scholarly journals Intracanal Cryotherapy and its Effects on the Postoperative Pain in Root Canal Therapy: Systematic Review & Meta-analysis Protocol.

2020 ◽  
Author(s):  
Durre Sadaf ◽  
Muhammad Zubair Ahmad ◽  
Igho Onakpoya
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Root Canal ◽  
Search Strategy ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Bias Assessment ◽  
Comprehensive Search ◽  
Comprehensive Search Strategy

Abstract Background: There are many research studies directing in lowering postoperative pain in root canal therapy. The use of intracanal cryotherapy in root canal treatment is recently introduced, and many researchers are inclined towards this techniques. This systematic review will give an insight into its application in endodontic therapy and its effects on postoperative pain.The aim of this systematic review is to evaluate the effect of intracanal cryotherapy on the postoperative pain in patients with pulp diseases and with or without peri-radicular infection during root canal therapy. This systematic review will include randomized controlled trials only. The studies should encompass patients with pulpal diseases, i.e. irreversible pulpitis and pulp necrosis in teeth. Previously root treated teeth, immature, and teeth with root resorption will not be included. Methods: We will conduct a comprehensive search strategy using electronic databases PubMed, EMBASE (Ovid), Scopus, and Cochrane library. A predefined inclusion and exclusion criteria will be utilized for the selection of studies. The reference list of selected studies will be manually searched. We will extract data from studies on a structured data collection form. At the same time, the risk of bias assessment of studies using the Cochrane risk of bias assessment tools will be performed by two reviewers independently. Furthermore, qualitative and quantitative data synthesis will be accomplished. The data will be presented in the form of table of summary of findings. Discussion: This systematic review will assess the role of intracanal cryotherapy in the form of cold saline irrigation as a final irrigant during root canal therapy. The quality of evidence will ranked as high, moderate low or very low using GRADE approach. Comprehensive search strategy, risk of bias assessment using Cochrane risk of bias assessment tool by two reviewers are the strength of this systematic review. Systematic review registration number: The protocol is registered with the International Prospective Register of Systematic Reviews. (PROSPERO CRD 42020163438)

Does Smear Layer Removal Influence Root Canal Therapy Outcome? A Systematic Review

2016 ◽  
Vol 40 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Andréa Vaz Braga Pintor ◽  
Marcello Rotter Marins dos Santos ◽  
Daniele Masterson Ferreira ◽  
Roberta Barcelos ◽  
Laura Guimarães Primo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Assessment Tool ◽  
Clinical Signs ◽  
Risk Of Bias ◽  
Smear Layer ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Removal Group

Objective: The aim of this systematic review was to determine whether the smear layer (SL) removal procedure influences the outcome of root canal treatment. Study design: We performed a search on Pubmed, Scopus, ISI Web of Science, Cochrane Library, Lilacs and SIGLE. We included randomized controlled clinical trials (RCT), with clinical and radiographic outcomes, conducted on subjects who had undergone root canal therapy. The protocol differed only in the SL removal or maintenance procedure. We evaluated the papers for risk of bias according to the Cochrane assessment tool. Results: A total of 1,983 articles were found, after removal of duplicates, 892 remained. We included two studies in this review. One study revealed a low risk of bias and a high success rate for the SL removal group compared to the non SL removal group (P = 0.04), while the other study had a high risk of bias and found no difference between the SL removal and non SL removal groups (P = 1.00). Conclusion: We concluded that the SL removal for root canal treatment of primary teeth with initial clinical signs and symptoms or pulpal necrotic status, could benefit the outcome, although further RCT should be performed to achieve evidence.

scholarly journals A Protocol on Antimicrobial effectiveness of adjunctive disinfection techniques during root canal therapy in patients with pulp necrosis and apical periodontitis. A Systematic Review & Meta-analysis

2019 ◽  
Author(s):  
Durre Sadaf ◽  
Zubair Ahmad ◽  
Igho - Onakpoya
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Risk Of Bias ◽  
Apical Periodontitis ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Root Canal Therapy ◽  
Related Factors ◽  
Mesh Terms ◽  
Antimicrobial Effectiveness

Abstract Background The primary objective of root canal therapy is to eliminate bacteria from the root canal system of teeth. However, standard chemo-mechanical disinfection has been found unable to remove bacteria within the root canals. Clinicians tempted to use additional disinfection techniques to achieve adequate level of disinfection. There is no such systematic review that could comprehensively compare the efficiency of all currently used disinfection techniques. This systematic review aims to compare the antimicrobial effectiveness of various adjunctive disinfection techniques with standards chemo-mechanical disinfection technique(needle syringe irrigation) used during root canal therapy in patients with pulp necrosis and apical periodontitis.Methods A well-defined structured clinical question in the form of PICO (Patients/Problem, Intervention, Comparison, Outcome) is designed. The unit of analysis in this review is a tooth. Teeth with apical periodontitis is a problem (P). Interventions (I) are supplemental disinfection techniques that include photodynamic therapy, passive ultrasonic irrigation, and negative pressure techniques. Comparison (C) will be standard chemo-mechanical disinfection technique. Outcome (O) is the effectiveness of antimicrobial activity in the form of detection of bacteria and colony-forming units (CFU). Keywords, MeSH terms, and synonyms will be searched through previous literature, books, and Medline database. We will perform a comprehensive search strategy using electronic databases MEDLINE (Ovid), EMBASE (Ovid), and Cochrane library. Hand searching of top endodontic journals and reference lists of selected studies will be carried out. Selection of studies will be made under predefined inclusion and exclusion criteria. Data extraction of selected studies will be done with two reviewers using a structured data collection form. At the same time, the risk of bias using the Cochrane risk of bias assessment tools will be carried out. A qualitative and quantitative data synthesis will be done. The data will be presented in the form of tables of summary of findings.Discussion All potential clinical, methodological, and patient's related factors responsible for heterogeneity will be explored and discussed. We will also compare the results of our systematic review with existing literature. Strength and limitations of the systematic review will be discussed.Systematic Review registration Our protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD#42019099141).

scholarly journals Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 573
Author(s):  
João Miguel Santos ◽  
Joana F. Pereira ◽  
Andréa Marques ◽  
Diana B. Sequeira ◽  
Shimon Friedman
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Small Sample ◽  
Risk Of Bias ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Posterior Teeth ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Irreversible Pulpitis

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.

scholarly journals Effectiveness of Matching Human Leukocyte Antigens (HLA) in Corneal Transplantation: A Systematic Review Protocol

2020 ◽  
Author(s):  
Gagandeep Singh Sachdeva ◽  
Joshua Piollo Cabada ◽  
Syed Saad Karim ◽  
Dmitry Lakvin Kahandawa ◽  
Kevin Anil Thomas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Corneal Transplantation ◽  
Human Leukocyte ◽  
Risk Of Bias ◽  
Corneal Graft ◽  
Hla Typing ◽  
Cochrane Library ◽  
Hla Matching ◽  
Bias Assessment ◽  
Graft Success

Abstract BackgroundCorneal transplantation is the most frequently performed transplantation in the UK. Despite this, the therapeutic value of matching Human Leukocyte Antigen (HLA) subtypes for transplanted corneas remains controversial. Ocular immune privilege was originally deemed to render matching unnecessary; however more recently, matching has demonstrated improved outcomes including graft success, amongst others. This systematic review aims to evaluate the effectiveness of major and minor antigen matching on graft outcomes in corneal transplantation. MethodsStandard systematic review methodology will be used to identify, select and extract data from observational studies and clinical trials assessing the effects of HLA matching on corneal graft outcomes. Bibliographic databases (Cochrane Library, EMBASE, MEDLINE, Web of Science, Scopus), clinical trial registers, abstract and conference proceedings, in addition to dissertation, thesis and grey literature will be searched. Neither date of publication nor language will be restricted, and non-English articles will be translated were necessary. The primary outcome will be to assess corneal graft success for different degrees of HLA matching/mismatching. The precise end outcome measure varies amongst studies and includes graft rejection, immunoreaction, failure and survival. Therefore, data will be extracted across all relevant outcome parameters and grouped for subsequent statistical tests. Risk of bias assessment will be completed, appropriate to each study design. Study selection, data extraction and risk of bias assessment will be independently completed by two reviewers. Data will be tabulated, and a narrative synthesis presented. Meta-analysis will be performed where there is sufficient homogeneity between studies to warrant its effective completion. Subgroup and sensitivity analysis will be undertaken if appropriate.DiscussionMany studies have investigated the effectiveness of HLA matching for corneal transplantation. A systematic review is needed to collate and analyse this evidence. Findings of this systematic review may form the basis of evidence-based recommendations on pre-operative HLA typing and matching of corneal grafts for transplantation.Systematic Review RegistrationPROSPERO reference CRD42020198882

Reconstruction versus no reconstruction of iliac crest defects following harvest for spinal fusion: a systematic review

2012 ◽  
Vol 16 (6) ◽  
pp. 565-572 ◽  
Author(s):  
Anthony M. T. Chau ◽  
Lileane L. Xu ◽  
Rhys van der Rijt ◽  
Johnny H. Y. Wong ◽  
Cristian Gragnaniello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Spinal Fusion ◽  
Functional Disability ◽  
Iliac Crest ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Reconstructive Procedures

Object Autologous bone from the iliac crest is commonly used for spinal fusion. However, its use is associated with significant donor site morbidity, especially pain. Reconstructive procedures of the iatrogenic defect have been investigated as a technique to alleviate these symptoms. The goal of this study was to assess the effects of reconstruction versus no reconstruction following iliac crest harvest in adults undergoing spine surgery. Methods The authors searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 4); MEDLINE (1948–Oct 2011); EMBASE (1947–Oct 2011); and the reference lists of articles. Randomized controlled trials (RCTs) or nonrandomized controlled trials (NRCTs) were included in the study. Two independent reviewers selected the studies, extracted data using a standardized collection form, and assessed for risk of bias. Results Three RCTs (96 patients) and 2 NRCTs (82 patients) were included. These had a moderate to high risk of bias. The results suggest that iliac crest reconstruction may be useful in reducing postoperative pain, minimizing functional disability, and improving cosmesis. No pattern of other clinical, radiological, or resource outcomes was identified. Conclusions Although the available evidence is suboptimal, this systematic review supports the notion that iliac crest reconstruction following harvest for spinal fusion may reduce postoperative pain, minimize functional disability, and improve cosmesis.

scholarly journals Perioperative intravenous lignocaine infusion for postoperative pain control in patients undergoing surgery of the spine: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036908
Author(s):  
Ana Licina ◽  
Andrew Silvers
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Evaluation System ◽  
Elective Surgery ◽  
Risk Of Bias ◽  
Hospital Length Of Stay ◽  
Primary Data ◽  
Cochrane Library ◽  
Control Group ◽  
Late Time

IntroductionIntravenous lignocaine is an amide local anaesthetic known for its analgesic, antihyperalgesic and anti-inflammatory properties. Administration of intravenous lignocaine has been shown to enhance perioperative recovery parameters. This is the protocol for a systematic review which intends to summarise the evidence base for perioperative intravenous lignocaine administration in patients undergoing spinal surgery.Methods and analysisOur primary outcomes include: postoperative pain scores at rest and movement at predefined early, intermediate and late time points and adverse events. Other outcomes of interest include perioperative opioid consumption, composite morbidity, surgical complications and hospital length of stay. We will include randomised controlled trials, which compared intravenous lignocaine infusion vs standard treatment for perioperative analgesia. We will search electronic databases from inception to present; MEDLINE, EMBASE and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two team members will independently screen all citations, full-text articles and abstract data. The individual study risk of bias will be appraised using the Cochrane risk of bias tool. We will obtain a risk ratio or mean difference (MD) from the intervention and control group event rates based on the nature of data. We will correct for the variable measurement tools by using the standardised MD (SMD). We will use a random-effects model to synthesise data. We will conduct five subgroup analysis: major versus minor surgery, emergency versus elective surgery, patients with chronic pain conditions versus patients without, duration of lignocaine infusion and adult versus paediatric. Confidence in cumulative evidence for will be classified according to the Grading of Recommendations, Assessment, Development and Evaluation system. We will construct summary of findings tables supported detailed evidence profile tables for predefined outcomes.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication.PROSPERO registration numberCRD420201963314

scholarly journals Effectiveness of matching human leukocyte antigens (HLA) in corneal transplantation: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gagandeep Singh Sachdeva ◽  
Joshua Piollo Cabada ◽  
Syed Saad Karim ◽  
Dmitry Lakvin Kahandawa ◽  
Kevin Anil Thomas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Corneal Transplantation ◽  
Human Leukocyte ◽  
Risk Of Bias ◽  
Corneal Graft ◽  
Hla Typing ◽  
Cochrane Library ◽  
Hla Matching ◽  
Bias Assessment ◽  
Graft Success

Abstract Background Corneal transplantation is the most frequently performed transplantation in the UK. Despite this, the therapeutic value of matching human leukocyte antigen (HLA) subtypes for transplanted corneas remains controversial. Ocular immune privilege was originally deemed to render matching unnecessary; however, more recently, matching has demonstrated improved outcomes including graft success, amongst others. This systematic review aims to evaluate the effectiveness of major and minor antigen matching on graft outcomes in corneal transplantation. Methods Standard systematic review methodology will be used to identify, select and extract data from observational studies and clinical trials assessing the effects of HLA matching on corneal graft outcomes. Bibliographic databases (Cochrane Library, EMBASE, MEDLINE, Web of Science, Scopus), clinical trial registers, abstract and conference proceedings, in addition to dissertation, thesis and grey literature will be searched. Neither date of publication nor language will be restricted, and non-English articles will be translated where necessary. The primary outcome will be to assess corneal graft success for different degrees of HLA matching/mismatching. The precise end outcome measure varies amongst studies and includes graft rejection, immunoreaction, failure and survival. Therefore, data will be extracted across all relevant outcome parameters and grouped for subsequent statistical tests. Risk of bias assessment will be completed, appropriate to each study design. Study selection, data extraction and risk of bias assessment will be independently completed by two reviewers. Data will be tabulated, and a narrative synthesis presented. Meta-analysis will be performed where there is sufficient homogeneity between studies to warrant its effective completion. Subgroup and sensitivity analysis will be undertaken if appropriate. Discussion Many studies have investigated the effectiveness of HLA matching for corneal transplantation. A systematic review is needed to collate and analyse this evidence. Findings of this systematic review may form the basis of evidence-based recommendations on pre-operative HLA typing and matching of corneal grafts for transplantation. Systematic review registration PROSPERO reference CRD42020198882

scholarly journals Opioid versus opioid-free analgesia after surgical discharge: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e035443
Author(s):  
Charbel El-Kefraoui ◽  
Ghadeer Olleik ◽  
Marc-Aurele Chay ◽  
Araz Kouyoumdjian ◽  
Philip Nguyen-Powanda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Major Surgery ◽  
Manuscript Submission ◽  
Health Crisis ◽  
Study Results

IntroductionExcessive prescribing after surgery has contributed to a public health crisis of opioid addiction and overdose in North America. However, the value of prescribing opioids to manage postoperative pain after surgical discharge remains unclear. We propose a systematic review and meta-analysis to assess the extent to which opioid analgesia impact postoperative pain intensity and adverse events in comparison to opioid-free analgesia in patients discharged after surgery.Methods and analysisMajor electronic databases (MEDLINE, Embase, Cochrane Library, Scopus, AMED, BIOSIS, CINAHL and PsycINFO) will be searched for multi-dose randomised-trials examining the comparative effectiveness of opioid versus opioid-free analgesia after surgical discharge. Studies published from January 1990 to July 2019 will be targeted, with no language restrictions. The search will be re-run before manuscript submission to include most recent literature. We will consider studies involving patients undergoing minor and major surgery. Teams of reviewers will, independently and in duplicate, assess eligibility, extract data and evaluate risk of bias. Our main outcomes of interest are pain intensity and postoperative vomiting. Study results will be pooled using random effects models. When trials report outcomes for a common domain (eg, pain intensity) using different scales, we will convert effect sizes to a common standard metric (eg, Visual Analogue Scale). Minimally important clinical differences reported in previous literature will be considered when interpreting results. Subgroup analyses defined a priori will be conducted to explore heterogeneity. Risk of bias will be assessed according to the Cochrane Collaboration's Risk of Bias Tool 2.0. The quality of evidence for all outcomes will be evaluated using the GRADE rating system.Ethics and disseminationEthical approval is not required since this is a systematic review of published studies. Our results will be published in a peer-reviewed journal and presented at relevant conferences. Further knowledge dissemination will be sought via public and patient organisations focussed on pain and opioid-related harms.

scholarly journals Comparison of the effectiveness of single- and multiple-sessions disinfection protocols against endotoxins in root canal infections: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gustavo G. Nascimento ◽  
Diego G. D. Rabello ◽  
Bruna J. M. Corazza ◽  
Ana P. M. Gomes ◽  
Eduardo G. Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Meta Analysis ◽  
Group Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Single Session ◽  
Literature Searches ◽  
Endodontic Infections

AbstractThis systematic review (SR) addressed the following common clinical question: What is more effective in reducing or eliminating endotoxin in endodontic infections—single or multiple-session treatments using calcium hydroxide medications? Literature searches of Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge, Scopus, and Google Scholar databases. Two reviewers independently assessed the eligibility for inclusion, extracted data, and evaluated the quality of the studies using the risk of bias tools. Electronic searches resulted in 358 articles, of which 32 studies were included for full-text assessment, and nine were included in this review. Meta-analysis pooling all the nine studies revealed lower levels of endotoxin for multiple-session treatment (P < 0.001). The sub-group analysis indicated no difference between single-session and 7 days of Ca(OH)2 medication (SMD − 0.32; P = 0.22). However, 14-days (I2 = 80.5%, P < 0.001) and 30-days (I2 = 78.9%, P < 0.01) of Ca(OH)2 medication was more effective than single-session treatment (both, p < 0.001). Overall, Overall, this SR provides evidence to support that multiple-session disinfection protocols with the placement of Ca(OH)2 medications are more effective in reducing the levels of endotoxin from root canal infections compared to single-session when applied for 14 and 30 days.

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