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Clinical Oral Investigations Jan 2023The aim of this systematic review was to examine the literature on aggressive and chronic periodontitis and orthodontics to clarify the therapy-relevant aspects of... (Review)
Review
OBJECTIVES
The aim of this systematic review was to examine the literature on aggressive and chronic periodontitis and orthodontics to clarify the therapy-relevant aspects of orthodontic treatment with altered biomechanics in periodontally compromised dentition.
MATERIALS AND METHODS
Literature searches were conducted in the electronic databases "PubMed" and "DIMDI" using the keywords "aggressive periodontitis AND ortho*," "aggressive periodontitis AND orthodontics," "chronic periodontitis AND ortho*," and "chronic periodontitis AND orthodontics" for the publication period from January 1990 to July 2022. In addition, a manual search was carried out in the selected trade journals "Community Dental Health," "European Journal of Oral Sciences," and "Parodontologie." Human clinical trials were included, whereas animal experimental studies, case reports, and reviews were generally excluded. The appropriate studies were selected, and the relevant data was tabulated according to different parameters, regarding the study design, the study structure, and the conduct of the study.
RESULTS
A total of 1067 articles were found in the preliminary electronic search. The manual search and review of all related bibliographies resulted in an additional 1591 hits. After the first screening, 43 articles were classified as potentially relevant and reviewed in their original form. After the suitability test, 5 studies with a total of 366 participants were included in the final evaluation. These included one randomized controlled trial and four low-evidence intervention studies. The studies were conducted in two university hospitals and three private practices. All participants underwent scaling and root plaining and periodontal surgery before the orthodontic treatment started. Mean probing pocket depth reduction before and after the interdisciplinary treatment was analyzed in all the included studies; mean difference in clinical attachment level in four of the studies was also included. All participants were enrolled in a continuous recall system. In all studies, orthodontic therapy in periodontally compromised patients improved function and esthetics, resulting in lower probing depths and clinical attachment gains.
CONCLUSIONS
Orthodontic treatment can be used for patients with reduced periodontal support to stabilize clinical findings and improve function and esthetics. The prerequisite for this is a profound knowledge of altered biomechanics and an adapted interdisciplinary treatment approach. Due to the large heterogeneity of the included studies and their limited methodological quality, the results obtained in this review must be considered critically. Further randomized controlled long-term studies with comparable study designs are necessary to obtain reliable and reproducible treatment results.
CLINICAL RELEVANCE
Patients with periodontal impairment can be successfully treated with orthodontics as part of interdisciplinary therapy. Orthodontic treatment has no negative impact on the periodontium; if minimal, controlled forces are used under non-inflammatory conditions.
Topics: Humans; Aggressive Periodontitis; Chronic Periodontitis; Dental Care; Esthetics, Dental; Treatment Outcome
PubMed: 36502508
DOI: 10.1007/s00784-022-04822-1 -
The Journal of Evidence-based Dental... Sep 2022This systematic review aimed to compare the clinical data including success rates, tissue preservation, esthetic results, and patient-reported outcomes between delayed... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review aimed to compare the clinical data including success rates, tissue preservation, esthetic results, and patient-reported outcomes between delayed implant placement after alveolar ridge preservation (ARP) and immediate implant placement (IIP).
MATERIAL AND METHODS
Both electronic and manual searches were performed for randomized controlled trials and cohort studies consisting of at least 10 cases per group and a follow-up of at least 1-year in duration. The primary outcome was the implant success rate and secondary outcomes were changes in marginal bone level (MBL), pink esthetic score (PES) and patient reported outcomes consisting of complications and satisfaction.
RESULTS
A total of 12 studies were included (8 randomized controlled trials and 4 cohort studies). This review contained 456 implants placed after ARP and 459 implants placed through IIP. The results from this meta-analysis showed that the success rates of implants placed through ARP protocol (98.68%) was significantly higher than that of implants placed through IIP protocol (95.21%) (RR = 1.03; 95% CI [1.01; 1.06]; P = .008; I = 0%).
CONCLUSION
The results from this meta-analysis and systematic review showed that implants placed through ARP protocol may demonstrate higher success rates compared to implants placed through IIP.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 36162892
DOI: 10.1016/j.jebdp.2022.101734 -
Clinical Oral Investigations Jan 2022This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket?
MATERIALS AND METHODS
The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials.
RESULTS
Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation.
CONCLUSIONS
Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons.
CLINICAL RELEVANCE
XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Biocompatible Materials; Bone Transplantation; Humans; Network Meta-Analysis; Tooth Extraction; Tooth Socket
PubMed: 34826029
DOI: 10.1007/s00784-021-04248-1 -
Orthodontics & Craniofacial Research Aug 2022This systematic review aimed to determine the effects of the interproximal enamel reduction (IPR) techniques used in orthodontics. Six databases were searched: PubMed,... (Review)
Review
This systematic review aimed to determine the effects of the interproximal enamel reduction (IPR) techniques used in orthodontics. Six databases were searched: PubMed, Scopus, Web of Science, Dentistry & Oral Sciences Source, ScienceDirect and Clinical Trials. Grey literature was sourced from Google Scholar. The risk of bias was assessed by Risk of Bias 2, Newcastle-Ottawa Scale and Robins-I depending on the design of the evaluated study. Additionally, the quality of the included studies was determined using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. This systematic review included randomized clinical trials, non-randomized clinical trials and observational studies with a control group that reported the effects of IPR for orthodontic purposes on the teeth and periodontium. Case reports, and in vitro and in vivo studies were excluded. Eight clinical studies match the eligibility criteria. As a result, no demineralization of the enamel, no increase in caries incidence, no periodontal changes or dental sensitivity was found after IPR. Also, considering the duration of orthodontic treatment, IPR resulted in a quicker technique than dental extractions. At the risk-of-bias assessment, all observational studies showed low risk, the non-randomized clinical trial had a critical bias, and all randomized clinical trials exhibited some concerns. The overall quality of the studies was found to be between low and very low. After the analysis of the data from included studies, it was concluded that the IPR procedures could be useful to treat dental crowding in orthodontic clinical practice without negative effects. However, more randomized controlled clinical trials with a longer follow-up time and high-quality studies are required to generate robust statements.
Topics: Humans; Dental Caries; Dental Enamel; Randomized Controlled Trials as Topic
PubMed: 34865310
DOI: 10.1111/ocr.12555 -
International Journal of Environmental... Nov 2022This systematic review aimed to investigate the effectiveness of hyaluronic acid (HA) on the clinical treatment outcomes of patients with gingival recession. A... (Review)
Review
This systematic review aimed to investigate the effectiveness of hyaluronic acid (HA) on the clinical treatment outcomes of patients with gingival recession. A systematic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Google Scholar for studies up to 15 August 2022. Two reviewers separately selected the papers for eligibility after conducting a thorough search. The study includes randomized controlled clinical trials in which participants were given HA in addition to periodontal treatment surgical procedures. The changes following the treatment protocol were evaluated for complete and mean root coverage as a primary outcome and gingival recession gain as the secondary outcome. Three articles met the eligibility criteria out of 557 titles. In periodontal surgery, HA exhibited better results in complete root coverage and mean root coverage when compared to the control group. Gingival recession reduction, clinical attachment level, and keratinized tissue gain were significantly increased compared to the control groups. However, the comparison presented in the following study might show heterogeneity among the studies and risk of bias in general. Given the scope of this analysis, results suggest that adjunctive treatment with HA gel for root coverage could be clinically beneficial.
Topics: Humans; Gingival Recession; Hyaluronic Acid; Gingiva; Guided Tissue Regeneration, Periodontal; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 36361208
DOI: 10.3390/ijerph192114330 -
Stomatologija 2021The aim of the systematic review was to analyze the effectiveness of Botox injections for the treatment of the gummy smile.
PURPOSE
The aim of the systematic review was to analyze the effectiveness of Botox injections for the treatment of the gummy smile.
MATERIALS AND METHODS
The systematic literature search was done in the databases: PubMed, Embase and Cochrane Library. The articles published from 2013 to 2020 were searched. Only studies on humans were included in this systematic literature review.
RESULTS
During the initial search a total number of 139 articles were detected. However, after the removal of duplications 105 articles were left. Regarding the application of inclusion and exclusion criteria, 6 articles were selected for this systematic literature review.
CONCLUSIONS
The results of this study suggested that botulinum toxin was an efficient method to treat the gummy smile.
Topics: Botulinum Toxins, Type A; Esthetics, Dental; Gingiva; Humans; Injections, Intramuscular; Smiling
PubMed: 35319495
DOI: No ID Found -
Journal of Periodontology Sep 2022The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of a bilaminar root coverage technique consisting of the combination of an... (Meta-Analysis)
Meta-Analysis Review
Does the subepithelial connective tissue graft in conjunction with a coronally advanced flap remain as the gold standard therapy for the treatment of single gingival recession defects? A systematic review and network meta-analysis.
BACKGROUND
The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of a bilaminar root coverage technique consisting of the combination of an autogenous subepithelial connective tissue graft (SCTG) and a coronally advanced flap (CAF) compared with the five most indicated alternative approaches for the treatment of single gingival recession defects (GRD).
METHODS
The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42020221362). Three electronic databases were searched up to September 30, 2021 to identify randomized controlled trials that involved the treatment of single GRD without interproximal tissue loss via root coverage procedures. A frequentist NMA was conducted for complete root coverage (CRC), mean root coverage (MRC), and keratinized tissue width (KTW) changes.
RESULTS
A total of 38 studies reporting on 830 patients and 1,265 GRD were included. SCTG + CAF was ranked as the most efficient treatment approach for MRC, CRC, and KTW gain at 6 and 12 months after surgery, except for MRC at the 12-month follow-up where enamel matrix derivative plus CAF exhibited superior results.
CONCLUSIONS
SCTG + CAF can be considered the gold standard for the treatment of single GRD.
Topics: Connective Tissue; Gingiva; Gingival Recession; Humans; Network Meta-Analysis; Tooth Root; Treatment Outcome
PubMed: 35451068
DOI: 10.1002/JPER.22-0167 -
Oral Diseases Jan 2023Periodontitis is a chronic non-communicable disease caused by a dysbiotic microbiota. Pathogens can spread to the bloodstream, colonize other tissues or organs, and... (Review)
Review
Periodontitis is a chronic non-communicable disease caused by a dysbiotic microbiota. Pathogens can spread to the bloodstream, colonize other tissues or organs, and favor the onset of other pathologies, such as Alzheimer's disease (AD). Pathogens could permanently or transiently colonize the brain and induce an immune response. Thus, we analyzed the evidence combining oral bacteria's detection in the brain, both in animals and humans affected with AD. This systematic review was carried out following the PRISMA guideline. Studies that detected oral bacteria at the brain level were selected. The search was carried out in the Medline, Latindex, SciELO, and Cochrane Library databases. SYRCLE tool and Newcastle-Ottawa Scale were used for the risk of bias assessment. 23 studies were selected according to the eligibility criteria. Infection with oral pathogens in animals was related to developing neuropathological characteristics of AD and bacteria detection in the brain. In patients with AD, oral bacteria were detected in brain tissues, and increased levels of pro-inflammatory cytokines were also detected. There is evidence of a microbiological susceptibility to develop AD when the most dysbiosis-associated oral bacteria are present. The presence of bacteria in the brain is related to AD's pathological characteristics, suggesting an etiological oral-brain axis.
Topics: Animals; Humans; Alzheimer Disease; Periodontitis; Bacteria; Microbiota; Brain; Dysbiosis
PubMed: 34698406
DOI: 10.1111/odi.14054 -
Journal of Clinical Periodontology Jun 2022To answer these PICO questions: #1: In adult patients with malocclusion, what are the effects of orthodontic tooth movement (OTM) on clinical attachment level (CAL)... (Meta-Analysis)
Meta-Analysis Review
AIM
To answer these PICO questions: #1: In adult patients with malocclusion, what are the effects of orthodontic tooth movement (OTM) on clinical attachment level (CAL) changes in treated periodontitis patients with a healthy but reduced periodontium compared to non-periodontitis patients? #2: In adult patients with treated periodontitis and malocclusion, which is the efficacy of skeletal anchorage devices compared to conventional systems in terms of orthodontic treatment outcomes?
MATERIAL AND METHODS
Seven databases were searched until June 2020 looking for randomized, non-randomized trials and case series. Mean effects (ME) and 95% confidence intervals (CIs) were calculated.
RESULTS
Twenty-six studies with high risk of bias were included. PICO#1: In 26 patients without periodontitis and in 69 treated periodontitis patients, minimal changes in periodontal outcomes were reported after orthodontic therapy (p > 0.05). A significant CAL gain (mm) (ME = 3.523; 95% CI [2.353; 4.693]; p < 0.001) was observed in 214 patients when periodontal outcomes were retrieved before a combined periodontal and orthodontic therapy. PICO#2: Orthodontic variables were scarcely reported, and objective assessment of the results on orthodontic therapy was missing.
CONCLUSIONS
Based on a small number of low-quality studies, in non-periodontitis and in stable treated periodontitis patients, OTM had no significant impact on periodontal outcomes.
Topics: Adult; Humans; Malocclusion; Periodontitis; Periodontium; Tooth Movement Techniques
PubMed: 33998045
DOI: 10.1111/jcpe.13487 -
Clinical Implant Dentistry and Related... Jun 2022To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP).
MATERIALS AND METHODS
Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.
RESULTS
Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.
CONCLUSION
SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Socket
PubMed: 35313067
DOI: 10.1111/cid.13079