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1.
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2.
Flávia Almeida Ribeiro Scalioni Camila Faria Carrada Carolina Castro Martins Rosangela Almeida Ribeiro Saul Martins Paiva 《Journal of the American Dental Association (1939)》2018,149(7):628-639.e11
Background
The authors systematically reviewed the scientific evidence of an association between periodontal disease and Down syndrome (DS).Types of Studies Reviewed
In this systematic review, the authors included observational studies in which the investigators assessed the prevalence, incidence, or experience of periodontal disease in patients with DS compared with that in healthy patients. The authors used the Population, Exposure, Comparison, Outcome structure. The population was patients of any age, the exposure was the presence of DS, the comparison was the absence of DS, and the outcome was the presence of periodontal disease. The authors conducted an electronic search in 5 databases through March 2017. Two independent reviewers assessed the risk of bias by using the Fowkes and Fulton scale. The authors performed a meta-analysis to compare periodontal disease among patients with DS and those without DS. The authors calculated a summary effect measure—standard mean difference—when evaluating the means of the oral hygiene index. The authors assessed the strength of evidence from the selected studies by using a modified Grading of Recommendations Assessment, Development and Evaluation system.Results
The authors included 23 case-control studies in the systematic review and submitted 3 to meta-analysis. In the qualitative analysis, results from most studies showed that the prevalence of some periodontal parameters was higher among patients with DS than among those without DS. Evaluations of the Fowkes and Fulton scale point to many methodological problems in the studies evaluated. Results of the meta-analysis revealed no differences between groups with regard to the oral hygiene index (standard mean difference, 0.05; 95% confidence interval, ?0.55 to 0.65; I2 = 0.0%).Conclusions and Practical Implications
Further research is required, in particular well-designed studies that avoid the deficiencies identified in the studies in this review. 相似文献3.
Riccardo Nucera Angela Militi Antonino Lo Giudice Vanessa Longo Rosamaria Fastuca Alberto Caprioglio Giancarlo Cordasco Moschos A. Papadopoulos 《Journal of Evidence》2018,18(1):41-58
Objective
To evaluate the skeletal and dental effects of headgear treatment by systematically reviewing the best available scientific evidence.Materials and Methods
A survey of articles published up to February 2017 investigating the effects of headgear in the treatment of patients with class II malocclusion was performed using 19 electronic databases. Only randomized clinical trials and prospective controlled clinical trials investigating growing patients with class II malocclusion treated with headgear were included. Two authors performed independently study selection, data extraction, and risk of bias assessment. All pooled data analyses were performed using the random-effect model. Statistical heterogeneity was evaluated.Results
In total, 6 trials were included (4 randomized clinical trials and 2 prospective controlled clinical trials), grouping data from 337 patients (170 treated patients and 167 untreated controls). The ages of the patients varied across the studies, but the majority of the trials had a sample with an age range between 8 and 9 years. The times of daily wear of the appliance varied across studies from 8 to 14 h/d. The significant mean differences in treatment effects compared with the untreated controls were ?1.41° per year for SNA angle cephalometric parameter (95% confidence interval [CI]: ?2.25° to ?0.56°), ?0.57 mm/y for anterior maxillary displacement (95% CI: ?0.75 to ?0.40 mm), ?1.42° per year for ANB angle cephalometric parameter (95% CI: ?2.12° to ?0.72°), and ?1.31 mm/y for the overjet cephalometric parameter (95% CI: ?2.34 to ?0.29 mm).Conclusion
Headgear treatment is effective in restricting sagittal maxillary growth and reducing the overjet in the short term. 相似文献4.
Yunchun Kuang Bo Hu Jin Chen Ge Feng Jinlin Song 《Journal of the American Dental Association (1939)》2017,148(10):750-759
Background
For this systematic review, the authors evaluated and synthesized the available scientific evidence related to the effects of periodontal endoscopy on the treatment of periodontitis.Methods
The authors searched PubMed, Embase, Cochrane Library, Chinese Scientific Journals database, China National Knowledge Infrastructure, and Chinese Medicine Premier’s Wanfang database for articles about periodontal endoscopy that were published through January 2017. The authors considered the percentage of residual calculus, average treatment time, bleeding on probing (BOP), gingival inflammation (GI), and probing depth (PD) as outcome measures. The authors extracted data and performed meta-analyses for groups of articles for which it was appropriate.Results
The authors identified 8 articles as being suitable for this systematic review. The investigators of 3 studies reported results related to BOP and GI that revealed some advantages of periodontal endoscopy over traditional scaling and root planing (SRP). The investigators of 4 studies explored PD and found no difference between periodontal endoscopy and traditional SRP. The authors could not perform meta-analyses on the study results related to BOP, GI, or PD. The percentage of residual calculus after periodontal endoscope–aided debridement was significantly less than the percentage of residual calculus after traditional SRP (mean difference, ?3.18; 95% confidence interval, ?4.86 to ?1.49; P = .002; heterogeneity I2 = 74%). The authors found that periodontal endoscopy took significantly more time than traditional SRP (mean difference, 6.01 minutes; 95% confidence interval, 4.23 to 7.8; P < .00001; heterogeneity I2 = 0%).Conclusions and Practical Implications
Periodontal endoscopy may provide additional benefits for calculus removal compared with traditional SRP, although it could take more time to perform. With respect to BOP, GI, and PD, the authors found no sufficient evidence to support the difference between the use of periodontal endoscopy and traditional SRP. The authors concluded that additional scientific research is required to assess the effects of periodontal endoscopy on the treatment of periodontitis. 相似文献5.
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6.
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7.
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8.
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9.
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10.
11.
Cameron G. Estrich Stephen E. Gruninger Ruth D. Lipman 《Journal of the American Dental Association (1939)》2017,148(3):164-171
Background
In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure.Methods
The authors obtained demographic characteristics and dental practice behaviors from participants in the annual American Dental Association Health Screening Program survey administered from 2002 through 2012. The authors assayed serum samples obtained from participants for L pneumophila antibodies. The authors used an adjusted logit model to evaluate predictors of positive results.Results
Among 5,431 participants, approximately 10% were positive for L pneumophila, with no significant differences between dental practitioners and nonpractitioners. Geographic location was the only significant predictor of seropositivity, with no increased risk of being exposed to L pneumophila associated with age, race, sex, years in practice, hours of practice per week, use of barrier protection, or infection control practices.Conclusions
Prevalence of L pneumophila antibodies was 10.4% among dental and nondental personnel. US Census division was the only significant predictor of seropositivity. The authors conclude that provision of dental care did not increase the risk of being exposed to Legionella.Practical Implications
Dentists should be aware of the prevalence of Legionella species in their practice areas to understand their personal risk of developing an infection. 相似文献12.
Introduction
The success of periodontal and endodontic treatments depends on the total recovery from both conditions regardless of their occurrence as independent or combined lesions. There is strong presumptive evidence that teeth with periodontal disease may cause pulpal inflammation and degeneration. Therefore, the goal of this study was to establish a correlation between periodontitis and pulp volume.Methods
Thirty-four dental images from 17 patients obtained by cone-beam computed tomography were analyzed by medical software to create three-dimensional images. Paired t test analysis was used for statistical analysis.Results
The statistical analysis showed that periodontitis had a significant effect on the volume and surface areas of the dental pulp (P < .05).Conclusions
The findings of this study showed that periodontitis causes pulp volume to reduce by approximately 20%. The use of three-dimensional models provides better understanding of the dental anatomy before endodontic treatment and, consequently, improvement of treatment outcomes. Additional studies are needed to investigate the effect of periodontal disease on pulp volume and surface area. 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.
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15.
Purpose
Maxillary downgraft (MD) and mandibular setback (MS) are problematic procedures in terms of postoperative stability. While the amount of intraoperative clockwise rotation (CWR) of the proximal segment (PS) after MS combined with MD has a positive correlation with the amount of MD, mandibular relapse after MS with MD in relation to intraoperative CWR of the PS has not been reported. Moreover, the effect of mandibular relapse on maxillary stability after MS with MD remains unclear. The purpose of this study is to evaluate mandibular and maxillary stability after MS with MD in relation to intraoperative CWR of the PS and amount of MD.Materials and Methods
The study included 57 patients who underwent bimaxillary orthognathic surgery. Patients were classified into two groups according to whether MD was performed or not performed: Group I had 2 mm or more MD; and Group II had less than 2 mm MD including vertical impaction or no vertical changes. The amount of surgical movement and postoperative relapse were cephalometrically evaluated and statistically analyzed.Results
There was no significant difference in MS between Groups I and II, however, the vertical movement of the maxilla was different significantly (p < 0.001). In Group I, the intraoperative CWR and postoperative CCWR of the PS was greater than that of Group II (p = 0.010; p < 0.001, respectively). Consequently, the anterior relapse of the mandible was greater in Group I than in Group II despite the same amount of MS in Groups I and II. In Group I, with direct bone contact using Le Fort I inclined osteotomy, vertical relapse at point A showed no statistical correlation with anterior relapse at point B, while the vertical and horizontal dental relapse at U1 showed significant correlations with anterior relapse at point B (r = ?0.403, p = 0.030; r = 0.581, p < 0.001, respectively).Conclusion
For more stable results, Le Fort I inclined osteotomy is recommended to obtain direct bone contact when moving the maxilla inferiorly. The PS must also be fixed while maintaining vertical bone step to prevent CWR. 相似文献16.
Ramon Targino Firmino Fernanda Morais Ferreira Saul Martins Paiva Ana Flávia Granville-Garcia Fabian Calixto Fraiz Carolina Castro Martins 《Journal of the American Dental Association (1939)》2017,148(8):604-613
Background
The authors systematically reviewed the scientific evidence regarding an association between oral health literacy (OHL) and oral conditions.Types of Studies Reviewed
The authors performed an electronic search of 8 databases up through October 2016, as well as a manual search. The authors included studies in which the investigators evaluated oral conditions and measured OHL through a validated tool and studies in which OHL was an explanatory variable. The authors assessed risk of bias by using the Newcastle-Ottawa Scale.Results
The authors included 10 cross-sectional studies. Risk of bias was high in most studies (n = 6). Dental caries and periodontal status were the most common oral conditions reported (each outcome was reported in 5 studies). Investigators in 4 studies found a statistically significant association between dental caries and lower levels of OHL (P < .05), with investigators in 3 of the studies finding this in primary teeth. A reduced number of teeth and loss of attachment were associated with lower levels of OHL (P < .05). Findings for deep periodontal pockets, bleeding on probing, severity of periodontal disease, history of extractions, dental treatment need, and dental plaque were inconclusive. Investigators barely reported other clinical conditions such as temporomandibular joint problems, oral mucosal lesions, enamel opacities, dental fluorosis, and use of and need for dental prostheses.Conclusions and Practical Implications
There seems to be a weak association between lower levels of OHL and dental caries in primary teeth. Similar findings for adults and between OHL and other oral conditions remain unsubstantiated because the results are controversial, with considerable clinical and statistical heterogeneity between studies. 相似文献17.
Karina Morais Faria Ana Carolina Prado Ribeiro Thais Bianca Brandão Wagner Gomes Silva Marcio Ajudarte Lopes Juliana Pereira Marcelo Corrêa Alves Luiz Alcino Gueiros Werner Harumiti Shintaku Cesar Augusto Migliorati Alan Roger Santos-Silva 《Journal of the American Dental Association (1939)》2018,149(5):382-391
Background
The purpose of this study was to evaluate whether intravenous (IV) bisphosphonate (BP) therapy can change the radiographic patterns of multiple myeloma (MM) in the jawbones.Methods
The authors evaluated panoramic radiographs obtained from 188 patients with MM for the presence of solitary osteolytic lesions, multiple osteolytic lesions, diffuse osteoporosis, diffuse sclerosis, lamina dura abnormalities, nonhealing alveolar sockets, and bone sequestration. The authors compared results obtained from patients treated with IV BPs with those obtained from patients who had never been exposed to BPs.Results
Multiple osteolytic lesions (P = .001), diffuse osteoporosis (P = .001), and diffuse sclerosis (P = .0036) occurred more often in the mandible in both groups. Solitary osteolytic lesions occurred less frequently in the BP group (P = .0078). Lamina dura abnormalities (P = .0006) and nonhealing alveolar sockets (P = .0021) were associated with BP treatment.Conclusions
IV BP therapy changes the radiographic patterns of MM in the jawbones.Practical Implications
The effect of BPs in the maxillofacial area is a matter of concern for health practitioners because this type of medication causes several alterations of the jawbones in patients with cancer. 相似文献18.
Travis Nelson Amelia Chim Barbara L. Sheller Christy M. McKinney JoAnna M. Scott 《Journal of the American Dental Association (1939)》2017,148(7):485-492
Background
The authors evaluated the effectiveness of a dental desensitization program for children with autism spectrum disorder (ASD) and determined characteristics associated with a successful dental examination.Methods
The authors performed a retrospective review of clinical behavioral data and previsit questionnaires for 168 children with ASD who attended a university-based dental desensitization program. Data elements included demographic, treatment, and behavioral characteristics. The primary outcome was receiving a minimal threshold examination (MTE) while seated in a dental chair.Results
An MTE was achieved for 77.4% of all children within 1 to 2 visits and 87.5% in 5 visits or less. Several factors predicted a successful dental examination: ability to be involved in group activities (relative risk [RR], 1.18; P = .02), ability to communicate verbally (RR, 1.17; P < .01), understanding of most language (RR, 1.14; P = .02), moderate versus severe caregiver-rated ASD severity (RR, 1.24; P = .04), and ability to dress self (RR, 1.27; P = .04).Conclusions
Desensitization was effective in achieving an MTE for most children. Those with characteristics consistent of a milder presentation of ASD were more likely to be successful.Practical Implications
Desensitization can be a successful approach to providing dental care for children with ASD. 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.
Navid Khalighinejad Anita Aminoshariae James C. Kulild Jeannie Wang Andre Mickel 《Journal of endodontics》2017,43(11):1781-1785