Deep Margin Elevation for Indirect Restorations: A Systematic Review

Background: The evolution of adhesive dentistry has increased the demand for improving the clinical outcomes of indirect restorations. There are several challenging factors in restoring teeth with deep interproximal lesions. Surgical crown lengthening has been the primary procedure to avoid violation of the biological width. In recent years, deep marginal elevation (DME) has been proposed as an alternative procedure for maintaining biological width in cases with subgingival defects. The aim of this review was to search for the best available evidence concerning the clinical outcomes of DME. Methodology: A comprehensive online search was performed using three different databases (using PubMed, the Cochrane Library, and the American dental association library for evidence-based dentistry). Four independent authors reviewed studies, collected data, and assessed the risk of bias. Results: The initial search revealed 1,763 studies. Duplicates were removed, and an extensive review was performed. Only six studies met the inclusion criteria and were accepted in the review. Conclusions: The systematic review advocates that DME is a reasonable, predictable, and reliable clinical procedure. There is a limitation of clinical studies in this field; therefore, more clinical studies with long-term follow-up periods are necessary.

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Predictors of Mid- to Long-Term Outcomes in Patients Experiencing a Knee Dislocation: A Systematic Review of Clinical Studies

The Journal of Knee Surgery ◽

10.1055/s-0041-1723762 ◽

2021 ◽

Author(s):

John-Rudolph H. Smith ◽

John W. Belk ◽

Jamie L. Friedman ◽

Jason L. Dragoo ◽

Rachel M. Frank ◽

...

Keyword(s):

Surgical Treatment ◽

Clinical Outcomes ◽

Clinical Studies ◽

Small Sample ◽

Cochrane Library ◽

Long Term Outcomes ◽

Short Term ◽

Female Sex

AbstractKnee dislocations (KDs) are devastating injuries for patients and present complex challenges for orthopaedic surgeons. Although short-term outcomes have been studied, there are few long-term outcomes of these injuries available in the literature. The purpose of this study is to determine factors that influence mid- to long-term clinical outcomes following surgical treatment of KD. A review of the current literature was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies published from 2010 to 2019 with a minimum 2-year follow-up that reported outcomes following surgical treatment of KDs. Ten studies (6 level III, 4 level IV) were included. At mid- (2–10 y) to long-term (>10 y) follow-up, concomitant arterial, cartilage, and combined meniscus damage were predictive factors for inferior Lysholm and International Knee Documentation Committee (IKDC) scores when compared with patients without these associated injuries. Although concomitant neurological damage may influence short-term outcomes due to decreased mobility, at longer follow-up periods it does not appear to predict worse clinical outcomes when compared with patients without concomitant neurological injury. Frank and polytrauma KDs have been associated with worse mid- to long-term outcomes when compared with transient and isolated KDs. Patients who underwent surgery within 6 weeks of trauma experienced better long-term outcomes than those who underwent surgery longer than 6 weeks after the initial injury. However, the small sample size of this study makes it difficult to make valid recommendations. Lastly, female sex, patients older than 30 years at the time of injury and a body mass index (BMI) greater than 35 kg/m2 are factors that have been associated with worse mid- to long-term Lysholm and IKDC scores. The results of this review suggest that female sex, age >30 years, BMI >35 kg/m2, concomitant cartilage damage, combined medial and lateral meniscal damage, KDs that do not spontaneously relocate, and KDs associated with polytrauma may predict worse results at mid- to long-term follow-up.

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Effect of airway administration of budesonide for bronchopulmonary dysplasia in premature infants: A Systematic Review and Meta-Analysis

10.21203/rs.2.16768/v1 ◽

2019 ◽

Author(s):

kaixu wang ◽

Long Chen ◽

Fang Li

Keyword(s):

Bronchopulmonary Dysplasia ◽

Premature Infants ◽

Meta Analysis ◽

Cochrane Library ◽

Optimal Timing ◽

Composite Outcome ◽

Long Term Follow Up ◽

The Cochrane Library

Abstract Objective: Bronchopulmonary dysplasia (BPD) is one of the major challenges in preterm infants despite the therapeutic improvement. Airway administration of budesonide might be a safe and effective way. However, the optimal timing of airway administration is under determined. The meta-analysis was designed to evaluate the effectiveness and safety of early (≤1d after birth) and late (>1d after birth) airway administration of budesonide in decreasing the incidence of BPD and death as the primary outcome . Methods: PubMed, EMBASE, the Cochrane Library, China national knowledge internet (CNKI), China biology medicine disc (CBM), WANFANG data, and China Science and Technology Journal Database were searched for RCTs that compared airway administration of budesonide with controls. The meta-analysis was performed using Review Manager 5.3. Results: Airway administration of budesonide decreased the risk of BPD at 36 weeks PMA and the composite outcome of BPD or death (RR=0.64, 95%CI: 0.55~0.75 and RR=0.71, 95%CI: 0.57~0.89).Moreover, 37% and 36% reduction was observed in the incidence of BPD and the composite outcome of BPD or death in the early airway administration group (≤1d) (RR=0.63, 95%CI: 0.53~0.75 and RR=0.64, 95%CI: 0.47~0.87 ), while no difference was found in late airway administration group (>1d) (RR=0.74, 95%CI: 0.49~1.13 and RR=0.88, 95%CI: 0.64~1.21). Conclusion: early airway administration (≤1d) of budesonide reduced the incidence of BPD alone or composite outcome of death or BPD, and it is safe without increasing death as well as other short-term side effects. However, because of the small number of infants in late airway administration group and lacking of long-term follow-up, more randomized controlled trials are needed to testify for the outcomes. Keywords: Budesonide, bronchopulmonary dysplasia, premature infants, meta-analysis, airway administration.

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The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10010051 ◽

2020 ◽

Vol 10 (1) ◽

pp. 51

Author(s):

Edoardo Giovannetti de Sanctis ◽

Edoardo Franceschetti ◽

Ferdinando De Dona ◽

Alessio Palumbo ◽

Michele Paciotti ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Platelet Rich Plasma ◽

Shoulder Function ◽

Rotator Cuff Tears ◽

Therapeutic Modality ◽

Cochrane Library ◽

Long Term Follow Up

(1) Background: Even though rotator cuff tears are the most frequent tendon injuries in adults, the effectiveness of conservatively treated partial-thickness tears still remains a matter of debate. The purpose of this review is to compare corticosteroid injections to other drugs in the treatment of partial rotator cuff tears, focusing on the effectiveness of this therapeutic modality in terms of pain and shoulder functionality. (2) Methods: A systematic electronic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. All studies comparing the use of corticosteroids and other infiltrative techniques in the treatment of partial lesions (excluding studies that considered subacromial impingement as inclusion criteria) were pooled, data were extracted and statistically analyzed. (3) Results: Nine studies were included in this systematic review. Those studies, composed by a total of 494 shoulders treated, have been published from 1985 to 2019. All compared techniques have shown a significant improvement over baseline condition. PRP (Platelet Rich Plasma) injections have been shown to be significantly more effective in both functional and pain control only in the long term. (4) Conclusions: None of the techniques prevail indisputably on the others. Anyway, the treatment of partial rotator cuff tears with PRP injections seems to lead to significantly better outcomes in terms of pain and shoulder function in long term follow up. Whereas in short and medium term follow up, PRP injections was superior only in terms of shoulder function. The small number of studies on prolotherapy did not enable us to provide an opinion on the outcomes of this technique.

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Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-102525 ◽

2020 ◽

pp. bjsports-2020-102525

Author(s):

Stefanos Karanasios ◽

Vasileios Korakakis ◽

Rod Whiteley ◽

Ioannis Vasilogeorgis ◽

Sarah Woodbridge ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Short Term ◽

Lateral Elbow ◽

Long Term Follow Up ◽

Wait And See ◽

Lateral Elbow Tendinopathy

ObjectiveTo evaluate the effectiveness of exercise compared with other conservative interventions in the management of lateral elbow tendinopathy (LET) on pain and function.DesignSystematic review and meta-analysis.MethodsWe used the Cochrane risk-of-bias tool 2 for randomised controlled trials (RCTs) to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation methodology to grade the certainty of evidence. Self-perceived improvement, pain intensity, pain-free grip strength (PFGS) and elbow disability were used as primary outcome measures.Eligibility criteriaRCTs assessing the effectiveness of exercise alone or as an additive intervention compared with passive interventions, wait-and-see or injections in patients with LET.Results30 RCTs (2123 participants, 5 comparator interventions) were identified. Exercise outperformed (low certainty) corticosteroid injections in all outcomes at all time points except short-term pain reduction. Clinically significant differences were found in PFGS at short-term (mean difference (MD): 12.15, (95% CI) 1.69 to 22.6), mid-term (MD: 22.45, 95% CI 3.63 to 41.3) and long-term follow-up (MD: 18, 95% CI 11.17 to 24.84). Statistically significant differences (very low certainty) for exercise compared with wait-and-see were found only in self-perceived improvement at short-term, pain reduction and elbow disability at short-term and long-term follow-up. Substantial heterogeneity in descriptions of equipment, load, duration and frequency of exercise programmes were evident.ConclusionsLow and very low certainty evidence suggests exercise is effective compared with passive interventions with or without invasive treatment in LET, but the effect is small.PROSPERO registration numberCRD42018082703.

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Implementation Intentions to Reduce Smoking: A Systematic Review of the Literature

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa235 ◽

2020 ◽

Author(s):

Charlotte J Hagerman ◽

Rebecca K Hoffman ◽

Sruthi Vaylay ◽

Tonya Dodge

Keyword(s):

Systematic Review ◽

Implementation Intentions ◽

Experimental Studies ◽

Implementation Intention ◽

Promising Tool ◽

Current Systematic Review ◽

Long Term Follow Up ◽

Positive Effect

Abstract Implementation intentions are a goal-setting technique in which an individual commits to perform a particular behavior when a specific context arises. Recently, researchers have begun studying how implementation intention (II) interventions can facilitate antismoking efforts. The current systematic review synthesized results of experimental studies that tested the effect of an II intervention on smoking cognitions and behavior. Of 29 reviewed articles, 11 studies met inclusion criteria. Nine studies (81.8%) tested an II intervention as a cessation tool for current smokers, whereas two tested II interventions as a tool to prevent smoking among predominantly nonsmoking adolescents. A majority of the studies (66.7%) testing II interventions as a cessation tool reported a positive effect on cessation at long-term follow-up. Of the two studies testing II interventions as a tool for prevention, one study found a positive effect on long-term follow-up. Methodology varied between the studies, highlighting the discrepancies between what researchers consider “implementation intentions” to be. II interventions are a promising tool for antismoking efforts, but more research is necessary to determine the best methodology and the populations for whom this intervention will be most effective. Implications Brief, free, and easily scalable, II interventions to prevent smoking are highly attractive for antismoking efforts. This review outlines the circumstances under which II interventions have demonstrated effectiveness in helping people resist smoking cigarettes. We illuminate gaps in the existing literature, limitations, methodological discrepancies between studies, and areas for future study.

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Outcomes of Arthroscopic Capsular Release in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119888173 ◽

2019 ◽

Vol 7 (12) ◽

pp. 232596711988817 ◽

Cited By ~ 1

Author(s):

Darby A. Houck ◽

John W. Belk ◽

Armando F. Vidal ◽

Eric C. McCarty ◽

Jonathan T. Bravman ◽

...

Keyword(s):

Systematic Review ◽

Clinical Outcomes ◽

Cochrane Library ◽

Recurrence Rates ◽

Capsular Release ◽

Arthroscopic Capsular Release ◽

Patient Reported ◽

Lateral Decubitus ◽

Beach Chair

Background: Arthroscopic capsular release (ACR) for the treatment of adhesive capsulitis of the shoulder can be performed in either the beach-chair (BC) or lateral decubitus (LD) position. Purpose: To determine the clinical outcomes and recurrence rates after ACR in the BC versus LD position. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library databases for studies reporting clinical outcomes of patients undergoing ACR in either the BC or LD position. All English-language literature from 1990 through 2017 reporting on clinical outcomes after ACR with a minimum 3-month follow-up were reviewed by 2 independent reviewers. Recurrence rates, range of motion (ROM) results, and patient-reported outcome (PRO) scores were collected. Study methodological quality was evaluated using the modified Coleman Methodology Score (MCMS). Results: A total of 30 studies (3 level 1 evidence, 2 level 2 evidence, 4 level 3 evidence, 21 level 4 evidence) including 665 shoulders undergoing ACR in the BC position (38.1% male; mean age, 52.0 ± 3.9 years; mean follow-up, 35.4 ± 18.4 months) and 603 shoulders in the LD position (41.8% male; mean age, 53.0 ± 2.3 years; mean follow-up, 37.2 ± 16.8 months) were included. There were no significant differences in overall mean recurrence rates between groups (BC, 2.5%; LD, 2.4%; P = .81) or in any PRO scores between groups ( P > .05). There were no significant differences in improvement in ROM between groups, including external rotation at the side (BC, 36.4°; LD, 42.8°; P = .91), forward flexion (BC, 64.4°; LD, 79.3°; P = .73), abduction (BC, 77.8°; LD, 81.5°; P = .82), or internal rotation in 90° of abduction (BC, 40.8°; LD, 45.5°; P = .70). Significantly more patients in the BC group (91.6%) underwent concomitant manipulation than in the LD group (63%) ( P < .0001). There were significantly more patients with diabetes in the LD group (22.4%) versus the BC group (9.6%) ( P < .0001). Conclusion: Low rates of recurrent shoulder stiffness and excellent improvements in ROM can be achieved after ACR in either the LD or BC position. Concomitant manipulation under anesthesia is performed more frequently in the BC position compared with the LD position.

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Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa794 ◽

2020 ◽

Author(s):

Isabelle Holscher ◽

Tijs J van den Berg ◽

Koen M A Dreijerink ◽

Anton F Engelsman ◽

Els J M Nieveen van Dijkum

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Weighted Mean ◽

Curative Surgery ◽

Endocrine Society ◽

Time To Recurrence ◽

The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

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Balloon-expandable stents for treatment of symptomatic middle cerebral artery stenosis: Clinical outcomes during long-term follow-up

Interventional Neuroradiology ◽

10.1177/1591019918786515 ◽

2018 ◽

Vol 24 (6) ◽

pp. 666-673 ◽

Cited By ~ 3

Author(s):

Sung Hyun Baik ◽

Hyo Sung Kwak ◽

Gyung Ho Chung ◽

Seung Bae Hwang

Keyword(s):

Middle Cerebral Artery ◽

Clinical Outcomes ◽

Cerebral Artery ◽

Reperfusion Therapy ◽

Stent Insertion ◽

Recurrence Rates ◽

Long Term Follow Up ◽

Ischemic Events

Background Insertion of a balloon-expandable stent (BES) in patients with symptomatic intracranial atherosclerosis is a treatment option for reperfusion therapy. In this study, we retrospectively reviewed clinical outcomes during long-term follow-up after insertion of balloon-expandable stents in patients with symptomatic middle cerebral artery (MCA) stenosis. Methods Institutional review board approval was obtained for retrospective review of patient data. Thirty-four patients (15 men, 19 women; median age, 67.5 years) with symptomatic MCA stenosis underwent balloon-expandable stent insertion between June 2008 and December 2010. Patient records were reviewed for angiographic findings and clinical outcomes during long-term follow-up. Results Of these patients, 22 presented with acute ischemic stroke with underlying MCA atherosclerosis and had good clinical outcomes (modified Rankin Scale score (mRS): 0–2) after reperfusion therapy. Indications for stenting for the remaining 12 patients were recurrent transient ischemic attacks (TIAs) refractory to medical therapy and MCA stenosis greater than 70%. During the poststenting follow-up period, which ranged from 61 to 108 months (median, 67.5 months), a TIA occurred in five patients. Of these five patients, one experienced a complete reocclusion of the MCA stent, and three had symptomatic restenosis. The remaining 29 patients did not experience any further ischemic events or restenosis during the follow-up period. Conclusions In our study, treatment with balloon-expandable stents in patients with symptomatic MCA stenosis resulted in low recurrence rates for both ischemic events and restenosis during long-term follow-up.

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