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Pediatric Dentistry Mar 2019The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of... (Meta-Analysis)
Meta-Analysis
The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of early childhood caries (ECC). Two reviewers searched various databases until January 2019. The Newcastle-Ottawa scale was used to perform risk of bias assessment. The included studies were categorized according to the World Bank classification. Data were summarized in a meta-analysis using fixed and random effects inverse-generic meta-analyses. A total of 7,034 records involving 89 studies that evaluated 1,352,097 individuals were included; 23 were high, 46 were moderate, and 20 were of low quality. A total of 123 risk factors were found. Meta-analysis revealed that the strongest risk factors found in the high-income countries were presence of dentinal caries (dmft greater than zero; odds ratio [OR] equals 4.21 [2.18 to 8.16]) and high levels of mutans streptococci (OR equals 3.83 [1.81 to 8.09]). In upper-middle-income countries, presence of enamel defects (OR equals 14.62 [6.10 to 35.03]) was found to be the strongest risk factor. The strongest risk factors associated with early childhood caries was the presence of enamel defects, presence of dentinal caries and high levels of mutans streptococci.
Topics: DMF Index; Dental Caries; Dental Enamel; Humans; Risk Factors; Streptococcus mutans
PubMed: 30992106
DOI: No ID Found -
BMC Oral Health Sep 2023The review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition.
METHODS
Longitudinal observational studies with at least 6 months follow-up and evaluating mutans streptococci presence in caries-free children under 6 years of age for the development of any cavitated or non-cavitated carious lesion. Six databases and grey literature were searched without any restrictions. Risk of bias was evaluated using the New Castle Ottawa scale for longitudinal studies, and the certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation using GRADEpro software. Meta-analysis was performed using a random effect (DerSimonian and Laird, DL) model, and heterogeneity was evaluated using tau-squared, I statistics and prediction interval. Sensitivity analysis was performed to assess the relationship between the mutans streptococci presence at baseline and the caries development, according to the sample and methods used for the microbiological assessment and the length of follow-up of the studies. Publication bias was checked by funnel plot using a random effect (DerSimonian and Laird, DL) model.
RESULTS
Twelve studies met the inclusion criteria and were included in the review. Four studies received a maximum of 9 stars, and among the remaining eight studies, six received 8 stars and the rest two studies were assigned 7 stars in the risk of bias scale. After pooling the results quantitatively, odds ratio (OR) was found to be 4.13 (95% CI: 3.33, 5.12), suggesting that children with mutans streptococci had 4 times higher odds of developing caries later (p < 0.001). Four studies were pooled to compare future caries experience among children with and without mutans streptococci at baseline, obtaining standardized mean difference (SMD) of 0.85 (95% CI: 0.33, 1.37), indicating a large effect (p < 0.001). Certainty of evidence was found to be moderate, and no publication bias was reported by the funnel plot criteria of symmetry.
CONCLUSIONS
Presence of mutans streptococci in a preschool child is a risk predictor for future caries experience. Early identification of children with increased caries-risk may facilitate in implementation of appropriate preventive strategies.
Topics: Humans; Child, Preschool; Dental Caries; Databases, Factual; Odds Ratio; Publication Bias; Software; Streptococcus mutans
PubMed: 37679718
DOI: 10.1186/s12903-023-03346-8 -
Clinical Oral Investigations Jul 2014Systematically review the available literature regarding the caries-preventive effect of probiotics. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Systematically review the available literature regarding the caries-preventive effect of probiotics.
DATA, SOURCES AND STUDY SELECTION
An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data.
RESULTS
Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (<10(5) CFU/ml) counts and significantly less patients had high (>10(6) CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (<10(4) CFU/ml) nor in high Lactobacillus (>10(6) CFU/ml) counts.
CONCLUSIONS
Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries.
CLINICAL RELEVANCE
There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts.
Topics: Adolescent; Adult; Aged; Child; Colony Count, Microbial; Humans; Lactobacillus; Middle Aged; Probiotics; Streptococcus mutans; Young Adult
PubMed: 24663813
DOI: 10.1007/s00784-014-1228-z -
Oral Health & Preventive Dentistry 2010The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on... (Review)
Review
PURPOSE
The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on the current quality of the literature regarding the relationship between early childhood caries (ECC) and these microorganisms.
MATERIALS AND METHODS
The authors searched PubMed, Scopus and Cochrane Library databases for papers from 1951 to 2007. The minimal inclusion requirements were assessment of preschool children reporting mutans streptococci counts, mainly in saliva and biofilm samples, and caries assessment. Since the heterogeneity of the studies did not allow a meta-analysis (chi(2) test), a qualitative analysis was conducted.
RESULTS
The electronic search yielded 120 articles, but only 16 scientific papers were critically appraised. Of the 16 scientific papers included in the review, only one cross-sectional study achieved a high value of evidence.
CONCLUSIONS
It was concluded that mutans streptococci levels are a strong risk indicator for ECC. However, further well designed longitudinal studies with high evidence values are required to confirm mutans streptococci levels as a significant ECC risk factor.
Topics: Chi-Square Distribution; Child, Preschool; Dental Caries; Dental Plaque; Humans; Infant; Risk Factors; Saliva; Streptococcus mutans
PubMed: 20480056
DOI: No ID Found -
Oman Medical Journal Mar 2023Eye infections can be caused by several microorganisms and the most common causative bacterial agents are staphylococci, streptococci, and This study aimed to estimate... (Review)
Review
OBJECTIVES
Eye infections can be caused by several microorganisms and the most common causative bacterial agents are staphylococci, streptococci, and This study aimed to estimate the prevalence of viridans group streptococci, and as the cause of ocular infections in Iran.
METHODS
We conducted a systematic search on the studies published by Iranian authors from January 2000 to December 2020 in Web of Science, PubMed, Scopus, and Embase. Eligible studies were selected according to the defined inclusion/exclusion criteria. Statistical heterogeneity between and within groups was estimated by the Q-statistic and I index. The funnel plots, Duval and Tweedie trim, and fill methods were obtained to evaluate the evidence of publication bias.
RESULTS
Twenty-seven studies were included in this review. According to the meta-analysis results, the prevalence of was 19.1% (95% CI: 12.5-28.1). It was estimated 6.9% (95% CI: 4.4-10.6), 6.7% (95% CI: 4.6-9.6), and 3.3% (95% CI: 1.8-5.8) for and viridans streptococci, respectively.
CONCLUSIONS
. is the prevalent bacterial agents responsible for eye-associated infections in Iran.
PubMed: 37132006
DOI: 10.5001/omj.2023.22 -
Acta Odontologica Scandinavica Nov 2020A systematic review of published data was conducted with the aim of assessing effects of xylitol and erythritol consumption on levels of mutans streptococci (MS) and the...
OBJECTIVE
A systematic review of published data was conducted with the aim of assessing effects of xylitol and erythritol consumption on levels of mutans streptococci (MS) and the oral microbiota.
MATERIALS AND METHODS
Electronic and hand searches were performed to find clinical microbiological studies concerning the consumption of xylitol and erythritol chewing gum or candies, and published between 2000 and 2019. Prospective randomized controlled clinical trials conducted in healthy subjects were included in the review.
RESULTS
The initial search identified 561 xylitol and 83 erythritol studies. After applying inclusion and exclusion criteria, 21 xylitol studies and one erythritol study were reviewed. The review identified nine xylitol studies with a fair or high quality, four conducted in children and five in adults, all demonstrating a decrease in MS levels in association with habitual consumption of xylitol. The three microbiota studies employing multispecies probe approaches revealed no effects for xylitol on the microbiota. The only erythritol study fulfilling the inclusion criteria showed no consistent effects on MS levels.
CONCLUSIONS
Xylitol consumption is likely to decrease MS counts but it may not change the overall microbiota. Xylitol shows thus properties of an oral prebiotic. More studies are needed to demonstrate the effects of erythritol on MS.
Topics: Adult; Chewing Gum; Child; Dental Caries; Erythritol; Humans; Microbiota; Prospective Studies; Saliva; Streptococcus mutans; Xylitol
PubMed: 32633595
DOI: 10.1080/00016357.2020.1788721 -
International Journal of Infectious... Apr 2022We aimed to describe the clinical, microbiological, and imaging characteristics of patients with infective endocarditis (IE) in studies from Latin America (LATAM). (Review)
Review
OBJECTIVES
We aimed to describe the clinical, microbiological, and imaging characteristics of patients with infective endocarditis (IE) in studies from Latin America (LATAM).
METHODS
A systematic search through PubMed, EMBASE, LILACS, and SciELO from inception until February 2021 was conducted. We included observational studies that assessed adults with IE from LATAM and reported data on clinical, microbiological, or imaging characteristics. Data were independently extracted by 2 authors and the risk of bias was evaluated by study design with its respective tool. Findings were summarized using descriptive statistics.
RESULTS
Forty-four studies were included. Most cases were male (68.5%), had a predisposing condition including valve disease (24.3%), or had a prosthetic valve (23.4%). Clinical manifestations included fever (83.9%), malaise (63.2%), or heart murmur (57.7%). A total of 36.4% and 27.1% developed heart failure or embolism, respectively. Blood cultures were negative in 23.9% and S. aureus (18.6%) and the viridans group streptococci (17.8%) were the most common isolates. Most cases were native valve IE (67.3%) affecting mainly left-sided valves. Echocardiographic findings included vegetations (84.3%) and regurgitation (75.9%). In-hospital mortality was 25.1%.
CONCLUSIONS
This is the first systematic review that evaluated the characteristics of IE in LATAM patients. A lack of multicenter studies reflects the need for these studies in LATAM.
Topics: Adult; Echocardiography; Endocarditis; Endocarditis, Bacterial; Humans; Latin America; Male; Retrospective Studies; Staphylococcus aureus
PubMed: 35181535
DOI: 10.1016/j.ijid.2022.02.022 -
American Journal of Otolaryngology 2021Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming... (Review)
Review
PURPOSE
Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming sinusitis, and dental specialists confirming endodontic sources. The purpose of this study was to conduct a multidisciplinary literature review to highlight clinical and microbiological features of ODS, and the most optimal diagnostic modalities to confirm endodontic disease.
METHODS
An extensive review of both medical and dental literature was performed by rhinologists, endodontists, and an infectious disease specialist. Frequencies of various clinical and microbiological features from ODS studies were collected, and averages were calculated. Different endodontic testing and imaging modalities were also evaluated on their abilities to confirm endodontic disease.
RESULTS
ODS patients most often present with unilateral sinonasal symptoms for over 3 months, purulence on nasal endoscopy, and overt dental pathology on computed tomography (CT). Subjective foul smell, and maxillary sinus cultures demonstrating anaerobes and α-streptococci (viridans group) may be more specific to ODS. For endodontic evaluations, cold pulp testing and cone-beam CT imaging are most optimal for confirming pulpal and periapical disease.
CONCLUSION
Diagnosing ODS requires collaboration between otolaryngologists and dental specialists. Clinicians should suspect ODS when patients present with unilateral sinonasal symptoms, especially foul smell. Patients will generally have purulent drainage on nasal endoscopy, and both sinus opacification and overt dental pathology on CT. However, some patients will have subtle or absent dental pathology on CT. For suspected endodontic disease, endodontists should be consulted for at least cold pulp testing, and ideally cone-beam CT.
Topics: Adult; Bacterial Infections; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinusitis; Middle Aged; Pulpitis; Tomography, X-Ray Computed; Viridans Streptococci
PubMed: 33486208
DOI: 10.1016/j.amjoto.2021.102925 -
European Journal of Oral Sciences Feb 2016Statins are medications administered orally and are widely used for lowering the blood cholesterol level. The aim of this study was to investigate the effects of orally... (Review)
Review
Statins are medications administered orally and are widely used for lowering the blood cholesterol level. The aim of this study was to investigate the effects of orally administered statins on microorganisms infecting oral and perioral tissues. We performed a systematic review of published studies of the in vitro antimicrobial effects of statins on bacteria, viruses, and fungi, and searched PubMed, Web of Science, Cochrane Central, and Google scholar. Studies show that most statins exhibit antimicrobial effects against various oral microorganisms. Simvastatin is most effective against the periodontal pathogens Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, and against most dental plaque bacteria, including Streptococcus mutans. Statins also exhibit antiviral properties against human cytomegalovirus, hepatitis B virus, and hepatitis C virus, and have antifungal properties against Candida albicans, Aspergillus fumigatus, and Zygomycetes spp. There were notable differences in the minimum inhibitory concentrations (MICs) between different studies, which may be attributed to differences in study design. Further studies are warranted to ascertain if statins can be solubilized so that patients, who have been prescribed statins for cardiovascular diseases, can use the medication as a swish and swallow, giving patients the added benefit of the antimicrobial action topically in the mouth against infectious oral diseases.
Topics: Candida albicans; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Microbial Sensitivity Tests; Mouth; Porphyromonas gingivalis; Streptococcus mutans
PubMed: 26718458
DOI: 10.1111/eos.12239 -
JAMA Cardiology Apr 2024The association between antibiotic prophylaxis and infective endocarditis after invasive dental procedures is still unclear. Indications for antibiotic prophylaxis were...
IMPORTANCE
The association between antibiotic prophylaxis and infective endocarditis after invasive dental procedures is still unclear. Indications for antibiotic prophylaxis were restricted by guidelines beginning in 2007.
OBJECTIVE
To systematically review and analyze existing evidence on the association between antibiotic prophylaxis and infective endocarditis following invasive dental procedures.
DATA SOURCES
PubMed, Cochrane-CENTRAL, Scopus, Web of Science, Proquest, Embase, Dentistry and Oral Sciences Source, and ClinicalTrials.gov were systematically searched from inception to May 2023.
STUDY SELECTION
Studies on the association between antibiotic prophylaxis and infective endocarditis following invasive dental procedures or time-trend analyses of infective endocarditis incidence before and after current antibiotic prophylaxis guidelines were included.
DATA EXTRACTION AND SYNTHESIS
Study quality was evaluated using structured tools. Data were extracted by independent observers. A pooled relative risk (RR) of developing infective endocarditis following invasive dental procedures in individuals who were receiving antibiotic prophylaxis vs those who were not was computed by random-effects meta-analysis.
MAIN OUTCOMES AND MEASURES
The outcome of interest was the incidence of infective endocarditis following invasive dental procedures in relation to antibiotic prophylaxis.
RESULTS
Of 11 217 records identified, 30 were included (1 152 345 infective endocarditis cases). Of them, 8 (including 12 substudies) were either case-control/crossover or cohort studies or self-controlled case series, while 22 were time-trend studies; all were of good quality. Eight of the 12 substudies with case-control/crossover, cohort, or self-controlled case series designs performed a formal statistical analysis; 5 supported a protective role of antibiotic prophylaxis, especially among individuals at high risk, while 3 did not. By meta-analysis, antibiotic prophylaxis was associated with a significantly lower risk of infective endocarditis after invasive dental procedures in individuals at high risk (pooled RR, 0.41; 95% CI, 0.29-0.57; P for heterogeneity = .51; I2, 0%). Nineteen of the 22 time-trend studies performed a formal pre-post statistical analysis; 9 found no significant changes in infective endocarditis incidence, 7 demonstrated a significant increase for the overall population or subpopulations (individuals at high and moderate risk, streptococcus-infective endocarditis, and viridans group streptococci-infective endocarditis), whereas 3 found a significant decrease for the overall population and among oral streptococcus-infective endocarditis.
CONCLUSIONS AND RELEVANCE
While results from time-trend studies were inconsistent, data from case-control/crossover, cohort, and self-controlled case series studies showed that use of antibiotic prophylaxis is associated with reduced risk of infective endocarditis following invasive dental procedures in individuals at high risk, while no association was proven for those at low/unknown risk, thereby supporting current American Heart Association and European Society of Cardiology recommendations. Currently, there is insufficient data to support any benefit of antibiotic prophylaxis in individuals at moderate risk.
PubMed: 38581643
DOI: 10.1001/jamacardio.2024.0873