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Journal of Dental Research Mar 2016The objective of this meta-analysis was to evaluate the prevalence of third molar (M3) impaction worldwide in individuals ≥17 y, from either sex, who had undergone... (Meta-Analysis)
Meta-Analysis Review
The objective of this meta-analysis was to evaluate the prevalence of third molar (M3) impaction worldwide in individuals ≥17 y, from either sex, who had undergone oral radiography and presented with no orofacial syndromes or defects. We performed a literature search using PubMed, ISI Web of Science, and Google Scholar and retrieved English and non-English articles from any period for review. We included studies reporting M3 impaction prevalence based on radiographic examination. Risk of bias was assessed regarding individuals with craniofacial syndromes, prior extraction of permanent teeth, multiple effect size estimates, and studies conflating lack of eruption with impaction. Our search yielded 49 studies involving 83,484 individuals. Worldwide M3 impaction prevalence was found to be 24.40% (95% confidence interval [95% CI]: 18.97% to 30.80%). The odds of M3 impaction in the mandible were 57.58% (95% CI: 43.3% to 68.3%, P < 0.0001) higher than in the maxilla, but we did not detect any difference in the odds of impaction between men and women (18.62%, 95% CI: -4.9% to 48.0%, P = 0.12). Mesioangular impaction was most common (41.17%, 95% CI: 33.8% to 49.0%), followed by vertical (25.55%, 95% CI: 20.0% to 32.0%), distoangular (12.17%, 95% CI: 9.1% to 16.0%), and horizontal (11.06%, 95% CI: 8.3% to 14.6%). Impaction of 1 (42.71%, 95% CI: 30.0% to 56.5%) or 2 (29.64%, 95% CI: 19.5% to 42.3%) M3s was much more common than 3 (12.04%, 95% CI: 7.2% to 19.3%) or 4 (8.74%, 95% CI: 5.2% to 14.5%). There were small differences among impaction prevalence depending on geographic region (F test, P = 0.049). Selection bias was evident because individuals had to undergo radiographic examination to be included in the analysis. The subgroup analysis by sex was underpowered. Worldwide M3 impaction prevalence is lower than previously reported. The percentage of individuals with impacted M3s is much smaller than the percentage that undergoes clinical treatment for M3 problems.
Topics: Forecasting; Global Health; Humans; Mandible; Maxilla; Molar, Third; Prevalence; Publication Bias; Tooth, Impacted
PubMed: 26561441
DOI: 10.1177/0022034515615857 -
The Japanese Dental Science Review Dec 2023Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and... (Review)
Review
Mutations in are the most common genetic cause of tooth agenesis (TA). The aim of this study was to systematically review the profiles of the TA and variants and establish their genotype-phenotype correlation. Forty articles were eligible for 178 patients and 61 mutations (26 in frame and 32 null mutations). mutations predominantly affected molars, mostly the second molar, and the mandibular first premolar was the least affected. More missing teeth were found in the maxilla than the mandible, and with null mutations than in-frame mutations. The number of missing teeth was correlated with the locations of the in-frame mutations with the C-terminus mutations demonstrating the fewest missing teeth. The null mutation location did not influence the number of missing teeth. Null mutations in all locations predominantly affected molars. For the in-frame mutations, a missing second molar was commonly associated with mutations in the highly conserved paired DNA-binding domain, particularly the linking peptide (100% prevalence). In contrast, C-terminus mutations were rarely associated with missing second molars and anterior teeth, but were commonly related to an absent second premolar. These finding indicate that the mutation type and position contribute to different degrees of loss of function that further differentially influences the manifestations of TA. This study provides novel information on the correlation of the genotype-phenotype, aiding in the genetic counseling for TA.
PubMed: 37159578
DOI: 10.1016/j.jdsr.2023.04.001 -
The Cochrane Database of Systematic... Dec 2015Crowns for primary molars are preformed and come in a variety of sizes and materials to be placed over decayed or developmentally defective teeth. They can be made... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Crowns for primary molars are preformed and come in a variety of sizes and materials to be placed over decayed or developmentally defective teeth. They can be made completely of stainless steel (know as 'preformed metal crowns' or PMCs), or to give better aesthetics, may be made of stainless steel with a white veneer cover or made wholly of a white ceramic material. In most cases, teeth are trimmed for the crowns to be fitted conventionally using a local anaesthetic. However, in the case of the Hall Technique, PMCs are pushed over the tooth with no local anaesthetic, carious tissue removal or tooth preparation. Crowns are recommended for restoring primary molar teeth that have had a pulp treatment, are very decayed or are badly broken down. However, few dental practitioners use them in clinical practice. This review updates the original review published in 2007.
OBJECTIVES
Primary objectiveTo evaluate the clinical effectiveness and safety of all types of preformed crowns for restoring primary teeth compared with conventional filling materials (such as amalgam, composite, glass ionomer, resin modified glass ionomer and compomers), other types of crowns or methods of crown placement, non-restorative caries treatment or no treatment. Secondary objectiveTo explore whether the extent of decay has an effect on the clinical outcome of primary teeth restored with all types of preformed crowns compared with those restored with conventional filling materials.
SEARCH METHODS
We searched the following electronic databases: Cochrane Oral Health Group Trials Register (to 21 January 2015), Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, 2014, Issue 12), MEDLINE via Ovid (1946 to 21 January 2015) and EMBASE via Ovid (1980 to 21 January 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials and Open Grey for grey literature (to 21 January 2015). No restrictions were placed on the language or date of publication when searching the databases.
SELECTION CRITERIA
Randomised controlled trials (RCTs) that assessed the effectiveness of crowns compared with fillings, other types of crowns, non-restorative approaches or no treatment in children with untreated tooth decay in one or more primary molar teeth. We would also have included trials comparing different methods of fitting crowns.For trials to be considered for this review, the success or failure of the interventions and other clinical outcomes had to be reported at least six months after intervention (with the exception of 'pain/discomfort during treatment and immediately postoperatively').
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the title and abstracts for each article from the search results. and independently assessed the full text for each potentially relevant study. At least two authors assessed risk of bias and extracted data using a piloted data extraction form.
MAIN RESULTS
We included five studies that evaluated three comparisons. Four studies compared crowns with fillings; two of them compared conventional PMCs with open sandwich restorations, and two compared PMCs fitted using the Hall Technique with fillings. One of these studies included a third arm, which allowed the comparison of PMCs (fitted using the Hall Technique) versus non-restorative caries treatment. In the two studies using crowns fitted using the conventional method, all teeth had undergone pulpotomy prior to the crown being placed. The final study compared two different types of crowns: PMCs versus aesthetic stainless steel crowns with white veneers. No RCT evidence was found that compared different methods of fitting preformed metal crowns (i.e. Hall Technique versus conventional technique).We considered outcomes reported at the dental appointment or within 24 hours of it, and in the short term (less than 12 months) or long term (12 months or more). Some of our outcomes of interest were not measured in the studies: time to restoration failure or retreatment, patient satisfaction and costs. Crowns versus fillingsAll studies in this comparison used PMCs. One study reported outcomes in the short term and found no reports of major failure or pain in either group. There was moderate quality evidence that the risk of major failure was lower in the crowns group in the long term (risk ratio (RR) 0.18, 95% confidence interval (CI) 0.06 to 0.56; 346 teeth in three studies, one conventional and two using Hall Technique). Similarly, there was moderate quality evidence that the risk of pain was lower in the long term for the crown group (RR 0.15, 95% CI 0.04 to 0.67; 312 teeth in two studies).Discomfort associated with the procedure was lower for crowns fitted using the Hall Technique than for fillings (RR 0.56, 95% CI 0.36 to 0.87; 381 teeth) (moderate quality evidence).It is uncertain whether there is a clinically important difference in the risk of gingival bleeding when using crowns rather than fillings, either in the short term (RR 1.69, 95% CI 0.61 to 4.66; 226 teeth) or long term (RR 1.74, 95% CI 0.99 to 3.06; 195 teeth, two studies using PMCs with conventional technique at 12 months) (low quality evidence). Crowns versus non-restorative caries treatmentOnly one study compared PMCs (fitted with the Hall Technique) with non-restorative caries treatment; the evidence quality was very low and we are therefore we are uncertain about the estimates. Metal crowns versus aesthetic crownsOne split-mouth study (11 participants) compared PMCs versus aesthetic crowns (stainless steel with white veneers). It provided very low quality evidence so no conclusions could be drawn.
AUTHORS' CONCLUSIONS
Crowns placed on primary molar teeth with carious lesions, or following pulp treatment, are likely to reduce the risk of major failure or pain in the long term compared to fillings. Crowns fitted using the Hall Technique may reduce discomfort at the time of treatment compared to fillings. The amount and quality of evidence for crowns compared to non-restorative caries, and for metal compared with aesthetic crowns, is very low. There are no RCTs comparing crowns fitted conventionally versus using the Hall Technique.
Topics: Child; Child, Preschool; Crowns; Dental Care for Children; Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent; Female; Humans; Male; Molar; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 26718872
DOI: 10.1002/14651858.CD005512.pub3 -
Frontiers in Medicine 2022The molar-incisor permineralização (MIH) is a qualitative enamel developing abnormality involving the occlusal and/or incisal third of one or more molars or permanent...
UNLABELLED
The molar-incisor permineralização (MIH) is a qualitative enamel developing abnormality involving the occlusal and/or incisal third of one or more molars or permanent incisors, caused by systemic factors. Several systemic disorders and environmental factors, such as respiratory diseases, have been reported as probable causes of MIH. Thus, this work aimed to evaluate whether respiratory diseases and MIH are associated. The searches were carried out in electronic databases, including PubMed, Scopus, Web of Science, the Cochrane Library, LILACS, OpenGrey, and Google Scholar. The acronym PECO was used, in which the P (population) was humans in permanent dentition stage; (E-exposure) molar-incisor hypomineralization; (C-comparison) reference population and (O - outcome) respiratory diseases. After the search retrieval, the duplicates were removed, and the articles were evaluated by title and abstract; then, the papers were read and thoroughly assessed. After selection, the risk of bias assessment was performed using the Newcastle-Ottawa Scale (NOS) for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the level of evidence. Three thousand six hundred and sixty six were found through the searches. After exclusion by duplicates, title, abstract, and full-reading, 13 articles remained. The articles included in this review evaluated the association of MIH with asthma, tonsilitis, pneumonia, and bronchitis. Most reports showed a low risk of bias. When exploring through GRADE, a very low level of evidence was found. We observed that the included studies showed that children with MIH had more respiratory diseases than the group that did not have MIH.
SYSTEMATIC REVIEW REGISTRATION
https://osf.io/un76d.
PubMed: 36590944
DOI: 10.3389/fmed.2022.990421 -
Journal of Oral and Maxillofacial... Sep 2023Third molar extraction can cause surgical trauma, which is associated with pain, edema, trismus, and functional limitations. The aim of the present systematic review was... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Third molar extraction can cause surgical trauma, which is associated with pain, edema, trismus, and functional limitations. The aim of the present systematic review was to investigate the effects of photobiomodulation (PBM) following the extraction of impacted mandibular third molars.
METHODS
An electronic search was conducted in 10 databases from inception up to October 2021 and the grey literature, with no restrictions regarding language or year of publication. Randomized controlled clinical trials (RCT) were included. Studies that were not RCTs were excluded. Reviewers independently analyzed titles and abstracts, followed by full-text analysis. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The exposure variable was the use of PBM and the outcomes were pain, edema, and trismus. Meta-analysis was performed using a random-effects model. The estimate was calculated considering standardized mean differences (SMD) and respective 95% confidence intervals (CI) obtained for each outcome on the first, second, third and seventh postoperative days. The level of evidence was assessed using the GRADE approach.
RESULTS
The search resulted in the 3,324 records. Thirty-three RCTs were included in the systematic review and 23 of these were included in the meta-analyses. The studies involved a total of 1,347 participants (56.6% female and 43.4% male) between 16 and 44 years of age. A greater reduction in pain was found in the PBM group compared to the control group on the third postoperative day (SMD: -1.09; 95% CI: -1.63; -0.55; P < .001; low certainty). Edema was discretely lower in the PBM group on the second postoperative day (SMD: -0.61; 95% CI: -1.09; -0.13; P < .001; low certainty) and trismus was discretely lower in the PBM group on the seventh postoperative day (SMD: 0.48; 95% CI: 0.00; 0.96; P < .001; very low certainty).
CONCLUSION
The evidence of the effect of PBM regarding the control of pain, edema, and trismus following third molar extractions is low or very low.
Topics: Male; Female; Humans; Molar, Third; Trismus; Pain, Postoperative; Tooth Extraction; Tooth, Impacted; Edema
PubMed: 37290483
DOI: 10.1016/j.joms.2023.05.007 -
Head & Face Medicine Mar 2018Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not...
BACKGROUND
Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in this case because it results in ankylosis of teeth. To the best of our knowledge, besides the study of Ahmad et al. (Eur J Orthod 28:535-540, 2006), no study has systematically analysed the clinical features of and factors associated with PFE. Therefore, the aim of this study was to systematically evaluate the current literature (from 2006 to 2017) for new insights and developments on the aetiology, diagnosis, genetics, and treatment options of PFE.
METHODS
Following the PRISMA guidelines, a systematic search was performed using the PubMed/Medline database for studies reporting on PFE. The following terms were used: "primary failure of tooth eruption", "primary failure of eruption", "tooth eruption failure", and "PFE".
RESULTS
Overall, 17 articles reporting clinical data of 314 patients were identified. In all patients, the molars were affected. In 81 reported cases, both the molars and the premolars were affected by PFE. Further, 38 patients' primary teeth were also affected. In 27 patients, no family members were affected. Additional dental anomalies were observed in 39 patients. A total of 51 different variants of the PTH1R gene associated with PFE were recorded.
CONCLUSIONS
Infraocclusion of the posterior teeth, especially if both sides are affected, is the hallmark of PFE. If a patient is affected by PFE, all teeth distal to the most mesial tooth are also affected by PFE. Primary teeth can also be impacted; however, this may not necessarily occur. If a patient is suspected of having PFE, a genetic test for mutation in the PTH1R gene should be recommended prior to any orthodontic treatment to avoid ankylosis. Treatment options depend on the patient's age and the clinical situation, and they must be evaluated individually.
Topics: Age Factors; Bicuspid; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Molar; Orthodontic Extrusion; Radiography, Panoramic; Sex Factors; Tooth Ankylosis; Tooth Eruption; Tooth, Deciduous; Tooth, Unerupted
PubMed: 29544499
DOI: 10.1186/s13005-018-0163-7 -
Archives of Oral Biology Nov 2017To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between... (Review)
Review
OBJECTIVES
To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between molar-incisor-hypomineralization-affected (MIH) enamel and unaffected enamel.
METHODS
Studies on extracted human teeth, clinically diagnosed with MIH, reporting on the microstructure, mechanical properties or the chemical composition and comparing them to unaffected enamel were reviewed. Electronic databases (PubMed, Embase and Google Scholar) were screened; hand searches and cross-referencing were also performed.
RESULTS
Twenty-two studies were included. Fifteen studies on a total of 201 teeth investigated the structural properties, including ten (141 teeth) on microstructure and seven (60 teeth) on mineral density; six (29 teeth) investigated the mechanical properties and eleven (87 teeth) investigated the chemical properties of MIH-affected enamel and compared them to unaffected enamel. Studies unambiguously found a reduction in mineral quantity and quality (reduced Ca and P content), reduction of hardness and modulus of elasticity (also in the clinically sound-appearing enamel bordering the MIH-lesion), an increase in porosity, carbon/carbonate concentrations and protein content compared to unaffected enamel.
FINDINGS
were ambiguous with regard to the extent of the lesion through the enamel to the enamel-dentin junction, the Ca/P ratio and the association between clinical appearance and defect severity.
CONCLUSIONS
There is an understanding of the changes related to MIH-affected enamel. The association of these changes with the clinical appearance and resulting implications for clinical management are unclear.
CLINICAL SIGNIFICANCE
MIH-affected enamel is greatly different from unaffected enamel. This has implications for management strategies. The possibility of correlating the clinical appearance of MIH-affected enamel with the severity of enamel changes and deducing clinical concepts (risk stratification etc.) is limited.
Topics: Dental Enamel; Dental Enamel Hypoplasia; Elasticity; Hardness; Humans; Incisor; Molar; Surface Properties
PubMed: 28843745
DOI: 10.1016/j.archoralbio.2017.08.008 -
Medicina (Kaunas, Lithuania) Feb 2023: Anecdotal evidence suggested variation in practices for antibiotic prescribing around dental procedures including route of administration of antibiotics, timing of the...
: Anecdotal evidence suggested variation in practices for antibiotic prescribing around dental procedures including route of administration of antibiotics, timing of the course prescribed (before, after or both), length of course prescribed, narrow vs. broad spectrum agents prescribed, use of single or combination of antibiotics, and the use of loading doses. This review aims to investigate this disparity of practices and the absence of global and local recent consensus on the most appropriate antibiotic interventions around invasive dental procedures. : Following PRISMA-P methodology, a systematic review of randomised controlled clinical trials was designed, reviewed, and entered on the PROSPERO website prior to commencement. Ethics approval was gained from the University of Wolverhampton Committee. Searches were performed using PubMed, Science Direct™, and the Cochrane Database, plus the bibliographies of studies identified. They investigated studies examining the efficacy and safety of any antibiotic regimen tested, independent of regimen used, versus a placebo, control, or no therapy, on outcomes in post third molar extraction. : The primary outcome of interest was postoperative infection and secondary outcomes were other post-surgical related complications of infectious nature and antibiotic adverse events. Sixteen RCTs were identified that met the selection criteria. Antibiotic use was reported to be safe, causing few adverse events. Meta-analysis of infection events showed antibiotics reduced the risk of an infection by 69%, but routine use for prophylaxis in uncomplicated procedures was not supported, and their role in patients with comorbidities or impaired immunity remains controversial. The effect on the incidence of dry socket showed no difference based upon regimen used. No significant benefit was found with respect to reduction of intraoral inflammation, wound dehiscence, haematoma, and lymphadenopathy. : The effect on postoperative pain reduction was inconclusive. Routine use of antibiotics around M3 extraction procedures is not supported, but their use in the presence of co-morbidities and or immunosuppression remains controversial to be confirmed by future studies.
Topics: Humans; Anti-Bacterial Agents; Antibiotic Prophylaxis; Meta-Analysis as Topic; Molar, Third; Postoperative Complications
PubMed: 36984426
DOI: 10.3390/medicina59030422 -
Clinical Oral Investigations Oct 2022To perform a systematic review on the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions. (Review)
Review
OBJECTIVE
To perform a systematic review on the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions.
MATERIAL AND METHODS
A systematic review modeled according to the PRISMA guidelines was conducted. The MEDLINE/PubMed, Cochrane Library, Embase, and Scopus databases were searched for relevant reports. To be included in the study sample, the studies were required to be randomized controlled trials (RCT) on the effects of listening to music on outcomes of third molar extraction. Two reviewers independently extracted the relevant data from the reports.
RESULTS
A total of 1882 studies were retrieved after the duplicates were removed. After applying the inclusion criteria, five studies were included for qualitative analysis. In 4 studies, music was played before and during the extraction of the impacted third molars. In one study, music was played only before the procedure. The genres varied from classic piano music to rock, pop, jazz, folk, and even hymns. Overall, music listening was beneficial for patients in reducing preoperative anxiety or anxiety during the procedure compared to control. However, only one study demonstrated a statistically significant decrease in systolic blood pressure.
CONCLUSIONS
Music may be an effective non-pharmacological measure to reduce preoperative anxiety in patients scheduled for third molar extraction; however, the hemodynamic effects and the effects on pain (both perioperative and postoperative) should be further explored.
CLINICAL RELEVANCE
The side effects of certain medications may be avoided if listening to music is used in third molar extractions.
Topics: Anxiety; Humans; Molar, Third; Music; Music Therapy; Pain
PubMed: 35999384
DOI: 10.1007/s00784-022-04640-5 -
International Journal of Paediatric... Jan 2017Molar incisor hypomineralization (MIH) is a defect of enamel. The lower strength of the enamel can lead to fractures that predispose for plaque accumulation and caries. (Review)
Review
BACKGROUND
Molar incisor hypomineralization (MIH) is a defect of enamel. The lower strength of the enamel can lead to fractures that predispose for plaque accumulation and caries.
AIM
This systematic review aimed to assess the association between MIH and caries.
DESIGN
Studies involving children of all ages, which reported results on MIH and caries in the permanent dentition, were considered eligible. A search was performed in PubMed and was limited to the period from January 2003 to November 2015, and to studies written in English. Reviews, meta-analyses, and case reports were excluded. The studies were evaluated by use of the Newcastle-Ottawa Quality Assessment Scale (NOS).
RESULTS
Seventeen publications were compiled in the review. Most publications reported that children with MIH have higher caries experience. One study did not observe a difference in DMF values among children affected or not by MIH. Three studies reported that children with MIH were 2.1 to 4.6 times more likely to have caries in the permanent dentition than children without MIH.
CONCLUSIONS
A significant association between MIH and caries was found. The results should, however, be interpreted cautiously due to the lack of high-quality studies. The present systematic review confirms the need for further well-designed studies.
Topics: Child; Dental Caries; Dental Enamel Hypoplasia; Dentition, Permanent; Humans; Incisor; Molar
PubMed: 27098755
DOI: 10.1111/ipd.12233