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Cureus Jul 2023Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective... (Review)
Review
Dental caries is a common dental health problem affecting all age groups across the globe. Accurate detection and assessment of dental caries are crucial for effective treatment and preventive measures. Teledentistry, which involves remote dental assessment using digital technologies, has shown promise as a potential tool for caries screening. This systematic review and meta-analysis aims to compare the dental caries scores obtained from clinical examinations and teledentistry assessments. Literature searches were conducted across databases such as PubMed, Embase, the Cochrane Library, Scopus, the Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO by using predefined search terms and inclusion criteria. Two reviewers separately extracted the data. The study designs, evaluation techniques, dentition types, mean scores, and follow-up times of the included studies were examined. The New Castle-Ottawa Scale was used to assess the risk of bias. Review Manager (RevMan) (computer program) Version 5.4, The Cochrane Collaboration 2020, was used for the quantitative assessment of the data. Eight studies met the inclusion criteria and were included in the review. The findings revealed that teledentistry assessments (based on intraoral photographs captured using smartphones or intraoral cameras) demonstrated comparable accuracy to traditional clinical examinations in detecting and assessing dental caries. Among the four studies that were quantitatively analysed, no significant difference was noted at p = 0.09. A mean difference of 0.64 (95% confidence interval (CI): -0.10; 1.38) suggested that clinical examination and teledentistry-based checkup were on par with each other for the detection of dental caries. The New Castle-Ottawa scale (NOS) grading indicated that the studies were of good quality. Teledentistry may be an effective approach for identifying and evaluating dental caries. However, further research is required to substantiate the findings observed in the present review.
PubMed: 37637546
DOI: 10.7759/cureus.42414 -
Healthcare (Basel, Switzerland) Aug 2023The goal of this systematic study was to investigate the effectiveness of selective, stepwise, and non-selective removal techniques for caries removal in permanent teeth... (Review)
Review
OBJECTIVE
The goal of this systematic study was to investigate the effectiveness of selective, stepwise, and non-selective removal techniques for caries removal in permanent teeth with deep carious lesions. The primary focus was the results found comparing techniques for caries removal to check whether there was pulp exposition; the secondary was the materials used for pulp protection and clinical findings reported within the included studies.
METHODS
The search was performed in two databases (PubMed/MEDLINE and Web Of Science). The studies included in this systematic review were selected based on eligibility criteria. The inclusion criteria were: (1) randomized controlled trials (RCTs), (2) that compared the total removal of carious tissue with selective removal in permanent teeth with deep carious lesions, (3) with a follow-up period of at least 6 months, and (4) publications in English. Regarding the exclusion criteria, the following were not considered: (1) articles published in other languages, (2) articles that did not compare the different types of total/selective decay removal, and (3) articles published before January 2008. The risk of bias and the quality of the included studies were independently assessed by two reviewers using the RoB 2 tool.
RESULTS
5 out of 105 potentially eligible studies were included. Regarding the teeth included in the study, three articles performed management only on permanent molars, while other studies also performed management on incisors/canines/premolars/molars. Management protocols were divided into nonselective caries removal and partial caries removal (selective/stepwise). The theory of non-selective caries removal was considered an excessive, unnecessarily invasive option and a form of outdated management, and selective removal was preferred.
CONCLUSION
The selective removal technique presented a higher success rate and fewer incidences of pulpal exposure than total removal, after up to 18 months of follow up. Moreover, only one session seemed to be a better management choice compared to two sessions because the cavity re-opening procedure is more prone to pulp exposure and highly depends on patient commitment. Otherwise, at 5 years of follow up, there was no difference between selective removal and total removal in management longevity. In addition, there were also no differences between the success of the materials used for definitive restorations in teeth subjected to any of the techniques evaluated.
PubMed: 37628535
DOI: 10.3390/healthcare11162338 -
BMC Oral Health Aug 2023This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.
OBJECTIVE
This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement.
MATERIALS AND METHODS
An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool.
RESULTS
Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch.
CONCLUSION
Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
Topics: Humans; Mandible; Orthodontic Appliances, Removable
PubMed: 37620781
DOI: 10.1186/s12903-023-03302-6 -
International Journal of Oral and... Jan 2024Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A... (Meta-Analysis)
Meta-Analysis Review
Clinicians frequently prescribe systemic antibiotics after lower third molar extractions to prevent complications such as surgical site infections and dry socket. A systematic review of randomised clinical trials was conducted to compare the risk of dry socket and surgical site infection after the removal of lower third molars with different prophylactic antibiotics. The occurrence of any antibiotic-related adverse event was also analysed. A pairwise and network meta-analysis was performed to establish direct and indirect comparisons of each outcome variable. Sixteen articles involving 2158 patients (2428 lower third molars) were included, and the following antibiotics were analysed: amoxicillin (with and without clavulanic acid), metronidazole, azithromycin, and clindamycin. Pooled results favoured the use of antibiotics to reduce dry socket and surgical site infection after the removal of a lower third molar, with a number needed to treat of 25 and 18, respectively. Although antibiotic prophylaxis was found to significantly reduce the risk of dry socket and surgical site infection in patients undergoing lower third molar extraction, the number of patients needed to treat was high. Thus, clinicians should evaluate the need to prescribe antibiotics taking into consideration the patient's systemic status and the individual risk of developing a postoperative infection.
Topics: Humans; Dry Socket; Antibiotic Prophylaxis; Surgical Wound Infection; Molar, Third; Network Meta-Analysis; Anti-Bacterial Agents; Tooth Extraction
PubMed: 37612199
DOI: 10.1016/j.ijom.2023.08.001 -
BMC Oral Health Aug 2023Molar-root incisor malformation (MRIM) is a seldom reported condition characterised by disturbances in root development of first permanent molars. This systematic review...
OBJECTIVES
Molar-root incisor malformation (MRIM) is a seldom reported condition characterised by disturbances in root development of first permanent molars. This systematic review aimed to collate the clinical characteristics of individuals diagnosed with MRIM.
MATERIALS AND METHODS
A systematic search strategy using PubMed, Embase, Web of Science, and SCOPUS databases was performed through to March 2023. Inclusion criteria were case reports or case series including a diagnosis consistent with MRIM. Critical appraisal for all included studies utilised the Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series and collation of clinical characteristics was performed in JBI System for the Unified Management, Assessment and Review of Information program.
RESULTS
The search identified 157 studies from which 35 satisfied the inclusion criteria. After full-text review, a total of 23 papers described the MRIM dental anomaly and were included in this paper. A total of 130 reported cases were retrieved, with age ranging 3-32 years, and males affected 1.16:1 females. Presence of neurological conditions, premature birth history, medication, and surgery within first years of life were synthesised and described.
CONCLUSIONS
The aetiology of MRIM is yet to be determined but epigenetic changes from significant medical history in the first years of life are likely to influence the development of this root malformation. First permanent molars were most commonly affected, but clinicians should be aware that permanent central incisors, primary teeth and other permanent teeth may also be affected.
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Male; Pregnancy; Young Adult; Awareness; Databases, Factual; Incisor; Molar; Tooth Abnormalities; Odontogenesis; Tooth Root
PubMed: 37596569
DOI: 10.1186/s12903-023-03275-6 -
Journal of Prosthodontic Research Apr 2024To systematically assess the influence of ambient light on the accuracy and scanning time of intraoral scanning.
PURPOSE
To systematically assess the influence of ambient light on the accuracy and scanning time of intraoral scanning.
STUDY SELECTION
The present systematic review (CRD 42022346672) was registered at the International Prospective Register of Systematic Reviews (PROSPERO) and was performed based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Electronic searches were conducted using PubMed, Web of Science, and EMBASE, complemented by gray literature, references, and citations of the included studies. The primary outcome was accuracy, and the scanning time was a secondary outcome. Owing to the high heterogeneity, the pooled data were analyzed descriptively.
RESULTS
Six in vitro and two in vivo experiments were performed. Three in vitro studies reported both the accuracy and scanning time of the intraoral scans, whereas the remaining studies exclusively evaluated the accuracy. The studies mainly investigated the influence of illumination levels (0-11000 lux) on intraoral scanning. Intraoral scans revealed optimal accuracy at 1000-lux illumination for complete-arch dentition scans, whereas the influence of illumination levels on 4-unit or shorter scans was not clinically significant. The intraoral scans obtained using confocal microscopy were less affected by the illumination levels than those obtained using the active triangulation technique. Furthermore, the scanning time tended to increase with increasing illumination.
CONCLUSIONS
Evidently from the limited number of studies conducted, ambient light illumination had considerable influence on the accuracy and scanning time of intraoral scanning, which appeared to be related to the scanning range and imaging technology.
Topics: Models, Dental; Imaging, Three-Dimensional; Computer-Aided Design; Dental Impression Technique
PubMed: 37574273
DOI: 10.2186/jpr.JPR_D_23_00098 -
European Journal of Orthodontics Nov 2023There are a few hypotheses for the origin of palatally impacted canines (PIC). Nevertheless, the results of different studies are controversial. (Meta-Analysis)
Meta-Analysis
BACKGROUND
There are a few hypotheses for the origin of palatally impacted canines (PIC). Nevertheless, the results of different studies are controversial.
OBJECTIVE
Considering the evidence available in the literature to determine the skeletal and dentoalveolar dimensions in patients with PIC using cone beam computed tomography (CBCT).
SEARCH METHODS
This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. The literature search with no publication date restriction in five databases and hand searching was performed until April 2023.
DATA COLLECTION AND ANALYSIS
Data assessing the skeletal and dentoalveolar characteristics of subjects with PIC evaluated with CBCT was extracted, and the studies' quality was evaluated with the Newcastle-Ottawa Scale (NOS). Skeletal and dentoalveolar characteristics of subjects with PIC were compared with non-impacted subjects or non-impacted sides. MedCalc software was used to perform the meta-analysis. Statistical heterogeneity was assessed using the chi-square and I-square tests.
RESULTS
The initial database search identified a total of 1153 studies. After applying the selection criteria, nine articles were included in the systematic review and meta-analysis. According to the NOS, all included articles were graded as "Good" quality. The meta-analysis showed a non-significant difference in measuring dentoalveolar height, alveolar first molar width, and basal lateral width. Controversial results were observed when evaluating both basal and alveolar first premolar widths. A significant difference was found when assessing anterior alveolar crest height and basal maxillary width.
CONCLUSIONS
Studies demonstrated the reduction of both dentoalveolar and skeletal maxillary parameters of the patients with PIC. The meta-analysis indicated that PIC correlates to both vertical and transverse skeletal dimensions of the maxilla. However, the results remain controversial. The findings should be interpreted with caution due to different study designs and unbalanced groups in the included studies; therefore, further research is needed for more reliable conclusions.
REGISTRATION
This systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022362124).
Topics: Humans; Maxilla; Cuspid; Incisor; Alveolar Process; Molar; Tooth, Impacted; Cone-Beam Computed Tomography
PubMed: 37552898
DOI: 10.1093/ejo/cjad050 -
Journal of the Mechanical Behavior of... Oct 2023This study aims to systematically review the literature and evaluate the effect of post-printing factors such as aging, heat, appliance fabrication and storage on the... (Review)
Review
OBJECTIVES
This study aims to systematically review the literature and evaluate the effect of post-printing factors such as aging, heat, appliance fabrication and storage on the dimensional accuracy of full-arch dental models manufactured by additive manufacturing (AM) technology for the intended use of working model purposes.
MATERIALS AND METHODS
Three online databases, Medline (Ovid), Scopus and Web of Science were screened and last searched in March 2023. In-vitro studies and publications involving any distortions and shrinkage to the additively manufactured (AMed) model after printing and post-processing were included. However, literature reviews, abstracts, publications in a language different from English, or publications not testing a dental model with an arch or dentition were excluded. The references cited in the studies included were also checked via Google Scholar to identify relevant published studies potentially missed.
RESULTS
The systematic search identified and screened 769 different studies after the removal of duplicates. After applying inclusion and exclusion criteria, a total of 30 relevant titles and abstracts were found, yielding six final selections after full-text screening. Four out of the six studies evaluated the effect of both storage and aging on the dimensional accuracy of AMed dental models. The other two studies assessed the dimensional accuracy after the fabrication of thermoformed and vacuum-formed appliances on the AMed dental model.
CONCLUSIONS
AMed models can be utilised as working models on the condition that specific printing parameters are followed and additional model design features are employed. No definitive conclusions can be drawn on standardised methods to assess the dimensional accuracy of AMed dental models after storage, aging and appliance fabrication. In addition, there is no consensus on specific storage periods for an AMed model. Majority of study designs removed the palatal region to create a horseshoe shaped model, making the results less applicable to a working model scenario requiring the palate for retention purposes. The parameters investigated on AMed models include storage, aging, and appliance fabrication through thermoforming and vacuum-forming. Printing densities of solid models and wall thickness of hollow models were shown to influence the accuracy of AMed models. Dimensional accuracy of AMed models have been shown to be affected during appliance fabrication through thermoforming and vacuum-forming in certain conditions.
SIGNIFICANCE
There is a clear need of standardisation when manufacturing AMed dental models for working model purposes. The current methods investigated in this study lack established protocols to accurately manufacture the AMed models, and effectively store and utilise an AMed dental model for fabrication of orthodontic and prosthodontic appliances.
PubMed: 37542769
DOI: 10.1016/j.jmbbm.2023.106057 -
Clinical Oral Investigations Sep 2023To explore the existing salivary, gingival crevicular fluid (GCF), blood, and serum biomarkers associated with grade C molar-incisor pattern (C/MIP) periodontitis in... (Meta-Analysis)
Meta-Analysis Review
AIM
To explore the existing salivary, gingival crevicular fluid (GCF), blood, and serum biomarkers associated with grade C molar-incisor pattern (C/MIP) periodontitis in systemically healthy children and young adults.
MATERIALS AND METHODS
Cross-sectional, case-control, and cohort studies on stage III grade C periodontitis or former equivalent diagnosis with analysis of molecular biomarkers in saliva, GCF, blood, or serum were retrieved from six databases and screened based on the eligibility criteria. The risk of bias in included studies was evaluated. Meta-analysis was planned for biomarkers assessed using the same detection methods and sample type in at least two papers.
RESULTS
Out of 5621 studies identified at initial screening, 28 papers were included in the qualitative analysis of which 2 were eligible for meta-analysis for IgG in serum samples. Eighty-seven biomarkers were assessed with the majority being higher in cases than in controls. Only the meta-analysis of total serum IgG with low heterogeneity value revealed a significant increase in its levels in C/MIPs compared to controls (standardised mean difference: 1.08; 95% CI: 0.76, 1.40).
CONCLUSION
There is a paucity of data on biomarkers associated with molar-incisor pattern periodontitis. Although serum IgG levels are raised, other more specific biomarkers in saliva, GCF, and blood/serum may be promising but require further investigation.
Topics: Humans; Child; Young Adult; Cross-Sectional Studies; Dental Enamel Hypoplasia; Incisor; Periodontitis; Biomarkers; Immunoglobulin G; Gingival Crevicular Fluid; Saliva
PubMed: 37535199
DOI: 10.1007/s00784-023-05169-x -
Brazilian Oral Research 2023The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head...
The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?" Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods.
Topics: Adult; Humans; Cross-Sectional Studies; Head and Neck Neoplasms; Oximetry; Dental Pulp Diseases; Radiation, Ionizing; Dental Pulp
PubMed: 37531515
DOI: 10.1590/1807-3107bor-2023.vol37.0079