Clinical longevity of direct and indirect posterior resin composite restorations: An updated systematic review and meta-analysis.

OBJECTIVES: To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth? DATA: Randomized controlled clinical trials (RCTs) investigating direct and indirect resin composite restorations in posterior permanent teeth were considered. SOURCES: Several electronic databases were searched, with no language or date restrictions. The revised Cochrane Collaboration's tool for assessing risk of bias (RoB-2) was used to analyze the studies; meta-analyses were run and the certainty of evidence was assessed by the GRADE tool. A subgroup meta-analysis was performed for resin composite restorations placed on posterior worn dentition. STUDY SELECTION: Twenty-three articles were included in qualitative synthesis, while 8 studies were used for meta-analyses. According to the RoB-2 tool, 5 studies were ranked as "low risk", 7 had "some concerns", while 11 papers were rated as "high risk" of bias. There were no statistically significant differences in short-term (p = 0.27; RR=1.54, 95% CI [0.72, 3.33]), medium-term (p = 0.27; RR=1.87, 95% CI [0.61, 5.72]) and long-term longevity (p = 0.86; RR=0.95, 95% CI [0.57, 1.59]). The choice of restorative technique had no influence on short-term survival of resin composite restorations placed on worn dentition (p = 0.13; RR=0.46, 95% CI [0.17, 1.25]). The certainty of evidence was rated as "very low". CONCLUSIONS: Direct and indirect resin composite restorations may show similar clinical longevity in posterior region, regardless of the observation period or substrate (wear-affected and non-affected dentition). The very low quality of evidence suggests that more long-term RCTs are needed to confirm our results.

The Link Between Apical Periodontitis and Gastrointestinal Diseases-A Systematic Review.

INTRODUCTION: This systematic review aimed to examine a potential link between apical periodontitis (AP) and gastrointestinal diseases (GIDs). METHODS: The protocol of the review has been registered in PROSPERO (CRD42022330771). The following engines were used with the aim of searching for relevant literature: PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, and grey literature, from inception to May 2022. There were no language restrictions included. Study selection, data collection, and synthesis have been performed by 2 independent reviewers. For the purpose of estimating the quality of studies, the Newcastle-Ottawa Scale was used. RESULTS: Four matched case control studies, as well as a single longitudinal cohort study were included in the final review. These were published between 2012 and 2017, and comprised 537 participants whose age range was 18 to 87 years. It was not possible to perform a meta-analysis due to different study designs and evaluated outcomes of included studies. Except for one study that was categorized as "Good," overall, for 4 out of 5 studies the quality was assessed as "Fair". CONCLUSIONS: This review highlighted sparse knowledge present in the literature concerned with the association between AP and GIDs. Available evidence reveals a potential link between impaired endodontic status, assessed by the number of root-filled teeth with periapical radiolucency, and GIDs. More research is needed to ascertain this association.

Critical analysis of the reporting quality of animal studies within Endodontics using the Preferred Reporting Items for Animal Studies in Endodontics (PRIASE) 2021 quality standard checklist.

AIM: To critically evaluate the reporting quality of a random sample of animal studies within the field of endodontics against the Preferred Reporting Items for Animal Studies in Endodontics (PRIASE) 2021 checklist and to investigate the association between the quality of reporting and several characteristics of the selected studies. METHODOLOGY: Fifty animal studies related to endodontics were randomly selected from the PubMed database with publication dates from January 2017 to December 2021. For each study, a score of '1' was given when the item of the PRIASE 2021 checklist was fully reported, whereas a score of '0' was given when an item was not reported; when the item was inadequately or partially reported, a score of '0.5' was given. Based on the overall scores allocated to each manuscript, they were allocated into three categories of reporting quality: low, moderate and high. Associations between study characteristics and reporting quality scores were also analysed. Descriptive statistics and Fisher's exact tests were used to describe the data and determine associations. The probability value of .05 was selected as the level of statistical significance. RESULTS: Based on the overall scores, four (8%) and 46 (92%) of the animal studies evaluated were categorized as 'High' and 'Moderate' reporting quality, respectively. A number of items were adequately reported in all studies related to background (Item 4a), relevance of methods/results (7a) and interpretation of images (11e), whereas only one item related to changes in protocol (6d) was not reported in any. No associations were confirmed between reporting quality scores and number of authors, origin of the corresponding author, journal of publication (endodontic specialty vs. non- specialty), impact factor or year of publication. CONCLUSIONS: Animal studies published in the specialty of endodontics were mostly of 'moderate' quality in terms of the quality of reporting. Adherence to the PRIASE 2021 guidelines will enhance the reporting of animal studies in the expectation that all future publications will be high quality.

Effectiveness of vital pulp treatment in managing nontraumatic pulpitis associated with no or nonspontaneous pain: A systematic review.

BACKGROUND: The exposed pulp has been the topic of numerous studies, but well-designed and well-executed comparative trials on the outcome and treatment of these teeth have been limited. OBJECTIVES: This study was conducted to answer the following questions: in patients with nontraumatic pulpitis associated with no or nonspontaneous pain in permanent teeth, (i) is direct pulp capping or pulpotomy (partial/full) as effective as selective or stepwise caries removal [Population/participants, Intervention(s), Comparator(s)/control, Outcome(s) (PICO) 1], (ii) is pulpotomy (partial/full) as effective as direct pulp capping (PICO 2) and (iii) is pulpotomy (partial/full) as effective as a pulpectomy (PICO 3), in terms of a combination of patient and clinical reported outcomes, with 'tooth survival' as the most critical outcome? METHODS: A literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials from inception to November 3rd 2021. Grey literature and contents of the major subject journals were examined. Eligibility criteria followed the PICO questions. Two independent reviewers performed study selection, data extraction and appraisal; disagreements were resolved by a third reviewer. The risk of bias was assessed by the revised Cochrane risk-of-bias tool for randomized trials. RESULTS: Three randomized clinical trials (RCTs) were included in the review. No study fulfilled the criteria to answer PICO 1. There were no significant differences in the reported outcomes between investigated treatments in all included RCTs. None of the included studies reported the most critical outcome 'tooth survival'. A high loss of patients during the follow-up period was observed. DISCUSSION: Although a few studies fulfilled strict eligible criteria, the results of this systematic review clearly highlight a paucity of available evidence. At the present time, clinical decisions cannot be substantiated by direct comparative trials. CONCLUSIONS: Based on limited evidence, this systematic review discovered no significant differences in effectiveness between compared vital pulp treatments in managing nontraumatic pulpitis associated with no or nonspontaneous pain. Further high-quality RCTs are necessary to investigate the effectiveness of direct pulp capping or pulpotomy (partial/full) compared to selective or stepwise caries removal. REGISTRATION: PROSPERO database (CRD42021259742).

Effectiveness of pulpotomy compared with root canal treatment in managing non-traumatic pulpitis associated with spontaneous pain: A systematic review and meta-analysis.

BACKGROUND: Pulpitis characterized by spontaneous pain can result in debilitating pain. Dogma has existed to offer only have two treatment options, namely root canal treatment (RCT) or extraction, although pulpotomy has always remained a potential treatment modality. OBJECTIVE: This review aimed to answer the following research question: 'Does pulpotomy (partial or full) (I) result in better patient and clinical reported outcomes (O), compared with RCT (C) in permanent teeth with pulpitis characterized by spontaneous pain (P) evaluated at various time intervals?' (T). METHODS: Two authors independently performed study selection, data extraction and risk of bias assessment. The literature search was conducted in the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. English language clinical trials comparing the patient and clinical reported outcomes between RCT and pulpotomy were included. The meta-analysis was performed on a fixed-effect model and the quality of evidence assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. RESULTS: Two randomized clinical trials were included. Amongst two trials, one has published four reports at different time points involving the same cohorts. The meta-analysis revealed no difference in postoperative pain (Day 7) between RCT and pulpotomy (OR = 0.99, 95% CI 0.63-1.55, I2  = 0%) and quality of evidence was graded as 'High'. Clinical success was high at year 1, 98% for both interventions, however, decreased over time to 78.1% (pulpotomy) and 75.3% (RCT) at 5 years. DISCUSSION: Pulpotomy is a definitive treatment modality that is as effective as RCT. This could have a significant impact on treatment of such patients affording the advantages of retaining a vital pulp and preventing the need for RCT. CONCLUSION: This review could only include two trials, hence there is insufficient evidence to draw robust conclusions. The clinical data accumulated so far suggests no difference in pain between RCT and pulpotomy at Day 7 postoperatively and a single randomized control trial suggests that the clinical success rate for both treatment modalities is similar long term. There is a need for more well-designed trials by different research groups to develop a stronger evidence base in this area. REGISTRATION: PROSPERO database (CRD42021259744).

Association between innate immunity gene polymorphisms and neonatal sepsis development: a systematic review and meta-analysis.

BACKGROUND: The aim of this meta-analysis was to analyze all available data from studies investigating associations between polymorphisms in genes responsible for innate immunity and neonatal sepsis development. METHODS: A comprehensive literature search, reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-S guidelines, was performed with no language restriction. Studies derived using the PICO (population, intervention, comparison and outcomes) strategy, with data on the genotype distribution for innate immunity gene polymorphisms in newborns with and without sepsis. Data were analyzed using Review Manager. The Cochran-Mantel-Haenszel test was used to calculate odds ratios with 95% confidence intervals. Heterogeneity was tested using the I2 index. RESULTS: From a total of 9428 possibly relevant articles, 33 qualified for inclusion in this systematic review. According to the STrengthening the REporting of Genetic Association Studies, 23 studies were found to be of moderate quality, while 10 were of low quality. The results showed an association of the mannose-binding lectin (MBL) exon 1 genetic polymorphism with the risk of culture-proven sepsis. Toll-like receptor (TLR) 4 rs4986791 genotype distribution suggests its association with the increased risk of culture-proven sepsis. The certainty of evidence per GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) varied from very low to low. Publication bias was not detected. CONCLUSIONS: Out of the 11 investigated single-nucleotide polymorphisms, this meta-analysis found a possible association between the risk for culture-proven sepsis and MBL exon 1 and TLR4 rs4986791 polymorphisms. There is an evident need for larger well-designed, multicentric observational studies investigating inflammatory gene polymorphisms in neonatal sepsis.

Herpesviruses in Periodontitis: An Umbrella Review.

BACKGROUND: Despite numerous studies indicating a high prevalence of herpesviruses in both apical and marginal periodontitis samples, their exact role in the pathogenesis of a periodontal disease is still unclear. OBJECTIVE: This umbrella review aimed to summarize data on herpesviruses detection in marginal periodontitis (MP) and apical periodontitis of endodontic origin (APEO) samples. METHODS: The study protocol has been drafted a priori and registered to the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020215922). The literature search was conducted using the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Database of Systematic Reviews, from inception to October 2020, with no language restrictions. Systematic reviews with or without meta-analysis that evaluated the association between the occurrence of herpesviruses and different forms of periodontal diseases were included. Other types of studies, including narrative reviews, were excluded. Two reviewers independently performed a literature search, data extraction, and quality assessment of included studies. Any disagreements or doubts were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool (A measurement tool to assess systematic reviews). RESULTS: Six systematic reviews were included in the current review. One was graded as high quality, another one was graded as moderate quality, whereas the other four were graded as critically low-quality reviews. The presence of herpesviruses in subgingival samples was associated with an increased risk of MP, supported by the corresponding meta-analyses. Although the association was strong (OR > 3.0), the confidence intervals were wide, heterogeneity was significant, and studies were of small sample size. In addition, publication bias was detected. Contrary, data from systematic reviews that assessed APEO and herpesviruses did not show any significant associations. CONCLUSIONS: Low-quality studies with high uncertainty suggest a strong association between herpesviruses and MP, but not with APEO.

Single nucleotide polymorphisms as a predisposing factor for the development of apical periodontitis-An umbrella review.

BACKGROUND: The interaction between heredity and different environmental factors in the modification of apical periodontitis (AP) susceptibility and prediction of its progression remain poorly elucidated. OBJECTIVES: This umbrella review aimed to (i) analyse the available relevant systematic reviews in an attempt to determine the association between genotype and allelic distribution of different single-nucleotide polymorphisms (SNPs) and the development of AP, (ii) report deficiencies and gaps in knowledge in this area and (iii) present recommendations to conduct future clinical studies and systematic reviews. METHODS: A literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Database of Systematic Reviews, from inception to October 2021, with no language restrictions, including a grey literature search. Systematic reviews with/without meta-analysis evaluating genotype and allelic distribution of different SNPs between adult patients with/ without AP were included. All other type of studies were excluded. The methodological quality was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR)-2 tool. Two independent reviewers were involved in study selection, data extraction and appraising the included reviews; disagreements were resolved by a third reviewer. RESULTS: The current study includes five systematic reviews. Three reviews performed meta-analysis. Three reviews were graded by AMSTAR 2 as 'critically low' quality, whereas the other two were graded as 'low' and 'moderate' quality. Two reviews indicated that carriers of specific genotypes and alleles of tumour necrosis factor-alpha (TNF-α) -308 G > A and interleukin 1-beta (IL-1ß) + 3954 C/T gene polymorphisms are more susceptible to an acute and persistent form of AP. However, high heterogeneity was observed. DISCUSSION: The statistical heterogeneity within included systematic reviews was a consequence of clinical and methodological diversity amongst primary studies. Although some of the included reviews suggested that carriers of specific genotype and/or allele of TNF-α -308 G > A and IL-1ß + 3954 C/T SNPs are more susceptible to AP, their conclusions should be interpreted with caution. CONCLUSIONS: No candidate genes could be identified as a definitive genetic risk or protective factor for the development and progression of AP, and further high-quality genome-wide association studies are warranted.

Methylation of tumour suppressor genes in benign and malignant salivary gland tumours: a systematic review and meta-analysis.

The aim of the present systematic review was to critically analyse the relationship between tumour suppressor genes (TSGs) promoter methylation, a potent mechanism of gene silencing, and the development of salivary gland tumours, as well as the possible effect on clinical/histological characteristics. Review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration ID CRD42020218511). A comprehensive search of Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials was performed utilizing relevant key terms, supplemented by a search of grey literature. Newcastle-Ottawa Quality Assessment Scale (NOQAS) was used for the quality assessment of included studies. Sixteen cross-sectional and 12 case-control studies were included in the review, predominantly dealing with methylation in TSGs related to DNA repair, cell cycle, and cell growth regulation and differentiation. Quantitative synthesis could be performed on P16 (inhibitor of cyclin-dependent kinase 4a), RASSF1A (Ras association domain family 1 isoform A) and MGMT (O6-methylguanine DNA methyltransferase) genes only. It showed that P16 and RASSF1A genes were more frequently methylated in salivary gland tumours compared to controls (P = .0002 and P < .0001, respectively), while no significant difference was observed for MGMT. Additionally, P16 did not appear to be related to malignant transformation of pleomorphic adenomas (P = .330). In conclusion, TSG methylation is involved in salivary gland tumour pathogenesis and several genes might play a considerable role. Further studies are needed for a better understanding of complex epigenetic deregulation during salivary gland tumour development and progression.

The influence of selective enamel etch and self-etch mode of universal adhesives' application on clinical behavior of composite restorations placed on non-carious cervical lesions: A systematic review and meta-analysis.

BACKGROUND: To answer the PICOS question: "Is the risk of retention loss equal for SEE and SE approach when universal adhesives and composite restorations are indicated for restoring NCCLs?" METHODS: Web of Science, PubMed, Cochrane Central Register of Controlled Trials, Scopus, Scientific Electronic Library Online, LILACS, Google Scholar™ and OpenGrey were searched. Only randomized controlled clinical trials in which NCCLs were restored with composites and universal adhesives applied in SEE or SE mode were included. The articles were assessed for the risk of bias, after which meta-analyses were run (fixed-effects model was applied; heterogeneity was explored using Cochran Q test and I2 statistics; α = 0.05) and the certainty of evidence was assessed by the GRADE tool. RESULTS: Fifteen articles were included in qualitative, while 7 articles were included in quantitative analysis. Seven studies were judged as "low" risk of bias, while 8 were considered as "unclear" risk of bias. Statistically significant difference for retention were observed at 6- and 18/24 months (p = 0.05; OR=0.42, 95% CI [0.18, 0.99]; very low certainty of evidence and p = 0.007; OR=0.31, 95% CI [0.13, 0.72]; low certainty of evidence, respectively), favoring SEE approach. No other significant differences in clinical outcomes were observed between SEE and SE approach (very low certainty of evidence). SIGNIFICANCE: When restoring NCCLs, clinicians might consider applying universal adhesives in SEE mode since it could lead to more predictable retention compared to SE approach up to 2 years of follow-up.

Gene polymorphisms in odontogenic keratocysts and ameloblastomas: A systematic review.

OBJECTIVES: The aim of this systematic review was to critically analyze available data on gene polymorphisms in odontogenic keratocysts (OKC) and ameloblastomas, including their possible relationship with clinical and histological features of these lesions. MATERIALS AND METHODS: A comprehensive search of Web of Science Scopus, PubMed, Cochrane Central Register of Controlled Trials and EMBASE was conducted using relevant key terms and supplemented by a gray literature search. Quality assessment of included studies was performed using criteria from the Strengthening the Reporting of Genetic Association (STREGA) statement. RESULTS: Ten studies were included in the final review. Survivin -31G/C, interleukin IL-1α -889 C/T, p53 codon 72 G/C, tumor necrosis factor TNF-α (-308G>A) and its receptor TNF-R1 (36A>G), glioma-associated oncogene homolog 1 rs2228224 and matrix metalloproteinase 2 rs243865 gene polymorphisms were reported to be associated with OKC. For ameloblastomas, p53 codon 72 G/C, X-ray repair cross-complementing protein 1-codons 194 and 399 and matrix metalloproteinase 9 rs3918242 gene polymorphisms were identified as risk factors. It was not possible to establish a relationship between specific polymorphisms and clinical and histological features of investigated lesions. CONCLUSIONS: Several gene polymorphisms might be considered as a risk factor for the development of these lesions. Future studies should investigate whether these polymorphisms might be used to identify patients with increased risk of recurrence or aggressive disease.

A bibliometric analysis of the top 100 most-cited case reports and case series in Endodontic journals.

AIM: To identify the top 100 most-cited case reports and case series published in Endodontic journals and to analyse their bibliometric characteristics. METHODOLOGY: The Clarivate Analytics' Web of Science (WoS), Scopus and PubMed databases were used to identify the top 100 most-cited case reports and case series in Endodontic journals. Complete bibliographic records of the selected case reports and case series were exported in plain text or BibTeX format and imported into the R environment for statistical computing and graphics. The following parameters were then analysed: names and affiliations of the authors, title, year of publication, journal of publication, first author, corresponding author, literature cited within reports, language, citation counts, impact factor of the journal, keywords, Keywords Plus and research topic. RESULTS: In total, 88 case reports and 12 case series published in English between 1977 and 2016 were identified as the most-cited reports in the field of Endodontics. The terms "case report(s)" or "case series" were not included in the title of 57 articles. The number of authors per report ranged from one to seven, with the average number of co-authors per report being 3.14. The most-cited author was M Trope (University of Pennsylvania, USA). The University of Washington and Private Practice, Cetraro, Italy, were the most productive institutions. The country whose case reports received the largest total number of citations was the United States. The largest number of the most-cited reports appeared in 2002, 2004 and 2007 (n = 7, respectively). According to the WoS database, the total number of citations ranged from 42 to 453, with the average number of citations per report being 79.97. The majority of the top 100 most-cited articles were published in the Journal of Endodontics and the International Endodontic Journal. The most frequently used author keywords were revascularization and mineral trioxide aggregate. The majority of the case reports and case series dealt with topics related to pulp regeneration. CONCLUSION: This bibliometric study provides a comprehensive overview on the progress, trends and current directions in clinical practice within the field of Endodontics.

Is clinical behavior of composite restorations placed in non-carious cervical lesions influenced by the application mode of universal adhesives? A systematic review and meta-analysis.

OBJECTIVE: To answer the following PICOS question: "Is the risk of retention loss, marginal discoloration, marginal adaptation and postoperative sensitivity (POS) equal for etch-and-rinse (EAR) compared to self-etch (SE) or selective-enamel etch (SEE) mode when restoring non carious cervical lesions (NCCLs) with universal adhesives?". METHODS: PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, OpenGrey and Google Scholar™ were searched. Randomized controlled clinical trials in which resin composites and universal adhesives were used for restoration of NCCLs were considered. Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analyses were performed using Revman; random-effects models were applied, and heterogeneity was tested using the I2 index. The significance level was set at p < 0.05. Certainty of evidence was assessed by GRADE tool. RESULTS: After screening, 20 articles were included in qualitative, while 14 articles were used for quantitative synthesis. Twelve studies ranked as "low", while 8 studies scored as "unclear" for risk of bias. At 12- and 18/24-months the risk for retention loss was higher for SE than for EAR groups (p = 0.005; RR = 0.22, 95% CI [0.08, 0.63],[moderate certainty of evidence and p = 0.0002; RR = 0.32, 95% CI [0.17, 0.58], moderate certainty of evidence, respectively). No significant differences were observed for marginal discoloration and adaptation (p > 0.05). The probability of POS occurrence was less in SE than in EAR groups (RR = 2.12, 95% CI [1.23, 3.64], moderate certainty of evidence). The certainty of evidence for other outcomes was scored as "low" or "moderate", depending on the follow-up period. SIGNIFICANCE: Using universal adhesives in EAR or SEE mode provides more predictable retention, while SE strategy reduces the risk of POS occurrence.

A bibliometric analysis of the dental scientific literature on COVID-19.

OBJECTIVES: The rapid production of a large volume of literature during the early phase of the COVID-19 outbreak created a substantial burden for clinicians and scientists. Therefore, this manuscript aims to identify and describe the scientific literature addressing COVID-19 from a dental research perspective, in terms of the manuscript origin, research domain, study type, and level of evidence (LoE). MATERIALS AND METHODS: Data were retrieved from Web of Science, Scopus, and PubMed. A descriptive analysis of bibliographic data, collaboration network, and keyword co-occurrence analysis were performed. Articles were further classified according to the field of interest, main research question, type of study, and LoE. RESULTS: The present study identified 296 dental scientific COVID-19 original papers, published in 89 journals, and co-authored by 1331 individuals affiliated with 429 institutions from 53 countries. Although 81.4% were single-country papers, extensive collaboration among the institutions of single countries (Italian, British, and Brazilian institutions) was observed. The main research areas were as follows: the potential use of saliva and other oral fluids as promising samples for COVID-19 testing, dental education, and guidelines for the prevention of COVID-19 transmission in dental practice. The majority of articles were narrative reviews, cross-sectional studies, and short communications. The overall LoE in the analyzed dental literature was low, with only two systematic reviews with the highest LoE I. CONCLUSION: The dental literature on the COVID-19 pandemic does not provide data relevant to the evidence-based decision-making process. Future studies with a high LoE are essential to gain precise knowledge on COVID-19 infection within the various fields of Dentistry. CLINICAL RELEVANCE: The published dental literature on COVID-19 consists principally of articles with a low level of scientific evidence which do not provide sufficient reliable high-quality evidence that is essential for decision making in clinical dental practice.

Tumor Necrosis Factor Alpha -308 G/A Single-Nucleotide Polymorphism and Apical Periodontitis: An Updated Systematic Review and Meta-analysis.

INTRODUCTION: This study aimed to perform a more precise estimation of the association between tumor necrosis factor alpha (TNF-α) -308 G/A single-nucleotide polymorphism (SNP) and the risk of development of apical periodontitis (AP) and its phenotypes based on all available published studies. METHODS: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is registered in PROSPERO (CRD42020176190). The literature search was conducted via Clarivate Analytics Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases from inception to December 2020 with no language restrictions. Two reviewers were involved independently in the study selection, data extraction, and appraising the studies that were included. The quality of the included studies was evaluated using the Strengthening the Reporting of Genetic Association and the Grading of Recommendations Assessment, Development and Evaluation system. The frequencies of the genotypes and alleles of the TNF-α (G>A 308, rs1800629) gene with 95% odds ratio were used. RESULTS: Four studies met the inclusion criteria with moderate risk of bias. This study revealed no significant association between TNF-α -308 G/A SNP and AP and the risk of AP development. Moreover, there was no significant association between genotype or allele frequency distribution and clinical manifestations (acute vs chronic) of AP. The certainty of evidence per the Grading of Recommendations Assessment, Development and Evaluation system was very low. CONCLUSIONS: Because of very low certainty of evidence, whether there is an association between TNF-α -308 G/A SNP and AP warrants further well-designed multicentric studies to adjudicate a better understanding of the role of genetic factors in the etiopathogenesis of AP.

Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 and 2020.

INTRODUCTION: This study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment (NSRCT) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020. METHODS: An electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies. RESULTS: Sixteen articles were included in the review. In total, 200,041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT. Forty-one percent of RCT teeth had AP, and 3.5% of untreated teeth had AP. Female patients were less prone to AP in endodontically treated teeth only, compared with male patients (P < .001). Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P < .001 and P < .001, respectively). Because of high heterogeneity, these results should be taken with caution. CONCLUSIONS: There is an increased AP prevalence in the adult general population compared with data from 2012 (6.3% versus 5.4%) in both endodontically treated (41.3% versus 35.9%) and untreated teeth (3.5% versus 2.1%). In addition, AP developed less frequently in female patients with endodontically treated teeth and in teeth with inadequate compared with adequate restorative and endodontic treatment.

Lack of association between glutathione S-transferase M1 and T1 gene polymorphisms and susceptibility to preeclampsia: An updated systematic review and meta-analysis.

Insufficient response to oxidative stress in placenta is proposed as a contributing factor for preeclampsia (PE) development. Glutathione S-transferases (GST) have significant role in detoxification processes. Conflicting results were published by several research groups regarding GST T1 and GST M1 deletion polymorphism as risk factors for PE. The aim of the present meta-analysis was to get a better understanding of the impact of these polymorphisms in preeclampsia development. To identify relevant case-control studies, the author team searched Clarivate Analytics Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, major subject journals, and gray literature. Pooled odds ratios and 95% confidence intervals for GST M1 and GST T1 deletion polymorphism and preeclampsia were derived from random effects models. This meta-analysis included 10 eligible studies. The pooled analyses showed no association between GST M1/GST T1 deletion polymorphisms and susceptibility to PE. Even though high heterogeneity was founded among results for GST M1 and double null genotypes, Egger's and Begg's tests (0.17 and 0.18, respectively) revealed no statistical evidence of publication bias among included studies. The present updated systematic review and meta-analysis found no association between GST M1 and GST T1 deletion polymorphism and PE risk.