Comparison of InvisalignⓇ Aligners versus Fixed Appliance Treatment in pain perception: a systematic review and meta-analysis

Abstract Background: This systematic review aimed to compare the pain discomfort levels between InvisalignⓇ aligners comparing with traditional fixed appliances at multiple time points, through Pain Visual Analog Scale (VAS). Methods: Four electronic databases (Pubmed, Medline, CENTRAL and Scholar) were searched up to February 2019. There were no restrictions on year and publication status. Randomized clinical trials (RCTs) and case-control studies comparing pain perception through VAS in patients treated with Invisalign aligners and with labial appliances were included. Risk of bias within and across studies was assessed using Cochrane tool and Newcastle-Ottawa Scale (NOS) approach. Random-effects meta-analysis were conducted. VAS score at 1, 3 and 7 days, and analgesic consumption was collected. Pairwise and Binary Random-Effects Meta-analyses were used to synthesize available data. Results: At the initial search, a total of 87 articles were retrieved. Following the review protocol, 4 articles met the inclusion criteria and were included, with a total of 214 participants (139 females, 75 males). All studies were considered of high methodological quality. The results demonstrate that Invisalign aligners seems to be associated with significantly less pain than fixed appliances at 7 days after beginning the orthodontic treatment, although at 1 and 3 days the pain experience was similar in both orthodontics appliances. In regard to the type of material, SmartTrackⓇ aligners appear to give significantly better comfort for orthodontic patients than previous standard material, being that 3 days after appliance’s insertion this pain differential becomes significant, and this difference is more pronounced at 7 days. Conclusion: Patients treated with Invisalign experience less pain discomfort than those treated with fixed appliances and consume less analgesics. Overall, Invisalign promotes better pain and discomfort experience for the patient in the course of orthodontic treatment. Larger RCTs are needed to definitely demonstrate these findings throughout the orthodontic treatment.

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Comparison of Pain Perception between Clear Aligners and Fixed Appliances: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app10124276 ◽

2020 ◽

Vol 10 (12) ◽

pp. 4276 ◽

Cited By ~ 1

Author(s):

Dinis Pereira ◽

Vanessa Machado ◽

João Botelho ◽

Luís Proença ◽

José João Mendes ◽

...

Keyword(s):

Random Effects ◽

Pain Perception ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Multiple Time ◽

Case Control Studies ◽

Newcastle Ottawa Scale ◽

Fixed Appliances ◽

Multiple Time Points ◽

Meta Analyses

We aimed to compare the pain discomfort levels between clear aligners and fixed appliances at multiple time points. Four electronic databases (Pubmed, Medline, CENTRAL and Scholar) were searched up to May 2020. There were no year or language restrictions. Randomized clinical trials and case–control studies comparing pain perception through pain visual analog scale (VAS) in patients treated with clear aligners and with fixed appliances were included. Risk of bias within and across studies was assessed using Cochrane tool and Newcastle–Ottawa Scale (NOS) approach. Random-effects meta-analysis were conducted. VAS score and analgesic consumption were collected. Random-effects meta-analyses were used to synthesize available data. Following the review protocol, five articles met the inclusion criteria and were included, with a total of 273 participants (177 females, 96 males). Overall, clear aligners were associated with significantly less pain than fixed appliances during the first seven days of orthodontic treatment. Patients treated with clear aligners experience less pain discomfort than those treated with fixed appliances and consume less analgesics, with SORT A recommendation.

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Abstract WMP112: Cilostazol versus Aspirin for Secondary Stroke Prevention: Systematic Review and Meta-Analysis

Stroke ◽

10.1161/str.51.suppl_1.wmp112 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Michelle P Lin ◽

Kevin M Barrett ◽

James F Meschia ◽

Benjamin H Eidelman ◽

Josephine F Huang ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Ischemic Stroke ◽

Random Effects ◽

Intracranial Hemorrhage ◽

Stroke Prevention ◽

Lower Risk ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Secondary Stroke Prevention

Introduction: Cilostazol has promise as an alternative to aspirin for secondary stroke prevention given its vasodilatory and anti-inflammatory properties in addition to platelet aggregation inhibition. We conducted a systematic review and meta-analysis to estimate the comparative effectiveness and safety of cilostazol compared to aspirin for stroke prevention in patients with previous stroke or TIA. Hypothesis: Cilostazol is more effective than aspirin in preventing recurrent ischemic stroke with lower risk of intracranial hemorrhage and bleeding. Methods: We searched PubMed and the Cochrane Central Register of Controlled Trials from inception to 2019. Randomized clinical trials that compared cilostazol vs aspirin and reported the endpoints of ischemic stroke, intracranial hemorrhage and bleeding were included. A random-effects estimate was computed based on Mantel-Haenszel methods. The pooled estimates with 95% confidence intervals were compared between cilostazol and aspirin and displayed as forest plots (Figure). Results: The search identified 5 randomized clinical trials comparing cilostazol vs aspirin for secondary stroke prevention that enrolled 7,240 patients from primarily Asian countries (3,615 received cilostazol and 3,625 received aspirin). The pooled results from the random-effects model showed that cilostazol was associated with significantly lower risk of recurrent ischemic stroke (Hazard ratio [HR] 0.70; 95%CI, 0.54-0.89), intracranial hemorrhage (HR 0.41; 95%CI, 0.25-0.65) and bleeding (HR 0.71; 95%CI, 0.55-0.91). See forest plots. Conclusion: This meta-analysis suggests cilostazol is more effective than aspirin in the prevention of recurrent ischemic stroke with lower risk of intracranial hemorrhage and bleeding. Confirmatory randomized trials of cilostazol for secondary stroke prevention to be performed in more generalizable populations are needed.

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Clinical Significance of Resistin Expression in Osteoarthritis: A Meta-Analysis

BioMed Research International ◽

10.1155/2014/208016 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 12

Author(s):

Xiao-Chuan Li ◽

Feng Tian ◽

Fei Wang

Keyword(s):

Systematic Review ◽

Random Effects ◽

Meta Analysis ◽

Case Control ◽

Random Effects Model ◽

Dutch Population ◽

Review Of Literature ◽

Case Control Studies ◽

Stratified Analysis ◽

Human Resistin

Background. The objective of this study was to conduct a systematic review of literature evaluating human resistin expression as a diagnostic factor in osteoarthritis development and to quantify the overall diagnostic effect.Method. Relevant studies were identified and evaluated for quality through multiple search strategies. Studies analyzing resistin expression in the development of OA were eligible for inclusion. Data from eligible studies were extracted and included into the meta-analysis using a random-effects model.Results. Four case-control studies consisting of a total of 375 OA patients and 214 controls as well as three sex-stratified analyses composed of 53 males and 104 females were incorporated into our meta-analysis. Our results revealed that resistin levels were significantly higher in male OA subjects and OA patients overall. Country-stratified analysis yielded significantly different estimates in resistin levels between male OA subjects and female OA subjects in the Canadian subgroup but not among the French and USA subgroups. Based on the resistin levels in OA cases and controls, resistin levels were heightened in OA patients in the Dutch population.Conclusion. These results support the hypothesis that high expression of resistin represents a significant and reproducible marker of poor progression in OA patients, especially in males.

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Effect of micro-osteoperforation on the rate of orthodontic tooth movement—a systematic review and a meta-analysis

European Journal of Orthodontics ◽

10.1093/ejo/cjz049 ◽

2019 ◽

Vol 42 (2) ◽

pp. 211-221 ◽

Cited By ~ 4

Author(s):

Mostafa Shahabee ◽

Hooman Shafaee ◽

Mostafa Abtahi ◽

Abdolrasoul Rangrazi ◽

Erfan Bardideh

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Orthodontic Treatment ◽

Randomized Clinical Trials ◽

Tooth Movement ◽

Root Resorption ◽

Meta Analysis ◽

Orthodontic Tooth Movement ◽

Mean Difference ◽

Canine Retraction

Abstract Background The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention. Objectives The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment. Search methods A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed. Selection criteria Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review. Data collection and analysis The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures. Results Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17–0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP. Conclusions The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient. Registration The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.

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Efficacy and Safety of Tocilizumab in Patients with COVID-19 : A Systematic Review and Meta-Analysis.

10.21203/rs.3.rs-136017/v1 ◽

2020 ◽

Author(s):

Zhenlu Li ◽

Qianqiu Che ◽

Mao Li ◽

Jianping Liu ◽

Rao Du ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Mortality Rate ◽

Disease Severity ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Significant Difference ◽

Critical Patients

Abstract Background Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used to treat patients with 2019 coronavirus disease (COVID-19). Numerous retrospective studies have shown beneficial treatment efficacy. Several recent randomized clinical trials have questioned the efficacy of TCZ in patients with COVID-19. Therefore, we performed an updated systematic review and meta-analysis to explore the effectiveness and safety of tocilizumab recently used for treating patients with COVID-19. Methods Randomized clinical trials (RCTs) and comparative studies that compared the outcomes between TCZ and standard of care (SOC) were analysed. PubMed, EMBASE, and the Cochrane Library (inception to November 20, 2020) were systematically searched. Primary outcomes included mortality and the rate of requirement for mechanical ventilation (MV). In addition, several subgroup analyses stratified by disease severity, publication type and TCZ administration were performed. Results Three RCTs, twenty-one cohort studies and nine case-control studies including 11,206 patients were finally included. The TCZ group included 2,794 patients (24.93%) and the SOC group included 8,412 patients (75.07%). The mortality rate (>14 days) of the TCZ group, 29.63% (590/1,991), was lower than the SOC group, 41.51% (2,380/5,734) (OR 0.64, 0.57 to 0.73; p <0.00001). However, no significant difference in-14-day mortality rates was observed between the two groups (13.53% vs 22.92%, p = 0.21). Meanwhile, the rate of MV was significantly decreased in the TCZ group compared with the SOC group (OR 0.42, 0.22 to 0.83; p = 0.01). According to the results of the subgroup analysis stratified by disease severity, TCZ only reduced the mortality rate for critical patients with COVID-19 compared with SOC (OR 0.60, 0.52 to 0.71; P < 0.00001), particularly for patients in the intensive care unit (ICU) or patients requiring MV. No statistically significant increase was recognized in the rates of secondary infections or thrombosis between the two groups. Conclusions This systematic review and meta-analysis found that the addition of tocilizumab to the SOC might reduce mortality after 14 days in patients with COVID-19, particularly critical patients requiring MV. More extensive RCTs with longer follow-up periods are needed to validate these findings.

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Endoscopic management of biliary leaks: a systematic review with meta-analysis

Endoscopy ◽

10.1055/a-0835-5940 ◽

2019 ◽

Vol 51 (11) ◽

pp. 1074-1081 ◽

Cited By ~ 3

Author(s):

Kenny Vlaemynck ◽

Lies Lahousse ◽

Aude Vanlander ◽

Hubert Piessevaux ◽

Pieter Hindryckx

Keyword(s):

Systematic Review ◽

Success Rate ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Endoscopic Management ◽

Case Control Studies ◽

Biliary Leak ◽

Added Benefit ◽

Nasobiliary Drainage

Abstract Background The first-line approach to the treatment of biliary leaks is endoscopic retrograde cholangiopancreatography. A variety of techniques can be used, including sphincterotomy, stenting, a combination of both techniques, or nasobiliary drainage. We performed a systematic review with meta-analysis to define the optimal strategy. Methods We searched MEDLINE/PubMed, EMBASE, CENTRAL, Scopus, Google Scholar, and Web of Science until January 2018 for randomized clinical trials, case-control studies, and prospective cohort studies. Data on procedure, success, and complication rate were extracted. Risk of bias was assessed. A network meta-analysis was performed to compare sphincterotomy alone vs. stenting alone vs. combination treatment. Stenting was further stratified into leak-bridging and short stenting. Results 11 studies out of 5085 references were included. Compared with sphincterotomy alone, the combination of sphincterotomy with leak-bridging stenting had the highest success rate (risk ratio [RR] 1.15, 95 % confidence interval [CI] 0.97 – 1.50), followed by leak-bridging stenting alone (RR 1.10, 95 %CI 0.84 – 1.44). For nonbridgeable leaks, stenting alone had a higher success rate than sphincterotomy alone (RR 1.07, 95 %CI 0.72 – 1.40). The combination of short stents with sphincterotomy had no added benefit (RR 0.94, 95 %CI 0.49 – 1.29). Overall quality of the included studies was considered to be moderate. Conclusions We recommend sphincterotomy with stenting if the biliary leak can be bridged. If not, stenting alone with a short stent may be preferred in order to avoid sphincterotomy-related complications. More and larger studies are needed to confirm these findings.

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The Association of Inflammatory Biomarker of Neutrophil-to-Lymphocyte Ratio with Spontaneous Preterm Delivery: A Systematic Review and Meta-analysis

Mediators of Inflammation ◽

10.1155/2021/6668381 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Sina Vakili ◽

Parham Torabinavid ◽

Reza Tabrizi ◽

Alireza Shojazadeh ◽

Nasrin Asadi ◽

...

Keyword(s):

Systematic Review ◽

Preterm Delivery ◽

Random Effects ◽

Meta Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Significant Heterogeneity ◽

Random Effects Model ◽

Case Control Studies ◽

Inflammatory Biomarker ◽

Lymphocyte Ratio

Background. Neutrophil-to-lymphocyte ratio (NLR), as an inflammatory biomarker, has been investigated in several studies for early prediction of preterm delivery. However, their findings seem to be controversial. Thus, this systematic review and meta-analysis was conducted to evaluate the role of NLR in predicting preterm delivery as compared to term controls. Methods. PubMed, Web of Science, Embase, Scopus, and Google Scholar were systematically searched from inception up to December 2020. Interstudy heterogeneity was assessed using Cochrane’s Q test and the I 2 statistic. The random-effects model was employed to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Results. Out of a total of 4369 recodes, fifteen articles including 3327 participants were enrolled. The meta-analysis finding using the random-effects model produced a pooled estimate suggesting a significantly higher NLR ( WMD = 1.23 , 95% CI: 0.40–2.07) in women with preterm delivery ( P = 0.01 ). We found significant heterogeneity across the included studies ( P < 0.001 , I 2 = 92.33 % ). However, interstudy heterogeneity exists mainly due to differences in the definition of preterm delivery ( I 2 = 0.0 % ). In the metaregression analysis, there was no significant effect of publication year ( B = − 0.288 , P = 0.088 ), total sample size ( B = − 0.002 , P = 0.276 ), and the mean age of cases ( B = − 0.06 , P = 0.692 ) on the association between NLR and preterm delivery. Conclusion. The results of this meta-analysis revealed that the NLR value is higher in patients with preterm delivery. The NLR could be a useful biomarker for predicting preterm delivery; however, further prospective case-control studies are required to produce stronger evidence.

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