ABSTRACT
Statement of the Problem: Dentin hypersensitivity (DH) is a common irritating condition. A precise sensitive test for its assessment can greatly aid in appropriate treatment planning. Purpose: This meta-analysis aims to compare the air blast and tactile tests for assessment of the efficacy Nd:YAG laser therapy versus non-laser treatments for DH in short-term and long-term follow-ups. Materials and Method: For this review, an electronic search of the literature was carried out in three databases by two researchers for English articles published until March 10, 2021. Pooling of the data extracted from the selected articles was performed according to the PRISMA statement by the random-effect model. The mean difference (MD) and 95% confidence interval (CI) of pain score before the treatment onset and during the follow-up period according to the visual analog scale (VAS) were calculated. The level of heterogeneity was assessed by the I2 test, and a funnel plot was drawn to assess the publication bias of the reviewed studies. Results: Of 152 articles primarily retrieved, 9 randomized clinical trials (RCTs) using the air blast test and 4 RCTs using the tactile test were subjected to quantitative synthesis. In the short-term follow-up and immediately after treatment, the air blast test showed superiority of laser therapy compared with non-laser treatments (SMD: 0.55, 95% CI: 0.05-1.04, p= 0.03). However, this difference was not significant according to the tactile test (SMD: 0.48. 95% CI: 0.01-0.96, p= 0.06). In the long-term follow-up, the difference between laser therapy and non-laser modalities was not significant according to both air blast (SMD= -0.38, 95% CI: -1.43-0.67, p= 0.48) and tactile (SMD=0.0, 95% CI: -0.38-0.38, p= 0.99) tests. Conclusion: Comparison of laser therapy and non-laser modalities in the short-term reveal-ed higher sensitivity of the air blast test due to its mechanism of action compared with the tactile test. Further studies are required to interpret the results in the long-term follow-up.
ABSTRACT
This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.
Subject(s)
Anti-Infective Agents , Chronic Periodontitis , Photochemotherapy , Humans , Photochemotherapy/methods , Metronidazole , Chronic Periodontitis/drug therapy , Incisor , Anti-Bacterial Agents/therapeutic use , Amoxicillin , Anti-Infective Agents/therapeutic useABSTRACT
Objectives: This systematic review and meta-analysis study sought to review the efficacy of amoxicillin/metronidazole dose and duration time in the treatment of stage II - III grade C periodontitis (aggressive periodontitis) after current follow-up. Material and Methods: An electronic search of the literature was performed in three main databases for relevant articles published until 31th of December 2021. According to the PRISMA statement, the extracted data from selected articles were pooled. The weighted mean difference (MD) and 95% confidence interval (CI) of clinical attachment level (CAL) gain and probing depth (PD) reduction at 3 and 6 months of follow-up were calculated. The heterogeneity of the data was evaluated by the I2 test. Results: The results of six randomized clinical trials revealed significant improvement of clinical parameters in moderate and severe pockets. Prescription of 400 to 500 mg metronidazole caused significant CAL gain changes just in moderate pockets (MD = 1.82; 95% CI = 1.11 to 2.53; P < 0.05). Conclusions: Amoxicillin/metronidazole has positive short-term effects as an adjunct to scaling and root planning for treatment of stage II - III grade C periodontitis. Higher doses of metronidazole (400 to 500 mg) are required for optimal efficacy regarding clinical attachment level gain.
ABSTRACT
STATEMENT OF THE PROBLEM: Studies on the efficacy of erbium laser for enhancement of enamel resistance to acid attacks and its effects on fluoride uptake by the enamel are limited. PURPOSE: This study sought to assess and compare the effects of erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation and application of acidulated phosphate fluoride (APF) gel (alone and in combination) on remineralization of artificial white spot lesions (WSLs). MATERIALS AND METHOD: This in vitro, experimental study evaluated 90 buccal and lingual slabs of extracted human premolars. The specimens underwent pH cycling to induce WSLs. They were then randomly divided into 6 groups of caries-free positive control (c+), negative control with WSLs (ws), 1.23% APF gel applied on the enamel (F), Er:YAG laser irradiation (80 mJ, 10 Hz, and 8 J/cm2) of enamel (L), APF gel application followed by laser irradiation (FL), and laser irradiation followed by fluoride gel application (LF). The fluoride ion content of specimens was measured before and after the intervention using a potentiometer. Data were analyzed by ANOVA (p< 0.05). RESULTS: APF gel application before/after laser irradiation maximally increased the fluoride uptake by the enamel (p= 0.000). Application of APF gel in group F and laser irradiation in group L increased fluoride uptake by the enamel, compared with groups 1 and 2 (p= 0.000). Laser- treated (L) and APF-treated (F) groups had no significant difference in this respect (p= 0.945). Maximum fluoride concentration was noted in combined laser and fluoride groups (FL=332.07ppm and LF=341.27ppm) with no significant difference between the two (p= 1.000). CONCLUSION: Er:YAG laser irradiation changes the chemical composition of enamel and probably promote its remineralization, especially when combined with APF gel application, which highlights its cariostatic potential.
