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Operative Dentistry Sep 2021Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule... (Meta-Analysis)
Meta-Analysis
Does Addition of 10-MDP Monomer in Self-etch Adhesive Systems Improve the Clinical Performance of Noncarious Cervical Lesion Restorations? A Systematic Review and Meta-analysis.
BACKGROUND
Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule made it attractive and added to self-etch adhesives.
OBJECTIVES
The objective of this Systematic Review (SR) and Meta-analysis (MA) was to determine whether systems with the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) functional monomer in their formula showed better clinical performance in restorations placed in noncarious cervical lesions (NCCL) when compared to systems without it. The PROSPERO registration number of the MA is CRD42016050538.
DATA AND SOURCES
An e-search was conducted through MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, OpenGrey, Clinical Trials, Current Controlled Trials, and EU Clinical Trials Register, and a search through the references of included studies was also performed. Randomized Controlled Clinical Trials, in which the effectiveness of self-etch adhesive systems, with or without the 10-MDP functional monomer for NCCL, was discussed, were included. Risk of bias was performed according to the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE.
STUDY SELECTION
The data were grouped, heterogeneity (I2) was tested, and after duplicate removal, 4208 manuscripts were retrieved. From these, 11 studies were included in the qualitative analysis (risk of bias), with nine classified as low risk and two unclear. GRADE analysis detected moderate-to-high certainty of evidence, so the quantitative synthesis [Meta-analysis (MA)] was performed including the 11 studies.
RESULTS AND CONCLUSION
There were no statistical differences in the clinical performance of restorations conducted using "with or without 10-MDP" adhesive types, for all evaluated criteria (p=0.05), with heterogeneity ranging from 0% to 53%. Thus, the presence of 10-MDP functional monomer did not influence the clinical performance of restorations placed in NCCL.
Topics: Dental Cements; Dental Restoration, Permanent; Durapatite; Methacrylates
PubMed: 35486508
DOI: 10.2341/20-053-LIT -
Arthroplasty (London, England) Feb 2021Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA,... (Review)
Review
INTRODUCTION
Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA, particularly during pregnancy and breastfeeding.
METHODS
We performed a systematic review of studies on effects that MMA may have in pregnancy in the context of exposure during orthopaedic surgery and dentistry. Review articles, studies lacking statistical data, single case reports and other evidence level V studies were excluded.
RESULTS
Nine studies were included. One basic science study demonstrated an increase in neuronal cell lysis and shrunken cell bodies when neocortical neurons were exposed to MMA monomer. Three animal studies exposed pregnant rodents to MMA via intraperitoneal injection or inhalation. Exposed fetuses in two studies had an increase in gross abnormalities such as hemangiomas, while there was no increase in teratologic effects in the third study. In dental workers exposed to MMA, two retrospective cohort studies did not find a statistically significant increase in birth defects or miscarriage. After exposure to MMA during total joint arthroplasty, two studies found that MMA levels were undetectable in the mothers' serum or breast milk. One study measuring the airborne levels of MMA during simulated joint arthroplasty found that concentrations never exceeded 1% of the recommended limit set forth by the Occupational Safety and Health Administration (OSHA).
CONCLUSIONS
Potential teratologic effects of MMA cannot be excluded by existing evidence. However, the typical MMA exposure levels for dental and orthopaedic personnel appear to be substantially less than currently proposed exposure limits.
PubMed: 35236460
DOI: 10.1186/s42836-020-00059-z -
Methods and Protocols Jan 2022The most used types of retention of implant-supported prostheses are screw-retained or cement-retained restorations. The advantages and disadvantages of both have been... (Review)
Review
BACKGROUND
The most used types of retention of implant-supported prostheses are screw-retained or cement-retained restorations. The advantages and disadvantages of both have been identified by various authors over the years. However, cement-retained implant crowns and fixed partial dentures are among the most used types of restorations in implant prostheses, due to their aesthetic and clinical advantages. When cemented prostheses are made on implants, the problem of cement residues is important and often associated with biological implant pathologies. The objective of this research was to establish to what extent the techniques to reduce excess cement really affect the volume of cement residues.
MATERIALS AND METHODS
This review was written following the PRISMA statement; a detailed search was carried out in three different electronic databases-PubMed, Scopus, and Cochrane Library. The inclusion criteria were prospective clinical studies, with at least 10 participants per group, and with at least 6 months of the follow-up period.
RESULTS
There have been many proposals for techniques supposed to reduce the amount of excess cement in the peri-implant sulcus and on the prosthetic components, but of these, which are exceptional in their in vitro capabilities, very few have been clinically validated, and this represents the real limitation and a great lack of knowledge regarding this topic. Three articles met the inclusion criteria, which were analyzed and compared, to obtain the information necessary for the purposes of the systematic review.
DISCUSSION
Extraoral cementation can reduce the excess cement, which, after a normal excess removal procedure, is, nevertheless, of such size that it does not affect the possibility of peri-implant pathologies developing. All these studies concluded that a small amount of cement residue is found in the gingival sulcus, and using eugenol-free oxide cements, the residues were only deposited on the metal surfaces, with a better peri-implant tissues health.
CONCLUSION
Despite the limitations of this study, it was possible to carefully analyze these characteristics and obtain valuable suggestions for daily clinical practice. Resinous cements are considered, due to the free monomers present in them, toxic for the soft tissues. The provisional zinc-oxide cements, also eugenol-free, represent the ideal choice. The different grades of retentive forces provided by these cements do not seem to have clinical effects on the decementation of restorations.
PubMed: 35076562
DOI: 10.3390/mps5010009 -
Journal of Esthetic and Restorative... Jan 2022Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP)... (Review)
Review
OBJECTIVES
Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP) ceramics. It has been widely discussed, however, that the differing composition and physical properties of new high-translucent zirconia generations (4Y-TZP and 5Y-TZP) may require alternative bonding materials and procedures. This paper reviewed in vitro studies on the success and durability of bonding protocols to high-translucent zirconia.
MATERIAL AND METHODS
A systematic search of PubMed and Cochrane Library for in vitro studies on bonding to new zirconia generations published until November 2020 was conducted and complemented by a manual search. Studies selected for review fulfilled the applied inclusion and exclusion criteria. The quality of the included studies was assessed with the Cochrane risk-of-bias tool for randomized trials.
RESULTS
Of 629 screened articles, 18 were included in this review. They investigated different surface pretreatment methods, primers, resin cements, aging procedures, and bond strength test protocols. The limited number of the identified studies and the heterogeneity of the extracted data did not allow to conduct a meta-analysis.
CONCLUSIONS
The available evidence suggests that resin bonding protocols successfully applied to conventional zirconia are also the most successful for high-translucent zirconia. Airborne particle abrasion and special phosphate monomer-containing primers or composite resin cements provide long-term durable resin bonds.
CLINICAL SIGNIFICANCE
Durable bonds can be established between high-translucent zirconia and resin cements. The bonding materials and procedures applied do not compromise their physical properties.
Topics: Ceramics; Dental Bonding; Dental Stress Analysis; Materials Testing; Resin Cements; Surface Properties; Zirconium
PubMed: 35072329
DOI: 10.1111/jerd.12876 -
Bioengineering (Basel, Switzerland) Jan 2022Three-dimensional (3D) resin medical-dental devices have been increasingly used in recent years after the emergence of digital technologies. In Orthodontics, therapies... (Review)
Review
Three-dimensional (3D) resin medical-dental devices have been increasingly used in recent years after the emergence of digital technologies. In Orthodontics, therapies with aligners have gained popularity, mainly due to the aggressive promotion policies developed by the industry. However, their systemic effects are largely unknown, with few studies evaluating the systemic toxicity of these materials. The release of bisphenol A and other residual monomers have cytotoxic, genotoxic, and estrogenic effects. This systematic review aims to analyze the release of toxic substances from 3D resins used in Orthodontics and their toxic systemic effects systematically. The PICO question asked was, "Does the use of 3D resins in orthodontic devices induce cytotoxic effects or changes in estrogen levels?". The search was carried out in several databases and according to PRISMA guidelines. In vitro, in vivo, and clinical studies were included. The in vitro studies' risk of bias was assessed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr. For the in vivo studies, the SYRCLE risk of bias tool was used, and for the clinical studies, the Cochrane tool. A total of 400 articles retrieved from the databases were initially scrutinized. Fourteen articles were included for qualitative analysis. The risk of bias was considered medium to high. Cytotoxic effects or estrogen levels cannot be confirmed based on the limited preliminary evidence given by in vitro studies. Evidence of the release of bisphenol A and other monomers from 3D resin devices, either in vitro or clinical studies, remains ambiguous. The few robust results in the current literature demonstrate the absolute need for further studies, especially given the possible implications for the young patient's fertility, which constitutes one of the largest groups of patients using these orthodontic devices.
PubMed: 35049724
DOI: 10.3390/bioengineering9010015 -
Restorative Dentistry & Endodontics Nov 2021The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current.
OBJECTIVES
The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current.
MATERIALS AND METHODS
The first search strategy was based on data available at PubMed, LILACS, Scielo, Scopus, and Cochrane Library, using a combination of descriptors such as "dentin bond agents OR adhesive system AND electric current OR electrobond" or "dentin bonding agents OR dentin bonding agent application OR adhesive system AND electric current OR electrobond", with no limit regarding the publication year. The second search strategy was based on the articles' references found previously. An additional search strategy was applied that concerned the proposed theme in the SBU-UNICAMP (Unicamp's Library System Institutional Repository).
RESULTS
Twelve studies published between 2006 and 2020 were found. The analyses of the selected studies showed that the use of electric current during adhesive systems application on dentin, whether conventional or self-conditioning, increases resinous monomer infiltration in the dentin substrate, which improves the hybridization processes and the bond strength of the restorative material to dentin.
CONCLUSIONS
Despite the favorable results related to the use of this technique, there is still no specific protocol for the application of adhesive systems under electric current.
PubMed: 34909419
DOI: 10.5395/rde.2021.46.e55 -
Endocrine, Metabolic & Immune Disorders... Aug 2022Endocrine disrupting chemicals (EDCs) are found in plastics, personal care products, household items, and other consumer goods. Risk assessments are intended to...
BACKGROUND
Endocrine disrupting chemicals (EDCs) are found in plastics, personal care products, household items, and other consumer goods. Risk assessments are intended to characterize a chemical's hazards, identify the doses at which adverse outcomes are observed, quantify exposure levels, and then compare these doses to determine the likelihood of risk in a given population. There are many problems with risk assessments for EDCs, allowing people to be exposed to levels that are later associated with serious health outcomes in epidemiology studies.
OBJECTIVE
In this review, we examine issues that affect the evaluation of EDCs in risk assessments (e.g., use of insensitive rodent strains and absence of disease-oriented outcomes in hazard assessments; inadequate exposure assessments). We then review one well-studied chemical, Bisphenol A (BPA; CAS #80-05-7) an EDC found in plastics, food packaging, and other consumer products. More than one hundred epidemiology studies suggest associations between BPA exposures and adverse health outcomes in environmentally exposed human populations.
RESULTS
We present support for the use of systematic review methodologies in the evaluation of BPA and other EDCs. Systematic reviews would allow studies to be evaluated for their reliability and risk of bias. They would also allow all data to be used in risk assessments, which is a requirement for some regulatory agencies.
CONCLUSION
Systematic review methodologies can be used to improve evaluations of BPA and other EDCs. Their use could help to restore faith in risk assessments and ensure that all data are utilized in decision-making. Regulatory agencies are urged to conduct transparent, well-documented and proper systematic reviews for BPA and other EDCs.
Topics: Benzhydryl Compounds; Endocrine Disruptors; Humans; Phenols; Plastics; Reproducibility of Results
PubMed: 34610783
DOI: 10.2174/1871530321666211005163614 -
Oral Health & Preventive Dentistry Jan 2021Incomplete polymerisation processes produce several leachable substances. The aim of this work was to review, through existing research and published literature, the...
PURPOSE
Incomplete polymerisation processes produce several leachable substances. The aim of this work was to review, through existing research and published literature, the genotoxic effect of residual monomers of polymers used in restorative dentistry.
MATERIALS AND METHODS
The selection of published studies was performed on six databases from January 2000 to June 2020. The keywords used were: 'genotoxicity' or 'DNA damage' and 'dental resin' or 'methacrylates' or 'residual monomers'. The selection was carried out according to the parameters and guidelines of the Preferred Reporting Items for Systematic Review and Metanalyses (PRISMA) and was based on patient, intervention, comparison, and outcome (PICO). The inclusion criteria were: in vitro and in vivo studies published in English that evaluated genotoxicity for residual monomers leached from polymers related to restorative dentistry. Case reports and review articles were excluded.
RESULTS
Twenty-seven studies met the eligibility criteria. Two categories were constructed based on the experimental design, in vivo and in vitro reports. For the in vitro research, two main methods of assessing DNA damage were reported in selected studies: micronucleus (MN) counting and alkaline comet assay. For in vivo reports, the main method for assessing genotoxic damage was MN counting.
CONCLUSION
From the electronic search, structured data extraction, and analysis by different independent reviewers, results from the present systematic review allow us to conclude that DNA damage is induced by monomers/co-monomers (triethylene glycol dimethacrylate, bisphenol-A-glycidyl methacrylate, urethane dimethacrylate, and 2-hydroxyethyl methacrylate) that are used in restorative dentistry. This systematic review highlights the need for more research on the use of monomers/co-monomers to properly assess clinical biocompatibility.
Topics: Bisphenol A-Glycidyl Methacrylate; Composite Resins; DNA Damage; Dentistry; Humans
PubMed: 34585872
DOI: 10.3290/j.ohpd.b2081469 -
Journal of Ethnopharmacology Jan 2022Isatidis Radix (called Banlangen, BLG in Chinese) and Isatidis Folium (called Daqingye, DQY in Chinese) are common traditional edible-medicinal herbs in detoxifying for...
ETHNOPHARMACOLOGICAL RELEVANCE
Isatidis Radix (called Banlangen, BLG in Chinese) and Isatidis Folium (called Daqingye, DQY in Chinese) are common traditional edible-medicinal herbs in detoxifying for thousands of years, have been traditionally applied in traditional Chinese medicine for centuries. Both of them are bitter in taste, coolness in nature, acting on the heart and stomach channels. They are often used to treat influenza and other viral infectious diseases in clinic, as well as could treat fever, dizziness, and cough and sore throat caused by lung heat.
AIMS OF THE REVIEW
This review aimed at summarizing the latest and comprehensive information of BLG and DQY on the ethnopharmacology, phytochemistry, pharmacology, toxicity and clinical application to explore the therapeutic potential of them. In addition, outlooks and perspective for possible future researches that related are also discussed.
MATERIALS AND METHODS
Related information concerning BLG and DQY were gathered from the internet database of Google Scholar, PubMed, Baidu Scholar, GeenMedical, CNKI and Web of Science, as well as other relevant textbooks, reviews, and documents (e.g., Chinese Pharmacopoeia, 2020 edition, Chinese herbal classic books and PhD and MSc thesis, etc.). Among of them with the keywords including "Isatis indigotica" "Isatidis Radix", "Isatidis Folium", "phytochemistry", "pharmacology", "toxicology", "clinical application" etc. and their combinations.
RESULTS
To date, 39 Chinese patent medicines containing BLG and/or DQY have been developed on basis of the data of NMPA. Besides, 304 and 142 compounds have been found in BLG and DQY, respectively. The main chemical differences between BLG and DQY were concentrated on alkaloids and lignans, such as indican, indirubin, (R, S)-epigoitrin, 4(3H)-quinazolinone, clemastanin B and isatindigotindolines A-D. In 2020 Edition ChP, (R, S)-goitrin and indirubin are now used as the official marker to monitor the quality of BLG and DQY, respectively. Modern pharmacology has mainly studied some monomer components such as 4(3H)-quinazolinone, clemastanin B, erucic acid and adenosine, etc., all of which have shown good effects. These active compounds can resist various viruses, such as influenza virus, respiratory syncytial virus, herpes simplex virus, etc.. By regulating the level of immunity and a variety of inflammatory factors, inhibit the growth and reproduction of the virus. At the same time, it is worth noting that different components of BLG and DQY lead to BLG is more powerful in antiviral and immunomodulatory activity than DQY, while DQY possesses a higher intensity than BLG in anti-oxidant activity.
CONCLUSION
By collecting and collating a large number of literature and various data websites, we concluded that the common compounds are mainly alkaloids. Recent findings regarding the phytochemical and pharmacological properties of BLG and DQY have confirmed their traditional uses in antiviral, antibacterial and treatment immune diseases. Without doubt, their significant differences on ethnopharmacology, phytochemistry and pharmacology can be used as evidence of separate list of BLG and DQY. For shortcomings, some comprehensive studies should be well designed for further utilization of BLG and DQY.
Topics: Animals; Drugs, Chinese Herbal; Ethnopharmacology; Humans; Isatis; Medicine, Chinese Traditional; Phytochemicals; Plant Leaves; Plant Roots
PubMed: 34543684
DOI: 10.1016/j.jep.2021.114648 -
Dental Materials : Official Publication... Oct 2021The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.
METHODS
This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.
RESULTS
From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.
SIGNIFICANCE
Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.
Topics: Bayes Theorem; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Materials Testing; Methacrylates; Resin Cements; Tensile Strength
PubMed: 34456050
DOI: 10.1016/j.dental.2021.08.014