Pub Date : 2025-06-01Epub Date: 2025-01-30DOI: 10.1016/j.jebdp.2025.102098
ESZTER HARDI , ANNA TAKÁCS , BIANCA GOLZIO NAVARRO CAVALCANTE , BENCE SZABÓ , ANDREA HARNOS , PÉTER HEGYI , Gábor Varga , ORSOLYA NÉMETH , ÁRPÁD JOÓB-FANCSALY
Background
The aim of this systematic review and meta-analysis was to assess whether pain, swelling and trismus following surgical removal of the lower third molar could be reduced by twin-mix injection.
Materials and Methods
MEDLINE, Embase and Cochrane Trials were searched for randomized controlled trials (RCTs) until 17th November 2022. Eight RCTs were included in the systematic review, and 7 in the meta-analysis. In this study, the twin-mix was compared with the conventional anesthetic solution. Outcomes were assessed on postoperative days 1, 3 and 7. Primary outcomes were swelling and trismus. Secondary outcomes were postoperative pain, pain score on local anesthetic injection, duration of soft tissue anesthesia, and latency of anesthesia. Risk of bias was assessed using the Cochrane ROB2 tool. Certainty of evidence was evaluated with the GRADE tool.
Results
On postoperative day 1, the twin-mix group showed significant reductions in facial swelling (MD: −3.51 mm; [−5.04 to −1.97]), trismus (MD: −1.7 mm; [−2.48 to −0.92]) and pain (MD: −1.07; [−1.49 to −0.65]). On day 3, swelling (MD: −4.64 mm; [−6.34 to −2.94]), trismus (MD: −1.08 mm; [−1.55 to −0.61]) and pain (MD: −0.62; [−1.09 to −0.15]) remained significantly reduced. On day 7, differences persisted for swelling (MD: −0.58 mm; [−0.76 to −0.40]) and trismus (MD: −0.42 mm; [−0.72 to −0.12]), but no significant difference was found in pain (MD: −0.29; [−0.65 to 0.07]). The twin-mix also significantly reduced pain under local anesthesia, shortened latency and prolonged duration of anesthesia.
Conclusion
In conclusion, the use of twin-mix is highly beneficial for pain relief, facial swelling and trismus following mandibular third molar surgical removal.
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Pub Date : 2025-06-01Epub Date: 2025-02-18DOI: 10.1016/j.jebdp.2025.102126
CHENGHUI LU M.Med , LANQING MO M.B.B.S , XIN LI M.Sc , GUANHUAN DU Ph.D , ZHENGQUAN CHEN M.Sc , FAN WU B.M , LILI CAI B.M , QING DU Ph.D , GUOYAO TANG Ph.D
BACKGROUND
Oral lichen planus (OLP) is a relatively common immunological mucocutaneous disease that causes pain, burning sensations and poor quality of life. The use of low-level light therapy (LLLT) to treat OLP is still debated. This systematic review and meta-analysis aimed to systematically and quantitatively assess the efficacy of LLLT in the treatment of OLP.
METHODS
The PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Web of Science electronic databases were searched up to February 28, 2023, to identify randomized controlled trials (RCTs) examining the use of LLLT in OLP patients reporting pain or other outcomes. The mean difference (MD) or log risk ratio (log RR) with 95% confidence intervals (CIs) were estimated separately for each outcome to determine the effect sizes. Subgroup analysis was used to detect the sources of heterogeneity. Sensitivity analysis was used to test the robustness of the pooled results. Funnel plots, Egger's test, and Begg's test were used to test publication bias. All the statistical analyses were performed using Stata 16.0 software. A graph of risk of bias was drawn using RevMan 5.4.1 software for the assessment of bias.
RESULTS
A total of twelve RCTs were included in this systematic review, 7 of which were also included in the meta-analysis. Among the included studies, 1 had a low risk of bias, whereas 7 had an unclear risk of bias. The meta-analysis results indicated that LLLT significantly improved long-term analgesic efficacy (over 12 weeks posttreatment, measured by the visual analogue scale; MD = -1.20, 95% CI -2.01 to -0.38, P < .001), whereas no significant changes were observed in either the short term (MD = -0.68, 95% CI -1.38 to 0.01, P = .05) or the medium term (MD = -0.89, 95% CI -1.96 to 0.17, P = .10). Furthermore, LLLT improved the clinical severity of lesions (as assessed by the biopsy sign scores or reticular atrophic erosive scores; MD = -1.13, 95% CI -1.62 to -0.63, P < .001) and reduced the recurrence rate (log RR = -1.34, 95% CI -2.30 to -0.37, P = .01). Additionally, there were no statistically significant differences in the clinical response rate (measured by efficacy indices; log RR = -0.12, 95% CI -0.37 to 0.13, P = .35). No adverse events related to LLLT were reported.
CONCLUSION
LLLT appears to alleviate pain, enhance the clinical outcomes of OLP lesions, and lower the likelihood of relapse in OLP patients. Future research should focus on longer intervention courses, larger sample sizes, and multidisciplinary intervention designs.
SYSTEMATIC REVIEW REGISTRATION
This meta-analysis was registered on PROSPERO (CRD42023384852).
背景：口腔扁平苔藓（OLP）是一种比较常见的免疫性粘膜皮肤病，可引起疼痛、灼烧感和生活质量差。使用低强度光疗法（LLLT）治疗OLP仍有争议。本系统综述和荟萃分析旨在系统和定量地评估LLLT治疗OLP的疗效。方法检索截至2023年2月28日的PubMed、Embase、护理与相关健康文献累积索引（CINAHL）、Cochrane图书馆和Web of Science电子数据库，以确定随机对照试验（RCTs），这些试验检验了LLLT在报告疼痛或其他结果的OLP患者中的应用。分别估计每个结果的95%置信区间（ci）的平均差（MD）或对数风险比（log RR），以确定效应大小。采用亚组分析来检测异质性的来源。采用敏感性分析检验合并结果的稳健性。采用漏斗图、Egger检验和Begg检验检验发表偏倚。采用Stata 16.0软件进行统计分析。采用RevMan 5.4.1软件绘制偏倚风险图，进行偏倚评估。结果本系统综述共纳入12项rct，其中7项纳入meta分析。在纳入的研究中，1项偏倚风险低，7项偏倚风险不明确。荟萃分析结果显示，LLLT显著提高了长期镇痛疗效(治疗后12周以上，用视觉模拟量表测量；MD = -1.20,95% CI -2.01 ~ -0.38, P <；.001)，而在短期内（MD = -0.68,95% CI -1.38至0.01,P = .05）或中期（MD = -0.89,95% CI -1.96至0.17,P = .10）均未观察到显著变化。此外，LLLT改善了病变的临床严重程度(通过活检体征评分或网状萎缩侵蚀评分评估；MD = -1.13,95% CI -1.62 ~ -0.63, P <；.001)并降低复发率（log RR = -1.34,95% CI -2.30 ~ -0.37, P = .01）。两组临床有效率(以疗效指标衡量；log RR = -0.12,95% CI -0.37 ~ 0.13, P = .35)。未报告与LLLT相关的不良事件。结论llt可减轻OLP患者的疼痛，改善OLP病变的临床预后，降低OLP患者复发的可能性。未来的研究应侧重于更长的干预疗程、更大的样本量和多学科干预设计。系统评价注册：该meta分析在PROSPERO注册（CRD42023384852）。
{"title":"EFFECTS OF LOW-LEVEL LIGHT THERAPY ON PAIN AND RELATED LESIONS IN PATIENTS WITH ORAL LICHEN PLANUS: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"CHENGHUI LU M.Med , LANQING MO M.B.B.S , XIN LI M.Sc , GUANHUAN DU Ph.D , ZHENGQUAN CHEN M.Sc , FAN WU B.M , LILI CAI B.M , QING DU Ph.D , GUOYAO TANG Ph.D","doi":"10.1016/j.jebdp.2025.102126","DOIUrl":"10.1016/j.jebdp.2025.102126","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Oral lichen planus (OLP) is a relatively common immunological mucocutaneous disease that causes pain, burning sensations and poor quality of life. The use of low-level light therapy (LLLT) to treat OLP is still debated. This systematic review and meta-analysis aimed to systematically and quantitatively assess the efficacy of LLLT in the treatment of OLP.</div></div><div><h3>METHODS</h3><div>The PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Web of Science electronic databases were searched up to February 28, 2023, to identify randomized controlled trials (RCTs) examining the use of LLLT in OLP patients reporting pain or other outcomes. The mean difference (MD) or <em>log</em> risk ratio (<em>log</em> RR) with 95% confidence intervals (<em>CI</em>s) were estimated separately for each outcome to determine the effect sizes. Subgroup analysis was used to detect the sources of heterogeneity. Sensitivity analysis was used to test the robustness of the pooled results. Funnel plots, Egger's test, and Begg's test were used to test publication bias. All the statistical analyses were performed using Stata 16.0 software. A graph of risk of bias was drawn using RevMan 5.4.1 software for the assessment of bias.</div></div><div><h3>RESULTS</h3><div>A total of twelve RCTs were included in this systematic review, 7 of which were also included in the meta-analysis. Among the included studies, 1 had a low risk of bias, whereas 7 had an unclear risk of bias. The meta-analysis results indicated that LLLT significantly improved long-term analgesic efficacy (over 12 weeks posttreatment, measured by the visual analogue scale; MD = -1.20, 95% <em>CI</em> -2.01 to -0.38, <em>P</em> < .001), whereas no significant changes were observed in either the short term (MD = -0.68, 95% <em>CI</em> -1.38 to 0.01, <em>P</em> = .05) or the medium term (MD = -0.89, 95% <em>CI</em> -1.96 to 0.17, <em>P</em> = .10). Furthermore, LLLT improved the clinical severity of lesions (as assessed by the biopsy sign scores or reticular atrophic erosive scores; MD = -1.13, 95% <em>CI</em> -1.62 to -0.63, <em>P</em> < .001) and reduced the recurrence rate (<em>log</em> RR = -1.34, 95% <em>CI</em> -2.30 to -0.37, <em>P</em> = .01). Additionally, there were no statistically significant differences in the clinical response rate (measured by efficacy indices; <em>log</em> RR = -0.12, 95% <em>CI</em> -0.37 to 0.13, <em>P</em> = .35). No adverse events related to LLLT were reported.</div></div><div><h3>CONCLUSION</h3><div>LLLT appears to alleviate pain, enhance the clinical outcomes of OLP lesions, and lower the likelihood of relapse in OLP patients. Future research should focus on longer intervention courses, larger sample sizes, and multidisciplinary intervention designs.</div></div><div><h3>SYSTEMATIC REVIEW REGISTRATION</h3><div>This meta-analysis was registered on PROSPERO (CRD42023384852).</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102126"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621183","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}
Pub Date : 2025-03-01Epub Date: 2025-02-11DOI: 10.1016/S1532-3382(25)00029-6
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Pub Date : 2025-03-01Epub Date: 2024-12-07DOI: 10.1016/j.jebdp.2024.102080
GISELA CRISTINA VIANNA CAMOLESI , AHMED SAMIR EL KATTAN , JOSÉ LOPEZ-LOPEZ , ANDRÉS BLANCO-CARRIÓN , ABEL GARCÍA-GARCÍA , PILAR GÁNDARA-VILA , MARIO PÉREZ-SAYÁNS
Objectives
To assess the impact of photobiomodulation therapy in pain, facial oedema, and trismus mitigation in the postoperative period after lower third molar extractions.
Methods
We conducted a comparison between active photobiomodulation and simulated photobiomodulation after both lower third molars extraction in the same patients, within a double-center clinical trial. The role of photobiomodulation was evaluated based on pain, measured using the VAS scale. Oedema and trismus, assessed through millimetric measurements. Additionally, analgesic consumption was monitored during the 7-day's postoperative period. The study adhered to the CONSORT checklist and was registered on the ClinicalTrials (NCT05255731). The Levene test was used to assess precision (α=0.05), and statistical analysis was performed using Jamovi software. Paired t-tests or the Wilcoxon test were employed to analyze the primary and secondary outcomes.
Results
The study included 83 patients and 166 randomization units. The study group showed a significant reduction in pain at all evaluation times (P < .01), as well as reductions in facial oedema and trismus on postoperative days 2 and 7 (P < .01). A significant difference in analgesic use was observed on all days, except on the seventh postoperative day.
Conclusion
The photobiomodulation protocol, using an 808 nm, 100 mW Ga-Al-As diode laser, applied both intraorally and extraorally in a single 30 seconds (3 Joules/per point) postoperative session, significantly reduced pain, oedema, and trismus following mandibular third molar extraction, particularly on postoperative days 2 and 7.
Clinical Significance
Photobiomodulation can be an effective complementary therapy for reducing pain, facial oedema, and trismus in patients after lower third molar extraction.
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Pub Date : 2025-03-01Epub Date: 2025-01-03DOI: 10.1016/j.jebdp.2025.102086
IMAN ABD-ELWAHAB RADI (REVIEWERS), YOUSSEF ATEF SHAKER IBRAHIM SAID
Article Title and Bibliographic Information
Revilla-León M, Gómez-Polo M, Vyas S, Barmak AB, Gallucci GO, Att W, Özcan M, Krishnamurthy VR. Artificial intelligence models for tooth-supported fixed and removable prosthodontics: A systematic review. J Prosthet Dent. 2023;129:276-92.
Source of Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Type of Study/Design
Systematic review with meta-analysis of data.
文章标题和参考书目InformationRevilla-León M， Gómez-Polo M, Vyas S, Barmak AB, Gallucci GO, Att W， Özcan M, Krishnamurthy VR。人工智能模型用于牙齿支持的固定和可移动修复：系统综述。[J]中华口腔医学杂志，2009;29(3):391 - 391。资金来源本研究未获得公共、商业或非营利部门资助机构的任何具体资助。研究类型/设计系统评价，数据荟萃分析。
{"title":"LIMITED EVIDENCE SUGGESTS ARTIFICIAL INTELLIGENCE SHOWS PROMISING PERFORMANCE IN OUTCOMES RELEVANT TO REMOVABLE AND FIXED PROSTHODONTIC FIELDS","authors":"IMAN ABD-ELWAHAB RADI (REVIEWERS), YOUSSEF ATEF SHAKER IBRAHIM SAID","doi":"10.1016/j.jebdp.2025.102086","DOIUrl":"10.1016/j.jebdp.2025.102086","url":null,"abstract":"<div><h3>Article Title and Bibliographic Information</h3><div>Revilla-León M, Gómez-Polo M, Vyas S, Barmak AB, Gallucci GO, Att W, Özcan M, Krishnamurthy VR. Artificial intelligence models for tooth-supported fixed and removable prosthodontics: A systematic review. J Prosthet Dent. 2023;129:276-92.</div></div><div><h3>Source of Funding</h3><div>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div><div><h3>Type of Study/Design</h3><div>Systematic review with meta-analysis of data.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102086"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141629","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}
Pub Date : 2025-03-01Epub Date: 2024-12-30DOI: 10.1016/j.jebdp.2024.102084
KASTURI SHUKLA , ASIYA M. ATTAR
Introduction
Teledentistry offers an opportunity to improve Patient-Centered Care (PCC) for dental patients. Evaluation of PCC in conventional and teledentistry requires the use of Dental Patient-Reported Outcome Measures (dPROMs). However, there is limited literature on the integration of dPROMs in teledentistry, and a need arises for the synthesis of existing knowledge, comprehending it and identifying the gaps. Hence, conducting a scoping review would systematically map out the key themes, provide insights into the trends and highlight knowledge gaps in the currently published literature.
Methods
Google Scholar, Scopus, and Web of Science databases were searched using a combination of keywords such as “Teledentistry,” “dental patient-reported outcome measures,” and “dPROMs.” Using established eligibility criteria, suitable records were exported and organized on an Excel sheet. Original research and review articles in English where dPROMs or its dimensions were used after a teledentistry session were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR) criteria was followed to report the results.
Results
Out of the 28 reviewed studies, majority were cross-sectional and were largely conducted in the UK, the USA, India, and Indonesia. Studies predominantly had adult population and female participants. Most studies highlighted dPROMs dimensions such as patient satisfaction, communication, and travel convenience, suggesting that dPROMs in teledentistry may enhance PCC.
Conclusion
Distinction between the indicators of PCC, like patient satisfaction and patient experience, is necessary. Future studies should concentrate on longitudinal studies across various demographic groups with standardized measurement and equal gender representation.
远程牙科为牙科患者提供了一个改善以患者为中心的护理（PCC）的机会。评估PCC在传统和远程牙科需要使用牙科患者报告的结果测量（dPROMs）。然而，关于dprom在远程医学中的整合的文献有限，因此需要综合现有知识，理解它并确定差距。因此，进行范围审查将系统地绘制出关键主题，提供对趋势的见解，并突出当前已发表文献中的知识差距。方法使用“远程牙科”、“牙科患者报告的结果测量”和“dprom”等关键词组合搜索google Scholar、Scopus和Web of Science数据库。使用已建立的资格标准，导出合适的记录并将其组织到Excel表格中。包括在远程医学会议后使用dprom或其维度的英文原始研究和评论文章。按照系统评价和荟萃分析扩展范围评价的首选报告项目（PRISMA-ScR）标准报告结果。结果在回顾的28项研究中，大多数是横断面研究，主要在英国、美国、印度和印度尼西亚进行。研究对象主要是成年人和女性。大多数研究强调了dPROMs的维度，如患者满意度、沟通和旅行便利，表明远程牙科中的dPROMs可能会提高PCC。结论对PCC的患者满意度和患者体验等指标进行区分是必要的。今后的研究应集中在各种人口群体的纵向研究，采用标准化的测量方法和平等的性别代表性。
{"title":"INTEGRATION OF DENTAL PATIENT-REPORTED OUTCOMES (dPROs) IN TELEDENTISTRY TO ENHANCE PATIENT-CENTERED CARE: A SCOPING REVIEW","authors":"KASTURI SHUKLA , ASIYA M. ATTAR","doi":"10.1016/j.jebdp.2024.102084","DOIUrl":"10.1016/j.jebdp.2024.102084","url":null,"abstract":"<div><h3>Introduction</h3><div>Teledentistry offers an opportunity to improve Patient-Centered Care (PCC) for dental patients. Evaluation of PCC in conventional and teledentistry requires the use of Dental Patient-Reported Outcome Measures (dPROMs). However, there is limited literature on the integration of dPROMs in teledentistry, and a need arises for the synthesis of existing knowledge, comprehending it and identifying the gaps. Hence, conducting a scoping review would systematically map out the key themes, provide insights into the trends and highlight knowledge gaps in the currently published literature.</div></div><div><h3>Methods</h3><div>Google Scholar, Scopus, and Web of Science databases were searched using a combination of keywords such as “Teledentistry,” “dental patient-reported outcome measures,” and “dPROMs.” Using established eligibility criteria, suitable records were exported and organized on an Excel sheet. Original research and review articles in English where dPROMs or its dimensions were used after a teledentistry session were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR) criteria was followed to report the results.</div></div><div><h3>Results</h3><div>Out of the 28 reviewed studies, majority were cross-sectional and were largely conducted in the UK, the USA, India, and Indonesia. Studies predominantly had adult population and female participants. Most studies highlighted dPROMs dimensions such as patient satisfaction, communication, and travel convenience, suggesting that dPROMs in teledentistry may enhance PCC.</div></div><div><h3>Conclusion</h3><div>Distinction between the indicators of PCC, like patient satisfaction and patient experience, is necessary. Future studies should concentrate on longitudinal studies across various demographic groups with standardized measurement and equal gender representation.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102084"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141611","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}
<div><h3>Objective</h3><div>The purpose of this research was to assess the effectiveness of clear aligners in treating various types of malocclusions when compared to fixed orthodontic appliances.</div></div><div><h3>Methods and Quality</h3><div>The following databases were searched: EMBASE (Ovid), Medline (Ovid), the Cochrane Library, Latin America and the Caribbean Literature on Health Sciences (Lilacs), Web of Science and EBMR review until October 2024. Additionally, Google scholar, PubMed were also searched for completion for including all relevant articles. No restrictions were placed on language or publication date, and only randomized controlled trials (RCTs) were included in this review. Evaluation of the potential for bias in randomized controlled trials (RCTs) was carried out with the use of the revised Cochrane Risk of Bias instrument (ROB tool 2). The primary outcome was the treatment accuracy of clear aligners vs fixed appliances and included orthodontic tooth movement in terms of anteroposterior discrepancy, transverse discrepancy, vertical discrepancy and overjet. The secondary outcomes included the effectiveness of treatment, such as duration of treatment, periodontal health, root resorption and patient satisfaction. Available data was meta-synthesized using Review Manager 5.4.</div></div><div><h3>Results</h3><div>About 21 RCT studies were selected from a total of 600 records and involved 970 participants. All 21 studies included a comparison of the effectiveness of clear aligners vs fixed appliances. About 3 of the studies were assessed to be at high risk of bias, whilst 14 of the studies were assessed to be at unclear risk of bias, and only 1 study was found to be at low risk of bias. Based on the primary outcome, there was no significant difference in the ABO objective grading scores, Little Irregularity Index and PAR scores between the fixed appliances and clear aligner treatments. Meta-analysis was only possible for secondary outcomes. The scores for plaque index (MD = -0.76, 95% CI, -1.14 to - 0.38, <em>P =</em> .00001), gingival index (MD = -0.61, 95% CI, -0.78 to - 0.44, <em>P =</em> .00001) and bleeding index (MD = -0.71, 95% CI, -0.92 to - 0.49, <em>P < .</em>0001) were significantly lower in clear aligners when compared to the fixed appliances. The patients quality of life at 6 months was significantly better for clear aligners compared with fixed appliances (MD = -4.37, 95% CI, -6.93 to -1.80, <em>P</em> < .0001). Clear aligners also appeared to have a better outcome for chairside time, pain and root resorption.</div></div><div><h3>Conclusion</h3><div>The overall quality of evidence from the included studies was low. Both clear aligners and fixed appliances worked well in treating simple malocclusions treated on a nonextraction basis. There was no significant difference in the ABO Objective Grading System, Little Irregularity index and PAR scores between the clear aligner and fixed appliance groups. There was low
目的评价透明矫正器与固定矫治器在治疗不同类型错牙合中的效果。方法和质量检索以下数据库：EMBASE （Ovid）、Medline （Ovid）、Cochrane图书馆、Latin America and Caribbean Literature on Health Sciences （Lilacs）、Web of Science和EBMR review，检索截止至2024年10月。此外，谷歌scholar， PubMed也被检索以完成包括所有相关文章。本综述对语言和发表日期没有限制，仅纳入随机对照试验（rct）。使用改进的Cochrane偏倚风险评估工具（ROB工具2）对随机对照试验（RCTs）的潜在偏倚进行评估。主要结果是透明矫正器与固定矫治器的治疗准确性，包括正畸牙齿移动的前后差异、横向差异、垂直差异和覆盖。次要结果包括治疗效果，如治疗持续时间、牙周健康、牙根吸收和患者满意度。使用Review Manager 5.4对可用数据进行元合成。结果从600份记录中选择了21项RCT研究，涉及970名受试者。所有21项研究都比较了透明矫正器与固定矫治器的有效性。约有3项研究被评估为高偏倚风险，14项研究被评估为不明确的偏倚风险，只有1项研究被发现为低偏倚风险。基于主要结局，固定矫治器和清除矫治器治疗的ABO客观分级评分、小不规则指数和PAR评分无显著差异。荟萃分析仅适用于次要结果。斑块指数（MD = -0.76,95% CI, -1.14 ~ - 0.38, P = 0.00001）、牙龈指数（MD = -0.61,95% CI, -0.78 ~ - 0.44, P = 0.00001）和出血指数(MD = -0.71,95% CI, -0.92 ~ - 0.49, P <；.0001)与固定矫治器相比，透明矫治器明显更低。与固定矫治器相比，使用透明矫正器患者6个月的生活质量明显更好(MD = -4.37,95% CI, -6.93 ~ -1.80, P <；。)。透明矫正器在椅侧时间、疼痛和牙根吸收方面也有更好的效果。结论纳入研究的证据质量总体较低。在不拔牙的基础上，清除矫正器和固定矫治器都能很好地治疗单纯性错颌。清除矫正器组与固定矫治器组在ABO客观评分系统、小不规则指数和PAR评分上无显著差异。有低质量的证据支持透明矫正器对牙周健康的改善，中等质量的证据支持透明矫正器对生活质量的改善。需要更多高质量的研究来评估清晰矫正器治疗复杂错颌的效果。
{"title":"EFFECTIVENESS OF CLEAR ORTHODONTIC ALIGNERS IN CORRECTING MALOCCLUSIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"MARYAM BANESHI MDS , LUCY O'MALLEY PhD , AHMED EL-ANGBAWI PhD , BADRI THIRUVENKATACHARI PhD","doi":"10.1016/j.jebdp.2024.102081","DOIUrl":"10.1016/j.jebdp.2024.102081","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this research was to assess the effectiveness of clear aligners in treating various types of malocclusions when compared to fixed orthodontic appliances.</div></div><div><h3>Methods and Quality</h3><div>The following databases were searched: EMBASE (Ovid), Medline (Ovid), the Cochrane Library, Latin America and the Caribbean Literature on Health Sciences (Lilacs), Web of Science and EBMR review until October 2024. Additionally, Google scholar, PubMed were also searched for completion for including all relevant articles. No restrictions were placed on language or publication date, and only randomized controlled trials (RCTs) were included in this review. Evaluation of the potential for bias in randomized controlled trials (RCTs) was carried out with the use of the revised Cochrane Risk of Bias instrument (ROB tool 2). The primary outcome was the treatment accuracy of clear aligners vs fixed appliances and included orthodontic tooth movement in terms of anteroposterior discrepancy, transverse discrepancy, vertical discrepancy and overjet. The secondary outcomes included the effectiveness of treatment, such as duration of treatment, periodontal health, root resorption and patient satisfaction. Available data was meta-synthesized using Review Manager 5.4.</div></div><div><h3>Results</h3><div>About 21 RCT studies were selected from a total of 600 records and involved 970 participants. All 21 studies included a comparison of the effectiveness of clear aligners vs fixed appliances. About 3 of the studies were assessed to be at high risk of bias, whilst 14 of the studies were assessed to be at unclear risk of bias, and only 1 study was found to be at low risk of bias. Based on the primary outcome, there was no significant difference in the ABO objective grading scores, Little Irregularity Index and PAR scores between the fixed appliances and clear aligner treatments. Meta-analysis was only possible for secondary outcomes. The scores for plaque index (MD = -0.76, 95% CI, -1.14 to - 0.38, <em>P =</em> .00001), gingival index (MD = -0.61, 95% CI, -0.78 to - 0.44, <em>P =</em> .00001) and bleeding index (MD = -0.71, 95% CI, -0.92 to - 0.49, <em>P < .</em>0001) were significantly lower in clear aligners when compared to the fixed appliances. The patients quality of life at 6 months was significantly better for clear aligners compared with fixed appliances (MD = -4.37, 95% CI, -6.93 to -1.80, <em>P</em> < .0001). Clear aligners also appeared to have a better outcome for chairside time, pain and root resorption.</div></div><div><h3>Conclusion</h3><div>The overall quality of evidence from the included studies was low. Both clear aligners and fixed appliances worked well in treating simple malocclusions treated on a nonextraction basis. There was no significant difference in the ABO Objective Grading System, Little Irregularity index and PAR scores between the clear aligner and fixed appliance groups. There was low","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102081"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141612","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}
Pub Date : 2025-03-01Epub Date: 2024-12-04DOI: 10.1016/j.jebdp.2024.102078
DANNA R. PAULSON , APARNA INGLESHWAR , NICOLE THEIS-MAHON , LIFENG LIN , MIKE T. JOHN
Objective
The relationship between general health and oral health is critical for understanding the broader implications of oral health on overall well-being and vice versa. The impact of oral and general health on individuals can be comprehensively captured by the concepts oral and general health-related quality of life (OHRQoL and HRQoL), respectively. This systematic review and meta-analysis aimed to synthesize existing evidence on the correlation between OHRQoL and HRQoL across different adult populations.
Methods
A comprehensive search strategy was executed across 6 databases (Ovid MEDLINE(R), Embase, CINAHL, APA PsycINFO, Web of Science Core Collection, and Scopus). The search included studies measuring OHRQoL with the Oral Health Impact Profile (OHIP) and HRQoL with a variety of generic patient-reported outcome measures (PROMs). Studies were included if they reported correlations between OHRQoL and HRQoL summary scores in adult populations across dental, medical, or nonpatient settings. If a study examined more than one population, each correlation was included for independent analysis. Data extraction and quality assessment were conducted by independent reviewers, with disagreements resolved by a third reviewer. Random effects meta-analysis was used to summarize the OHRQoL-HRQoL correlations.
Results
From 10 studies, 13 populations (N=6,053 participants) were included in the analysis. The correlation between general health and oral health-related quality of life was of medium size (r=0.41, 95% CI: 0.32–0.50) with high heterogeneity across populations (I2=95%). Results were not unduly influenced by individual populations, study quality, or publication bias.
Conclusions
The correlation between oral health and general health is of medium size, highlighting the potential for medical-dental integration to enhance patient and community health outcomes.
{"title":"THE CORRELATION BETWEEN ORAL AND GENERAL HEALTH-RELATED QUALITY OF LIFE IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"DANNA R. PAULSON , APARNA INGLESHWAR , NICOLE THEIS-MAHON , LIFENG LIN , MIKE T. JOHN","doi":"10.1016/j.jebdp.2024.102078","DOIUrl":"10.1016/j.jebdp.2024.102078","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between general health and oral health is critical for understanding the broader implications of oral health on overall well-being and vice versa. The impact of oral and general health on individuals can be comprehensively captured by the concepts oral and general health-related quality of life (OHRQoL and HRQoL), respectively. This systematic review and meta-analysis aimed to synthesize existing evidence on the correlation between OHRQoL and HRQoL across different adult populations.</div></div><div><h3>Methods</h3><div>A comprehensive search strategy was executed across 6 databases (Ovid MEDLINE(R), Embase, CINAHL, APA PsycINFO, Web of Science Core Collection, and Scopus). The search included studies measuring OHRQoL with the Oral Health Impact Profile (OHIP) and HRQoL with a variety of generic patient-reported outcome measures (PROMs). Studies were included if they reported correlations between OHRQoL and HRQoL summary scores in adult populations across dental, medical, or nonpatient settings. If a study examined more than one population, each correlation was included for independent analysis. Data extraction and quality assessment were conducted by independent reviewers, with disagreements resolved by a third reviewer. Random effects meta-analysis was used to summarize the OHRQoL-HRQoL correlations.</div></div><div><h3>Results</h3><div>From 10 studies, 13 populations (N=6,053 participants) were included in the analysis. The correlation between general health and oral health-related quality of life was of medium size (r=0.41, 95% CI: 0.32–0.50) with high heterogeneity across populations (I<sup>2</sup>=95%). Results were not unduly influenced by individual populations, study quality, or publication bias.</div></div><div><h3>Conclusions</h3><div>The correlation between oral health and general health is of medium size, highlighting the potential for medical-dental integration to enhance patient and community health outcomes.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102078"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-11-02DOI: 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.
{"title":"POSTOPERATIVE STABILITY OF AESTHETIC OUTCOMES FOLLOWING RESIN INFILTRATION OF HYPOMINERALISED AND DEMINERALISED ENAMEL LESIONS: A SYSTEMATIC REVIEW","authors":"Marie Véguer , Elsa Garot , David J Manton , Olivia Kérourédan","doi":"10.1016/j.jebdp.2024.102052","DOIUrl":"10.1016/j.jebdp.2024.102052","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Data/Sources</h3><div>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.</div></div><div><h3>Study selection</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102052"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-28DOI: 10.1016/j.jebdp.2024.102082
FOLAKE B. LAWAL , MIKE T. JOHN , ABIMBOLA M OLADAYO , DANNA R. PAULSON , NICOLE THEIS-MAHON , APARNA INGLESHWAR
Introduction
The project “Mapping Oral Disease Impact with a Common Metric” (MOM) characterizes the functional, pain-related, aesthetic, and broader psychosocial impacts of oral diseases and conditions using the 4 oral health-related quality of life (OHRQoL) dimensions: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. MOM's 4-dimensional oral health impact information in children was provided by Omara et al. in 2021. We aimed to update this information in 2024 by performing a new systematic review.
Methods
We performed a systematic review following PRISMA guidelines to identify original studies assessing the OHRQoL of children <18 years using the Oral Health Impact Profile (OHIP). OHIP publications were retrieved from 2 sources: (i) articles identified by Omara et al., 2021 (search date: 9 January 2019) and (ii) newly identified articles published from 2019 to 2024 in the following databases: Embase+Embase Classic (via Ovid), CINAHL, APA PsycINFO (via Ovid), Scopus, and Web of Science (Core Collection). Abstracts of 1128 articles were screened. The full-text of 199 articles was reviewed, and 24 articles were included. Their OHIP information was mapped into the 4-dimensional OHRQoL framework.
Results
Across 3 settings (general population subjects, dental patients, and medical patients) we identified 24 publications. They provided four-dimensional OHRQoL information for 49 populations in 55 samples (N = 8307 study participants). The Orofacial Appearance dimension had the highest impact, while the Psychosocial Impact dimension had the lowest. Functional impact scores were higher than pain-related impact scores. Among dental patients, those with anterior tooth extraction without replacement had the highest impact score within the Orofacial Appearance dimension.
Conclusion
Children's 4-dimensional oral health impact information in the “Mapping Oral Disease Impact with a Common Metric” (MOM) project was updated in 2024 with a systematic review. The findings for Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact in children are aligned with findings in adults using the same 4-dimensional impact measurements.
“用一种通用度量方法绘制口腔疾病影响”（MOM）项目利用口腔健康相关生活质量（OHRQoL） 4个维度：口腔功能、口腔面部疼痛、口腔面部外观和社会心理影响，描述了口腔疾病和病症的功能、疼痛相关、美学和更广泛的社会心理影响。MOM对儿童口腔健康的四维影响信息由Omara等人于2021年提供。我们的目标是在2024年通过进行新的系统评价来更新这些信息。方法：我们按照PRISMA指南进行了一项系统综述，以确定使用口腔健康影响概况（OHIP）评估18岁儿童OHRQoL的原始研究。OHIP出版物从两个来源检索：(i) Omara et al.， 2021年确定的文章（检索日期：2019年1月9日）和（ii） 2019年至2024年在以下数据库中发表的新确定的文章：Embase+Embase Classic（通过Ovid）， CINAHL, APA PsycINFO（通过Ovid）， Scopus和Web of Science（核心馆藏）。筛选了1128篇文章的摘要。全文199篇，收录24篇。他们的OHIP信息被映射到4维OHRQoL框架中。结果在3种情况下（普通人群、牙科患者和内科患者），我们确定了24篇出版物。他们提供了55个样本中49个人群（N = 8307名研究参与者）的四维OHRQoL信息。口腔面部外貌维度影响最大，而心理社会影响维度影响最小。功能影响评分高于疼痛相关影响评分。在牙科患者中，前牙拔牙不更换的患者在口腔面部外观维度上的影响评分最高。结论“口腔疾病影响测绘”（MOM）项目于2024年更新了儿童口腔健康的四维影响信息，并进行了系统评价。使用相同的四维影响测量，儿童的口腔功能、口面疼痛、口面外观和心理社会影响的研究结果与成人的研究结果一致。
{"title":"ORAL HEALTH IMPACT AMONG CHILDREN: A SYSTEMATIC REVIEW UPDATE IN 2024","authors":"FOLAKE B. LAWAL , MIKE T. JOHN , ABIMBOLA M OLADAYO , DANNA R. PAULSON , NICOLE THEIS-MAHON , APARNA INGLESHWAR","doi":"10.1016/j.jebdp.2024.102082","DOIUrl":"10.1016/j.jebdp.2024.102082","url":null,"abstract":"<div><h3>Introduction</h3><div>The project “Mapping Oral Disease Impact with a Common Metric” (MOM) characterizes the functional, pain-related, aesthetic, and broader psychosocial impacts of oral diseases and conditions using the 4 oral health-related quality of life (OHRQoL) dimensions: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. MOM's 4-dimensional oral health impact information in children was provided by Omara et al. in 2021. We aimed to update this information in 2024 by performing a new systematic review.</div></div><div><h3>Methods</h3><div>We performed a systematic review following PRISMA guidelines to identify original studies assessing the OHRQoL of children <18 years using the Oral Health Impact Profile (OHIP). OHIP publications were retrieved from 2 sources: (i) articles identified by Omara et al., 2021 (search date: 9 January 2019) and (ii) newly identified articles published from 2019 to 2024 in the following databases: Embase+Embase Classic (via Ovid), CINAHL, APA PsycINFO (via Ovid), Scopus, and Web of Science (Core Collection). Abstracts of 1128 articles were screened. The full-text of 199 articles was reviewed, and 24 articles were included. Their OHIP information was mapped into the 4-dimensional OHRQoL framework.</div></div><div><h3>Results</h3><div>Across 3 settings (general population subjects, dental patients, and medical patients) we identified 24 publications. They provided four-dimensional OHRQoL information for 49 populations in 55 samples (N = 8307 study participants). The Orofacial Appearance dimension had the highest impact, while the Psychosocial Impact dimension had the lowest. Functional impact scores were higher than pain-related impact scores. Among dental patients, those with anterior tooth extraction without replacement had the highest impact score within the Orofacial Appearance dimension.</div></div><div><h3>Conclusion</h3><div>Children's 4-dimensional oral health impact information in the “Mapping Oral Disease Impact with a Common Metric” (MOM) project was updated in 2024 with a systematic review. The findings for Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact in children are aligned with findings in adults using the same 4-dimensional impact measurements.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102082"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141639","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}
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