Pub Date : 2025-07-23DOI: 10.1038/s41432-025-01180-1
Quang Tuan Lam, Minh Huu Nhat Le, I-Ta Lee, Nguyen Quoc Khanh Le
Recent advancements in the You Only Look Once (YOLO) algorithm show promise for dental caries diagnosis. We aimed to evaluate the diagnostic performance of different YOLO versions using photographic and radiographic images for caries detection. We searched PubMed (MEDLINE), EMBASE, Web of Science, and Scopus for studies up to December 12, 2024. Studies using any YOLO version for caries detection were included. Binary diagnostic accuracy data were extracted to calculate pooled sensitivity, specificity, and area under the curve (AUC) using a bivariate random-effects model. Quality was assessed with QUADAS-2 and the Radiomics Quality Score (RQS). This review is registered in PROSPERO (CRD42024615440). We included 15 studies in the systematic review and 14 in the meta-analysis. Overall, YOLO-based models achieved a pooled sensitivity of 79.3% and specificity of 84.9%, with an AUC of 0.832. YOLO using radiographic images demonstrated higher specificity (92.5% vs 72.0%) and AUC (0.847 vs 0.735) than using photographic images, while sensitivity was similar (78.6% vs 80.0%). Differences between YOLO versions (v5 and earlier vs v6 and later) and the use of external validation did not significantly affect diagnostic accuracy. Radiograph-based YOLO models showed superior specificity to photograph-based models, reflecting the higher diagnostic detail of radiographs. However, photographic approaches are completely radiation-free and more accessible, which could benefit screening in low-resource settings. Newer YOLO versions did not significantly outperform older versions, likely due to the limited complexity of the task and dataset constraints in current studies. YOLO algorithms provide a reliable tool for dental caries detection. Radiograph imaging combined with YOLO offers enhanced diagnostic specificity, while even older YOLO versions remain effective for caries detection in practice.
目的：你只看一次（YOLO）算法的最新进展显示了龋齿诊断的希望。我们的目的是评估不同的YOLO版本的诊断性能，使用摄影和放射图像检测龋。方法：检索截至2024年12月12日的PubMed （MEDLINE）、EMBASE、Web of Science和Scopus。使用任何YOLO版本进行龋齿检测的研究都包括在内。提取二元诊断准确性数据，使用二元随机效应模型计算合并敏感性、特异性和曲线下面积（AUC）。采用QUADAS-2和放射组学质量评分（RQS）评估质量。本综述已在PROSPERO注册（CRD42024615440）。结果：我们在系统评价中纳入了15项研究，在meta分析中纳入了14项研究。总体而言，基于yolo的模型的总灵敏度为79.3%，特异性为84.9%，AUC为0.832。x线影像的YOLO特异性（92.5% vs 72.0%）和AUC （0.847 vs 0.735）高于摄影影像，而灵敏度相似（78.6% vs 80.0%）。YOLO版本之间的差异（v5和更早的版本与v6和更高的版本）和外部验证的使用并没有显著影响诊断的准确性。讨论：基于x线片的YOLO模型比基于照片的模型具有更好的特异性，反映了x线片更高的诊断细节。然而，照相方法是完全无辐射和更容易获得的，这可能有利于在资源匮乏的情况下进行筛查。较新的YOLO版本并没有明显优于旧版本，这可能是由于当前研究中任务和数据集约束的复杂性有限。结论：YOLO算法为龋病检测提供了可靠的工具。x线影像结合YOLO提供了增强的诊断特异性，而即使是较老的YOLO版本在龋齿检测中仍然有效。
{"title":"Evaluating YOLO for dental caries diagnosis: a systematic review and meta-analysis","authors":"Quang Tuan Lam, Minh Huu Nhat Le, I-Ta Lee, Nguyen Quoc Khanh Le","doi":"10.1038/s41432-025-01180-1","DOIUrl":"10.1038/s41432-025-01180-1","url":null,"abstract":"Recent advancements in the You Only Look Once (YOLO) algorithm show promise for dental caries diagnosis. We aimed to evaluate the diagnostic performance of different YOLO versions using photographic and radiographic images for caries detection. We searched PubMed (MEDLINE), EMBASE, Web of Science, and Scopus for studies up to December 12, 2024. Studies using any YOLO version for caries detection were included. Binary diagnostic accuracy data were extracted to calculate pooled sensitivity, specificity, and area under the curve (AUC) using a bivariate random-effects model. Quality was assessed with QUADAS-2 and the Radiomics Quality Score (RQS). This review is registered in PROSPERO (CRD42024615440). We included 15 studies in the systematic review and 14 in the meta-analysis. Overall, YOLO-based models achieved a pooled sensitivity of 79.3% and specificity of 84.9%, with an AUC of 0.832. YOLO using radiographic images demonstrated higher specificity (92.5% vs 72.0%) and AUC (0.847 vs 0.735) than using photographic images, while sensitivity was similar (78.6% vs 80.0%). Differences between YOLO versions (v5 and earlier vs v6 and later) and the use of external validation did not significantly affect diagnostic accuracy. Radiograph-based YOLO models showed superior specificity to photograph-based models, reflecting the higher diagnostic detail of radiographs. However, photographic approaches are completely radiation-free and more accessible, which could benefit screening in low-resource settings. Newer YOLO versions did not significantly outperform older versions, likely due to the limited complexity of the task and dataset constraints in current studies. YOLO algorithms provide a reliable tool for dental caries detection. Radiograph imaging combined with YOLO offers enhanced diagnostic specificity, while even older YOLO versions remain effective for caries detection in practice.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 4","pages":"176-176"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697991","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}
Pub Date : 2025-07-22DOI: 10.1038/s41432-025-01179-8
Liana Rita Nicole Umbrio, Hieu Michael Pham, Abdul B. Barmak, Nasser Assery, Elli Anna Kotsailidi
To evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on periodontal status through a systematic review and meta-analysis. Nine databases were searched for clinical studies up to September 2024 to identify clinical studies comparing periodontal parameters such as probing depth (PD), clinical attachment level (CAL), marginal bone level (MBL), and gingival and plaque indices (GI and PI) between SSRI-users and non-users. Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Random-effects meta-analyses of mean differences (MD) were performed. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of available evidence. Five cross-sectional studies, including a total of 1254 patients (54.15% females) and 13170 teeth, were included. The use of SSRIs was significantly associated with inferior MBL (MD, 0.10; 95% confidence interval, 0.01 to 0.20) compared to non-users. No significant differences were observed in PD, CAL, and GI between SSRI-users and non-users. The overall quality of evidence was low, and all studies presented a moderate risk of bias. Based on a low level of available scientific evidence, the use of SSRIs has a marginal yet significant effect on MBL. However, there is no direct association between SSRIs usage and periodontal parameters such as PD, CAL, and GI. Nonetheless, further research is warranted.
{"title":"Association between selective serotonin reuptake inhibitors and the periodontal status: a systematic review and meta-analysis of observational clinical studies","authors":"Liana Rita Nicole Umbrio, Hieu Michael Pham, Abdul B. Barmak, Nasser Assery, Elli Anna Kotsailidi","doi":"10.1038/s41432-025-01179-8","DOIUrl":"10.1038/s41432-025-01179-8","url":null,"abstract":"To evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on periodontal status through a systematic review and meta-analysis. Nine databases were searched for clinical studies up to September 2024 to identify clinical studies comparing periodontal parameters such as probing depth (PD), clinical attachment level (CAL), marginal bone level (MBL), and gingival and plaque indices (GI and PI) between SSRI-users and non-users. Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Random-effects meta-analyses of mean differences (MD) were performed. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of available evidence. Five cross-sectional studies, including a total of 1254 patients (54.15% females) and 13170 teeth, were included. The use of SSRIs was significantly associated with inferior MBL (MD, 0.10; 95% confidence interval, 0.01 to 0.20) compared to non-users. No significant differences were observed in PD, CAL, and GI between SSRI-users and non-users. The overall quality of evidence was low, and all studies presented a moderate risk of bias. Based on a low level of available scientific evidence, the use of SSRIs has a marginal yet significant effect on MBL. However, there is no direct association between SSRIs usage and periodontal parameters such as PD, CAL, and GI. Nonetheless, further research is warranted.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 4","pages":"177-177"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682247","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}
Pub Date : 2025-07-15DOI: 10.1038/s41432-025-01174-z
StJohn Crean
{"title":"Dental science for the medical professional: an evidence-based approach.","authors":"StJohn Crean","doi":"10.1038/s41432-025-01174-z","DOIUrl":"https://doi.org/10.1038/s41432-025-01174-z","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642185","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}
Pub Date : 2025-06-19DOI: 10.1038/s41432-025-01175-y
Patrick Quinn, Mairead Harding
Leghrouz L, Khole M R, Splieth C H, Schmoekel J. Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial. Caries Res 2024; 58: 399–406. A two-arm single-blinded randomised controlled clinical trial to investigate the effects of the differential learning method versus conventional tooth brushing instruction by assessing changes in plaque levels and gingivitis in children aged three to eight years. Children aged three to eight years with poor oral hygiene at baseline, needing parental assistance with tooth brushing, and available to attend follow-up appointments were included in the study. Exclusion criteria included children with acute dental pain, those with serious systemic diseases requiring special attention during dental care, and those who refused to participate in the study. Participants were randomly assigned to the test and control groups by self-drawing an unlabelled envelope from a box. The sealed envelopes contained oral hygiene instructions with exercises to use the differential learning method for the test group and children in the control group received the usual tooth brushing instructions. Participants were asked to follow the instructions at home for 28 days. The sample size was calculated according to previous similar oral hygiene studies, with a final sample size of 29 participants in each group to allow for dropouts of approximately 30%. Data was analysed using Microsoft Excel, with the significance threshold set at p < 0.05. Descriptive analysis included the calculation of means, standard deviation, absolute numbers, and percentages. Comparisons between the two groups were made using the independent samples t-test for quantitative variables and the chi-squared test for categorical variables. Two calibrated and blinded examiners recorded the papillary bleeding index (PBI) and the Quigley-Hein Index for dental plaque (QHI) at baseline and at the first and second recall visits at four and twelve weeks respectively. Of the 58 children recruited for the study, 46 were included in the final analysis with 22 in the control group and 24 in the test group. At baseline, there were no significant differences between the groups with respect to plaque and gingival indices. At the first recall, a statistically significant difference in the PBI index was found in favour of the test group (test: 0.1 ± 0.2 v. control: 0.3 ± 0.2; p < 0.001) but the difference in relation to the QHI index was not statistically significant (test: 2.1 ± 0.9 v. control 2.6 ± 0.9; p = 0.07). At the second recall, statistically significant differences in both indices were found in favour of the test group (PBI test: 0.1 ± 0.2 v. PBI control: 0.5 ± 0.2; p < 0.001; QHI test: 2.1 ± 0.9 v. QHI control: 3.2 ± 1; p < 0.001). The authors of the study concluded that simple instructions with the differential learning method for home tooth brushing can lead to significantly greater improvements in oral hygiene in chi
Leghrouz L, Khole M R, splth C H, Schmoekel J.刷牙学习方法的差异与传统？一项随机对照临床试验。龋齿研究2024；58: 399 - 406。设计：一项双臂单盲随机对照临床试验，通过评估3至8岁儿童牙菌斑水平和牙龈炎的变化，研究差异学习方法与传统刷牙指导的影响。病例选择：研究对象为年龄在3至8岁之间、口腔卫生基线较差、需要父母帮助刷牙、可参加随访预约的儿童。排除标准包括患有急性牙痛的儿童、患有严重全身性疾病需要在牙科护理中特别注意的儿童以及拒绝参加研究的儿童。通过从一个盒子里自己画一个没有标签的信封，参与者被随机分配到试验组和对照组。密封的信封里有口腔卫生说明和练习，实验组的孩子使用不同的学习方法，对照组的孩子则接受常规的刷牙说明。参与者被要求在家中按照指示进行28天。数据分析：样本量是根据之前类似的口腔卫生研究计算的，每组最终样本量为29名参与者，允许大约30%的辍学率。结果：两名校准和盲法检查人员分别在基线和第4周和第12周的第一次和第二次召回访问时记录了牙菌斑的乳头状出血指数（PBI）和Quigley-Hein指数（QHI）。在参与研究的58名儿童中，有46名被纳入最终分析，其中22名在对照组，24名在试验组。在基线时，两组之间在菌斑和牙龈指数方面没有显著差异。在第一次召回时，发现实验组的PBI指数有统计学显著差异（测试：0.1±0.2 v）。对照：0.3±0.2；p结论：该研究的作者得出结论，与传统的口腔卫生指导相比，家庭刷牙的简单指导与差异学习方法可以显著改善口腔卫生，特别是在中期保持阶段。
{"title":"Tooth brushing learning methods: time to change practice?","authors":"Patrick Quinn, Mairead Harding","doi":"10.1038/s41432-025-01175-y","DOIUrl":"10.1038/s41432-025-01175-y","url":null,"abstract":"Leghrouz L, Khole M R, Splieth C H, Schmoekel J. Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial. Caries Res 2024; 58: 399–406. A two-arm single-blinded randomised controlled clinical trial to investigate the effects of the differential learning method versus conventional tooth brushing instruction by assessing changes in plaque levels and gingivitis in children aged three to eight years. Children aged three to eight years with poor oral hygiene at baseline, needing parental assistance with tooth brushing, and available to attend follow-up appointments were included in the study. Exclusion criteria included children with acute dental pain, those with serious systemic diseases requiring special attention during dental care, and those who refused to participate in the study. Participants were randomly assigned to the test and control groups by self-drawing an unlabelled envelope from a box. The sealed envelopes contained oral hygiene instructions with exercises to use the differential learning method for the test group and children in the control group received the usual tooth brushing instructions. Participants were asked to follow the instructions at home for 28 days. The sample size was calculated according to previous similar oral hygiene studies, with a final sample size of 29 participants in each group to allow for dropouts of approximately 30%. Data was analysed using Microsoft Excel, with the significance threshold set at p < 0.05. Descriptive analysis included the calculation of means, standard deviation, absolute numbers, and percentages. Comparisons between the two groups were made using the independent samples t-test for quantitative variables and the chi-squared test for categorical variables. Two calibrated and blinded examiners recorded the papillary bleeding index (PBI) and the Quigley-Hein Index for dental plaque (QHI) at baseline and at the first and second recall visits at four and twelve weeks respectively. Of the 58 children recruited for the study, 46 were included in the final analysis with 22 in the control group and 24 in the test group. At baseline, there were no significant differences between the groups with respect to plaque and gingival indices. At the first recall, a statistically significant difference in the PBI index was found in favour of the test group (test: 0.1 ± 0.2 v. control: 0.3 ± 0.2; p < 0.001) but the difference in relation to the QHI index was not statistically significant (test: 2.1 ± 0.9 v. control 2.6 ± 0.9; p = 0.07). At the second recall, statistically significant differences in both indices were found in favour of the test group (PBI test: 0.1 ± 0.2 v. PBI control: 0.5 ± 0.2; p < 0.001; QHI test: 2.1 ± 0.9 v. QHI control: 3.2 ± 1; p < 0.001). The authors of the study concluded that simple instructions with the differential learning method for home tooth brushing can lead to significantly greater improvements in oral hygiene in chi","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"135-136"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01175-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-19DOI: 10.1038/s41432-025-01177-w
Reanna Craig, Gerry McKenna
{"title":"Correction: What role do luting cements play in zirconia crown survival?","authors":"Reanna Craig, Gerry McKenna","doi":"10.1038/s41432-025-01177-w","DOIUrl":"10.1038/s41432-025-01177-w","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332721","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}
Pub Date : 2025-06-19DOI: 10.1038/s41432-025-01176-x
Lydia Cross
Taylor KW, Eftim SE, Sibrizzi CA, Blain RB, Magnuson K, Hartman PA, Rooney AA, Bucher JR. Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr 2025; 179: 282–292. A literature search without language restrictions was undertaken in October 2023 using the following databases: BIOSIS, Embase, PsycINFO, PubMed, Scopus, Web of Science, CNKI, and Wanfang. Two independent reviewers screened studies based on the title and abstract. Studies were included if the exposure was fluoride and the outcome was a quantitative measure of children’s intelligence. In studies with multiple fluoride exposure levels, the highest was considered the exposure and the lowest the reference. Exclusion criteria included case reports, articles without original data, and conference abstracts. Full text articles were then screened. Translation assistance was obtained for non-English studies. Data was extracted by one extractor and verified by a second. Risk-of-bias was evaluated by two independent trained assessors using the National Toxicology Programme’s OHAT approach. Three meta-analyses were conducted: mean-effects, dose-response mean-effects, and regression slopes. Subgroup and sensitivity analyses were undertaken, including subgroup analyses without high risk-of-bias studies. 74 studies were included, of which 59 reported mean IQ scores for group-level exposures and 19 reported regression slopes for individual-level exposures. Children exposed to higher levels of fluoride had statistically significantly lower IQs than those exposed to lower levels (standardised mean difference (SMD), −0.45; 95%CI, −0.57 to −0.33; P < 0.001). A dose-response association was also reported, with lower IQ scores reported with increasing fluoride exposure with a SMD of −0.15 (95%CI, −0.20 to −0.11; P < 0.001) for water fluoride levels and −0.15 (95%CI, −0.23 to −0.07; P < 0.001) for urinary fluoride levels. Fluoride exposure concentrations of <4 mg/L, <2 mg/L, and <1.5 mg/L were analysed. For water fluoride <1.5 mg/L, the association was not statistically significant. In the regression slopes meta-analysis, a 1 mg/L increase in urinary fluoride was associated with a decrease in IQ score of 1.63 points (95%CI, −2.33 to −0.93; P < 0.001); the effect size was smaller when analysis was limited to low risk-of-bias studies (decrease of 1.14 points (95%CI, −1.68 to −0.61; P < 0.001)). An inverse association was found between fluoride exposure and children’s IQ scores, including an inverse dose-response association. This association was less certain at water fluoride concentrations <1.5 mg/L.
Taylor KW, Eftim SE, Sibrizzi CA, Blain RB, Magnuson K, Hartman PA, Rooney AA, Bucher JR。氟化物暴露与儿童智商：系统评价和荟萃分析。JAMA pediatrics 2025；179: 282 - 292。数据来源：于2023年10月进行无语言限制的文献检索，检索数据库为：BIOSIS、Embase、PsycINFO、PubMed、Scopus、Web of Science、CNKI、万方。研究选择：两位独立审稿人根据标题和摘要筛选研究。如果接触的是氟化物，研究结果是对儿童智力的定量测量，研究也包括在内。在有多种氟化物接触水平的研究中，最高的被认为是接触，最低的被认为是参考。排除标准包括病例报告、没有原始数据的文章和会议摘要。然后对全文文章进行筛选。非英语研究获得了翻译协助。数据提取和合成：数据由一个提取器提取，由另一个提取器验证。偏倚风险由两名经过独立培训的评估人员使用国家毒理学规划的OHAT方法进行评估。进行了三项荟萃分析：平均效应、剂量-反应平均效应和回归斜率。进行了亚组和敏感性分析，包括无高偏倚风险研究的亚组分析。结果：纳入了74项研究，其中59项报告了群体水平暴露的平均智商分数，19项报告了个人水平暴露的回归斜率。接触较高水平氟化物的儿童的智商在统计学上显著低于接触较低水平氟化物的儿童(标准化平均差（SMD）， -0.45；95%CI, -0.57 ~ -0.33；结论：氟化物暴露与儿童智商得分呈负相关，包括剂量反应负相关。这种联系在水的氟化物浓度上不太确定
{"title":"Fluoride: friend or foe? Exploring the effect of fluoride exposure on children’s IQ scores","authors":"Lydia Cross","doi":"10.1038/s41432-025-01176-x","DOIUrl":"10.1038/s41432-025-01176-x","url":null,"abstract":"Taylor KW, Eftim SE, Sibrizzi CA, Blain RB, Magnuson K, Hartman PA, Rooney AA, Bucher JR. Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr 2025; 179: 282–292. A literature search without language restrictions was undertaken in October 2023 using the following databases: BIOSIS, Embase, PsycINFO, PubMed, Scopus, Web of Science, CNKI, and Wanfang. Two independent reviewers screened studies based on the title and abstract. Studies were included if the exposure was fluoride and the outcome was a quantitative measure of children’s intelligence. In studies with multiple fluoride exposure levels, the highest was considered the exposure and the lowest the reference. Exclusion criteria included case reports, articles without original data, and conference abstracts. Full text articles were then screened. Translation assistance was obtained for non-English studies. Data was extracted by one extractor and verified by a second. Risk-of-bias was evaluated by two independent trained assessors using the National Toxicology Programme’s OHAT approach. Three meta-analyses were conducted: mean-effects, dose-response mean-effects, and regression slopes. Subgroup and sensitivity analyses were undertaken, including subgroup analyses without high risk-of-bias studies. 74 studies were included, of which 59 reported mean IQ scores for group-level exposures and 19 reported regression slopes for individual-level exposures. Children exposed to higher levels of fluoride had statistically significantly lower IQs than those exposed to lower levels (standardised mean difference (SMD), −0.45; 95%CI, −0.57 to −0.33; P < 0.001). A dose-response association was also reported, with lower IQ scores reported with increasing fluoride exposure with a SMD of −0.15 (95%CI, −0.20 to −0.11; P < 0.001) for water fluoride levels and −0.15 (95%CI, −0.23 to −0.07; P < 0.001) for urinary fluoride levels. Fluoride exposure concentrations of <4 mg/L, <2 mg/L, and <1.5 mg/L were analysed. For water fluoride <1.5 mg/L, the association was not statistically significant. In the regression slopes meta-analysis, a 1 mg/L increase in urinary fluoride was associated with a decrease in IQ score of 1.63 points (95%CI, −2.33 to −0.93; P < 0.001); the effect size was smaller when analysis was limited to low risk-of-bias studies (decrease of 1.14 points (95%CI, −1.68 to −0.61; P < 0.001)). An inverse association was found between fluoride exposure and children’s IQ scores, including an inverse dose-response association. This association was less certain at water fluoride concentrations <1.5 mg/L.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"137-138"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332722","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}
Lucchese A, Marcolina M, Mancini N et al. A comparison of the alterations of oral microbiome with fixed orthodontic therapy and clear aligners: a systematic review. J Oral Microbiol 2025; 17: 2372751. The review searched multiple electronic databases (PubMed, Cochrane Library, Embase, Web of Science, Scopus, Ovid, Dentistry and Oral Sciences Source) and gray literature (OpenGray) up to May 30, 2023. The selection of the studies was processed according to PRISMA guidelines. Two reviewers independently screened titles and abstracts, with disagreements resolved by a third reviewer. Full-text articles were then assessed for eligibility based on pre-defined inclusion/exclusion criteria (RCTs, nRCTs, cohort studies; at least two time points for analysis; minimum 10 patients; clear aligners vs. fixed appliances or comparison between them; patients with good systemic health not taking medications). Data extraction from the included studies was carried out by two reviewers in consultation with a third reviewer to define the variables for extraction and resolve any disagreements. Extracted data included study characteristics (author, year, design, sample size, patient age), intervention details, sample collection methods (saliva, plaque), microbial analysis methods (16S rRNA sequencing, PCR, BANA test), and microbiological outcomes. A qualitative synthesis was performed due to the heterogeneity of the included studies, precluding meta-analysis. A total of 484 articles were identified, with 9 studies that met the inclusion and exclusion criteria: eight non-randomized controlled trials and one randomized controlled trial. Sample sizes ranged from 10 to 77 participants. Various microbial analysis methods were employed, including 16S rRNA gene sequencing (5 studies), PCR (3 studies), and the BANA test (1 study). Following the application of rating scales, 1 article was classified as having a low risk of bias, 6 as having a moderate risk, and 2 as having a serious risk of bias. The review suggests that clear aligners may be associated with a less detrimental impact on the oral microbiome compared to fixed appliances, possibly due to improved oral hygiene. Both therapies alter the oral microbiome; however, the changes caused by aligners are more conducive to better oral health compared to fixed appliances.
评述：Lucchese A， Marcolina M， Mancini N等。固定正畸治疗和透明矫正器口腔微生物组变化的比较：一项系统综述。口腔微生物学杂志；17: 2372751。数据来源：本综述检索了截至2023年5月30日的多个电子数据库（PubMed, Cochrane Library, Embase, Web of Science, Scopus, Ovid, Dentistry and Oral Sciences Source）和灰色文献（OpenGray）。研究选择：根据PRISMA指南对研究进行选择。两位审稿人独立筛选标题和摘要，分歧由第三位审稿人解决。然后根据预先定义的纳入/排除标准评估全文文章的合格性(rct、nrct、队列研究；至少两个时间点进行分析；最少10名患者；明确对准器与固定器具或两者之间的比较；全身健康，不服用药物的患者)。数据提取和综合：从纳入的研究中提取数据由两名审稿人在与第三名审稿人协商后进行，以确定提取的变量并解决任何分歧。提取的数据包括研究特征（作者、年份、设计、样本量、患者年龄）、干预细节、样本收集方法（唾液、菌斑）、微生物分析方法（16S rRNA测序、PCR、BANA检测）和微生物学结果。由于纳入研究的异质性，排除了meta分析，进行了定性综合。结果：共纳入484篇文献，9项研究符合纳入和排除标准：8项非随机对照试验和1项随机对照试验。样本量从10到77人不等。采用多种微生物分析方法，包括16S rRNA基因测序（5项研究）、PCR（3项研究）和BANA检测（1项研究）。应用评定量表后，1篇文章被分类为低偏倚风险，6篇文章被分类为中等偏倚风险，2篇文章被分类为严重偏倚风险。结论：该综述表明，与固定矫治器相比，透明矫正器可能对口腔微生物群的有害影响较小，这可能是由于改善了口腔卫生。这两种疗法都能改变口腔微生物群；然而，与固定矫治器相比，矫正器带来的改变更有利于口腔健康。
{"title":"A comparative review of the oral microbiome in clear aligners and fixed orthodontic appliances","authors":"Anand Marya, Thantrira Porntaveetus, Katsushi Okazaki, Abdolreza Jamilian","doi":"10.1038/s41432-025-01173-0","DOIUrl":"10.1038/s41432-025-01173-0","url":null,"abstract":"Lucchese A, Marcolina M, Mancini N et al. A comparison of the alterations of oral microbiome with fixed orthodontic therapy and clear aligners: a systematic review. J Oral Microbiol 2025; 17: 2372751. The review searched multiple electronic databases (PubMed, Cochrane Library, Embase, Web of Science, Scopus, Ovid, Dentistry and Oral Sciences Source) and gray literature (OpenGray) up to May 30, 2023. The selection of the studies was processed according to PRISMA guidelines. Two reviewers independently screened titles and abstracts, with disagreements resolved by a third reviewer. Full-text articles were then assessed for eligibility based on pre-defined inclusion/exclusion criteria (RCTs, nRCTs, cohort studies; at least two time points for analysis; minimum 10 patients; clear aligners vs. fixed appliances or comparison between them; patients with good systemic health not taking medications). Data extraction from the included studies was carried out by two reviewers in consultation with a third reviewer to define the variables for extraction and resolve any disagreements. Extracted data included study characteristics (author, year, design, sample size, patient age), intervention details, sample collection methods (saliva, plaque), microbial analysis methods (16S rRNA sequencing, PCR, BANA test), and microbiological outcomes. A qualitative synthesis was performed due to the heterogeneity of the included studies, precluding meta-analysis. A total of 484 articles were identified, with 9 studies that met the inclusion and exclusion criteria: eight non-randomized controlled trials and one randomized controlled trial. Sample sizes ranged from 10 to 77 participants. Various microbial analysis methods were employed, including 16S rRNA gene sequencing (5 studies), PCR (3 studies), and the BANA test (1 study). Following the application of rating scales, 1 article was classified as having a low risk of bias, 6 as having a moderate risk, and 2 as having a serious risk of bias. The review suggests that clear aligners may be associated with a less detrimental impact on the oral microbiome compared to fixed appliances, possibly due to improved oral hygiene. Both therapies alter the oral microbiome; however, the changes caused by aligners are more conducive to better oral health compared to fixed appliances.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"132-134"},"PeriodicalIF":2.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293610","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}
Pub Date : 2025-06-10DOI: 10.1038/s41432-025-01170-3
Meenakshi Lall
Silva E J N L D, Pinto K P, Riche F N S J et al. Success of primary teeth pulpotomy using calcium silicate cements: a systematic review and meta-analysis of randomised clinical trials. Pediatr Dent 2024; 46: 373–395. This systematic review and meta-analysis of randomised clinical trials aimed to evaluate and compare the outcomes of pulpotomy procedures using Mineral Trioxide Aggregate (MTA) and other Calcium-Silicate Cements (CSCs). The review protocol was registered with PROSPERO (CRD42023479322) and adhered to PRISMA 2020 guidelines. Two independent reviewers conducted a comprehensive systematic search across PubMed®, Cochrane Library, Scopus, Web of Science™, Embase®, and ScienceDirect®, supplemented by manual searches and OpenGrey. Eligible studies were selected according to the PICOS criteria, including only randomised clinical trials that reported clinical and radiographic evaluations of pulpotomies with a minimum follow-up period of six months. The certainty of evidence was appraised using the GRADE framework, evaluating domains such as risk of bias, inconsistency, indirectness, imprecision, and publication bias. Two reviewers independently assessed the severity of each domain. Meta-analyses were performed using RevMan 5.3, comparing clinical and radiographic success rates of MTA pulpotomies with those of alternative materials, based on dichotomous outcomes and patient recall. Risk of bias was assessed using the Cochrane RoB-2 tool, and the overall certainty of evidence was determined according to the GRADE methodology. A total of 662 articles were initially identified, with 26 studies included after screening and full-text review. Quality appraisal showed seven studies at low risk of bias, two with some concerns, and 17 at high risk, mainly due to poor randomisation, missing intention-to-treat analyses, and high attrition. Despite challenges in radiographic blinding, outcome and reporting biases remained consistently low. Meta-analyses compared pulpotomy outcomes in primary teeth treated with MTA versus other CSCs. No significant differences were observed between MTA and Biodentine™ in clinical success (P > 0.05), though MTA showed higher radiographic success at 12 months (P < 0.05). No significant differences were found between MTA and TheraCal® or Portland cement (P > 0.05). Data were insufficient for analyses by pulpotomy type, tooth type, or irrigant used. The overall quality of evidence was low, due to a serious risk of bias and imprecision. Publication bias appeared minimal, and studies were free from private sector funding. This systematic review and meta-analysis demonstrated that mineral trioxide aggregate (MTA) and other calcium silicate-based cements (CSCs) are effective materials for managing pulpotomies in primary teeth. Although MTA exhibited superior treatment outcomes at 12 months compared to Biodentine™, no significant difference in overall efficacy was observed between the two materials at 24 months. However, th
评论：Silva E J N L D， Pinto K P， Riche F N S J等。硅酸钙骨水泥成功的乳牙切髓：随机临床试验的系统回顾和荟萃分析。儿科Dent 2024；46: 373 - 395。本研究对随机临床试验进行了系统回顾和荟萃分析，旨在评估和比较使用三氧化矿物骨料（MTA）和其他硅酸钙水泥（CSCs）进行髓切开术的结果。方法：审查方案在PROSPERO注册（CRD42023479322），并遵守PRISMA 2020指南。两位独立审稿人对PubMed®、Cochrane Library、Scopus、Web of Science™、Embase®和ScienceDirect®进行了全面的系统检索，并辅以人工检索和OpenGrey。根据PICOS标准选择符合条件的研究，仅包括随机临床试验，这些试验报告了髓质切开术的临床和放射学评估，随访时间至少为6个月。使用GRADE框架评估证据的确定性，评估偏倚风险、不一致性、间隔性、不精确性和发表偏倚等领域。两名评审人员独立评估每个领域的严重性。使用RevMan 5.3进行meta分析，比较MTA髓切术与替代材料髓切术的临床和影像学成功率，基于二分类结果和患者回忆。使用Cochrane rob2工具评估偏倚风险，并根据GRADE方法确定证据的总体确定性。结果：最初共纳入662篇文献，筛选和全文综述后纳入26篇研究。质量评估显示，7项研究存在低偏倚风险，2项存在一些问题，17项存在高风险，主要原因是随机化较差、缺少意向治疗分析和高损耗率。尽管放射学盲法存在挑战，但结果和报告偏差始终保持在较低水平。荟萃分析比较了MTA与其他CSCs治疗的乳牙切牙结果。MTA和Biodentine™在临床成功率方面没有显著差异（P < 0.05），尽管MTA在12个月时的放射学成功率更高（P < 0.05）。数据不充分，无法分析牙髓切开术类型、牙齿类型或使用的冲洗剂。由于严重的偏倚和不精确风险，证据的总体质量较低。发表偏倚似乎很小，而且研究没有得到私营部门的资助。结论：本系统综述和荟萃分析表明，矿物三氧化物聚集体（MTA）和其他硅酸钙基水泥（CSCs）是处理乳牙切髓术的有效材料。尽管MTA在12个月时的治疗效果优于Biodentine™，但在24个月时，两种材料的总疗效没有显著差异。然而，支持这些发现的证据的确定性被评估为较低，强调需要进一步的研究，采用可靠的研究设计和延长随访时间，以更全面地了解不同材料的椎髓切开术的结果。
{"title":"Is there a difference in the success rate of pulpotomies in primary teeth when using mineral trioxide aggregate (MTA) compared to other calcium-silicate cements (CSC)?","authors":"Meenakshi Lall","doi":"10.1038/s41432-025-01170-3","DOIUrl":"10.1038/s41432-025-01170-3","url":null,"abstract":"Silva E J N L D, Pinto K P, Riche F N S J et al. Success of primary teeth pulpotomy using calcium silicate cements: a systematic review and meta-analysis of randomised clinical trials. Pediatr Dent 2024; 46: 373–395. This systematic review and meta-analysis of randomised clinical trials aimed to evaluate and compare the outcomes of pulpotomy procedures using Mineral Trioxide Aggregate (MTA) and other Calcium-Silicate Cements (CSCs). The review protocol was registered with PROSPERO (CRD42023479322) and adhered to PRISMA 2020 guidelines. Two independent reviewers conducted a comprehensive systematic search across PubMed®, Cochrane Library, Scopus, Web of Science™, Embase®, and ScienceDirect®, supplemented by manual searches and OpenGrey. Eligible studies were selected according to the PICOS criteria, including only randomised clinical trials that reported clinical and radiographic evaluations of pulpotomies with a minimum follow-up period of six months. The certainty of evidence was appraised using the GRADE framework, evaluating domains such as risk of bias, inconsistency, indirectness, imprecision, and publication bias. Two reviewers independently assessed the severity of each domain. Meta-analyses were performed using RevMan 5.3, comparing clinical and radiographic success rates of MTA pulpotomies with those of alternative materials, based on dichotomous outcomes and patient recall. Risk of bias was assessed using the Cochrane RoB-2 tool, and the overall certainty of evidence was determined according to the GRADE methodology. A total of 662 articles were initially identified, with 26 studies included after screening and full-text review. Quality appraisal showed seven studies at low risk of bias, two with some concerns, and 17 at high risk, mainly due to poor randomisation, missing intention-to-treat analyses, and high attrition. Despite challenges in radiographic blinding, outcome and reporting biases remained consistently low. Meta-analyses compared pulpotomy outcomes in primary teeth treated with MTA versus other CSCs. No significant differences were observed between MTA and Biodentine™ in clinical success (P > 0.05), though MTA showed higher radiographic success at 12 months (P < 0.05). No significant differences were found between MTA and TheraCal® or Portland cement (P > 0.05). Data were insufficient for analyses by pulpotomy type, tooth type, or irrigant used. The overall quality of evidence was low, due to a serious risk of bias and imprecision. Publication bias appeared minimal, and studies were free from private sector funding. This systematic review and meta-analysis demonstrated that mineral trioxide aggregate (MTA) and other calcium silicate-based cements (CSCs) are effective materials for managing pulpotomies in primary teeth. Although MTA exhibited superior treatment outcomes at 12 months compared to Biodentine™, no significant difference in overall efficacy was observed between the two materials at 24 months. However, th","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"128-129"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265801","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}
Pub Date : 2025-06-10DOI: 10.1038/s41432-025-01169-w
Annabell Harman, Bryan Murchie
Esati J, Amran T, Weiger R, Alsulaimani L, Blatz M B, Eggmann F. Adverse effects of ultrasonic instrumentation and air polishing on dental restorations: a systematic review of laboratory studies. J Esthet Restor Dent 2025; https://doi.org/10.1111/jerd.13428 . A systematic review of the literature was conducted, assessing the potential for adverse effects on surface roughness and marginal integrity with use of ultrasonic instrumentation and air polishing on variety of dental restorations. With the aim to guide clinical practice to aid mitigation of adverse effects. Five databases: Cochrane Library, OpenGrey through DANS, PubMed, Scopus, and Web of Science, and supplemental manual searches were used to identify relevant literature. The review adhered to the PRISMA guidelines. Publications were included between 1978 and 2022. Population: dental restorations or restorative biomaterials in vitro. Intervention: ultrasonic instrumentation and/or air polishing. Comparison: no debridement procedure or paste polishing. Outcome: surface roughness and/or marginal quality. Forty-two laboratory studies were included in the final analysis. The studies evaluated data to answer the following research question: In specimens made of or featuring dental restorations or restorative biomaterials, how does the use of ultrasonic instrumentation and/or air polishing, compared with no debridement procedure or paste polishing, affect the surface roughness and/or marginal quality? Data extracted included: author(s) and year, laboratory studies, biomaterials evaluated, specimen quantity, specimen geometry, grouping methodology, types of ultrasonic and/or air polishing devices used, air polishing powders, device operational settings, application type and duration of ultrasonic and/or air polishing, assessments of surface roughness and marginal quality, and the observed effects on both surface roughness and marginal quality. Biomaterial assessed included: porcelain fused to metal (PFM), zirconia (ZrO2), lithium disilicate (LDS), polymer-infiltrated ceramic network material (PICN), fine-structure felspathic ceramic (FSFC), gold alloy, amalgam, resin-modified glass ionomer cements (RMGIC), conventional and flowable resin-based composite (RBC), and silorane-based RBCs restorations. Studies measured surface roughness via contact profilometry, scanning electron microscopy, and atomic force microscopy. Ra was used as a parameter for surface roughness. Stereomicroscopy and confocal laser microscopy were used to assess marginal quality. Risk of bias was assessed using the RoBDEMAT tool. Ultrasonic instrumentation and air polishing both negatively impacted surface roughness. Air polishing with sodium bicarbonate and calcium carbonate powders had a significantly greater effect on surface roughness, compared with erythritol and glycine powders. The surface roughness for RBCs and RMGICs were the most affected by ultrasonic instrumentation. In comparison, ZrO2 and LDS restorations were fou
[1]李建军，李建军，李建军，等。超声仪器与空气抛光对口腔修复体的影响研究综述。[J]；https://doi.org/10.1111/jerd.13428目的：对文献进行系统回顾，评估超声仪器和空气抛光在各种牙科修复体中对表面粗糙度和边缘完整性的潜在不利影响。目的是指导临床实践，帮助减轻不良反应。数据来源：五个数据库：Cochrane Library、OpenGrey through DANS、PubMed、Scopus和Web of Science，并使用补充人工检索来识别相关文献。审查遵循PRISMA准则。研究选择：纳入1978 - 2022年间的出版物。人群：牙体修复体或体外修复生物材料。干预：超声波仪器和/或空气抛光。对比：无清创术，无膏体抛光。结果：表面粗糙度和/或边缘质量。最后的分析包括42项实验室研究。这些研究对数据进行了评估，以回答以下研究问题：在由牙齿修复体或修复性生物材料制成或以其为特征的标本中，与不使用清创程序或膏体抛光相比，使用超声仪器和/或空气抛光对表面粗糙度和/或边缘质量的影响如何？数据提取和合成：提取的数据包括：作者和年份、实验室研究、评估的生物材料、样品数量、样品几何形状、分组方法、使用的超声波和/或空气抛光设备的类型、空气抛光粉末、设备操作设置、超声波和/或空气抛光的应用类型和持续时间、表面粗糙度和边缘质量的评估，以及观察到的对表面粗糙度和边缘质量的影响。评估的生物材料包括：金属烤瓷（PFM）、氧化锆（ZrO2）、二硅酸锂（LDS）、聚合物浸润陶瓷网络材料（PICN）、精细结构felspathic陶瓷（FSFC）、金合金、汞合金、树脂改性玻璃离子水泥（RMGIC）、常规和可流动的树脂基复合材料（RBC）和硅烷基红细胞修复体。研究测量表面粗糙度通过接触轮廓术，扫描电子显微镜，和原子力显微镜。Ra作为表面粗糙度的参数。体视显微镜和激光共聚焦显微镜评估边缘质量。使用RoBDEMAT工具评估偏倚风险。结果：超声仪器和空气抛光对表面粗糙度均有负面影响。与赤藓糖醇和甘氨酸粉末相比，碳酸氢钠和碳酸钙粉末对表面粗糙度的影响更大。超声仪器对红细胞和rmgic表面粗糙度的影响最大。相比之下，ZrO2和LDS修复体的抗性水平最高。三项研究发现，使用橡胶杯和抛光膏可以减轻仪器仪表后表面粗糙度的增加。超声仪器和空气抛光方法都会导致不良的边际质量结果。瓷肩缘较窄（0.7毫米）的冠尤其容易受到影响。与RBC修复体相比，RMGIC和汞合金修复体对边缘质量的不利影响更大。结论：建议使用较少研磨粉的空气抛光，包括赤藓糖醇和甘氨酸，以减轻表面损伤和边缘界面的变化。另一个重要的临床考虑是修复材料的类型。与所有其他材料相比，高强度陶瓷修复体，如LDS和ZrO2，更耐表面粗化。
{"title":"Do ultrasonic instrumentation and air polishing procedures adversely affect dental restorations?","authors":"Annabell Harman, Bryan Murchie","doi":"10.1038/s41432-025-01169-w","DOIUrl":"10.1038/s41432-025-01169-w","url":null,"abstract":"Esati J, Amran T, Weiger R, Alsulaimani L, Blatz M B, Eggmann F. Adverse effects of ultrasonic instrumentation and air polishing on dental restorations: a systematic review of laboratory studies. J Esthet Restor Dent 2025; https://doi.org/10.1111/jerd.13428 . A systematic review of the literature was conducted, assessing the potential for adverse effects on surface roughness and marginal integrity with use of ultrasonic instrumentation and air polishing on variety of dental restorations. With the aim to guide clinical practice to aid mitigation of adverse effects. Five databases: Cochrane Library, OpenGrey through DANS, PubMed, Scopus, and Web of Science, and supplemental manual searches were used to identify relevant literature. The review adhered to the PRISMA guidelines. Publications were included between 1978 and 2022. Population: dental restorations or restorative biomaterials in vitro. Intervention: ultrasonic instrumentation and/or air polishing. Comparison: no debridement procedure or paste polishing. Outcome: surface roughness and/or marginal quality. Forty-two laboratory studies were included in the final analysis. The studies evaluated data to answer the following research question: In specimens made of or featuring dental restorations or restorative biomaterials, how does the use of ultrasonic instrumentation and/or air polishing, compared with no debridement procedure or paste polishing, affect the surface roughness and/or marginal quality? Data extracted included: author(s) and year, laboratory studies, biomaterials evaluated, specimen quantity, specimen geometry, grouping methodology, types of ultrasonic and/or air polishing devices used, air polishing powders, device operational settings, application type and duration of ultrasonic and/or air polishing, assessments of surface roughness and marginal quality, and the observed effects on both surface roughness and marginal quality. Biomaterial assessed included: porcelain fused to metal (PFM), zirconia (ZrO2), lithium disilicate (LDS), polymer-infiltrated ceramic network material (PICN), fine-structure felspathic ceramic (FSFC), gold alloy, amalgam, resin-modified glass ionomer cements (RMGIC), conventional and flowable resin-based composite (RBC), and silorane-based RBCs restorations. Studies measured surface roughness via contact profilometry, scanning electron microscopy, and atomic force microscopy. Ra was used as a parameter for surface roughness. Stereomicroscopy and confocal laser microscopy were used to assess marginal quality. Risk of bias was assessed using the RoBDEMAT tool. Ultrasonic instrumentation and air polishing both negatively impacted surface roughness. Air polishing with sodium bicarbonate and calcium carbonate powders had a significantly greater effect on surface roughness, compared with erythritol and glycine powders. The surface roughness for RBCs and RMGICs were the most affected by ultrasonic instrumentation. In comparison, ZrO2 and LDS restorations were fou","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"125-127"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01169-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-07DOI: 10.1038/s41432-025-01158-z
Larry Z. Lockerman
Fatima S, Taneja S, Aggarwal V, Dheer A, Taneja P. Effect of cryotherapy, laser therapy and intraligamentary dexamethasone injection on post-treatment pain after single visit RCT-A double-blinded, randomized placebo-controlled trial. J Oral Biol Craniofac Res. 2025; https://doi.org/10.1016/j.jobcr.2025.01.005 . Patients were allocated to 4 groups or 25 subjects, Group-1: placebo, Group-2: Intraligamentary injection of dexamethasone, Group-3: cryotherapy (saline at a temperature of 2.5 °C was used as an irrigant in the canals prior to obturation), Group-4: cold laser therapy. Patients were instructed to record postoperative pain intensity and intake of analgesics after 6, 12, 24, 48, and 72 h. Researchgate.net, Google Scholar, pmc.ncbi.nlm.nih.gov Individuals diagnosed with molar necrotic pulps and symptomatic apical periodontitis. Systemically healthy patients, aged 18–65 years, diagnosed with symptomatic apical periodontitis in a mandibular molar requiring a primary endodontic procedure, with a preoperative VAS score of ≥7.3.2. Included patients with a history of allergy to any of the experimental drugs or local anesthetic solutions, patients who were medically compromised, and patients who had taken steroids, antibiotics, or analgesics within the previous 24 h. The study reported that patients in the placebo group exhibited statistically significantly higher intensity. Group 3 (cryotherapy) showed less pain at all time intervals. The study reported that the adjuvant pain management therapies reduced the intensity of postoperative pain and the frequency of analgesic intake.
{"title":"Beyond statistical significance: when statistically significant post operative endodontic procedures might reduce pain affecting a minority of patients seen clinically","authors":"Larry Z. Lockerman","doi":"10.1038/s41432-025-01158-z","DOIUrl":"10.1038/s41432-025-01158-z","url":null,"abstract":"Fatima S, Taneja S, Aggarwal V, Dheer A, Taneja P. Effect of cryotherapy, laser therapy and intraligamentary dexamethasone injection on post-treatment pain after single visit RCT-A double-blinded, randomized placebo-controlled trial. J Oral Biol Craniofac Res. 2025; https://doi.org/10.1016/j.jobcr.2025.01.005 . Patients were allocated to 4 groups or 25 subjects, Group-1: placebo, Group-2: Intraligamentary injection of dexamethasone, Group-3: cryotherapy (saline at a temperature of 2.5 °C was used as an irrigant in the canals prior to obturation), Group-4: cold laser therapy. Patients were instructed to record postoperative pain intensity and intake of analgesics after 6, 12, 24, 48, and 72 h. Researchgate.net, Google Scholar, pmc.ncbi.nlm.nih.gov Individuals diagnosed with molar necrotic pulps and symptomatic apical periodontitis. Systemically healthy patients, aged 18–65 years, diagnosed with symptomatic apical periodontitis in a mandibular molar requiring a primary endodontic procedure, with a preoperative VAS score of ≥7.3.2. Included patients with a history of allergy to any of the experimental drugs or local anesthetic solutions, patients who were medically compromised, and patients who had taken steroids, antibiotics, or analgesics within the previous 24 h. The study reported that patients in the placebo group exhibited statistically significantly higher intensity. Group 3 (cryotherapy) showed less pain at all time intervals. The study reported that the adjuvant pain management therapies reduced the intensity of postoperative pain and the frequency of analgesic intake.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"107-108"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247208","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}
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