Effect of endodontic sealer on postoperative pain: a network meta-analysis.

This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted. Trial Registration: PROSPERO Identifier: CRD42020215314.

Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology.

OBJECTIVES: This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies. METHODS: A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0. RESULTS: A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36). CONCLUSIONS: The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement. CLINICAL RELEVANCE: Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.

Bioactive toothpastes in dentin hypersensitivity treatment: A systematic review.

The use of bioactive materials is a recent proposal in the treatment of dentin hypersensitivity (DH) due to the ability to stimulate the neoformation of a barrier on dentin surface. Questions have arisen about the effectiveness of the materials to reduce DH when compared to the control groups (placebo or non-bioactive substance). Thus, the aim of this systematic review was to evaluate the randomized controlled trials in adult patients for DH treatment with a dentifrice containing bioactive glass, applied either at-home or in-office. Methods: The study was registered in PROSPERO and followed PRISMA guidelines. Searches were carried out in four databases (Pubmed/Medline, CENTRAL, Wbb of Science, LILACS) spanning from February 2020 to March 2020, with no language or publication date restrictions. A supplementary hand-search was performed by checking the list of references. The so-called gray literature of the national and international databases for theses and dissertations, as well as unfinished, in progress and unpublished studies were also searched. Results: After reading the titles and abstracts, articles that were duplicated (74 records) or unrelated to the systematic review (76 records) were excluded. Fifteen studies were evaluated considering seven at low risk of bias, four at high risk and four at moderate risk. Conclusion: The bioactive compounds at low concentrations (2.5-7.5%) can be used as treatment of DH both at-home and in-office.

Are healthcare workers immunized after receiving hepatitis B vaccination according to recommended guidelines? A systematic review and meta-analysis.

OBJECTIVES: Nowadays, it is believed that more than 240 million people worldwide are infected with the hepatitis B virus (HBV), associated with irreversible health-related consequences, represented by hepatic failure, cirrhosis, and hepatocellular carcinoma, and already are ranked as 15th cause of human death around the world. METHODS: A systematic review and a meta-analysis were performed to evaluate the effectiveness of vaccination and immunization on health professionals against HBV. The review was registered at the PROSPERO database (CRD42017075643). A search for cross-sectional studies was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and in the gray literature. The Effective Public Health Practice Project Modified Scale was used to evaluate the internal quality of the studies included. RESULTS: A total of 1865 articles were identified after the removal of duplicates. Of these, 790 studies remained after screening the titles and abstracts. Finally, ten studies remained after full-text reading for qualitative analysis, all of which were used in the meta-analysis. A significant difference was found in the vaccine protocol for health professionals immunized against hepatitis B, compared to those not immunized. The risk ratio was 7.37 (95% confidence interval = 3.92-13.83; P < 0.00001). CONCLUSION: This study showed that the vaccine protocol is effective in immunizing health professionals against hepatitis B.

Influência do ProTaper/ProTaper Next, comparado a outros sistemas rotatórios/reciprocantes, no risco e na intensidade da dor pós-operatória após instrumentação endodôntica em pacientes adultos: uma revisão sistemática e metanálise / Influence of ProTaper/ProTaper Next, compared to other rotatory/reciprocating systems, on the risk and intensity of postoperative pain after endodontic instrumentation in adult patients: a systematic review and meta-analysis

Introdução: O sucesso da terapia endodôntica depende não apenas de sua eficácia e conclusão adequada, mas também do mínimo desconforto do paciente. Objetivo: O objetivo dessa revisão sistemática e metanálise é avaliar o risco e a intensidade da dor endodôntica pós-instrumentação em pacientes adultos. Métodos: Uma pesquisa abrangente foi realizada no MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO e Cochrane Library e SIGLE, sem restrições. Também foram pesquisadas a conferência anual dos resumos da IADR (1990-2016) e o registro de ensaios não publicados e em andamento. As dissertações e teses foram pesquisadas utilizando-se os bancos de dados das dissertações ProQuest e das bases de teses Periódicos Capes. Apenas ensaios clínicos randomizados que compararam o risco ou a intensidade da dor resultante do tratamento endodôntico em pacientes adultos foram incluídos. Resultados: Após a remoção das duplicatas, 827 artigos foram identificados. Após a triagem do título e resumo, restaram 26 estudos, dos quais 13 foram ainda excluídos, permanecendo 10 para análise qualitativa e 7 para a metanálise. Não foi observada diferença significativa no risco/ intensidade da dor após o tratamento endodôntico nesse estudo. O risco de dor foi de 1,09, com intervalo de confiança de 95%, variando de 0,87 a 1,38 (p=0,45). A diferença padronizada g de Hedges nas médias da intensidade da dor após 24 horas foi de ­ 0,05, com intervalo de confiança variando de ­ 0,21 a 0,11 (p=0,53). Conclusões: Nessa metanálise, não foram encontradas diferenças no risco e na intensidade da dor após o tratamento endodôntico com ProTaper e outros sistemas rotatórios ou reciprocantes (AU).

Introduction: The success of endodontic therapy depends not merely on their efficacy and proper completion but also on minimal patient discomfort. The purpose of this systematic review and meta-analysis is to evaluate the risk and intensity of post instrumentation endodontic pain in adult patients. Methods: A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The annual conference of the IADR abstracts (1990-2016), and unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and the Periodicos Capes Theses Databases. Only randomized clinical trials that compared the risk or intensity of pain resulting from endodontic treatment in adult patients were included. Results: After the removal of duplicates, 827 articles were identified. After title and abstract screening, 26 studies remained. Thirteen studies were further excluded while 10 studies remained for qualitative analyses and 7 for the meta-analysis. No significant difference in the risk/intensity of pain after endodontic treatment was observed in this study. The risk of pain ratio was 1.09, with a 95% confidence interval of 0.87 to 1.38 (p = 0.45). The Hedges g standardized difference in means of pain intensity at 24 h was -0.05, with a confidence interval varying from -0.21 to 0.11 (p = 0.53). Conclusions: No differences in risk and intensity of pain after endodontic treatment with ProTaper and other rotatory or reciprocating systems were found in this meta-analysis (AU).

Nanofilled/nanohybrid and hybrid resin-based composite in patients with direct restorations in posterior teeth: A systematic review and meta-analysis.

OBJECTIVE: A systematic review and a meta-analysis were performed to answer the following research question: Are there differences in the color match and surface texture of nanofilled/nanohybrid and hybrid composite in patients with direct posterior restorations? DATA: Randomized clinical trials that compared nanofilled/nanohybrid and hybrid composite in direct restoration in posterior teeth were included. For the analysis of the bias the risk of bias tool (RoB) was used. Meta-analyses of different pairs (nanofilled vs. hybrid and nanohybrid vs. hybrid composite) were conducted for surface texture and color match and other secondary outcomes at different follow-ups, using a random effects model. Heterogeneity was assessed with the Cochran Q test and I2 statistics. GRADE was used to assess the quality of the evidence. SOURCES: A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE, without restrictions. IADR abstracts (2001-2019), unpublished and ongoing trials registries, dissertations and theses were also searched. STUDY SELECTION: 28 studies remained. No study was considered to be at low RoB; four studies were judged to have high RoB, and the remaining were judged to have unclear RoB. RESULTS: For the primary and secondary outcomes variables no significant differences were detected between nanofilled/nanohybrid restorations and hybrid composite restorations in any of the study follow-ups (p > 0.08). The body of evidence for surface texture and color match was classified as moderate or low. CONCLUSION: No evidence of difference was found between nanofilled/nanohybrid and hybrid composite in any of the clinical parameters evaluated.

Injeção de agregados plaquetários no rejuvenescimento facial: uma revisão sistemática / Injection of platelet aggregates in facial rejuvenation: a systematic review

Introdução: Essa revisão sistemática foi conduzida para avaliar se a associação da aplicação da injeção de agregados plaquetários quando comparada a outras terapias faciais favorece no rejuvenescimento facial em pacientes adultos. Métodos: A pesquisa buscou ensaios clínicos randomizados que compararam uso de técnicas de rejuvenescimento facial isoladas com as mesmas técnicas aliadas à injeção de agregados plaquetários. A busca foi realizada em bases de dados indexadas e literatura cinzenta. A ferramenta de risco de viés da "Cochrane Collaboration" foi aplicada para a avaliação da qualidade dos estudos. Resultados: Foram identificados 7137 artigos. Apenas quatro estudos permaneceram na síntese qualitativa, e os demais foram considerados com risco indefinido de viés nos domínios chaves. Conclusão: Existem poucos estudos na literatura que comparam o uso de agregados plaquetários em rejuvenescimento facial e os que estão disponíveis têm risco de viés "indefinido" ou "alto". Há necessidade de realizar mais estudos clínicos bem delineados que comparem o uso de injeção de agregados plaquetários associados ou não às técnicas de rejuvenescimento facial.

Introduction: This systematic review was conducted to assess whether the use of a platelet aggregate injection with or without associated facial rejuvenation techniques favors facial rejuvenation in adult patients. Methods: Randomized clinical trials that compared the use of techniques for facial rejuvenation alone with the same techniques coupled with the injection of platelet aggregates were searched. The search was performed in indexed databases and in the gray literature. The Cochrane Collaboration bias risk tool was applied to assess the quality of the studies. Results: In total, 7137 articles were identified. Only four studies remained in the qualitative synthesis, and the others were considered as having undefined bias risk in the key domains. Conclusion: There are few studies in the literature that compare the use of platelet aggregates in facial rejuvenation and those that are available have a risk of "undefined" or "high" bias. There is a need for more well-designed clinical studies comparing the use of platelet aggregate injection with or without associated facial rejuvenation techniques.

Do anterior and posterior teeth treated with post-and-core restorations have similar failure rates? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The association between tooth type, location in the dental arch, and selection of a post-and-core system for endodontically treated teeth is unclear. Information on the influence of these parameters on the failure rate of teeth treated with post-and-core restorations is needed. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the available evidence on the failure rates of anterior and posterior teeth treated with post-and-core restorations. MATERIAL AND METHODS: A search was performed in PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and Gray literature for randomized clinical trials comparing the failure rates of anterior and posterior teeth treated with post-and-core restorations. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. RESULTS: The search strategy identified 2526 articles, and 6 studies were included in the meta-analysis. No difference in the failure rate of post-and-core restorations placed in anterior and posterior teeth was found in most studies. The risk ratio for anterior versus posterior teeth was 1.06 (95% confidence interval [CI], 0.69-1.64; P=.79). The risk ratio for incisors versus canines was 3.08 (95% CI, 0.56-17.04; P=.20) and that for premolars versus molars was 0.45 (95% CI, 0.12-1.74; P=.25). The risk ratio for prefabricated glass fiber posts on anterior versus posterior teeth was 1.13 (95% CI, 0.61-2.09; P=.70) and that for metal posts was 1.10 (95% CI, 0.64-1.91; P=.72). CONCLUSIONS: The failure rates in anterior and posterior teeth treated with post-and-core restorations were similar at short- to medium-term follow-up. More well-designed clinical trials comparing the survival and failure rates of anterior and posterior teeth treated with post-and-core restorations with longer follow-up times are needed.

Are Glass-Ionomer Cement Restorations in Cervical Lesions More Long-Lasting than Resin-based Composite Resins? A Systematic Review and Meta-Analysis.

PURPOSE: To compare the the loss of retention and color match of glass-ionomer cements (GIC) and resin-based composites (RC) in noncarious cervical lesions. Other secondary outcomes (surface texture, marginal adaptation, marginal discoloration, and secondary caries) were evaluated in a systematic review and meta-analysis. MATERIALS AND METHODS: A comprehensive search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane. We included only randomized clinical trials. The quality of the evidence for each outcome was assessed using the GRADE tool. RESULTS: A total of 1530 articles were identified, but only 19 reports remained for analysis, all of which were judged to possess "unclear" risk of bias. GIC showed higher retention rates in all follow-ups (1 to 3 years, p < 0.0001; at 5 years, p < 0.00001). No difference was observed for marginal discoloration, marginal adaptation and secondary caries in all follow-ups (p > 0.05). RC showed better color match than GIC only at 2 years (p = 0.03). Higher roughness was observed in GIC in all follow-ups (at 1 year p = 0.0003; at 3 years p = 0.0004). Quality of evidence was graded as moderate or low due to unclear risk of bias and imprecision in some outcomes. CONCLUSION: The loss of retention of RMGIC/GIC was inferior to that of RC, but a higher roughness was observed in the RMGIC/GIC when compared to RC in all follow-ups of the clinical studies evaluated. In addition, the color match was better with RC only in the 2-year follow-up when compared to GIC. The quality of evidence was judged as moderate to low in these two outcomes.

A Randomized Clinical Trial Evaluating Rubber Dam Clamp Pain Reduction from a New Topical Liposomal Anesthetic Gel.

PURPOSE: Discomfort during rubber dam clamp often occurs in pediatric dentistry. The purpose of this randomized, triple-blind, clinical trial was to evaluate the effect of pain reduction using a new topical liposomal thermo-sensitive gel (TLTG) or a placebo gel during rubber dam clamp isolation for sealants in children. METHODS: Eighty-one children (eight to 12 years old) had LTSG or the placebo gel with random assignment placed around the gingival tissue of their permanent mandibular first molars. A clamp was placed after two minutes on the teeth, and intensity of pain was registered using a Wong-Baker FACES scale and an 11-point numerical scale. The data were evaluated using McNemar's test and Wilcoxon signed rank test. RESULTS: The odds ratio for pain (OR equals 0.7; 95 percent confidence interval equals 0.3 to 1.8) was not statistically significant (P=0.52). However, there was a small difference in the pain intensity between liposomal and placebo groups for both scales (P<0.05). CONCLUSION: The liposomal thermo-sensitive anesthetic gel may reduce, to a small extent, the pain intensity in children submitted to rubber dam isolation before resin sealant placement.

Does smoking habit increase the micronuclei frequency in the oral mucosa of adults compared to non-smokers? A systematic review and meta-analysis.

OBJECTIVES: A systematic review of clinical studies to evaluate the frequency of micronuclei in the oral mucosa of smokers and non-smokers in adult patients was performed. MATERIALS AND METHODS: A comprehensive search was carried out on MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO, and Cochrane Library and SIGLE without restrictions. Dissertations and thesis were searched using the ProQuest Dissertations and Periodicos Capes Thesis Databases. We included only cross-sectional clinical trials that compared the frequency of micronuclei in the oral mucosa of smokers and non-smokers in adult patients. DATA: After the removal of duplicates, 1338 articles were identified. After title and abstract screening, 35 studies remained. Eighteen studies were further excluded, whereas 17 studies remained for qualitative analysis and 16 for the meta-analysis of the primary and secondary outcomes. A significant difference in the frequency of micronuclei in smokers when compared to non-smokers was observed in the present study. CONCLUSIONS: Despite the high variation in the methodology of the assessed studies, this study showed a higher frequency of micronuclei in exfoliated cells of smokers compared to non-smokers. CLINICAL SIGNIFICANCE: The use of tobacco is associated with cytotoxic and genotoxic effects because a higher frequency of micronuclei in exfoliated cells of smokers was observed.

Effectiveness of and tooth sensitivity with at-home bleaching in smokers: a multicenter clinical trial.

BACKGROUND: The authors conducted a 2-center controlled clinical study to show the equivalence of at-home bleaching in smokers and nonsmokers at 1 week and 1 month and evaluate tooth sensitivity (TS). METHODS: The authors selected 60 smokers and 60 nonsmokers with central incisors of shade A2 or darker. The participants performed bleaching with 10% carbamide peroxide for 3 hours daily for 3 weeks. The authors evaluated the color by using a shade guide and a spectrophotometer before, during, and after bleaching (1 week and 1 month). Patients recorded TS by using a 0-4 scale and a visual analog scale. The authors used multivariable regression analysis to test factors associated with color change and TS (α = .05). RESULTS: Smokers and nonsmokers showed significant color change statistically equivalent to within ± 2.0 units at 1 week after bleaching. Overall, color shade improved by 4.1 shade guide units (95% confidence interval [CI], 3.7-4.5) and 7.8 units of color change measured with the spectrophotometer (95% CI, 7.1-8.5) at 1 month. None of the factors affected the TS risk. TS absolute risk and intensity were similar between groups (P > .05), with an overall estimate of 47% (95% CI, 38-56%). CONCLUSIONS: The immediate effectiveness of whitening- and bleaching-related TS were not affected by smoking. PRACTICAL IMPLICATIONS: Smoking did not affect the immediate color change (1 week). Effective whitening was achieved regardless of whether the patient was a smoker. However, this equivalence was not apparent 1 month after bleaching, with smokers having slightly darker teeth.