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Journal of Endodontics Apr 2024The success rates of NS-ReTx have varied across decades of prior research. Nonetheless, recent endodontic advances have substantially enhanced case management. This... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The success rates of NS-ReTx have varied across decades of prior research. Nonetheless, recent endodontic advances have substantially enhanced case management. This systematic review aimed to identify rigorous studies on contemporary NS-ReTx, investigating both periapical healing-evaluated strictly for complete resolution or loosely for size reduction of periapical radiolucency-and success, denoting clinical normalcy combined with periapical healing.
METHODS
We systematically searched MEDLINE, Embase, Web of Science, the Cochrane Library, and gray literature from January 1988 to December 2022. Article selection and data extraction were independently conducted by 3 reviewers. Selected studies underwent risk of bias assessment, and evidence quality using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Meta-analysis and meta-regression established pooled outcome rates, 95% confidence intervals (CIs), and significant clinical prognostic factors (P < .05).
RESULTS
Twenty-nine articles were included. Pooled periapical healing rates using strict and loose criteria were 78.8% (95% CI: 75.2-82.4) and 87.5% (95% CI: 83.8-91.2), respectively. Pooled success rates using strict and loose criteria were 78.0% (95% CI: 74.9-81.2) and 86.4% (95% CI: 82.6-90.1), respectively. Meta-regression analyses revealed significant influences on NS-ReTx outcomes (P < .05), including periapical status, lesion size, apical root filling extent, and follow-up duration.
CONCLUSIONS
Contemporary NS-ReTx shows encouraging outcomes, achieving periapical healing and success rates ranging from approximately 78% (strict criteria) to 87% (loose criteria). The absence of or smaller preoperative lesions, adequate root filling length, and extended follow-ups significantly improve NS-ReTx outcomes. Integrating these factors into treatment planning is pivotal for optimizing the outcome of NS-ReTx.
Topics: Humans; Root Canal Therapy; Randomized Controlled Trials as Topic; Cohort Studies; Retreatment; Treatment Outcome
PubMed: 38280514
DOI: 10.1016/j.joen.2024.01.013 -
Medicina (Kaunas, Lithuania) Dec 2023: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to... (Meta-Analysis)
Meta-Analysis Review
Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies.
: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. : The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. : The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was -1.22 degrees (95% CI, -1.06--1.39), the mean coronal deviation was -0.15 mm (95% CI, -0.24--0.07), and the mean apical deviation was -0.19 mm (95% CI, -0.27--0.10). : The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery.
Topics: Humans; Dental Implants; Robotics; Surgery, Computer-Assisted; Research Design; Computers; Imaging, Three-Dimensional
PubMed: 38276045
DOI: 10.3390/medicina60010011 -
Korean Journal of Orthodontics Jan 2024: This systematic review aimed to evaluate the correlation between vitamin D levels and the rate of tooth movement, external apical root resorption, bone biomarker...
OBJECTIVE
: This systematic review aimed to evaluate the correlation between vitamin D levels and the rate of tooth movement, external apical root resorption, bone biomarker expression, and bone remodeling.
METHODS
: Three databases (PubMed, Scopus, and Web of Science) were systematically searched from inception until 14th March 2023 to identify studies investigating the correlation between orthodontic tooth movement and vitamin D in animals and humans. The quality assessment was made in accordance with the Joanna Briggs Institute Critical Appraisal Checklist.
RESULTS
: Overall, 519 records were identified, and 19 were selected for the qualitative synthesis. Eleven studies investigated the effect of local administration (injections in the periodontal ligament, to the gingiva distal to the teeth, or submucosae palatal area) and systemic administration (oral supplementation) of vitamin D on tooth movement, external apical root movement, pro-inflammatory cytokines, and bone remodeling factors. The remaining eight studies investigated the correlation between serum vitamin D levels and salivary vitamin D levels on bone turnover markers and tooth movement.
CONCLUSIONS
: The findings of this systematic review support that vitamin D3 local injections might increase the rate of tooth movement via the receptor activator of the nuclear factor-kB/osteoprotegerin axis. However, the non-uniform study designs and the different protocols and outcome methods make it challenging to draw reliable conclusions.
PubMed: 38268460
DOI: 10.4041/kjod23.064 -
BMC Oral Health Jan 2024Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This systematic review and meta-analysis aim to study the characterization of root and canal morphology of the first mandibular premolar using micro-computed tomography.
METHODOLOGY
The literature search was conducted using electronic web databases like PubMed, Scopus, ScienceDirect and Cochrane with the chosen MeSH key words and data was retrieved until May 2023. Further to perform the statistical analysis, R v 4.3.1 software with "meta", 'metafor" "metaviz" " ggplot2" package was used, and results were represented by odds ratios (OR) and the percentage of forest plots along a 95 per cent confidence interval (CI).
RESULTS
The total number of studies meeting the inclusion criteria was 13; these studies were conducted on mandibular first premolar using Micro-CT; the total sample size was 1817. To scan the sample, an X-ray micro-focus CT system (Siemens Inveon CT, Erlangen, Germany) was used in four studies and seven different machines were used in the respective studies. Mimics 10.01 software (Materialize, Leuven, Belgium) and NRecon v.1.6.9 software (Bruker, Kontich, Belgium) were commonly operated. The minimum and maximum voxel size ranges between 11.94 and 50 μm. Vertucci's classification was frequently used (9), while one study applied Ahmed et al. and Vertucci's classification.
CONCLUSION
This systematic review provides essential information about the root and canal configurations, radicular grooves, accessory canals, and apical foramina through Micro-CT, aiming to improve the accuracy of endodontic treatment and help practitioners.
Topics: Humans; Dental Pulp Cavity; X-Ray Microtomography; Bicuspid; Tooth Root; Mandible
PubMed: 38167114
DOI: 10.1186/s12903-023-03624-5 -
Brazilian Dental Journal 2023The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical...
BACKGROUND
The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951).
METHODOLOGY
A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies.
RESULTS
Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%.
CONCLUSIONS
The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.
Topics: Humans; Case-Control Studies; Periapical Periodontitis; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 38133464
DOI: 10.1590/0103-6440202305471 -
Anaesthesia, Critical Care & Pain... Apr 2024Septic cardiomyopathy is associated with poor outcomes but its definition remains unclear. In a previous meta-analysis, left ventricular (LV) longitudinal strain (LS)... (Meta-Analysis)
Meta-Analysis Review
Mortality in patients with septic cardiomyopathy identified by longitudinal strain by speckle tracking echocardiography: An updated systematic review and meta-analysis with trial sequential analysis.
BACKGROUND
Septic cardiomyopathy is associated with poor outcomes but its definition remains unclear. In a previous meta-analysis, left ventricular (LV) longitudinal strain (LS) showed significant prognostic value in septic patients, but findings were not robust due to a limited number of studies, differences in effect size and no adjustment for confounders.
METHODS
We conducted an updated systematic review (PubMed and Scopus up to 14.02.2023) and meta-analysis to investigate the association between LS and survival in septic patients. We included studies reporting global (from three apical views) or regional LS (one or two apical windows). A secondary analysis evaluated the association between LV ejection fraction (EF) and survival using data from the selected studies.
RESULTS
We included fourteen studies (1678 patients, survival 69.6%) and demonstrated an association between better performance (more negative LS) and survival with a mean difference (MD) of -1.45%[-2.10, -0.80] (p < 0.0001;I = 42%). No subgroup differences were found stratifying studies according to number of views used to calculate LS (p = 0.31;I = 16%), severity of sepsis (p = 0.42;I = 0%), and sepsis criteria (p = 0.59;I = 0%). Trial sequential analysis and sensitivity analyses confirmed the primary findings. Grade of evidence was low. In the included studies, thirteen reported LVEF and we found an association between higher LVEF and survival (MD = 2.44% [0.44,4.45]; p = 0.02;I = 42%).
CONCLUSIONS
We confirmed that more negative LS values are associated with higher survival in septic patients. The clinical relevance of this difference and whether the use of LS may improve understanding of septic cardiomyopathy and prognostication deserve further investigation. The association found between LVEF and survival is of unlikely clinical meaning.
REGISTRATION
PROSPERO number CRD42023432354.
Topics: Humans; Ventricular Function, Left; Echocardiography; Stroke Volume; Cardiomyopathies; Sepsis; Ventricular Dysfunction, Left
PubMed: 38128732
DOI: 10.1016/j.accpm.2023.101339 -
Frontiers in Toxicology 2023Japanese medaka () is an acceptable small laboratory fish model for the evaluation and assessment of endocrine-disrupting chemicals (EDCs) found in the environment. In...
Japanese medaka () is an acceptable small laboratory fish model for the evaluation and assessment of endocrine-disrupting chemicals (EDCs) found in the environment. In this research, we used this fish as a potential tool for the identification of EDCs that have a significant impact on human health. We conducted an electronic search in PubMed (http://www.ncbi.nlm.nih.gov/pubmed) and Google Scholar (https://scholar.google.com/) using the search terms, Japanese medaka, , and endocrine disruptions, and sorted 205 articles consisting of 128 chemicals that showed potential effects on estrogen-androgen-thyroid-steroidogenesis (EATS) pathways of Japanese medaka. From these chemicals, 14 compounds, namely, 17β-estradiol (E2), ethinylestradiol (EE2), tamoxifen (TAM), 11-ketotestosterone (11-KT), 17β-trenbolone (TRB), flutamide (FLU), vinclozolin (VIN), triiodothyronine (T3), perfluorooctanoic acid (PFOA), tetrabromobisphenol A (TBBPA), terephthalic acid (TPA), trifloxystrobin (TRF), ketoconazole (KTC), and prochloraz (PCZ), were selected as references and used for the identification of apical endpoints within the EATS modalities. Among these endpoints, during classification, priorities are given to sex reversal (masculinization of females and feminization of males), gonad histology (testis-ova or ovotestis), secondary sex characteristics (anal fin papillae of males), plasma and liver vitellogenin (VTG) contents in males, swim bladder inflation during larval development, hepatic vitellogenin () and choriogenin () genes in the liver of males, and several genes, including estrogen-androgen-thyroid receptors in the hypothalamus-pituitary-gonad/thyroid axis (HPG/T). After reviewing 205 articles, we identified 108 (52.68%), 46 (22.43%), 19 (9.26%), 22 (17.18%), and 26 (12.68%) papers that represented studies on estrogen endocrine disruptors (EEDs), androgen endocrine disruptors (AEDs), thyroid endocrine disruptors (TEDs), and/or steroidogenesis modulators (MOS), respectively. Most importantly, among 128 EDCs, 32 (25%), 22 (17.18%), 15 (11.8%), and 14 (10.93%) chemicals were classified as EEDs, AEDs, TEDs, and MOS, respectively. We also identified 43 (33.59%) chemicals as high-priority candidates for tier 2 tests, and 13 chemicals (10.15%) show enough potential to be considered EDCs without any further tier-based studies. Although our literature search was unable to identify the EATS targets of 45 chemicals (35%) studied in 60 (29.26%) of the 205 articles, our approach has sufficient potential to further move the laboratory-based research data on Japanese medaka for applications in regulatory risk assessments in humans.
PubMed: 38090358
DOI: 10.3389/ftox.2023.1272368 -
Journal of Clinical and Experimental... Nov 2023The indicated treatment in cases of apical periodontitis (AP), a disease very prevalent in diabetic patients, is root canal treatment (RCT). This study aims to conduct a... (Review)
Review
BACKGROUND
The indicated treatment in cases of apical periodontitis (AP), a disease very prevalent in diabetic patients, is root canal treatment (RCT). This study aims to conduct a systematic review with meta-analysis to answer the following PICO question: In adult patients, does the absence or presence of diabetes affect the prevalence of root filled teeth (RFT)"?
MATERIAL AND METHODS
PRISMA Guidelines have been followed to carry out this systematic review. A literature search was undertaken in PubMed-MEDLINE, Embase and Scielo. All studies reporting the prevalence of RFT in diabetic patients and control subjects using radiographic examination were included. Study characteristics and risk ratios with 95% CIs were extracted. Random-effects meta-analyses were performed.
RESULTS
Five studies fulfilled the inclusion criteria. Prevalence of RFT were estimated with 701 people and 15,882 teeth. Among diabetic patients, 6.1% of teeth had undergone RCT, while in controls this percentage was 3% (OR = 1.7; 95% CI = 1.0 - 2.9; p = 0.065). Among diabetic patients, 65% had at least one RFT, while in controls this percentage dropped to 55% (OR = 1.4; 95% CI = 0.5 - 3.7; > 0.05). The certainty of evidence was low.
CONCLUSIONS
The prevalence of RFT in diabetic patients is almost double that in the control population, however this result is only marginally significant. Dentists must take into account the high prevalence of RFT in diabetic patients, investigating the presence of diabetes in those patients in whom a high frequency of RCT is observed. Diabetes, endodontics, epidemiology, root canal treatment, root filled teeth, prevalence, survey, population-based study.
PubMed: 38074167
DOI: 10.4317/jced.61011 -
Restorative Dentistry & Endodontics Nov 2023This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal... (Review)
Review
This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the "PubMed, Web of Science, and Scopus" databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.
PubMed: 38053776
DOI: 10.5395/rde.2023.48.e34 -
Materials (Basel, Switzerland) Nov 2023Regenerative techniques are increasingly applied in endodontic surgery, but different materials may have varying impacts on soft and hard tissue healing. This systematic... (Review)
Review
Regenerative techniques are increasingly applied in endodontic surgery, but different materials may have varying impacts on soft and hard tissue healing. This systematic review aims to evaluate the effectiveness of autologous platelet concentrates (APCs) in clinical and radiographic healing after endodontic surgery. The data for this systematic review were processed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for improving the reporting of systematic reviews and meta-analyses. A literature search was conducted until October 2023 on PubMed, Scopus, and Cochrane Databases. Randomized controlled trials and controlled clinical trials addressing the use of APCs in patients who presented persistent periapical lesions and needed periapical surgery were included. Dual publications, narrative reviews, systematic reviews, case series, questionnaires, animal studies, case reports, letters to the editor, in vitro studies, and abstracts were excluded. In total, the search resulted in 14 papers. Clinical and radiographical findings were reported, showing that when APCs were used, patients exhibited less pain and swelling and a greater reduction of apical radiolucency after 12 months follow-up on average. However, the moderate/high risk of bias of included studies and their high heterogeneity, do not allow one to draw definitive conclusions on the effectiveness of APC after endodontic surgery.
PubMed: 38005117
DOI: 10.3390/ma16227187