Pub Date : 2025-02-27DOI: 10.1038/s41432-025-01130-x
Larry Z. Lockerman
Zhang J, Chen G, Li W, Xu T, Gao X Upper airway changes after orthodontic extraction treatment in adults: a preliminary study using cone beam computed tomography. PLoS ONE 2015; https://doi.org/10.1371/journal.pone.0143233 . Retrospective study and untreated matched controls. PubMed, journals.plos.org, researchgate.net, Google Scholar. This retrospective study enrolled 18 adults with Class II and hyperdivergent skeletal malocclusion (5 males and 13 females, 24.1 ± 3.8 years of age, BMI 20.33 ± 1.77 kg/m2). And 18 untreated controls were matched 1:1 with the treated patients for age, sex, BMI, and skeletal pattern. Age >18 years; sagittal Class II (ANB > 4.7°) and vertical hyperdivergent (MP/SN > 37.7°) skeletal pattern; convex profile evaluated by E line; no missing teeth except for the third molars; orthodontic camouflage treatment with extraction of four premolars and maximum anchorage using mini-screws; and available CBCT data both before and after treatment. Body mass index (BMI) > 25 kg/m2. Rapid maxillary expansion, protraction facemask therapy, extra-oral force to push molars distally, functional appliances, and orthognathic surgery. History of cleft lip or palate. Hyperplasia of tonsils or adenoids or history of tonsillectomy/adenoidectomy. Snoring or other sleep disorders. Four premolar extraction, upper incisors retracted 7.87 mm, lower incisors retracted 6.10 mm. The cross-sectional area of the upper airway was not changed, but the sagittal dimension between the soft palate and the posterior pharyngeal wall were significantly decreased. The study reported that its null hypothesis was not rejected, with no significant difference in the airway size and significant compression of the sagittal posterior airway.
{"title":"Unmasking the hidden risks: clinical implications of 4 premolar extraction orthodontics on health and upper airway dynamics","authors":"Larry Z. Lockerman","doi":"10.1038/s41432-025-01130-x","DOIUrl":"10.1038/s41432-025-01130-x","url":null,"abstract":"Zhang J, Chen G, Li W, Xu T, Gao X Upper airway changes after orthodontic extraction treatment in adults: a preliminary study using cone beam computed tomography. PLoS ONE 2015; https://doi.org/10.1371/journal.pone.0143233 . Retrospective study and untreated matched controls. PubMed, journals.plos.org, researchgate.net, Google Scholar. This retrospective study enrolled 18 adults with Class II and hyperdivergent skeletal malocclusion (5 males and 13 females, 24.1 ± 3.8 years of age, BMI 20.33 ± 1.77 kg/m2). And 18 untreated controls were matched 1:1 with the treated patients for age, sex, BMI, and skeletal pattern. Age >18 years; sagittal Class II (ANB > 4.7°) and vertical hyperdivergent (MP/SN > 37.7°) skeletal pattern; convex profile evaluated by E line; no missing teeth except for the third molars; orthodontic camouflage treatment with extraction of four premolars and maximum anchorage using mini-screws; and available CBCT data both before and after treatment. Body mass index (BMI) > 25 kg/m2. Rapid maxillary expansion, protraction facemask therapy, extra-oral force to push molars distally, functional appliances, and orthognathic surgery. History of cleft lip or palate. Hyperplasia of tonsils or adenoids or history of tonsillectomy/adenoidectomy. Snoring or other sleep disorders. Four premolar extraction, upper incisors retracted 7.87 mm, lower incisors retracted 6.10 mm. The cross-sectional area of the upper airway was not changed, but the sagittal dimension between the soft palate and the posterior pharyngeal wall were significantly decreased. The study reported that its null hypothesis was not rejected, with no significant difference in the airway size and significant compression of the sagittal posterior airway.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"63-64"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522973","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 : 2025-02-26DOI: 10.1038/s41432-025-01125-8
Orion O’Brien, Greig D. Taylor
Feldens C A, de Barros Coelho E M R, Vítolo M R, Rogrigues P H, Kramer P F, Peres K G Effectiveness of a sugar consumption prevention programme in the first year of life on the occurrence of early childhood caries: a multicentric randomized trial in Brazil. Caries Res 2024; https://doi.org/10.1159/000541028 . A multi-centre randomised controlled trial was carried out in Brazil. The intervention group received nutritional counselling based on dietary guidelines produced by UNICEF. The control group received standard dietary and maternal counselling provided by the hospital provider. Randomisation of participants was completed through a computer-based system with an investigator blinded to the recruitment process. Patients were followed up monthly using a combination of phone calls and home visits. Pregnant women were recruited from four hospitals, across three state capitals, participating in the Baby Friendly Hospital Initiative. Mothers were to be at least 18 years of age, testing negative for HIV/HTLV1, and had an uncomplicated pregnancy. Their newborns had to have a gestational age of more than 37 weeks and weigh more than 2.5 kg. A newborn with increased hospital stays due to infection or neonatal conditions which affected breastfeeding were not included. Sample size calculation was undertaken. Baseline data was collected. At 6- and 12-month intervals, a combination of validated questionnaires, including 24-hour recalls, and interviews were used to assess the diet. Oral health assessments were carried out by a blinded, trained and calibrated paediatric dentist. The primary outcome was a reduction in ECC. Effect measures (relative risk [RR]) were calculated to determine the effect of the intervention on not consuming sugar at 6 months and on the mean number of sugary items consumed at 12 months. Baseline demographic data were similar, with no significant differences noted, between the intervention and control groups. The probability of not consuming sugar in the first 6-months was 2.4 times less in the intervention group relative to the control group (p = 0.016). ECC was diagnosed in 17.4% of the whole sample; however, no significant difference was noted between groups at any time point (p = 0.281). Increased intervention to the mother in the first 6-months of life was effective at reducing the amount of sugar intake. However, this did not lead to a statistically significant reduction in ECC.
Feldens C A, de Barros Coelho E M R, Vítolo M R, Rogrigues P H, Kramer P F， Peres K G：一项在巴西开展的多中心随机试验：生命第一年预防糖摄入规划对儿童早期龋齿发生的有效性。龋齿研究2024；https://doi.org/10.1159/000541028 .研究设计：在巴西进行了一项多中心随机对照试验。干预组根据儿童基金会制定的膳食准则接受营养咨询。对照组接受医院提供的标准饮食和产妇咨询。参与者的随机化是通过基于计算机的系统完成的，研究者对招募过程不知情。每月通过电话和家访对患者进行随访。样本：孕妇是从三个州首府的四家医院招募的，她们参加了“爱婴医院倡议”。母亲必须年满18岁，HIV/HTLV1检测呈阴性，并且没有并发症的怀孕。这些新生儿的胎龄必须超过37周，体重必须超过2.5公斤。由于感染或影响母乳喂养的新生儿状况而住院时间增加的新生儿未包括在内。进行样本量计算。数据分析：收集基线数据。每隔6个月和12个月，使用有效问卷的组合，包括24小时回忆和访谈来评估饮食。口腔健康评估由一名盲法、经过培训和校准的儿科牙医进行。主要结局是ECC减少。计算效果测量（相对风险[RR]），以确定干预对6个月时不吃糖和12个月时平均吃糖量的影响。结果：干预组和对照组的基线人口统计数据相似，无显著差异。干预组前6个月不吃糖的概率是对照组的2.4倍（p = 0.016）。17.4%的患者诊断为ECC；然而，各组间在任何时间点均无显著差异（p = 0.281）。结论：在母亲出生后的前6个月增加干预对减少糖的摄入量是有效的。然而，这并没有导致统计学上显著的ECC减少。
{"title":"Can we rely on delaying the uptake of sugar consumption in the prevention of early childhood caries?","authors":"Orion O’Brien, Greig D. Taylor","doi":"10.1038/s41432-025-01125-8","DOIUrl":"10.1038/s41432-025-01125-8","url":null,"abstract":"Feldens C A, de Barros Coelho E M R, Vítolo M R, Rogrigues P H, Kramer P F, Peres K G Effectiveness of a sugar consumption prevention programme in the first year of life on the occurrence of early childhood caries: a multicentric randomized trial in Brazil. Caries Res 2024; https://doi.org/10.1159/000541028 . A multi-centre randomised controlled trial was carried out in Brazil. The intervention group received nutritional counselling based on dietary guidelines produced by UNICEF. The control group received standard dietary and maternal counselling provided by the hospital provider. Randomisation of participants was completed through a computer-based system with an investigator blinded to the recruitment process. Patients were followed up monthly using a combination of phone calls and home visits. Pregnant women were recruited from four hospitals, across three state capitals, participating in the Baby Friendly Hospital Initiative. Mothers were to be at least 18 years of age, testing negative for HIV/HTLV1, and had an uncomplicated pregnancy. Their newborns had to have a gestational age of more than 37 weeks and weigh more than 2.5 kg. A newborn with increased hospital stays due to infection or neonatal conditions which affected breastfeeding were not included. Sample size calculation was undertaken. Baseline data was collected. At 6- and 12-month intervals, a combination of validated questionnaires, including 24-hour recalls, and interviews were used to assess the diet. Oral health assessments were carried out by a blinded, trained and calibrated paediatric dentist. The primary outcome was a reduction in ECC. Effect measures (relative risk [RR]) were calculated to determine the effect of the intervention on not consuming sugar at 6 months and on the mean number of sugary items consumed at 12 months. Baseline demographic data were similar, with no significant differences noted, between the intervention and control groups. The probability of not consuming sugar in the first 6-months was 2.4 times less in the intervention group relative to the control group (p = 0.016). ECC was diagnosed in 17.4% of the whole sample; however, no significant difference was noted between groups at any time point (p = 0.281). Increased intervention to the mother in the first 6-months of life was effective at reducing the amount of sugar intake. However, this did not lead to a statistically significant reduction in ECC.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"36-37"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-025-01125-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515031","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 : 2025-02-25DOI: 10.1038/s41432-025-01129-4
Mariana Pires da Costa, Nicolli de Araújo Meckelburg, Lucas Alves Jural, Andreia Vaz Braga Pintor, Guido Maranon-Vásquez, Tiago Braga Rabello, Marcela Baraúna Magno, Lucianne Cople Maia
To investigate whether the use of sports mouthguards (SMG) influences salivary parameters and oral health indices. Electronic searches were conducted across six major databases and two sources of gray literature in July 2024, with no restrictions on language or publication date. Interventional studies assessing oral parameters in participants with and without SMG were included. Risk of bias (ROB) was evaluated using the NIH—NHLBI Quality Assessment Tools for before-and-after studies. Descriptive synthesis was performed, and the certainty of evidence was assessed with the GRADE approach. Four studies met the inclusion criteria, encompassing a total of 202 male and female athletes aged 8 to 24 years. ROB ratings were classified as fair in three studies (75%) and poor in one study (25%). Evaluated salivary parameters included pH, stimulated and unstimulated flow rates, microbial count, saliva consistency, and buffering capacity. Additionally, oral indices such as full mouth plaque and bleeding scores were assessed. The studies demonstrated high heterogeneity in collection and analysis methods, outcome evaluation, and follow-up duration. Overall, the influence of SMG use on salivary pH (n = 4; 100%) and stimulated flow rate (n = 2; 100%) was inconclusive. SMG use did not affect microbial count (n = 2; 100%) or saliva consistency (n = 1; 100%) but was associated with a decrease in buffering capacity (n = 1; 100%). An increase was noted in unstimulated flow rate (n = 1; 100%) and oral indices (n = 1; 100%) with SMG use. The certainty of the evidence was rated as very low for all evaluated parameters. SMG use appears to impact saliva’s buffering capacity but does not influence its consistency or microbial count. Despite the limited literature and methodological limitations of existing studies, this systematic review provides insights that could inform the design of more rigorous primary research, ultimately strengthening the evidence base on this topic.
{"title":"Does the use of sports mouthguards influence salivary parameters and oral health indices? A systematic review","authors":"Mariana Pires da Costa, Nicolli de Araújo Meckelburg, Lucas Alves Jural, Andreia Vaz Braga Pintor, Guido Maranon-Vásquez, Tiago Braga Rabello, Marcela Baraúna Magno, Lucianne Cople Maia","doi":"10.1038/s41432-025-01129-4","DOIUrl":"10.1038/s41432-025-01129-4","url":null,"abstract":"To investigate whether the use of sports mouthguards (SMG) influences salivary parameters and oral health indices. Electronic searches were conducted across six major databases and two sources of gray literature in July 2024, with no restrictions on language or publication date. Interventional studies assessing oral parameters in participants with and without SMG were included. Risk of bias (ROB) was evaluated using the NIH—NHLBI Quality Assessment Tools for before-and-after studies. Descriptive synthesis was performed, and the certainty of evidence was assessed with the GRADE approach. Four studies met the inclusion criteria, encompassing a total of 202 male and female athletes aged 8 to 24 years. ROB ratings were classified as fair in three studies (75%) and poor in one study (25%). Evaluated salivary parameters included pH, stimulated and unstimulated flow rates, microbial count, saliva consistency, and buffering capacity. Additionally, oral indices such as full mouth plaque and bleeding scores were assessed. The studies demonstrated high heterogeneity in collection and analysis methods, outcome evaluation, and follow-up duration. Overall, the influence of SMG use on salivary pH (n = 4; 100%) and stimulated flow rate (n = 2; 100%) was inconclusive. SMG use did not affect microbial count (n = 2; 100%) or saliva consistency (n = 1; 100%) but was associated with a decrease in buffering capacity (n = 1; 100%). An increase was noted in unstimulated flow rate (n = 1; 100%) and oral indices (n = 1; 100%) with SMG use. The certainty of the evidence was rated as very low for all evaluated parameters. SMG use appears to impact saliva’s buffering capacity but does not influence its consistency or microbial count. Despite the limited literature and methodological limitations of existing studies, this systematic review provides insights that could inform the design of more rigorous primary research, ultimately strengthening the evidence base on this topic.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"146-146"},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500121","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 : 2025-02-21DOI: 10.1038/s41432-025-01123-w
Neeraj Gugnani, Shalini Gugnani
Pawinska M, Paszynska E, Amaechi B T, Meyer F, Enax J, Limeback H Clinical evidence of caries prevention by hydroxyapatite: an updated systematic review and meta-analysis. J Dent 2024; https://doi.org/10.1016/j.jdent.2024.105429 . The search strategy for this review aimed at finding the published articles in which hydroxyapatite has been used as an intervention agent for caries prevention, compared with either active control like fluoride-products, placebo, or no interventions. For this, authors used a combination of keywords indicative of various PICOS framework elements. The search was carried out in various electronic databases, including Pubmed, Embase, Scopus, Web of Science, and Google Scholar. Both clinical trials and in-situ studies were included in this review. A total of 1245 articles were retrieved from the search, but 1227 articles were removed as they did not meet the inclusion/exclusion criteria. A total of 18 articles, including clinical trials and in-situ studies, were included in the review. All the included articles were assessed for quality using NHLBI criteria before including them in the meta-analysis. The outcome measures from the clinical trials mainly included the caries incidence, recorded as dmft(s)/DMFT(S) or using ICDAS criteria, while the data for outcome measures from in-situ studies included different surrogate markers. The meta-analysis done for the included clinical trials depicted HAP toothpastes to be significantly better for caries prevention when compared with the placebo toothpastes (pooled OR = 2.51). The results also favored HAP toothpaste when compared with fluoride toothpaste (pooled OR = 1.1) but the results were non-significant. For in-situ studies too, significant results were obtained, favouring HAP toothpaste in terms of lesion depth (overall mean change of 1.15 µm) and bacterial loads (overall mean reduction of 65%), while non-significant results, favouring HAP, were obtained in terms of remineralization (overall mean change of 2.8%). HAP toothpastes are found to be effective in preventing caries and can be considered as good alternative for fluoride.
Pawinska M, Paszynska E, Amaechi B T, Meyer F, Enax J, Limeback H。羟基磷灰石预防龋病的临床证据：最新的系统评价和荟萃分析。[J] Dent 2024；https://doi.org/10.1016/j.jdent.2024.105429 .数据来源：本综述的检索策略旨在找到羟基磷灰石被用作预防龋齿干预剂的已发表文章，与氟化物产品、安慰剂或无干预等主动对照进行比较。为此，作者使用了表示各种PICOS框架元素的关键字组合。检索在各种电子数据库中进行，包括Pubmed， Embase, Scopus， Web of Science和b谷歌Scholar。研究选择：本综述包括临床试验和原位研究。从检索中共检索到1245篇文章，但由于不符合纳入/排除标准，删除了1227篇文章。共纳入18篇文章，包括临床试验和原位研究。数据提取和综合：所有纳入的文章在纳入meta分析之前，均采用NHLBI标准进行质量评估。临床试验的结果测量主要包括龋发病率，记录为dmft(s)/ dmft(s)或使用ICDAS标准，而原位研究的结果测量数据包括不同的替代标记物。结果：对纳入的临床试验进行的荟萃分析显示，与安慰剂牙膏相比，HAP牙膏在预防龋齿方面明显更好（合并OR = 2.51）。与含氟牙膏相比，结果也更有利于含氟牙膏（合并OR = 1.1），但结果不显著。在原位研究中，也获得了显著的结果，在病变深度（总体平均变化1.15µm）和细菌负荷（总体平均减少65%）方面有利于HAP牙膏，而在再矿化方面获得了不显著的结果，有利于HAP牙膏（总体平均变化2.8%）。结论：HAP牙膏具有良好的防龋效果，可作为氟化物的良好替代品。
{"title":"Do we have enough evidence to recommend hydroxyapatite toothpaste for preventing dental caries?","authors":"Neeraj Gugnani, Shalini Gugnani","doi":"10.1038/s41432-025-01123-w","DOIUrl":"10.1038/s41432-025-01123-w","url":null,"abstract":"Pawinska M, Paszynska E, Amaechi B T, Meyer F, Enax J, Limeback H Clinical evidence of caries prevention by hydroxyapatite: an updated systematic review and meta-analysis. J Dent 2024; https://doi.org/10.1016/j.jdent.2024.105429 . The search strategy for this review aimed at finding the published articles in which hydroxyapatite has been used as an intervention agent for caries prevention, compared with either active control like fluoride-products, placebo, or no interventions. For this, authors used a combination of keywords indicative of various PICOS framework elements. The search was carried out in various electronic databases, including Pubmed, Embase, Scopus, Web of Science, and Google Scholar. Both clinical trials and in-situ studies were included in this review. A total of 1245 articles were retrieved from the search, but 1227 articles were removed as they did not meet the inclusion/exclusion criteria. A total of 18 articles, including clinical trials and in-situ studies, were included in the review. All the included articles were assessed for quality using NHLBI criteria before including them in the meta-analysis. The outcome measures from the clinical trials mainly included the caries incidence, recorded as dmft(s)/DMFT(S) or using ICDAS criteria, while the data for outcome measures from in-situ studies included different surrogate markers. The meta-analysis done for the included clinical trials depicted HAP toothpastes to be significantly better for caries prevention when compared with the placebo toothpastes (pooled OR = 2.51). The results also favored HAP toothpaste when compared with fluoride toothpaste (pooled OR = 1.1) but the results were non-significant. For in-situ studies too, significant results were obtained, favouring HAP toothpaste in terms of lesion depth (overall mean change of 1.15 µm) and bacterial loads (overall mean reduction of 65%), while non-significant results, favouring HAP, were obtained in terms of remineralization (overall mean change of 2.8%). HAP toothpastes are found to be effective in preventing caries and can be considered as good alternative for fluoride.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"38-39"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472352","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 : 2025-02-20DOI: 10.1038/s41432-025-01127-6
Nicola Goodship, Greig Taylor
Nezhad H M, Ashourioun A, Sadeghdaghighi A The effect of virtual reality for anxiety and pain in dentistry: a systematic review and meta-analysis. Community Dent Health 2024; 41: 248–255. A systematic search was conducted across PubMed and Cochrane Library up to April 2024. The article type was limited to Randomised Controlled Trials, comparing virtual reality (VR) interventions with non-VR methods in dental settings. The selection followed the PRISMA-P guidelines. Using the PICOS framework, studies involving dental patients of any age utilising VR during dental treatments and reporting outcomes on anxiety and pain were included. Data extraction and quality appraisal were conducted independently by two reviewers using both the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach and the Risk of Bias 2 (ROB-2) tool. Meta-analyses used a random-effects model. A total of 263 studies resulted in the inclusion of 27 studies, encompassing several dental treatments. Evidence quality ranged from low to moderate. Meta-analysis of 14 studies, encompassing 957 patients, revealed VR significantly reduced anxiety in children (SMD −1.44, 95% CI −2.24 to −0.63, low quality of evidence). Metal-analysis of five studies (485 patients) revealed VR had no effect on adults’ anxiety (SMD -0.35, 95% CI -1.11 to 0.4, low level of certainty). VR significantly reduced pain in both children (11 studies, 791 participants) (SMD −1.11, 95% CI −1.65 to −0.57, moderate level of certainty) and adults (6 studies, 557 participants) (SMD −0.59, 95% CI −1.187 to −0.001, low evidence quality). Heterogeneity was high across studies. The study concluded that VR is a promising intervention for reducing anxiety and pain in children during dental procedures, and pain reduction in adults. The authors suggested further research is needed to standardise the VR content and explore its impact across different age groups and dental procedures.
相关评论：Nezhad H M, Ashourioun A, Sadeghdaghighi A 虚拟现实对牙科焦虑和疼痛的影响：系统综述和荟萃分析。Community Dent Health 2024; 41: 248-255.Data sources：截至 2024 年 4 月，在 PubMed 和 Cochrane 图书馆进行了系统检索：文章类型仅限于随机对照试验，比较牙科环境中的虚拟现实（VR）干预与非虚拟现实方法。选择遵循 PRISMA-P 指南。利用 PICOS 框架，纳入了涉及任何年龄段的牙科患者在牙科治疗过程中使用 VR 并报告焦虑和疼痛结果的研究：数据提取和质量评估由两名审稿人独立完成，他们同时使用了推荐、评估、发展和评价分级（GRADE）方法和偏倚风险2（ROB-2）工具。元分析采用随机效应模型：共有 263 项研究，最终纳入了 27 项研究，包括多种牙科治疗方法。证据质量从低到中等不等。对 14 项研究（包括 957 名患者）进行的元分析表明，VR 能显著减轻儿童的焦虑（SMD -1.44, 95% CI -2.24 to -0.63，证据质量低）。对五项研究（485 名患者）进行的金属分析表明，VR 对成年人的焦虑症没有影响（SMD -0.35，95% CI -1.11 至 0.4，证据确定性低）。VR 能明显减轻儿童（11 项研究，791 名参与者）和成人（6 项研究，557 名参与者）的疼痛（SMD -0.59，95% CI -1.187 -0.001，证据质量低）。不同研究之间的异质性很高：研究得出结论：VR 是一种很有前景的干预方法，可以减轻儿童在牙科治疗过程中的焦虑和疼痛，并减轻成人的疼痛。作者建议需要进一步研究，以标准化 VR 内容，并探索其对不同年龄组和牙科手术的影响。
{"title":"Can virtual reality reduce anxiety and pain in dental patients?","authors":"Nicola Goodship, Greig Taylor","doi":"10.1038/s41432-025-01127-6","DOIUrl":"10.1038/s41432-025-01127-6","url":null,"abstract":"Nezhad H M, Ashourioun A, Sadeghdaghighi A The effect of virtual reality for anxiety and pain in dentistry: a systematic review and meta-analysis. Community Dent Health 2024; 41: 248–255. A systematic search was conducted across PubMed and Cochrane Library up to April 2024. The article type was limited to Randomised Controlled Trials, comparing virtual reality (VR) interventions with non-VR methods in dental settings. The selection followed the PRISMA-P guidelines. Using the PICOS framework, studies involving dental patients of any age utilising VR during dental treatments and reporting outcomes on anxiety and pain were included. Data extraction and quality appraisal were conducted independently by two reviewers using both the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach and the Risk of Bias 2 (ROB-2) tool. Meta-analyses used a random-effects model. A total of 263 studies resulted in the inclusion of 27 studies, encompassing several dental treatments. Evidence quality ranged from low to moderate. Meta-analysis of 14 studies, encompassing 957 patients, revealed VR significantly reduced anxiety in children (SMD −1.44, 95% CI −2.24 to −0.63, low quality of evidence). Metal-analysis of five studies (485 patients) revealed VR had no effect on adults’ anxiety (SMD -0.35, 95% CI -1.11 to 0.4, low level of certainty). VR significantly reduced pain in both children (11 studies, 791 participants) (SMD −1.11, 95% CI −1.65 to −0.57, moderate level of certainty) and adults (6 studies, 557 participants) (SMD −0.59, 95% CI −1.187 to −0.001, low evidence quality). Heterogeneity was high across studies. The study concluded that VR is a promising intervention for reducing anxiety and pain in children during dental procedures, and pain reduction in adults. The authors suggested further research is needed to standardise the VR content and explore its impact across different age groups and dental procedures.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"59-60"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-025-01127-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467543","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}
Five electronic databases (PubMed, Embase, Central, Web of Science, and Epistemonikos) and grey literature were systematically searched up to November 22, 2021 to identify studies relevant to patient-reported outcome measures (PROMs) in peri-implant soft tissue augmentation. Two authors independently reviewed the title, abstrac (screening phase), and full text (eligibility phase) of the articles after removing the duplicates, based on the pre-established inclusion criteria. A total of 29 clinical studies (19 randomized clinical trials, 7 non-randomized studies, and 3 case series) fulfilled the eligibility criteria based on the PICO framework. Data were independently extracted from the included studies by two authors using data extraction tables. The mean values of PROMs were pooled and analyzed with the weighted mean difference (WMD) and 95% confidence intervals (CIs) to summarize and compare the studies. Eleven subgroup meta-analyses (including 2–6 studies in each) were conducted using random-effect models to determine the differences in mean values of PROMs (pain scores on the Visual Analog Scale [VAS], analgesic consumption, satisfaction on VAS, aesthetic perception, surgery duration, and quality of life) between soft tissue autografts and substitutes. For mucosal thickness gain, pain perception was significantly reduced with soft tissue substitutes compared to subepithelial connective tissue graft (SCTG) at both 0–100 (n = 4; WMD = 14.91 VAS units; 95% CI: 6.42–23.40; P < 0.0006) and 0–10 VAS scale (n = 4; WMD = 1.62 VAS units; 95% CI: 0.01–3.23; P = 0.05). Similar results of significantly reduced pain with soft tissue substitutes on a 0–100 (n = 2; WMD = 21.43 VAS units; 95% CI: 12.58–30.28; P < 0.0001) and 0–10 VAS scale (n = 4; WMD = 1.65 VAS units; 95% CI: 0.66–2.64; P = 0.001) were found for keratinized tissue gain. Furthermore, with soft tissue substitutes painkiller consumption (n = 6; WMD = 1.56 tablets; 95% CI: 1.22–1.91; P < 0.00001) and surgery time (n = 5; WMD = 10.9 min; 95% CI: 4.60–17.19; P < 0.00001) were significantly less in comparison to autogenous grafts. Patient satisfaction, aesthetic perception, and quality of life did not differ significantly between soft tissue substitutes and autogenous grafts for soft tissue augmentation around implants. PROMs in terms of postoperative pain, analgesic intake, and surgery duration are significantly improved with the use of soft tissue substitutes for peri-implant soft tissue augmentation. Similar levels of patient satisfaction and aesthetic perception were achieved with soft tissue substitutes as with autogenous grafts, without impairing the clinical outcomes.
数据来源：系统检索截至2021年11月22日的5个电子数据库（PubMed、Embase、Central、Web of Science和Epistemonikos）和灰色文献，以确定与种植体周围软组织增强术中患者报告的结果测量（PROMs）相关的研究。研究选择：两位作者根据预先确定的纳入标准，在删除重复文献后，独立审查文章的标题、摘要（筛选阶段）和全文（合格阶段）。共有29项临床研究（19项随机临床试验，7项非随机研究和3例病例系列）符合基于PICO框架的入选标准。数据提取和综合：由两位作者使用数据提取表从纳入的研究中独立提取数据。采用加权平均差（WMD）和95%置信区间（ci）对PROMs的平均值进行汇总分析，总结比较研究结果。采用随机效应模型进行了11个亚组荟萃分析（每个亚组包括2-6个研究），以确定自体软组织移植物和替代品之间PROMs（视觉模拟量表[VAS]疼痛评分、镇痛药消耗、VAS满意度、美感、手术持续时间和生活质量）平均值的差异。结果：对于粘膜厚度增加，与上皮下结缔组织移植物（SCTG）相比，软组织替代物在0-100时的疼痛感知显著降低(n = 4；WMD = 14.91 VAS单位；95% ci: 6.42-23.40；P结论：使用软组织代用品进行种植体周围软组织隆胸，在术后疼痛、镇痛摄入、手术时间等方面均有明显改善。与自体移植物相比，软组织替代物获得了相似的患者满意度和美感水平，而不影响临床结果。
{"title":"Soft tissue substitutes improve patient-reported outcomes in peri-implant soft tissue augmentation","authors":"Vikender Singh Yadav, Kanika Makker, Anika Dawar, Aditi Nanda","doi":"10.1038/s41432-025-01121-y","DOIUrl":"10.1038/s41432-025-01121-y","url":null,"abstract":"Five electronic databases (PubMed, Embase, Central, Web of Science, and Epistemonikos) and grey literature were systematically searched up to November 22, 2021 to identify studies relevant to patient-reported outcome measures (PROMs) in peri-implant soft tissue augmentation. Two authors independently reviewed the title, abstrac (screening phase), and full text (eligibility phase) of the articles after removing the duplicates, based on the pre-established inclusion criteria. A total of 29 clinical studies (19 randomized clinical trials, 7 non-randomized studies, and 3 case series) fulfilled the eligibility criteria based on the PICO framework. Data were independently extracted from the included studies by two authors using data extraction tables. The mean values of PROMs were pooled and analyzed with the weighted mean difference (WMD) and 95% confidence intervals (CIs) to summarize and compare the studies. Eleven subgroup meta-analyses (including 2–6 studies in each) were conducted using random-effect models to determine the differences in mean values of PROMs (pain scores on the Visual Analog Scale [VAS], analgesic consumption, satisfaction on VAS, aesthetic perception, surgery duration, and quality of life) between soft tissue autografts and substitutes. For mucosal thickness gain, pain perception was significantly reduced with soft tissue substitutes compared to subepithelial connective tissue graft (SCTG) at both 0–100 (n = 4; WMD = 14.91 VAS units; 95% CI: 6.42–23.40; P < 0.0006) and 0–10 VAS scale (n = 4; WMD = 1.62 VAS units; 95% CI: 0.01–3.23; P = 0.05). Similar results of significantly reduced pain with soft tissue substitutes on a 0–100 (n = 2; WMD = 21.43 VAS units; 95% CI: 12.58–30.28; P < 0.0001) and 0–10 VAS scale (n = 4; WMD = 1.65 VAS units; 95% CI: 0.66–2.64; P = 0.001) were found for keratinized tissue gain. Furthermore, with soft tissue substitutes painkiller consumption (n = 6; WMD = 1.56 tablets; 95% CI: 1.22–1.91; P < 0.00001) and surgery time (n = 5; WMD = 10.9 min; 95% CI: 4.60–17.19; P < 0.00001) were significantly less in comparison to autogenous grafts. Patient satisfaction, aesthetic perception, and quality of life did not differ significantly between soft tissue substitutes and autogenous grafts for soft tissue augmentation around implants. PROMs in terms of postoperative pain, analgesic intake, and surgery duration are significantly improved with the use of soft tissue substitutes for peri-implant soft tissue augmentation. Similar levels of patient satisfaction and aesthetic perception were achieved with soft tissue substitutes as with autogenous grafts, without impairing the clinical outcomes.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"26-28"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425435","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 : 2025-02-13DOI: 10.1038/s41432-025-01118-7
Lydia Cross
A search of four databases (PubMed, EBSCOhost, Medline, and Google Scholar) identified studies for inclusion. Two reviewers independently selected articles for review. Studies published in English between January 2000 and June 2024 were selected. Studies that described the association of oral health and depression, and those with an oral health factor as the independent variable and depression as the dependent variable were eligible. Systematic reviews and case reports were excluded. Data was extracted from 31 eligible articles, which included both cross-sectional and prospective cohort studies, by two reviewers independently. The results of each study were narratively described; no meta-analysis was carried out due to heterogeneity between the studies. The authors reported that results were observed after controlling confounding factors. Each reviewer independently evaluated the studies’ methodological quality and validity using the Joanna Briggs Institute (JBI) tool for cross-sectional studies. There were mixed results regarding the impact of oral health on depression. Some studies reported significantly increased risk of depression with both tooth loss and oral pain, whilst others reported no association. Impaired oral function was consistently associated with symptoms of depression. The review concluded that oral health has a significant impact on depression and that there is a bi-directional relationship between the two, necessitating targeted interventions to improve oral health and thus positively impact mental health.
{"title":"Is depression influenced by oral health?","authors":"Lydia Cross","doi":"10.1038/s41432-025-01118-7","DOIUrl":"10.1038/s41432-025-01118-7","url":null,"abstract":"A search of four databases (PubMed, EBSCOhost, Medline, and Google Scholar) identified studies for inclusion. Two reviewers independently selected articles for review. Studies published in English between January 2000 and June 2024 were selected. Studies that described the association of oral health and depression, and those with an oral health factor as the independent variable and depression as the dependent variable were eligible. Systematic reviews and case reports were excluded. Data was extracted from 31 eligible articles, which included both cross-sectional and prospective cohort studies, by two reviewers independently. The results of each study were narratively described; no meta-analysis was carried out due to heterogeneity between the studies. The authors reported that results were observed after controlling confounding factors. Each reviewer independently evaluated the studies’ methodological quality and validity using the Joanna Briggs Institute (JBI) tool for cross-sectional studies. There were mixed results regarding the impact of oral health on depression. Some studies reported significantly increased risk of depression with both tooth loss and oral pain, whilst others reported no association. Impaired oral function was consistently associated with symptoms of depression. The review concluded that oral health has a significant impact on depression and that there is a bi-directional relationship between the two, necessitating targeted interventions to improve oral health and thus positively impact mental health.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"57-58"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413817","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 : 2025-02-13DOI: 10.1038/s41432-025-01119-6
Rajpal Tattar, Joshua Jackson, Richard Holliday
Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) are a popular alternative to traditional tobacco smoking. Objective: To evaluate the effect of ENDS use on periodontal health. A protocol was published in accordance with PRISMA standards. Subjects with periodontal health, gingivitis and periodontitis were included. Reviews, case reports, letters, abstracts, narratives and expert opinions were excluded. Databases searched included PubMed, Embase, Web of Science, CINAHL Plus, and Dentistry & Oral Sciences Source up until February 2024. Risk of bias was evaluated using the Newcastle-Ottawa Scale, ROBINS-I and the RoB 2 tools. 40 eligible studies were included. Smokers had poorer clinical outcomes than ENDS users and non-smokers/former smokers, apart from bleeding on probing and gingival indices. There was no difference between ENDS users and non-smokers/former smokers in markers of periodontal destruction (pocket probing depths/marginal bone loss). ENDS users had higher plaque scores than non-smokers/former smokers. ENDS use leads to unique microbial changes compared to tobacco smokers and higher pro-inflammatory markers compared to non-smokers/former smokers. Within the limitations of the included studies which are at high risk of bias, we found evidence that ENDS use had some impact on periodontal parameters compared to non-smokers/former smokers. Tobacco smokers had consistently worst outcomes. CRD42024496560.
背景：电子尼古丁传递系统（ENDS，电子烟）是传统吸烟的一种流行替代品。目的：评价ENDS的使用对牙周健康的影响。方法：按照PRISMA标准发布治疗方案。研究对象包括牙周健康、牙龈炎和牙周炎患者。综述、病例报告、信函、摘要、叙述和专家意见被排除在外。检索的数据库包括PubMed， Embase, Web of Science， CINAHL Plus和Dentistry & Oral Sciences Source，截止到2024年2月。使用纽卡斯尔-渥太华量表、ROBINS-I和rob2工具评估偏倚风险。结果：纳入了40项符合条件的研究。除了牙诊和牙龈指数出血外，吸烟者的临床结果比ENDS使用者和非吸烟者/前吸烟者差。ENDS使用者与非吸烟者/前吸烟者在牙周破坏标志物（牙袋探测深度/边缘骨质流失）方面没有差异。ENDS使用者的斑块评分高于非吸烟者/前吸烟者。与吸烟者相比，终端的使用导致了独特的微生物变化，与非吸烟者/前吸烟者相比，终端的使用导致了更高的促炎标志物。结论：在纳入的高偏倚风险研究的局限性内，我们发现与非吸烟者/前吸烟者相比，使用ENDS对牙周参数有一定影响的证据。吸烟者的结果一直最糟糕。注册prospero 2024: crd42024496560。
{"title":"The impact of e-cigarette use on periodontal health: a systematic review and meta-analysis","authors":"Rajpal Tattar, Joshua Jackson, Richard Holliday","doi":"10.1038/s41432-025-01119-6","DOIUrl":"10.1038/s41432-025-01119-6","url":null,"abstract":"Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) are a popular alternative to traditional tobacco smoking. Objective: To evaluate the effect of ENDS use on periodontal health. A protocol was published in accordance with PRISMA standards. Subjects with periodontal health, gingivitis and periodontitis were included. Reviews, case reports, letters, abstracts, narratives and expert opinions were excluded. Databases searched included PubMed, Embase, Web of Science, CINAHL Plus, and Dentistry & Oral Sciences Source up until February 2024. Risk of bias was evaluated using the Newcastle-Ottawa Scale, ROBINS-I and the RoB 2 tools. 40 eligible studies were included. Smokers had poorer clinical outcomes than ENDS users and non-smokers/former smokers, apart from bleeding on probing and gingival indices. There was no difference between ENDS users and non-smokers/former smokers in markers of periodontal destruction (pocket probing depths/marginal bone loss). ENDS users had higher plaque scores than non-smokers/former smokers. ENDS use leads to unique microbial changes compared to tobacco smokers and higher pro-inflammatory markers compared to non-smokers/former smokers. Within the limitations of the included studies which are at high risk of bias, we found evidence that ENDS use had some impact on periodontal parameters compared to non-smokers/former smokers. Tobacco smokers had consistently worst outcomes. CRD42024496560.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"117-118"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413822","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 : 2025-02-13DOI: 10.1038/s41432-025-01117-8
Rahul Mohandas, Subhashree Mohapatra
Benzydamine mouthwash is beneficial in avoiding radiation-induced oral mucositis (RIOM) in patients with head and neck cancer, but it is also expensive and has negative side effects, while herbal mouthwashes offer a potential, easily accessible alternative with less side effects and bioactive characteristics. Hence, the aim of the systematic review and network meta-analysis was to assess and compare the efficacy of herbal mouthwash and benzydamine mouthwash in preventing RIOM among head and neck cancer patients. After searching Scopus, PubMed, Cochrane, Science Direct, EBSCO Host, Lilacs, Science Direct, Web of Science, and Google Scholar from the earliest available year till July 15, 2024, 79 articles were obtained. Four full-text publications met the eligibility requirements and underwent additional processing for data extraction. PICO Strategy: P: Head and neck cancer patients, I: Herbal mouthwash, C: Benzydamine mouthwash, O: Reduction in radiation-induced oral mucositis. The review only comprised randomised controlled trials. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool respectively. Curcumin mouthwash was most effective in reducing the incidence of oral mucositis followed by sumac-rose and turmeric mouthwash. Curcumin, turmeric, and sumac-rose mouthwashes were found to be effective in delaying the onset of oral mucositis as compared to the benzydamine group. Turmeric mouthwash followed by curcumin and sumac-rose mouthwash were found to be more effective in reducing the severity of oral mucositis. The current review concludes that curcumin, turmeric, and sumac-rose mouthwashes are more effective than benzydamine mouthwash in preventing RIOM. These natural alternatives show promising results for improving patient outcomes and should be investigated further to be used clinically. CRD42024570913
背景：苯胺漱口水有助于避免头颈癌患者的放射性口腔黏膜炎（RIOM），但它也很昂贵并且有副作用，而草药漱口水提供了一个潜在的，容易获得的替代品，副作用更小，生物活性更强。因此，本系统评价和网络荟萃分析的目的是评估和比较草药漱口水和苄胺漱口水在预防头颈癌患者RIOM的疗效。方法：检索Scopus、PubMed、Cochrane、Science Direct、EBSCO Host、Lilacs、Science Direct、Web of Science、谷歌Scholar等最早可查年份至2024年7月15日的论文79篇。四份全文出版物符合资格要求，并进行了额外的数据提取处理。PICO策略：P：头颈癌患者，I：草药漱口水，C：苄胺漱口水，O：减少放射性口腔黏膜炎。该综述仅包括随机对照试验。分别使用rob2工具和GRADE工具评估偏倚风险和证据质量。结果：姜黄素漱口水对降低口腔黏膜炎的发生率最有效，其次为紫苏玫瑰漱口水和姜黄漱口水。与苯胺组相比，姜黄素、姜黄和漆树玫瑰漱口水在延缓口腔黏膜炎发作方面被发现有效。姜黄漱口水，其次是姜黄素漱口水和漆树玫瑰漱口水，在减轻口腔黏膜炎的严重程度方面更有效。结论：姜黄素、姜黄、漆树玫瑰漱口水对RIOM的预防效果优于苄胺漱口水。这些天然替代品在改善患者预后方面显示出有希望的结果，应进一步研究以用于临床。普洛斯彼罗注册号：CRD42024570913。
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The prospective observational study aimed to record the short-term patient-reported outcomes (PROMs) like pain, swelling, difficulty in mouth opening, and oral health quality of life (oral health impact profile-14), following a single-site tooth extraction and guided bone regeneration(GBR) using resorbable membrane and bone allograft. Correlation of PROMs with clinical/intra-surgical parameters like flap advancement, gingival and mucosal thickness, surgery duration, and wound opening were observed. PROMs and clinical parameters were assessed pre-operatively and on days 2,4,7 and 14 during the postoperative two weeks. Systemically healthy, non-smoker twenty-seven patients fulfilling the inclusion criteria of the dentate site with immediate post-extraction buccal dehiscence ≥4 mm were recruited. Only one tooth site from each patient was included in the study. The severity of pain, swelling, and difficulty in mouth opening were reported as zero, mild (1–3), moderate(4–6), and severe(7–10) using visual analog scores(VAS). The number of patients experiencing symptoms was presented as a percentage. Mean, standard error, median values, and IQR are reported for all OHIP-14 domains at various time points. Spearmen’s coefficient was used to correlate four PROMs for overall values for each time point separately and to correlate with clinical parameters. P < 0.05 was considered statistically significant. VAS for all PROMs peaked on post-surgical day 2 and improved until day 14. Most patients experienced no or mild symptoms during postoperative two weeks, with moderate to severe responses reported by 41–56% of patients on day 2. All PROMs correlated significantly with each other, with a strong correlation between VAS for pain and swelling. In the context of post-surgical oral health quality of life (OHIP-14), patients reported physical pain as the most experienced outcome, followed by psychological discomfort at all time points. All three PROMs pain, swelling, and difficulty of mouth opening positively correlated with all domains of OHIP-14, with the strongest correlation between the physical pain domain with VAS pain(day 7) and VAS swelling(day 2). Measured gingival thickness, mucosal thickness, flap advancement, and duration of surgery were 0.42 ± 0.04 mm, 0.2 ± 0.02 mm,6.8 ± 0.5 mm, and 123 ± 6 min, respectively. All clinical parameters and pre-operative PROMs correlated with post-operative PROMs. Wound opening was maximum on day 7 with an average extent of 3.3 mm and prevalence in 81.5%patients. Wound opening and duration of surgery were highly correlated with pain and flap advancement with difficulty of mouth opening on 7 th day. OHIP-14 was strongly associated with gingival thickness and wound healing on days 2 and 7, respectively. Short-term postoperative patient-reported outcomes are most severe on the second-day post-GBR. Clinical parameters like soft tissue thickness, flap advancement, and wound opening duration of surgery impact the PROMs like p
{"title":"Short-term patient-reported outcomes correlate with clinical parameters in guided bone regeneration","authors":"Anika Dawar, Vikender Singh Yadav, Aditi Nanda, Vandana Gupta","doi":"10.1038/s41432-025-01115-w","DOIUrl":"10.1038/s41432-025-01115-w","url":null,"abstract":"The prospective observational study aimed to record the short-term patient-reported outcomes (PROMs) like pain, swelling, difficulty in mouth opening, and oral health quality of life (oral health impact profile-14), following a single-site tooth extraction and guided bone regeneration(GBR) using resorbable membrane and bone allograft. Correlation of PROMs with clinical/intra-surgical parameters like flap advancement, gingival and mucosal thickness, surgery duration, and wound opening were observed. PROMs and clinical parameters were assessed pre-operatively and on days 2,4,7 and 14 during the postoperative two weeks. Systemically healthy, non-smoker twenty-seven patients fulfilling the inclusion criteria of the dentate site with immediate post-extraction buccal dehiscence ≥4 mm were recruited. Only one tooth site from each patient was included in the study. The severity of pain, swelling, and difficulty in mouth opening were reported as zero, mild (1–3), moderate(4–6), and severe(7–10) using visual analog scores(VAS). The number of patients experiencing symptoms was presented as a percentage. Mean, standard error, median values, and IQR are reported for all OHIP-14 domains at various time points. Spearmen’s coefficient was used to correlate four PROMs for overall values for each time point separately and to correlate with clinical parameters. P < 0.05 was considered statistically significant. VAS for all PROMs peaked on post-surgical day 2 and improved until day 14. Most patients experienced no or mild symptoms during postoperative two weeks, with moderate to severe responses reported by 41–56% of patients on day 2. All PROMs correlated significantly with each other, with a strong correlation between VAS for pain and swelling. In the context of post-surgical oral health quality of life (OHIP-14), patients reported physical pain as the most experienced outcome, followed by psychological discomfort at all time points. All three PROMs pain, swelling, and difficulty of mouth opening positively correlated with all domains of OHIP-14, with the strongest correlation between the physical pain domain with VAS pain(day 7) and VAS swelling(day 2). Measured gingival thickness, mucosal thickness, flap advancement, and duration of surgery were 0.42 ± 0.04 mm, 0.2 ± 0.02 mm,6.8 ± 0.5 mm, and 123 ± 6 min, respectively. All clinical parameters and pre-operative PROMs correlated with post-operative PROMs. Wound opening was maximum on day 7 with an average extent of 3.3 mm and prevalence in 81.5%patients. Wound opening and duration of surgery were highly correlated with pain and flap advancement with difficulty of mouth opening on 7 th day. OHIP-14 was strongly associated with gingival thickness and wound healing on days 2 and 7, respectively. Short-term postoperative patient-reported outcomes are most severe on the second-day post-GBR. Clinical parameters like soft tissue thickness, flap advancement, and wound opening duration of surgery impact the PROMs like p","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 1","pages":"32-33"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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