医学教育环境评估量表在我国口腔医学生中应用的信度与效度分析

目的：评价医学教育环境评估量表（DREEM）在我国口腔医学生中应用的信度和效度。方法：采用DREEM量表中文版在重庆医科大学口腔医学本科生中进行问卷调查,最终对调查结果进行统计学分析,考评量表的信度和效度。其中信度采用内部一致性信度和分半信度进行分析;效度采用探索性因素分析和收敛效度进行分析。采用SPSS 22.0软件包对数据进行信度和效度检验。结果：共回收有效问卷260份。量表总的Cronbach α系数为0.936,Guttman 分半信度系数为0.816。经过探索性因子分析,提取5个因子,累积贡献率达47.071%,显示量表存在预想的连带关系和逻辑关系。量表的Spearman等级相关系数为0.447~0.556之间。结论：医学教育环境评估量表在我国口腔医学生中应用具有良好的信度和效度,可在我国口腔医学教育环境的评价中进一步推广应用。     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

低强度激光缓解正畸疼痛的系统评价

目的评价低强度激光治疗（low-level laser therapy,LLLT）缓解正畸疼痛的治疗效果及风险。方法依据Cochrane Handbook和PRISMA statement的规范化要求,检索1980-2014年2月Cochrane CENTRAL、Medline、PubMed、Embase、CNKI和CBM数据库;同时手工检索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位评价者依据Cochrane系统评价者手册5.1版独立完成。在独立进行数据提取后,运用Review Manager 5.1软件进行Meta分析。结果共纳入4个随机对照试验、1个不完全随机对照试验和3个临床对照试验,共计4个国家,644例患者。偏倚风险评价显示4个随机对照试验为中度偏倚风险,1个不完全随机对照试验和3个临床对照试验均为高度偏倚风险。Meta分析结果显示：LLLT使正畸后疼痛发生率降低了19%[RR=0.81,95%CI（0.69,0.96）,P=0.01]。与空白对照组相比,LLLT缩短了正畸疼痛达峰时间[MD=-0.42,95%CI（-0.74,-0.10）,P=0.009],使正畸疼痛呈现提前消退的趋势[MD=-1.37,95%CI（-3.37,0.64）,P=0.18],LLLT使6 h内的疼痛强度显著降低[MD=-1.97,95%CI（-2.37,-1.56）,P〈0.001],24 h内疼痛视觉模拟评分值仍持续降低[MD=-2.50,95%CI（-3.67,-1.32）,P〈0.001],48 h镇疼效果仍显著（MD=-2.83,95%CI（-3.90,-1.75）,P〈0.001]。结论由于纳入文献的方法学缺陷和偏倚风险限制,LLLT缓解正畸疼痛的证据存在,但尚显薄弱,需要更多大型优质的临床随机对照试验支撑。     

国内口腔医学领域系统评价、meta分析的方法学和报告质量评价

]目的：评价国内发表的口腔医学领域的系统评价、meta分析的方法学和报告质量。方法计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方医药期刊数据库和维普中文科技期刊全文数据库,检索时间从建库至2014年8月30日。查找关于口腔医学领域的系统评价、meta分析的中文文献,由2名研究人员独立筛查文献,采用AMSTAR和PRISMA评价量表对文献的方法学质量和报告质量进行评价和交叉核对,如遇分歧则讨论解决。结果共纳入204篇文献,文献方法学质量评分最高为9分,最低为0分,平均4.95±2.45分。问题主要体现在文献检索不够全面系统,没有提供纳入和排除的研究文献清单,缺乏对发表偏倚的评估等方面。报告质量评分最高为21分,最低为4分,平均为14.07±3.62分。主要问题表现在摘要、收集资料报告不规范、偏倚控制及总结等方面报道不全面。结论目前国内口腔医学领域已发表的系统评价、meta分析方法学质量普遍较低,报告质量也有待提高。     

口腔扁平苔藓患者口腔健康相关生活质量的初步研究

目的通过口腔健康影响程度量表（OHIP）-14中文版了解口腔扁平苔藓患者口腔健康相关生活质量情况,探讨其应用于口腔扁平苔藓临床诊疗的可靠性和准确性。方法采用OHIP-14中文版对51例口腔扁平苔藓患者进行问卷调查,同时采用视觉类比标尺（VAS）对疼痛程度进行评分,REU评分系统对病损情况进行评分。通过SPSS 16.0软件对量表的信度和效度进行统计分析。结果OHIP-14的得分为21.67±9.45,量表的内部一致性Cronbach’s α系数为0.901,因子分析提取的5个公因子与量表各领域有密切的逻辑关系,量表得分与REU分值和VAS分值间呈正相关关系（r=0.608,0.807;P<0.000）。结论OHIP-14中文版评测口腔扁平苔藓患者的口腔健康相关生活质量具有较好的信度和效度,可为病情评估提供参考。     

2种疼痛评估工具在口腔颌面外科ICU患者中的信度和效度评价

目的: 探讨2种疼痛评估工具在口腔颌面外科ICU患者中的信度和效度。方法: 选取上海交通大学医学院附属第九人民医院ICU收住的30例口腔颌面外科患者,分别由2名评估者在进行密闭式吸痰和非侵入性测量血压的护理干预时,采用中文版危重症患者疼痛观察量表（CPOT）和疼痛评估量表（BPS）对患者进行疼痛评估,采集患者操作前5 min、操作时和操作后20 min的疼痛评分。对意识清醒且配合者,由研究人员采集密闭式吸痰操作后患者主诉的数字疼痛评分。采用SPSS17.0软件包对数据进行信度和效度校验。结果: 中文版CPOT和BPS的内部一致性Cronbach α系数分别为0.809和0.878。在区分效度方面,2种评估工具在侵入性操作中的得分显著高于其他评估过程的得分（P<0.05）;在校标效度方面,在侵入性操作过程中危重症患者疼痛观察量表（CPOT）和疼痛评估量表（BPS）与患者主诉的数字疼痛评分Spearman相关系数分别为0.542（P=0.000）、0.461（P=0.000）,均呈正相关。在灵敏度和特异度方面,当CPOT的最佳疼痛节点为3.5分时,灵敏度和特异度分别为55%、96.7%, ROC曲线下面积(AUC)为0.799;当BPS的最佳疼痛节点为7分时,灵敏度和特异度分别为50%、100%,ROC曲线下面积为0.743。结论: 中文版CPOT和BPS都有良好的信度和效度,均适合于口腔颌面外科患者的疼痛评估。     

脱钙异体冻干骨联合富血小板衍生物治疗牙周骨内缺损疗效的Meta分析

目的 系统评价脱钙异体冻干骨（DFDBA）联合富血小板衍生物治疗牙周病导致的骨内缺损的有效性。方法 在PubMed、Web of Science、Embase、Cochrane Library、中国学术期刊网全文数据库等数据库中检索2016年5月之前发表的关于DFDBA联合富血小板衍生物治疗牙周病导致的骨内缺损的临床随机对照研究（RCT）。对纳入的文献研究进行质量评价。应用RevMan 5.3软件进行Meta分析。结果 9篇RCT文献纳入Meta分析,共194例患者,303个位点。Meta分析结果显示:DFDBA联合富血小板衍生物试验组较对照组可以降低短期组（6个月）和长期组（12~18个月）的牙周袋探诊深度,均数差（MD）分别为0.75 mm[95%可信区间（CI）（0.31 mm,1.20 mm）,P=0.001 0]、0.87 mm[95%CI（0.02 mm,1.72 mm）,P=0.04];增加短期组（6个月）和长期组（12~18个月）的临床附着水平,MD分别为0.65 mm[95%CI（0.08 mm,1.22 mm）,P=0.03]、1.31 mm[95%CI（0.60 mm,2.01 mm）,P=0.000 3];减少长期组（12~18个月）的牙龈退缩[MD为-0.58 mm,95%CI（-0.78 mm,-0.38 mm）,P<0.000 01];增加短期组（6个月）和长期组（12~18个月）的骨充填高度,MD分别为0.52 mm[95%CI（0.03 mm,1.00 mm）,P=0.04]、1.26 mm[95%CI（0.65 mm,1.86 mm）,P=0.000 1]。结论 DFDBA联合富血小板衍生物能有效治疗牙周病导致的骨内缺损,效果优于单用组。但因为此次纳入研究较少,质量不高且样本量较小,所以仍需高质量的、大样本的RCT来进一步验证。     

牙周病与早产低体重儿风险相关性：一项基于病例-对照研究的Meta分析

目的：采用Meta分析的方法评价牙周病与早产低体重儿（preterm low birth weight,PLBW）发病风险的关系。方法：计算机检索PubMed、Embase、中国知网、万方和中国生物医学文献数据库,检索时限均为从建库至2013年9月30日,同时追溯纳入文献的参考文献。由2位评价者独立筛选文献、提取资料及进行方法学质量评价后,采用RevMan5.2软件进行Meta分析。结果：最终纳入17个病例-对照研究。Meta分析结果显示：暴露于牙周病可以显著增加PLBW发生率3.00倍[OR=3.00,95%CI=（2.05-4.39）,P〈0.001],敏感性分析结果稳健性较好;按种族地区亚组分析显示,美洲人群[OR=3.72,95%CI=（2.10-6.56）,P〈0.001]和亚洲人群[OR=3.28,95%CI=（1.74-6.15）,P=0.0002]罹患PLBW的风险显著高于欧洲人群[OR=1.85,95%CI=（0.94-3.61）,P=0.007]。未检测到明显发表偏倚。结论：当前证据表明牙周炎是PLBW的有意义的危险因素。     

错(牙合)畸形影响量表（MIQ中文版）的研制与应用

目的通过对英文版错(牙合)畸形影响量表（Malocclusion Impact Questionnaire,MIQ）汉化后进行验证研究及性质考评,探讨汉化版本在中国青少年群体中应用的可行性。方法依据国际生存质量评价项目的标准程序,对MIQ进行翻译、回译、文化适配和版本更新,建立汉化错(牙合)畸形影响量表;应用汉化量表和儿童感知问卷（11～14岁）调查161例正畸患者的口腔健康生存质量,考评汉化量表的信度与效度。结果回收有效问卷161份。量表的内部一致性克朗巴哈α系数（Cronbach’sα）为0.887,条目与量表间的相关系数为0.0001～0.824;量表得分与儿童感知问卷（11～14岁）得分呈正相关,相关系数为0.444(P<0.001）。结论汉化版的错(牙合)畸形影响量表（MIQ中文版）具有良好的信度与效度,可在正畸临床治疗时在青少年群体中应用。     

儿童口腔健康相关生存质量量表信度与效度的验证研究

目的 通过对8～15岁儿童口腔健康相关生存质量量表(COHIP)中文版信度与效度的验证研究,探讨其在中国适龄儿童中应用的可行性.方法 按照国际生存质量评价项目的标准程序,对英文原版COHIP系列问卷中的儿童问卷、父母问卷分别进行翻译、回译、文化调适和改造,建立中文版COHIP,形成适应儿童口腔健康和治疗需求的自我评估问卷、内容效度指数(CvI)合格的评估量表.使用该系列量表对8～15岁的儿童及其家长进行儿童口腔健康相关生存质量调查,考评量表的信度和效度.结果 1 189对儿童及家长接受问卷调查,收回有效问卷1 143份,量表完成率为96.1％.COHIP儿童表内部一致性Cronbach's α[系数为0.903,条目-量表相关系数为0.134～0.611,Guttman分半信度系数为0.798,组内相关系数(ICC)为0.926.COHIP家长表内部一致性Cronbach'sα系数为0.796,条目-量表相关系数为0.121～0.614,Guttman分半信度系数为0.796,ICC为0.931.因子分析显示中文版量表所包含的条目存在预想的逻辑关系.结论 中文版COHIP具有良好的信度和效度,其良好的心理测量学性质为其在中国适龄儿童中的应用提供了理论依据.     

Quality assessment of systematic reviews on vertical bone regeneration

The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti’s method^® and Cohen’s kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean ±95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson’s correlation coefficient = ?0.84; P < 0.01). Cohen’s inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.     

An overview of systematic reviews on the effectiveness of periodontal treatment to improve glycaemic control

Several systematic reviews with meta‐analyses on the effectiveness of periodontal treatment to improve glycaemic control have been published. So far no overview of these systematic reviews has been performed. The main objective of this report was to assess critically these systematic reviews to provide the reader with a high‐level synthesis of research evidence. MEDLINE (via PubMed) and EMBASE databases were searched independently and in duplicate to identify systematic reviews with meta‐analyses of clinical studies that assessed the relationship between diabetes mellitus and periodontitis. The last database search was performed on 10 March 2015. The reference lists of included systematic reviews were also scrutinized for further publications. The methodological quality of the included systematic reviews was assessed independently with two validated checklists (AMSTAR and OQAQ) by two authors. Disagreements in the assessment were resolved by consensus. A total of 226 potential publications were initially retrieved. Eleven systematic reviews with meta‐analyses were finally included. Glycosylated haemoglobin A1c (HbA1c) was the most commonly used clinical endpoint. Meta‐analytic estimates from systematic reviews generated an average reduction of 0.46% (median 0.40%) of HbA1c in patients with diabetes mellitus who received periodontal treatment. These meta‐analyses had, nevertheless, methodological limitations such as inclusion of trials with different types of risk of bias that hinder more robust conclusions. A recent meta‐analysis that included recently published large randomized controlled trials did not show significant change in the level of HbA1c at the 6 mo follow‐up. The AMSTAR checklist generated results that were more conservative than OQAQ. Findings from this overview do not support the information that periodontal treatment may improve glycaemic control. Methodological issues described in this overview may guide further research on this topic.     

An AMSTAR assessment of the methodological quality of systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS)

Background

Systematic reviews are not an assembly of anecdotes but a distillation of current best available evidence on a particular topic and as such have an important role to play in evidence-based healthcare. A substantial proportion of these systematic reviews focus on interventions, and are able to provide clinicians with the opportunity to understand and translate the best available evidence on the effects of these healthcare interventions into clinical practice. The importance of systematic reviews in summarising and identifying the gaps in evidence which might inform new research initiatives is also widely acknowledged. Their potential impact on practice and research makes their methodological quality especially important as it may directly influence their utility for clinicians, patients and policy makers. The objectives of this study were to identify systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS) and to evaluate their methodological quality using the evaluation tool, AMSTAR.

Methods

Potentially eligible systematic reviews in JAOS were identified through an electronic search of the Scientific Electronic Library Online (SciELO). Details of the relevant aspects of methodology as reported in these systematic reviews were extracted from the full text publications. Methodological quality was assessed independently by two reviewers using the AMSTAR questionnaire.

Results

Five systematic reviews were identified, one of which was subsequently excluded as it was a review of a diagnostic test. Summary AMSTAR scores for the four included reviews were: 1, 5, 2 and 4 out of a maximum score of 11 (range 1-5, mean 3) with only one of the reviews scoring 5.

Conclusion

AMSTAR evaluation of the methodological quality of the relatively small number of systematic reviews published in JAOS illustrated that there was room for improvement. Pre-publication and editorial appraisal of future systematic reviews might benefit from the application of tools such as AMSTAR and is to be recommended.     

Methodological Quality Assessment of Meta-analyses and Systematic Reviews of the Relationship Between Periodontal and Systemic Diseases

ObjectivesThe aims of this article are to identify all the published systematic reviews (SRs) and meta-analyses (MAs) that studied the relationship between periodontal and systemic diseases and to assess their quality using 2 scales (the Overview Quality Assessment Questionnaire [OQAQ] and A Measurement Tool to Assess Systematic Reviews [AMSTAR] checklist).MethodsFor SRs and MAs to be included, they should have investigated one of the following systemic diseases: pulmonary conditions, cardiac conditions, endocrine conditions, cancer, blood disorders, psychological conditions, anxiety, depression, mood disorders, and several other diseases. Two investigators screened MEDLINE via PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews. The tools used to evaluate quality were the AMSTAR scale and OQAQ. The protocol was prospectively registered in PROSPERO (CRD42018102208).ResultsThe search strategy found 691 unique articles, 42 of which met the eligibility criteria and were included in this review. Diabetes mellitus was the most investigated disease (14 out of 42 studies), followed by obesity (11 studies) and cardiovascular diseases (5 studies). A total of 40 reviews reported on the characteristics of included studies, and, as per the AMSTAR scale, 39 reviews had an a priori design. The number of reviews that fulfilled the status of publication criterion was the lowest (7 reviews only), followed by the number used in the assessment of publication bias (11 reviews). The number of high-quality reviews was higher with the OQAQ than with the AMSTAR checklist (33 vs 25 studies), but the AMSTAR showed a higher number of medium-quality reviews than the OQAQ (14 vs 6 studies). Both showed the same number of low-quality reviews.ConclusionsHigh-quality SRs and MAs are crucial to understanding the relationship between systemic and periodontal diseases. Medical practitioners must be able to inform patients about oral health and specific periodontal health concerns.     

用"系统评价和Meta分析报告规范"评价口腔医学领域中文Meta分析的报告质量

目的 使用"系统评价和Meta分析报告规范"(preferred reporting items for systematic reviews and meta-analysis,PRISMA)量表评价口腔医学领域中文Meta分析的报告质量,探索影响报告质量的因素并了解国内口腔医学Meta分析的报告现状.方法 计算机检索中国生物医学文献数据库(Chinese BioMedical Literature Database,CBM)、维普中文科技期刊数据库(VIP Database for Chinese Technical Periodicals,VIP)和中国期刊全文数据库(China National Knowledge Infrastructure,CNKI),手工检索19种中文口腔医学杂志,检索已发表的口腔医学类Meta分析.进行文献纳入、数据提取并使用PRISMA评价其报告质量,如有异议则通过讨论达成共识.结果 纳入34篇Meta分析文献,以口腔内科学和口腔颌面外科学两个亚学科为主,仅涉及病因性和防治性两类Meta分析.近年来Meta分析论文发表的数量有所上升,但是报告质量普遍不高,平均得分为(13.6±4.2)分.是否发表于循证医学专业期刊(标化β=0.53,t=4.15,P<0.001)、Meta分析发表距今年限(标化β=-0.44,t=-3.28,P=0.001)是Meta分析的报告质量的主要影响因素,敏感分析显示结果 较稳定.结论 我国中文口腔医学Meta分析的报告质量有待提高,建议口腔医师更多地学习循证医学知识,制作口腔医学Meta分析时参考PRISMA的要求撰写.

Abstract：

Objective To determine the current status and influence hctors of reporting quality of the Chinese meta-analysis on stomatology.Methods A comprehensive electronic search was carried out through Chinese BioMedical Literature Database(CBM),VIP Databage for Chinese Technical Periodicals (VIP)and China National Knowledge Infrastructure(CNKI)and a hand searching was also performed through 19 stomatologieal journals in Chinese to identify meta-analysis on stomatology.Two reviewers took responsibility for study inclusion,data extraction and reporting quality assessment with preferred reporting items for systematic reviews and meta-analysis(PRISMA)in duplicate and any disagreement was resolved by discussion.Results A total of 34 meta-analysis on stomatology were eligible,most of them were ou oral medicine and oral and maxillofacial surgery,and mainly focusing on etiology,prevention and treatment of oral diseases.The number of the meta-analysis increased during recent years.Reporting quality of the meta-analysis was not hish and the PRISMA scored(13.6±4.2).The main factors that influenced the reporting quality of meta-analysis were published on evidence-based medicine journals(adjusted β=0.53,t=4.15,showed that this outcome was stable.Conclusions Reposing quality of the Chinese meta-analysis on stomatology is low.To provide sufficient evidence to the clinicians and promote the development of evidencebased dentistry in China,experts on stomatology should study the knowledge of evidence-based medicine and comply with PRISMA statement when producing the meta-analysis.     

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

Background

Temporomandibular joint disorders (TMJD) are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1) identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2) evaluate their methodological quality, and (3) evaluate the evidence grade within the systematic reviews.

Methods

A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis) comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July). Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP) were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews.

Results

The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd). In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies.

Conclusion

The results indicate that in spite of the widespread impact of TMJD, and the multitude of potential interventions, clinicians have expended sparse attention to systematically implementing clinical trial methodology that would improve validity and reliability of outcome measures. With some 20 years of knowledge of evidence-based healthcare, the meager attention to these issues begins to raise ethical issues about TMJD trial conduct and clinical care.     

Quality Assessment of Systematic Reviews on Short Dental Implants

Background: Critical analysis of published systematic reviews may help in understanding their strengths and weaknesses and identifying areas that need improvement. Short dental implants are becoming an important addition to the existing dental armamentarium. The aim of this overview is to analyze the quality of published systematic reviews focused on short dental implants using established checklists such as the assessment of multiple systematic reviews (AMSTAR). Methods: A search was conducted to retrieve reviews that used a systematic approach in article selection focusing on short dental implants in humans. Based on a set of inclusion and exclusion criteria, a total of 10 reviews were selected. Two independent reviewers appraised the quality of the selected reviews using AMSTAR and the checklist proposed by Glenny et al. in 2003. Each article was given a total score based on the number of criteria that it fulfilled. Results: Six reviews satisfied ≤4 of the 11 AMSTAR items, and only two reviews satisfied nine of the 11 items. This study shows that published systematic reviews on short dental implants exhibit significant structural and methodological variability. Quality assessment using the Glenny checklist further confirmed the variability in the way systematic reviews were conducted and/or reported. A high correlation was observed between the two checklists’ scores. Conclusions: Uniformity in the way systematic reviews are conducted and/or reported will increase the validity and clinical applicability of future reviews.     

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.     

Quality Assessment of Systematic Reviews on Periodontal Regeneration in Humans

Background: Systematic reviews represent the highest form of evidence in the current hierarchy of evidence‐based dentistry. Critical analysis of published systematic reviews may help to analyze their strengths and weaknesses and to identify areas that need future improvement. The aim of this overview is to determine and compare the quality of systematic reviews published in the field of periodontal regeneration using established checklists, such as the Assessment of Multiple Systematic Reviews (AMSTAR) guidelines. Methods: A systematic search was conducted to retrieve reviews on periodontal regeneration in humans. A total of 14 systematic reviews were selected using a set of inclusion and exclusion criteria. Two independent reviewers appraised the quality of the selected reviews using AMSTAR guidelines. Each article was given an AMSTAR total score, based on the number of AMSTAR criteria that were fulfilled. The quality of included reviews was further assessed using a checklist proposed in 2003. Results: Only one of the selected systematic reviews satisfied all the AMSTAR guidelines, whereas two reviews satisfied just two of the 11 items. This study shows that published systematic reviews on periodontal regeneration exhibit significant structural and methodologic variability. Quality assessment using the additional checklist further confirmed the variability in the way systematic reviews were conducted and/or reported. Conclusion: Consideration of guidelines for quality assessment, such as AMSTAR, when designing and conducting systematic reviews may increase the validity and clinical applicability of future reviews.