Effectiveness of Whitening Strips Use Compared With Supervised Dental Bleaching: A Systematic Review and Meta-analysis

2020 ◽  
Vol 45 (6) ◽  
pp. E289-E307
Author(s):  
GRV da Rosa ◽  
BM Maran ◽  
VL Schmitt ◽  
AD Loguercio ◽  
A Reis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Color Change ◽  
Meta Analysis ◽  
Permanent Dentition ◽  
Dental Bleaching ◽  
Color Alteration ◽  
Human Eyes ◽  
At Home

Clinical Relevance Bleaching performed at home while under the supervision of a dentist provides greater color alteration compared with whitening strips when evaluated with a spectrophotometer, although the color alteration was undetectable by unaided human eyes. SUMMARY Objective: A systematic review and meta-analysis were performed to answer the following research question: Does the use of whitening strips (WS) lead to an equivalent color change compared with supervised dental bleaching in patients with permanent dentition? Methods: A search was performed on August 10, 2017 (updated on March 22, 2019), in PubMed, the Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature database, Cochrane Library, Scopus, Web of Science, and SIGLE, without restrictions regarding date or language. Abstracts from the International Association for Dental Research, unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (parallel or split mouth) in patients with permanent dentition that compared WS with dentist-supervised dental bleaching performed at home (AH) or in office (IO) were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A meta-analysis with subgroup analysis (low and high peroxide concentration) was conducted for color change ΔE* (spectrophotometer) and ΔSGU (shade guide units), risk and intensity of tooth sensitivity (TS), gingival irritation (GI), and patient satisfaction using a random effects model. Heterogeneity was assessed with the Cochrane Q test and I2 statistics. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of the evidence. Results: After the removal of duplicates, followed by title and abstract screening, 20 studies remained. Only two studies were considered to have a low RoB; 11 had a high RoB, and seven had an unclear RoB. For WS versus IO, data were not available for the meta-analysis. For WS versus AH bleaching, a significant difference in ΔE* favoring the AH group was observed (standardized mean difference [SMD] = −0.50, 95% confidence interval [CI] −0.79 to 0.21), but the risk (risk ratio = 0.78, 95% CI 0.65 to 0.93) and intensity of TS (SMD = −0.30, 95% CI −0.56 to −0.04) were lower in the WS group. Color change in ΔSGU, risk and intensity of GI, and patient satisfaction were not significantly different between groups (p>0.20). The quality of evidence for ΔE*, risk and intensity of TS, and intensity of GI were graded as moderate. Conclusion: Although the risk and intensity of TS were lower in the WS group, dentist-supervised at-home bleaching led to a better color change when measured with a spectrophotometer, although the color alteration was undetectable by unaided human eyes.

Tooth Sensitivity After Dental Bleaching With a Desensitizer-containing and a Desensitizer-free Bleaching Gel: A Systematic Review and Meta-analysis

2019 ◽  
Vol 44 (2) ◽  
pp. E58-E74 ◽  
Author(s):  
M Rezende ◽  
FM Coppla ◽  
K Chemin ◽  
AC Chibinski ◽  
AD Loguercio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin American ◽  
Risk Ratio ◽  
Color Change ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Tooth Sensitivity ◽  
Dental Bleaching ◽  
Gingival Irritation

SUMMARY Objectives: A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity (TS) after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel in adult patients. Color change and risk of gingival sensitivity was also evaluated. Methods: A comprehensive search was performed MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), EMBASE and Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions to identify randomized clinical trials. Abstracts from the annual conference of the International Association for Dental Research (1990–2016), unpublished and ongoing trials registries, dissertations, and theses were also searched. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development and Evaluation (GRADE) approach. Data: After duplicates were removed, 1352 articles were identified. After title and abstract screening, only 47 studies remained for qualitative evaluation. Most of the studies had unclear risk of bias. No difference between groups were observed for the risk ratio of TS (risk ratio = 0.99; 95% confidence interval [CI] = 0.74–1.33); intensity of TS (standardized difference in means [SMD] = 0.04; 95% CI = 0.79–0.70); color change in shade guide units (SMD – 0.04; 95% CI = 0.50–0.42); color change in ΔE* (SMD = 0.41 (95% CI = 0.07–0.89); and risk ratio of gingival irritation (SMD = 1.05; 95% CI = 0.81–1.36). Except for the risk of TS, graded as moderate quality of evidence, all other outcomes were rated as low and very low quality. Conclusions: Incorporating desensitizers in the bleaching gel did not reduce the risk of TS, and the quality of this evidence was considered moderate. On the other hand, the intensity of TS, color change, and risk of gingival irritation was similar between groups, but the quality of the evidence for these outcomes was graded as low or very low, thus reducing the level of confidence in these outcomes.

Home-Based Exercise for People With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-12
Author(s):  
Renata Valle Pedroso ◽  
Miguel Adriano Sanchez-Lastra ◽  
Laura Iglesias Comesaña ◽  
Carlos Ayán
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Home Based ◽  
The Impact ◽  
At Home

Background: Exercise performed at home could be a useful therapy for people with chronic kidney disease. This systematic review and meta-analysis aimed at describing the characteristics, main findings, methodological quality, and adherence rate reported in the existent randomized controlled trials that have provided information regarding the impact of home-based exercise programs on people with chronic kidney disease. Methods: Electronic databases (MEDLINE/PubMed, SPORTDiscus, Scopus, and CENTRAL) were searched up to April 2021, using the keywords: “Exercise”; “Home”; “Kidney Disease.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was adopted. Jadad scale and Cochrane’s tool were used to assess the methodological quality and risk of bias. Results: Out of the 14 studies finally selected, 11 were included in the meta-analysis and most presented high methodological quality. The meta-analysis showed significant effects of home-based exercise on fitness and quality of life, but a little impact on renal function. Although exercise performed at home was mostly feasible and safe, adherence was not high and a considerable number of dropouts were observed. Conclusion: Home-based exercise has positive effects on the fitness’ level and on the quality of life on people with chronic kidney disease. Future studies are needed to identify whether exercise performed at home is a better physical therapy option than center-based exercise.

scholarly journals The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zahra Rezaei-Shahsavarloo ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Robbert J. J. Gobbens ◽  
Abbas Ebadi ◽  
Gholamreza Ghaedamini Harouni
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Patient Satisfaction ◽  
Older People ◽  
Meta Analysis ◽  
Clinical State ◽  
Frail Older Adults ◽  
Hospitalized Older Adults ◽  
The Impact

Abstract Background One of the most challenging issues for the elderly population is the clinical state of frailty. Frailty is defined as a cumulative decline across psychological, physical, and social functioning. Hospitalization is one of the most stressful events for older people who are becoming frail. The aim of the present study was to determine the effectiveness of interventions focused on management of frailty in hospitalized frail older adults. Methods A systematic review and meta-analysis of research was conducted using the Medline, Embase, Cochrane, ProQuest, CINAHL, SCOPUS and Web of Science electronic databases for papers published between 2000 and 2019. Randomized controlled studies were included that were aimed at the management of frailty in hospitalized older adults. The outcomes which were examined included frailty; physical, psychological, and social domains; length of stay in hospital; re-hospitalization; mortality; patient satisfaction; and the need for post discharge placement. Results After screening 7976 records and 243 full-text articles, seven studies (3 interventions) were included, involving 1009 hospitalized older patients. The quality of these studies was fair to poor and the risk of publication bias in the studies was low. Meta-analysis of the studies showed statistically significant differences between the intervention and control groups for the management of frailty in hospitalized older adults (ES = 0.35; 95% CI: 0. 067–0.632; z = 2.43; P < 0.015). However, none of the included studies evaluated social status, only a few of the studies evaluated other secondary outcomes. The analysis also showed that a Comprehensive Geriatric Assessment unit intervention was effective in addressing physical and psychological frailty, re-hospitalization, mortality, and patient satisfaction. Conclusions Interventions for hospitalized frail older adults are effective in management of frailty. Multidimensional interventions conducted by a multidisciplinary specialist team in geriatric settings are likely to be effective in the care of hospitalized frail elderly. Due to the low number of RCTs carried out in a hospital setting and the low quality of existing studies, there is a need for new RCTs to be carried out to generate a protocol appropriate for frail older people.

scholarly journals Patient satisfaction with nursing care in Ethiopia: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Henok Mulugeta ◽  
Fasil Wagnew ◽  
Getenet Dessie ◽  
Henok Biresaw ◽  
Tesfa Dejenie Habtewold
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Nursing Care ◽  
Addis Ababa ◽  
Care Service ◽  
Meta Analysis ◽  
Health Care Service ◽  
National Level ◽  
Cochrane Library

AbstractBackgroundPatient satisfaction with nursing care has been considered as the most important predictor of the overall patient satisfaction with hospital service and quality of health care service at large. However, the national level of patient satisfaction with nursing care remains unknown. Hence, the objective of this systematic review and meta-analysis was to estimate patient satisfaction with nursing care in Ethiopia.MethodsStudies were accessed through an electronic web-based search strategy from PubMed, Cochrane Library, Google Scholar, Embase, PsycINFO and CINAHL by using combination search terms. Qualities of each included article assessed by using a modified version of the Newcastle-Ottawa Scale for cross-sectional studies. All statistical analyses were done using STATA version 14 software. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for reporting results.ResultsOf 1,166 records screened, 15 studies with 6091 participants were included. The estimated pooled level of patient satisfaction with nursing care in Ethiopia was 55.15% (95% CI (47.35, 62.95%)). Based on the subgroup analysis, the estimated level of patient satisfaction was 61.84% (95% CI: 44.49, 79.2) in Addis Ababa, 54.24 %(95%CI: 46.84, 61.65) in Amhara region, 44.06% (95%CI: 38.09, 50.03) in SNNP, and 53.02 %(95% CI: 50.03, 56.00) in other regions. Patients who have one nurse in charge [(OR 1.08(0.45, 2.62)], with no history of previous hospitalization [(OR 1.37(0.82, 2.31)], living in the urban area [(OR 1.07(0.70, 1.65)], / and those who have no comorbid disease [(OR 1.08(0.48, 2.62)] were more likely to be satisfied with nursing care than their counterparts even though it was not statistically significant.ConclusionThis meta-analysis revealed that about one in two patients were not satisfied with the nursing care provided in Ethiopia. Therefore, Ministry of Health should give more emphasis to the quality of nursing care in order to increase patient satisfaction which is important to improve the overall quality of healthcare service.

scholarly journals At-home vs In-office Bleaching: A Systematic Review and Meta-analysis

2016 ◽  
Vol 41 (4) ◽  
pp. 341-356 ◽  
Author(s):  
JL de Geus ◽  
LM Wambier ◽  
S Kossatz ◽  
AD Loguercio ◽  
A Reis
Keyword(s):  
Systematic Review ◽  
Latin American ◽  
Meta Analysis ◽  
Adult Patients ◽  
Cochrane Library ◽  
Annual Conference ◽  
Tooth Sensitivity ◽  
Dental Bleaching ◽  
Significant Difference ◽  
At Home

SUMMARY Objective: A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity during in-office and at-home bleaching in adult patients. The efficacy of dental bleaching was also evaluated. Methods: A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and System for Information on Grey Literature in Europe without restrictions. The annual conference of the International Association for Dental Research abstracts (1990-2014) and unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. Only randomized clinical trials that compared the prevalence or intensity of tooth sensitivity during in-office and at-home bleaching in adult patients were included and studies that evaluated the efficacy of these dental bleaching techniques, in terms of shade guide units (ΔSGU) and in terms of color difference measured with a spectrophotometer (ΔE*). Results: After the removal of duplicates, 1139 articles were identified. After title and abstract screening, 29 studies remained. Fifteen studies were further excluded, whereas 12 studies remained for qualitative analyses and 8 for the meta-analysis of the primary and secondary outcomes. No significant difference in the risk/intensity of tooth sensitivity or in bleaching efficacy was observed in the present study. Conclusion: In an overall comparison of at-home and in-office bleaching, no differences were detected, either regarding risk/intensity of tooth sensitivity or the effectiveness of the bleaching treatment. This comparison, however, does not take into consideration variations in the protocols (daily usage time, number of bleaching sessions, and product concentration) of the bleaching techniques in the studies included.

Sign in / Sign up

Export Citation Format

Share Document