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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 -
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 -
BMC Oral Health Aug 2023To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in... (Meta-Analysis)
Meta-Analysis
White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis.
OBJECTIVE
To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances.
METHODS
Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software.
RESULTS
A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD - 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances.
CONCLUSIONS
A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies.
CLINICAL RELEVANCE
For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health.
REGISTRATION
Open Science Framework (DOI: https://doi.org/10.17605/osf.io/kcpvb ).
Topics: Humans; Dental Caries Susceptibility; Bacteria; Dental Caries; Dental Plaque; Orthodontic Appliances, Removable
PubMed: 37635207
DOI: 10.1186/s12903-023-03257-8 -
International Dental Journal Feb 2024Denture plaque, a biofilm that develops on denture surfaces, could contribute to many oral and systemic afflictions. Hence, a quantitative assessment of denture plaque... (Review)
Review
Denture plaque, a biofilm that develops on denture surfaces, could contribute to many oral and systemic afflictions. Hence, a quantitative assessment of denture plaque is important to evaluate the denture hygiene of denture wearers, particularly to prevent plaque biofilm-associated diseases. The aim of this systematic review, therefore, was to review and summarize the visual denture hygiene assessment methods using denture plaque indices and with planimetries published in the literature. English language studies published up to March 2022 in four electronic databases, PubMed, Medline, Embase, and Cochrane Library, were searched, followed by a manual search of Google Scholar by two assessors. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) whenever possible. Details of the visual assessment methods, including the types of denture assessed, its materials and its surfaces, as well as the use of a disclosing agent, were the main outcomes. Of 492 screened studies, 74 were included per the inclusion and exclusion criteria. Of these, 60 studies utilized various denture plaque indices while 18 used planimetries. 43 out of 60 studies with indices and 17 out of 18 studies with planimetries used disclosing agents for visual evaluation of plaque. A total of 21 indices were described in the included studies, of which seven graded a divided denture surface, while the remainder graded entire denture surface. Of the 18 planimetric assessments, one study quantified squares of the disclosed plaques on denture images, 16 studies quantified such pixels with computer programs, and a single study quantified points, pixels, and contour of plaque areas. In summary, denture plaque indices appear to be popular in denture plaque assessment due to their simplicity. Computerized planimetric assessment, though more time-consuming, provides a more accurate assessment of plaque load as it is less prone to subjectivity and assessor errors.
Topics: Humans; Oral Hygiene; Dental Plaque; Biofilms; Dental Plaque Index; Dentures
PubMed: 37479594
DOI: 10.1016/j.identj.2023.06.010 -
BMC Oral Health Apr 2023Mouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients.
METHODS
By April 16, 2022, multiple databases and grey literature were searched based on the PICOS strategy. Randomized controlled trials in orthodontic patients evaluating the efficacy of mouthwashes with at least one microbial parameter and/or plaque- and/or gingival inflammation-related index were included. Relevant data were extracted, and the risk of bias was evaluated using Cochrane's tool. Individual mean and standard deviation of the outcomes in mouthwashes and placebos/blank controls were pooled to estimate the weighted mean differences (WMDs) and 95% confidence intervals (95%CIs). Sensitivity analysis, and certainty of evidence were evaluated.
RESULTS
Of 1684 articles, 32 studies satisfied the eligibility criteria, and nine were included for meta-analysis. Missing outcome data was the primary source of bias. Compared to blank controls, the short-term application of fluoride mouthwashes significantly reduced the colony counts of Mutans streptococci (MS), while the long-term application may not be effective. Compared to placebos or blank controls, Chlorhexidine mouthwashes significantly reduced the colony counts of multiple microorganisms in the short-term. Compared to placebos or blank controls, herbal mouthwashes showed the inhibitory effect of MS in the short-term, with some results lacking statistical significance. After meta-analysis, significant lower plaque- and gingival inflammation-related indexes were observed in the Chlorhexidine mouthwashes groups [Gingival Index: WMD = -0.45, 95%CI = -0.70 to -0.20 (placebos as control); WMD = -0.54, 95%CI = -0.96 to -0.13 (blank controls); Plaque Index: WMD = -0.70, 95%CI = -1.12 to -0.27 (blank controls)]. Significant lower gingival inflammation-related indexes were observed in the herbal mouthwashes groups [Gingival Index: WMD = -0.20, 95%CI = -0.32 to -0.09 (blank controls)].
CONCLUSIONS
The short-term application of fluoride mouthwashes may reduce the colony counts of cariogenic bacteria, but the long-term effect is not evident. Chlorhexidine may reduce the colony counts of multiple microorganisms in the short-term. Short-term application Chlorhexidine and herbal mouthwashes may effectively reduce plaque- and gingival inflammation-related indexes. However, the risk of bias, inconsistency, and imprecision in the included studies may reduce the certainty of the evidence.
Topics: Humans; Mouthwashes; Chlorhexidine; Fluorides; Gingivitis; Inflammation; Dental Plaque; Dental Plaque Index; Anti-Infective Agents, Local
PubMed: 37024817
DOI: 10.1186/s12903-023-02920-4 -
Indian Journal of Dental Research :... 2022Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes (MT).
AIM
To evaluate the effectiveness of CT compared to MT in dental plaque removal.
METHODS
Studies comparing the efficiency of CT and MT in dental plaque removal measured by Turesky Modification of Quigley-Hein Plaque Index (TMQHI), Quigley-Hein Plaque Index (QHI), or Silness Loe Plaque Index (SLPI) were identified in PubMed, Medline Web of Science, Google Scholar, and the CENTRAL. Results and effect sizes estimate are presented as mean difference, and subgroup analysis is presented separately for non-randomised interventional studies and randomised intervention studies. Risk of bias was assessed using the Cochrane risk of bias tool (ROBINS-I and ROB2 tool).
RESULTS
A total of 10 studies were included in the systematic review, whereas six out of 10 studies were included in the meta-analysis. Both CT and MT were effective in plaque reduction over time when compared individually using the TMQHI and SLPI scores. The overall pooled summary showed no difference in CT and MT's dental plaque removal ability when measured using the TMQHI score. Similarly, there was no difference in CT and MT's dental plaque removal ability when measured using the SLPI score.
CONCLUSION
There is no significant difference in CT and MT's plaque removal ability. Therefore, CT should only be recommended for children and individuals with a disability or manual dexterity.
OBJECTIVE
Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal.
Topics: Child; Humans; Dental Devices, Home Care; Gingivitis; Dental Plaque; Toothbrushing; Dental Plaque Index; Equipment Design
PubMed: 37006013
DOI: 10.4103/ijdr.ijdr_1158_21 -
BMC Oral Health Mar 2023Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips that cause no harm to dentinal walls. This review explores the intracanal cleaning efficacy of EDDY compared with UAI in vitro.
METHODS
The systematic review was registered in the PROSPERO database (CRD42021235826). A literature search was conducted in six electronic databases. In vitro studies that compared the removal of smear layer, debris, soft tissue or microbes in root canals between EDDY and UAI were included. Data extraction and quality assessment were performed. Meta-analyses were conducted on smear layer removal and debris elimination with the standardized mean difference (SMD). Heterogeneity was measured using the I test and the Chi test. The random-effect model was used when I > 50%, or p < 0.1, otherwise the fixed-effect model was applied. The level of significance was set at p < 0.05.
RESULTS
19 articles were included in this systematic review and 7 articles were included in meta-analyses. Meta-analyses on smear layer removal showed unimportant differences between EDDY and UAI at any canal third (coronal [SMD = 0.08, 95% confidence interval (95%CI): -0.29 to 0.45; p = 0.44, I = 0%]; middle [SMD = 0.02, 95% CI: -0.44 to 0.47; p = 0.94, I = 0%]; apical [SMD = 0.01, 95%CI: -0.35 to 0.38; p = 0.70, I = 0%]). Meta-analyses on debris removal evaluated by scanning electron microscope (coronal [SMD = 0.03, 95% CI: -0.41 to 0.46; p = 0.27, I = 23%]; middle [SMD = -0.24, 95% CI: -0.83 to 0.35; p = 0.80, I = 0%]; apical [SMD = 0.24, 95%CI: -0.20 to 0.67; p = 0.36, I = 2%]) and micro-CT (SMD = 0.36, 95% CI: -0.67 to 1.40; p = 0.03, I = 70%) both found insignificant differences. No meta-analysis was undertaken on soft-tissue removal and disinfection due to the various study designs, but the qualitative analyses implied that EDDY achieved similar performance to UAI in both aspects.
CONCLUSIONS
Limited evidence indicated that EDDY was comparable to UAI in removing smear layer, debris, soft tissue and microbes ex vivo. Considering UAI may damage canal walls, EDDY might be a substitute for UAI in irrigation activation. But more randomized clinical trials are required to explore the clinical extrapolation of the results in this review.
Topics: Humans; Dental Pulp Cavity; Root Canal Preparation; Smear Layer; Root Canal Irrigants; Therapeutic Irrigation; Microscopy, Electron, Scanning; Sodium Hypochlorite
PubMed: 36932445
DOI: 10.1186/s12903-023-02875-6 -
The Journal of Clinical Pediatric... Mar 2023This paper systematically evaluate the effects of probiotics on preventing caries in preschool children. The present systematic review was conducted following the... (Meta-Analysis)
Meta-Analysis
This paper systematically evaluate the effects of probiotics on preventing caries in preschool children. The present systematic review was conducted following the Transparent Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recorded in the International prospective register of systematic reviews (PROSPERO) database (registration no: CRD42022325286). Literature were screened from PubMed, Embase, Web of Sciences, China National Knowledge Infrastructure (CNKI), Wanfang and other databases from inception to April 2022 to identify randomized controlled trials on the clinical efficacies of probiotics in preventing dental caries in preschool children and extract relevant data. The meta-analysis was performed using the RevMan5.4 software and the Stata16. Cochrane handbook was used to assess the risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADEprofiler 3.6) was used to determine the evidence quality. A total of 17 randomized controlled trials were eligible, of which two trials had certain levels of bias and 15 had a low risk of bias. Evidence quality assessment showed that the included trials were of medium quality. The meta-analysis results showed that was associated with a reduced incidence ( = 0.005) and progression ( < 0.001) of caries in preschool children. Probiotics could reduce the number of high-level Streptococcus mutans in saliva ( 0.00001) but could not reduce the number of Streptococcus mutans in dental plaque nor the amount of Lactobacillus in the saliva and dental plaque. Current evidence shows that probiotics could prevent caries in preschool children, but was more effective in preventing caries than others. Although probiotics could reduce high levels of Streptococcus mutans in saliva, they could not reduce the amount of Lactobacillus in saliva and dental plaque.
Topics: Humans; Child, Preschool; Dental Caries; Dental Plaque; Dental Caries Susceptibility; Streptococcus mutans; Lactobacillus; Probiotics
PubMed: 36890746
DOI: 10.22514/jocpd.2023.014 -
Indian Journal of Dental Research :... 2022Dental caries is a global oral health problem caused due to localized demineralization of the enamel. Chemical plaque control is used as an adjuvant to mechanical plaque... (Meta-Analysis)
Meta-Analysis Review
Dental caries is a global oral health problem caused due to localized demineralization of the enamel. Chemical plaque control is used as an adjuvant to mechanical plaque control in removing biofilm, thereby preventing dental caries. In recent times, there has been a renewed interest in nature-based products. This systematic review aimed to analyse the existing literature to compare the effectiveness of herbal and conventional dentifrices on prevention of dental caries. A search was done in the databases of PubMed and Google Scholar in July 2020 for the related topic. A hand search was done from the references of primary studies and other clinical trial registry sites. Randomized control trials, comparative clinical trials, and in vitro studies in which the effectiveness of herbal and conventional dentifrices on prevention of dental caries were included after review by the reviewers. The systematic search revealed a total of thirty-two publications from which ten publications were included. Five studies were clinical studies and five were in vitro studies. All the studies used microbiological analysis for the determination of cariogenic microorganisms in plaque and saliva, whereas one study used pH of plaque and saliva. Among the included studies, all studies had a high risk of bias with level 2 evidence. With the evidence available, it can be concluded that herbal dentifrices and fluoride dentifrices have similar antimicrobial activity against cariogenic microorganisms.
Topics: Humans; Toothpastes; Dental Caries; Dentifrices; Fluorides; Dental Enamel; Dental Plaque; Cariostatic Agents
PubMed: 36656198
DOI: 10.4103/ijdr.ijdr_404_21 -
Clinical and Experimental Dental... Feb 2023To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients.
MATERIAL AND METHODS
A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses.
RESULTS
Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events.
CONCLUSIONS
Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding. This effect appears comparable to that of flossing, while PDICT may achieve higher patient acceptance/compliance.
Topics: Humans; Dental Devices, Home Care; Toothbrushing; Gingivitis; Dental Plaque; Gingiva
PubMed: 36562267
DOI: 10.1002/cre2.691