Effectiveness of herbal oral care products in reducing dental plaque and gingivitis: an overview of systematic reviews.

Introduction: Numerous clinical trials and systematic reviews have investigated the effectiveness of both herbal and conventional oral care approaches to reducing plaque and gingivitis. However, their findings vary and are inconsistent. Thus, the objective of this umbrella review is to compile data from systematic reviews and provide an overview of the effects of herbal oral care products on tooth plaque and gingivitis. Methods: A comprehensive search of the literature was performed in 6 databases for systematic reviews with or without meta-analyses, published up to 30 May 2023, without any language restrictions. Only clinical trials comparing herbal oral care products (in the form of mouthrinse or toothpaste) against standard oral care products or placebo were considered. Results: Some herbal oral care products, particularly in the form of mouthrinses, have a similar level of positive effect on plaque and gingivitis reduction and, thus, can be used as an adjunct to traditional dentifrices. However, the shorter duration of trials (<4 weeks) and reported publication bias in the clinical trials mean that these findings must be interpreted with caution. Conclusion: To accurately determine the impact of various herbal extracts on periodontal health, well-designed, long-term, and controlled trials that adhere to standardized protocols must be carried out.

Introduction: On a étudié l'efficacité d'approches de soins buccodentaires classiques et à base de plantes pour lutter contre la plaque dentaire et la gingivite dans le cadre de nombreux essais cliniques et revues systématiques. Toutefois, leurs conclusions ont été variables et incohérentes. Cette revue générale vise donc à compiler des données issues de revues systématiques et de présenter un aperçu des effets des produits de soins buccodentaires à base de plantes sur la plaque dentaire et la gingivite. Méthodes: On a procédé à une recherche documentaire exhaustive dans 6 bases de données pour effectuer des revues systématiques, avec ou sans méta-analyses, sans aucune restriction relative à la langue de l'étude, publiées avant le 30 mai 2023. Seuls des essais cliniques comparant des produits de soins buccodentaires à base de plantes (sous forme de rincebouche ou de dentifrice) à des produits de soins buccodentaires classiques ou à des placebos ont été envisagés. Résultats: Quelques produits de soins buccodentaires à base de plantes, en particulier les rince-bouches de ce type, ont des effets positifs comparables en matière de réduction de la plaque et de la gingivite et peuvent donc être utilisés en complément des dentifrices ordinaires. Toutefois, ces résultats doivent être interprétés avec prudence du fait de la durée relativement courte des essais (moins de 4 semaines) et du biais de publication signalé dans les essais cliniques. Conclusion: Pour déterminer avec précision les effets de divers extraits de plantes sur la santé parodontale, il est nécessaire d'avoir recours à des essais bien conçus, à long terme et contrôlés, qui respectent des protocoles normalisés.

Correlation between rheumatoid arthritis and chronic periodontitis: a systematic review and meta-analysis.

INTRODUCTION: The aim of this article is to summarize, compare, and assess possible association in individuals with or without rheumatoid arthritis (RA) for periodontitis. EVIDENCE ACQUISITION: Three study repositories were searched for quantitative studies examining the relationship between periodontal disease and rheumatoid arthritis between 2000 and December 2022. Quality was evaluated using the Newcastle Ottawa Scale (NOS). The standardized mean difference (SMD), with a random effect model and a P value of 0.05 as the significance level, was utilized as a summary statistic measure. EVIDENCE SYNTHESIS: Fourteen papers were included in the descriptive synthesis. Thirteen were qualified for meta-analysis. Our findings suggest a link between the two conditions in terms of clinical attachment levels (CAL), tooth loss, Plaque Index, and probing depth. The estimated SMD for CAL was found to be 0.68 (95% CI: 0.15-1.21) (P<0.01). For tooth loss, the forest plot analysis revealed an SMD of 1.62 (95% CI: 0.48-2.76) (P=0.005). Similarly, for pocket depth, the SMD was 0.53; CI: 0.07-0.99 (P>0.05). The pooled estimates for plaque index were 0.29; CI: 0.03-0.61 (P>0.05). The funnel plot showed a symmetric distribution with the absence of systematic heterogeneity. CONCLUSIONS: Although our data suggest a link between periodontal disease and rheumatoid arthritis, larger population-based investigations are needed to validate this connection. Case-control studies must pave the way to more rigorous investigations with well-defined populations and clinical outcomes as primary outcome measures.

Oral health status of prisoners in India: A systematic review and meta-analysis.

AIMS: Given the high prevalence of oral health problems among prisoners, the goal of this systematic review is to provide a better knowledge of the scope of this problem. METHODS: Electronic searches of PubMed/MEDLINE, Embase, Scopus, and Google Scholar were performed. Studies that investigated inmates aged 18 or older with oral health problems were eligible. Variables reported in four or less studies were described narratively. Conversely, for variables reported in more than four studies, a meta-analysis was performed using random effect model. Furthermore, meta-regression and sensitivity analysis is also performed to evaluate moderator effect on outcome. Doi and LFT index is applied to assess publication bias. RESULTS: Out of 494 results, 12 studies were included. The pooled prevalence of caries among prisoners is 78.42% (59.48%-92.58%). On meta-regression, the prevalence of caries appears to be lower in studies with a higher male percentage; however, non-significant (p = .079) due to small sample size. Community periodontal index (CPI) scores revealed periodontal disease, with scores of 3 and 4. Moreover, a significant need for oral hygiene instruction, prosthesis, extraction, and tooth ache, periodontal disease, oral mucosal lesions, leucoplakia, attrition, abrasion, bruxism, and smoking behaviors were also reported. CONCLUSION: Poor oral health status in the incarcerated population highlights the urgent need for comprehensive oral health intervention in prisons.

Oral health status among the transgender population of India: A systematic review and meta-analysis.

BACKGROUND: The invisibility of the transgender population within official records, combined with other socio-economic factors, impacts oral health status among transgender people. Hence, our systematic review and meta-analysis aim to generate a pooled estimate of the oral health status of the transgender community in India. MATERIAL AND METHODS: A systematic search was performed across four databases. The studies included a quantitative research design conducted in India and involved self-identified transgender individuals. The pooled prevalence was determined at a 95% confidence interval (CI). Q-statistics and the I2 test were utilized to evaluate the source of heterogeneity. Leave-one-out analysis and Baujat plots were used to detect outliers within the studies. A Doi plot and LFK index were employed to assess the publication bias. RESULTS: A total of 12 studies comprising 1566 transgender participants were included. The pooled prevalence of toothbrush use among transgenders in India was found at 83% (95% CI: 0.73-0.91), smoking = 12% (CI: 0.03-0.26), smokeless tobacco = 53% (CI = 0.38-0.68), dental caries = 78% (CI: 67%-88%), calculus = 65% (CI: 0.4-0.86), and bleeding 18% (CI:0.08-0.32). CONCLUSION: Oral health disparities among Indian transgender individuals are evident in the low toothbrush usage, an elevated prevalence of tobacco use, and dental disorders such as calculus, cavities, and bleeding. Tailored dental health programs that include inclusive healthcare services and awareness are essential. PROSPERO REGISTRATION: CRD42023468872.

Human resource shortage in India's health sector: a scoping review of the current landscape.

BACKGROUND: For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at healthcare facilities. We conducted a scoping review to map the current state of human resources for health (HRH) in India and the reasons behind its shortage. METHODS: A systematic search was conducted in various electronic databases, from the earliest available date till February 2024. We applied a uniform analytical framework to all the primary research reports and adopted the "descriptive-analytical" method from the narrative paradigm. Inductive thematic analysis was conducted to arrange the retrieved data into categories based on related themes after creating a chart of HRH problems. RESULTS: A total of 9675 articles were retrieved for this review. 88 full texts were included for the final data analysis. The shortage was addressed in 30.6% studies (n = 27) whereas 69.3% of studies (n = 61) addressed reasons for the shortage. The thematic analysis of data regarding reasons for the shortage yielded five kinds of HRH-related problems such as inadequate HRH production, job dissatisfaction, brain drain, regulatory issues, and lack of training, monitoring, and evaluation that were causing a scarcity of HRH in India. CONCLUSION: There has been a persistent shortage and inequitable distribution of human resources in India with the rural expert cadres experiencing the most severe shortage. The health department needs to establish a productive recruitment system if long-term solutions are to be achieved. It is important to address the slow and sporadic nature of the recruitment system and the issue of job insecurity among medical officers, which in turn affects their other employment benefits, such as salary, pension, and recognition for the years of service.

Effectiveness of fluoride mouthrinse in prevention of demineralization during fixed orthodontic treatment: A systematic review and meta-analysis.

Enamel demineralization is a very common occurrence around bonded brackets in an orthodontic practice. Fluoride (FLR) applications have been used to prevent decalcification and further progression of white spot lesions. The purpose of this systematic review and meta-analysis was to systematically appraise available literature on the effectiveness of fluoride mouthrinse in the prevention of demineralization around fixed orthodontic appliances. A search was conducted for randomized controlled clinical trials among four electronic databases (MEDLINE, Google Scholar, PubMed, and Cochrane Review) through MeSH terms and keywords. Studies were excluded if random allocation was not conducted, or if they were animal or in vitro studies. About 146 articles were screened and 5 studies were selected for the present review. Only two studies were selected for MA due to variations in the measurement of outcomes among studies. This review concluded that rinsing with FLR in the course of the fixed orthodontic treatment lessens demineralization around the bracket. Using FLR mouthrinse to inhibit the formation of white spot lesions or dental caries in patients with multiple cavities or restoration can be considered in clinical practice.

A Brief Review on Engaging and Interactive Learning for Children: Exploring the Potential of Metaverse-Based Oral Health Promotion.

The importance of oral health for overall health makes it critical to establish proper oral hygiene practices in children early on. The traditional approaches to teaching children about dental health may not be successful since they may not be able to keep their interest. Metaverse technology offers a promising alternative, allowing for the design of engaging and immersive worlds that can effectively educate children about oral health. Despite the growing interest in the use of metaverse technology in healthcare, there is a lack of comprehensive reviews on its potential for oral health promotion in children. This review aims to fill this gap by providing an overview of the current state of metaverse-based oral health promotion for children, discussing its benefits and challenges, and highlighting its potential for improving children's oral health. By conducting this review, the authors hope to provide new information on the potential of metaverse-based oral health promotion for children and to contribute to the ongoing discussion on the use of metaverse technology in healthcare. This review may also provide valuable insights for dental organizations and practitioners interested in using metaverse technology to promote oral health and healthy living among children.

Bibliographic analysis and evaluation of the mesh keywords in the journal of prosthodontics: Implant, esthetic, and reconstructive dentistry.

BACKGROUND: Various studies have been conducted to analyze data via bibliometric analysis in different dentistry, including prosthetic dentistry. However, these studies evaluated the most cited published articles in dentistry. OBJECTIVE: To analyze and evaluate the characteristic development of several mesh keywords in the Journal of Prosthodontics - Implant, Esthetic, and Reconstructive Dentistry between 1992 and 2022. METHODS: The Scopus databases was searched to retrieve the data related to 8 categories, including published articles, most cited documents, authors and organizations, and maximum articles cited during the evaluation period. The data retrieved were exported to a Microsoft Excel sheet and were analyzed using the bibliometrix package. The data were first analyzed for ten years and then for 30 years. The highest of 10 were reported for each category, and co-authorship, reoccurrence, and linked data were also reported. RESULTS: 2603 published documents were recorded from the Scopus databases. Articles comprised 87.9% of the total published work, followed by review articles at 5.46%. The most productive decade was between 2013 and 2022. 3793 terms were used during the evaluation period, with the maximum number in 2003-2012 (2481). A total of 5392 keywords were used during 1992-2022, with the highest number (3232) from 2013 to 2022. A total of 6108 authors were acknowledged, with the maximum number (3964) from 2013 to 2022 and the fewest (767) from 1992 to 2002. Authors from different countries increased from 17 countries in 1992-2002 to 52 countries in 2013-2022 (total = 63 countries). Similarly, the number of organizations increased from 312 organizations in 1992-2002 to 1315 organizations in 2013-2022 (total = 1976 organizations). CONCLUSION: The current bibliometric analysis delivered a comprehensive overview about more spread research topics and its impactful role in contemporary dentistry, especially prosthetic dentistry.

Mini Crestal Sinus Lift With Bone Grafting and Simultaneous Insertion of Implants in Severe Maxillary Conditions as an Alternative to Lateral Sinus Lift: Multicase Study Report of Different Techniques.

The present study evaluates the efficacy and clinical outcomes of crestal sinus lift techniques used to elevate the sinus floor simultaneously with bone grafting and implant placement as a possible and reproducible alternative to lateral sinus lift. Patients underwent different crestal sinus elevation techniques. The heterologous biomaterial was used as graft material, and multiple implants were placed simultaneously after sinus augmentation. Radiographic and clinical examinations were performed during follow-up. All procedures were successfully performed without any apparent perforation of the Schneider membrane. The sinus floor was augmented with an average height of 5 mm (range: 2.8-7.4 mm). The implants healed smoothly with healing screws. Peri-implant marginal bone was stable with a mean follow-up of 50 months (range: 33-71 mo). No complications were observed during the follow-up. Based on the limited data collected in this study, the new crestal sinus elevation approach can effectively raise the sinus floor and reduce the incidence of postoperative complications. Other cases with long-term follow-up are needed to confirm and improve this crestal sinus lift technique.

India's Union Budget 2023-Healthcare allocation leaves much to be desired.

Healthcare is an imperative sector for India, considering the huge population in the country and the sub-par health facilities available to a majority of the country's people. In this scenario, and given the havoc wreaked by the COVID-19 pandemic, owing to India's lack of optimal healthcare infrastructure, a large part of the healthcare industry expected that India's Union Budget 2023 would provide significant outlays for the sector. However, with the budgetary outlay for healthcare coming in at the 10th position from the top, this hope was severely dashed, leading to questions about the country's interest in providing healthcare facilities to its people. This article discusses the various facets of the Union Budget, and the lack of focus on healthcare, while also delineating the reasons why budgetary focus on healthcare is imperative for a developing country like India. It has also brought forth potential solutions, such as a public-private partnership in healthcare, which could ensure increased access to healthcare, improved quality of healthcare, reduced costs, and enhanced innovation and research.

Clinico-pathological and prognostic overview of metastasizing ameloblastoma: An overview of the systematic reviews.

Background: Metastasizing Ameloblastoma (MA) is an aggressive variant of ameloblastoma (AM) with the ability to metastasize without cytological malignant changes. Thus it aims to comprehensively review the clinico-pathological and prognostic aspects of MA through integration of current literature. Methods: Electronic searches were conducted in PubMed-MEDLINE, Scopus, Web of Science and Google Scholar. Two independent reviewers screened abstracts and evaluated paper eligibility. AMSTAR2 checklist was used to assessed methodological quality of included systematic reviews (SRs). Results: From 390 initial papers, 279 underwent eligibility screening, with five systematic reviews (SRs) meeting inclusion criteria. Six hundred sixty-one MA cases were found in five SRs that were included. MA predominantly affects men, exhibits mandible preference, and occurs in individuals in their fourth or fifth decade. Benign metastatic deposits commonly manifest in lungs and lymph nodes. Distant metastasis probability rises with multiple recurrences and incomplete surgical removal. Tumor recurrence and metastasis unfavorably impact clinical outcomes. Quality of evidence assessment was absent across SRs; four SRs were critically low in methodological quality. Conclusions: AM's metastatic potential lacks predictability. Early/multiple recurrences post-treatment may signal poor prognosis, warranting vigilant follow-up. Methodical analysis of each AM case is imperative to comprehend the metastatic-benign histology relationship.

Comparative evaluation of three different regression-equation-based mixed dentition analysis of children for prediction of the mesiodistal width of permanent canine and premolars.

BACKGROUND: Dental malocclusion is common all over the world, and it is caused by a difference in arch length and tooth size. This necessitates mixed dentition analysis for early intervention treatment planning such as eruption guiding, serial extraction, space maintainer, space regainer, and jaw extension. The aim of the study is to comparatively evaluate three different regression equation based mixed dentition analysis of children for prediction of the mesiodistal width of permanent canine and premolars in population of Vidarbha region. METHODS: This study comprised of 300 patients aged 13 to 16 years old. The impressions of patients were poured, and the mesiodistal width of their teeth was measured and documented. Three independent analyses were performed using the Ling and Wong method (L&W), the Bernabe and Flores-Mir method (B&F), and the Tanaka and Johnston method (T&J), and the results were compared to the sum of permanent canine and premolar teeth (SPCP). ANOVA with post hoc analysis was used to compare the predicted mesiodistal diameter (MDD) by analysis to the SPCP observed on cast. RESULTS: The mesiodistal width of SPCP of maxilla and mandibular teeth had statistically significant difference (P<0.001) with the predicted width by Ling and Wong method, Bernabe and Flores method and Tanaka and Johnston method for patients of Vidarbha region. CONCLUSIONS: The study concluded that all the three analysis overestimated the mesiodistal width of the sum of permanent canine and premolar in the patients. Tananka and Johnston analysis method was better in predicting the SPCP of the children of Vidarbha region.

Maxillary Sinus Floor Augmentation With Allograft Alone Compared With Alternate Grafting Materials: A Systematic Review and Meta-Analysis.

A meta-analysis of scientific literature was conducted to ascertain the superiority between allografts and other regenerative grafts for maxillary sinus floor augmentation (MSFA). Review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and registered in PROSPERO-CRD42023392766. Electronic databases like PubMed, Google scholar and Ebsco Host were searched from 2000 to December 2022 for studies reporting MSFA using allografts or other regenerative grafts. Quality assessment of included studies was evaluated using the Cochrane risk of bias (ROB)-2 tool for randomized controlled trials through its domains. Risk of bias summary graph and ROB summary applicability concern were plotted using RevMan software version 5.3. The standardized mean difference was used as a summary statistic measure with random effect model and P value <0.05 as statistically significant. Four studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which all 4 studies were suitable for meta-analysis. Pooled estimate through standardized mean difference signifies that new bone formation was more or less similar for both graft materials, whereas regenerative grafts showed more residual bone grafts (P>0.05). Publication bias through funnel plot showed symmetric distribution with the absence of systematic heterogeneity. Both allografts and other regenerative grafts are equally effective in the MSFA in terms of new bone formation, whereras regenerative grafts showed more residual bone grafts. Furthermore, randomized controlled trials are required to establish evidence in outcomes involving sinus floor augmentation and different graft materials.

Ultraviolet disinfection (UV-D) robots: bridging the gaps in dentistry.

Maintaining a microbe-free environment in healthcare facilities has become increasingly crucial for minimizing virus transmission, especially in the wake of recent epidemics like COVID-19. To meet the urgent need for ongoing sterilization, autonomous ultraviolet disinfection (UV-D) robots have emerged as vital tools. These robots are gaining popularity due to their automated nature, cost advantages, and ability to instantly disinfect rooms and workspaces without relying on human labor. Integrating disinfection robots into medical facilities reduces infection risk, lowers conventional cleaning costs, and instills greater confidence in patient safety. However, UV-D robots should complement rather than replace routine manual cleaning. To optimize the functionality of UV-D robots in medical settings, additional hospital and device design modifications are necessary to address visibility challenges. Achieving seamless integration requires more technical advancements and clinical investigations across various institutions. This mini-review presents an overview of advanced applications that demand disinfection, highlighting their limitations and challenges. Despite their potential, little comprehensive research has been conducted on the sterilizing impact of disinfection robots in the dental industry. By serving as a starting point for future research, this review aims to bridge the gaps in knowledge and identify unresolved issues. Our objective is to provide an extensive guide to UV-D robots, encompassing design requirements, technological breakthroughs, and in-depth use in healthcare and dentistry facilities. Understanding the capabilities and limitations of UV-D robots will aid in harnessing their potential to revolutionize infection control practices in the medical and dental fields.

Expression of transforming growth factor-ß in oral submucous fibrosis: A systematic review.

Oral submucous fibrosis (OSF) is a potentially malignant disorder characterised by inflammation and progressive fibrosis. Transforming growth factor-ß (TGF-ß) has been established as a master regulator of fibrosis in various organs; however, lack of systematic review on expression of TGF-ß and its isoforms in OSF restrict the understanding of their behaviour in its pathogenesis. Online electronic databases, such as PubMed Medline, Cochrane Library, Embase, and Scopus, were searched from their respective dates of inception till 31st March 2022. Human studies related to TGF-ß expression in histopathologically diagnosed OSF cases, with or without malignant transformation, were included and assessed using a Cochrane risk of bias assessment tool: For non randomised studies of interventions (ACROBAT NRSI). The electronic literature search yielded 394 articles. Of those, ten articles met the inclusion criteria and involved total of 579 OSF patients. The risk of bias (RoB) was low to moderate. These studies demonstrated a significant positive expression of TGF-ß and its isoforms in OSF compared to that in normal tissue samples. An increased pan TGF-ß expression was observed in the early stages of OSF, and an increased expression of TGF-ß1 and TGF-ß2 were seen in advanced stages of OSF. Stage wise expression of TGF-ß3 has not been discussed in the included studies. No significant relationship was observed between epithelial dysplasia and TGF-ß expression in OSF. The distinct pattern in the expression of pan TGF-ß, TGF-ß1 and TGF-ß2 in various stages of OSF indicates their different roles in OSF progression. We believe isoform targeted studies exploring stage wise expression of the marker will open new treatment avenues for OSF.