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Preventive Medicine Jun 2024This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use. (Review)
Review
OBJECTIVE
This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use.
METHODS
We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines.
RESULTS
The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing.
CONCLUSIONS
The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance. The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937.
PubMed: 38901743
DOI: 10.1016/j.ypmed.2024.108043 -
Sleep & Breathing = Schlaf & Atmung Jun 2024The goal of this review is to provide sleep physicians, dentists, and researchers with an evidence-based overview of the literature on smart mandibular advancement... (Review)
Review
PURPOSE
The goal of this review is to provide sleep physicians, dentists, and researchers with an evidence-based overview of the literature on smart mandibular advancement devices (MADs) for the treatment of obstructive sleep apnea.
METHODS
A systematic literature search was conducted by two blinded reviewers and an information specialist. A smart MAD was defined as any MAD with additional functionality besides mandibular protrusion. The bibliographic databases Medline, Embase, and Scopus were used to identify relevant publications. Studies were included if they described any stage of development of smart MADs. A total of 3162 titles and abstracts were screened for their relevance. In total, 58 articles were selected for full-text screening, 26 of which were included in this review.
RESULTS
The overall quality of the available literature was low. Most of the studies were observational, clinical or applied-research articles. The authors classified MADs into two main groups: passive and active. Passive MADs measured patient data, most commonly patient compliance. Active MADs adjusted protrusion of the mandible in response to patient data and were found in various phases of technological readiness (in development, demonstration, or deployment).
CONCLUSION
Innovations in smart mandibular advancement devices most frequently track patient compliance. Devices measuring other health parameters and active, feedback-controlled, devices are increasingly reported on. However, studies demonstrating their added benefit over traditional methods remain sparse. With further study, smart mandibular advancement devices have the potential to improve the efficiency of obstructive sleep apnea treatment and provide new treatment possibilities.
PubMed: 38886278
DOI: 10.1007/s11325-024-03068-3 -
International Journal of Paediatric... Jun 2024Understanding of socioeconomic context might enable more efficient evidence-based preventive strategies in oral health. (Review)
Review
BACKGROUND
Understanding of socioeconomic context might enable more efficient evidence-based preventive strategies in oral health.
AIM
The study assessed the caries-related socioeconomic macro-factors in 12-year-olds across European countries.
DESIGN
This systematic review involved epidemiological surveys on the caries status of 12-year-olds from 2011 to 2022. DMFT was analyzed in relation to gross national income (GNI), United Nations Statistical Division geographical categorization of European countries (M49), unemployment rate, Human Development Index (HDI), and per capita expenditure on dental health care. A meta-analysis was performed for countries reporting data on DMFT, stratified by GNI, and geographical location of European countries, using a random-effects model.
RESULTS
The study involved 493 360 children from 36 countries in the geographic region of Europe. The analysis confirmed a strong negative correlation between income and caries experience (p < .01). Children living in higher-income countries showed 90% lower odds of poor oral health than in middle-income countries. Children living in West Europe showed 90% lower odds of poor oral health than children living in East Europe.
CONCLUSION
The strong effect of macro-level socioeconomic contexts on children's oral health suggests favoring upstream preventive oral health strategies in countries with economic growth difficulties, Eastern and Southern parts of Europe.
PubMed: 38881267
DOI: 10.1111/ipd.13224 -
Journal of Dentistry Jun 2024Dentists' diagnostic accuracy in detecting periapical radiolucency varies considerably. This systematic review and meta-analysis aimed to investigate the accuracy of... (Review)
Review
OBJECTIVES
Dentists' diagnostic accuracy in detecting periapical radiolucency varies considerably. This systematic review and meta-analysis aimed to investigate the accuracy of artificial intelligence (AI) for detecting periapical radiolucency.
DATA
Studies reporting diagnostic accuracy and utilizing AI for periapical radiolucency detection, published until November 2023, were eligible for inclusion. Meta-analysis was conducted using the online MetaDTA Tool to calculate pooled sensitivity and specificity. Risk of bias was evaluated using QUADAS-2.
SOURCES
A comprehensive search was conducted in PubMed/MEDLINE, ScienceDirect, and Institute of Electrical and Electronics Engineers (IEEE) Xplore databases. Studies reporting diagnostic accuracy and utilizing AI tools for periapical radiolucency detection, published until November 2023, were eligible for inclusion.
STUDY SELECTION
We identified 210 articles, of which 24 met the criteria for inclusion in the review. All but one study used one type of convolutional neural network. The body of evidence comes with an overall unclear to high risk of bias and several applicability concerns. Four of the twenty-four studies were included in a meta-analysis. AI showed a pooled sensitivity and specificity of 0.94 (95 % CI = 0.90-0.96) and 0.96 (95 % CI = 0.91-0.98), respectively.
CONCLUSIONS
AI demonstrated high specificity and sensitivity for detecting periapical radiolucencies. However, the current landscape suggests a need for diverse study designs beyond traditional diagnostic accuracy studies. Prospective real-life randomized controlled trials using heterogeneous data are needed to demonstrate the true value of AI.
CLINICAL SIGNIFICANCE
Artificial intelligence tools seem to have the potential to support detecting periapical radiolucencies on imagery. Notably, nearly all studies did not test fully fledged software systems but measured the mere accuracy of AI models in diagnostic accuracy studies. The true value of currently available AI-based software for lesion detection on both 2D and 3D radiographs remains uncertain.
PubMed: 38851523
DOI: 10.1016/j.jdent.2024.105104 -
Cureus May 2024Antibiotics are commonly prescribed as a preventive measure, particularly post-tooth extraction, aiming to minimize the risk of infection. Preemptive analgesia functions... (Review)
Review
Antibiotics are commonly prescribed as a preventive measure, particularly post-tooth extraction, aiming to minimize the risk of infection. Preemptive analgesia functions by disrupting the nervous system's ability to encode pain stimuli, thus preventing the formation of pain memory. Dentists often recommend analgesics and antibiotics either as adjuncts or sole treatments for various dental conditions, offering both efficacy and cost-effectiveness. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, and Lilac, using MeSH terms relevant to the role of antibiotics and analgesics in systemically ill patients undergoing tooth extraction. Out of 178 articles screened, 83 underwent full-text assessment for eligibility, and six were selected for qualitative analysis. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring methodological rigor and transparent reporting. Across diverse study populations, the role of antibiotics and analgesics consistently demonstrated a statistically significant impact. Hence, the utilization of analgesics and antibiotics plays a pivotal role in preventing infection following tooth extraction in systemically ill patients, thereby promoting optimal oral hygiene and overall health.
PubMed: 38840997
DOI: 10.7759/cureus.59711 -
The Journal of Craniofacial Surgery Jun 2024Odontogenic cutaneous fistula (OCF) is a pathologic communication between the cutaneous surface of the face and oral cavity. Majority of oral cutaneous fistulas are...
BACKGROUND
Odontogenic cutaneous fistula (OCF) is a pathologic communication between the cutaneous surface of the face and oral cavity. Majority of oral cutaneous fistulas are reported to arise from chronic dental infection. Delay in treatment may result in chronic tissue injury as well as cosmetic deformities. Lesions are often misdiagnosed, leading to delayed management. Misdiagnosis may be the result of the variability of clinical morphological presentation and location of lesions compounded by the lack of knowledge that these lesions can have dental etiology. It is estimated that half of patients with OCF undergo multiple dermatologic surgical operations, antibiotic regimens, and other excisions and biopsies before a correct diagnosis is made. Herein, we present a systematic review to detail cases of odontogenic cutaneous lesions that had been previously misdiagnosed or managed inappropriately. In addition, we include a case report from our own institution. The aims are to demonstrate various presentations of OCF, increase awareness of plastic surgeons and oral maxillofacial surgeons to this pathological condition, and reinforce the importance of prompt diagnosis and treatment.
METHODS
The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in PubMed, Web of Science, and Cochrane databases from January 1, 2013 to July 24, 2023. The following search terms were utilized: "odontogenic cutaneous fistula" OR "odontogenic cutaneous sinus."
RESULTS
Twenty-three articles published between 2013 and 2023 were included in this review. In addition, we report a case from our own institution. A total of 28 cases were included in the review.
CONCLUSIONS
Diagnosis of OCF is challenging for numerous reasons. Misdiagnosis can lead to multiple trials of antibiotics and surgical procedures as well as reoccurrence of the lesion. Cases summarized highlight the importance of communication between oral maxillofacial surgery, plastic surgery, other medical subspecialists, and dentists in the evaluation of patients with head and neck lesions. Physicians should consider dental etiology in the differential diagnosis of orofacial skin lesions, even if teeth appear normal on oral examination.
Topics: Adult; Humans; Male; Cutaneous Fistula; Dental Fistula; Diagnosis, Differential; Diagnostic Errors
PubMed: 38829145
DOI: 10.1097/SCS.0000000000010144 -
Oral health status among the transgender population of India: A systematic review and meta-analysis.Special Care in Dentistry : Official... May 2024The invisibility of the transgender population within official records, combined with other socio-economic factors, impacts oral health status among transgender people.... (Review)
Review
BACKGROUND
The invisibility of the transgender population within official records, combined with other socio-economic factors, impacts oral health status among transgender people. Hence, our systematic review and meta-analysis aim to generate a pooled estimate of the oral health status of the transgender community in India.
MATERIAL AND METHODS
A systematic search was performed across four databases. The studies included a quantitative research design conducted in India and involved self-identified transgender individuals. The pooled prevalence was determined at a 95% confidence interval (CI). Q-statistics and the I test were utilized to evaluate the source of heterogeneity. Leave-one-out analysis and Baujat plots were used to detect outliers within the studies. A Doi plot and LFK index were employed to assess the publication bias.
RESULTS
A total of 12 studies comprising 1566 transgender participants were included. The pooled prevalence of toothbrush use among transgenders in India was found at 83% (95% CI: 0.73-0.91), smoking = 12% (CI: 0.03-0.26), smokeless tobacco = 53% (CI = 0.38-0.68), dental caries = 78% (CI: 67%-88%), calculus = 65% (CI: 0.4-0.86), and bleeding 18% (CI:0.08-0.32).
CONCLUSION
Oral health disparities among Indian transgender individuals are evident in the low toothbrush usage, an elevated prevalence of tobacco use, and dental disorders such as calculus, cavities, and bleeding. Tailored dental health programs that include inclusive healthcare services and awareness are essential.
PROSPERO REGISTRATION
CRD42023468872.
PubMed: 38807264
DOI: 10.1111/scd.13027 -
Journal of Clinical Periodontology Jul 2024To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short... (Meta-Analysis)
Meta-Analysis Comparative Study Review
Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading.
AIM
To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios.
MATERIALS AND METHODS
Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses.
RESULTS
Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar.
CONCLUSIONS
Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift.
TRIAL REGISTRATION
PROSPERO ID: CRD42021254365.
Topics: Humans; Dental Implants; Randomized Controlled Trials as Topic; Dental Prosthesis Design; Dental Restoration Failure; Dental Implantation, Endosseous; Alveolar Bone Loss
PubMed: 38764386
DOI: 10.1111/jcpe.13981 -
Japan Journal of Nursing Science : JJNS May 2024This systematic review aimed to assess the effect of non-pharmacologic perioperative oral hygiene care on reduced incidence of postoperative pneumonia (PP), surgical... (Review)
Review
AIM
This systematic review aimed to assess the effect of non-pharmacologic perioperative oral hygiene care on reduced incidence of postoperative pneumonia (PP), surgical site infection (SSI), and the length of hospital stay in patients with cancer, and to describe the details of oral hygiene care.
METHODS
We searched seven databases. Eligibility criteria were based on perioperative oral hygiene care provided by healthcare professionals to patients aged ≥18 years who were surgically treated under general anesthesia and were evaluated for the incidence of PP and SSI. We reported risk ratios (RR) for dichotomous outcomes for PP and SSI using a fixed-effects model of meta-analysis.
RESULTS
The search resulted in 850 articles, among which two were randomized controlled trials (RCTs) and 21 were observational studies. Most studies indicated that dentists and medical care providers performed a combination of oral cleaning, and oral hygiene instructions. In RCTs, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.86; p = .60), while in observational studies, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.55; p < .001) and SSI (RR, 0.47; p < .001). The length of hospital stay was also significantly reduced (p < .05). However, the effectiveness of nursing intervention was not clear.
CONCLUSIONS
Perioperative oral hygiene care implemented by healthcare professionals prevented PP and SSI and reduced length of hospital stays for patients after cancer surgery. As daily perioperative oral hygiene care is performed by nurses, it is necessary to research the effects of oral hygiene by nurses in the future.
PubMed: 38757361
DOI: 10.1111/jjns.12600 -
Special Care in Dentistry : Official... May 2024
PubMed: 38757306
DOI: 10.1111/scd.13011