Systematic review and meta-analysis of diagnostic studies of proximal surface caries

Abstract Aim This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. Material and methods PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. Results From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81–0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. Conclusion The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. Clinical relevance BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.

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Systematic review and meta-analysis of diagnostic methods for occlusal surface caries

Clinical Oral Investigations ◽

10.1007/s00784-021-04024-1 ◽

2021 ◽

Author(s):

Svetlana Kapor ◽

Mila Janjic Rankovic ◽

Yegane Khazaei ◽

Alexander Crispin ◽

Ina Schüler ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Performance ◽

Meta Analysis ◽

Diagnostic Methods ◽

Laser Fluorescence ◽

Caries Detection ◽

Detection Level ◽

Dentin Caries

Abstract Aim This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.

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Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis

Journal of Evidence-Based Medicine ◽

10.1111/jebm.12227 ◽

2016 ◽

Vol 9 (4) ◽

pp. 213-224 ◽

Cited By ~ 5

Author(s):

Maria I Rosa ◽

Vilson S Schambeck ◽

Eduardo R Dondossola ◽

Maria CM Alexandre ◽

Lisiane Tuon ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Laser Fluorescence ◽

Caries Detection ◽

Permanent Teeth

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Aplicação do Laser na Cariologia: diagnóstico, prevenção e tratamento

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v8i6.3196 ◽

2019 ◽

Vol 8 (6) ◽

Author(s):

Ana Luzia Araújo Batista ◽

Thamyres Maria Silva Simões ◽

Maria das Graças Barbosa da Silva ◽

Maria Helena Chaves de Vasconcelos Catão

Keyword(s):

Systematic Review ◽

Laser Irradiation ◽

Primary Teeth ◽

Er:Yag Laser ◽

Meta Analysis ◽

Laser Fluorescence ◽

Caries Detection ◽

Permanent Teeth ◽

Topical Fluoride

Nas últimas décadas, um dos grandes avanços na Área da Saúde foi o desenvolvimento dos aparelhos de Laser, que possibilitou uma nova abordagem nos procedimentos odontológicos. A Laserterapia tem diversas aplicabilidades na Cariologia, seja como método de diagnóstico, como auxiliar nas medidas preventivas ou como tratamento da cárie dentária. Portanto, o objetivo desta revisão é proporcionar uma leitura atualizada da aplicabilidade da Laserterapia na Cariologia e, para tanto, foi realizada uma revisão literária sistematizada, na base de dados MEDLINE – Pubmed, abrangendo os últimos anos. Mediante esse estudo literário e considerando a evolução dos estudos científicos, ainda existem controvérsias a respeito da eficácia clínica do Laser na Cariologia.Descritores: Lasers; Cárie Dentária; Flúor.ReferênciasSichani AV, Javadinejad S, Ghafari R. Diagnostic value of DIAGNOdent in detecting caries under composite restorations of primary molars. Dent Res J. 2016;13(4):327-32.Montedori A, Abraha I, Orso M, D'errico PG, Pagano S, Lombardo G. Lasers for caries removal in deciduous and permanent teeth. Cochrane Database Syst Rev. 2016;26(9):CD010229.Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RS, Graciano AX et al. Antibacterial photodynamic therapy for dental caries: evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther. 2012;9(2):122-31.Bahrololoomi Z, Fotuhi Ardakani F, Sorouri M. In vitro comparison of the effects of diode laser and co2 laser on topical fluoride uptake in primary teeth. J Dent (Tehran). 2015;12(8):585-91.Nokhbatolfoghahaie H, Alikhasi M, Chiniforush N, Khoei F, Safavi N, Yaghoub Zadeh B. Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods. J Lasers Med Sci. 2013; 4(4):159-67.Melo M, Pascual A, Camps I, Del Campo Á, Ata-Ali J. Caries diagnosis using light fluorescence devices in comparison with traditional visual and tactile evaluation: a prospective study in 152 patients. Odontology. 2017;105(3):283-90.Gimenez T, Braga MM, Raggio DP, Deery C, Ricketts DN, Mendes FM. Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. PLoS One. 2013;8(4):e60421.Kositbowornchai S, Sukanya C, Tidarat T, Chanoggarn T. Caries detection under composite restorations by laser fluorescence and digital radiography. Clin Oral Investig. 2013; 17(9):2079-84.Rosa MI, Schambeck VS, Dondossola ER, Alexandre MC, Tuon L, Grande AJ, Hugo F. Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis. J Evid Based Med. 2016; 9(4):213-24.Heravi F, Ahrari F, Mahdavi M, Basafa S. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries. J Clin Exp Dent. 2014;6(2):e121-26.Mang TS, Tayal DP, Baier R. Photodynamic therapy as an alternative treatment for disinfection of bacteria in oral biofilms. Lasers Surg Med. 2012;44(7):588-96.Fornaini C, Brulat N, Milia G, Rockl A, Rocca JP. The use of sub-ablative Er:YAG laser irradiation in prevention of dental caries during orthodontic treatment. Laser Ther. 2014;23(3):173-81.Karandish M. The efficiency of laser application on the enamel surface: a systematic review. J Lasers Med Sci. 2014;5(3):108-14.Twetman S, Axelsson S, Dahlén G, Espelid I, Mejàre I, Norlund A et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71(3-4):388-97.Bahrololoomi Z, Lotfian M. Effect of diode laser irradiation combined with topical fluoride on enamel microhardness of primary teeth. J Dent (Tehran). 2015;12(2):85-9.Ramos-Oliveira TM, Ramos TM, Esteves-Oliveira M, Apel C, Fischer H, Eduardo CP et al. Potential of CO2 lasers (10.6 µm) associated with fluorides in inhibiting human enamel erosion. Braz Oral Res. 2014;28(1):1-6.Souza-Gabriel AE, Turssi CP, Colucci V, Tenuta LM, Serra MC, Corona SA. In situ study of the anticariogenic potential of fluoride varnish combined with CO2 laser on enamel. Arch Oral Biol. 2015;60(6):804-10.

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Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis (Preprint)

10.2196/preprints.25500 ◽

2020 ◽

Author(s):

Henry Peng

Keyword(s):

Systematic Review ◽

Clinical Studies ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Future Research ◽

In Vitro Testing ◽

Screening Process ◽

Prevention And Treatment

BACKGROUND The coronavirus disease (COVID-19) pandemic caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly worldwide. Currently, no vaccine or specific therapeutics are available to prevent and/or treat COVID-19. Convalescent plasma (CP) obtained from patients following resolution of COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle, and in many clinical reports. OBJECTIVE We sought to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitatively analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. METHODS PubMed, Web of Science and Embase were continuously searched for studies assessing the use of CP for COVID-19 including clinical studies, commentaries, reviews, guidelines/protocols and in vitro testing of CP antibodies. Screening process and data extraction were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality appraisal of all clinical studies was conducted using an universal tool independent on study designs. Meta-analysis of case-controlled and randomized controlled trials (RCTs) was conducted using a random-effects model. RESULTS Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, 35 in vitro testing of CP antibodies, matched the criteria. Positive results have been mostly observed so far when utilising CP for the treatment of COVID-19. There are remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies in particular case reports and case series had poor quality. Only one RCT was of high quality. Randomized and non-randomized data were found in two and 11 studies, respectively and included for meta-analysis suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. CONCLUSIONS There is developing support for CP therapy particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in COVID-19 patients. Future research is necessary to fill the knowledge gap regarding prevention and treatment of COVID-19 patients with CP while vaccines and other treatment are being developed.

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Accuracy of Dynamic Computer-Assisted Implant Placement: A Systematic Review and Meta-Analysis of Clinical and In Vitro Studies

Journal of Clinical Medicine ◽

10.3390/jcm10040704 ◽

2021 ◽

Vol 10 (4) ◽

pp. 704 ◽

Cited By ~ 3

Author(s):

Sigmar Schnutenhaus ◽

Cornelia Edelmann ◽

Anne Knipper ◽

Ralph G. Luthardt

Keyword(s):

Systematic Review ◽

Clinical Studies ◽

Literature Search ◽

Meta Analysis ◽

In Vitro Studies ◽

Computer Assisted ◽

Implant Placement ◽

Angle Deviation ◽

Dynamic Navigation

The aim of this systematic review and meta-analysis is to analyze the accuracy of implant placement using computer-assisted dynamic navigation procedures. An electronic literature search was carried out, supplemented by a manual search. The literature search was completed in June 2020. The results of in vitro and clinical studies were recorded separately from each other. For inclusion in the review, the studies had to examine at least the prosthetically relevant parameters for angle deviation, as well as global deviation or lateral deviation at the platform of the implant. Sixteen of 320 articles were included in the investigation: nine in vitro and seven clinical studies. The meta-analysis showed values of 4.1° for the clinical studies (95% CI, 3.12–5.10) and 3.7° for the in vitro studies (95% CI, 2.31–5.10) in terms of the angle deviation. The global deviation at the implant apex of the implant was 1.00 mm for the clinical studies (95% CI, 0.83–1.16) and 0.91 mm for the in vitro studies (95% CI, 0.60–1.12). These values indicate no significant difference between the clinical and in vitro studies. The results of this systematic review show a clinical accuracy of dynamic computer-assisted navigation that is comparable to that of static navigation. However, the dynamic navigation systems show a great heterogeneity that must be taken into account. Moreover, currently there are few clinical data available. Therefore, further investigations into the practicability of dynamic navigation seem necessary.

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