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Evidence-based Dentistry Jun 2024A systematic review and meta-analysis of the literature was carried out assessing the success rate of root canal retreatment using gutta percha. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A systematic review and meta-analysis of the literature was carried out assessing the success rate of root canal retreatment using gutta percha.
DATA SOURCES
Four of the largest databases were used to identify existing literature with no date or language restrictions. PubMed, Cochrane, ScienceDirect, Scopus and other additional sources were searched. Grey literature was also reviewed.
STUDY SELECTION
Two authors, with Master's degrees in endodontics and with extensive university teaching experience, were selected to screen the databases to identify suitable studies. In case the authors were not able to agree during the study selection process, a third investigator was consulted. Specific inclusion and exclusion criteria were outlined and adhered to in the study selection. Two randomised controlled trials, seven single arm prospective studies and one single arm ambispective study published before the 10th of December 2022 were included. These studies evaluated the success of root canal re-treatment, obturated with gutta percha with at least a 1-year follow-up. Nine of the studies were published between 1998 and 2022. Seven studies were conducted in Europe, one in North America and one in Asia.
DATA EXTRACTION AND SYNTHESIS
Standard Cochrane methods to assess interval validity were used. Risk of bias in individual studies was assessed using The Newcastle-Ottawa quality assessment scale (NOS) for single-arm studies, and the Cochrane risk of bias tool (RoB2) was used for randomised controlled trials. Outcome measures were standardised as either success or failure of root canal retreatment. Success was classified into 2 different criteria: Strict criteria = absence of clinical signs and symptoms and radiographically normal periodontal ligament space; and Loose criteria = absence of clinical signs and symptoms and absence or reduction of apical radiolucency in the control radiograph. Statistical analysis was undertaken using R software and the Freeman-Turkey transformation was performed. Results were visualised using forest plots. Heterogeneity between studies was measured using the Cochrane Q test and I values.
RESULTS
Whilst following strict criteria, the success rate of non-surgical root canal retreatment obturated with gutta percha was 71% for 1-3 years follow-up (95% CI, 0.66-0.77) and 77% for 4-5 years follow-up (95% CI, 0.67-0.86). Heterogeneity was moderate (I = 61.4) and low (I = 0.0), respectively. Factors reducing the success rate of root canal re-retreatment under the strict criteria were older patients, mandibular teeth, molar teeth, the presence of a peri-apical radiolucency, teeth with a previous radiolucency, large peri-apical radiolucency's, higher initial periapical index scores and multiple visit-retreatments. Following the loose criteria, the success rate of non-surgical root canal re-treatment obturated with gutta percha was 87% for 1-3 years follow-up (95% CI, 0.79-0.93) with significant heterogeneity across the studies (I = 88.5%). Factors influencing the success rate under the loose criteria were large periapical lesions >5 mm and higher initial periapical index (PAI) scores.
CONCLUSIONS
Non-surgical root canal retreatment results in favourable outcomes. However, there are several factors which can result in a lower success rate: the presence and size of a periapical radiolucency, a higher initial PAI score, multiple-visit retreatments, and the size and position of the tooth.
Topics: Gutta-Percha; Humans; Retreatment; Root Canal Therapy; Root Canal Filling Materials; Root Canal Obturation; Treatment Outcome
PubMed: 38796553
DOI: 10.1038/s41432-024-01019-1 -
Cost Effectiveness and Resource... May 2024There is some evidence that differentiated service delivery (DSD) models, which use a client-centered approach to simplify and increase access to care, improve clinical... (Review)
Review
BACKGROUND
There is some evidence that differentiated service delivery (DSD) models, which use a client-centered approach to simplify and increase access to care, improve clinical outcomes among people living with HIV (PLHIV) in high HIV prevalence countries. Integrating economic strengthening tools (e.g., microcredit, cash transfers, food assistance) within DSD models can help address the poverty-related barriers to HIV antiretroviral therapy (ART). Yet there is minimal evidence of the cost-effectiveness of these types of multilevel care delivery models, which potentially prohibits their wider implementation.
METHODS
Using a qualitative systematic review, this article synthesizes the literature surrounding the cost-effectiveness of differentiated service delivery models that employ economic strengthening initiatives to improve HIV treatment adherence in low- and middle-income countries. We searched three academic databases for randomized controlled trials and observational studies published from January 2000 through March 2024 in Sub-Saharan Africa. The quality of each study was scored using a validated appraisal system.
RESULTS
Eighty-nine full texts were reviewed and 3 met all eligibility criteria. Two of the three included articles were specific to adolescents living with HIV. Economic strengthening opportunities varied by care model, and included developmental savings accounts, microenterprise workshops, and cash and non-cash conditional incentives. The main drivers of programmatic and per-patient costs were ART medications, CD4 cell count testing, and economic strengthening activities.
CONCLUSION
All economic evaluations in this review found that including economic strengthening as part of comprehensive differentiated service delivery was cost-effective at a willingness to pay threshold of at least 2 times the national per capita gross domestic product. Two of the three studies in this review focused on adolescents, suggesting that these types of care models may be especially cost-effective for youth entering adulthood. All studies were from the provider perspective, indicating that additional evidence is needed to inform the potential cost-savings of DSD and economic strengthening interventions to patients and society. Randomized trials testing the effectiveness of DSD models that integrate economic strengthening should place greater emphasis on costing these types of programs to inform the potential for bringing these types of multilevel interventions to scale.
PubMed: 38790050
DOI: 10.1186/s12962-024-00557-w -
Tooth movement with dental anchorage vs. skeletal anchorage: A systematic review of clinical trials.Journal of Orthodontic Science 2024The aim of this study is to compare the time and movement of orthodontic treatment using dental anchorage and skeletal anchorage in adolescent and adult patients with... (Review)
Review
The aim of this study is to compare the time and movement of orthodontic treatment using dental anchorage and skeletal anchorage in adolescent and adult patients with dental malocclusions. A systematic search was conducted in the Embase, PubMed, Lilacs, Cochrane, Trip, and Scopus databases up to October 2022. All the articles were selected using title and abstract, applying the inclusion and exclusion criteria. Disagreements were resolved with a third author. Finally, a full-text selection took place. The data extraction was conducted by two authors who independently evaluated the risk of bias. The methodological quality of the randomized clinical trials was evaluated using the Cochrane tool for the evaluation of the randomized clinical trials. Six articles were included in the data analysis. There were four clinical trials and two randomized clinical trials. A total of 176 patients was obtained with an age range between 14 and 46 years. Four studies showed significant differences when comparing the two anchorages in retraction or distalization of tooth groups, and two showed no differences when using dental and skeletal anchorage for vertical movements; only the articles with vertical movements showed relapse. We can conclude that skeletal anchorage generates precise and stable horizontal movements without overloading or changing the position of the molar. Future studies must incorporate three-dimensional technology for greater clinical accuracy.
PubMed: 38784081
DOI: 10.4103/jos.jos_4_23 -
Epilepsy & Behavior Reports 2024Exercise interventions in epilepsy have been shown to improve seizure frequency, physical capacity, quality of life, mood, and cognitive functioning. However, the... (Review)
Review
Exercise interventions in epilepsy have been shown to improve seizure frequency, physical capacity, quality of life, mood, and cognitive functioning. However, the effectiveness of exercise in improving sleep in epilepsy is less clear. The purpose of this report is to identify the published literature regarding exercise interventions in people with epilepsy to determine 1) what proportion of published clinical trials assess sleep as an outcome, and 2) what benefits of exercise interventions on sleep have been observed. We searched the PubMed, PsycINFO, and SCOPUS electronic databases using the search terms "epilepsy AND [exercise OR physical activity]" and identified 23 articles reporting on 18 unique clinical trials. Nine studies were conducted in adults, five in children, and four in adults and children with active seizures, controlled seizures, or both. Exercise modalities included aerobic exercise, strength training, walking, and yoga, among others, and some also included educational and motivational components. Exercise effects on sleep were tested in four studies, two of which only included indirect measures of sleep- and rest-related fatigue, with mixed results. Of the two reports assessing sleep directly, one reported marginal non-significant improvements in subjective sleep quality and no improvements in objective sleep quality in children after twelve weeks of walking, and the other reported no benefits in subjective sleep quality after twelve weeks of combined aerobic, strength, and flexibility training in adults. Given the health benefits of sleep and detrimental effects of sleep deprivation in epilepsy, epilepsy researchers need to assess the effects of exercise interventions on sleep.
PubMed: 38779424
DOI: 10.1016/j.ebr.2024.100675 -
Psychology Research and Behavior... 2024In the Indian setting, communal riots characterized by intergroup violence have been common and have had an impact on the lives of both people and communities. The goal... (Review)
Review
OBJECTIVE
In the Indian setting, communal riots characterized by intergroup violence have been common and have had an impact on the lives of both people and communities. The goal of this systematic review is to investigate the psychological effects of Indian communal riots in depth. Through a comprehensive review of the literature, the study aims to identify recurring themes, patterns, and variances in the psychological effects encountered by victims of community violence.
METHODS
The researcher searched Science Direct, PubMed, Web of Science, Google Scholar, and PsycINFO for research published between the year 2000 and the year 2022 in each of these databases. The Newcastle-Ottawa Scale was employed to evaluate the study's quality.
RESULTS
After identifying 1189 publications in all, 195 of them were chosen for full-text examination, and 41 research were ultimately included. Twenty studies examined depression and mental health with a prevalence rate of 49%. Five studies (12%) examined post-traumatic stress disorder. In places devastated by riots, the prevalence of post-traumatic stress disorder varied from 4% to 41%. Other studies investigated anxiety, alcohol abuse, and homelessness. However, two studies revealed that group activities could lower depression and suicide rates, perhaps as a result of increased social cohesiveness and group catharsis among subpopulations.
CONCLUSION
The researcher investigated the connection between collective activities and mental health in this systematic review, providing strong evidence that riots, protests, and other collective actions-even peaceful ones-can harm mental health outcomes. Thus, healthcare providers must be aware of the psychological and emotional effects of riots, revolutions, and demonstrations. It is essential to do more study on this newly identified sociopolitical driver of mental health.
PubMed: 38766318
DOI: 10.2147/PRBM.S455783 -
The British Journal of Oral &... Jun 2024This systematic review aimed to evaluate results reported in the literature regarding the success rate of the titanium mesh technique for the placement of dental... (Review)
Review
This systematic review aimed to evaluate results reported in the literature regarding the success rate of the titanium mesh technique for the placement of dental implants. The topic focused on titanium mesh used as a physical barrier for ridge reconstruction in cases of partial or total edentulism. The authors conducted an electronic search of four databases up to October 2023. Six articles fulfilled the inclusion criteria and were analysed. A total of 100 titanium meshes with a minimum of 4.6 months follow up after surgery were studied, and 241 implants were placed. The review shows that the use of titanium mesh is a predictable method for the rehabilitation of complex atrophic sites. Further investigation generating long-term data is needed to confirm these findings.
Topics: Humans; Titanium; Surgical Mesh; Bone Regeneration; Dental Implantation, Endosseous; Dental Implants; Alveolar Ridge Augmentation; Guided Tissue Regeneration, Periodontal
PubMed: 38760261
DOI: 10.1016/j.bjoms.2024.04.005 -
Frontiers in Psychology 2024Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers...
Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts' effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.
PubMed: 38756485
DOI: 10.3389/fpsyg.2024.1321373 -
The Science of the Total Environment Jul 2024Climate change will impact the carrot seed industry globally. One adaptation strategy to limit climatic impacts on the production of commercial carrot seeds is...
Pollen-mediated gene flow from wild carrots (Daucus carota L. subsp. carota) affects the production of commercial carrot seeds (Daucus carota L. subsp. sativus) internationally and in New Zealand in the context of climate change: A systematic review.
Climate change will impact the carrot seed industry globally. One adaptation strategy to limit climatic impacts on the production of commercial carrot seeds is geographical shift. However, production must be shifted to climate-optimal places that are free from weeds such as wild carrots to avoid genetic contamination via hybridization. The process of gene flow between wild and cultivated carrots is critical to enable management of wild carrots in the face of climate change. This review systematically assesses the resilience of wild carrots to climate change and their impact on commercial carrot seed production globally with a focus on New Zealand as a major carrot seed producer. The literature was critically analyzed based on three specific components: i) resilience of wild carrots to climate change ii) genetic contamination between wild and cultivated carrots, and iii) management of wild carrots. The majority of the articles were published between 2013 and 2023 (64.71 %), and most of these studies were conducted in Europe (37.26 %) and North America (27.45 %). Country-wise analysis demonstrated that the majority of the studies were carried out in the United States (23.53 %) and the Netherlands (11.77 %). There was limited research conducted in other regions, especially in Oceania (1.96 %). Spatial distribution analysis revealed that the wild carrot was reported in around 100 countries. In New Zealand the North Island has a higher incidence of wild carrot invasion than the South Island. The findings indicated that the wild carrot is becoming more adaptable to climate change, compromising the genetic purity of cultivated carrots due to pollen flow from wild to cultivated carrots. Therefore, ongoing research will be helpful in developing sustainable weed management strategies and predicting potential geographical invasiveness. This study provides a guide for scientists, policymakers, industrialists, and farmers to control wild carrots and produce genetically pure commercial seeds amid climate change.
Topics: Climate Change; Daucus carota; Gene Flow; New Zealand; Pollen; Seeds
PubMed: 38754518
DOI: 10.1016/j.scitotenv.2024.173269 -
Brain Impairment : a Multidisciplinary... May 2024Background There is a need for improved access to evidence-based interventions supporting the wellbeing of caregivers of adults with acquired brain injury (ABI)....
Background There is a need for improved access to evidence-based interventions supporting the wellbeing of caregivers of adults with acquired brain injury (ABI). Remotely delivered interventions could address this need. The present systematic review sought to collate studies evaluating remotely delivered interventions designed to improve the wellbeing of caregivers of adults with an ABI, to summarise findings and to comment on the quality of this research. Methods Systematic searches were conducted up until December 2023. Study characteristics, populations, interventions and outcomes were outlined, and papers were appraised on methodological quality. The review was pre-registered (PROSPERO: CRD42020189235). Results Eleven studies meeting inclusion criteria were identified. Methodological quality was generally low to adequate. Most studies evaluated an intervention for caregivers of people with stroke, with a variety of types of interventions trialled. The majority of studies reported non-significant findings on wellbeing outcomes when compared to control conditions. Conclusions There is limited evidence supporting a remotely delivered intervention to improve wellbeing outcomes for ABI caregivers. Specific recommendations are provided, including the development of a core set of outcomes and replication of findings over time, which can improve research into the development and evaluation of remote interventions for this population.
Topics: Humans; Caregivers; Brain Injuries; Telemedicine; Adult; Quality of Life
PubMed: 38753958
DOI: 10.1071/IB23099 -
ELife May 2024Zoonotic disease dynamics in wildlife hosts are rarely quantified at macroecological scales due to the lack of systematic surveys. Non-human primates (NHPs) host a... (Meta-Analysis)
Meta-Analysis
Zoonotic disease dynamics in wildlife hosts are rarely quantified at macroecological scales due to the lack of systematic surveys. Non-human primates (NHPs) host a zoonotic malaria of public health concern and the main barrier to malaria elimination in Southeast Asia. Understanding of regional infection dynamics in wildlife is limited. Here, we systematically assemble reports of NHP and investigate geographic determinants of prevalence in reservoir species. Meta-analysis of 6322 NHPs from 148 sites reveals that prevalence is heterogeneous across Southeast Asia, with low overall prevalence and high estimates for Malaysian Borneo. We find that regions exhibiting higher prevalence in NHPs overlap with human infection hotspots. In wildlife and humans, parasite transmission is linked to land conversion and fragmentation. By assembling remote sensing data and fitting statistical models to prevalence at multiple spatial scales, we identify novel relationships between in NHPs and forest fragmentation. This suggests that higher prevalence may be contingent on habitat complexity, which would begin to explain observed geographic variation in parasite burden. These findings address critical gaps in understanding regional epidemiology and indicate that prevalence in simian reservoirs may be a key spatial driver of human spillover risk.
Topics: Animals; Humans; Asia, Southeastern; Ecosystem; Malaria; Plasmodium knowlesi; Prevalence; Primate Diseases; Primates; Zoonoses
PubMed: 38753426
DOI: 10.7554/eLife.88616