-
BMC Oral Health Jun 2024To determine the prevalence, case-fatality rate, and associated risk-factors of Noma in children in Nigeria. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine the prevalence, case-fatality rate, and associated risk-factors of Noma in children in Nigeria.
METHODS
Search was conducted in PubMed, Google Scholar, and Cochrane Library databases. Data were extraction using a double-blind approach. Discrepancies were resolved by a third reviewer. Heterogeneity was evaluated using I statistics. Random-effects model was used for the meta-analysis and subgroup analysis was conducted. The study quality was evaluated using standard Critical-Appraisal-Checklist.
RESULTS
Of the 1652 articles identified, 12 studies that met the inclusion criteria included 871 cases of Noma. Two studies had high-risk of bias and were excluded in the meta-analysis. Pooled prevalence of Noma was 2.95% (95%CI:2.19-3.71; Z = 7.60; p < 0.00001, I:100.0). Case fatality was reported in one study. Sex-distribution had a male-to-female ratio of 1.1:1. Malnutrition (88.42%, 95%CI:52.84-124.00; I:100.0), measles (40.60%; 95% CI:31.56-49.65; I:100.0) and malaria (30.75%; 95% CI:30.06-31.45; I:100.0) were the most notable associated risk-factors. Prevalence of Noma was non-significantly lower in southern (1.96%,95%CI:1.49-2.44;6 studies) than in northern (4.43%; 95%CI:-0.98-9.83; 4 studies) Nigeria. One study reported the prevalence of Noma in children younger than 5 years.
CONCLUSIONS
About every 3 in 100 children in Nigeria had Noma and the prevalence was non-significantly higher in northern than southern Nigeria. Malnutrition, measles, and malaria were major associated risk-factors. Case-fatality rate and prevalence based on different age-groups were inconclusive.
Topics: Humans; Nigeria; Prevalence; Risk Factors; Child; Noma; Child, Preschool
PubMed: 38867180
DOI: 10.1186/s12903-024-04451-y -
Acta Odontologica Scandinavica Jun 2024Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate...
OBJECTIVE
Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate the efficacy, safety, and long-term outcomes of hyaluronic acid injection in the treatment of black triangles and reconstruction of lost interdental papilla in anterior teeth.
MATERIALS AND METHODS
The protocol was registered in PROSPERO (CRD42023446875) and in accordance with the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 'PRISMA'. The search involved four databases, PubMed/MEDLINE, The Cochrane Library, Google Scholar, and ProQuest for ''grey literature' with additional manual search for studies published up to May 2024. Human clinical studies of a prospective nature (randomised clinical trials and prospective cohort studies) were included. Exclusion criteria were case reports, case series, review articles, letter to editor, personal opinion, and animal studies. Furthermore, studies which utilised hyaluronic acid injection in conjunction with other therapeutic material, tissue graft, or any surgical procedure were also excluded. The data were extracted independently by the two authors and incorporated after consensus. The risk of bias was assessed using the RoB2: the revised Cochrane risk of bias tool for randomised clinical trials and the Newcastle Ottawa scale for prospective cohort studies.
RESULTS
24 studies, 15 prospective clinical studies and nine randomised clinical trials, were included with a total of 898 interdental papillae injected with hyaluronic acid. The studies showed promising outcomes in the reconstruction of lost interdental papilla with minimal adverse reactions. Risk of bias assessment among prospective clinical studies revealed 13 good quality studies with only two poor studies while the randomised clinical trials consisted of three with low, one with some concern, and five studies with high risk of bias. However, due to the high heterogeneity, a meta-analysis was not feasible. Conclusion: Hyaluronic acid injection is an effective minimally invasive approach in treating black triangles and reconstructing lost interdental papilla in the anterior teeth. Further long-term well-designed randomised clinical trials employing standardised procedures are essential to validate this treatment and provide better quality of evidence.
Topics: Hyaluronic Acid; Humans; Dental Papilla
PubMed: 38864684
DOI: 10.2340/aos.v83.40864 -
BMC Oral Health Jun 2024This systematic review aims to comparatively analyse the amount of dentin removal by free hand and static guided endodontics with dynamic navigation system (DNS) in...
OBJECTIVE
This systematic review aims to comparatively analyse the amount of dentin removal by free hand and static guided endodontics with dynamic navigation system (DNS) in endodontic access cavity preparation.
METHODS
The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Based on the structured PICO framework of "Comparative evaluation of dynamic navigation system (I) to freehand (C) and static guided endodontics (C) in endodontic access cavity preparation on the preservation of tooth structure (O) when assessed on permanent human teeth (P)", the keywords were formulated and the articles were retrieved from three databases namely PubMed, Scopus and Embase, based on the keywords from the time of inception of DNS till June 2023. The risk of bias assessment was done using a modified Joanne Briggs Institute checklist, which evaluated domains such as randomisation, sample size, image acquisition using CBCT, angulation, accuracy and time taken. As the data was heterogenous, a quantitative meta-analysis was not performed.
RESULTS
Initially, 174 articles were retrieved from the three databases, 30 duplicates were removed, after title check 108 articles were excluded and following abstract check only 10 articles qualified for full text analysis. On reviewing the 10 full text articles, 5 articles were excluded and the remaining 5 articles were subjected to the risk of bias analysis which showed that 2 articles displayed low risk of bias and three articles showed high risk of bias. The RoB analysis revealed that only 2 studies evaluated the preservation of dentin in terms of accuracy, angulation and time taken proving the increased precision with minimal loss of tooth structure using DNS. In both the studies, DNS proved to be superior to free hand technique in terms of precision, accuracy and efficiency in locating the canals during access cavity preparation with maximal preservation of tooth structure.
CONCLUSION
With the minimal literature evidences, the present systematic review highlights maximal preservation of dentin using DNS. However, further invitro and invivo studies comparing the free hand, static guided endodontics to DNS must be carried out for its translation into clinical practice.
CLINICAL SIGNIFICANCE
Dynamic navigation system provides maximal preservation of dentin during access cavity preparation.
Topics: Humans; Dentin; Root Canal Preparation
PubMed: 38858636
DOI: 10.1186/s12903-024-04450-z -
Photodiagnosis and Photodynamic Therapy Jun 2024This systematic review assessed the effectiveness of photodynamic therapy (PDT) in patients with recurrent oral squamous cell carcinoma (OSCC). (Review)
Review
BACKGROUND
This systematic review assessed the effectiveness of photodynamic therapy (PDT) in patients with recurrent oral squamous cell carcinoma (OSCC).
METHODS
Clinical studies on recurrent OSCC treated with PDT alone were included. Combined treatment strategies were excluded. The search was performed on Medline/Pubmed, Cochrane Library, Embase, Web of Science and ClinicalTrials.gov, manual search, and grey literature.
RESULTS
The eleven included studies were observational. The risk of bias and methodological quality were evaluated using the Newcastle-Ottawa Quality Assessment Scale. The studies reported the use of hematoporphyrin derivative, Photofrin, Foscan and 5-aminolevulinic acid. Data on treatment response and survival was collected. Secondarily, postoperative courses and patient's quality of life/acceptance were reported whenever available. Photofrin and Foscan were the most used photosensitisers, with more complete responses. Lesions responding less favourably were on posterior regions or deep-seated in the tissue.
CONCLUSIONS
Although treatment response differs between treatment protocols, PDT stands as a viable treatment option to be considered, as it can achieve therapeutic results and disease-free, long-lasting periods. Partial treatment responses may be of interest when achieving eligibility for other treatment strategies. Despite this study's limitations, which considered four photosensitisers, Photofrin was the most used but more recent photosensitisers like Foscan have greater chemical stability, tissue penetration, and may be more efficacious on recurrent OSCC.
PubMed: 38857775
DOI: 10.1016/j.pdpdt.2024.104242 -
European Review For Medical and... May 2024Periimplantitis (PI) is a complex multifactorial chronic disease caused by interactions between bacteria, host immune-inflammatory responses, and genetic or... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Periimplantitis (PI) is a complex multifactorial chronic disease caused by interactions between bacteria, host immune-inflammatory responses, and genetic or environmental factors that modify buccal eutrophism. In daily clinical practice, an increase in the prevalence of PI (8%) determined the need to establish the PI causes and set optimal therapeutic strategies. The interleukin family (IL-1), a group of cytokines, triggers and perpetuates peri-implantitis. Therefore, they could be used as biomarkers for diagnosis and treatment. This systematic review aimed to analyze the correlation between IL-1 allelic polymorphism (IL-1A -889, IL-1β -511, IL-1β +3954) and the PI disease.
MATERIALS AND METHODS
Selected databases were PubMed, Scopus, and Cochrane Library. The search strategy included the following terms: "dental implants"; "periimplantitis"; "interleukin-IL-1"; "polymorphism"; "perimplant bone loss". Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A meta-analysis was conducted on five of 40 review articles. p-values, confidence intervals (CI), and Odds ratios (OR) were assessed. In 4 articles, the p-value was lower than 0.05, confirming the statistical significance of the result.
RESULTS
The prevalence of the selected studies reported the existence of a causal association between polymorphisms of IL-1 and the onset of peri-implantitis, especially for IL-1 allelic variants associated with further polymorphic genes encoding for IL-6, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinases (MMP)-8, IL-1Na, IL-8, IL-18, osteopontin (OPN). In addition, the presence of the IL-1 polymorphism and PI is particularly higher in smokers, diabetes, and autoimmune disease patients.
CONCLUSIONS
The detection of salivary biomarkers is, therefore, a diagnostic tool with a high potential to intercept the PI early and act with appropriate and non-invasive treatment. Due to the continued technological innovation in biomarkers and diagnostic sciences, further studies are needed to investigate the role of these biochemical mediators. The results of studies and the recent technological innovation in biomarkers and diagnostic sciences will allow further research to investigate the role of these biochemical mediators.
Topics: Humans; Peri-Implantitis; Polymorphism, Genetic; Interleukin-1; Dental Implants
PubMed: 38856132
DOI: 10.26355/eurrev_202405_36293 -
JPRAS Open Jun 2024The use of acellular dermal matrix (ADM) in breast reconstruction was described for the first time in 2000s. Recently, ADMs have been used not only in reconstructive... (Review)
Review
BACKGROUND
The use of acellular dermal matrix (ADM) in breast reconstruction was described for the first time in 2000s. Recently, ADMs have been used not only in reconstructive surgery but also in cosmetic breast surgery for both primary and revision indications. Therefore, the matrices represent an important support to recent surgical techniques for breast augmentation in treatment or prevention of complications. Conversely, ADMs can affect operative times, costs, and additional complications related to their placement. A review of the literature was carried out to evaluate the efficacy, safety, and indication for the use of these matrices in cosmetic breast surgery.
METHODS
A literature review was conducted including manuscripts published up to April 2023 on breast augmentation using ADM. PubMed and MEDLINE were the databases used for research. The keywords used were "Breast augmentation" and "Acellular Dermal Matrix." Non-English language articles have been excluded.
RESULTS
The initial search for "breast augmentation" yielded 7900 results, which were further reviewed for "Acellular Dermal Matrices" in breast augmentation, selecting 74 articles. Following further screening, 12 articles were included in the review. A total of 787 patients were treated with breast augmentation and ADM placement. The main indication was capsular contracture (60%).
CONCLUSIONS
The current evidence from the published scientific literature, albeit limited, suggests the indication for the use of ADM in revision surgery, to support the prosthetic pocket, to minimize the risk of capsular contracture and its recurrence.
PubMed: 38854623
DOI: 10.1016/j.jpra.2024.02.004 -
Cureus May 2024Forensic anthropology and forensic medicine both have been fascinating fields that deal with mandibular characteristics and sex determination. Researchers may determine... (Review)
Review
Forensic anthropology and forensic medicine both have been fascinating fields that deal with mandibular characteristics and sex determination. Researchers may determine an individual's biological sex with amazing precision by examining the size, shape, and proportions of the mandible. This information is useful for anthropological studies and criminal investigations. This systematic review aims to evaluate the consistency and validity of using mandibles as a method for gender determination across different populations. A systematic search was conducted in PubMed, Web of Science, and Scopus databases. Further, a manual search was carried out to find additional studies. Mandibular parameters and other relevant data about research were extracted from the included studies. Random effects meta-analysis was carried out for four parameters. A total of nine studies were included in the systematic review out of 76 initial search results. All studies were in vitro. Nine studies were included in the qualitative analysis, whereas only seven studies were included in the meta-analysis. A total of 2385 individuals (1193 male and 1192 female) were evaluated in the included studies. The parameters assessed were as follows: minimum ramus breadth (MiRB), maximum ramus breadth (MaRB), projective ramus height (PRH), bigonial width (BGW), gonial angle (GA), and antegonial angle (AGA). Meta-analysis was conducted for four parameters out of six. For the two parameters, meta-analysis was not conducted as only one study was evaluated. Meta-analyses of PRH obtained a high degree of heterogeneity (99%), mean difference (MD) of 4.06 mm, and p-value of p=0.09. Meta-analysis of BGW obtained 93% heterogeneity, MD of 9.03 mm, and p=0.0007. Meta-analysis of GA showed 99% heterogeneity, MD of 3.44 mm, and p=0.66. Meta-analysis of AGA obtained a low heterogeneity of 30%, MD of -0.77 mm, and p=0.23. The parameter, BGW, can be considered a useful tool in identifying sex. The parameters, PRH, GA, and AGA, cannot be preferred as a reliable tool in identifying the sex of an individual in forensic contexts.
PubMed: 38854199
DOI: 10.7759/cureus.59965 -
International Dental Journal Jun 2024Dental radiography is widely used in dental practices and offers a valuable resource for the development of AI technology. Consequently, many researchers have been drawn... (Review)
Review
Dental radiography is widely used in dental practices and offers a valuable resource for the development of AI technology. Consequently, many researchers have been drawn to explore its application in different areas. The current systematic review was undertaken to critically appraise developments and performance of artificial intelligence (AI) models designed for tooth numbering and detection using dento-maxillofacial radiographic images. In order to maintain the integrity of their methodology, the authors of this systematic review followed the diagnostic test accuracy criteria outlined in PRISMA-DTA. Electronic search was done by navigating through various databases such as PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar, and the Saudi Digital Library for the articles published from 2018 to 2023. Sixteen articles that met the inclusion exclusion criteria were subjected to risk of bias assessment using QUADAS-2 and certainty of evidence was assessed using GRADE approach.AI technology has been mainly applied for automated tooth detection and numbering, to detect teeth in CBCT images, to identify dental treatment patterns and approaches. The AI models utilised in the studies included exhibited a highest precision of 99.4% for tooth detection and 98% for tooth numbering. The use of AI as a supplementary diagnostic tool in the field of dental radiology holds great potential.
PubMed: 38851931
DOI: 10.1016/j.identj.2024.04.021 -
BMC Oral Health Jun 2024Oral lichen planus is a chronic and potentially malignant disorder of oral mucosa. Corticosteroids are used as first-line therapy for oral lichen planus patients;... (Meta-Analysis)
Meta-Analysis Comparative Study
BACKGROUND
Oral lichen planus is a chronic and potentially malignant disorder of oral mucosa. Corticosteroids are used as first-line therapy for oral lichen planus patients; however, they have many side effects. Platelet concentrates (platelet-rich plasma and platelet-rich fibrin) are autologous bioactive materials. This systematic review investigated the effects of autologous platelet concentrates compared to topical steroids in treating symptomatic oral lichen planus patients.
MATERIALS AND METHODS
A systematic literature search was performed in PubMed, Web of Science, Scopus, Embase, and Cochrane for randomized controlled trials. Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines were observed for article selection. For the pooling of studies, meta-analysis using Standardized Mean Differences by random effects model was carried out to estimate summary effect sizes for the treatment of oral lichen planus.
RESULTS
A total of six studies, incorporating 109 oral lichen planus patients, were involved. Both treatment modalities showed a statistically significant improvement in the outcome parameters (lesion size, pain score, Thongprasom score) from the baseline to the end of treatment and further to the follow-up visits. There was no significant difference in the pooled estimate SMD of pain decline in patients of the two groups (SMD = 0.17 (95% CI: -0.47 to 0.81); I = 63.6%). The SMD of Thongprasom score in patients receiving autologous platelet concentrates was lower than the corticosteroid groups, with no significant effect size (SMD= -2.88 (95% CI: -5.51 to -0.25); I = 91.7%). Therefore, there was no statistically significant difference between the autologous platelet concentrates and topical steroids regarding pain and clinical score.
CONCLUSION
Autologous platelet concentrates, and topical steroids decreased the size of lesions, Thongprasom scale, and pain in oral lichen planus patients, but the difference between the two treatments was not statistically significant. Thus, autologous platelet concentrates could be considered as an alternative treatment to topical steroids.
Topics: Lichen Planus, Oral; Humans; Platelet-Rich Plasma; Platelet-Rich Fibrin; Administration, Topical; Adrenal Cortex Hormones
PubMed: 38851685
DOI: 10.1186/s12903-024-04443-y -
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