-
International Journal of Paediatric... Nov 2022Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature.
AIM
To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI.
DESIGN
Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta-analyses.
RESULTS
Fifteen cross-sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta-analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63-5.68, I = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58-1.02, I = 96%), gingivitis (MD = 0.69, 95% CI = 0.02-1.37, I = 100%), calculus (MD = 0.04, 95% CI = 0.03-0.06, I = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24-1.18, I = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68-1.13, I = 26%).
CONCLUSION
Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.
Topics: Adolescent; Child; Cross-Sectional Studies; Dental Caries; Dental Plaque; Gingivitis; Humans; Oral Health
PubMed: 35445456
DOI: 10.1111/ipd.12967 -
The International Journal of... 2010The focus of this systematic review was to assess the published data concerning zirconia dental implant abutments from various aspects. (Review)
Review
PURPOSE
The focus of this systematic review was to assess the published data concerning zirconia dental implant abutments from various aspects.
MATERIALS AND METHODS
To identify suitable literature, an electronic search was performed using PubMed. The keywords "zirconia," "zirconium," "ceramic," "dental abutments," "dental implants," "plaque," and "bacteria" were included. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Articles were divided into four groups: (1) studies on the mechanical properties of zirconia abutments, (2) studies on the peri-implant soft tissues around zirconia abutments, (3) studies on plaque accumulation on zirconia, and (4) clinical studies on the survival of zirconia abutments.
RESULTS
The initial literature search resulted in 380 articles. For groups 1 to 4, 11, 4, 7, and 3 articles satisfied the inclusion and exclusion criteria, respectively. Only 1 randomized clinical study was identified. Review of the selected articles showed that zirconia abutments were reliable in the anterior region from both biologic and mechanical points of view. Furthermore, zirconia abutments may represent a material surface less attractive for early plaque retention compared to titanium. Three clinical follow-up studies indicated that zirconia abutments could function without fracture and peri-implant lesions.
CONCLUSIONS
Based on the reviewed literature, zirconia has the potential to be used as a dental abutment material, although some issues have to be studied further.
Topics: Dental Abutments; Dental Implants; Dental Materials; Dental Plaque; Dental Prosthesis Design; Humans; Mechanical Phenomena; Periodontium; Survival Analysis; Zirconium
PubMed: 20617217
DOI: No ID Found -
International Journal of Paediatric... Jul 2022To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P). (Meta-Analysis)
Meta-Analysis Review
AIM
To conduct a systematic review and to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P).
DESIGN
The authors searched six indexed databases without any linguistic limitation through July 2021. The eligibility criteria were observational studies that compared the periodontal clinical measures of individuals with CL/P to those without CL/P. A meta-analysis was conducted using random-effects models with inverse variance weighting.
RESULTS
The literature search generated 1277 records, and 40 full-text articles were reviewed. Twenty-three studies comprising 3235 individuals from four continents fulfilled our selection criteria. The meta-analysis revealed a significant difference in mean plaque index scores (MD = 0.31, 95% CI = 0.22, 0.41), gingival index scores (MD = 0.50, 95% CI = 0.24, 0.77), and periodontal pocket depth (MD = 0.64, 95% CI = 0.12, 1.16) between individuals with and without CL/P. A slight increase in clinical attachment loss was detected among individuals with CL/P; however, such an increase may have little clinical significance.
CONCLUSIONS
As age is positively related to periodontal disease progression, and individuals with CL/P are more likely to present with more plaque accumulation and gingival inflammation, clinicians should reinforce preventive dental care from an early age.
Topics: Cleft Lip; Cleft Palate; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Periodontal Diseases
PubMed: 34626516
DOI: 10.1111/ipd.12934 -
International Journal of Dental Hygiene Jun 2024Professional oral hygiene is essential to prevent peri-implant disease. Appropriate instruments should be employed for implant-supported restorations: they should... (Review)
Review
OBJECTIVES
Professional oral hygiene is essential to prevent peri-implant disease. Appropriate instruments should be employed for implant-supported restorations: they should effectively remove deposits without damaging dental implant surface. The aim of the present systematic review is to investigate the efficacy and safety of erythritol air-polishing in implant-supported rehabilitations, compared to alternative hygienic techniques.
MATERIALS AND METHODS
The guidelines reported in the indications of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were employed for this systematic review. The focused question was: 'what is the effect of erythritol air-polishing on dental implant surfaces regarding its cleansing efficacy and/or safety?' The final online search was conducted on 13 August 2023; MEDLINE-PubMed, Scopus and Cochrane Library were employed. Comparative in vitro or in vivo original studies were included.
RESULTS
The initial database search yielded 128 entries; the final selection comprised 15 articles. The risk of bias was evaluated using the Newcastle Ottawa scale (NOS), the Cochrane Handbook for Systematic Reviews of Interventions, GRADE method. Ultrasonic scaling with PEEK tips, glycine air-polishing and cold atmospheric plasma were the devices most frequently compared to erythritol powder in the included studies. Erythritol air-polishing appeared to be significantly more effective in reducing biofilm compared to other treatments, without causing any significant damage to the implant surface and peri-implant tissues, promoting a good biological response.
CONCLUSION
Erythritol air-polishing showed promising results for professional oral hygiene in implant-supported restorations. According to this systematic review, it is effective and safe for removing biofilm from titanium dental implants.
PubMed: 38825804
DOI: 10.1111/idh.12836 -
Journal of Dentistry Dec 2023To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use. (Review)
Review
OBJECTIVES
To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use.
DATA
Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies comparing dental plaque detection using digitalized systems against a standard reference were included.
SOURCES
PubMed and Scopus were screened from 01 January 2013 to 28 September 2023. Bibliographies of primary studies and principal peer-reviewed scientific journals were manually searched.
STUDY SELECTION
The initial search identified 576 articles, with a total of 13 included in the review, published between 2015 and 2023. Most of the studies included (77 %) were cross-sectional with three being prospective. Digital devices captured 2D and 3D images via cameras and intra-oral scanners, respectively. The Turesky's modified plaque index was the most frequent clinical index. Correlation with clinical examination was moderate to strong, with good to excellent intra- and inter-system agreement.
CONCLUSIONS
Within the limitations of this scoping review, image analysis-based plaque detection systems demonstrated good correlations with clinical plaque indices, using both 2D and 3D imaging systems. Whilst digital plaque detection devices offer advantages in terms of procedural standardization and reproducibility, they also have limitations, therefore currently, their application should be underpinned by a comprehensive clinical examination.
CLINICAL SIGNIFICANCE
Digital plaque detection tools, that provide standardized measurements and store acquired images, facilitate more informed feedback to patients. This objective analysis may enhance clinician confidence in their utility for clinical trials and other applications.
Topics: Humans; Reproducibility of Results; Dental Plaque; Prospective Studies; Dental Plaque Index; Imaging, Three-Dimensional
PubMed: 37939996
DOI: 10.1016/j.jdent.2023.104772 -
Einstein (Sao Paulo, Brazil) 2015To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying... (Review)
Review
To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying studies as to the grade of recommendation and level of evidence. The review was based on PubMed, LILACS, and Scopus databases, from January 1st, 2000 until December 31st, 2012. Studies evaluating oral hygiene care related to nosocomial infections in patients hospitalized in intensive care units were selected according to the inclusion criteria. Full published articles available in English, Spanish, or Portuguese, which approached chemical or mechanical oral hygiene techniques in preventing pneumonia, interventions performed, and their results were included. After analysis, the articles were classified according to level of evidence and grade of recommendation according to the criteria of the Oxford Centre for Evidence-Based Medicine. A total of 297 abstracts were found, 14 of which were full articles that met our criteria. Most articles included a study group with chlorhexidine users and a control group with placebo users for oral hygiene in the prevention of pneumonia. All articles were classified as B in the level of evidence, and 12 articles were classified as 2B and two articles as 2C in grade of recommendation. It was observed that the control of oral biofilm reduces the incidence of nosocomial pneumonia, but the fact that most articles had an intermediate grade of recommendation makes clear the need to conduct randomized controlled trials with minimal bias to establish future guidelines for oral hygiene in intensive care units.
Topics: Chlorhexidine; Cross Infection; Dental Plaque; Disinfectants; Evidence-Based Practice; Humans; Intensive Care Units; Oral Hygiene; Pneumonia, Ventilator-Associated; Randomized Controlled Trials as Topic; Respiration, Artificial; Toothbrushing
PubMed: 25946053
DOI: 10.1590/S1679-45082015RW2980 -
The Cochrane Database of Systematic... Dec 2011Good oral hygiene is thought to be important for oral health. This review is to determine the effectiveness of flossing in addition to toothbrushing for preventing gum... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Good oral hygiene is thought to be important for oral health. This review is to determine the effectiveness of flossing in addition to toothbrushing for preventing gum disease and dental caries in adults.
OBJECTIVES
To assess the effects of flossing in addition to toothbrushing, as compared with toothbrushing alone, in the management of periodontal diseases and dental caries in adults.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 17 October 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4), MEDLINE via OVID (1950 to 17 October 2011), EMBASE via OVID (1980 to 17 October 2011), CINAHL via EBSCO (1980 to 17 October 2011), LILACS via BIREME (1982 to 17 October 2011), ZETOC Conference Proceedings (1980 to 17 October 2011), Web of Science Conference Proceedings (1990 to 17 October 2011), Clinicaltrials.gov (to 17 October 2011) and the metaRegister of Controlled Clinical Trials (to 17 October 2011). We imposed no restrictions regarding language or date of publication. We contacted manufacturers of dental floss to identify trials.
SELECTION CRITERIA
We included randomised controlled trials conducted comparing toothbrushing and flossing with only toothbrushing, in adults.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed risk of bias for the included studies and extracted data. We contacted trial authors for further details where these were unclear. The effect measure for each meta-analysis was the standardised mean difference (SMD) with 95% confidence intervals (CI) using random-effects models. We examined potential sources of heterogeneity, along with sensitivity analyses omitting trials at high risk of bias.
MAIN RESULTS
Twelve trials were included in this review, with a total of 582 participants in flossing plus toothbrushing (intervention) groups and 501 participants in toothbrushing (control) groups. All included trials reported the outcomes of plaque and gingivitis. Seven of the included trials were assessed as at unclear risk of bias and five were at high risk of bias.Flossing plus toothbrushing showed a statistically significant benefit compared to toothbrushing in reducing gingivitis at the three time points studied, the SMD being -0.36 (95% CI -0.66 to -0.05) at 1 month, SMD -0.41 (95% CI -0.68 to -0.14) at 3 months and SMD -0.72 (95% CI -1.09 to -0.35) at 6 months. The 1-month estimate translates to a 0.13 point reduction on a 0 to 3 point scale for Loe-Silness gingivitis index, and the 3 and 6 month results translate to 0.20 and 0.09 reductions on the same scale.Overall there is weak, very unreliable evidence which suggests that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 or 3 months.None of the included trials reported data for the outcomes of caries, calculus, clinical attachment loss, or quality of life. There was some inconsistent reporting of adverse effects.
AUTHORS' CONCLUSIONS
There is some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. There is weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months. No studies reported the effectiveness of flossing plus toothbrushing for preventing dental caries.
Topics: Adult; Dental Caries; Dental Devices, Home Care; Dental Plaque; Gingivitis; Humans; Periodontal Diseases; Randomized Controlled Trials as Topic; Toothbrushing
PubMed: 22161438
DOI: 10.1002/14651858.CD008829.pub2 -
BMC Oral Health Apr 2023Mouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients.
METHODS
By April 16, 2022, multiple databases and grey literature were searched based on the PICOS strategy. Randomized controlled trials in orthodontic patients evaluating the efficacy of mouthwashes with at least one microbial parameter and/or plaque- and/or gingival inflammation-related index were included. Relevant data were extracted, and the risk of bias was evaluated using Cochrane's tool. Individual mean and standard deviation of the outcomes in mouthwashes and placebos/blank controls were pooled to estimate the weighted mean differences (WMDs) and 95% confidence intervals (95%CIs). Sensitivity analysis, and certainty of evidence were evaluated.
RESULTS
Of 1684 articles, 32 studies satisfied the eligibility criteria, and nine were included for meta-analysis. Missing outcome data was the primary source of bias. Compared to blank controls, the short-term application of fluoride mouthwashes significantly reduced the colony counts of Mutans streptococci (MS), while the long-term application may not be effective. Compared to placebos or blank controls, Chlorhexidine mouthwashes significantly reduced the colony counts of multiple microorganisms in the short-term. Compared to placebos or blank controls, herbal mouthwashes showed the inhibitory effect of MS in the short-term, with some results lacking statistical significance. After meta-analysis, significant lower plaque- and gingival inflammation-related indexes were observed in the Chlorhexidine mouthwashes groups [Gingival Index: WMD = -0.45, 95%CI = -0.70 to -0.20 (placebos as control); WMD = -0.54, 95%CI = -0.96 to -0.13 (blank controls); Plaque Index: WMD = -0.70, 95%CI = -1.12 to -0.27 (blank controls)]. Significant lower gingival inflammation-related indexes were observed in the herbal mouthwashes groups [Gingival Index: WMD = -0.20, 95%CI = -0.32 to -0.09 (blank controls)].
CONCLUSIONS
The short-term application of fluoride mouthwashes may reduce the colony counts of cariogenic bacteria, but the long-term effect is not evident. Chlorhexidine may reduce the colony counts of multiple microorganisms in the short-term. Short-term application Chlorhexidine and herbal mouthwashes may effectively reduce plaque- and gingival inflammation-related indexes. However, the risk of bias, inconsistency, and imprecision in the included studies may reduce the certainty of the evidence.
Topics: Humans; Mouthwashes; Chlorhexidine; Fluorides; Gingivitis; Inflammation; Dental Plaque; Dental Plaque Index; Anti-Infective Agents, Local
PubMed: 37024817
DOI: 10.1186/s12903-023-02920-4 -
Journal of Dentistry Jun 2010The goal of this report is to present the current state of the evidence evaluating the efficacy of anti-plaque, anti-gingivitis mouthrinses and to determine the clinical... (Review)
Review
OBJECTIVE
The goal of this report is to present the current state of the evidence evaluating the efficacy of anti-plaque, anti-gingivitis mouthrinses and to determine the clinical relevance of the evidence.
MATERIAL AND METHODS
To accomplish this goal a two stage approach was used. First a systematic review of the literature was done to find any systematic review that evaluated the efficacy of anti-plaque, anti-gingivitis mouthrinses from long term (six months) randomized placebo controlled clinical trials. Secondly, the clinical relevance was determined by comparing the percent reduction in plaque and gingivitis attributable to the anti-plaque, anti-gingivitis mouthrinses to change over time in the placebo groups attributable to adult prophylaxis and oral hygiene instructions.
RESULTS
Three systematic reviews and one meta-analysis were found that evaluated the efficacy of anti-plaque, anti-gingivitis mouthrinses. The systematic reviews concluded that there is strong evidence supporting the efficacy of chlorhexidine and essential oils as anti-plaque, anti-gingivitis mouthrinses. The evidence for cetyl pyridinium chloride (CPC) was weaker due to few clinical trials testing the same formulations of CPC. There was one meta-analysis of studies from a manufacture of Delmopinol, but it was not a systematic review of the literature. The report based on the meta-analysis concluded that Delmopinol was an effective anti-plaque, anti-gingivitis agent. Evaluation of clinical relevance by estimating percent reduction due to the active agents and changes over time in the placebo groups, demonstrated that the clinical effect of both chlorhexidine and essential oil containing mouthrinses met or exceeded reductions over time for placebo groups. Again the results for CPC were less consistent, but were similar to reductions over time in the placebo groups.
CONCLUSIONS
These results suggest that the clinical benefits of anti-plaque, anti-gingivitis mouthrinses are similar to the benefits of oral prophylaxis and oral hygiene instructions at six month recall appointments.
Topics: Adult; Aged; Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Dental Prophylaxis; Drug Combinations; Evidence-Based Dentistry; Gingivitis; Humans; Middle Aged; Mouthwashes; Oils, Volatile; Oral Hygiene; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 20621242
DOI: 10.1016/S0300-5712(10)70004-X -
Journal of Clinical Periodontology Jul 2020To evaluate the efficacy of adjunctive therapies in reducing gingivitis and plaque by means of a systematic review of randomized clinical trials (RCTs). (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the efficacy of adjunctive therapies in reducing gingivitis and plaque by means of a systematic review of randomized clinical trials (RCTs).
MATERIAL AND METHODS
A search protocol was designed to identify 6-month RCTs that investigated the efficacy of adjuncts to mechanical plaque control on gingivitis and plaque. Following screening, relevant information was extracted, and quality and potential risk of bias were estimated. Mean treatment differences were calculated to obtain standardized mean differences and weighted mean differences (SMD and WMD) as appropriate.
RESULTS
Meta-analyses included 70 studies of adjunctive antiseptics. Compared with mechanical plaque control alone, adjuncts yielded statistically significant reductions in gingival index (n = 72; SMD = -1.268; 95% CI [-1.489; -1.047]; p < .001; I = 96.2%), bleeding (%) (n = 26, WMD=-14.62%; 95% CI [-18.01%; -11.23%]; p < .001; I = 95.1%), plaque index (n = 93, SMD = -1.017; 95% CI [-1.194; -0.840]; p < .001; I = 95.3%) and plaque (%) (n = 23; WMD = -18.20%; 95% CI [-24.00%; -12.50%]; p < .001; I = 96.9%). Mouthrinses resulted in greater reductions in per cent plaque compared with dentifrices (meta-regression, coefficient = 13.80%; 95% CI [2.40%; 25.10%]; p = .020). The antiseptic agents were similarly effective in reducing gingivitis and plaque in patients with dental plaque-induced gingivitis (intact periodontium) or previously treated periodontitis with gingival inflammation.
CONCLUSION
Adjunctive antiseptics in mouthrinses and dentifrices provide statistically significant reductions in gingival, bleeding and plaque indices.
Topics: Anti-Infective Agents, Local; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Inflammation
PubMed: 31869441
DOI: 10.1111/jcpe.13244