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Clinical and Experimental Dental... Jun 2024Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that... (Review)
Review
OBJECTIVES
Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps.
METHODS
The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting.
RESULTS
Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices.
CONCLUSIONS
Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.
Topics: Humans; Therapeutic Irrigation; Oral Hygiene; Oral Health; Dental Caries; Periodontal Diseases
PubMed: 38881230
DOI: 10.1002/cre2.912 -
Journal of the National Medical... Sep 1989
Topics: Female; Humans; Pelvic Inflammatory Disease; Risk Factors; Therapeutic Irrigation; Vagina
PubMed: 2778841
DOI: No ID Found -
Anaesthesia Sep 1993
Topics: Equipment Design; Equipment Safety; Humans; Pressure; Therapeutic Irrigation
PubMed: 8214525
DOI: 10.1111/j.1365-2044.1993.tb07635.x -
The Cochrane Database of Systematic... Dec 2015The Cochrane Oral Health Group withdrew this review as of Issue 12, 2015. The review is out of date and does not meet current Cochrane methodological standards. It will... (Review)
Review
The Cochrane Oral Health Group withdrew this review as of Issue 12, 2015. The review is out of date and does not meet current Cochrane methodological standards. It will be superseded by a new Cochrane review on Surgical interventions for managing temporomandibular disorders. The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Adult; Arthroscopy; Humans; Manipulation, Orthopedic; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders; Therapeutic Irrigation; Tissue Adhesions
PubMed: 26677172
DOI: 10.1002/14651858.CD004973.pub3 -
Asian Journal of Surgery Jan 2021
Topics: Automation; Humans; Intraoperative Period; Kidney Calculi; Lithotripsy; Perfusion; Pliability; Safety; Therapeutic Irrigation; Ureteroscopy
PubMed: 33176969
DOI: 10.1016/j.asjsur.2020.10.013 -
BMC Gastroenterology Oct 2015Trans-anal irrigation (TAI) is used widely to treat bowel dysfunction, although evidence for its use in adult chronic functional constipation remains unclear. Long-term... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Trans-anal irrigation (TAI) is used widely to treat bowel dysfunction, although evidence for its use in adult chronic functional constipation remains unclear. Long-term outcome data are lacking, and the effectiveness of therapy in this patient group is not definitively known.
METHODS
Evidence for effectiveness and safety was reviewed and the quality of studies was assessed. Primary research articles of patients with chronic functional constipation, treated with TAI as outpatients and published in English in indexed journals were eligible. Searching included major bibliographical databases and search terms: bowel dysfunction, defecation, constipation and irrigation. Fixed- and random-effect meta-analyses were performed.
RESULTS
Seven eligible uncontrolled studies, including 254 patients, of retrospective or prospective design were identified. The definition of treatment response varied and was investigator-determined. The fixed-effect pooled response rate (the proportion of patients with a positive outcome based on investigator-reported response for each study) was 50.4 % (95 % CI: 44.3-56.5 %) but featured substantial heterogeneity (I(2) = 67.1 %). A random-effects estimate was similar: 50.9 % (95 % CI: 39.4-62.3 %). Adverse events were inconsistently reported but were commonplace and minor.
CONCLUSIONS
The reported success rate of irrigation for functional constipation is about 50 %, comparable to or better than the response seen in trials of pharmacological therapies. TAI is a safe treatment benefitting some patients with functional constipation, which is a chronic refractory condition. However findings for TAI vary, possibly due to varying methodology and context. Well-designed prospective trials are required to improve the current weak evidence base.
Topics: Adult; Anal Canal; Chronic Disease; Constipation; Female; Humans; Male; Middle Aged; Prospective Studies; Retrospective Studies; Therapeutic Irrigation; Treatment Outcome
PubMed: 26474758
DOI: 10.1186/s12876-015-0354-7 -
European Journal of Trauma and... Feb 2023In orthopedic and trauma surgery, pulsatile lavage systems are used to clean soft tissue. This may be necessary in septic surgeries or in case of contaminated wounds...
BACKGROUND
In orthopedic and trauma surgery, pulsatile lavage systems are used to clean soft tissue. This may be necessary in septic surgeries or in case of contaminated wounds after trauma. Positive features such as reduction of bacterial contamination and removal of foreign particles are counterbalanced by negative aspects such as bacterial seeding in deeper tissue layers, damage to various tissues and even cases of air embolism.
PURPOSE
The aim of this prospective experimental in vitro study was to compare impact pressure and flow rate in three different pulsatile lavage systems and to determine, whether these parameters alter their ability to reach deeper soft tissue layers.
METHODS
To test the penetration of soft tissue, the muscle tissue was flushed with contrast medium instead of saline fluid and afterwards scanned by computed tomography.
RESULTS
Impact pressure and flow rate showed significant differences between the different systems. There were no significant differences between the three devices in terms of total penetration volume, but there were significant differences in penetration depth.
CONCLUSION
In this study, we found that higher impact pressure leads to deeper penetration and therefore bacteria are likely to be transferred to deeper tissue layers.
Topics: Humans; Therapeutic Irrigation; Prospective Studies
PubMed: 36098797
DOI: 10.1007/s00068-022-02067-x -
BioMed Research International 2020To assess patients' experience of ultrasound-guided percutaneous irrigation of rotator cuff calcific tendinopathy (US-PICT).
PURPOSE
To assess patients' experience of ultrasound-guided percutaneous irrigation of rotator cuff calcific tendinopathy (US-PICT).
METHODS
Ninety-one patients (58 females; mean age: 50.5 ± 8.3 years) treated by US-PICT (local anesthesia, single-needle lavage, and intrabursal steroid injection) answered to a list of questions regarding their experience of the procedure before treatment, immediately after treatment, and three months later. The Borg CR10 scale was used to evaluate perceived pain, discomfort during anesthetic injection, and anxiety. The Wilcoxon, Spearman's rho, linear regression, and chi-square statistics were used.
RESULTS
81/91 patients complained mild discomfort during the injection of anesthetics (2, 1-2). Pain scores during US-PICT were very low (0, 0-1), with 70% patients having not experienced pain. After treatment, we found a significant reduction of pain (before: 8, 7-8; 3-month: 3, 1-6; < .001) and anxiety (before: 5, 2-7; during treatment: 2, 1-7; = 0.010), with high overall satisfaction (immediately after: 10, 9-10; 3-month: 9, 7-10) and confidence in the possibility of recovery (immediately after: 9, 8-10; 3-month: 10, 8-10), respectively. Treatments performed before US-PICT were not statistically associated with pain relief ( = 0.389) and clinical improvement ( = 0.937). We found a correlation between satisfaction immediately postprocedure and confidence in the possibility of recovery ( = 0.002) and between satisfaction three months after treatment and clinical improvement ( < 0.001) and patients' reminds about the description of the procedure ( = 0.005) and of the potential complications ( = 0.035).
CONCLUSIONS
US-PICT is a mildly painful, comfortable, and well-tolerated procedure, regardless of any previous treatments. Patients' satisfaction is correlated with clinical benefit and full explanation of the procedure and its complications.
Topics: Adult; Anxiety; Arthralgia; Calcinosis; Female; Humans; Male; Middle Aged; Patient Satisfaction; Rotator Cuff; Tendinopathy; Therapeutic Irrigation; Treatment Outcome; Ultrasonography, Interventional
PubMed: 32596294
DOI: 10.1155/2020/3086395 -
Archives of Sexual Behavior Oct 2021Receptive anal sex is the primary means through which HIV is transmitted among men who have sex with men (MSM). Recently, researchers have begun investigating the role...
Receptive anal sex is the primary means through which HIV is transmitted among men who have sex with men (MSM). Recently, researchers have begun investigating the role that rectal douching may play in amplifying risk for transmission. Yet, there is limited research on the frequency with which MSM douche, the products they use, and how this may vary across sociodemographic characteristics. A U.S. national sample of 4745 MSM completed an online survey that assessed their douching behavior, demographic characteristics, sexual behavior, and their anal sexual positioning (i.e., top, bottom, versatile). Nearly two-thirds (65.8%) had engaged in rectal douching in the last three months. Among those who douched, water was commonly reported (84.2%) and 20.1% reported using commercial enemas (e.g., Fleet), as well as water and soap (15.0%)-numbers exceed 100% as some participants reported more than one. Men who douched reported significantly more receptive and insertive condomless anal sex acts in the prior 3 months. One-in-ten men reported rectal bleeding after douching. Compared to HIV-negative participants who had not taken PrEP, participants had higher odds of reporting douching in the past 3 months if they were HIV-negative and currently on PrEP (AOR = 1.82), HIV-negative and previously used PrEP (AOR = 1.58), and HIV-positive (AOR = 1.83). Douching was common in this sample. Given that douching could amplify risk for HIV transmission, healthcare providers should discuss douching safety with their patients, with a focus on harm reduction (e.g., reduce risk of bleeding, as opposed to abstinence from douching).
Topics: HIV Infections; Homosexuality, Male; Humans; Male; Sexual Behavior; Sexual and Gender Minorities; Therapeutic Irrigation
PubMed: 34590220
DOI: 10.1007/s10508-021-01933-w -
Ostomy/wound Management Mar 2013Pressure ulcers are major complications of reduced mobility and/or sensation. Pulsatile lavage therapy delivers localized hydrotherapy directly to the wound utilizing a... (Review)
Review
Pressure ulcers are major complications of reduced mobility and/or sensation. Pulsatile lavage therapy delivers localized hydrotherapy directly to the wound utilizing a pulsatile pressurized stream of normal saline. The purpose of this study was to evaluate the clinical safety of pulsatile lavage therapy, provided daily at the bedside, in routine management of Stage III and Stage IV pressure ulcers. Charts from 28 male patients with Stage III and Stage IV pressure ulcers and spinal cord injury (SCI) or spinal cord disorders (SCD) were retrospectively reviewed for documentation of adverse events/safety concerns. Mean therapy duration was 46 days (SD 37 days, range 6-152 days). Treatment was interrupted for 6 days in one patient due to minor wound bleeding. No other adverse events, including backsplash injuries, were documented. The results of this chart review suggest pulsatile lavage therapy can be administered at the patient's bedside without adverse events if appropriate protocols are followed. Additional research to confirm the efficacy and effectiveness of this treatment modality in a broader subject population is warranted.
Topics: Cohort Studies; Humans; Pressure Ulcer; Retrospective Studies; Spinal Cord Injuries; Therapeutic Irrigation
PubMed: 23475450
DOI: No ID Found