Is there a correlation between dental and cervical vertebrae maturation stages in growing subjects? A systematic review with meta-analysis.

OBJECTIVE: To assess the evidence on the relationship between dental and cervical vertebrae maturation. MATERIALS AND METHODS: Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence. RESULTS: Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine (n = 7318; r = 0.692; 95% CI: 0.656-0.724), first premolar (n = 6194; r = 0.689; 95% CI: 0.649-0.725), second premolar (n = 6194; r = 0.695; 95% CI: 0.659-0.729), and second molar (n = 7905; r = 0.698; 95% CI: 0.652-0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity. CONCLUSIONS: The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality. CLINICAL RELEVANCE: Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs.

What is the effectiveness of titanium tetrafluoride to prevent or treat dental caries and tooth erosion? A systematic review.

OBJECTIVES: Answer the question: What is the effectiveness of titanium tetrafluoride (TiF4) when compared to other fluorides, placebo solution or a negative control to prevent or treat dental caries and tooth erosion? MATERIALS AND METHODS: This review is in accordance with PRISMA guidelines. In vivo and in situ studies that used TiF4 over enamel or dentine were included. Electronic searches were conducted on MEDLINE, Scopus, Embase, WOS, Cochrane Library, VLH, Clinical Trials and OpenGrey. Risk of bias (ROB) assessments used RoB2 and ROBINS-I for randomized and non-randomized controlled trials (RCTs and on-RCTs); Syrcle's ROB tool for animal studies; and a modified tool proposed by Hollanders for in situ studies. RESULTS: A total of 28 studies met the eligibility criteria. From these, 6 were in humans (3 RCT and 3 Non-RCT); 4 were in animals and 18 were in situ. For in vivo studies, all RCTs have some concerns related to ROB and all of the non-RCT studies were classified as with serious risk. One animal study had a low and three a high ROB. Regarding in situ studies, seven had a low, ten had an average and only one had a high ROB. The certainty of the evidence (GRADE) ranged from moderate to very low. CONCLUSIONS: Although most of the results suggest a positive effect of TiF4 on the prevention and treatment of caries and dental erosion, it is not possible to have definitive conclusions due to the high studies' methodological heterogeneity, and the low quality of evidence for most outcomes. REGISTRATION: The protocol of this syste. atic review was registered in the OPEN SCIENCE FRAMEWORK database (osf.io/6dgs9) DOI:10.17605/OSF.IO/KUZA7 on 6 August 2020.

Is the caregivers' oral health related to dental caries in children or adolescents? A systematic review.

OBJECTIVES: This systematic review aimed to evaluate evidence on the relation between the caregivers' oral health condition and dental caries prevalence in their offspring. MATERIALS AND METHODS: Scientific literature was searched in PubMed, Scopus, LILACS, Web of Science, the Cochrane Library databases, and Grey Literature. Observational studies were included if mentioning oral health conditions in caregivers and dental caries in offsprings. The internal validity of the selected articles was judged by two evaluators according to a previously published guideline based on eight questions (1 point each). Studies included were divided into low methodological quality (1-3 points), moderate (4-6 points), or high (7-8 points) according to the quality assessment. The GRADE approach was used to assess the quality of evidence provided by the selected studies. RESULTS: Initially, 12.458 records were recovered, of which 54 full-text articles were evaluated. Hand search added 5 records, but after application of the exclusion criteria, only 16 articles which met the adopted eligibility criteria remained. Critical assessment scored one study as low, 10 moderate, and 5 with high validity. Most of the studies plotted correlations between the variables (12) while 4 studies compared DMFT (3) or ICDAS (1) scores between caries-active/caries-free children with caries experience in caregivers. Regarding the main study question, 15 studies (93.7%), containing 5704 caregivers and 5467 children/adolescents, found a significant relationship between mothers/caregivers and children's/adolescents' caries prevalence; one study found this relationship only for individuals showing active caries and one study did not disclose any relationship between caries prevalence in caregivers-children's/adolescents' pairs. The overall evidence was, however, qualified as low due to problems in the imprecision of the included studies. CONCLUSIONS: Caregivers' oral health may be considered as an important risk marker in children's and adolescent's caries prevalence. CLINICAL RELEVANCE: Assuming the contribution of caregivers' oral health conditions on dental caries in their offspring may help to establish control measures for such prevalent disease in the family environment.

Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis.

OBJECTIVES: The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis. MATERIALS AND METHODS: MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. DATA: After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at "low" risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was -0.45 (95 % CI -0.69 to -0.21), which favored tray-delivered CP products (p < 0.001). The color change in ΔSGU (p = 0.70), tooth sensitivity (p = 0.83), and gingival irritation (p = 0.62) were not significantly different between groups. CONCLUSIONS: Tray-delivered CP gels showed a slightly better whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity. CLINICAL SIGNIFICANCE: Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.

The cost of oral cancer: A systematic review.

Although clinical and epidemiological aspects of oral cancers (OC) are well-documented in the literature, there is a lack of evidence on the economic burden of OC. This study aims to provide a comprehensive systematic assessment on the economic burden of OC based on available evidence worldwide. A systematic review was conducted. The population was any individual, who were exposed to OC, considered here as lip (LC), oral cavity (OCC), or oropharynx (OPC) cancer. The outcome was information on direct (medical and non-medical) and indirect (productivity loss and early death) costs. The data sources included Scopus, Web of Science, Cochrane, BVS, and NHS EED. A search of grey literature (ISPOR and INAHTA proceedings) and a manual search in the reference lists of the included publications were performed (PROSPERO no. CRD42020172471). We identified 24 studies from 2001 to 2021, distributed by 15 countries, in 4 continents. In some developed western countries, the costs of LC, OCC, and OPC reached an average of Gross Domestic Product per capita of 18%, 75%, and 127%, respectively. Inpatient costs for OC and LC were 968% and 384% higher than those for outpatients, respectively. Advanced cancer staging was more costly (from ~22% to 373%) than the early cancer staging. The economic burden of oral cancer is substantial, though underestimated.

Efficacy of viscosupplementation with hyaluronic acid in temporomandibular disorders: A systematic review.

OBJECTIVE: To perform a systematic review of the viscosupplementation effectiveness with hyaluronic acid (HA) in the articular Temporomandibular Dysfunctions (TMDs) clinical management. METHOD: Electronic searches were performed in the following databases: MEDLINE (via PubMed), Scopus, Web of Science, Cochrane Library, EMBASE, LILACS, BBO, SIGLE (System for Information on Grey Literature in Europe), ClinicalTrials.gov, and the Brazilian Clinical Trials Registry (ReBec). Only randomized clinical trials that evaluated the intra-articular administration of HA or its derivatives in osteoarthritis and/or anterior displacement of the temporomandibular joint (TMJ) disc were included. The primary outcomes evaluated were patients' self-report of pain and/or discomfort in the TMJ. Each study was assessed for the risk of bias, using the Cochrane collaboration's risk of bias tool. RESULTS: A total of 640 studies were obtained in the electronic search. After the application of the eligibility criteria, manual search, and duplicate removal, 21 articles were included. Five articles classified their volunteers with internal derangements of the TMJ, in 4 articles the treatment was directed to participants with disc displacement with reduction and the other articles evaluated HA therapy in osteoarthritis. The protocols presented heterogeneity, varying in the form of application, associated or not with arthrocentesis, number of applications, molecular weight, dose and concentration. Nine studies presented high risk of bias. CONCLUSION: Due to the heterogeneity and methodological inconsistencies of the studies evaluated, it was not possible to establish the efficacy of HA in articular TMDs.

Aplicação do peer review of electronic search strategies para avaliação da qualidade das estratégias de busca das revisões sistemáticas

As decisões de saúde se baseiam em evidências científicas e estas são o produto da pesquisa científica publicada. As revisões sistemáticas e as metanálises são os tipos de estudo considerados de excelência na produção de evidências da área biomédica e, para a realização desses estudos, é necessária uma ampla busca da literatura nas bases de dados bibliográficas. A construção de estratégias de busca em bases de dados eletrônicas foi identificada como ponto chave na base da evidência das revisões sistemáticas, sendo esta uma tarefa própria do profissional da informação. Avaliar as estratégias de busca é importante e pode contribuir para aumentar a qualidade das revisões sistemáticas. Este trabalho objetiva utilizar o Peer Review of Eletronic Search Strategies para a análise qualitativa das estratégias de busca de 57 estudos selecionados, seguido de uma análise quantitativa. Com o intuito de traçar um panorama local e temático, foram escolhidos estudos com autores de instituições brasileiras da área de odontologia no ano de 2015. Os resultados mostraram que a maioria das estratégias analisadas foram reportadas de forma deficiente e o que foi publicado contém erros que não garantem a reprodutibilidade da busca. A base da evidência dessas revisões sistemáticas pode estar comprometida, o que reforça a necessidade da participação de profissionais da informação nas equipes de revisões sistemáticas.

Research Trends on Preventive and Therapeutic Use of TIF4 for Dental Caries and Erosion

Abstract Objective: To evaluate TIF4 preventive and therapeutic use in caries and erosive lesions. Material and Methods: Searches were performed in six databases. Studies evaluating TiF4 use in vitro, in situ, and in vivo in caries and erosive lesions were included and imported into VantagePoint™ (VP). Data about publication year, authors, country, journal, study design, outcomes, TIF4 vehicles, application and intervention time, cariogenic challenge, erosive cycles, effects (positive/ negative /null) and approach (preventive/therapeutic) were analyzed through VP and Excel. Results: 93 published studies were included and an increase in publications was observed between 2010 and 2021. Forty-three authors published three or more articles, of which 67.4% were developed in Brazil and published in Caries Research (22.6%). 69.9% were in vitro studies with erosion assays (59.1%) and with preventive approaches (67.4%). The principal vehicle was a solution (69.9%) with a 1-min single application (58.0%) and with an intervention time of 5-7 days (22.6%). The principal cariogenic challenge in vitro was pH cycling (11.8%); in situ was sucrose + biofilm (6.2%); and in vivo, biofilm (6.2%). The most used erosive cycle was 4× per day in in vitro studies (20.4%) and 1× in vivo (2.1%). A positive effect was observed in prevention (41.9%) and treatment (24.7%) studies. Conclusion: TIF4 has shown a positive effect in prevention and therapeutic treatments for dental caries and erosion (AU).

Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: A systematic review and meta-analysis.

OBJECTIVES: A systematic review and meta-analysis were performed on the risk and intensity of postoperative sensitivity (POS) in posterior resin composite restorations bonded with self-etch (SE) and etch-and-rinse (ER) adhesives. SOURCE: A comprehensive search was performed in the MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The abstracts of the annual conference of the IADR (1990-2014), unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periodicos Capes Theses databases. STUDY SELECTION: We included randomized clinical trials that compared the clinical effectiveness of SE and ER used for direct resin composite restorations in permanent dentition of adult patients. The risk/intensity of POS was the primary outcome. The risk of bias tool of the Cochrane Collaboration was used. The meta-analysis was performed on the studies considered 'low' risk of bias. DATA: After duplicates removal, 2600 articles were identified but only 29 remained in the qualitative synthesis. Five were considered to be 'high' risk of bias and eleven were considered to be 'unclear' in the key domains, yielding 13 studies for meta-analysis. The overall relative risk of the spontaneous POS was 0.63 (95% CI 0.35 to 1.15), while the stimuli-induced POS was 0.99 (95% CI 0.63 to 1.56). The overall standardized mean difference was 0.08 (95%CI -0.19 to 0.35). No overall effect was revealed in the meta-analyses, meaning that no influence of the ER or SE strategy on POS. SIGNIFICANCE: The type of adhesive strategy (ER or SE) for posterior resin composite restorations does not influence the risk and intensity of POS. CRD42014006617.

Effect of enamel bevel on retention of cervical composite resin restorations: A systematic review and meta-analysis.

OBJECTIVES: To identify if enamel bevelling, compared to no treatment, improves the retention rates and marginal discolouration of cervical composite restorations in non-carious cervical lesions (NCCLs) of adult patients, through a systematic review of the literature and meta-analysis. SOURCES: MEDLINE, Scopus, Web of Science, LILACS, BBO Library, Cochrane Library and SIGLE were searched without restrictions, as well as the abstracts of the annual conference of the IADR and the trials registry. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. STUDY SELECTION: We included randomised clinical trials (RCTs) that compared the retention rates restorations in NCCLs placed with or without bevel with at least 1-year follow-up. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. DATA: After duplicate removal, 1356 articles were identified. After abstract screening, 14 studies remained and this number was reduced to four after examination of the full-texts. Only two were considered to have a 'low' risk of bias. The overall risk difference was 0.0 (95% CI -0.04 to 0.04) for the retention rate (p=0.91) and 0.05 (-0.02 to 0.13) for the marginal discolouration (p=0.17). CONCLUSIONS: No superiority of bevelled restorations was observed in the short-term follow-up of 1-year, although this conclusion was based on only two RCTs. There is not enough evidence to support the bevelled technique over non-bevelled for NCCLs over longer periods of time. Better standardization and reporting of RCTs of enamel bevelling are necessary in longer-term follow-ups. CLINICAL SIGNIFICANCE: The literature still lacks a body of evidence to support the benefits of enamel bevel over non-bevelled for longer-term follow-ups, and future randomised clinical trials with low risk of bias should be conducted.