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Photobiomodulation, Photomedicine, and... Aug 2023This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical... (Meta-Analysis)
Meta-Analysis Review
Clinical and Radiographic Outcomes of Adjunctive Photodynamic Therapy for Treating Peri-Implant Mucositis Among Cigarette Smokers and Diabetics: A Systematic Review and Meta-Analysis.
This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical and radiographic outcomes among cigarette smokers and diabetics with peri-implant mucositis (piM). Randomized controlled trials, assessing the clinical and radiographic parameters of aPDT versus MD alone among smokers and diabetics with piM, were included in the study. Meta-analyses were conducted to calculate the standard mean difference with a 95% confidence interval. The methodological quality of the included studies was assessed utilizing the modified Jadad quality scale. The meta-analyses found statistically significant differences between the impact of adjunct aPDT and MD alone on the peri-implant plaque index (PI), probing depth (PD), and bleeding on probing among smokers and diabetics with piM at the final follow-up visit. However, no significant differences were found between the impact of adjunct aPDT and MD alone on the peri-implant crestal bone loss among smokers and diabetics with piM at the final follow-up. The application of aPDT as an adjunctive to MD demonstrated improved scores of the peri-implant clinical parameters among smokers and diabetics with piM in comparison with MD alone.
Topics: Humans; Smokers; Combined Modality Therapy; Mucositis; Debridement; Photochemotherapy; Peri-Implantitis; Anti-Infective Agents; Tobacco Products; Diabetes Mellitus
PubMed: 37506360
DOI: 10.1089/photob.2023.0046 -
Dentistry Journal Jun 2023This systematic review synthesizes the existing evidence in the literature regarding the association of propolis with controlled delivery systems (DDSs) and its... (Review)
Review
This systematic review synthesizes the existing evidence in the literature regarding the association of propolis with controlled delivery systems (DDSs) and its potential therapeutic action in dental medicine. Two independent reviewers performed a literature search up to 1 June 2023 in five databases: PubMed/Medline, Web of Science, Cochrane Library, Scopus, and Embase, to identify the eligible studies. Clinical, in situ, and in vitro studies that investigated the incorporation of propolis as the main agent in DDSs for dental medicine were included in this study. Review articles, clinical cases, theses, dissertations, conference abstracts, and studies that had no application in dentistry were excluded. A total of 2019 records were initially identified. After carefully examining 21 full-text articles, 12 in vitro studies, 4 clinical, 1 animal model, and 3 in vivo and in vitro studies were included (n = 21). Relevant data were extracted from the included studies and analyzed qualitatively. The use of propolis has been reported in cariology, endodontics, periodontics, stomatology, and dental implants. Propolis has shown non-cytotoxic, osteoinductive, antimicrobial, and anti-inflammatory properties. Moreover, propolis can be released from DDS for prolonged periods, presenting biocompatibility, safety, and potential advantage for applications in dental medicine.
PubMed: 37504228
DOI: 10.3390/dj11070162 -
International Ophthalmology Nov 2023To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in... (Meta-Analysis)
Meta-Analysis Review
The efficacy of 2 different phakic intraocular lens implant in keratoconus as an isolated procedure or combined with collagen crosslinking and intra-stromal corneal ring segments: a systematic review and meta-analysis.
PURPOSE
To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in keratoconus.
METHODS
Data extracted from the publications meeting the selection. The outcome parameters included mean pre- and post-operative uncorrected distance visual acuity, corrected distance visual acuity (CDVA), sphere and cylinder of refraction and complications. Available data analyzed with Cochrane Review Manager.
RESULTS
A total of 23 studies including 464 eyes were included. All the parameters showed significant improvement in all subgroups other than CDVA in ACPIOL + CXL subgroup and cylinder in PIOL + CXL subgroups. There was not a significant difference between PCPIOL and ACPIOL in the outcomes, exception was more improvement of CDVA in "ACPIOL only" than" PCPIOL only" subgroup.
CONCLUSION
Both PCPIOLs and ACPIOLs are comparably safe and efficient options in management of KCN and their efficacy significantly improves when combined with CXL/ICRS.
Topics: Humans; Phakic Intraocular Lenses; Photosensitizing Agents; Keratoconus; Riboflavin; Collagen; Corneal Topography; Cross-Linking Reagents; Corneal Stroma
PubMed: 37470861
DOI: 10.1007/s10792-023-02813-z -
The American Journal of Cardiology Sep 2023Intracoronary imaging (ICI) facilitates stent implant by characterizing the lesion calcification, providing accurate vessel dimensions, and optimizing the stent results.... (Meta-Analysis)
Meta-Analysis
Intracoronary Imaging Versus Coronary Angiography Guidance for Implantation of Second and Third Generation Drug Eluting Stents in a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Intracoronary imaging (ICI) facilitates stent implant by characterizing the lesion calcification, providing accurate vessel dimensions, and optimizing the stent results. We sought to investigate the outcomes of routine ICI versus coronary angiography (CA) to guide percutaneous coronary intervention (PCI) with second- and third-generation drug-eluting stents. A systematic search of PubMed, Medline, and Cochrane databases was conducted from their inception to July 16, 2022 for randomized controlled trials comparing routine ICI with CA. The primary outcome was major adverse cardiovascular events. The secondary outcomes of interest were target lesion revascularization, target vessel revascularization, myocardial infarction, stent thrombosis, and cardiac and all-cause mortality. A random-effects model was used to calculate the pooled incidence and relative risk (RR) with 95% confidence intervals (CIs). A total of 9 randomized controlled trials with 5,879 patients (2,870 ICI-guided and 3,009 CA-guided PCI) met the inclusion criteria. The ICI and CA groups were similar in demographic characteristics and co-morbidity profiles. Compared with CA, patients in the routine ICI-guided PCI group had lower rates of major adverse cardiovascular events (RR 0.61, 95% CI 0.48 to 0.78, p <0.0001), target lesion revascularization (RR 0.60, 95% CI 0.43 to 0.83, p = 0.002), target vessel revascularization (RR 0.72, 95% CI 0.51 to 1.00, p = 0.05), and myocardial infarction (RR 0.48, 95% CI 0.25 to 0.95, p = 0.03). There were no significant differences in stent thrombosis or cardiac/all-cause mortality between the 2 strategies. In conclusion, routine ICI-guided PCI strategy, compared with CA guidance alone, is associated with improved clinical outcomes, largely driven by lower repeat revascularization.
Topics: Humans; Drug-Eluting Stents; Coronary Angiography; Coronary Artery Disease; Percutaneous Coronary Intervention; Risk Factors; Randomized Controlled Trials as Topic; Myocardial Infarction; Stents; Thrombosis; Treatment Outcome
PubMed: 37423173
DOI: 10.1016/j.amjcard.2023.06.073 -
Lasers in Medical Science Jun 2023Photodynamic therapy (PDT) has been suggested as an adjunctive therapeutic approach for peri-implantitis. This systematic review aimed to assess the clinical and... (Meta-Analysis)
Meta-Analysis
Clinical and radiographic outcomes of adjunctive photodynamic therapy for treating peri-implantitis among diabetics and cigarette smokers: a systematic review of randomized controlled trials.
Photodynamic therapy (PDT) has been suggested as an adjunctive therapeutic approach for peri-implantitis. This systematic review aimed to assess the clinical and radiographic outcomes of adjunctive PDT (aPDT) for the treatment of peri-implantitis among diabetics and cigarette smokers. Randomized controlled trials (RCTs), which assessed the clinical and radiographic outcomes of aPDT versus other intervention(s) and/or MD alone among diabetics and smokers with peri-implantitis, were considered eligible for the review. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the modified Jadad quality scale. The meta-analysis revealed no significant differences between the influence of aPDT and other intervention/MD alone on the peri-implant PI among diabetics at the final follow-up. However, statistically significant improvements in the peri-implant PD, BOP, and CBL were observed after the application of aPDT among diabetics. Similarly, no significant differences were found between the influence of aPDT and other interventions/MD alone on the peri-implant PD among smokers with peri-implant diseases at the final follow-up. However, statistically significant improvements in the peri-implant PI, BOP, and CBL were observed after the application of aPDT among smokers. Significant improvements in the peri-implant PD, BOP, and CBL among diabetics and the peri-implant PI, BOP, and CBL among smokers after the application of aPDT at the final follow-up. However, large-scale, well-designed, and long-term RCTs are recommended in this domain.
Topics: Humans; Diabetes Mellitus; Peri-Implantitis; Photochemotherapy; Randomized Controlled Trials as Topic; Smokers; Tobacco Products
PubMed: 37335369
DOI: 10.1007/s10103-023-03807-0 -
Oral and Maxillofacial Surgery Jun 2024The purpose of this systematic review was to compare the clinical outcomes of dental implants in users of antihypertensive medication with those of nonusers. (Review)
Review
PURPOSE
The purpose of this systematic review was to compare the clinical outcomes of dental implants in users of antihypertensive medication with those of nonusers.
METHODS
This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews under the number CRD42022319336. The electronic databases Medline (PubMed) and Central Cochrane were searched for relevant scientific literature published in English through May 2022. The focused question was, "Do patients taking antihypertensive medications have a similar impact on the clinical outcome and survival of dental implants compared with nonusers?".
RESULTS
A total of 49 articles were found, of which 3 articles were finally selected for a qualitative synthesis. The three studies included 959 patients. In all three studies, the commonly used medication was renin-angiotensin system (RAS) inhibitors. Two studies mentioned implant survival rate, which was 99.4% in antihypertensive medication users and 96.1% in the nonusers. One study found a higher implant stability quotient (ISQ) in patients taking antihypertensive medication (75.7 ± 5.9) compared with patients not taking antihypertensive medication (73.7 ± 8.1).
CONCLUSIONS
The limited available evidence showed that patient taking antihypertensive medications had comparable success rate and implant stability to patients not taking medications. The studies included patients taking different antihypertensive medications, so a drug-specific conclusion regarding the clinical outcome of dental implants is not possible. Further studies are needed, including patients taking certain antihypertensive medications, to determine their effects on dental implants.
Topics: Humans; Antihypertensive Agents; Dental Implants; Hypertension; Dental Restoration Failure; Treatment Outcome
PubMed: 37330427
DOI: 10.1007/s10006-023-01167-1 -
Frontiers in Cellular and Infection... 2023Peri-implant diseases are pathological conditions that affect the survival of dental implants. Etiological studies are limited, accepting a prevalence of 20% at the... (Meta-Analysis)
Meta-Analysis Review
Peri-implant diseases are pathological conditions that affect the survival of dental implants. Etiological studies are limited, accepting a prevalence of 20% at the implant level and 24% at the patient level. The benefits of adjuvant metronidazole are controversial. A systematic review and meta-analysis of RCTs according to PRISMA and PICOS was performed with an electronic search over the last 10 years in MEDLINE (PubMed), WOS, Embase, and Cochrane Library. The risk of bias was measured using the Cochrane Risk of Bias tool and the methodological quality using the Jadad scale. Meta-analysis was performed with RevMan version 5.4.1, based on mean difference and standard deviation, with 95% confidence intervals; the random-effects model was selected, and the threshold for statistical significance was defined as < 0.05. A total of 38 studies were collected and five were selected. Finally, one of the studies was eliminated because of unanalyzable results. All studies reached a high methodological quality. A total of 289 patients were studied with follow-up periods from 2 weeks to 1 year. Statistical significance was only found, with respect to the use of adjunctive metronidazole, in the pooled analysis of the studies ( = 0.02) and in the analysis of the radiographic values reported on peri-implant marginal bone levels, in the studies with a 3-month follow-up ( = 0.03). Discrepancies in the use of systemic metronidazole require long-term randomized clinical trials (RCTs) to determine the role of antibiotics in the treatment of peri-implantitis.
Topics: Humans; Peri-Implantitis; Metronidazole; Anti-Bacterial Agents; Combined Modality Therapy; Bias
PubMed: 37287463
DOI: 10.3389/fcimb.2023.1149055 -
Journal of Stomatology, Oral and... Dec 2023Dental implants are a common solution for edentulous patients. This systematic review and meta-analysis aimed to determine whether locally delivered diphosphonates... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Dental implants are a common solution for edentulous patients. This systematic review and meta-analysis aimed to determine whether locally delivered diphosphonates influence the osseointegration of dental implants in humans.
MATERIAL & METHODS
In March 2023, we conducted an electronic systematic literature search using three databases (MEDLINE/PubMed, Embase, Web of Science). We included randomized trials documenting locally delivered diphosphonates in partly edentulous patients. Two independent reviewers evaluated study eligibility, extracted data, and assessed study quality.
RESULTS
We have identified 752 studies, out of which 7 studies involving 154 patients met the inclusion criteria. The overall meta-analysis indicates that diphosphonates are associated with marginal bone loss during the pre-loading period (mean difference (MD) of -0.18 mm, 95% CI -0.24 to -0.12, p<0.00001; I²=83%), marginal bone loss after one year (MD -0.35 mm, 95% CI -0.56 to -0.14, p = 0.0009; I²=14%), and five years loading (MD -0.34 mm, 95% CI -0.56 to -0.13, p = 0.002; I²=0%). However, the drug did not seem to affect the implant survival rate (risk ratios (RR) of 1.02, 95% CI 0.98 to 1.08, P = 0.33; I²=9%).
DISCUSSION
This study suggests that local use of diphosphonates does not affect implant survival, but it does reduce marginal bone loss and improve the osseointegration of dental implants in humans. However, future research must be more standardized and address methodological biases to draw more conclusive findings.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Diphosphonates; Dental Restoration Failure; Osseointegration; Mouth, Edentulous
PubMed: 37276968
DOI: 10.1016/j.jormas.2023.101521 -
Otology & Neurotology : Official... Jul 2023To review otology-related studies using the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database to identify the...
OBJECTIVE
To review otology-related studies using the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database to identify the opportunities and limitations of using MAUDE.
DATABASES REVIEWED
PubMed, Science Direct, Web of Science, SCOPUS, and EMBASE.
METHODS
All studies reporting otology-related adverse events extracted from MAUDE were included from June 20, 2002, to 2022. Two reviewers independently screened abstracts, selected articles for exclusion, extracted data, and appraised studies. Critical appraisal was done according to the National Institutes of Health quality assessment tool for case series.
RESULTS
The search yielded 5,645 studies, of which 8 studies met the inclusion criteria. All eight studies were case series; three evaluated cochlear implants, two evaluated osseointegrated hearing implants, and one evaluated illuminated operating microscope use. Quality assessment revealed all studies to be of poor quality. The most common domains contributing to these ratings included unclear study population, lack of consecutive participants, comparability of participants, clear and consistent outcome measures, and appropriate statistical analysis.
CONCLUSION
Otology studies using the MAUDE database are of poor quality. This was primarily due to MAUDE's structural limitations as a passive surveillance system using nonstandardized free-text reports. The quality of studies also suffered from inappropriate analysis of MAUDE data, given its design. The utility of MAUDE could be improved by implementing case report best practices and converting the free fields to allow controlled and adaptive responses wherever possible to help standardize adverse event reporting.
Topics: United States; Humans; United States Food and Drug Administration; Databases, Factual
PubMed: 37254239
DOI: 10.1097/MAO.0000000000003899 -
Journal of Plastic, Reconstructive &... Jul 2023The impact of chemotherapy on complications following breast reconstruction surgery (BRS) is currently inconclusive. This meta-analysis investigates the impact of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The impact of chemotherapy on complications following breast reconstruction surgery (BRS) is currently inconclusive. This meta-analysis investigates the impact of chemotherapy on complication rates in BRS.
METHODS
Preferred Reporting in Systematic Review and Meta-Analysis (PRISMA) guidelines was used to search relevant studies published from January 2006 to March 2022. The complication rates of neoadjuvant systemic therapy (NST) and adjuvant systemic therapy (AST) were analyzed via RevMan software 5.4, and a P value of< 0.05 was considered significant. The quality of selected studies was performed using the Newcastle-Ottawa scale for quality assessment.
RESULTS
A total of 18 studies comprising 49,217 patients were included. There was no significant difference in the total complications rate, major complications, or minor complications between NST and BRS or control. The rate of wound dehiscence was higher in the NST group compared with the BRS only group [RR= 1.54, 95% CI, (1.08, 2.18), P = 0.02], and the rate of infection was lower in the NST group compared with the BRS only group, [RR= 0.75, 95% CI, (0.61, 0.94), P = 0.01]. No significant difference in the rates of hematoma, seroma, skin necrosis, and implant loss was detected between NST and AST, or NST with BRS only. No statistically significant differences in total complication rates were observed between flap and implant BRS types (P = 0.88).
CONCLUSION
No significant differences between AST and NST were detected for complications. Significantly, NST had more wound dehiscence and less infection rates compared with BRS only groups, possibly reflecting selection bias or issues in the design of reported studies.
LEVEL OF EVIDENCE
I.
Topics: Humans; Female; Postoperative Complications; Mammaplasty; Surgical Flaps; Combined Modality Therapy; Neoadjuvant Therapy; Breast Neoplasms
PubMed: 37182249
DOI: 10.1016/j.bjps.2023.04.007