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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 -
Pediatric Dentistry Sep 2023The purpose of this study was to review the in vitro literature on shear bond strength (SBS) and microleakage of pit and fissure sealant materials in contaminated... (Meta-Analysis)
Meta-Analysis
The purpose of this study was to review the in vitro literature on shear bond strength (SBS) and microleakage of pit and fissure sealant materials in contaminated (water, human, or artificial saliva) and non-contaminated conditions. PubMed, Web of Science™, Scopus, Embase™, and Cochrane Library databases were used as data sources. Of the 974 studies identified, 56 were considered eligible for full-text screening and 32 were selected for data extraction. The meta-analysis demonstrated that contaminated conditions decreased the SBS of the sealants by 4.33 MPa. In the contaminated subgroup analysis, both unfilled (Clinpro™, 3M™) and filled (FluroShield, Dentsply) resin-based sealants achieved a similar SBS (P=0.82). Regarding the outcome measurements, extensive methodological heterogeneity was found among the studies for SBS measurements (I 2 equals greater than or equal to 84 percent; P<0.001), whereas homogeneity was found for microleakage (I 2 equals 84 percent; P=0.85). When evaluating resin-based sealants, the level of microleakage in the contaminated and non- contaminated groups was not significantly different (P=0.1). Surface contamination decreases the bond strength between contaminated enamel and both unfilled and filled resin-based sealants, which affects the clinical effectiveness of sealants.
Topics: Humans; Pit and Fissure Sealants; Bisphenol A-Glycidyl Methacrylate; Dental Bonding; Saliva; Dental Enamel; Shear Strength; Materials Testing
PubMed: 37904265
DOI: No ID Found -
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 -
The European Journal of Prosthodontics... Nov 2023Pit and fissure sealants are effective in preventing caries disease, however, they may present flaws that damage the physical barrier leading to treatment failure.
INTRODUCTION
Pit and fissure sealants are effective in preventing caries disease, however, they may present flaws that damage the physical barrier leading to treatment failure.
OBJECTIVE
To answer the question ''Do pit and fissure sealants present good adhering to the dental structure when analyzed by their resistance to shear/microshear?".
METHODS
This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and was recorded in Open Science Framework. Embase, PubMed, SCOPUS, and Web of Science databases were used for the search strategy. The articles were selected according to the eligibility criteria. The risk of bias was performed with the adaptation of the quasi-experimental studies tool by Joanna Briggs Institute (JBI).
RESULTS
1245 studies were found in the databases when applying the search strategy, after removal of duplicates 881 were evaluated and 44 were selected. After applying the JBI tool, 30 studies presented low risk and 15 moderate risk of bias. Meta-analysis was not possible to performed due to the heterogeneity of the studies.
CONCLUSION
The adhesion is dependent on the application protocol, and among the protocols evaluated, conditioning with 37% phosphoric acid for 60 seconds and contamination of the substrate, as these can affect sealant adhesion.
Topics: Humans; Dental Caries; Pit and Fissure Sealants; Shear Strength
PubMed: 37721539
DOI: 10.1922/EJPRD_2503Ferreira14 -
Journal of Dental Research, Dental... 2023This systematic review aimed to evaluate the available scientific evidence concerning the effects of topical fluoride treatment on the bond strength of pit and fissure... (Review)
Review
BACKGROUND
This systematic review aimed to evaluate the available scientific evidence concerning the effects of topical fluoride treatment on the bond strength of pit and fissure sealants. Prevention of dental caries is one of the crucial issues in pediatric dentistry. Pit and fissure sealant and fluoride therapies are two caries prevention procedures that may be performed in one session. However, fluoride therapy may affect the bond strength of pit and fissure sealants.
METHODS
An electronic search for in vitro studies published in English and Persian on topical fluoride therapy and the bond strength of pit and fissure sealants was performed via PubMed/ Medline, Web of Science, Google Scholar, Embase, and Scopus databases until May 2022. The articles were independently reviewed for quality by two reviewers. Textual data were analyzed manually, and the bond strength of sealants placed after fluoride application was compared with control groups.
RESULTS
A total of 8482 articles were initially identified and reviewed by two independent reviewers, and 13 were selected for full-text evaluation. Finally, six articles were included in the systematic review. A total of 250 teeth were studied, 148 of which were in the case group (fluoride group) and 102 in the control group. Tensile and shear bond strengths were compared between groups in the studies.
CONCLUSION
In the studies in which the tooth surfaces were washed after applying fluoride, there was no change in the fissure sealant bond strength. However, in studies in which fluoride was not washed, the bond strength decreased significantly, independent of the fluoride type.
PubMed: 37649817
DOI: 10.34172/joddd.2023.39160 -
Journal of the Mechanical Behavior of... Sep 2023The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This... (Review)
Review
The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This review included in vitro studies with full-length English-language articles reporting on the physicomechanical properties of nanofilled RBS until February 2023. PubMed, Web of Sciences, Scopus, and LILACS databases were accessed for literature searches. The review was formulated based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. The search resulted in 539 papers, of which 22 were eligible to be included in the review. Inorganic, polymeric, core-shell, and composite nanomaterials were used to reinforce the studied RBS. The inherent nature of the nanomaterial used, its morphology, concentration, and volume used were the primary parameters that determined the nanomaterial's success as a filler in RBS. These parameters also influenced their interaction with the resin matrix, which influenced the final physicomechanical properties of RBS. The use of nanofillers that were non-agglomerated and well dispersed in the resin matrix enhanced the physicomechanical properties of RBS.
Topics: Humans; Pit and Fissure Sealants; Nanostructures; Polymers; Reference Standards; Dental Caries
PubMed: 37499522
DOI: 10.1016/j.jmbbm.2023.106037 -
Frontiers in Pediatrics 2023The fetal alcohol spectrum disorder is a group of developmental disorders caused by maternal alcohol consumption. Patients with fetal alcohol syndrome show abnormal... (Review)
Review
BACKGROUND
The fetal alcohol spectrum disorder is a group of developmental disorders caused by maternal alcohol consumption. Patients with fetal alcohol syndrome show abnormal orofacial features. This review presents an overview over the facial, oral, dental or orthodontic findings and diagnostic tools concerning these features.
METHODS
For this systematic review Cochrane, Medline and Embase databases were considered and the review was performed according to the PRISMA checklist. Two independent reviewers evaluated all studies and recorded results in a summary of findings table. Risk of bias was analyzed via Quadas-2 checklist.
RESULTS
61 studies were eligible for inclusion. All included studies were clinical studies. Methods and results of the studies were not comparable, guidelines or methods for the detection of FASD varied across studies. Facial features most often measured or found as distinguishing parameter were: palpebral fissure length, interpupillary or innercanthal distance, philtrum, upper lip, midfacial hypoplasia or head circumference.
CONCLUSIONS
This review shows that to date a multitude of heterogeneous guidelines exists for the diagnosis of FASD. Uniform, objective diagnostic criteria and parameters for the orofacial region in FASD diagnosis are needed. A bio database with values and parameters for different ethnicities and age groups should be made available for diagnosis.
PubMed: 37360373
DOI: 10.3389/fped.2023.1169570 -
Community Dentistry and Oral... Dec 2023There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate... (Review)
Review
BACKGROUND
There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate outcomes used in randomized clinical trials for caries prevention, pit and fissure sealants and fluoridated dentifrices, according to the Prentice criteria.
METHODS
A systematic review was conducted in MEDLINE (PubMed), LILACS and Scopus databases up to 05 October 2022. The grey literature and the list of eligible studies' references were also screened. The search was conducted, selecting randomized clinical trials focussed on dental caries prevention using pit and fissure sealants or fluoridated dentifrices and with at least one surrogate endpoint for cavitated caries lesions. The risk of each surrogate endpoint and for the occurrence of cavitated caries lesions was calculated and compared. The association between each surrogate and the presence of cavitation was quantified, and each outcome was assessed graphically for validity according to the Prentice criteria.
RESULTS
For pit and fissure sealants, from 1696 potentially eligible studies, 51 were included; while for fluoridated dentifrices, of 3887 potentially eligible studies, four were included. Possible surrogates assessed were retention of sealants, presence of white spot lesions, presence of plaque or marginal discoloration around the sealants, oral hygiene index, radiographic and fluorescence caries lesion assessments. However, only the retention of sealants and the presence of white spot lesions could be evaluated for their validity according to the Prentice criteria.
CONCLUSION
Loss of retention of sealants and the presence of white spot lesions do not fulfil all of the Prentice criteria. Therefore, they cannot be considered valid surrogates for caries prevention.
Topics: Humans; Dental Caries; Pit and Fissure Sealants; Dental Caries Susceptibility; Dentifrices; Biomarkers; Randomized Controlled Trials as Topic
PubMed: 37246464
DOI: 10.1111/cdoe.12861