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Correction: Cannabidiol - an effective analgesic for toothache? 更正:大麻二酚--治疗牙痛的有效镇痛剂?
Q3 Dentistry Pub Date : 2024-05-13 DOI: 10.1038/s41432-024-01012-8
Siofra Murphy, Ellis Hayes
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引用次数: 0
Does periodontitis have any association with mild cognitive impairment? 牙周炎与轻度认知障碍有关系吗?
Q3 Dentistry Pub Date : 2024-05-09 DOI: 10.1038/s41432-024-01015-5
Neeraj Gugnani, Shalini Gugnani
This study aimed at determining the association between periodontitis and mild cognitive impairment. For this, different electronic databases, including PubMed, Scopus, Embase and Web of Science, were searched for finding the relevant literature. In addition, hand searching of relevant journals was also done to find gray literature. The systematic review included observational studies only. Accordingly, case-control, cohort and cross-sectional studies were searched. The search strategy was based on PECO framework, wherein the studies which included patients with/without periodontitis and patients with/without mild cognitive impairment (MCI) were included. A total of 7 studies were included and the data from these studies and the data including bibliographic details, demographic data, data about periodontitis, presence of MCI etc. was extracted from the included articles. The extracted data, was then assessed for heterogeneity using clinical parameters and I2 statistical test. Owing to low heterogeneity, fixed-effects model was used for meta-analysis. Meta-analysis was done to determine the association between periodontitis and MCI and significantly higher incidence of MCI was found in patients with periodontitis OR = OR, 1.70 (95% CI: 1.24–2.32, p < 0.001). A subgroup analysis was done by including the studies comparing incidence of MCI in patients with severe periodontitis, which resulted in even stronger association with an OR of 2.09 (95% CI: 1.49–2.92, p < 0.001). Lastly, periodontal parameters, including CAL, PPD, and PI were compared amongst patients with/without MCI. Significant differences were observed for both CAL and PI, with worsening of values in patients with MCI. Observed mean difference for CAL and PI were 0.44 (95% CI: 0.12–0.75) and 0.72 (95% CI:0.50–0.93), respectively. NS differences were observed for PPD values with a mean difference of 0.21 and 95% CI as −0.08 to 0.49. Strong association between periodontitis and MCI was observed, indicating periodontitis to be a risk factor for MCI.
数据来源:本研究旨在确定牙周炎与轻度认知障碍之间的关系。为此,研究人员检索了不同的电子数据库,包括 PubMed、Scopus、Embase 和 Web of Science,以查找相关文献。此外,还对相关期刊进行了人工检索,以查找灰色文献:系统综述仅包括观察性研究。因此,检索了病例对照、队列和横断面研究。搜索策略基于 PECO 框架,其中包括牙周炎患者/无牙周炎患者和轻度认知障碍(MCI)患者/无轻度认知障碍患者的研究:共纳入了 7 项研究,并从这些研究中提取了数据,包括详细的文献资料、人口统计学数据、牙周炎数据、是否存在 MCI 等。然后使用临床参数和 I2 统计检验对提取的数据进行异质性评估。由于异质性较低,因此采用固定效应模型进行荟萃分析:结果:通过荟萃分析确定了牙周炎与 MCI 之间的关系,发现牙周炎患者 MCI 的发病率明显较高,OR = OR, 1.70 (95% CI: 1.24-2.32, p 结论:牙周炎与 MCI 之间的关系密切:牙周炎与 MCI 之间存在密切联系,表明牙周炎是 MCI 的危险因素之一。
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引用次数: 0
Antibiotic prophylaxis may effectively reduce early failures after beginner-conducted dental implant surgery 抗生素预防可有效减少初学者进行种植牙手术后的早期失败率
Q3 Dentistry Pub Date : 2024-05-08 DOI: 10.1038/s41432-024-01011-9
Omer Waleed Majid
A randomized, double-blind, placebo-controlled clinical trial. To assess the impact of antibiotic prophylaxis on postoperative recovery and implant short-term survival in clinically healthy patients who underwent placement of 2–4 dental implants by inexperienced operators. The study adhered to the ethical guidelines of the Helsinki declaration, and followed the CONSORT protocol for randomized controlled trials (RCTs). Signed consent forms were provided by all patients. Included were healthy individuals aged over 18 years, with sufficient and fully healed alveolar ridge (undergone extraction at least 3 months prior), requiring placement of 2–4 dental implants, and were classified as ASA I or II. Exclusion criteria were: systemic diseases, hypersensitivity to penicillin, pregnancy or lactation, smoking, recent antibiotic usage, and history of periodontitis. Patients were randomly allocated into 2 groups: the antibiotic group received 1 g of amoxicillin one hour before surgery, while the placebo group was given starch-filled capsules that looked identical to the antibiotic. All implants were installed through 2-stage procedures by students of a specialization course in implant surgery, employing a standardized procedure and armamentarium. Each patient was evaluated preoperatively, and at 2 days and 7 days postoperatively, for the following parameters: mouth opening, experienced pain (using a visual analog scale), and signs of infection (fistula, wound ulceration, tissue necrosis, flap dehiscence, and purulent exudates). Implant survival was monitored for up to 90 days after implant surgery. A total of 90 patients (224 implants) were included: 43 patients (108 implants) in the antibiotic group, and 47 patients (116 implants) in the placebo group. Overall, there were 58 women and 32 men, aged from 23 to 70 years old. In terms of mouth opening, pain, and infection parameters, no statistically significant differences were observed between the groups at any of the time points evaluated. Similarly, there was no statistically significant difference regarding antibiotic usage and implant loss at the patient level (p = 0.06). However, at the implant level, significantly higher implant loss rate was noted in the placebo group (14.9%) compared to the antibiotic group (2.3%) [p < 0.05]. Prophylactic antibiotic administration effectively reduced the occurrence of implant loss after implant surgery performed by inexperienced practitioners.
研究设计一项随机、双盲、安慰剂对照临床试验。目的评估抗生素预防对临床健康、由缺乏经验的操作者植入 2-4 个牙科种植体的患者术后恢复和种植体短期存活率的影响。方法该研究遵守赫尔辛基宣言的伦理准则,并遵循随机对照试验 (RCT) 的 CONSORT 协议。所有患者均提供了签名同意书。研究对象包括年龄在18岁以上、牙槽嵴充分且完全愈合(至少在3个月前进行过拔牙)、需要植入2-4颗种植体、ASA分类为I级或II级的健康人。排除标准包括:全身性疾病、对青霉素过敏、怀孕或哺乳期、吸烟、近期使用过抗生素以及有牙周炎病史。患者被随机分为两组:抗生素组在手术前一小时服用1克阿莫西林,安慰剂组服用与抗生素相同的淀粉填充胶囊。所有的种植体都是由种植手术专业课程的学生采用标准化的程序和设备分两步安装的。每位患者在术前、术后 2 天和 7 天均接受了以下评估:张口情况、疼痛感(使用视觉模拟量表)和感染迹象(瘘管、伤口溃疡、组织坏死、皮瓣开裂和化脓性渗出物)。对植入手术后 90 天内的植入物存活情况进行了监测:抗生素组有 43 名患者(108 个种植体),安慰剂组有 47 名患者(116 个种植体)。其中,女性 58 人,男性 32 人,年龄从 23 岁到 70 岁不等。就张口、疼痛和感染参数而言,在任何一个评估时间点,两组之间都没有发现明显的统计学差异。同样,在抗生素使用和种植体脱落方面,患者之间也没有明显的统计学差异(P = 0.06)。结论预防性抗生素用药可有效减少由经验不足的医生进行种植手术后种植体脱落的情况。
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引用次数: 0
What do we really know about vital pulp therapy? 我们对牙髓治疗了解多少?
Q3 Dentistry Pub Date : 2024-05-07 DOI: 10.1038/s41432-024-01008-4
Jacqueline Fraser, Scott Webster
Retrospective cohort study using STROBE cohort reporting guidelines. Patients from Mehr Dental Clinic in Tehran, Iran, who received different types of vital pulp therapy (VPT) by a single endodontist, due to carious pulpal exposure, between April 2011 and October 2022. These were: Full Pulpotomy (FP), Miniature Pulpotomy (MP) and Direct Pulp Capping (DPC). Data were accessed via the dental clinic’s electronic database. Patients were deemed eligible if they had pulpal exposure due to caries, but not trauma. Pre-operative, immediate post-operative and at least one follow-up radiograph at a minimum 3-month interval were required. Demographic, diagnostic, and procedural data as well as informed consent were also required. Teeth with probing depths greater than 4 mm or pulpal necrosis were excluded. Patient, tooth and treatment factors were statistically analysed for an outcome of success or failure using a Cox proportional hazards model. Kaplan/Meier curves were used to establish the mean survival times. The Log-rank test was used to compare survival across the three treatment groups. The Omnibus test of model and the −2 log likelihood ratio (-2LL) were used to assess sensitivity and model fitness. Statistical analyses were determined using the IBM SPSS Statistics for Windows Version 21.0, with P value set at <0.05. 1257 VPTs from 1149 patients had complete data and were used in the analysis. 802 cases were excluded due to no follow up radiograph. The VPT cases were divided into FP (n = 272), MP (n = 217) and DPC (n = 768). The average follow up was 42.21 months, with an overall 116-month survival rate of 99.1% and success rate of 91.6%. FP had a mean survival time of 99.43 months; for MP it was 104.26 months; for DPC it was 102.27 months. There were no significant differences between these groups (P = 0.363). There were statistically significant correlations between symptomatic Irreversible Periodontitis (IP), radiographic signs of Apical Periodontitis (AP), restoration type, restoration surfaces and the outcome of VPT. This is one of the largest cohort studies of its kind, with over 1250 cases of various VPT techniques in 10 years. There was deviation from gold standard practice, with lack of rubber dam. A lack of haemostasis after 2 min could be construed as bacterially infected pulpal tissue and require further resection of pulp. Yet, these approaches still resulted in successful outcomes. Another interesting finding was that symptomatic IP with associated AP was treated with VPT, with a 78% success rate. Considering this study and other emerging evidence in the literature, application of VPT as an alternative to conventional Root Canal Treatment could be adopted in general practice, depending on the skills and knowledge of the practitioner and patient preferences.
设计采用 STROBE 队列报告指南进行回顾性队列研究:伊朗德黑兰 Mehr 牙科诊所的患者,这些患者在 2011 年 4 月至 2022 年 10 月期间因龋髓暴露而接受了不同类型的牙髓治疗 (VPT),由一名牙髓病学家负责治疗。这些治疗包括全牙髓切除术 (FP)、微型牙髓切除术 (MP) 和直接牙髓盖髓术 (DPC)。数据通过牙科诊所的电子数据库获取。如果患者因龋齿而导致牙髓暴露,但没有外伤,则被视为符合条件。患者需要进行术前、术后即刻和至少一次间隔 3 个月的随访拍片。还需要提供人口统计学、诊断和手术数据以及知情同意书。探诊深度大于 4 毫米或牙髓坏死的牙齿不在研究范围内:数据分析:采用 Cox 比例危险度模型对患者、牙齿和治疗因素的成功或失败结果进行统计分析。Kaplan/Meier 曲线用于确定平均生存时间。对数秩检验用于比较三个治疗组的存活率。模型综合测试和-2对数似然比(-2LL)用于评估灵敏度和模型适配性。统计分析采用 IBM SPSS Statistics for Windows Version 21.0,P 值设定为结果:来自 1149 名患者的 1257 份 VPT 具有完整的数据并被用于分析。802例因没有随访X光片而被排除在外。VPT 病例分为 FP(n = 272)、MP(n = 217)和 DPC(n = 768)。平均随访时间为 42.21 个月,116 个月的总体存活率为 99.1%,成功率为 91.6%。FP 的平均存活时间为 99.43 个月;MP 为 104.26 个月;DPC 为 102.27 个月。这些组别之间没有明显差异(P = 0.363)。无症状的不可逆牙周炎(IP)、根尖牙周炎(AP)的影像学表现、修复类型、修复表面与 VPT 的结果之间存在统计学意义上的相关性:这是同类研究中规模最大的队列研究之一,在 10 年中有超过 1250 个病例采用了各种 VPT 技术。这项研究偏离了黄金标准,没有使用橡胶坝。2 分钟后仍未止血可视为牙髓组织受细菌感染,需要进一步切除牙髓。然而,这些方法仍然取得了成功。另一个有趣的发现是,对伴有 AP 的无症状 IP 采用 VPT 治疗,成功率高达 78%。考虑到这项研究和其他文献中新出现的证据,根据医生的技能和知识以及患者的偏好,VPT 可以作为传统根管治疗的替代方法在全科实践中应用。
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引用次数: 0
Multi-nutrients and periodontal disease – a new adjunct to improving treatment outcomes? A randomised placebo-control clinical trial 多种营养素与牙周病--改善治疗效果的新辅助手段?随机安慰剂对照临床试验
Q3 Dentistry Pub Date : 2024-05-02 DOI: 10.1038/s41432-024-01010-w
Ryan McSorley
This study by Laky et al. is a single-centre, double-blinded randomised placebo-controlled clinical trial, examining the effects of micronutrient supplementation in combination with non-surgical hygiene phase therapy (nsHPT) for Stage III and IV periodontal disease. The study was carried out at the Medical University of Vienna (Austria), School of Dentistry. The patients enrolled in the study were randomised to receive a commercially available multi-nutrient supplement (containing: vitamin C, vitamin E, zinc, selenium, alpha-lipoic-acid, cranberry extract, grapeseed extract, and coenzyme Q10) or a cellulose placebo to take for 2 months, alongside a course of non-surgical hygiene phase therapy. At baseline, the patients had a periodontal index screening (PSI) performed. Patients scoring >3 and meeting the inclusion criteria were enrolled in the trial. Oral hygiene instruction and patient education was performed, followed by 1 or more sessions of nsHPT depending on the clinical assessment of each patient, and a full periodontal probing depth (PPD) chart was recorded. The patients were then randomised to receive either the multi-nutrient supplement or the placebo to take twice daily for 8 weeks. Following this 8-week period the PPD as well as bleeding on probing (BOP), gingival recession (GR) and clinical attachment loss (CAL) were measured. The randomisation was carried out by a study-independent member of staff at the centre using a computer programme. A total of 149 patients were assessed for eligibility for this trial. Out of these patients, 83 were deemed to be unsuitable for the trial as they failed to meet the inclusion criteria, and 24 declined to participate. A total of 42 patients were then randomised to each arm of the study. The inclusion criteria included patients with Stage III and IV periodontal disease. Patients were deemed eligible if they met the following criteria: presence of 18 or more scorable teeth (excluding 3rd molars); >4 teeth with PPD of >6 mm; CAL > 5 mm, and no previous periodontal treatment in the past. Percentage bone loss at the most severe site, smoking status, and presence of diabetes and diabetic control were all taken into consideration. Patients were deemed ineligible for the trial if they were pregnant or under 18 years old. Exclusion criteria also included: recent periodontal abscess; a past or current co-morbidity which may confound the results of the study or endanger patients partaking in the study (i.e. malignancy, rheumatoid arthritis, and other severe systemic conditions); and obesity. PPD was used as the primary variable in this study. Other measured outcomes such as GR, CAL, BOP and other measurements taken, such as papillary bleeding index (PBI) and papillary inflamed surface area (PISA), were considered as secondary outcome variables. A variety of tests were used in order to assess the collected data. The Kolmogorov‒Smirnov test and Levene test were used for the equality of variances
设计这项由 Laky 等人进行的研究是一项单中心、双盲随机安慰剂对照临床试验,考察了微量营养素补充剂结合非手术卫生期疗法 (nsHPT) 治疗 III 期和 IV 期牙周病的效果。该研究在奥地利维也纳医科大学牙科学院进行。参加研究的患者被随机分配接受市售的多种营养素补充剂(含维生素 C、维生素 E、锌、硒、α-硫辛酸、蔓越莓提取物、葡萄籽提取物和辅酶 Q10)或纤维素安慰剂,在接受非手术卫生阶段疗法的同时服用 2 个月。在基线期,患者进行了牙周指数筛查(PSI)。评分为3分且符合纳入标准的患者被纳入试验。在进行口腔卫生指导和患者教育后,根据每位患者的临床评估结果,进行1次或多次nsHPT治疗,并记录完整的牙周探诊深度(PPD)图表。然后,患者被随机分配接受多种营养素补充剂或安慰剂,每天服用两次,连续服用 8 周。8 周后,测量 PPD 以及探诊出血 (BOP)、牙龈退缩 (GR) 和临床附着丧失 (CAL)。病例选择共有 149 名患者接受了试验资格评估。在这些患者中,83人因不符合纳入标准而被认为不适合参加试验,24人拒绝参加。随后,共有 42 名患者被随机分配到研究的各个臂中。纳入标准包括牙周病 III 期和 IV 期患者。符合以下条件的患者被认为符合条件:有 18 颗或更多的可修复牙齿(不包括第三磨牙);4 颗牙齿的 PPD 为 6 毫米;CAL 为 5 毫米,且既往未接受过牙周治疗。最严重部位的骨质流失百分比、吸烟状况、是否患有糖尿病以及糖尿病控制情况均在考虑之列。怀孕或未满 18 岁的患者不符合试验资格。排除标准还包括:近期牙周脓肿;过去或现在患有可能影响研究结果或危及参与研究的患者的并发症(如恶性肿瘤、类风湿性关节炎和其他严重的全身性疾病);肥胖。其他测量结果,如GR、CAL、BOP和其他测量结果,如乳头出血指数(PBI)和乳头炎症表面积(PISA),被视为次要结果变量。为了评估收集到的数据,我们使用了多种检验方法。Kolmogorov-Smirnov检验和Levene检验用于检验方差是否相等,ICC和95% CI用于比较牙周图上的PPD(单位:毫米)。干预和安慰剂之间的分类数据采用卡方检验或费雪检验。基线数据和再评估数据的比较采用 McNemar 检验。所有数据均使用统计软件进行分析。结果纳入分析的患者人数减少到干预组 n = 20 人,安慰剂组 n = 19 人。由于各种原因,包括需要使用抗生素和失去随访机会,导致患者死亡。作者总结说,在试验的每个组中,牙周和卫生指标总体上都有所改善。结果表明,干预组的 PPD 下降幅度明显较高;但是,经过数据分析后发现,这些结果在统计学上并不显著。作者总结说,与安慰剂和 nsHPT 相比,为接受牙周病 III 期和 IV 期治疗的患者添加多种营养素补充剂以及 nsHPT 可降低 PPD 和 BOP。
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引用次数: 0
Periodontal manifestations of local and systemic diseases: Color atlas and text 局部和全身疾病的牙周表现:彩色图集和文本
Q3 Dentistry Pub Date : 2024-04-30 DOI: 10.1038/s41432-024-01004-8
Philip M. Preshaw
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引用次数: 0
Cannabidiol - an effective analgesic for toothache? 大麻二酚--治疗牙痛的有效镇痛剂?
Q3 Dentistry Pub Date : 2024-04-22 DOI: 10.1038/s41432-024-01007-5
Siofra Murphy, Ellis Hayes
The study by Chrepa et al. is a randomised, placebo-controlled, triple-arm, phase IIA clinical trial with double masking which investigates the effectiveness and safety of Cannabidiol (CBD) as an analgesic for acute dental pain. The intervention drug, Epidiolex is an FDA-approved CBD oral solution (100 mg/ml) derived from the cannabis plant. The psychoactive ingredient tetrahydrocannabinol (THC) is not included. The maximum recommended daily dose of Epidiolex is 20 mg/kg. 64 patients with moderate-severe odontogenic pain participated in the study and REDCap software was utilised to randomly assign participants into groups: CBD10 (10 mg/kg), CBD20 (20 mg/kg) and placebo. A single dose of the respective oral solution was administered, and participants monitored for 3 h. Patients remained blinded to group assignment, as did the outcome assessor. The provider was not blinded. The primary outcome measure was VAS (visual analogue scale) pain difference, compared to baseline and recorded at 7 subsequent marked times following administration (15, 30, 45, 60, 90, 120, 180 min). Additional outcome measures were also recorded: changes in bite force, pain intensity differences, the onset of significant pain relief, the maximum pain relief, psychoactive effects, mood changes and adverse events. 40 female and 21 male patients with moderate-severe odontogenic pain (defined as ≥30 on a 100 mm VAS) with a diagnosis of irreversible pulpitis or pulp necrosis and symptomatic apical periodontitis were included. Participation required a negative test for recent drug and alcohol use, a negative pregnancy test and no use of analgesics within 6 h of the trial. Pregnancy, breastfeeding, hepatic impairment, recreational cannabis users and patients taking CBD metabolising drugs were excluded along with those with an ASA classification above III. Patient characteristics recorded included: age, gender, race, tooth type affected, weight and BMI. Mixed model analysis was used to compare numerical variables among the cohorts at the marked time intervals. VAS, bite force, Bowdle and Bond/Lader questionnaires were recorded. Inter-group analysis was completed using parametric and non-parametric post-hoc tests, including Holm–Bonferroni adjustment and the Shapiro–Wilk test, to evaluate data normality. NNTs were calculated for both CBD doses- the number of patients needing treatment before one patient experiences a minimum of 50% pain relief. X² tests were used to analyse categorical variables: pain intensity and adverse events. JMP software was used for the statistical analysis. 64 participants had originally enroled in the study, but three were excluded from data analysis due to ‘unrealistic results’, reporting complete pain relief within the first 15 min. 20 participants were given CBD10, 20 were given CBD20 and 21 placebo. 68% of the participants were Hispanic/Latino whilst 11% were white. The average age was 44 +/− 13.7. There was equal distribution of age, sex, race, tooth type
Chrepa 等人的研究是一项随机、安慰剂对照、三臂、IIA 期临床试验,采用双重掩蔽,调查大麻二酚 (CBD) 作为急性牙痛镇痛剂的有效性和安全性。干预药物 Epidiolex 是一种经 FDA 批准的 CBD 口服液(100 毫克/毫升),提取自大麻植物。其中不含精神活性成分四氢大麻酚(THC)。Epidiolex 的最大推荐日剂量为 20 毫克/千克。64 名中度-重度牙源性疼痛患者参加了研究,研究人员利用 REDCap 软件将参与者随机分配到不同的组别:CBD10 组(10 毫克/千克)、CBD20 组(20 毫克/千克)和安慰剂组。患者和结果评估者对分组分配均无知情权。提供者不设盲法。主要结果指标是 VAS(视觉模拟量表)疼痛差异,与基线进行比较,并在给药后的 7 个标记时间(15、30、45、60、90、120 和 180 分钟)进行记录。此外,还记录了其他结果指标:咬合力变化、疼痛强度差异、疼痛明显缓解开始时间、最大疼痛缓解时间、精神作用、情绪变化和不良反应。40 名女性和 21 名男性患者患有中度-重度牙源性疼痛(定义为 100 毫米 VAS 值≥30),诊断为不可逆牙髓炎或牙髓坏死以及有症状的根尖牙周炎。参试者必须通过近期吸毒和酗酒检测,妊娠检测呈阴性,且在试验开始前 6 小时内未使用镇痛剂。妊娠、母乳喂养、肝功能受损、使用大麻娱乐和服用 CBD 代谢药物的患者以及 ASA 分级高于 III 级的患者均被排除在外。记录的患者特征包括:年龄、性别、种族、患牙类型、体重和体重指数。混合模型分析用于比较各组患者在标记时间间隔内的数值变量。记录了 VAS、咬合力、Bowdle 和 Bond/Lader 问卷。使用参数和非参数事后检验完成了组间分析,包括 Holm-Bonferroni 调整和 Shapiro-Wilk 检验,以评估数据的正态性。计算了两种 CBD 剂量的 NNT--在一名患者疼痛缓解至少 50%之前需要接受治疗的患者人数。X²检验用于分析分类变量:疼痛强度和不良事件。统计分析使用了 JMP 软件。最初有 64 名参与者报名参加研究,但有 3 人因 "不切实际的结果 "而被排除在数据分析之外,他们报告说在最初 15 分钟内疼痛完全缓解。20 名参与者服用了 CBD10,20 名服用了 CBD20,21 名服用了安慰剂。68%的参与者为西班牙/拉丁美洲人,11%为白人。平均年龄为 44 +/- 13.7 岁。年龄、性别、种族、牙齿类型、体重和体重指数的分布均等(p > 0.05)。在 3 小时的观察期内,没有受试者需要止痛治疗。与基线 VAS 相比,CBD10 在用药 30 分钟后疼痛明显缓解,而 CBD20 在用药 15 分钟后疼痛明显缓解(p < 0.05)。服用 CBD10 60 分钟和 CBD20 120 分钟后,疼痛缓解率分别达到 50%。据报道,两者在 180 分钟时的疼痛最大减轻幅度均为基线的 73%。安慰剂组的疼痛较基线减轻 33%,180 分钟时 VAS 疼痛中位数为 67%。45.4% 的 CBD10 和 46.6% 的 CBD20 在 1-6 小时后需要止痛,而安慰剂组为 37.5% (p > 0.05)。在 90 分钟和 180 分钟时,CBD10 和 CBD20 组的咬合力都有所提高,而安慰剂组在不同时间点之间没有显著差异。在评估疼痛强度时,CBD 组的疼痛减轻与时间的延长有明显相关性(p < 0.001),而安慰剂组则无明显相关性(p = 0.0521)。在 Bowdle 或 Bond/Lader 问题上,组间和组内差异无统计学意义(p > 0.05)。在 3 小时的观察期内,CBD10 的镇静症状是安慰剂的 14 倍(p < 0.05),而 CBD20 的镇静症状是安慰剂的 8 倍(p < 0.05)。在 3 小时内,CBD20 出现腹泻和腹痛的几率是安慰剂的 10 倍(p < 0.05),有些人的疼痛超过了 3 小时,但在一天内就缓解了。根据这项随机临床试验,纯 CBD 药物 Epidiolex 可有效镇痛急性牙痛。
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引用次数: 0
Impact of war on oral health: a systematic review 战争对口腔健康的影响:系统回顾
Q3 Dentistry Pub Date : 2024-04-15 DOI: 10.1038/s41432-024-01006-6
Manali Deb Barma, Upendra Singh Bhadauria, Bharathi Purohit, Sneha Malhotra, Deepali Agarwal, Harsh Priya
To systematically review the evidence from published literature about the impact of war on oral health among children and adults. The electronic search was carried out in the following databases Pubmed, Cochrane, Scopus, Embase, Google Scholar. In vitro studies, cross-sectional, case control studies, and randomized controlled trials conducted during the war time were included. Cross-sectional and case control studies were assessed based on the Newcastle-Ottawa Scale, whereas randomized controlled trials were assessed based on the ROBINS-I tool. In-vitro studies included in this review were assessed using the United States national toxicology program tool. The search strategy yielded a total of 5126 articles and finally 21 articles were included in the review. The influence of war on oral health was categorized among both the children and adult population. A total of 14 studies were carried out in children whereas the remaining seven studies were carried out in adults. A decrease in dental caries was observed in more war-prone areas due to the limited availability of carbohydrates and sugar. Severe periodontal disease in the adult population, mainly due to less availability of food and diminished oral hygiene habits, was also reported. This review underscores the multifaceted impact of war on oral health, revealing a notable prevalence of periodontal problems, craniofacial injuries and varying rates of dental caries across affected populations.
方法在以下数据库中进行电子检索:Pubmed、Cochrane、Scopus、Embase、Google Scholar。包括战争期间进行的体外研究、横断面研究、病例对照研究和随机对照试验。横断面研究和病例对照研究根据纽卡斯尔-渥太华量表进行评估,而随机对照试验则根据 ROBINS-I 工具进行评估。本综述中的体外研究使用美国国家毒理学计划工具进行评估。战争对口腔健康的影响在儿童和成人人群中进行了分类。共有 14 项研究针对儿童,其余 7 项研究针对成人。在战争多发地区,由于碳水化合物和糖的供应有限,龋齿率有所下降。结论 这篇综述强调了战争对口腔健康的多方面影响,揭示了受影响人群中牙周问题、颅颌面损伤和不同龋齿率的显著发生率。
{"title":"Impact of war on oral health: a systematic review","authors":"Manali Deb Barma,&nbsp;Upendra Singh Bhadauria,&nbsp;Bharathi Purohit,&nbsp;Sneha Malhotra,&nbsp;Deepali Agarwal,&nbsp;Harsh Priya","doi":"10.1038/s41432-024-01006-6","DOIUrl":"10.1038/s41432-024-01006-6","url":null,"abstract":"To systematically review the evidence from published literature about the impact of war on oral health among children and adults. The electronic search was carried out in the following databases Pubmed, Cochrane, Scopus, Embase, Google Scholar. In vitro studies, cross-sectional, case control studies, and&nbsp;randomized controlled trials conducted during the war time were included.&nbsp;Cross-sectional and case control studies were assessed based on the&nbsp;Newcastle-Ottawa Scale, whereas randomized controlled trials were assessed based on the ROBINS-I tool. In-vitro studies included in this review were assessed using the United States national toxicology program tool. The search strategy yielded a total of 5126 articles and finally 21 articles were included in the review. The influence of war on oral health was categorized among both&nbsp;the children and adult population. A total of 14 studies were carried out in children whereas the remaining seven studies were carried out in adults.&nbsp;A decrease in dental caries was observed in more war-prone areas due to the limited availability of carbohydrates and sugar. Severe periodontal disease in the adult population, mainly due to less availability of food and diminished oral hygiene habits, was also reported. This review underscores the multifaceted impact of war on oral health, revealing a notable prevalence of periodontal problems, craniofacial injuries and varying rates of dental caries across affected populations.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 3","pages":"167-168"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140575612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment: a systematic review and meta-analysis 牙冠折断前牙粘接碎片脱落的风险:系统回顾和荟萃分析
Q3 Dentistry Pub Date : 2024-04-12 DOI: 10.1038/s41432-024-01003-9
Nitesh Tewari, Zafer Cehreli, Partha Haldar, Mohammad Atif, Aws Alani, Morankar Rahul
To identify the factors affecting the risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment. The study protocol followed the best practices of evidence-based medicine and was registered in PROSPERO. A comprehensive literature search was performed electronically in six databases (PubMed, Embase, SCOPUS, Web-of-Science, Lilacs, and Cochrane) on 18-09-2023. It was saved in EndNote-online and duplicates were removed. Selection of articles was performed in two stages, followed by data-extraction, risk of bias assessment, data-analysis, and meta-analysis. The quality of evidence for the outcomes was assessed by the GRADE-approach. The study included six articles that had similar selection protocols with variations in duration from trauma to treatment and the observation period. Only one study employed pre-attachment fragment preparation and three performed post-attachment reinforcements. Overall loss of fragment was 20% (95%CI–13,30%). When the risk ratio for loss of restoration or fragment was compared, it was found to be 2.21 (95%CI–1.52,3.21) in uncomplicated crown fractures, 2.54 (95%CI–1.35,4.79) in complicated crown fractures. The risk of bias was found to be low in two and moderate in four studies. Grade of evidence for all the outcomes was very low. Fragment loss was lowest in uncomplicated crown fractures where reinforcement had been performed, and highest when bonding was done in complicated crown fractures without reinforcement. The risk of fragment loss was higher than the loss of composite restorations.
目的确定影响冠折断前牙粘接片脱落风险的因素。方法研究方案遵循循证医学的最佳实践,并在 PROSPERO 上进行了注册。2023 年 9 月 18 日,在六个数据库(PubMed、Embase、SCOPUS、Web-of-Science、Lilacs 和 Cochrane)中进行了全面的电子文献检索。搜索结果保存在 EndNote-online 中,并删除了重复内容。文章筛选分两个阶段进行,然后是数据提取、偏倚风险评估、数据分析和荟萃分析。结果该研究包括六篇文章,这些文章的选择方案相似,但从创伤到治疗的持续时间和观察期有所不同。只有一项研究采用了附着前碎片准备,三项研究进行了附着后加固。碎片损失率总体为 20% (95%CI-13,30%)。在比较修复体或碎片损失的风险比时发现,非复杂牙冠骨折的风险比为2.21(95%CI-1.52,3.21),复杂牙冠骨折的风险比为2.54(95%CI-1.35,4.79)。两项研究的偏倚风险较低,四项研究的偏倚风险中等。所有结果的证据等级都很低。结论在进行了加固的无并发症牙冠骨折中,碎片脱落率最低,而在未进行加固的复杂牙冠骨折中进行粘接时,碎片脱落率最高。碎片脱落的风险高于复合修复体脱落的风险。
{"title":"The risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment: a systematic review and meta-analysis","authors":"Nitesh Tewari,&nbsp;Zafer Cehreli,&nbsp;Partha Haldar,&nbsp;Mohammad Atif,&nbsp;Aws Alani,&nbsp;Morankar Rahul","doi":"10.1038/s41432-024-01003-9","DOIUrl":"10.1038/s41432-024-01003-9","url":null,"abstract":"To identify the factors affecting the risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment. The study protocol followed the best practices of evidence-based medicine and was registered in PROSPERO. A comprehensive literature search was performed electronically in six databases (PubMed, Embase, SCOPUS, Web-of-Science, Lilacs, and Cochrane) on 18-09-2023. It was saved in EndNote-online and duplicates were removed. Selection of articles was performed in two stages, followed by data-extraction, risk of bias assessment, data-analysis, and meta-analysis. The quality of evidence for the outcomes was assessed by the GRADE-approach. The study included six articles that had similar selection protocols with variations in duration from trauma to treatment and the observation period. Only one study employed pre-attachment fragment preparation and three performed post-attachment reinforcements. Overall loss of fragment was 20% (95%CI–13,30%). When the risk ratio for loss of restoration or fragment was compared, it was found to be 2.21 (95%CI–1.52,3.21) in uncomplicated crown fractures, 2.54 (95%CI–1.35,4.79) in complicated crown fractures. The risk of bias was found to be low in two and moderate in four studies. Grade of evidence for all the outcomes was very low. Fragment loss was lowest in uncomplicated crown fractures where reinforcement had been performed, and highest when bonding was done in complicated crown fractures without reinforcement. The risk of fragment loss was higher than the loss of composite restorations.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 3","pages":"167-167"},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140575761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tooth whitening: an evidence-based perspective 牙齿美白:循证观点
Q3 Dentistry Pub Date : 2024-04-12 DOI: 10.1038/s41432-024-01005-7
Karina Irusa
{"title":"Tooth whitening: an evidence-based perspective","authors":"Karina Irusa","doi":"10.1038/s41432-024-01005-7","DOIUrl":"10.1038/s41432-024-01005-7","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 2","pages":"62-62"},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140575705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Evidence-based dentistry
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