scholarly journals Particulate Production and Composite Dust during Routine Dental Procedures. A Systematic Review with Meta-Analyses

Materials ◽  
2020 ◽  
Vol 13 (11) ◽  
pp. 2513 ◽  
Author(s):  
Anna Iliadi ◽  
Despina Koletsi ◽  
Theodore Eliades ◽  
George Eliades
Keyword(s):  
Systematic Review ◽  
Risk Of Bias ◽  
P Value ◽  
Dental Practice ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Manual Search ◽  
Dust Generation ◽  
Dental Procedures ◽  
Meta Analyses

Composite dust generation is most likely a continuous and daily procedure in dental practice settings. The aim of this systematic review was to identify, compile and evaluate existing evidence on interventions and composite material properties related to the production of aerosolized dust during routine dental procedures. Seven electronic databases were searched, with no limits, supplemented by a manual search, on 27 April 2020 for published and unpublished research. Eligibility criteria comprised of studies of any design, describing composite dust production related to the implementation of any procedure in dental practice. Study selection, data extraction and risk of bias (RoB) assessment was undertaken independently either in duplicate, or confirmed by a second reviewer. Random effects meta-analyses of standardized mean differences (SMD) with associated 95% confidence intervals (CIs) were employed where applicable. A total of 375 articles were initially identified, resulting in 13 articles being included in the qualitative synthesis, of which 5 contributed to meta-analyses overall. Risk of bias recordings ranged between low and high, pertaining to unclear/raising some concerns, in most cases. All types of composites, irrespective of the filler particles, released significant amounts of nano-sized particles after being ground, with potentially disruptive respiratory effects. Evidence supported increased % distribution of particles < 100 nm for nanocomposite Filtek Supreme XTE compared to both conventional hybrid Z100MP (SMD: 1.96, 95% CI: 0.85, 3.07; p-value; 0.001) and nano- hybrid Tetric EvoCeram (SMD: 1.62, 95% CI: 0.56, 2.68; p-value: 0.003). For cytotoxicity considerations of generated aerosolized particles, both nanocomposites Filtek Supreme XTE and nanohybrid GradiO revealed negative effects on bronchial epithelial cell viability, as represented by % formazan reduction at 330–400 μg/mL for 24 hours, with no recorded differences between them (SMD: 0.19; 95% CI: −0.17, 0.55; p-value: 0.30). Effective and more rigorous management of dental procedures potentially liable to the generation of considerable amounts of aerosolized composite dust should be prioritized in contemporary dental practice. In essence, protective measures for the clinician and the practices’ personnel should also be systematically promoted and additional interventions may be considered in view of the existing evidence.

Is dental agenesis associated with craniofacial morphology pattern? A systematic review and meta-analysis

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 ◽  
...  
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Craniofacial Morphology ◽  
Eligibility Criteria ◽  
Manual Search ◽  
Meta Analyses

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 &lt; 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).

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 96 (3) ◽  
pp. 261-269 ◽  
Author(s):  
D.C. Penoni ◽  
T.K.S. Fidalgo ◽  
S.R. Torres ◽  
V.M. Varela ◽  
D. Masterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postmenopausal Women ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Qualitative Synthesis ◽  
Mineral Density ◽  
Clinical Attachment Loss ◽  
Attachment Loss ◽  
Meta Analyses ◽  
Periodontal Attachment

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20–0.49], P < 0.001; osteopenia = 0.07 mm [95% CI, 0.01–0.13], P = 0.02). Only studies with lower risk of bias were available for the analysis of CAL severity. Women with low BMD presented more severe attachment loss, represented as mean percentage of sites with CAL ≥4 mm (osteoporosis = 3.04 [95% CI, 1.23–4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36–3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74–7.40], P < 0.001). This systematic review and meta-analysis indicates that postmenopausal women with osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.

scholarly journals Antioxidants as Adjuvants in Periodontitis Treatment: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-24 ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Nathallia Neves Duarte ◽  
Priscila Cunha Nascimento ◽  
Marcela Barauna Magno ◽  
Nathalia Carolina Fernandes Fagundes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Conventional Therapy ◽  
Meta Analysis ◽  
Clinical Parameter ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Clinical Attachment Loss ◽  
Nonsurgical Periodontal Therapy ◽  
Significant Difference ◽  
Meta Analyses

This systematic review with meta-analysis aimed to evaluate the effect of antioxidants as an adjuvant in periodontitis treatment. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane, Lilacs, OpenGrey, and Google Scholar. Based on the PICO strategy, the inclusion criteria comprised interventional studies including periodontitis patients (participants) treated with conventional therapy and antioxidants (intervention) compared to patients treated only with conventional therapy (control) where the periodontal response (outcome) was evaluated. The risk of bias was evaluated using the Cochrane RoB tool (for randomized studies) and ROBINS-I tool (for nonrandomized studies). Quantitative data were analyzed in five random effects meta-analyses considering the following periodontal parameters: clinical attachment loss (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing depth (PD). After all, the level of certainty was measured with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool. Among the 1884 studies identified, only 15 interventional studies were according to the eligibility criteria and they were included in our review. From them, 4 articles presented a high risk of bias. The meta-analysis showed a statistically significant difference for CAL (SMD 0.29 (0.04, 0.55), p=0.03, I2=13%), PI (SMD 0.41 (0.18, 0.64), p=0.0005, I2=47%), and BOP (SMD 0.55 (0.27, 0.83), p=0.0001, I2=0%). The GRADE tool showed a moderate to high certainty in the quality of evidence depending on the clinical parameter and antioxidants used. These results suggest that the use of antioxidants is an adjunct approach to nonsurgical periodontal therapy which may be helpful in controlling the periodontal status.

scholarly journals Safety Considerations for Thermoplastic-Type Appliances Used as Orthodontic Aligners or Retainers. A Systematic Review and Meta-Analysis of Clinical and In-Vitro Research

Materials ◽  
2020 ◽  
Vol 13 (8) ◽  
pp. 1843 ◽  
Author(s):  
Anna Iliadi ◽  
Despina Koletsi ◽  
Spyridon N. Papageorgiou ◽  
Theodore Eliades
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Current Data ◽  
Risk Of Bias ◽  
P Value ◽  
Laboratory Studies ◽  
Qualitative Synthesis ◽  
Safety Considerations

Use of thermoplastic material in orthodontics, either as aligner or as retainer appliances, is common practice and is likely to increase in the years to come. However, no systematic assessment on safety considerations of these adjuncts has been implemented up to date. The aim of this systematic review was to collectively appraise the existing evidence from both clinical and laboratory studies, on whether these appliances are associated with any estrogenic/cytotoxic effects or bisphenol-A (BPA) and monomer leaching. Eight electronic databases were searched with no limits in December 22, 2019, for published and unpublished research. Eligibility criteria comprised of studies of any design, describing use of any type of thermoplastic aligner. Study selection, data extraction and risk of bias (RoB) assessment was done independently, either in duplicate or confirmed by a second reviewer. Random effects meta-analyses of weighted mean differences (WMD) with associated 95% Confidence Intervals (CIs) were planned. Quality of the evidence was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 58 articles were initially identified, while 5 were included in qualitative synthesis and 2 of those contributed to the quantitative syntheses. Four studies were in-vitro, while one was a randomized controlled trial; all assessed some type of orthodontic aligner or retainer, either as-received or retrieved. Risk of bias recordings ranged between unclear and high for all studies. Proliferation induction capacity of thermoplastic appliances’ eluents on MCF-7 cells failed to be confirmed compared to beta-estradiol (2 studies: 5% v/v, WMD: −182.08; 95% CI: −198.83, −165.33; p-value < 0.001; and 20% v/v, WMD: −184.53; 95% CI: −206.17, −162.88; p-value < 0.001). No cytotoxic activity was detected as well. In addition, although evidence from in-vitro studies was indicative of no traceable detection of BPA or other monomers, the findings from a single clinical trial were allied to increased levels of BPA in whole stimulated saliva, after up to 30 days of thermoplastic retainer usage, compared to standard Hawley retainer. The quality of the evidence overall was low to medium. Current data from in-vitro research are indicative of an absence of an estrogenic or cytotoxic effect of thermoplastic aligners or retainers. Regarding BPA or monomer release, evidence from clinical and laboratory studies appear inconsistent.

scholarly journals Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Shahida Mohd-Said ◽  
Tuti Ningseh Mohd-Dom ◽  
Nawal Suhaimi ◽  
Haslina Rani ◽  
Colman McGrath
Keyword(s):  
Systematic Review ◽  
Bacterial Contamination ◽  
Scientific Basis ◽  
Risk Of Bias ◽  
Dental Procedures ◽  
Mouth Rinses ◽  
Study Characteristics ◽  
Dental Setting ◽  
Meta Analyses ◽  
Mouth Rinsing

Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations.Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting.Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies.Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18–70). Agreement between assessors was high (Kappa &gt;0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias.Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.

Voice, Articulation, and Prosody Contribute to Listener Perceptions of Speaker Gender: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 61 (2) ◽  
pp. 266-297 ◽  
Author(s):  
Yeptain Leung ◽  
Jennifer Oates ◽  
Siew Pang Chan
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Voice Quality ◽  
Significant Risk ◽  
Verbal Communication ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Gender Perception ◽  
Meta Analyses

PurposeThe aim of this study was to provide a systematic review of the aspects of verbal communication contributing to listener perceptions of speaker gender with a view to providing clinicians with guidance for the selection of the training goals when working with transsexual individuals.MethodPreferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines were adopted in this systematic review. Studies evaluating the contribution of aspects of verbal communication to listener perceptions of speaker gender were rated against a new risk of bias assessment tool. Relevant data were extracted, and narrative synthesis was then conducted. Meta-analyses were conducted when appropriate data were available.ResultsThirty-eight articles met the eligibility criteria. Meta-analysis showed speaking fundamental frequency contributing to 41.6% of the variance in gender perception. Auditory-perceptual and acoustic measures of pitch, resonance, loudness, articulation, and intonation were found to be associated with listeners' perceptions of speaker gender. Tempo and stress were not significantly associated. Mixed findings were found as to the contribution of a breathy voice quality to gender perception. Nonetheless, there exists significant risk of bias in this body of research.ConclusionsSpeech and language clinicians working with transsexual individuals may use the results of this review for goal setting. Further research is required to redress the significant risk of bias.

scholarly journals Relationship between Headache and Myofascial Pain: Systematic Review

2021 ◽  
pp. 37-52
Author(s):  
May Wathiq Alkhudhairy ◽  
Ashwag Saleem Aldafiri ◽  
Yara Hamed Alsayegh ◽  
Wesam Saad Bin Saeed ◽  
Nadia Kamal Albather
Keyword(s):  
Systematic Review ◽  
Myofascial Pain ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Double Blind ◽  
Headache Disability ◽  
Meta Analyses ◽  
The Relationship

Aims: To systematically investigate the relationship between headache and myofascial. Study design: Systematic Review. Place and Duration of Study: Department of Oral and Maxillofacial surgery, Riyadh Elm University, Riyadh, Saudi Arabia. Between June 2020 and November 2021. Methodology: A systematic search of the literature was conducted between 2006 and 2019 in seven electronic databases (Brain, Pub Med, ScienceDirect database, NCBI, Web of Science Core Collection, Google Scholar, Scopus, and Saudi digital library). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed and the clinical question in PICO format was the relationship between headache and myofascial pain. The initial search resulted in 663 articles. Only 9 studies were selected for qualitative synthesis after fulfilling the eligibility criteria (three double blind Randomized Controlled Trials RCTs and one retrospective cohort study). The results showed that there is a consistent trend in the literature supporting the relationship between headache and MFP. Results: The first search showed 663 articles. A total of 110 duplicates were eliminated. After filtering by reading titles and abstracts and discarding any extraneous topics or goals that are not directly connected to this systematic review, the first phase comprised 49 publications. There were 14 papers that needed to be reviewed and evaluated for eligibility. Nine articles were chosen for the final evaluation after full text screening. Conclusion: The findings point to a significant association between headache disability and musculoskeletal disorders of the head and neck. The absence of an agreement in Orofacial Pain research methodology, unified approaches, has an impact on the optimal collecting requirements for a systematic review.

The Effects of Agility Ladders on Performance: A Systematic Review

2020 ◽  
Author(s):  
José Afonso ◽  
Israel Teoldo da Costa ◽  
Miguel Camões ◽  
Ana Silva ◽  
Ricardo Franco Lima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Trials ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Synthesis Methods ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Healthy Humans ◽  
Physical Skills

AbstractThe goal of this systematic review was to evaluate the effects of exercise programs using agility ladders and to assess the quality of available evidence. Search was conducted in October of 2019 using the following databases: Cochrane Library, PEDro, PubMed, Scopus and Web of Science. Study eligibility criteria included randomized trials or randomized controlled trials using agility ladders drills. Participants were healthy humans of any health status. The study appraisal and synthesis methods followed the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and a qualitative synthesis of the main results of each study were applied. Only five studies met our criteria, lasting between 4 and 8 weeks. Only two studies evaluated the effects of ladder drills on more than one dimension. Lack of description of the specific exercises that were used limits reproducibility of current studies. With one exception, the articles had low risk of bias for most domains. Despite the widespread popularity of agility ladder drills, research is scarce and problematic, with poorly described protocols and mostly unidimensional performance measures. Claims that agility ladders improve agility and other physical skills is premature, given the nature and quality of existing research.

scholarly journals Regenerative Treatment of Peri-implantitis: A Systematic Review

2021 ◽  
Author(s):  
Khadija Amine ◽  
Youssef Radaj ◽  
Amina Gharibi ◽  
Jamila Kissa
Keyword(s):  
Systematic Review ◽  
Bone Regeneration ◽  
Randomized Clinical Trials ◽  
Smoking Status ◽  
Case Series ◽  
Risk Of Bias ◽  
P Value ◽  
Pocket Depth ◽  
Bone Gain ◽  
Meta Analyses

Objectives: The aim of this systematic review was to assess the clinical efficacy of bone regeneration for treatment of peri-implantitis. Materials and Methods: Electronic search of the literature was performed to identify randomized clinical trials (RCTs) and case series on treatment of peri-implantitis using bone regeneration procedures with at least 6 months of follow-up. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) were applied. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Results: Two RCTs and 16 case series with a total of 520 treated patients (2002 implants) were included. Bone regenerative procedures showed controversial results regarding bone fill. Two studies reported statistically significant bone gain while four studies reported insignificant bone gain. Other studies reported bone gain with no P value. Pocket depth (PD) reduction varied among the studies since four studies reported a significant reduction in PD while four others reported insignificant reduction in PD. Other studies reported a reduction in PD with no P value. Bone regeneration procedures seemed to decrease bleeding on probing (BOP) but they did not seem conducive to increase the width of keratinized gingiva. Increased keratinized gingiva was noted in cases with subepithelial grafts. Conclusion: Evaluation of the effectiveness of bone regeneration techniques in this systematic review presented limitations related to heterogeneity in patient selection (age, history of periodontitis, smoking status and implant system), means of disinfection and decontamination, and variability of the materials used for treatment.

Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review

2021 ◽  
pp. 1-16
Author(s):  
Zoë Thijs ◽  
Laura Bruneel ◽  
Guy De Pauw ◽  
Kristiane M. Van Lierde
Keyword(s):  
Systematic Review ◽  
Risk Of Bias ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Eligibility Criteria ◽  
High Prevalence ◽  
Tongue Position ◽  
Articulation Disorders ◽  
Level 2 ◽  
Unclear Risk

<b><i>Background:</i></b> Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed. <b><i>Summary:</i></b> The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123–81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. <b><i>Key Messages:</i></b> The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.

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