Efficiency of molar distalization associated with second and third molar eruption stage

Objective:To evaluate the efficiency of molar distalization associated with the second and third molar eruption stage.Materials and Methods:A systematic computerized database search was conducted using several databases. Adaptations of the terms molar distalization and distalizing appliances were used. The reference lists of all the selected articles were also searched for any potential articles that might have been missed in the electronic search. The data provided in the selected publications were grouped and analyzed in terms of molar distalization with respect to various eruption stages of maxillary second and third molars.Results:Out of the 13 initially identified articles only four fulfilled the final selection criteria. Three of the four studies showed no statistical significance in linear molar distalization based on the eruptive stage of the second and/or third molars, while one study found that the amount of distal movement of the first molars was significantly greater in the group with unerupted second molars. Only one study found that the amount of molar tipping that occurred as a result of distalization was related to the eruption stage of the maxillary molars. Similarly, three of the four studies found that molar distalization time was not significantly affected by eruption of the second or third molars.Conclusion:The effect of maxillary second and third molar eruption stage on molar distalization—both linear and angular distalization—appears to be minimal. This conclusion is only based on low–level of evidence clinical trials. The large variability in the outcomes should be considered clinically.     

The Significance of Keratinized Mucosa on Implant Health: A Systematic Review

Background: Whether a minimal width of keratinized mucosa (KM) is required to maintain peri‐implant tissue health has been a topic of interest. This systematic review and meta‐analysis aims to investigate the effect of KM on various peri‐implant health‐related parameters. Methods: An electronic search of five databases (from 1965 to October 2012) and a hand search of peer‐reviewed journals for relevant articles were performed. Human cross‐sectional or longitudinal studies with data on the relationship between the amount of KM around dental implants and various peri‐implant parameters, with a follow‐up period of at least 6 months, were included. Results: Eleven studies, seven cross‐sectional and four longitudinal, were included. Weighted mean difference (WMD) and confidence interval (CI) were calculated with meta‐analyses for each clinical parameter. The results showed statistically significant differences in plaque index (PI) and modified PI (WMD = ?0.27, 95% CI = ?0.43 to ?0.11), modified gingival index (mGI) (WMD = ?0.48, 95% CI = ?0.70 to ?0.27), mucosal recession (MR) (WMD = ?0.60 mm, 95% CI = ?0.85 to ?0.36 mm), and attachment loss (AL) (WMD = ?0.35 mm, 95% CI = ?0.65 mm to ?0.06 mm), all favoring implants with wide KM. However, comparisons of other parameters (bleeding on probing, modified bleeding index, GI, probing depth, and radiographic bone loss) did not reach statistically significant differences. The result of heterogeneity test showed only one parameter (AL, P value for the χ² test = 0.30 and I² test = 18%) had a low degree of heterogeneity among analyzed studies; meta‐analyses of other parameters presented moderate‐to‐high degree of heterogeneity. Limitations of the present review include limited number of selected studies (n = 11), existence of heterogeneity and publication bias, and only English‐written articles searched. Conclusion: Based on current available evidence, a lack of adequate KM around endosseous dental implants is associated with more plaque accumulation, tissue inflammation, MR, and AL.     

The impact of periodontitis on oral health‐related quality of life: a review of the evidence from observational studies

Modern population based oral health management requires a complete understanding of the impact of disease in order to provide efficient and effective oral health care and guidance. Periodontitis is an important cause of tooth loss and has been shown to be associated with a number of systemic conditions. The impact of oral conditions and disorders on quality of life has been extensively studied. However, the impact of periodontitis on quality of life has received less attention. This review summarizes the literature on the impact of periodontitis on oral health‐related quality of life (OHRQoL). Relevant publications were identified after searching the MEDLINE and EMBASE electronic databases. Screening of titles and abstracts and data extraction was conducted. Only observational studies were included in this review. Most of the reviewed studies reported a negative impact of periodontitis on OHRQoL. However, the reporting standards varied across studies. Moreover, most of the studies were conducted in developed countries.     

Effectiveness of arginine-containing toothpastes in treating dentine hypersensitivity: A systematic review

Objectives

To evaluate by way of a systematic review the effectiveness of arginine-containing desensitising toothpastes in comparison to control agents in reducing dentine hypersensitivity.

Data sources

Electronic databases were searched including: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS (30/03/2012). Reference lists of eligible studies and systematic reviews were cross-checked in an attempt to identify additional studies. Strategies to identify grey literature were employed.

Study selection inclusion criteria

Controlled Clinical Trials (CCTs) and Randomised Controlled Trials (RCTs) comparing arginine-containing desensitising toothpastes to non-arginine-containing control toothpastes.Two review authors independently screened the titles and abstracts of studies identified. Data collection forms were completed for included studies.

Outcomes

Changes in sensitivity to tactile and air-blast stimuli. A subjective assessment of sensitivity was also sought.

Conclusion

Data identified indicates a potential role for arginine-containing toothpastes in managing dentine hypersensitivity. However, this conclusion is based on small sample sizes and the studies identified did not follow patients up in the medium to long term. The authors recommend that there is a need for well-designed RCTs to be conducted prior to any definitive recommendations being made.

Clinical significance

Dentine hypersensitivity is a common condition. Its multi-factorial aetiology has led to several treatment modalities being advocated. The continued introduction of new desensitising agents suggests that no product has yet proven ultimately successful. Arginine-containing toothpastes have recently been introduced, this article systematically reviews the evidence relating to their effectiveness.     

地塞米松冠周注射预防下颌阻生第三磨牙拔除后肿胀及张口受限的系统评价

目的 评价地塞米松（DM）冠周注射对下颌阻生第三磨牙拔除术后肿胀及张口受限的预防效果。方法 检索Cochrane图书馆临床随机对照试验库、PUBMED、荷兰医学文摘（EMBASE）和中国生物医学文献数据库;同时手检纳入文献的参考文献及中文口腔医学杂志。偏倚风险评价由2位评价者使用Cochrane系统评价者手册5.0版介绍的偏倚风险评价标准独立完成,同时独立进行数据提取。运用Revman 5.1软件进行Meta分析。结果 共纳入7篇随机对照试验,涉及患者684名,偏倚风险评价显示6个研究为中度偏倚风险,1个研究为高度偏倚风险。Meta分析的结果显示,4～5 mg DM冠周注射能够使患者术后1～2 d内最大张口度大6.77 mm（P=0.02）,同时能够减少51%的中-重度张口受限的发生率（P<0.000 01）,并且在控制面部肿胀方面效果显著（P<0.05）。注射4 mg DM与8 mg DM在各项指标中无显著差别（P>0.05）。结论 选择4～5 mg的DM冠周注射能够较好地控制下颌阻生第三磨牙拔除术后面部肿胀和张口受限,但还需要更多的临床随机对照试验的支持。     

超声器械与手用器械龈下刮治疗效比较的meta分析

目的：通过Meta分析评价超声器械与手用器械龈下刮治比较治疗成人慢性牙周炎的临床疗效。方法：计算机检索PubMed、CochraneLibrary、EMbase、CNKI、CBM、WanFangData等6个电子数据库,查找所有有关超声与手工龈下刮治比较治疗慢性牙周炎的随机对照试验（RCTs）。并追索所有纳入文献的参考文献,文献检索时限均从建库至2012年11月。由2名评价员按照纳入和排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan5．0软件进行Meta分析。结果：最终7个RCT、224例受试者纳入本系统评价。Meta分析结果显示,超声与手工龈下刮治术后3个月复查时探诊深度、附着水平的改变无统计学差异;术后6个月复查时探诊深度、附着水平的改变无统计学差异。结论：现有研究证据表明,在牙周基础治疗过程中,采用超声与手工两种方法进行龈下刮治疗效相似。     

Mental health following traumatic physical injury: An integrative literature review

Aim

To investigate the state of knowledge on the relationship between physical trauma and mental health in patients admitted to hospital with traumatic physical injury.

Background

Adults who sustain traumatic physical injury can experience a range of mental health problems related to the injury and subsequent changes in physical health and function. However early screening and identification of mental health problems after traumatic physical injury is inconsistent and not routine during the hospital admission process for the physically injured patient.

Methods

Integrative review methods were used. Data were sourced for the period 1995–2010 from EMBASE, CINAHL, MEDLINE and PsycINFO and hand searching of key references. Abstracts were screened by 3 researchers against inclusion/exclusion criteria. Forty-one papers met the inclusion criteria. Data were retrieved, appraised for quality, analysed, and synthesised into 5 main categories.

Results

Forty-one primary research papers on the relationship between mental health and traumatic physical injury were reviewed. Studies showed that post-traumatic stress disorder, depression and anxiety were frequent sequelae associated with traumatic physical injury. However, these conditions were poorly identified and treated in the acute hospital phase despite their effect on physical health.

Conclusion

There is limited understanding of the experience of traumatic physical injury, particularly in relation to mental health. Greater translation of research findings to practice is needed in order to promote routine screening, early identification and referral to treatment for mental health problems in this patient group.