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Journal of Clinical Medicine Feb 2024This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms,... (Review)
Review
INTRODUCTION
This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis.
MATERIALS AND METHODS
Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available.
RESULTS
The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent.
CONCLUSIONS
The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues.
PubMed: 38592254
DOI: 10.3390/jcm13051382 -
Dentistry Journal Apr 2023Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning,... (Review)
Review
Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis.
Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, "(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists)." Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis ( < 0.05) after being sub-grouped into "Opening vs. Closure" and "No remodeling vs. Dental remodeling vs. Dental and gingival remodeling" groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided.
PubMed: 37185483
DOI: 10.3390/dj11040105 -
Journal of Dentistry Nov 2020To review leadership for dentists in patient facing, primary care dental practice. (Review)
Review
OBJECTIVES
To review leadership for dentists in patient facing, primary care dental practice.
METHODS
A three stage systematic review with narrative synthesis included stage 1: a scoping overview of management and leadership policy context; stage 2: systematic review of review of leadership in healthcare; and stage 3: systematic focused review of leadership in patient-facing dental practice.
RESULTS
The healthcare literature mirrors the generic literature in relation to the temporal evolution of leadership theories. Policy papers influence healthcare literature, though these are generally written by independent bodies, link solely to medical publications, and are often commissioned from the grand strategic level thereby grounding them in a politicised system. The healthcare leadership literature offers few studies at the operational (patient care) level of leadership, with none of these focused explicitly on dentistry and dental practice. Numerous aims, definitions, models, conceptualisations, and links to theories of leadership are reported. The stage 1 literature demonstrates more contemporaneous ideas of leadership, while the dental practice literature is too often grounded in outdated concepts and theories.
CONCLUSIONS
The overarching trend is from leaders to leadership; with no unified definition, model, theory, concept nor aim recognised. The fundamental importance of specific context and the reaction of others to leadership is reinforced. Leadership theories aligned to healthcare include Engaging, Authentic, Collective and the Transformational-Transactional continuum. Leadership is a dynamic, socially constructed process, only occurring in a group setting. Consisting of multiple moderating variables that demonstrate reciprocal influence on one another, these influences are neither equal nor stable. (246 words) CLINICAL SIGNIFICANCE: Leadership is embedded in regulatory guidance and standards relating to general dental practice. It is therefore crucial to have an evidenced based understanding of what leadership means in this context, and what further work is necessary to support clinicians in the leadership domain.
Topics: Delivery of Health Care; General Practice, Dental; Humans; Leadership
PubMed: 32961259
DOI: 10.1016/j.jdent.2020.103480 -
Journal of Clinical and Experimental... Oct 2022Patients with odontogenic infections are commonly prescribed antimicrobials on an experiential base without knowing the precise microorganisms implicated. The aim of... (Review)
Review
BACKGROUND
Patients with odontogenic infections are commonly prescribed antimicrobials on an experiential base without knowing the precise microorganisms implicated. The aim of this systematic scoping review is to evaluate the prevalence and proportions of antimicrobial-resistant species in patients with odontogenic infections.
MATERIAL AND METHODS
A systematic scoping review of scientific evidence was accomplished involving different databases.
RESULTS
Eight randomized clinical trials and 13 prospective observational studies were included. These investigations analyzed 1506 patients. The species that showed higher levels of resistance included aerobic and facultative anaerobe such as , and . In obligate anaerobes sampled were Peptostreptococcos spp., Bacteroides spp., and Prevotella spp. Staphylococcus showed resistance to ampicillin, piperacillin, clindamycin, amoxicillin, metronidazole, and penicillin. Streptococcus had resistance to metronidazole, clindamycin, doxycycline, penicillin, and amoxicillin. Peptostreptococcus spp. presented resistance to penicillin, amoxicillin, erythromycin, and cefalexin. Gram-negative microorganisms had resistance to tetracycline, ciprofloxacin, azithromycin, amoxicillin, erythromycin, and penicillin. Bacteroides spp. exhibited resistance to penicillin, erythromycin, and gentamicin. Prevotella spp. showed resistance to penicillin, amoxicillin, erythromycin, clindamycin, levofloxacin, and imipenem. Finally, Klebsiella spp. displayed resistance to ampicillin, amoxicillin, moxifloxacin, and cefalexin. Interestingly, one clinical trial showed that after therapy there was a reduction in sensitivity of 18% for azithromycin and 26% for spiramycin.
CONCLUSIONS
Most of the microorganisms had resistance to diverse groups of antimicrobials. Suitable antimicrobials must be prescribed founded on the microbial samples, culture susceptibility, and clinical progression of the odontogenic infection. Furthermore, it was observed high levels of resistance to antimicrobials that have been used in local and systemic therapy of oral cavity infections. A preponderance of anaerobic microorganisms over aerobic ones was observed. Antibiotic resistance, odontogenic infections, efficacy, microorganisms, scoping review.
PubMed: 36320675
DOI: 10.4317/jced.59830 -
Journal of Clinical and Experimental... Apr 2023The bone growth factor was a conditioning circumstance that limited the use of implants in children and adolescents, which, in cases of anodontia or severe oligodontia,... (Review)
Review
BACKGROUND
The bone growth factor was a conditioning circumstance that limited the use of implants in children and adolescents, which, in cases of anodontia or severe oligodontia, forced pediatric dentists to abandon their use, leaving children with removable prostheses, at an age and in a social context with increasingly functional and esthetic demands. Purpose. The objective is to assess which variables influence the survival of dental implants in pediatric patients with severe agenesis.
MATERIAL AND METHODS
A search was carried out in the Pubmed, Scopus and Web of Science databases, which was completed with a manual search.
RESULTS
The following variables were extracted from the selected studies: author and year, number of patients or cases described, age, gender, number of implants, follow-up time, implanted area, percentage of success or failure, medical and dental history of the patients, type of treatment and study design.
CONCLUSIONS
The use of implants as a treatment at an early age has been a controversial issue. Using the appropriate preventive measures, the clinician can offer the child or adolescent a better life quality, esthetics and functionality, until the growth completion period allows for more complex and extensive rehabilitative treatments. A success rate of 89.8% was established for these implants, with no association with follow-up time or type of implant used. The highest survival rates were reported in the anterior mandibular region. Pediatric dentistry, ectodermal dysplasia, anodontia, oligodontia and dental implant.
PubMed: 37152493
DOI: 10.4317/jced.60168 -
Diagnostics (Basel, Switzerland) Nov 2023This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the... (Review)
Review
Oral Complications Associated with the Piercing of Oral and Perioral Tissues and the Corresponding Degree of Awareness among Public and Professionals: A Systematic Review.
This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the corresponding society. The second objective was determining public/professional sectors' awareness of the subject. This research followed PRISMA and Cochrane guidelines for conducting systematic reviews and searching scientific databases, including PubMed, Scopus, Cochrane, and Google Scholar, until April 2023. Cross-sectional, cohort, and case-control studies in English were deemed eligible. The methodological quality of the included studies was assessed using proper quality assessment guidelines. Of the 965 initial articles retrieved, 34 were considered suitable for qualitative synthesis after screening procedures and removing duplicates and irrelevant records. There appears to be an imbalance between the general public's low and dentists' high awareness. This draws attention to the shortage of professional and societal knowledge-sharing and education initiatives. Women were more than twice as likely as men to have oral piercings. Piercing usage had a low incidence among a cohort of students with a mean age of 16. Merely circumstantial evidence has indicated a plausible correlation between oral and perioral piercings and the emergence of secondary bacterial and fungal colonization, particularly periodontopathogenic bacteria and Candida albicans. Furthermore, several adverse consequences have been observed linked to various piercings-such as lip and tongue piercings. These include caries, gingivitis/periodontitis, dental fractures, enamel chipping/cracks, plaque buildup, bone loss, bleeding, inflammation, and swelling. Given the risks involved and the complications that might impair oral health, the prevalence of oral piercings is alarming. As a result, public health authorities need to firmly support initiatives to raise awareness of the risks associated with oral/perioral piercings. For piercers to enhance their expertise in this field, professional training is necessary because there is a shortage of knowledge on the possible adverse effects of piercings.
PubMed: 37958268
DOI: 10.3390/diagnostics13213371 -
Preventive Medicine Jun 2024This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use. (Review)
Review
OBJECTIVE
This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use.
METHODS
We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines.
RESULTS
The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing.
CONCLUSIONS
The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance. The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937.
PubMed: 38901743
DOI: 10.1016/j.ypmed.2024.108043 -
L' Orthodontie Francaise Jun 2020For several decades, orthodontists and periodontists have repeated that orthodontics have no harmful consequences on the periodontium when it is healthy or treated....
For several decades, orthodontists and periodontists have repeated that orthodontics have no harmful consequences on the periodontium when it is healthy or treated. However, a systematic review of the literature undermines this common refrain and concludes that there is a lack of reliable evidences of the positive effects of orthodontics on periodontal health with, in the best periodontal conditions, slight adverse effects. It is therefore the responsibility of orthodontists to keep the periodontal cost of orthodontic treatment as low as possible. How to make sure that this « at best » does not turn into an « at worst » ? In order to minimize the deleterious consequences of orthodontic treatment on the periodontium, the orthodontist must be able to specify which patients she/he can immediately consider providing orthodontic treatment and those on whom periodontal treatment is mandatory before all. The orthodontist must therefore transform, for a few minutes, into a periodontist in order to recognize the eight signs of loss of attachment and the six risk factors for periodontitis, exposed in this article. Both needs for periodontal and orthodontic treatment have to be measured and would not be efficient without the patient's and the practitioners' motivation.
Topics: Dentists; Female; Humans; Male; Orthodontics; Periodontal Diseases; Periodontics; Periodontium
PubMed: 33146131
DOI: 10.1684/orthodfr.2020.6 -
Journal of Clinical Medicine Nov 2020Dental caries is the most prevalent dental disease worldwide, and neural networks and artificial intelligence are increasingly being used in the field of dentistry. This... (Review)
Review
Dental caries is the most prevalent dental disease worldwide, and neural networks and artificial intelligence are increasingly being used in the field of dentistry. This systematic review aims to identify the state of the art of neural networks in caries detection and diagnosis. A search was conducted in PubMed, Institute of Electrical and Electronics Engineers (IEEE) Xplore, and ScienceDirect. Data extraction was performed independently by two reviewers. The quality of the selected studies was assessed using the Cochrane Handbook tool. Thirteen studies were included. Most of the included studies employed periapical, near-infrared light transillumination, and bitewing radiography. The image databases ranged from 87 to 3000 images, with a mean of 669 images. Seven of the included studies labeled the dental caries in each image by experienced dentists. Not all of the studies detailed how caries was defined, and not all detailed the type of carious lesion detected. Each study included in this review used a different neural network and different outcome metrics. All this variability complicates the conclusions that can be made about the reliability or not of a neural network to detect and diagnose caries. A comparison between neural network and dentist results is also necessary.
PubMed: 33172056
DOI: 10.3390/jcm9113579 -
Clinical Oral Investigations Feb 2021Severe periodontitis has been associated with endothelial dysfunction and arterial stiffness. The present study aimed to provide a critical appraisal and a meta-analysis... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Severe periodontitis has been associated with endothelial dysfunction and arterial stiffness. The present study aimed to provide a critical appraisal and a meta-analysis of the literature investigating pulse wave velocity (PWV) in patients with and without severe periodontitis and to assess whether treatments influence PWV.
MATERIALS AND METHODS
English literature was searched on multiple databases up to April 2020 by two independent reviewers. Studies comparing PWV between patients with and without severe periodontitis or assessing the impact of periodontal treatments on PWV were searched and retrieved. Pool data analyses with random effect models were performed. The risk of bias was assessed using Newcastle-Ottawa Scale and RoB2 tools.
RESULTS
Seventeen studies were selected. Of these, 10 were used for the meta-analysis. Twelve were cross-sectional studies and 5 interventional studies, including 3176 patients, of whom 1894 had severe periodontitis and 1282 were considered as the controls (without severe periodontitis). Based on carotid-femoral PWV measurement, patients with severe periodontitis (n = 309) have a significantly higher PVW than patients with non-severe periodontitis (n = 213), with a mean difference of 0.84 m/s (95% CI 0.50-1.18; p < 0.0001; I = 5%). Similarly, carotid-radial or brachial-ankle PWV values were significantly higher in patients with severe periodontitis. Results concerning the effect of non-surgical periodontal therapy were not conclusive. Overall, 9 studies (53%) were classified at a low risk of bias.
CONCLUSIONS
The present study demonstrates that patients with severe periodontitis have higher PWV compared to patients with non-severe periodontitis.
CLINICAL SIGNIFICANCE
Severe periodontitis is associated with arterial stiffness, supporting the mutual involvement of dentists and physicians.
Topics: Carotid Arteries; Cross-Sectional Studies; Humans; Periodontitis; Pulse Wave Analysis; Risk Factors; Vascular Stiffness
PubMed: 33415378
DOI: 10.1007/s00784-020-03718-2