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American Journal of Orthodontics and... Dec 2021This systematic review aimed to identify, evaluate, and provide a synthesis of the available literature on the proximal enamel thickness (PET) of permanent teeth. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
This systematic review aimed to identify, evaluate, and provide a synthesis of the available literature on the proximal enamel thickness (PET) of permanent teeth.
METHODS
The eligibility criteria were studies that assessed the PET of the permanent teeth. A search of studies in Medline (via PubMed), the Cochrane Library, Scopus, Web of Science, Embase, and Lilacs databases that measured PET was conducted until August 31, 2020. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias for systematic reviews involving cross-sectional studies. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. PET data generated from the systematic review were summarized by random-effects inverse-generic meta-analysis.
RESULTS
From 1388 potentially eligible studies, 11 were considered for systematic review and meta-analysis. The measurement of PET was done with radiographs, microscopes, microtomographs, or profilometers. In total, 4019 mesial and distal surfaces involving 2118 teeth were assessed. All included studies showed low to moderate risk of bias, whereas GRADE revealed that the level of evidence was low. Greater mesial and distal enamel thickness was observed for the premolars and molars, whereas it was least for the mandibular central incisors. The least difference of 0.02 mm (95% confidence interval [CI], -0.07 to 0.11 and -0.06 to 0.09, respectively) between mesial and distal sides was observed for the maxillary and mandibular second molars, whereas the maximum difference of 0.12 mm (95% CI, 0.07-0.17 and 0.07-0.16, respectively) was observed for the maxillary central incisors and maxillary first premolars. The meta-analysis indicated a moderate level of heterogeneity (I of 45%). The funnel plot revealed minimal publication bias.
CONCLUSIONS
The summary effect of the meta-analysis revealed that the thickness of the enamel on the distal aspect was greater than on the mesial aspect by an average of 0.10 mm (95% CI, 0.09-0.12). This finding would be of relevance to all disciplines of dentistry and especially for the clinician planning interproximal reduction, a procedure that is routinely done for clear aligner therapy.
Topics: Cross-Sectional Studies; Dental Caries; Dental Enamel; Dentition, Permanent; Humans; Molar
PubMed: 34420845
DOI: 10.1016/j.ajodo.2021.05.007 -
Bone Reports Dec 2021There is no cure for osteogenesis imperfecta (OI), and current treatments can only partially correct the bone phenotype. Stem cell therapy holds potential to improve...
There is no cure for osteogenesis imperfecta (OI), and current treatments can only partially correct the bone phenotype. Stem cell therapy holds potential to improve bone quality and quantity in OI. Here, we conduct a systematic review and meta-analysis of published studies to investigate the efficacy of stem cell therapy to rescue bone brittleness in mouse models of OI. Identified studies included bone marrow, mesenchymal stem cells, and human fetal stem cells. Effect size of fracture incidence, maximum load, stiffness, cortical thickness, bone volume fraction, and raw engraftment rates were pooled in a random-effects meta-analysis. Cell type, cell number, injection route, mouse age, irradiation, anatomical bone, and follow up time were considered as moderators. It was not possible to investigate further parameters due to the lack of standards of investigation between the studies. Despite the use of mice in the majority of the investigations considered and the lack of sham mice as control, this study demonstrates the promising potential of stem cell therapy to reduce fractures in OI. Although their low engraftment, cell therapy in mouse models of OI had a beneficial effect on maximum load, but not on stiffness, cortical thickness and bone volume. These parameters all depend on bone geometry and do not inform on its material properties. Being bone fractures the primary symptom of OI, there is a critical need to measure the fracture toughness of OI bone treated with stem cells to assess the actual efficacy of the treatment to rescue OI bone brittleness.
PubMed: 34368408
DOI: 10.1016/j.bonr.2021.101108 -
International Orthodontics Sep 2021To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking.
MATERIALS AND METHODS
The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size≥10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs).
RESULTS
A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42-1.75mm, while it was thicker for the posterior teeth (0.78-4.31mm). The palatal plate thickness ranged from 0.97-8.13mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4-3.71mm and 0.38-5.44mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66-6.31mm) and lingual (2.31-7.77mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers.
CONCLUSIONS
This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.
Topics: Cone-Beam Computed Tomography; Humans; Incisor; Likelihood Functions; Mandible; Maxilla
PubMed: 34366263
DOI: 10.1016/j.ortho.2021.07.002 -
Journal of Clinical Medicine Jun 2021All corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and... (Review)
Review
All corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and accelerated technique led to marked improvement in visual acuity. We determined the efficacy and safety of corneal cross-linking (CXL) in pediatric keratoconus by conducting a systematic review and meta-analysis. The PubMed and Cochrane databases were searched for relevant studies on the effects of standard, transepithelial, and/or accelerated CXL protocols in patients aged 18 years or younger. Standardized mean differences with 95% confidence intervals were calculated to compare the data collected at baseline and 12 months. The primary outcomes were maximum keratometry (Kmax) and uncorrected visual acuity (UCVA), and the secondary outcomes were the thinnest corneal thickness (TCT), best-corrected visual acuity (BCVA), and manifest refraction spherical equivalent or cylindrical refraction. Our search yielded 7913 publications, of which 26 were included in our systematic review and 21 were included in the meta-analysis. Standard CXL significantly improved the Kmax, UCVA, and BCVA, and significantly decreased the TCT. Accelerated CXL significantly improved UCVA and BCVA. In the transepithelial and accelerated-transepithelial CXL methods, each measurable parameter did not change after treatments. All CXL techniques attenuated disease progression in patients with pediatric keratoconus for at least one year. Standard and accelerated CXL led to marked improvement in visual acuity.
PubMed: 34203646
DOI: 10.3390/jcm10122626 -
Frontiers in Sports and Active Living 2021Post-exercise cold-water immersion (CWI) is a widely accepted recovery strategy for maintaining physical performance output. However, existing review articles about the...
Post-exercise cold-water immersion (CWI) is a widely accepted recovery strategy for maintaining physical performance output. However, existing review articles about the effects of CWI commonly pool data from very heterogenous study designs and thus, do rarely differentiate between different muscles, different CWI-protocols (duration, temperature, etc.), different forms of activating the muscles before CWI, and different thickness of the subcutaneous adipose tissue. This systematic review therefore aimed to investigate the effects of one particular post-exercise CWI protocol (10°C for 10 min) on intramuscular temperature changes in the quadriceps femoris muscle while accounting for skinfold thickness. An electronic search was conducted on PubMed, LIVIVO, Cochrane Library, and PEDro databases. Pooled data on intramuscular temperature changes were plotted with respect to intramuscular depth to visualize the influence of skinfold thickness. Spearman's rho (r) was used to assess a possible linear association between skinfold thickness and intramuscular temperature changes. A meta-analysis was performed to investigate the effect of CWI on pre-post intramuscular temperature for each measurement depth. A total of six articles met the inclusion criteria. Maximum intramuscular temperature reduction was 6.40°C with skinfold thickness of 6.50 mm at a depth of 1 cm, 4.50°C with skinfold thickness of 11.00 mm at a depth of 2 cm, and only 1.61°C with skinfold thickness of 10.79 mm at a depth of 3 cm. However, no significant correlations between skinfold thickness and intramuscular temperature reductions were observed at a depth of 1 cm ( = 0.0), at 2 cm ( = -0.8) and at 3 cm ( = -0.5; all > 0.05). The CWI protocol resulted in significant temperature reductions in the muscle tissue layers at 1 cm ( = -1.92 [95% CI: -3.01 to -0.83] and 2 cm ( = -1.63 [95% CI: -2.20 to -1.06]) but not at 3 cm ( < 0.05). Skinfold thickness and thus, subcutaneous adipose tissue, seems to influence temperature reductions in the muscle tissue only to a small degree. These findings might be useful for practitioners as they demonstrate different intramuscular temperature reductions after a specific post-exercise CWI protocol (10°C for 10 min) in the quadriceps femoris muscle.
PubMed: 34027405
DOI: 10.3389/fspor.2021.660092 -
Cardiovascular Revascularization... Mar 2022Intravascular lithotripsy (IVL) is a recently introduced therapeutic modality in the management of calcified coronary lesions (CCAD). IVL delivers sonic pressure waves... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intravascular lithotripsy (IVL) is a recently introduced therapeutic modality in the management of calcified coronary lesions (CCAD). IVL delivers sonic pressure waves to modulate calcium, hence promote vessel compliance and optimize stent deployment.
METHODS
We performed a comprehensive literature search for studies that evaluated the utility of adjunctive IVL. The primary outcomes of our study were the clinical success, defined as the ability of IVL to produce residual diameter stenosis <50% (RDS < 50%) after stenting with no evidence of in-hospital major adverse cardiac events, and the angiographic success, defined as success in facilitating stent delivery with RDS < 50% and without serious angiographic complications. The secondary outcomes included post-IVL and post-stenting changes in lumen area, calcium angle, and the maximum calcium thickness. Proportional analysis was used for binary data and mean difference was used for continuous data. All meta-analyses were conducted using a random-effect model and 95% confidence intervals (CIs) were included.
RESULTS
A total of eight single-arm observational studies, including 980 patients (1011 lesions), were included. 48.8% of the patients presented with acute coronary syndrome. Severe calcifications were present in 97% of lesions. Clinical success was achieved in 95.4% of patients (95%CI:92.9%-97.9%). Angiographic success was achieved in 97% of patients (95%CI:95%-99%). There was an overall increase in postprocedural lumen area as well as significant reduction of calcium angle and maximum calcium thickness.
CONCLUSIONS
IVL seems to have excellent efficacy and safety in the management of CCAD. However, adequately powered RCTs are needed to evaluate IVL compared to other calcium/plaque modifying techniques.
Topics: Calcium; Humans; Lithotripsy; Stents; Treatment Outcome; Vascular Calcification
PubMed: 34024748
DOI: 10.1016/j.carrev.2021.05.009 -
Journal of Physical Activity & Health Jun 2021The present study aimed to systematically review the literature on the effects of physical training on neuromuscular parameters in patients with type 1 diabetes mellitus... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The present study aimed to systematically review the literature on the effects of physical training on neuromuscular parameters in patients with type 1 diabetes mellitus (T1DM).
METHODS
The PubMed, Scopus, EMBASE, and COCHRANE databases were accessed in September 2020. Clinical trials that evaluated the effects of physical training on neuromuscular parameters (maximum strength, resistance strength, muscle power, muscle quality, and muscle thickness) of patients with T1DM compared with a control group were considered eligible. The results were presented as the standardized mean difference with 95% confidence intervals. Effect size (ES) calculations were performed using the fixed effect method, with α = .05.
RESULTS
Combined training increased the maximum strength levels in individuals with T1DM to a lesser extent than in healthy individuals (ES: 0.363; P = .038). Strength training increased the maximum strength (ES: 1.067; P < .001), as well as combined training (ES: 0.943; P < .001); both compared with aerobic training in patients with T1DM. Strength training increased the maximum strength in a similar magnitude to combined training in patients with T1DM (ES: -0.114; P = .624).
CONCLUSION
Both combined training and strength training represent effective strategies for improving the maximum strength in individuals with T1DM.
Topics: Diabetes Mellitus, Type 1; Exercise; Humans; Muscle Strength; Resistance Training
PubMed: 33952708
DOI: 10.1123/jpah.2020-0797 -
Acta Obstetricia Et Gynecologica... Aug 2021Magnetic resonance imaging (MRI) diagnosis of adenomyosis is considered the most accurate non-invasive technique, but remains subjective, with no consensus on which... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Magnetic resonance imaging (MRI) diagnosis of adenomyosis is considered the most accurate non-invasive technique, but remains subjective, with no consensus on which diagnostic parameters are most accurate. We aimed to systematically review the literature on how adenomyosis can be objectively quantified on MRI in a scoping manner, to review the diagnostic performance of these characteristics compared with histopathological diagnosis, and to summarize correlations between measures of adenomyosis on MRI and clinical outcomes.
MATERIAL AND METHODS
We searched databases Pubmed, Embase, and Cochrane for relevant literature up to April 2020 according to PRISMA guidelines. We included studies that objectively assessed adenomyosis on MRI, and separately assessed studies investigating the diagnostic performance of MRI vs histopathology for inclusion in a meta-analysis. The QUADAS-2 tool was used for risk of bias, with many studies showing an unclear or high risk of bias.
RESULTS
Eighty studies were included, of which 14 assessed the diagnostic performance of individual MRI parameters, with four included in the meta-analysis of diagnostic accuracy. Common MRI parameters were: junctional zone (JZ) characteristics, such as maximum JZ thickness-pooled sensitivity 71.6% (95% CI 46.0%-88.2%), specificity 85.5% (52.3%-97.0%); JZ differential-pooled sensitivity 58.9% (95% CI 44.3%-72.1%), specificity 83.2% (95% CI 71.3%-90.8%); and JZ to myometrial ratio-pooled sensitivity 63.3% (95% CI 51.9%-73.4%), specificity 79.4% (95% CI 42.0%-95.4%); adenomyosis lesion size, uterine morphology (pooled sensitivity 42.9% (95% CI 15.9%-74.9%), specificity 87.7%, (95% CI 37.9-98.8) and changes in signal intensity-eg, presence of myometrium cysts; pooled 59.6% (95% CI 41.6%-75.4%) and specificity of 96.1% (95% CI 80.7%-99.3%). Other MRI parameters have been used for adenomyosis diagnosis, but their diagnostic performance is unknown. Few studies attempted to correlate adenomyosis MRI phenotype to clinical outcomes.
CONCLUSIONS
A wide range of objective parameters for adenomyosis exist on MRI; however, in many cases their individual diagnostic performance remains uncertain. JZ characteristics remain the most widely used and investigated with acceptable diagnostic accuracy. Specific research is needed into how these objective measures of adenomyosis can be correlated to clinical outcomes.
Topics: Adenomyosis; Female; Humans; Magnetic Resonance Imaging; Predictive Value of Tests
PubMed: 33682087
DOI: 10.1111/aogs.14139 -
American Journal of Obstetrics &... May 2021The aim of this systematic review and meta-analysis was to define the means and the upper limits of normal for endometrial thickness and uterine measurements in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to define the means and the upper limits of normal for endometrial thickness and uterine measurements in uncomplicated pregnancies at different postpartum periods.
DATA SOURCES
A search was conducted in the Medline, Embase, Cinahl, and Clinicaltrials.gov databases up to January 30, 2020.
STUDY ELIGIBILITY CRITERIA
We included studies reporting sonographic parameters of the uterus in the normal postpartum period.
METHODS
The continuous variables were expressed as means with standard deviations. The upper limits of normal were defined as the 95th percentile. Clinically significant differences in the uterine measurements between subgroups were defined as ≥2 cm; significant differences in the uterine volume were defined as >10%. The primary outcome was the endometrial thickness; others sonographic parameters that were analyzed were the uterine anteroposterior diameter, longitudinal diameter, width, and volume.
RESULTS
A total of 5260 articles were identified. Of these, 80 were assessed for their eligibility for inclusion and 32 studies were included in this systematic review. These studies included 3106 women (55% multiparas and 82% with vaginal deliveries) who underwent transabdominal and/or transvaginal ultrasound from the first postpartum day to a maximum of 6 weeks postpartum. The upper limit of normal (95th percentile) for the endometrial thickness was 25 mm by 7 days postpartum and this continued to decrease (18 mm at 14 days, 12 mm at 4 weeks, and 9 mm at 6 weeks) in a similar manner for all the women regardless of parity or mode of delivery. All the other uterine measurements also gradually decreased during the puerperium for all the women regardless of parity or mode of delivery.
CONCLUSION
These upper limits of normal for the postpartum endometrium and uterine measurements in uncomplicated pregnancies provide clinical guidance for the sonographic evaluation of women with complicated postpartum courses.
Topics: Delivery, Obstetric; Female; Humans; Postpartum Period; Pregnancy; Prospective Studies; Ultrasonography; Uterus
PubMed: 33493704
DOI: 10.1016/j.ajogmf.2021.100318 -
Archives of Gynecology and Obstetrics Feb 2021Cesarean scar pregnancy (CSP) is one of the serious complications associated with cesarean delivery (CD). This meta-analysis aims to identify risk factors associated... (Meta-Analysis)
Meta-Analysis
PURPOSE
Cesarean scar pregnancy (CSP) is one of the serious complications associated with cesarean delivery (CD). This meta-analysis aims to identify risk factors associated with massive hemorrhage during the CSP treatment.
METHODS
Eight electronic databases were searched for case-control studies published before December 31th, 2018, which compared the possible factors causing massive bleeding during the CSP treatment. Quantitative synthesis was performed by RevMan 5.3. Sensitivity analysis and publication bias were performed by Stata 12.0.
RESULTS
Total 20 case - control studies including 3101 CSP patients with previous CD met the inclusion criteria. Bleeding group had 573 patients and the control group had 2528 patients. The risk factors for massive bleeding during CSP treatment included multiple gravidities (MD = 0.15, 95% CI 0.03-0.28, P = 0.73), big maximum diameter of gestation sac (MD = 18.49 mm, 95%CI 15.34-21.65, P < 0.01), high gestational days (MD = 8.98 days, 95% CI 4.12-13.84, P < 0.01), high β-HCG level (MD = 21.39 IU/ml, 95% CI 7.36-35.41, P = 0.03; MD = 3.02 U/ml, 95% CI 0.21-5.84, P < 0.01) and rich blood flow around the lesion (OR = 6.73, 95% CI 3.93-11.51, P = 0.59). While, thick myometrium (MD = - 4.94 mm, 95% CI - 6.12 to - 3.75, P < 0.01) may be protective factor.
CONCLUSIONS
Multiple gravidities, big gestation sac, large gestational days, high serum β-HCG level, abundant blood supply to pregnancy sac and thin myometrium maybe the risk factors for massive bleeding during the CSP treatment.
Topics: Adult; Case-Control Studies; Cesarean Section; Chorionic Gonadotropin, beta Subunit, Human; Cicatrix; Female; Gestational Sac; Humans; Myometrium; Postoperative Complications; Pregnancy; Pregnancy, Ectopic; Risk Factors; Treatment Outcome; Uterine Hemorrhage; Uterus
PubMed: 33219842
DOI: 10.1007/s00404-020-05877-9