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.     

Clinical performance of tooth implant–supported removable partial dentures: a systematic review and meta-analysis

Clinical Oral Investigations - To assess the clinical performance of tooth implant–supported removable partial dentures in terms of abutment survival in relation to the attachment system...     

Efficacy of nano-hydroxyapatite on caries prevention—a systematic review and meta-analysis

Clinical Oral Investigations - The review systematically explored in vivo or in situ studies investigating the efficacy of nano-hydroxyapatite (nHA) to reduce initiation of or to remineralize...     

The impact of malocclusions on oral health-related quality of life in children—a systematic review and meta-analysis

Introduction

A limited amount of systematic literature reviews on the association between malocclusions and oral health-related quality of life (OHRQOL) summarize inconclusive results. Therefore, we conduct a systematic review and meta-analysis on the association of malocclusions with OHRQOL in children.

Methods

Relevant studies were identified in Pubmed, Embase, Cochrane, Google Scholar and other databases. All studies with data on malocclusions or orthodontic treatment need and OHRQOL in children were included. Methodological quality of the studies was assessed with the Newcastle-Ottawa Scale (NOS). Random effects models were used to estimate summary effect measures for the association between malocclusion and OHRQOL in a continuous and a categorical data analysis. Tests for heterogeneity, publication bias and sensitivity of results were performed.

Results

In total, 40 cross-sectional studies were included in the meta-analyses. Summary measures of the continuous data show that OHRQOL was significantly lowered in children with malocclusions (standardized mean difference (95 % CI]?=?0.29 (0.19–0.38)). The summary odds ratio for having an impact on OHRQOL was 1.74 times higher in children with malocclusion than in children without malocclusions. Heterogeneity among studies was partly explained by malocclusion assessment, age of the children and country of study conduction.

Conclusion

Our results provide evidence for a clear inverse association of malocclusion with OHRQOL. We also showed that the strength of the association differed depending on the age of the children and their cultural environment.

Clinical relevance

Dentists benefit from understanding the patient differences regarding the impact of malocclusions.

     

Heating and preheating of dental restorative materials—a systematic review

Clinical Oral Investigations - To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the...     

Is the clinical performance of composite resin restorations in posterior teeth similar if restored with incremental or bulk-filling techniques? A systematic review and meta-analysis

Clinical Oral Investigations - A systematic review was performed to analyze the clinical performance of class I and II restorations in posterior teeth placed with the incremental or the...     

Association of Helicobacter pylori with oral potentially malignant disorders and oral squamous cell carcinoma—a systematic review and meta-analysis

Objective

To assess any potential association between Helicobacter pylori and oral squamous cell carcinoma/oral potentially malignant disorders.

Materials and methods

Data mining was done using PubMed, Cochrane Library, and SCOPUS databases. The search included articles published up to May 2019. Newcastle-Ottawa scale was used to score the quality of the included articles. Data including the type of study, the sample population, the type of oral lesion, and the resulting statistical data were extracted.

Results

Out of 131 screened articles, only 15 articles fulfilled the eligibility criteria. Among the 15 studies, 9 focused on oral squamous cell carcinoma and 6 focused on oral potentially malignant disorders. Eight out of the 9 oral squamous cell carcinoma studies were included in the meta-analysis. Forest plot was generated using the odds ratio and confidence intervals calculated for each of the included studies. Due to the lack of sufficient studies, the meta-analysis was not performed for oral potentially malignant disorders.

Conclusion

Due to the contradictory results of the included studies, it was not possible to make any conclusive statement on the potential association of H. pylori with oral squamous cell carcinoma. The variations in the methodology, especially the differences in the sensitivity/specificity of the diagnostic modalities could be the cause for differential results.

Clinical relevance

Although the association of H. pylori with oral squamous cell carcinoma could not be confirmed, it is vital to reduce the excess oral microbial load, especially in patients exhibiting oral mucosal changes with no history of associated risk factors.

     

Efficacy and complications of orbital fat decompression in Graves’ orbitopathy: a systematic review and meta-analysis

In Graves’ orbitopathy, surgical decompression is often needed for functional and aesthetic reasons. This meta-analysis was performed to assess the efficacy and safety of fat removal orbital decompression (FROD) alone to treat exophthalmos in Graves’ orbitopathy. A systematic search was conducted in PubMed/MEDLINE, Web of Science, and Cochrane Library for studies published before August 2018. Random-effects meta-analyses were applied; weighted means and weighted proportions with corresponding 95% confidence intervals (CI) were calculated. Study quality and quality of evidence for each individual outcome were analyzed. Of 1908 records initially identified, 13 observational studies were selected, representing 4820 orbits in 2514 patients. Weighted Hertel exophthalmometry was 23.10 mm (95% CI 21.77–24.43 mm) preoperative and 19.31 mm (95% CI 17.81–20.81 mm) postoperative. The weighted mean difference was 3.81 mm (95% CI 3.41–4.21 mm). Five studies reported an improvement of diplopia after surgery, occurring in 943 of 1172 patients (weighted proportion 0.50, 95% CI 0.15–0.85). Persistent new onset diplopia was reported in five studies, or 124 of 1277 patients (weighted proportion 0.15, 95% CI 0.03–0.27). No serious adverse events were reported. Results support the effectiveness and safety of FROD to treat mild-to-moderate exophthalmos in Graves’ orbitopathy. Prospective and controlled trials are needed to improve the level of evidence.     

Management of sinus graft infection—a systematic review

Sinus graft infections are rare but serious complications, as they are associated with significant morbidity and sinus graft loss. The aim of this study was to systematically review the management of sinus graft infection in order to define which protocols should be implemented. The terms searched in each database were “sinus graft infection management”, “maxillary sinus lift infection”, “maxillary sinus graft infection”, “maxillary sinus elevation infection”, and “maxillary sinus augmentation infection”. The management of the sinus graft infection was assessed. The outcomes evaluated were maxillary sinus health and dental implantation results. The initial search yielded 1190 results. Eighteen articles were included, reporting a total of 3319 patients and 217 sinus graft infections. Drainage was performed with an intraoral approach in 13 studies, an endoscopic approach in two studies, and a combined approach in three studies. In every study, a disease-free sinus was finally obtained in all patients, but the outcomes of the graft and the dental implant were more varied. It is not possible to define the best treatment protocol for sinus graft infections based on the published data, since the level of evidence is poor. Management is very heterogeneous. This review highlights the necessity of surgical treatment associated with antibiotic therapy.     

Efficacy of antimicrobial agents incorporated in orthodontic bonding systems: a systematic review and meta-analysis

Aims: The purpose of this study was to evaluate the efficacy of orthodontic bonding systems containing different antimicrobial agents, as well as the influence of antimicrobial agent incorporation in the bonding properties of these materials.

Methods: Eight databases were searched: PubMed (Medline), Web of Science, Scopus, Lilacs, Ibecs, BBO, Scielo and Google Scholar. Any study that evaluated antimicrobial activity in experimental or commercial orthodontic bonding systems was included.

Data extraction: Data were tabulated independently and in duplicated by two authors on pre-designed data collection form.

Data synthesis: The global analysis was carried out using a random-effects model, and pooled-effect estimates were obtained by comparing the standardised mean difference of each antimicrobial orthodontic adhesive with the respective control group. A p-value?Results: Thirty-two studies were included in the qualitative analysis; of these, 22 studies were included in the meta-analysis. Antimicrobial agents such as silver nanoparticles, benzalkonium chloride, chlorhexidine, triclosan, cetylpyridinium chloride, Galla chinensis extract, acid ursolic, dimethylaminododecyl methacrylate, dimethylaminohexadecyl methacrylate, 2-methacryloyloxyethyl phosphorylcholine, 1,3,5-triacryloylhexahydro-1,3,5-triazine, zinc oxide and titanium oxide have been incorporated into orthodontic bonding systems. The antimicrobial agent incorporation in orthodontic bonding systems showed higher antimicrobial activity than the control group in agar diffusion (overall standardised mean difference: 3.71; 95% CI 2.98 to 4.43) and optical density tests (0.41; 95% CI ?0.05 to 0.86) (p?Conclusions: Although there is evidence of antibacterial activity from in vitro studies, clinical and long-term studies are still necessary to confirm the effectiveness of antibacterial orthodontic bonding systems in preventing caries disease.     

Clinical performance of polyacid-modified resin restorations using ”softstart-polymerization”

This study investigated the influence of ”softstart-polymerization” on the clinical performance and marginal integrity of polyacid-modified resin restorations (PMR) in class V cavities. Eighty PMR restorations were placed in 20 patients [40 Dyract (DY); 40 Hytac (HY)] with (n _pat =10) and without preparation (n _pat =10). Restorations were light cured for 40 s either conventionally (CP) or with a lower light intensity for the first 10 s (SSP). Each patient received four restorations (DY-CP, DY-SSP, HY-CP, HY-SSP), which were examined clinically according to modified USPHS criteria, and by quantitative SEM-analysis after 7 days (baseline), 6 months and 1 year. Statistical analysis was performed using the Mann-Whitney-U test (P≤ 0.05) and error rates method. Clinically, no restoration showed recurrent caries or crevices. After 1 year, margins of 24–47% of the HY- and 36–53% of the DY-restorations were rated ”Bravo”. Marginal discoloration occurred in 20–37% in HY- and in 18–21% in DY-restorations. The error rates method revealed no significant differences between materials or between polymerization modes with and without preparation. Pairwise testing showed that without preparation, the marginal adaptation to dentin was significantly worse compared to enamel for HY with both polymerization modes, for DY with SSP. With preparation, no significant differences were found. Cavity preparation may have an influence on differences in marginal quality between enamel and dentin. Received: 1 February 1999 / Accepted: 19 April 1999     

Is surface roughness of resin composites affected by operator's performance?

PURPOSE: To assess intra-individual and inter-individual differences in applying finishing diamonds and rubber polishers to composite specimens with special reference to surface roughness. METHODS: The composite Herculite XRV was used to fabricate 120 specimens. Four human operators with varying experience (Operators 1 to 4) and an automatic mechanical device (Operator 5) were selected for the task of preparation. At baseline, six specimens were prepared by each operator using a 30 microm finishing diamond and six other specimens were prepared by each operator using Astropol polishing cups. After 48 hours, the entire procedure was repeated using new specimens and instruments. All the specimens were assessed for surface roughness by optical profilometry. Average roughness (Ra) and profile-length ratio (LR) were calculated. Intra-individual (baseline/48 hours) and inter-individual (Operators 1 to 5) differences were statistically analyzed by two-way and one-way ANOVA. RESULTS: With respect to finishing, there was a significant interindividual effect between the four human operators and the mechanical device in terms of Ra (P = 0.007) but not in terms of LR. With respect to polishing, the five test groups had a significant effect on Ra and LR values (P < 0.001 in both cases). Overall, finishing and polishing performed at baseline or after 48 hours had no significant effect on surface roughness values.     

Management of osteoradionecrosis of the jaws with pentoxifylline–tocopherol: a systematic review of the literature and meta-analysis

Osteoradionecrosis (ORN) of the jaws remains among the most commonly encountered and challenging complications of radiotherapy to the head and neck. The purpose of this study was to provide a review of the medical management for ORN and evaluate the reported outcomes with the use of pentoxifylline and tocopherol (PENTO), by means of a systematic review and meta-analysis. The predictor variable was the use of PENTO in the treatment of ORN. The outcome variable was the proportion of full recovery or significant improvement not requiring further intervention. The likelihood function was used to combine the studies and estimate the proportion and standard deviation of each outcome by the maximum likelihood estimation. Seven studies met the inclusion criteria. A total 211 patients were treated. One hundred twenty-six patients recovered fully or improved significantly not requiring further intervention. Sixty patients remained the same, 10 were lost to follow-up, and the disease progressed in 15. The current literature supports the use of PENTO in the treatment of ORN of the jaws. Additional well-designed prospective studies are needed in order to further validate the regimen that can then be employed in the treatment of ORN.     

Medical practitioners’ educational competence about oral and oropharyngeal carcinoma: a systematic review and meta-analysis

Medical practitioners’ (MP) role is pivotal in primary prevention, early diagnosis, prompt referral and effective management of oral and oropharyngeal carcinomas (OC/OPC), which raises the importance of their effective OC/OPC education at all levels of medical education. The purpose of this systematic review was to summarise the available scientific evidence about their educational competence in dealing with OC/OPC. We made a systematic search of papers in the English language in MEDLINE, Scopus, Cochrane Library CENTRAL and CINAHL databases from their inception until December 2018. Overall, 23 cross-sectional and three interventional studies have been selected for the systematic review and 18 of these were included in the meta-analyses. Excluding tobacco use (synthesised estimate of 95% of respondents identified tobacco as an OC/OPC risk factor, 95% CI of synthesised estimate 92% to 97%) and alcohol consumption (65%, 95%CI 52% to 77%), less than half of MP (approximately) were knowledgeable about important OC/OPC risk factors including human papilloma virus (42%, 95% CI 30% to 54%), poor diet (34%, 95% CI 17% to 54%), and advancing age (45%, 95% CI 21% to 70%). There was a low to moderate level of awareness among MP regarding common precancerous oral lesions involving leukoplakia (56%, 95% CI 32% to 79%), erythroplakia (30%, 95% CI 8% to 58%), and oral lichen planus (13%, 95% CI 0 to 41%). Moderate knowledge was also recorded about frequent sites of OC development involving the tongue (48%, 95% CI 33% to 64%) and floor of the mouth (37%, 95% CI 19% to 57%). Most MP enquired about tobacco use (86%, 95% CI 74% to 96%), and alcohol consumption (73%, 95% CI 47% to 94%) during history taking, and expressed willingness to be given supplementary OC/OPC education (78%, 95% CI 54% to 96%), as well. With regard to the incidence of intraoral screening, 27% of MP (95% CI 12% to 46%) make an intraoral examination as a routine. Interestingly, studies from each continent yielded significantly different outcomes to some research questions in the review. From the MP’s perspective, clinical time restrictions and deficiencies in organised training were recognised as the main barriers towards their OC/OPC educational competence. The findings of this systematic review indicated the existence of deficiencies in knowledge and misconceptions, neglected preventive responsibilities, and associated barriers towards OC/OPC. A need for improved OC/OPC training at all levels of medical education is required to increase competence worldwide.     

Is surface roughness of direct resin composite restorations material and polisher-dependent? A systematic review

Statement of Problem

Direct resin composite bonding offers a highly esthetic, minimally invasive option for the treatment of anterior teeth however the challenge to improve their longevity remains. Direct resin composite restorations are limited by the risk of staining which may be influenced by the final surface roughness (Ra) of composite achieved.

Purpose

The purpose of this review is to investigate, using a systematic approach, whether the final surface roughness of anterior composite restorations is affected by the interaction between resin composite and polishing systems.

Materials and Methods

The review was conducted by 3 independent reviewers and included articles published up to January 21, 2021. Three electronic databases were searched: Medline, Embase, and Web of Science. Studies assessing a quantitative effect of polishing methods on the Ra of direct composite resin materials published after the year 2000 and restricted to the English language were included.

Results

The database search for the effect of polishing systems on composite materials retrieved 125 eligible studies. Twelve duplicate records were removed. The resulting records were screened using title and abstract leading to 38 reports which were sought for retrieval. Application of eligibility criteria led to 11 studies included in the review. Hand searching of these studies yielded no additional papers.

Conclusions

There is insufficient evidence to determine whether combination of composite and polisher influences final Ra. More research is required to determine if there is an optimum combination of polisher and composite.

Clinical Implications

Polishing should be completed following planned finishing procedures. The approximation to the final surface and which finishing burs to use, if any, should be considered when planning a restoration. Durafill VS predictably achieves an acceptable Ra by different polishers.     

The immunohistochemical profile of basal cell nevus syndrome–associated and sporadic odontogenic keratocysts: a systematic review and meta-analysis

Clinical Oral Investigations - To provide a systematic review of the literature on studies comparing the immunoprofile of nevoid basal cell carcinoma syndrome (BCNS)–associated and sporadic...