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Systematic Reviews Apr 2024Endodontic therapy in pediatric dentistry is a challenging procedure, especially for special needs, uncooperative, and very young patients. A new conservative approach... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Endodontic therapy in pediatric dentistry is a challenging procedure, especially for special needs, uncooperative, and very young patients. A new conservative approach which is the non-instrumental endodontic treatment (NIET) has been developed to simplify the management of primary teeth requiring pulpectomy. This review aimed to compare the efficiency of NIET and conventional endodontic treatment in primary teeth.
METHODS
Electronic databases including MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Scopus without restrictions on publication year or publication language were searched. Only randomized clinical trials reporting clinical and radiographical outcomes of NIET and conventional pulpectomy on primary teeth were considered eligible. Two reviewers extracted the data according to the PRISMA statement and assessed the bias risk using the revised Cochrane risk-of-bias tool and a meta-analysis was performed.
RESULTS
From 3322 screened articles, seven articles meeting the inclusion criteria were included. The selected studies included 283 primary molars, of 213 children aged between 3 and 9 years, treated by NIET and conventional pulpectomy, and had follow-up periods ranging from 1 month to tooth exfoliation. Two studies reported good success rates for both the NIET technique and endodontic therapy with no statistically significant difference while three studies showed radiographical significant differences with a low success rate for the NIET technique. Only one study reported better outcomes in the pulpectomy group with statistically significant differences. The quantitative grouping of the included studies showed no significant differences between NIET and conventional endodontic therapy regarding clinical and radiographical success (p value > 0.05).
CONCLUSION
No difference between the NIET technique and the conventional endodontic therapy in primary molars requiring pulpectomy could be confirmed. Results of the present review need to be interpreted with caution since the quality of evidence according to the GRADE was considered as moderate to very low. Therefore, additional clinical trials on the NIET technique are recommended.
Topics: Child; Child, Preschool; Humans; Molar; Pulpectomy; Randomized Controlled Trials as Topic; Root Canal Therapy; Tooth, Deciduous; Treatment Outcome
PubMed: 38664717
DOI: 10.1186/s13643-024-02505-4 -
BMC Oral Health Apr 2024Oral health impacts systemic health, individual well-being, and quality of life. It is important to identify conditions that may exacerbate oral disease to aid public...
BACKGROUND
Oral health impacts systemic health, individual well-being, and quality of life. It is important to identify conditions that may exacerbate oral disease to aid public health and policy development and promote targeted patient treatment strategies. Developmental defects can increase an individual's risk of dental caries, hypersensitivity, premature tooth wear, erosion, and poor aesthetics. As part of an ongoing study assessing oral health in adults with cystic fibrosis at Cork University Dental School and Hospital, a systematic review of available literature was conducted to assess the prevalence of enamel defects in people with cystic fibrosis.
AIMS
To critically evaluate the literature to determine if the prevalence of developmental defects of enamel is higher in people with cystic fibrosis (PwCF).
METHODS
Data Sources: Three online databases were searched Embase, Scopus, and Web of Science Core Collection. Studies that examined an association between cystic fibrosis and developmental defects of enamel were included in this systematic review.
RESULTS
The initial search identified 116 publications from the following databases Embase, Web of Science Core Collection, and Scopus. Eleven studies were included for qualitative analysis. Nine studies concluded that PwCF had a higher prevalence of enamel defects than control people and one study found no difference in cystic fibrosis (CF) status. All studies had a risk of bias that may influence study results and their interpretation.
CONCLUSIONS
The results of the systematic review show a consistent pattern that PwCF have a higher prevalence of DDE than people without CF. Genetic dysfunction, chronic systemic infections, and long-term antibiotic use are possible aetiological causes. This review highlights the need for future studies to investigate if DDEs are caused by the underlying CFTR mutation or as a consequence of disease manifestations and/or management.
Topics: Adult; Humans; Prevalence; Cystic Fibrosis; Dental Caries; Quality of Life; Dental Enamel; Developmental Defects of Enamel
PubMed: 38609911
DOI: 10.1186/s12903-024-04227-4 -
Journal of Dentistry May 2024Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in permanent dentition.
STUDY SELECTION
Observational studies reporting anamnestic risk factors for erosive tooth wear. Methodological quality and risk of bias were assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Risk factors were visually presented in a heatmap, and where possible, random-effects meta-analyses were performed for the odds ratios (ORs) of risk factors.
SOURCES
Electronic databases (MEDLINE, Embase, Scopus, and Web of Science) and manual searches in February 2023. The protocol was registered in PROSPERO (CRD4202339776).
DATA
A total of 87 publications reporting on 71 studies were included in the systematic review. The studies examined a variety of anamnestic risk factors (n = 80) that were categorized into ten domains (socio-demographics, socio-economics, general health, oral diseases, medication, oral hygiene, food, beverages, dietary habits, and leisure-related risk factors). Meta-analyses revealed significant associations between erosive tooth wear and male gender (p<0.001; OR=1.30, 95 % CI: 1.16-1.44), regurgitation (p=0.033; OR=2.27, 95 % CI: 1.41-3.65), digestive disorders (p<0.001; OR=1.81, 95 % CI: 1.48-2.21), consumption of acidic foods (p=0.033; OR=2.40, 95 % CI: 1.44-4.00), seasoning sauces (p=0.003; OR=1.28, 95 % CI: 1.13-1.44), nutritional supplements (p=0.019; OR=1.73, 95 % CI: 1.28-2.35), and carbonated drinks (p=0.019; OR=1.43, 95 % CI: 1.17-1.75). Most included studies exhibited low bias risk.
CONCLUSIONS
Observational studies investigated a variety of anamnestic risk factors for erosive tooth wear. Future studies should employ validated questionnaires, particularly considering the most important risk factors.
CLINICAL SIGNIFICANCE
Erosive tooth wear is a prevalent condition. Clinicians should concentrate primarily on symptoms of gastroesophageal reflux disease and dietary factors when screening patients at risk for erosive tooth wear.
Topics: Humans; Risk Factors; Tooth Erosion; Tooth Wear; Feeding Behavior; Male; Female; Oral Hygiene; Sex Factors; Cross-Sectional Studies
PubMed: 38552999
DOI: 10.1016/j.jdent.2024.104962 -
Medicina (Kaunas, Lithuania) Mar 2024Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often... (Review)
Review
Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors.
Topics: Humans; Tooth, Impacted; Molar, Third; Tooth Extraction; Biological Factors
PubMed: 38541199
DOI: 10.3390/medicina60030473 -
Healthcare (Basel, Switzerland) Mar 2024Dysphagia commonly affects older adults, making them nutritionally vulnerable. There is significant variation in the reported prevalence of dysphagia in aged care. The... (Review)
Review
Dysphagia commonly affects older adults, making them nutritionally vulnerable. There is significant variation in the reported prevalence of dysphagia in aged care. The aim of this systematic review and meta-analysis was to determine the prevalence of dysphagia in individuals living in residential aged care facilities using appropriate assessment methods, and in four subgroups at higher risk: individuals with nervous system diseases, dementia, malnutrition, and poor dentition. Scopus, Web of Science, Medline, and CINAHL Plus were searched, and study selection was conducted in Covidence. Meta-analysis using a random effects model was used to obtain the pooled prevalence of dysphagia. Seven studies were eligible for inclusion. Dysphagia prevalence ranged from 16 to 69.6%. The pooled prevalence of dysphagia was 56.11% (95% CI 39.363-72.172, < 0.0001, I = 98.61%). Sensitivity analysis examining the prevalence of dysphagia using only the CSE indicated a pooled prevalence of 60.90% (95% CI 57.557-64.211, = 0.9994, I = 0%). Only one study each reported on dysphagia prevalence in individuals with nervous system diseases (31%), poor dentition (92%), and dementia (68.4%), meaning that meta-analysis could not be completed. No studies reported on the prevalence of dysphagia in individuals with malnutrition. The prevalence of dysphagia is high amongst residents of aged care facilities. This evidence should be used to guide improvements in the health outcomes and quality of life of aged care residents. Future research should explore the prevalence in the subgroups at higher risk.
PubMed: 38540613
DOI: 10.3390/healthcare12060649 -
Dentistry Journal Mar 2024Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the... (Review)
Review
Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the effectiveness of ozone applications for the treatment of caries in primary dentition. According to PRISMA guidelines, a systematic literature search was performed up to 6 January 2024. Clinical studies using ozone to treat caries of deciduous teeth were considered for inclusion. Out of the 215 records retrieved, seven studies were eventually included in the review, all of which used gaseous ozone. Four studies were judged at high risk of bias, two at low risk, and one of some concerns. The great heterogeneity of designs, outcomes, and protocols made it impossible to conduct a meta-analysis. Despite some limitations, the evidence yielded by the included studies suggests that ozone application, regardless of the protocol applied, is comparable to other interventions in terms of clinical outcomes and anti-bacterial activity, with no reported adverse effects and good patient acceptance. Therefore, ozone application may be a non-invasive approach to treat caries in primary dentition, especially in very young and poorly cooperative patients. Further standardized and rigorous studies are, however, needed to identify the best clinical protocols for this specific field.
PubMed: 38534293
DOI: 10.3390/dj12030069 -
European Journal of Paediatric Dentistry Jun 2024Periapical cysts of primary teeth are pathologic entities which are seldom encountered in the clinical practice. Most frequently, these lesions arise in correspondence...
AIM
Periapical cysts of primary teeth are pathologic entities which are seldom encountered in the clinical practice. Most frequently, these lesions arise in correspondence with primary teeth presenting previous pulp therapy, severe carious lesions, or a history of previous trauma. The aim of the present study is to systematically review the treatment modalities of periapical cysts of the deciduous, along with the reporting of a clinical case.
MATERIALS
A case of periapical cyst treated with marsupialization occurring in an 11-year-old patient is described. A literature search was devised to retrieve studies reporting the treatment of periapical cysts, and involved papers published in the Cochrane Oral Health Group specialist trials, MEDLINE via PubMed, and EMBASE up to March 2023. A total of 39 articles were retrieved. Following title and abstract analysis, 27 articles were selected for full-text analysis, with the final inclusion of 24 articles.
CONCLUSION
Periapical cysts of primary teeth present an overall good prognosis irrespective of the treatment option adopted. The performance of a prompt diagnosis appears of utmost importance, as the extraction of the primary teeth involved implies the management of the residual space for the correct positioning of the corresponding permanent teeth.
Topics: Humans; Tooth, Deciduous; Child; Radicular Cyst; Male
PubMed: 38533834
DOI: 10.23804/ejpd.2024.1993 -
BMC Oral Health Mar 2024The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age...
BACKGROUND
The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions.
METHODS
The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023.
RESULTS
One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated.
CONCLUSION
DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail.
TRIAL REGISTRATION
This study was registered in the PROSPERO database (CRD42023454207).
Topics: Male; Female; Humans; Malocclusion; Malocclusion, Angle Class III; Tooth
PubMed: 38528527
DOI: 10.1186/s12903-024-04143-7 -
BMC Oral Health Mar 2024Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants.
METHODS
The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature.
RESULTS
The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth.
CONCLUSION
Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched.
TRIAL REGISTRATION
Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.
Topics: Child; Male; Humans; Dental Caries; Prevalence; Dental Caries Susceptibility; Dentition, Permanent
PubMed: 38528487
DOI: 10.1186/s12903-024-04125-9 -
BMC Oral Health Mar 2024Historically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient... (Meta-Analysis)
Meta-Analysis
Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis.
OBJECTIVES
Historically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence.
MATERIALS AND METHODS
The present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines.
RESULTS
After the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits.
CONCLUSIONS
In summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets.
CLINICAL RELEVANCE
Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.
Topics: Adult; Humans; Tooth Cervix; Tooth Diseases; Tooth Attrition; Dental Caries; Risk Factors
PubMed: 38519922
DOI: 10.1186/s12903-024-04154-4