ABSTRACT
BACKGROUND: Chloroquine and hydroxychloroquine are 2 medications used to treat some systemic diseases. OBJECTIVE: The aim of this scoping review was to assess the occurrence of oral pigmentation induced by chloroquine or hydroxychloroquine and to understand the pathogenic mechanism behind this phenomenon. METHODS: The review was performed according to the list of PRISMA SrC recommendations and the JBI Manual for Evidence Synthesis for Scoping Reviews. MEDLINE (PubMed), Scopus, EMBASE, SciELO, Web of Science, Lilacs, and LIVIVO were primary sources, and "gray literature" was searched in OpenThesis and Open Access Thesis and Dissertations (OATD). Studies that screened the occurrence of oral pigmentation associated to the use of chloroquine or hydroxychloroquine were considered eligible. No restrictions of year and language of publication were applied. Study selection and data extraction were performed by 2 independent reviewers. The risk of bias was assessed through the JBI tool, depending on the design of the selected studies. RESULTS: The initial search resulted in 2238 studies, of which 19 were eligible. Sixteen studies were case reports, 2 had case-control design and 1 was cross-sectional. Throughout the studies, 44 cases of oral pigmentation were reported. The hard palate was the anatomic region most affected with pigmentation (66%). According to the case reports, most of the lesions (44%) were bluish-gray. The minimum time from the beginning of treatment (chloroquine or hydroxychloroquine) to the occurrence of pigmentation was 6 months. The mean treatment time with the medications was 4.9 years, and the mean drug dosage was 244 mg. Most of the studies (63.1%) had low risk of bias (high methodological quality). CONCLUSIONS: The outcomes of this study suggest that hyperpigmentation depend on drug dosage and treatment length. Hyperpigmentation was detected after a long period of treatment with chloroquine or hydroxychloroquine.
Subject(s)
Hydroxychloroquine , Hyperpigmentation , Chloroquine/adverse effects , Cross-Sectional Studies , Humans , Hydroxychloroquine/therapeutic use , Hyperpigmentation/drug therapy , PigmentationABSTRACT
This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.
Subject(s)
Pneumonia, Ventilator-Associated , Chlorhexidine , Humans , Intensive Care Units , Pneumonia, Ventilator-Associated/prevention & control , Respiration, Artificial , ToothbrushingABSTRACT
This study aimed to systematically review the literature to assess the effect of preemptive intravenous ibuprofen on pain reduction after lower third molar surgery. Nine databases (PubMed, Scopus, LILACS, SciELO, Embase, Web of Science, Cochrane, Open Gray, and Open Thesis) were used as sources of research, including "grey literature." The protocol was registered in PROSPERO. Only randomized clinical trials evaluating the effects of preemptive intravenous ibuprofen on pain during and immediately after the extraction of lower third molars were included, without restrictions of year and language. Two reviewers independently performed the study selection, data extraction, and assessment of the risk of bias. The "Joanna Briggs Institute for Randomized Controlled Trials" tool was used to assess the risk of bias. Each study was categorized according to the percentage of positive responses to the questions corresponding to the assessment instrument. The results were measured narratively/descriptively. The initial search resulted in 3,257 records, of which only three studies (n=150 participants) met the eligibility criteria and were included in the qualitative analysis. All studies were published in 2019. The risk of bias ranged from low to moderate. Two studies found significant pain reduction within 48 h after the procedure. In conclusion, the use of preemptive intravenous ibuprofen for extracting third molars reduces pain and analgesic consumption after the surgical procedure.
Subject(s)
Ibuprofen , Molar, Third , Humans , Ibuprofen/therapeutic use , Molar, Third/surgery , Pain, Postoperative/prevention & control , Randomized Controlled Trials as TopicABSTRACT
OBJECTIVES: The low resistance to fracture has limited the use of indirect composite resins for dental restorations, particularly in regions that are exposed to strong occlusal forces. To overcome this issue, different types of reinforcement for composites have been proposed, one of which is carbon nanotubes (CNTs). The aim of this study was to evaluate the flexural resistance of one commercial indirect composite resin (Sinfony, 3M/ESPE) after incorporation of single-wall carbon nanotubes (SWCNTs; Sigma-Aldrich, Inc., St. Louis, Missouri, United States) with or without the silanization form. MATERIALS AND METHODS: Specimens of composite resin were fabricated in a Teflon mold. The composite resin was prepared according to the manufacturer's instructions (n = 10 for each group), with SWCNTs in three concentrations. STATISTICAL ANALYSIS: The SWCNTs and SWCNT/SiO2-ATES specimens were evaluated by transmission electron microscopy, and a flexural test was conducted according to the ISO 4049/2009. Flexural strength data in MPa were submitted to one-way ANOVA following Tukey (p < 0.05). RESULTS: The SWCNTs did not improve the flexural strength of indirect composite resin when compared with the control, independent of the concentration added (p > 0.05). However, when SWCNTs and SWCNTs/SiO2-ATES were compared, the SWCNTs/SiO2-ATES showed higher values than the three concentrations of SWCNTs (p < 0.05). CONCLUSION: The silanization process improves the SWCNTs strength proprieties, but the modification of chemical bonding between SWCNT and SWCNT/SiO2-ATES modified resins, in different concentrations, did not improve the composite resin flexural strength.
ABSTRACT
Background: This study aimed to search for scientific evidence concerning the accuracy of computer-assistedanalysis for diagnosing odontogenic cysts.Material and Methods: A systematic review was conducted according to the PRISMA statements and consideringeleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD 42020189349). ThePECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were in-cluded. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool.Results: Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria andwere included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst,odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed.All selected articles scored low risk of bias. In three studies, the best performances were achieved when the twosubtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showinga success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the den-tigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improvedsignificantly the classification rates. Conclusions: The overall evaluation showed all studies presented high accuracy rates of computer-aided systems inclassifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity ofthe studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendationabout their use is not possible.(AU)
Subject(s)
Humans , Male , Female , Odontogenic Cysts/diagnostic imaging , Radicular Cyst , Mandible/abnormalities , Image Processing, Computer-Assisted , Oral Health , Pathology, Oral , Surgery, Oral , Oral MedicineABSTRACT
Background: Primary burning mouth syndrome (BMS) is a chronic clinical condition of idiopathic mainly char-acterized by pain and a burning sensation in the oral cavity. The application of laser at low intensity therapy is atreatment option. This systematic review evaluated the efficacy of laser therapy in treating symptoms of burningmouth syndrome.Material and Methods: The study was formulated according to the PRISMA and Cochrane guidelines. Seven da-tabases were used as primary sources of research. Only randomized controlled clinical trials were included. Theefficacy of the therapy was estimated comparing the values of the visual and numerical scales of pain before andafter laser treatment, through qualitative analysis.Results: The search resulted in 348 records and only eight filled the eligibility criteria and were included. All stud-ies evaluated pain and / or a burning sensation considering a time interval of two to ten weeks. The total sampleconsisted of 314 patients submitted to treatment: 123 from the control group, who participated with laser off orwith the tip blocked, and 191 from the intervention group, treated with low-level laser therapy. The female genderstood out and the average age of the participants was 60.89 years. The main symptoms reported were pain and aburning sensation in the oral mucosa and tongue. The parameters adopted by the authors for laser treatment werediverse and the variables were not fully described in the published studies. Visual analog and numerical scaleswere used to assess symptoms and only three studies showed statistical significance.Conclusions: It is suggested that laser therapy may be an effective alternative in the treatment of BMS. New ran-domized clinical trials should consider well-established protocols to better understand the efficacy of laser therapywithout confounding the effects.(AU)
Subject(s)
Humans , Low-Level Light Therapy , Burning Mouth Syndrome , Oral Health , Oral Medicine , Pathology, OralABSTRACT
This study aimed to systematically review the literature to assess the effect of preemptive intravenous ibuprofen on pain reduction after lower third molar surgery. Nine databases (PubMed, Scopus, LILACS, SciELO, Embase, Web of Science, Cochrane, Open Gray, and Open Thesis) were used as sources of research, including "grey literature." The protocol was registered in PROSPERO. Only randomized clinical trials evaluating the effects of preemptive intravenous ibuprofen on pain during and immediately after the extraction of lower third molars were included, without restrictions of year and language. Two reviewers independently performed the study selection, data extraction, and assessment of the risk of bias. The "Joanna Briggs Institute for Randomized Controlled Trials" tool was used to assess the risk of bias. Each study was categorized according to the percentage of positive responses to the questions corresponding to the assessment instrument. The results were measured narratively/descriptively. The initial search resulted in 3,257 records, of which only three studies (n=150 participants) met the eligibility criteria and were included in the qualitative analysis. All studies were published in 2019. The risk of bias ranged from low to moderate. Two studies found significant pain reduction within 48 h after the procedure. In conclusion, the use of preemptive intravenous ibuprofen for extracting third molars reduces pain and analgesic consumption after the surgical procedure.
Subject(s)
Humans , Ibuprofen/therapeutic use , Molar, Third/surgery , Pain, Postoperative/prevention & control , Randomized Controlled Trials as TopicABSTRACT
This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.
Subject(s)
Humans , Pneumonia, Ventilator-Associated/prevention & control , Respiration, Artificial , Toothbrushing , Chlorhexidine , Intensive Care UnitsABSTRACT
OBJECTIVE: This study describes 9 cases of myiasis affecting the head and neck region and discusses the demographic distribution, treatment, clinical characteristics, and sequelae of the disease in light of the literature. STUDY DESIGN: The study was performed in 2 steps. In the first part, 9 cases seen over a period of 10 years at the Emergency Department of Hospital da Restauração in Brazil were studied. In the second part, a literature search was performed in PubMed for articles on head and neck myiasis published from 1975 to March 2017. RESULTS: The case series mainly consisted of male patients in their 30s. The palate was the most commonly affected site. Myiasis was caused by Cochliomyia hominivorax in all patients, who were treated by mechanical removal of the larvae and debridement of necrotic tissue, followed by oral ivermectin. All patients had sequelae resulting from bone destruction. CONCLUSIONS: Head and neck myiasis generally affects individuals with poor hygiene habits, drug users, and individuals with neurologic and psychosocial disorders. The treatment of choice is mechanical removal of larvae and surgical debridement combined with oral ivermectin. This study provides information that could help clinicians in the diagnosis and management of this condition.
