Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis

A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = −0.001; p = 0.001) and the onlay material used (beta = −0.064; p = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.

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Clinical Behavior and Complications of Mandibular Full-Arch Fixed Dental Prostheses Supported by Three Dental Implants. A Systematic Review and Meta-Analysis

Biology ◽

10.3390/biology10040308 ◽

2021 ◽

Vol 10 (4) ◽

pp. 308

Author(s):

Luis Sánchez-Labrador ◽

Pedro Molinero-Mourelle ◽

Jorge Cortés-Bretón Brinkmann ◽

Juan Carlos Prados-Frutos ◽

Miguel Gómez-Polo ◽

...

Keyword(s):

Systematic Review ◽

Survival Rate ◽

Dental Implants ◽

Meta Analysis ◽

Clinical Behavior ◽

Manual Search ◽

Dental Prostheses ◽

Edentulous Mandible ◽

Patient Reported

This systematic review and meta-analysis set out to assess the clinical behavior of mandibular implant-supported fixed complete dental prostheses (ISFCDP) on three dental implants by analyzing implant and prosthetic survival rates, marginal bone loss, biological/technical complications, and patient-reported outcomes. The review was conducted according to PRISMA guidelines. Electronic searches were conducted in the Medline (PubMed), Web of Science, and Cochrane databases, complimented by a manual search in specialist journals for relevant articles published up to February 2021. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence in the studies reviewed. The study included 13 articles with 728 patients treated with 2184 implants. A mean implant survival rate of 95.9% (95% CI: 94.6–97.3%) and a prosthetic survival rate of 97.0% (95% CI: 95.7–98.3%) were obtained over 1–6-year follow-up periods. Mandibular implant-supported fixed complete dental prostheses on three dental implants would appear to be a viable option for restoring the edentulous mandible in comparison with mandibular ISFCDP on more than three implants. Further comparative studies are needed, with adequate protocols, as well as sufficient sample sizes and follow-up periods to confirm these findings.

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Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis

Gerontology ◽

10.1159/000517099 ◽

2021 ◽

pp. 1-16

Author(s):

Jane Xu ◽

Ching S. Wan ◽

Kiriakos Ktoris ◽

Esmee M. Reijnierse ◽

Andrea B. Maier

Keyword(s):

Systematic Review ◽

Working Group ◽

Meta Analysis ◽

Nursing Home Residents ◽

Community Dwelling ◽

Risk Of Mortality ◽

European Working ◽

Subgroup Analyses ◽

Meta Analyses

Background: Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis. Objective: This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. Methods: A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria – cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. Results: Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. Conclusions: Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.

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Effectiveness of e-cigarettes in smoking cessation: a systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1226 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Oberndorfer ◽

I Grabovac ◽

S Haider ◽

T E Dorner

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Meta Analysis ◽

Current Evidence ◽

Promising Alternative ◽

Quality Of Evidence ◽

Different Populations ◽

Meta Analyses

Abstract Background Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to synthesise the current evidence regarding the effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy (NRT) and or counselling) published between 01/01/2014 and 01/05/2019. Data from eligible studies were extracted and used for random-effects meta-analyses. Results Our literature review yielded 13190 publications with 10 studies being identified as eligible for systematic review, covering 8362 participants, and 8 for meta-analyses (n = 30 - 6006). Using the last follow-up of eligible studies, the proportion of smokers achieving abstinence was 1.67 [95CI:0.99 - 2.81] times higher in nicotine EC users compared to non-nicotine EC users. The proportion of abstinent smokers was 1.69 [95CI:1.25 - 2.27] times higher in EC users compared to participants receiving NRT. EC users showed a 2.70 [95CI:1.15 - 6.30] times higher proportion of abstinent smokers in comparison to participants solely receiving counselling. Conclusions Our analysis showed modest effects of nicotine-ECs compared to non-nicotine ECs. When compared to NRT or counselling, results suggest that nicotine EC may be more effective for smoking cessation. As ECs also help maintaining routinized behaviour and social aspects of smoking, we hypothesise that this may explain their advantage as a tool for smoking cessation. However, given the small number of included studies, different populations, heterogeneous designs, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. More comparable data is needed to strengthen confidence in the quality of evidence. Key messages The number of previous studies assessing the effectiveness of ECs for smoking cessation is limited. Further, comparability of these studies is restricted, weakening the quality of evidence. Although current evidence on the effectiveness of ECs for smoking cessation is inconclusive, our meta-analyses suggest that ECs could be a promising alternative tool in attempts to achieve abstinence.

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Can nurses improve self-management among pediatric patients? A systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckz185.604 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Mele ◽

A Nardi ◽

G P Prencipe ◽

G Migliara ◽

A Massimi ◽

...

Keyword(s):

Systematic Review ◽

Educational Intervention ◽

Pediatric Patients ◽

Meta Analysis ◽

Educational Interventions ◽

Risk Of Bias ◽

Ed Visits ◽

Meta Analyses ◽

Almost All

Abstract Background Few studies report educational interventions for pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them and improve their health. The aim of this systematic review and meta-analysis was to synthesize evidence about behavioral changes in life style, disease management and clinical outcome in pediatric patients after a structured educational intervention delivered by nurses. Methods A systematic review of the literature was carried out in MEDLINE, Scopus and CINHAL including only RCTs. Methodological quality of the studies was assessed using Cochrane tool. Meta-analyses on HbA1c reduction for diabetes and hospitalization, emergency department (ED) visits and medication for asthma were carried-out. Results Of the 3559 papers initially retrieved, 5 regarding diabetes and 19 asthma met the inclusion criteria for the systematic review and 14 for the meta-analyses. Included studies were highly heterogeneous in terms of type of intervention and follow-up duration. Almost all the studies showed an improvement but only few were statistically significant. All studies regarding diabetes showed a low risk of bias (only one RCTs had a high risk of bias in one domain), while almost all RCTs on asthma showed a high risk of bias. The pooled mean differences in favor of the experimental groups were: HBA1c -0.02 (IC95%: -0.26 - 0.22), Hospitalization 0.58 (IC95%: 0.19 - 1.78), Medication -0.10 (IC95%: -0.43 - 0.23), ED Visits 0.82 (IC95%: 0.44 - 1.54). Conclusions There is a general agreement about the central role of educational intervention delivered by nurses to pediatric patients and the assessment of the behavioral changes after educational interventions is strongly recommended in pediatric population. However, more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients in the management of their own chronic disease. Key messages educational intervention delivered by nurses to pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them. more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients.

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Retention strategies in longitudinal cohort studies: A systematic review and meta-analysis

10.31234/osf.io/fzk2w ◽

2018 ◽

Author(s):

Samantha Teague ◽

George Joseph Youssef ◽

Jacqui A Macdonald ◽

Emma Sciberras ◽

Adrian B. R. Shatte ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Retention Rate ◽

Meta Analysis ◽

Retention Strategies ◽

Longitudinal Cohort ◽

Research Designs ◽

Reduction Strategies ◽

Meta Analyses

Background: Participant retention strategies that minimise attrition in longitudinal cohort studies have evolved considerably in recent years. This study aimed to assess, via systematic review and meta-analysis, the effectiveness of both traditional strategies and contemporary innovations for retention adopted by longitudinal cohort studies in the past decade.Methods: Health research databases were searched for retention strategies used within longitudinal cohort studies published in the 10-years prior, with 142 eligible longitudinal cohort studies identified (140 articles; sample size range: 30 to 61,895). Details on retention strategies and rates, research designs, and participant demographics were extracted. Meta-analyses of retained proportions were performed to examine the association between cohort retention rate and individual and thematically grouped retention strategies.Results: Results identified 95 retention strategies, broadly classed as either: barrier-reduction, community-building, follow-up/reminder, or tracing strategies. Forty-four of these strategies had not been identified in previous reviews. Meta-regressions indicated that studies using barrier-reduction strategies retained 10% more of their sample (95%CI [0.13 to 1.09]; p=.01); however, studies using follow-up/reminder strategies lost an additional 10% of their sample (95%CI [-1.19 to -0.21]; p<.01). The overall number of strategies employed was not associated with retention.Conclusions: Employing a larger number of retention strategies may not be associated with improved retention in longitudinal cohort studies, contrary to earlier narrative reviews. Results suggest that strategies that aim to reduce participant burden (e.g., flexibility in data collection methods) might be most effective in maximising cohort retention.

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Prognosis of Regenerative Endodontic Procedures in Mature Teeth: A Systematic Review and Meta-Analysis of Clinical and Radiographic Parameters

Materials ◽

10.3390/ma14164418 ◽

2021 ◽

Vol 14 (16) ◽

pp. 4418

Author(s):

Pantaleo Scelza ◽

Fabiano Gonçalves ◽

Isleine Caldas ◽

Fernanda Nunes ◽

Emanuelle Stellet Lourenço ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Periapical Lesion ◽

Immature Teeth ◽

Radiographic Parameters ◽

Sensitivity Tests ◽

High Incidence ◽

Before And After ◽

Meta Analyses

This work aimed to investigate the use of Regenerative Endodontic Procedures (REP) on the treatment of pulp necrosis in mature teeth through systematic review and meta-analysis of evidence on clinical and radiographic parameters before and after REP. A search was performed in different databases on 9 September 2020, including seven clinical studies and randomized controlled trials (RCT). The methodological quality was assessed using Revised Cochrane risk-of-bias (RoB 2) and Before-and-After tools. Meta-analyses were performed to evaluate the success incidences regarding the reduction of periapical lesion and recovery of sensitivity. The certainty of the evidence was assessed using GRADE. Meta-analysis showed a high overall success of 0.95 (0.92, 0.98) I2 = 6%, with high periapical lesion reduction at 12 months (0.93 (0.86, 0.96) I2 = 37%) and by the end of follow-up (0.91 (0.83, 0.96) I2 = 13%). Lower incidences of positive sensitivity response were identified for the electrical (0.58 (0.46, 0.70) I2 = 51%) and cold tests (0.70 (0.54, 0.84) I2 = 68%). The calculated levels of REP success were similar to those reported for immature teeth. With a very low certainty of evidence, the meta-analysis showed a high incidence of REP’s success for mature teeth with necrotic pulp evidenced by periapical lesion reduction and moderate positive responses to sensitivity tests.

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Hospitalisation and length of hospital stay following first-episode psychosis: systematic review and meta-analysis of longitudinal studies

Psychological Medicine ◽

10.1017/s0033291719000904 ◽

2019 ◽

Vol 50 (6) ◽

pp. 991-1001 ◽

Cited By ~ 2

Author(s):

Olesya Ajnakina ◽

Brendon Stubbs ◽

Emma Francis ◽

Fiona Gaughran ◽

Anthony S. David ◽

...

Keyword(s):

Systematic Review ◽

Longitudinal Studies ◽

Meta Analysis ◽

First Episode Psychosis ◽

Psychotic Symptoms ◽

First Episode ◽

Hospitalised Patients ◽

Episode Psychosis ◽

Over Time

AbstractBackgroundReducing hospitalisation and length of stay (LOS) in hospital following first episode psychosis (FEP) is important, yet reliable measures of these outcomes and their moderators are lacking. We conducted a systematic review and meta-analysis to investigate the proportion of FEP cases who were hospitalised after their first contact with services and the LOS in a hospital during follow-up.MethodsStudies were identified from a systematic search across major electronic databases from inception to October 2017. Random effects meta-analyses and meta-regression analyses were conducted.Results81 longitudinal studies encompassing data for 23 280 FEP patients with an average follow-up length of 7 years were included. 55% (95% CI 50.3–60.5%) of FEP cases were hospitalised at least once during follow-up with the pooled average LOS of 116.7 days (95% CI 95.1–138.3). Older age of illness onset and being in a stable relationship were associated with a lower proportion of people who were hospitalised. While the proportion of hospitalised patients has not decreased over time, LOS has, with the sharpest reduction in the latest time period. The proportion of patients hospitalised during follow-up was highest in Australia and New Zealand (78.4%) compared to Europe (58.1%) and North America (48.0%); and lowest in Asia (32.5%). Black ethnicity and longer duration of untreated psychosis were associated with longer LOS; while less severe psychotic symptoms at baseline were associated with shorter LOS.ConclusionOne in two FEP cases required hospitalisation at least once during a 7-year follow-up with an average length of hospitalisation of 4 months during this period. LOS has declined over time, particularly in those countries in which it was previously longest.

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Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-029826 ◽

2019 ◽

Vol 9 (10) ◽

pp. e029826 ◽

Cited By ~ 3

Author(s):

Qi Yan ◽

Xinyu Wu ◽

Meiying Su ◽

Fang Hua ◽

Bin Shi

Keyword(s):

Systematic Review ◽

Survival Rate ◽

Meta Analysis ◽

Sinus Floor Elevation ◽

Moderate Quality ◽

Short Implants ◽

Posterior Maxilla ◽

Sinus Floor ◽

Quality Evidence

ObjectivesTo compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation.DesignA systematic review and meta-analysis based on randomised controlled trials (RCTs).Data sourcesElectronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed.Eligibility criteriaRCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation were included. Outcome measures included implant survival (primary outcome), marginal bone loss (MBL), complications and patient satisfaction.Data extraction and synthesisRisks of bias in and across studies were evaluated. Meta-analysis, subgroup analysis and sensitivity analysis were undertaken. Quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation.ResultsA total of seven RCTs involving 310 participants were included. No significant difference in survival rate was found for 1–3 years follow-up (RR 1.01, 95% CI 0.97 to 1.04, p=0.74, I²=0%, moderate-quality evidence) or for 3 years or longer follow-up (RR 1.00, 95% CI 0.97 to 1.04, p=0.79, I²=0%, moderate-quality evidence). However, short implants (≤6 mm) showed significantly less MBL in 1–3 years follow-up (MD=−0.13 mm, 95% CI −0.21 to 0.05; p=0.001, I²=87%, low-quality evidence) and in 3 years or longer follow-up (MD=−0.25 mm, 95% CI −0.40 to 0.10; p=0.001, I²=0%, moderate-quality evidence). In addition, short implant (≤6 mm) resulted in fewer postsurgery reaction (RR 0.11, 95% CI 0.14 to 0.31, p<0.001, I²=40%, moderate-quality evidence) and sinus perforation or infection (RR 0.11, 95% CI 0.02 to 0.63, p=0.01, I²=0%, moderate-quality evidence).ConclusionsFor atrophic posterior maxilla, short implants (≤6 mm) are a promising alternative to sinus floor elevation, with comparable survival rate, less MBL and postsurgery reactions. Additional high-quality studies are needed to evaluate the long-term effectiveness of short implants (≤6 mm).Trial registeration numberThe protocol has been registered at PROSPERO (CRD42018103531).

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Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034541 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034541

Author(s):

Charlotte Wahlich ◽

Umar A R Chaudhry ◽

Rebecca Fortescue ◽

Derek G Cook ◽

Shashivadan Hirani ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Community Based ◽

Intervention Effects ◽

Meta Analyses

ObjectiveTo identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months.DesignSystematic review and meta-analysis.Data sourcesSeven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019.Eligibility criteriaRCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded.Data extraction and synthesisTwo independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA).ResultsOf 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies).ConclusionsThere are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits.PROSPERO registration numberCRD42017075753.

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Association of Body Mass Index with Mortality in Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00052 ◽

2016 ◽

Vol 36 (3) ◽

pp. 315-325 ◽

Cited By ~ 19

Author(s):

Seyed-Foad Ahmadi ◽

Golara Zahmatkesh ◽

Elani Streja ◽

Rajnish Mehrotra ◽

Connie M. Rhee ◽

...

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Peritoneal Dialysis ◽

Body Mass ◽

Meta Analysis ◽

Dialysis Patients ◽

Risk Of Death ◽

Study Results ◽

Meta Analyses

Background Although higher body mass index (BMI) is associated with better outcomes in hemodialysis patients, the relationship in peritoneal dialysis (PD) patients is less clear. We aimed to synthesize the results from all large and high-quality studies to examine whether underweight, overweight, or obesity is associated with any significantly different risk of death in peritoneal dialysis patients. Methods We searched MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane CENTRAL, and screened 7,123 retrieved studies for inclusion. Two investigators independently selected the studies using predefined criteria and assessed each study's quality using the Newcastle-Ottawa Quality Assessment Scale. We meta-analyzed the results of the largest studies with no overlap in their data sources. Results We included 9 studies ( n = 156,562) in the systematic review and 4 studies in the meta-analyses. When examined without stratifying studies by follow-up duration, the results of the studies were inconsistent. Hence, we pooled the study results stratified based upon their follow-up durations, as suggested by a large study, and observed that being underweight was associated with higher 1-year mortality but had no significant association with 2- and 3- to 5-year mortalities. In contrast, being overweight or obese was associated with lower 1-year mortality but it had no significant association with 2-, and 3- to 5-year mortalities. Conclusion Over the short-term, being underweight was associated with higher mortality and being overweight or obese was associated with lower mortality. The associations of body mass with mortality were not significant over the long-term.

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