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Journal of Periodontology Jan 2021The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous approaches to augment soft tissue volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial for peri-implant health has been subject of debate in the field of implant dentistry. The aim of this systematic review was to analyze the evidence regarding the efficacy of soft tissue augmentation procedures aimed at modifying the PSP and their impact on peri-implant health.
METHODS
A comprehensive search was performed to identify clinical studies that involved soft tissue augmentation around dental implants and reported findings on KMW, MT, and/or STH changes. The effect of the intervention on peri-implant health was also assessed. Selected articles were classified based on the general type of surgical approach to increase PSP, either bilaminar or an apically positioned flap (APF) technique. A network meta-analysis including only randomized-controlled trials (RCTs) reporting on PSP outcomes was conducted to assess and compare different techniques.
RESULTS
A total of 52 articles were included in the qualitative analysis, and 23 RCTs were included as part of the network meta-analysis. Sixteen RCTs reported the outcomes of PSP modification therapy with bilaminar techniques, whereas 7 involved the use of APF. The analysis showed that bilaminar techniques in combination with soft tissue grafts (connective tissue graft [CTG], collagen matrix [CM], and acellular dermal matrix [ADM]) resulted in a significant increase in MT compared to non-augmented sites. In particular, CTG and ADM were associated with higher MT gain as compared to CM and non-augmented sites. However, no significant differences in KMW were observed across different bilaminar techniques. PSP modification via a bilaminar approach utilizing either CTG or CM showed beneficial effects on marginal bone level stability. APF-based approaches in combination with free gingival graft (FGG), CTG, CM, or ADM showed a significant KMW gain compared to non-augmented sites. However, compared to APF alone, only FGG exhibited a significantly higher KMW gain. APF with any evaluated soft tissue graft was associated with with reduction of probing depth, soft tissue dehiscence and plaque index compared to non-augmented sites compared to non-augmented sites. The evidence regarding the effect of PSP modification via APF-based approaches on peri-implant marginal bone loss or preservation is inconclusive.
CONCLUSIONS
Bilaminar approach involving CTG or ADM obtained the highest amount of MT gain, whereas APF in combination with FGG was the most effective technique for increasing KMW. KMW augmentation via APF was associated with a significant reduction in probing depth, soft tissue dehiscence and plaque index, regardless of the soft tissue grafting material employed, whereas bilaminar techniques with CTG or CM showed beneficial effects on marginal bone level stability.
Topics: Connective Tissue; Dental Implants; Gingiva; Network Meta-Analysis; Phenotype
PubMed: 32710810
DOI: 10.1002/JPER.19-0716 -
International Journal of Environmental... Oct 2019The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to...
The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.
Topics: Aged; Homes for the Aged; Humans; Nursing Homes; Oral Health; Quality of Life
PubMed: 31717812
DOI: 10.3390/ijerph16214132 -
Cureus Nov 2023Nasal congestion is a common issue stemming from various factors such as allergies and anatomical variations. Allergic rhinitis frequently leads to nasal congestion. The... (Review)
Review
Nasal congestion is a common issue stemming from various factors such as allergies and anatomical variations. Allergic rhinitis frequently leads to nasal congestion. The pathophysiology involves inflammation, swelling, and mucus production in the nasal mucosa. Multiple treatments are available, including oral phenylephrine, an over-the-counter or prescription option. However, the effectiveness and safety of phenylephrine have been subjects of debate. This systematic review aims to provide an updated perspective on the efficacy of oral phenylephrine versus placebo in addressing nasal congestion in adults. We conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a systematic review involving searches on PubMed, Cochrane, and Scopus databases. Inclusion/exclusion criteria were defined to identify high-quality studies. The focus was on randomized controlled trials (RCTs) and case-control studies published in English between 1998 and 2023, involving adult populations. The interventions compared oral phenylephrine with placebo or standard care, with outcomes centering on changes in nasal congestion symptoms and nasal airway resistance. We identified four articles that met the criteria. These studies exhibited varied designs and populations. The findings consistently indicated that phenylephrine was not more effective than a placebo in relieving nasal congestion. This systematic review demonstrates that oral phenylephrine did not offer substantial relief from nasal congestion compared to a placebo in adults. The studies featured diverse designs, yet the prevailing conclusion was that phenylephrine's efficacy was limited. Safety assessments showed no life-threatening adverse events, with common side effects including headaches and mild discomfort. In summary, this systematic review indicates that oral phenylephrine is not significantly more effective than a placebo in alleviating nasal congestion in adults. Clinicians should explore alternative treatment options, considering the review's limitations. Additional research may be needed to clarify the role of oral phenylephrine in managing nasal congestion.
PubMed: 38125218
DOI: 10.7759/cureus.49074 -
Dental and Medical Problems 2020Burning mouth syndrome (BMS) is idiopathic chronic oral pain, associated with depression, anxiety and pain symptoms. The BMS symptoms include a burning sensation in the...
Burning mouth syndrome (BMS) is idiopathic chronic oral pain, associated with depression, anxiety and pain symptoms. The BMS symptoms include a burning sensation in the tongue and/or other oral mucosa with no underlying medical or dental reasons. As many BMS patients suffer from psychiatric comorbidities, several psychotropic drugs are included in the management of BMS, reducing the complaint, while managing anxiety, depression and pain disorders. In this review, a search of the published literature regarding the management of BMS was conducted. We discuss the BMS etiology, clinically associated symptoms and available treatment options. The current evidence supports some BMS interventions, including alpha-lipoic acid (ALA), clonazepam, capsaicin, and low-level laser therapy (LLLT); however, there is a lack of robust scientific evidence, and large-scale clinical trials with long follow-up periods are needed to establish the role of these BMS management options. This knowledge could raise the awareness of dentists, psychiatrists and general practitioners about these challenges and the available kinds of treatment to improve multidisciplinary management for better health outcomes.
Topics: Burning Mouth Syndrome; Capsaicin; Clonazepam; Humans; Low-Level Light Therapy; Pain
PubMed: 33113291
DOI: 10.17219/dmp/120991 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2023Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this...
BACKGROUND
Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity.
MATERIAL AND METHODS
we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago.
RESULTS
we used the following keywords: "treatment", "aphtous stomatitis", "canker sores"; combined with Boolean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7th day was of -6,29 ± 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 ± 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 ± 1,6 points, and a reduction of the size of the lesions of 4,42 ± 1,02mm on the 7th day.
CONCLUSIONS
Besides the classic treatments for RAS, we have to take into account other treatment modalities, above all the different kinds of laser.
Topics: Humans; Chitosan; Stomatitis, Aphthous; Stomatitis; Mouth Mucosa; Pain
PubMed: 36173717
DOI: 10.4317/medoral.25604 -
Acta Odontologica Latinoamericana : AOL Apr 2023Oral mucositis (OM) is a frequent complication in cancer patients who are undergoing chemotherapy or radiotherapy. It manifests as an inflammation of the oral mucosa,...
UNLABELLED
Oral mucositis (OM) is a frequent complication in cancer patients who are undergoing chemotherapy or radiotherapy. It manifests as an inflammation of the oral mucosa, sometimes provoking severe consequences such as eating limitations, difficulty in speaking, and possibly superinfection.
AIM
The aim of this review was to update the evidence published during the last five years on the treatment of oral mucositis induced by radiotherapy and/or chemotherapy in patients with cancer.
MATERIALS AND METHOD
A search was conducted in Pubmed, Scielo and Scopus, using the search terms mucositis, stomatitis, therapy, treatment, oral cancer, oral squamous cell carcinoma, head and neck cancer and head and neck carcinoma, with Mesh terms and free terms, from 2017 to January 2023. The systematic review was conducted in accordance with the PRISMA guidelines.
RESULTS
A total 287 articles were retrieved, of which 86 were selected by title and abstract, and 18 were included after full-text analysis. The most frequently assessed variables were OM severity, pain intensity and healing time. Treatment types were diverse, and included drugs, mouthwashes, medicines based on plant extracts, cryotherapy and low-intensity laser therapies.
CONCLUSION
Dentoxol mouthwashes, Plantago major extract, thyme honey extract, zinc oxide paste, vitamin B complex combined with GeneTime, and the consumption of L-glutamine are effective in diminishing the severity of OM. Pain intensity was lower with doxepin mouthwashes and diphenhydramine-lidocaine-antacid mouthwashes.
Topics: Humans; Mucositis; Radiotherapy
PubMed: 37314054
DOI: 10.54589/aol.36/1/3 -
Clinical Oral Investigations Aug 2020The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with other commonly utilized treatment modalities for root... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with other commonly utilized treatment modalities for root coverage procedures.
MATERIALS AND METHODS
The eligibility criteria comprised randomized controlled trials (RCTs) comparing the performance of PRF with that of other modalities in the treatment of Miller class I or II (Cairo RT I) gingival recessions. Studies were classified into 5 categories as follows: (1) coronally advanced flap (CAF) alone vs CAF/PRF, (2) CAF/connective tissue graft (CAF/CTG) vs CAF/PRF, (3) CAF/enamel matrix derivative (CAF/EMD) vs CAF/PRF, (4) CAF/amnion membrane (CAF/AM) vs CAF/PRF, and (5) CAF/CTG vs CAF/CTG/PRF. Studies were evaluated for percentage of relative root coverage (rRC; primary outcome), clinical attachment level (CAL), keratinized mucosa width (KMW), and probing depth (PD) (secondary outcomes).
RESULTS
From 976 articles identified, 17 RCTs were included. The use of PRF statistically significantly increased rRC and CAL compared with CAF alone. No change in KMW or reduction in PD was reported. Compared with PRF, CTG resulted in statistically significantly better KMW and RC. No statistically significant differences were reported between the CAF/PRF and CAF/EMD groups or between the CAF/PRF and CAF/AM groups for any of the investigated parameters.
CONCLUSIONS
The use of CAF/PRF improved rRC and CAL compared with the use of CAF alone. While similar outcomes were observed between CAF/PRF and CAF/CTG for CAL and PD change, the latter group led to statistically significantly better outcomes in terms of rRC and KTW. In summary, the use of PRF in conjunction with CAF may represent a valid treatment modality for gingival recessions exhibiting adequate baseline KMW.
CLINICAL RELEVANCE
The data indicate that the use of PRF in conjunction with CAF statistically significantly improves rRC when compared with CAF alone but did not improve KMW. Therefore, in cases with limited baseline KMW, the use of CTG may be preferred over PRF.
Topics: Connective Tissue; Gingiva; Gingival Recession; Humans; Platelet-Rich Fibrin; Surgical Flaps; Tooth Root; Treatment Outcome
PubMed: 32591868
DOI: 10.1007/s00784-020-03400-7 -
Medicina (Kaunas, Lithuania) Mar 2023: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It... (Review)
Review
: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It causes deformity and limits daily activities and the quality of life. In 75% of patients, there is bone involvement. This review aims to evaluate the principal findings in the jaw by a Cone-beam computed tomography (CBTC) and X-ray orthopantomography; : PubMed, Web of Science, Lilacs and Scopus were systematically searched until 31 December 2022. In addition, a manual search was performed using the bibliography of selected articles and a Google Scholar search. Clinical studies were selected that considered principal radiographic findings in radiography in a group of patients affected by GD. : Out of 5079 papers, four studies were included. The main findings are generalized rarefaction and enlarged narrow space, anodontia. : The exact mechanism of bone manifestation is probably due to the infiltration of Gaucher cells in the bone marrow and, consequently, the destruction of bone architecture. All long bones are a potential means of skeletal manifestation. The jaw is more affected than the maxilla, and the principal features are cortical thinning, osteosclerosis, pseudocystic lesions, mental demineralization, flattening in the head of the condyle, effacement of anatomical structures, thickening of maxillary sinus mucosa. The dentist plays a crucial role in diagnosing and treating these patients. Sometimes the diagnosis can be made by a simple panoramic radiograph. All long bones are affected, and the mandible is particularly involved.
Topics: Humans; Gaucher Disease; Quality of Life; Radiography; Cone-Beam Computed Tomography; Bone Marrow
PubMed: 37109627
DOI: 10.3390/medicina59040670 -
Journal of Stomatology, Oral and... Oct 2022This systematic review purposed to investigate reports of oral lesions in confirmed COVID-19 patients summarizing clinical characteristics, histological findings,...
This systematic review purposed to investigate reports of oral lesions in confirmed COVID-19 patients summarizing clinical characteristics, histological findings, treatment and correlation of oral lesions and COVID-19 severity. Electronic search was conducted on November 2021 using seven databases to identify case reports/series describing lesions in oral mucosa in COVID-19 confirmed cases. A total of 5,179 studies were found, being 39 eligible from 19 countries, totalling 116 cases. It was observed only COVID-19 non-vaccinated cases and no sex or age predilection. The oral lesions presentation was mostly single location (69.8%), commonly in the tongue, lips, and palate, being ulcer the main clinical presentation. According to severity index for COVID-19, the reports were more frequent in patients with mild and moderate symptoms, being 75.8% in acute phase. The oral lesion appearance in post-acute COVID-19 were described after 14 to two months after patient recovery. Histologically, keratinocytes with perinuclear vacuolization, thrombosis and mononuclear inflammatory infiltrate were also described with the presence of the virus in keratinocytes, endothelial cells, and minor salivary glands. In conclusion, health care professionals should consider COVID-19 association when patient present ulcerated oral lesions and mild to moderate symptoms for COVID-19 or had acute-COVID-19.
Topics: COVID-19; Endothelial Cells; Humans; Mouth Mucosa
PubMed: 35550190
DOI: 10.1016/j.jormas.2022.05.005 -
Medicine Dec 2021SARS-CoV-2 is the virus responsible for coronavirus disease-19 (COVID-19) disease, which has been shown to trigger multiple affectations. One of the first tissue areas...
BACKGROUND
SARS-CoV-2 is the virus responsible for coronavirus disease-19 (COVID-19) disease, which has been shown to trigger multiple affectations. One of the first tissue areas to come into contact with the virus is the oral cavity, which develops various alterations. Hence, the objective of this systematic review was to identify the main signs and symptoms of this disease in the oral cavity, and the following research question was established: What are the main oral signs and symptoms in COVID-19-positive persons?
METHODS
The electronic databases of PUBMED, SCOPUS, and SCIENCE DIRECT were analyzed, the keywords "ORAL DISEASES," "ORAL MANIFESTACTIONS," and "COVID-19" were used taking into account the following inclusion criteria: studies whose main objective was oral manifestations secondary to the confirmation of COVID-19, plus clinical cases, case series, and retrospective or prospective studies. For the assessment of the risk of bias the JBI Critical Appraisal Checklist for Case Series tool was used.
RESULTS
A total of 18 studies were included, the most common initial signs/symptoms after contagion of SARS-CoV-2 were dysgeusia, dry mouth, and burning mouth, and the main signs/symptoms were the presence of ulcerative lesions, dysgeusia, and Candida albicans infections.
CONCLUSIONS
It is very important to detect any alteration in the mucosa in patients with COVID-19 and to provide assertive treatment to avoid complications, and try to maintain adequate oral hygiene throughout the course of the disease to avoid the colonization of opportunistic microorganisms and to avoid complications both orally and systemically.
Topics: COVID-19; Candidiasis, Oral; Dysgeusia; Humans; Mouth; Mouth Diseases; Prospective Studies; Retrospective Studies
PubMed: 34941133
DOI: 10.1097/MD.0000000000028327