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Clinical Oral Investigations May 2024This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and regions based on cone-beam computed tomography (CBCT) studies.
MATERIALS AND METHODS
PubMed, Scopus, Embase, Web of Science, and Open-Grey were searched up to October 2023 according to specific keywords. A hand search was conducted on the references of the included studies and articles from three peer-reviewed journals in endodontics. The main variable of interest was the prevalence of MMC. Additional data such as the total number of included cases, age and country of the population, CBCT device information, voxel size, and field of view details were also extracted. Extracted data were analyzed qualitatively with the JBI quality assessment checklist and quantitatively with STATA software.
RESULTS
Of 32,793 studied teeth, the cumulative prevalence of MMC in both mandibular 1 and 2 molars was 3.11% (95% CI: 2.00-4.44%). The subgroup analysis reveals a prevalence of 4.15% (95% CI: 2.69-5.89%) for mandibular 1 molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2 molars. The highest prevalence of MMC in 1 molar was attributed to South Asia (11.24%) and Africa (6.61%).
CONCLUSIONS
The prevalence of MMC varies among regions. Clinicians should be aware of the potential prevalence of MMC, particularly in mandibular first molars, as a missed MMC could result in endodontic failure.
CLINICAL RELEVANCE
The presence of MMCs varies in different geographic regions (0% to 29.7%). Clinicians should always look for MMC when doing an endodontic treatment on mandibular molars, as the presence of this canal is not uncommon. We suggest searching for this canal as if searching for the second mesiobuccal canal of maxillary 1st molars.
Topics: Humans; Cone-Beam Computed Tomography; Mandible; Molar; Prevalence; Dental Pulp Cavity; Global Health
PubMed: 38743355
DOI: 10.1007/s00784-024-05660-z -
Journal of Clinical and Experimental... Apr 2024To evaluate the influence of chemotherapy on the prevalence of trismus in irradiated head and neck cancer patients. (Review)
Review
BACKGROUND
To evaluate the influence of chemotherapy on the prevalence of trismus in irradiated head and neck cancer patients.
MATERIAL AND METHODS
This systematic review guided by PRISMA-2020 and registered in PROSPERO (CRD42021255377) screened 963 articles in 7 scientific-databases (PubMed, Lilacs, Livivo, Scopus, Embase, Web of Science, EBSCO) and 3 grey-literature databases (Open Grey, Google Scholar, ProQuest) and eight articles were included for qualitative synthesis, meta-analysis (combined odds ratio, inverse variance method plus random effects), heterogeneity analysis (I² and Tau²), one-of-out evaluation and publication bias analysis (Eggs' and Begg's tests) (RevMan®, <0.05). The Newcastle-Ottawa Quality Assessment Scale Cohort Studies was used to assess the risk of bias (RoB). The classification assessment, development, and recommendations (GRADE) approach was used to assess the certainty of evidence.
RESULTS
The eight articles evaluated 1474 patients treated with chemoradiotherapy and 858 patients treated with radiotherapy. Five articles had low RoB, and three had high RoB. Chemoradiotherapy significantly (=0.0003) increased the prevalence of trismus (OR=2.55, 95% CI = 1.53-4.23) compared to radiotherapy, with significant (=0.010) but low heterogeneity (I²=59%;Tau²=0.29). There was no significant risk of publication bias, one-out analysis showed no significant difference between studies, and GRADE showed a moderate level of evidence. Trismus was directly associated to worse quality of life.
CONCLUSIONS
The incidence of trismus increases when chemotherapy is combined with radiotherapy for head and neck cancer, which negatively impacts the quality of life. Radiotherapy, Chemoradiotherapy, Head and Neck Neoplasms, Trismus, Quality of Life.
PubMed: 38725825
DOI: 10.4317/jced.61385 -
Frontiers in Pharmacology 2024Recurrent aphthous ulcer (RAU) had high prevalence and lacked widely recognized treatment. Total glucosides of paeony (TGP) was used in the treatment of RAU in recent...
Recurrent aphthous ulcer (RAU) had high prevalence and lacked widely recognized treatment. Total glucosides of paeony (TGP) was used in the treatment of RAU in recent years. This study was to summarize the efficacy and safety of TGP in the treatment of RAU. We searched eight commonly used databases for relevant studies that published before 1 November 2023. Primary outcome was visual analogue scale (VAS). Secondary outcomes included overall response rate, significant response rate, ulcer healing time, interval, number of ulcers, and serum inflammatory factors. We conducted the meta-analysis, assessed risk of bias and the confidence of the evidence, by using Stata 15.0, Review Manager 5.4, and Gradepro. Nine randomized controlled trials (RCTs) encompassing 883 patients with RAU were included in the final analysis. The VAS in the TGP group was lower than that in the control group ( = -1.18, = -1.58 to -0.78, < 0.001, moderate-certainty evidence), subgroup analysis suggested longer (>8 weeks) medication and observation led to a more significant reduction in pain ( = 0.02). Moreover, TGP had higher overall response rate ( = 1.18, = 1.04 to 1.33, = 0.008, very low-certainty evidence) and significant response rate ( = 1.72, = 1.38 to 2.14, < 0.001, very low-certainty evidence), accelerated ulcer healing ( = -1.79, = -2.67 to -0.91, < 0.001, low-certainty evidence), and extended intervals ( = 23.60, = 14.17 to 33.03, < 0.001, very low-certainty evidence). The efficacy of TGP in reducing the number of ulcers showed no significant difference compared to the control group ( = -1.66, = -3.60 to 0.28, = 0.09, low-certainty evidence). Moreover, TGP treatment was associated with a higher incidence of abdominal symptoms ( = 3.27, = 1.62 to 6.60, < 0.001). TGP appears to hold promise as a widely-used clinical therapeutic option for treating RAU. Nevertheless, further rigorous studies of high quality are required to validate its effectiveness. : https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=471154, Identifier CRD42023471154.
PubMed: 38716235
DOI: 10.3389/fphar.2024.1378782 -
Dental Materials : Official Publication... Jun 2024Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental implants is electrochemical anodization, which may generate a nanotubular surface (TiO nanotubes) with antibacterial potential and osteoinductive features. This systematic review and meta-analysis aims to elucidate the possible antibacterial properties of the surface in question compared to the untreated titanium surface.
SOURCES
For that purpose, was performed a systematic search on the bases PubMed, Lilacs, Embase, Web Of Science, Cinahl, and Cochrane Central, as well as, manual searches and gray literature.
STUDY SELECTION
The searches resulted in 742 articles, of which 156 followed for full-text reading. Then, 37 were included in the systematic review and 8 were included in meta-analysis.
RESULTS
Fifteen studies revealed significant antibacterial protection using TiO nanotube surfaces, while 15 studies found no statistical difference between control and nanotextured surfaces. Meta-analysis of in vitro studies demonstrated relevant bacterial reduction only for studies investigating Staphylococcus aureus in a period of 6 h. Meta-analysis of in vivo studies revealed three times lower bacterial adhesion and proliferation on TiO nanotube surfaces.
CONCLUSIONS
TiO nanotube topography as a surface for dental implants in preclinical research has demonstrated a positive relationship with antibacterial properties, nevertheless, factors such as anodization protocols, bacteria strains, and mono-culture methods should be taken into consideration, consequently, further studies are necessary to promote clinical translatability.
Topics: Titanium; Nanotubes; Dental Implants; Surface Properties; Anti-Bacterial Agents; Bacterial Adhesion; Humans; Staphylococcus aureus
PubMed: 38714394
DOI: 10.1016/j.dental.2024.04.009 -
Contemporary Clinical Dentistry 2024Urine as a biofluid has been rarely used as a diagnostic fluid in oral diseases. The article aims to systematically review the utility of human urinary carcinogen... (Review)
Review
AIM
Urine as a biofluid has been rarely used as a diagnostic fluid in oral diseases. The article aims to systematically review the utility of human urinary carcinogen metabolites as an approach for obtaining important information about tobacco and cancer.
MATERIALS AND METHODS
The following article reviews the use of urine and its metabolites as biomarkers in various lesions of the oral cavity including oral squamous cell carcinoma and as a screening method in evaluating tobacco and its components. A bibliographic comprehensive search was carried out in the main databases: PUBMED, SciELO, Google Scholar, VHL, and LILACS for articles that were published from 1985 to 2020. The inclusion criteria were "urinary metabolites," "oral cancer/HNSCC," "body fluids," "tobacco," and "metabolomics." A total of 55 articles were collected which included laboratory studies, systematic reviews, and literature of urinary metabolites in tobacco users.
RESULTS
Most of the studies carried out show accurate results with high sensitivity of urinary metabolite biomarkers in individuals with tobacco-based habits and lesions caused by them.
CONCLUSION
The review indicates that urinary metabolite analysis demonstrates its applicability for the diagnosis and prognosis of disease. Urine is a remarkable and useful biofluid for routine testing and provides an excellent resource for the discovery of novel biomarkers, with an advantage over tissue biopsy samples due to the ease and less invasive nature of collection.
PubMed: 38707674
DOI: 10.4103/ccd.ccd_23_21 -
Journal of Applied Biomaterials &... 2024Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs)... (Review)
Review
Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs) are more appropriate. This study's objective was to analyze the available research on full-ceramic RBFDPs. In this study, Web of Science, MEDLINE/PubMed, Scopus, Embase, Cochrane Library, and Google Scholar databases were searched for articles published in English between 2010 and 2020. A total of 14 studies were reviewed based on the eligibility criteria. The results showed that using a cantilever design with one abutment had an advantage over two abutments. Additionally, it was proposed that preparations designed with retentive aids, such as a proximal box, groove, and pinhole, could improve RBFDP survival rates. IPS e.max ZirCAD, In-Ceram alumina, and zirconia CAD/CAM were the most commonly used framework materials. Most studies used air abrasion, salinization, or hydrofluoric acid for surface treatment. Adhesive resin cements were the most frequently used type of cement. The survival rate of In-Ceram ceramics (85.3%-94.8%) was lower than that of In-Ceram zirconia and IPS e.max ZirCAD. Debonding, followed by framework fracture, was the leading cause of failure. Following 3-10 years follow-up, the survival percentage of all-ceramic RBFDPs ranged from 76% to 100%. Although RBFDPs have demonstrated satisfactory success as a conservative treatment, long-term follow-ups and higher sample sizes in clinical research are required to gain more reliable outcomes on the clinical success rate of various RBFDP designs.
Topics: Humans; Ceramics; Resin Cements; Dental Porcelain; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed, Resin-Bonded; Zirconium
PubMed: 38706266
DOI: 10.1177/22808000241250118 -
Clinical Oral Investigations May 2024There are 500 million patients living with diabetes mellitus worldwide and 50% of them remain undiagnosed. Routine periodontal probing provides gingival crevicular... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
There are 500 million patients living with diabetes mellitus worldwide and 50% of them remain undiagnosed. Routine periodontal probing provides gingival crevicular blood in patients with gingivitis. Gingival blood may be useful for diabetes screening without the need for any expensive, painful or time-consuming method by using convenient glucometers. Therefore, the objective of this systematic review and meta-analysis is to answer the question to "is there a difference in glucose or HbA1c levels (O) in patients with positive gingival bleeding (P) measured on gingival crevicular blood (GCB) (I) compared to finger prick capillary blood (CB) (C).
MATERIALS AND METHODS
The authors performed an electronic search of six databases using identical MeSH phrases. Only human clinical studies without limitations on the year of publication were considered. Data extraction was done by using standardized data collection sheets. Risk of bias assessment were conducted using QUADAS-2 and QUADAS-C. Meta-analyses were carried out with the random effects model to aggregate the correlation coefficients and the difference between the means between gingival and capillary blood reading, using 95% confidence intervals.
RESULTS
The database and manual search yielded 268 articles, from which the selection procedure provided 36 articles for full-text screening, and the final pool of eligible articles composed of 23 studies with 1680 patients. Meta-analysis results on glycemic levels showed differences between the GCB and CB procedures in patients with and without diabetes with values of -6.80 [-17.35; 3.76] and - 4.36 [-9.89; 1.18], respectively. Statistically significant correlations were found (p = 0.001) between GCB and CB measurements in patients with (0.97 [0.927; 0.987]) and without diabetes (0.927 [0.873; 0.958]).
CONCLUSION
Gingival blood could prove to be useful to identify patients with undiagnosed diabetes when the necessary amount of uncontaminated blood is present. However, this technique is limited by the possibility of contamination, prandial status and inaccuracies, so it is unsuited to address the patient's glycemic control accurately.
Topics: Humans; Glycated Hemoglobin; Blood Glucose; Gingival Crevicular Fluid; Reproducibility of Results; Diabetes Mellitus
PubMed: 38702475
DOI: 10.1007/s00784-024-05685-4 -
Acta Odontologica Scandinavica May 2024The aim of this work was to explore the potential of polyphenol supplement consumption in enhancing the treatment of periodontitis and diabetes mellitus in both diabetic...
OBJECTIVE
The aim of this work was to explore the potential of polyphenol supplement consumption in enhancing the treatment of periodontitis and diabetes mellitus in both diabetic animals and humans.
MATERIALS AND METHODS
A comprehensive search across eight databases (MEDLINE, EBSCO, Taylor & Francis, PRIMO, Web of Science, Wiley Online Library, ScienceDirect, and SAGE Journals) and two registers (ClinicalTrials.gov and Cochrane Library Trials) was conducted. Methodological quality assessment employed the Cochrane Collaboration Risk of Bias Assessment Tool for randomised controlled trials and the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for experimental animal studies.
RESULTS
Ten articles meeting inclusion criteria were identified. Three clinical studies demonstrated significant reductions in probing depth (PD) and clinical attachment loss (CAL). Ginger supplementation showed a decrease in CAL (-0.57 ± 0.50 vs. -0.14 ± 0.35, p = 0.003) and PD (-0.52 ± 0.51 vs. -0.19 ± 0.51, p = 0.04), while resveratrol supplementation exhibited a reduction in PD (-1.1 ± 0.58 vs. -0.6 ± 0.47, p < 0.001). Additionally, cranberry juice supplementation led to a decrease in PD (-0.56 ± 0.03, p < 0.001). However, there was no significant improvement in inflammation status. Although polyphenol supplementation did not impact fasting blood glucose levels, it did result in improved insulin resistance (3.66 ± 0.97 vs. 4.49 ± 1.56, p = 0.045). In diabetic animals, six studies reported a significant reduction (p < 0.05) in bone loss along with marked improvements in inflammation status.
CONCLUSIONS
Despite the promising results observed in the included studies, the overall evidence supporting the positive effects of polyphenols on periodontal and diabetes mellitus status, along with their anti-inflammatory properties, remains inadequate.
Topics: Polyphenols; Periodontitis; Humans; Animals; Diabetes Mellitus; Dietary Supplements
PubMed: 38700145
DOI: 10.2340/aos.v83.40484 -
Acta Odontologica Scandinavica May 2024This systematic review aimed at evaluating the reliability of dental maturation (DM) according to Demirjian method compared to hand and wrist maturation (HWM) to assess...
OBJECTIVES
This systematic review aimed at evaluating the reliability of dental maturation (DM) according to Demirjian method compared to hand and wrist maturation (HWM) to assess skeletal maturity (SM) in growing subjects, to identify the teeth and the corresponding mineralisation stages related to the pubertal growth spurt (PGS).
MATERIALS AND METHODS
PubMed, Scopus, and Web of Science were systematically searched until January 5th, 2024, to identify observational cross-sectional studies that assessed the reliability of Demirjian method compared to the HWM methods (i.e., Grave and Brown and Fishman) in growing subjects. The quality assessment was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist.
RESULTS
Out of 136 papers suitable for title/abstract screening, 19 included studies. Of them, 17 papers showed the reliability of Demirjian DM method compared to HWM Fishman and Grave and Brown methods to assess SM in growing subjects. According to JBI Critical Appraisal Checklist, 12 papers were high-quality studies and 7 papers were medium-quality studies. Conclusions: The mandibular second molar might be considered as the best indicator compared to other teeth and that the peak of growth occurs no earlier than stage F in females and stage G in males according to Demirjian method. Also, the mandibular canine might be analysed as indicator of SM in males, and results suggest that the peak of growth occurs no earlier than maturation stage F according to Demirjian method, only in male subjects. Further studies are needed to confirm these findings.
Topics: Humans; Reproducibility of Results; Wrist; Tooth Calcification; Age Determination by Skeleton; Hand; Age Determination by Teeth; Cross-Sectional Studies; Female; Male; Child
PubMed: 38699981
DOI: 10.2340/aos.v83.40485 -
International Journal of Implant... May 2024The purpose of this systematic review was to explore and identify the factors that influence the accuracy of intraoral scanning in implant dentistry, with a specific... (Review)
Review
PURPOSE
The purpose of this systematic review was to explore and identify the factors that influence the accuracy of intraoral scanning in implant dentistry, with a specific focus on scan bodies (ISBs).
METHODS
Following the PRISMA 2020 guidelines, this study conducted a thorough electronic search across MedLine, PubMed, and Scopus to identify relevant studies. Articles were screened based on titles, abstracts, and full texts for relevance. The Robins I tool assessed the risk of bias in various study types. Data extraction occurred based on predetermined parameters for studying specimens and assessing outcomes.
RESULTS
16 studies met the specified criteria and were consequently included in the systematic review. Due to variations in variables and methods across the selected studies, statistical comparison of results was not feasible. Therefore, a descriptive review approach was chosen, acknowledging the substantial heterogeneity in the reviewed literature.
CONCLUSIONS
The precision of virtual scan results is contingent upon diverse characteristics of ISBs and implants. These factors encompass their placement within the dental arch, structural design, shape, material composition, color, and the manufacturing system, all of which contribute to scan accuracy. Additionally, considerations such as the intraoral scanner (IOS) type, scanning technique, use of scan aids, inter-implant distance, scan span, and the number of implants warrant evaluation. In the context of capturing implant positions, intraoral scanning with ISBs demonstrates comparable accuracy to traditional impression methods, particularly in single and short-span scenarios. However, the existing data lacks sufficient information on in vivo applications to formulate clinical recommendations.
Topics: Humans; Dental Implants; Imaging, Three-Dimensional; Computer-Aided Design; Dental Implantation, Endosseous; Dental Prosthesis Design
PubMed: 38691258
DOI: 10.1186/s40729-024-00543-0