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Dental and Medical Problems 2020Burning mouth syndrome (BMS) is idiopathic chronic oral pain, associated with depression, anxiety and pain symptoms. The BMS symptoms include a burning sensation in the...
Burning mouth syndrome (BMS) is idiopathic chronic oral pain, associated with depression, anxiety and pain symptoms. The BMS symptoms include a burning sensation in the tongue and/or other oral mucosa with no underlying medical or dental reasons. As many BMS patients suffer from psychiatric comorbidities, several psychotropic drugs are included in the management of BMS, reducing the complaint, while managing anxiety, depression and pain disorders. In this review, a search of the published literature regarding the management of BMS was conducted. We discuss the BMS etiology, clinically associated symptoms and available treatment options. The current evidence supports some BMS interventions, including alpha-lipoic acid (ALA), clonazepam, capsaicin, and low-level laser therapy (LLLT); however, there is a lack of robust scientific evidence, and large-scale clinical trials with long follow-up periods are needed to establish the role of these BMS management options. This knowledge could raise the awareness of dentists, psychiatrists and general practitioners about these challenges and the available kinds of treatment to improve multidisciplinary management for better health outcomes.
Topics: Burning Mouth Syndrome; Capsaicin; Clonazepam; Humans; Low-Level Light Therapy; Pain
PubMed: 33113291
DOI: 10.17219/dmp/120991 -
JAMA Sep 2011Although technology-enhanced simulation has widespread appeal, its effectiveness remains uncertain. A comprehensive synthesis of evidence may inform the use of... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Although technology-enhanced simulation has widespread appeal, its effectiveness remains uncertain. A comprehensive synthesis of evidence may inform the use of simulation in health professions education.
OBJECTIVE
To summarize the outcomes of technology-enhanced simulation training for health professions learners in comparison with no intervention.
DATA SOURCE
Systematic search of MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011.
STUDY SELECTION
Original research in any language evaluating simulation compared with no intervention for training practicing and student physicians, nurses, dentists, and other health care professionals.
DATA EXTRACTION
Reviewers working in duplicate evaluated quality and abstracted information on learners, instructional design (curricular integration, distributing training over multiple days, feedback, mastery learning, and repetitive practice), and outcomes. We coded skills (performance in a test setting) separately for time, process, and product measures, and similarly classified patient care behaviors.
DATA SYNTHESIS
From a pool of 10,903 articles, we identified 609 eligible studies enrolling 35,226 trainees. Of these, 137 were randomized studies, 67 were nonrandomized studies with 2 or more groups, and 405 used a single-group pretest-posttest design. We pooled effect sizes using random effects. Heterogeneity was large (I(2)>50%) in all main analyses. In comparison with no intervention, pooled effect sizes were 1.20 (95% CI, 1.04-1.35) for knowledge outcomes (n = 118 studies), 1.14 (95% CI, 1.03-1.25) for time skills (n = 210), 1.09 (95% CI, 1.03-1.16) for process skills (n = 426), 1.18 (95% CI, 0.98-1.37) for product skills (n = 54), 0.79 (95% CI, 0.47-1.10) for time behaviors (n = 20), 0.81 (95% CI, 0.66-0.96) for other behaviors (n = 50), and 0.50 (95% CI, 0.34-0.66) for direct effects on patients (n = 32). Subgroup analyses revealed no consistent statistically significant interactions between simulation training and instructional design features or study quality.
CONCLUSION
In comparison with no intervention, technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviors and moderate effects for patient-related outcomes.
Topics: Computer Simulation; Computer-Assisted Instruction; Education, Medical; Education, Professional; Health Personnel; Humans
PubMed: 21900138
DOI: 10.1001/jama.2011.1234 -
Dental Materials : Official Publication... Jan 2023This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations. (Review)
Review
OBJECTIVES
This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations.
METHODS
A systematic search was performed in PubMed, Scopus, and Web of Science databases for articles reporting data from primary longitudinal clinical studies on composite longevity published 2011-2021. Prospective or retrospective studies with restorations in permanent dentition, with follow-up periods of at least 5 years were included.
RESULTS
In total, 33 articles were included with different study designs, practice settings, datasets, countries of origin, and sample sizes. Annual failure rates of restorations ranged from 0.08% to 6.3%. Survival rates varied between 23% and 97.7%, success rates varied between 43.4% and 98.7%. Secondary caries, fractures, and esthetic compromise were main reasons for failures. Risk factors for reduced restoration durability included patient-level factors (e.g., caries risk, parafunctional habits, number of check-ups per year, socioeconomic status), dentist factors (different operators, operator's experience), and tooth/restoration factors (endodontic treatment, type of tooth, number of restored surfaces). Patient gender and the composite used generally did not influence durability.
SIGNIFICANCE
A number of risk factors are involved in the longevity of composite restorations. Differences between composites play a minor role in durability, assuming that materials and techniques are properly applied by dentists. Patient factors play a major role in longevity. The decision-making process implemented by dentists relative to the diagnosis of aging or failed restorations may also affect the longevity of restorations. Clinicians should treat patients comprehensively and promote a healthy lifestyle to ensure longevity.
Topics: Humans; Composite Resins; Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent
PubMed: 36494241
DOI: 10.1016/j.dental.2022.11.009 -
Journal of Dentistry Jul 2022Detecting caries lesions is challenging for dentists, and deep learning models may help practitioners to increase accuracy and reliability. We aimed to systematically... (Review)
Review
OBJECTIVES
Detecting caries lesions is challenging for dentists, and deep learning models may help practitioners to increase accuracy and reliability. We aimed to systematically review deep learning studies on caries detection.
DATA
We selected diagnostic accuracy studies that used deep learning models on dental imagery (including radiographs, photographs, optical coherence tomography images, near-infrared light transillumination images). The latest version of the quality assessment tool for diagnostic accuracy studies (QUADAS-2) tool was used for risk of bias assessment. Meta-analysis was not performed due to heterogeneity in the studies methods and their performance measurements.
SOURCES
Databases (Medline via PubMed, Google Scholar, Scopus, Embase) and a repository (ArXiv) were screened for publications published after 2010, without any limitation on language.
STUDY SELECTION
From 252 potentially eligible references, 48 studies were assessed full-text and 42 included, using classification (n = 26), object detection (n = 6), or segmentation models (n = 10). A wide range of performance metrics was used; image, object or pixel accuracy ranged between 68%-99%. The minority of studies (n = 11) showed a low risk of biases in all domains, and 13 studies (31.0%) low risk for concerns regarding applicability. The accuracy of caries classification models varied, i.e. 71% to 96% on intra-oral photographs, 82% to 99.2% on peri-apical radiographs, 87.6% to 95.4% on bitewing radiographs, 68.0% to 78.0% on near-infrared transillumination images, 88.7% to 95.2% on optical coherence tomography images, and 86.1% to 96.1% on panoramic radiographs. Pooled diagnostic odds ratios varied from 2.27 to 32,767. For detection and segmentation models, heterogeneity in reporting did not allow useful pooling.
CONCLUSION
An increasing number of studies investigated caries detection using deep learning, with a diverse types of architectures being employed. Reported accuracy seems promising, while study and reporting quality are currently low.
CLINICAL SIGNIFICANCE
Deep learning models can be considered as an assistant for decisions regarding the presence or absence of carious lesions.
Topics: Deep Learning; Dental Caries; Dental Caries Susceptibility; Humans; Reproducibility of Results; Sensitivity and Specificity
PubMed: 35367318
DOI: 10.1016/j.jdent.2022.104115 -
BMJ Open Feb 2017Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated the risk of complications after single-visit or multiple-visit root canal treatment using meta-analysis and trial-sequential analysis.
DATA
Controlled trials comparing single-visit versus multiple-visit root canal treatment of permanent teeth were included. Trials needed to assess the risk of long-term complications (pain, infection, new/persisting/increasing periapical lesions ≥1 year after treatment), short-term pain or flare-up (acute exacerbation of initiation or continuation of root canal treatment).
SOURCES
Electronic databases (PubMed, EMBASE, Cochrane Central) were screened, random-effects meta-analyses performed and trial-sequential analysis used to control for risk of random errors. Evidence was graded according to GRADE.
STUDY SELECTION
29 trials (4341 patients) were included, all but 6 showing high risk of bias. Based on 10 trials (1257 teeth), risk of complications was not significantly different in single-visit versus multiple-visit treatment (risk ratio (RR) 1.00 (95% CI 0.75 to 1.35); weak evidence). Based on 20 studies (3008 teeth), risk of pain did not significantly differ between treatments (RR 0.99 (95% CI 0.76 to 1.30); moderate evidence). Risk of flare-up was recorded by 8 studies (1110 teeth) and was significantly higher after single-visit versus multiple-visit treatment (RR 2.13 (95% CI 1.16 to 3.89); very weak evidence). Trial-sequential analysis revealed that firm evidence for benefit, harm or futility was not reached for any of the outcomes.
CONCLUSIONS
There is insufficient evidence to rule out whether important differences between both strategies exist.
CLINICAL SIGNIFICANCE
Dentists can provide root canal treatment in 1 or multiple visits. Given the possibly increased risk of flare-ups, multiple-visit treatment might be preferred for certain teeth (eg, those with periapical lesions).
Topics: Humans; Office Visits; Pain, Postoperative; Randomized Controlled Trials as Topic; Root Canal Therapy; Symptom Flare Up
PubMed: 28148534
DOI: 10.1136/bmjopen-2016-013115 -
European Journal of Paediatric Dentistry Jun 2019The use of antibiotics by health care professionals has benefitted humankind to a great extent. Recent reports show an increasing trend of antibiotic prescription by...
AIM
The use of antibiotics by health care professionals has benefitted humankind to a great extent. Recent reports show an increasing trend of antibiotic prescription by paediatric dentists. This systematic review aims to address the current pattern of antibiotics prescription among the paediatric dental population according to the evidence-based literature. The question of research addressed here deals with the assessment of the correlation of the injudicious prescription of antibacterial agents and antibiotic resistance among the population of interest.
METHODS
Electronic search databases: PubMed, Ovid and Cochrane Library, were used to review studies as per their relevance and findings. Keywords for search were associated with population: 'paediatric patients', intervention: 'antibiotics treatment', 'prescribing behaviour', and outcomes: 'antibiotic resistance' RESULTS: A total of 542 abstracts were identified, 45 of which met the inclusion criteria and were reviewed. A multifactorial relationship leading to increased prescription of antibiotics in paediatric dentistry was observed. Very few studies actually correlated this prescribing behaviour with resistance to these drugs. No consensus regarding the duration of antibiotic therapy or prophylaxis was found.
CONCLUSION
Insufficient literature support necessitates the requirement of increased evidence to draw a definitive association between the prescribing trends of antibiotics in paediatric dentistry and drug resistance. The development of intervention programmes like antibiotic stewardship ensuring collaboration between patients and paediatric dentists can ensure effective antibiotic prescription.
Topics: Anti-Bacterial Agents; Child; Dentists; Humans; Pediatric Dentistry
PubMed: 31246090
DOI: 10.23804/ejpd.2019.20.02.10 -
Oral Health & Preventive Dentistry Oct 2020Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this...
PURPOSE
Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this systematic review is to identify and assess the quality of evidence of the effectiveness of manual toothbrushing techniques in the existing literature.
METHODS
A broad search was conducted on the electronic databases Medline via Ovid, PubMed and EBSCO Dentistry & Oral Sciences. Included studies examined manual toothbrushing technique efficiency. Articles were assessed utilising the Cochrane Collaboration's tool for assessing risk of bias. Thirteen studies met the inclusion criteria and were included in this review. These included five randomised controlled trials (RCT), seven experimental non-randomised control studies and one in vitro study.
RESULTS
Of the 3190 articles identified, 40 were relevant to manual toothbrushing and 13 were included in the final review. Studies indicating statistically significantly superior plaque removal for a given technique were Bass (one), modified Bass (one), Charter's (two), Fones (two), scrub (two), roll (one), modified Stillman (one), toothpick method (one). Four studies exhibited no statistically significant difference in effectiveness of plaque removal. Unfortunately, considerable variation was found between studies, making a definitive conclusion impossible in terms of an ideal manual toothbrushing technique that would promote plaque removal and reduce gingivitis.
CONCLUSION
There is still insufficient evidence for suggesting that one toothbrushing method is more effective than another in plaque removal and reduction of gingivitis. Excessive variability in many aspects of the design and methodology of the selected studies hinder conclusions on an ideal manual toothbrushing technique. Experimental randomised controlled trials that follow the CONSORT guidelines are required to provide adequate-quality evidence and make any definitive conclusions on the relative effectiveness of manual toothbrushing techniques.
Topics: Dental Care; Dental Plaque; Gingivitis; Humans; Oral Health; Toothbrushing
PubMed: 33028052
DOI: 10.3290/j.ohpd.a45354 -
Journal of Clinical Periodontology Jun 2023To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in... (Review)
Review
Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe).
AIM
To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non-communicable diseases (NCDs) and promoting healthy lifestyles.
MATERIALS AND METHODS
The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings.
RESULTS
Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID-19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors.
CONCLUSIONS
Closer collaboration between OHPs and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated.
Topics: Humans; Consensus; Cardiovascular Diseases; COVID-19; Periodontal Diseases; Periodontitis; Respiratory Tract Diseases; Europe; Diabetes Mellitus
PubMed: 36935200
DOI: 10.1111/jcpe.13807 -
The Journal of Evidence-based Dental... Jun 2021Coronary disease and Hypertension are highly prevalent health problems worldwide, with the latter being one of the most common diseases in patients visiting dental... (Review)
Review
BACKGROUND
Coronary disease and Hypertension are highly prevalent health problems worldwide, with the latter being one of the most common diseases in patients visiting dental clinics. Local anesthetics (LAs) with vasoconstrictor agents (VC) are known to be commonly used in dental practice. For the above-mentioned reasons, dentists should know how to adapt and treat patients with these hazardous conditions.
OBJECTIVE
The aim of this study was to find out if the use of local anesthetics (LAs) in combination with vasoconstrictor (VC) agents in dental treatment presents a risk in patient with a known history of Hypertension and/or Coronary disease.
MATERIALS AND METHODS
This systematic review was conducted in accordance with The PRISMA guidelines and registered on the PROSPERO database (CRD42020187369). The search strategy was based on Mesh terms, Boolean operator AND, and the PICO model. It was designed to identify all the randomized clinical trials (RCTs) published in the last 30 years, which assessed whether the use of LA with VC agents in dental treatment produces a significant increase/decrease in hemodynamics in patients with known history of Hypertension and/or Coronary disease. The Cochrane Collaboration's tool was used to assess risk of bias of the included RCTs.
RESULTS
An initial electronic search resulted in 87 papers; however only 9 RCTs met the inclusion criteria. There was a total of 482 subjects (N = 482), of which 412 had a known history of Hypertension or Coronary disease.
CONCLUSIONS
According to the literature reviewed, the use of 1 to 2 cartridges of local anesthetics with 1:80,000, 1:100,000 or 1:200,000 epinephrine in patients with controlled Hypertension and/ or Coronary disease is safe. Randomized clinical trials are essential in determining the safety or risks associated with the use of LAs with VC agents in patients with poorly controlled Hypertension and Coronary disease.
Topics: Anesthetics, Local; Coronary Artery Disease; Dental Care; Humans; Hypertension; Vasoconstrictor Agents
PubMed: 34391560
DOI: 10.1016/j.jebdp.2021.101569 -
International Journal of Dental Hygiene Nov 2018Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk... (Review)
Review
OBJECTIVES
Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk factors. Proper seat selection and use of magnification loupes are promoted for their ergonomic benefits. The aim of this review was to evaluate the existing empirical evidence on the effect of the above interventions on (i) correction of poor posture and (ii) reduction in musculoskeletal pain.
METHODS
The review was conducted according to the PRISMA guidelines. The review protocol was registered with PROSPERO (CRD42017058580). The Medline via Ovid, CINHAL via EBSCO, Web of Science, OpenGrey and EThOS electronic databases were searched. Prospective experimental studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies.
RESULTS
Eight studies were included in the review. Four investigated the effect of loupes on posture and musculoskeletal pain, 4 the effect of the saddle seats on posture and one of the latter explored the combined effect of magnification and use of saddle seats on posture.
CONCLUSIONS
Based on a limited number of studies, the use of ergonomic saddle seats and dental loupes leads to improved working postures. The use of loupes appears to relieve shoulder, arm and hand pain. However, their effect on neck pain is scarce. None of the studies reported on the effect of the saddle seats on musculoskeletal pain. Future well-powered prospective longitudinal studies are deemed necessary to confirm the conclusions of this review.
Topics: Dental Hygienists; Dentists; Ergonomics; Humans; Lenses; Musculoskeletal Diseases; Occupational Diseases; Posture; Risk Factors; Sitting Position
PubMed: 29318741
DOI: 10.1111/idh.12327