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Journal of Indian Society of... 2021Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival... (Review)
Review
BACKGROUND
Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss.
OBJECTIVE
The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries.
MATERIALS AND METHODS
It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made.
RESULTS
Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession ( = 0.79), papilla height ( = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth ( = 0.006) and clinical attachment loss ( = 0.0004) were observed for the two flap designs in probing depth ( = 0.006) and clinical attachment loss ( = 0.0004).
CONCLUSIONS
The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.
PubMed: 34158683
DOI: 10.4103/jisp.jisp_290_20 -
Journal of Clinical Medicine Jan 2021The aim of this systematic review and meta-analysis was to analyze the efficacy of the computer-aided static navigation technique on the accuracy of root apex location... (Review)
Review
UNLABELLED
The aim of this systematic review and meta-analysis was to analyze the efficacy of the computer-aided static navigation technique on the accuracy of root apex location in endodontic microsurgery.
MATERIAL AND METHODS
A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the apex location rate of the computer-aided static navigation techniques applied to endodontic microsurgery. A total of four databases were consulted in the literature search: Pubmed-Medline, Scopus, Cochrane, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and the quantitative analysis.
RESULTS
The root apex location success rate stated at 96.8% (confidence interval (CI): 93.0-100%) of the cases performed through a computer-aided static navigation technique. The prediction interval ranges from 91.4% to 100%. The meta-analysis did not detect heterogeneity between the combined studies (Q-test = 6.15; -value = 0.407; I2 = 2.4%). The computer-aided static navigation techniques showed a root apex location success rate 27 times higher than conventional endodontic microsurgery procedures (Q test = 0.80; = 0.671; I2 = 0%). Three studies of computer-aided static navigation techniques and control group were compared using a random effects model with the Mantel-Haenszel method with a statistically significant odds success ratio of 27.7, with a 95% confidence interval between 11.3 and 68.1 (z test = 7.23; < 0.0001).
CONCLUSIONS
According to in vitro studies analyzed, endodontic microsurgeries performed through computer-aided static navigation techniques show a high precision.
PubMed: 33467707
DOI: 10.3390/jcm10020313 -
Journal of Endodontics Jan 2019A systematic review and meta-analysis were conducted to report combined and individual weighted pooled outcome rates for crown resection (CR) and root resection (RR)... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
A systematic review and meta-analysis were conducted to report combined and individual weighted pooled outcome rates for crown resection (CR) and root resection (RR) procedures.
METHODS
Three electronic databases (PubMed [MEDLINE], Scopus, and the Cochrane Library) were searched to identify human studies in 12 languages on CR (hemisection, trisection, and premolarization) and RR (amputations and RRs without removal of crown portions). Five peer-reviewed journals, references of relevant publications, and reviews were hand searched. Assessment by 3 independent reviewers was based on the following predefined Population, Intervention, Comparison, Outcome, Study Design question: "For teeth in patients undergoing surgical therapy by CR versus RR, what is the expected probability of survival according to longitudinal studies with strictly defined outcome measurements and inclusion/exclusion criteria?" Clinical investigations with at least 12 months of follow-up were included. Studies and level of evidence were appraised using the Newcastle-Ottawa Scale and Grading of Recommendations, Assessment, Development and Evaluations.
RESULTS
Thirty-four articles were obtained for final analysis. Data could be extracted from 19 studies (CR and RR OVERALL: N = 2667 [19 studies], CR: n = 111 [3 studies], and RR: n = 1127 [9 studies]). A random effects model showed weighted mean survival rates of 85.6% (95% confidence interval [CI], 76.7-91.5) for CR and RR procedures OVERALL. Individual data showed weighted mean survival rates of 81.9% (95% CI, 72.0-88.8) for CR and 87.2% (95% CI, 71.7-94.8) for RR. There was no statistically significant difference between CR and RR (P = .89, odds ratio calculation) or between maxillary and mandibular molars (P = .81, Fisher exact test).
CONCLUSIONS
Overall, CR and RR procedures showed good outcome rates. Large-scale randomized controlled trials should be conducted to strengthen the evidence.
Topics: Apicoectomy; Databases, Bibliographic; Follow-Up Studies; Humans; Outcome Assessment, Health Care; Tooth Crown; Tooth Root
PubMed: 30527594
DOI: 10.1016/j.joen.2018.10.003 -
Journal of Endodontics May 2017The aim of this systematic review was to answer the following clinical question: Which is the best treatment option for a pulpally involved tooth? (Comparative Study)
Comparative Study Review
INTRODUCTION
The aim of this systematic review was to answer the following clinical question: Which is the best treatment option for a pulpally involved tooth?
METHODS
An electronic search was conducted in the Cochrane, PubMed (MEDLINE), and ScienceDirect databases between December 2015 and February 2016. A manual search was also performed. The inclusion criteria were randomized clinical trials, prospective or retrospective cohort studies, and cross-sectional studies performed on humans with at least 1 year of follow-up and published within the last 10 years. Two researchers independently screened the title and abstract of every article identified in the search in order to establish its eligibility. The selected articles were classified into different levels of evidence by means of the Strength of Recommendation Taxonomy criteria.
RESULTS
Sixty articles met the inclusion criteria for this systematic review. The survival rate of single-tooth implants was greater than the success rate of the distinct conservative treatments. However, among comparative studies, no important differences between both treatments were observed until at least 8 years later.
CONCLUSIONS
The endodontic treatment and the implant placement are both valid and complementary options for planning oral rehabilitation. Although a level B recommendation can be stated, these results come from retrospective comparative studies because there is a lack of randomized clinical studies comparing both types of therapeutic options.
Topics: Apicoectomy; Dental Implantation; Dental Pulp Diseases; Humans; Retreatment; Tooth Extraction
PubMed: 28343928
DOI: 10.1016/j.joen.2017.01.004