Pub Date : 2024-06-29DOI: 10.1038/s41432-024-01033-3
Leandro Bueno Gobbo, Lucas Peixoto de Araújo, Walbert de Andrade Vieira, Adriana de-Jesus-Soares, José Flávio Affonso de Almeida, Caio Cezar Randi Ferraz
This systematic review aimed to assess the impact of Passive Ultrasonic Irrigation on the periapical healing rate of primary root canal treatment compared to conventional syringe irrigation. Registered a priori in the PROSPERO database, this review was conducted by two independent reviewers who performed an electronic search up to December 2023. The search included databases such as MEDLINE (PubMed), Scopus, Web of Science, Embase, LILACS, and the Cochrane Library, as well as grey literature. We included randomized clinical trials (RCTs) that focused on patients undergoing primary root canal treatments. The study compared intervention groups using PUI with control groups that did not use activation techniques. Periapical healing was assessed over follow-up periods of at least six months, utilizing either periapical radiographs or cone-beam computed tomography. To synthesize the findings, a meta-analysis and trial sequence analysis were conducted, employing the Relative Risk as the measure of effect, with a 95% confidence interval. The GRADE approach was utilized to assess the certainty of the evidence. The meta-analysis incorporated three RCTs, involving 474 patients (501 teeth). The analysis revealed that PUI led to a higher rate of periapical healing compared to CSI (Relative Risk: 1.10; 95% Confidence Interval: 1.01-1.21, I² = 0%), with moderate certainty of evidence. Despite the limited number of high-quality RCTs, the findings showed a positive impact of PUI on periapical healing rates in primary root canal treatments, in comparison to CSI. CRD42021290894.
{"title":"Impact of passive ultrasonic irrigation on the outcome of non-surgical root canal treatment: a systematic review and meta-analysis of randomized clinical trials","authors":"Leandro Bueno Gobbo, Lucas Peixoto de Araújo, Walbert de Andrade Vieira, Adriana de-Jesus-Soares, José Flávio Affonso de Almeida, Caio Cezar Randi Ferraz","doi":"10.1038/s41432-024-01033-3","DOIUrl":"10.1038/s41432-024-01033-3","url":null,"abstract":"This systematic review aimed to assess the impact of Passive Ultrasonic Irrigation on the periapical healing rate of primary root canal treatment compared to conventional syringe irrigation. Registered a priori in the PROSPERO database, this review was conducted by two independent reviewers who performed an electronic search up to December 2023. The search included databases such as MEDLINE (PubMed), Scopus, Web of Science, Embase, LILACS, and the Cochrane Library, as well as grey literature. We included randomized clinical trials (RCTs) that focused on patients undergoing primary root canal treatments. The study compared intervention groups using PUI with control groups that did not use activation techniques. Periapical healing was assessed over follow-up periods of at least six months, utilizing either periapical radiographs or cone-beam computed tomography. To synthesize the findings, a meta-analysis and trial sequence analysis were conducted, employing the Relative Risk as the measure of effect, with a 95% confidence interval. The GRADE approach was utilized to assess the certainty of the evidence. The meta-analysis incorporated three RCTs, involving 474 patients (501 teeth). The analysis revealed that PUI led to a higher rate of periapical healing compared to CSI (Relative Risk: 1.10; 95% Confidence Interval: 1.01-1.21, I² = 0%), with moderate certainty of evidence. Despite the limited number of high-quality RCTs, the findings showed a positive impact of PUI on periapical healing rates in primary root canal treatments, in comparison to CSI. CRD42021290894.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"212-213"},"PeriodicalIF":0.0,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476272","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 : 2024-06-28DOI: 10.1038/s41432-024-01030-6
Waleed Almutairi, Brett Duane
The study was designed as a single-blinded, parallel, randomized controlled trial to compare the effectiveness of the Salvadora persica toothbrush (MTB), Salvadora persica chewing stick (MCS), and a standard toothbrush (STB) in controlling plaque and gingivitis. A total of 78 participants were randomly divided into three groups and instructed to use their assigned oral hygiene tool in a standardized manner for three. Participants were non-dental students and staff of Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, selected through convenience sampling. They met specific inclusion criteria, such as being systemically healthy, having ≥20 teeth, and having a Basic Periodontal Examination score of 0, 1, or 2, with no periodontal pockets greater than 5.5 mm. Clinical outcomes were measured using the Plaque Index (PI) and Periodontal Inflamed Surface Area (PISA) at baseline, one-, and three-weeks post-intervention. Data analysis was performed using mixed-model analysis of variance for continuous variables and Fisher’s exact test for categorical variables. All three groups showed significant improvements in plaque levels and severity of gingivitis from baseline to three weeks post-intervention. The MCS group demonstrated a significant improvement in mean PISA values of the anterior teeth compared to the MTB and STB groups. However, there was no significant difference in plaque level reduction or overall gingivitis severity among the three groups. This indicates that when used correctly, Salvadora persica toothbrushes and chewing sticks are as effective as standard toothbrushes in plaque control and gingival health. The study concludes that both Salvadora persica toothbrushes and chewing sticks can serve as effective alternatives to the standard toothbrush for plaque control and gingival health. This showcases the beneficial anti-plaque and anti-gingivitis properties of Salvadora persica. However, the effectiveness of these oral hygiene tools is contingent upon the correct usage techniques.
{"title":"Can traditional oral hygiene methods compete with conventional toothbrushes in effectiveness?","authors":"Waleed Almutairi, Brett Duane","doi":"10.1038/s41432-024-01030-6","DOIUrl":"10.1038/s41432-024-01030-6","url":null,"abstract":"The study was designed as a single-blinded, parallel, randomized controlled trial to compare the effectiveness of the Salvadora persica toothbrush (MTB), Salvadora persica chewing stick (MCS), and a standard toothbrush (STB) in controlling plaque and gingivitis. A total of 78 participants were randomly divided into three groups and instructed to use their assigned oral hygiene tool in a standardized manner for three. Participants were non-dental students and staff of Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, selected through convenience sampling. They met specific inclusion criteria, such as being systemically healthy, having ≥20 teeth, and having a Basic Periodontal Examination score of 0, 1, or 2, with no periodontal pockets greater than 5.5 mm. Clinical outcomes were measured using the Plaque Index (PI) and Periodontal Inflamed Surface Area (PISA) at baseline, one-, and three-weeks post-intervention. Data analysis was performed using mixed-model analysis of variance for continuous variables and Fisher’s exact test for categorical variables. All three groups showed significant improvements in plaque levels and severity of gingivitis from baseline to three weeks post-intervention. The MCS group demonstrated a significant improvement in mean PISA values of the anterior teeth compared to the MTB and STB groups. However, there was no significant difference in plaque level reduction or overall gingivitis severity among the three groups. This indicates that when used correctly, Salvadora persica toothbrushes and chewing sticks are as effective as standard toothbrushes in plaque control and gingival health. The study concludes that both Salvadora persica toothbrushes and chewing sticks can serve as effective alternatives to the standard toothbrush for plaque control and gingival health. This showcases the beneficial anti-plaque and anti-gingivitis properties of Salvadora persica. However, the effectiveness of these oral hygiene tools is contingent upon the correct usage techniques.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 3","pages":"154-155"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01030-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467301","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 : 2024-06-21DOI: 10.1038/s41432-024-01028-0
Pegah Sadeghnezhad, Alireza Sarraf Shirazi, Alireza Borouziniat, Sara Majidinia, Pouria Soltaninezhad, Amir Hossein Nejat
Restorative dentistry faces complex challenges with deep proximal surface destruction, requiring novel approaches like DME (Deep Margin Elevation). In order to achieve the best results while treating severe tooth damage, this study examines the advantages, disadvantages, and possible collaborations of different treatments. This systematic review investigates the efficacy of DME as an adjunctive procedure in restorative dentistry, specifically focusing on its impact on microleakage. The study adheres to PRISMA guidelines and employs the PICOS framework for eligibility criteria. 394 potentially qualifying studies were discovered and thorough literature search was carried out via databases. After applying inclusion criteria, 7 studies were included in the analysis. Articles were selected based on criteria that included indirect restoration and performing DME and were compared with indirect restorations without DME. Composite resin was used for DME. Other materials for DME performing, including GI and composite flow, were systematically reviewed. Data analysis was done by biostat software (α = 0.05). The meta-analysis of selected studies reveals a statistically significant positive effect of DME on reduction of microleakage (p = 0.001). The results of this study underscore the potential of DME in addressing subgingival margin challenges and provide valuable insights for restorative dentistry practices.
{"title":"Enhancing subgingival margin restoration: a comprehensive review and meta-analysis of deep margin elevation’s impact on microleakage","authors":"Pegah Sadeghnezhad, Alireza Sarraf Shirazi, Alireza Borouziniat, Sara Majidinia, Pouria Soltaninezhad, Amir Hossein Nejat","doi":"10.1038/s41432-024-01028-0","DOIUrl":"10.1038/s41432-024-01028-0","url":null,"abstract":"Restorative dentistry faces complex challenges with deep proximal surface destruction, requiring novel approaches like DME (Deep Margin Elevation). In order to achieve the best results while treating severe tooth damage, this study examines the advantages, disadvantages, and possible collaborations of different treatments. This systematic review investigates the efficacy of DME as an adjunctive procedure in restorative dentistry, specifically focusing on its impact on microleakage. The study adheres to PRISMA guidelines and employs the PICOS framework for eligibility criteria. 394 potentially qualifying studies were discovered and thorough literature search was carried out via databases. After applying inclusion criteria, 7 studies were included in the analysis. Articles were selected based on criteria that included indirect restoration and performing DME and were compared with indirect restorations without DME. Composite resin was used for DME. Other materials for DME performing, including GI and composite flow, were systematically reviewed. Data analysis was done by biostat software (α = 0.05). The meta-analysis of selected studies reveals a statistically significant positive effect of DME on reduction of microleakage (p = 0.001). The results of this study underscore the potential of DME in addressing subgingival margin challenges and provide valuable insights for restorative dentistry practices.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"212-212"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436794","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 : 2024-06-20DOI: 10.1038/s41432-024-01031-5
Ana Luisa Amaral, David Herrera, Bodil Lund, Sérgio Araújo Andrade
A critical review on the use of antimicrobials in dentistry. To provide a general overview of the use of antimicrobials in dentistry. The paper was divided into different topics, starting with an approach to understanding both commensal and pathogenic oral microbiota. Subsequently, emphasis was placed on the main categories of antibiotics used in dentistry (β-lactams, tetracyclines, macrolides, lincosamides, nitroimidazoles and quinolones), and the basis for their prescription. Finally, the implications between systemic diseases and the use of orally-administered antibiotics are presented. The study suggests that an adequate medical history can minimize the risk of systemic adverse effects, unwanted drug interactions, and allergies related to the use of antibiotics. In this regard, when facing a potential history of allergy to a particular group of antibiotics, the prescription of a different group is mandatory. In most indications, β-lactam antibiotics represent the first-choice in dentistry. Moreover, a short-term prescription of antibiotics when treating acute oral infections is recommended. The use should be extended for 2 to 3 days following the resolution of the infection, with an average duration of 6 days in order to prevent the development of antibiotic resistance. Oral infections should be managed with interventions aiming at the elimination/reduction of the associated pathogens. Furthermore, inadequate prescription of antibiotics can lead to potential risks to the patient such as allergy, adverse effects, and development of microbial resistance.
{"title":"What is the science underpinning the prescription of antibiotics in dentistry?","authors":"Ana Luisa Amaral, David Herrera, Bodil Lund, Sérgio Araújo Andrade","doi":"10.1038/s41432-024-01031-5","DOIUrl":"10.1038/s41432-024-01031-5","url":null,"abstract":"A critical review on the use of antimicrobials in dentistry. To provide a general overview of the use of antimicrobials in dentistry. The paper was divided into different topics, starting with an approach to understanding both commensal and pathogenic oral microbiota. Subsequently, emphasis was placed on the main categories of antibiotics used in dentistry (β-lactams, tetracyclines, macrolides, lincosamides, nitroimidazoles and quinolones), and the basis for their prescription. Finally, the implications between systemic diseases and the use of orally-administered antibiotics are presented. The study suggests that an adequate medical history can minimize the risk of systemic adverse effects, unwanted drug interactions, and allergies related to the use of antibiotics. In this regard, when facing a potential history of allergy to a particular group of antibiotics, the prescription of a different group is mandatory. In most indications, β-lactam antibiotics represent the first-choice in dentistry. Moreover, a short-term prescription of antibiotics when treating acute oral infections is recommended. The use should be extended for 2 to 3 days following the resolution of the infection, with an average duration of 6 days in order to prevent the development of antibiotic resistance. Oral infections should be managed with interventions aiming at the elimination/reduction of the associated pathogens. Furthermore, inadequate prescription of antibiotics can lead to potential risks to the patient such as allergy, adverse effects, and development of microbial resistance.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"196-197"},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01031-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431755","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 : 2024-06-13DOI: 10.1038/s41432-024-01029-z
Rahma ElNaghy, Mona El Sayed, Radwa Alsherbiny Alnaghy, Majd Hasanin
Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The systematic review was registered in advance on PROSPERO, and was conducted following the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA checklist. An electronic search in three databases (PubMed, Scopus, and Embase) was conducted by two authors to evaluate studies published from 1990 until May 2023. The review question was defined in PICOS format as follows: Population (P), subjects with permanent dentition who having/had orthodontic therapy; Exposure (E), orthodontic therapy with fixed orthodontic appliance; Comparison/Control (C), no orthodontic treatment or intervention; Outcome (O), assessing incidence and/or prevalence of initial caries lesions (ICLs) at subject and teeth levels was the primary outcome, whereas evaluating the influence of demographics and treatment-related variables were secondary outcomes; studies (S), randomized clinical trials, non-randomized clinical studies, cohort and cross-sectional studies. Meta-analysis was conducted of three or more included studies had comparable findings. The following factors were calculated for each study; sample size, number of patients with ICLs, number of teeth with ICLs, number of teeth affected per patient, and number of surfaces affected. Statistical heterogeneity of effects among studies was assessed by means of the Cochran’s test was used to evaluate the statistical heterogeneity of effects in the included studies. Funnel plot approach was used to assess publication bias, whereas Begg’s and Egger’s correlation test were used to identify asymmetry. Meta-analysis was conducted using a random effects model owing to high methodological and clinical heterogeneity. A descriptive analysis was presented when the meta-analyses appeared inappropriate. Statistical significance level was set at p < 0.05 for all statistical analyses. 21 studies were included in the qualitative synthesis (systematic review); 11 RCTs; 7 NRSIs, and 3 observation studies. Of the included studies, 19 studies were analyzed in the quantitative synthesis (meta-analysis). In regard to the prevalence rate of ICLs; 57% of patients had ICLs, with a mean of 2.24 lesions per patient and 22% of surfaces were affected. In regard to the incidence rate; 48% of patients developed new ICLs, with a mean of 2.29 new lesions per patient, and 15% of surfaces became affected. Both prevalence and incidence rates were positively associated with the duration of the orthodontic therapy (P = 0.01 and P < 0.01, respectively), illustrating an elevation in the ICLs numbers as the treatment duration (number of months) increases. There was no association between patients’ age and ICLs numbers. Orthodontic therapy using fixed appliances can increase the risk of accumulating plaque and developing caries lesion. However, other risk factors may play a role in developin
{"title":"Does orthodontic treatment using fixed appliances cause initial caries lesions?","authors":"Rahma ElNaghy, Mona El Sayed, Radwa Alsherbiny Alnaghy, Majd Hasanin","doi":"10.1038/s41432-024-01029-z","DOIUrl":"10.1038/s41432-024-01029-z","url":null,"abstract":"Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The systematic review was registered in advance on PROSPERO, and was conducted following the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA checklist. An electronic search in three databases (PubMed, Scopus, and Embase) was conducted by two authors to evaluate studies published from 1990 until May 2023. The review question was defined in PICOS format as follows: Population (P), subjects with permanent dentition who having/had orthodontic therapy; Exposure (E), orthodontic therapy with fixed orthodontic appliance; Comparison/Control (C), no orthodontic treatment or intervention; Outcome (O), assessing incidence and/or prevalence of initial caries lesions (ICLs) at subject and teeth levels was the primary outcome, whereas evaluating the influence of demographics and treatment-related variables were secondary outcomes; studies (S), randomized clinical trials, non-randomized clinical studies, cohort and cross-sectional studies. Meta-analysis was conducted of three or more included studies had comparable findings. The following factors were calculated for each study; sample size, number of patients with ICLs, number of teeth with ICLs, number of teeth affected per patient, and number of surfaces affected. Statistical heterogeneity of effects among studies was assessed by means of the Cochran’s test was used to evaluate the statistical heterogeneity of effects in the included studies. Funnel plot approach was used to assess publication bias, whereas Begg’s and Egger’s correlation test were used to identify asymmetry. Meta-analysis was conducted using a random effects model owing to high methodological and clinical heterogeneity. A descriptive analysis was presented when the meta-analyses appeared inappropriate. Statistical significance level was set at p < 0.05 for all statistical analyses. 21 studies were included in the qualitative synthesis (systematic review); 11 RCTs; 7 NRSIs, and 3 observation studies. Of the included studies, 19 studies were analyzed in the quantitative synthesis (meta-analysis). In regard to the prevalence rate of ICLs; 57% of patients had ICLs, with a mean of 2.24 lesions per patient and 22% of surfaces were affected. In regard to the incidence rate; 48% of patients developed new ICLs, with a mean of 2.29 new lesions per patient, and 15% of surfaces became affected. Both prevalence and incidence rates were positively associated with the duration of the orthodontic therapy (P = 0.01 and P < 0.01, respectively), illustrating an elevation in the ICLs numbers as the treatment duration (number of months) increases. There was no association between patients’ age and ICLs numbers. Orthodontic therapy using fixed appliances can increase the risk of accumulating plaque and developing caries lesion. However, other risk factors may play a role in developin","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 3","pages":"134-135"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316926","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 : 2024-06-12DOI: 10.1038/s41432-024-01027-1
Ana Luisa Amaral, Bodil Lund, Sérgio Araújo Andrade
Prospective, parallel, randomized, double-blind, clinical trial. Participants were at least 30 years old, who were systemically healthy, with stages III-IV, grades B-C periodontitis. Of the 50 eligible individuals for the study, 40 were divided into 2 equal groups. The test group received doses of 500 mg of metronidazole, while the control group received a placebo, both administered three times a day for 7 days, commencing immediately after periodontal surgery. All patients were followed up at 3-, 6-, 9-, and 12-months post-surgery. The study utilized probing depth, clinical attachment level, bleeding on probing, and plaque index as parameters for determining the outcomes at each assessment. Microbiological samples were collected for the detection and quantification of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia DNA. In order to analyze quantitative variables in a comparison between the test and control groups, Student’s t-tests or Mann-Whitney U tests were utilized. For categorical results, chi-square or Fisher tests were employed. For both probing depth and clinical attachment level, repeated measures ANOVA was used. The statistical significance level was set at p ≤ 0.05. The study found statistically significant differences for probing depth (mean difference, MD = 0.31 mm, 95% confidence interval, CI [0.13; 0.49]; p = 0.001) and clinical attachment level (MD = 0.64 mm, 95% CI [0.02; 1.27]; p = 0.044) only 3 months after surgery, with a reduction observed in the test group. However, despite being statistically significant, these results lack clinical relevance. Although the study found statistically significant results for clinical attachment level (MD = 0.66 mm, 95% CI [0.01; 1.31]; p = 0.045) and probing depth (MD = 0.28 mm, 95% CI [0.09; 0.46]; p = 0.004), these findings do not represent clinically significant gains. Therefore, no evidence was demonstrated to support the use of systemic metronidazole as adjunctive therapy to periodontal surgery.
{"title":"Would it really be necessary to use metronidazole as an adjunct in the surgical treatment of periodontitis?","authors":"Ana Luisa Amaral, Bodil Lund, Sérgio Araújo Andrade","doi":"10.1038/s41432-024-01027-1","DOIUrl":"10.1038/s41432-024-01027-1","url":null,"abstract":"Prospective, parallel, randomized, double-blind, clinical trial. Participants were at least 30 years old, who were systemically healthy, with stages III-IV, grades B-C periodontitis. Of the 50 eligible individuals for the study, 40 were divided into 2 equal groups. The test group received doses of 500 mg of metronidazole, while the control group received a placebo, both administered three times a day for 7 days, commencing immediately after periodontal surgery. All patients were followed up at 3-, 6-, 9-, and 12-months post-surgery. The study utilized probing depth, clinical attachment level, bleeding on probing, and plaque index as parameters for determining the outcomes at each assessment. Microbiological samples were collected for the detection and quantification of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia DNA. In order to analyze quantitative variables in a comparison between the test and control groups, Student’s t-tests or Mann-Whitney U tests were utilized. For categorical results, chi-square or Fisher tests were employed. For both probing depth and clinical attachment level, repeated measures ANOVA was used. The statistical significance level was set at p ≤ 0.05. The study found statistically significant differences for probing depth (mean difference, MD = 0.31 mm, 95% confidence interval, CI [0.13; 0.49]; p = 0.001) and clinical attachment level (MD = 0.64 mm, 95% CI [0.02; 1.27]; p = 0.044) only 3 months after surgery, with a reduction observed in the test group. However, despite being statistically significant, these results lack clinical relevance. Although the study found statistically significant results for clinical attachment level (MD = 0.66 mm, 95% CI [0.01; 1.31]; p = 0.045) and probing depth (MD = 0.28 mm, 95% CI [0.09; 0.46]; p = 0.004), these findings do not represent clinically significant gains. Therefore, no evidence was demonstrated to support the use of systemic metronidazole as adjunctive therapy to periodontal surgery.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"180-181"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01027-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310379","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 : 2024-06-12DOI: 10.1038/s41432-024-01024-4
Hamoun Sabri, Sara Alhachache, Pramiti Saxena, Prerana Dubey, Paolo Nava, Syed Hanan Rufai, Farzin Sarkarat
The aim of this systematic review was to comprehensively explore the current trends and therapeutic approaches in which an operating microscope (OM) is used in periodontics and dental implant surgeries. A systematic search strategy was built to detect studies including various surgical techniques performed under an OM. PubMed, EMBASE, and SCOPUS databases were searched. No limitations in terms of time and language were applied. The data regarding the study design, type of procedure, treatment groups, and surgical outcomes were collected and analyzed descriptively. In addition, a bibliometric analysis was performed concerning the co-authorship and keyword co-occurrence network. Out of 1985 articles, finally, 55 met the inclusion criteria. Current periodontal and implant microsurgery trends consist of: periodontal therapy, dental implant microsurgery, soft tissue grafting and periodontal plastic surgery, bone augmentation, ridge preservation, and ortho-perio microsurgery. The bibliometric analysis revealed “guided tissue regeneration”, “periodontal regeneration” and “root coverage” being the most repeated keywords (landmark nodes). 132 authors within 29 clusters were identified, publishing within the frameworks of “periodontal and implant microsurgery”. Within its limitations, this systematic review provides an overview of the latest trends in periodontal and implant microsurgery when considering the use of an OM as the magnification tool. Also, it discusses the reported success and outcomes of the mentioned procedures.
{"title":"Microsurgery in periodontics and oral implantology: a systematic review of current clinical applications and outcomes","authors":"Hamoun Sabri, Sara Alhachache, Pramiti Saxena, Prerana Dubey, Paolo Nava, Syed Hanan Rufai, Farzin Sarkarat","doi":"10.1038/s41432-024-01024-4","DOIUrl":"10.1038/s41432-024-01024-4","url":null,"abstract":"The aim of this systematic review was to comprehensively explore the current trends and therapeutic approaches in which an operating microscope (OM) is used in periodontics and dental implant surgeries. A systematic search strategy was built to detect studies including various surgical techniques performed under an OM. PubMed, EMBASE, and SCOPUS databases were searched. No limitations in terms of time and language were applied. The data regarding the study design, type of procedure, treatment groups, and surgical outcomes were collected and analyzed descriptively. In addition, a bibliometric analysis was performed concerning the co-authorship and keyword co-occurrence network. Out of 1985 articles, finally, 55 met the inclusion criteria. Current periodontal and implant microsurgery trends consist of: periodontal therapy, dental implant microsurgery, soft tissue grafting and periodontal plastic surgery, bone augmentation, ridge preservation, and ortho-perio microsurgery. The bibliometric analysis revealed “guided tissue regeneration”, “periodontal regeneration” and “root coverage” being the most repeated keywords (landmark nodes). 132 authors within 29 clusters were identified, publishing within the frameworks of “periodontal and implant microsurgery”. Within its limitations, this systematic review provides an overview of the latest trends in periodontal and implant microsurgery when considering the use of an OM as the magnification tool. Also, it discusses the reported success and outcomes of the mentioned procedures.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"211-212"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310378","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 : 2024-06-12DOI: 10.1038/s41432-024-01026-2
Ana Luisa Amaral, Bashir Abdulgader Lwaleed, Jerry Elmer Bouquot, Sérgio Araújo Andrade
A comprehensive search was conducted on PubMed and Embase, adhering to the principles outlined in the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The search strategy was subsequently registered on PROSPERO. Articles were chosen based on an analysis of titles and abstracts, with no restrictions on publication date, language, or participant age. In vitro studies, animal studies, and literature reviews were excluded from consideration. Clinical trials in humans, case reports, or case series that reported the use of imiquimod for treating conditions in the oral or labial mucosa were included in this study. Results from duplicate articles were excluded from the analysis. Out of a total of 601 references initially identified, only 28 studies were included in the review. These studies were classified based on the use of imiquimod into three groups: potentially malignant disorders and oral cancer, lesions related to HPV, and autoimmune conditions. In all cases presented in the article, there is an occurrence of both local and systemic side effects. The study elucidated the off-label use of imiquimod in oral pathologies, whether potentially malignant, cancerous, autoimmune, or associated with HPV infection. However, it was observed that further research is warranted for the development of a specific formulation for the oral mucosa, ensuring the drug’s sustained presence at its active site of action without interference from saliva and minimizing potential side effects.
{"title":"How safe is off-label use of imiquimod in oral lesions?","authors":"Ana Luisa Amaral, Bashir Abdulgader Lwaleed, Jerry Elmer Bouquot, Sérgio Araújo Andrade","doi":"10.1038/s41432-024-01026-2","DOIUrl":"10.1038/s41432-024-01026-2","url":null,"abstract":"A comprehensive search was conducted on PubMed and Embase, adhering to the principles outlined in the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The search strategy was subsequently registered on PROSPERO. Articles were chosen based on an analysis of titles and abstracts, with no restrictions on publication date, language, or participant age. In vitro studies, animal studies, and literature reviews were excluded from consideration. Clinical trials in humans, case reports, or case series that reported the use of imiquimod for treating conditions in the oral or labial mucosa were included in this study. Results from duplicate articles were excluded from the analysis. Out of a total of 601 references initially identified, only 28 studies were included in the review. These studies were classified based on the use of imiquimod into three groups: potentially malignant disorders and oral cancer, lesions related to HPV, and autoimmune conditions. In all cases presented in the article, there is an occurrence of both local and systemic side effects. The study elucidated the off-label use of imiquimod in oral pathologies, whether potentially malignant, cancerous, autoimmune, or associated with HPV infection. However, it was observed that further research is warranted for the development of a specific formulation for the oral mucosa, ensuring the drug’s sustained presence at its active site of action without interference from saliva and minimizing potential side effects.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"176-177"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01026-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310377","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 : 2024-06-07DOI: 10.1038/s41432-024-01021-7
Sadie Karia, Lucy Tiplady
A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were searched. Journal articles published between January 2007 and January 2023 were identified. Studies that assessed malocclusion indices and oral function were included. Non-English articles and irrelevant studies were excluded. A total of 480 articles were identified. Following exclusion, 29 articles were included in the systematic review. Data was compiled using Microsoft Excel. Information from each article was extracted including study design, evaluation criteria of malocclusion and oral function, and findings. Studies were assessed using the STROBE GRADE approach. The results were compiled in a brief narrative review investigating the type and strength of the association between malocclusion and ingestion. Malocclusion was recorded using Index of Treatment Need, Dental Aesthetic Index, Goslon Yardstick Index, Index of Complexity Outcomes and Need, Peer Assessment Rating, Angle’s classification, Specific Severity Score, dental inter-arch relation and cephalometric analysis. Ingestion was measured by bite force, electromyography, mixing ability index, bolus granulometric analysis, video analysis of kinetic parameters during mastication, and subjective questionnaires. Of the 29 articles identified, 20 demonstrated a negative impact of malocclusion on oral ingestion, highlighting impaired masticatory efficiency, bite force and subjective difficulties. Eight studies found no significant association. One study, which used two questionnaires, found a significant relationship between eating and malocclusion using one questionnaire but not the other. Limitations in current research methodologies were identified, particularly the heterogeneity in assessment tools. The indicators used to assess ingestion and malocclusion are flawed, with questionable reliability. No study was able to identify which features or severity of malocclusion impact ingestion. The relationship between ingestion and malocclusion could not be quantified and the need for longitudinal and case report studies was deemed essential to establish causality. This review underscores the importance of considering how malocclusion impacts function in orthodontic treatment planning. Future research should focus on standardised assessment methods for measuring malocclusion and oral ingestion to establish the nature of the relationship between the two. This will ultimately guide orthodontic intervention aiming to enhance oral function.
{"title":"Bad bites bite back: a commentary on the impact of malocclusion on oral ingestion","authors":"Sadie Karia, Lucy Tiplady","doi":"10.1038/s41432-024-01021-7","DOIUrl":"10.1038/s41432-024-01021-7","url":null,"abstract":"A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were searched. Journal articles published between January 2007 and January 2023 were identified. Studies that assessed malocclusion indices and oral function were included. Non-English articles and irrelevant studies were excluded. A total of 480 articles were identified. Following exclusion, 29 articles were included in the systematic review. Data was compiled using Microsoft Excel. Information from each article was extracted including study design, evaluation criteria of malocclusion and oral function, and findings. Studies were assessed using the STROBE GRADE approach. The results were compiled in a brief narrative review investigating the type and strength of the association between malocclusion and ingestion. Malocclusion was recorded using Index of Treatment Need, Dental Aesthetic Index, Goslon Yardstick Index, Index of Complexity Outcomes and Need, Peer Assessment Rating, Angle’s classification, Specific Severity Score, dental inter-arch relation and cephalometric analysis. Ingestion was measured by bite force, electromyography, mixing ability index, bolus granulometric analysis, video analysis of kinetic parameters during mastication, and subjective questionnaires. Of the 29 articles identified, 20 demonstrated a negative impact of malocclusion on oral ingestion, highlighting impaired masticatory efficiency, bite force and subjective difficulties. Eight studies found no significant association. One study, which used two questionnaires, found a significant relationship between eating and malocclusion using one questionnaire but not the other. Limitations in current research methodologies were identified, particularly the heterogeneity in assessment tools. The indicators used to assess ingestion and malocclusion are flawed, with questionable reliability. No study was able to identify which features or severity of malocclusion impact ingestion. The relationship between ingestion and malocclusion could not be quantified and the need for longitudinal and case report studies was deemed essential to establish causality. This review underscores the importance of considering how malocclusion impacts function in orthodontic treatment planning. Future research should focus on standardised assessment methods for measuring malocclusion and oral ingestion to establish the nature of the relationship between the two. This will ultimately guide orthodontic intervention aiming to enhance oral function.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 2","pages":"108-109"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287935","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 : 2024-06-06DOI: 10.1038/s41432-024-01025-3
Samantha Watt
Interrupted time series analysis. An interrupted time series (ITS) analysis was conducted to determine if there was an association between the announcement and implementation of the soft drinks industry levy (SDIL) and rates of hospital admission for tooth extractions due to dental caries in children. Hospital Episode Statistics (HES) were used on hospital admissions for tooth extraction of one or more primary or permanent tooth due to a primary diagnosis of dental caries in children aged 0–18 years attending a National Health Service (NHS) hospital in England from January 2012 (pre-SDIL) to February 2020 (post-SDIL implementation). HES data were grouped and summarised by Index of Multiple Deprivation (IMD) and age group. There was an absolute reduction of 3.7% (95% CI 5.3% to 2.2%) per 100,000 population/month and a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0–18 years) compared if there had been no announcement of the SDIL (counterfactual scenario). Reductions were observed in children living in most areas regardless of the level of deprivation and most notably in the youngest children (<10 years). An ITS analysis of administrative data on hospital admissions found the announcement of the UK SDIL was associated with improvements (reduction) in the incidence of hospital admissions for tooth extractions due to dental caries. This study provides evidence of benefits of the UK SDIL to children’s oral health.
{"title":"What is the impact of the UK soft drinks industry levy on childhood tooth decay?","authors":"Samantha Watt","doi":"10.1038/s41432-024-01025-3","DOIUrl":"10.1038/s41432-024-01025-3","url":null,"abstract":"Interrupted time series analysis. An interrupted time series (ITS) analysis was conducted to determine if there was an association between the announcement and implementation of the soft drinks industry levy (SDIL) and rates of hospital admission for tooth extractions due to dental caries in children. Hospital Episode Statistics (HES) were used on hospital admissions for tooth extraction of one or more primary or permanent tooth due to a primary diagnosis of dental caries in children aged 0–18 years attending a National Health Service (NHS) hospital in England from January 2012 (pre-SDIL) to February 2020 (post-SDIL implementation). HES data were grouped and summarised by Index of Multiple Deprivation (IMD) and age group. There was an absolute reduction of 3.7% (95% CI 5.3% to 2.2%) per 100,000 population/month and a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0–18 years) compared if there had been no announcement of the SDIL (counterfactual scenario). Reductions were observed in children living in most areas regardless of the level of deprivation and most notably in the youngest children (<10 years). An ITS analysis of administrative data on hospital admissions found the announcement of the UK SDIL was associated with improvements (reduction) in the incidence of hospital admissions for tooth extractions due to dental caries. This study provides evidence of benefits of the UK SDIL to children’s oral health.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 2","pages":"91-92"},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283443","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}
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