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The Saudi Dental Journal Nov 2021The use of bioactive materials is a recent proposal in the treatment of dentin hypersensitivity (DH) due to the ability to stimulate the neoformation of a barrier on... (Review)
Review
The use of bioactive materials is a recent proposal in the treatment of dentin hypersensitivity (DH) due to the ability to stimulate the neoformation of a barrier on dentin surface. Questions have arisen about the effectiveness of the materials to reduce DH when compared to the control groups (placebo or non-bioactive substance). Thus, the aim of this systematic review was to evaluate the randomized controlled trials in adult patients for DH treatment with a dentifrice containing bioactive glass, applied either at-home or in-office. : The study was registered in PROSPERO and followed PRISMA guidelines. Searches were carried out in four databases (Pubmed/Medline, CENTRAL, Wbb of Science, LILACS) spanning from February 2020 to March 2020, with no language or publication date restrictions. A supplementary hand-search was performed by checking the list of references. The so-called gray literature of the national and international databases for theses and dissertations, as well as unfinished, in progress and unpublished studies were also searched. : After reading the titles and abstracts, articles that were duplicated (74 records) or unrelated to the systematic review (76 records) were excluded. Fifteen studies were evaluated considering seven at low risk of bias, four at high risk and four at moderate risk. The bioactive compounds at low concentrations (2.5-7.5%) can be used as treatment of DH both at-home and in-office.
PubMed: 34803279
DOI: 10.1016/j.sdentj.2021.04.004 -
Bioengineering (Basel, Switzerland) Apr 2023Dentin hypersensitivity (DH) pain is a persistent clinical problem, which is a common condition known to affect patients' quality of life (QoL), but no treatment has... (Review)
Review
Dentin hypersensitivity (DH) pain is a persistent clinical problem, which is a common condition known to affect patients' quality of life (QoL), but no treatment has ever been agreed upon. Calcium phosphates, available in different forms, have properties that allow sealing the dentinal tubules, which may relieve dentin hypersensitivity. The aim of this systematic review is to evaluate the ability of different formulations of calcium phosphate to reduce dentin hypersensitivity pain level in clinical studies. The inclusion criterion was as follows: clinical randomized controlled studies using calcium phosphates in treating dentin hypersensitivity. In December 2022, three electronic databases (Pubmed, Cochrane and Embase) were searched. The search strategy was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The bias assessment risks results were carried out using the Cochrane Collaboration tool. A total of 20 articles were included and analyzed in this systematic review. The results show that calcium phosphates have properties that reduce DH-associated pain. Data compilation showed a statistically significant difference in DH pain level between T0 and 4 weeks. This VAS level reduction is estimated at about -2.5 compared to the initial level. The biomimetic and non-toxic characteristics of these materials make them a major asset in treating dentin hypersensitivity.
PubMed: 37106634
DOI: 10.3390/bioengineering10040447 -
Frontiers in Oral Health 2023Selective caries removal aims to remove carious tissue in deep dentin lesions. However, a discussion stands on the value of antiseptics and chemomechanical adjuvant... (Review)
Review
OBJECTIVES
Selective caries removal aims to remove carious tissue in deep dentin lesions. However, a discussion stands on the value of antiseptics and chemomechanical adjuvant methods to reduce the bacterial load on residual caries lesions. This systematic review has addressed two main clinical questions to compare the antimicrobial efficacy of available methods using (1) antiseptic or (2) chemomechanical agents before restoring dentin carious lesions.
METHODS
We included randomized and non-randomized controlled trials (RCTs/ NRCTs). We searched eight databases from inception to October 2021. Paired reviewers independently screened studies, extracted data, and assessed the risk of bias. The primary outcome was the reduction in the number of total bacterial in dentin, whereas secondary outcomes were reduction in the number of and . We used the ratio of ratio of post-treatment to baseline means between two interventions in the logarithmic scale as a proper effect measure. Certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation approach.
RESULTS
We included 14 RCTs and 9 NRCTs, with nine interventions. Regardless the method, the number of bacteria at baseline was similar or exceeded that after the intervention, particularly in NRCTs. The evidence was inconclusive for most comparisons. Among antiseptic agents, chlorhexidine (CHX) resulted in an average of 1.14 times [95% confidence interval (CI): 1.08-1.21] more total bacterial than photodynamic therapy in RCTs. Among NRCTS, the natural agents resulted in five times more total bacterial than CHX (95% CI: 2-11). For chemomechanical methods, the control resulted in eight times (95% CI: 4-17) more total bacterial than Carisolv (SHAA).
CONCLUSIONS
The certainty of the evidence was very low for all comparisons showing uncertainty whether one treatment could be more effective than another for dentin disinfection. So far, exclusively removing soft carious dentin would be enough to reduce the bacterial count.
PubMed: 36908693
DOI: 10.3389/froh.2023.1110634 -
Biomimetics (Basel, Switzerland) Jan 2023Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures.... (Review)
Review
Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures. Prevention of DH and control of symptoms are highly desirable. Hydroxyapatite (HAP) has been shown in vitro to block dentinal tubules and in vivo to be a safe and effective additive in oral care products that reduce DH clinically. This study's aim was to conduct a systematic review and meta-analysis of the current evidence that HAP-containing oral care products reduce DH. Databases were searched, and only clinical trials in humans were included; studies conducted in vitro or on animals were not included. Publications in a foreign language were translated and included. We found 44 published clinical trials appropriate for systematic analysis. More than half of the trials had high-quality GRADE scores. HAP significantly reduced dentin hypersensitivity compared to placebo (39.5%; CI 95% [48.93; 30.06]), compared to fluoride (23%; CI 95% [34.18; 11.82]), and with a non-significant tendency compared to other desensitizing agents (10.2%; CI 95% [21.76; -19.26]). In conclusion, the meta-analysis showed that HAP added to oral care products is a more effective agent than fluoride in controlling dentin hypersensitivity and may be superior to other desensitizers.
PubMed: 36648809
DOI: 10.3390/biomimetics8010023 -
Journal of International Society of... 2023Matrix metalloproteinases (MMPs) cause degradation of the dentinal matrix, as they act actively on collagen fibrils, leading to their deterioration and collapse. MMP... (Review)
Review
AIMS AND OBJECTIVES
Matrix metalloproteinases (MMPs) cause degradation of the dentinal matrix, as they act actively on collagen fibrils, leading to their deterioration and collapse. MMP inhibitors are known to be used for the pre-treatment of human dentin before bonding. Most studies on the MMP inhibitors examined the effect of MMP inhibitors on bonding to sound dentin (SD), but few examine their effect on bonding to caries affected dentin (CAD). This systematic review aims to identify and summarize studies that have applied MMP inhibitors for pre-treatment of CAD, and examine the microtensile bond strength (µTBS), bond durability, and the mode of failure.
MATERIALS AND METHODS
A systematic review was performed using the PubMed database according to the PRISMA guidelines. A total of 785 original articles published between 2010 and 2022 were initially retrieved. Six studies were selected based on predefined inclusion-exclusion criteria, and their outcomes were extracted and analyzed. The methodological quality assessment was performed using a combined checklist that utilizes the reporting criteria mentioned in the checklist for reporting in-vitro studies guidelines and guidelines for reporting pre-clinical studies on dental materials.
RESULTS
All six studies included here showed a definitive increase of the µTBS when MMP inhibitors were applied to the CAD. The mode of failure was found to be predominantly adhesive in nature. The deviation in the values of µTBS was approximately 2-5 MPa on immediate and delayed testing.
CONCLUSION
MMP-inhibiting agents could be considered for the pretreatment of teeth with CAD as a part of their tooth preparation area, thereby allowing the clinician to retain CAD and bond to the CAD without endangering the vital pulp.
PubMed: 37564167
DOI: 10.4103/jispcd.JISPCD_5_23 -
Materials (Basel, Switzerland) Jun 2020In the era of biology-driven endodontics, vital pulp therapies are regaining popularity as a valid clinical option to postpone root-canal treatment. In this sense, many... (Review)
Review
Cytotoxicity and Bioactivity of Dental Pulp-Capping Agents towards Human Tooth-Pulp Cells: A Systematic Review of In-Vitro Studies and Meta-Analysis of Randomized and Controlled Clinical Trials.
In the era of biology-driven endodontics, vital pulp therapies are regaining popularity as a valid clinical option to postpone root-canal treatment. In this sense, many different materials are available in the market for pulp-capping purposes. The main aim of this systematic review and meta-analysis was to examine literature regarding cytotoxicity and bioactivity of pulp-capping agents by exposure of human dental pulp cells of primary origin to these materials. A secondary objective was to evaluate the inflammatory reaction and reparative dentin-bridge formation induced by the different pulp-capping agents on human pulp tissue. A literature search strategy was carried out on , and the databases. The last search was done on 1 May 2020. No filters or language restrictions were initially applied. Two researchers independently selected the studies and extracted the data. In vitro studies were included when human dental pulp cells of primary origin were (in)directly exposed to pulp-capping agents. Parallel or split-mouth randomized or controlled clinical trials (RCT or CCT) were selected to investigate the effects of different pulp-capping agents on the inflammation and reparative bridge-formation capacity of human pulp tissue. Data were synthesized via (95% confidence interval) with fixed or random effects models, depending on the homogeneity of the studies. The (95% confidence interval) were presented for the sake of interpretation. In total, 26 in vitro and 30 in vivo studies were included in the systematic review and meta-analysis, respectively. The qualitative analysis of data suggested that resin-free hydraulic calcium-silicate cements promote cell viability and bioactivity towards human dental pulp cells better than resin-based calcium-silicate cements, glass ionomers and calcium-hydroxide cements. The meta-analysis of the in vivo studies indicated that calcium-hydroxide powder/saline promotes reparative bridge formation better than the popular commercial resin-free calcium-silicate cement Pro-Root MTA (Dentsply-Sirona), although the difference was borderline non-significant ( = 0.06), and better than calcium-hydroxide cements ( < 0.0001). Moreover, resin-free pulp-capping agents fostered the formation of a complete reparative bridge better than resin-based materials ( < 0.001). On the other hand, no difference was found among the different materials tested regarding the inflammatory effect provoked at human pulp tissue. Calcium-hydroxide (CH) powder and Pro-Root MTA (Dentsply-Sirona) have shown excellent biocompatibility in vitro and in vivo when tested on human cells and teeth. Their use after many years of research and clinical experience seems safe and proven for vital pulp therapy in healthy individuals, given that an aseptic environment (rubber dam isolation) is provided. Although evidence suggests that most modern hydraulic calcium-silicate cements promote bioactivity when exposed to human dental pulp cells, care should be taken when these new materials are clinically applied in patients, as small changes in their composition might have big consequences on their clinical efficacy. Pure calcium-hydroxide powder/saline and the commercial resin-free hydraulic calcium-silicate cement Pro-Root MTA (Dentsply-Sirona) are the best options to provide a complete reparative bridge upon vital pulp therapy. CRD42020164374.
PubMed: 32545425
DOI: 10.3390/ma13122670 -
Materials (Basel, Switzerland) Aug 2022The role of endogenous Matrix Metallo Proteinases in resin dentin bond deterioration over time has been well documented. The present study aimed to systematically review...
BACKGROUND
The role of endogenous Matrix Metallo Proteinases in resin dentin bond deterioration over time has been well documented. The present study aimed to systematically review the literature; in vitro and ex vivo studies that assessed the outcomes of natural cross-linkers for immediate and long-term tensile bond strength were included.
METHODS
The manuscript search was carried out in six electronic databases-PubMed/MEDLINE, LILACS, SciELO, Cochrane, Web of Science and DOAJ, without publication year limits. Only manuscripts in English (including the translated articles) were selected, and the last search was performed in December 2020. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed.
RESULTS
From the 128 potentially eligible studies, 48 full-text articles were assessed for eligibility. After eligibility assessment and exclusions, 14 studies were considered for systematic review and seven studies for meta-analysis. Amongst the selected studies for meta-analysis, three had a medium and four had a low risk of bias.
CONCLUSIONS
It was evidenced by the available data that Proanthocyanidin is the most efficient natural cross-linker to date, in preserving the bond strength even after ageing.
PubMed: 36013786
DOI: 10.3390/ma15165650 -
Journal of Conservative Dentistry and... 2023Laser-assisted direct pulp capping (DPC) has considerable advantages compared to traditional methods such as: decontaminant effect; hemostatic and coagulant effect;... (Review)
Review
BACKGROUND
Laser-assisted direct pulp capping (DPC) has considerable advantages compared to traditional methods such as: decontaminant effect; hemostatic and coagulant effect; reduced rise in pulp temperature; reduction of intracavitary pressure; dentinal melting; and biostimulation effect.
OBJECTIVE
The aim of this study was to conduct a systematic review of the literature and meta-analysis to evaluate the effectiveness of laser as adjuvant therapy in DPC among permanent teeth.
METHODS
Research question was formulated based on the population, intervention, comparison, and outcomes strategy. A comprehensive electronic literature search was conducted through Cochrane, PubMed, and Google scholar using MeSH words, text words, and Boolean operators, independently by two reviewers. Based on the specified inclusion and exclusion criteria, the selected articles were subjected to quality assessment and the risk of bias (ROB) was evaluated. Cochrane ROB 2.0 and Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools were used to assess the ROB.
RESULTS
Initially, 45 studies recovered, 9 articles were selected for systematic review and 7 articles could be included in the meta-analysis. Teeth treated with low level laser therapy pulp capping therapy showed lower clinical/radiological failure as compared to nonlaser pulp capping therapy with an odds ratio of 0.24 (95% confidence interval = 0.15-0.38; Z = 6.15); and the difference between two groups was statistically significant ( < 0.00001).
DISCUSSION
This systematic review and meta-analysis included both the randomized and nonrandomized controlled trial (RCT). The non-RCTs had low ROB when compared to the RCTs included in the study. All included RCT studies met the inclusion and exclusion criteria, but some did not adequately describe their methods in detail.
CONCLUSION
Based on the limited evidence, the results of the meta-analysis demonstrated DPC treatment could achieve better clinical outcomes with the aid of lasers.
PubMed: 38292366
DOI: 10.4103/jcd.jcd_344_23 -
Biomimetics (Basel, Switzerland) Nov 2022Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any... (Review)
Review
Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle−Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I2 = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies.
PubMed: 36546911
DOI: 10.3390/biomimetics7040211 -
Journal of Oral Biology and... 2024Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other... (Review)
Review
INTRODUCTION
Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other diseases/conditions affecting the alveolar bone. The use of autogenous dentin-derived ABG has been considered as the composition of dentin appears to be nearly analogous to that of bone.
OBJECTIVE
This systematic review aims to assess the efficacy of dentin-derived ABG for alveolar augmentation of post-extraction sockets or other alveolar bone defects by evaluating volume gain and histomorphometric data.
MATERIAL AND METHODS
A search of systematic literature was conducted in Pubmed, Scopus, Web of Science, and Embase from database inception to October 2023. The review included both randomized controlled trials (RCT), pilot studies, clinical trials, and retrospective studies reporting on dentin-derived ABG use for alveolar augmentation.
RESULTS
Overall, 298 articles were obtained from the initial search. From these articles, 21 articles met the inclusion criteria and were included for descriptive analysis. All of the studies indicated low risk of bias. Studies of dentin-derived ABG, which used bone-derived grafts as the control group, have shown significantly higher percentages of new bone formation, gain in vertical and horizontal dimensions, and less reduction in dimensions.
CONCLUSIONS
Dentin-derived ABG was effective in volume maintenance, indicating promising results via histomorphometric and radiographic analysis.
PubMed: 38832290
DOI: 10.1016/j.jobcr.2024.05.005