Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis

Aim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify articles that reported on the defects and/or fracture of NiTi instrument used clinically (Jan 1980 till Aug 2021), with additional search manually by going through the list of references of the initially screened articles. Those satisfying the inclusion and exclusion criteria were entered into the analysis.Study Eligibility Criteria, Participants, and Interventions: All studies from the said databases reporting on NiTi root canal instruments that were deformed or separated during normal clinical use.Study Appraisal and Synthesis Methods: Studies with data available and suitable for meta-analysis were grouped according to the general design of the NiTi instruments for comparison. Safety quotient value was calculated based on the rate of instrument distortion and fracture.Results: Various instrument designs exhibited different incidences of distortion and fracture, hence a different “safety quotient” (ratio of the amount of deformed instruments to that of fractures in use). Heat-treated files showed the highest safety quotient value. All brands of NiTi file demonstrated a statistically significantly lower incidence of fracture, if treated as disposable instruments after clinical use in a patient.Limitations: Inclusion of articles written in English only, and grouping of file systems into general design types in the analysis.Conclusions and Implications of Key Findings: NiTi endodontic files should be scrutinized for defects before being used in the root canal. Disposing the NiTi instruments after clinical use in a patient (so-called “single use”) is recommended for minimizing fracture clinically. Certain instrument designs tend to show discernible deformation before they should fracture in the next use.

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Effects of Hot Sterilization on Torsional Properties of Endodontic Instruments: Systematic Review with Meta-Analysis

Materials ◽

10.3390/ma12132190 ◽

2019 ◽

Vol 12 (13) ◽

pp. 2190 ◽

Cited By ~ 3

Author(s):

Mario Dioguardi ◽

Diego Sovereto ◽

Riccardo Aiuto ◽

Luigi Laino ◽

Gaetano Illuzzi ◽

...

Keyword(s):

Meta Analysis ◽

Physical And Mechanical Properties ◽

Cyclic Fatigue ◽

Eligibility Criteria ◽

Torsional Fatigue ◽

Dental Instruments ◽

Niti Instruments ◽

Cutting Capacity ◽

Torsional Properties ◽

Physical And Mechanical Characteristics

Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.

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PIWI proteins as prognostic markers in cancer: a systematic review and meta-analysis

10.1101/663468 ◽

2019 ◽

Author(s):

Alexios-Fotios A. Mentis ◽

Efthimios Dardiotis ◽

Athanassios G. Papavassiliou

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Data Extraction ◽

Meta Analysis ◽

Cancer Site ◽

Synthesis Methods ◽

Eligibility Criteria ◽

Cross Sectional ◽

Protein Levels ◽

Low Expression

ABSTRACTBackgroundPIWI proteins, which interact with piRNAs, are implicated in stem cell and germ cell regulation, but have been detected in various cancers, as well.ObjectivesIn this systematic review, we explored, for the first time in the literature (to our knowledge), the association between prognosis in patients with cancer and intratumoral expression of PIWI proteins.Data sourcesPubMed, Embase and Web of Knowledge databases were searched for the relevant cohort studies.Study eligibility criteriaProspective or retrospective cohort studies investigating the association of intratumoral mRNA or protein expression of different types of PIWI proteins with survival, metastasis or recurrence of various types of cancers in the systematic review. Exclusion of cross-sectional studies, of studies on the prognostic value of genetic polymorphism of PIWI genes, of studies re-analyzed previously published databases, and of conference abstracts and non-English articles.ParticipantsTwenty-six studies with 4,299 participants were included in the systematic review.InterventionsPooled Hazard Ratios (HRs) and their 95% Confidence Intervals (CIs) were calculated for different PIWI proteins separately, by pooling of log of the calculated HRs using the random-effects model.Study appraisal and synthesis methodsData extraction was performed using a pre-designed form and quality of the studies was assessed using REMARK criteria. Heterogeneity assessed using the I2 index and the Cochran Q test. Publication bias assessed using funnel plots and Egger’s regression.ResultsThe pooled HR of mortality in high compared to low expression of HIWI, HILI and PIWIL4 was 1.87 (CI95%: 1.31-2.66, p < 0.05), 1.09 (CI95%: 0.58-2.07, p = 0.79) and 0.44 (CI95%: 0.25-0.76, p < 0.05), respectively. The pooled HR of recurrence in in high compared to low expression of HIWI and HILI was 1.72 (CI95%: 1.20-2.49, p < 0.05) and 1.98 (CI95%: 0.65-5.98, p = 0.23), respectively.LimitationsExclusion of studies not in English; Discrepancy between mRNA and protein levels, and the respective analytical methods; Only one cancer site – PIWI protein pair investigated in three or more studies.Conclusions and Implications of Key FindingsThe prognosis of cancer patients is worse with higher HIWI and lower PIWIL4 expression, although the results are highly variable for different cancers. The expression of these proteins can be used for personalized prognostication and treatment of individual patients.Systematic review registration numberNot registered.

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Systematic review and meta-analysis for the value of thyroid disorder screening in men with ejaculatory dysfunction

10.22541/au.161646210.03509101/v1 ◽

2021 ◽

Author(s):

Ahmet Cihan ◽

Ahmet Adil Esen

Keyword(s):

Clinical Studies ◽

Meta Analysis ◽

Thyroid Stimulating Hormone ◽

Synthesis Methods ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

Eligibility Criteria ◽

Delayed Ejaculation ◽

Ejaculatory Dysfunction ◽

Serum Tsh

Abstract Objective: To demonstrate evidence from available clinical studies to clarify the scientific points that have been achieved in relation to thyroid disorders and ejaculatory dysfunction. Data sources: Clinical trial articles published in English on Medline. Eligibility criteria: Clinical studies that investigated the association of thyroid disorders with the ejaculatory function of subjects and the trials evaluating the effect of thyroid dysfunction treatment on the ejaculatory function of the subjects were eligible. Synthesis methods: We searched Medline with “ejaculation” and different combinations of “thyroid,” “serum TSH,” “serum T3,” “serum T4” keywords in PubMed. Results: Standardized mean serum thyroid-stimulating hormone (TSH) levels in premature ejaculation (PE) sufferers differed from non-PE control subjects (p=.05). Hyperthyroidism was associated with increased odds among PE subjects (OR=2.0, p=.03). Delayed ejaculation was seen with increased odds in hypothyroid patients compared with hyperthyroidism patients (OR=57, p=.0001). Serum TSH and mean intra-vaginal ejaculation latency time (IELT) of the subjects showed a correlation both before and after treatment for thyroid disorder. Treatment of thyroid disorders improved the mean IELT measures of the subjects. The overall estimate of the effect of hyperthyroidism treatment on mean IELT was .64 (p=.0001) in the random-effects model. Limitations: The low quality and quantity of evidence from available studies limited the interpretation of our study findings. Conclusions: The causal relationship between ejaculatory dysfunction and thyroid disorders remains to be clarified. Sufferers of delayed ejaculation acquired PE subjects, and PE sufferers who have accompanying erectile dysfunction and/or anxiety may benefit from thyroid disorder investigation.

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The incidence of dentinal cracks during root canal preparations with reciprocating single-file and rotary-file systems: A meta-analysis

Dental Materials Journal ◽

10.4012/dmj.2016-208 ◽

2017 ◽

Vol 36 (3) ◽

pp. 243-252 ◽

Cited By ~ 1

Author(s):

Xi WEI ◽

Bo HU ◽

Haiyang PENG ◽

Ming TANG ◽

Jinlin SONG

Keyword(s):

Root Canal ◽

Meta Analysis ◽

File Systems ◽

Single File

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Metagenomic Assessment of Different Interventions for Treatment of Chronic Periodontitis: A Systematic Review and Meta-Analysis

The Open Dentistry Journal ◽

10.2174/1874210601913010557 ◽

2019 ◽

Vol 13 (1) ◽

pp. 557-566

Author(s):

Jazia A. Alblowi ◽

Ayat Gamal-Abdel Naser

Keyword(s):

Chronic Periodontitis ◽

Meta Analysis ◽

Grey Literature ◽

Risk Of Bias ◽

The Body ◽

Synthesis Methods ◽

Eligibility Criteria ◽

Before And After ◽

Furcation Involvement ◽

Enamel Matrix Derivatives

Background: Chronic periodontitis is attributed to oral microbial imbalance and host inflammatory reaction. Objective: Our review addresses the question of: Are the available interventions able to regain oral microbial balance in patients having chronic periodontitis? Data Sources: We performed a comprehensive systematic search of MEDLine via Pubmed, Cochrane CENTRAL, Clinicalkey, Clarivate Analytics, Springer materials, Wiley, SAGE, Elsevier, Taylor & Francis group, and Wolter Kluwer, together with hand searching and searching the grey literature. Eligibility Criteria: We included interventional studies testing the microbiome analysis using metagenomic techniques as an outcome to any intervention for chronic periodontitis. Study Appraisal and Synthesis Methods: All studies were imported in Mendeley. The risk of bias was assessed using the specific tool for each study design. The results were analysed using RevMan. All the review steps were performed in duplicates. Results: The search yielded 2700 records. After exclusion steps, 10 records were found eligible. We included 5 RCTs, 1 non-RCT, 3 before-and-after studies, and 1 ongoing study. The studies tested non-surgical periodontal treatment with and without antibiotic coverage, probiotics, sodium hypochlorite rinse, and different toothpaste ingredients. One RCT tested the use of enamel matrix derivatives in cases with furcation involvement. Limitations: The eligible available studies were small in number. Also, the risk of bias and lack of a standardized protocol impaired the ability to pool all the results. Conclusions: The body of the available evidence is not sufficient, and future studies are recommended to better evaluate the effect of periodontal treatments on the periodontal microbiome.

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Accuracy of mRNA HPV Tests for Triage of Precursor Lesions and Cervical Cancer: A Systematic Review and Meta-Analysis

Journal of Oncology ◽

10.1155/2019/6935030 ◽

2019 ◽

Vol 2019 ◽

pp. 1-14 ◽

Cited By ~ 3

Author(s):

Ana Cristina L. Macedo ◽

João Carlos N. Gonçalves ◽

Daniela Vicente Bavaresco ◽

Antonio José Grande ◽

Napoleão Chiaramonte Silva ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Meta Analysis ◽

Grey Literature ◽

Intraepithelial Neoplasia ◽

Hpv Infection ◽

Superior Performance ◽

Cochrane Library ◽

Synthesis Methods ◽

Eligibility Criteria

Objective. This systematic review evaluates the accuracy of the mRNA HPV biomarker in cervical smears to identify cervical intraepithelial neoplasia (CIN) 2 or 3 and cervical cancer. Data Source. Eligible studies were identified by performing a search of electronic databases on Medline via Pubmed, Lilacs, Cochrane Library, Embase, and Grey literature for papers published between January 1990 and June 2018. Study Eligibility Criteria. As no randomized studies were identified, this review focuses on observational studies in which the mRNA HPV diagnostic test was compared to a histopathology reference standard. We analyzed studies that included women screened for cervical cancer using mRNA HPV. Study Appraisal and Synthesis Methods. After screening, 61 studies including 29,674 patients met the inclusion criteria and were analyzed. Dichotomization was performed by defining CIN2 or worse (CIN2+) versus CIN1, HPV infection, and normal (CIN 1-). The analysis was discriminated by the following tests: Aptima, PreTect HPV Profeer, NucliSens EasyQ HPV, OncoTect, and Quantivirus. Results. Analyzing by technique, Aptima, with 28 studies, exhibited superior performance, showing for the outcomes CIN2+ and CIN3+ an AUC of 0.88 (0.82-0.95) and 0.91 (0.84-0.99), a pooled sensitivity of 92.8% (95%CI 91.9-93.7) and 95.6% (95%CI 94.5-96.5), and a pooled specificity of 60.5% (95%CI 59.8-61.3) and 61.9% (95%CI 61.1-62.7), respectively. Conclusion. This study supports the current hypothesis that the mRNA HPV assay is an adequate tool for secondary cervical cancer screening.

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Prevalence of hyperuricemia in adolescents from 2000 to 2019 in Asia: A meta-analysis

10.21203/rs.3.rs-16198/v2 ◽

2020 ◽

Author(s):

Lihui Chen ◽

Shuguang Han ◽

Fengjing Liu ◽

Si Chen ◽

Xiaoting Chen ◽

...

Keyword(s):

Publication Bias ◽

Age Of Onset ◽

Meta Analysis ◽

Mainland China ◽

Cochrane Library ◽

Synthesis Methods ◽

Eligibility Criteria ◽

Cross Sectional ◽

Author Study ◽

The Impact

Abstract Background: Studies of the prevalence of hyperuricemia in adolescents have been limited to specific areas and the prevalence in Asia is unknown. Objectives: This study was to determine the prevalence of hyperuricemia in adolescents in Asia from 2000 to 2019.Data sources: A comprehensive search was conducted to identify all relevant cross-sectional studies in Pubmed, Embase, and Cochrane library databases.Study eligibility criteria: “hyperuricemia” and “adolescent” were the two critical inclusion criteria. Participants, and interventions: Adolescents;Study appraisal and synthesis methods: Two reviewers independently extracted data and assessed study quality using STROBE check list. Extracted information included the first author, study year, country, publication year, sample size, number of cases, and age of onset. Heterogeneity among studies was evaluated using the Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger’s test. Results: The meta-analysis included 11 articles. The pooled prevalence of hyperuricemia in adolescents in Asia was 15.4% (95% CI 9.5-21.2%) and the prevalence of adolescents in Taiwan was higher than that in mainland China. The prevalence in coastal areas was higher than that in inland areas. The prevalence of men was higher than that of women. After excluding the high prevalence study in Taiwan, the prevalence of adolescents has been increasing year by year. Publication bias was observed but the results did not change after a trim and fill test, indicating that the impact of this bias was likely insignificant.Limitations: The diagnostic criteria for hyperuricemia for adolescents varied among the studies; some studies used their own cut-off values for hyperuricemia in adolescents.Conclusions and implications of key findings: Hyperuricemia prevalence in adolescents is high and continues to increase. The prevalence varies with geography, gender, and time. Effective measures should be taken to prevent any further increase in the incidence of adolescent hyperuricemia.Systematic review registration number: Not applicable.

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Evaluation of Dentinal Crack Formation by ProTaper Next, HyFlex CM and Wave One Reciprocating File Systems at the Apical and Middle Third of Root in Mandibular Molars - An In-Vitro Scanning Electron Microscope Analysis

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/532 ◽

2021 ◽

Vol 10 (32) ◽

pp. 2597-2601

Author(s):

Gis George ◽

Ranjini M. A ◽

Swapna D. V ◽

Rashmi K ◽

Jesline Merly James ◽

...

Keyword(s):

Electron Microscope ◽

Scanning Electron Microscope ◽

Root Canal ◽

Crack Formation ◽

File Systems ◽

Mandibular Molars ◽

Significant Difference ◽

Niti Instruments ◽

Scanning Electron

BACKGROUND Advances in root canal instruments have led to lesser frequency of dentinal crack formation. Not many studies have been reported in literature that compare crack formation using instruments based on control memory (CM) and M wire technology. The study intended to evaluate and compare the prevalence of dentinal cracks formed by ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex CM (Coltene, Whaldent) and Wave One (Dentsply, Maillefer) reciprocating file systems at the apical and middle third of the mesiobuccal root canal of mandibular molars under scanning electron microscope (SEM). METHODS Forty-five extracted sound human mandibular molars were decoronated and mesial roots were retained followed by root canal instrumentation using ProTaper Next, HyFlex CM and WaveOne reciprocating files. Roots were then sectioned perpendicular to the long axis of teeth and viewed under scanning electron microscope to detect the presence of cracks. RESULTS ProTaper Next system produced more cracks compared with HyFlex and Wave One (P < 0.05) but there was no statistically significant difference between all the three groups. All the file systems showed more incidences of cracks in the apical third compared to middle third. CONCLUSIONS All the NiTi instruments produced cracks and the highest incidence of cracks was seen in the apical third compared to middle third region. KEY WORDS Dentinal Cracks, HyFlex CM, ProTaper Next, Root Canal, Wave One

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The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8071821 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Guiyu Feng ◽

Mei Han ◽

Xun Li ◽

Le Geng ◽

Yingchun Miao

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Grey Literature ◽

Clinical Effectiveness ◽

Cochrane Library ◽

Controlled Trials ◽

Synthesis Methods ◽

China National Knowledge Infrastructure ◽

Eligibility Criteria ◽

Randomized Controlled

Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.

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