Journal of Evidence-Based Dental Practice最新文献

英文中文

POSTOPERATIVE STABILITY OF AESTHETIC OUTCOMES FOLLOWING RESIN INFILTRATION OF HYPOMINERALISED AND DEMINERALISED ENAMEL LESIONS: A SYSTEMATIC REVIEW 低矿化和脱矿化釉质病变树脂浸润术后美学效果的稳定性：系统回顾

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-11-02 DOI: 10.1016/j.jebdp.2024.102052

Marie Véguer , Elsa Garot , David J Manton , Olivia Kérourédan

Objectives

As the need for efficient and minimally invasive strategies for the aesthetic management of hypomineralised and demineralised enamel lesions is critical, this systematic review aimed to assess the postoperative stability of aesthetic outcomes achieved after resin infiltration in permanent incisors, canines and premolars.

Data/Sources

This systematic review was conducted according to the PRISMA guidelines. The search strategy was based on PICO reporting system. Publications (up to September 2024) investigating the postoperative stability of aesthetic outcomes following resin infiltration of hypomineralised and demineralised enamel lesions were identified in a systematic search using MEDLINE/PubMed, Scopus and DOSS electronic databases. Only clinical studies were included. Additionally, science mapping analysis and quality assessment of selected full-text articles were performed using keyword co-occurrence networking on VOSviewer and the NIH Before-After Cohort Study assessment tool or Rob 2 tool, respectively.

Study selection

From an initial total of 664 studies, 15 were included in the final analysis, based on inclusion/exclusion criteria. A total number of 1518 teeth from 374 patients were included. All studies showed that the outcome obtained after resin infiltration of hypomineralised and demineralised lesions remained aesthetically stable over short, medium and long periods. However, this review highlighted that most of these studies: i/ exclusively focused on a single criterion, colourimetry, ii/ were restricted to short follow-up periods, and iii/ displayed a moderate risk of bias.

Conclusions

This systematic literature review highlights good stability of postoperative aesthetic outcomes following resin infiltration of hypomineralised and demineralised enamel lesions in permanent teeth. However, additional clinical studies are needed in order to achieve a higher level of scientific evidence regarding the longevity of this therapeutic intervention.

目的由于对低矿化和脱矿化牙釉质病变的美学治疗亟需高效和微创的策略，本系统综述旨在评估恒切牙、犬齿和前磨牙树脂浸润术后美学效果的稳定性。检索策略基于 PICO 报告系统。通过使用 MEDLINE/PubMed、Scopus 和 DOSS 电子数据库进行系统性检索，确定了研究树脂浸润低矿化和脱矿化牙釉质病变术后美学效果稳定性的文献（截至 2024 年 9 月）。只纳入了临床研究。此外，还分别使用 VOSviewer 和 NIH 前后队列研究评估工具或 Rob 2 工具上的关键词共现网络对所选全文进行了科学图谱分析和质量评估。共纳入了 374 名患者的 1518 颗牙齿。所有研究都表明，低矿化和脱矿化病变的树脂浸润后，其结果在短期、中期和长期内保持美观稳定。然而，本综述强调了这些研究中的大多数：i/只关注单一标准，即比色法；ii/仅限于较短的随访期；iii/显示出中等程度的偏倚风险。结论本系统性文献综述强调了树脂浸润恒牙低矿化和脱矿釉质病变后术后美学效果的良好稳定性。但是，还需要进行更多的临床研究，以便为这种治疗干预的持久性提供更高水平的科学证据。

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引用次数: 0

ORAL CARE AND DENTAL INTERVENTIONS SHOW MIXED AND UNCLEAR EFFECTS ON COGNITIVE FUNCTION 口腔护理和牙科干预对认知功能的影响参差不齐且不明确

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-19 DOI: 10.1016/j.jebdp.2024.102039

ARCHANA PRADHAN (REVIEWERS), ARASH GHANBARZADEGAN, THILINI N. JAYASINGHE

Article Title and Bibliographic Information

DO ORAL CARE AND REHABILITATION IMPROVE COGNITIVE FUNCTION?

A SYSTEMATIC REVIEW OF CLINICAL STUDIES

Inamochi Y, Ogino Y, Harada K, Fueki K, Ayukawa Y, Nishimura M, Maekawa K, Kang Y, Hirai T, Kuboki T. DO ORAL CARE AND REHABILITATION IMPROVE COGNITIVE FUNCTION? A SYSTEMATIC REVIEW OF CLINICAL STUDIES. J Evid Based Dent Pract. 2024 Mar;24(1):101948. 10.1016/j.jebdp.2023.101948. Epub 2023 Oct 19. PMID: 38448117.

SOURCE OF FUNDING

None.

Type of Study/Design

Systematic review.

文章标题和参考文献信息口腔护理和康复是否改善认知功能？口腔护理和康复能改善认知功能吗？临床研究的系统回顾。J Evid Based Dent Pract.2024 Mar;24(1):101948.10.1016/j.jebdp.2023.101948.Epub 2023 Oct 19.PMID: 38448117.SOURCE OF FUNDINGNone.Type of Study/DesignSystematic review.

引用次数: 0

HYALURONIC ACID INJECTION MAY BE EFFECTIVE FOR RECONSTRUCTION OF MILD TO MODERATE LOSS OF INTERDENTAL PAPILLA IN ADULT PATIENTS IN THE SHORT TERM 透明质酸注射在短期内可能对成年患者重建轻度至中度牙间乳头缺失有效

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-19 DOI: 10.1016/j.jebdp.2024.102044

HSIN HSU (REVIEWERS), JOHNSON HSIN-CHUNG CHENG, CHIN-WEI WANG

Article Title and Bibliographic Information

The use of hyaluronic acid injection for treatment of black triangle and reconstruction of lost interdental papilla in anterior teeth: a systematic review.

ACTA ODONTOLOGICA SCANDINAVICA 2024; VOL. 83: 371-391. DOI: https://doi.org/10.2340/aos.v83.40864.

Source of funding

The author did not report any financial support for this systematic review.

Type of study/design

Systematic review.

文章标题和参考文献信息使用透明质酸注射治疗前牙黑三角和重建缺失的牙间乳头：系统综述.ACTA ODONTOLOGICA SCANDINAVICA 2024; VOL.83: 371-391.DOI: https://doi.org/10.2340/aos.v83.40864.Source 资助作者未报告本系统综述获得任何资助。研究类型/设计系统综述。

引用次数: 0

CAD/CAM-FABRICATED RPD FRAMEWORKS SHOW LOWER FIT ACCURACY COMPARED TO CONVENTIONAL CASTING, WITH INDIRECT 3D PRINTING OFFERING COMPARABLE RESULTS 与传统铸造相比，CAD/CAM 制造的 Rpd 框架的配合精度较低，而间接 3D 打印的结果与之相当

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-19 DOI: 10.1016/j.jebdp.2024.102043

CHING YEE CONSTANCE LAW (REVIEWER)

Article Title and Bibliographic Information

Accuracy of removable partial denture metal frameworks fabricated by computer-aided design/computer-aided manufacturing method: A systematic review and meta-analysis. Mai HY, Mai HN, Kim HJ, Lee J, Lee DH. J Evid-Base Dent Pract. 2022 Sep 1;22(3):101681.

Source of Funding

Government: Korean Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, Republic of Korea, the Ministry of Food and Drug Safety (202011A02).

Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (2020R1I1A1A01062967).

Type of Study/Design

Systematic review with meta-analysis of data.

文章标题和参考文献信息采用计算机辅助设计/计算机辅助制造方法制作的可摘局部义齿金属框架的准确性：系统综述和荟萃分析。Mai HY, Mai HN, Kim HJ, Lee J, Lee DH.J Evid-Base Dent Pract.2022 Sep 1;22(3):101681.Funding SourceGovernment：由韩国政府（科学和信息通信技术部、贸易、工业和能源部、大韩民国保健福祉部、食品和药品安全部（202011A02））资助的韩国医疗设备开发基金拨款。由韩国政府（MSIT）资助的国家研究基金会（NRF）生物和医疗技术开发项目（2020R1I1A1A01062967）。研究/设计类型系统回顾与数据荟萃分析。

引用次数: 0

A MULTICENTER, RANDOMIZED, OPEN-LABEL, PLACEBO-CONTROLLED CLINICAL TRIAL OF THE EFFECT OF CETYLPYRIDINIUM CHLORIDE (CPC) MOUTHWASH AND ON-DEMAND AQUEOUS CHLORINE DIOXIDE MOUTHWASH ON SARS-COV-2 VIRAL TITER IN PATIENTS WITH MILD COVID-19 一项多中心、随机、开放标签、安慰剂对照临床试验：西乙吡啶氯化铵（cpc）漱口水和按需二氧化氯水溶液漱口水对轻度柯维-19 患者沙士-柯维-2 病毒滴度的影响

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-17 DOI: 10.1016/j.jebdp.2024.102040

DAISUKE ONOZUKA PhD , KEIJI KONISHI MD , SATOKO TAKATERA PhD , MASAHIDE OSAKI MD , SHOUGEN SUMIYOSHI MD , YUSUKE TAKAHASHI MD , SHIGETO HAMAGUCHI MD, PhD , YASUO IMOTO PhD , SATOSHI KUTSUNA MD, PhD

Objectives

The established effect of cetylpyridinium chloride (CPC) mouthwash on SARS-CoV-2 viral titers is unclear. No clinical trial has examined the impact of on-demand aqueous chlorine dioxide mouthwash on SARS-CoV-2 viral titer.

Methods

In this multicenter, 3-armed, randomized, open-label, placebo-controlled clinical trial involving mildly symptomatic COVID-19 patients, we randomly assigned them to receive 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of purified water as a placebo mouthwash in a 1:1:1 ratio. The primary measurement was the SARS-CoV-2 viral titer in saliva, evaluated by a mixed-effects linear regression model.

Results

49 patients received CPC mouthwash (n=16), on-demand aqueous chlorine dioxide mouthwash (n=16), and placebo (n=17) between January 14, 2024, and February 20, 2024. 0.05% CPC mouthwash significantly reduced salivary viral titer at 10 minutes postuse (-0.97 log₁₀ PFU/mL; 95% CI, -1.64 to -0.30; P = .004), while no such effect was observed at 30 minutes (difference vs placebo, -0.26 log₁₀ PFU/mL; 95% CI, -0.92 to 0.40; P = .435) or 60 minutes (difference vs. placebo, -0.05 log₁₀ PFU/mL; 95% CI, -0.68 to 0.58; P = .877). 0.01% on-demand chlorine dioxide mouthwash did not reduce salivary viral titer at 10 minutes, 30 minutes, or 60 minutes compared to placebo.

Conclusions

10 minutes after using a 0.05% CPC mouthwash, the salivary viral titer of SARS-CoV-2 decreased compared to placebo. 0.01% on-demand aqueous chlorine dioxide mouthwash and placebo had no significant difference in SARS-CoV-2 viral titers.

Trial Registration

Japan Registry of Clinical Trials (jRCT): jRCTs031230566.

目的西吡啶氯化物（CPC）漱口水对 SARS-CoV-2 病毒滴度的影响尚不明确。方法在这项多中心、三组、随机、开放标签、安慰剂对照临床试验中，我们将轻度症状的 COVID-19 患者随机分配到 20 mL 0.05% CPC、10 mL 0.01% 按需二氧化氯水溶液或 20 mL 纯净水作为安慰剂，比例为 1:1:1。结果49 名患者在 2024 年 1 月 14 日至 2024 年 2 月 20 日期间接受了 CPC 漱口水（16 人）、按需二氧化氯水漱口水（16 人）和安慰剂（17 人）。使用后 10 分钟，0.05% CPC 漱口水可显著降低唾液病毒滴度（-0.97 log10 PFU/mL；95% CI，-1.64 至-0.30；P = .004），而 30 分钟后则未观察到此类效果（与安慰剂相比，差异为-0.26 log10 PFU/mL；95% CI，-0.92 至 0.40；P = .435）或 60 分钟（与安慰剂相比，差异为 -0.05 log10 PFU/mL；95% CI，-0.68 至 0.58；P = .877）。结论使用 0.05% CPC 漱口水 10 分钟后，SARS-CoV-2 的唾液病毒滴度与安慰剂相比有所下降。试验注册日本临床试验注册中心（jRCT）：jRCTs031230566.

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引用次数: 0

ARTIFICIAL INTELLIGENCE IN DENTAL SHADE-MATCHING SHOWS PROMISING POTENTIAL FOR PRECISION IN RESTORATIVE DENTISTRY, THOUGH REQUIRING FURTHER IMPROVEMENT 人工智能在牙科色调匹配中的应用显示出在牙科修复中实现精确性的巨大潜力，但仍需进一步改进

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-17 DOI: 10.1016/j.jebdp.2024.102042

AHMED YASEEN ALQUTAIBI (Reviewer)

Article Title and Bibliographic Information

Shetty, S., et al. (2023). “Artificial intelligence systems in dental shade-matching: A systematic review.” J Prosthodont. DOI: 10.1111/jopr.13805.

Source of Funding

Information not available.

Type of Study/Design

Systematic review.

文章标题和书目信息Shetty, S., et al. (2023)."牙科阴影匹配中的人工智能系统：系统综述》。J Prosthodont.DOI：10.1111/jopr.13805.经费来源信息不详研究/设计类型系统综述。

引用次数: 0

IMMEDIATE IMPLANT PLACEMENT AND LOADING IN THE MAXILLARY ESTHETIC ZONE DEMONSTRATE HIGH SURVIVAL RATES, BUT ESTHETIC AND FUNCTIONAL SUCCESS DATA IS STILL NEEDED 上颌美学区的即刻种植体植入和装载显示出较高的存活率，但仍需要美学和功能方面的成功数据

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-13 DOI: 10.1016/j.jebdp.2024.102036

KELVIN I. AFRASHTEHFAR (REVIEWERS), LOVELY M. ANNAMMA, MAHER A. ALSHAYEB, ALAIN MANUEL CHAPLE-GIL

Article Title and Bibliographic Information

Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res. 2023 Sep;34 Suppl 26:304-348. doi:10.1111/clr.14109.

Source of Funding

Although it is not explicitly reported, it is understood that this study was supported by the International Team for Implantology (ITI) as part of their latest consensus initiative.

Type of Study/Design

Systematic review (with meta-analysis).

文章标题和参考文献信息Hamilton A、Gonzaga L、Amorim K、Wittneben JG、Martig L、Morton D、Martin W、Gallucci GO、Wismeijer D.上颌美学区单牙替换即刻种植体植入和即刻加载的选择标准：系统回顾和荟萃分析。Doi:10.1111/clr.14109.经费来源虽然没有明确报道，但据了解，这项研究得到了国际种植团队（ITI）的支持，是其最新共识倡议的一部分。研究/设计类型系统综述（含荟萃分析）。

引用次数: 0

COMPARISON OF INTRAORAL CAMERAS AND SMARTPHONES IN EARLY CHILDHOOD CARIES DETECTION: A DIAGNOSTIC ACCURACY STUDY 口内照相机和智能手机在儿童早期龋齿检测中的比较：诊断准确性研究

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-13 DOI: 10.1016/j.jebdp.2024.102041

NOURHAN M. ALY , Mona K. El Kashlan , Nicolas Giraudeau , Maha El Tantawi

Objectives

Early Childhood Caries (ECC) is a major public health problem affecting children worldwide. Teledentistry offers innovative approaches for ECC detection, particularly in areas with limited access to care. This study compared the accuracy of intraoral cameras and smartphones in relation to visual clinical examination in detecting ECC.

Methods

A prospective diagnostic accuracy study was conducted in a rural area near Alexandria, Egypt, involving children under 6 years old. An intraoral camera (C50 Full HD with fluorescence) or a smartphone (Samsung Galaxy A24) captured intraoral structures after randomizing the children into 2 groups. The reference standard was visual clinical examination under daylight without magnification or drying. Teeth were categorized using the Caries Assessment Spectrum and Treatment (CAST) index criteria based on clinical examination, intraoral camera videos and smartphone photos. Sensitivity, specificity, and accuracy were calculated for the 2 methods at 3 thresholds: enamel caries, dentin caries and enamel/dentin caries combined.

Results

The study included 116 children, mean (SD) age = 4.3 (1.0) years, 83.6% with untreated decay and mean (SD) number of decayed teeth = 4.03 (3.50). Both the intraoral camera and the smartphone had high specificity and accuracy at the 3 thresholds (≥90%). The lowest sensitivity was in the case of detecting enamel lesion (intraoral camera = 77.5% and smartphone = 68.5%).

Conclusion

Enamel caries was detected by the intraoral camera more accurately than the smartphone. Despite this, both devices exhibited high specificity and accuracy at all diagnostic thresholds. Smartphones present a good alternative for intraoral cameras in underserved areas, improving ECC detection and care.

目标儿童早期龋齿（ECC）是影响全球儿童的一个主要公共卫生问题。远程牙科为ECC检测提供了创新方法，尤其是在医疗条件有限的地区。本研究比较了口内照相机和智能手机与视觉临床检查在检测 ECC 方面的准确性。方法在埃及亚历山大附近的一个农村地区开展了一项前瞻性诊断准确性研究，涉及 6 岁以下儿童。在将儿童随机分为两组后，口内照相机（C50 全高清荧光照相机）或智能手机（三星 Galaxy A24）捕捉口内结构。参考标准是在日光下进行目测临床检查，无需放大或烘干。根据临床检查、口内相机视频和智能手机照片，采用龋齿评估谱和治疗（CAST）指数标准对牙齿进行分类。在3个阈值（釉质龋、牙本质龋和釉质/牙本质合并龋）下，计算了2种方法的敏感性、特异性和准确性。口内照相机和智能手机在 3 个阈值下均具有较高的特异性和准确性（≥90%）。结论：口内照相机比智能手机更准确地检测出龋齿。尽管如此，两种设备在所有诊断阈值下都表现出较高的特异性和准确性。在服务不足的地区，智能手机是口内照相机的良好替代品，可改善ECC的检测和护理。

{"title":"COMPARISON OF INTRAORAL CAMERAS AND SMARTPHONES IN EARLY CHILDHOOD CARIES DETECTION: A DIAGNOSTIC ACCURACY STUDY","authors":"NOURHAN M. ALY , Mona K. El Kashlan , Nicolas Giraudeau , Maha El Tantawi","doi":"10.1016/j.jebdp.2024.102041","DOIUrl":"10.1016/j.jebdp.2024.102041","url":null,"abstract":"<div><h3>Objectives</h3><div>Early Childhood Caries (ECC) is a major public health problem affecting children worldwide. Teledentistry offers innovative approaches for ECC detection, particularly in areas with limited access to care. This study compared the accuracy of intraoral cameras and smartphones in relation to visual clinical examination in detecting ECC.</div></div><div><h3>Methods</h3><div>A prospective diagnostic accuracy study was conducted in a rural area near Alexandria, Egypt, involving children under 6 years old. An intraoral camera (C50 Full HD with fluorescence) or a smartphone (Samsung Galaxy A24) captured intraoral structures after randomizing the children into 2 groups. The reference standard was visual clinical examination under daylight without magnification or drying. Teeth were categorized using the Caries Assessment Spectrum and Treatment (CAST) index criteria based on clinical examination, intraoral camera videos and smartphone photos. Sensitivity, specificity, and accuracy were calculated for the 2 methods at 3 thresholds: enamel caries, dentin caries and enamel/dentin caries combined.</div></div><div><h3>Results</h3><div>The study included 116 children, mean (SD) age = 4.3 (1.0) years, 83.6% with untreated decay and mean (SD) number of decayed teeth = 4.03 (3.50). Both the intraoral camera and the smartphone had high specificity and accuracy at the 3 thresholds (≥90%). The lowest sensitivity was in the case of detecting enamel lesion (intraoral camera = 77.5% and smartphone = 68.5%).</div></div><div><h3>Conclusion</h3><div>Enamel caries was detected by the intraoral camera more accurately than the smartphone. Despite this, both devices exhibited high specificity and accuracy at all diagnostic thresholds. Smartphones present a good alternative for intraoral cameras in underserved areas, improving ECC detection and care.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"24 4","pages":"Article 102041"},"PeriodicalIF":4.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SUCRALFATE MAY BE AN EFFECTIVE TOPICAL AGENT IN PREVENTING ORAL MUCOSITIS 蔗糖酸盐可能是预防口腔黏膜炎的有效外用药剂

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-12 DOI: 10.1016/j.jebdp.2024.102037

LINDA L. CHENG (REVIEWER)

Article Title and Bibliographic Information

Coppini M, Caponio VCA, Mauceri R, Bizzoca ME, Laino L, Lorenzo-Pouso AI, Russo D, Troiano G, Silva FFVE, Lo Muzio L, Campisi G. Efficacy of topical agents in oral mucositis prevention: Systematic review and network meta-analysis. Oral Dis. 2024. doi: 10.1111/odi.15046. Epub ahead of print. PMID: 38923624.

Source of Funding

This research has been partly funded by the Active Pharmacovigilance Project Fund (AIFA project “ADR in Dentistry in the Digital Age: From Reporting to Specialist Consultation with a Click”—“ADR in Odontoiatria nell'era informatica: dalla segnalazione alla visita specialistica con un click,” led by Prof. G. Campisi). The authors declare no conflicts of interest.

Type of Study/Design

Systematic review with network meta-analysis.

文章标题和参考文献信息Coppini M、Caponio VCA、Mauceri R、Bizzoca ME、Laino L、Lorenzo-Pouso AI、Russo D、Troiano G、Silva FFVE、Lo Muzio L、Campisi G.预防口腔黏膜炎局部用药的疗效：系统综述和网络荟萃分析。Oral Dis.DOI: 10.1111/ODI.15046.Epub ahead of print.PMID：38923624.经费来源本研究得到了主动药物警戒项目基金（AIFA 项目 "数字时代牙科中的 ADR：G. Campisi教授领导）。作者声明无利益冲突。研究/设计类型系统综述与网络荟萃分析。

引用次数: 0

Impact of Oral Infection on Organ Transplantation: A Systematic Review 口腔感染对器官移植的影响：系统回顾

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice

Pub Date : 2024-09-05 DOI: 10.1016/j.jebdp.2024.102035

Jenny Olsson , Sylvia Hunfjörd , Oscar Braun , Birgitta Häggman-Henrikson , Anna Ljunggren

Objectives

Posttransplant infections may lead to dire consequences in immunocompromised organ recipients. Oral foci of infection are therefore often eliminated prior to solid organ transplantation to reduce posttransplant morbidity. However, despite increasing numbers of organ transplantations the necessity of pretransplant dental treatment and its effect on transplant outcome remains uncertain. The aim of the present systematic review was to evaluate the impact of oral foci of infection and pretransplant dental treatment on adverse events following solid organ transplantation.

Methods

Studies on adult patients undergoing solid organ transplantation with/without oral infection or with/without pretransplant dental treatment were eligible. An electronic search in PubMed, Scopus, Web of Science, CINAHL and Cochrane was conducted up to June 11, 2024. Screening of eligibility, data extraction and risk-of-bias assessment of the included studies with the Newcastle-Ottawa Scale were done independently by two reviewers. Data were synthesized with a narrative approach.

Results

In total, 4035 unique publications were identified. After full text assessment of 75 studies nine cohort studies on liver, kidney, heart and/or lung transplantation based on 727 patients were included. Two studies based on 161 patients found a significant increase of infectious complications after liver transplantation when no dental treatment was performed. Presence of oral foci increased the risk of hospitalization after kidney transplantation in one study but was associated with lower infection rate after lung transplantation in another study. No studies found significant impact on mortality or on organ rejection. Overall, the quality of the included studies was good with low or medium risk-of-bias.

Conclusion

To our knowledge, this is the first systematic review on the impact of oral infection on organ transplantation. The results suggest a possible link between persisting oral infection and posttransplant infectious complications, thus lending support to the elimination of oral infectious foci before solid organ transplantation.

目的移植后感染可能会给免疫力低下的器官受者带来严重后果。因此，通常在实体器官移植前消除口腔感染灶，以降低移植后发病率。然而，尽管器官移植数量不断增加，移植前牙科治疗的必要性及其对移植结果的影响仍不确定。本系统综述旨在评估口腔感染灶和移植前牙科治疗对实体器官移植后不良事件的影响。截至 2024 年 6 月 11 日，在 PubMed、Scopus、Web of Science、CINAHL 和 Cochrane 中进行了电子检索。资格筛选、数据提取以及使用纽卡斯尔-渥太华量表对纳入研究进行偏倚风险评估均由两名审稿人独立完成。结果共发现 4035 篇独特的出版物。在对 75 项研究进行全文评估后，纳入了 9 项关于肝、肾、心脏和/或肺移植的队列研究，共涉及 727 名患者。其中两项研究（共 161 名患者）发现，如果没有进行牙科治疗，肝移植术后感染性并发症的发生率会显著增加。在一项研究中，存在口腔病灶会增加肾移植后住院的风险，但在另一项研究中，存在口腔病灶与肺移植后较低的感染率有关。没有研究发现口腔病灶对死亡率或器官排斥反应有重大影响。总体而言，纳入研究的质量较好，偏倚风险较低或中等。结论据我们所知，这是第一篇关于口腔感染对器官移植影响的系统综述。研究结果表明，持续口腔感染与移植后感染性并发症之间可能存在联系，因此支持在实体器官移植前消除口腔感染灶。

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