Accuracy and reliability of magnetic resonance imaging in orthodontic diagnosis and treatment planning-a systematic review and meta-analysis.

BACKGROUND: Magnetic resonance imaging (MRI) is a non-ionizing imaging technique. Using MRI in dentistry may potentially lower the general radiation dose of the examined population, provided MRI can replace various radiation-based images. Furthermore, novel MRI imaging modalities for three-dimensional and two-dimensional cephalometrics have recently been developed for orthodontic diagnosis. OBJECTIVES: This systematic review aimed to determine the diagnostic accuracy and reliability of MRI in orthodontic diagnosis and treatment planning. SEARCH METHODS: An electronic search was conducted on 20 November 2022 in the following databases: PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane. The search was updated on 30 August 2023. Furthermore, a grey literature search was performed in Google Scholar and Open-Grey. SELECTION CRITERIA: This review included descriptive, observational, cohort studies, cross-sectional, case-control studies, and randomized/non-randomized trials related to the research question. The study excluded studies related to patients with syndromes, chronic diseases, craniofacial anomalies, or bone diseases. DATA COLLECTION AND ANALYSIS: The included studies were quality assessed using the "Joanna Brigg's Critical Appraisal Tool for diagnostic test accuracy". The GRADE approach for non-randomized studies was used for strength-of-evidence analysis. RESULTS: Eight of the 10 included studies compared MRI with either cone beam computed tomography or lateral cephalogram and found a high intra- and inter-rater agreement for landmark identification. The risk of bias was high in four studies, moderate in three, and low in three studies. Homogeneity was lacking among the included studies in terms of MRI imaging parameters and sample characteristics. This should be taken into consideration by future studies where uniformity with respect to these parameters may be considered. CONCLUSIONS: Despite dissimilarity and heterogeneity in the sample population and other methodological aspects, all the included studies concluded that MRI enjoyed considerable intra- and inter-examiner reliability and was comparable to current diagnostic standards in orthodontics. Furthermore, the studies agreed on the innovative potential of MRI in radiation-free diagnosis and treatment planning in orthodontics in the future. REGISTRATION: CRD number: CRD420223XXXXX.

Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis.

This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

Development of patient-specific finite element model for study of composite dental implants.

Traumatic dental injuries can occur due to various reasons such as accidents, sports injuries, fights, falls, and others. These injuries can affect the teeth, gums, and surrounding tissues, and can range from minor chips and cracks to severe fractures, dislocations, and avulsions (when the tooth is completely knocked out of the socket). The most common way to address this is by replacing affected teeth with dental implants. The purpose of this research is to evaluate the use of composite materials in dental implants and compare them with the traditionally used materials using a patient specific cone beam computed tomography (CBCT) based finite element model (FEM). To conduct this research, two different implant groups i.e., traditional implant and composite implant were designed using Titanium grade 4, zirconium oxide-reinforced lithium silicate (ZLS), and Zirconia (ZrO2). Six dental implants were designed namely Ti implant, ZLS implant, ZrO2implant, Ti-ZrO2composite, Ti-ZLS composite, and ZLS-ZrO2composite using 3D modelling software. Detailed full-scale 3D models of patient specific dental implant were developed and traumatic loading conditions were applied to the enamel of central incisor teeth or crown of dental implant, and maxilla was constrained in all directions. It was found that the use of composite materials for dental implants can reduce the stresses over the surface of abutment and implant as compared to traditional implants. The detailed models developed as a part of this study can advance the research on dental implants, and with further experimental validation allow the use of composite materials for fabrication of more stable dental implants.

Risk factors associated with traumatic dental injuries in individuals with special healthcare needs-A systematic review and meta-analysis.

BACKGROUND/AIM: Individuals with special healthcare needs (SHCN) are more likely to sustain traumatic dental injuries (TDIs) due to distinct risk factors. The aim of this review was to assess various risk factors associated with TDIs in individuals with SHCN. MATERIALS AND METHODS: The protocol was designed according to the recommendations of the Cochrane-handbook, Joanna Briggs Institute, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (CRD42022357422). A comprehensive search was performed in PubMed, LILACS, Web of Science, EMBASE and Scopus using a pre-defined strategy without any limitation of language and year of publication. It was last updated on 25 April 2023. Studies addressing the TDIs in individuals with SHCN were included. Data extraction and analyses were performed, risk of bias (ROB) assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta-analysis was performed using random-effects model. RESULTS: A total of 21 studies were included in the review. They were categorized according to the target disease/condition: cerebral palsy (n = 5), ADHD and autism spectrum disorders (n = 5), visually impaired (n = 4), and multiple disorders (n = 7). The studies showed variability in the design and methods; however, 17 out of 21 studies showed moderate to low ROB. Increased overjet and lip incompetence were the main risk factors reported in the studies. The commonest injuries were observed to be enamel and enamel and dentine fractures. CONCLUSION: The overall pooled prevalence of TDI in individuals with special healthcare needs was 23.16% with 20.98% in males and 27.06% in females. Overjet >3 mm and inadequate lip coverage were found to be associated with a higher risk of TDI in all the categories of individuals with special healthcare needs except ADHD and ASD. Falls at home in cerebral palsy, falls while walking and self-harm in ADHD and ASD, falls at home and collision in visual impairment, and unspecified falls in multiple disorders could be identified as the most common cause of TDI.

Comparative assessment of scientific reach and utilization of the International Association of Dental Traumatology 2020 guidelines: An altmetric and citation analysis.

BACKGROUND/AIM: The updated version of the International Association of Dental Traumatology (IADT) guidelines was published online in May 2020 in the form of four papers. They are extensively used in dental trauma education in textbooks, undergraduate and postgraduate programs, and clinical workshops. Hence, this study aimed to assess the impact, global scientific reach, and utilization of these guidelines through altmetric and citation analysis. MATERIAL AND METHODS: The protocol was prepared after an expert group discussion. Dimensions database was used to derive the altmetric and citation data on April 10th, 2023. The data was extracted by using a self-designed pre-piloted form by two authors independently. The citing articles were further categorized into the type of study and the domains and subdomains of dental traumatology. The VOSviewer program was utilized to explore the correlation between the subdomains and the overlap of citations was assessed by creating a citation matrix. RESULTS: A total of 552 citations had been collectively received by the four papers. The highest was seen for the guidelines for fracture and luxation in permanent teeth (FL), avulsion in permanent teeth (AV), general introduction (GI), and primary teeth (PT). Dental Traumatology had the maximum number of citing papers for each guideline. They were from 52 countries with English being the commonest language. Overall, the maximum number of citations had been received in narrative reviews (n = 104) and the majority of cited papers were categorized in the therapeutic domains. The most common subdomain for the papers that cited GI, FL, and AV was "treatment protocols in permanent teeth", while it was "awareness of prevention and emergency management of traumatic dental injuries" for the papers that had cited PT. CONCLUSIONS: This analysis highlighted that the IADT 2020 guidelines are globally popular resources, which are widely used by the researchers across specialities and are intended towards clinical application.

Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials.

BACKGROUND: School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children. AIM: This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents. DESIGN: Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer. RESULTS: The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low. CONCLUSION: Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate.

BACKGROUND: Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. OBJECTIVES: To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. SEARCH METHODS: The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. SELECTION CRITERIA: Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. DATA COLLECTION AND ANALYSIS: A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. RESULTS: A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. CONCLUSIONS: The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. REGISTRATION: A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).

Prevalence of sports-related traumatic orofacial and dental injuries in Asian countries: a systematic review and meta-analysis.

INTRODUCTION: The head and face, due to their prominent positions, are at risk of intentional and unintentional injuries in the majority of competitive sports. There are regional preferences for sports and differences in infrastructural facilities. The majority of the recommendations for sports have been based on the studies conducted in the western world. Hence, this systematic review aimed to estimate the prevalence of sports-related orofacial and dental injuries in professional-sportspersons living in Asian countries. EVIDENCE ACQUISITION: A protocol was prepared as per the best practices of evidence-based medicine and registered (PROSPERO-CRD42021252488). Search strategy was based on the research question and conducted in six databases using text words and MeSH terms. Scrutiny of title and abstracts and later full-texts were done as per eligibility criteria. Data extraction was done using a pre-piloted sheet and the risk of bias (ROB) was assessed. Qualitative synthesis and meta-analyses were performed and the strength of evidence was assessed by using GRADE-approach. EVIDENCE SYNTHESIS: Twenty-three studies published between 1998 to 2021 and from nine countries were included. The highest numbers were from Türkiye (N.=7). The total number of professional sportspersons assessed in all the included studies was 14,457. The highest prevalence of orofacial and dental injuries observed was 66.18% and the highest prevalence of dental injuries was 39.81%. Low risk of bias was seen only in four studies. The changes were observed during the sensitivity analysis with all the meta-analyses showing significant publication bias and heterogeneity. CONCLUSIONS: The pooled prevalence of the combined orofacial and dental injuries was found to be 40.6%, while that of orofacial injury was 17.1% and dental injuries was 15.9%. There were 23 studies included in this review which covered 27 different sports from nine Asian countries. A high level of heterogeneity and the high ROB were observed in the majority of the studies. Further studies on the basis of the recommendations provided in the systematic review will improve the quality of evidence in this area in future.

Global status of knowledge of parents for emergency management of traumatic dental injuries: a systematic review and meta-analysis.

RESEARCH PROTOCOL: The protocol was developed as per the recommendations of the Cochrane-handbook and PRISMA and was registered in PROSPERO. LITERATURE SEARCH: Search was performed by using MeSH-Terms and keywords in PubMed, Scopus, Embase, Web of Sciences, Lilacs, and Cochrane databases and gray literature sources 15th July 2022. There were no limits regarding the year of publication and language. Hand-searching of included articles was also performed. Titles and abstracts and later full texts were screened as per strict inclusion and exclusion criteria. DATA EXTRACTION: Self-designed pilot-tested form was used. QUALITY APPRAISAL: Risk of bias was analyzed through Joanna-Brigg's-Institute's-critical appraisal checklist. The evidence analysis was done by using the GRADE approach. DATA ANALYSIS: Qualitative synthesis was performed for describing the study characteristics, details of sampling, and results of various questionnaires. It was discussed by the expert group and presented using KAP heat map. Meta-analysis was done by using Random Effects Model. RESULTS AND INTERPRETATION: The risk of bias was found to be low in seven and moderate in one study. It was observed that >50% of parents knew about the urgency to seek professional advice after TDI. Only <50% of parents were confident of their ability to identify the injured tooth, clean the soiled avulsed tooth, and perform the replantation. Appropriate responses regarding immediate action after tooth avulsion were given by 54.5% (95% CI: 50.2-58.8, p = 0.042) of parents. The knowledge of the parents regarding the emergency management of TDI was found to be inadequate. The majority of them were interested in obtaining information about dental trauma first aid.

Does dental trauma have impact on the oral health-related quality of life of children and adolescents?

RESEARCH QUESTION: Does dental trauma have impact on the oral health-related quality of life of children and adolescents? RESEARCH PROTOCOL: Protocol was designed as per the best practices of evidence-based medicine, guidelines for umbrella reviews and registered in PROSPERO. LITERATURE SEARCH: PubMed, Scopus, Embase, Web of Sciences and Lilacs were searched for studies meeting the inclusion criteria from start of databases to 15th July 2021. Grey literature and registries of systematic review protocols were also searched. Hand searching of the references of included articles was also performed. The literature search was updated on 15th October 2021. Scrutiny of the titles and abstracts and later full text was done as per the inclusion and exclusion criteria. DATA EXTRACTION: Self-designed pre-piloted form was used by two reviewers. QUALITY APPRAISAL: AMSTAR-2 was used to assess the quality of systematic reviews, PRISMA was used to check reporting-characteristics and citation-matrix was used to evaluate study-overlap. Quality of evidence was assessed by using Kohler's-criteria. DATA ANALYSIS: Qualitative synthesis was performed for describing the study characteristics, details of sampling and the tool of OHRQoL used. The meta-analytic data was used for evaluating the evidence and its strength for each of the outcomes. RESULTS AND INTERPRETATION: A significant impact of all types of TDI on OHRQoL in children and adolescents was observed. The effect of uncomplicated TDI on OHRQoL in children and all ages showed no difference from controls. Though the quality of evidence in these interpretations was weak.

Cone-Beam Computed Tomographic Assessment of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to evaluate the maxillary sinus characteristics of patients with cleft lip and palate (CLP).The study included manuscripts which met the following criteria: (1) study of individuals with CLP in any age group or gender and (2) study of individuals in whom assessment of maxillary sinus characteristics had been done by cone-beam computed tomography. Studies with (1) individuals having special health-care needs and (2) individuals with any syndrome affecting the development of the head and neck were excluded.In total, 11 articles were included in the review, based on the inclusion and exclusion criteria. Pooled maxillary sinus volume (MSV) on the cleft sides of patients with unilateral cleft lip and palate (UCLP) was found to be 9433.14 mm3 (95% CI, 7453.99-11 412.30), which was significantly smaller than that of controls. The meta-analyses also revealed significantly reduced MSV on the cleft sides of patients with UCLP. The differences between cleft and noncleft sides of the patients with UCLP were not found to be statistically significant. Strength-of-evidence was found to be moderate in 4 characteristics, along with 10 out of 11 articles showing low risk-of-bias.It was concluded that MSV was reduced and mucosal thickening was increased/present in patients with CLP as compared with controls. The differences between MSV of cleft and noncleft sides of the patients with UCLP could not be established. However, heterogeneity was found in terms of sample size, stratification of samples by age, and evaluation of some confounding factors.

Global Trends in Knowledge, Attitude, and Awareness of Orthodontists Regarding the Management of Patients with Cleft lip and/or Palate: A Systematic Review.

The aim of the present systematic review was to assess the trends in knowledge, attitude, awareness, and practice among orthodontists regarding the management of patients with cleft lip and/or palate.An a priori protocol was developed as per the best practices of evidence-based medicine and registered in Prospero (CRD42022306107). The literature search was conducted electronically, using MeSH-terms, keywords, and Boolean-operators "AND" and "OR" in different combinations in multiple databases and screening of titles and abstracts followed by full-text evaluation was performed. The risk of bias (ROB) was assessed using Joanna Briggs Institute critical appraisal checklist.Five studies were included in the qualitative synthesis and three of them showed a high ROB. When participants were questioned about which other specialists worked in the cleft team in addition to the orthodontists, 84% of them in one study reported it to be general dentists. Furthermore, the absence of an interdisciplinary team was reported in two studies from Africa. When asked about the percentage of their practice devoted to the care of patients with cleft lip and palate (CLP) one study reported that 52% of orthodontists had treated <10 such patients in their entire career.The present systematic review highlights the lack of knowledge and experience among orthodontists and orthodontic residents regarding the management of patients with CLP. Efforts must be made to design validated questionnaires and conduct methodologically sound studies in different geographical locations to develop adequate modules for improving the knowledge of orthodontists in this domain.

How Informative Is YouTube Regarding Feeding in Infants with Cleft Lip and Palate?

OBJECTIVE: To assess the characteristics of popular videos on YouTube about the feeding of infants with cleft lip and palate (CLP) and analyze the adequacy of information provided by them. DESIGN: A cross-sectional design was used. METHODS: YouTube was systematically searched for consecutive relevant videos about the feeding of infants with CLP, using predefined keyword combinations, without any limitations on language or duration. Scrutiny of the top 50 videos for each keyword combination was performed and a self-designed data-extraction sheet was used. A content adequacy index was developed by an expert group, and used to assess content adequacy, classifying it into categories from excellent to poor. RESULTS: From an initial retrieval of 200 videos, 42 were included in the final assessment. The videos originated from nine different countries, with more than half coming from the USA and in English. Five of the videos came from the channel of the American Cleft Palate-Craniofacial Association. Content adequacy analysis showed that no video could be classified as excellent, while 33.3% were classified as optimal, 21.4% as suboptimal and 45.2% as poor. CONCLUSIONS: The content adequacy of the majority of videos on YouTube, relating to the feeding of infants with CLP was inadequate, with only one third of them achieving optimal content adequacy. Efforts must be made to develop informative and standardized videos for social media and video-sharing platforms, perhaps through professional associations to ensure that families with an infant with CLP receive appropriate information.

How far have we come? A historic scoping review of dental traumatology literature.

The status of the protocols used for the management of dental trauma (DT) in the eighteenth and early nineteenth-century is largely unknown. The end of World War II saw a tremendous resurgence of high quality research and the development of codes of ethics and publishing. The aim of this scoping review was to analyse articles related to aspects of DT published before 1945 in the English language. An expert group discussion was done to create an a priori protocol based on the PRISMA-2020-guidelines' extension for scoping reviews. A systematic search strategy based upon the Population (P), Exposure (E), Comparator (C), Outcome (O) and Time (T) was performed in five databases on 10 February 2022. Filters were used to identify the literature until 1945, and duplicates were removed. The scrutiny of the titles and abstracts and later the full texts was performed as per the pre-defined eligibility criteria. The grey literature and archives of the English language dentistry literature were searched, and a reference search was also performed. A total of 13 studies were selected from the databases and 20 from the reference searching. The first reported article was from the year 1872. Two other case reports had been published by 1899 and three more before World War I (1914). The majority of the studies originated from the United States of America. Nineteen were case reports, five were original research articles, two were classifications and guidelines papers, and one was a review. During the period before 1945, 33 articles were published regarding DT. The articles were mostly related to the description of cases, although there were a few original research papers. A significant observation, contrary to popular belief, was the presence of articles related to conservative management of injuries to tooth roots and the dental pulp. A progression in terms of the quality of protocols over time was also observed.

Sources of support and Conflicts of interests.

The aim of this letter to the editor was to highlight the importance of adding sources of support and conflicts of interests in the published articles so that they are adequately analysed for their quality by using AMSTAR-2 tool.

Comparative evaluation of fragment reattachment protocols for the management of teeth with crown-root fractures.

BACKGROUND/AIM: A crown-root fracture is a fracture of both the crown and the root of a tooth. The International Association of Dental Traumatology (2020) guidelines recommended fragment reattachment and stabilization of loose fragments as an immediate management protocol for uncomplicated crown-root fractures. However, the lack of evidence and unpredictability make it a less popular treatment option. The aim of this study was to compare three protocols of fragment reattachment for the management of teeth with crown-root fractures. METHODOLOGY: Eighty mandibular bovine incisors with similar dimensions and no structural deformities were selected and randomized into four groups: Group I (Control/sound teeth); Group II (no rehydration); Group III (rehydration in distilled water for 15 min) and Group IV (rehydration in a humidification chamber for 15 min). A fracture was simulated to extend from the labial side of the middle-third of the crown to the palatal side of the cervical-third of the root. Fragments were exposed to the environment under normal temperature and pressure. Fragments were later reattached as per the standard protocol following the rehydration as specified for each group. Samples were subjected to thermocycling, and the force required to fracture them was evaluated by using a universal testing machine. RESULTS: The highest mean force required to fracture was seen in Group IV (208.27 ± 75.99 N) followed by Group III (182.01 ± 90.13 N) and Group II (158.85 ± 68.04 N). These differences were statistically significant. Comparison of the mean difference of force required to fracture between pairs of groups revealed statistically significant mean differences only between the controls and each experimental group. CONCLUSION: The force required to fracture the reattached fragments in teeth with crown-root fractures was affected by rehydration of the fragments. The force was higher in fragments reattached after rehydration, and the highest force was required in the teeth that had been rehydrated in a humidification chamber.

Success of medicaments and techniques for pulpotomy of primary teeth: An overview of systematic reviews.

BACKGROUND: Pulpotomy is an effective, vital pulp therapy procedure for caries-affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable. AIM: The aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison. DESIGN: This review followed the principles of evidence-based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self-designed pilot-tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta-analyses. RESULTS: The scrutiny of 62 full-text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta-analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full-strength/1:5 diluted and full-strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data. CONCLUSIONS: The pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries-affected primary teeth and elucidates the domains that require primary studies in the future.

An effective method to summarise the outcomes of questionnaire-based studies in systematic reviews.

With an increased number of questionnaire-based knowledge, attitude, practice and other types of studies, there is a need to perform evidence-based research in such designs as well. The systematic reviews (SR) and meta-analyses (MA) of the questionnaire-based studies are difficult to conduct and summarise due to the wide variations in the questions included in each of them. The presentation of these reviews often leads to ambiguous conclusions, and meta-analysis is not possible due to wide heterogeneity. This paper aims to highlight a method known as the 'Knowledge-Attitude-Practice' or 'KAP' Heat Map, which was developed and validated for the effective presentation of the outcomes of varied questionnaires in systematic reviews.

'CARE compliance' of case reports published in Dental Traumatology in the past two decades: A bibliometric analysis.

BACKGROUND/AIMS: The journal Dental Traumatology (DT) is one of the best resources in the field of dental traumatology. It has always encouraged publication of case reports of good quality. The CARE statement (2011) was developed for uniform and transparent reporting of cases in medical sciences. Since case reports are inseparable from the DT literature, the aim of this bibliometric-analysis was to evaluate the case reports published in the DT in the last two decades (2001-2021) and assess their compliance regarding CARE guidelines for elucidating the trends in DT and the reporting quality of these papers. METHODOLOGY: Two authors independently observed the tables of contents in all issues of DT from 2002-2021 and identified case reports. Selected articles were scrutinized to determine their eligibility. Data extraction was performed, case reports were segregated into domains, and their CARE compliance was evaluated by using a self-designed-validated method. Differences between the case reports published in two decades (2002-2011 and 2012-2021) were analysed with the Chi-square test. RESULTS: A total of 1612 articles published between February 2002 and October 2021 were scrutinized to identify 357 case reports with 277 from the period of 2002-2011 and 80 between 2012 and 2021. The highest number of case reports originated from Asia (2002-2011:135, 2012-2021:28). The CARE compliances of the majority of reports in the decade of 2002-2011 were between 75 and 85% (good) while the CARE compliances of the majority of reports from 2012-2021 were between 85 and 95% (very good) or >95% (excellent). These differences were statistically significant (p < .005). CONCLUSIONS: The number of case reports published in the decade of 2002-2011 were more than three times the number of case reports published in the decade of 2012-2021. The highest number of reports in both decades were from Asia and belonged to the therapeutic and prognostic domains. The CARE compliances of the reports in the decade of 2012-2021 were better than those from 2002-2011.