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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 -
Toxicology and Industrial Health Nov 2023Good mechanical properties and low costs have led to a global expansion of plastic production and use. Unfortunately, much of this material can be released into the... (Review)
Review
Good mechanical properties and low costs have led to a global expansion of plastic production and use. Unfortunately, much of this material can be released into the environment as a waste product and cleaved into micro- and nanoplastics (NPs) whose impact on the environment and human health is still largely unknown. Considering the growing worldwide awareness on exposure to chemicals that can act as endocrine disruptors, a systematic review was performed to assess the impact of NPs on the endocrine function of in vitro and in vivo models. Although a limited number of investigations is currently available, retrieved findings showed that NPs may induce changes in endocrine system functionality, with evident alterations in reproductive and thyroid hormones and gene expression patterns, also with a trans-generational impact. Nanoplastic size, concentration, and the co-exposure to other endocrine disrupting pollutants may have an influencing role on these effects. Overall, although it is still too early to draw conclusions regarding the human health risks derived from NPs, these preliminary results support the need for further studies employing a wider range of plastic polymer types, concentrations, and time points as well as species and life stages to address a great variety of endocrine outcomes and to achieve a broader and shared consensus on the role of NPs as endocrine disruptors.
Topics: Humans; Microplastics; Endocrine Disruptors; Reproduction; Environmental Pollutants; Endocrine System
PubMed: 37753827
DOI: 10.1177/07482337231203053 -
Journal of Dentistry Sep 2021This systematic review and meta-analysis evaluated the effects of non-thermal atmospheric plasma (NTAP) treatment on dentin wetting and adhesive-dentin bond strength. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and meta-analysis evaluated the effects of non-thermal atmospheric plasma (NTAP) treatment on dentin wetting and adhesive-dentin bond strength.
DATA/SOURCES
This report followed the PRISMA 2020 statement. Two reviewers conducted literature search of MEDLINE, Web of Science and Scopus databases up to the end of November 2020. Included in vitro studies compared the effect of NTAP on treated dentin of non-carious, intact, extracted human third molar teeth with different control groups. Studies with no adequate methods, missing data, lack of control group, or those using animal teeth were excluded. The random effects model was used to summarize the treatment effect with standardized mean difference (SMD) and 95% CI. Risk of bias was assessed using the custom Cochrane Collaboration's tool.
STUDY SELECTION/RESULTS
Seventeen studies met inclusion criteria. The effects on dentin wetting were reported in favor of NTAP (SMD -5.38; 95% CI [-6.97, -3.78]; p<0.00001; I2=81%). Regarding adhesive-dentin bond strength, statistically significant differences between the NTAP and control group were in favor of NTAP in the short-term (SMD 1.92; 95%CI [1.35, 2.50]; p<0.00001; I2=97%), and long-term (SMD 3.28; 95%CI [2.46, 4.09]; p<0.00001; I2=97%). A limitation of meta-analysis is moderate heterogeneity caused by methodological differences and lack of data, which was evaluated through risk of bias and sensitivity analysis.
CONCLUSIONS
NTAP substantially improves dentin wetting and adhesive-dentin bond strength with 30 seconds exposure time and up to 10 mm tip-to-surface distances being sufficient for positive NTAP effects on bonding efficiency.
FUNDING
ON172207 and III41008 from the Ministry of Education, Science and Technological Development, Republic of Serbia. NP is funded by MESTD grant number 451-03-68/2020-14/200024.
CLINICAL SIGNIFICANCE
This systematic review and meta-analysis substantiate potential applicability of NTAP treatment of dentin in improving adhesive bonding clinically. Further research should be based on the optimized parameters such as time and distance with additional refinement of NTAP power.
Topics: Animals; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Plasma Gases; Resin Cements
PubMed: 34363890
DOI: 10.1016/j.jdent.2021.103765 -
Journal of the World Federation of... Dec 2021The study evaluated and compared the force decay of orthodontic elastomeric chains/modules in both in vivo and in vitro settings. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The study evaluated and compared the force decay of orthodontic elastomeric chains/modules in both in vivo and in vitro settings.
METHODS
A protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was formulated and registered with the International Prospective Register of Systematic Reviews. A total of 53 articles (44 in vitro and 9 in vivo studies) found via search of the electronic databases of Cochrane and the National Library of Medicine (MEDLINE; PubMed), and manual search of the gray literature from institutional library resources, were selected. Data extraction, quality analysis, risk of bias assessment, and meta-analysis of the level of force decay of elastomeric chains/modules were conducted per standard protocol, and suitable statistical analyses were applied.
RESULTS
The mean force decay in the in vivo setting was 41.9% at 24 hours, 42.6% after 1 week, 46.8% after 2 weeks, and 55.0% after 3 weeks. Similarly, the force decay in the in vitro studies was 38.9% at 24 hours, 42.1% after 1 week, 44.6% after 2 weeks, and 51.1% after 3 weeks. However, at the 95% confidence interval, the force decay rates of in vivo and in vitro studies overlap, with a statistically insignificant difference in force decay observed in the in vivo and in vitro settings.
CONCLUSIONS
This systematic review and meta-analysis observed more force decay in the in vivo studies versus the in vitro studies (although this difference was statistically insignificant), with the maximum force decay occurring during the initial days, with a reduction to approximately 50% within 3 weeks. Hence, change of the elastomeric chains/module, at intervals of 3 weeks, is advised. (PROSPERO registration no. CRD42020209535).
Topics: Elasticity; Elastomers; Mechanical Phenomena; Orthodontic Appliances; United States
PubMed: 34364839
DOI: 10.1016/j.ejwf.2021.07.003 -
Journal of Ethnopharmacology Jan 2024Astragalus mongholicus (AM) is a Qi-tonifying and immune-regulating herb widely used in traditional Chinese medicine (TCM), which is increasingly regarded as a profound... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Astragalus mongholicus (AM) is a Qi-tonifying and immune-regulating herb widely used in traditional Chinese medicine (TCM), which is increasingly regarded as a profound complementary medication in the treatment of fibrosis disease. Astragaloside (AS), astragaloside flavonoids (AF) and astragaloside polysaccharides (APS) are the main active ingredients of Astragalus Mongholicus (AM) that have a significant therapeutic effect on liver fibrosis.
AIM OF THE STUDY
This systematic review and meta-analysis aims to evaluate the effects and possible mechanisms of the main active ingredients of AM including astragaloside (AS), astragalus flavone (AF) and astragalus polysaccharide (APS) in animal models of liver fibrosis.
MATERIALS AND METHODS
We systematically searched ten databases PubMed, Web of Science, Embase, Scopus, CINAHL, ProQuest database, China National Knowledge Internet (CNKI), VIP Information Chinese Periodical Service Platform (VIP), WangFang database and China Biology Medicine Disc (CBM) to identify relevant animal studies from inception to November 2022. The SYRCLE's risk of bias tool was used to assess the methodological quality. The statistical analysis was performed using RevMan 5.4 software.
RESULTS
Twenty-three studies involving 482 animals were included. Studies quality scores ranged from 4 to 5. Alanine aminotransferase (ALT) (SMD, -3.87; 95% CI, -5.09 to -2.65; P < 0.00001) aminotransferase (AST) (SMD, -4.43; 95% CI, -5.77 to -3.08; P < 0.00001), hydroxyproline (HYP) (SMD, -2.94; 95% CI, -3.83 to -2.05; P < 0.00001) and transforming growth factor-β1 (TGF-β1) (SMD, -2.82; 95% CI, -3.57 to -2.06; P < 0.00001) were the main outcome measures to be analyzed. The meta-analysis revealed that the main active ingredients of AM lowered the levels of known risk factors including liver index (SMD, -1.25; 95% CI, -1.63 to -0.87; P < 0.00001), degree of liver fibrosis (SMD, -1.93; 95% CI, -2.57 to -1.28; P < 0.00001), collagen α type I (Col)-1 (SMD, -3.71; 95% CI, -5.63 to -1.79; P = 0.0001), hyaluronic acid (HA) (SMD, -2.65; 95% CI, -3.69 to -1.61; P < 0.00001), laminin (LN) (SMD, -2.06; 95% CI, -2.51 to -1.61; P < 0.00001), type IV collagen (CIV) (SMD, -3.04; 95% CI, -4.34 to -1.74; P < 0.00001), procollagen typeIII (PCIII) (SMD, -2.60; 95% CI, -3.15 to -2.05; P < 0.00001), albumin (ALB) (SMD, -1.19; 95% CI, -1.63 to -0.75; P < 0.00001), total bilirubin (TBiL) (SMD, -3.63; 95% CI, -5.39 to -1.88; P < 0.0001), α-smooth muscle actin (α-SMA) (SMD, -5.27; 95% CI, -6.94 to -3.61; P < 0.00001) and Smad3 (SMD, -4.11; 95% CI, -7.17 to -1.05; P = 0.009) level.
CONCLUSION
Our meta-analysis demonstrates the effective role of the main active ingredients of AM in preclinical studies of liver fibrosis. The underlying mechanisms may be related to attenuation of oxidative stress, modulation of inflammatory response and inhibition of collagen production. However, due to the significant heterogeneity and poor quality of included studies, positive findings should be treated cautiously.
REGISTRATION
PROSPERO ID CRD42023382282.
Topics: Animals; Astragalus propinquus; Liver Cirrhosis; Collagen; Collagen Type I; Models, Animal
PubMed: 37722514
DOI: 10.1016/j.jep.2023.117198 -
Clinical and Experimental Dental... Dec 2023The aim of this study was to review the selection criteria of resin cements for different types of partial coverage restorations (PCRs) and investigate if the type of... (Review)
Review
OBJECTIVE
The aim of this study was to review the selection criteria of resin cements for different types of partial coverage restorations (PCRs) and investigate if the type of restorations or restorative materials affect the type of selected resin cement.
MATERIALS AND METHODS
An electronic search (1991-2023) was performed in PubMed, Medline, Scopus, and Google Scholar databases by combinations of related keywords.
RESULTS
A total of 68 articles were included to review the selection criteria based on the advantages, disadvantages, indications, and performance of resin cements for different types of PCRs.
CONCLUSIONS
The survival and success of PCRs are largely affected by appropriate cement selection. Self-curing and dual-curing resin cements have been recommended for the cementation of metallic PCRs. The PCRs fabricated from thin, translucent, and low-strength ceramics could be adhesively bonded by light-cure conventional resin cements. Self-etching and self-adhesive cements, especially dual-cure types, are not generally indicated for laminate veneers.
Topics: Resin Cements; Ceramics; Dental Cements; Cementation
PubMed: 37427500
DOI: 10.1002/cre2.761 -
Evidence-based Dentistry Sep 2022Design Systematic review. Case selection This systematic review had a focused and structured research question in term of PICO (Population, Intervention, Comparison and... (Review)
Review
Design Systematic review. Case selection This systematic review had a focused and structured research question in term of PICO (Population, Intervention, Comparison and Outcomes). Patients included within the study were those with undergoing primary root canal treatment on a permanent tooth. The intervention was obturation with gutta percha and a resin-based sealer in comparison to obturation with gutta percha and another sealer type. The primary outcome being measured was post-operative pain incidence and/or intensity. An additional, secondary outcome, aimed to assess analgesic intake following treatment.Data analysis Data analysis was carried out by two independent reviewers using a specifically designed template which gave a concise summary of the study included within the review. The form allowed the following details to be recorded: whether a single operator completed treatment; pulpal status; irrigants used; sealer placement technique and type; obturation technique and quality; evaluation time; and outcome measures. An assessment was carried out of each study to ascertain the risk of bias which was categorised as low risk, having some areas of concerns or high risk.Six studies were included within the quantitative analysis which involved analysis of post-operative pain experiences at specified intervals. Qualitative data analysis was completed using a digital software package which allowed comparable results to be combined.Results The results from this systematic review demonstrated no significant difference in post-operative pain incidence between endodontic treatment using resin or non-resin sealers. While seven of the studies had high risk of overall bias, four were deemed low risk, and the majority of studies confirmed that there was no significant difference in the intensity of pain between the two groups. This review also confirmed that analgesic intake is not increased in patients where resin-based sealers are used when compared to non-resin sealers.Conclusion There is no significant difference in post-operative pain when resin-based root canal sealers are used when compared to other root canal sealers. For both resin and non-resin sealers, analgesics use, pain incidence post-operatively and intensity of pain reduce after 24 hours.
Topics: Epoxy Resins; Gutta-Percha; Humans; Pain, Postoperative; Root Canal Filling Materials; Root Canal Obturation
PubMed: 36151287
DOI: 10.1038/s41432-022-0804-3 -
Advances in Medical Sciences Mar 2022Developing a vaccine with improved immunogenicity is still a growing priority for many diseases. Different types of adjuvants may be beneficial to initiate and maintain... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Developing a vaccine with improved immunogenicity is still a growing priority for many diseases. Different types of adjuvants may be beneficial to initiate and maintain the long-lasting immunogenicity of vaccines. Evidence has shown that polysaccharide adjuvants are efficient in improving immunological mechanisms with their biocompatibility and biodegradability characteristics. In this study, we aimed to investigate the safety and efficacy of Advax an adjuvant derived from delta inulin.
METHODS
A systematic research was performed in Pubmed, Web of Science, and Scopus databases for the following keywords; "Advax" OR "delta inulin" until December 14th, 2020. RevMan 5.4.1 software was used for cumulative meta-analysis and bias analysis. We also used GraphPad Prism 6 software for the figures.
RESULTS
In the cumulative meta-analysis, it was found that seroconversion and geometric mean titers (GMT) levels significantly increased in Advax-adjuvanted group (mean difference: 12.31, 95% Cl [4.14, 20.47], p = 0.003; 17.10, 95% Cl [4.35, 29.85], p = 0.009, respectively). We also observed that Advax could be effective in improving immunogenicity by inducing T-cell responses and plasmablast generation in viral vaccines.
CONCLUSIONS
In this study, it was shown that Advax is a safe and well-tolerated adjuvant. Advax could be a potent adjuvant in increasing the protection and immunogenicity of different vaccines without safety issues. However, further studies are needed to verify these effects of Advax adjuvant.
Topics: Adjuvants, Immunologic; Antibodies, Viral; Inulin
PubMed: 34562856
DOI: 10.1016/j.advms.2021.09.002 -
Journal of Back and Musculoskeletal... 2023Marathon running is an extreme sport with a distance of about 42 kilometers. Its relationship to high-sensitivity cardiac troponin (hs-cTn) remains controversial. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Marathon running is an extreme sport with a distance of about 42 kilometers. Its relationship to high-sensitivity cardiac troponin (hs-cTn) remains controversial.
OBJECTIVE
As the gold standard for detecting myocardial injury, the trends of hs-cTn before and after a marathon were investigated and analyzed.
METHODS
A literature search was conducted in PubMed, EMBASE, and Cochrane Library databases by combing the keywords marathon and troponin, and studies regarding high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after marathon running (not for half-marathon and ultra-marathon) were included. "Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group" were used to assess the risk of bias. Statistical analysis was performed using Review Manager, presenting data as mean values and 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were performed if there was high heterogeneity among studies based on I2 statistic.
RESULTS
A total of 13 studies involving 824 marathoners were included in this systematic review and meta-analysis. Both hs-cTnI (MD 68.79 ng/L, [95% CI 53.22, 84.37], p< 0.001) and hs-cTnT (MD 42.91 ng/L, [95% CI 30.39, 55.43], p< 0.001) were elevated after running a marathon, but the concentration of hs-cTnT returned to baseline after 72 to 96 h post-race (MD 0.11 ng/L, [95% CI -1.30, 1.52], p= 0.88). The results of subgroup analysis demonstrated that the 99th percentile upper reference limit of hs-cTnT might be the source of heterogeneity.
CONCLUSION
The concentrations of hs-cTnI and hs-cTnT were increased after marathon running, but the change of hs-cTnT is usually not seen as irreversible myocardial injury.
Topics: Humans; Marathon Running; Troponin I; Troponin T; Male; Adult; Middle Aged
PubMed: 37248881
DOI: 10.3233/BMR-220352 -
Sexual Medicine Reviews Oct 2022Vaginal stenosis is a distressing side effect of radiation therapy that can impair quality of life. Dilator therapy is an option for patients undergoing pelvic... (Review)
Review
INTRODUCTION
Vaginal stenosis is a distressing side effect of radiation therapy that can impair quality of life. Dilator therapy is an option for patients undergoing pelvic radiotherapy to mitigate vaginal stenosis. Currently, the dilators given to patients by most hospitals are made of plastic, compared to silicone dilators which are available on the market for purchase.
OBJECTIVES
We conducted a systematic literature review to find information to guide clinical recommendations to pelvic radiotherapy patients on potential differences regarding the use of plastic vs silicone dilators with regard to efficacy, cost, and patient preferences.
METHODS
A systematic literature review was conducted in Embase, MEDLINE, and PubMed using Emtree terms. To be included in the review, papers needed to: focus on female patients undergoing radiation therapy, assess a vaginal dilator, measure any dilator intervention outcome, and specifically compare plastic vs silicone dilators for any measured outcome (either qualitative or quantitative).
RESULTS
The initial search yielded 195 articles. Two area experts, with a third expert for arbitration, read each article and found that none met all review inclusion criteria. No studies were found that compared silicone to plastic dilators with regard to efficacy in treating vaginal stenosis due to radiation therapy, no studies were found that compared cost or cost-effectiveness of the 2 dilator types, and no studies were found comparing patient preferences or experiences (eg, comfort, adherence, ease of use) between the 2 dilator types.
CONCLUSION
The materials used to create dilators have never been rigorously compared in the context of radiotherapy-related vaginal stenosis. Institutions and patients have no data to guide their choice. Significantly more research at the patient and institutional level is needed to explore the potential long-term quality of life and cost benefits of improved adherence with silicone dilator use, and to guide shared decision-making regarding dilator choice. Morgan O, Lopez MD, Martinez AJC, et al. Systematic Review of Comparisons Between Plastic and Silicone Dilators: Revealing a Knowledge Gap. Sex Med Rev 2022;10:513-519.
Topics: Constriction, Pathologic; Female; Humans; Plastics; Quality of Life; Silicones; Vagina
PubMed: 36030181
DOI: 10.1016/j.sxmr.2022.06.008