Pub Date : 2025-04-10DOI: 10.1038/s41432-025-01135-6
Ravinder S. Saini, Syed Altafuddin Quadri, Masroor Ahmed Kanji, Rayan Ibrahim H Binduhayyim, Anna Avetisyan, Seyed Ali Mosaddad, Artak Heboyan
This study aimed to evaluate the influence of scanning speed and distance on the precision and quality of digital intraoral scans. The PICO strategy was employed to delineate the inclusion and exclusion criteria. The acquired records underwent filtration according to eligibility criteria, with essential information subsequently extracted. The meta-analysis, facilitated by Review Manager 5.4, utilized chi-square and the inconsistency index, along with forest plots. The standardized mean difference (SMD) was employed for the comparative analysis of study groups. Additionally, the study encompassed assessments of publication bias and the quality of included studies. The search was conducted using three Internet databases: PubMed, ScienceDirect, and the Cochrane Library. Among the evaluated scanners (Trios 3, Trios 4, iTero, Primescan, Medit i500), only TRIOS 3 exhibited a statistically significant sensitivity to scanning parameters (SMD = −4.03; 95% CI: −7.26 to −0.80; P = 0.01). Increased scanning distances and faster speeds markedly reduced its accuracy, likely due to its older optical technology lacking real-time error correction features present in newer models like TRIOS 4 and Primescan. No significant effects were observed for TRIOS 4, Primescan, or Medit i500 (P > 0.05), suggesting their advanced hardware/software mitigates parameter variability. Clinicians using TRIOS 3 should prioritize shorter scanning distances (5–10 mm) and slower speeds to optimize accuracy, as its performance is highly dependent on operator-controlled parameters. In contrast, newer scanners (e.g., TRIOS 4, Primescan) demonstrate greater resilience to distance/speed variations, enabling flexible clinical workflows. These findings underscore the importance of device-specific protocols to enhance digital impression reliability in restorative and prosthetic dentistry.
{"title":"Analyzing the influence of scanning speeds and distances on digital intraoral scans: a systematic review and meta-analysis","authors":"Ravinder S. Saini, Syed Altafuddin Quadri, Masroor Ahmed Kanji, Rayan Ibrahim H Binduhayyim, Anna Avetisyan, Seyed Ali Mosaddad, Artak Heboyan","doi":"10.1038/s41432-025-01135-6","DOIUrl":"10.1038/s41432-025-01135-6","url":null,"abstract":"This study aimed to evaluate the influence of scanning speed and distance on the precision and quality of digital intraoral scans. The PICO strategy was employed to delineate the inclusion and exclusion criteria. The acquired records underwent filtration according to eligibility criteria, with essential information subsequently extracted. The meta-analysis, facilitated by Review Manager 5.4, utilized chi-square and the inconsistency index, along with forest plots. The standardized mean difference (SMD) was employed for the comparative analysis of study groups. Additionally, the study encompassed assessments of publication bias and the quality of included studies. The search was conducted using three Internet databases: PubMed, ScienceDirect, and the Cochrane Library. Among the evaluated scanners (Trios 3, Trios 4, iTero, Primescan, Medit i500), only TRIOS 3 exhibited a statistically significant sensitivity to scanning parameters (SMD = −4.03; 95% CI: −7.26 to −0.80; P = 0.01). Increased scanning distances and faster speeds markedly reduced its accuracy, likely due to its older optical technology lacking real-time error correction features present in newer models like TRIOS 4 and Primescan. No significant effects were observed for TRIOS 4, Primescan, or Medit i500 (P > 0.05), suggesting their advanced hardware/software mitigates parameter variability. Clinicians using TRIOS 3 should prioritize shorter scanning distances (5–10 mm) and slower speeds to optimize accuracy, as its performance is highly dependent on operator-controlled parameters. In contrast, newer scanners (e.g., TRIOS 4, Primescan) demonstrate greater resilience to distance/speed variations, enabling flexible clinical workflows. These findings underscore the importance of device-specific protocols to enhance digital impression reliability in restorative and prosthetic dentistry.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"148-148"},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980817","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 : 2025-03-21DOI: 10.1038/s41432-025-01134-7
Soundar Ida Mahizha, Joseph Annrose, Jeyebalaji Mano Christaine Angelo, Israel Domilin Shyni, G. valanthan veda Giri
To thoroughly review Deep Convolutional Neural Networks for detecting interproximal caries with bitewing radiographs. Data was collected from studies that utilized Deep Convolutional Neural Networks (DCNN) focused on the analysis of bitewing radiographs taken with intraoral X-ray units. A comprehensive literature search was conducted across various scholarly databases including Google Scholar, MDPI, PubMed, ResearchGate, ScienceDirect, and IEEE Xplore, encompassing 2014 to 2024. The risk of bias assessment utilized the current version of the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). After reviewing 291 articles, 10 studies met the criteria and were analyzed. All 10 studies used bitewing radiographs, focusing on deep learning tasks such as segmentation, classification, and detection. The sample sizes varied widely from 112 to 3,989 participants. Convolutional neural networks (CNNs) were the most commonly used model. According to the QUADAS-2 assessment, only 40% of the studies included in this review were found to have a low risk of bias in the reference standard domain. A Deep Convolutional Neural Networks based caries detection system helps in the early identification of caries by analyzing bitewing radiographs and reduces diagnostic errors. By identifying early-stage lesions, patients can undergo minimally invasive treatments instead of more complex procedures, thereby improving patient outcomes in dental care. This systematic review provides an overview of various studies that utilize deep learning models to identify interproximal caries lesions in bitewing radiographs. It highlights the efficacy of YOLOv8 in detecting interproximal caries from bitewing radiographs compared to other Deep CNN models.
{"title":"Deep convolutional neural networks for early detection of interproximal caries using bitewing radiographs: A systematic review","authors":"Soundar Ida Mahizha, Joseph Annrose, Jeyebalaji Mano Christaine Angelo, Israel Domilin Shyni, G. valanthan veda Giri","doi":"10.1038/s41432-025-01134-7","DOIUrl":"10.1038/s41432-025-01134-7","url":null,"abstract":"To thoroughly review Deep Convolutional Neural Networks for detecting interproximal caries with bitewing radiographs. Data was collected from studies that utilized Deep Convolutional Neural Networks (DCNN) focused on the analysis of bitewing radiographs taken with intraoral X-ray units. A comprehensive literature search was conducted across various scholarly databases including Google Scholar, MDPI, PubMed, ResearchGate, ScienceDirect, and IEEE Xplore, encompassing 2014 to 2024. The risk of bias assessment utilized the current version of the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). After reviewing 291 articles, 10 studies met the criteria and were analyzed. All 10 studies used bitewing radiographs, focusing on deep learning tasks such as segmentation, classification, and detection. The sample sizes varied widely from 112 to 3,989 participants. Convolutional neural networks (CNNs) were the most commonly used model. According to the QUADAS-2 assessment, only 40% of the studies included in this review were found to have a low risk of bias in the reference standard domain. A Deep Convolutional Neural Networks based caries detection system helps in the early identification of caries by analyzing bitewing radiographs and reduces diagnostic errors. By identifying early-stage lesions, patients can undergo minimally invasive treatments instead of more complex procedures, thereby improving patient outcomes in dental care. This systematic review provides an overview of various studies that utilize deep learning models to identify interproximal caries lesions in bitewing radiographs. It highlights the efficacy of YOLOv8 in detecting interproximal caries from bitewing radiographs compared to other Deep CNN models.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"117-117"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669583","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 : 2025-03-13DOI: 10.1038/s41432-025-01128-5
Meenakshi Lall
Tavares B S, Bendo C B, Fernandes I B, Coelho V S, Ramos-Jorge M L, Ramos-Jorge J Dental caries in anterior teeth of babies can predict the occurrence of severe dental caries in posterior teeth: a 3-year cohort study. Eur Arch Paediatr Dent 2024; https://doi.org/10.1007/s40368-024-00968-6 . A three-year study of 1–2 years old toddlers to check if the dental caries of primary anterior teeth is a precursor to them developing severe caries on their primary molars. A cohort of 99 children, between the ages of 1–2 years old, reviewed for dental caries. This study looked at the toddlers at the baseline and then reviewed them after three years. Primary independent variable in this study was carious anterior tooth. Consideration given to independent variables like economic status, primary carers’ education, oral hygiene (including nighttime routine), history of tooth ache, and sucrose intake. Differences between the presence and absence of severe dental caries in posterior teeth according to independent variables were evaluated using the chi-square test. Unadjusted and adjusted relative risks for the association between independent variables and the incidence of severe caries in posterior teeth were estimated using Poisson regression models with robust variance. There is threefold increased risk of developing severe dental caries in posterior teeth for the children who had caries in anterior teeth at the baseline (RR 3.33; 95% CI 2.06–5.37). This high-risk group belonged to low-income families (RR 2.75; 95% CI 1.40–5.39), who did not perform nighttime oral hygiene (RR 1.76; 95% CI 1.10–2.80), and had a higher frequency of sucrose intake (RR 4.07; 95% CI 2.03–8.19), at the baseline and at follow-up. The presence of dental caries in the primary anterior teeth of 1 to 2-year-old toddlers can have a higher incidence of severe caries in posterior teeth. Other factors e.g. low economic status, absence of nighttime oral hygiene, high sucrose intake both at baseline and follow-up were considerable risk factors for the presence of severe dental caries in the primary posterior teeth.
Tavares B S, Bendo C B, Fernandes I B, Coelho V S, Ramos-Jorge M L， Ramos-Jorge J：一项3年队列研究：婴儿前牙龋齿可以预测后牙严重龋齿的发生。欧洲儿科儿科门诊2024；https://doi.org/10.1007/s40368-024-00968-6 .目的：对1-2岁的幼儿进行为期三年的研究，以检查他们乳牙前牙的龋齿是否是他们乳牙发生严重龋齿的前兆。方法：对99名年龄在1-2岁之间的儿童进行龋齿检查。这项研究在基线时观察幼儿，然后在三年后对他们进行评估。本研究的主要自变量是前牙龋齿。考虑到独立变量，如经济状况、主要照顾者的教育程度、口腔卫生（包括夜间常规）、牙痛史和蔗糖摄入量。采用卡方检验评价后牙有无严重龋病的自变量差异。使用具有稳健方差的泊松回归模型估计独立变量与后牙严重龋齿发生率之间关联的未调整和调整的相对风险。结果：基线前牙有龋的儿童后牙发生严重龋病的风险增加3倍(RR 3.33；95% ci 2.06-5.37)。该高危人群属于低收入家庭(RR 2.75；95% CI 1.40-5.39)，未进行夜间口腔卫生的患者(RR 1.76；95% CI 1.10-2.80)，并且摄入蔗糖的频率更高(RR 4.07；95% CI 2.03-8.19)，基线和随访时。结论：1 ~ 2岁幼儿前乳牙出现龋齿，后乳牙出现严重龋齿的发生率较高。其他因素，如经济状况不佳、夜间缺乏口腔卫生、基线和随访时高蔗糖摄入量是导致后牙发生严重龋齿的重要危险因素。
{"title":"Can caries in anterior teeth of toddlers predict severe caries in posterior teeth?","authors":"Meenakshi Lall","doi":"10.1038/s41432-025-01128-5","DOIUrl":"10.1038/s41432-025-01128-5","url":null,"abstract":"Tavares B S, Bendo C B, Fernandes I B, Coelho V S, Ramos-Jorge M L, Ramos-Jorge J Dental caries in anterior teeth of babies can predict the occurrence of severe dental caries in posterior teeth: a 3-year cohort study. Eur Arch Paediatr Dent 2024; https://doi.org/10.1007/s40368-024-00968-6 . A three-year study of 1–2 years old toddlers to check if the dental caries of primary anterior teeth is a precursor to them developing severe caries on their primary molars. A cohort of 99 children, between the ages of 1–2 years old, reviewed for dental caries. This study looked at the toddlers at the baseline and then reviewed them after three years. Primary independent variable in this study was carious anterior tooth. Consideration given to independent variables like economic status, primary carers’ education, oral hygiene (including nighttime routine), history of tooth ache, and sucrose intake. Differences between the presence and absence of severe dental caries in posterior teeth according to independent variables were evaluated using the chi-square test. Unadjusted and adjusted relative risks for the association between independent variables and the incidence of severe caries in posterior teeth were estimated using Poisson regression models with robust variance. There is threefold increased risk of developing severe dental caries in posterior teeth for the children who had caries in anterior teeth at the baseline (RR 3.33; 95% CI 2.06–5.37). This high-risk group belonged to low-income families (RR 2.75; 95% CI 1.40–5.39), who did not perform nighttime oral hygiene (RR 1.76; 95% CI 1.10–2.80), and had a higher frequency of sucrose intake (RR 4.07; 95% CI 2.03–8.19), at the baseline and at follow-up. The presence of dental caries in the primary anterior teeth of 1 to 2-year-old toddlers can have a higher incidence of severe caries in posterior teeth. Other factors e.g. low economic status, absence of nighttime oral hygiene, high sucrose intake both at baseline and follow-up were considerable risk factors for the presence of severe dental caries in the primary posterior teeth.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"40-41"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624014","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 : 2025-03-13DOI: 10.1038/s41432-025-01132-9
Carolina Rodríguez-Medina, Sandra Amaya Sánchez, Adolfo Contreras, Javier Enrique Botero
Periodontitis and various noncommunicable diseases (NCDs) have been proposed to have a bidirectional relationship. The purpose of this umbrella review is (1) to synthesize the evidence and (2) to grade the strength and certainty of the scientific evidence regarding the bidirectional association between periodontitis and NCDs. Electronic databases were systematically searched from January 2021 and July 2024; MEDLINE (via PubMed), Embase and SciELO. Potential epidemiologic systematic reviews with meta-analysis that studied the bidirectional association between periodontitis and NCDs were identified by two independent reviewers and filtered by title and abstract according to the selection criteria. The strength and the quality and certainty of the evidence was assessed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guide. 561,554 potential results were identified. After removing duplicates and excluding records deemed ineligible by automated filters, 450 results were screened by title and abstract. This process led to 41 records being appraised in full-text. Of these, 17 were further excluded leaving a total of 24 systematic reviews that met the inclusion criteria. 24 systematic reviews with a total of 32 NCDs were appraised and consolidated. Risk of bias assessment indicated that 21 systematic reviews (87.5%) demonstrated low bias (high quality), 2 had medium bias, and 1 exhibited high bias (low quality). Key issues identified included the formulation of explicit research questions, critical appraisal, data extraction, and publication bias. The association between periodontitis and NCDs was strong in 1 systematic review, moderate in 8, weak in 10 and absent in 7 systematic reviews. The strength of the association between NCDs and periodontitis was moderate in 6 systematic reviews and weak in 3 systematic reviews. The size of the reported effect (odds ratio/risk ratio/hazard ratio) was broader with increasing strength. Although data supports the association between periodontitis and some NCDs, and to a lesser extent between some NCDs and periodontitis, the certainty of the evidence was classified as low to very low. There is some data that, with varying degrees of association and low to very low certainty, provide evidence that periodontitis may be a potential risk factor for some NCDs and vice versa.
{"title":"Grading the strength and certainty of the scientific evidence of the bidirectional association between periodontitis and noncommunicable diseases: an umbrella review","authors":"Carolina Rodríguez-Medina, Sandra Amaya Sánchez, Adolfo Contreras, Javier Enrique Botero","doi":"10.1038/s41432-025-01132-9","DOIUrl":"10.1038/s41432-025-01132-9","url":null,"abstract":"Periodontitis and various noncommunicable diseases (NCDs) have been proposed to have a bidirectional relationship. The purpose of this umbrella review is (1) to synthesize the evidence and (2) to grade the strength and certainty of the scientific evidence regarding the bidirectional association between periodontitis and NCDs. Electronic databases were systematically searched from January 2021 and July 2024; MEDLINE (via PubMed), Embase and SciELO. Potential epidemiologic systematic reviews with meta-analysis that studied the bidirectional association between periodontitis and NCDs were identified by two independent reviewers and filtered by title and abstract according to the selection criteria. The strength and the quality and certainty of the evidence was assessed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guide. 561,554 potential results were identified. After removing duplicates and excluding records deemed ineligible by automated filters, 450 results were screened by title and abstract. This process led to 41 records being appraised in full-text. Of these, 17 were further excluded leaving a total of 24 systematic reviews that met the inclusion criteria. 24 systematic reviews with a total of 32 NCDs were appraised and consolidated. Risk of bias assessment indicated that 21 systematic reviews (87.5%) demonstrated low bias (high quality), 2 had medium bias, and 1 exhibited high bias (low quality). Key issues identified included the formulation of explicit research questions, critical appraisal, data extraction, and publication bias. The association between periodontitis and NCDs was strong in 1 systematic review, moderate in 8, weak in 10 and absent in 7 systematic reviews. The strength of the association between NCDs and periodontitis was moderate in 6 systematic reviews and weak in 3 systematic reviews. The size of the reported effect (odds ratio/risk ratio/hazard ratio) was broader with increasing strength. Although data supports the association between periodontitis and some NCDs, and to a lesser extent between some NCDs and periodontitis, the certainty of the evidence was classified as low to very low. There is some data that, with varying degrees of association and low to very low certainty, provide evidence that periodontitis may be a potential risk factor for some NCDs and vice versa.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"147-147"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01132-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623508","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 : 2025-03-13DOI: 10.1038/s41432-024-01078-4
Razieh Jabbarian, Mehdi Ranjbaran, Aida Mokhlesi, Samin Hosseini
Early childhood dental caries (ECC) is a prevalent dental condition affecting infants and young children, characterized by one or more carious lesions in primary teeth. ECC risk factors include malnutrition, genetic predisposition, specific dietary habits, lack of fluoride, and prolonged bottle feeding. A comprehensive prevalence estimate is crucial for understanding the extent of dental caries in the population. So, this study aimed to determine the prevalence of ECC and its associated risk factors in Iranian children. A comprehensive literature search was conducted in Scopus, Web of Science, PubMed, Google Scholar, ACECR Scientific Information Database ( www.ACECRScientific Information Database.ir ), and Magiran research databases. Eligible English and Persian studies published between 2006 and 2024 were reviewed and analyzed. The studies on ECC prevalence were identified and included in the meta-analysis. Random effect models were utilized to calculate the pooled prevalence, and meta-regression and sensitivity analyses were conducted to assess sources of heterogeneity in the systematic review of risk factors. The meta-analysis encompassed thirty eligible studies, providing the prevalence of ECC in Iran, with an estimated prevalence of 61.7%. Meta-regression analysis indicated a non-statistically significant increase in ECC prevalence with age and a substantial slight decrease over time. Additionally, 68 Studies evaluated categories such as age, gender, sociodemographic factors, microbial flora, oral hygiene, breast/bottle feeding, and dietary. Significant ECC-related factors identified included parents’ education and occupation, breastfeeding, and oral hygiene. The overall prevalence of ECC in Iran was estimated at 61.7%, with notable heterogeneity. Most of the studies extensively evaluated sociodemographic factors as risk factors.
目的：儿童早期龋齿（ECC）是一种影响婴幼儿的常见牙齿疾病，其特征是一种或多种乳牙龋齿病变。ECC的危险因素包括营养不良、遗传易感性、特定的饮食习惯、缺乏氟化物和长时间的奶瓶喂养。全面的患病率估计对于了解人群中龋齿的程度至关重要。因此，本研究旨在确定ECC在伊朗儿童中的患病率及其相关危险因素。方法：在Scopus、Web of Science、PubMed、谷歌Scholar、ACECR科学信息数据库（www.ACECRScientific Information Database）中进行综合文献检索。ir)和Magiran研究数据库。对2006年至2024年间发表的符合条件的英语和波斯语研究进行了回顾和分析。对ECC患病率的研究进行鉴定并纳入meta分析。采用随机效应模型计算合并患病率，并进行meta回归和敏感性分析，以评估风险因素系统评价中的异质性来源。结果：荟萃分析包括30项符合条件的研究，提供了ECC在伊朗的患病率，估计患病率为61.7%。meta回归分析显示，随着年龄的增长，ECC患病率呈非统计学意义上的显著增加，随着时间的推移，患病率略有下降。此外，68项研究评估了年龄、性别、社会人口因素、微生物菌群、口腔卫生、母乳/奶瓶喂养和饮食等类别。发现的与大肠杆菌相关的重要因素包括父母的教育和职业、母乳喂养和口腔卫生。结论：ECC在伊朗的总体患病率估计为61.7%，具有显著的异质性。大多数研究广泛地评估了社会人口因素作为危险因素。
{"title":"Iranian early childhood dental caries: a comprehensive systematic review and meta-analysis of prevalence and associated risk factors","authors":"Razieh Jabbarian, Mehdi Ranjbaran, Aida Mokhlesi, Samin Hosseini","doi":"10.1038/s41432-024-01078-4","DOIUrl":"10.1038/s41432-024-01078-4","url":null,"abstract":"Early childhood dental caries (ECC) is a prevalent dental condition affecting infants and young children, characterized by one or more carious lesions in primary teeth. ECC risk factors include malnutrition, genetic predisposition, specific dietary habits, lack of fluoride, and prolonged bottle feeding. A comprehensive prevalence estimate is crucial for understanding the extent of dental caries in the population. So, this study aimed to determine the prevalence of ECC and its associated risk factors in Iranian children. A comprehensive literature search was conducted in Scopus, Web of Science, PubMed, Google Scholar, ACECR Scientific Information Database ( www.ACECRScientific Information Database.ir ), and Magiran research databases. Eligible English and Persian studies published between 2006 and 2024 were reviewed and analyzed. The studies on ECC prevalence were identified and included in the meta-analysis. Random effect models were utilized to calculate the pooled prevalence, and meta-regression and sensitivity analyses were conducted to assess sources of heterogeneity in the systematic review of risk factors. The meta-analysis encompassed thirty eligible studies, providing the prevalence of ECC in Iran, with an estimated prevalence of 61.7%. Meta-regression analysis indicated a non-statistically significant increase in ECC prevalence with age and a substantial slight decrease over time. Additionally, 68 Studies evaluated categories such as age, gender, sociodemographic factors, microbial flora, oral hygiene, breast/bottle feeding, and dietary. Significant ECC-related factors identified included parents’ education and occupation, breastfeeding, and oral hygiene. The overall prevalence of ECC in Iran was estimated at 61.7%, with notable heterogeneity. Most of the studies extensively evaluated sociodemographic factors as risk factors.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"66-66"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623588","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}
Osteopontin (OPN) is linked to cancer progression, metastasis, and treatment resistance in head and neck cancer (HNC). This meta-analysis evaluated OPN as a prognostic biomarker in HNC. A comprehensive search was conducted for studies published up to December 2023, including English papers on HNC analyzing OPN expression. Data extraction, quality assessment, and quantitative analysis were performed using fixed and random effect models with 95% CI. Heterogeneity and publication bias were assessed with I2 and Egger’s regression test. Fifty-one studies were included. OPN expression was significantly elevated in tissue and plasma in HNC compared to control (SMD 0.98; 95% CI 0.47–1.49; I2 = 13%; p < 0.00). High plasma OPN predicted poor survival (HR: 2.00; I2 = 64%; P = 0.03), as did high tissue OPN (hazard ratio: 2.71, 95% confidence interval = 1.51–4.87; I2 = 49.4%, p > 0.05). Elevated plasma OPN correlated with smoking, poorly differentiated neoplasms, larger tumors, advanced stage, and lymph node metastasis. Positive tissue OPN was associated with nodal involvement, advanced stage, male gender, and smoking. OPN is a robust prognostic biomarker in HNC, indicating tumor aggressiveness and poor prognostic outcomes. Standardized measurement protocols and further validation in prospective studies are necessary.
背景：骨桥蛋白（OPN）与头颈癌（HNC）的癌症进展、转移和治疗耐药有关。本荟萃分析评估了OPN作为HNC预后生物标志物的作用。方法：全面检索截至2023年12月发表的论文，包括HNC分析OPN表达的英文论文。采用95% CI的固定效应和随机效应模型进行数据提取、质量评估和定量分析。采用I2和Egger回归检验评估异质性和发表偏倚。结果：纳入51项研究。与对照组相比，HNC患者组织和血浆中OPN表达显著升高(SMD 0.98；95% ci 0.47-1.49；i2 = 13%；p 0.05)。血浆OPN升高与吸烟、低分化肿瘤、较大肿瘤、晚期和淋巴结转移相关。组织OPN阳性与淋巴结受累、晚期、男性和吸烟有关。结论：OPN是HNC中一种强有力的预后生物标志物，表明肿瘤侵袭性和不良预后。标准化的测量方案和进一步的前瞻性研究验证是必要的。
{"title":"Osteopontin as a prognostic biomarker in head and neck cancer– a systematic review and meta-analysis","authors":"Nadisha Piyarathne, Kalani Hettiarachchi, Monal Yuwanati, Gowri Sivaramakrishnan, Anand Ramanathan, Ruwan Jayasinghe, Sanaa Chala, Akhilanand Chaurasia","doi":"10.1038/s41432-025-01133-8","DOIUrl":"10.1038/s41432-025-01133-8","url":null,"abstract":"Osteopontin (OPN) is linked to cancer progression, metastasis, and treatment resistance in head and neck cancer (HNC). This meta-analysis evaluated OPN as a prognostic biomarker in HNC. A comprehensive search was conducted for studies published up to December 2023, including English papers on HNC analyzing OPN expression. Data extraction, quality assessment, and quantitative analysis were performed using fixed and random effect models with 95% CI. Heterogeneity and publication bias were assessed with I2 and Egger’s regression test. Fifty-one studies were included. OPN expression was significantly elevated in tissue and plasma in HNC compared to control (SMD 0.98; 95% CI 0.47–1.49; I2 = 13%; p < 0.00). High plasma OPN predicted poor survival (HR: 2.00; I2 = 64%; P = 0.03), as did high tissue OPN (hazard ratio: 2.71, 95% confidence interval = 1.51–4.87; I2 = 49.4%, p > 0.05). Elevated plasma OPN correlated with smoking, poorly differentiated neoplasms, larger tumors, advanced stage, and lymph node metastasis. Positive tissue OPN was associated with nodal involvement, advanced stage, male gender, and smoking. OPN is a robust prognostic biomarker in HNC, indicating tumor aggressiveness and poor prognostic outcomes. Standardized measurement protocols and further validation in prospective studies are necessary.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"146-147"},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614100","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 : 2025-03-11DOI: 10.1038/s41432-025-01126-7
Madeline Archer
Fehrenbach J, de Soares J L S, do Nascimento Foly J C S, Miotti L L, Münchow E A Mechanical performance of endocrown restorations in anterior teeth: A systematic review and network meta-analysis. Dent Mater 2025; https://doi.org/10.1016/j.dental.2024.10.012 . A systematic review and network meta-analysis (NMA) of anterior endocrown mechanical performance compared to conventional crowns on endodontically treated teeth (ETT). An online search of major databases was conducted and relevant studies were selected. Data was extracted and meta-analyses performed comparing mechanical outcomes of anterior endocrowns to other crown systems. Endocrowns on the anterior dentition can be considered if mechanical fracture is a concern, however more research needs to be done before definitive case selection. Two independent reviewers searched six electronic databases (PubMed, Scopus, Web of Science, Embase, SciELO and LILACS) using compounded terms like ETT and anterior and endocrown along with their variates. Manual searches were also done from the reference list of chosen studies. Following the search titles were put through Rayyan, an AI-powered systematic reviewer to remove duplicates. The reviewers then screened 25 random titles and abstracts independently and repeated this with a third reviewer. Inclusion criteria were studies examining anterior ETT and endocrown compared with a different restoration. Exclusion criteria were non-experimental studies, theses, languages other than English Spanish or Portuguese and studies not evaluating mechanical performance. From this 24 studies were read in full and 11 were selected for the review. Bias risk assessment was done by two reviewers using the RoBDEMAT tool for in vitro studies and ROBFEAD tool for Finite Element Analysis (FEA) studies. The studies are scored as low, med, or high risk according to each tool’s domains. Two reviewers extracted the data onto Microsoft Excel including authors name and year of publication, tooth type, endocrown depth, distance between the CEJ and finishing line,surface treatment, luting agent, thermocycling method, etc. Data synthesis and analysis was performed by MetaInsight V4 4.0.0 and two independent NMA’s were made. The first NMA used load-to-fracture data and a mean difference outcome while the second used irreparable fracture data and a risk ratio outcome. Both used a 95% credible interval(Crl). Comparisons were evaluated using Surface Under the Cumulative ranking Curve (SUCRA), where a value closer to 100% indicates greater resistance to fracture. Eight studies used in vitro experiments, most of them investigating load-to-fracture and failure mode of fractured restorations and one study the pull-out bond strength. The remaining three studies used FEA models and examined von mises criterion by quantifying a material’s fracture under stress. The first NMA considered load-to-fracture data and examined five studies. The probabilistic analysis showed teeth restored with a Glass Fi
Fehrenbach, de Soares, J L S, do Nascimento Foly, J C S, Miotti, L L, m nchow E, A .前牙内冠修复体力学性能的系统评价和网络meta分析。Dent Mater 2025；https://doi.org/10.1016/j.dental.2024.10.012 .目的和方法：系统回顾和网络荟萃分析（NMA）对根管治疗牙齿（ETT）前牙冠与传统牙冠力学性能的比较。在线检索各大数据库，选取相关研究。提取数据并进行荟萃分析，比较前牙髓与其他牙冠系统的力学结果。如果担心机械骨折，可以考虑在前牙列上使用牙髓冠，但是在确定病例选择之前需要做更多的研究。数据来源：两名独立审稿人检索了六个电子数据库（PubMed, Scopus, Web of Science, Embase， SciELO和LILACS），使用ETT和anterior and endocrown等复合术语及其变量。还从所选研究的参考列表中进行了人工搜索。搜索后的标题将通过人工智能系统审稿人Rayyan来删除重复内容。然后，审稿人独立筛选了25个随机标题和摘要，并与第三位审稿人重复了这一过程。研究选择：纳入标准是检查前路ETT和内冠与不同修复体的比较。排除标准是非实验研究、论文、英语、西班牙语或葡萄牙语以外的语言以及不评估机械性能的研究。从这24项研究中，有11项被选为综述。偏倚风险评估由两位评论者使用体外研究的RoBDEMAT工具和有限元分析（FEA）研究的ROBFEAD工具完成。根据每个工具的领域，这些研究被分为低风险、中等风险或高风险。数据提取与综合：两位审稿人将数据提取到Microsoft Excel中，包括作者姓名、发表年份、牙型、内冠深度、CEJ与终点线的距离、表面处理、luting剂、热循环方法等。采用MetaInsight V4 4.0.0软件对数据进行综合分析，并进行两次独立的NMA。第一个NMA使用载荷-骨折数据和平均差异结果，而第二个NMA使用不可修复骨折数据和风险比结果。两者均使用95%可信区间（Crl）。使用累积等级曲线下的表面（SUCRA）进行比较，其中接近100%的值表示更强的抗破裂能力。结果：8项研究采用了体外实验，其中大部分研究的是断裂修复体的载荷-断裂和破坏模式，1项研究的是拔出键合强度。其余三项研究使用了有限元模型，并通过量化材料在应力下的断裂来检验冯米塞斯准则。第一个NMA考虑了载荷-断裂数据，并检查了五项研究。概率分析显示，玻璃纤维桩(GFP) +复合冠修复牙体的修复效果最佳（SUCRA = 95.23%），其载荷-断裂值（MD 165.0, 95% CRL 28.3, 301.0）高于复合内冠组（MD 78.1, 95% CRL 6.21, 150.0）。排名最低的是GFP +陶瓷冠组，中间有陶瓷内冠和不带桩的陶瓷冠。第二个NMA分析了来自五项研究的不可修复骨折数据。复合内冠组发生灾难性骨折的风险较GFP瓷冠组低（RR = 0.413, 95% Crl = 0.152, 0.859） （RR = 1.36, 95% Crl = 1.09, 1.80）。概率分析显示，复合牙冠发生不可修复性骨折的风险最低（SUCRA = 96.84%），其次为无核陶瓷牙冠组、陶瓷牙冠组和GFP牙冠组。结论：在实验室和模型试验中，牙髓修复体在机械负荷下的表现与其他修复体相似，因此牙髓修复体可能是治疗前牙的可行选择。GRADE评分低，因为偏倚风险高。
{"title":"What about anterior endocrowns?","authors":"Madeline Archer","doi":"10.1038/s41432-025-01126-7","DOIUrl":"10.1038/s41432-025-01126-7","url":null,"abstract":"Fehrenbach J, de Soares J L S, do Nascimento Foly J C S, Miotti L L, Münchow E A Mechanical performance of endocrown restorations in anterior teeth: A systematic review and network meta-analysis. Dent Mater 2025; https://doi.org/10.1016/j.dental.2024.10.012 . A systematic review and network meta-analysis (NMA) of anterior endocrown mechanical performance compared to conventional crowns on endodontically treated teeth (ETT). An online search of major databases was conducted and relevant studies were selected. Data was extracted and meta-analyses performed comparing mechanical outcomes of anterior endocrowns to other crown systems. Endocrowns on the anterior dentition can be considered if mechanical fracture is a concern, however more research needs to be done before definitive case selection. Two independent reviewers searched six electronic databases (PubMed, Scopus, Web of Science, Embase, SciELO and LILACS) using compounded terms like ETT and anterior and endocrown along with their variates. Manual searches were also done from the reference list of chosen studies. Following the search titles were put through Rayyan, an AI-powered systematic reviewer to remove duplicates. The reviewers then screened 25 random titles and abstracts independently and repeated this with a third reviewer. Inclusion criteria were studies examining anterior ETT and endocrown compared with a different restoration. Exclusion criteria were non-experimental studies, theses, languages other than English Spanish or Portuguese and studies not evaluating mechanical performance. From this 24 studies were read in full and 11 were selected for the review. Bias risk assessment was done by two reviewers using the RoBDEMAT tool for in vitro studies and ROBFEAD tool for Finite Element Analysis (FEA) studies. The studies are scored as low, med, or high risk according to each tool’s domains. Two reviewers extracted the data onto Microsoft Excel including authors name and year of publication, tooth type, endocrown depth, distance between the CEJ and finishing line,surface treatment, luting agent, thermocycling method, etc. Data synthesis and analysis was performed by MetaInsight V4 4.0.0 and two independent NMA’s were made. The first NMA used load-to-fracture data and a mean difference outcome while the second used irreparable fracture data and a risk ratio outcome. Both used a 95% credible interval(Crl). Comparisons were evaluated using Surface Under the Cumulative ranking Curve (SUCRA), where a value closer to 100% indicates greater resistance to fracture. Eight studies used in vitro experiments, most of them investigating load-to-fracture and failure mode of fractured restorations and one study the pull-out bond strength. The remaining three studies used FEA models and examined von mises criterion by quantifying a material’s fracture under stress. The first NMA considered load-to-fracture data and examined five studies. The probabilistic analysis showed teeth restored with a Glass Fi","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"10-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603095","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 : 2025-03-06DOI: 10.1038/s41432-025-01120-z
Manas Dave, Rajpal Tattar
Sukumar S, Rahmanyar Z, El Jurf H Q et al. Mapping the oral resistome: a systematic review. J Med Microbiol 2024; https://doi.org/10.1099/jmm.0.001866 . This systematic review, without meta-analysis, aimed to map the oral resistome by analysing clinical studies that detected bacterial antimicrobial resistance genes (ARGs) in the oral cavity using molecular techniques. The researchers used Medline, Embase, Web of Science, CINAHL and Scopus databases from January 2015 to August 2023. This systematic review included cross-sectional or longitudinal clinical studies that detected ARGs using molecular techniques; specifically polymerase chain reaction (PCR) or next-generation sequencing (NGS) metagenomics for samples from the oral cavity (saliva, gingival biofilm, pulp, or oral mucosa). Studies were excluded if they were in vitro or animal studies, literature reviews and not focused on ARG detection. Five reviewers independently screened titles and abstracts based on inclusion criteria. Full-text reports were then independently assessed for eligibility by three reviewers. Extracted data encompassed publication details, sample size, country, molecular methods used, number of ARGs detected, participants’ health status, antibiotic exposure, and sample location within the oral cavity. Out of 580 initially identified studies, 15 met the inclusion criteria. These studies, published between 2015 and 2023 from 12 different countries, employed either PCR (n = 10) or NGS metagenomics (n = 5) to detect ARGs from a pool of 1486 participants (1 study did not report on the number of participants). PCR-based studies identified an average of 7 ARGs (range 1–20), while NGS studies identified an average of 34 ARGs (range 7–70). In total, 159 unique ARGs conferring resistance to 22 antibiotic classes were identified across six regions of the oral cavity. The supragingival biofilm and saliva exhibited the highest richness of ARGs, defined by the number of unique ARGs detected. Genes conferring resistance to 19 antibiotic classes were present in the supragingival biofilm. Notably, 49 ARGs, including tetracycline and macrolide resistance genes, were found across all sampled locations, indicating a widespread distribution within the oral cavity. Thirteen studies reported on bacterial species associated with ARGs. NGS studies identified a mean of 65 ARG-carrying bacterial species, compared to a mean of 4 species in PCR studies. Specifically, 25 ARG-carrying species were identified in PCR studies, while NGS studies identified 177 species. Four studies reported ARGs associated with streptococcal species implicated in distant-site infections such as infective endocarditis. ESKAPE pathogens (group of highly virulent multidrug-resistant bacteria) were detected with ARGs in various oral sites using both PCR and NGS methods. Comparisons between healthy and diseased states revealed that a healthy oral microbiome harbours a more diverse resistome at the antibiotic class level. Th
Sukumar S, Rahmanyar Z， El Jurf H Q等。绘制口腔抵抗组：系统回顾。中华微生物学杂志2024；https://doi.org/10.1099/jmm.0.001866 .设计：本系统综述未进行meta分析，旨在通过分析使用分子技术检测口腔细菌抗微生物药物耐药基因（ARGs）的临床研究，绘制口腔抵抗组图谱。数据来源：2015年1月至2023年8月，研究人员使用Medline， Embase, Web of Science， CINAHL和Scopus数据库。研究选择：本系统综述包括使用分子技术检测ARGs的横断面或纵向临床研究；特别是聚合酶链反应（PCR）或下一代测序（NGS）宏基因组学，用于口腔样本（唾液，牙龈生物膜，牙髓或口腔粘膜）。排除体外或动物研究、文献综述和不关注ARG检测的研究。数据提取和综合：五名审稿人根据纳入标准独立筛选标题和摘要。全文报告随后由三名审稿人独立评估是否合格。提取的数据包括发表细节、样本量、国家、使用的分子方法、检测到的ARGs数量、参与者的健康状况、抗生素暴露和样本在口腔内的位置。结果：580项初步确定的研究中，15项符合纳入标准。这些研究发表于2015年至2023年间，来自12个不同的国家，采用PCR （n = 10）或NGS宏基因组学（n = 5）从1486名参与者中检测ARGs（1项研究未报告参与者数量）。基于pcr的研究平均鉴定出7种arg（范围1-20），而NGS研究平均鉴定出34种arg（范围7-70）。在口腔的6个区域共鉴定出159种对22种抗生素具有耐药性的独特ARGs。龈上生物膜和唾液显示出最高的ARGs丰度，这是由检测到的独特ARGs的数量来定义的。在龈上生物膜中存在对19种抗生素具有抗性的基因。值得注意的是，包括四环素和大环内酯类耐药基因在内的49种ARGs在所有采样地点均被发现，表明其在口腔内分布广泛。13项研究报告了与ARGs相关的细菌种类。NGS研究平均鉴定出65种携带arg的细菌，而PCR研究平均鉴定出4种。其中，PCR研究鉴定出25种携带arg的物种，而NGS研究鉴定出177种。四项研究报告了ARGs与远端感染（如感染性心内膜炎）相关的链球菌种类。应用PCR和NGS方法检测ESKAPE病原菌（一组高毒力多重耐药菌）在口腔各部位的ARGs。健康和患病状态之间的比较表明，健康的口腔微生物组在抗生素类水平上具有更多样化的抗性组。在健康和疾病中，龈上抵抗组的组成最丰富，在龋齿病例中，四环素ARGs在龈上抵抗组和唾液抵抗组中占主导地位。结论：对这15项研究的口腔抵抗组的分析发现，三个ARGs存在于口腔的所有部位，表明存在一个核心抵抗组。与PCR研究相比，NGS研究提供了更多的见解；然而，整体研究基础有限。需要进一步的综合研究来全面绘制口腔抵抗组。
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Pub Date : 2025-03-05DOI: 10.1038/s41432-024-01096-2
Sophie Rimmer, Marianne Dobson
This single-centre, short-term randomized control trial (RCT) assesses the effect of systemic amoxicillin and metronidazole as an adjunct to SRP in patients with severe periodontitis and type 2 diabetes mellitus (T2DM) on glycaemic control, over a 3-month period. The authors hypothesize that adjunctive systemic antibiotics will decrease systemic inflammation and subsequently improve glucose control. Baseline periodontal examinations and haematological tests were performed for all subjects. Subsequently, subgingival scaling and root planning (SRP) procedures were performed by a single periodontist for both the test and control groups. The test group received 500 mg amoxicillin and 200 mg metronidazole TDS for 7 days in the same week of the SRP procedure. Three months later, periodontal examinations were repeated by blinded examiners and haematological tests were repeated. Maintenance periodontal therapy was provided at this time. A convenience sample of patients visiting the periodontal department between 2016-2022 was used. Participants included were aged 40–75; diagnosed with T2DM for >2 years; HbA1c of 6.5–10%, had stable medication regimens and >15 remaining teeth. Participants had a periodontal diagnosis of generalized severe chronic periodontitis or stage III-IV generalized periodontitis based on the 1999 and 2018 classifications respectively. Exclusion criteria related to coexisting inflammatory or infectious diseases (e.g. malignancy, coronary heart disease or hepatitis); adjustment in diet or glycaemic control strategy; severe diabetic complications; pregnancy or lactation; allergies to amoxicillin or metronidazole; periodontal treatment or antibiotics within 3 months prior; smoking and alcohol abuse. The primary clinical outcome was a change in HbA1c. Secondary outcomes included the effect on periodontal parameters and haematological markers of inflammation. Periodontal parameters measured were probing depth (PD), bleeding index (BI), Plaque index (PI), periodontally inflamed surface area (PISA), and clinical attachment level (CAL). Haematological parameters were glycated haemoglobin (HbA1c), fasting blood glucose (FBG), neutrophil-to-lymphocyte ratio (NLR), and white blood cell (WBC) count. For data analysis, poorly controlled T2DM was defined as baseline HbA1c > 7.5%. Statistical significance was defined as p < 0.05. Analysis within and between the two groups was analysed with Student’s t-tests when data followed a normal distribution and the Mann-Whitney U test for non-normally distributed data. Chi-square testing was used to compare categorical variables. Uni- and multivariable binary logistic regression was employed to analyze the effectors related to HbA1c decrease. Intention-to-treat analysis was carried out for all enroled participants. 49 participants were enroled in the study; 23 were assigned to the SRP-only group and 26 to the SRP + antibiotics group. Nine participants were lost to follow-up. HbA1c levels decrease
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