Pub Date : 2025-05-12DOI: 10.1038/s41432-025-01146-3
J. Shanti Swarup, Rathika Thomas, Jessica Rucharitha, V. R. Arunkumar, Vasanthi V
Hydroxyapatite (HAp) derived from chicken eggshells has recently gained significant interest in tissue engineering and regenerative medicine. This paper aims to review the synthesis, properties and applications of eggshell-derived hydroxyapatite (E-HAp) in dentistry. A comprehensive literature search was conducted in PubMed and Scopus databases, along with a grey literature search. The references of selected studies were also manually reviewed to identify additional relevant articles. No restrictions were applied for language or publication year. Two independent reviewers carried out the study selection and data extraction processes. Seventeen studies met the inclusion criteria and were included in the qualitative analysis. Most studies were in vitro investigations focused on applications such as dentinal tubule sealing (n = 4) and remineralization of initial enamel caries lesions (n = 4). E-HAp was also studied for tissue engineering applications, including alveolar ridge preservation as a bone graft material (n = 5) and periodontal regeneration (n = 2). Additional applications included regenerative endodontics (n = 3) and use as a pulp capping agent (n = 2). E-HAp shows a wide range of applications in dentistry, particularly in tissue engineering and regenerative dentistry, marking it as a promising biomaterial in dentistry.
{"title":"Eggshell-derived hydroxyapatite as a biomaterial in dentistry: a scoping review of synthesis, properties and applications","authors":"J. Shanti Swarup, Rathika Thomas, Jessica Rucharitha, V. R. Arunkumar, Vasanthi V","doi":"10.1038/s41432-025-01146-3","DOIUrl":"10.1038/s41432-025-01146-3","url":null,"abstract":"Hydroxyapatite (HAp) derived from chicken eggshells has recently gained significant interest in tissue engineering and regenerative medicine. This paper aims to review the synthesis, properties and applications of eggshell-derived hydroxyapatite (E-HAp) in dentistry. A comprehensive literature search was conducted in PubMed and Scopus databases, along with a grey literature search. The references of selected studies were also manually reviewed to identify additional relevant articles. No restrictions were applied for language or publication year. Two independent reviewers carried out the study selection and data extraction processes. Seventeen studies met the inclusion criteria and were included in the qualitative analysis. Most studies were in vitro investigations focused on applications such as dentinal tubule sealing (n = 4) and remineralization of initial enamel caries lesions (n = 4). E-HAp was also studied for tissue engineering applications, including alveolar ridge preservation as a bone graft material (n = 5) and periodontal regeneration (n = 2). Additional applications included regenerative endodontics (n = 3) and use as a pulp capping agent (n = 2). E-HAp shows a wide range of applications in dentistry, particularly in tissue engineering and regenerative dentistry, marking it as a promising biomaterial in dentistry.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"153-153"},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976228","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}
Oral diseases are a major public health concern in Low and Middle Income Countries (LMICs), where effective treatment requires multiple appointments. Despite its importance, limited research has explored appointment adherence among adults in these settings. This scoping review identifies the barriers and facilitators to attending dental care appointments in LMICs. The current review followed JBI Scoping Review Methodology. The Databases of Dentistry, Oral Sciences Source (EBSCO), MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, Scopus and grey literature sources were searched systematically from inception till November 2024. Two independent reviewers performed data extraction using a customized JBI data extraction form. The Theoretical Domains Framework categorized barriers and facilitators of dental appointment keeping. Findings were tabulated and synthesized narratively with recommendations to improve dental attendance. Ten articles met the inclusion criteria after being screened through 5571 titles, abstracts, and 210 full texts. Knowledge, social and professional roles and identity, beliefs about capabilities, consequences, memory, attention, decision-making processes, environmental context and resources, social influence, and emotion are the main domains under which barriers and facilitators were identified. Environmental context and resource constraints were the most common barriers, while social influence was the main facilitator. The dental appointment adherence issues were determined to be comparable in public practice and university settings. It is necessary to acknowledge the barriers and facilitators to dental appointment keeping to improve the effectiveness of the dental health system, ensure continuity of care, and encourage better patient-doctor relationships. Tailored interventions are required in the dental setting to effectively manage and reduce disparities in patient care.
{"title":"Barriers to and facilitators for attending dental care appointments among adults in low- and middle-income countries: a scoping review","authors":"Vineetha Karuveettil, Swati Sapna, Praneetha Jain, Gurleen Kaur Anand","doi":"10.1038/s41432-025-01148-1","DOIUrl":"10.1038/s41432-025-01148-1","url":null,"abstract":"Oral diseases are a major public health concern in Low and Middle Income Countries (LMICs), where effective treatment requires multiple appointments. Despite its importance, limited research has explored appointment adherence among adults in these settings. This scoping review identifies the barriers and facilitators to attending dental care appointments in LMICs. The current review followed JBI Scoping Review Methodology. The Databases of Dentistry, Oral Sciences Source (EBSCO), MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, Scopus and grey literature sources were searched systematically from inception till November 2024. Two independent reviewers performed data extraction using a customized JBI data extraction form. The Theoretical Domains Framework categorized barriers and facilitators of dental appointment keeping. Findings were tabulated and synthesized narratively with recommendations to improve dental attendance. Ten articles met the inclusion criteria after being screened through 5571 titles, abstracts, and 210 full texts. Knowledge, social and professional roles and identity, beliefs about capabilities, consequences, memory, attention, decision-making processes, environmental context and resources, social influence, and emotion are the main domains under which barriers and facilitators were identified. Environmental context and resource constraints were the most common barriers, while social influence was the main facilitator. The dental appointment adherence issues were determined to be comparable in public practice and university settings. It is necessary to acknowledge the barriers and facilitators to dental appointment keeping to improve the effectiveness of the dental health system, ensure continuity of care, and encourage better patient-doctor relationships. Tailored interventions are required in the dental setting to effectively manage and reduce disparities in patient care.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"150-151"},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980818","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 : 2025-05-10DOI: 10.1038/s41432-025-01144-5
Rodolfo de Carvalho Oliveira, Jonathan Rafael Garbim, Ana Laura Passaro, Tamara Kerber Tedesco, Daniela Prócida Raggio
Common causes of destruction in primary anterior teeth include dental caries and trauma. This systematic review evaluated the success rate of restorative techniques for these cases. Systematic searches were conducted in Medline (PubMed), Scopus, Web of Science, Cochrane, Embase, and ProQuest until February 2024. Randomized controlled trials and non-randomized studies of interventions with ≥12 months of follow-up were included. Exclusion criteria were: studies with >30% loss to follow-up, unclear evaluation criteria, management under general anesthesia, unhealthy patients, or lacking individual success data. A meta-analysis assessed success rates, with subgroup analyses. Risk of bias was evaluated using RoB 2 and ROBINS-I, and evidence certainty was assessed using the GRADE system. Eight studies involving 852 teeth from 271 children aged 2–9 years, with follow-ups of 3–36 months, were included. The meta-analysis revealed a 71% success rate at 12 months for all techniques. Strip crowns (79%) and zirconia crowns (70%) had the highest success rates for teeth without endodontic treatment. Intracanal posts (resin or glass fiber) achieved an 83% success rate for teeth requiring endodontic treatment. Evidence certainty was low. Strip crowns and zirconia crowns performed well for teeth without endodontic treatment, with strip crowns offering a simpler and less technique-sensitive option. Biological restorations had poorer outcomes due to their complexity, sensitivity, and the need for a tooth biobank, raising legal and logistical challenges. Although zirconia crowns require extensive subgingival preparation, they align less with minimally invasive principles compared to strip crowns. Intracanal posts showed high success rates for teeth needing endodontic treatment, regardless of the material used. Strip crowns appear to be a suitable option for restoring primary anterior teeth that do not require endodontic treatment. For teeth requiring endodontic treatment, the use of intracanal posts combined with strip crowns seems to yield satisfactory results.
目的：造成初级前牙破坏的常见原因包括龋齿和外伤。本系统综述评估了这些病例的修复技术的成功率。方法：系统检索Medline （PubMed）、Scopus、Web of Science、Cochrane、Embase和ProQuest，检索截止至2024年2月。纳入随访≥12个月的干预措施的随机对照试验和非随机研究。排除标准为：> ~ 30%随访损失、评价标准不明确、全麻下管理、患者身体不健康或缺乏个体成功数据的研究。荟萃分析评估了成功率，并进行了亚组分析。使用rob2和ROBINS-I评估偏倚风险，使用GRADE系统评估证据确定性。结果：纳入8项研究，涉及271例2 ~ 9岁儿童852颗牙齿，随访3 ~ 36个月。荟萃分析显示，所有技术的12个月成功率为71%。条带冠（79%）和氧化锆冠（70%）对未进行根管治疗的牙齿成功率最高。对于需要根管治疗的牙齿，管内桩（树脂或玻璃纤维）的成功率为83%。证据确定性较低。讨论：条状冠和氧化锆冠在没有根管治疗的牙齿上表现良好，条状冠提供了一种更简单、更低技术敏感性的选择。生物修复由于其复杂性、敏感性和对牙齿生物库的需求，增加了法律和后勤方面的挑战，结果较差。虽然氧化锆冠需要广泛的龈下准备，但与条状冠相比，它们更不符合微创原则。管内桩显示高成功率的牙齿需要根管治疗，无论使用的材料。结论：条带冠是一种不需要根管治疗的修复前牙的合适选择。对于需要根管治疗的牙齿，使用管内桩结合条状冠似乎能产生令人满意的结果。
{"title":"Restorative strategies for deciduous anterior teeth: A systematic review and meta-analysis","authors":"Rodolfo de Carvalho Oliveira, Jonathan Rafael Garbim, Ana Laura Passaro, Tamara Kerber Tedesco, Daniela Prócida Raggio","doi":"10.1038/s41432-025-01144-5","DOIUrl":"10.1038/s41432-025-01144-5","url":null,"abstract":"Common causes of destruction in primary anterior teeth include dental caries and trauma. This systematic review evaluated the success rate of restorative techniques for these cases. Systematic searches were conducted in Medline (PubMed), Scopus, Web of Science, Cochrane, Embase, and ProQuest until February 2024. Randomized controlled trials and non-randomized studies of interventions with ≥12 months of follow-up were included. Exclusion criteria were: studies with >30% loss to follow-up, unclear evaluation criteria, management under general anesthesia, unhealthy patients, or lacking individual success data. A meta-analysis assessed success rates, with subgroup analyses. Risk of bias was evaluated using RoB 2 and ROBINS-I, and evidence certainty was assessed using the GRADE system. Eight studies involving 852 teeth from 271 children aged 2–9 years, with follow-ups of 3–36 months, were included. The meta-analysis revealed a 71% success rate at 12 months for all techniques. Strip crowns (79%) and zirconia crowns (70%) had the highest success rates for teeth without endodontic treatment. Intracanal posts (resin or glass fiber) achieved an 83% success rate for teeth requiring endodontic treatment. Evidence certainty was low. Strip crowns and zirconia crowns performed well for teeth without endodontic treatment, with strip crowns offering a simpler and less technique-sensitive option. Biological restorations had poorer outcomes due to their complexity, sensitivity, and the need for a tooth biobank, raising legal and logistical challenges. Although zirconia crowns require extensive subgingival preparation, they align less with minimally invasive principles compared to strip crowns. Intracanal posts showed high success rates for teeth needing endodontic treatment, regardless of the material used. Strip crowns appear to be a suitable option for restoring primary anterior teeth that do not require endodontic treatment. For teeth requiring endodontic treatment, the use of intracanal posts combined with strip crowns seems to yield satisfactory results.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"149-149"},"PeriodicalIF":2.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004610","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 : 2025-05-09DOI: 10.1038/s41432-025-01154-3
C. Albert Yeung
Reis P P G, Jorge R C, Marañón-Vásquez G A, Fidalgo T K D S, Maia L C, Soviero V M. Impact of clinical consequences of pulp involvement due to caries on oral health-related quality of life in children and adolescents: a systematic review and meta-analysis. Caries Res 2025; 59: 71–83. Six electronic databases (PubMed, Scopus, Web of Science, Embase, BBO/VHL and Cochrane Library) and Google Scholar were searched in August 2022. Handsearching of the reference lists in the included studies were also carried out. Observational studies that assessed children/adolescents with clinical consequences of pulp involvement due to dental caries compared with those without them and its impact on their oral health-related quality of life (OHRQoL) were included. Pulp involvement should have been clinically assessed as pulp exposure (both vital and necrotic), abscess or fistula. Two review authors independently scanned the titles and available abstracts of all the articles identified through the electronic searches. The full text of studies that appeared to meet the inclusion criteria or for which there were insufficient data in the title and abstract were obtained to make a definitive decision. A third review author was consulted in cases of disagreement. All rejected studies and reasons for excluding them were recorded in the table for the list of excluded publications. Data were independently extracted from the included studies by two review authors using data extraction tables. The methodological quality assessment was conducted using the JBI critical appraisal checklist for analytical cross-sectional studies. The studies were grouped according to participants’ age range (preschoolers, schoolchildren and adolescents) and instruments used to measure OHRQoL. To be included in the meta-analyses, the studies should have used PUFA index. The mean differences (MD) or the standardised mean differences (SMD) were calculated for numerical outcome and odds ratio (OR) was calculated for dichotomous outcome. Robustness, heterogeneity, certainty of evidence and publication bias were assessed. All 29 included studies were cross-sectional and the sample sizes ranged from 30 to 1794 participants. Fourteen studies assessed preschoolers, nine assessed schoolchildren, four assessed adolescents and two assessed children and adolescents. Most studies used PUFA index to assess the exposure. ECOHIS (preschoolers) and CPQ (children/adolescents) were the main tools used to assess the outcome. Only five articles fully adhered to the quality criteria. The meta-analyses revealed the following main results: (a) preschoolers: MD −10.79 (95% CI −16.50 to −5.09); (b) schoolchildren: MD −5.12 (95% CI −7.51 to −2.72); (c) adolescents: MD −1.86 (95% CI −4.59 to 0.87); (d) overall impact: SMD −2.18 (95% CI −3.21 to −1.15) and OR 0.52 (95% CI 0.30–0.90). Clinical consequences of pulp involvement negatively impacted the OHRQoL of children. In adolescents, this impact was not observed. However, the
[1]王晓明，王晓明，王晓明，王晓明，王晓明。口腔龋病对儿童和青少年口腔健康的影响：一项系统评价和meta分析。龋齿研究2025；59: 71 - 83。数据来源：检索于2022年8月PubMed、Scopus、Web of Science、Embase、BBO/VHL、Cochrane Library等6个电子数据库和谷歌Scholar。手工检索纳入研究的参考文献表。研究选择：纳入观察性研究，评估儿童/青少年因龋齿而受牙髓损害的临床后果与未受龋齿影响的儿童/青少年及其对口腔健康相关生活质量（OHRQoL）的影响。牙髓受累应被临床评估为牙髓暴露（包括重要的和坏死的）、脓肿或瘘管。两位综述作者独立扫描了通过电子检索确定的所有文章的标题和可用摘要。获得了似乎符合纳入标准或标题和摘要中数据不足的研究的全文，以作出明确的决定。在意见不一致的情况下，咨询第三位综述作者。所有被拒绝的研究及其被排除的原因都记录在被排除出版物列表的表中。数据提取和综合：由两位综述作者使用数据提取表独立地从纳入的研究中提取数据。方法学质量评估使用JBI关键评估清单进行分析性横断面研究。这些研究根据参与者的年龄范围（学龄前儿童、学龄儿童和青少年）和测量OHRQoL所用的工具进行分组。纳入meta分析的研究应该使用PUFA指数。数值结果计算平均差异（MD）或标准化平均差异（SMD），二分类结果计算优势比（or）。评估稳健性、异质性、证据确定性和发表偏倚。结果：所有纳入的29项研究均为横断面研究，样本量从30至1794名参与者不等。14项研究评估了学龄前儿童，9项评估了学龄儿童，4项评估了青少年，2项评估了儿童和青少年。大多数研究使用PUFA指数来评估暴露程度。ECOHIS（学龄前儿童）和CPQ（儿童/青少年）是评估结果的主要工具。只有5件物品完全符合质量标准。meta分析揭示了以下主要结果：(a)学龄前儿童：MD为-10.79 (95% CI为-16.50 ~ -5.09)；(b)学童：MD为-5.12 (95% CI为-7.51至-2.72)；(c)青少年：MD -1.86 (95% CI -4.59 ~ 0.87)；(d)总体影响：SMD -2.18 （95% CI -3.21至-1.15）和OR 0.52 （95% CI 0.30-0.90）。结论：牙髓受累的临床后果对儿童的OHRQoL有负面影响。在青少年中，没有观察到这种影响。然而，这些结果必须谨慎解释，因为证据的确定性非常低，而且存在偏倚风险和相当大的异质性，表明结果不一致。
{"title":"Do clinical consequences of pulp involvement due to dental caries cause impact on quality of life of children and adolescents?","authors":"C. Albert Yeung","doi":"10.1038/s41432-025-01154-3","DOIUrl":"10.1038/s41432-025-01154-3","url":null,"abstract":"Reis P P G, Jorge R C, Marañón-Vásquez G A, Fidalgo T K D S, Maia L C, Soviero V M. Impact of clinical consequences of pulp involvement due to caries on oral health-related quality of life in children and adolescents: a systematic review and meta-analysis. Caries Res 2025; 59: 71–83. Six electronic databases (PubMed, Scopus, Web of Science, Embase, BBO/VHL and Cochrane Library) and Google Scholar were searched in August 2022. Handsearching of the reference lists in the included studies were also carried out. Observational studies that assessed children/adolescents with clinical consequences of pulp involvement due to dental caries compared with those without them and its impact on their oral health-related quality of life (OHRQoL) were included. Pulp involvement should have been clinically assessed as pulp exposure (both vital and necrotic), abscess or fistula. Two review authors independently scanned the titles and available abstracts of all the articles identified through the electronic searches. The full text of studies that appeared to meet the inclusion criteria or for which there were insufficient data in the title and abstract were obtained to make a definitive decision. A third review author was consulted in cases of disagreement. All rejected studies and reasons for excluding them were recorded in the table for the list of excluded publications. Data were independently extracted from the included studies by two review authors using data extraction tables. The methodological quality assessment was conducted using the JBI critical appraisal checklist for analytical cross-sectional studies. The studies were grouped according to participants’ age range (preschoolers, schoolchildren and adolescents) and instruments used to measure OHRQoL. To be included in the meta-analyses, the studies should have used PUFA index. The mean differences (MD) or the standardised mean differences (SMD) were calculated for numerical outcome and odds ratio (OR) was calculated for dichotomous outcome. Robustness, heterogeneity, certainty of evidence and publication bias were assessed. All 29 included studies were cross-sectional and the sample sizes ranged from 30 to 1794 participants. Fourteen studies assessed preschoolers, nine assessed schoolchildren, four assessed adolescents and two assessed children and adolescents. Most studies used PUFA index to assess the exposure. ECOHIS (preschoolers) and CPQ (children/adolescents) were the main tools used to assess the outcome. Only five articles fully adhered to the quality criteria. The meta-analyses revealed the following main results: (a) preschoolers: MD −10.79 (95% CI −16.50 to −5.09); (b) schoolchildren: MD −5.12 (95% CI −7.51 to −2.72); (c) adolescents: MD −1.86 (95% CI −4.59 to 0.87); (d) overall impact: SMD −2.18 (95% CI −3.21 to −1.15) and OR 0.52 (95% CI 0.30–0.90). Clinical consequences of pulp involvement negatively impacted the OHRQoL of children. In adolescents, this impact was not observed. However, the","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"95-96"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062411","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 : 2025-05-09DOI: 10.1038/s41432-025-01150-7
Lata Goyal, Komal Kaur Saroya, Shipra Gupta, Shubham Sareen
Ma X, Zhang Y, Wang J et al. Association between denture restoration for tooth loss and cognitive impairment: a systematic review and meta-analysis. J Prosthodont Res 2025; https://doi.org/10.2186/jpr.JPR_D_24_00060 . A search was conducted across five electronic databases, including PubMed, EMBASE, Cochrane Library, MEDLINE, and CNKI, from January 2000 to January 2024. The search strategy included keywords related to tooth loss, dentures, cognitive function, memory loss and dementia. Reference lists of relevant studies were also screened to identify additional articles. The search was limited to the English language only. Observational studies examining the association between denture restoration and cognitive impairment were included. Eligible studies had to report cognitive impairment or dementia as the outcome and denture restoration as the exposure factor. Six studies with a total of 24,252 participants met the inclusion criteria. Two independent reviewers extracted relevant data, including study design, participant characteristics, dental status, cognitive assessment methods, and statistical results. Meta-analysis was conducted using risk ratios (RR) with 95% confidence intervals (CI), applying a random-effects model due to clinical and methodological variations. Newcastle-Ottawa Scale and the Agency for Healthcare research and quality scale were used for quality assessment of included studies. Beg- Mazumdar and Egger regression tests were used to assess the publication bias. The meta-analysis revealed that participants with tooth loss without dentures had a 1.27-fold higher odds of having cognitive impairment, whereas those with dentures had only a 1.02-fold odds. A dose-response analysis showed that each additional missing tooth increased the cognitive impairment risk by 1.009 times in the non-denture group, while the denture group exhibited a lower risk increase of 1.003 times. Heterogeneity was influenced by follow-up duration and cognitive assessment tools. There was significant evidence of publication bias in non denture group as compared to the denture restoration group which showed nonsignificant evidence of publication bias. This study suggests denture restoration is associated with a reduced risk of cognitive impairment in individuals with tooth loss. The findings highlight the potential protective role of timely denture rehabilitation in mitigating cognitive decline. Future research should focus on longitudinal and interventional studies to establish causality.
{"title":"Association between restoration of missing teeth with dentures and cognitive function","authors":"Lata Goyal, Komal Kaur Saroya, Shipra Gupta, Shubham Sareen","doi":"10.1038/s41432-025-01150-7","DOIUrl":"10.1038/s41432-025-01150-7","url":null,"abstract":"Ma X, Zhang Y, Wang J et al. Association between denture restoration for tooth loss and cognitive impairment: a systematic review and meta-analysis. J Prosthodont Res 2025; https://doi.org/10.2186/jpr.JPR_D_24_00060 . A search was conducted across five electronic databases, including PubMed, EMBASE, Cochrane Library, MEDLINE, and CNKI, from January 2000 to January 2024. The search strategy included keywords related to tooth loss, dentures, cognitive function, memory loss and dementia. Reference lists of relevant studies were also screened to identify additional articles. The search was limited to the English language only. Observational studies examining the association between denture restoration and cognitive impairment were included. Eligible studies had to report cognitive impairment or dementia as the outcome and denture restoration as the exposure factor. Six studies with a total of 24,252 participants met the inclusion criteria. Two independent reviewers extracted relevant data, including study design, participant characteristics, dental status, cognitive assessment methods, and statistical results. Meta-analysis was conducted using risk ratios (RR) with 95% confidence intervals (CI), applying a random-effects model due to clinical and methodological variations. Newcastle-Ottawa Scale and the Agency for Healthcare research and quality scale were used for quality assessment of included studies. Beg- Mazumdar and Egger regression tests were used to assess the publication bias. The meta-analysis revealed that participants with tooth loss without dentures had a 1.27-fold higher odds of having cognitive impairment, whereas those with dentures had only a 1.02-fold odds. A dose-response analysis showed that each additional missing tooth increased the cognitive impairment risk by 1.009 times in the non-denture group, while the denture group exhibited a lower risk increase of 1.003 times. Heterogeneity was influenced by follow-up duration and cognitive assessment tools. There was significant evidence of publication bias in non denture group as compared to the denture restoration group which showed nonsignificant evidence of publication bias. This study suggests denture restoration is associated with a reduced risk of cognitive impairment in individuals with tooth loss. The findings highlight the potential protective role of timely denture rehabilitation in mitigating cognitive decline. Future research should focus on longitudinal and interventional studies to establish causality.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"85-86"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989809","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 : 2025-05-09DOI: 10.1038/s41432-025-01147-2
Paramarshi Das, Upendra Singh Bhadauria, Bharathi M. Purohit, Harsh Priya, Prasanta Majumder, Manali Deb Barma
Sugar Sweetened Beverages (SSB) can significantly influence saliva leading to a more acidic environment which makes our oral cavity prone to various oral diseases. This study investigates the influence of SSBs on salivary parameters by analyzing the existing plethora of research. To systematically review and analyze the impact of SSBs on changes in salivary pH, flow rate and bacterial proliferation. Pubmed, Embase, EBSCO, Web of Science, and Cochrane databases were searched using the PECO strategy. Risk of Bias was assessed using Newcastle Ottawa Scale and Cochrane Risk of Bias assessment tools. Meta-analysis was conducted among the eligible studies using a random effects model. A total of twenty eight studies were found eligible after a thorough PRISMA search in the databases. Many studies consistently demonstrated a rapid decline in salivary pH post-SSB consumption, creating an acidic environment conducive to enamel demineralization. Few studies also reported reduced salivary flow rate and prolonged oral clearance times. Increased proliferation of acidogenic bacteria and fungi was noted. Risk of bias was low overall, but a few studies reported limitations such as randomization bias and missing data. Consumption of sugar sweetened beverages significantly impact salivary parameters, fostering an oral environment prone to diseases such as dental caries and periodontal infections. Public health interventions and policies are essential to reduce SSB consumption and promote oral health.
含糖饮料（SSB）可以显著影响唾液，导致更酸性的环境，使我们的口腔容易患各种口腔疾病。本研究通过分析已有的大量研究，探讨了SSBs对唾液参数的影响。目的：系统回顾和分析SSBs对唾液pH、流速和细菌增殖的影响。方法：使用PECO策略检索Pubmed， Embase， EBSCO， Web of Science和Cochrane数据库。偏倚风险采用纽卡斯尔渥太华量表和Cochrane偏倚风险评估工具进行评估。采用随机效应模型对符合条件的研究进行meta分析。结果：在数据库中进行彻底的PRISMA检索后，共有28项研究被发现符合条件。许多研究一致表明，食用ssb后唾液pH值迅速下降，形成有利于牙釉质脱矿的酸性环境。少数研究也报道了唾液流率降低和口腔清除时间延长。注意到产酸细菌和真菌的增殖增加。偏倚风险总体上较低，但少数研究报告了随机偏倚和缺失数据等局限性。结论：饮用含糖饮料会显著影响唾液参数，形成易患龋齿和牙周感染等疾病的口腔环境。公共卫生干预措施和政策对于减少SSB消费和促进口腔健康至关重要。
{"title":"Impact of sugar-sweetened beverages on salivary parameters: A systematic review & meta-analysis","authors":"Paramarshi Das, Upendra Singh Bhadauria, Bharathi M. Purohit, Harsh Priya, Prasanta Majumder, Manali Deb Barma","doi":"10.1038/s41432-025-01147-2","DOIUrl":"10.1038/s41432-025-01147-2","url":null,"abstract":"Sugar Sweetened Beverages (SSB) can significantly influence saliva leading to a more acidic environment which makes our oral cavity prone to various oral diseases. This study investigates the influence of SSBs on salivary parameters by analyzing the existing plethora of research. To systematically review and analyze the impact of SSBs on changes in salivary pH, flow rate and bacterial proliferation. Pubmed, Embase, EBSCO, Web of Science, and Cochrane databases were searched using the PECO strategy. Risk of Bias was assessed using Newcastle Ottawa Scale and Cochrane Risk of Bias assessment tools. Meta-analysis was conducted among the eligible studies using a random effects model. A total of twenty eight studies were found eligible after a thorough PRISMA search in the databases. Many studies consistently demonstrated a rapid decline in salivary pH post-SSB consumption, creating an acidic environment conducive to enamel demineralization. Few studies also reported reduced salivary flow rate and prolonged oral clearance times. Increased proliferation of acidogenic bacteria and fungi was noted. Risk of bias was low overall, but a few studies reported limitations such as randomization bias and missing data. Consumption of sugar sweetened beverages significantly impact salivary parameters, fostering an oral environment prone to diseases such as dental caries and periodontal infections. Public health interventions and policies are essential to reduce SSB consumption and promote oral health.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"152-153"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985376","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 : 2025-05-07DOI: 10.1038/s41432-025-01137-4
Kelvin I. Afrashtehfar
Malhotra T, Kumar Yadav B, Singh Phukela S et al. A comparative evaluation of prosthetic and biologic outcomes as influenced by two different implant restorative materials: a prospective, split-mouth study. Int J Prosthodont. 2025; https://doi.org/10.11607/ijp.8729 . This was a prospective split-mouth study, where each patient received monolithic zirconia and metal-ceramic implant-supported crowns on contralateral sides in the same arch. This design guaranteed direct intra-patient comparison, reducing inter-individual variability. Twenty partially edentulous patients (14 males, 6 females) were selected based on strict inclusion criteria, ensuring bilateral posterior implant placement with opposing natural dentition. Patients with parafunctional habits, active periodontal disease, or systemic conditions affecting bone metabolism were excluded. Implant placement and prosthetic restoration were performed per standard clinical protocols. The study assessed outcomes at baseline, 1-year, and 2-year follow-ups, measuring prosthetic integrity, periodontal health, and inflammatory markers. Clinical indices (plaque index, bleeding on probing, probing depth), peri-implant crevicular fluid biomarkers (MMP-8 levels), and prosthetic performance (USPHS criteria) were statistically analysed using chi-square tests, ANOVA, and Student t-tests, with significance set at P < 0.05. Both materials showed 100% implant and prosthetic survival rate over 2 years. Metal-ceramic crowns exhibited higher incidences of ceramic chipping and screw loosening, while monolithic zirconia crowns demonstrated greater mechanical stability but poorer aesthetic match. No significant differences in marginal bone loss (MBL) or MMP-8 inflammatory marker levels were observed between groups. However, higher plaque index (PI) and probing depth (PD) were recorded for metal-ceramic crowns. Monolithic zirconia crowns demonstrate superior mechanical reliability and fewer technical complications but have aesthetic limitations compared to metal-ceramic crowns. Biologic outcomes were comparable between both materials. Clinicians should weigh mechanical durability versus aesthetic demands when selecting implant-supported restorations. Further long-term studies are recommended to validate these findings.
{"title":"Monolithic zirconia outperforms metal-ceramic in mechanical reliability for single implant crowns but lacks long-term validation","authors":"Kelvin I. Afrashtehfar","doi":"10.1038/s41432-025-01137-4","DOIUrl":"10.1038/s41432-025-01137-4","url":null,"abstract":"Malhotra T, Kumar Yadav B, Singh Phukela S et al. A comparative evaluation of prosthetic and biologic outcomes as influenced by two different implant restorative materials: a prospective, split-mouth study. Int J Prosthodont. 2025; https://doi.org/10.11607/ijp.8729 . This was a prospective split-mouth study, where each patient received monolithic zirconia and metal-ceramic implant-supported crowns on contralateral sides in the same arch. This design guaranteed direct intra-patient comparison, reducing inter-individual variability. Twenty partially edentulous patients (14 males, 6 females) were selected based on strict inclusion criteria, ensuring bilateral posterior implant placement with opposing natural dentition. Patients with parafunctional habits, active periodontal disease, or systemic conditions affecting bone metabolism were excluded. Implant placement and prosthetic restoration were performed per standard clinical protocols. The study assessed outcomes at baseline, 1-year, and 2-year follow-ups, measuring prosthetic integrity, periodontal health, and inflammatory markers. Clinical indices (plaque index, bleeding on probing, probing depth), peri-implant crevicular fluid biomarkers (MMP-8 levels), and prosthetic performance (USPHS criteria) were statistically analysed using chi-square tests, ANOVA, and Student t-tests, with significance set at P < 0.05. Both materials showed 100% implant and prosthetic survival rate over 2 years. Metal-ceramic crowns exhibited higher incidences of ceramic chipping and screw loosening, while monolithic zirconia crowns demonstrated greater mechanical stability but poorer aesthetic match. No significant differences in marginal bone loss (MBL) or MMP-8 inflammatory marker levels were observed between groups. However, higher plaque index (PI) and probing depth (PD) were recorded for metal-ceramic crowns. Monolithic zirconia crowns demonstrate superior mechanical reliability and fewer technical complications but have aesthetic limitations compared to metal-ceramic crowns. Biologic outcomes were comparable between both materials. Clinicians should weigh mechanical durability versus aesthetic demands when selecting implant-supported restorations. Further long-term studies are recommended to validate these findings.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"76-77"},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963818","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 : 2025-05-06DOI: 10.1038/s41432-025-01155-2
Omer Waleed Majid
Gaspar J, Botelho J, Proença L et al. Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement: a randomized clinical trial on patient-reported outcome measures. Clin Implant Dent Relat Res 2024; 26: 113–126. A randomized, controlled, parallel-arm clinical trial. To compare patient-reported and surgical outcomes between osseodensification (OD) and lateral window (LW) techniques for sinus floor elevation (SFE) with concurrent implant placement. The study received approval from the local Ethics Committee, followed the Helsinki Declaration and CONSORT guidelines, and obtained written informed consent from all participants. Eligibility criteria included adults aged 18 or older, in good systemic health, with a missing posterior maxillary tooth, residual bone height (RBH) ≤ 4 mm, and crestal bone width >6 mm. Patients were randomly assigned to either the OD group or the LW group. Both techniques involved simultaneous single implant placement, and all surgical and prosthetic procedures were performed by one experienced clinician. Primary outcomes were pain (measured on a visual analogue scale), and quality of life (QoL) using a modified Oral Health Impact Profile-14 (OHIP-14) questionnaire, assessed daily for the first week postoperatively. Patients also self-reported symptoms like edema, hematoma, and epistaxis using a 5-point Likert scale. Secondary outcomes included implant stability (ISQ), surgery duration, complications, and analgesic use. Follow up extended for 1 year. A total of 20 participants (8 males, 12 females; mean age 47.9 years) were included in the study. Up to Day 3, pain levels were significantly lower (p < 0.05) in OD group, which also had a significantly reduced average analgesic intake throughout the first postoperative week (p < 0.001) compared to LW group. The OHIP-14 total scores were significantly lower in OD group on all days except Day 5 (p < 0.05). The mean surgical time was significantly shorter in the OD group (33 vs. 71 min; p < 0.001). Additionally, postoperative symptoms and complications were significantly fewer (p < 0.001), and the ISQ at 6 months was higher in the OD group (p < 0.05). All implants were restored using screw-retained zirconia crowns, with a 100% success rate. Both OD and LW techniques were effective for SFE with simultaneous implant placement in cases with RBH ≤ 4 mm. However, OD showed superior short-term outcomes, including less pain and swelling, faster surgery, lower analgesic use, and improved QoL measures.
{"title":"Minimally invasive advantage? Patient feedback supports osseodensification in sinus lift surgery","authors":"Omer Waleed Majid","doi":"10.1038/s41432-025-01155-2","DOIUrl":"10.1038/s41432-025-01155-2","url":null,"abstract":"Gaspar J, Botelho J, Proença L et al. Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement: a randomized clinical trial on patient-reported outcome measures. Clin Implant Dent Relat Res 2024; 26: 113–126. A randomized, controlled, parallel-arm clinical trial. To compare patient-reported and surgical outcomes between osseodensification (OD) and lateral window (LW) techniques for sinus floor elevation (SFE) with concurrent implant placement. The study received approval from the local Ethics Committee, followed the Helsinki Declaration and CONSORT guidelines, and obtained written informed consent from all participants. Eligibility criteria included adults aged 18 or older, in good systemic health, with a missing posterior maxillary tooth, residual bone height (RBH) ≤ 4 mm, and crestal bone width >6 mm. Patients were randomly assigned to either the OD group or the LW group. Both techniques involved simultaneous single implant placement, and all surgical and prosthetic procedures were performed by one experienced clinician. Primary outcomes were pain (measured on a visual analogue scale), and quality of life (QoL) using a modified Oral Health Impact Profile-14 (OHIP-14) questionnaire, assessed daily for the first week postoperatively. Patients also self-reported symptoms like edema, hematoma, and epistaxis using a 5-point Likert scale. Secondary outcomes included implant stability (ISQ), surgery duration, complications, and analgesic use. Follow up extended for 1 year. A total of 20 participants (8 males, 12 females; mean age 47.9 years) were included in the study. Up to Day 3, pain levels were significantly lower (p < 0.05) in OD group, which also had a significantly reduced average analgesic intake throughout the first postoperative week (p < 0.001) compared to LW group. The OHIP-14 total scores were significantly lower in OD group on all days except Day 5 (p < 0.05). The mean surgical time was significantly shorter in the OD group (33 vs. 71 min; p < 0.001). Additionally, postoperative symptoms and complications were significantly fewer (p < 0.001), and the ISQ at 6 months was higher in the OD group (p < 0.05). All implants were restored using screw-retained zirconia crowns, with a 100% success rate. Both OD and LW techniques were effective for SFE with simultaneous implant placement in cases with RBH ≤ 4 mm. However, OD showed superior short-term outcomes, including less pain and swelling, faster surgery, lower analgesic use, and improved QoL measures.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"123-124"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960068","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 : 2025-05-06DOI: 10.1038/s41432-025-01153-4
Omer Waleed Majid
Saatchi M, Mohammadi G, Iranmanesh P et al. Articaine buccal infiltration for mandibular first molars with symptomatic irreversible pulpitis: is it as effective as inferior alveolar nerve block with lidocaine? A systematic review and meta-analysis. Clin Oral Investig 2025; 29: 146. A systematic review and meta-analysis. To compare the anesthetic success rate of 4% articaine buccal infiltration (BI) with 2% lidocaine inferior alveolar nerve block (IANB) for lower first molars (LM1) presenting with symptomatic irreversible pulpitis. This systematic review, registered in PROSPERO and conducted per PRISMA guidelines, included randomized clinical trials (RCTs) on adults (≥18 years) with symptomatic irreversible pulpitis in LM1, using a single cartridge (1.7–1.8 ml) of either articaine BI or lidocaine IANB as the primary injection. Studies were excluded if they were non-RCTs, used other anesthetics or techniques, included supplemental injections, used articaine BI as a secondary method, or did not report results specific to LM1. Anesthetic success was defined as patient-reported pain <4 on a visual analog scale (VAS) during cavity access or canal instrumentation. A comprehensive English-language search was conducted across five databases and gray literature sources, with manual searches of key journals and textbooks. Two independent reviewers handled screening and data extraction. Risk of bias was assessed with the Cochrane RoB2 tool. A fixed-effect meta-analysis estimated pooled risk ratios, with tests for heterogeneity and publication bias. Trial Sequential Analysis (TSA) was utilized to evaluate the robustness of the evidence, and the GRADE approach assessed certainty. From 780 initial records, five RCTs met the inclusion criteria after full screening. These trials included 405 patients aged 18–65, each comparing 4% articaine BI (1:100,000 epinephrine) against 2% lidocaine IANB (three with 1:100,000 and two with 1:200,000 epinephrine). No adverse effects were reported in three studies; the remaining two did not address safety. Risk of bias was low in three trials, with two showing some concerns due to unclear randomization and blinding. No publication bias was detected. Of the 405 first molars with irreversible pulpitis, 284 cases (70%) demonstrated successful pulpal anesthesia. The meta-analysis showed similar anesthetic success rates between articaine BI (72.2%) and lidocaine IANB (68.1%) [RR = 1.06, 95% CI: 0.93–1.20, I2 = 24.51%]. However, TSA indicated that current evidence is inconclusive due to insufficient sample size. According to GRADE, the overall certainty of evidence was rated as moderate, with concerns primarily related to imprecision. Moderate evidence indicates that 4% articaine BI offers anesthetic efficacy comparable to 2% lidocaine IANB for LM1 with symptomatic irreversible pulpitis. Although additional high-quality clinical trials are needed to validate these results, articaine BI may present a promising alternative to the tra
{"title":"Articaine buccal infiltration for mandibular first molars with irreversible pulpitis: is the evidence enough?","authors":"Omer Waleed Majid","doi":"10.1038/s41432-025-01153-4","DOIUrl":"10.1038/s41432-025-01153-4","url":null,"abstract":"Saatchi M, Mohammadi G, Iranmanesh P et al. Articaine buccal infiltration for mandibular first molars with symptomatic irreversible pulpitis: is it as effective as inferior alveolar nerve block with lidocaine? A systematic review and meta-analysis. Clin Oral Investig 2025; 29: 146. A systematic review and meta-analysis. To compare the anesthetic success rate of 4% articaine buccal infiltration (BI) with 2% lidocaine inferior alveolar nerve block (IANB) for lower first molars (LM1) presenting with symptomatic irreversible pulpitis. This systematic review, registered in PROSPERO and conducted per PRISMA guidelines, included randomized clinical trials (RCTs) on adults (≥18 years) with symptomatic irreversible pulpitis in LM1, using a single cartridge (1.7–1.8 ml) of either articaine BI or lidocaine IANB as the primary injection. Studies were excluded if they were non-RCTs, used other anesthetics or techniques, included supplemental injections, used articaine BI as a secondary method, or did not report results specific to LM1. Anesthetic success was defined as patient-reported pain <4 on a visual analog scale (VAS) during cavity access or canal instrumentation. A comprehensive English-language search was conducted across five databases and gray literature sources, with manual searches of key journals and textbooks. Two independent reviewers handled screening and data extraction. Risk of bias was assessed with the Cochrane RoB2 tool. A fixed-effect meta-analysis estimated pooled risk ratios, with tests for heterogeneity and publication bias. Trial Sequential Analysis (TSA) was utilized to evaluate the robustness of the evidence, and the GRADE approach assessed certainty. From 780 initial records, five RCTs met the inclusion criteria after full screening. These trials included 405 patients aged 18–65, each comparing 4% articaine BI (1:100,000 epinephrine) against 2% lidocaine IANB (three with 1:100,000 and two with 1:200,000 epinephrine). No adverse effects were reported in three studies; the remaining two did not address safety. Risk of bias was low in three trials, with two showing some concerns due to unclear randomization and blinding. No publication bias was detected. Of the 405 first molars with irreversible pulpitis, 284 cases (70%) demonstrated successful pulpal anesthesia. The meta-analysis showed similar anesthetic success rates between articaine BI (72.2%) and lidocaine IANB (68.1%) [RR = 1.06, 95% CI: 0.93–1.20, I2 = 24.51%]. However, TSA indicated that current evidence is inconclusive due to insufficient sample size. According to GRADE, the overall certainty of evidence was rated as moderate, with concerns primarily related to imprecision. Moderate evidence indicates that 4% articaine BI offers anesthetic efficacy comparable to 2% lidocaine IANB for LM1 with symptomatic irreversible pulpitis. Although additional high-quality clinical trials are needed to validate these results, articaine BI may present a promising alternative to the tra","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"89-90"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970611","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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