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Trends in Systemic Antibiotic Therapy of Endodontic Infections: a Survey among Dental Practitioners in Lithuania. 牙髓感染的全身抗生素治疗趋势:立陶宛牙科从业者的调查。
Pub Date : 2020-03-31 eCollection Date: 2020-01-01 DOI: 10.5037/jomr.2020.11102
Alexander Mende, Tadas Venskutonis, Migle Mackeviciute

Objectives: Prescription trends to certain antibiotic classes in Lithuania have been observed. Considering the potential contribution to antimicrobial resistance and the evidence of inappropriate prescriptions highlights, the periodical assessment of antibiotic consumption trends is required. The aim of this study was to assess prescription behaviours of Lithuanian general dental practitioners concerning the systemic antibiotic therapy of endodontic infections.

Material and methods: A sample of 198 Lithuanian dentists, registered on the database of the Lithuanian Dental Chamber, provided anonymous information about their clinical work by means of an online questionnaire.

Results: Among the participants, antibiotics were prescribed in less than 20% of endodontic cases. Most common diagnosis for the prescription was symptomatic apical periodontitis with periostitis (90%) and apical abscesses with systemic involvement (54%). Amoxicillin and co-amoxiclav were the preferred choices for the antimicrobial therapy. The preference of clavulanic acid combination over simple usage of amoxicillin is increasing relative to the participants age (P = 0.016) and working experience (P = 0.008). Clindamycin is prescribed in cases of allergy to beta-lactams. Practitioners with less years of clinical activity were more likely to prescribe antibiotics for spreading infections, than their associates with more than 10 years of practice (P < 0.001).

Conclusions: Clinicians of higher age were found to be more likely to prescribe broad-spectrum antibiotic combinations compared to their younger associates. The majority of practitioners were aware of the clinical recommendations.

目的:观察立陶宛某些抗生素类别的处方趋势。考虑到对抗菌素耐药性的潜在贡献和不适当处方的证据,需要定期评估抗生素消费趋势。本研究的目的是评估立陶宛全科牙科医生对牙髓感染的全身抗生素治疗的处方行为。材料和方法:198名立陶宛牙医的样本,在立陶宛牙科协会的数据库中注册,通过在线问卷的方式提供了关于他们临床工作的匿名信息。结果:在参与者中,不到20%的根管病例开了抗生素。最常见的诊断是症状性根尖牙周炎伴骨膜炎(90%)和全身累及的根尖脓肿(54%)。阿莫西林和共阿莫西拉夫是首选的抗菌药物。与年龄(P = 0.016)和工作经验(P = 0.008)相关,克拉维酸联合用药比阿莫西林单用更受青睐。克林霉素是在对内酰胺过敏的情况下开的处方。与从业10年以上的医生相比,临床活动年限较短的医生更有可能为传播性感染开抗生素(P < 0.001)。结论:与年轻的同事相比,年龄较大的临床医生更有可能开出广谱抗生素组合。大多数从业人员都知道临床建议。
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引用次数: 1
Assessment of the Depth of Clinically Detected Approximal Caries Lesions Using Digital Imaging Fiber-Optic Transillumination in Comparison to Periapical Radiographs. 数字成像光纤透照与根尖周围x线片对临床发现的近龋深度的评估。
Pub Date : 2020-03-31 eCollection Date: 2020-01-01 DOI: 10.5037/jomr.2020.11103
Auste Antipoviene, Monika Girijotaite, Egle Aida Bendoraitiene

Objectives: The aim of present prospective clinical trial was to assess the depth of clinically detected approximal caries lesions using digital imaging fiber-optic transillumination in comparison to periapical radiographs.

Material and methods: One calibrated examiner diagnosed 31 approximal carious lesions in 10 patients with a mean age of 21.8 (SD 1.1) years. The lesions were assessed using digital imaging fiber-optic transillumination (DIFOTI) and digital periapical radiographs (PA). Depending on the depth of the lesions, scores for demineralisation in PA (R) and DIFOTI (F) images were given by two examiners: R0/F0 - no demineralisation, R1/F1 - demineralisation confined to the outer half of the enamel, R2/F2 - into the inner half of the enamel, 3/3 - along the amelodentinal junction, R3/F3 - into the outer half of dentine, R4/F4 - into the inner part of the dentine. Spearman's rank correlation coefficient and kappa were calculated.

Results: Spearman's rank correlation coefficient between DIFOTI and PA was 0.031 (P > 0.05), kappa was 0.077. In 26% of the cases, DIFOTI showed higher scores of demineralisation, relative to PA. In 36% of the cases, PA showed higher scores of demineralisation than DIFOTI. PA showed demineralisation into the outer and inner half of the dentine in 89% of the cases with underlying shadow and in 70% of the cases with opacities.

Conclusions: Digital imaging fibre optic transillumination and periapical radiographs produce evaluations of the depth of approximal caries lesions that do not match.

目的:本前瞻性临床试验的目的是评估使用数字成像光纤透照与根尖周围x线片比较临床检测到的近龋病变的深度。材料和方法:一名校准的检查员在10名平均年龄为21.8岁(SD 1.1)岁的患者中诊断出31个近似龋齿病变。使用数字成像光纤透照(DIFOTI)和数字根尖周围x线片(PA)评估病变。根据病变的深度,PA (R)和DIFOTI (F)图像中的脱矿评分由两名检查人员给出:R0/F0 -无脱矿,R1/F1 -脱矿局限于牙釉质的外半部,R2/F2 -进入牙釉质的内半部,3/3 -沿着釉牙釉质交界处,R3/F3 -进入牙釉质的外半部,R4/F4 -进入牙釉质的内半部。计算Spearman等级相关系数和kappa。结果:DIFOTI与PA的Spearman等级相关系数为0.031 (P > 0.05), kappa为0.077。在26%的病例中,与PA相比,DIFOTI显示出更高的脱矿评分。在36%的病例中,PA表现出比DIFOTI更高的脱矿得分。PA显示89%有下影的病例和70%有混浊的病例牙本质的外半部和内半部脱矿。结论:数字成像、光纤透照和根尖周围x线片对近龋病变深度的评价不一致。
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引用次数: 1
Maxillary Alveolar Ridge Expansion with Split-Crest Technique Compared with Lateral Ridge Augmentation with Autogenous Bone Block Graft: a Systematic Review. 上颌牙槽嵴裂嵴扩展技术与自体骨块侧嵴增强技术的比较:系统综述。
Pub Date : 2019-12-30 eCollection Date: 2019-10-01 DOI: 10.5037/jomr.2019.10402
Thomas Starch-Jensen, Jonas Peter Becktor

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after maxillary alveolar ridge expansion with split-crest technique compared with lateral ridge augmentation with autogenous bone block graft.

Material and methods: A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until 8th of February, 2018 were included.

Results: One comparative and four noncomparative studies fulfilled the inclusion criteria. Both treatment modalities disclosed high survival rate of implants with few complications. High survival rate of prosthesis, implant stability values, limited peri-implant marginal bone loss and gain in maxillary alveolar ridge width were reported with the split-crest technique. Patient-reported outcome measure and length of patient treatment time was not assessed in any of the included studies.

Conclusions: The split-crest technique seems to be useful for horizontal augmentation of maxillary alveolar deficiencies with high survival rate of prosthesis and implants. However, further long-term randomized controlled trials with larger patient sample as well as assessment of patient-reported outcome measures and patient treatment time are needed before well-defined conclusions can be provided about the two treatment modalities.

目的:本系统综述的目的是验证采用裂嵴技术进行上颌牙槽嵴扩张与采用自体骨块移植进行侧嵴增加后种植体治疗结果无差异的假设。材料和方法:在MEDLINE (PubMed)、Embase和Cochrane图书馆进行检索,并结合手工检索相关期刊。纳入了2018年2月8日之前以英文发表的人类研究。结果:1项比较研究和4项非比较研究符合纳入标准。两种治疗方式均显示种植体成活率高,并发症少。结果表明:采用裂嵴技术种植体成活率高,种植体稳定性好,种植体周围边缘骨丢失少,上颌牙槽嵴宽度增加。纳入的任何研究均未评估患者报告的结果测量和患者治疗时间长度。结论:劈裂嵴技术可用于上颌牙槽缺损的水平隆高,假体和种植体成活率高。然而,在提供关于这两种治疗方式的明确结论之前,需要进一步进行更大患者样本的长期随机对照试验,以及对患者报告的结果测量和患者治疗时间的评估。
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引用次数: 28
Oral Health Awareness among International Dental and Medical Students at Lithuanian University of Health Sciences: a Cross-Sectional Study. 立陶宛健康科学大学国际牙科和医科学生的口腔健康意识:一项横断面研究。
Pub Date : 2019-12-30 eCollection Date: 2019-10-01 DOI: 10.5037/jomr.2019.10403
Sandra Petrauskiene, Hava Mushayev, Gintare Zemgulyte, Julija Narbutaite

Objectives: To evaluate the self-reported oral health awareness, knowledge and attitude among international dental and medical students at the Lithuanian University of Health Sciences (Kaunas, Lithuania).

Material and methods: A cross-sectional study was conducted among international medical and dental students at the Lithuanian University of Health Sciences in 2016 - 2017. The students were invited to participate in the survey before the beginning of a lecture, and they were informed that participation was voluntary and anonymous. In total, 282 students participated in the study, with a response rate of 92.1%. A self-administered English questionnaire consisting of 25 items with options on a Likert scale (agree, neither agree nor disagree and disagree) about oral health problems and their relation to general health status was used to assess a student's oral health awareness, attitude and knowledge. The level of significance was set at P < 0.05.

Results: Overall good, fair and poor oral health awareness was reported by 71.3%, 24.1% and 4.6%, respectively, of the international dental and medical students (P < 0.05). The mean score of oral health awareness was 18.2 (standard deviation [SD 3.27]), showing overall good oral health awareness. Moreover, the international dental students reported higher oral health awareness than medical students (19.14 [SD 3.25] vs 17.44 [SD 3.1]) (P < 0.001). Comparing this mean score by gender, no statistically significant difference was found (18.33 [SD 3.39] vs 18.05 [SD 3.16]) (P = 0.371).

Conclusions: Overall oral health awareness among international dental and medical students was high. Meanwhile, international dental students reported higher oral health awareness than international medical students.

目的:评估立陶宛健康科学大学(考纳斯,立陶宛)国际牙科和医科学生自我报告的口腔健康意识、知识和态度。材料和方法:2016 - 2017年在立陶宛健康科学大学的国际医学和牙科学生中进行了一项横断面研究。学生们被邀请在讲座开始前参与调查,他们被告知参与是自愿和匿名的。共有282名学生参与了研究,回复率为92.1%。采用李克特量表(同意、不同意、不同意、不同意)对口腔健康问题及其与总体健康状况的关系进行问卷调查,问卷共25个项目。P < 0.05为显著性水平。结果:口腔健康意识总体良好的占71.3%,一般的占24.1%,差的占4.6% (P < 0.05)。口腔健康意识平均得分为18.2分(标准差[SD 3.27]),总体口腔健康意识较好。此外,国际牙科学生的口腔健康意识高于医科学生(19.14 [SD 3.25]比17.44 [SD 3.1]) (P < 0.001)。按性别比较平均得分,差异无统计学意义(18.33 [SD 3.39] vs 18.05 [SD 3.16]) (P = 0.371)。结论:留学生口腔健康意识总体较高。与此同时,国际牙科学生报告的口腔健康意识高于国际医科学生。
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引用次数: 8
Maxillary Sinus Floor Augmentation With or Without Barrier Membrane Coverage of the Lateral Window: a Systematic Review and Meta-Analysis. 上颌窦底增强有或没有侧窗屏障膜覆盖:系统回顾和荟萃分析。
Pub Date : 2019-12-30 eCollection Date: 2019-10-01 DOI: 10.5037/jomr.2019.10401
Thomas Starch-Jensen, Daniel Deluiz, Kirsten Duch, Eduardo Muniz Barretto Tinoco

Objectives: Test the hypothesis of no difference in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window.

Material and methods: A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 5th of July, 2019 were included. Randomised controlled trials and controlled trials with an observation period of minimum six months were included. Primary outcomes included survival of suprastructures and implants. Secondary outcomes included implant stability quotient, peri-implant marginal bone loss, bone regeneration, patient-reported outcome measures, biologic and mechanical complications.

Results: The electronic search and hand-searching resulted in 1068 entries. Six randomised controlled trials characterised by low to high risk of bias and one controlled trial with high risk of bias fulfilled the inclusion criteria. High implant survival rate was reported with both treatment modalities. Meta-analyses disclosed a mean difference of newly formed bone of 6.4% (confidence interval = 0 to 12.9) and non-mineralised tissue of -1.1% (confidence interval = -2.7 to 0.5), indicating more newly formed bone and diminished non-mineralised with barrier membrane coverage.

Conclusions: There seem to be no statistically significant differences in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. However, barrier membrane coverage increases percentage of newly formed bone and diminishes proliferation of non-mineralised tissue. Thus, barrier membrane coverage seems to be beneficial and also preventing displacement of the grafting material.

目的:验证有或无侧窗屏障膜覆盖的上颌窦底增强后种植体治疗结果无差异的假设。材料和方法:在MEDLINE (PubMed)、Embase和Cochrane图书馆进行检索,并结合手工检索相关期刊。纳入了2019年7月5日之前用英语发表的人类研究。纳入随机对照试验和观察期至少为6个月的对照试验。主要结局包括上结构和种植体的存活。次要结果包括种植体稳定性系数、种植体周围边缘骨丢失、骨再生、患者报告的结果测量、生物和机械并发症。结果:电子检索和手工检索共获得1068项。6项低至高偏倚风险的随机对照试验和1项高偏倚风险的对照试验符合纳入标准。两种治疗方式均有较高的种植体存活率。荟萃分析显示,新生骨的平均差异为6.4%(置信区间= 0至12.9),非矿化组织的平均差异为-1.1%(置信区间= -2.7至0.5),表明新生骨更多,非矿化的屏障膜覆盖率减少。结论:上颌窦底增强术有或无侧窗屏障膜覆盖后种植体治疗效果无统计学差异。然而,屏障膜的覆盖增加了新形成骨的百分比,并减少了非矿化组织的增殖。因此,屏障膜覆盖似乎是有益的,也可以防止接枝材料的位移。
{"title":"Maxillary Sinus Floor Augmentation With or Without Barrier Membrane Coverage of the Lateral Window: a Systematic Review and Meta-Analysis.","authors":"Thomas Starch-Jensen,&nbsp;Daniel Deluiz,&nbsp;Kirsten Duch,&nbsp;Eduardo Muniz Barretto Tinoco","doi":"10.5037/jomr.2019.10401","DOIUrl":"https://doi.org/10.5037/jomr.2019.10401","url":null,"abstract":"<p><strong>Objectives: </strong>Test the hypothesis of no difference in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window.</p><p><strong>Material and methods: </strong>A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 5th of July, 2019 were included. Randomised controlled trials and controlled trials with an observation period of minimum six months were included. Primary outcomes included survival of suprastructures and implants. Secondary outcomes included implant stability quotient, peri-implant marginal bone loss, bone regeneration, patient-reported outcome measures, biologic and mechanical complications.</p><p><strong>Results: </strong>The electronic search and hand-searching resulted in 1068 entries. Six randomised controlled trials characterised by low to high risk of bias and one controlled trial with high risk of bias fulfilled the inclusion criteria. High implant survival rate was reported with both treatment modalities. Meta-analyses disclosed a mean difference of newly formed bone of 6.4% (confidence interval = 0 to 12.9) and non-mineralised tissue of -1.1% (confidence interval = -2.7 to 0.5), indicating more newly formed bone and diminished non-mineralised with barrier membrane coverage.</p><p><strong>Conclusions: </strong>There seem to be no statistically significant differences in implant treatment outcomes after maxillary sinus floor augmentation with or without barrier membrane coverage of the lateral window. However, barrier membrane coverage increases percentage of newly formed bone and diminishes proliferation of non-mineralised tissue. Thus, barrier membrane coverage seems to be beneficial and also preventing displacement of the grafting material.</p>","PeriodicalId":230885,"journal":{"name":"Journal of Oral & Maxillofacial Research","volume":"10 4","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/df/jomr-10-e1.PMC7012617.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37726677","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}
引用次数: 11
Myositis Ossificans Traumatica of the Temporal Muscle: a Case Report and Literature Review Emphasizing Radiographic Features on Computed Tomography and Magnetic Resonance Imaging. 颞肌外伤性骨化性肌炎1例报告及文献回顾,强调电脑断层及核磁共振影像的影像特征。
Pub Date : 2019-12-30 eCollection Date: 2019-10-01 DOI: 10.5037/jomr.2019.10405
Erika Antonia Dos Anjos Ramos, Luciana Munhoz, Basílio Almeida Milani, Fernando Pando de Matos, Emiko Saito Arita

Objectives: Heterotopic bone formation within a muscle is designated as 'myositis ossificans', and it is associated with multiple aetiologies, such as trauma, genetic predisposition, post-infection, or undetermined causes. When the disease develops as a result of a trauma, the myositis ossificans is classified as 'myositis ossificans traumatica'. In this case report, a case of myositis ossificans traumatica is described, emphasizing its imaging features. Additionally, a literature review of the imaging features of myositis ossificans is discussed.

Material and methods: A 60-year old male patient presented with restricted mouth opening and pain during mastication. Multislice computed tomography and magnetic resonance imaging examinations were conducted. Case reports in the literature of myositis ossificans were searched databases from August 1984 until April 2019 using the keyword 'masticatory muscles' combined with 'myositis'; 'inflammatory myositis'; infectious myositis'; 'inflammatory muscle diseases'; 'focal myositis' and 'proliferative myositis'. Data was summarised and evaluated according to a critical appraisal checklist for case reports.

Results: Multislice computed tomography demonstrated an ectopic hyperdense area arising from the coronoid bone and within the temporal muscle. Magnetic resonance imaging demonstrated the same area with a hypointense signal. In the literature review, 53 myositis ossificans cases were identified, and 12 cases affecting the temporal muscle were found.

Conclusions: The main imaging feature of myositis ossificans is the presence of a radiopaque, hyperdense or hypointense mass in the affected muscle, which is seen on multislice computed tomography and magnetic resonance imaging, respectively. The final diagnosis is through histopathological examination, although imaging can suggest the most likely diagnosis.

目的:肌肉内异位骨形成被称为“骨化性肌炎”,它与多种病因有关,如创伤、遗传易感性、感染后或未确定原因。当疾病发展为创伤的结果,骨化性肌炎被分类为“创伤性骨化性肌炎”。在这个病例报告中,我们描述了一例外伤性骨化性肌炎,并强调了其影像学特征。此外,本文还讨论了骨化性肌炎的影像学特征。材料与方法:60岁男性患者,以咀嚼时开口受限、疼痛为主。进行多层计算机断层扫描和磁共振成像检查。检索数据库中1984年8月至2019年4月期间骨化性肌炎文献中的病例报告,检索关键词为“咀嚼肌”和“肌炎”;“炎症性肌炎”;传染性肌炎”;“炎症性肌肉疾病”;“局灶性肌炎”和“增生性肌炎”。根据病例报告的关键评估清单对数据进行总结和评估。结果:多层计算机断层扫描显示一个异位高密度区起源于冠状骨和颞肌内。磁共振成像显示同一区域有低信号。在文献回顾中,发现53例骨化性肌炎,其中12例累及颞肌。结论:骨化性肌炎的主要影像学特征是在受影响的肌肉中存在不透明、高密度或低密度的肿块,分别在多层计算机断层扫描和磁共振成像上可见。最终的诊断是通过组织病理学检查,尽管影像学可以建议最有可能的诊断。
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引用次数: 3
Dental Fear and Dental Health and Attendance among Finnish Male Prisoners. 芬兰男性囚犯对牙医的恐惧、牙齿健康和护理。
Pub Date : 2019-12-30 eCollection Date: 2019-10-01 DOI: 10.5037/jomr.2019.10404
Raija Vainionpää, Paula Pesonen, Marja-Liisa Laitala, Vesa Pohjola, Vuokko Anttonen
ABSTRACT Objectives The aim of the present study was to evaluate the prevalence of dental fear and the associations between dental fear and dental health and dental attendance among Finnish prisoners. Material and Methods Eighty-nine voluntary male prisoners from the Pelso Prison participated in this cross-sectional clinical study between September 2014 and February 2015. Forty-six (51.7%) of them were also interviewed for their background factors, dental fear and dental attendance. To evaluate the prisoners’ level of dental fear, the Modified Dental Anxiety Scale and Dental Visual Analogue Scale were used. The numbers of decayed, missing, filled and remaining teeth reported dental health. For analyses Pearson’s Chi-square test, Fisher’s exact test, logistic regression analyses and the independent samples Kruskall-Wallis test were conducted. Results Among male prisoners four out of 46 (8.7%) reported severe and fourteen out of 46 (30.4%) moderate dental fear, 60.9% had mild or no dental fear. Those with no dental fear visited a dentist regularly more often than those with dental fear. The use of snuff and number of medications were positively associated with severe dental fear. Conclusions Dental fear is common among Finnish male prisoners. High number of prescribed medications, use of snuff and irregular dental attendance may indicate severe dental fear among Finnish male prisoners.
目的:本研究的目的是评估芬兰囚犯中牙科恐惧的患病率以及牙科恐惧与牙齿健康和牙科就诊之间的关系。材料与方法:2014年9月至2015年2月,89名来自Pelso监狱的自愿男性囚犯参与了这项横断面临床研究。其中46人(51.7%)还接受了背景因素、牙科恐惧和牙科就诊情况的访谈。采用改良牙科焦虑量表和牙科视觉模拟量表评估囚犯的牙科恐惧程度。蛀牙、缺牙、补牙和剩余牙齿的数量报告了牙齿健康状况。分析采用Pearson卡方检验、Fisher精确检验、logistic回归分析和独立样本Kruskall-Wallis检验。结果:46名男性囚犯中有4名(8.7%)报告严重牙科恐惧,46名男性囚犯中有14名(30.4%)报告中度牙科恐惧,60.9%报告轻度或无牙科恐惧。那些没有牙医恐惧症的人比那些有牙医恐惧症的人更经常地去看牙医。鼻烟的使用和药物的数量与严重的牙科恐惧呈正相关。结论:对牙齿的恐惧在芬兰男性囚犯中很常见。大量处方药物、使用鼻烟和不定期看牙医可能表明芬兰男性囚犯对牙医有严重的恐惧。
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引用次数: 6
Extraction Socket Preservation with or without Membranes, Soft Tissue Influence on Post Extraction Alveolar Ridge Preservation: a Systematic Review 有膜或无膜的拔牙槽保存,软组织对拔牙后牙槽嵴保存的影响:一项系统综述
Pub Date : 2019-09-05 DOI: 10.5037/jomr.2019.10305
R. Faria‐Almeida, Inesa Astramskaite-Januseviciene, A. Puišys, Francisco Correia
ABSTRACT Objectives The purpose of this systematic review was to assess quantitatively and qualitatively the influence of two different factors: membranes and soft tissue graft influence for the extraction socket preservation. Material and Methods A wide-ranging electronic search was performed in six databases up to 30 of November 2018 in order to identify all the clinical and randomized clinical trials performed in humans published with no data restriction. The inclusion criteria were extraction socket preservation with and without membranes or a soft tissue graft in a intact socket with at least six months of follow-up, have more than 12 patients or treat more than 12 sites per group and evaluated at least one of the primary outcomes measures (radiographic measures histological assessment, clinical measures). Results From an initial search of 1524 studies only 6 papers fulfil the inclusion and exclusion criterions. All the six selected papers, presented a wide heterogeneity of treatments used, evaluated variables and observation period that made impossible to recommend any specific techniques and/or material to achieve better results. The limited data found suggest that the used of membrane reveals to achieve better results. It wasn’t possible to observe in any clinical trial that compares the used of soft tissue graft. Conclusions New trials need to be performed in order to identify what specific techniques and/or materials are better to decrease the reabsorption of the socket after tooth extraction. Clinical trials designed to understand when/how the soft tissues grafts influence at the socket preservation is needed.
目的本系统综述的目的是定量和定性地评估两个不同因素:膜和软组织移植物对拔牙窝保存的影响。材料和方法在截至2018年11月30日的六个数据库中进行了广泛的电子检索,以确定所有已发表的无数据限制的人类临床和随机临床试验。纳入标准为:至少随访6个月,有或没有膜的拔牙窝保存,或在完整的窝内移植软组织,每组有超过12例患者或治疗超过12个部位,并评估至少一项主要结果测量(放射测量、组织学评估、临床测量)。结果初步检索1524篇文献,仅有6篇符合纳入和排除标准。所有入选的六篇论文均显示了所使用的治疗方法的广泛异质性,评估了变量和观察期,因此不可能推荐任何特定的技术和/或材料来获得更好的结果。发现的有限数据表明,使用膜揭示可以达到更好的效果。不可能在任何临床试验中观察到比较软组织移植的使用。结论需要进行新的试验,以确定哪些具体的技术和/或材料可以更好地减少拔牙后牙槽的再吸收。临床试验旨在了解何时/如何软组织移植物影响窝保存是必要的。
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引用次数: 30
Extraction Socket Preservation Using Growth Factors and Stem Cells: a Systematic Review 使用生长因子和干细胞保存提取窝:系统综述
Pub Date : 2019-09-05 DOI: 10.5037/jomr.2019.10307
Mindaugas Pranskunas, P. Galindo-Moreno, M. Padial-Molina
ABSTRACT Objectives To evaluate the reported literature on the use of stem cells or growth factors for post extraction treatment of the alveolar bone. Material and Methods A NCBI PubMed and PubMed Central databases search was conducted between September 2010 and August 2018, to identify animal or clinical studies reporting the clinical, radiographical and/or histological outcomes of socket preservation techniques after applying mesenchymal stem cells or growth factors. Only studies published in English language in the last 10 years were included in the study. Results Eleven studies were identified fulfilling the inclusion criteria. They evaluate a total of 386 post extraction sockets. The main tested materials identified in the current review were bone morphogenetic protein-2 - 3 studies and mesenchymal stem cells - 3 studies. Other comparators were bone morphogenetic protein-9, platelet-derived growth factor-BB homodimers and bone marrow. Overall evaluation indicate positive results for all test groups showing differences in final socket width between 0.64 and 1.28 mm favouring the test groups. Histologically, no particular differences are detected between test and control groups. Most of the studies present low risk of bias. Conclusions In general, the use of mesenchymal stem cells or bioactive osteogenic molecules favours bone regeneration after tooth extraction, as evaluated clinically, radiographically and histologically. However, specific differences that support particular recommendations are still unclear in light of the current published evidence. Future studies should include the standardization of the mesenchymal stem cells selection and purification as well as dosage and delivery methods of bioactive molecules.
【摘要】目的评价干细胞或生长因子用于牙槽骨拔牙后治疗的文献报道。材料和方法在2010年9月至2018年8月期间对NCBI PubMed和PubMed Central数据库进行了检索,以确定报告应用间充质干细胞或生长因子后窝保存技术的临床、放射学和/或组织学结果的动物或临床研究。该研究只包括过去10年用英语发表的研究。结果11项研究符合纳入标准。它们总共评估了386个提取后插槽。本综述确定的主要测试材料是骨形态发生蛋白-2 - 3研究和间充质干细胞- 3研究。其他比较物是骨形态发生蛋白-9、血小板衍生生长因子- bb同二聚体和骨髓。总体评价表明,所有测试组的结果都是积极的,显示出最终插座宽度在0.64和1.28 mm之间的差异,这对测试组有利。组织学上,在实验组和对照组之间没有发现特别的差异。大多数研究显示偏倚风险较低。总的来说,临床、影像学和组织学评价表明,使用间充质干细胞或生物活性成骨分子有利于拔牙后骨再生。然而,根据目前公布的证据,支持特定建议的具体差异仍不清楚。未来的研究应包括间充质干细胞的选择和纯化的标准化以及生物活性分子的剂量和递送方法。
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引用次数: 14
Dental Implant Outcomes in Grafted Sockets: a Systematic Review and Meta-Analysis 牙槽骨移植的种植效果:系统回顾和荟萃分析
Pub Date : 2019-09-05 DOI: 10.5037/jomr.2019.10308
A. Ramanauskaite, Tiago Borges, B. Almeida, A. Correia
ABSTRACT Objectives To assess the treatment outcomes of the dental implants placed in the grafted sockets. Material and Methods A search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles. Results The present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseases Conclusions Implants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.
【摘要】目的评价牙槽内种植体的治疗效果。材料和方法制定了一项搜索方案,从种植体存活率(主要结果)、边缘骨水平(MBL)变化、临床参数(即探诊时出血、探诊深度)、种植体周围疾病的发生和美学结果(次要结果)等方面评估种植体放置在移植牙槽内的治疗结果。随机对照临床试验(rct)、对照临床试验和前瞻性研究进行了至少12个月的随访,至少10例患者至少有一颗牙种植体插入到移植的牙槽中。在MEDLINE (PubMed)检索到2019年4月1日之前发表的相关文章。采用随机效应模型对入选的符合条件的文章进行meta分析。结果本分析纳入7项随机对照试验。随访1 ~ 4年后,种植体在移植窝内的成活率为95% ~ 100%。结果发现,植入未移植愈合部位的MBL损失明显大于植入先前移植的槽位的MBL损失(加权平均差= -1.961 mm, P < 0.0001)。就MBL的变化而言,立即插入的种植体与先前移植的种植体之间没有差异。这些纳入的研究均未报道临床参数或种植体周围疾病的发生。结论与未移植的种植体相比,种植体插入先前移植过的种植体存活率高,边缘骨水平损失小。
{"title":"Dental Implant Outcomes in Grafted Sockets: a Systematic Review and Meta-Analysis","authors":"A. Ramanauskaite, Tiago Borges, B. Almeida, A. Correia","doi":"10.5037/jomr.2019.10308","DOIUrl":"https://doi.org/10.5037/jomr.2019.10308","url":null,"abstract":"ABSTRACT Objectives To assess the treatment outcomes of the dental implants placed in the grafted sockets. Material and Methods A search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles. Results The present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseases Conclusions Implants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.","PeriodicalId":230885,"journal":{"name":"Journal of Oral & Maxillofacial Research","volume":"386 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122989745","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}
引用次数: 16
期刊
Journal of Oral & Maxillofacial Research
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