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1.
Qian Jiang Jialing Li Li Mei Jing Du Luca Levrini Gian Marco Abbate Huang Li 《Journal of the American Dental Association (1939)》2018,149(8):712-720.e12
Background
Clear aligners have become increasingly popular because of their esthetics and comfort. The authors’ aim in this systematic review was to compare periodontal health in patients undergoing orthodontic treatment with clear aligners with that of those undergoing orthodontic treatment with fixed appliances.Types of Studies Reviewed
The authors systematically searched the PubMed, Web of Science, Cochrane Library, and Embase databases to collect related studies. After extracting data and assessing quality, the authors performed a meta-analysis and trial sequential analysis. The authors used the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of the evidence.Results
The authors included 9 studies in the quantitative synthesis analysis. Clear aligners were better for periodontal health, including plaque index (mean difference [MD], ?0.53; 95% confidence interval [CI], ?0.85 to ?0.20; P = .001), gingival index (MD, ?0.27; 95% CI, ?0.37 to ?0.17; P < .001), and probing depth (MD, ?0.35; 95% CI, ?0.67 to ?0.03; P = .03), than were fixed appliances. However, the trial sequential analysis outcome indicated a false-positive meta-analysis result for probing depth. The authors downgraded the level of the evidence because of the risk of bias and inconsistency.Conclusions and Practical Implications
Clear aligners were better for periodontal health than fixed appliances and might be recommended for patients at high risk of developing gingivitis. However, high-quality studies still are required. 相似文献2.
Sayna Shamszadeh Armin Shirvani Mohammad Jafar Eghbal Saeed Asgary 《Journal of endodontics》2018,44(7):1057-1065
Introduction
The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of corticosteroids on postoperative endodontic pain and to determine/adjust between-trial heterogeneity using meta-regression analysis.Methods
A systematic literature search was conducted to identify randomized clinical trials using corticosteroids to manage postoperative endodontic pain in adults. The outcome measure was pain intensity scores at 6, 12, and 24 hours postoperatively. Standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using the random effect inverse variance method. The level of significance was set at P < .05. Meta-regression analysis was also performed to examine the associations between effect sizes and study-level covariates.Results
Eighteen randomized clinical trials, comprising 1088 patients, were included. Corticosteroids significantly reduced the incidence of postoperative pain in endodontic patients at 6 hours (SMD = ?1.03; 95% CI, ?1.55 to ?0.51; P = .000), 12 hours (SMD = ?1.089; 95% CI, ?1.71 to ?0.46; P = .001), and 24 hours (SMD = ?0.957; 95% CI, ?1.34 to ?0.56; P = .000). Meta-regression analysis showed that the type and dose of drug, performing intention-to-treat analysis, and using rescue medication could significantly influence the effect size at different time points.Conclusions
Corticosteroids had a postoperative pain-reducing effect in endodontic patients, and the choice of drug regimens could be an important predictor of pain reduction. 相似文献3.
Branca Heloisa Oliveira Joana Cunha-Cruz Anjana Rajendra Richard Niederman 《Journal of the American Dental Association (1939)》2018,149(8):671-679.e1
Background
In this systematic review, the authors aim to assess the effect of silver diamine fluoride (SDF) in preventing and arresting caries in exposed root surfaces of adults.Types of Studies Reviewed
Two reviewers independently searched for controlled clinical trials with at least 12 months of follow-up, without language or date of publication restraints, in 8 electronic databases, 5 registries of ongoing trials, and reference lists of narrative reviews.Results
The authors found 2,356 unique records and included 3 trials in which the investigators randomly assigned 895 older adults. Investigators in all studies compared SDF with placebo; investigators in 1 also compared 38% SDF with chlorhexidine and sodium fluoride varnishes. The primary effect measures were the weighted mean differences (WMDs) in decayed or filled root surfaces (DFRS) and the mean differences in arrested carious lesions between SDF and control groups. The studies had low risk of bias in most domains. SDF applications had a significantly better preventive effect in comparison with placebo (WMD DFRS: 24 months, ?0.56; 95% confidence interval, ?0.77 to ?0.36; 30 months or more, ?0.80; 95% confidence interval, ?1.19 to ?0.42), and they were as effective as either chlorhexidine or sodium fluoride varnish in preventing new root carious lesions. SDF also provided a significantly higher caries arrest effect than did placebo (pooled results not calculated). Complaints about black staining of the carious lesions by SDF were rare among older adults.Conclusions and Practical Implications
Yearly 38% SDF applications to exposed root surfaces of older adults are a simple, inexpensive, and effective way of preventing caries initiation and progression. 相似文献4.
Background
Autogenous intraoral block grafting is the gold standard augmentation technique for moderate-to-severe horizontal ridge deficiency. However, the graft undergoes variable resorption during healing that might jeopardize the outcome of the procedure. Several studies hypothesized that covering the graft with a membrane decreases the amount of graft resorption, but this effect is not established in the literature.Objective
The objective of this study is to assess the clinical value of covering intraoral block grafts with membranes in horizontal ridge augmentation regarding graft resorption (primary outcome), graft success, net bone gain, and complications (secondary outcomes).Data sources
Till August 2017, the review team conducted an electronic search including PubMed, EMBASE, Cochrane, and LILACS databases; we also identified other articles through hand searching. The search terms included alveolar ridge augmentation, bone transplantation, block graft, guided bone regeneration, membranes, resorbable membrane, and nonresorbable membrane.Study selection
The review included human randomized controlled trials, controlled clinical trials, cohort studies, and case–control studies in English that compared membrane coverage to no membrane coverage of autogenous intraoral block grafts and reported the amount of graft resorption after > 3-month follow-up.Study appraisal
Two authors independently assessed the risk of bias using the Cochrane risk of bias tool, and the third reviewer was the judge in case of conflict.Data extraction
Two authors independently filled the effective practice and organization of care form for data extraction, and the third reviewer revised the data.Data synthesis
The statistical method of choice was the generic inverse variance, and the results were pooled using random-effect models, with the effect size measure being mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes.Results
The review members screened 2266 records; we excluded 2231 records by the title and abstract and screened 35 full-text records for eligibility, from which we excluded 32 articles for certain reasons (the most common were a different comparison and excluded study design). Three randomized controlled trials were included in the quantitative and qualitative analyses of this review, providing the data for 41 participants with 49 sites. Data analysis showed a statistically significant potential benefit of membrane coverage in decreasing the amount of graft resorption of intraoral block grafts (MD: ?1.20 mm, 95% confidence interval [CI]: ?2.11 to ?0.30, P = .009). There was no statistically significant benefit from the use of membranes regarding graft success (RR: 1.02, 95% CI: 0.89–1.17, P = .79) and net bone gain (MD: 0.46, 95% CI: ?0.16 to 1.09, P = .15). The use of membranes did not show a statistically significant increase in the incidence of complications (RR: 1.80, 95% CI: 0.55–5.96, P = .33). The reviewers judged all the studies as of fair quality regarding the risk of bias.Conclusion
The use of membranes decreased the graft resorption, but there was no difference regarding graft success and net bone gain. The use of membranes did not increase complications. Furthermore, properly conducted studies should be used to justify the adjunctive use of barrier membranes with block grafts. 相似文献5.
Mary Charles Haigler Einas Abdulrehman Savitha Siddappa Rekha Kishore Mariela Padilla Reyes Enciso 《Journal of the American Dental Association (1939)》2018,149(11):940-952.e2
Background
The authors conducted a systematic review and meta-analysis to determine whether arthrocentesis or arthroscopy combined with platelet-rich plasma (PRP) or platelet-rich growth factor (PRGF) injection compared with no injection or saline injection (control group) or hyaluronic acid (HA) injection reduced pain and increased maximum mouth opening (MMO) in patients with temporomandibular joint (TMJ) osteoarthritis (OA).Types of Studies Reviewed
The authors used the Cochrane Library, Embase, PubMed, Web of Science, Google Scholar databases and hand searched reference lists through May 4, 2018, to identify randomized controlled trials and controlled trials including patients with TMJ OA receiving injections (PRP or PRGF versus other). The authors assessed the risk of bias according to the Cochrane guidelines.Results
The authors screened 36 abstracts. They included 5 studies (3 randomized controlled trials and 2 controlled trials) with a total of 285 patients with TMJ OA in this review. The authors assessed all 5 studies as being at high risk of bias. The quality of evidence was very low owing to statistical heterogeneity, small sample size, or high risk of bias. Meta-analyses with 2 studies showed a visual analog scale pain improvement from baseline of ?2.778 units (0-10 scale, 0 = no pain, 10 = worst pain) favorable to PRP or PRGF compared with findings in control groups (95% confidence interval [CI], ?3.504 to ?2.052; P < .001) and an improvement of ?0.968 favorable to PRP or PRGF compared with findings in HA groups (95% CI, ?1.854 to ?0.082; P = .032). The authors found no significant increase in MMO in those receiving PRP or PRGF compared with that in the control or HA groups.Conclusions and Practical Implications
Although the results of the included studies showed that arthrocentesis or arthroscopy with PRP or PRGF, saline, or HA injections all reduced pain and increased mouth opening, the evidence was of very low quality. Further studies are needed to confirm these preliminary results showing that PRP or PRGF with arthrocentesis or arthroscopy significantly improved pain but did not increase MMO compared with findings in the control or HA groups. 相似文献6.
Jaakko Paunonen Mika Helminen Timo Peltomäki 《Journal of cranio-maxillo-facial surgery》2018,46(9):1421-1426
Introduction
Aim of this study was 1) to evaluate long-term dental/skeletal stability in patients with mandibular retrognathia corrected by BSSO, and 2) to examine factors associated with relapse.Materials and methods
Seventy-seven of initial 151 study cohort subjects who had undergone orthognathic surgery in 2007–2011 agreed to participate. Present paper presents data on dental/skeletal stability in 46 patients; 31 patients were excluded because of missing calibration indicator in one of the patients' pre-operative cephalometric radiographs, or because of pregnancy. Pre-operative (T1), post-operative (T2) and long-term follow-up (T3) radiographs and patient's files were used in the study.Results
Based on overjet measurements, mean mandibular advancement was 5.7 mm and mean relapse 0.1 mm. Mean pre-operative overbite was 5.4 mm, reduction at surgery 3.4 mm and mean relapse 1.1 mm, a statistically significant change. Mean mandibular advancement measured from condyle tognathion (Co-Gn) was 6.5 mm. Relapse in Co-Gn was 1.6 mm on average, i.e., about 25% of the advancement. Amount of advancement, fixation method, patient's age or gender or orthodontist/surgeon experience did not have influence on relapse.Conclusions
Mandibular advancement with BSSO in healthy Class II patients is considered a stable procedure. 25% skeletal relapse was found with clinically non-significant dental changes. 相似文献7.
Elika Madani Ralf Smeets Eric Freiwald Maryam Setareh Sanj Ole Jung Daniel Grubeanu Henning Hanken Anders Henningsen 《Journal of cranio-maxillo-facial surgery》2018,46(7):1139-1146
Purpose
The preservation of peri-implant bone is one requirement for long-term success of dental implants. The purpose of this study was to evaluate the impact of subcrestal placement on the crestal bone level of immediate versus delayed placed implants after loading.Materials and methods
In this retrospective study, data of 159 patients who received 330 implants was analyzed. Implants were placed subcrestally, crestally or supracrestally into fresh sockets or healed sites. Vertical bone level height was assessed radiographically and implants were followed up annually. The influence of patient and implant related risk factors for peri-implant bone loss was evaluated using a linear mixed model.Results
Depth of implant placement was significantly correlated with peri-implant bone loss (P = 0.001, 95% CI). Least effective loss of crestal bone was determined when implants were placed between 1 mm and 1.99 mm subcrestally. Smoking significantly enhanced the risk of peri-implant bone loss (P = 0.04, 95% CI). Immediate implant placement was not positively correlated with peri-implant bone loss (P = 0.51, 95% CI).Conclusion
Within the limits of this study, implant placement 1.08 mm subcrestally may be recommendable in order to avoid supracrestal expositions of platform-switched titanium implants over time. 相似文献8.
Introduction
The aim of this study was to assess differences in cyclic fatigue (CF) life of contemporary heat-treated nickel-titanium rotary instruments at room and body temperatures and to document corresponding phase transformations.Methods
Forty Hyflex EDM (H-EDM) files (Coltene, Cuyahoga Falls, OH [#25/.08, manufactured by electrical discharge machining]) and 40 TRUShape (TS) files (Dentsply Tulsa Dental Specialties, Tulsa, OK [#25/.06v, manufactured by grinding and shape setting]) were divided into 2 groups (n = 20) for CF resistance tests in a water bath either at room (22°C ± 0.5°C) or body temperature (37°C ± 0.5°C). Instruments were rotated in a simulated canal (angle = 60°, radius = 3 mm, and center of the curvature 5 mm from the tip) until fracture occurred. The motor was controlled by an electric circuit that was interrupted after instrument fracture. The mean half-life and beta and eta Weibull parameters were determined and compared. Two instruments of each brand were subjected to differential scanning calorimetry (DSC).Results
While TS instruments lasted significantly longer at room temperature (mean life = 234.7 seconds; 95% confidence interval [CI], 209–263.6) than at body temperature (mean life = 83.2 seconds; 95% CI, 76–91.1), temperature did not affect H-EDM behavior (room temperature mean life = 725.4 seconds; 95% CI, 658.8–798.8 and body temperature mean life = 717.9 seconds; 95% CI, 636.8–809.3). H-EDM instruments significantly outlasted TS instruments at both temperatures. At body temperature, TS was predominantly austenitic, whereas H-EDM was martensitic or in R-phase. TS was in a mixed austenitic/martensitic phase at 22°C, whereas H-EDM was in the same state as at 37°C.Conclusions
H-EDM had a longer fatigue life than TS, which showed a marked decrease in fatigue life at body temperature; neither the life span nor the state of the microstructure in the DSC differed for H-EDM between room or body temperature. 相似文献9.
Wenzhi Niu Penglai Wang Shaoyue Zhu Zongxiang Liu Ping Ji 《The Journal of prosthetic dentistry》2017,117(1):34-40
Statement of problem
Whether microthreads in the crestal portion can reduce the amount of marginal bone loss (MBL) around implants has not yet been determined.Purpose
The purpose of this systematic review was to investigate the marginal bone loss around dental implants with and without microthreads in the neck.Material and methods
This review was based on the PRISMA guidelines. An electronic search with no restrictions on language was performed from inception to August 19, 2015, in PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Sciences, and AMED (Ovid) databases. A manual search was also performed. Randomized clinical trials (RCTs) that compared the MBL between implants with and without microthreads in the neck were included. Qualitative synthesis and meta-analysis were performed. MBL was measured by using the mean difference (MD). Review Manager v5.3 software was used for meta-analysis (α=.05).Results
Five articles were included in the qualitative synthesis, and 3 articles were included in the meta-analysis. Four studies found that a microthread design can significantly reduce MBL under functional loading, whereas 1 study found no signi?cant difference. The homogeneity test of meta-analysis confirmed acceptable heterogeneity among the 3 studies (I2=0.49). A random-effects model was used. The result shows that MBL around implants with microthread design can be reduced signi?cantly (P=.030; MD: ?0.09; CI: ?0.18 to ?0.01).Conclusions
Meta-analysis showed that microthread design in the implant neck can reduce the amount of MBL; however, RCTs included in the review were few and the difference was small. In clinical practice, an implant with a roughened surface and microthreaded neck could be selected to maintain bone level. 相似文献10.
Michael C. Lynch Roland Perfekt James A. McGuire Jeffery Milleman John Gallob Pejmon Amini Kimberly Milleman 《Journal of the American Dental Association (1939)》2018,149(7):608-618
Background
Dentinal hypersensitivity is a prevalent oral condition that can be treated with in-office application of potassium oxalate (KO), which has US Food and Drug Administration 510(k) clearance. In this study, the authors assessed a KO mouthrinse for home use. The authors evaluated clinically meaningful improvement by analyzing the proportions of participants who responded to treatment.Methods
In this multicenter, double-blind, parallel-group controlled study, the authors randomly assigned 375 participants with dentinal hypersensitivity to 1 of 2 mouthrinse groups: KO (189 participants) and placebo (186 participants). Participants used their assigned mouthrinses for 4 weeks. Each participant’s success (defined as a ≥ 30% reduction from baseline in mean cold air stimulus response) was the primary efficacy measurement. The authors further defined success, on the basis of 2012 criteria from the American Dental Association, as a statistically significant difference of 20% or more between experimental and placebo groups for 1 sensitivity index.Results
KO mouthrinse had statistically significantly higher success rates (the primary efficacy measurement) than did placebo (69.3% versus 44.6%; estimated odds ratio [OR], 2.817; 95% confidence interval [CI], 1.843 to 4.307; P < .001). At week 4, KO had statistically significant improvements compared with placebo in cold air stimulus score (estimated difference, ?14.27 millimeters; 95% CI, ?18.68 to ?9.87; 35.6% improvement; P < .001) and tactile sensitivity (estimated difference, 13.45 grams; 95% CI, 9.83 to 17.08; 88.0% improvement; P < .001). The authors also observed statistically significant improvements for KO at week 2. Cold air stimulus and tactile sensitivity scores at weeks 2 and 4 were secondary efficacy measurements.Conclusions
This study’s results demonstrated that KO mouthrinse used as an adjunct to toothbrushing statistically and clinically significantly controlled and reduced dentinal hypersensitivity.Practical Implications
Clinicians can use these results when determining appropriate at-home care regimens for patients with hypersensitivity. 相似文献11.
Yi-Fang Huang Chung-Ta Chang Chih-Hsin Muo Hsiang-Hsi Hong Yu-Fu Shen Chia-Chang Lin Shih-Ping Liu 《Journal of cranio-maxillo-facial surgery》2018,46(11):1979-1983
Purpose
The aim of this study was to investigate how the physical variables of fibular reconstructed mandibles with dental implants affects the relative bite force in oral cancer patients.Materials and methods
Over 7 years of follow-up, 13 oral cancer patients were enrolled who included 51 successful implants in the fibular flap. The tactile sensor analyzer evaluated the bite force. The crown-implant ratio, fibular, and rehabilitated dental length were measured using radiographic images. Linear regression was used to analyze the bite force related to the variables of the implants in the fibular reconstructed mandible.Results
Even when the results showed no statistical significance (P > 0.05), increasing the crown-implant ratio, length of the fibular flap, and implant prosthetic reconstructed dentition had a tendency to decrease the bite force (estimate from ?0.08% to ?4.27%); there was a positive trend of occlusal force and the length of rehabilitative dentition compared with the dental antagonist (estimate = 6.95).Conclusion
In this study, the crown-implant ratio, implant dentition, and fibular flap length revealed no significant impact on the bite force or implant success in oral cancer patients; however, a trend to weaken the bite force was suggested once the numerical values of these variables increased. 相似文献12.
Sébastien Mbuyi-musanzayi Tony J. Kayembe Marc K. Kashal Prosper T. Lukusa Prosper M. Kalenga François K. Tshilombo Koenraad Devriendt Hervé Reychler 《Journal of cranio-maxillo-facial surgery》2018,46(7):1051-1058
Purpose
To determine the incidence and risk factors of occurrence of non-syndromic cleft lip and/or cleft palate (NSCLP) in Lubumbashi.Method
A case-control study was conducted in the health district of Lubumbashi from February 2012 to December 2015. An exhaustive sampling, collecting all newborns with cleft lip and/or cleft palate (CL ± P) in maternity wards was conducted. From a total of 172 cases, 162 non-syndromic cases were recruited. For each case, one clinically normal newborn control was selected.Results
NSCLP had an incidence of 1/1258 live births (0.8/1000). We found significant associations with a family history of cleft lip and palate (CLP) (x2family history = 11.5, p = 0.0007), maternal alcohol intake (OR = 19.3, 95% CI: 1.9–197.1), paternal alcohol during the periconceptional period and the first trimester of pregnancy (OR = 18.7, 95% CI: 3.9–89.2), maternal educational level lower than high school (OR = 9.5, 95% CI: 2.0–44.7), clay (Pemba) consumption during pregnancy (OR = 38.3, 95% CI: 9.3–157.0), the use of insecticides in the evening (OR = 130.3, 95% CI: 13.2–1286.9), indoor cooking with charcoal (Makala) (OR = 6.5, 95% CI: 1.22–34.5), and regular consumption of Kapolowe fish, supposedly contaminated with heavy metals (OR = 29.5, 95% CI: 7.4–116.7).Conclusion
Several environmental risk factors highly prevalent in Central Africa for facial clefting were found. 相似文献13.
Sanket R. Nagarkar Jorge Perdigão Wook-Jin Seong Nicole Theis-Mahon 《Journal of the American Dental Association (1939)》2018,149(2):139-147.e1
Background
The primary objective of this systematic review was to investigate the survival of full-coverage restorations fabricated by using digital impressions (DIs) versus that of those fabricated by using conventional impressions. The authors also compared secondary outcomes of marginal and internal fit and occlusal and interproximal contacts.Types of Studies Reviewed
The authors conducted a systematic literature search in multiple databases to identify clinical trials with no restrictions by publication type, date, or language. The authors assessed study-level risk of bias and outcome-level strength of evidence. The authors performed a meta-analysis by using a random-effects model.Results
Ten studies met the inclusion criteria. The authors identified no studies in which the investigators compared the impression techniques with respect to survival of full-coverage restorations. Mean differences for marginal gap and internal gap were ?9.0 micrometers (95% confidence interval, ?18.9 to 0.9) and ?15.6 μm (95% confidence interval, ?42.6 to 11.4), respectively. Studies assessing internal gap were substantially heterogeneous (I2 = 72%; P = .003).Conclusions and Practical Implications
Research is lacking to draw robust conclusions about the relative benefits of DIs in terms of restoration survival. Low-quality evidence for marginal fit and internal fit suggested similar performance for both techniques. Evidence quality for interproximal contact and occlusal contact was very low and insufficient to draw any conclusions regarding how the impression techniques compared. Given the uncertainty of the evidence, results should be interpreted with caution. With increasing popularity and adoption of digital scanners by dentists, pragmatic practice-based trials involving standardized, patient-centered outcomes may improve confidence in the comparative effectiveness of DIs. 相似文献14.
Qian Chen Jin Chen Bo Hu Ge Feng Jinlin Song 《Journal of the American Dental Association (1939)》2017,148(2):81-91
Background
The authors conducted a systematic review and meta-analysis on the effect of dexamethasone (DX) on edema, trismus, and pain during early and late postoperative periods after third-molar (M3) extraction.Types of Studies Reviewed
The authors identified eligible reports by searching PubMed, Embase, and the Cochrane Central Register of Controlled Trials up through April 2016. The full text of the studies that met the minimum inclusion requirements were those in which the investigators evaluated the effects of submucosal injection of DX compared with inactive treatments in patients undergoing surgical extraction of an M3.Results
The authors included 11 eligible trials in this study. Participants receiving DX had significantly less edema during both early (standardized mean difference, 3.28; 95% confidence interval [CI], 2.21-4.36; P < .00001) and late (standardized mean difference, 0.56; 95% CI, 0.27-0.86; P < .00001) periods after surgery, as well as less trismus than did control participants during the early (standardized mean difference, 5.34; 95% CI, 2.44-8.24; P = .004) phase, but there was no strong evidence for the reduction of trismus in the late period. Because of heterogeneity in intervention and outcome assessments across the studies, the authors only qualitatively summarized pain outcomes.Conclusions and Practical Implications
The findings of this study suggest that submucosal injection of DX reduced not only early and late edema but also early trismus in experimental compared with control participants after M3 extraction, which makes it a likely choice for dental clinical use. However, larger and higher-quality trials are needed to guard against bias to confirm the effect in late trismus and pain. 相似文献15.
Alex Lvovsky Shir Bachrach Hyeon-Cheol Kim Ajinkya Pawar Oleg Levinzon Joe Ben Itzhak Michael Solomonov 《Journal of endodontics》2018,44(4):555-558
Introduction
This study aimed to investigate the difference in the location of the inferior alveolar nerve (IAN) in relation to the apices of mandibular molars in 3 different populations using cone-beam computed tomographic (CBCT) imaging and to assess the proportion of teeth in close proximity (a distance of 1 mm or less) to the IAN.Methods
Random CBCT images (N = 1224, Israel = 408, South Korea = 416, and India = 400) were examined. The shortest distance to the mandibular canal was measured by imaging software.Results
The mean distance was 4.81 ± 2.15 mm. The mean distances for Israel, South Korea, and India were 4.60 ± 2.37 mm, 5.45 ± 2.13 mm, and 4.35 ± 1.76 mm, respectively. The distance in samples obtained from South Korea was significantly larger than the distance in samples obtained from Israel and India (P < .05). Samples from Israel exhibited close proximity in 6.6% of samples versus 3% in samples from India and 0.7% of samples from South Korea, a statistically significant difference (P < .05).Conclusions
Although variation in tooth morphology in different populations was widely researched, the variation in the location of the IAN in relation to tooth apices of different populations was not addressed in the literature. Our study reveals that a difference in the distance of the apices to the IAN exists between populations as well as a difference in the proportion of teeth in close proximity to the IAN. 相似文献16.
Wenjuan Zhou Zhonghao Liu Liansheng Song Chia-ling Kuo David M. Shafer 《Journal of Evidence》2018,18(1):28-40
Objectives
To systematically review the current dental literature regarding clinical accuracy of guided implant surgery and to analyze the involved clinical factors.Material and Methods
PubMed and Cochrane Central Register of Controlled Trials were searched. Meta-analysis and meta-regression analysis were performed. Clinical studies with the following outcome measurements were included: (1) angle deviation, (2) deviation at the entry point, and (3) deviation at the apex. The involved clinical factors were further evaluated.Results
Fourteen clinical studies from 1951 articles initially identified met the inclusion criteria. Meta-regression analysis revealed a mean deviation at the entry point of 1.25 mm (95% confidence interval [CI]: 1.22-1.29), 1.57 mm (95% CI: 1.53-1.62) at the apex, and 4.1° in angle (95% CI: 3.97-4.23). A statistically significant difference (P < .001) was observed in angular deviations between the maxilla and mandible. Partially guided surgery showed a statistically significant greater deviation in angle (P < .001), at the entry point (P < .001), and at the apex (P < .001) compared with totally guided surgery. The outcome of guided surgery with flapless approach indicated significantly more accuracy in angle (P < .001), at the entry point (P < .001), and at apex (P < .001). Significant differences were observed in angular deviation based on the use of fixation screw (P < .001).Conclusions
The position of guide, guide fixation, type of guide, and flap approach could influence the accuracy of computer-aided implant surgery. A totally guided system using fixation screws with a flapless protocol demonstrated the greatest accuracy. Future clinical research should use a standardized measurement technique for improved accuracy. 相似文献17.
Thomas J. Hilton Ellen Funkhouser Jack L. Ferracane Gregg H. Gilbert Camille Baltuck Paul Benjamin David Louis Rahma Mungia Cyril Meyerowitz 《Journal of the American Dental Association (1939)》2017,148(4):246-256.e1
Background
Cracked teeth are ubiquitous in the adult dentition. The objective of this study was to determine which patient traits and behaviors and external tooth and crack characteristics correlate with cracked teeth being symptomatic.Methods
Dentists in The National Dental Practice-Based Research Network enrolled a convenience sample of patients each with a single, vital posterior tooth with at least 1 observable external crack in this observational study; they enrolled 2,975 cracked teeth from 209 practitioners. The authors collected data at the patient level, tooth level, and crack level. They used generalized estimating equations to obtain significant (P < .05) independent odds ratios (OR) associated with teeth that were symptomatic for a crack.Results
Characteristics positively associated with cracked tooth symptoms, after adjusting for demographics, included patients who clenched, ground, or pressed their teeth together (OR, 1.30; 95% confidence interval [CI], 1.12-1.50), molars (OR, 1.58; 95% CI, 1.30-1.92), teeth with a wear facet through enamel (OR, 1.22; 95% CI, 1.01-1.40), carious lesions (OR, 1.31; 95% CI, 1.07-1.60), cracks that were on the distal surface of the tooth (OR, 1.31; 95% CI, 1.13-1.52), and cracks that blocked transilluminated light (OR, 1.31, 95% CI, 1.09-1.57). Teeth with stained cracks were negatively associated with having cracked tooth symptoms (OR, 0.68; 95% CI, 0.55-0.84).Conclusions
The greatest likelihood of a cracked tooth being symptomatic was found when patients reported clenching or grinding their teeth and had a molar with a distal crack that blocked transilluminated light.Practical Implications
This information can help inform dentists in the decision-making process regarding the prognosis for a cracked tooth. 相似文献18.
Beatriz Dulcineia Mendes Souza Kamile Leonardi Dutra Morgane Marion Kuntze Eduardo Antunes Bortoluzzi Carlos Flores-Mir Jessie Reyes-Carmona Wilson Tadeu Felippe André Luís Porporatti Graziela De Luca Canto 《Journal of endodontics》2018,44(8):1216-1227
Introduction
An avulsion injury is a serious trauma to pulp and periodontal tissues. After avulsion and replantation, teeth are at risk of infection and root resorption, which may affect treatment outcome and survival rate. Thus, the purpose of this systematic review was to evaluate the incidence of root resorption after the replantation of avulsed teeth.Methods
Two reviewers searched 7 electronic databases for observational studies involving human subjects that evaluated the incidence of root resorption after tooth avulsion. Risk of bias (RoB) was evaluated using the Meta-Analysis of Statistics Assessment and Review Instrument, and the quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.Results
Of the 1507 articles, 23 met the inclusion criteria. A meta-analysis was conducted and showed that the incidence of internal root resorption was 1.2% (95% confidence interval [CI], 0.02–5.50). Regarding external root resorption, the incidence of surface root resorption was 13.3% (95% CI, 6.21–22.62), that of inflammatory root resorption was 23.2% (95% CI, 13.94–34.19), and that of replacement root resorption was 51.0% (95% CI, 40.10–62.00). Two studies presented a high RoB, 16 had a moderate RoB, and 11 had a low RoB. The overall level of evidence identified was very low.Conclusions
The incidence of root resorption after avulsion and replantation in descending order was replacement root resorption > inflammatory root resorption > surface root resorption > internal root resorption. 相似文献19.
Nicolas M. Oreskovic German O. Gallucci Isabelle I. Chase Carly E. Milliren Tracy K. Richmond 《Journal of the American Dental Association (1939)》2017,148(12):930-935
Background
Dental and cardiometabolic diseases are highly prevalent, share many common risk factors, and begin during youth. Despite poor dental health being known to influence dietary behaviors that are in turn linked to cardiometabolic health, the role of oral health on concomitant and future cardiometabolic disease is understudied. We sought to determine the association of oral health with cardiometabolic markers during adolescence and early adulthood.Methods
Our sample included 11,556 participants with data from waves 1 (when participants were aged 12 to 19 years) and 4 (when they were aged 26 to 32 years) of the National Longitudinal Study of Adolescent to Adult Health. Multivariable linear and logistic regression separately examined associations between different markers of oral health (that is, missing teeth, periodontal disease, and deferred dental care) and markers of cardiometabolic health (that is, lipids, blood pressure, and body mass index), adjusting for sociodemographic characteristics.Results
Mean age was 29 years at follow-up (wave 4). In adjusted analyses, deferred dental care during both adolescence (β = 1.25; 95% confidence interval [CI], 0.6 to 2.0; P = .001) and early adulthood (β = 0.9; 95% CI, 0.4 to 1.3; P < .001) was associated with an increased body mass index during early adulthood. Deferred dental care in early adulthood was also associated with increased systolic (β = 0.9; 95% CI, 0.4 to 1.5; P = .002) and diastolic (β = 1.0; 95% CI, 0.5 to 1.5; P < .001) blood pressure values and an increased likelihood of being hypertensive (odds ratio = 1.2; 95% CI, 1.0 to 1.3; P = .03).Conclusions
In this nationally representative study deferred dental care during adolescence and concurrently in early adulthood was associated with poorer cardiometabolic disease during early adulthood. Providing better access to dental care may have benefits not only for oral health but also for long-term cardiometabolic health.Practical Implications
Deferred dental care during adolescence and early adulthood, but not recent tooth loss or periodontal disease, is associated with increased risk of cardiometabolic disease. 相似文献20.
Andreea C. Didilescu Corina M. Cristache Mihai Andrei Georgeta Voicu Paula Perlea 《Journal of the American Dental Association (1939)》2018,149(10):903-917.e4