scholarly journals Role of Dental Implant Homecare in Mucositis and Peri-implantitis Prevention: A Literature Overview

2019 ◽  
Vol 13 (1) ◽  
pp. 470-477
Author(s):  
Vittorio Checchi ◽  
Fabrizio Racca ◽  
Davide Bencivenni ◽  
Laura Lo Bianco
Keyword(s):  
Clinical Trials ◽  
Home Care ◽  
Cohort Studies ◽  
Dental Implants ◽  
Randomized Clinical Trials ◽  
Current Knowledge ◽  
Good Evidence ◽  
Inclusion Criteria ◽  
Dental Floss ◽  
Care Practices

Background: Correlation between high plaque index and inflammatory lesions around dental implants has been shown and this highlights the importance of patient plaque control. Until now, knowledge of peri-implant home care practices has been based on periodontal devices. Objective: The aim of this overview is to identify the presence of scientific evidence that peri-implant homecare plays a role in mucositis and peri-implantitis prevention. Methods: Different databases were used in order to detect publications reflecting the inclusion criteria. The search looked into peri-implant homecare studies published from 1991 to 2019 and the terms used for the identification of keywords were: Dental implants, Brush, Interproximal brushing, Interdental brushing, Power toothbrush, Cleaning, Interdental cleaning, Interspace cleaning, Flossing, Super floss, Mouth rinses, Chlorhexidine. The type of studies included in the selection for this structured review were Randomized Clinical Trials, Controlled Clinical Trials, Systematic Reviews, Reviews, Cohort Studies and Clinical cases. Results: Seven studies fulfilled all the inclusion criteria: 3 RCTs, one Consensus report, one cohort study, one systematic review and one review. Other 14 studies that partially met the inclusion criteria were analyzed and classified into 3 different levels of evidence: good evidence for RCTs, fair evidence for case control and cohort studies and poor evidence for expert opinion and case report. Conclusion: Not much research has been done regarding homecare implant maintenance. Scientific literature seems to show little evidence regarding these practices therefore most of the current knowledge comes from the periodontal literature. Manual and powered toothbrushes, dental floss and interdental brushes seem to be useful in maintaining peri-implant health. The use of antiseptic rinses or gels does not seem to have any beneficial effects. It can be concluded that to better understand which are the most effective home care practices to prevent mucositis and peri-implantitis in implant-rehabilitated patients, new specific high evidence studies are needed.

scholarly journals Diferentes técnicas para o tratamento de dentes com rizogênese incompleta e necrose pulpar: uma revisão sistemática

2021 ◽  
Vol 62 (1) ◽  
pp. 129-150
Author(s):  
Camila Borba ◽  
Cíntia Jacobsen ◽  
Guilherme Pauletto ◽  
Carina Michelon ◽  
Mariana De Carlo Bello
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Mineral Trioxide Aggregate ◽  
Inclusion Criteria ◽  
Manual Search ◽  
Irrigation Solution ◽  
Rate Of Success

Introduction: The objective of this systematic review was to compare the apexification techniques of calcium hydroxide (Ca(OH)2), or mineral trioxide aggregate (MTA), with the pulp regeneration technique, using cohort studies, and non-randomized and randomized clinical trials. Methods: The methodology was based on electronic research in the following databases: PubMed, MEDLINE, Google Scholar, SciELO, and LILACS. In addition, a manual search was carried out using the references that were listed in the articles found. Results: A total of 403 potentially eligible studies were found, with seven being included in the inclusion criteria of this systematic review. The seven studies involved a total of 312 teeth. The minimum time of a follow-up period was 12 months. The irrigation solution most used was sodium hypochlorite, for both of the apexification and revascularization techniques. The medication commonly chosen in the apexification groups was Ca(OH)2, with antibiotic triple paste in the revascularization groups. The clinical rate of success in the groups treated with revascularization varied from 76% to 100%, while in the groups treated with apexification, it ranged from 68% to 100%. Only two studies reached a success rate equal to 100%. Conclusions: Variable levels of evidence were observed in relation to the treatments. However, it was confirmed that revascularization is an excellent option since its outcomes produced a greater gain of thickness and root length, besides developing a decrease in the apical foramen.

scholarly journals Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

2020 ◽  
pp. 1-16
Author(s):  
David M. Robinson ◽  
Christine Eng ◽  
Steven Makovitch ◽  
Joshua B. Rothenberg ◽  
Stephanie DeLuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Inclusion Criteria ◽  
Serious Adverse Events ◽  
Bias Risk ◽  
Glenohumeral Osteoarthritis ◽  
Functional Outcome Measures

BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

scholarly journals The Effects of Nonpharmacological Treatment on Uremic Pruritus Patients: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Chiu-Feng Wu ◽  
Ya-Chu Hsiao ◽  
Pi-Chen Ko
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Inclusion Criteria ◽  
Uremic Pruritus ◽  
Jadad Scale ◽  
Analysis And Synthesis ◽  
Nonpharmacological Treatments

Background. Around 50–90% of hemodialysis patients develop pruritus. Although studies examining nonpharmacological treatments for itchy skin have been conducted, the conclusions have not been decisive. Purpose. Through a systematic review of the literature, this study aimed to understand nonpharmacological interventions carried out in clinical trials for uremic pruritus and to evaluate and consolidate the information regarding these improvements and their effectiveness. Methods. A literature search focusing on studies published between January 2004 and December 2013 was conducted from 5 electronic databases. After screening based on inclusion criteria and excluding duplicates, nonpharmacological treatments examined in randomized clinical trials were selected for further analysis and synthesis. A modified Jadad scale was used to evaluate the quality of the identified articles. Results. Seven nonpharmacological studies met the inclusion criteria. The interventions to improve uremic pruritus included using emollients, phototherapy, acupuncture, and thermal therapy. Research showed that using emollients, phototherapy, and acupuncture significantly reduces uremic pruritus. Conclusion. Nonpharmacological interventions are effective for hemodialysis patients with pruritus. Emollients were found to provide the most relief compared to the other methods and constitute a readily available and cost-effective intervention to improve pruritus symptoms.

scholarly journals Esthetics outcomes in patients submitted to pterional craniotomy and its variants: A scoping review

2021 ◽  
Vol 12 ◽  
pp. 461
Author(s):  
Daniel Buzaglo Gonçalves ◽  
Maria Izabel Andrade dos Santos ◽  
Lucas de Cristo Rojas Cabral ◽  
Louise Makarem Oliveira ◽  
Gabriela Campos da Silva Coutinho ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Patient Satisfaction ◽  
Muscle Atrophy ◽  
Randomized Clinical Trials ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Temporal Muscle ◽  
Pterional Craniotomy ◽  
Main Complaint ◽  
Evidence Level

Background: Highly performed nowadays, the pterional craniotomy (PC) has several widespread variants. However, these procedures are associated with complications such as temporalis muscle atrophy, facial nerve frontal branch damage, and masticatory difficulties. The postoperative cranial aesthetic is, nonetheless, the main setback according to patients. This review aims to map different pterional approaches focusing on final aesthetics. Methods: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were classified through the Oxford method. We searched PubMed/MEDLINE, EMBASE, and Cochrane Library from January 1969 to February 2021 for cohorts and randomized clinical trials that met our inclusion criteria. Results: 1484 articles were initially retrieved from the databases. 1328 articles did not fit the inclusion criteria. 118 duplicates were found. 38 studies were found eligible for the established criteria. 27 (71.05%) were retrospective cohorts, with low evidence level. Only 5 (13.15%) clinical trials were found eligible to the criteria. The majority of the studies (36/38) had the 2B OXFORD evidence level. A limited number of studies addressed cosmetic outcomes and patient satisfaction. The temporal muscle atrophy or temporal hollowing seems to be the patient’s main complaint. Only 17 (44.73%) studies addressed patient satisfaction regarding the aesthetics, and only 10 (26.31%) of the studies reported the cosmetic outcome as a primary outcome. Nevertheless, minimally invasive approaches appear to overcome most cosmetic complaints and should be performed whenever possible. Conclusion: There are several variants of the classic PC. The esthetic outcomes are poorly evaluated. The majority of the studies were low evidence articles.

Randomized clinical trials in oncology stopped early for benefit (RCTSEB)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6039-6039 ◽  
Author(s):  
E. Segota ◽  
H. P. Soares ◽  
B. Djulbegovic ◽  
A. Kumar ◽  
D. Bassler ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Guidelines ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Hematologic Malignancies ◽  
True Positive ◽  
Inclusion Criteria ◽  
Early Results ◽  
Cancer Guidelines ◽  
The Impact

6039 Background: Randomized clinical trials (RCT) that stop earlier than planned because of apparent benefit often receive great attention. However, how often these early results get confirmed by other subsequent meta-analysis/randomized studies, and how often results get included in clinical guidelines is not known. We conducted systematic review of oncologic RCTSEB to further determine if the results from RCTSEB are confirmed by the subsequent studies and/or included in guidelines. Methods: RCT of any intervention reported as having stopped early because of the results favoring the intervention were previously identified (JAMA.2005;294:2203).Trials with interventions in prevention and treatment of solid and hematologic malignancies were included for this review. Citation search was conducted by two reviewers to identify meta-analysis (MA), systematic reviews (SR) and RCTs that used similar trial design as the RCTSEB. National Comprehensive Cancer Guidelines were reviewed to identify the impact of the results on recommendations on clinical practice. Results: 33 trials were identified, and 5 were excluded because they did not fit the inclusion criteria. MA/SR were available for the assessment of interventions reported in 15/28 RCTSEB. Results of subsequent MA confirmed 12/15 findings, while 3 trials were contradicted. Of the remaining 13 trials, for 7 there was at least one subsequent RCT identified. 6/7 were confirmed as beneficial in the subsequent RCTs and 1 was contradicted. For 6/28 RCTSEB we did not find any subsequent MA/SR/RCTS. We also looked at the inclusion of interventions from RCTSEB in the clinical guidelines. 18/28 interventions from RCTSEB were mentioned in the formulation of clinical guidelines.16/18 were recommended as true positive recommendations. The other 2 interventions which were addressed in the guidelines were either not confirmed (n = 1) or incorrectly recommended (n = 1). Conclusions: In this set of oncology of RCTSEBs the findings were subsequently confirmed in 64% (18/28) cases. Guidelines developers used 2/28 (7%) of RCTSEB for which reliable confirmatory data were available. However, caution should be applied in the interpretation of our results because the same RCTSEB was also included in confirmatory MAs which possibly could have introduced bias. No significant financial relationships to disclose.

Efficacy of acupuncture in the management of fatigue related to breast cancer antineoplastic treatment: a systematic review

2019 ◽  
Vol 9 (2) ◽  
pp. 264-272
Author(s):  
Ana Carolina Moraes Costa ◽  
Alena Peixoto Medrado
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Total Sample ◽  
Inclusion Criteria ◽  
Antineoplastic Treatment

INTRODUCTION: Breast cancer is the most prevalent cancer among women worldwide. Similar to chemotherapy, antineoplastic treatment is associated with many side effects, with fatigue being one of the most common. It is important to investigate potential treatments, especially non-pharmacological alternatives, to control symptoms that directly affect women’s quality of life. OBJECTIVE: The objective of this study was to provide scientific evidence to verify the efficacy of acupuncture in the management of fatigue in patients with breast cancer. METHODS: This study involved a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Randomized clinical trials published in indexed scientific journals were compiled. The literature search was performed using the electronic databases, PubMed, PEDro, and BIREME, using the descriptors ‘breast cancer’, ‘fatigue’, ‘acupuncture’, and ‘randomized trial’. Inclusion criteria included fully available online articles that were classified as randomised clinical trials published from 2012 to 2017 in either English or Portuguese. Study eligibility was based on the Population, Intervention, Control, Outcome, and Study (PICO) design criteria, in which the (1) population included women 18–65 years of age with breast cancer, (2) intervention was acupuncture, (3) comparison referred to standard care or sham acupuncture, and (4) outcome was the evaluation of fatigue. The PEDro scale was applied to evaluate the quality of the studies. WebQualis was also used to evaluate the quality of the journals of the selected articles. RESULTS: In total, 66 articles were selected, but only four fulfilled all inclusion criteria, giving a total sample size of 620 women. All trials evaluated the effect of acupuncture on fatigue and other symptoms related to the treatment of breast cancer with different treatment durations. Three articles reported statistically significant results, and all articles described clinical improvement in fatigue after the application of acupuncture. The average PEDro score of the manuscripts was 6.25. All articles were published in non-Brazilian journals with WebQualis scores that ranged from B2 to A1. CONCLUSION: Scientific evidence confirms the efficacy of acupuncture in the management of fatigue reported by women with breast cancer. Acupuncture was effective in reducing fatigue in the studies selected for this review.

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