MTA and Ferric Sulfate in Pulpotomy Outcomes of Primary Molars: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 39 (1) ◽  
pp. 1-8 ◽  
Author(s):  
S Asgary ◽  
A Shirvani ◽  
M Fazlyab
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mineral Trioxide Aggregate ◽  
Ferric Sulfate ◽  
Primary Molars ◽  
Eligibility Criteria ◽  
Primary Molar ◽  
Long Term Treatment

Objective: Methods of systematic review and meta analysis were employed to compare the success rate of pulpotomy of primary molars using mineral trioxide aggregate (MTA) and ferric sulfate (FS) as two regenerative and preservative agents, respectively. Study design: After raising a PICO question (In pulpotomy of vital carious-exposed primary molars, how does MTA compare to FS in terms of clinical and radiographic outcomes?) and determining the search strategy, MeSH-matching keywords were searched in four electronic databases and retrieved papers were examined in titles, and if necessary abstracts and full texts, to be relevant. Randomized clinical trials (RCTs) evaluating pulpotomy of vital primary molars after carious/traumatic exposure conducted with either FS or MTA, with at least a 6-month recall, tooth restorability, and those considering clinical and radiographic signs/symptoms, were included. The nonrandomized allocation and absence of comparison between the treatment groups caused the exclusion of the article. The quality of the RCTs and also their risk of bias (low, moderate, high), were assessed using a modification of van Tulder list; for meta-analysis of the matching studies, the extracted data were analyzed by Mantel Hanszel analysis. Results: A total number of 620 articles were found. After exclusion of the common titles and application of the eligibility criteria, 4 RCTs [12-month follow-up: n=3, 24-month follow-up: n=4, in total: 264 teeth) comparing MTA and FS, were selected. It was showed that the 12-month outcome of both materials were similar [RR= 0.642 (CI 95%: 0.225-1.833, P=0.407)], while the two-year follow-up results revealed significant differences in treatment outcome, in favor of MTA [RR was 0.300 (CI 95%: 0.132-0.683, P=0.004)]. Conclusion: MTA demonstrated superior long-term treatment outcomes in pulpotomy of primary molars than FS. Clinical Significance: Considering the advantages of MTA compared to FS and its better clinical results, use of this bioregenerative material in primary molar pulpotomy is recommended.

scholarly journals Zidovudine/Lamivudine vs. Abacavir/Lamivudine vs. Tenofovir/Emtricitabine in fixed-dose combinations as initial treatment for HIV patients: a systematic review and network meta-analysis

2017 ◽  
pp. 70-81 ◽  
Author(s):  
Juan Carlos Alzate Angel ◽  
Marcela María Duque Molina ◽  
Héctor Iván García García
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Initial Treatment ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Fixed Dose ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Statistical Heterogeneity

Introduction: Initial treatment of the HIV is based on the use of three drugs, two of which are nucleoside analog reverse-transcriptase inhibitors. There are three combinations of these drugs which have been approved by different guidelines, each with divergent results in terms of efficacy and safety.Objective: To compare the efficacy and safety of these three combinations.Methods: Systematic review and network meta-analysis of randomized clinical trials comparing fixed doses of Tenofovir Disoproxil Fumarate / Emtricitabine (TDF/FTC), Abacavir / Lamivudine (ABC/3TC) and Zidovudine / Lamivudine (ZDV/3TC).Results: Seven clinical trials met the eligibility criteria. The results suggested higher efficacy with TDF/FTC vs. ABC/3TC at 96 weeks and vs. ZDV/3TC at 48 weeks. However, there is clinical and statistical heterogeneity. Subgroup analysis were performed by third drug and by level of viral load prior to treatment, and found no differences in virological control. Network meta-analysis could only be carried out with TDF/FTC vs. ZDV/3TC, and the proportion of patients with virological response, with no differences at 48 weeks nor at 96 weeks. Direct comparisons showed an increased risk of bone marrow suppression of ZDV/3TC vs. TDF/FTC and of ABC/3TC hypersensitivity reactions vs. ZDV/3TCConclusions: The results did not show differences in effectiveness among the interventions. However, due to the heterogeneity of the third drug and the follow-up time between the included studies, this result is not definitive. The results raise the need for further studies to help improve treatment recommendations in patients infected with HIV.

scholarly journals Evaluation of formocresol, calcium hydroxide, ferric sulfate, and MTA primary molar pulpotomies

2014 ◽  
Vol 08 (02) ◽  
pp. 234-240 ◽  
Author(s):  
Esma Yildiz ◽  
Gul Tosun
Keyword(s):  
Calcium Hydroxide ◽  
Clinical Symptoms ◽  
Clinical Success ◽  
Mineral Trioxide Aggregate ◽  
Ferric Sulfate ◽  
Primary Molars ◽  
Success Rates ◽  
Chi Square ◽  
Primary Molar

ABSTRACT Objective: The aim of this study is to evaluate four different pulpotomy medicaments in primary molars. Materials and Methods: A total of 147 primary molars with deep caries were treated with four different pulpotomy medicaments (FC: formocresol, FS: ferric sulfate, CH: calcium hydroxide, and MTA: mineral trioxide aggregate) in this study. The criteria for tooth selection for inclusion were no clinical and radiographic evidence of pulp pathology. During 30 months of follow-up at 6-month intervals, clinical and radiographic success and failures were recorded. The differences between the groups were statistically analyzed using the Chi-square test and Kaplan-Meier analysis. Results: At 30 months, clinical success rates were 100%, 95.2%, 96.4%, and 85% in the FC, FS, MTA, and CH groups, respectively. In radiographic analysis, the MTA group had the highest (96.4%), and the CH group had the lowest success rate (85%). There were no clinical and radiographic differences between materials (P > 0.05). Conclusions: Although there were no differences between materials, only in the CH group did three teeth require extraction due to further clinical symptoms of radiographic failures during the 30-month follow-up period. None of the failed teeth in the other groups required extraction during the 30-month follow-up period.

scholarly journals Exercise-Based Interventions to Enhance Long-Term Sustainability of Physical Activity in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2019 ◽  
Vol 16 (14) ◽  
pp. 2527 ◽  
Author(s):  
Sansano-Nadal ◽  
Giné-Garriga ◽  
Brach ◽  
Wert ◽  
Jerez-Roig ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Active Control ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Exercise Interventions ◽  
Mean Differences

Exercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.

scholarly journals Impact of surgical maxillomandibular advancement upon pharyngeal airway volume and the apnoea–hypopnoea index in the treatment of obstructive sleep apnoea: systematic review and meta-analysis

2019 ◽  
Vol 6 (1) ◽  
pp. e000402 ◽  
Author(s):  
Maria Giralt-Hernando ◽  
Adaia Valls-Ontañón ◽  
Raquel Guijarro-Martínez ◽  
Jorge Masià-Gridilla ◽  
Federico Hernández-Alfaro
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Maxillomandibular Advancement ◽  
Subsequent Decrease ◽  
Obstructive Sleep

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.

scholarly journals Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan Chen ◽  
Xinlei Chen ◽  
Yali Zhang ◽  
Fangjie Zhou ◽  
Jiaxin Deng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Mineral Trioxide Aggregate ◽  
Systemic Review ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Success Rates ◽  
The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

scholarly journals Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 447
Author(s):  
Diogo Pinto ◽  
Andréa Marques ◽  
Joana F. Pereira ◽  
Paulo J. Palma ◽  
João Miguel Santos
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Filling Material ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endodontic Microsurgery

Background and objectives: The long-term outcome of endodontic microsurgery (EMS) performed on root-filled teeth affected by post-treatment apical periodontitis (AP) has been a matter of debate, re-launched by the introduction of novel root-end filling materials which have been proven to improve the short-term outcome of EMS. The purpose of this systematic review and meta-analysis is to evaluate the clinical and radiographic long-term outcome of endodontic microsurgery in teeth diagnosed with secondary AP through radiographic evaluation. Materials and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion and exclusion criteria were defined a priori to select the best longitudinal evidence. Only randomized clinical trials (RCT) and prospective clinical studies (PCS), with a follow-up ≥ 2-year, and exhibiting well-established clinical and radiographic outcome criteria, were selected. Results: A total of 573 articles were obtained, from which 10 fulfill inclusion criteria: 6 PCS and 4 RCT. Meta-analysis showed a pooled proportion of success rate of 91.3%, from an overall amount of 453 treated teeth included in RCT; from overall 839 included teeth in PCS, a pooled success rate of 78.4% was observed, with the follow-up time ranging from 2 to 13-years. Survival rate outcomes varied from 79 to 100% for the same follow-up period. Five prognostic factors with influence on the outcome were disclosed: smoking habits, tooth location and type, absence/presence of dentinal defects, interproximal bone level, and root-end filling material. Conclusions: High success rates and predictable results can be expected when EMS is performed by trained endodontists, allowing good prognosis and preservation of teeth affected by secondary AP.

Effects of Telehomecare Interventions on the Management and Complications of Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Hamidreza Dehghan ◽  
Maryam Morshediam ◽  
Arezoo Dehghani ◽  
Masoud Mirzaei ◽  
Farhad Fatehi
Keyword(s):  
Systematic Review ◽  
Clinical Decision Making ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Health Resources ◽  
Diabetes Type 2 ◽  
Clinical Decision ◽  
Long Distance ◽  
Eligibility Criteria

Background: Diabetes is one of the most serious health challenges of the 21st century. The number of adults with diabetes has roughly tripled in the last 20 years. The increased burden of chronic diseases and scarce health resources compel healthcare systems to make modern patients more self-sufficient by requiring them to play a more active part in the treatment and management of their disease. Tele-home-care is a method of distance intervention through the transmission of electronic data for follow-up, education, prevention, clinical decision-making, and treatment modulation that has a high potential for the population with diabetes. Previous studies have not systematically evaluated the effects of different features of long-distance caregiving on diabetes at different stages of disease severity. Objectives: The present study describes a protocol for a systematic review and meta-analysis for summarizing the evidence comparing telehomecare interventions on diabetes management and its complications. Methods: PubMed, Scopus, ISI Web of Science, Cochrane databases, HTA (Health Technology Assessment), NHS EED (NHS Economic Evaluation Database), DARE (Database of Abstract of  Reviews of Effects), Embase, and SID will be searched using medical subject heading (MeSH) keywords. Controlled clinical trials in patients with type 1 diabetes, type 2 diabetes, and gestational diabetes will be selected based on predefined eligibility criteria. The risk of bias in studies will be checked using the JADAD score. The mean difference and its standard deviation will be calculated to be used as effect size. A random-effects meta-analysis was performed to pool the results. Subgroup analysis and meta-regression will be conducted to explore the possible sources of heterogeneity. Conclusion: The systematic review and meta-analysis provided by the results of a systematic review can be useful to endocrinologists, physicians, public health policymakers, and the general population.

scholarly journals Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis

BMJ ◽  
2019 ◽  
pp. l6109 ◽  
Author(s):  
Thomas Heisser ◽  
Le Peng ◽  
Korbinian Weigl ◽  
Michael Hoffmeister ◽  
Hermann Brenner
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Quality Ratings ◽  
Advanced Neoplasm

AbstractObjectiveTo review and summarise the evidence on the prevalence of colorectal adenomas and cancers at a follow-up screening colonoscopy after negative index colonoscopy, stratified by interval between examinations and by sex.DesignSystematic review and meta-analysis of all available studies.Data sourcesPubMed, Web of Science, and Embase. Two investigators independently extracted characteristics and results of identified studies and performed standardised quality ratings.Eligibility criteriaStudies assessing the outcome of a follow-up colonoscopy among participants at average risk for colorectal cancer with a negative previous colonoscopy (no adenomas).Results28 studies were identified, including 22 cohort studies, five cross sectional studies, and one case-control study. Findings for an interval between colonoscopies of one to five, five to 10, and more than 10 years were reported by 17, 16, and three studies, respectively. Summary estimates of prevalences of any neoplasm were 20.7% (95% confidence interval 15.8% to 25.5%), 23.0% (18.0% to 28.0%), and 21.9% (14.9% to 29.0%) for one to five, five to 10, and more than 10 years between colonoscopies. Corresponding summary estimates of prevalences of any advanced neoplasm were 2.8% (2.0% to 3.7%), 3.2% (2.2% to 4.1%), and 7.0% (5.3% to 8.7%). Seven studies also reported findings stratified by sex. Summary estimates stratified by interval and sex were consistently higher for men than for women.ConclusionsAlthough detection of any neoplasms was observed in more than 20% of participants within five years of a negative screening colonoscopy, detection of advanced neoplasms within 10 years was rare. Our findings suggest that 10 year intervals for colonoscopy screening after a negative colonoscopy, as currently recommended, may be adequate, but more studies are needed to strengthen the empirical basis for pertinent recommendations and to investigate even longer intervals.Study registrationProspero CRD42019127842.

scholarly journals Systemic Antibiotic Prophylaxis to Reduce Early Implant Failure: A Systematic Review and Meta-Analysis

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 698
Author(s):  
Elisabet Roca-Millan ◽  
Albert Estrugo-Devesa ◽  
Alexandra Merlos ◽  
Enric Jané-Salas ◽  
Teresa Vinuesa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Implant Failure ◽  
Electronic Search ◽  
Preoperative Antibiotic Prophylaxis ◽  
Systemic Antibiotics ◽  
Systemic Antibiotic Prophylaxis

Systemic antibiotics are routinely prescribed in implant procedures, but the lack of consensus causes large differences between clinicians regarding antibiotic prophylaxis regimens. The objectives of this systematic review are to assess the need to prescribe antibiotics to prevent early implant failure and find the most appropriate antibiotic prophylaxis regimen. The electronic search was conducted in PubMed/MEDLINE, Scielo and Cochrane Central Trials Database for randomized clinical trials of at least 3 months of follow-up. Eleven studies were included in the qualitative analysis. Antibiotics were found to statistically significantly reduce early implant failures (RR = 0.30, 95% CI: 0.19–0.47, p < 0.00001; heterogeneity I2 = 0%, p = 0.54). No differences were seen between preoperative or both pre- and postoperative antibiotic regimens (RR = 0.57, 95% CI: 0.21–1.55, p = 0.27; heterogeneity I2 = 0%, p = 0.37). A single preoperative antibiotic prophylaxis dose was found to be enough to significantly reduce early implant failures compared to no antibiotic (RR = 0.34, 95% CI: 0.21–0.53, p < 0.00001; heterogeneity I2 = 0%, p = 0.61). In conclusion, in healthy patients a single antibiotic prophylaxis dose is indicated to prevent early implant failure.

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