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Journal of Dentistry Nov 2016The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth.
SOURCES
PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions.
STUDY SELECTION
We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment.
DATA
After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up.
CONCLUSIONS
Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth.
CLINICAL SIGNIFICANCE
Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt.
Topics: Composite Resins; Dental Caries; Dental Restoration, Permanent; Dentition, Permanent; Humans; Molar
PubMed: 27523636
DOI: 10.1016/j.jdent.2016.08.003 -
Orthodontics & Craniofacial Research Nov 2019The aim of this review was to systematically appraise the evidence on aligner mechanics and forces and moments generated across difference types of aligners. In vitro-... (Meta-Analysis)
Meta-Analysis Review
The aim of this review was to systematically appraise the evidence on aligner mechanics and forces and moments generated across difference types of aligners. In vitro- laboratory studies for model simulated tooth movement with aligners. Database searches within Medline via Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS via BIREME Virtual Health Library. Unpublished literature was also searched in Open Grey, ClinicalTrials.gov (www.clinicaltrials.gov), the National Research Register (www.controlled-trials.com) and Center for Open Science (Open Science Framework), using the terms "aligner" AND "orthodontic". Risk of bias assessment was based on the Cochrane Risk of Bias tool. Random effects meta-analyses were conducted. A total of 447 studies were identified through electronic search and after careful consideration of pre- defined eligibility criteria, 13 deemed eligible for inclusion, while 2 were included in the quantitative synthesis. When palatal tipping of the upper central incisor through PET-G aligners was considered, aligner thickness of 0.5, 0.625 or 0.75 mm was not associated with a significantly different moment to force (M/F) ratio, given a common gingival edge width of 3-4 mm. Aligner thickness does not appear to possess a significant role in forces and moments generated by clear aligners under specific settings, while the most commonly examined tooth movements are tipping and rotation. The findings of this review may be applicable to certain conditions in laboratory settings.
Topics: Incisor; Orthodontic Appliance Design; Palate; Rotation; Tooth Movement Techniques
PubMed: 31237410
DOI: 10.1111/ocr.12333 -
Journal of Esthetic and Restorative... Jan 2022This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations.
MATERIALS AND METHODS
The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered.
RESULTS
Following title screening and full-text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias-2 tool, two studies were classified as "some concerns" for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow-up (low certainty of evidence according to GRADE).
CONCLUSION
There is low-certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations.
CLINICAL SIGNIFICANCE
There is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations.
Topics: Adult; Composite Resins; Dentin; Humans; Molar
PubMed: 34859939
DOI: 10.1111/jerd.12841 -
The Cochrane Database of Systematic... Jul 2021Traditionally, cavitated carious lesions and those extending into dentine have been treated by 'complete' removal of carious tissue, i.e. non-selective removal and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Traditionally, cavitated carious lesions and those extending into dentine have been treated by 'complete' removal of carious tissue, i.e. non-selective removal and conventional restoration (CR). Alternative strategies for managing cavitated or dentine carious lesions remove less or none of the carious tissue and include selective carious tissue removal (or selective excavation (SE)), stepwise carious tissue removal (SW), sealing carious lesions using sealant materials, sealing using preformed metal crowns (Hall Technique, HT), and non-restorative cavity control (NRCC).
OBJECTIVES
To determine the comparative effectiveness of interventions (CR, SE, SW, sealing of carious lesions using sealant materials or preformed metal crowns (HT), or NRCC) to treat carious lesions conventionally considered to require restorations (cavitated or micro-cavitated lesions, or occlusal lesions that are clinically non-cavitated but clinically/radiographically extend into dentine) in primary or permanent teeth with vital (sensitive) pulps.
SEARCH METHODS
An information specialist searched four bibliographic databases to 21 July 2020 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: We included randomised clinical trials comparing different levels of carious tissue removal, as listed above, against each other, placebo, or no treatment. Participants had permanent or primary teeth (or both), and vital pulps (i.e. no irreversible pulpitis/pulp necrosis), and carious lesions conventionally considered to need a restoration (i.e. cavitated lesions, or non- or micro-cavitated lesions radiographically extending into dentine). The primary outcome was failure, a composite measure of pulp exposure, endodontic therapy, tooth extraction, and restorative complications (including resealing of sealed lesions).
DATA COLLECTION AND ANALYSIS
Pairs of review authors independently screened search results, extracted data, and assessed the risk of bias in the studies and the overall certainty of the evidence using GRADE criteria. We measured treatment effects through analysing dichotomous outcomes (presence/absence of complications) and expressing them as odds ratios (OR) with 95% confidence intervals (CI). For failure in the subgroup of deep lesions, we used network meta-analysis to assess and rank the relative effectiveness of different interventions.
MAIN RESULTS
We included 27 studies with 3350 participants and 4195 teeth/lesions, which were conducted in 11 countries and published between 1977 and 2020. Twenty-four studies used a parallel-group design and three were split-mouth. Two studies included adults only, 20 included children/adolescents only and five included both. Ten studies evaluated permanent teeth, 16 evaluated primary teeth and one evaluated both. Three studies treated non-cavitated lesions; 12 treated cavitated, deep lesions, and 12 treated cavitated but not deep lesions or lesions of varying depth. Seventeen studies compared conventional treatment (CR) with a less invasive treatment: SE (8), SW (4), two HT (2), sealing with sealant materials (4) and NRCC (1). Other comparisons were: SE versus HT (2); SE versus SW (4); SE versus sealing with sealant materials (2); sealant materials versus no sealing (2). Follow-up times varied from no follow-up (pulp exposure during treatment) to 120 months, the most common being 12 to 24 months. All studies were at overall high risk of bias. Effect of interventions Sealing using sealants versus other interventions for non-cavitated or cavitated but not deep lesions There was insufficient evidence of a difference between sealing with sealants and CR (OR 5.00, 95% CI 0.51 to 49.27; 1 study, 41 teeth, permanent teeth, cavitated), sealing versus SE (OR 3.11, 95% CI 0.11 to 85.52; 2 studies, 82 primary teeth, cavitated) or sealing versus no treatment (OR 0.05, 95% CI 0.00 to 2.71; 2 studies, 103 permanent teeth, non-cavitated), but we assessed all as very low-certainty evidence. HT, CR, SE, NRCC for cavitated, but not deep lesions in primary teeth The odds of failure may be higher for CR than HT (OR 8.35, 95% CI 3.73 to 18.68; 2 studies, 249 teeth; low-certainty evidence) and lower for HT than NRCC (OR 0.19, 95% CI 0.05 to 0.74; 1 study, 84 teeth, very low-certainty evidence). There was insufficient evidence of a difference between SE versus HT (OR 8.94, 95% CI 0.57 to 139.67; 2 studies, 586 teeth) or CR versus NRCC (OR 1.16, 95% CI 0.50 to 2.71; 1 study, 102 teeth), both very low-certainty evidence. CR, SE, SW for deep lesions The odds of failure were higher for CR than SW in permanent teeth (OR 2.06, 95% CI 1.34 to 3.17; 3 studies, 398 teeth; moderate-certainty evidence), but not primary teeth (OR 2.43, 95% CI 0.65 to 9.12; 1 study, 63 teeth; very low-certainty evidence). The odds of failure may be higher for CR than SE in permanent teeth (OR 11.32, 95% CI 1.97 to 65.02; 2 studies, 179 teeth) and primary teeth (OR 4.43, 95% CI 1.04 to 18.77; 4 studies, 265 teeth), both very low-certainty evidence. Notably, two studies compared CR versus SE in cavitated, but not deep lesions, with insufficient evidence of a difference in outcome (OR 0.62, 95% CI 0.21 to 1.88; 204 teeth; very low-certainty evidence). The odds of failure were higher for SW than SE in permanent teeth (OR 2.25, 95% CI 1.33 to 3.82; 3 studies, 371 teeth; moderate-certainty evidence), but not primary teeth (OR 2.05, 95% CI 0.49 to 8.62; 2 studies, 126 teeth; very low-certainty evidence). For deep lesions, a network meta-analysis showed the probability of failure to be greatest for CR compared with SE, SW and HT.
AUTHORS' CONCLUSIONS
Compared with CR, there were lower numbers of failures with HT and SE in the primary dentition, and with SE and SW in the permanent dentition. Most studies showed high risk of bias and limited precision of estimates due to small sample size and typically limited numbers of failures, resulting in assessments of low or very low certainty of evidence for most comparisons.
Topics: Adolescent; Adult; Bias; Child; Child, Preschool; Crowns; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Restoration Failure; Dentin; Dentition, Permanent; Humans; Middle Aged; Network Meta-Analysis; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 34280957
DOI: 10.1002/14651858.CD013039.pub2 -
Journal of Esthetic and Restorative... Jan 2019Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor...
INTRODUCTION
Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects.
OBJECTIVE
To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization.
MATERIALS AND METHODS
PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews.
RESULTS
From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements.
CONCLUSIONS
Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion).
CLINICAL SIGNIFICANCE
Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.
Topics: Dental Enamel; Dental Enamel Hypoplasia; Humans; Incisor; Molar; Pit and Fissure Sealants
PubMed: 30284749
DOI: 10.1111/jerd.12420 -
Journal of Clinical Periodontology Oct 2014The objectives of this review were as follows: What are characteristics used to define various forms of periodontal biotypes? What are their anatomic dimensions in... (Review)
Review
AIM
The objectives of this review were as follows: What are characteristics used to define various forms of periodontal biotypes? What are their anatomic dimensions in relation to the definition? In addition, what is the association between these various characteristics in relation to the periodontal biotypes? Furthermore, what is the prevalence of various forms of periodontal biotypes in the population?
MATERIAL AND METHODS
The PubMed-MEDLINE, the Cochrane-CENTRAL and EMBASE databases were searched through up and till June 2013 to identify any appropriate studies regarding the aim. Appropriate studies were those reporting characteristics of various forms of periodontal biotype and its dimensions. These characteristics were gingival thickness (GT), gingival morphotype (GM), tooth dimensions (TD), keratinized tissue (KT) and bone morphotype (BM).
RESULTS AND CONCLUSIONS
The search yielded 2581 unique papers, after selection resulted in 12 publications that met the eligibility criteria. In general, the available definitions are found to be unclear and sometimes inconsistent. However, based on the available literature, the three biotypes thin scalloped, thick flat and thick scalloped seem a comprehensive categorization in defining periodontal biotypes in the population. The dental, gingival and osseous dimensions have a weak to moderate association. Only between gingival thickness, keratinized tissue and bone morphotype uniform positive associations are found.
Topics: Alveolar Process; Classification; Gingiva; Humans; Keratins; Periodontium; Tooth
PubMed: 24836578
DOI: 10.1111/jcpe.12275 -
The Cochrane Database of Systematic... Jul 2020Pathology relating to mandibular wisdom teeth is a frequent presentation to oral and maxillofacial surgeons, and surgical removal of mandibular wisdom teeth is a common... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pathology relating to mandibular wisdom teeth is a frequent presentation to oral and maxillofacial surgeons, and surgical removal of mandibular wisdom teeth is a common operation. The indications for surgical removal of these teeth are alleviation of local pain, swelling and trismus, and also the prevention of spread of infection that may occasionally threaten life. Surgery is commonly associated with short-term postoperative pain, swelling and trismus. Less frequently, infection, dry socket (alveolar osteitis) and trigeminal nerve injuries may occur. This review focuses on the optimal methods in order to improve patient experience and minimise postoperative morbidity.
OBJECTIVES
To compare the relative benefits and risks of different techniques for surgical removal of mandibular wisdom teeth.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 8 July 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library; 2019, Issue 6), MEDLINE Ovid (1946 to 8 July 2019), and Embase Ovid (1980 to 8 July 2019). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication.
SELECTION CRITERIA
Randomised controlled trials comparing different surgical techniques for the removal of mandibular wisdom teeth.
DATA COLLECTION AND ANALYSIS
Three review authors were involved in assessing the relevance of identified studies, evaluated the risk of bias in included studies and extracted data. We used risk ratios (RRs) for dichotomous data in parallel-group trials (or Peto odds ratios if the event rate was low), odds ratios (ORs) for dichotomous data in cross-over or split-mouth studies, and mean differences (MDs) for continuous data. We took into account the pairing of the split-mouth studies in our analyses, and combined parallel-group and split-mouth studies using the generic inverse-variance method. We used the fixed-effect model for three studies or fewer, and random-effects model for more than three studies.
MAIN RESULTS
We included 62 trials with 4643 participants. Several of the trials excluded individuals who were not in excellent health. We assessed 33 of the studies (53%) as being at high risk of bias and 29 as unclear. We report results for our primary outcomes below. Comparisons of different suturing techniques and of drain versus no drain did not report any of our primary outcomes. No studies provided useable data for any of our primary outcomes in relation to coronectomy. There is insufficient evidence to determine whether envelope or triangular flap designs led to more alveolar osteitis (OR 0.33, 95% confidence interval (CI) 0.09 to 1.23; 5 studies; low-certainty evidence), wound infection (OR 0.29, 95% CI 0.04 to 2.06; 2 studies; low-certainty evidence), or permanent altered tongue sensation (Peto OR 4.48, 95% CI 0.07 to 286.49; 1 study; very low-certainty evidence). In terms of other adverse effects, two studies reported wound dehiscence at up to 30 days after surgery, but found no difference in risk between interventions. There is insufficient evidence to determine whether the use of a lingual retractor affected the risk of permanent altered sensation compared to not using one (Peto OR 0.14, 95% CI 0.00 to 6.82; 1 study; very low-certainty evidence). None of our other primary outcomes were reported by studies included in this comparison. There is insufficient evidence to determine whether lingual split with chisel is better than a surgical hand-piece for bone removal in terms of wound infection (OR 1.00, 95% CI 0.31 to 3.21; 1 study; very low-certainty evidence). Alveolar osteitis, permanent altered sensation, and other adverse effects were not reported. There is insufficient evidence to determine whether there is any difference in alveolar osteitis according to irrigation method (mechanical versus manual: RR 0.33, 95% CI 0.01 to 8.09; 1 study) or irrigation volume (high versus low; RR 0.52, 95% CI 0.27 to 1.02; 1 study), or whether there is any difference in postoperative infection according to irrigation method (mechanical versus manual: RR 0.50, 95% CI 0.05 to 5.43; 1 study) or irrigation volume (low versus high; RR 0.17, 95% CI 0.02 to 1.37; 1 study) (all very low-certainty evidence). These studies did not report permanent altered sensation and adverse effects. There is insufficient evidence to determine whether primary or secondary wound closure led to more alveolar osteitis (RR 0.99, 95% CI 0.41 to 2.40; 3 studies; low-certainty evidence), wound infection (RR 4.77, 95% CI 0.24 to 96.34; 1 study; very low-certainty evidence), or adverse effects (bleeding) (RR 0.41, 95% CI 0.11 to 1.47; 1 study; very low-certainty evidence). These studies did not report permanent sensation changes. Placing platelet rich plasma (PRP) or platelet rich fibrin (PRF) in sockets may reduce the incidence of alveolar osteitis (OR 0.39, 95% CI 0.22 to 0.67; 2 studies), but the evidence is of low certainty. Our other primary outcomes were not reported.
AUTHORS' CONCLUSIONS
In this 2020 update, we added 27 new studies to the original 35 in the 2014 review. Unfortunately, even with the addition of these studies, we have been unable to draw many meaningful conclusions. The small number of trials evaluating each comparison and reporting our primary outcomes, along with methodological biases in the included trials, means that the body of evidence for each of the nine comparisons evaluated is of low or very low certainty. Participant populations in the trials may not be representative of the general population, or even the population undergoing third molar surgery. Many trials excluded individuals who were not in good health, and several excluded those with active infection or who had deep impactions of their third molars. Consequently, we are unable to make firm recommendations to surgeons to inform their techniques for removal of mandibular third molars. The evidence is uncertain, though we note that there is some limited evidence that placing PRP or PRF in sockets may reduce the incidence of dry socket. The evidence provided in this review may be used as a guide for surgeons when selecting and refining their surgical techniques. Ongoing studies may allow us to provide more definitive conclusions in the future.
Topics: Adult; Bias; Drainage; Dry Socket; Humans; Lip; Mandible; Middle Aged; Molar, Third; Postoperative Complications; Randomized Controlled Trials as Topic; Sensation Disorders; Surgical Flaps; Surgical Wound Infection; Therapeutic Irrigation; Tongue; Tooth Extraction; Tooth, Impacted; Wound Closure Techniques; Young Adult
PubMed: 32712962
DOI: 10.1002/14651858.CD004345.pub3 -
Periodontology 2000 Feb 2024Three years into the coronavirus disease 2019 (COVID-19) pandemic, there are still growing concerns with the emergence of different variants, unknown long- and... (Meta-Analysis)
Meta-Analysis
Three years into the coronavirus disease 2019 (COVID-19) pandemic, there are still growing concerns with the emergence of different variants, unknown long- and short-term effects of the virus, and potential biological mechanisms underlying etiopathogenesis and increased risk for morbidity and mortality. The role of the microbiome in human physiology and the initiation and progression of several oral and systemic diseases have been actively studied in the past decade. With the proof of viral transmission, carriage, and a potential role in etiopathogenesis, saliva and the oral environment have been a focus of COVID-19 research beyond diagnostic purposes. The oral environment hosts diverse microbial communities and contributes to human oral and systemic health. Several investigations have identified disruptions in the oral microbiome in COVID-19 patients. However, all these studies are cross-sectional in nature and present heterogeneity in study design, techniques, and analysis. Therefore, in this undertaking, we (a) systematically reviewed the current literature associating COVID-19 with changes in the microbiome; (b) performed a re-analysis of publicly available data as a means to standardize the analysis, and (c) reported alterations in the microbial characteristics in COVID-19 patients compared to negative controls. Overall, we identified that COVID-19 is associated with oral microbial dysbiosis with significant reduction in diversity. However, alterations in specific bacterial members differed across the study. Re-analysis from our pipeline shed light on Neisseria as the potential key microbial member associated with COVID-19.
Topics: Humans; COVID-19; Dysbiosis; Microbiota; Mouth; Oropharynx; Saliva; SARS-CoV-2
PubMed: 37277934
DOI: 10.1111/prd.12489 -
American Journal of Orthodontics and... Nov 2016The emphasis on dental esthetics has increased in recent years. There are, however, differences in esthetic perceptions among professional and lay groups. The aim of... (Review)
Review
INTRODUCTION
The emphasis on dental esthetics has increased in recent years. There are, however, differences in esthetic perceptions among professional and lay groups. The aim of this comprehensive review was to update previous reviews and answer the following research question: Can lay thresholds for acceptance of smile esthetic anomalies be defined?
METHODS
A systematic search in the medical literature (PubMed, PMC, NLM, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACs) was performed to identify all peer-reviewed articles reporting data regarding evaluations of laypeople's perceptions of dental esthetic factors.
RESULTS
Of the 6032 analyzed articles, 66 studies were selected for the final review process. Among the selected articles investigated perceptions of diastema, 15 analyzed modifications in tooth size and shape, 8 considered incisor positions, 15 evaluated midline discrepancies, 16 investigated buccal corridors, 26 analyzed gingival display and design, 3 considered lip height, and 20 investigated miscellaneous factors. Threshold values were identified for the following features: diastema (0-2 mm), tooth size and shape of incisor position, midline discrepancy (0-3 mm), buccal corridors (5-16 mm), gingival exposure (1.5-4 mm), occlusal canting (0°-4°), and overbite (2-5 mm). Furthermore, few other smile characteristics were found to be significantly associated with perception of smile aesthetics, even though any threshold could be detected.
CONCLUSIONS
On the basis of the obtained results, threshold values for the main features of smile and dental esthetics could be identified. Limitations of the present study were the heterogeneity of data which made it impossible to perform a meta-analysis, and the lack of information about sample selection and selective outcome reporting.
Topics: Attitude to Health; Esthetics, Dental; Facial Expression; Humans; Mouth; Tooth
PubMed: 27871700
DOI: 10.1016/j.ajodo.2016.06.022 -
Head & Neck Aug 2020The submental island flap (SMIF) is frequently utilized as an alternative to free tissue transfer (FTT) in oral cavity reconstruction. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The submental island flap (SMIF) is frequently utilized as an alternative to free tissue transfer (FTT) in oral cavity reconstruction.
METHODS
Studies directly comparing SMIF and FTT for oral cavity defects were included. Data were pooled with random-effects meta-analysis to calculate standardized mean differences and risk differences. Heterogeneity was evaluated with the I statistic.
RESULTS
Five studies were included in the analysis. The aggregate sample sizes for SMIF and FTT cohorts were 122 and 127, respectively. SMIF was correlated with both reduced operative time and hospitalization by a large effect size. The rate of total flap loss was comparable. SMIF was associated with lower donor site morbidity. There was no difference in the rate of disease recurrence between the two procedures.
CONCLUSIONS
SMIF is associated with less operative time, shorter hospitalization, fewer perioperative complications, and potentially similar disease recurrence rates compared to FTT for the reconstruction of oral cavity defects.
Topics: Free Tissue Flaps; Humans; Mouth Neoplasms; Neoplasm Recurrence, Local; Plastic Surgery Procedures; Retrospective Studies
PubMed: 32092220
DOI: 10.1002/hed.26121