Does the Type of Solvent in Dental Adhesives Influence the Clinical Performance of Composite Restorations Placed in Noncarious Cervical Lesions? A Systematic Review and Meta-analysis

2020 ◽  
Vol 45 (5) ◽  
pp. E237-E254
Author(s):  
RBE Lins ◽  
M Sebold ◽  
MB Magno ◽  
LC Maia ◽  
LRM Martins ◽  
...  

Clinical Relevance According to the clinical and scientific evidence presented in this systematic review and meta-analysis, dental adhesives containing either organic solvent (acetone or alcohol) can be used to achieve similar clinical performance and longevity of composite restorations. SUMMARY Objectives: This systematic review and meta-analysis compared the clinical performance and survival rates of composite restorations placed in noncarious cervical lesions (NCCLs) using dental adhesives containing acetone or alcohol-based solvents. Methods and Materials: PubMed, Scopus, Web of Science, Virtual Health Library (VHL) LILACS, Cochrane Library, OpenGrey, Clinical Trials, and Rebec were searched. MeSH terms, supplementary concepts, synonyms, and free keywords were used in the search strategy. All references were crosschecked by two independent investigators following the PICOS strategy (population, NCCLs; intervention, acetone-based bonding agent; comparison, alcohol-based bonding agent; outcome, clinical evaluation parameters and survival rates; study design, randomized controlled clinical trials). Cochrane Collaboration’s tool was used to assess risk of bias, and two distinct meta-analyses were performed using the RevMan software. The prevalence of success and the total number of restorations for each group (acetone- or alcohol-based) were used to calculate the risk difference at a confidence interval of 95%. Random-effects models were applied, and heterogeneity was assessed using the I2 index in the pooled and subgrouped meta-analyses. The certainty of evidence was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: A total of 7876 studies were retrieved, from which 27 studies were selected for the systematic review. Ten studies were classified as “low risk of bias” and included in the meta-analyses. Overall heterogeneity was not significant (I2 = 0.00%). The clinical performance of restorations placed with bonding agents based on both solvents for each of the available parameters presented no statistical significance for any of the meta-analyses (p>0.05). Conclusion: Scientific evidence suggests composite restorations placed with acetone or alcohol-based dental adhesives present similar clinical performance and survival rates in NCCLs.

2019 ◽  
Vol 42 (5) ◽  
pp. 534-543
Author(s):  
Amanda Silva Rodrigues ◽  
Leonardo Santos Antunes ◽  
Liz Helena Moraes Pinheiro ◽  
Ludmila Silva Guimarães ◽  
José De Albuquerque Calansans-Maia ◽  
...  

Abstract Background/objective Craniofacial discrepancies have been associated with congenital dental anomalies. The aim of this study was to determine if there is any scientific evidence in the literature regarding the association between dental agenesis and craniofacial morphology. Materials and methods A systematic review and meta-analysis following the PRISMA Statement were conducted and registered in PROSPERO database. A broad search was conducted on databases (PubMed, Virtual Health Library, Web of Science, and Scopus) and grey literature. Articles that were selected based on predetermined eligibility criteria were assessed for quality and risk of bias according to the guidelines described by Folkes and Fulton. Those articles with similarities were submitted to meta-analysis using the RevMan 5.3 program. The certainty of the evidence was tested using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Results An electronic search of 975 articles resulted in 12 articles. These and four articles identified through manual search were eligible to be assessed for methodological quality and the risk of bias. Eleven articles presented moderate to high methodological quality. The included articles observed a reduced mandibular plane, a smaller maxilla and more differences with the increase in the severity of dental agenesis. Seven articles were included in the meta-analyses. Dental agenesis presented smaller SNA angle (P < 0.0001/CI −1.74 [−2.55, −0.92]) with moderate certainty of the evidence; and smaller ANB angle (P = 0.01/CI −0.80 [−1.44, −0.17]), with low certainty of the evidence. Conclusions This systematic review and meta-analysis demonstrated that dental agenesis may be associated with specific craniofacial morphology. Further studies are necessary due to the variation of the certainty of the evidence. Conflict of interest none declared. Registration PROSPERO (CRD42017055882).


2021 ◽  
Vol 5 (1) ◽  
pp. e001129
Author(s):  
Bill Stevenson ◽  
Wubshet Tesfaye ◽  
Julia Christenson ◽  
Cynthia Mathew ◽  
Solomon Abrha ◽  
...  

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.


2021 ◽  
Vol 11 (6) ◽  
pp. 755
Author(s):  
Falonn Contreras-Osorio ◽  
Christian Campos-Jara ◽  
Cristian Martínez-Salazar ◽  
Luis Chirosa-Ríos ◽  
Darío Martínez-García

One of the most studied aspects of children’s cognitive development is that of the development of the executive function, and research has shown that physical activity has been demonstrated as a key factor in its enhancement. This meta-analysis aims to assess the impact of specific sports interventions on the executive function of children and teenagers. A systematic review was carried out on 1 November 2020 to search for published scientific evidence that analysed different sports programs that possibly affected executive function in students. Longitudinal studies, which assessed the effects of sports interventions on subjects between 6 and 18 years old, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of eight studies, with 424 subjects overall, met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibitory control, and cognitive flexibility. The random-effects model for meta-analyses was performed with RevMan version 5.3 to facilitate the analysis of the studies. Large effect sizes were found in all categories: working memory (ES −1.25; 95% CI −1.70; −0.79; p < 0.0001); inhibitory control (ES −1.30; 95% CI −1.98; −0.63; p < 0.00001); and cognitive flexibility (ES −1.52; 95% CI −2.20; −0.83; p < 0.00001). Our analysis concluded that healthy children and teenagers should be encouraged to practice sports in order to improve their executive function at every stage of their development.


2021 ◽  
Vol 10 (13) ◽  
pp. 2760
Author(s):  
María León-López ◽  
Daniel Cabanillas-Balsera ◽  
Victoria Areal-Quecuty ◽  
Jenifer Martín-González ◽  
María C. Jiménez-Sánchez ◽  
...  

Aim. To conduct a systematic review and meta-analysis according to the following PICO question: in extracted human permanent teeth, does preflaring, compared with unflared canals, influence the accuracy of WL determination with EAL? Material and Methods. A systematic review was conducted according to the PRISMA checklist, using the following databases: PubMed, Science Direct, Scopus, and Web of Science. Studies related to WL determination using EAL both in preflared and unflared root canals of extracted human teeth were included. The outcome of interest was the accuracy of the electronic WL determination. A quality assessment of the included studies was performed, determining the risk of bias. The meta-analyses were calculated with the 5.4 RevMan software using the inverse variance method with random effects. PROSPERO registration: CRD42021243412. Results. Ten experimental studies fulfilled the inclusion criteria, and most of them found that preflaring increases the accuracy of the EALs in WL determination. The calculated OR was 1.98 (95% CI = 1.65–2.37; p < 0.00001; I2 = 10%), indicating that the determination of WL by EALs is almost twice as accurate in preflared canals. The accuracy of Root ZX in WL determination increases more than three times (OR = 3.25; p < 0.00001). Preflaring with Protaper files significantly increases the accuracy of EALs (OR = 1.76; p < 0.00001). The total risk of bias of the included studies was low. No obvious publication bias was observed. Conclusions. The results indicate a significant increase in the accuracy of WL determination with EAL after preflaring, doubling the percentage of exact measurements. Preflaring should be recommended as an important step during mechanical enlargement of the root canal, not only because it improves the access of the files to the canal, but also because it allows one to obtain more accurate electronic determinations of WL.


2021 ◽  
Vol 67 (1) ◽  
pp. 27-34
Author(s):  
Fernanda Cardoso ◽  
Jéssica Breder ◽  
Priscila Apolinário ◽  
Henrique Oliveia ◽  
Maria Saidel ◽  
...  

BACKGROUND: Plantago major is a medicinal plant that has been used for centuries to treat various health conditions including wounds. PURPOSE: To investigate the effectiveness of the topical use of P major in healing skin wounds in animal models. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted. Seven (7) electronic databases (Virtual Health Library, Public/Publisher MEDLINE, Scopus, Web of Science, Embase, Cumulative Index of Nursing and Allied Health Literature, and CAB Direct) were searched for controlled studies published in English from January 2006 to March 2020. The Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies tools guided the evaluation of the studies and determined their quality. The Systematic Review Center for Laboratory Animal Experimentation was used to assess the risk of bias. RESULTS: Of the 176 publications identified, 4 met the inclusion criteria. Studies included 20 to 100 animals and varying concentrations of P major. There were no reports of losses during research. Wound healing was assessed between 17 and 21 days following wounding. The best response in terms of wound contraction rate occurred with 10%, 20%, and 50% concentrations when compared with control groups. One (1) study did not have an animal ethics committee review. All studies had a high risk of bias and a lack of methodological rigor. CONCLUSION: The results of this review did not find evidence about the in vivo effectiveness of P major for wound healing. More rigorous preclinical studies with adequate sample sizes are required to identify the best concentrations and formulations as well as increase understanding about the mechanisms of action of P major in wound healing.


Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 1
Author(s):  
Hye Won Lee ◽  
Lin Ang ◽  
Jung Tae Kim ◽  
Myeong Soo Lee

Background and Objectives: This review aimed to provide an updated review of evidence regarding the effects of aromatherapy in relieving symptoms of burn injuries, focusing on pain and physiological distress. Materials and Methods: Fifteen databases (including five English databases, four Korean medical databases, and four Iranian databases) and trial registries were searched for studies published between their dates of inception and July 2021. Two review authors individually performed study selection, data extraction, and risk of bias assessment, and any discrepancies were solved by a third review author. Results: Eight RCTs met our inclusion criteria and were analyzed in this updated systematic review. Our meta-analyses revealed that inhaled aromatherapy plus routine care showed beneficial effects in relieving pain after dressing, as compared to placebo plus routine care (p < 0.00001) and routine care alone (p = 0.02). Additionally, inhaled aromatherapy plus routine care (p < 0.00001) and aromatherapy massage plus routine care (p < 0.0001) also showed superior effects in calming anxiety, as compared to routine care alone. None of the included studies reported on AEs. Overall, the risk of bias across the studies was concerning. Conclusions: This updated review and synthesis of the studies had brought a more detailed understanding of the potential application of aromatherapy for easing the pain and anxiety of burn patients.


F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1760 ◽  
Author(s):  
Matthew J. Page ◽  
Lisa Bero ◽  
Cynthia M. Kroeger ◽  
Zhaoli Dai ◽  
Sally McDonald ◽  
...  

Background: Dietary guidelines should be informed by systematic reviews (SRs) of the available scientific evidence. However, if the SRs that underpin dietary guidelines are flawed in their design, conduct or reporting, the recommendations contained therein may be misleading or harmful. To date there has been little empirical investigation of bias due to selective inclusion of results, and bias due to missing results, in SRs of food/diet-outcome relationships. Objectives: To explore in SRs with meta-analyses of the association between food/diet and health-related outcomes: (i) whether systematic reviewers selectively included study effect estimates in meta-analyses when multiple effect estimates were available; (ii) what impact selective inclusion of study effect estimates may have on meta-analytic effects, and; (iii) the risk of bias due to missing results (publication bias and selective non-reporting bias) in meta-analyses. Methods: We will systematically search for SRs with meta-analysis of the association between food/diet and health-related outcomes in a generally healthy population, published between January 2018 and June 2019. We will randomly sort titles and abstracts and screen them until we identify 50 eligible SRs. The first reported meta-analysis of a binary or continuous outcome in each SR (the ‘index meta-analysis’) will be evaluated. We will extract from study reports all study effect estimates that were eligible for inclusion in the index meta-analyses (e.g. from multiple instruments and time points) and will quantify and test for evidence of selective inclusion of results. We will also assess the risk of bias due to missing results in the index meta-analyses using a new tool (ROB-ME). Ethics and dissemination: Ethics approval is not required because information will only be extracted from published studies. Dissemination of the results will be through peer-reviewed publications and presentations at conferences. We will make all data collected from this study publicly available via the Open Science Framework.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Steven Kwasi Korang ◽  
Sophie Juul ◽  
Emil Eik Nielsen ◽  
Joshua Feinberg ◽  
Faiza Siddiqui ◽  
...  

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) which has rapidly spread worldwide. Several human randomized clinical trials assessing potential vaccines are currently underway. There is an urgent need for a living systematic review that continuously assesses the beneficial and harmful effects of all available vaccines for COVID-19. Methods/design We will conduct a living systematic review based on searches of major medical databases (e.g., MEDLINE, EMBASE, CENTRAL) and clinical trial registries from their inception onwards to identify relevant randomized clinical trials. We will update the literature search once a week to continuously assess if new evidence is available. Two review authors will independently extract data and conduct risk of bias assessments. We will include randomized clinical trials comparing any vaccine aiming to prevent COVID-19 (including but not limited to messenger RNA; DNA; non-replicating viral vector; replicating viral vector; inactivated virus; protein subunit; dendritic cell; other vaccines) with any comparator (placebo; “active placebo;” no intervention; standard care; an “active” intervention; another vaccine for COVID-19) for participants in all age groups. Primary outcomes will be all-cause mortality; a diagnosis of COVID-19; and serious adverse events. Secondary outcomes will be quality of life and non-serious adverse events. The living systematic review will include aggregate data meta-analyses, trial sequential analyses, network meta-analyses, and individual patient data meta-analyses. Within-study bias will be assessed using Cochrane risk of bias tool. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) and Confidence in Network Meta-Analysis (CINeMA) approaches will be used to assess certainty of evidence. Observational studies describing harms identified during the search for trials will also be included and described and analyzed separately. Discussion COVID-19 has become a pandemic with substantial mortality. A living systematic review assessing the beneficial and harmful effects of different vaccines is urgently needed. This living systematic review will regularly inform best practice in vaccine prevention and clinical research of this highly prevalent disease. Systematic review registration PROSPERO CRD42020196492


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024886 ◽  
Author(s):  
Klaus Munkholm ◽  
Asger Sand Paludan-Müller ◽  
Kim Boesen

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 6-6
Author(s):  
Daan Voeten ◽  
Chantal Den Bakker ◽  
Donald Van Der Peet

Abstract Background Standard therapy for resectable oesophageal carcinoma is trimodality therapy (TMT) consisting of neoadjuvant chemoradiotherapy and oesophagectomy. Evidence of survival advantage of TMT over organ preserving definitive chemoradiotherapy (dCRT) is inconclusive. The aim of this study is to compare survival between TMT and dCRT. Methods A systematic review and meta-analyses were conducted. Randomised controlled trials and observational studies on primary resectable, curatively treated, oesophageal carcinoma patients above 18 years were included. Three online databases were searched for studies comparing TMT with dCRT. Primary outcomes were two-, three- and five-year overall survival rates. Risk of bias was assessed using the Cochrane risk of bias tools for RCTs and cohort studies. Results Thirty-two studies described in 35 articles were included in this systematic review, thirty-three were included in the meta-analyses. Two-, three- and five-year overall survival was significantly lower in dCRT compared to TMT, with relative risks (RR) of 0.69 (95%CI, 0.57–0.83), 0.76 (95%CI, 0.63–0.92), and 0.57 (95%CI, 0.47–0.71) respectively. However, when only analysing studies with equal patient groups at baseline no differences for two-, three- and five-year overall survival were found with RRs of 0.83 (95%CI, 0.62–1.10), 0.81 (95%CI 0.57–1.14), 0.63 (95%CI, 0.36–1.12). The forest plot for three-year overall survival is presented in figure 1. Figure 1. 3 year overall survival rates Conclusion Despite limitations of the available evidence these meta-analyses suggest there is no survival advantage for TMT over dCRT, assuming comparable groups at baseline. Selection of surgical candidates in oesophageal carcinoma should be part of personalised and tailored care. Disclosure All authors have declared no conflicts of interest.


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