Orally Administered Probiotics Decrease Aggregatibacter actinomycetemcomitans but Not Other Periodontal Pathogenic Bacteria Counts in the Oral Cavity: A Systematic Review and Meta-Analysis

Introduction: At the initial part of the gastrointestinal tract, multiple tissues serve the normal function of food delivery. Periodontal structures are integral elements of these. When they deteriorate, it is extremely challenging to regenerate and reconstruct them. The conventional intervention for periodontal disease is scaling and root planning with the aim of reducing pathogenic bacteria. However, periodontal pathogens can rapidly recolonize treated areas. Probiotics have been proposed as novel tools for managing oral health by suppressing pathogenic bacteria through their anti-inflammatory effect, but the available data are controversial.Aim: Therefore, we performed a meta-analysis to study the effect of probiotics on periodontal pathogenic bacteria.Methods: The study was registered in PROSPERO under registration number CRD42018094903. A comprehensive literature search from four electronic databases (PubMed, Cochrane CENTRAL, Embase, and Web of Science) yielded nine eligible records for statistical analysis. Studies measuring bacterial counts in saliva and supra- and subgingival plaque were included. Bacterial counts were analyzed using standard mean difference (SMD) and by a random effects model with the DerSimonian–Laird estimation.Results: The results showed a significant decrease in the overall count of Aggregatibacter actinomycetemcomitans in the probiotic-treated group compared to the control at 4 weeks (SMD: −0.28; 95% CI: −0.56–−0.01; p = 0.045) but not later. Analyzing the bacterial counts in subgroups, namely, in saliva and supra- and subgingival plaque, separately, yielded no significant difference. Probiotics had no significant effect on the overall count of Porphyromonas gingivalis at 4 weeks (SMD: −0.02; 95% CI: −0.35−0.31; p = 0.914) or later. Subgroup analysis also revealed no significant difference between treatment and control groups nor did probiotics significantly decrease the overall and subgroup bacterial counts of Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum.Conclusion: Our data support the beneficial effect of probiotics in reducing A. actinomycetemcomitans counts, but not of other key periodontal pathogenic bacteria in periodontal disease patients. However, due to the complex mechanism associated with periodontal disease and the limitations of the available studies, there is a further need for well-designed randomized clinical trials to assess the efficacy of probiotics.

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Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis

Operative Dentistry ◽

10.2341/19-064-l ◽

2020 ◽

Vol 45 (6) ◽

pp. 589-597

Author(s):

BGS Casado ◽

EP Pellizzer ◽

JR Souto Maior ◽

CAA Lemos ◽

BCE Vasconcelos ◽

...

Keyword(s):

Randomized Clinical Trials ◽

Color Change ◽

Meta Analysis ◽

Present Review ◽

Cochrane Library ◽

Light Sources ◽

Eligibility Criteria ◽

Tooth Color ◽

Significant Difference ◽

Meta Analyses

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

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Comparison of Sampling Techniques For qPCR Quantification of Periodontal Pathogens

Revista de Chimie ◽

10.37358/rc.17.12.5993 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2853-2856 ◽

Cited By ~ 3

Author(s):

Igor Jelihovschi ◽

Cristian Drochioi ◽

Aida Corina Badescu ◽

Raoul Vasile Lupusoru ◽

Alexandra Elena Munteanu ◽

...

Keyword(s):

Periodontal Disease ◽

Periodontal Diseases ◽

Pcr Analysis ◽

Treponema Denticola ◽

Subgingival Plaque ◽

Periodontal Pathogens ◽

Radiographic Evidence ◽

Gingival Bleeding ◽

As Species ◽

Qpcr Quantification

The diagnosis of periodontal disease is mainly based on use of clinical and radiographic evidence. In this study we employed a quantitative PCR analysis of Aggregatibacter actinomycetemcomitans and Treponema denticola as species strongly involved in periodontal diseases, burden in periodontal pockets to detect the main sampling factors that interfere with qPCR results. From 22 patients with advanced periodontal disease, subgingival plaque was comparatively collected by paper points and periodontal Gracey curettes. Samples were collected from the same situs in presence of gingival bleeding and absence of bleeding. The concordance and agreement of results between samples were assessed. The present study demonstrates that subgingival plaque sampling with sterile absorbable paper points is often accompanied by gingival bleeding resulting in quantification biases of periodontal pathogens.

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Antimicrobial Efficacy of Propolis in Comparison to Chlorhexidine against Enterococcus faecalis: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app11083469 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3469

Author(s):

Khalid H. Almadi ◽

Muhammad Adeel Ahmed ◽

Tuba Ghazal ◽

Rizwan Jouhar ◽

Mazen F. Alkahtany ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Meta Analysis ◽

Mean Difference ◽

Permanent Teeth ◽

Antibacterial Efficacy ◽

Chi Square ◽

Reporting Standard ◽

Standard Mean Difference ◽

Significant Difference ◽

Chi Square Test

Propolis is proposed to possess antibacterial and anti-inflammatory properties, which can be used in endodontic applications. However, evidence on its efficacy in comparison to chlorhexidine against Enterococcus faecalis (E. faecalis) is controversial. The aim of the current study was to compare the antibacterial efficacy of Propolis and chlorhexidine as an intracanal medicament against E. faecalis in extracted human permanent teeth. The focused question was, “Does Propolis show better antibacterial efficacy than Chlorhexidine (CHX) as an intracanal medicament against E. faecalis in extracted human permanent teeth?”. Databases including PubMed/Medline, Scopus, EMBASE, ISI-Web of Science were searched from 1990 to August 2020 using different combinations of the following keywords: “Propolis”, “Intracanal medicament”, “E. faecalis”, “Antibacterial activity” and “Chlorhexidine”. Ten studies fulfilling inclusion criteria were considered for qualitative analysis, followed by quantitative analysis of eight studies. Heterogeneity was calculated for colony forming units (CFU) of E. Faecalis using the Chi-square test and I2 statistics. Forest plots were computed reporting standard mean difference (SMD) of outcomes and 95% confidence intervals. The overall mean difference for CFU of E. faecalis showed a statistically significant difference between the antibacterial efficacy of Propolis and CHX (SMD = 3.20 [1.70, 4.69] Z = 4.20; p < 0.001). CHX showed superior antibacterial efficacy against E. faecalis compared to Propolis.

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Acupuncture for post-stroke depression: a systematic review and meta-analysis

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03277-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ran Liu ◽

Kun Zhang ◽

Qiu-yu Tong ◽

Guang-wei Cui ◽

Wen Ma ◽

...

Keyword(s):

Adverse Events ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Quality Of Evidence ◽

Post Stroke ◽

Assessment Development ◽

Significant Difference ◽

Post Stroke Depression ◽

Meta Analyses

Abstract Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. Conclusions The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.

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Effectiveness of Single-surface ART Restorations in the Permanent Dentition: A Meta-analysis

Journal of Dental Research ◽

10.1177/154405910408300207 ◽

2004 ◽

Vol 83 (2) ◽

pp. 120-123 ◽

Cited By ~ 93

Author(s):

J.E. Frencken ◽

M.A. van ’t Hof ◽

W.E. van Amerongen ◽

C.J. Holmgren

Keyword(s):

Randomized Clinical Trials ◽

Meta Analysis ◽

Permanent Teeth ◽

Atraumatic Restorative Treatment ◽

Restorative Treatment ◽

The Past ◽

Significant Difference ◽

Maximum Period ◽

Amalgam Restorations ◽

Late Group

Over the past few years, there has been an increase in the number of studies reporting on various aspects of the Atraumatic Restorative Treatment (ART) approach. Five randomized clinical trials in which ART restorations with glass ionomers were compared with amalgam restorations in permanent teeth for a maximum period of 3 yrs constituted the database. This meta-analysis divided the publications into ‘early’ (1987–1992) and ‘late’ (1995-) studies on the basis of improvements in the approach. The analysis showed that, in the ‘early’ studies, single-surface amalgam restorations survived statistically significantly longer than comparable ART restorations after 1, 2, and 3 yrs. This trend did not continue into the late group of studies; no statistically significant difference between the 2 types of restorations was found. Based on the available data, it appears that there is no difference in survival results between single-surface ART restorations and amalgam restorations in permanent teeth over the first 3 yrs.

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Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00237-5 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Ahmed M. Ahmed ◽

Osama G. Hassan ◽

Ahmed A. Khalifa

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Pinch Strength ◽

Symptom Severity Scale ◽

Significant Difference ◽

Tunnel Syndrome

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.

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Abstract 1122‐000223: Direct to Angiography Suite versus Conventional Imaging in Suspected Large Vessel Occlusion Strokes: A Meta‐Analysis

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000223 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Mahmoud H Mohammaden ◽

Mohamed Elfil ◽

Mohamed Fahmy Doheim ◽

Agostinho Camara Pinheiro ◽

Alhamza R Al‐Bayati ◽

...

Keyword(s):

Randomized Clinical Trials ◽

Meta Analysis ◽

Functional Independence ◽

Large Vessel ◽

Cochrane Library ◽

Conventional Imaging ◽

Large Vessel Occlusion ◽

Vessel Occlusion ◽

Angiography Suite ◽

Significant Difference

Introduction : Direct transfer to angiography suite (DTAS) for patients with suspected large vessel occlusion strokes potentially requiring mechanical thrombectomy has been shown to shorten treatment times and improve outcomes compared to conventional imaging (CI) selection. This meta‐analysis compares both approaches to build more concrete evidence. Methods : The potentially relevant studies that were published in four electronic databases/search engines (PubMed, Web of Science, Cochrane Library, and Scopus) till August 2021 were reviewed. Eligible studies were included if they enrolled >10 patients in both groups, were published in English and reported baseline and procedural characteristics and 90‐day outcomes. Relevant data were then extracted and analyzed. Results : Among 4514 searched studies, six qualified for the analysis. Time from door to puncture (MD = ‐26.76minutes, 95 % CI [‐39.48, ‐14.03], P< 0.0001) as well as door to reperfusion (MD = ‐27.21 minutes,95% CI [‐47.42, ‐7.01], P = 0.008) were significantly shorter and the rates of functional independence(mRS0‐2: RR = 1.28, 95% CI [1.03, 1.60], P = 0.03) at 90‐days were significantly higher in the DTAS versus the CI approach. There was no statistically significant difference between DTAS and CI groups in terms of successful reperfusion (modified Thrombolysis In Cerebral Infraction [mTICI] score2B‐3: RR = 0.99, 95% CI [0.93, 1.06], P = 0.86), near complete/ full reperfusion (mTICI 2C‐3: RR = 0.84,95% CI [0.68, 1.04], P = 0.11), or fair outcomes at 90‐days (mRS 0–3: RR = 1.05, 95% CI [0.67, 1.64],P = 0.84). Moreover, there was no difference between groups regarding symptomatic intracranial hemorrhage (RR = 0.81, 95% CI [0.55, 1.17], P = 0.26) or 90 day‐mortality (RR = 0.85, 95% CI [0.59, 1.24],P = 0.41). Conclusions : Our meta‐analysis showed that DTAS significantly improves time metrics and functional outcome with comparable safety to the CI approach. Multicenter randomized clinical trials are ongoing to confirm these results.

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Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.654711 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mohit Agrawal ◽

Kanwaljeet Garg ◽

Raghu Samala ◽

Roopa Rajan ◽

Vikas Naik ◽

...

Keyword(s):

Essential Tremor ◽

Focused Ultrasound ◽

Rating Scale ◽

Meta Analysis ◽

Post Procedure ◽

Standard Mean Difference ◽

Significant Difference ◽

Long Term Follow Up

Background: Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET.Methods: A systematic literature review was done. The post procedure changes in the Clinical Rating Scale for Tremor (CRST) score, hand score, disability and quality of life scores were analyzed.Results: We found 29 studies evaluating 617 patients. DTI based targeting was utilized in six cohorts. A significant difference was observed in the pooled standard mean difference between the pre and postoperative total CRST score (p-value < 0.001 and 0.0002), hand score (p-value 0.03 and 0.02); and the disability at 12 months (p-value 0.01). Head pain and dizziness were the most in procedure complications. The immediate pooled proportion of ataxia was 50%, while it was 20% for sensory complications, which, respectively, declined to 31 and 13% on long term follow up. A significant reduction (p = 0.03) in immediate ataxia related complications was seen with DTI targeting.Conclusion: MRgFUS for ET seems to be an effective procedure for relieving unilateral tremor. Use of DTI based targeting revealed a significant reduction in post procedure ataxia related complications as compared to traditional targeting techniques. Analysis of other complications further revealed a decreasing trend on follow up.

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Comparison of Oral Hygiene Status and Relative Abundance of Periodontal Pathogens Between Individuals With and Without Intellectual Disabilities: a Cross-Sectional Study

10.21203/rs.3.rs-49931/v1 ◽

2020 ◽

Author(s):

Yuki Oda ◽

Chiaki Furutani ◽

Reo Kawano ◽

Jumpei Murakami ◽

Yuika Mizota ◽

...

Keyword(s):

Periodontal Disease ◽

Relative Abundance ◽

Outpatient Clinic ◽

High Throughput Sequencing ◽

Analysis Of Covariance ◽

University Hospital ◽

Permanent Teeth ◽

Control Group ◽

Periodontal Pathogens ◽

Significant Difference

Abstract Background: Studies have reported a high prevalence of periodontal disease in individuals with intellectual disability (ID). The aim of this study was to compare the relative abundance of periodontal pathogens (red, orange, yellow, purple, and green complexes) between individuals with ID and healthy controls.Methods: Of the 31 subjects enrolled in this study, 16 with severe ID were selected from the outpatient clinic of the Special Care Dentistry of Hiroshima University Hospital, and 14 healthy subjects were selected from the outpatient clinic of another department at the same hospital. Dental plaque was sampled after oral examination. Decayed, missing, and filled permanent teeth (DMFT) counts were obtained and periodontal measurements were taken using the papillary-marginal-attached (PMA) index, plaque index (PI), gingival index (GI), and probing depth (PD). Gene sequencing (16S rRNA) was performed for each sample using next-generation high-throughput sequencing methods. The relative abundance of the periodontal pathogens and the clinical parameters were compared. An unpaired t-test was used to compare the oral health status in both groups and analysis of covariance was performed to compare the relative abundance of each pathogen.Results: No statistically significant difference in DMFT was observed between the two groups. However, significant differences in the median PMA index, PI, and GI were noted between the groups (P < 0.0001). In addition, the mean PD in the ID group was significantly higher than that in the control group (P < 0.0001). The relative abundances of Tannerella spp. and Treponema spp. were significantly higher in the ID group when compared to the control group at the genus level (P = 0.0383 and 0.0432, respectively); alternatively, the relative abundance of Porphyromonas spp. was significantly lower in the ID group (P < 0.0001).Conclusions: The PMA index, PI, GI, and PD were significantly lower in the ID group than in the control group. On the other hand, no significant difference in DMFT was observed between the two groups. Furthermore, our findings indicate that Tannerella forsythia might be more closely associated with periodontal disease than Porphyromonas gingivalis in individuals with ID.

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Assessment of the Ovarian Reserve by Serum Anti-Müllerian Hormone in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis

International Archives of Allergy and Immunology ◽

10.1159/000520133 ◽

2021 ◽

pp. 1-8

Author(s):

Xian-hui Zhang ◽

Ying-an Zhang ◽

Xin Chen ◽

Peng-yan Qiao ◽

Li-yun Zhang

Keyword(s):

Rheumatoid Arthritis ◽

Ovarian Reserve ◽

Meta Analysis ◽

Cochrane Library ◽

Dmard Treatment ◽

Standard Mean Difference ◽

Increased Risk ◽

Significant Difference ◽

Newcastle Ottawa Scale ◽

The Cochrane Library

Background: The ovarian reserve has been reported to be diminished in patients with rheumatoid arthritis. However, these results are still controversial. Anti-Müllerian hormone (AMH) is considered a reliable biomarker for the ovarian reserve. We thus performed a meta-analysis to evaluate the AMH levels and the effect of DMARDs on the ovarian reserve in rheumatoid arthritis patients. Methods: PubMed, EMBASE, the Cochrane Library, and 2 Chinese databases (CNKI and Wanfang database), up to September 2021, were searched for relevant studies. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Pooled standard mean difference (SMD) with 95% confidence intervals (CIs) were determined with the random-effects model. The heterogeneity was described by I2 statistic and p value from the Cochrane Q test. Results: Eight eligible studies (679 patients and 1,460 controls) were included in the meta-analysis. Compared with healthy control, the AMH levels in RA patients were significantly lower with the pooled SMD of −0.40 (95% CI: −0.66 to −0.14). However, in comparison of AMH with and without DMARD treatment, there was no significant difference with the pooled SMD of −0.1 (95% CI: −0.39 to 0.19). Conclusion: The results indicated that there was an increased risk of ovarian failure in RA patients and which is not related to DMARD treatment.

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