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Special Care in Dentistry : Official... Feb 2024To compare manual and powered toothbrushes in older adults and to culminate available clinical evidence concerning efficiency with respect to plaque removal and reduced... (Review)
Review
OBJECTIVE
To compare manual and powered toothbrushes in older adults and to culminate available clinical evidence concerning efficiency with respect to plaque removal and reduced gingivitis.
BACKGROUND
Manual dexterity decreases with age, negatively impacting daily activities, including oral hygiene practices. Effective plaque control in this age group is directly related to nutrition and overall health. Therefore, developing oral health interventions tailored to the ageing population is essential.
MATERIAL AND METHODS
This systematic review was registered with PROSPERO (Registration No. CRD42023415876). Five electronic databases were searched to identify randomized controlled trials published from inception until March 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta-analyses were also performed for gingival, plaque, and bleeding indices.
RESULTS
A total of 2118 records were identified, and six eligible publications were retrieved. Comparison of Plaque Indices between powered and manual toothbrushes showed a Standard mean difference (SMD) of -0.10; 95% CI [-0.37, 0.18] (p = .38). Comparison of the gingival index and bleeding index between powered and manual toothbrushes showed an SMD of -0.28; 95% CI [-0.72, 0.16] (p = .22) and SMD of -0.03 [-0.38, 0.32] (p = .84), respectively.
CONCLUSION
According to the available literature, this study suggests the need for more streamlined research to support the superiority of either powered or manual toothbrushes in improving oral health (as measured by the indices) among the older population. The results will hence have significant reverberations for older adults looking to improve their oral hygiene practices.
PubMed: 38348549
DOI: 10.1111/scd.12974 -
Caries Research Feb 2024A growing number of studies on diagnostic imaging show superior efficiency and accuracy of computer-aided diagnostic systems compared to certified dentists. This...
INTRODUCTION
A growing number of studies on diagnostic imaging show superior efficiency and accuracy of computer-aided diagnostic systems compared to certified dentists. This methodological systematic review aims to evaluate the different methodological approaches used by studies focusing on machine learning and deep learning and that have used radiographic databases to classify, detect, and segment dental caries.
METHODS
The protocol was registered in PROSPERO before data collection (CRD42022348097). Literature research was performed in MEDLINE, Embase, IEEE Xplore, and Web of Science until December 2022, without language restrictions. Studies and surveys using a dental radiographic database for the classification, detection, or segmentation of carious lesions were sought. Records deemed eligible were retrieved and further assessed for inclusion by two reviewers who resolved any discrepancies through consensus. A third reviewer was consulted when any disagreements or discrepancies persist between the two reviewers. After data extraction, the same reviewers assessed the methodological quality using the CLAIM and QUADAS-AI checklists.
RESULTS
After screening 325 articles, 35 studies were eligible and included. The bitewing was the most commonly used radiograph (n=17) at the time when detection (n=15) was the most explored computer vision task. The sample sizes used ranged from 95 to 38437, while the augmented training set ranged from 300 to 315786. Convolutional neural network (CNN) was the most commonly used model. The mean completeness of CLAIM items was 49 % (SD ± 34%). The applicability of the CLAIM checklist items revealed several weaknesses in the methodology of the selected studies: most of the studies were monocentric, and only 9% of them used an external test set when evaluating the model's performance. The QUADAS-AI tool revealed that only 43% of the studies included in this systematic review were at low risk of bias concerning the standard reference domain.
CONCLUSION
This review demonstrates that the overall scientific quality of studies conducted to feed AI algorithms is low. Some improvement in the design and validation of studies can be made with the development of a standardized guideline for the reproducibility and generalizability of results and, thus, their clinical applications.
PubMed: 38342096
DOI: 10.1159/000536277 -
Medical Science Monitor : International... Feb 2024Telemedicine technologies allow distribution of health-related services and information and can include electronic and telecommunication technologies, remote patient and...
A Systematic Review of Publications on Perceptions and Management of Chronic Medical Conditions Using Telemedicine Remote Consultations by Primary Healthcare Professionals April 2020 to December 2021 During the COVID-19 Pandemic.
Telemedicine technologies allow distribution of health-related services and information and can include electronic and telecommunication technologies, remote patient and clinician contact, referral and prescribing, patient education, and monitoring. This systematic review aimed to evaluate publications on the perceptions and management of chronic medical conditions using telehealth remote consultations by primary healthcare professionals between April 2020 and December 2021 during the COVID-19 pandemic. Electronic databases, including Cinhal, PubMed, Science Direct, and ProQuest were searched to extract qualitative studies relevant to the topic. Inclusion criteria were developed based on the Population, Exposure, and Outcomes scoping framework. The target population was healthcare professionals working in primary care settings. Included studies encompassed various types of telemedicine, such as synchronous telemedicine, video conferencing, telephone conversations, and smart devices. Eight studies were included. Synchronous telemedicine was highly effective in ensuring the continuity of care and treatment, providing patients with convenience, improved access to treatment, and earlier disease management. Video conferencing and telephone consultations were the most common methods used. Challenges included concerns about patient privacy, technology literacy, and acceptance. Telemedicine was commended for its ability to provide access to immediate expert medical advice and eliminate the need for long-distance travel, contributing to increased patient compliance. Synchronous telemedicine is a promising solution for managing chronic conditions during and after the COVID-19 pandemic, offering benefits to patients and healthcare professionals. To maximize its potential, concerns regarding patient privacy, confidentiality, and technology literacy need to be addressed. Proper legislation and regulations are required for long-term success of telemedicine, making it a valuable component of healthcare systems.
Topics: Humans; Remote Consultation; COVID-19; Pandemics; Telemedicine; Chronic Disease; Primary Health Care
PubMed: 38341609
DOI: 10.12659/MSM.943383 -
Journal of Clinical Medicine Jan 2024The period of pregnancy is characterized by a multitude of diverse changes that exert a notable impact on the oral cavity of women. During this gestational phase,... (Review)
Review
The period of pregnancy is characterized by a multitude of diverse changes that exert a notable impact on the oral cavity of women. During this gestational phase, patients necessitate tailored oral care and specific recommendations to preempt and address potential oral diseases. This systematic review aimed to perform a detailed analysis of the research studies that focused on the oral manifestations observed in pregnant women. A meticulous search was conducted in the databases Medline, Scopus, and Scielo by employing the following search terms: ((pregnant OR pregnancy)) AND (("oral manifestation*") OR ("oral health")). Articles that were published between 2013 and 2023 and written in English or Spanish and studies that scrutinized oral manifestations in pregnant women and included a diagnosis conducted by a qualified dentist were selected; we excluded articles published before 2013, articles that could not be accessed in full text, studies whose patients were not pregnant women at the time of the study, studies where patients were selected because they had a specific disease, studies where the clinical examination was not performed by a dentist, and articles written in languages other than English or Spanish. Subsequently, the risk of bias in the chosen articles was assessed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. A total of 20 studies were included in the analysis, following the exclusion and inclusion criteria. These studies were categorized as cross-sectional, cohort, longitudinal, or case-control. Various oral manifestations in pregnant women were examined, with five studies comparing these manifestations with those observed in nonpregnant women. The most prevalent oral manifestations associated with pregnancy encompass dental caries, periodontitis, gingivitis, pyogenic granuloma, and candidiasis. Nonetheless, less common lesions may also emerge during the course of pregnancy.
PubMed: 38337401
DOI: 10.3390/jcm13030707 -
International Endodontic Journal May 2024There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the... (Review)
Review
BACKGROUND
There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the decision-making process in choosing conservative or invasive treatments is influenced by several factors, particularly in permanent teeth with irreversible pulpitis.
OBJECTIVES
The objective of the study was to systematically review the literature regarding factors that influence decision-making for vital pulp therapy (VPT) as definitive treatment option in permanent mature teeth diagnosed with irreversible pulpitis.
METHODS
Two independent reviewers searched five electronic databases (PubMed, Embase, Web of Science, Scopus and Cochrane Library). Grey literature was searched through Google Scholar and contact with experts. Defined search keys were applied, and all peer-reviewed literature published with no language nor publication date limits were included. The All studies investigating the factors influencing treatment decision-making in mature permanent teeth with irreversible pulpitis were included. The quality of included studies was assessed by two independent reviewers using the Joanna Briggs Institute quality assessment tool.
RESULTS
Six articles were included in the review. All included studies used questionnaires to characterize clinician preferences and attitudes in choosing treatment options for mature permanent teeth with irreversible pulpitis. The available evidence suggests that dentist-related factors have a significant influence on the chosen treatment in teeth with irreversible pulpitis, with speciality training and years of experience influencing the choice of VPT over other treatment options. COVID-19 reportedly swayed the dentists' decision to favour VPT. Only one article studied the influence of patient-related factors, such as age and presence of spontaneous pain on decision-making. Of note, a history of cardiovascular disease moved dentists towards prescribing VPT.
DISCUSSION
Collectively, the included studies demonstrated an overriding influence of dentist-related factors on choosing among treatment options for painful teeth diagnosed with irreversible pulpitis. Patient-related factors were acknowledged but there are also potential factors such as socio-economic constraints that were not included in the component studies.
CONCLUSION
In teeth with irreversible pulpitis clinicians educational background influence the decision towards a specific treatment option. Further data, preferably derived from clinical records, is necessary in future investigations to explore the effect of other important factors related to both dentists and patients.
REGISTRATION
PROSPERO database (CRD42022339653).
Topics: Humans; Pulpitis; Dentition, Permanent; Dental Care; Pain; Pulpotomy
PubMed: 38326290
DOI: 10.1111/iej.14036 -
The Journal of Contemporary Dental... Dec 2023The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental...
AIMS
The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry.
BACKGROUND
The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols.
REVIEW RESULTS
Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials.
CONCLUSION
The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice.
CLINICAL SIGNIFICANCE
Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, . Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.
Topics: Child; Humans; Cost-Benefit Analysis; Dental Atraumatic Restorative Treatment; Tooth, Deciduous; Dental Restoration, Permanent; Esthetics, Dental; Dental Caries; Dental Materials; Pain; Parents
PubMed: 38317401
DOI: 10.5005/jp-journals-10024-3607 -
Clinics (Sao Paulo, Brazil) 2024The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC).
METHODS
The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI).
RESULTS
There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66).
CONCLUSIONS
The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.
Topics: Humans; Stomach Neoplasms; Periodontal Diseases; Adenocarcinoma; Cohort Studies; Case-Control Studies
PubMed: 38301538
DOI: 10.1016/j.clinsp.2023.100321 -
Journal of Taibah University Medical... Apr 2024This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of... (Review)
Review
OBJECTIVES
This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of foundational understanding of AI in dentistry.
METHODS
This systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in May 2023. The eligibility criteria included cross-sectional studies published in English until July 2023, focusing solely on dentists or dental students. Data on AI knowledge, use, and perceptions were extracted and assessed for bias risk with the Joanna Briggs Institute checklist.
RESULTS
Of 408 publications, 22 relevant articles were identified, and 13 studies were included in the review. The average basic AI knowledge score was 58.62 % among dental students and 71.75 % among dentists. More dental students (72.01 %) than dentists (62.60 %) believed in AI's potential for advancing dentistry.
CONCLUSIONS
Thorough AI instruction in dental schools and continuing education programs for practitioners are urgently needed to maximize AI's potential benefits in dentistry. An integrated PhD program could drive revolutionary discoveries and improve patient care globally. Embracing AI with informed understanding and training will position dental professionals at the forefront of technological advancements in the field.
PubMed: 38293587
DOI: 10.1016/j.jtumed.2023.12.010 -
Revista Cientifica Odontologica... 2023The dentist and auxiliary personnel are in constant risk of occupational diseases such as: allergies, infections, skin or eye injuries; that could affect patients. A... (Review)
Review
INTRODUCTION
The dentist and auxiliary personnel are in constant risk of occupational diseases such as: allergies, infections, skin or eye injuries; that could affect patients. A problem of social interest are the ocular injuries that occur to dental personnel. The literature reveals the prevalence of eye injuries in dental practice that are associated with solid particles, fluid splashes. Our objective was, through a systematic review, to review the types of ocular injuries and their associated factors that occurred in dental practice.
MATERIAL AND METHODS
The relevant studies were searched in the databases: PubMed, Scopus, Ebsco, among others. The search included cross-sectional studies that evaluated the evidence on ocular injuries occurring in dental practice, excluding literature reviews, letters to the reader, and editorials.
RESULTS
Eight studies were included to develop the systematic review; determining that the associated factors of ocular injuries occurred in dental practice are: a) occasional use of ocular protection b) age c) sex d) years of practice and the types of ocular injuries are the entry of liquids and foreign bodies.
CONCLUSIONS
Deficiency in compliance with eye or facial protection protocols in dental practice, cause eye injuries; Type of fluid entry, foreign bodies, splash of biological fluids or conjunctivitis. These eye injuries are generated from associated factors such as the occasional use of eye protection, age, sex, and others.
PubMed: 38287994
DOI: 10.21142/2523-2754-1103-2023-169 -
Journal of Dental Education Apr 2024The purpose of this study was to conduct a scoping review to examine and summarize the characteristics of research related to mental health (MH) screenings and/or... (Review)
Review
OBJECTIVE
The purpose of this study was to conduct a scoping review to examine and summarize the characteristics of research related to mental health (MH) screenings and/or referrals to treatment in dental practices.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews and searched multiple databases for terms connected with dental care, MH concerns, screening, and referral. Included articles: (1) described care provided in a dental practice, (2) described a situation where the patient is experiencing the potential MH problem, (3) did not involve dental anxiety exclusively, and (4) involved some form of MH screening and/or referral to treatment. Article analysis included a summary of key study characteristics, types of evidence, study design, and central concepts and definitions.
RESULTS
The search generated 2050 records, with 26 ultimately included. Most studies involved only adults (22, 85%), but only three (12%) reported on rurality (two urban; one mixed) and only two each (8%) reported race or ethnicity. Fifteen (58%) articles were prospective and 11 (42%) were retrospective. The studies varied widely in study designs, from 11 (42%) cross-sectional methodologies to only one (4%) randomized controlled trial. Thirty-four screening tools were used to screen for symptoms of 43 MH conditions, with depression and anxiety screened for most frequently. Few articles discussed making referrals, practice workflows, or follow-up outcomes.
CONCLUSIONS
Included studies provide evidence of viable options for dental practitioners regarding MH screening, referring, and conducting follow-up, but lack specificity regarding these processes. Overall, more research is needed to clarify what workflows are most efficient for dental practitioners and efficacious in identifying patients with MH concerns.
Topics: Adult; Humans; Mental Health; Retrospective Studies; Cross-Sectional Studies; Dentists; Prospective Studies; Professional Role; Referral and Consultation
PubMed: 38282325
DOI: 10.1002/jdd.13444