Materials Sealing Preventing Biofilm Formation in Implant/Abutment Joints: Which Is the Most Effective? A Systematic Review and Meta-Analysis

The purpose of this systematic review was to evaluate the literature available for materials exhibiting the best efficacy in preventing biofilm formation in the interior of implants. We searched PubMed/MEDLINE, Scopus, and Cochrane databases. This review is registered with the PROSPERO database and followed the suitability of the PRISMA protocol. The initial search resulted in 326 articles from the databases. After they were read, 8 articles remained, and the inclusion and exclusion criteria were applied. Six of these 8 articles were classified as in vitro and 2 were classified as in situ. The regions of the implants evaluated ranged from the interface of the pieces to the occlusal upper access of the abutment. The implant connections evaluated the Morse taper, external connection, and internal connection. Meta-analysis of the quantitative data was performed at a significance level of .05. Cotton exhibited poor control of infiltration, even in combination with other materials. Isolated gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape with composite resin (CR) or GP performed better as physical barriers. The best results for chemical barriers were observed by the application of 1% chlorhexidine gluconate (CG) gel, thymol varnish, and the deposition of Ag films onto the surface. The applied meta-analysis did not show a significant difference in comparison between the different types of implant connections (P > .05). The application of CG and thymol varnish antimicrobials was effective in preventing biofilm formation and easy clinical execution; these could be used in combination with CR, GP, and PTFE.

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Alternative Tendon Coaptations to the Pulvertaft Weave Technique: A Systematic Review and Meta-Analysis of Biomechanical Studies

Hand ◽

10.1177/15589447211043213 ◽

2021 ◽

pp. 155894472110432

Author(s):

Emily M. Graham ◽

Jeremie D. Oliver ◽

Russell Hendrycks ◽

Dino Maglic ◽

Shaun D. Mendenhall

Keyword(s):

Systematic Review ◽

Yield Strength ◽

Random Effects ◽

Meta Analysis ◽

Dichotomous Data ◽

Inverse Variance ◽

Significant Difference ◽

Alternative Techniques ◽

Meta Analyses

Background The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques. Methods Articles included for qualitative and/or qualitative analysis were identified following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the meta-analysis were analyzed either as continuous data with inverse variance and random effects or as dichotomous data using a Mantel-Haenszel analysis assuming random effects to calculate an odds ratio. Results A comprehensive electronic search yielded 8 studies meeting inclusion criteria for meta-analysis. Two studies with a total of 65 tendon coaptations demonstrated no significant difference in strength between the PT and traditional side-to-side (STS) techniques ( P = .92). Two studies with a total of 43 tendon coaptations showed that the STS with 1 weave has a higher yield strength than the PT ( P = .03). Two studies with a total of 62 tendon repairs demonstrated no significant difference in strength between the PT and the step-cut (SC) techniques ( P = .70). The final 2 studies included 46 tendon repairs and demonstrated that the wrap around (WA) technique has a higher yield strength than the PT ( P < .001). Conclusions The STS, SC, and WA techniques are preferred for improving tendon form. The STS and WA techniques have superior yield strengths than the PT, and the SC technique withstands similar stress to failure as the PT.

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Bond Strength of Self-Adhesive Flowable Composites and Glass Ionomer Cements to Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Materials ◽

10.3390/ma14216694 ◽

2021 ◽

Vol 14 (21) ◽

pp. 6694

Author(s):

Flavia Iaculli ◽

Alessandro Salucci ◽

Gianni Di Giorgio ◽

Valeria Luzzi ◽

Gaetano Ierardo ◽

...

Keyword(s):

Systematic Review ◽

Bond Strength ◽

Primary Teeth ◽

Meta Analysis ◽

Deciduous Teeth ◽

Glass Ionomer Cements ◽

Glass Ionomer ◽

Significant Difference ◽

Flowable Composites

Background: Conventional composites are largely used in pediatric restorative dentistry and demonstrate successful clinical outcomes. However, the need for simplification of operative steps in young or uncooperative children demands reliable alternatives. Therefore, the aim of the present systematic review and meta-analysis was to evaluate the in vitro bond strength of glass ionomer cements (GICs) and self-adhesive flowable composites (SFCs) on deciduous teeth. Methods: A comprehensive literature search according to the PRISMA checklist was manually and electronically performed by two independent reviewers through the following databases: MEDLINE/PubMed, Google Scholar, Scopus, and Embase, to include in vitro studies comparing GICs and SFCs bond strength values of restorations on primary teeth. In addition, three groups of meta-analyses were conducted using random-effects models. Results: Three articles meeting the inclusion criteria were selected and subjected to both qualitative and quantitative assessment. No statistically significant difference was found between SFC versus GIC; however, both groups significantly differed with conventional flowable composites (CFs). Conclusions: Despite the absence of significant difference in bond strength values, SFCs may be considered a valid alternative to GICs in the restoration of deciduous teeth, although CFs proved better in vitro performances.

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Effects of Aging on the Color and Translucency of Monolithic Translucent Y-TZP Ceramics: A Systematic Review and Meta-Analysis of In Vitro Studies

BioMed Research International ◽

10.1155/2021/8875023 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Chang-yuan Zhang ◽

Check Agingu ◽

James Kit Hon Tsoi ◽

Hao Yu

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Tetragonal Zirconia ◽

In Vitro Studies ◽

Cochrane Library ◽

Hydrothermal Aging ◽

Significant Difference ◽

Effects Of Aging ◽

Meta Analyses

Background. Monolithic restorations made of translucent yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have become popular over the past few decades. However, whether aging affects the color and translucency of monolithic translucent Y-TZP is unclear. Objective. The aim of this systematic review and meta-analysis of in vitro studies was to evaluate the effects of aging on the color and translucency of monolithic translucent Y-TZP ceramics. Materials and Methods. This systematic review/meta-analysis was reported according to the PRISMA statement and registered in the OSF registries (https://osf.io/5qjmu). Four databases including Medline via the PubMed, Embase, and Web of Science databases and the Cochrane Library were searched using no publication year and language limits. The last search was executed on November 20, 2020. In vitro studies comparing the translucency and/or color of monolithic translucent Y-TZP ceramics before and after simulated aging were selected. Meta-analyses were performed using Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK) with random-effects models at a significance level of 0.05. A risk-of-bias assessment was also performed for the included studies. Results. Of the 188 potentially relevant studies, 13 were included in the systematic review. The hydrothermal aging duration ranged from 1 to 100 h at relatively similar temperatures (~134°C). In the general meta-analyses, the aged Y-TZP ceramics exhibited similar translucency parameter (TP), L ∗ , and b ∗ values compared with the nonaged controls ( P = .73 , P = .49 , and P = .62 , respectively). Moreover, there was a significant difference between the aged and nonaged Y-TZP ceramics in the a ∗ value ( P = .03 ; MD = − 0.26 ; 95% CI = − 0.51 to − 0.02 ), favoring the nonaged Y-TZP ceramics. The subgroup analyses showed that the duration of aging contributed to changes in the translucency and color of the Y-TZP ceramics. Conclusions. The optical properties of monolithic translucent Y-TZP ceramics were stable after hydrothermal aging at 134°C and 0.2 MPa for ≤20 h. Moreover, clinically unacceptable changes in the translucency and color of monolithic translucent Y-TZP ceramics were found after hydrothermal aging for >20 h.

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Effect of MTA versus CEM apical plugs on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

BMC Oral Health ◽

10.1186/s12903-021-01641-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ensieh Grayli ◽

Abbas Dashtban ◽

Leyla Shadan ◽

Naser Behnampour ◽

Elham Afshari

Keyword(s):

Fracture Resistance ◽

Testing Machine ◽

In Vitro Study ◽

Control Group ◽

Significance Level ◽

Cast Metal ◽

Immature Teeth ◽

Gutta Percha ◽

Significant Difference

Abstract Background Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different apical plug materials (MTA and Calcium enriched mixture cement) at varied thicknesses on fracture resistance of teeth restored with cast metal posts. Methods A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups (n = 8) according to apical plug (control group: No plug, group MTA5: 5 mm MTA plug, group CEM5: 5 mm CEM plug, group MTA3: 3 mm MTA plug, group CEM3: 3 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using One-way ANOVA and Dunnett’s T3 tests with significance level at P value < 0.05. Results The analysis showed a significant difference of fracture resistance between groups (P value < 0.05). The mean fracture resistance of samples in control group was significantly lower than MTA5 (P value = 0.003). There was no significant difference between other groups (P value > 0.05). Conclusions Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 3 mm MTA apical plug or either 3 or 5 mm CEM apical plug.

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In vitro Inhibition of Biofilm Formation on Silicon Rubber Voice Prosthesis: Α Systematic Review and Meta-Analysis

ORL ◽

10.1159/000516345 ◽

2021 ◽

pp. 1-20

Author(s):

Alexios Tsikopoulos ◽

Efi Petinaki ◽

Charalampos Festas ◽

Konstantinos Tsikopoulos ◽

Gabriele Meroni ◽

...

Keyword(s):

Surface Modification ◽

Silicone Rubber ◽

Subgroup Analysis ◽

Biofilm Formation ◽

Meta Analysis ◽

Bacterial Biofilm ◽

Biofilm Inhibition ◽

Voice Prostheses ◽

Significant Difference

Introduction: Biofilm formation on voice prostheses is the primary reason for their premature implant dysfunction. Multiple strategies have been proposed over the last decades to achieve inhibition of biofilm formation on these devices. The purpose of this study was to assess the results of the available in vitro biofilm inhibition modalities on silicone rubber voice prostheses. Methods: We conducted a systematic search in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases up to February 29, 2020. A total of 33 in vitro laboratory studies investigating the efficacy of different coating methods against Candida, Staphylococcus, Streptococcus, Lactobacilli, and Rothia biofilm growth on silicone rubber medical devices were included. Subgroup analysis linked to the type of prevention modality was carried out, and quality assessment was performed with the use of the modified CONSORT tool. Results: Data from 33 studies were included in qualitative analysis, of which 12 qualified for quantitative analysis. For yeast biofilm formation assessment, there was a statistically significant difference in favor of the intervention group (standardized mean difference [SMD] = −1.20; 95% confidence interval [CI] [−1.73, −0.66]; p < 0.0001). Subgroup analysis showed that combined methods (active and passive surface modification) are the most effective for biofilm inhibition in yeast (SMD = −2.53; 95% CI [−4.02, −1.03]; p = 0.00001). No statistically significant differences between intervention and control groups were shown for bacterial biofilm inhibition (SMD = −0.09; 95% CI [−0.68, 0.46]; p = 0.65), and the results from the subgroup analysis found no notable differences between the surface modification methods. After analyzing data on polymicrobial biofilms, a statistically significant difference in favor of prevention methods in comparison with the control group was detected (SMD = −2.59; 95% CI [−7.48, 2.31]; p = 0.30). Conclusions: The meta-analysis on biofilm inhibition demonstrated significant differences in favor of yeast biofilm inhibition compared to bacteria. A stronger inhibition with the application of passive or combined active and passive surface modification techniques was reported.

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Does Finishing and Polishing of Restorative Materials Affect Bacterial Adhesion and Biofilm Formation? A Systematic Review

Operative Dentistry ◽

10.2341/17-073-l ◽

2018 ◽

Vol 43 (1) ◽

pp. E37-E52 ◽

Cited By ~ 20

Author(s):

DAM Dutra ◽

GKR Pereira ◽

KZ Kantorski ◽

LF Valandro ◽

FB Zanatta

Keyword(s):

Systematic Review ◽

Bacterial Adhesion ◽

Biofilm Formation ◽

Surface Characteristics ◽

Periodontal Inflammation ◽

Restorative Materials ◽

The Impact

SUMMARY Biofilm (bacterial plaque) accumulation on the surface of restorative materials favors the occurrence of secondary caries and periodontal inflammation. Surface characteristics of restorations can be modified by finishing and/or polishing procedures and may affect bacterial adhesion. The aim of this systematic review was to characterize how finishing and polishing methods affect the surface properties of different restorative materials with regard to bacterial adhesion and biofilm formation. Searches were carried out in MEDLINE-PubMed, EMBASE, Cochrane-CENTRAL, and LILACS databases. From 2882 potential articles found in the initial searches, only 18 met the eligible criteria and were included in this review (12 with in vitro design, four with in situ design, and two clinical trials). However, they presented high heterogeneity regarding materials considered and methodology for evaluating the desired outcome. Risk bias analysis showed that only two studies presented low risk (whereas 11 showed high and five showed medium risk). Thus, only descriptive analyses considering study design, materials, intervention (finishing/polishing), surface characteristics (roughness and surface free energy), and protocol for biofilm formation (bacterial adhesion) could be performed. Some conclusions could be drawn: the impact of roughness on bacterial adhesion seems to be related not to a roughness threshold (as previously believed) but rather to a range, the range of surface roughness among different polishing methods is wide and material dependent, finishing invariably creates a rougher surface and should always be followed by a polishing method, each dental material requires its own treatment modality to obtain and maintain as smooth a surface as possible, and in vitro designs do not seem to be powerful tools to draw relevant conclusions, so in vivo and in situ designs become strongly recommended.

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Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19

Jornal Brasileiro de Economia da Saúde ◽

10.21115/jbes.v13.n2.p186-220 ◽

2021 ◽

Vol 13 (2) ◽

pp. 186-220

Author(s):

André Santos ◽

◽

Érica Gonçalves ◽

Ananda Oliveira ◽

Douglas Lima ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Standard Of Care ◽

P Value ◽

Serious Adverse Events ◽

Risk Of Death ◽

Increased Risk ◽

Significant Difference

Objective: Because of preliminary results from in vitro studies, hydroxychloroquine (HCQ) and chloroquine (CQ) have been proposed as possible treatments for COVID-19, but the clinical evidence is discordant. This study aims to evaluate the safety and efficacy of CQ and HCQ for the treatment of COVID-19. Methods: A systematic review with meta-analysis was performed. An electronic search was conducted in four databases for randomized controlled trials that compared HCQ or CQ with standard-of-care. A complementary search was performed. A quantitative synthesis of clinical outcomes was performed using the inverse variance method adjusting for a random-effects model. Results: In total, 16 studies were included. The meta-analysis found no significant difference between intervention and control groups in terms of mortality at the most extended follow-up (RR = 1.09, CI95% = 0.99-1.19, p-value = 0.08), patients with negative PCR results (RR = 0.99, CI95% = 0.89-1.10, p-value = 0.86), or serious adverse events (RR = 2.21, CI95% = 0.89-5.47, p-value = 0.09). HCQ was associated with an increased risk of adverse events (RR = 2.28, CI95% = 1.36-2.83, p-value < 0.01). The quality of evidence varied from very low to high. Conclusion: There is no evidence that HCQ reduces the risk of death or improves cure rates in patients with COVID-19, but it might be associated with an increased risk of adverse events

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Concordance Rate between HER2 Immunohistochemistry and in Situ Hybridization in Gastric Carcinoma: Systematic Review and Meta-Analysis

The International Journal of Biological Markers ◽

10.5301/jbm.5000171 ◽

2016 ◽

Vol 31 (1) ◽

pp. 1-10 ◽

Cited By ~ 11

Author(s):

Jung-Soo Pyo ◽

Jin Hee Sohn ◽

Woo Ho Kim

Keyword(s):

Systematic Review ◽

In Situ Hybridization ◽

Gastric Carcinoma ◽

Diagnostic Accuracy ◽

Diagnostic Test ◽

Meta Analysis ◽

Diagnostic Test Accuracy ◽

Test Accuracy ◽

Significant Difference

Purpose The aim of this study was to investigate the diagnostic accuracy of HER2 immunohistochemistry (IHC) in gastric carcinoma (GC) through a systematic review, meta-analysis and diagnostic test accuracy review. Method The current study included 12,679 GC cases and 181 subsets in 45 eligible studies. We performed concordance analysis between HER2 IHC and in situ hybridization (ISH) in GC. Diagnostic test accuracy was analyzed and the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve was calculated. Results HER2 amplification rates were 3.0%, 31.8%, and 93.0% in the IHC score 0/1+, 2+, and 3+ groups, respectively. The concordance rates between IHC and ISH were 0.969 (95% confidence interval [CI] 0.962-0.975), 0.393 (95% CI 0.331-0.458) and 0.915 (95% CI 0.882-0.939) in the HER2 IHC score 0/1+, 2+, and 3+ groups, respectively. For all the HER2 IHC score groups, the positive rates were higher in the silver ISH (SISH) subgroup than in the fluorescence ISH (FISH) and chromogenic ISH (CISH) subgroups. In diagnostic test accuracy review, the pooled sensitivity and specificity were 0.86 (95% CI 0.84-0.87) and 0.91 (95% CI 0.90-0.91). The AUC on SROC curve was 0.958. However, there was no significant difference in the values of AUC between the ISH methods. Conclusions Our results showed that HER2 IHC was well concordant with ISH in HER2 IHC score 0/1+ or 3+. Although this meta-analysis showed higher diagnostic accuracy of HER2 IHC, more detailed criteria for HER2 IHC score 2+ cases will be required to predict HER2 status.

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