Clinical and radiographic success of pulpotomy and pulpectomy in primary and permanent teeth: a Systematic Review and Meta-Analysis.

Background: This systematic review evaluated the long-term clinical effectiveness of Biodentine in vital pulp therapy procedures. Material and Methods: Two independent reviewers searched the PubMed, Scopus, Web of Science, Cochrane, LILACS, and DOSS databases for articles published until August 2023. Review Manager and GRADEpro software were used for the analysis, and the Revman5.3 program was used for the meta-analysis. Initially, 297 publications were found, of which 12 studies, including 1385 clinical evaluations and 881 radiographic evaluations, were considered for qualitative and quantitative analysis. Results: Regarding the therapeutic indication, Biodentine presented a clinical success rate of: 96.38% for primary teeth submitted to pulpotomy, in a follow-up of 3-24 months, 97.18% for permanent teeth submitted to direct pulp capping in a follow-up of 3-54 months and 99.24% for primary teeth submitted to indirect pulp capping at a follow-up of 3-12 months. In radiographic analyses, a success rate of: 89.82% was observed for primary teeth submitted to pulpotomy at a follow-up of 3-24 months and for permanent teeth submitted to indirect pulp capping at a follow-up of 3-12 months. Conclusions: Biodentine is a reliable material for applications similar to that of mineral trioxide aggregate, with high long-term clinical and radiographic success rates, in primary and permanent teeth, regardless of the therapeutic indication. The efficacy and benefits of Biodentine, make it a promising endodontic material. Key words:Systematic review, Dental materials, Pulpotomy.

Photobiomodulation Reduces Pain-Related Symptoms Without Interfering in the Efficacy of In-Office Tooth Bleaching: A Systematic Review and Meta-Analysis of Placebo-Controlled Clinical Trials.

Objective: This systematic review aimed to determine whether the use of photobiomodulation (PBM) with low-level laser therapy prevents tooth sensitivity induced by in-office tooth bleaching with hydrogen. Methods: Placebo-controlled clinical trials were included to evaluate the efficacy of PBM with low-level laser therapy in the prevention of tooth sensitivity after in-office tooth bleaching. Searches were conducted on the Medline database via PubMed, Scopus, Web of Science, EBSCO, SciELO, LILACS, Cochrane, DOSS, and Google Scholar until July 2020, and fixed-effects meta-analysis was performed for tooth sensitivity [standardized mean differences (MDs)] and color changes (MDs). Results: Five studies were included in this systematic review and meta-analysis, with a total of 288 patients, 123 patients in the PBM group and 165 patients in the placebo group. In the meta-analysis, despite high heterogeneity, PBM significantly reduced the tooth sensitivity after the first [p < 0.001; Cohen's d = -0.32, 95% confidence interval (CI) = -0.46 to -0.18], second (p < 0.001; Cohen's d = -0.30, 95% CI = -0.46 to -0.15), and third (p < 0.001; Cohen's d = -0.82, 95% CI = -1.06 to -0.58) sessions of in-office tooth bleaching, without impairing the ΔE (p = 0.300). Conclusions: The results of this systematic review and meta-analysis suggest that PBM significantly prevents pain-related symptoms after the first three weekly sessions of in-office tooth bleaching with hydrogen.

Does Platelet-Rich Fibrin Prevent Hemorrhagic Complications After Dental Extractions in Patients Using Oral Anticoagulant Therapy?

PURPOSE: The number of anticoagulated patients requiring dental extractions and other minor dentoalveolar surgical procedures has increased significantly. The purpose of this study was to determine whether the use of platelet-rich fibrin (PRF) prevents hemorrhagic complications after dental extractions in patients being treated with oral anticoagulants. METHODS: A 2-phase PROSPERO-registered systematic review of published within-subject controlled trials (CRD42020186678) was conducted in accordance with the PRISMA statement. Searches were conducted through Medline via PubMed, Web of Science, LILACS, Central Cochrane, Scopus, DOSS, and Google Scholar, until May 2020. The predictor variable was the study group (PRF vs use/non-use of other hemostatic agents). The main outcome of interest was the risk of bleeding after tooth extraction and the covariates were postoperative complications. Data analysis included synthesis of results, risk of bias (RoB) evaluation, meta-analysis (random effects; I²-based heterogeneity; 95% confidence), and certainty of evidence assessment. RESULTS: From a total of 216 articles, 3 articles (low-moderate RoB) were included for evaluation in this systematic review and meta-analysis. A total of 130 patients were involved. The outcomes of the meta-analysis showed that the use of PRF in extraction wounds did not reduce the risk of bleeding after extraction in anticoagulated patients (P= .330; I² = 99%). Furthermore, the use of PRF did not improve pain scores (P = .470; I² = 96%) or the risk of postoperative alveolitis (P = .4300; I² = 38%) in anticoagulated patients. The certainty of the evidence ranged from moderate to low. CONCLUSIONS: The findings of this systematic review and meta-analysis suggest that PRF does not prevent hemorrhagic complications after tooth extraction in patients using oral anticoagulant therapy.