Impact of contracted endodontic cavities on instrumentation efficacy—A systematic review

The aim of the present systematic review was to summarise and evaluate the studies comparing the role of contracted endodontic cavities (CECs) and traditional endodontic cavities (TECs) in terms of instrumentation efficacy. The present systematic review comprised of a search of the online databases of Cochrane, PubMed, Google Scholar and grey literature. The articles which were pertaining to instrumentation efficacy in contracted and traditional endodontic cavities were selected based on the PRISMA checklist. Out of the 660 articles which were obtained, irrelevant articles were excluded and a total of 17 articles were selected for this systematic review which assessed the instrumentation efficacy. Eleven studies compared the volume of dentin removed and canal transportation ability. Four studies compared the pulp debridement, and two studies compared the anti-bacterial efficacy between the two groups. The extrusion of debris between the groups was compared by one study. Out of the 17 studies included, 11 studies proved that contracted endodontic cavities negatively impacted the instrumentation efficacy. Hence, the data suggest that the traditional endodontic access cavities have better results when comparing the instrumentation efficacy.     

Do endodontic compounds induce genetic damage? A comprehensive review

Taking into consideration genetic damage plays an important role in carcinogenesis, the purpose of this paper is to provide an overview on the genotoxic potential of some endodontic compounds currently used in dentistry, such as formocresol, paramonochlorophenol, calcium hydroxide, resin-based sealers, phenolic compounds, chlorhexidine, mineral trioxide aggregate, and others. Some of these compounds appear capable of exerting noxious activity on the genetic material. The action mechanisms are discussed. Therefore, this is an area that warrants investigation since the estimation of risk of these substances with respect to genotoxicity will be added to those used for regulatory purposes in improving oral health and preventing oral carcinogenesis.     

Surface smoothness of resin composites after polishing—A systematic review and network meta-analysis of in vitro studies

A systematic review and network meta-analysis was performed to provide evidence for the best polishing protocol for different types of resin composites to minimize surface roughness. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, EMBASE, and Cochrane Library on July 2, 2019 (updated in December, 2020). In vitro studies that included at least two systems for polishing resin composites and analyzed surface roughness were included. The risk of bias was evaluated. A random-effects Bayesian-mixed treatment comparison model was used to compare surface roughness in resin composites with the different types of polishers. Surface under the cumulative ranking curve (SUCRA) analysis was performed to rank the probability for the best polishing system. After removal of duplicates, title and abstract screening yielded 34 studies. Network meta-analysis was not possible for hybrid and microhybrid composites. SUCRA analysis showed that abrasive paper discs allowed greater surface smoothness for nanohybrid and nanofill composites to a probability of between 83% and 91.6%. Silicon carbide brush had a 78.2% probability of being the best system for microfill composites. The use of abrasive paper disc polishers showed a favorable result in nanofill and nanohybrid resin composites. Silicon carbide brush has a greater chance of promoting a smoother surface for microfill resin composites.     

Do bulk‐fill resins decrease the restorative time in posterior teeth? A systematic review and meta‐analysis of in vitro studies

The aim of the present study was to compare the restorative time for filling cavities in posterior teeth using bulk‐fill and conventional resin composites through a systematic review and meta‐analysis. A search for clinical trials and laboratory studies was performed in PubMed/MEDLINE, Scopus, the Latin American and Caribbean Health Sciences Literature database, the Brazilian Library in Dentistry, Cochrane Library, Clinical Trials, and ReBEC (Registro Brasileiro de Ensaios Clínicos) databases without publication year or language restriction. Two reviewers identified eligible studies according to the inclusion criteria: bulk‐fill compared to conventional resin in class I or II, and the restorative time as an outcome. A meta‐analysis of the restorative time mean difference between composites was performed (inverse variance method, random effects model; Z‐test, P ≤ .05). From the 662 eligible studies, 133 were selected for full‐text analysis; three were included in the systematic review and in the meta‐analysis. Overall, the restorative time was lower when bulk‐fill was used (P = .0007, Z = 3.37), as the subgroup full‐body bulk‐fill (P < .00001, Z = 21.00). There was no difference in restorative time between flowable bulk‐fill and conventional resins (P = .08, Z = 1.76). Moderate‐to‐substantial heterogeneity was detected. Full‐body bulk‐fill composites decrease the restorative time in posterior teeth compared to conventional resins. Full‐body bulk‐fill resins require a shorter restorative time to perform restorations in posterior teeth than conventional resins, but the same is not valid for flowable bulk‐fill resin composites.     

Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses

Clinical Oral Investigations - To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy...     

Do fixed orthodontic appliances adversely affect the periodontium? A systematic review of systematic reviews

This overview aimed to summarize the available systematic reviews that assess the effects of treatment with fixed orthodontic appliances (FOAs) on the periodontium. Unrestricted electronic search of nine databases and additional manual searches were performed up to January 2019. Systematic reviews and meta analyses that assessed the effect of FOAs on the periodontal parameters were included. The methodological quality of the included reviews was evaluated using the A Measurement Tool to Assess Systematic Reviews2 (AMSTAR 2). The initial search yielded 2529 articles from which 19 were included in the current study. AMSTAR 2 scores ranged from critically low to high quality. The quality of evidence ranged from very low to low. The superiority of the periodontal outcomes of self-ligating brackets over conventional brackets could not be proven. The available evidence regarding the effects of FOAs on the periodontium is controversial and of very low quality. The short-term effects of FOAs were temporary worsening the periodontal parameters. Some conclusions regarding the periodontal outcomes of self-ligating brackets could be withdrawn. Future high-quality trials are required. The review was registered at the International prospective register of systematic reviews with registration number CRD42018106662.     

Efficacy of proportional versus high condylectomy in active condylar hyperplasia — A systematic review

ObjectiveTo perform a systematic literature review to test the efficacy of proportional condylectomy versus high condylectomy in patients with active condylar hyperplasia, in terms of avoiding secondary surgeries.MethodFollowing a search of Medline (Pubmed), Embase, Scopus, Web of Science and Cochrane databases, ten studies were included for qualitative analysis, and two studies were included for meta-analysis. Quality assessment was performed using the Newcastle–Ottawa scale for cohort studies and the 18-item modified Delphi technique for case series.Results259 patients were included in the qualitative analysis, with a weighted arithmetic mean age of 20.4 years, and a female:male ratio of 2:1. Meta-analysis was carried out for 52 patients, and it was found that proportional condylectomy reduced the need for secondary surgery (p = 0.0003). Although this evidence had limitations, excised bone on proportional condylectomy was superior when compared with excised bone on high condylectomy, re-establishing the occlusal plane, resulting in fewer asymmetries, and therefore reducing the need for further surgery.ConclusionsThis systematic review showed a tendency for proportional condylectomies to avoid additional surgeries; however, more comparative studies are necessary.     

Do nanofill or submicron composites show improved smoothness and gloss? A systematic review of in vitro studies

Objectives

Despite nanofill and submicron composites’ aim to provide high initial polishing combined with superior smoothness and gloss retention, the question still remains whether clinicians should consider using these new materials over traditional microhybrids. The aim of this paper was to systematically review the literature on how nanofills and submicrons react to polishing procedures and surface challenges in vitro compared with microhybrids. The paper has also given an overview of the compositional characteristics of all resin composites and polishing systems whose performance was presented herein.

Data

The database search for the effect of filler size on surface smoothness and gloss of commercial composites retrieved 702 eligible studies. After deduplication, 438 records were examined by the titles and abstracts; 400 studies were excluded and 38 articles were assessed for full-text reading. An additional 11 papers were selected by hand-searching. In total, 28 articles met inclusion criteria and were included in the study.

Sources

The databases analyzed were MEDLINE/PubMed, ISI Web of Science, and SciVerse Scopus.

Study selection

Papers were selected if they presented a comparison between nanofill or submicron and microhybrid composites with quantitative analysis of smoothness and/or gloss on baseline and/or after any aging protocol to assess smoothness and gloss retention. Only in vitro studies written in English were included.

Conclusions

There is no in vitro evidence to support the choice for nanofill or submicron composites over traditional microhybrids based on better surface smoothness and/or gloss, or based upon maintenance of those superficial characteristics after surface challenges.     

Does the use of natural products for endodontic therapy in primary teeth have sufficient evidence for clinical practice? A scoping review

Clinical Oral Investigations - The use of natural products for pulp therapy has experienced a remarkable advancement in recent years. The aim was to provide a critical appraisal of the safety and...     

Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era?

To answer a clinical research question: ‘is there any association between features of dental occlusion and temporomandibular disorders (TMD)?’ A systematic literature review was performed. Inclusion was based on: (i) the type of study, viz., clinical studies on adults assessing the association between TMD (e.g., signs, symptoms, specific diagnoses) and features of dental occlusion by means of single or multiple variable analysis, and (ii) their internal validity, viz., use of clinical assessment approaches to TMD diagnosis. The search accounted for 25 papers included in the review, 10 of which with multiple variable analysis. Quality assessment showed some possible shortcomings, mainly related with the unspecified representativeness of study populations. Seventeen (N = 17) articles compared TMD patients with non‐TMD individuals, whilst eight papers compared the features of dental occlusion in individuals with TMD signs/symptoms and healthy subjects in non‐patient populations. Findings are quite consistent towards a lack of clinically relevant association between TMD and dental occlusion. Only two (i.e., centric relation [CR]‐maximum intercuspation [MI] slide and mediotrusive interferences) of the almost forty occlusion features evaluated in the various studies were associated with TMD in the majority (e.g., at least 50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses. Such association does not imply a causal relationship and may even have opposite implications than commonly believed (i.e., interferences being the result, and not the cause, of TMD). Findings support the absence of a disease‐specific association. Based on that, there seems to lack ground to further hypothesise a role for dental occlusion in the pathophysiology of TMD. Clinicians are encouraged to abandon the old gnathological paradigm in TMD practice.     

Do ball-type attachment systems for overdenture result in better patient-satisfaction? A systematic review of randomized crossover clinical trial

ObjectiveThis review is to compare patient-satisfaction with ball-type overdenture attachment systems with others attachment systems.Material and methodsThis study was registered in PROSPERO (CRD42018097234) and adheres the PRISMA guidelines. Electronic searches on PubMed/MEDLINE, Scopus, Cochrane, and Web of Science databases for published articles were performed before October 2020. The PICO question was: “Do patients with a ball-type overdenture retention system have greater satisfaction, when compared to other attachment systems?” The evaluation of risk of bias was performed using the Cochrane risk of bias tool.ResultsAfter searching the databases, seven articles were selected out of a total of 2583. A total of 312 implants were placed in 139 patients, with a mean age of 65.9 years. The risk of bias in the included studies varied according to the different domains in a risk of uncertain bias or low bias risk. No difference was found between the ball attachment systems and the others systems, with respect to patient-satisfaction. The meta-analysis revealed no statistically significant difference between the ball systems and another systems (P = 0.11; MD: 10.90; 95% CI: −2.55 to 24.35).ConclusionsRegarding patient general satisfaction, it was not possible to determine differences between the ball system and another types of attachment system for overdenture. The ball-type system was statistically superior only to the magnet system.     

Do patients benefit from orthognathic surgery? A systematic review on the effects of elective orthognathic surgery on psychosocial functioning and patient satisfaction

The main purpose of this systematic review was to determine the current state of evidence regarding patient satisfaction with, and the impact of, orthognathic surgery on psychosocial functioning of patients 17 yr of age and older. A secondary aim was to determine whether individuals with psychiatric disorders and mental health conditions are more likely to be dissatisfied with the treatment outcome than those without. We systematically searched PubMed, PsycInfo, and Embase for relevant studies (up to 6 June 2016). After selection of articles we determined the Directness of Evidence (DoE) and Risk of Bias (RoB). We identified 3,948 studies (1,053 studies in Pubmed, 2,023 in Embase, and 872 in PsycInfo). Of these, 87 remained after screening of title and abstract, while after full‐text screening only nine remained for DoE and RoB assessment. All nine studies had a high RoB and a low or moderate DoE. The quality of the methods of studies, published to date, on the effects of orthognathic surgery on patient satisfaction or the psychosocial impact carry a high RoB. Therefore, these do not allow inferences on the effects of orthognathic surgery on patient satisfaction or their psychosocial functioning.     

Could medications and biologic factors affect post-orthodontic tooth movement changes? A systematic review of animal studies

Immediately after the removal of orthodontic appliances, the teeth might start to drift away from their corrected position in an attempt to reach a new equilibrium. Medications and biologic factors could potentially modulate these processes. The objective of the present systematic review is to systematically investigate and appraise the quality of the evidence regarding the effect of various medications and biologic factors on the rate of relapse following active tooth movement. Search without restrictions in eight databases and hand searching until April 2020 were conducted. Studies performed on animal models investigating the effects of medication and biologic factors on the rate of relapse following orthodontic tooth movement were considered. Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed. Seventeen studies were finally identified, mostly at either high or unclear risk of bias. Ketorolac did not show any significant effects on relapse, while the administration of tetracycline, atorvastatin, psoralen and raloxifene decreased it. Overall, the same result was observed with bisphosphonates with the exception of low dosage of risedronate, which did not have an effect. Osteoprotegerin and strontium resulted in reduced relapse, but not in the immediate post-administration period. Inconsistent or conflicting effects were noted after the use of simvastatin and relaxin. The quality of the available evidence was considered at best as low. It can be concluded that specific medications and biologic factors may have an effect on the rate of relapse following tooth movement. The orthodontist should be knowledgeable about the substances potentially affecting retention.     

Does TGF-β play a role in degenerative temporomandibular joint diseases? A systematic review

Objectives: The objective of this review was to assess the literature for evidence investigating the role of TGF-β in temporomandibular joint disease with osteoarthritis.

Method: An electronic and manual search was carried out on the databases, MEDLINE/PubMed, Cochrane Library, Web Of Science, and EMBASE, from 1975 to December 2015 by two independent evaluators to identify clinical and laboratory trials in English.

Results: The search produced 693 records. Following a process of selection based on certain criteria, eight articles were included.

Discussion: This systematic review suggests that TGF-β administration alone does not result in joint regeneration; other factors may be involved, such as TGF-β receptor expression ,and TGF-β receptor mutations that do not allow a correct transduction, resulting in TGF-β deficiency. The anabolism induced by this growth factor is also able to neutralize the catabolic processes that are elevated in osteoarthritis. Therefore, further studies are essential to determine how the concentration of TGF-β in the temporomandibular joints acts as a potential marker for the development of degenerative conditions.