The effect of complete dentures on edentulous patients' oral health-related quality of life in long-term: A systematic review and meta-analysis.

BACKGROUND: To evaluate whether the long-term use of complete dentures (CD) into promotes significant changes in the oral health-related quality of life (OHRQoL) in edentulous patients. METHODS: A systematic review and meta-analysis was conducted. A broad search in Pubmed, Web of Science, Scopus, Cochrane Library, Grey Literature, clinical trials registers and manual search was done. The eligibility criteria were based on population, intervention, comparisons and outcome: (P) edentulous patients, (I) CDs rehabilitation, (C) OHRQoL after CD, (O) change in scores of OHRQoL. Two independent reviewers applied the eligibility criteria, collected qualitative data, performed methodological quality and evaluated the certainty of the evidence (grading of recommendations assessment, development and evaluation). The meta-analysis was analyzed in RevMan 5.4 with 95% confidence intervals (CIs) and P < 0.05. RESULTS: A total of 2452 records were identified. Twenty-four articles were included in qualitative synthesis. Nineteen studies were qualified as good, 3 as fair and 2 as poor quality. Twelve studies were included in quantitative analysis (meta-analysis). The use of CD did not improved OHRQoL in a period of 3 months through the assessment of the Geriatric Oral Health Assessment Index (GOHAI) instrument (P = 0.55; CI; 6.86 [-15.60, 29.31]), and Oral Health Impact Profile-14 (OHIP-14) (P = 0.05; CI; -14.91 [-29.87, 0.04]), with very low certainty of evidence. In a long term, 6 months, GOHAI instrument (P < 0.00001; CI; 16.22 [10.70, 21.74]), OHIP 20 (P = 0.02; CI; -11.09 [-20.54, -1.64]) and OHIP-EDENT (P = 0.0004; CI; -8.59 [-13.32, -3.86]) showed improvement on OHRQoL, with very low and low evidence of certainty, respectively. CONCLUSION: CD has the strong potential to contribute to oral health-related quality of life in long-term.

Antimicrobial Photodynamic Therapy as an Adjunct for Clinical Partial Removal of Deciduous Carious Tissue: A Minimally Invasive Approach.

This study aimed to evaluate the use of antimicrobial photodynamic therapy (aPDT) as an adjunct for minimally invasive treatment (partial removal of carious tissue-PRCT) of deciduous carious tissue evaluating its efficacy in reducing microorganisms. For that, a clinical study was design including children with deciduous molars with active deep caries lesions (DCL). PRCT was performed and remaining dentin was treated with 100 µg mL-1 methylene blue solution (5 min) and than irradiated with a low power laser emitting red light (InGaAIP-indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 300 J cm-2 ; 90 s; 9 J). The colony forming units (CFU) count after PRCT and after PRCT + aPDT/mg of dentin were compared for total microorganisms, including Candida spp., the mutans streptococci group, Streptococcus spp. and Lactobacillus spp. The dentin was classified (color, consistency and humidity). The microbial reduction varied from 69.88% to 86.29% and was significantly observed for total microorganisms, mutans streptococci, Streptococcus spp. and Lactobacillus spp (P < 0.001). The dentin type did not influence reduction of microorganisms (P > 0.05). The aPDT presents a promising future for clinical use as an adjunct for the reduction of microorganisms in PRCT of DCL in all kinds of dentin.

Association between Apical Periodontitis and Interleukin Gene Polymorphisms: A Systematic Review and Meta-analysis.

INTRODUCTION: Genetic polymorphisms may result in altered gene expression or functional changes of the encoded molecules and could possibly generate a deficient immunity. Consequently, individuals with specific genotypes could be more susceptible to disease or could present an increase in disease severity. Our study is aimed to verify, through a systematic review and meta-analysis registered in the PROSPERO database (CRD42016043905), whether currently available evidence supports a relationship between interleukin gene polymorphisms and apical periodontitis (AP). METHODS: A broad search for studies was conducted. The following databases were used: PubMed, Scopus, Web of Science, and the Virtual Health Library (MEDLINE, SciELO, IBECS, and LILACS). The Medical Subject Headings (MeSH) terms "Periapical Periodontitis," "Periapical Abscess," "Polymorphism, Genetic," and "Polymorphism, Single Nucleotide" were used. MeSH synonyms, related terms, and free terms were included. After application of the eligibility criteria, selected studies were qualified by assessment of their methodologic quality. A fixed effects model was used for the meta-analysis. RESULTS: The initial search identified 71 references. After excluding duplicate abstracts, 33 were selected. From these, 6 were eligible for quality assessment; 5 were classified as being of moderate quality, and 1 was classified as being of high quality. CONCLUSIONS: From these included studies, polymorphisms in IL1B, IL6, and IL8 were associated with AP. Polymorphisms in IL1A, IL10, or IL12B were not associated with AP regardless of the methodology used. The meta-analysis suggested that the genotype and allele distribution of IL1B (+3954 C/T) gene polymorphism was different in post-treatment AP. More research in this area is warranted to confirm these results.

Antimicrobial Photodynamic Therapy Associated with Conventional Endodontic Treatment: A Clinical and Molecular Microbiological Study.

This study evaluated antimicrobial photodynamic therapy (aPDT) as an adjunct to endodontic treatment. Ten uniradicular teeth (control group (CG) = 4 (2 and test group (TG) = 6) with primary endodontic infections, from both genders, between 17 and 65 years old, were analyzed. Microbiological samples were collected before and after chemical-mechanical instrumentation (CMI), after aPDT (for the TG), and after the removal of the temporary restorations (second session). In TG, the aPDT was performed with 100 µg mL-1 methylene blue and irradiated with low power laser (InGaAIP, 660 nm; 100 mW; 40 s) with a fiber-coupled optical laser. Another irradiation (3 J; 30 s; spot size of 3 mm2 ) was performed in the gingiva close to the apical foramen. The PCR was performed, after previous whole-genome amplification, for Enterococcus faecalis, Candida genus and Bacteria domain. For TG, a positive tooth for Candida spp. before of the CMI presented negative results in subsequent samples. Additionally, E. faecalis species was present in four samples before CMI, two after CMI, in one after the aPDT and was not detected at the second session. aPDT may be an effective adjunct therapy, resulting in a reduction (P = 0.0286) of the incidence of E. faecalis before root canal obturation.

The effectiveness of pulp revascularization in root formation of necrotic immature permanent teeth: A systematic review.

OBJECTIVE: The objective of the present study was to carry out a systematic review to analyse the effectiveness of pulp revascularization in the root formation of necrotic immature permanent teeth, as well as the level of scientific evidence regarding this theme. MATERIALS AND METHODS: The methodology was based on searching electronic databases such as Web of Science, Pubmed, BVS (Medline, Scielo, Lilacs and BBO), Scopus and Cochrane, including manual searches for the references listed in the studies found. The terms used for the literature search were pulp revascularization and endodontics. RESULTS: Initially, 277 articles were identified from the electronic databases; 17 studies remained after analysis and exclusion of duplicates; exclusion criteria also eliminated six articles; 11 remained for evaluation. CONCLUSIONS: Although the results found in the present systematic review are relevant, the scientific evidence should be interpreted with caution as the articles report different methods and evaluation parameters. Despite the capacity of the pulp revascularization technique to stimulate the development of the apical closure and thickening of radicular dentin, several aspects still remain unknown, like the key factors of this repair, the type of tissue formed and the long-term prognosis.

Efficacy of antimicrobial photodynamic therapy for root canals infected with Enterococcus faecalis.

Effective decontamination of root canal systems is a constant concern in clinical practice. In this article, we compare the performance of photodynamic therapy (PDT) and sodium hypochlorite (NaOCl) in reducing the amount of Enterococcus faecalis in root canals. Relevant studies were identified by searching electronic databases, including Web of Science, PubMed, BVS (Medline, Scielo, Lilacs and BBO), Scopus, and Cochrane, and by manually searching the references of identified studies. The terms used in the literature search were "photodynamic therapy" and "Enterococcus faecalis". We selected 13 experimental studies that exclusively assessed the performance of PDT in reducing E. faecalis in root canals of human teeth. In an evaluation of methodological quality, 12 articles were classified as moderate-quality reports and 1 as a high-quality report. No article needed to be excluded because of low-quality methodology. The results showed that PDT had a better antimicrobial effect when used as an adjuvant endodontic treatment to NaOCl. However, this finding should be carefully interpreted, as there are few relevant studies and the methods of the selected studies varied.

Assessing the responsiveness of the Brazilian FIS to treatment for traumatic dental injury.

OBJECTIVE: This study aimed to assess the responsiveness of the Brazilian version of the Family Impact Scale (B-FIS) to describe changes in the quality of life (QoL) after treatment for traumatic dental injury (TDI). METHODS: After applying the eligibility criteria, 156 patients from 2 to 14 years old, who were attending a dental trauma center, were selected over an 18-month period. QoL was evaluated at two different appointments: A1 (after TDI) and A2 (after TDI treatment). The B-FIS scores were calculated using the additive method. The responsiveness was analyzed by standardized response means (SRMs). RESULTS: Mean B-FIS scores were 12.1 (7.5 SD) and 2.7 (4.4 SD), while the median scores were 12.0 and 2.0, at A1 and A2 (P < 0.01), respectively. The B-FIS responsiveness scores dropped 9.4 points after TDI treatment. The change was observed as a decrease in the impact after TDI treatment, demonstrating a positive reduction in its absolute number as well as an improvement in the family's QoL. The SRM achieved was as follows: 1.2 total scale, 1.1 parental emotions, 0.5 family conflicts, 0.9 parental/family activity, 0.1 financial burden. The B-FIS scores indicated that TDI has significant impact on the family's QoL in A1 and still has impact in A2. The change was observed as a positive decrease in the impact after TDI treatment. CONCLUSIONS: The responsiveness of the FIS (Brazilian version) in detecting the family's change in QoL after TDI treatment was confirmed by SRM.

Preparation time and sealing effect of cavities prepared by an ultrasonic device and a high-speed diamond rotary cutting system.

The purpose of this study was to compare a high-speed handpiece to an ultrasonic device regarding the time taken for cavity preparation in bovine incisor teeth (n = 12), and to evaluate microleakage after the restorations. Two cylindrical cavities each were prepared on the labial surfaces of 12 teeth. One of them was made with a diamond tip in group 1 (G(1) = 12) coupled with a high-speed handpiece, and the other with a chemical vapor deposition (CVD) tip in group 2 (G(2) = 12) coupled with an ultra-sound device (n = 24). The time taken for each preparation was measured with a stopwatch. The cavities were treated with adhesive (Scotchbond Multipurpose, 3M), restored with composite (Filtek Z250, 3M), finished and polished, and then the prepared teeth were immersed in a 50% silver nitrate solution. The samples were cut in the mesio-distal direction and evaluated for microleakage. Data were analyzed using the Wilcoxon test (P < 0.01). The results revealed that the time taken to prepare cavities was 7.9 times shorter in G(1). There was no microleakage in 100% of the samples indicated by the absence of dye penetration in G(1), and 46% in G(2). It was concluded that the performance of the high-speed handpiece was better than that of the oscillatory system, in terms of both the time taken for preparation and the microleakage.