-
Brazilian Oral Research 2023The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head...
The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?" Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods.
Topics: Adult; Humans; Cross-Sectional Studies; Head and Neck Neoplasms; Oximetry; Dental Pulp Diseases; Radiation, Ionizing; Dental Pulp
PubMed: 37531515
DOI: 10.1590/1807-3107bor-2023.vol37.0079 -
European Journal of Medical Research Jul 2023Dental pulp stem cells (DPSCs) are adult stem cells with multi-directional differentiation potential derived from ectoderm. Vitro experiments have shown that adding... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dental pulp stem cells (DPSCs) are adult stem cells with multi-directional differentiation potential derived from ectoderm. Vitro experiments have shown that adding cytokines can help DPSCs to be transformed from multipotent stem cells to osteoblasts. TGF-β has been proved to have an effect on the proliferation and mineralization of bone tissue, but its effect on the osteogenesis and proliferation of dental pulp stem cells is still uncertain. We aim to determine the effect of TGF-β on the osteogenesis and proliferation of dental pulp stem cells.
METHODS
We have identified studies from the Cochrane Central Register of Controlled Trials, PubMed, Embase, and China national knowledge infrastructure (CNKI) for studies interested in TGF-β and proliferation and differentiation of dental pulp stem cells in the following indicators: A490 (an index for evaluating cell proliferation), bone sialoprotein (BSP), Col plasmid-1 (Col-1), osteocalcin (OCN), runt-related transcription factor 2 (Runx-2); and the number of mineralized nodules. Any language restrictions were rejected. Furthermore, we drew a forest plot for each outcome. We conducted a sensitivity analysis, data analysis, heterogeneity, and publication bias test. We evaluate the quality of each study under the guidance of Cochrane's tool for quality assessment.
RESULTS
The pooled data showed that TGF-β could promote the proliferation and ossification of dental pulp stem cells. All the included results support this conclusion except for the number of mineralized nodules: TGF-β increases the A490 index (SMD 3.11, 95% CI [0.54-5.69]), promotes the production of BSP (SMD 3.11, 95% CI [0.81-6.77]), promotes the expression of Col-1 (SMD 4.71, 95% CI [1.25-8.16]) and Runx-2 (SMD 3.37, 95% CI [- 0.63 to 7.36]), increases the content of OCN (SMD 4.32, 95% CI [1.20-7.44]) in dental pulp, and has no significant effect on the number of mineralized nodules (SMD 3.87, 95% CI [- 1.76 to 9.51]) in dental pulp stem cells.
CONCLUSIONS
TGF-β promotes the proliferation and osteogenesis of dental pulp stem cells.
Topics: Humans; Cell Differentiation; Cell Proliferation; Cells, Cultured; Dental Pulp; Osteogenesis; Stem Cells; Transforming Growth Factor beta
PubMed: 37501191
DOI: 10.1186/s40001-023-01227-y -
Journal of the American Dental... Aug 2023Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis. The authors searched the Epistemonikos database, including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the US clinical trials registry (ClinicalTrials.gov) from inception until April 2023. Pairs of reviewers independently screened titles and abstracts, then full texts of trials were identified as potentially eligible. After duplicate data abstraction, the authors conducted random-effects meta-analyses. Risk of bias was assessed using Version 2 of the Cochrane Risk of Bias tool and certainty of the evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Forty randomized controlled trials proved eligible. The evidence suggested that corticosteroids compared with a placebo provided a trivial reduction in pain intensity measured 6 hours (mean difference, 8.79 points lower; 95% CI, 14.8 to 2.77 points lower; low certainty) and 24 hours after surgical tooth extraction (mean difference, 8.89 points lower; 95% CI, 10.71 to 7.06 points lower; very low certainty). The authors found no important difference between corticosteroids and a placebo with regard to incidence of postoperative infection (risk difference, 0%; 95% CI, -1% to 1%; low certainty) and alveolar osteitis (risk difference, 0%; 95% CI, -3% to 4%; very low certainty).
PRACTICAL IMPLICATIONS
Low and very low certainty evidence suggests that there is a trivial difference regarding postoperative pain intensity and adverse effects of corticosteroids administered orally, submucosally, or intramuscularly compared with a placebo in patients undergoing third-molar extractions.
Topics: Humans; Molar, Third; Acute Pain; Adrenal Cortex Hormones; Dry Socket; Postoperative Complications; Pain, Postoperative
PubMed: 37500235
DOI: 10.1016/j.adaj.2023.04.018 -
European Journal of Clinical... Sep 2023Hematogenous osteomyelitis caused by Streptococcus intermedius is rare, particularly in immunocompetent adults. The aim of this paper is to provide an overview of the... (Review)
Review
Hematogenous osteomyelitis caused by Streptococcus intermedius is rare, particularly in immunocompetent adults. The aim of this paper is to provide an overview of the clinical presentation, prognosis as well as treatment of this disease, with the focus on immunocompetent adults. Six medical literature libraries were searched to identify studies reporting on Streptococcus intermedius induced hematogenous osteomyelitis in immunocompetent adults. In addition, we presented a case of a 44-year-old man from our institution that is illustrative for this disease. Four case reports describing four patients were identified by this systematic literature review. Hence, the data of five patients (including our case) were assessed. The most common presenting symptom was localised pain, followed by fever. Portal entries were found in two patients (general periodontitis and necrotic dentition). The localisations of osteomyelitis were diverse: femoral (two patients), lumbar spine (two patients), and the iliac bone (one patient). Treatment strategies varied strongly, but antibiotics (penicillins) were administered in each case, and two patients underwent surgical debridement. Follow-up ranged from 2 weeks to more than 6 months; one patient died from septic shock. Only a very limited number of immunocompetent adults with Streptococcus intermedius induced hematogenous osteomyelitis have been described. Based on the available data, we summarised the clinical presentation, prognosis as well as treatment of hematogenous osteomyelitis caused by Streptococcus intermedius in this patient population.
Topics: Male; Humans; Adult; Streptococcus intermedius; Anti-Bacterial Agents; Prognosis; Osteomyelitis
PubMed: 37468663
DOI: 10.1007/s10096-023-04640-7 -
Dental and Medical Problems 2023This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving occlusal settling (occlusal contact points/areas) after orthodontic treatment. We searched the Cochrane Library, PubMed, CINAHL Plus, and Dental & Oral Sciences Source (DOSS), as well as SIGLE, Google Scholar and ClinicalTrials.gov for eligible studies. We included randomized and non-randomized controlled trials along with cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the randomized controlled trials (RCTs), the Cochrane Collaboration risk-of-bias (RoB) tool was utilized, whereas the Newcastle-Ottawa Scale (NOS) was used to assess the quality of cohort studies.We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating the illegible ones based on duplication, titles, abstracts, and objectives. Bonded retainers (BRs) allowed faster and better posterior occlusal settling as compared to the Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. The Essix retainer (ER) showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BRs and removable retainers. In conclusion, HR allowed better overall occlusal settling as compared to other retainers. However, BRs allowed faster settling in the posterior tooth region. The Essix retainer showed poor settling of occlusion. Overall, there is an insufficient number of high-quality RCTs to provide additional evidence, and further high-quality RCTs are needed.
Topics: Humans; Orthodontic Retainers; Tooth; Malocclusion
PubMed: 37458399
DOI: 10.17219/dmp/146194 -
Clinical Oral Investigations Aug 2023To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone.
MATERIALS AND METHODS
A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted.
RESULTS
Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP).
CONCLUSION
The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed.
CLINICAL RELEVANCE
When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
Topics: Humans; Tooth Socket; Alveolar Process; Osteogenesis; Tooth; Platelet-Rich Plasma; Tooth Extraction; Fibrin; Alveolar Ridge Augmentation
PubMed: 37439800
DOI: 10.1007/s00784-023-05126-8 -
Brazilian Oral Research 2023This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and... (Meta-Analysis)
Meta-Analysis
This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.
Topics: Child; Humans; Dental Enamel Hypoplasia; Dental Anxiety; Molar; Molar Hypomineralization; Surveys and Questionnaires; Prevalence
PubMed: 37436292
DOI: 10.1590/1807-3107bor-2023.vol37.0069 -
Evidence-based Dentistry Sep 2023Systematic review.
DESIGN
Systematic review.
REVIEW QUESTION
Does splinting of traumatised primary teeth improve clinical outcomes?
CASE SELECTION
Clinical studies published after 2003 reporting trauma (luxation, root fracture or alveolar fracture) to primary teeth, with a minimum follow-up of 6 months, were eligible for inclusion. Case reports were excluded, but case series were included. Studies reporting the outcome of splinting following avulsion injuries were excluded, as current guidance does not recommend re-implantation of teeth for these injuries.
DATA ANALYSIS
Two researchers independently assessed the risk of bias in the included studies, with a third researcher resolving any disagreements. The same two independent researchers conducted a quality assessment of the included studies.
RESULTS
Three retrospective studies met the inclusion criteria. Only one of these studies had a control group. High success rates were reported for the management of teeth with root fractures. A benefit for splinting teeth with lateral luxation was not identified. No alveolar fractures were included.
CONCLUSIONS
This review suggests that the outcome of the management of root fractures in primary teeth may benefit from flexible splinting. However, the evidence base is low.
Topics: Humans; Splints; Retrospective Studies; Tooth Root; Incisor; Tooth, Deciduous
PubMed: 37433924
DOI: 10.1038/s41432-023-00914-3 -
Indian Journal of Dental Research :... 2023To determine the clinical performance of zirconia abutment (ZA) by comparing with a titanium abutment (TA) and sub-mucosal-modified zirconia abutment. A systematic... (Meta-Analysis)
Meta-Analysis
To determine the clinical performance of zirconia abutment (ZA) by comparing with a titanium abutment (TA) and sub-mucosal-modified zirconia abutment. A systematic search was conducted to retrieve eligible randomised controlled trials (RCTs) from Medline, Cochrane Library, SCOPUS, Embase, Web of Science, and Google Scholar. A search was further divided in two parts. Part I comprises eligible RCTs between zirconia abutment and titanium abutment, and part II included RCTs of zirconia abutment with sub-mucosal modified, pink-veneered glass ceramic versus non-veneered zirconia abutment. Esthetic, biological, and abutment survival was a primary outcome, and technical complications were included as an additional outcome. Fifteen eligible RCTs (Part I: N = 9 and Part II: N = 6) were evaluated, and a total of 362 abutments in 364 subjects were analysed for outcome variables. A sub-group meta-analysis reported no significant difference for Esthetic outcome. However, the overall mean (p =0.03) was higher for zirconia group in those of thin gingival phenotype. Spectrophotometric evaluation of peri-implant mucosal Esthetic does not show any significant difference. Similarly, pink-veneered versus non-veneered group reported no significant difference for thin (<2 mm) and thick (>2 mm) mucosal attachment. Biological outcome does not show any significant difference for comparable groups in both parts. There is marginally lower abutment survival for internally connected zirconia abutment (ZA: 95.4% TA: 100%). Zirconia abutment exhibited excellent Esthetic compared to titanium abutment in those of thin gingival phenotype. Sub-mucosa veneering of zirconia abutment with pink glass ceramic does not show any favourable Esthetic outcome compared to the non-veneered surface.
Topics: Titanium; Dental Abutments; Esthetics, Dental; Tooth; Zirconium; Crowns; Randomized Controlled Trials as Topic
PubMed: 37417063
DOI: 10.4103/ijdr.ijdr_465_22 -
The Journal of Clinical Pediatric... Jul 2023This scoping review aims to summarize the available evidence on strategies employed in preventing caries in patients with molar incisor hypo-mineralization (MIH). MIH... (Review)
Review
This scoping review aims to summarize the available evidence on strategies employed in preventing caries in patients with molar incisor hypo-mineralization (MIH). MIH refers to an enamel defect involving opacities, and sometimes post-eruptive degradation due to enamel porosity; resulting in outcomes ranging from a mild atypical caries to severe coronary destruction. A systematic review was conducted for literature in PubMed, Cochrane Library, Epistemonikos and Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). The search was aimed at studies published between January 2010 and February 2022. Data were independently selected and extracted. 989 studies were found from the systematic search and 8 studies met the eligibility criteria. Most studies evaluated remineralization and cariogenic risk, both of which are crucial elements in caries prevention, as well as decreased sensitivity. The included studies investigated fluoride varnish, dental sealants, giomers, casein, and Icon as preventative methods for dental caries. Several methods for preventing dental caries in paediatric patients with MIH exist, but more research is needed to determine their effectiveness and safety. Any preventive intervention should consider the etiological aspects of the disease, the risk of caries, the type and extent of lesions, hypersensitivity level and patient's age. Collaboration between patients and carers is critical for disease diagnosis and caries prevention.
Topics: Humans; Child; Dental Caries; Dental Enamel Hypoplasia; Molar Hypomineralization; Dental Enamel; Molar; Prevalence
PubMed: 37408341
DOI: 10.22514/jocpd.2023.030