Pub Date : 2025-02-11DOI: 10.1016/S1532-3382(25)00028-4
{"title":"Statement of Purpose/Levels of Evidence","authors":"","doi":"10.1016/S1532-3382(25)00028-4","DOIUrl":"10.1016/S1532-3382(25)00028-4","url":null,"abstract":"","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102113"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379307","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 : 2025-02-11DOI: 10.1016/S1532-3382(25)00030-2
{"title":"Information for Authors","authors":"","doi":"10.1016/S1532-3382(25)00030-2","DOIUrl":"10.1016/S1532-3382(25)00030-2","url":null,"abstract":"","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 1","pages":"Article 102115"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379309","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 : 2025-02-07DOI: 10.1016/j.jebdp.2025.102121
PIERLUIGI MARIANI DDS , DIANA RUSSO DDS, PhD , MARCO CICCIÙ DDS, PhD , LUIGI LAINO DDS, PhD
Introduction
Odontogenic Keratocystic (OKC) and Ameloblastoma (AB) are pathological entities characterized by aggressive behavior, slow growth, local invasiveness, and high recurrence rates. The aim of this systematic review with meta-analysis and trial sequential analysis (TSA) is to assess the prognostic role of extracting involved teeth during the surgical enucleation of OKCs and ABs in terms of recurrence risk.
Materials and Methods
A search was conducted in PubMed/Medline, Scopus, and Web of Science databases for studies reporting data on teeth extraction and recurrence rates. This systematic review was performed according to guidelines in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Meta-analysis was performed using the Mantel-Haenszel method with a random-effects model due to heterogeneity. The TSA was conducted to control and reduce for type I and II errors of statistical analysis.
Results
Six studies were identified and analyzed qualitatively and quantitatively. A total of 737 lesions (674 OKCs and 64 ABs) were included, of which 508 had involved teeth. The meta-analysis included 451 OKCs; 367 lesions were treated with teeth extraction, and in 141 cases, the teeth were preserved. The overall Risk Ratio was 0.17 (95% CI: [0.04, 0.74]; P < .0001) for OKCs. Quantitative analysis could not be performed for ABs.
Conclusion
The analysis revealed that tooth extraction contextually to the enucleation of the lesion reduces the risk of recurrence by approximately 83% in the OKCs; this appears to have the same trend for ABs, but more evidence is needed.
牙源性角化囊瘤（OKC）和成釉细胞瘤（AB）是一种具有侵袭性、生长缓慢、局部侵袭性和高复发率的病理实体。本系统综述采用荟萃分析和试验序贯分析（TSA），目的是评估在OKCs和ABs手术摘除过程中，在复发风险方面拔除受病牙齿的预后作用。材料和方法在PubMed/Medline、Scopus和Web of Science数据库中检索报告拔牙和复发率数据的研究。本系统评价按照Cochrane手册和系统评价和荟萃分析首选报告项目（PRISMA）声明的指南进行。meta分析采用Mantel-Haenszel方法，由于异质性，采用随机效应模型。进行TSA以控制和减少统计分析的I型和II型误差。结果对6项研究进行定性和定量分析。共纳入737例病变（674例OKCs和64例ABs），其中508例累及牙齿。meta分析纳入451名okc；对367例病变进行拔牙治疗，141例保存完好。总风险比为0.17 (95% CI: [0.04, 0.74]；P & lt;0.0001)。结论分析显示，在切除病变核的情况下拔牙可使OKCs的复发风险降低约83%；这似乎与ABs的趋势相同，但还需要更多的证据。
{"title":"THE MANAGEMENT OF TEETH IN ODONTOGENIC KERATOCYST AND AMELOBLASTOMA AND ITS PROGNOSTIC ROLE IN RECURRENCE: A SYSTEMATIC REVIEW AND META-ANALYSIS WITH TRIAL SEQUENTIAL ANALYSIS","authors":"PIERLUIGI MARIANI DDS , DIANA RUSSO DDS, PhD , MARCO CICCIÙ DDS, PhD , LUIGI LAINO DDS, PhD","doi":"10.1016/j.jebdp.2025.102121","DOIUrl":"10.1016/j.jebdp.2025.102121","url":null,"abstract":"<div><h3>Introduction</h3><div>Odontogenic Keratocystic (OKC) and Ameloblastoma (AB) are pathological entities characterized by aggressive behavior, slow growth, local invasiveness, and high recurrence rates. The aim of this systematic review with meta-analysis and trial sequential analysis (TSA) is to assess the prognostic role of extracting involved teeth during the surgical enucleation of OKCs and ABs in terms of recurrence risk.</div></div><div><h3>Materials and Methods</h3><div>A search was conducted in PubMed/Medline, Scopus, and Web of Science databases for studies reporting data on teeth extraction and recurrence rates. This systematic review was performed according to guidelines in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Meta-analysis was performed using the Mantel-Haenszel method with a random-effects model due to heterogeneity. The TSA was conducted to control and reduce for type I and II errors of statistical analysis.</div></div><div><h3>Results</h3><div>Six studies were identified and analyzed qualitatively and quantitatively. A total of 737 lesions (674 OKCs and 64 ABs) were included, of which 508 had involved teeth. The meta-analysis included 451 OKCs; 367 lesions were treated with teeth extraction, and in 141 cases, the teeth were preserved. The overall Risk Ratio was 0.17 (95% CI: [0.04, 0.74]; <em>P</em> < .0001) for OKCs. Quantitative analysis could not be performed for ABs.</div></div><div><h3>Conclusion</h3><div>The analysis revealed that tooth extraction contextually to the enucleation of the lesion reduces the risk of recurrence by approximately 83% in the OKCs; this appears to have the same trend for ABs, but more evidence is needed.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102121"},"PeriodicalIF":4.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577589","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 : 2025-01-31DOI: 10.1016/j.jebdp.2025.102095
NAVARRO-FRAILE ESTRELLA , DEHESA-SANTOS ALEXANDRA , CHEN YUN , JUAN CARLOS PALMA-FERNÁNDEZ , IGLESIAS-LINARES ALEJANDRO
Introduction
External apical root resorption (EARR) is an undesirable loss of hard tissues of the tooth root frequently affecting to the maxillary incisors. The magnitude of orthodontic forces is a major treatment-related factor associated with EARR occurrence in orthodontics. The primary aim of the present randomized clinical trial was (i) to quantify the impact of a sequence of personalized force archwires on EARR compared to the conventional standard of care and (ii) compare the 3D-quantification of EARR using two quantification methods (manual or automated AI-aided segmentation).
Material and Methods
A superiority two arms-parallel-randomized clinical trial (RCT) was conducted to quantify the EARR of two regime forces [CONSORT-guidelines]. A total of 18/43 patients were randomly assigned [block-size: 4] to Control Group [Ni-Ti archwires sequence] or Experimental Group [selective individualized force archwires]. After 142 days sectorial CBCT were obtained; upper incisors were segmented manually and with AI and the volume/length of root quantified. Method error/descriptive statistics (mean; SD; range) and Student t-test were used to assess the differences between groups (Post hoc adjustment for confounders [95% CI; P < .05]).
Results
The total root volume loss detected by AI was 2.44 ± 6.59 mm3 / 2.42 ± 4.75 mm3 (P > .05) and the mean root length loss was 0.20± 0.23mm/0.42 ± 0.43 mm (P = .045) for control/test group, respectively. Despite length loss showed similar changes when it was quantified with both methods, manual and automatic segmentations (P > .05), differences are observed at volume loss. The results demonstrated greater volume loss detection with manual segmentation than with AI-aided segmentation at the global level, volume by thirds, and 4 mm from the apex. However, as we approached apically, the differences equalized and even diminished, resulting in a greater loss with automatic segmentation 1 mm from the apex in the EG (P = .011).
Conclusions
A non direct-force-dependent effect over EARR (6 months) was observed. Individualized force induces slightly higher root resorption at the apical third at 1-2 mm.
{"title":"AI-AIDED VOLUMETRIC ROOT RESORPTION ASSESSMENT FOLLOWING PERSONALIZED FORCES IN ORTHODONTICS: PRELIMINARY RESULTS OF A RANDOMIZED CLINICAL TRIAL","authors":"NAVARRO-FRAILE ESTRELLA , DEHESA-SANTOS ALEXANDRA , CHEN YUN , JUAN CARLOS PALMA-FERNÁNDEZ , IGLESIAS-LINARES ALEJANDRO","doi":"10.1016/j.jebdp.2025.102095","DOIUrl":"10.1016/j.jebdp.2025.102095","url":null,"abstract":"<div><h3>Introduction</h3><div>External apical root resorption (EARR) is an undesirable loss of hard tissues of the tooth root frequently affecting to the maxillary incisors. The magnitude of orthodontic forces is a major treatment-related factor associated with EARR occurrence in orthodontics. The primary aim of the present randomized clinical trial was (i) to quantify the impact of a sequence of personalized force archwires on EARR compared to the conventional standard of care and (ii) compare the 3D-quantification of EARR using two quantification methods (manual or automated AI-aided segmentation).</div></div><div><h3>Material and Methods</h3><div>A superiority two arms-parallel-randomized clinical trial (RCT) was conducted to quantify the EARR of two regime forces [CONSORT-guidelines]. A total of 18/43 patients were randomly assigned [block-size: 4] to C<em>ontrol Group</em> [Ni-Ti archwires sequence] or E<em>xperimental Group</em> [selective <em>individualized</em> force archwires]. After 142 days sectorial CBCT were obtained; upper incisors were segmented manually and with AI and the volume/length of root quantified. Method error/descriptive statistics (mean; SD; range) and Student <em>t</em>-test were used to assess the differences between groups (<em>Post hoc</em> adjustment for confounders [95% CI; <em>P</em> < .05]).</div></div><div><h3>Results</h3><div>The total root volume loss detected by AI was 2.44 ± 6.59 mm<sup>3</sup> / 2.42 ± 4.75 mm<sup>3</sup> (<em>P</em> > .05) and the mean root length loss was 0.20± 0.23mm/0.42 ± 0.43 mm (<em>P</em> = .045) for control/test group, respectively. Despite length loss showed similar changes when it was quantified with both methods, manual and automatic segmentations (<em>P</em> > .05), differences are observed at volume loss. The results demonstrated greater volume loss detection with manual segmentation than with AI-aided segmentation at the global level, volume by thirds, and 4 mm from the apex. However, as we approached apically, the differences equalized and even diminished, resulting in a greater loss with automatic segmentation 1 mm from the apex in the EG (<em>P</em> = .011).</div></div><div><h3>Conclusions</h3><div>A non direct-force-dependent effect over EARR (6 months) was observed. Individualized force induces slightly higher root resorption at the apical third at 1-2 mm.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102095"},"PeriodicalIF":4.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464297","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 : 2025-01-30DOI: 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.
{"title":"TWIN-MIX INJECTION REDUCES POSTOPERATIVE COMPLICATIONS AFTER LOWER THIRD MOLAR REMOVAL—A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS","authors":"ESZTER HARDI , ANNA TAKÁCS , BIANCA GOLZIO NAVARRO CAVALCANTE , BENCE SZABÓ , ANDREA HARNOS , PÉTER HEGYI , Gábor Varga , ORSOLYA NÉMETH , ÁRPÁD JOÓB-FANCSALY","doi":"10.1016/j.jebdp.2025.102098","DOIUrl":"10.1016/j.jebdp.2025.102098","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>In conclusion, the use of twin-mix is highly beneficial for pain relief, facial swelling and trismus following mandibular third molar surgical removal.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102098"},"PeriodicalIF":4.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453029","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 : 2025-01-25DOI: 10.1016/j.jebdp.2025.102097
MARIJA S. MILIC , BOZIDAR BRKOVIC , MILAN VUCETIC , VLADIMIR S. TODOROVIC , DRAGICA STOJIC
Objectives
This clinical trial aimed to evaluate and compare parameters of intraoral soft tissue anesthesia and cardiovascular function, and prevalence of local side effects in patients with and without diabetes mellitus type 2 (DMT2), after maxillary infiltration anesthesia obtained with 2% lidocaine with either clonidine (15mcg/ml) or epinephrine (1:100.000).
Methods
Sixty-three DMT2 and 52 nondiabetic (H) patients scheduled for tooth extraction were randomly assigned to receive one of the local anesthetic solutions for maxillary infiltration anesthesia: 2 mL of lidocaine with clonidine (LC) or 2 mL of lidocaine with epinephrine (LE). Parameters of soft tissue anesthesia (onset, duration and width of anesthetic field) were evaluated by pinprick test. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were monitored with patient monitor, before and until 30 minutes after anesthesia application. Presence of postoperative hyperalgesia and paresthesia during 7 postoperative days was tested with ethylene-chloride spray and monofilaments set for quantitative sensory testing, respectively. Requests for rescue analgesic were recorded for 24 hours after tooth extraction.
Results
Onset of maxillary infiltration anesthesia was significantly shorter in DMT2 vs. H groups (P < .05), regardless of local anesthetic solution used. Duration of anesthesia was 59% longer in DMT2-LE vs. H-LE (P < .05), and 28% longer in DMT2-LC vs. H-LC groups (P < .05). Maxillary infiltration anesthesia lasted 37,9% longer in DMT2-LE vs. DMT2-LC (182.09 ± 57.86 min vs. 139.48 ± 21.86 min) (P < .05). Width of anesthetic field was significantly increased in diabetic vs. nondiabetic participants (P < .05), as well as in DMT2-LE vs. DMT2-LC (35.19 ± 1.67mm vs. 27.07 ± 1.06 mm) (P < .05). SBP was significantly decreased within DM-LC and H-LC groups from 15th to 30th minute, in comparison with baseline values. Significant increase in HR was observed from 5th to 30th minute in diabetic and nondiabetic patients who received LE, compared to baseline values. Postoperative paresthesia was significantly more present in DMT2-LE vs. DMT2-LC (P < .05), while it was not observed in nondiabetic patients.
Conclusions
Shorter onset and prolonged duration of maxillary infiltration anesthesia are present in DMT2 setting. Clonidine appears to be a safe alternative to epinephrine for intraoral anesthesia in DMT2, with respect to anesthetic efficacy, cardiovascular safety and prevalence of local side effects.
目的：本临床试验旨在评价和比较2%利多卡因与可乐定（15mcg/ml）或肾上腺素（1:10万）上颌浸润麻醉后伴有和不伴有2型糖尿病（DMT2）患者的口腔软组织麻醉参数、心血管功能和局部副作用发生率。方法将63例DMT2患者和52例非糖尿病患者随机分为两组，分别给予2 mL利多卡因加可乐定（LC）和2 mL利多卡因加肾上腺素（LE）进行上颌浸润麻醉。针刺试验评价软组织麻醉的起效、持续时间、麻醉场宽度等参数。在麻醉前和麻醉后30分钟用监护仪监测收缩压（SBP）、舒张压（DBP）和心率（HR）。术后7天内，分别用氯乙烯喷雾剂和单丝组进行定量感觉测试，检测术后有无痛觉过敏和感觉异常。记录拔牙后24小时的抢救性镇痛请求。结果DMT2组上颌浸润麻醉的起始时间明显短于H组(P <；0.05)，无论使用何种局麻溶液。DMT2-LE组麻醉时间比H-LE组长59% (P <；0.05)， DMT2-LC组比H-LC组延长28% (P <；. 05)。DMT2-LE组上颌浸润麻醉持续时间比DMT2-LC组长37.9%(182.09±57.86 min vs 139.48±21.86 min) (P <；. 05)。与非糖尿病患者相比，糖尿病患者麻醉视野宽度显著增加(P <；0.05)，以及DMT2-LE与DMT2-LC(35.19±1.67mm vs. 27.07±1.06 mm) (P <；. 05)。与基线值相比，DM-LC组和H-LC组在第15 ~ 30分钟的收缩压显著降低。与基线值相比，在接受LE治疗的糖尿病和非糖尿病患者中，从第5分钟到第30分钟，HR显著增加。术后感觉异常在DMT2-LE组明显多于DMT2-LC组(P <；0.05)，而在非糖尿病患者中未观察到。结论DMT2患者上颌浸润麻醉起效时间较短，持续时间较长。在麻醉效果、心血管安全性和局部副作用发生率方面，可乐定似乎是DMT2患者口服麻醉中肾上腺素的安全替代品。
{"title":"EFFICACY AND SAFETY OF LIDOCAINE WITH CLONIDINE FOR MAXILLARY INFILTRATION ANESTHESIA IN PATIENTS WITH DIABETES MELLITUS TYPE 2: DOUBLE-BLIND, RANDOMIZED CLINICAL TRIAL","authors":"MARIJA S. MILIC , BOZIDAR BRKOVIC , MILAN VUCETIC , VLADIMIR S. TODOROVIC , DRAGICA STOJIC","doi":"10.1016/j.jebdp.2025.102097","DOIUrl":"10.1016/j.jebdp.2025.102097","url":null,"abstract":"<div><h3>Objectives</h3><div>This clinical trial aimed to evaluate and compare parameters of intraoral soft tissue anesthesia and cardiovascular function, and prevalence of local side effects in patients with and without diabetes mellitus type 2 (DMT2), after maxillary infiltration anesthesia obtained with 2% lidocaine with either clonidine (15mcg/ml) or epinephrine (1:100.000).</div></div><div><h3>Methods</h3><div>Sixty-three DMT2 and 52 nondiabetic (H) patients scheduled for tooth extraction were randomly assigned to receive one of the local anesthetic solutions for maxillary infiltration anesthesia: 2 mL of lidocaine with clonidine (LC) or 2 mL of lidocaine with epinephrine (LE). Parameters of soft tissue anesthesia (onset, duration and width of anesthetic field) were evaluated by <em>pinprick</em> test. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were monitored with patient monitor, before and until 30 minutes after anesthesia application. Presence of postoperative hyperalgesia and paresthesia during 7 postoperative days was tested with ethylene-chloride spray and monofilaments set for quantitative sensory testing, respectively. Requests for rescue analgesic were recorded for 24 hours after tooth extraction.</div></div><div><h3>Results</h3><div>Onset of maxillary infiltration anesthesia was significantly shorter in DMT2 vs. H groups (<em>P</em> < .05), regardless of local anesthetic solution used. Duration of anesthesia was 59% longer in DMT2-LE vs. H-LE (<em>P</em> < .05), and 28% longer in DMT2-LC vs. H-LC groups (<em>P</em> < .05). Maxillary infiltration anesthesia lasted 37,9% longer in DMT2-LE vs. DMT2-LC (182.09 ± 57.86 min vs. 139.48 ± 21.86 min) (<em>P</em> < .05). Width of anesthetic field was significantly increased in diabetic vs. nondiabetic participants (<em>P</em> < .05), as well as in DMT2-LE vs. DMT2-LC (35.19 ± 1.67mm vs. 27.07 ± 1.06 mm) (<em>P</em> < .05). SBP was significantly decreased within DM-LC and H-LC groups from 15th to 30th minute, in comparison with baseline values. Significant increase in HR was observed from 5th to 30th minute in diabetic and nondiabetic patients who received LE, compared to baseline values. Postoperative paresthesia was significantly more present in DMT2-LE vs. DMT2-LC (<em>P</em> < .05), while it was not observed in nondiabetic patients.</div></div><div><h3>Conclusions</h3><div>Shorter onset and prolonged duration of maxillary infiltration anesthesia are present in DMT2 setting. Clonidine appears to be a safe alternative to epinephrine for intraoral anesthesia in DMT2, with respect to anesthetic efficacy, cardiovascular safety and prevalence of local side effects.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102097"},"PeriodicalIF":4.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429092","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 : 2025-01-23DOI: 10.1016/j.jebdp.2025.102094
DONG-HEE KIM, GYEONG-SOON HAN
Introduction
The association between periodontitis and dementia remains controversial. Therefore, we analyzed this association focusing on the severity of periodontitis and type of dementia.
Methods
We searched the PubMed, Embase, Web of Science, and gray literature (OpenGrey, ProQuest) databases from inception to June 30, 2021, and pooled the data for meta-analysis. Fixed- or random-effects models were employed to calculate odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) to evaluate the strength of the associations between periodontitis and dementia.
Results
Thirteen case-control and 11 cohort studies were selected. The analysis of entire studies indicated an association between periodontitis and dementia, with an OR of 2.26 (95% CI, 1.65−3.09; P < .0001) and HR of 1.15 (95% CI, 1.04−1.27; P = .0006). According to periodontitis severity, the risk of dementia was significantly associated with severe periodontitis (OR = 2.85; 95% CI, 2.16−3.74; P = .038), but not with less-than-moderate periodontitis (OR = 0.94; 95% CI, 0.64−1.40; P = .66). In particular, patients with severe periodontitis had a 6.87-fold higher risk of Alzheimer's dementia (OR = 6.87; 95% CI, 2.55−18.54; P = .04) and 2.92-fold higher risk of cognitive impairment (OR = 2.92, 95% CI, 2.15−3.96; P = .36).
Conclusions
We found a strong association between periodontitis and dementia, with severe periodontitis identified as a potential risk factor for Alzheimer's dementia. Therefore, timely management of periodontitis to prevent its progression may help prevent dementia.
{"title":"PERIODONTITIS AS A RISK FACTOR FOR DEMENTIA: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"DONG-HEE KIM, GYEONG-SOON HAN","doi":"10.1016/j.jebdp.2025.102094","DOIUrl":"10.1016/j.jebdp.2025.102094","url":null,"abstract":"<div><h3>Introduction</h3><div>The association between periodontitis and dementia remains controversial. Therefore, we analyzed this association focusing on the severity of periodontitis and type of dementia.</div></div><div><h3>Methods</h3><div>We searched the PubMed, Embase, Web of Science, and gray literature (OpenGrey, ProQuest) databases from inception to June 30, 2021, and pooled the data for meta-analysis. Fixed- or random-effects models were employed to calculate odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) to evaluate the strength of the associations between periodontitis and dementia.</div></div><div><h3>Results</h3><div>Thirteen case-control and 11 cohort studies were selected. The analysis of entire studies indicated an association between periodontitis and dementia, with an OR of 2.26 (95% CI, 1.65−3.09; <em>P</em> < .0001) and HR of 1.15 (95% CI, 1.04−1.27; <em>P</em> = .0006). According to periodontitis severity, the risk of dementia was significantly associated with severe periodontitis (OR = 2.85; 95% CI, 2.16−3.74; <em>P</em> = .038), but not with less-than-moderate periodontitis (OR = 0.94; 95% CI, 0.64−1.40; <em>P</em> = .66). In particular, patients with severe periodontitis had a 6.87-fold higher risk of Alzheimer's dementia (OR = 6.87; 95% CI, 2.55−18.54; <em>P</em> = .04) and 2.92-fold higher risk of cognitive impairment (OR = 2.92, 95% CI, 2.15−3.96; <em>P</em> = .36).</div></div><div><h3>Conclusions</h3><div>We found a strong association between periodontitis and dementia, with severe periodontitis identified as a potential risk factor for Alzheimer's dementia. Therefore, timely management of periodontitis to prevent its progression may help prevent dementia.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102094"},"PeriodicalIF":4.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429091","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 : 2025-01-23DOI: 10.1016/j.jebdp.2025.102096
GIORGIA STORNELLI , GIULIA PETRUCCI , VITO CARLO ALBERTO CAPONIO , ELOISA SARDELLA , GIUSEPPE BALICE , BEATRICE FEMMINELLA , MICHELE PAOLANTONIO , ILARIA CELA , TIRTHA RAJ ACHARYA , NAYANSI JHA , NAGENDRA KUMAR KAUSHIK , EUN HA CHOI , VALENTINA PUCA , ROSSELLA GRANDE , VITTORIA PERROTTI
Aim
The utilization of cold atmospheric plasma (CAP) in dentistry presents a promising avenue for novel therapeutic interventions. This systematic review of in vivo studies aimed at summarizing the existing evidence regarding the efficacy of CAP as a treatment for biofilms associated with periodontitis and peri-implantitis. The objective was to advance the definition and standardization of protocols and facilitate the integration of CAP treatment as a chair-side practice.
Materials and Methods
This review was registered in PROSPERO database (CRD42023404757), and a comprehensive search was conducted following PRISMA guidelines and using PubMed, Scopus, Web of Science, and Embase databases.
Results
In total, 9 in vivo studies were included, 1 on humans and 8 on animal models. A notable reduction in residual bacteria when CAP was combined with conventional therapies in both periodontitis and peri-implantitis models was observed. Biochemical and histological assays demonstrated a decrease in inflammatory cytokines within crevicular fluid and oral tissues.
Conclusions
Current evidence suggests that CAP shows promise for periodontitis and peri-implantitis treatment, but further clinical trials with larger cohorts and standardized protocols are needed to confirm its efficacy and safety.
目的低温常压等离子体（CAP）在口腔医学中的应用为新的治疗手段提供了一条有前景的途径。本系统综述了体内研究，旨在总结现有证据，证明CAP治疗牙周炎和种植周炎相关生物膜的有效性。目的是促进协议的定义和标准化，并促进CAP治疗作为一种主席边实践的整合。材料和方法本综述在PROSPERO数据库注册（CRD42023404757），并根据PRISMA指南和PubMed、Scopus、Web of Science和Embase数据库进行全面检索。结果共纳入9项体内实验，1项人体实验，8项动物实验。观察到在牙周炎和种植周炎模型中，CAP与常规治疗联合使用时，残留细菌显著减少。生化和组织学分析显示，沟液和口腔组织中的炎症细胞因子减少。目前的证据表明，CAP对牙周炎和种植周炎的治疗有希望，但需要进一步的临床试验和更大的队列和标准化的方案来证实其有效性和安全性。
{"title":"TRANSLATIONAL APPLICATION OF COLD ATMOSPHERIC PLASMA IN PERIODONTOLOGY AND IMPLANTOLOGY: WHERE ARE WE? A SYSTEMATIC REVIEW OF IN VIVO STUDIES IN HUMAN AND ANIMAL MODELS","authors":"GIORGIA STORNELLI , GIULIA PETRUCCI , VITO CARLO ALBERTO CAPONIO , ELOISA SARDELLA , GIUSEPPE BALICE , BEATRICE FEMMINELLA , MICHELE PAOLANTONIO , ILARIA CELA , TIRTHA RAJ ACHARYA , NAYANSI JHA , NAGENDRA KUMAR KAUSHIK , EUN HA CHOI , VALENTINA PUCA , ROSSELLA GRANDE , VITTORIA PERROTTI","doi":"10.1016/j.jebdp.2025.102096","DOIUrl":"10.1016/j.jebdp.2025.102096","url":null,"abstract":"<div><h3>Aim</h3><div>The utilization of cold atmospheric plasma (CAP) in dentistry presents a promising avenue for novel therapeutic interventions. This systematic review of in vivo studies aimed at summarizing the existing evidence regarding the efficacy of CAP as a treatment for biofilms associated with periodontitis and peri-implantitis. The objective was to advance the definition and standardization of protocols and facilitate the integration of CAP treatment as a chair-side practice.</div></div><div><h3>Materials and Methods</h3><div>This review was registered in PROSPERO database (CRD42023404757), and a comprehensive search was conducted following PRISMA guidelines and using PubMed, Scopus, Web of Science, and Embase databases.</div></div><div><h3>Results</h3><div>In total, 9 in vivo studies were included, 1 on humans and 8 on animal models. A notable reduction in residual bacteria when CAP was combined with conventional therapies in both periodontitis and peri-implantitis models was observed. Biochemical and histological assays demonstrated a decrease in inflammatory cytokines within crevicular fluid and oral tissues.</div></div><div><h3>Conclusions</h3><div>Current evidence suggests that CAP shows promise for periodontitis and peri-implantitis treatment, but further clinical trials with larger cohorts and standardized protocols are needed to confirm its efficacy and safety.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102096"},"PeriodicalIF":4.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422713","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}
The aim of the study was to investigate the efficacy of ammonium fluoride solution (AFS) combined with nano sol calcium fluoride (nano-CaF2) for the treatment of active buccal white spot lesions (WSLs) in permanent dentition.
Materials and Methods
Participants with at least 2 WSLs in different quadrants were included in the splitmouth randomized clinical trial. The WSLs meeting the inclusion criteria (n = 60) were randomly assigned into test and control groups. The WSLs in test group (n = 30) received AFS (25,000 ppmF-) and nano-CaF2 (41,400 ppmF-) as a 2-step treatment (Experimental product, Ivoclar Vivadent AG, Schaan, Liechtenstein), while the WSLs in control group (n = 30) received 1-step ammonium fluoride varnish (AFV, 7700 ppmF-, Fluor Protector S, Ivoclar Vivadent AG) treatment. The WSLs were quantitatively assessed using QLF (QrayCam, AIOBIO, Seoul, Republic of Korea) and qualitatively assessed using International Caries Detection and Assessment System (ICDAS-II) and Nyvad criteria at baseline, 1, 6 and 12-months follow-ups. The difference in QLF parameters within each group (Friedman test) and between groups (Wilcoxon test) was analyzed. Binary logistic regression model was used to compare the odds of the WSLs showed regression between the groups based on qualitative assessment.
Results
Overall, 56 WSLs in 21 participants (ages ranged from 14 to 40 years) could be evaluated. Quantitatively, mineral loss (ΔF average and ΔF max), lesion size (WS area) and volume (ΔQ) decreased significantly in test group (P = .001) at 6 and 12 months compared to baseline, whereas no significant difference was found in control group (P > .05). Intergroup comparison showed greater reduction in ΔF average and ΔF max values in the test group compared to control group at 6-month`s follow-up (P = .05). Qualitatively assessed regression rate was higher in test group compared to control group at 6 and 12-months (P < .05).
Conclusion
Caries preventive efficacy of AFS + nano-CF2 was found to be superior to AFV based on both quantitative and qualitative assessment in high caries risk adolescents and young adults.
Clinical Relevance
Two-step treatment with high level of AFS and nano sol CaF2 might be a better option compared to 1-step AFV treatment for the management of WSLs.
{"title":"EFFICACY OF A REMINERALIZATION AGENT CONTAINING AMMONIUM FLUORIDE SOLUTION AND NANO SOL CALCIUM FLUORIDE FOR TREATMENT OF INITIAL BUCCAL CARIES LESIONS: A SPLIT-MOUTH RANDOMIZED CONTROLLED CLINICAL TRIAL","authors":"BURCU GÖZETİCİ-ÇİL DDS, PhD , SAFİYE SELİN KÖYMEN DDS, PhD , AYŞE TAŞ DDS, PhD , HİLAL YILANCI DDS, PhD , MUTLU ÖZCAN DDS, DMD, PhD","doi":"10.1016/j.jebdp.2025.102093","DOIUrl":"10.1016/j.jebdp.2025.102093","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to investigate the efficacy of ammonium fluoride solution (AFS) combined with nano sol calcium fluoride (nano-CaF<sub>2</sub>) for the treatment of active buccal white spot lesions (WSLs) in permanent dentition.</div></div><div><h3>Materials and Methods</h3><div>Participants with at least 2 WSLs in different quadrants were included in the splitmouth randomized clinical trial. The WSLs meeting the inclusion criteria (n = 60) were randomly assigned into test and control groups. The WSLs in test group (n = 30) received AFS (25,000 ppmF<sup>-</sup>) and nano-CaF<sub>2</sub> (41,400 ppmF<sup>-</sup>) as a 2-step treatment (Experimental product, Ivoclar Vivadent AG, Schaan, Liechtenstein), while the WSLs in control group (n = 30) received 1-step ammonium fluoride varnish (AFV, 7700 ppmF<sup>-</sup>, Fluor Protector S, Ivoclar Vivadent AG) treatment. The WSLs were quantitatively assessed using QLF (QrayCam, AIOBIO, Seoul, Republic of Korea) and qualitatively assessed using International Caries Detection and Assessment System (ICDAS-II) and Nyvad criteria at baseline, 1, 6 and 12-months follow-ups. The difference in QLF parameters within each group (Friedman test) and between groups (Wilcoxon test) was analyzed. Binary logistic regression model was used to compare the odds of the WSLs showed regression between the groups based on qualitative assessment.</div></div><div><h3>Results</h3><div>Overall, 56 WSLs in 21 participants (ages ranged from 14 to 40 years) could be evaluated. Quantitatively, mineral loss (ΔF average and ΔF max), lesion size (WS area) and volume (ΔQ) decreased significantly in test group (<em>P</em> = .001) at 6 and 12 months compared to baseline, whereas no significant difference was found in control group (<em>P</em> > .05). Intergroup comparison showed greater reduction in ΔF average and ΔF max values in the test group compared to control group at 6-month`s follow-up (<em>P</em> = .05). Qualitatively assessed regression rate was higher in test group compared to control group at 6 and 12-months (<em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>Caries preventive efficacy of AFS + nano-CF2 was found to be superior to AFV based on both quantitative and qualitative assessment in high caries risk adolescents and young adults.</div></div><div><h3>Clinical Relevance</h3><div>Two-step treatment with high level of AFS and nano sol CaF<sub>2</sub> might be a better option compared to 1-step AFV treatment for the management of WSLs.</div></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"25 2","pages":"Article 102093"},"PeriodicalIF":4.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550597","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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