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AUTONOMOUS ROBOTIC SURGERY SEEMS PROMISING AS AN ACCURATE TECHNOLOGY FOR SINGLE-TOOTH IMPLANT PLACEMENT IN THE ESTHETIC ZONE 自主机器人手术作为一种精确的技术,有望在美学区域进行单牙植入
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101915
Kelvin I. Afrashtehfar (REVIEWERS), Carlos A. Jurado, Nour K. Assaleh, Hyeonjong Lee

Article Title and Bibliographic Information

Yang S, Chen J, Li A, Deng K, Li P, Xu S. Accuracy of autonomous robotic surgery for single-tooth implant placement: a case series. J Dent. 2023;132:104451. doi:10.1016/j.jdent.2023.104451. Epub 2023 Feb 11. PMID: 36781099.

Source of Funding

This case series study was supported by grants from the Guangdong Basic and Applied Basic Research Foundation, Science and Technology Projects in Guangzhou, Science Research Cultivation Program, and Clinical Research Initiation Plan of the Stomatological Hospital, Southern Medical University, China.

Type of Study/Design

Case series. No a priori power calculation or pilot data. Nonconsecutive participant recruitment.

文章标题和书目InformationYang年代,陈J,李,邓K, P,徐美国自治机器人手术的准确性对单齿植入位置:系列。[J] .中国生物医学工程学报,2009;22(2):451 - 451。doi: 10.1016 / j.jdent.2023.104451。Epub 2023 Feb 11。PMID: 36781099。本病例系列研究由广东省基础与应用基础研究基金、广州市科技专项、科研培养计划和南方医科大学口腔医院临床研究启动计划资助。研究/设计案例系列类型。没有先验的功率计算或试验数据。非连续参与者招募。
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引用次数: 1
ASSOCIATION OF ORAL MICROBIOTA AND PERIODONTAL DISEASE WITH LUNG CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS 口腔微生物群和牙周病与肺癌的关系:一项系统综述和荟萃分析。
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101897
Kai Zhang BDS , Cheng He PhD , Yuan Qiu BDS , Xiuyang Li PhD , Jian Hu PhD , Baiping Fu DMD

Objectives

Evidence of oral microbiota perturbations has been accumulated for lung cancers. This review focused on the oral microbiota alterations in population suffering from lung cancer. In addition, we also discussed conflicting data about the association between oral microbiota dysbiosis and risk of lung cancer.

Methods

A systematic search was conducted in Medline, Embase, PubMed, and Cochrane Library databases. The studies evaluated diversity and abundance of oral microbes in healthy and lung cancer individuals as well as association of periodontal disease and pathogens with lung cancer. Of 3559 studies, 28 included studies were performed in qualitative analysis, and 25 studies were used in meta-analyses for quantitative assessment. Heterogeneity was analyzed by using I² and chi-squared Q test statistics. Statistical analyses were performed by using the RevMan 5.4 software.

Results

Compared with the control, lung cancer patients had lower alpha diversity (Shannon: SMD = -0.54; 95% CI, -0.90 to -0.19; P < .01, I2 = 71%). In nested case-control studies, individuals with decreased alpha diversity tended to have an increased risk of lung cancer (observed species: HR = 0.90; 95% CI, 0.85-0.96; P < .01, I2 = 0%; Shannon: HR = 0.89; 95% CI, 0.83-0.95; P < .01, I2 = 0%). Overall, no strong evidence of association of relative abundance with specific oral microbes with lung cancers was found because of inconsistent data. No associations were found between periodontal pathogens and lung cancer risk (red complex: HR = 1.12, 95% CI: 0.42-3.02, P = .82, I2 = 62%; orange complex: HR =1.77, 95% CI: 0.78-3.98, P = .17, I2 = 36%), expect for Fusobacterium nucleatum (HR = 2.27, 95% CI: 1.13-4.58, P = .02, I2 = 0%). The positive association of periodontal disease with lung cancer risk was found (HR = 1.58, 95% CI: 1.25-2.00, P < .001, I2= 0%) with increase of periodontal diseases severity (HR = 2.39, 95% CI: 1.57-3.66, P < .001, I2 = 0%). However, such association was not found in never-smoker participants (HR = 1.00, 95% CI: 0.76-1.31, P = .37, I2= 7%).

Conclusions

Lower alpha diversity of oral microbiome may be associated with a greater risk of lung cancer and might serve as a predictive signal of lung cancer risk. There was no strong evidence of relative abundance of oral microbial taxa and periodontal pathogens in lung cancer patients. Fusobacterium nucleatum might be a potential microbial candidate of biomarkers in lung cancer. Periodontal disease may be positively associated with lung cancer risk by confounding of smoking, but not an independent risk factor.

目的:已经积累了肺癌患者口腔微生物群紊乱的证据。本文综述了癌症患者口腔微生物群的变化。此外,我们还讨论了关于口腔微生物群生态失调与癌症风险之间关系的相互矛盾的数据。方法:在Medline、Embase、PubMed和Cochrane Library数据库中进行系统检索。研究评估了健康人和癌症患者口腔微生物的多样性和丰度,以及牙周病和病原体与癌症的关系。在3559项研究中,28项纳入研究进行了定性分析,25项研究用于荟萃分析进行定量评估。利用I²和卡方Q检验统计量分析异质性。使用RevMan 5.4软件进行统计分析。结果:与对照组相比,癌症患者的α多样性较低(Shannon:SMD = -0.54;95%可信区间为-0.90~-0.19;P<0.01,I2 = 71%)。在嵌套病例对照研究中,α多样性降低的个体患癌症的风险往往增加(观察物种:HR = 0.90;95%可信区间0.85-0.96;P<0.01,I2 = 0%;Shannon:人力资源 = 0.89;95%可信区间0.83-0.95;P<0.01,I2 = 0%)。总体而言,由于数据不一致,没有发现与特定口腔微生物的相对丰度与肺癌相关的有力证据。牙周病原体与肺癌癌症风险之间未发现相关性(红色复合体:HR = 1.12,95%置信区间:0.42-3.02,P = .82,I2 = 62%;橙色复合体:HR=1.77,95%可信区间:0.78-3.98,P = .17,I2 = 36%),预计有核梭杆菌(HR = 2.27,95%置信区间:1.13-4.58,P = .02,I2 = 0%)。牙周病与肺癌风险呈正相关(HR = 1.58,95%CI:1.25-2.00,P<.001,I2=0%)随牙周病严重程度的增加(HR = 2.39,95%CI:1.57-3.66,P<.001,I2 = 0%)。然而,在从不吸烟的参与者中没有发现这种关联(HR = 1.00,95%置信区间:0.76-1.31,P = .37,I2=7%)。结论:口腔微生物组α多样性较低可能与癌症风险较高有关,并可能作为癌症风险的预测信号。没有强有力的证据表明癌症患者的口腔微生物分类群和牙周病原体相对丰富。核梭杆菌可能是癌症生物标志物的潜在候选微生物。牙周病可能通过吸烟的混淆与肺癌癌症风险呈正相关,但不是一个独立的风险因素。
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引用次数: 0
IMPACT OF LOADING PROTOCOL OF 2-IMPLANT BAR-RETAINED MANDIBULAR OVERDENTURES ON ORAL HEALTH-RELATED QUALITY OF LIFE: A RANDOMIZED CONTROLLED TRIAL 2种植体棒固位下颌覆盖义齿加载方案对口腔健康相关生活质量的影响:一项随机对照试验
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101891
DANIEL R. REISSMANN , MARTIN SCHIMMEL , DOMINIK KRAUS , MILAN STOILOV , MURALI SRINIVASAN , NORBERT ENKLING

Objectives

Aim was to assess whether immediate loading (IL) is more effective than delayed loading (DL) for 2-implant bar-retained mandibular overdentures in terms of oral health-related quality of life (OHRQoL) improvement over a period of 24-month.

Methods

In this randomized controlled trial, 32 edentulous patients (mean age: 65.7 ± 10.6 years, 50.0% female) were included. Potential participants had to be unsatisfied with the retention of their current mandibular complete denture and demanded implant treatment for inclusion in the study. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP) at baseline before treatment and 1, 3, 6, 12, and 24 months after implant loading and insertion of implant-retained bars for overdenture support. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement.

Results

Patients’ OHRQoL impairment at baseline was substantial indicated by mean OHIP summary score of 45.1 points. OHIP summary scores decreased substantially from baseline to 1-month follow-up to a mean of 33.5 points (P = .020). OHRQoL further improved during study period indicated by OHIP summary score of 25.7 points at 24-month follow-up. Raw treatment effects (IL vs. DL) ranged from -1.2 OHIP points for 12-month follow-up to 5.8 OHIP points for 24-month follow-up. Assuming constant treatment and time effects, treatment effect was small and not statistically significant (-0.7 OHIP points; P= .918).

Conclusion

A 2-implant bar-retained mandibular overdentures substantially improves OHRQoL over a period of at least 24 months. There seems to be no significant effect of implant loading protocol.

目的:评估在24个月的口腔健康相关生活质量(OHRQoL)改善方面,即刻装填(IL)是否比延迟装填(DL)更有效。方法随机对照试验32例无牙患者,平均年龄65.7±10.6岁,女性50.0%。潜在的参与者必须对他们目前的下颌全口义齿保留不满意,并要求种植治疗纳入研究。在治疗前和种植体装载和种植体保留杆插入用于覆盖义齿支持后的1、3、6、12和24个月,通过49项口腔健康影响量表(OHIP)对OHRQoL进行评估。以患者为随机效应和非结构化协方差矩阵建立混合效应模型,以解决重复结果测量问题。结果OHIP平均总分为45.1分,表明患者在基线时的OHRQoL下降明显。OHIP综合评分从基线到1个月随访显著下降至平均33.5分(P = 0.020)。OHRQoL在研究期间进一步改善,随访24个月OHIP总评分为25.7分。原始治疗效果(IL vs DL)从12个月随访的-1.2 OHIP点数到24个月随访的5.8 OHIP点数不等。假设治疗和时间效应不变,治疗效果较小且无统计学意义(-0.7 OHIP点;P = .918)。结论2种植体棒固位下颌覆盖义齿可显著改善OHRQoL,至少持续24个月。植入物加载方案似乎没有显著影响。
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引用次数: 0
Statement of Purpose/Levels of Evidence 目的陈述/证据水平
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/S1532-3382(23)00096-9
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引用次数: 0
SMOKERS MAY BE SUBJECT TO A HIGHER RISK OF SCHNEIDERIAN MEMBRANE PERFORATION THAN NONSMOKERS DURING MAXILLARY SINUS AUGMENTATION 在上颌窦增强术中,吸烟者比非吸烟者发生施耐德膜穿孔的风险更高
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101887
Ahmed Yaseen Alqutaibi (REVIEWERS), Abdulmajeed Abdulaziz Baik, Sary Borzangy

Article Title and Bibliographic Information

Association between smoking and Schneiderian membrane perforation during maxillary sinus floor augmentation: A systematic review and meta-analysis. Wang, X., Ma, S., Lin, L., & Yao, Q. Clinical Implant Dentistry and Related Research. 2022., 25.1: 166–176.

Source of Funding

National Natural Science Foundation of China, Grant/Award Number: 81801021; Hunan Provincial Health Commission, Grant/Award Number: B202308056991.

Type of Study/Design

Systematic review and meta-analysis

上颌窦底增强术中吸烟与施耐德膜穿孔的关系:一项系统综述和荟萃分析。王晓,马,S.,林,L., &;姚强。临床种植牙医学及相关研究。2022。, 25(1): 166-176。基金来源:国家自然科学基金,资助/奖励号:81801021;湖南省卫生健康委员会,资助/奖励号:B202308056991。研究类型/设计系统回顾和荟萃分析
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引用次数: 0
Comparison between two different local hemostatic methods for dental extractions in patients on dual antiplatelet therapy: a within-person, single-blind, randomized study 双重抗血小板治疗患者拔牙时两种不同局部止血方法的比较:一项人体内、单盲、随机研究
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101863
Bruno Guardieiro , Marcela Alves Santos-Paul , Remo Holanda de Mendonça Furtado , Talia Dalçóquio , Rocío Salsoso , Itamara Lúcia Itagiba Neves , Ricardo Simões Neves , Cyrillo Cavalheiro Filho , Luciano Moreira Baracioli , José Carlos Nicolau

Background

Dual antiplatelet therapy (DAPT) provides additional risk reduction of ischemic events compared to aspirin monotherapy, at cost of higher bleeding risk. There are few data comparing new techniques for reducing bleeding after dental extractions in these patients.

Purpose

This study investigated the effectiveness of the HemCon Dental Dressing (HDD) compared to oxidized cellulose gauze.

Materials and methods

This randomized study included 60 patients on DAPT who required at least two dental extractions (120 procedures). Each surgical site was randomized to HDD or oxidized regenerated cellulose gauze as the local hemostatic method. Intra-oral bleeding time was measured immediately after the dental extraction and represents our main endpoint for comparison of both hemostatic agents. Prolonged bleeding, platelet reactivity measured by Multiplate Analyser (ADPtest and ASPItest) and tissue healing comparison after 7 days were also investigated.

Results

Intra-oral bleeding time was lower in HDD compared with control (2 [2-5] vs. 5 [2-8] minutes, P=0.001). Prolonged postoperative bleeding was observed in 7 cases (11.6%), all of them successfully managed with local sterile gauze pressure. More HDD treated sites presented better healing when compared with control sites [21 (36.8%) vs. 5 (8.8%), P=0.03]. There was poor correlation between platelet reactivity and intra-oral bleeding time.

Conclusions

In patients on DAPT, HDD resulted in a lower intra-oral bleeding time compared to oxidized cellulose gauze after dental extractions. Moreover, HDD also seems to improve healing conditions.

背景:与阿司匹林单药治疗相比,双重抗血小板治疗(DAPT)提供了额外的缺血性事件风险降低,但代价是出血风险较高。很少有数据比较减少这些患者拔牙后出血的新技术。目的研究HemCon牙科敷料(HDD)与氧化纤维素纱布的疗效。材料和方法本随机研究包括60例需要至少两次拔牙(120次手术)的DAPT患者。每个手术部位随机选择HDD或氧化再生纤维素纱布作为局部止血方法。拔牙后立即测量口腔内出血时间,这是我们比较两种止血药物的主要终点。延长出血,多板分析仪测定血小板反应性(ADPtest和ASPItest)和7天后组织愈合比较。结果HDD组口腔出血时间明显低于对照组(2 [2-5]vs. 5 [2-8] min, P=0.001)。术后出血时间延长7例(11.6%),均经局部无菌纱布压紧处理成功。与对照组相比,HDD治疗部位愈后愈好[21(36.8%)比5 (8.8%),P=0.03]。血小板反应性与口腔出血时间相关性较差。结论在DAPT患者中,与氧化纤维素纱布相比,HDD可缩短拔牙后口腔内出血时间。此外,硬盘似乎也能改善愈合条件。
{"title":"Comparison between two different local hemostatic methods for dental extractions in patients on dual antiplatelet therapy: a within-person, single-blind, randomized study","authors":"Bruno Guardieiro ,&nbsp;Marcela Alves Santos-Paul ,&nbsp;Remo Holanda de Mendonça Furtado ,&nbsp;Talia Dalçóquio ,&nbsp;Rocío Salsoso ,&nbsp;Itamara Lúcia Itagiba Neves ,&nbsp;Ricardo Simões Neves ,&nbsp;Cyrillo Cavalheiro Filho ,&nbsp;Luciano Moreira Baracioli ,&nbsp;José Carlos Nicolau","doi":"10.1016/j.jebdp.2023.101863","DOIUrl":"10.1016/j.jebdp.2023.101863","url":null,"abstract":"<div><h3>Background</h3><p>Dual antiplatelet therapy (DAPT) provides additional risk reduction of ischemic events compared to aspirin monotherapy, at cost of higher bleeding risk. There are few data comparing new techniques for reducing bleeding after dental extractions in these patients.</p></div><div><h3>Purpose</h3><p>This study investigated the effectiveness of the HemCon Dental Dressing (HDD) compared to oxidized cellulose gauze.</p></div><div><h3>Materials and methods</h3><p>This randomized study included 60 patients on DAPT who required at least two dental extractions (120 procedures). Each surgical site was randomized to HDD or oxidized regenerated cellulose gauze as the local hemostatic method. Intra-oral bleeding time was measured immediately after the dental extraction and represents our main endpoint for comparison of both hemostatic agents. Prolonged bleeding, platelet reactivity measured by Multiplate Analyser (ADPtest and ASPItest) and tissue healing comparison after 7 days were also investigated.</p></div><div><h3>Results</h3><p>Intra-oral bleeding time was lower in HDD compared with control (2 [2-5] vs. 5 [2-8] minutes, <em>P</em>=0.001). Prolonged postoperative bleeding was observed in 7 cases (11.6%), all of them successfully managed with local sterile gauze pressure. More HDD treated sites presented better healing when compared with control sites [21 (36.8%) vs. 5 (8.8%), <em>P</em>=0.03]. There was poor correlation between platelet reactivity and intra-oral bleeding time.</p></div><div><h3>Conclusions</h3><p>In patients on DAPT, HDD resulted in a lower intra-oral bleeding time compared to oxidized cellulose gauze after dental extractions. Moreover, HDD also seems to improve healing conditions.</p></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10256080","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: 1
INTRAORAL SCANNING AND CONVENTIONAL IMPRESSION MAY HAVE SIMILAR TIME EFFICIENCY FOR COMPLETE COVERAGE CROWNS AND THREE-UNIT FIXED TOOTH-SUPPORTED PROSTHESES 对于全覆盖冠和三单元固定牙支撑修复体,口内扫描和常规印模具有相似的时间效率
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101894
Iman Abd-Elwahab Radi (REVIEWERS), Mohamed Amr ElKhashab

Article Title and Bibliographic Information

Bandiaky ON, Le Bars P, Gaudin A, Hardouin JB, Cheraud-Carpentier M, Mbodj EB, Soueidan A. Comparative assessment of complete-coverage, fixed tooth-supported prostheses fabricated from digital scans or conventional impressions: A systematic review and meta-analysis. J Prosthet Dent. 2022 Jan;127(1):71–79. doi: 10.1016/j.prosdent.2020.09.017. Epub 2020 Nov 2. PMID: 33,143,901.

Source of Funding

Information not available

Type of Study/Design

Systematic review with meta-analysis of data.

bandiaky ON, Le Bars P, Gaudin A, Hardouin JB, Cheraud-Carpentier M, Mbodj EB, Soueidan A.基于数字扫描和传统印模的全覆盖固定牙支撑假体的比较分析。[J] .中华口腔医学杂志,2011,27(1):1 - 7。doi: 10.1016 / j.prosdent.2020.09.017。Epub 2020 11月2日。PMID: 33143901。资金来源信息不可用研究类型/设计对数据进行meta分析的系统评价。
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引用次数: 0
THE CONTENTS, METHODS, AND ASSESSMENT OF EVIDENCE-BASED DENTISTRY EDUCATION: A SCOPING REVIEW 循证牙科教育的内容、方法和评估:范围综述
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101895
Qiujing Li BDS , Shijia Tang BDS , Xueqian Yu MS , Anne-Marie Glenny Phd , Fang Hua Phd

Objective

With evidence-based dentistry (EBD) having a far-reaching influence on oral healthcare, dental educators worldwide have made joint efforts to integrate EBD-related knowledge and skills into dental education. The present scoping review aims to identify and summarize the existing teaching contents, teaching methods, and assessment strategies of EBD education.

Methods

Electronic (PubMed and Embase) and manual searches were performed to identify articles related to both “dental education” and “evidence-based practice.” Based on predetermined eligibility criteria, articles were selected by 2 reviewers, independently and in duplicate. Data synthesis was conducted based on teaching contents, teaching strategies, and teaching assessment.

Results

Of the 1758 articles found in the literature searches, 74 were deemed eligible and included in this review. A total of 4 basic skills (problem formulation, literature searching, critical appraisal, and research methodology), 5 teaching methods, and 6 assessment strategies were identified. In most of the articles, 2, or more skills were taught, and a combination of traditional strategies for teaching and its assessment (eg, courses and questionnaire survey) was involved. Other teaching methods, such as journal clubs and workshops, were seldom used, and validated assessment tools accounted for a relatively small proportion of the assessment strategies involved.

Conclusions

The contents, methods and assessment of EBD education have been widely studied and discussed. However, the current literature focuses mainly on teaching of critical appraisal skills, traditional teaching methods, and short-term outcome assessments. Future research in this area can be aimed at integrating all EBD-related skills into educational models, studying multifaceted teaching approaches, and developing comprehensive teaching outcome assessment methods based on validated tools and dental patient-reported outcomes.

目的循证牙科(EBD)对口腔健康产生了深远的影响,世界各地的牙科教育工作者都在共同努力,将循证牙科相关知识和技能融入牙科教育中。本次范围审查旨在识别和总结现有的EBD教育的教学内容、教学方法和评估策略。方法通过电子检索(PubMed和Embase)和人工检索来识别与“牙科教育”和“循证实践”相关的文章。根据预先确定的资格标准,文章由两名独立的审稿人选择,一式两份。从教学内容、教学策略、教学评价三个方面进行数据综合。结果在文献检索中发现的1758篇文章中,74篇被认为符合条件并被纳入本综述。共确定了4项基本技能(问题制定、文献检索、批判性评价和研究方法)、5种教学方法和6种评估策略。在大多数文章中,教授了2种或更多的技能,并结合了传统的教学和评估策略(例如,课程和问卷调查)。很少使用其他教学方法,如期刊俱乐部和讲习班,有效的评估工具在所涉及的评估策略中所占比例相对较小。结论EBD教育的内容、方法和评价得到了广泛的研究和探讨。然而,目前的文献主要侧重于关键评估技能的教学、传统的教学方法和短期结果评估。该领域未来的研究将致力于将所有ebd相关技能整合到教育模式中,研究多方面的教学方法,并基于经过验证的工具和牙科患者报告的结果开发综合的教学结果评估方法。
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引用次数: 0
EFFICACY AND SAFETY OF A DEXAMETHASONE-BASED MOUTHWASH TO PREVENT CHEMOTHERAPY-INDUCED STOMATITIS IN WOMEN WITH BREAST CANCER: A MULTICENTRE, OPEN-LABEL, RANDOMISED PHASE 2 STUDY 基于地塞米松的漱口水预防乳腺癌女性化疗引起的口炎的有效性和安全性:一项多中心、开放标签、随机2期研究
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101896
Sayaka Kuba M.D., PhD , Shigeto Maeda M.D., PhD , Kenichiro Shibata M.D., PhD , Sakiko Soutome D.D.S., PhD , Kosho Yamanouchi M.D., PhD , Megumi Matsumoto M.D., PhD , Aya Tanaka M.D., PhD , Michi Morita M.D., PhD , Toshiko Hatachi M.D. , Ryota Otsubo M.D., PhD , Hiroshi Yano M.D., PhD , Yumiko Kawashita D.D.S., PhD , Shuntaro Sato PhD , Hideki Taniguchi M.D., PhD , Kengo Kanetaka M.D., PhD , Masahiro Umeda D.D.S., PhD , Takeshi Nagayasu M.D., PhD , Susumu Eguchi M.D., PhD

Purpose

No standard approach other than oral care is available for preventing chemotherapy-induced stomatitis in patients with breast cancer. In this randomized, controlled phase 2 trial, we aimed to assess the efficacy and safety of a dexamethasone-based mouthwash in preventing chemotherapy-induced stomatitis in patients with early breast cancer.

Basic procedures

Patients with breast cancer scheduled for epirubicin and cyclophosphamide (EC) or docetaxel and cyclophosphamide (TC) therapy were selected and allocated in a 1:1 ratio to the intervention and control groups. The intervention group received chemotherapy, oral care, and a dexamethasone-based mouthwash, whereas the control group received chemotherapy and oral care. The primary endpoint was the incidence of stomatitis. This was a phase 2 study, and the significance level for the analysis of the primary endpoint was set a priori at 0.2.

Main findings

Data pertaining to 58 patients in the control group and 59 patients in the intervention group were analyzed. Stomatitis incidence was 55% and 38% in the control and intervention groups, respectively (risk ratio, 0.68; 80% confidence interval, 0.52-0.88; P = .052). Stomatitis severity was lower in the intervention group than in the control group (P = .03). The proportion of patients who adhered to the mouthwash regimen was 87% (interquartile range, 67.8%-95.3%). No severe oral infections were observed.

Principal conclusions

The dexamethasone-based mouthwash safely reduced stomatitis incidence and severity in patients receiving chemotherapy for early breast cancer. Phase 3 clinical trials are warranted for validating our results.

目的:除了口腔护理外,没有其他标准的方法可以预防乳腺癌患者化疗引起的口腔炎。在这项随机对照2期试验中,我们旨在评估地塞米松漱口水预防早期乳腺癌患者化疗引起的口炎的有效性和安全性。选择表柔比星和环磷酰胺(EC)或多西他赛和环磷酰胺(TC)治疗的乳腺癌患者,按1:1的比例分配到干预组和对照组。干预组接受化疗、口腔护理和地塞米松漱口水,对照组接受化疗和口腔护理。主要终点是口腔炎的发生率。这是一项2期研究,主要终点分析的显著性水平先验设置为0.2。主要发现:对照组58例,干预组59例。对照组和干预组口腔炎发生率分别为55%和38%(风险比0.68;80%置信区间为0.52-0.88;P = .052)。干预组口腔炎严重程度低于对照组(P = .03)。坚持使用漱口水方案的患者比例为87%(四分位数间距为67.8% ~ 95.3%)。未见严重口腔感染。以地塞米松为基础的漱口水可以安全地降低早期乳腺癌化疗患者口炎的发生率和严重程度。3期临床试验是为了验证我们的结果。
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引用次数: 0
ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS 器官感觉和口臭测量评估在器官内口臭中相关性不好:一项系统综述和荟萃分析。
IF 3.6 4区 医学 Q1 Dentistry Pub Date : 2023-09-01 DOI: 10.1016/j.jebdp.2023.101862
Eszter Szalai , Péter Tajti , Bence Szabó , Tamás Kói , Péter Hegyi , László Márk Czumbel , Gábor Varga , Beáta Kerémi

Background

The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis?

Methods

This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random–effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot.

Results

A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01.

Discussion

None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.

背景:诊断口腔口臭的金标准方法是主观感官测量。设备支持的方法在世界范围内也很普遍。在流行病期间进行感官测量的挑战和安全问题以及测量设备替代品的多样性提出了我们的临床问题:哪种照度计最适合诊断口臭?方法:该系统综述在PROSPERO(ID CRD42022320024)中登记。搜索于2022年3月23日在以下电子数据库中进行:MEDLINE、Embase、Scopus、Web of Science和CENTRAL。包括有或没有口臭的成年人群,排除有系统性疾病的患者。比较了感官(主观)测量和设备支持(客观)方法;主要结果是相关系数,次要结果是装置的特异性和敏感性。QUADAS-2和QUADAS-C用于评估研究中的偏倚风险。对结果进行随机效应荟萃分析,并将次要结果绘制在通用ROC图上。结果:在5个数据库中共发现1231条记录。经过筛选过程,76篇文章符合系统综述的条件,14635名患者参与了定性分析。硫化物监测仪的Spearman相关系数(c.c.)为0.65;95%置信区间:[0.53-0.74];I2 = 95%,P<0.01。便携式气相色谱分析的Spearman系数为0.69;95%置信区间:[0.63-0.74];I2 = 12%,P<0.01。气相色谱法的合并Spearman系数为0.76;95%置信区间:[0.67-0.83];I2 = 0%,P<.01讨论:没有一种最常用的照度计被证明显著优于其他照度计。Halimeter和OralChroma测量与成人口腔口臭的感官水平没有很好的相关性。因此,需要开发更好的光度计作为感官测量的替代品。
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Journal of Evidence-Based Dental Practice
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