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Journal of Clinical Periodontology 2002To systematically review the evidence on the prevalence of root sensitivity following periodontal therapy. (Review)
Review
OBJECTIVES
To systematically review the evidence on the prevalence of root sensitivity following periodontal therapy.
MATERIAL AND METHODS
Cross-sectional and longitudinal clinical studies were searched for in electronic databases, hand searched journals and through contact with authors directly. The screening and data extraction were conducted by several reviewers independently. The main outcome measure was prevalence of root sensitivity following periodontal therapy.
RESULTS
The prevalence of root sensitivity was 9-23% before and 54-55% after periodontal therapy. An increase in the intensity of root sensitivity occurred 1-3 weeks following therapy, after which it decreased.
CONCLUSIONS
It is concluded that there are insufficient randomized controlled trials to adequately address the stipulated question. However, based on the scarce evidence from only two studies, root sensitivity occurs in approximately half of the patients following subgingival scaling and root planing. The intensity of root sensitivity increases for a few weeks after therapy, after which it decreases. In clinical practice, it may be recommended that patients should be made aware of the potential for root sensitivity prior to treatment. In research, it may be recommended to conduct randomized controlled and prospective studies with both short and long follow-up periods. Furthermore, to investigate the effects and the relationship of root instrumentation with the aetiology of root sensitivity, the efficacy of preventive and therapeutic regimes for root sensitivity, and the incidence and severity of root sensitivity by subjective patient-reporting, and the response to different modes of stimuli. Protocols should follow the criteria used in dentine hypersensitivity studies.
Topics: Clinical Trials as Topic; Dental Scaling; Dentin Sensitivity; Humans; Periodontitis
PubMed: 12787217
DOI: 10.1034/j.1600-051x.29.s3.10.x -
Journal of Dentistry Jan 2015Conventionally, caries excavation is performed until only hard dentine remains, while more selective and reliable criteria might be available. We aimed at systematically... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Conventionally, caries excavation is performed until only hard dentine remains, while more selective and reliable criteria might be available. We aimed at systematically comparing the effects of using different excavation criteria via network meta-analysis.
SOURCES
Electronic databases were searched for randomised or non-randomised clinical trials (RCTs/NRCTs) evaluating excavation of cavitated lesions.
DATA
Criteria were divided into six groups: Excavation until pulpo-proximal dentine on the cavity floor was (1) either hard on probing, (2) slightly softened on probing, (3) not stainable by caries-detector-dye, or until (4) self-limiting polymer burs, (5) fluorescence-assisted devices or (6) chemo-mechanical gels indicated termination of the excavation. Evaluation of risk of complications, risk of pain/discomfort, excavation time, and number of remaining bacteria were then undertaken using Bayesian network meta-analysis.
STUDY SELECTION
28 studies (19 RCTs, 9 NRCTs) with 1782 patients (2555 lesions), most of them investigating primary teeth, were included. Risk of complications was highest when excavating until only non-stainable dentine remained, and lowest when not attempting to remove all softened dentine. Risk of pain significantly decreased if self-limiting chemo-mechanical excavation or fluorescence-assisted lasers were used instead of excavating until all dentine was hard. When not attempting to remove all softened dentine, the time required for excavation was shortest, whilst the greatest number bacteria remained.
CONCLUSIONS
Not attempting to remove all softened or stainable dentine might reduce the risk of complications. Data regarding self-limiting excavation is insufficient for definitive conclusions. Excavation criteria should be validated against clinically relevant outcomes.
CLINICAL SIGNIFICANCE
Given current evidence, dentists might not need to attempt excavation until only hard dentin remains in proximity to the pulp. Instead, their choice of excavation criterion or method should be guided by clinical requirements and outcomes.
Topics: Bayes Theorem; Clinical Trials as Topic; Dental Care; Dental Cavity Preparation; Dental Pulp Cavity; Dentin; Humans; Network Meta-Analysis; Pain; Tooth, Deciduous
PubMed: 25456612
DOI: 10.1016/j.jdent.2014.10.004 -
Experimental and Therapeutic Medicine Oct 2014The aim of the present study was to compare the root canal preparation ability of rotary nickel-titanium (NiTi) Hero 642 and K3 files in curved mandibular or maxillary...
The aim of the present study was to compare the root canal preparation ability of rotary nickel-titanium (NiTi) Hero 642 and K3 files in curved mandibular or maxillary molars. A total of 40 extracted mandibular molars with two separate mesial canals, an apical width of approximately size ≤15 and a root canal curvature of 15-30° were randomly divided into two groups and instrumented using Hero 642 (n=20) or K3 files (n=20). Canal straightening, working length, transportation, cross-sectional area, minimum dentin thickness and the canal angle curvature degree were examined, and a systematic review of the literature was conducted. No statistically significant differences were observed between the two groups with regard to the mean degree of straightening, mean change in working length, mean transportation, amount of dentin removed or remaining minimum dentin thickness (P>0.05). The canal angle curvature decreased in the two groups postoperatively. The systematic review identified six studies, and overall the two files performed similarly in the majority of categories examined. Therefore, the rotary NiTi Hero 642 and K3 files demonstrated comparable shaping abilities and maintenance of working length.
PubMed: 25187795
DOI: 10.3892/etm.2014.1853 -
Journal of Dentistry Jun 2016Inhibition of hybrid layer degradation, for example via inhibition of matrix-metallo-proteinases (MMP) could reduce risk of retention loss and failure of adhesively... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Inhibition of hybrid layer degradation, for example via inhibition of matrix-metallo-proteinases (MMP) could reduce risk of retention loss and failure of adhesively placed restorations. This systematic review investigated such inhibitory pretreatment qualitatively and via meta- and trial-sequential-analysis.
DATA SOURCES
We included randomized clinical trials comparing degradation inhibitory cavity pretreatment versus no, placebo or alternative treatments prior adhesive placement of resin-based restorations. Trials reporting retention loss or failure (graded bravo-delta in USPHS or similar criteria) were included. Trial selection, data extraction, and risk of bias assessment were conducted independently by two reviewers. Fixed- or random-effects intention-to-treat, per-protocol, and scenario meta-analyses were performed, and trial-sequential-analysis used to control for risk of random errors. Electronic databases (PubMed, Embase, Cochrane CENTRAL) were systematically screened, and hand searches and cross-referencing performed.
STUDY SELECTION
The ten included trials involved 208 patients (695 cavities) and used chlorhexidine (seven trials), ethanol-wet-bonding (two trials), and quaternary ammonium compounds for degradation inhibition. All but one trial had high risk of bias. Follow-up ranged from 6 to 36 months. Risk of retention loss was not significantly decreased after pretreatment (per-protocol OR [95% CI] 1.37 [0.68/2.77], intention-to-treat: 1.25 [0.76/2.04]). This was found for risk of restoration failure as well (per-protocol: 0.86 [0.56/1.34], intention-to-treat: 1.22 [0.83/1.80]). Scenario analyses found great uncertainty introduced by attrition. According to trial sequential analysis, no firm evidence was reached.
CONCLUSIONS
There is insufficient evidence to recommend or refute degradation inhibitory cavity pretreatment prior adhesively placing resin-based restorations. This may change if teeth are followed-up for longer.
CLINICAL SIGNIFICANCE
Dentists can perform cavity pretreatments for inhibition of hybrid layer degradation, but a beneficial effect is not supported by sufficient evidence. The impact of further effects (e.g. disinfection, pulp-irritation) remains unclear.
Topics: Chlorhexidine; Cost-Benefit Analysis; Dental Caries; Dental Cavity Lining; Follow-Up Studies; Humans; Risk Assessment; Survival Analysis
PubMed: 27107550
DOI: 10.1016/j.jdent.2016.04.007 -
Brazilian Oral Research 2015This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond... (Review)
Review
This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.
Topics: Analysis of Variance; Animals; Cattle; Cementation; Dental Prosthesis Retention; Dentin Desensitizing Agents; Glass; Humans; Post and Core Technique; Resin Cements; Treatment Outcome
PubMed: 26083089
DOI: 10.1590/1807-3107BOR-2015.vol29.0074 -
Clinical Oral Investigations Dec 2020Controversy exists regarding the effectiveness of delayed toothbrushing in decreasing erosive tooth wear (ETW). The purpose of this systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Controversy exists regarding the effectiveness of delayed toothbrushing in decreasing erosive tooth wear (ETW). The purpose of this systematic review and meta-analysis was to assess the effects of delayed toothbrushing on ETW.
MATERIALS AND METHODS
This systematic review and meta-analysis was conducted according to the PRISMA statement and registered in PROSPERO (CRD42020200463). PubMed, Embase, and Web of Science databases were systematically searched with no publication year limits. Screening and data extraction were performed independently by two reviewers. In situ and in vitro studies comparing ETW after delayed and immediate toothbrushing following an erosive attack were included. Review Manager software 5.3 (The Cochrane Collaboration, Oxford, UK) was used for statistical analyses. Heterogeneity was assessed with the Cochran Q test and I statistics.
RESULTS
Of the 565 potentially relevant studies, 26 full-text articles were assessed for eligibility. Twelve articles were included in the systematic review, and 11 were included in the qualitative analyses. No significant difference in the ETW of human enamel was observed between delayed and immediate toothbrushing (P = 0.13), whereas significantly less ETW of bovine enamel was observed after delayed toothbrushing (P < 0.001). No significant difference in the ETW of bovine dentin was observed between delayed and immediate toothbrushing (P = 0.34). Studies on human dentin were not available. Subgroup analyses revealed a significant contribution of the use of fluoridated toothpaste to decreasing the ETW of human enamel after erosion and toothbrush abrasion (P = 0.02).
CONCLUSIONS
Bovine and human teeth behaved differently in response to erosion and toothbrush abrasion. Delayed toothbrushing after an erosive attack was not effective at decreasing the ETW of human enamel compared to immediate toothbrushing, whereas it was effective at decreasing the ETW of bovine enamel.
CLINICAL RELEVANCE
Delayed toothbrushing alone after the consumption of erosive foodstuffs or beverages is not capable of preventing erosive enamel wear.
Topics: Animals; Beverages; Cattle; Dental Enamel; Humans; Tooth Abrasion; Tooth Erosion; Tooth Wear; Toothbrushing
PubMed: 33052542
DOI: 10.1007/s00784-020-03614-9 -
The Journal of Contemporary Dental... Oct 2022Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA...
OBJECTIVE
Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months.
DESIGN
In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence.
RESULTS
About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low.
CONCLUSION
Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.
Topics: Polymethacrylic Acids; Dental Materials; Dentin Sensitivity; Dentin Desensitizing Agents; Pain Management; Lasers; Humans
PubMed: 37073920
DOI: 10.5005/jp-journals-10024-3420 -
Scientific Reports Aug 2021To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot... (Meta-Analysis)
Meta-Analysis
To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot lesions (WSL) during orthodontic treatment with fixed appliances. Electronic databases (Pubmed, CENTRAL, EMBASE) were screened for studies. No language restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Primary outcome included assessment of WSL with visual-tactile assessment and/or laser fluorescence measurements. Twenty-four studies with 1117 patients (age: 11-40 years) and 12,809 teeth were included. Overall, 34 different sealants or bonding materials were analysed. Fourteen studies analysed fluoride and 14 studies non-fluoride releasing materials. Meta-analysis for visual tactile assessment revealed that sealants significantly decreased the initiation of WSL compared to untreated control (RR [95%CI] = 0.70 [0.53; 0.93]; very low level of evidence). Materials releasing fluoride did not decrease initiation of WSL compared to those with no fluoride release (RR [95%CI] = 0.84 [0.70; 1.01]; very low level of evidence). For laser fluorescence measurements no meta-analysis could be performed. The use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL. Furthermore, there is no evidence supporting that fluoride-releasing sealants or bonding materials are more effective than those without fluoride release. No gold standard prevention strategy to prevent WSL during treatment with fixed orthodontic appliances has been established yet. However, based on only a limited number of studies the use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL.
Topics: Adolescent; Adult; Child; Dental Caries; Dental Enamel; Dentin-Bonding Agents; Fluorides; Humans; Orthodontic Brackets; Pit and Fissure Sealants; Resins, Synthetic; Tooth Demineralization; Treatment Outcome; Young Adult
PubMed: 34400668
DOI: 10.1038/s41598-021-95888-6 -
Odontology Apr 2024The aim of this systematic review (SR) compared the effect of xenogeneic collagen matrix (XCM) vs. connective tissue graft (CTG) for the treatment of multiple gingival... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review (SR) compared the effect of xenogeneic collagen matrix (XCM) vs. connective tissue graft (CTG) for the treatment of multiple gingival recession (MGR) Miller Class I and II or Cairo type I. Five databases were searched up to August 2022 for randomized clinical trials (RCTs) comparing the clinical effects of XCM vs. CTG in the treatment of MGR. The random effects model of mean differences was used to determine reduction of gingival recession (GR), gain in keratinized tissue width (KTW), gain in gingival thickness (GT) and gain in clinical attachment level (CAL). The risk ratio was used to complete root coverage (CRC) at 6 and 12 months. 10 RCTs, representing 1095 and 649 GR at 6 and 12 months, respectively, were included in this SR. The meta-analysis showed no statistically significant difference in GR reduction, KTW gain GT gain or CAL gain between groups at 6 months. However, at 12 months of follow-up, differences favoring the control group were observed (p < 0.05). CRC was significantly higher in the CTG group at 6 and 12 months. Regarding dentine hypersensitivity (DH), no statistically significant differences were found between groups at 6 and 12 months of follow-up (p < 0.05). At 12 months, CTG showed significantly superior clinical results in the treatment of MGR: however, this difference was not observed in the decrease of DH.
Topics: Humans; Gingival Recession; Treatment Outcome; Surgical Flaps; Tooth Root; Collagen; Connective Tissue; Gingiva
PubMed: 37898589
DOI: 10.1007/s10266-023-00863-4 -
Evidence-based Dentistry Mar 2024To evaluate the efficacy of Odontopaste in reducing the microbial load in endodontics compared to other intracanal medicaments.
AIM
To evaluate the efficacy of Odontopaste in reducing the microbial load in endodontics compared to other intracanal medicaments.
MATERIALS AND METHODS
The literature was electronically searched on PubMed, Google Scholar, Scopus, Ovid Medline and Web of Science. In-vitro, ex-vivo and in-vivo studies that evaluated the antimicrobial efficacy of Odontopaste were included. The risk of bias was assessed using the Quality Assessment Tool for In Vitro Studies.
RESULTS
A total of four in-vitro studies were included in the systematic review. One study showed that Odontopaste had significantly more microbial cell growth on roots in all dentine depths compared to other medicaments or test agents. Another study found that Odontopaste significantly decreased colony-forming units compared to propolis and chlorhexidine. Further results showed that Odontopaste did not significantly decrease microbial numbers when used in isolation. Additionally, combining Odontopaste and calcium hydroxide did not enhance the effectiveness of calcium hydroxide. The studies had a medium to high risk of bias.
CONCLUSION
There is insufficient high-quality evidence to assess the antimicrobial efficacy of Odontopaste compared to other intracanal medicaments. Further research is required to determine Odontopaste's efficacy as an antimicrobial medicament in endodontics.
PubMed: 38538855
DOI: 10.1038/s41432-024-01000-y