Periodontal disease and cardiovascular disease: umbrella review.

BACKGROUND: Periodontal disease (PD) is an infectious and inflammatory condition that affects the tissues surrounding and supporting the teeth. It has been suggested that PD may be associated with cardiovascular disease (CVD), one of the leading causes of mortality worldwide. Our study aimed to investigate the association between PD and CVD through an umbrella review. METHODS: A comprehensive search was conducted until April 2024 across various electronic databases, including PubMed, Cochrane Library, Scopus, SciELO, Web of Science, Google Scholar, ProQuest Dissertations and Theses, and OpenGrey. Systematic reviews with or without meta-analysis were considered for inclusion, without any limitations on time or language, provided they examined primary studies linking PD with CVD. The AMSTAR-2 tool was employed to assess the quality and overall confidence of the included studies. RESULTS: After the initial search, a total of 516 articles were identified. Following the application of selection criteria, 41 articles remained for further consideration. All these studies indicated an association between PD and CVD, with odds ratios and risk ratios ranging from 1.22 to 4.42 and 1.14 to 2.88, respectively. CONCLUSIONS: Systematic reviews with high overall confidence support the association between PD, tooth loss, and cardiovascular diseases. However, it is crucial to interpret these results with caution due to methodological limitations. The potential public health relevance justifies preventive and corrective oral health strategies. Additionally, the need for rigorous future research is highlighted to strengthen the evidence and guide effective public health strategies.

Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis.

BACKGROUND: To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. METHODS: A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results. RESULTS: The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs. CONCLUSION: The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations.

Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review.

Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.

Association between Periodontal Disease and Obesity: Umbrella Review.

Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.

Antimicrobial Efficacy of the Use of Mouthwash with Cetylpiridinium Chloride for Aerosol Producing Procedures. A Systematic Review / Eficacia antimicrobiana del uso del enjuague bucal con cloruro de cetilpiridinio en procedimientos que generan aerosoles. Revisión sistemática

Abstract The present research aims to determine the antimicrobial efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), before aerosol producing dental procedures. A data search was performed during August 2021 in five databases MEDLINE (PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Randomized clinical trials (RCTs) were included based on the PICO question, comparing the efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), versus other mouthwashes and water, before aerosol producing dental procedures, papers in English, Spanish and Portuguese were included without time limits. The risk of the included studies was evaluated with the tool RoB 2.0. Number of registration PROSPERO N° CRD42021275982. 120 papers were obtained in the preliminary search, discarding those that didn't comply with the selection criteria, leaving only 3 studies. These papers reported the use of cetylpyridinium chloride (CPC) was effective for the reduction of bacteria during the ultrasonic prophylactic procedure. The use of CPC mouthwashes previous to the dental treatment with ultrasonic prophylaxis showed only antibacterial capacity.

Resumen El presente trabajo de investigación tiene como objetivo determinar la eficacia antimicrobiana de los colutorios a base de cloruro de Cetilpiridinio (CPC), previo a tratamientos dentales que generen aerosol. Se realizó una búsqueda bibliográfica hasta agosto del 2021 en cinco bases de datos: MEDLINE (vía PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) y Google Scholar. Se incluyeron ensayos clínicos aleatorizados (ECAs), basándose en la pregunta PICOS, que compare la eficacia del colutorio a base de cloruro de Cetilpiridinio (CPC) con otro colutorio, placebo o agua, previo a un tratamiento dental que genere aerosol, en los idiomas español, inglés o portugués y sin límite de tiempo. El riesgo de los estudios incluidos se evaluó con la herramienta RoB 2.0. Número de registro PROSPERO N° CRD42021275982. Se obtuvo un total de 120 artículos en la búsqueda preliminar, descartando aquellos que no cumplían con los criterios de selección, quedando sólo 3articulos. Estos artículos informaron que el uso de CPC es efectivo para la reducción de bacterias durante el procedimiento de profilaxis con ultrasonido. El uso de los enjuagues bucales a base de CPC previo al tratamiento dental de profilaxis con ultrasonido sólo tiene eficacia antibacteriana.

Association between the Risk of Preterm Birth and Low Birth Weight with Periodontal Disease in Pregnant Women: An Umbrella Review.

BACKGROUND: The purpose of this review is to determine the association between the risk of preterm birth and low birth weight in newborns and periodontal disease in pregnant women. METHODS: A bibliographic search was carried out until November 2021 in the following biomedical databases: PubMed/Medline, Cochrane Library, Scopus, EMBASE, Web of Science, Scielo, LILACS and Google Scholar. Studies reporting the association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women, which were systematic reviews, in English and without time limits were included. AMSTAR-2 was used to assess the risk of the included studies, and the GRADEPro GDT tool was used to assess the quality of the evidence and the strength of the recommendation of the results. RESULTS: The preliminary search yielded a total of 161 articles, discarding those that did not meet the selection criteria, leaving only 15 articles. Seven articles were entered into a meta-analysis, and it was found that there is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women. CONCLUSIONS: There is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women.

Biomechanics of anterior endocrowns with different designs and depths: Study of finite elements.

Background: To date, there is no clear consensus in the literature on which endocrown design and depth is the most effective treatment option for restoring endodontically treated maxillary central incisors. Aim: To determine the stress distribution of the anterior endocrowns by means of finite element analysis. Material and Methods: Nine 3D finite element models (groups A - I) were made, each one representing a restoration system of endodontically treated upper central incisors. The models were endocrowns with and without ferrules at 0, 1, 3, and 5 mm depth and a post-core stump control group. A static load of 100N of force was applied to the palatal face at 45º from the long axis of the tooth. The Von Mise values and the maximum stress in the crown, dentin and resin cementum were evaluated separately. Results: The maximum stress distribution was C < B < A < D < H < F < E < G < I and the Von Mises stresses were in the upper 1/3 of the retainer of endocrowns A, B, C and D. ; in the vestibular neck in endocrowns E and F; in the final 1/3 of the retainer in the endocrown G; in the middle 1/3 of the retainer in the H endocrown; and at the level of the vestibular neck of the crown in model I. Conclusions: The smallest distribution of maximum and Von Mises stresses was observed in model C. Key words:Finite element analysis, Biomechanics, upper central incisor, endodontically treated teeth, dental restoration.

Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic.

The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress.

Association between orthodontic treatment and the occurrence of temporomandibular disorders: A systematic review and meta-analysis.

Background: Temporomandibular disorders (TMD) are related to a series of clinical manifestations that appear in the form of pain. Currently, there is controversy about the appearance of TMDs after orthodontic treatment. Therefore, the objective of the present study was to determine the association between orthodontic treatment and the occurrence of Temporomandibular Disorders (TMD). Material and Methods: A bibliographic search was carried out until April 2022, in the following electronic databases: Pubmed/Medline, Scopus, Scielo, Google Scholar and Web of Science. We included studies that were case-control and cohort studies, dealing with the association between orthodontic treatment and TMD, in English and Spanish, and with no time limit. The Newcastle-Ottawa scale was used to assess risk in the included studies. In addition, RevMan 5.3 was considered for meta-analysis, using as a measure the ODDS ratio in a random-effects model with a 95% confidence interval. Results: The preliminary search yielded a total of 686 articles, discarding those that did not meet the selection criteria, leaving only 6 articles. These studies reported that there is a significant association between orthodontic treatment and the occurrence of TMD, equivalent to an ODDS ratio of 1.84 with a confidence interval of 1.19-2.83. Conclusions: It is concluded that there is an association between orthodontic treatment and the occurrence of TMD, therefore, a person undergoing orthodontic treatment is up to 1.84 times more likely to develop TMD. Key words:Orthodontic treatment, temporomandibular disorders, orthodontics, cases and controls, cohorts, review, Meta-Analysis.

Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth-A Systematic Review and Meta-Analysis.

The use of autologous platelet concentrates (APCs) in regenerative endodontic procedures is inconsistent and unclear. The aim of this meta-analysis was to evaluate the effectiveness of autologous platelet concentrates compared to traditional blood-clot regeneration for the management of young, immature, necrotic, permanent teeth. The digital databases MEDLINE, SCOPUS, CENTRAL, Web of Science, and EMBASE were searched to identify ten randomized clinical trials. The outcomes at postoperative follow-up, such as dentinal wall thickness (DWT), increase in root length (RL), calcific barrier formation (CB), apical closure (AC), vitality response (VR), and success rate (SR), were subjected to both qualitative synthesis and quantitative meta-analysis. The meta-analysis showed that APCs significantly improved apical closure (risk ratio (RR) = 1.17; 95% CI: 1.01, 1.37; p = 0.04) and response to vitality pulp tests (RR = 1.61; 95% CI: 1.03, 2.52; p = 0.04), whereas no significant effect was observed on root lengthening, dentin wall thickness, or success rate of immature, necrotic teeth treated with regenerative endodontics. APCs could be beneficial when treating young, immature, necrotic, permanent teeth regarding better apical closure and improved response to vitality tests.

Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis was to determine the clinical effectiveness of bulk-fill and conventional resin in composite restorations. A bibliographic search was carried out until May 2020, in the biomedical databases Pubmed/MEDLINE, EMBASE, Scopus, CENTRAL and Web of Science. The study selection criteria were: randomized clinical trials, in English, with no time limit, with a follow-up greater than or equal to 6 months and that reported the clinical effects (absence of fractures, absence of discoloration or marginal staining, adequate adaptation marginal, absence of post-operative sensitivity, absence of secondary caries, adequate color stability and translucency, proper surface texture, proper anatomical form, adequate tooth integrity without wear, adequate restoration integrity, proper occlusion, absence of inflammation and adequate point of contact) of restorations made with conventional and bulk resins. The risk of bias of the study was analyzed using the Cochrane Manual of Systematic Reviews of Interventions. Sixteen articles were eligible and included in the study. The results indicated that there is no difference between restorations with conventional and bulk resins for the type of restoration, type of tooth restored and restoration technique used. However, further properly designed clinical studies are required in order to reach a better conclusion.

Effects of Surface Treatments of Glass Fiber-Reinforced Post on Bond Strength to Root Dentine: A Systematic Review.

The objective of this systematic review was to determine the influence of surface treatment of glass fiber posts on bond strength to dentine. Laboratory studies were searched in MEDLINE, PubMed, Embase, PubMed Central, Scopus, and Web of Science search engine. All authors interdependently screened all identified articles for eligibility. The included studies were assessed for bias. Because of the considerable heterogeneity of the studies, a meta-analysis was not possible. Twelve articles were found eligible and included in the review. An assessment of the risk of bias in the included studies provided a result that classified the studies as low, medium, and high risk of bias. The available evidence indicated that the coronal region of the root canal bonded better to the glass fiber post than apical regions. Phosphoric acid, hydrogen peroxide, and silane application enhance post's retentiveness. In light of the current evidence, surface treatment strategies increase the bond strength of glass fiber post to dentine. However, recommendations for standardized testing methods and reporting of future clinical studies are required to maintain clinically relevant information and to understand the effects of various surface treatment of glass fiber post and their bond strength with dentine walls of the root canal.

Efectividad de la benzocaina en gel al 20% y la lidocaina en solución al 10% en pacientes que requieren punción en la mucosa oral: un ensayo clínico controlado aleatorizado cruzado a triple ciego / Effectiveness of benzocaine gel at 20% and lidocaine solution at 10% in patients requiring puncture in the oral mucosa: a randomized controlled crossover triple blind clinical trial

El objetivo del presente estudio fue determinar y comparar la efectividad de la Benzocaína en gel al 20% y la Lidocaína en solución al 10% en pacientes que requerían punción en la mucosa oral. El presente es un ensayo clínico controlado aleatorizado a triple ciego y de diseño cross-over. Se llevó a cabo en la clínica dental de la Unidad de Segunda Especialización en Estomatología (USEE) de la Universidad Nacional de Trujillo, durante los meses de Noviembre y Diciembre del 2010 y de Enero a Marzo del 2011. La muestra estuvo conformada por 60 pacientes, cada paciente firmó un consentimiento informado y se le realizó un análisis de su estado de ansiedad mediante la escala de ansiedad estado-rasgo (IDARE). Antes de realizar la punción en la mucosa oral se aplicó 4 preparados (2 anestésicos tópicos y 2 placebos) para después determinar y comparar la efectividad de los preparados en la reducción del dolor usando la escala visual análoga (EVA). Para la recolección de los datos se usó una ficha especial para tal fin. Para la comparación de la efectividad de los preparados se empleó el Análisis de Varianza (ANOVA). La efectividad de los anestésicos en gel y en solución fue evaluada empleando el test de Tuckey para comparaciones múltiples y el T de students. La significación estadística fue del 5%. Se encontró que la Benzocaína en gel al 20% y la Lidocaína en solución al 10% son efectivos para reducir el dolor a la punción y que no existe una relación estadísticamente significativa (p= 0,0575) entre la efectividad de cada uno de ellos. La administración de Benzocaína en gel al 20% o de la Lidocaína en solución al 10% reduce el dolor a la punción en igual magnitud y pueden ser usados indistintamente en la práctica odontológica diaria.

The objective of this study was to determine the effectiveness of benzocaine 20% gel and lidocaine in 10% solution in patients requiring puncture in the oral mucosa. This is a randomized controlled clinical trial to triple-blind, cross-over design. It was held at the dental clinic of the Unit of Second Specialization in Dentistry (usee) of the National University of Trujillo, in the months of November and December 2010 and January to March 2011. The sample consisted of 60 patients, each patient signed an informed consent and underwent a review of their status by anxiety scale state-trait anxiety (STAI). Before the puncture in the oral mucosa four preparations (2 topical anesthetics and 2 placebo) and then determine and compare the effectiveness of preparations in reducing pain using a visual analogue scale (VAS) was applied. For data collection a special token was used for that purpose. For comparison of the effectiveness of preparations Analysis of Variance (ANOVA). The effectiveness of the gel and anesthetic solution was evaluated using Tukey's test for multiple comparisons and students T. Statistical significance was 5%. We found that benzocaine 20% gel and lidocaine in 10% solution are effective at reducing pain at the puncture and that there is no statistically significant relationship (p= 0.0575) between the effectiveness of each. The administration of benzocaine 20% gel or lidocaine in 10% solution to reduce pain puncture equal and can be used interchangeably in everyday dental practice.