), modified Stillman (one), toothpick method (one). Four studies exhibited no statistically significant difference in effectiveness of plaque removal. Unfortunately, considerable variation was found between studies, making a definitive conclusion impossible in terms of an ideal manual toothbrushing technique that would promote plaque removal and reduce gingivitis.
CONCLUSION
There is still insufficient evidence for suggesting that one toothbrushing method is more effective than another in plaque removal and reduction of gingivitis. Excessive variability in many aspects of the design and methodology of the selected studies hinder conclusions on an ideal manual toothbrushing technique. Experimental randomised controlled trials that follow the CONSORT guidelines are required to provide adequate-quality evidence and make any definitive conclusions on the relative effectiveness of manual toothbrushing techniques.
Topics: Dental Care; Dental Plaque; Gingivitis; Humans; Oral Health; Toothbrushing
PubMed: 33028052
DOI: 10.3290/j.ohpd.a45354 -
Oral Health & Preventive Dentistry Jun 2022To summarise the available data on the effects of chlorhexidine (CHX) mouthwash in treating gingivitis during treatment with fixed orthodontic appliances. (Meta-Analysis)
Meta-Analysis
PURPOSE
To summarise the available data on the effects of chlorhexidine (CHX) mouthwash in treating gingivitis during treatment with fixed orthodontic appliances.
MATERIALS AND METHODS
Multiple electronic databases were searched up to December 7th, 2021. Only randomised controlled trials (RCTs) were eligible for inclusion. The quality of the included RCTs was assessed with the Cochrane risk of bias tool for randomised trials (RoB 2.0). After data extraction and risk of bias assessment, differences were recorded in several oral hygiene indices in time and mean percentage change in those indices using different antimicrobial solutions.
RESULTS
Fourteen studies were deemed eligible for inclusion, reporting on a total of 602 patients with an age range of 11-35 years. The experimental solution was a 0.06%, 0.12%, or 0.2% CHX mouthwash with the control either a placebo mouthwash or a selection from a variety of mouthwashes. Treatment duration varied from 1 day to almost 5 months and the follow-up period varied from 1 min to 5 months. Chlorhexidine mouthrinses led to reduced plaque accumulation and gingival inflammation during orthodontic treatment, while at the same time, some of the control group mouthrinses were deemed equally effective. No statistically significant difference was detected in the meta-analysis between CHX and mouthwashes with propolis/probiotics/herbs in terms of the gingival index at 3 to 4 weeks (mean difference 0.07, 95% CI: -0.18, 0.31, p = 0.59).
CONCLUSION
Chlorhexidine mouthwash in orthodontic patients successfully controls gingival inflammation and bleeding when compared to untreated controls, but is equally effective as other mouthrinses where various oral health indices are concerned.
Topics: Adolescent; Adult; Child; Chlorhexidine; Dental Plaque; Gingivitis; Humans; Inflammation; Mouthwashes; Young Adult
PubMed: 35762364
DOI: 10.3290/j.ohpd.b3170043 -
Journal of Clinical Periodontology Sep 2023Consumption of free sugars has been associated with chronic non-communicable diseases. The aim of the study was to investigate the effect of free-sugar consumption on... (Meta-Analysis)
Meta-Analysis Review
AIM
Consumption of free sugars has been associated with chronic non-communicable diseases. The aim of the study was to investigate the effect of free-sugar consumption on gingival inflammation using a systematic review and meta-analysis based on the PICO question 'What impact does the restriction of free sugars have on the inflammation of gingival tissue?'
MATERIALS AND METHODS
Literature review and analyses were based on the Cochrane Handbook for Systematic Reviews of Interventions. Controlled clinical studies reporting on free-sugar interventions and gingival inflammation were included. Risk of bias was performed with ROBINS-I and ROB-2, and effect sizes were estimated with robust variance meta-regressions.
RESULTS
Of the 1777 primarily identified studies, 1768 were excluded, and 9 studies with 209 participants with gingival inflammation measures were included. Six of these studies reported on the dental plaque scores of 113 participants. Restriction of free sugars, when compared with no such restriction, was associated with statistically significantly improved gingival health scores (standard mean difference [SMD] = -0.92; 95% confidence interval [CI]: -1.43 to -0.42, p < .004; I [heterogeneity] = 46.8) and a trend towards lower dental plaque scores (SMD = -0.61; 95% CI: -1.28 to 0.05, p < .07; I = 41.3). The observed improvement of gingival inflammation scores with restricted consumption of free sugar was robust against various statistical imputations. No meta-regression models were feasible because of the limited number of studies. The median publication year was 1982. Risk-of-bias analysis showed a moderate risk in all studies.
CONCLUSION
Restriction of free sugar was shown to be associated with reduced gingival inflammation. The systematic review was registered at PROSPERO (CRD 42020157914).
Topics: Humans; Dental Plaque; Sugars; Gingivitis; Inflammation; Dental Plaque Index
PubMed: 37246336
DOI: 10.1111/jcpe.13831 -
Journal of Periodontal Research Oct 2023To investigate the existence of any association between new putative periodontal pathogens and periodontitis. Two independent reviewers conducted electronic literature... (Meta-Analysis)
Meta-Analysis Review
To investigate the existence of any association between new putative periodontal pathogens and periodontitis. Two independent reviewers conducted electronic literature searches in the MEDLINE (PubMed), EMBASE, DOSS and Google Scholar databases as well as a manual search to identify eligible clinical studies prior to November 2022. Studies comparing the prevalence of microorganisms other than the already-known periodontal pathogens in subgingival plaque and/or saliva samples between subjects with periodontitis and subject with periodontal health were included. Meta-analyses were performed on data provided by the included studies. Fifty studies including a total of 2739 periodontitis subjects and 1747 subjects with periodontal health were included. The Archaea domain and 25 bacterial species (Anaeroglobus geminatus, Bacteroidales [G-2] bacterium HMT 274, Desulfobulbus sp. HMT 041, Dialister invisus, Dialister pneumosintes, Eubacterium brachy, Enterococcus faecalis, Eubacterium nodatum, Eubacterium saphenum, Filifactor alocis, Fretibacterium sp. HMT 360, Fretibacterium sp. HMT 362, Mogibacterium timidum, Peptoniphilaceae sp. HMT 113, Peptostreptococcus stomatis, Porphyromonas endodontalis, Slackia exigua, Streptococcus gordonii, Selenomonas sputigena, Treponema amylovorum, Treponema lecithinolyticum, Treponema maltophilum, Treponema medium, Treponema parvum and Treponema socranskii) were found to be statistically significantly associated with periodontitis. Network studies should be conducted to investigate the role of these newly identified periodontitis-associated microorganisms through interspecies interaction and host-microbe crosstalk analyses.
Topics: Humans; Bacteria; Periodontitis; Dental Plaque; Bacteroides; Eubacterium
PubMed: 37572051
DOI: 10.1111/jre.13173 -
Oral Diseases Oct 2022To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA)... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures.
MATERIALS AND METHODS
Clinical trials with the outcome "bacteraemia in children" were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions.
RESULTS
Among 11 of 13 studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7%-56% patients following single-tooth extractions, in 22%-46% after manual toothbrushing (MTB), and in 26%-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55).
CONCLUSION
Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.
Topics: Bacteremia; Child; Dental Plaque; Gingivitis; Humans; Network Meta-Analysis; Toothbrushing
PubMed: 34245644
DOI: 10.1111/odi.13957 -
International Journal of Dental Hygiene Feb 2022The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and gingivitis.
METHODS
A comprehensive online search of multiple databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed to identify all relevant studies published up to August 2020, using the following keywords: curcumin, turmeric, gingivitis, periodontal health, and plaque control. All clinical trials that compared the efficacy of curcumin mouthwash with chlorhexidine in controlling dental plaque and gingivitis were included. Data were analysed using Review Manager (RevMan) 5.3 software. The risk of bias was evaluated by two independent reviewers using the Cochrane assessment tool.
RESULTS
Six randomized clinical trials (comprising 320 subjects) fulfilled the eligibility criteria. Five studies showed a high risk of bias and only one study showed a low risk of bias. The pooled data of the six included studies revealed comparable efficacy of curcumin and chlorhexidine in reducing dental plaque (I = 91%; standardized mean difference [SMD]: 0.27, 95% CI: -0.53, 1.07, p = 0. 51) and gingival inflammation (I = 40%; SMD: -0.13, 95% CI: -0.35, 0.09, p = 0.24), with no statistically significant differences between the two groups.
CONCLUSION
The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Curcumin; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Mouthwashes
PubMed: 34013606
DOI: 10.1111/idh.12518 -
International Journal of Paediatric... Jul 2022To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P). (Meta-Analysis)
Meta-Analysis Review
AIM
To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P).
DESIGN
The authors searched six indexed databases without any linguistic limitation through July 2021. The eligibility criteria were observational studies that compared the periodontal clinical measures of individuals with CL/P to those without CL/P. A meta-analysis was conducted using random-effects models with inverse variance weighting.
RESULTS
The literature search generated 1277 records, and 40 full-text articles were reviewed. Twenty-three studies comprising 3235 individuals from four continents fulfilled our selection criteria. The meta-analysis revealed a significant difference in mean plaque index scores (MD = 0.31, 95% CI = 0.22, 0.41), gingival index scores (MD = 0.50, 95% CI = 0.24, 0.77), and periodontal pocket depth (MD = 0.64, 95% CI = 0.12, 1.16) between individuals with and without CL/P. A slight increase in clinical attachment loss was detected among individuals with CL/P; however, such an increase may have little clinical significance.
CONCLUSIONS
As age is positively related to periodontal disease progression, and individuals with CL/P are more likely to present with more plaque accumulation and gingival inflammation, clinicians should reinforce preventive dental care from an early age.
Topics: Cleft Lip; Cleft Palate; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Periodontal Diseases
PubMed: 34626516
DOI: 10.1111/ipd.12934