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Lasers in Medical Science Apr 2024To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic... (Meta-Analysis)
Meta-Analysis Review
To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic brackets, around restoration and in caries susceptible pits and fissures). PubMed was searched using the following keyword sequence; (Laser therapy OR laser irradiation OR laser application) AND (enamel caries prevention OR enamel demineralization OR enamel remineralization OR early enamel caries OR early-enamel caries OR enamel resistance OR enamel decalcification OR white spot lesions WSLs OR incipient lesion OR enamel decay OR enamel Dissolution OR enamel microhardness) AND (clinical trial OR Randomized clinical trial OR In situ study). The latest literature search was ended by "30 January 2023". PubMed was used as a primary data base for study selection. Scopus, EBSCO, and Google scholar are checked in our study after results of systematic search on PubMed. Only duplicates were found. Two meta-analyses were carried out. The first, clinical meta-analysis on incidence of white spot lesions (WSLs) following CO2 laser irradiation of enamel. The second meta-analysis on ex-vivo/in situ effect of CO2 laser on microhardness of enamel. In each meta-analysis three studies were included. Risk of bias was assessed. The search identified eight studies (four ex-vivo and four clinical trials). Regarding the clinical meta-analysis, the overall standardized mean difference was 0.21 [ 95% confidence interval (CI): 0.15-0.30, p < 0.00001]. This indicates that the incidence of new WSLs in patients who received low power CO laser treatment was highly significantly lower than placebo groups. The heterogeneity was considerable (I = 71%). In the second meta-analysis, the overall standardized mean difference was 49.55 [ 95% confidence interval (CI): 37.74, 61.37, p < 0.00001]. This indicates that microhardness of enamel receiving low power (0.4-5 W) CO laser irradiation is highly significantly lower than control untreated enamel. The heterogeneity was substantial (I = 48%). Within the limitations of this study, Low level laser therapy concept with CO2 laser seems to be effective in preventing enamel caries.Prospero registration number: CRD42023437379.
Topics: Humans; Carbon Dioxide; Dental Caries Susceptibility; Lasers; Dental Caries; Low-Level Light Therapy; Randomized Controlled Trials as Topic
PubMed: 38635085
DOI: 10.1007/s10103-024-04049-4 -
Clinical Oral Investigations Apr 2024To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic... (Meta-Analysis)
Meta-Analysis
Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis.
OBJECTIVE
To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP).
MATERIALS AND METHODS
A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed.
RESULTS
The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005).
CONCLUSION
In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies.
CLINICAL RELEVANCE
Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.
Topics: Child; Humans; Adolescent; Cleft Lip; Cleft Palate; Dental Caries; Microbiota
PubMed: 38587683
DOI: 10.1007/s00784-024-05624-3 -
Annals of Medicine and Surgery (2012) Feb 2024Lateral internal sphincterotomy (LIS) has been the gold standard for treating chronic anal fissure (CAF) that persists despite other measures. The authors aim to... (Review)
Review
BACKGROUND
Lateral internal sphincterotomy (LIS) has been the gold standard for treating chronic anal fissure (CAF) that persists despite other measures. The authors aim to evaluate the effects of the close method (CLIS) of performing LIS as compared to the open method (OLIS).
METHODS
Databases were searched for relevant studies and results were screened to identify eligible articles, and all concerned outcomes were pooled as odd ratio (OR) or mean difference (MD) with 95% CI in the meta-analysis models using RevMan 5.4.
RESULTS
Pooled data from 16 trials with 1,711 patients with idiopathic CAF showed that the CLIS has significant lower risk of delayed fissure healing [OR: 0.28, 95% CI (0.10, 0.77), = 0.01], duration of hospital stay [MD: -0.82 with 95% CI (-1.07, -0.57), < 0.00001] and postoperative visual analogue pain score (VAPS) at 24 h [MD: -0.30 with 95% CI (-0.39, -0.21), < 0.00001]. Also, the risk of overall complications [OR: 0.33 with 95% CI (0.19, 0.55), < 0.0001], incontinence [OR: 0.28 with 95% CI (0.20, 0.38), < 0.00001], and postoperative pain [OR: 0.56 with 95% CI (0.35, 0.91), = 0.02] was significantly lower with CLIS.
CONCLUSION
CLIS is a safer option than OLIS for treating anal fissure. The risk of delayed fissure healing, incontinence, post-op pain and overall complication was significantly lower. However, the risk of surgical site infection, postoperative bleeding and recurrence did not differ. Future research with more prolonged follow-up is necessary to document recurrence reliably.
PubMed: 38333259
DOI: 10.1097/MS9.0000000000001593 -
The Journal of Clinical Pediatric... Sep 2023The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries...
The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries prevention. We searched four electronic databases including the Cochrane Oral Health Group's Trials Register (till 03 June 2022), Web of Science (from 1945 to 03 June 2022), PubMed (from 1996 to 03 June 2022), and EMBASE Ovid (from 1980 to 03 June 2022) to identify the cost and effectiveness of PFSs and FVs in decreasing dental caries incidence. Two researchers independently screened search results, extracted data from the included studies, and conducted the risk of bias assessments. The main characteristics of the included studies were extracted and analyzed. The initial search produced 874 articles. After removing duplicates and full-text review, 19 studies were included. In this study: nine studies were on PFSs comparison with control; five on PFSs comparison with FVs; and five on FVs comparison with control. Regarding the type of economic evaluation (EE), 13 studies conducted cost-effectiveness analysis, five conducted cost-utility analyses, and one conducted both cost-effectiveness analysis and cost-utility analyses. The cost-effectiveness evaluation of PFSs and FVs in the available studies was limited. The prevalence of dental caries, payers' willingness to pay, length of follow-ups, delivery settings, retention rate of PFS, and application intervals of FV can affect the economic evaluation of these two methods for dental caries prevention. Therefore, more studies in the future are need to draw clear conclusions about which method is more cost-effective for the two preventive interventions in future.
Topics: Humans; Cost-Benefit Analysis; Fluorides, Topical; Pit and Fissure Sealants; Dental Caries; Cost-Effectiveness Analysis
PubMed: 37732430
DOI: 10.22514/jocpd.2023.048