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International Journal of Environmental... Oct 2022In this review, we evaluated the clinical efficacy of interventions used for the treatment of endo-perio lesions (EPL). (Review)
Review
BACKGROUND
In this review, we evaluated the clinical efficacy of interventions used for the treatment of endo-perio lesions (EPL).
METHODS
A systematic scoping review of clinical trials was developed.
RESULTS
Seven clinical trials were studied. In at least one study group of six of the seven evaluated trials, endodontic and periodontal treatments were performed simultaneously. All trials showed improvement in probing depth in the studied groups; nevertheless, the experimental groups of five studies demonstrated a statistically significant reduction in this parameter. An increase in clinical attachment level was also reported ( < 0.05). Most trials reported an increase in the filling of the bone defect following therapy ( < 0.05). Mechanical periodontal therapy implemented simultaneously with endodontic therapy demonstrated efficacy in the treatment of concurrent EPL without communication. Endodontic treatment and immediate periodontal surgery did not affect the result of the management of combined EPL with apical communication. The use of diode laser, the management of platelet-rich fibrin (PRF) and titanium-prepared PRF, and the implementation of bone grafts plus endodontic treatment with mineral-trioxide or gutta-percha seems to be an adequate strategy in patients with EPL.
CONCLUSIONS
The treatment of EPL using simultaneous endodontic and periodontal therapies seems to be an acceptable treatment alternative.
Topics: Humans; Gutta-Percha; Titanium; Treatment Outcome
PubMed: 36294232
DOI: 10.3390/ijerph192013649 -
Journal of Prosthodontics : Official... Jun 2022To systematically review past studies to determine the effect of various solutions on the color of denture teeth, thus answering the question in regards to which type of... (Review)
Review
PURPOSE
To systematically review past studies to determine the effect of various solutions on the color of denture teeth, thus answering the question in regards to which type of denture teeth has the best optical properties after exposure to various solutions. The method of measuring the color of artificial teeth was also evaluated as a secondary outcome.
MATERIALS AND METHODS
A search of studies that quantitatively investigated the influence of immersion solutions on the color change of denture teeth was conducted. Ovid MEDLINE, PubMed and Scopus databases were searched from 1997 to April 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used during article selection. Data regarding the effect of immersion solutions, accelerated aging and surface treatments on color change were gathered. Methodologies used to assess optical properties were also summarized and compared. The modified CONSORT checklist was used to determine the risk of bias of past studied included in this review.
RESULTS
One hundred thirty-three studies were identified after removing duplicates. Forty-one studies were selected for full-text analysis, and 35 remaining papers met the inclusion criteria and were therefore included in this systematic review. Thirty-two in vitro studies and 3 in vivo studies were included in the review. All studies reported that immersion in various solutions has a significant influence on the change in color and optical properties of denture teeth. However, the discoloration of denture teeth is still clinically acceptable in most studies. Exposure to various solutions also affected the translucency parameter of denture teeth. Most studies also investigated the surface roughness and hardness along with the optical properties, and reported that immersion cycles did not cause changes in surface roughness of denture teeth, while hardness was affected. The optical properties of PMMA denture teeth have been studied extensively, whereas that of CAD/CAM and 3D printed denture teeth is limited.
CONCLUSIONS
Color stability of CAD/CAM milled denture teeth is comparable to conventional PMMA denture teeth. There are contradictory findings in terms of color stability of 3D printed denture teeth as compared to conventional PMMA denture teeth. Staining by coffee is worst among the common beverages and solutions investigated. Denture teeth can show color changes after immersion in staining beverages as early as one week. The degree of discoloration of denture teeth after immersion is time dependent, with the larger extent in the initial phase.
Topics: Acrylic Resins; Color; Materials Testing; Polymethyl Methacrylate; Surface Properties
PubMed: 34516027
DOI: 10.1111/jopr.13429 -
Journal of Pharmacy Practice Feb 2018Patients at the highest risk of hyperkalemia are those with chronic kidney disease (CKD) stages 3 and 4. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Patients at the highest risk of hyperkalemia are those with chronic kidney disease (CKD) stages 3 and 4.
OBJECTIVE
To evaluate the efficacy and safety of patiromer in hyperkalemia in patients with heart failure or CKD.
METHODS
The Cochrane Renal Group's Specialized Register was searched through contact with the Trials' Search Coordinator. We aimed at including randomized controlled trials with patiromer in patients with developed or risks of developing hyperkalemia, comparing against an active comparator or placebo. Three studies matched our inclusion and exclusion criteria, which we included in the meta-analysis. All-cause mortality, reduction in hospitalization, episodes of hypokalemia or hyperkalemia, and cardiovascular and gastrointestinal adverse events during the treatment period were our primary outcomes. Serial change in serum potassium (K) until end of treatment or follow-up during the trial period and all other reported adverse reactions during the treatment period were our secondary outcomes. Meta-analysis (RevMan version 5.3.5) and descriptive statistics were used.
RESULTS
There was a non-significant improvement in all-cause mortality and serious cardiovascular events with patiromer than placebo. Hospitalization data were unavailable. Although serious gastrointestinal events were more common with placebo, there was a significant reduction ( P = .02) in the risk of non-serious gastrointestinal events with placebo. Patiromer lowered serum K more than placebo, and there were more patients developing hyperkalemia with placebo. High-dose patiromer was associated with better efficacy in some parameters but with more adverse events.
CONCLUSION
Although patiromer seems promising, more trials with active comparator are essential to finalize its indication and use in hyperkalemia.
Topics: Humans; Hyperkalemia; Polymers; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 28402156
DOI: 10.1177/0897190017692921 -
Dental Materials : Official Publication... May 2022The present review is an update of a systematic review that has been published in 2012. Meanwhile, many new clinical trials on resin composites had been published. New... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The present review is an update of a systematic review that has been published in 2012. Meanwhile, many new clinical trials on resin composites had been published. New materials such as bulk fill resin composites and new glass-ionomer (GIC) based materials had been introduced. The focus of this review was to evaluate the longevity in relation to the material class and adhesive class, while adjusting for a possible study bias effect.
MATERIAL AND METHODS
The database PUBMED/SCOPUS were searched for clinical trials on posterior resin composites. The inclusion criteria were: (1) studies published between 2000 and 2019, (2) prospective clinical trial with at least 2 years of observation; (2) minimal number of restorations at last recall = 20; (3) report on drop-out rate; (4) report of operative technique and used materials; (5) utilisation of Ryge, modified Ryge or FDI evaluation criteria. The bias of each study was assessed by two independent reviewers using Cochrane Collaboration's tool for assessing risk of bias in randomised trials. For the statistical analysis, linear mixed models fitted on the individual data recorded along time have been used with random effects to account for study, patients and experiment effects. P-values smaller than 0.05 were considered significant.
RESULTS
Of the 423 clinical trials, 62 studies (including 110 experiments) met the inclusion criteria. Material class was divided according to the composite filler in microhybrid (39 experiments/2807 restorations), nanohybrid (24 experiments/1254 restorations), and hybrid (22 experiments/1255 restorations). So-called bulk fill materials were treated as a separate category (9 experiments/506 restorations) as were the GIC (11 experiments/2121 restorations) and the compomer materials (5 experiments/238 restorations). Only one study (1.6%) had low risk of bias, 42 (67.7%) were assessed to have unclear risk of bias and 19 (30.6%) had a high risk of bias. In 52.3% of the studies Class II and Class I restorations had been placed. After 10 years, the survival rate for resin composite restorations dropped to about 85-90% with no significant difference between hybrid, microhybrid and nao-hybrid resin materials. The main reasons for restoration replacement were bulk fractures and wear, which accounted for a about 70% of replacements. Caries at the restorative margins accounted for about 20% of the replacements, and retention loss, inacceptable colour match or marginal integrity, endodontic treatment or cusp fracture for about 10% of the replacements of the resin composite restorations. For compomer and GIC restorations the mean overall survival rate was about 80% after 6 years. For GIC, the main reasons for failure were substantial loss of anatomical contour along with loss of proximal contacts and retention loss. Mainly fractures reduced the longevity of compomers restorations. Also, there was no statistically significant difference between hybrid, micro-hybrid, nano-hybrid and bulk fill resin composites with regard to colour match, surface texture, material fractures, and anatomical form.
CONCLUSIONS
Posterior resin composite restorations that were placed with the enamel etch technique showed the best overall performance; the longevity was not significantly influenced by the filler type or viscosity of resin composite material. With regard to colour match, surface texture and anatomical form, nanohybrid resins were not significantly superior to hybrid or microhybrid resin composites. Compomer and GIC restorations demonstrated considerable shortcomings and had a significant shorter longevity.
Topics: Compomers; Composite Resins; Dental Caries; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Prospective Studies; Treatment Outcome
PubMed: 35221127
DOI: 10.1016/j.dental.2021.10.018 -
Frontiers in Public Health 2023Micro/nano-plastics (MNPs) are considered a heterogeneous class of environmental contaminants that cause multiple toxic effects on biological species. As the commonly... (Meta-Analysis)
Meta-Analysis
Micro/nano-plastics (MNPs) are considered a heterogeneous class of environmental contaminants that cause multiple toxic effects on biological species. As the commonly used mammalian models to study the effects of MNPs with regard to their toxic effects, the mouse and rat models are making a great contribution to the disciplines of environmental toxicology and medical health. However, the toxic effects of MNPs have not been systematically summarized. Therefore, a systematic review and a meta-analysis of the toxic effects of MNPs on mouse/rat models were conducted. A total of seven main categories were established in this systematic review, and 24 subcategories were further divided according to the specific physiological significance of the endpoint or the classification of the physiological system, which covered all the selected pieces of literature. A total of 1,762 biological endpoints were found, and 52.78% of them were significantly affected. This fact indicates that there are relative factors, including the size, polymer type, concentration, and exposure time of MNPs and different sexes of mouse/rat models that could significantly affect the biological endpoints. These biological endpoints can be classified into various factors, such as the dose-response relationships between MNP concentration and physiological categories of the nervous system, growth, reproduction, digestive tract histopathology, and inflammatory cytokine level, among others. MNPs negatively affected the blood glucose metabolism, lipid metabolism, and reproductive function in mice. The reproductive function in male mice is more sensitive to the toxic effects of MNPs. These findings also provide insights into and directions for exploring the evidence and mechanisms of the toxic effects of MNPs on human health. It is clear that more research is required on the pathological mechanisms at the molecular level and the long-term effects of tissue accumulation.
Topics: Rats; Mice; Male; Humans; Animals; Plastics; Microplastics; Mammals
PubMed: 37275491
DOI: 10.3389/fpubh.2023.1103289 -
Clinical Oral Implants Research Sep 2023To compare and report on the performance of implant-supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing. (Review)
Review
AIM
To compare and report on the performance of implant-supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing.
METHODS
An electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies).
RESULTS
Of 2'184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta-analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin-modified ceramics and different types of polymer-based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results.
CONCLUSION
Despite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated.
Topics: Humans; Prospective Studies; Retrospective Studies; Dental Implants; Ceramics; Polymers
PubMed: 37750533
DOI: 10.1111/clr.14085 -
Current Environmental Health Reports Jun 2023Despite increasing awareness of the ubiquity of microplastics (MPs) in our environments, little is known about their risk of developmental toxicity. Even less is known... (Review)
Review
PURPOSE OF REVIEW
Despite increasing awareness of the ubiquity of microplastics (MPs) in our environments, little is known about their risk of developmental toxicity. Even less is known about the environmental distribution and associated toxicity of nanoplastics (NPs). Here, we review the current literature on the capacity for MPs and NPs to be transported across the placental barrier and the potential to exert toxicity on the developing fetus.
RECENT FINDINGS
This review includes 11 research articles covering in vitro, in vivo, and ex vivo models, and observational studies. The current literature confirms the placental translocation of MPs and NPs, depending on physicochemical properties such as size, charge, and chemical modification as well as protein corona formation. Specific transport mechanisms for translocation remain unclear. There is emerging evidence of placental and fetal toxicity due to plastic particles based on animal and in vitro studies. Nine out of eleven studies examined in this review found that plastic particles were capable of placental translocation. In the future, more studies are needed to confirm and quantify the existence of MPs and NPs in human placentas. Additionally, translocation of different plastic particle types and heterogenous mixtures across the placenta, exposure at different periods of gestation, and associations with adverse birth and other developmental outcomes should also be investigated.
Topics: Animals; Pregnancy; Female; Humans; Placenta; Plastics; Microplastics; Water Pollutants, Chemical
PubMed: 36848019
DOI: 10.1007/s40572-023-00391-x -
Applied Radiation and Isotopes :... Jan 2019Radiotherapy has rapidly improved because of the use of new equipment and techniques. Hence, the appeal for a feasible and accurate three-dimensional (3D) dosimetry... (Meta-Analysis)
Meta-Analysis Review
Radiotherapy has rapidly improved because of the use of new equipment and techniques. Hence, the appeal for a feasible and accurate three-dimensional (3D) dosimetry system has increased. In this regard, gel dosimetry systems are accurate 3D dosimeters with high resolution. This systematic review evaluates the clinical applications of polymer gel dosimeters in radiotherapy. To find the clinical applications of polymer gel dosimeters in radiotherapy, a full systematic literature search was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in electronic databases up to January 31, 2017, with use of search-related terms in the titles and abstracts of articles. A total of 765 articles were screened in accordance with our inclusion and exclusion criteria. Eventually, 53 articles were included in the study. The findings show that most clinical applications of polymer gel dosimeters relate to external radiotherapy. Most of the gel dosimeters studied have acceptable dose accuracy as a 3D dosimeter with high resolution. It is difficult to judge which is the best polymer gel dosimeter to use in a clinical setting, because each gel dosimeter has advantages and limitations. For example, methacrylic acid-based gel dosimeters have high dose sensitivity and low toxicity, while their dose response is beam energy dependent; in contrast, N-isopropylacrylamide gel dosimeters have low dose resolution, but their sensitivity is lower and they are relatively toxic.
Topics: Boron Neutron Capture Therapy; Brachytherapy; Gels; Humans; Imaging, Three-Dimensional; Polymers; Radiation Dosimeters; Radiotherapy Dosage; Reproducibility of Results
PubMed: 30390500
DOI: 10.1016/j.apradiso.2018.08.018 -
The Science of the Total Environment Dec 2022This systematic review aims to summarize the current knowledge on biological effects of micro- and nanoplastics (MNPs) on human health based on mammalian systems. An...
This systematic review aims to summarize the current knowledge on biological effects of micro- and nanoplastics (MNPs) on human health based on mammalian systems. An extensive search of the literature led to a total of 133 primary research articles on the health relevance of MNPs. Our findings revealed that although the study of MNP cytotoxicity and inflammatory response represents a major research theme, most studies (105 articles) focused on the effects of polystyrene MNPs due to their wide availability as a well characterised research material that can be manufactured with a large range of particle sizes, fluorescence labelling as well as various surface modifications. Among the 133 studies covered in this review, 117 articles reported adverse health effects after being exposed to MNPs. Mammalian in vitro studies identified multiple biological effects including cytotoxicity, oxidative stress, inflammatory response, genotoxicity, embryotoxicity, hepatotoxicity, neurotoxicity, renal toxicity and even carcinogenicity, while rodent in vivo models confirmed the bioaccumulation of MNPs in the liver, spleen, kidney, brain, lung and gut, presenting adverse effects at different levels including reproductive toxic effects and trans-generational toxicity. In contrast, the remaining 16 studies indicated an insignificant impact of MNPs on humans. A few studies attempted to investigate the mechanisms or factors driving the toxicity of MNPs and identified several determining factors including size, concentration, shape, surface charge, attached pollutants and weathering process, which, however, were not benchmarked or considered by most studies. This review demonstrates that there are still many inconsistencies in the evaluation of the potential health effects of MNPs due to the lack of comparability between studies. Current limitations hindering the attainment of reproducible conclusions as well as recommendations for future research directions are also presented.
Topics: Animals; Humans; Environmental Pollutants; Mammals; Microplastics; Particle Size; Plastics; Polystyrenes
PubMed: 35987230
DOI: 10.1016/j.scitotenv.2022.158111 -
Environmental Pollution (Barking, Essex... Jan 2021Microplastics receive significant societal and scientific attention due to increasing concerns about their impact on the environment and human health. Marine mammals are...
Microplastics receive significant societal and scientific attention due to increasing concerns about their impact on the environment and human health. Marine mammals are considered indicators for marine ecosystem health and many species are of conservation concern due to a multitude of anthropogenic stressors. Marine mammals may be vulnerable to microplastic exposure from the environment, via direct ingestion from sea water, and indirect uptake from their prey. Here we present the first systematic review of literature on microplastics and marine mammals, composing of 30 studies in total. The majority of studies examined the gastrointestinal tracts of beached, bycaught or hunted cetaceans and pinnipeds, and found that microplastics were present in all but one study, and the abundance varied between 0 and 88 particles per animal. Additionally, microplastics in pinniped scats (faeces) were detected in eight out of ten studies, with incidences ranging from 0% of animals to 100%. Our review highlights considerable methodological and reporting deficiencies and differences among papers, making comparisons and extrapolation across studies difficult. We suggest best practices to avoid these issues in future studies. In addition to empirical studies that quantified microplastics in animals and scat, ten studies out of 30 (all focussing on cetaceans) tried to estimate the risk of exposure using two main approaches; i) overlaying microplastic in the environment (water or prey) with cetacean habitat or ii) proposing biological or chemical biomarkers of exposure. We discuss advice and best practices on research into the exposure and impact of microplastics in marine mammals. This work on marine ecosystem health indicator species will provide valuable and comparable information in the future.
Topics: Animals; Caniformia; Ecosystem; Environmental Monitoring; Humans; Microplastics; Plastics; Water Pollutants, Chemical
PubMed: 33288297
DOI: 10.1016/j.envpol.2020.116142