scholarly journals Efficacy of Therapeutic Endoscopy for Gastrointestinal Lesion (GI): A network meta-analysis

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Tian-xi Wang ◽  
Jun Zhang ◽  
Li-hong Cui ◽  
Jingjing Tian ◽  
Rongna Wei
Keyword(s):  
Endoscopic Therapy ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Credible Interval ◽  
Therapeutic Endoscopy ◽  
Gi Bleeding ◽  
Band Ligation ◽  
Creative Commons ◽  
Significant Difference ◽  
Gastrointestinal Lesion

Objective: Endoscopic therapy can reduce the risks of rebleeding, continued bleeding, need for surgery, and mortality. The objective of this systematic review was to compare the different modalities of endoscopic therapy for GI bleeding. Methods: Studies were identified by searching electronic databases MEDLINE. We selected all available clinical studies published after 2000 that assessed efficacy and/or safety of different endoscopic hemostatic techniques in treating GI bleeding. The outcomes evaluated included initial hemostasis, rebleeding rate, and 30-day all-cause mortality. Network meta-analyses were performed to summarize the treatment effects. Results: Total 20 studies involving 1845 patients were evaluated. Ten different treatment categories including mechanic, ablative, injection, and combined therapy were compared in our analysis in terms of their efficacy in stopping bleeding and complications. Band ligation [rate: 0.757; 95% Credible Interval (0.565, 0.887)] and injection therapy [rate: 0.891; 95% CI (0.791, 0.944)] had inferior efficacy in attaining initial hemostasis compared to others. Combined therapy of band ligation and HPC and hemoclip may represent the best options for preventing rebleeding and mortality respectively. No significant difference was found among other treatments in terms of complications. Conclusions: We recommend the application of hemoclips in treating GI bleeding due to its high hemostasis efficacy and low risk of 30-day mortality. How to cite this:Wang TX, Zhang J, Cui LH, Tian JJ Wei R. Efficacy of Therapeutic Endoscopy for Gastrointestinal Lesion (GI): A network meta-analysis. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.636 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Combined Therapy of Hypertensive Nephropathy with Breviscapine Injection and Antihypertensive Drugs: A Systematic Review and a Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-17 ◽  
Author(s):  
Lihua Wu ◽  
Ming Liu ◽  
Zhuyuan Fang
Keyword(s):  
Clinical Efficacy ◽  
Antihypertensive Drugs ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Lower Systolic Blood Pressure ◽  
Hypertensive Nephropathy ◽  
Chinese Populations ◽  
Significant Difference

Objective. To evaluate the beneficial and adverse effects of breviscapine injection in combination with antihypertensive drugs for treating hypertensive nephropathy in clinical practice. Methods. We searched PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data for relevant literature. The timeframe of retrieval was set from the founding date of each database to September 28, 2018. Results. Fourteen papers were included in this study. The quality of all the studies included was determined to be low. All studies were conducted with Chinese populations. Meta-analysis showed that, compared with single-use antihypertensive drugs, using breviscapine injection in combination with antihypertensive drugs to treat hypertensive nephropathy can reduce serum creatinine (Scr) [WMD = –35.16, 95% CI(–50.01, –20.31), P ≤ 0.001], blood urea nitrogen (BUN) [WMD = –2.00, 95% CI(–3.07, –0.94), P ≤ 0.001], 24-hour urinary total protein (24 h UTP) [WMD = –0.04, 95% CI(–0.05, –0.02), P ≤ 0.001], and the beta-2-microglobulin (B2M) [WMD = –0.09, 95% CI(–0.11, –0.07), P ≤ 0.001], improve creatinine clearance rate (Ccr) [WMD = 7.84, 95% CI(5.20, 10.49), P ≤ 0.001], and increase the clinical efficacy [RR = 1.27, 95% CI(1.05, 1.53), P = 0.014], but does not lower systolic blood pressure (SBP) [WMD = –1.02, 95% CI(–2.88, 0.84), P = 0.281]. There was no significant difference in adverse events between experimental groups and control groups. Conclusion. Breviscapine injection in combination with antihypertensive drugs can improve clinical efficacy and Ccr and reduce Scr, BUN, 24 h UTP, and B2M in patients with hypertensive nephropathy. The present meta-analysis indicated that breviscapine injection can serve as a renal protective effect to patients with hypertensive nephropathy. However, the evidence of methodological quality and sample sizes is weak, and thus, further standardized research is required.

Bayesian network meta-analysis (NMA) of complete remission without or with incomplete hematologic recovery (CR/CRi) to CPX-351, FLAG, and standard 7+3 (7+3) chemotherapy in the treatment of newly diagnosed secondary acute myeloid leukemia (sAML).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18514-e18514
Author(s):  
Mok Oh ◽  
Bernard Marini ◽  
Anthony Perissinotti ◽  
Lydia Benitez ◽  
Patrick William Burke ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Indirect Comparison ◽  
Credible Interval ◽  
Molar Ratio ◽  
High Dose ◽  
Newly Diagnosed ◽  
Comparative Efficacy ◽  
Secondary Acute Myeloid Leukemia ◽  
Significant Difference

e18514 Background: Patients (pts) sAML have poor outcomes (CR/CRi= 25-35%) with standard 7+3 induction chemotherapy (7+3). CPX-351 (liposomal encapsulated daunorubicin + cytarabine at a synergistic 5:1 molar ratio) was approved recently for sAML based on improvements in CR/CRi and survival but high cost and toxicity has discouraged its use. FLAG (fludarabine + high-dose cytarabine + granulocyte colony stimulating factor) have emerged as a lower cost, safe alternatives; however, outcomes between CPX-351 and FLAG have yet to be compared. In the absence of a direct trial, we aimed to estimate indirectly by Bayesian NMA the comparative efficacy of CPX-351, FLAG, and 7+3 therapy for sAML patients. Methods: Publications that compared FLAG or CPX-351 to 7+3 in newly diagnosed sAML were identified through a search of PubMed. CR/CRi rates were used in a Bayesian NMA to assess the direct (CPX-351 vs 7+3; FLAG vs 7+3) and indirect (CPX-351 vs FLAG) comparative efficacy of these regimens. Fixed (FE) and random effect (RE) analyses were conducted to estimate pooled odds ratios (OR) with 95% credible interval (CrI). Results: Of 169 identified articles, four studies (three RCT and one retrospective cohort) on a total of 781 pts in three treatment arms were retained. NMA showed no significant difference in pooled CR/CRi rates between CPX-351 and FLAG in both FE and RE models. However, pts receiving either FLAG or CPX-351 had significantly higher CR/CRi than those receiving 7+3 in both FE and RE models as shown in the table. Conclusions: This NMA suggests that both CPX-351 and FLAG prevail in CR/CRi efficacy over 7+3. In indirect comparison, CPX-351 and FLAG are equivalent in efficacy. The cost implications of these results remain to be established. [Table: see text]

scholarly journals ROMIPLOSTIM AND ELTROMBOPAG FOR IMMUNE THROMBOCYTOPENIA: METHODS FOR INDIRECT COMPARISON

2012 ◽  
Vol 28 (3) ◽  
pp. 249-258 ◽  
Author(s):  
Katy L. Cooper ◽  
Patrick Fitzgerald ◽  
Kerry Dillingham ◽  
Kawitha Helme ◽  
Ron Akehurst
Keyword(s):  
Immune Thrombocytopenia ◽  
Meta Analysis ◽  
Indirect Comparison ◽  
Indirect Evidence ◽  
Credible Interval ◽  
Posterior Probabilities ◽  
Platelet Response ◽  
Single Model ◽  
Bayesian Approaches ◽  
Significant Difference

Objectives:Immune thrombocytopenia (ITP) causes increased platelet destruction and suboptimal platelet production, increasing risk of bleeding. This analysis uses a Bayesian metaregression model to indirectly compare effectiveness of the thrombopoietin mimetics romiplostim and eltrombopag for increasing platelet counts, and contrasts the results with those of non-Bayesian approaches.Methods:Ten databases were searched during 2010. Placebo-controlled trials of 24 weeks’ duration were included. An indirect comparison was undertaken using Bayesian metaregression, which includes all trials in a single model. This was compared with previous analyses in which data for each intervention were combined using simple pooling, logistic regression or meta-analysis, followed by indirect comparison of pooled values using the Bucher method.Results:Two trials of romiplostim and one of eltrombopag were included. The indirect evidence suggests romiplostim significantly improves overall platelet response compared with eltrombopag. Bayesian metaregression gave an odds ratio (OR) for eltrombopag versus romiplostim of 0.11 (95 percent credible interval 0.02–0.66);pvalues and Bayesian posterior probabilities ranged from 0.01 to 0.05 for all analyses. There was no significant difference in durable platelet response in any of the analyses, although the direction of effect favored romiplostim (OR = 0.15; 95 percent credible interval, 0.01–1.88);pvalues and Bayesian posterior probabilities ranged from 0.08 to 0.40 across analyses. Results were relatively consistent between analyses.Conclusions:Bayesian metaregression generated similar results to other indirect comparison methods, and may be considered the most robust as it incorporates all data in a single model and accounts appropriately for parameter uncertainty.

scholarly journals Effect of Combined Statin and Antihypertensive Therapy in Patients with Hypertension: A Systematic Review and Meta-Analysis

Cardiology ◽  
2020 ◽  
Vol 145 (12) ◽  
pp. 802-812
Author(s):  
Ying Wang ◽  
Long Jiang ◽  
Shu-Jun Feng ◽  
Xin-Ying Tang ◽  
Ze-Min Kuang
Keyword(s):  
Randomized Controlled Trials ◽  
Antihypertensive Therapy ◽  
Therapy Group ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

<b><i>Introduction:</i></b> This meta-analysis aimed to explore the preventive effects of combined statin and antihypertensive therapy on major cardiovascular outcomes in patients with hypertension. <b><i>Methods:</i></b> PubMed, Embase, and the Cochrane Library databases and reference lists of published studies were systematically searched throughout October 9, 2019. Studies designed as randomized controlled trials and investigating the effects of combined statin and antihypertensive therapy versus antihypertensive therapy alone were included. Data abstraction and quality of included studies were assessed by 2 independent authors. The summary results were calculated using relative risks (RRs) with 95% CIs employing a random-effects model. <b><i>Results:</i></b> A total of 8 randomized controlled trials including 38,618 patients were finally enrolled. The summary RRs indicated that the combined therapy significantly reduced the risk of major adverse cardiovascular events compared with antihypertensive therapy alone (RR 0.79; 95% CI 0.71–0.88; <i>p</i> &#x3c; 0.001). Furthermore, the patients in the combined therapy group also experienced less myocardial infarction (RR 0.67; 95% CI 0.53–0.84; <i>p</i> = 0.001) and stroke risks (RR 0.82; 95% CI 0.72–0.94; <i>p</i> = 0.005), while no significant difference was observed between combined therapy and antihypertensive therapy alone regarding cardiac death (RR 0.96; 95% CI 0.84–1.08; <i>p</i> = 0.465) and all-cause mortality (RR 0.95; 95% CI 0.86–1.04; <i>p</i> = 0.277). <b><i>Conclusion:</i></b> These findings suggested that combined statin and antihypertensive therapy was associated with more cardiovascular benefits compared with antihypertensive therapy alone.

scholarly journals Gastro-Intestinal Tract Complications During Antithrombotic Therapy

2018 ◽  
Vol 14 (3) ◽  
pp. 15-26 ◽  
Author(s):  
E. V. Moroz ◽  
E. N. Artemkin ◽  
E. V. Kryukov ◽  
V. A. Chernetsov
Keyword(s):  
Digestive System ◽  
Combined Therapy ◽  
Smoking Habit ◽  
Erosive Esophagitis ◽  
Gastric Ulcers ◽  
Gi Bleeding ◽  
Elderly Age ◽  
Wide Range ◽  
Significant Difference ◽  
H Pylori

Use of antithrombotic aids (ATA)  significantly  impact  the prevention of life-threatening cardiovascular complications. ATA applications, however, are associated with a wide range of adverse digestive system responses. Due to, continuously growing clinical use of ATA this problem has become a current challenge of contemporary medicine.Purpose of the study was to evaluate the patterns of digestive system damage in patients receiving ATA.Materials and Methods. 672 patients were examined, 91.0% males, 46.7±17.4 years of age, who had digestive system changes that  occurred  due to ATA intake. 71 patients were admitted for treatment after gastrointestinal (GI) bleeding; other  patients were hospitalized  because of disorders  of the digestive  system or erosive and ulcerous changes of the digestive  system detected by endoscopy.  The following parameters were  evaluated:  GI bleeding sources, character of complaints,  the endoscopic patterns due to intake of different ATAs (low doses of aspirin, warfarin, clopidogrel,  dabigatran, rivaroxaban, low-molecular  heparin,  combined  therapy), and of risk factors for GI complications.Results. The sources of GI bleeding (n=71) included  gastric ulcers and/or erosions (39.4%), duodenum ulcers and/or erosions (21.1%), colon ulcers and/or erosions (28.2%), unknown  (11.3%). The majority of 672 patients noticed  various  complaints:  sensation  of heaviness  in epigastrium (62.8%),  gastralgia  (46.7%),  burning  sensation (34.3%). Endoscopy found erosive esophagitis (13.2%), ulcers in stomach and/or duodenum (11.6%), multiple (  10) erosions of stomach or duodenum (17.1%), sporadic erosions of stomach or duodenum (24.4%). In 32.3% cases no erosive or ulcerous alterations were found. H. pylori was identified in 57.9% of patients. There was no significant difference in character of alterations in the upper digestive system between patients who received different ATA treatment, except of frequent erosive esophagitis in those patients who received dabigatran (16.8%). The elderly age (  65 years), ulcer history, concomitant intake of NSAIDS, H. pylori presence, and smoking habit were associated with a higher occurrence of pathological alterations of digestive system. Presence  of gastralgia  did not correlate with the development of erosive and ulcerous alterations.Conclusion. In majority of patients who received ATA, the commonly observed erosive and ulcerous alterations in the digestive system might become a source of bleeding.

scholarly journals Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

2020 ◽  
Author(s):  
Lingyun Ma ◽  
Daohuang Luo ◽  
Ting Yang ◽  
Songtao Wu ◽  
Min Li ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Liver Enzyme ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Fasting Plasma ◽  
Number Of Patients ◽  
Significant Difference

Abstract Background: Acromegaly is a rare, chronic and severe disease. Drug therapy including somatostatin analogues, dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not respond to surgery. The use of combination therapy with PEG and SAs has become more common over the last decade. We performed this study to accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, ClinicalTrials.gov, Scopus, Web of Science, Chinese Biomedical Literature Database and Trip database were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1 . Sensitivity analysis was conducted to explore heterogeneity. Results : Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 66% (95% CI: 52%–78%; I 2 =62.59%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L -1 ; 95% CI: −0.374 to 0.397 mmol*L -1 ; P=0.954) or glycosylated haemoglobin (ES: -0.074%; 95% CI: −0.166% to 0.315%; P=0.544) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 8% to 21%) of the patients. There was no significant difference for serious adverse events and treatment discontinuation due to adverse event between SAs monotherapy group and combination therapy group. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The therapy also decreased significantly FPI levels with a neutral effect on glucose parameters in acromegaly patients. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

scholarly journals Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

2020 ◽  
Author(s):  
Lingyun Ma ◽  
Daohuang Luo ◽  
Ting Yang ◽  
Songtao Wu ◽  
Min Li ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Liver Enzyme ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Fasting Plasma ◽  
Number Of Patients ◽  
Significant Difference

Abstract Background: Acromegaly is a rare, chronic and severe disease. Drug therapy including somatostatin analogues, dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not respond to surgery. The use of combination therapy with PEG and SAs has become more common over the last decade. We performed this study to accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, ClinicalTrials.gov, Scopus, Web of Science, Chinese Biomedical Literature Database and Trip database were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1. Sensitivity analysis was conducted to explore heterogeneity. Results: Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 66% (95% CI: 52%–78%; I2=62.59%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L-1; 95% CI: −0.374 to 0.397 mmol*L-1; P=0.954) or glycosylated haemoglobin (ES: -0.074%; 95% CI: −0.166% to 0.315%; P=0.544) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 8% to 21%) of the patients. There was no significant difference for serious adverse events and treatment discontinuation due to adverse event between SAs monotherapy group and combination therapy group. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The therapy also decreased significantly FPI levels with a neutral effect on glucose parameters in acromegaly patients. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

Role of anthracyclines in neoadjuvant anti-HER2 regimens for HER2+ breast cancer (BC): A network meta-analysis (NMA).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 577-577
Author(s):  
Giacomo Pelizzari ◽  
Lorenzo Gerratana ◽  
Debora Basile ◽  
Michele Bartoletti ◽  
Camilla Lisanti ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Single Agent ◽  
Credible Interval ◽  
Complete Response ◽  
Current Debate ◽  
Her2 Breast Cancer ◽  
Significant Difference ◽  
Relevant Role ◽  
Indirect Comparisons

577 Background: It is matter of current debate which would be the best chemotherapy backbone of neoadjuvant HER2-targeted therapy for HER2+ BC. The TRAIN 2 trial showed no significant difference in terms of pathological complete response (pCR) when anthracyclines–based (CTA) or anthracyclines–free regimens (CT) were combined with dual HER2 blockade. However, it remains unclear how anthracyclines may influence the relative benefit across different anti-HER2 treatments. Methods: A systematic review was conducted which included all phase II/III randomized clinical trials (RCTs) comparing different neoadjuvant regimens for HER2+ BC. pCR (yT0/isN0) was the outcome of interest. Indirect comparisons of all combination of anti-HER2 agents with CTA or CT were estimated with a random-effects frequentist NMA. Estimated pCR rates were inferred adopting a Bayesian NMA. Results: 17 RCTs (3933 patients) were included. Overall, 8 arms were identified, comprising all possible combinations of CTA and CT with trastuzumab (H), lapatinib (L) and dual HER2 blockade (D) but also CTA and D only. Odds ratios (OR) for pCR and 95% confidence interval (CI) of selected NMA comparisons are shown in the table. Estimated rates of pCR for each treatment and 95% credible interval (CrI) are reported in the table. Conclusions: Through indirect comparisons, no significant pCR gain was found for CTA vs CT when combined to D, H and L. In particular, considering double vs single-agent anti-HER2 regimens, D-CT remains superior to H-CTA, supporting a possible omission of anthracyclines when dual anti-HER2 block is used. On the contrary, our pooled estimate suggests a more relevant role for anthracyclines when comparing H-CT/A vs CTA. Moreover, we estimated a 4% pCR gain for D-CTA vs D-CT, and an 8% higher pCR rate for H-CTA vs H-CT. [Table: see text]

Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis

2020 ◽  
Vol 45 (6) ◽  
pp. 589-597
Author(s):  
BGS Casado ◽  
EP Pellizzer ◽  
JR Souto Maior ◽  
CAA Lemos ◽  
BCE Vasconcelos ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Color Change ◽  
Meta Analysis ◽  
Present Review ◽  
Cochrane Library ◽  
Light Sources ◽  
Eligibility Criteria ◽  
Tooth Color ◽  
Significant Difference ◽  
Meta Analyses

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

Sign in / Sign up

Export Citation Format

Share Document