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Oral Health & Preventive Dentistry Jun 2024To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT). (Meta-Analysis)
Meta-Analysis Review
The Effect of Local Application of Tea Tree Oil Adjunctive to Daily Oral Maintenance and Nonsurgical Periodontal Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Studies.
PURPOSE
To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT).
MATERIALS AND METHODS
Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events.
RESULTS
Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies.
CONCLUSION
There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO.
Topics: Humans; Tea Tree Oil; Randomized Controlled Trials as Topic; Dental Scaling; Mouthwashes; Dental Plaque; Oral Hygiene; Root Planing; Dental Plaque Index; Combined Modality Therapy; Treatment Outcome; Phytotherapy; Periodontal Diseases
PubMed: 38864380
DOI: 10.3290/j.ohpd.b5458585 -
International Journal of Dental Hygiene Jun 2024Professional oral hygiene is essential to prevent peri-implant disease. Appropriate instruments should be employed for implant-supported restorations: they should... (Review)
Review
OBJECTIVES
Professional oral hygiene is essential to prevent peri-implant disease. Appropriate instruments should be employed for implant-supported restorations: they should effectively remove deposits without damaging dental implant surface. The aim of the present systematic review is to investigate the efficacy and safety of erythritol air-polishing in implant-supported rehabilitations, compared to alternative hygienic techniques.
MATERIALS AND METHODS
The guidelines reported in the indications of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were employed for this systematic review. The focused question was: 'what is the effect of erythritol air-polishing on dental implant surfaces regarding its cleansing efficacy and/or safety?' The final online search was conducted on 13 August 2023; MEDLINE-PubMed, Scopus and Cochrane Library were employed. Comparative in vitro or in vivo original studies were included.
RESULTS
The initial database search yielded 128 entries; the final selection comprised 15 articles. The risk of bias was evaluated using the Newcastle Ottawa scale (NOS), the Cochrane Handbook for Systematic Reviews of Interventions, GRADE method. Ultrasonic scaling with PEEK tips, glycine air-polishing and cold atmospheric plasma were the devices most frequently compared to erythritol powder in the included studies. Erythritol air-polishing appeared to be significantly more effective in reducing biofilm compared to other treatments, without causing any significant damage to the implant surface and peri-implant tissues, promoting a good biological response.
CONCLUSION
Erythritol air-polishing showed promising results for professional oral hygiene in implant-supported restorations. According to this systematic review, it is effective and safe for removing biofilm from titanium dental implants.
PubMed: 38825804
DOI: 10.1111/idh.12836 -
Journal of Stomatology, Oral and... Apr 2024Oral metastatic sarcomas (OMSs) occur only occasionally, and information about their characteristics is based on the restricted number of cases reported in the...
Oral metastatic sarcomas (OMSs) occur only occasionally, and information about their characteristics is based on the restricted number of cases reported in the literature. This study aims to systematically review the English literature to recognize the clinicopathologic characteristics of OMSs. An electronic search was performed in PubMed Central and Scopus databases. The search included all the published articles (human case reports and case series) up till April 2023, with no time restrictions. OMSs were slightly more prevalent in males in their fifth to seventh decades of life. However, a high percentage of OMSs has been reported in the second decade of life. Lower extremities, breasts and uterus are the most common primary origin of metastatic sarcoma. Gingiva and mandible were common locations in the oral cavity for metastatic deposits. Generally, they demonstrated widespread affliction. The mean time interval between primary tumor detection and diagnosis of the oral metastasis was about 33.54 ± 36.19 months. Death was reported in 83 patients (67.48 %) with a mean survival rate of 7.98 ± 10.30 months. The most common microscopic tumor types were leiomyosarcoma (n = 21, 17 %), followed by angiosarcoma (n = 20, 16.26 %) and osteosarcoma (n = 18, 14.63 %). In conclusion, while oral metastases of sarcomas are not common, those should be considered in the differential diagnosis of the oral lesions. Although OMSs show a high occurrence in the 7th decade of the life, the average age of patients with oral involvement is lower than the overall metastatic lesions. OMSs may present as widespread disease with poor prognosis.
Topics: Humans; Mouth Neoplasms; Sarcoma; Female; Male
PubMed: 38738551
DOI: 10.1016/j.jormas.2023.101656 -
The Journal of Oral Implantology Dec 2023Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for... (Meta-Analysis)
Meta-Analysis
Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.
Topics: Humans; Peri-Implantitis; Dental Implants; Mucositis; Dental Polishing; Biofilms
PubMed: 38258587
DOI: 10.1563/aaid-joi-D-23-00114 -
Community Dental Health Feb 2024Individuals with special needs requiring special care are more vulnerable to oral health problems. Sign language is a communication medium and language of instruction... (Meta-Analysis)
Meta-Analysis
Sign language based educational interventions vs. other educational interventions to improve the oral health of hearing-impaired individuals: A systematic review and meta-analysis.
OBJECTIVE
Individuals with special needs requiring special care are more vulnerable to oral health problems. Sign language is a communication medium and language of instruction for individuals with hearing impairments. The purpose of this systematic review and meta-analysis was to assess the effectiveness of sign language-based educational interventions compared to other educational interventions in improving the oral health of hearing-impaired individuals.
METHODS
PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials databases were searched without any restriction on the publication date. Analytical and experimental studies that evaluated and compared the effectiveness of sign language with other educational intervention groups such as videos, posters etc were included.
RESULTS
Initially, 5568 records were identified. Three relevant publications from India were eligible and included in the systematic review and meta-analysis. Differences were reported in favour of sign language over other interventions concerning plaque status, gingival health, and oral hygiene status.
CONCLUSION
Sign language-based interventions were found to be effective. However, further studies in different locations and populations are required to support their effectiveness.
Topics: Humans; Dental Plaque; Hearing; Oral Health; Oral Hygiene; Sign Language; Deafness
PubMed: 37988657
DOI: 10.1922/CDH_00109Bhadauria06 -
Journal of Dentistry Dec 2023To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use. (Review)
Review
OBJECTIVES
To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use.
DATA
Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies comparing dental plaque detection using digitalized systems against a standard reference were included.
SOURCES
PubMed and Scopus were screened from 01 January 2013 to 28 September 2023. Bibliographies of primary studies and principal peer-reviewed scientific journals were manually searched.
STUDY SELECTION
The initial search identified 576 articles, with a total of 13 included in the review, published between 2015 and 2023. Most of the studies included (77 %) were cross-sectional with three being prospective. Digital devices captured 2D and 3D images via cameras and intra-oral scanners, respectively. The Turesky's modified plaque index was the most frequent clinical index. Correlation with clinical examination was moderate to strong, with good to excellent intra- and inter-system agreement.
CONCLUSIONS
Within the limitations of this scoping review, image analysis-based plaque detection systems demonstrated good correlations with clinical plaque indices, using both 2D and 3D imaging systems. Whilst digital plaque detection devices offer advantages in terms of procedural standardization and reproducibility, they also have limitations, therefore currently, their application should be underpinned by a comprehensive clinical examination.
CLINICAL SIGNIFICANCE
Digital plaque detection tools, that provide standardized measurements and store acquired images, facilitate more informed feedback to patients. This objective analysis may enhance clinician confidence in their utility for clinical trials and other applications.
Topics: Humans; Reproducibility of Results; Dental Plaque; Prospective Studies; Dental Plaque Index; Imaging, Three-Dimensional
PubMed: 37939996
DOI: 10.1016/j.jdent.2023.104772 -
Microscopy Research and Technique Feb 2024The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan... (Meta-Analysis)
Meta-Analysis Review
The comparative of chitosan and chitosan nanoparticle versus ethylenediaminetetraacetic acid on the smear layer removal: A systematic review and meta-analysis of in vitro study.
The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan nanoparticles (Ch-NPs). A search was performed in four electronic databases (Web of Science, PubMed, Scopus, and Cochrane). The included studies were assessed by two reviewers using Joanna Briggs Institute's critical appraisal checklist for the quasi-experimental studies. Outcomes obtained by scanning electron microscopy (SEM) and conventional methods were presented as standardized mean differences alongside 95% confidence intervals. Seven investigations employed 212 single-root teeth. In the apical section (p = .317, 95% CI = -0.820 to 0.266, Tau = 0.387), middle segment (p = .914, 95% CI = -1.019 to 0.912, Tau = 1.027), and coronal segment (p = .277, 95% CI = -1.008 to 0.289, Tau = 0.378). This meta-analysis found no difference between Ch, Ch-NPs, and EDTA in removing the smear layer in the three segments. This systematic review is designed to show evidence related to the PICO question, in which our outcome is smear layer removal and not the clinical success of such a treatment. RESEARCH HIGHLIGHTS: The study aimed to compare the effectiveness of chitosan and chitosan nanoparticles with ethylenediaminetetraacetic acid (EDTA) in removing the smear layer, a layer of debris and organic material on the tooth surface, through a systematic review and meta-analysis. The removal of the smear layer is crucial for successful dental treatments, as it enhances the adhesion of restorative materials and improves the penetration of antimicrobial agents into dentinal tubules. The researchers conducted a systematic review and meta-analysis, searching various databases of electron microscopy results for relevant in vitro studies comparing the effects of chitosan or chitosan nanoparticles with EDTA on smear layer removal. The results encourage further exploration of chitosan and chitosan nanoparticles for clinical use in dentistry, while considering their specific applications and long-term effects.
Topics: Humans; Edetic Acid; Chitosan; Smear Layer; Root Canal Preparation; Sodium Hypochlorite; Root Canal Irrigants; Microscopy, Electron, Scanning; Dental Pulp Cavity
PubMed: 37732467
DOI: 10.1002/jemt.24423 -
International Journal of Dental Hygiene Feb 2024This systematic review and meta-analysis tests the effectiveness of dental water jet (DWJ) with manual toothbrushes (MTB) compared to MTB alone in oral health... (Meta-Analysis)
Meta-Analysis Review
The effectiveness of dental water jet in reducing dental plaque and gingival bleeding in orthodontic patients: A systematic review and meta-analysis of randomized clinical trials.
INTRODUCTION
This systematic review and meta-analysis tests the effectiveness of dental water jet (DWJ) with manual toothbrushes (MTB) compared to MTB alone in oral health maintenance in orthodontic patients.
METHODS
Four databases were systematically searched: PubMed, Scopus, Web of Science (WoS) and Cochrane Library until 6 January 2022 using a combination of medical subject heading (MeSH) terms and keywords. Randomized clinical trials (RCTs) were only included and critically appraised using the Cochrane Risk of Bias (ROB) tool. The mean difference (MD) effect measure was calculated using the Mantel-Haenszel statistical test (95% confidence interval [CI]) to compare both study groups (p-value < 0.05).
RESULTS
After reviewing 5881 studies from a systematic search, six were selected for inclusion, with four involved in the quantitative analysis. The risk of bias was low in two studies, moderate in two studies and high in the remaining two studies. The meta-analysis showed a significant improvement in plaque index and bleeding scores in DWJ + MTB group compared MTB alone group in orthodontic patients with generalized gingivitis (MD = -0.75, 95% CI [-1.29, -0.22], p = 0.006) and (MD = -0.17, 95% CI [-0.27, -0.08], p = 0.0003), respectively. However, no significant improvement was detected between both groups in the gingival index.
CONCLUSIONS
The use of DWJ as an adjunctive device in addition to MTB can be an effective strategy for maintaining oral hygiene in orthodontic patients with gingivitis. However, more high-quality RCTs are needed to confirm the findings.
Topics: Humans; Dental Plaque; Water; Randomized Controlled Trials as Topic; Oral Hygiene; Gingivitis; Gingival Hemorrhage; Dental Plaque Index
PubMed: 37694518
DOI: 10.1111/idh.12741 -
Journal of Pharmacy & Bioallied Sciences Jul 2023Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar...
Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar bone remaining intact. There may be involvement of vertical bone loss. Local drug deliveries such as Boric acid, alendronate gel, and other drugs exhibited anti-inflammatory, antibacterial & osteoblastic differentiation activity. The present systematic review compares the drugs based on their outcomes and pharmacological action. To analzse & compare various forms of local drug delivery systems on a class II furcation. A search was conducted using PubMed, Google scholar, science direct, and Pub Med central using MeSH terms - local drug delivery in periodontics, boric acid in the management of class II mandibular furcation, simvastatin in the treatment of furcation. A total of 560 articles were screened; 58 out of 560 were full-text articles accessed for eligibility, and five articles were included in the systematic review. PRISMA guidelines were used for reporting this review. In addition, five randomized controlled trials were enclosed and used in this systematic review. The various local drugs used in treating class II mandibular furcation defects are effective in the prevention of bleeding on probing, bone resorption, gingival bleeding index and increase in the bone fill, and microbial deposit removal. The managing of class II mandibular furcation defect with the drugs mentioned in this review can be effective by reducing several clinical parameters such as bleeding on probing, gingival indices, osteoblastic differentiation, bone fill, etc., Considering the results of the studies, it can be concluded that it can be used as a therapeutic therapy against class II furcation defects with positive outcomes.
PubMed: 37654351
DOI: 10.4103/jpbs.jpbs_572_22 -
International Journal of Dental Hygiene Feb 2024A meta-analytic review was performed to critically synthesize the evidence of oil pulling on improving the parameters of gingival health, plaque control and bacteria... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
A meta-analytic review was performed to critically synthesize the evidence of oil pulling on improving the parameters of gingival health, plaque control and bacteria counts against chlorhexidine and other mouthwash or oral hygiene practices.
METHODS
Databases including Medline, Embase and bibliographies were searched from inception to 1 April 2023. Randomized controlled trials (RCTs) with 7 days or longer duration of oil pulling with edible oils in comparison to chlorhexidine or other mouthwashes or oral hygiene practice concerning the parameters of plaque index scores (PI), gingival index scores (GI), modified gingival index scores (MGI) and bacteria counts were included. Cochrane's Risk of Bias (ROB) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework were employed to determine the quality of evidence. Two authors independently conducted study selection and data extraction. Meta-analyses of the effect of oil pulling on the parameters were conducted using an inverse-variance random-effects model.
RESULTS
Twenty-five trials involving 1184 participants were included. Twenty-one trials comparing oil pulling (n = 535) to chlorhexidine (n = 286) and non-chlorhexidine intervention (n = 205) were pooled for meta-analysis. More than half of the trials (n = 17) involved participants with no reported oral health issues. The duration of intervention ranged from 7 to 45 days, with half of the trials using sesame oil. When compared to non-chlorhexidine mouthwash interventions, oil pulling clinically and significantly improved MGI scores (Standardized mean difference, SMD = -1.14; 95% confidence interval [CI]: -1.31, -0.97). Chlorhexidine was more effective in reducing the PI scores compared to oil pulling, with an SMD of 0.33 (95% CI: 0.17, 0.49). The overall quality of the body of evidence was very low.
CONCLUSIONS
There was a probable benefit of oil pulling in improving gingival health. Chlorhexidine remained superior in reducing the amount of plaque, compared to oil pulling. However, there was very low certainty in the evidence albeit the clinically beneficial effect of oil pulling intervention.
Topics: Humans; Mouthwashes; Chlorhexidine; Oral Health; Oral Hygiene; Dental Plaque; Oils
PubMed: 37635453
DOI: 10.1111/idh.12725