-
Materials (Basel, Switzerland) Mar 2023Head and neck cancers are a significant global health burden, with radiation therapy being a frequently utilized treatment. The aim of this systematic review was to... (Review)
Review
Head and neck cancers are a significant global health burden, with radiation therapy being a frequently utilized treatment. The aim of this systematic review was to provide a critical appraisal of laboratory studies that assessed the effect of irradiation on the adhesive performance of resin-based biomaterials. The analysis included 23 laboratory studies obtained from five databases, with most studies using human enamel, dentin, or both, and bonding procedures involving the fabrication of direct restorations, standardized specimens, bonding of orthodontic brackets, and luting of endodontic fiber posts. The protocols used for irradiation varied, with most studies exposing specimens made from extracted teeth to irradiation using cabinet irradiators to simulate treatment of head and neck cancer. The findings indicate that irradiation reduces the bond strength of dental adhesives and resin-based composites on flat, ground enamel and dentin specimens, with different adhesives and timing of irradiation having a significant impact on adhesive performance. Irradiation also increased microleakage in most studies. The effect of irradiation on marginal adaptation of direct resin-based composite restorations was inconclusive. This systematic review indicates that irradiation has detrimental effects on the adhesive performance of resin-based biomaterials and highlights the need for further clinical and laboratory studies evaluating the performance of adhesive materials and approaches to improve it.
PubMed: 37048873
DOI: 10.3390/ma16072580 -
Dental and Medical Problems 2023Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically.
OBJECTIVES
The present study aimed to review clinical trials on the treatment of DH with laser therapy through a systematic review and meta-analysis.
MATERIAL AND METHODS
The search of electronic databases resulted in 562 publications up to April 2020. The inclusion criteria were studies carried out on humans and reporting on the treatment of DH with laser therapy. Case reports, literature reviews and systematic reviews were excluded. Selected by abstract, potentially eligible papers were read in full (n = 160). Independent examiners performed data extraction and the assessment of the risk of bias.
RESULTS
A total of 34 studies were included in the analysis, and 11 in the quantitative analysis. It was observed that most studies followed up patients for a maximum of 6 months (55%). Through the meta-analysis, we observed statistically significant differences between the average pain before and after 3 months of treatment with highand low-power lasers. However, through indirect comparisons, it was observed that the high-power laser showed a greater tendency to reduce the pain levels after 3 months of treatment as compared to the low-power laser, but without a statistically significant difference.
CONCLUSIONS
It was possible to conclude that regardless of the type of laser used in the treatment of DH, this treatment is an effective option for the control of pain symptoms. However, it was not possible to establish a defined treatment protocol, since the evaluation methods are very different from each other. Text for Rewiew and clinical cases.
Topics: Humans; Dentin Sensitivity; Laser Therapy; Low-Level Light Therapy; Treatment Outcome; Lasers
PubMed: 37023343
DOI: 10.17219/dmp/151482 -
European Endodontic Journal Mar 2023A systematic review and meta-analysis were conducted to evaluate the effect of endodontic irrigation on the mineral content of root canal dentine. A systematic search... (Meta-Analysis)
Meta-Analysis
A systematic review and meta-analysis were conducted to evaluate the effect of endodontic irrigation on the mineral content of root canal dentine. A systematic search was performed in the following databases: PubMed, Web of Science, Scopus, Cochrane, ProQuest, and Wiley. The quality assessment of the articles was performed. The meta-analysis was carried out using the random effects model in the Stata 16 software (p<0.05). The results showed that Er: YAG Laser had a significant effect on the removal of the phosphorus content of dentine (Hedges' g=-0.49; 95% CI: -0.85, -0.13; I2=0.0%). In addition, the EDTA 5Min had a lower removal effect compared to the control group on the magnesium content of dentine (Hedges' g=0.58; 95% CI: 0.00, 1.16; I2=0.0%). Other irrigations had no significant effect on other on the mineral content of root canal dentine. Evidence was found to support that most root canal irrigation protocols did not have a significantly affected in terms of the mineral content of root dentine. (EEJ-2022-11-140).
Topics: Dental Pulp Cavity; Root Canal Irrigants; Root Canal Therapy; Minerals; Dentin
PubMed: 37010204
DOI: 10.14744/eej.2023.88528 -
Medicina (Kaunas, Lithuania) Mar 2023The use of desensitizing agents (DA) after tooth preparation to prevent hypersensitivity is well documented in the literature. A fixed dental prosthesis (FDP) should... (Review)
Review
The use of desensitizing agents (DA) after tooth preparation to prevent hypersensitivity is well documented in the literature. A fixed dental prosthesis (FDP) should have good retention to be successful. Inadequate retention may result in microleakage, secondary caries, and, eventually, dislodgement of the FDP. The effect of DAs on the retention of FDPs has been widely studied in the literature, but the results are conflicting. Thus, this study aimed to conduct a systematic review to assess the effect of dentine desensitizing agents, used to prevent post-cementation hypersensitivity, on the retention of cemented FDPs. The null hypothesis framed was that there is no effect of dentine desensitizing agents on the retention of cemented FDPs. The focused PICO question was as follows: "Does the application of dentine desensitizing agents (I) affect the retention (O) of cemented fixed dental prosthesis (P) when compared to non-dentine desensitizing groups (C)"? Four electronic databases were systematically searched and, on the basis of the predefined inclusion and exclusion criteria, 23 articles were included in this systematic review. A modified CONSORT scale for in vitro studies was used to assess the quality of the selected studies, as all included studies were in vitro studies. Most of the studies compared the effect of more than one type of DA on retention. The results of the selected studies varied due to differences in the composition of tested dentine DAs and types of luting cements. Within the limitations of this study, it can be concluded that the retention values of FDPs cemented using zinc phosphate cement were reduced with most of the DAs, whereas retention values increased when GIC, resin-modified GIC, and resin cements were used with the majority of DAs. These findings are important, as they can guide dentists in selecting the DA before cementing the crowns with the luting agent of their choice, without compromising the retention of the crowns.
Topics: Humans; Glass Ionomer Cements; Materials Testing; Stress, Mechanical; Crowns; Resin Cements
PubMed: 36984516
DOI: 10.3390/medicina59030515 -
Materials (Basel, Switzerland) Mar 2023The purpose of this systematic review was to evaluate how an antioxidant treatment would influence the immediate bond strength of dental adhesives to endodontically... (Review)
Review
The purpose of this systematic review was to evaluate how an antioxidant treatment would influence the immediate bond strength of dental adhesives to endodontically treated dentine. Scientific evidence was researched in five databases using selected descriptors. Two independent reviewers conducted the investigation and assessed the data and methodological quality of the studies. Inclusion and exclusion criteria were specified for article selection; only studies in English and published between 2001 and 2022 were evaluated. A total of 18 studies were selected and analysed. According to most studies, the irrigation procedure and substrate preparation in endodontic therapy may affect the immediate bond strength. Antioxidants can improve bond strength and adhesion following the use of the most frequently used irrigants in root canal treatments. Therefore, antioxidant treatment can be considered a proper technique to enhance the bond strength of endodontically treated teeth.
PubMed: 36984145
DOI: 10.3390/ma16062260 -
Journal of Functional Biomaterials Feb 2023Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this... (Review)
Review
Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this study is to evaluate the effectiveness of autologous tooth as a grafting material and examine the properties of this material and its interactions with bone metabolism. PubMed, Scopus, Cochrane Library, and Web of Science were searched to find articles addressing our topic published from 1 January 2012 up to 22 November 2022, and a total of 1516 studies were identified. Eighteen papers in all were considered in this review for qualitative analysis. Demineralized dentin can be used as a graft material, since it shows high cell compatibility and promotes rapid bone regeneration by striking an ideal balance between bone resorption and production; it also has several benefits, such as quick recovery times, high-quality newly formed bone, low costs, no risk of disease transmission, the ability to be performed as an outpatient procedure, and no donor-related postoperative complications. Demineralization is a crucial step in the tooth treatment process, which includes cleaning, grinding, and demineralization. Since the presence of hydroxyapatite crystals prevents the release of growth factors, demineralization is essential for effective regenerative surgery. Even though the relationship between the bone system and dysbiosis has not yet been fully explored, this study highlights an association between bone and gut microbes. The creation of additional scientific studies to build upon and enhance the findings of this study should be a future objective of scientific research.
PubMed: 36976056
DOI: 10.3390/jfb14030132 -
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 -
Frontiers in Oral Health 2023Selective caries removal aims to remove carious tissue in deep dentin lesions. However, a discussion stands on the value of antiseptics and chemomechanical adjuvant... (Review)
Review
OBJECTIVES
Selective caries removal aims to remove carious tissue in deep dentin lesions. However, a discussion stands on the value of antiseptics and chemomechanical adjuvant methods to reduce the bacterial load on residual caries lesions. This systematic review has addressed two main clinical questions to compare the antimicrobial efficacy of available methods using (1) antiseptic or (2) chemomechanical agents before restoring dentin carious lesions.
METHODS
We included randomized and non-randomized controlled trials (RCTs/ NRCTs). We searched eight databases from inception to October 2021. Paired reviewers independently screened studies, extracted data, and assessed the risk of bias. The primary outcome was the reduction in the number of total bacterial in dentin, whereas secondary outcomes were reduction in the number of and . We used the ratio of ratio of post-treatment to baseline means between two interventions in the logarithmic scale as a proper effect measure. Certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation approach.
RESULTS
We included 14 RCTs and 9 NRCTs, with nine interventions. Regardless the method, the number of bacteria at baseline was similar or exceeded that after the intervention, particularly in NRCTs. The evidence was inconclusive for most comparisons. Among antiseptic agents, chlorhexidine (CHX) resulted in an average of 1.14 times [95% confidence interval (CI): 1.08-1.21] more total bacterial than photodynamic therapy in RCTs. Among NRCTS, the natural agents resulted in five times more total bacterial than CHX (95% CI: 2-11). For chemomechanical methods, the control resulted in eight times (95% CI: 4-17) more total bacterial than Carisolv (SHAA).
CONCLUSIONS
The certainty of the evidence was very low for all comparisons showing uncertainty whether one treatment could be more effective than another for dentin disinfection. So far, exclusively removing soft carious dentin would be enough to reduce the bacterial count.
PubMed: 36908693
DOI: 10.3389/froh.2023.1110634 -
Frontiers in Dentistry 2022The purpose of this study was to systematically review the literature and use meta-analysis to investigate whether chlorhexidine (CHX) application after acid etching as...
The purpose of this study was to systematically review the literature and use meta-analysis to investigate whether chlorhexidine (CHX) application after acid etching as an adjunct treatment has any influence on the immediate and delayed bond strength to primary dentin. In this review, PubMed, ISI (all data bases), Scopus and Cochrane were searched according to the selected keywords up to April 30, 2018. The full texts of all published articles that met our primary inclusion criteria were obtained. The studies were analyzed in two parts: in vitro studies that evaluated the effect of CHX application during the bonding procedures (application after acid etching) on immediate and delay dentin bond strength of resin-dentin interface. The initial search yielded 214 publications, of which 8 were selected after thorough methodological assessment. None of the clinical studies fulfilled the eligibility criteria. Our results indicated that in comparison to the control group, CHX significantly reduced immediate resin-dentin bond strength (P=0.043). These values were increased after aging (P<0.001). Based on this invitro Meta-analysis CHX application, improve resin-dentin bond strength durability in primary teeth.
PubMed: 36873616
DOI: 10.18502/fid.v19i39.11749 -
European Journal of Dentistry Feb 2024The field of dentistry has seen various technological advances regarding caries detection, some lesions still prove to be difficult to detect. A reasonably new detection...
The field of dentistry has seen various technological advances regarding caries detection, some lesions still prove to be difficult to detect. A reasonably new detection method, near-infrared (NIR), has shown good results in caries detection. This systematic review aims to compare NIR with conventional methods in terms of caries detection. Online databases (PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest) were used for the literature search. The search was performed from January 2015 till December-2020. A total of 770 articles were selected, of that 17 articles qualified for the final analysis as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles were assessed according to a modified Critical Appraisal Skills Programme checklist, and then synthesis of the review started. The inclusion criteria were clinical trials done in vivo on teeth with active caries of vital or nonvital teeth. This review excluded nonpeer reviewed articles, case reports, case series, opinions, abstracts, non-English written articles, studies of subjects with arrested caries, or teeth with developmental defects of tooth structure and teeth having environmental defects of tooth structure, as well as in-vitro studies. The review compared near-infrared technology with radiography, visual inspection, and laser fluorescence in terms of caries detection, sensitivity, specificity, and accuracy. The sensitivity of NIR ranged from 99.1 to 29.1%. Studies showed that NIR exhibited higher sensitivity for occlusal enamel and dentin caries. The specificity of NIR ranged from 94.1 to 20.0%. In enamel and dentinal occlusal caries, NIR demonstrated lower specificity than that of radiograph. The specificity of NIR in early proximal caries was low. Accuracy was determined in 5 out of 17 studies where the values ranged from 97.1 to 29.1%. The accuracy of NIR was the highest for dentinal occlusal caries. NIR shows promising evidence as an adjunct in caries examination due to its high sensitivity and specificity; however, more studies are required to determine its full potential in different situations.
PubMed: 36870328
DOI: 10.1055/s-0043-1761187