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International Journal of Dental Hygiene May 2017This systematic review aimed to evaluate the scientific evidence on the efficacy of desensitizing mouthwashes for the treatment of dentin hypersensitivity (DH) and root... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
This systematic review aimed to evaluate the scientific evidence on the efficacy of desensitizing mouthwashes for the treatment of dentin hypersensitivity (DH) and root sensitivity (RS).
MATERIAL AND METHODS
A thorough search in MEDLINE, PubMed and Cochrane Plus Library was conducted up to February 2015. Randomized clinical trials, parallel, double-blinded and placebo-controlled, with a follow-up of at least 6 weeks, reporting changes on response to tactile stimuli, thermal/evaporative stimuli or patients' subjective assessment of the pain experienced during their daily life after the home use of desensitizing mouthwashes were considered for inclusion.
RESULTS
The screening of titles and abstracts resulted in seven publications meeting the eligibility criteria. The desensitizing agents evaluated were potassium nitrate (n = 5), aluminium lactate (n = 1) and sodium fluoride (n = 1). A meta-analysis for each of the hypersensitivity stimuli was performed. Results demonstrated statistically significant reduction in sensitivity scores favouring test group when DH was assessed by means of patients' self-reported pain experience (SMD at 8 weeks = 0.77; 95% CI [0.23; 1.31]; P = 0.005). No significant effects were detected in response to tactile or thermal/evaporative stimuli. Meta-regression analysis demonstrated a tendency towards an increased effect favouring test group for the patients' subjective perception, whereas tactile and thermal/evaporative stimuli showed a slight tendency towards a reduction in the efficacy of the test mouthwash.
CONCLUSIONS
There exists a tendency towards a decrease in DH or RS scores with time in both treatment groups, with significant differences in favour of test group when sensitivity is evaluated in terms of patients' self-reported sensitivity symptoms.
Topics: Aluminum Compounds; Dentin Desensitizing Agents; Dentin Sensitivity; Double-Blind Method; Follow-Up Studies; Lactates; Mouthwashes; Nitrates; Pain Measurement; Potassium Compounds; Randomized Controlled Trials as Topic; Self Report; Sodium Fluoride; Tooth Root
PubMed: 27762076
DOI: 10.1111/idh.12250 -
Clinical Oral Investigations Jan 2023For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects.
MATERIAL AND METHODS
Databases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p ≤ 0.05. The I value and the Q-test were used to assess the heterogeneity.
RESULTS
A total of 14 in vitro trials were subjected to the meta-analysis. Within the study's limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p = 0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p = 0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p > 0.05). Among the removal methods of temporary cements, the AlO abrasion restored the decreased bond strength (p = 0.07) and performed better than hand instruments alone (p = 0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p = 0.05, 95% CI = - 1.62 to 0).
CONCLUSIONS
The choices of IDS, polycarboxylate and calcium hydroxide temporary cements, AlO abrasion removal method were feasible and efficient to enhance the bond strength.
CLINICAL RELEVANCE
It is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The AlO abrasion of cleaning dentin can minimize the negative effects of temporary cement.
Topics: Resin Cements; Dental Bonding; Dentin-Bonding Agents; Calcium Hydroxide; Dental Cements; Materials Testing; Dentin; Tensile Strength; Dental Stress Analysis
PubMed: 36422719
DOI: 10.1007/s00784-022-04790-6 -
Journal of Functional Biomaterials May 2024The aim of this study was to evaluate the effect of different irrigating solutions as well as their combination and activation modes on root canal dentin microhardness.... (Review)
Review
The aim of this study was to evaluate the effect of different irrigating solutions as well as their combination and activation modes on root canal dentin microhardness. The protocol was registered in PROSPERO and PRISMA guidelines were followed. The structured question was as follows: "Which type of irrigating solution used in endodontic treatment causes more change in dentin microhardness?" The literature was screened via PubMed, Google Scholar, Scopus, and Science Direct. The last search was carried out in February 2023 with English language restriction. Two reviewers independently performed screening and evaluation of articles. A total of 470 articles were retrieved from all the databases, whereas only 114 articles were selected for full-text analysis. After applying eligibility criteria, 44 studies were evaluated and included in this review. The results showed that with increased contact time with irrigants, dentin microhardness decreases. Increased contact time with sodium hypochlorite (NaOCl) was associated with more reduction in dentin microhardness compared with other irrigants. Other irrigants, with the exception of distilled water, including EDTA, citric acid, herbal irrigants, glycolic acid, phytic acid, etc., in this study significantly decreased dentin microhardness. The maximum reduction in dentin microhardness was seen with 2.5% NaOCl after 15 min of contact time. The use of irrigating solutions alters the chemical composition of dentin, thereby decreasing its microhardness, which affects the clinical performance of endodontically treated teeth.
PubMed: 38786643
DOI: 10.3390/jfb15050132 -
Iranian Endodontic Journal 2021The aim of our systematic review was to assess the impact of gutta-percha solvents on the bond strength of endodontic sealers to intraradicular dentin using the push-out... (Review)
Review
INTRODUCTION
The aim of our systematic review was to assess the impact of gutta-percha solvents on the bond strength of endodontic sealers to intraradicular dentin using the push-out bond test.
METHODS AND MATERIALS
The literature was searched in databases (PubMed, Web of Science and Scopus) up to September 2020, using the following search terms: (bond strength AND solvent* AND sealer* AND (tooth root OR dentin OR retreatment OR root canal). No date limits were implemented, and English languages were included. The question research was constructed based on the PICO () strategy: "Does gutta-percha solvents effect the bond strength of sealers to intraradicular dentin?". The studies were analyzed by two reviewers and were included if they utilized extracted permanent human teeth with completely formed apices, as well as assessed the influence of gutta-percha solvents on the bond strength of sealers to intraradicular dentin using push-out bond test. Review articles, case reports and studies that included immature, bovine or artificial teeth were excluded. The risk of bias was evaluated based on the Cochrane criteria adopted to studies.
RESULTS
Thirty-two papers were analyzed, seven accomplished the eligibility criteria and were selected for our systematic review. The global risk of bias was high. Due to variations in the methodological variables, a meta-analysis could not be performed.
CONCLUSION
Our systematic review highlighted the adverse effect of chloroform, which decreased the bond strength of different sealers, and the generally higher bond strength of epoxy resin-based sealers, detected with the push-out bond test. We recommend the standardization of methods in future studies to obtain a more definitive conclusion about the influence of solvents on the bond strength of sealers to intraradicular dentin.
PubMed: 36704416
DOI: 10.22037/iej.v16i1.29297 -
Journal of Dentistry Apr 2018This study aimed to evaluate if in patients with dentin hypersensitivity (DH), the DH treatments are able to improve individuals' oral health related quality of life... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to evaluate if in patients with dentin hypersensitivity (DH), the DH treatments are able to improve individuals' oral health related quality of life (OHRQoL).
DATA AND SOURCES
A systematic review was performed based on PRISMA guidelines (PROSPERO CRD42016050864). Clinical trials reporting OHRQoL before and after DH treatment were included. The search was performed in the PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, LILACS, EMBASE and Scielo databases until May 2017. Hand searches and grey literature were included. Three researches independently selected the studies, extracted data, and assessed the methodological quality. The risk of bias was estimated based on the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed by I test. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
STUDY SELECTION
Six clinical trials were included. DH was assessed by evaporative, cold, and tactile stimuli. OHRQoL was evaluated by OHIP-14 and DHEQ questionnaires. In-home and in-office desensitizing agents for DH treatment were used. The revised studies reported statistically significant reduction of DH and significant improvement in quality of life after treatment (p<0.05). Two studies were judged as high risk of bias. The studies presented high heterogeneity (I=0.8407). The evidence was very low to moderate.
CONCLUSIONS
The studies indicated decreasing of DH and improving of OHRQoL after DH treatment, although, they presented low to moderate methodological quality.
CLINICAL SIGNIFICANCE
The Oral Health Relate Quality of Life of whom complaint of DH can be improved after DH treatment.
Topics: Databases, Factual; Dentin; Dentin Desensitizing Agents; Dentin Sensitivity; Humans; Oral Health; Quality of Life
PubMed: 29262305
DOI: 10.1016/j.jdent.2017.12.007 -
Clinical Oral Investigations Jan 2014Decay of teeth, erosion and disintegration of hard dental tissue are a clinically often seen side effect after radiotherapy for tumours in the head and neck region. To... (Review)
Review
INTRODUCTION
Decay of teeth, erosion and disintegration of hard dental tissue are a clinically often seen side effect after radiotherapy for tumours in the head and neck region. To investigate if these side effects are due to structural changes in dental hard tissues, the current literature was searched. It can influence the quality of life gravely.
METHOD
A systematic PubMed (Medline) search was done and of the 374 hits, 11 articles were included. During the reading of these articles, 10 additional useful references to other articles were retrieved. An extra search was done on "A.M. Kielbassa", a key writer in many articles on this subject. Four extra articles were found. So in total, 25 articles were analysed in this systematic review.
RESULTS
Tooth destruction occurs often and soon after irradiation. There is no difference between decay in irradiated and non-irradiated teeth. The locations and the progressiveness of the destruction are different in irradiated then in non-irradiated teeth. Several studies show changes in the structure and micro hardness of enamel, the dentinoenamel junction (DEJ) and dentin. The biomechanical properties are dramatically decreased. The odds of moderate/severe tooth damage increased with the irradiation dose.
CONCLUSION
In conclusion the results of this systematic review show a great amount of changes and damages at all levels of the hard dental tissues, enamel, DEJ and dentin. These findings substantiate the idea that the formation of recurrent and atypical patterns of dental caries in irradiated teeth is, not only due to loss of saliva but a combination of both hyposalivation and the direct effects on hard dental tissue. The formation of atypical caries is furthermore increased due to poor oral hygiene, the increase of soft and carbohydrate-rich substance and changes of the bacterial micro flora and proteins.
CLINICAL RELEVANCE
This article is written to understand more about the cause of destruction of teeth after radiotherapy. This way, a more adequate preventive and restorative treatment plan can be drawn up for an individual patient.
Topics: Dental Enamel; Dentin; Head and Neck Neoplasms; Humans; Radiotherapy; Tooth
PubMed: 23873320
DOI: 10.1007/s00784-013-1034-z -
Australian Dental Journal Sep 2015Carious affected dentine (CAD) represents a very common substrate in adhesive dentistry. Despite its ability to interact with adhesive systems, the intrinsic character... (Review)
Review
BACKGROUND
Carious affected dentine (CAD) represents a very common substrate in adhesive dentistry. Despite its ability to interact with adhesive systems, the intrinsic character of CAD leads to lower bonding compared with sound dentine, regardless of the adhesive systems used. This low bonding may be more susceptible to leakage and hydrolysis of the interface by matrix metalloproteinases (MMPs). This systematic review aimed to determine current knowledge of CAD bonding, together with bond strength and MMP inhibitors' ability to prevent hybrid layer instability.
METHODS
MEDLINE/Pubmed, Scopus and The Cochrane Library databases were electronically searched for articles published from 1 January 1960 to 31 August 2014. Two reviewers independently screened and included papers according to predefined selection criteria.
RESULTS
The electronic searches identified 320 studies. After title, abstract and full-text examinations, 139 articles met the inclusion criteria. Data highlighted that a poor resin saturation of the already demineralized collagen matrix in CAD is strictly related to nanoleakage in interdiffusion and is the basis of the progressive decrease in strength with hydrolysis by MMPs. The use of mild self-etching systems seems to be the more accredited method to establish bonding in CAD. Inhibitors of MMPs may ensure better performance of CAD bonding, allowing undisturbed remineralization of the affected matrix.
CONCLUSIONS
CAD bonding needs further understanding and improvement, particularly to enhance the strength and durability of the hybrid layer.
Topics: Dental Bonding; Dental Caries; Dental Cements; Dental Leakage; Dentin; Humans; Matrix Metalloproteinase Inhibitors; Stress, Mechanical
PubMed: 25790344
DOI: 10.1111/adj.12309 -
The Journal of Prosthetic Dentistry Apr 2024Evidence on the long-term clinical assessment and longevity of ceramic veneers bonded to different substrates is limited. (Review)
Review
STATEMENT OF PROBLEM
Evidence on the long-term clinical assessment and longevity of ceramic veneers bonded to different substrates is limited.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the effect of various substrates, including enamel, dentin, or an existing composite resin restoration, on the clinical survival and complication rates of ceramic veneers.
MATERIAL AND METHODS
The PubMed, Scopus, and the Cochrane Library electronic databases were searched, and related journals were hand searched without time or language restrictions to identify clinical trials that compared the survival rate and clinical complication rates when bonding ceramic veneers to different tooth substrates. The success rate of the included participants was estimated by the number of veneers that did not require a clinical intervention, and the survival rate by all veneers that did not fail absolutely. The risk difference (RD) with 95% confidence intervals (CIs) for dichotomous outcomes was used to quantify the intervention effect.
RESULTS
Of 973 screened articles, 6 clinical studies were included. The survival and success rates varied depending on the bonding substrate. Enamel-bonded veneers had almost perfect rates of survival (99% with a range of 98% to 100%) and success (99% with a range of 98% to 100%). Veneers bonded to composite resin or surfaces with minimal dentin exposure had slightly lower survival rates (94% with a range of 91% to 97% and 95% with a range of 91% to 100%, respectively) and success rates (70% with a range of 60% to 80% and 95% with a range of 90% to 99%). Severe dentin exposure significantly decreased both survival rates (91% with a range of 84% to 98%) and success rates (74% with a range of 64% to 85%). The combined findings suggested that ceramic veneers bonded to enamel had fewer clinical complications (RD: -0.04; 95% CI: -0.09 to 0.02) and lower failure rates (RD: -0.13; 95% CI: -0.32 to 0.07) compared with those bonded to exposed dentin. Additionally, veneers attached to teeth with minimal dentin exposure were significantly less likely to require clinical interventions (RD: -0.16; 95% CI: -0.31 to -0.01) and had a reduced incidence of failure (RD: -0.08; 95% CI: -0.17 to 0.01) compared with those with severe dentin exposure.
CONCLUSIONS
Ceramic veneers bonded to enamel showed higher survival and success rates with lower clinical incidences of complications and failure than those bonded to dentin or teeth with existing composite resin restorations.
PubMed: 38604905
DOI: 10.1016/j.prosdent.2024.03.019 -
Odontology Jan 2023This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of... (Review)
Review
This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of different considerations: effect on smear layer removal, influence on sealer bond strength, activation effect by means of sonic or ultrasonic devices, effects on dentine surface, antibacterial activity, and effectiveness boost for regenerative procedures, releasing growth factors from dentin. To evaluate the results of CA as a final irrigant and compare them to other chelating agents. This review followed the PRISMA checklist. An electronic search was conducted in MEDLINE (OVID), Scopus (Elsevier) and the Web of Science (Thomson Reuters) databases. Risk of bias of included studies was evaluated using the modified CONSORT checklist and the PRIRATE checklist 2020 guidelines. 39 studies fulfilled the eligibility criteria to be included in this review: 27 in vitro studies using extracted human teeth, 10 in vitro studies using human dentin disks, and 2 RCT. Citric acid has proven to be effective in smear layer removal, showing better results in coronal and middle root thirds, improving its effect when combined with manual dynamic activation. There is no agreement regarding citric acid effect on sealer adhesion and adaptation to root canal walls due to heterogeneity within studies. Citric acid irrigation can decrease dentine microhardness and cause decalcification and erosion, especially when used before NaOCl. Citric acid has proven to be beneficial in regenerative endodontic procedures due to higher TGF-β1 release.Trial registration: Prospero database CRD42021267055.
Topics: Humans; Citric Acid; Edetic Acid; Smear Layer; Dental Pulp Cavity; Root Canal Preparation; Root Canal Irrigants; Dentin; Microscopy, Electron, Scanning; Sodium Hypochlorite
PubMed: 36220913
DOI: 10.1007/s10266-022-00744-2 -
Operative Dentistry Nov 2020One-step self-etch adhesive systems provide a clinical time gain, decreasing the number of clinical steps. When a clinician is able to follow a simpler process of... (Meta-Analysis)
Meta-Analysis
CLINICAL RELEVANCE
One-step self-etch adhesive systems provide a clinical time gain, decreasing the number of clinical steps. When a clinician is able to follow a simpler process of adhesion there is less chance of adhesive failure.
SUMMARY
Objective: A systematic review and meta-analyses were performed to evaluate whether one-step self-etching (1SSE) adhesive systems are as effective as two-step self-etching (2SSE) adhesives in noncarious cervical lesion (NCCL) restorations.Methods: This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded in the PROSPERO (CRD42018096747). Electronic systematic searches were conducted in the following databases: PubMed/MEDLINE, Scopus, and Cochrane Library for published articles. Only randomized clinical trials that compared 1SSE with 2SSE adhesives systems were selected. The outcomes were retention, postoperative sensitivity, secondary caries, color match, marginal discoloration, marginal adaptation, and anatomical form.Results: The searches resulted in 476 studies. After applying the eligibility criteria, five randomized controlled trials were selected in which 822 restorations in NCCLs were distributed in 237 patients. The results showed no statistical difference between 1SSE and 2SSE in relation to retention (p=0.23; relative risk [RR]=1.55; 95% confidence interval [CI]=0.76, 3.19), postoperative sensitivity ( p=0.50; RR=3.00; 95% CI=0.13, 70.64), Secondary caries (p=0.63; RR=0.68; 95% CI=0.14, 3.31), color match (p=0.41; RR=0.64; 95% CI=0.23, 1.83), marginal discoloration (p=0.93; RR=1.02; 95% CI=0.65, 1.61), and anatomical form (p=0.56; RR=1.38; 95% CI=0.46, 4.13). However there was statistical difference in relation to marginal adaptation ( p=0.01; RR=1.95; 95% CI=1.14, 3.34).Conclusion: This systematic review with meta-analysis revealed that both 1SSE and 2SSE adhesive systems have comparable clinical effectiveness in a follow-up period of 12 to 24 months, except in relation to marginal adaptation.
Topics: Adhesives; Composite Resins; Dental Cements; Dental Marginal Adaptation; Dental Restoration, Permanent; Dentin-Bonding Agents; Humans; Resin Cements; Tooth Cervix
PubMed: 32503033
DOI: 10.2341/19-185-L