Clinical parameters in soft tissue adjunctive periodontal procedures for orthodontic patients: surgical laser vs scalpel -: A systematic review

ABSTRACT Objectives To systematically review existing literature regarding clinical parameters comparing surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients. Methods and Materials MEDLINE, Scopus, Web of Science, The Cochrane Library, LILACS, Bibliografia Brasileira de Odontologia (Brazilian Dental Literature - BBO), Embase, Open Grey, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination for the Improvement of Higher Education Personnel - CAPES), and Google Scholar were searched up to December 2020 without language restriction. Clinical trials comparing clinical parameters from surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients were selected. Risk of bias (RoB) assessments were performed using the Cochrane RoB2 tool. Narrative syntheses were performed, and the certainty of evidence was determined using the GRADE tool. Results Five randomized clinical trials were included. One study was rated as low RoB, whereas others presented some concerns or high RoB. The studies were highly heterogeneous in relation to the procedure performed, laser protocol, outcomes evaluated, and follow-up periods. In general, regardless of the procedure and laser protocol used, the studies did not show significant differences between laser and scalpel for the outcomes of probing pocket depth, clinical crown length, gingival index, and relapse rate. Pain and bleeding were significantly lower with the use of laser compared with the scalpel. The certainty of evidence ranged from moderate to very low. Conclusions The existing literature on the subject is scarce and very heterogeneous and has methodological limitations. Based on the available evidence, it is not possible to draw definitive conclusions about the beneficial effect of laser use in orthodontic patients.

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assessment of periimplant soft tissue condition with morse taper abutment connection

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v21i00.8664977 ◽

2021 ◽

Vol 21 ◽

pp. e224977

Author(s):

Puspa Puspita Lasminingrum ◽

Aldilla Miranda ◽

Dyah Nindita Carolina ◽

Prajna Metta

Keyword(s):

Soft Tissue ◽

Rapid Review ◽

Clinical Parameters ◽

Gingival Index ◽

Literature Searching ◽

Pocket Depth ◽

Plaque Score ◽

Probing Pocket Depth ◽

Mucosal Thickness ◽

Assessment Results

Aim: This study aims to evaluate the clinical assessment results of periimplant soft tissue with morse taper (internal abutment connection). Methods: The study was conducted using a rapid review by searching the articles from PubMed NCBI and Cochrane by using keywords. All articles were selected by the year, duplication, title, abstract, full-text, and finally, all selected articles were processed for final review. Following clinical parameters were included; Periimplant Probing Pocket Depth (PPD), Plaque Score (PS), modified Plaque Index (mPI), Mucosal Thickness (MTh), Gingival Height (GH), periimplant mucosal zenith, Pink Esthetic Score (PES), Bleeding On Probing (BOP), Sulcus Bleeding Index (SBI), and modified Gingival Index (mGI). Results: 9 selected articles were obtained from the initial literature searching count of 70 articles. The overall samples included 326 morse taper implants. Based on the evaluation, 3 out of 4 articles reported pocket depth < 4 mm, no bleeding was reported in 2 out of 4 articles. 4 out of 4 articles reported low plaque accumulation, low soft tissue recession was reported in 3 out of 3 articles, and 4 out of 4 articles reported acceptable PES values. Conclusion: The evaluations indicate that the morse taper (internal abutment connection) has favorable assessment results based on various clinical parameters.

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Doxorubicin/Adriamycin Monotherapy or Plus Ifosfamide in First-Line Treatment for Advanced Soft Tissue Sarcoma: A Pooled Analysis of Randomized Trials

Frontiers in Oncology ◽

10.3389/fonc.2021.762288 ◽

2021 ◽

Vol 11 ◽

Author(s):

Bi-Cheng Wang ◽

Bo-Hua Kuang ◽

Bo-Ya Xiao ◽

Guo-He Lin

Keyword(s):

Clinical Trials ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Randomized Clinical Trials ◽

Objective Response ◽

Pooled Analysis ◽

Cochrane Library ◽

First Line ◽

Open Label ◽

Advanced Soft Tissue Sarcoma

BackgroundDoxorubicin/Adriamycin (ADM) alone or combined with ifosfamide (IFO) (AI) is available for previously untreated advanced soft tissue sarcoma (ASTS). However, the clinical choice between them remains controversial. In this pooled analysis, we comprehensively compared the efficacy and tolerability of AI versus ADM in patients with ASTS.MethodsPubMed, Web of Science, EMBASE, and Cochrane Library were systematically searched from inception to April 14, 2021. Eligible studies were randomized clinical trials comparing AI to ADM. The primary outcomes were overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Discontinuation rate (DR) and toxic death (TD) were explored as secondary outcomes.ResultsOverall, three open-label randomized phase 2/3 clinical trials with a total of 1108 newly diagnosed ASTS patients were enrolled. Between AI and ADM, pooled hazard ratios were 0.93 (95% confidence interval 0.58-1.50, p = 0.78) for OS and 0.85 (0.57-1.25, p = 0.41) for PFS. While pooled risk ratios for ORR, DR, and TD were 1.37 (0.94-1.99, p = 0.10), 1.04 (0.74-1.46, p = 0.82), and 0.68 (0.19-2.36, p = 0.54) respectively. No publication bias was observed across the studies.ConclusionIn the first-line setting, adding IFO to ADM failed to benefit ASTS patients against ADM alone, even with comparable tolerability.

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Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

Current Pharmaceutical Design ◽

10.2174/1381612825666190701155737 ◽

2019 ◽

Vol 25 (15) ◽

pp. 1783-1790 ◽

Cited By ~ 3

Author(s):

Rosario Pastor ◽

Josep A. Tur

Keyword(s):

Weight Loss ◽

Clinical Trials ◽

Systematic Reviews ◽

Randomized Clinical Trials ◽

Statistical Tests ◽

Overweight And Obesity ◽

Cochrane Library ◽

Medical Subject Headings ◽

Mesh Terms ◽

Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

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Origin of MMP-8 and Lactoferrin levels from gingival crevicular fluid, salivary glands and whole saliva

BMC Oral Health ◽

10.1186/s12903-021-01743-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liza L. Ramenzoni ◽

Deborah Hofer ◽

Alex Solderer ◽

Daniel Wiedemeier ◽

Thomas Attin ◽

...

Keyword(s):

Matrix Metalloproteinase ◽

Salivary Glands ◽

Gingival Crevicular Fluid ◽

Clinical Parameters ◽

Pocket Depth ◽

Active Matrix ◽

Probing Pocket Depth ◽

Whole Saliva ◽

Biomarker Testing ◽

Crevicular Fluid

Abstract Background Pathologically elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis. This study aimed to assess the origin of MMP-8 and Lactoferrin in periodontitis patients and to identify the degree to which conventional clinical parameters correlate with their presence. Methods A total of ten periodontitis and ten healthy patients were included in this study. Whole saliva (stimulated and unstimulated), parotid/sublingual glandular fluid and gingival crevicular fluid from pockets and sulci were tested for MMP-8 and Lactoferrin and protein concentrations were quantified using an ELISA assay. Clinical parameters were checked for potential associations with MMP-8 and Lactoferrin levels. Results Periodontal patients presented higher concentrations of MMP-8 and Lactoferrin in pockets than other sources (P = 0.03). Lactoferrin measurement was higher in the parotid compared to sublingual glandular fluid in periodontitis patients (P = 0.03). Increased probing pocket depth was positively correlated with high MMP-8 and Lactoferrin levels. Conclusions Periodontal pockets appear to be the major source of active matrix metalloproteinase and Lactoferrin, which also may also enter the oral cavity through the salivary glands. Since clinically healthy sites in periodontitis patients also had elevated biomarker levels, gingival crevicular fluid biomarker testing may be more predictive of future tissue breakdown than conventional clinical parameters.

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Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods

Medicina ◽

10.3390/medicina57040387 ◽

2021 ◽

Vol 57 (4) ◽

pp. 387

Author(s):

Karolina Eva Romeikienė ◽

Daiva Bartkevičienė

Keyword(s):

Clinical Trials ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Randomized Clinical Trials ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Pelvic Floor Dysfunction ◽

Pelvic Organ ◽

Cochrane Library ◽

Muscle Training

Every woman needs to know about the importance of the function of pelvic-floor muscles and pelvic organ prolapse prevention, especially pregnant women because parity and labor are the factors which have the biggest influence on having pelvic organ prolapse in the future. In this article, we searched for methods of training and rehabilitation in prepartum and postpartum periods and their effectiveness. The search for publications in English was made in two databases during the period from August 2020 to October 2020 in Cochrane Library and PubMed. 77 articles were left in total after selection—9 systematic reviews and 68 clinical trials. Existing full-text papers were reviewed after this selection. Unfinished randomized clinical trials, those which were designed as strategies for national health systems, and those which were not pelvic-floor muscle-training-specified were excluded after this step. Most trials were high to moderate overall risk of bias. Many of reviews had low quality of evidence. Despite clinical heterogeneity among the clinical trials, pelvic-floor muscle training shows promising results. Most of the studies demonstrate the positive effect of pelvic-floor muscle training in prepartum and postpartum periods on pelvic-floor dysfunction prevention, in particular in urinary incontinence symptoms. However more high-quality, standardized, long-follow-up-period studies are needed.

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Abstract P391: Marine N-3 Fatty Acids Reduce Atherosclerosis Cardiovascular Disease: A Systemic Review and Meta-analysis of Clinical Trials

Circulation ◽

10.1161/circ.127.suppl_12.ap391 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Akira Sekikawa ◽

Nobutake Hirooka ◽

Abhishek Vishnu ◽

Vashudha Ahuja ◽

Emmanuel Sampene ◽

...

Keyword(s):

Cardiovascular Disease ◽

Fatty Acids ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Imaging Techniques ◽

Meta Analysis ◽

Quantitative Information ◽

Systemic Review ◽

Cochrane Library ◽

Cardiac Imaging Techniques

Introduction: Although marine n-3 fatty acids are believed to be cardioprotective through their anti-arrhythmic, anti-thrombotic, anti-atherogenic and other effects, results from recent meta-analyses of marine n-3 fatty acids on cardiovascular disease (CVD) are controversial. We performed a meta-analysis of marine n-3 fatty acids on CVD outcomes in randomized clinical trials (RCTs) to test the hypothesis that marine n-3 fatty acids are anti-atherogenic. We also tested the hypothesis that such benefit is dose-dependent. Methods: A systematic review of English language articles using PubMed, EMBASE and Cochrane Library through Aug 2012 was performed selecting RCTs evaluating the effect of marine n-3 fatty acids intake for 2 years or more on cardiovascular diseases, coronary disease, arteriosclerosis, cardiac imaging techniques, and carotid artery ultrasound. Descriptive and quantitative information was extracted. Odds ratios were calculated for cardiac event outcome. Correlation coefficients were obtained from studies of which outcome is intima-media thickness (IMT) and coronary lumen diameter (CD). We converted the estimates into a single effect size; the log odds ratio and its corresponding standard error. Results: Of 14,236 citations retrieved, 13 studies were selected, including studies reporting IMT (n=3) and CD (n=2) and major CVD events (n=8). Overall, marine n-3 fatty acids significantly reduced atherosclerotic CVD (RR 0.94: 95%CI 0.90 to 0.99, p<0.05). There was no evidence of heterogeneity (p=0.65) or publication bias (p=0.37, Begg’s test). A sub-analysis among 8 studies of major CVD events showed the similar results (RR 0.94: 95% CI 0.89 to 0.99, p<0.05). Another sub-analysis among 4 studies excluding sudden cardiac death as an outcome showed RR of 0.91 (95% CI 0.82 to 1.02, p=0.097). A meta-regression analysis shows that dose of marine n-3 fatty acids was inversely associated with CVD outcome, although the association was not statistically significant (p=0.06). Conclusions: The result of our meta-analysis supports a modest anti-atherogenic effect of marine n-3 fatty acids. This benefit may be proportional to the amount of marine n-3 fatty acids consumed.

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Clinical and Molecular Characteristics Associated with Survival in Advanced Melanoma Treated with Checkpoint Inhibitors

Journal of Oncology ◽

10.1155/2018/6279871 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Sunil Badami ◽

Sunil Upadhaya ◽

Ravi Kanth Velagapudi ◽

Pushyami Mikkilineni ◽

Ranju Kunwor ◽

...

Keyword(s):

Clinical Trials ◽

Randomized Clinical Trials ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Random Effect ◽

Eastern Cooperative Oncology Group ◽

Advanced Melanoma ◽

Cochrane Library ◽

Molecular Characteristics ◽

Significant Heterogeneity

Background. We performed meta-analysis to gather more evidence regarding clinical-molecular subgroups associated with better overall survival (OS) in advanced melanoma treated with checkpoint inhibitors. Materials and Methods. We performed a systematic search of PubMed, Scopus, Cochrane Library, and clinical trial.gov. Randomized clinical trials that compared a checkpoint inhibitor (nivolumab or pembrolizumab) with investigator choice chemotherapy or ipilimumab were included in our study. Hazard ratios (HR) and confidence interval (CI) were calculated for progression-free survival (PFS) and OS for each subgroup using generic inverse model along with the random effect method. Results. A total of 6 clinical trials were eligible for the meta-analysis. OS was prolonged in wild BRAF subgroup (HR 0.65, 95% CI 0.49-0.85, p 0.002), Programmed cell death subgroup (PD-1+) (HR 0.57, 95% CI 0.41-0.80, p 0.001), and high lactate dehydrogenase (LDH) level subgroup (HR 0.60, 95% CI 0.38-0.95, p 0.03). Similarly, we found increased OS in eastern cooperative oncology group (ECOG) 1, males and age >65 years subgroups. Conclusions. Checkpoint inhibitors significantly increased OS in patients with wild BRAF, positive PD-1, and high LDH. However, results should be interpreted keeping in mind associated significant heterogeneity. The results of this study should help in designing future clinical trials.

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Photobiomodulation for the Treatment of Primary Headache: Systematic Review of Randomized Clinical Trials

Life ◽

10.3390/life12010098 ◽

2022 ◽

Vol 12 (1) ◽

pp. 98

Author(s):

Andréa Oliver Gomes ◽

Ana Luiza Cabrera Martimbianco ◽

Aldo Brugnera Junior ◽

Anna Carolina Ratto Tempestini Horliana ◽

Tamiris da Silva ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Adjuvant Treatment ◽

Randomized Clinical Trials ◽

Primary Headache ◽

Risk Of Bias ◽

Cochrane Library ◽

Sham Treatment ◽

Methodological Assessment ◽

Grade Approach

The purpose of this study was to evaluate the efficacy and safety of photobiomodulation as an adjuvant treatment for primary headache. A systematic review of randomized clinical trials was performed. For such, electronic searches were performed in the MEDLINE, Embase, Cochrane Library, LILACS, PEDro, PsycInfo, Clinicaltrials.gov., and WHO/ICTRP databases, with no restrictions imposed regarding language or year of publication. We included studies that assessed any photobiomodulation therapy as an adjuvant treatment for primary headache compared to sham treatment, no treatment, or another intervention. The methodological assessment was conducted using the Cochrane Risk of Bias tool. The certainty of the evidence was classified using the GRADE approach. Four randomized clinical trials were included. Most of the included studies had an overall high risk of bias. Compared to sham treatment, photobiomodulation had a clinically important effect on pain in individuals with primary headache. Despite the benefits reported for other outcomes, the estimates were imprecise, and the certainty of the evidence was graded as low. These findings are considered insufficient to support the use of photobiomodulation in the treatment of primary headache. Randomized clinical trials, with higher methodological quality, are needed to enhance the reliability of the estimated effects.

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COMPARATIVE EVALUATION OF EFFICACY OF SCALING AND ROOT PLANING WITH AND WITHOUT CHLORHEXIDINE CHIP AND DIODE LASER IN CHRONIC PERIODONTITIS PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i11.2287 ◽

2021 ◽

Vol 5 (11) ◽

Author(s):

Reya Shree ◽

Varun Dahiya ◽

Pradeep Shukla ◽

Prerna Kataria ◽

Mona Dagar

Keyword(s):

Diode Laser ◽

Chronic Periodontitis ◽

Control Group ◽

Clinical Parameters ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Before And After ◽

Laser Group

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.

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AESTHETIC AMELIORATION OF GINGIVAL RECESSION BY MODIFIED CORONALLY ADVANCED FLAP PROCEDURE: A 6 MONTHS FOLLOW-UP INTERVENTIONAL STUDY

10.36106/ijsr/6517791 ◽

2021 ◽

pp. 78-80

Author(s):

Namburi Rajesh ◽

Rajendran Poornima

Keyword(s):

Gingival Recession ◽

Class I ◽

Clinical Parameters ◽

Pocket Depth ◽

Coronally Advanced Flap ◽

Probing Pocket Depth ◽

Anterior Teeth ◽

Flap Procedure ◽

Attached Gingiva

Background:In recent times, aesthetics has become a major reason for the patients to seek the dentist. Gingival recession of the anterior teeth leads to long tooth appearance thereby hampering the aesthetics. The aim of the present study is to assess the efciency of modied coronally advanced ap (MCAF) technique in combination with platelet-rich brin (PRF) for recession coverage of Miller's class I and II cases. Materials and method: 10 patients with Miller's class I or class II gingiva were treated by modied coronally advanced ap (MCAF) technique in combination with platelet-rich brin (PRF). The clinical parameters such as gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), width of attached gingiva (WAG), thickness of attached gingiva (TAG) and the height of gingival recession (HGR) were recorded at baseline, 3 months and 6 months follow-up visits. Results: All the clinical parameters showed signicant improvement at 3 months and 6 months post-operatively when compared with the baseline values. The results obtained during the initial follow-up visit remained stable over a period of 6 months. Conclusion: MCAF is a foreseeable technique to achieve gingival recession coverage. Additionally, the use of PRF enables in improved WAG and TAG due to the release of growth factors.

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