Effectiveness of gold nanoparticles in prevention and treatment of oral mucositis in animal models: a systematic review.

BACKGROUND: Oral mucositis remains a significant complication during cancer therapy with no effective treatment. Gold nanoparticles offer anti-inflammatory, antioxidant properties with low toxicity. This study systematically reviews the literature assessing gold nanoparticles in the management of oral mucositis in animal models. METHODS: A literature search was undertaken using MEDLINE, Embase, PubMed, and Web of Science databases, using the format for Systematic Review Centre for Laboratory Animal Experimentation. Prior to the review, the protocol was registered in the systematic review register, PROSPERO (registration no. CRD42021272169). Outcome measures included ulceration, histopathological scores, inflammatory mediators, microbial growth, and pain. Study quality was analysed by SYRCLE risk-of-bias tool. RESULTS: Only one study met the inclusion criteria, documenting reduction in ulceration, inflammatory, and oxidative biomarkers. Exposure to AuNPs prevented inflammatory response induced by 5-fluorouracil in oral mucosa of hamsters. However, a high risk of bias necessitates further research. CONCLUSION: This review identifies a potential therapeutic strategy for prevention and management of oral mucositis. It also provides future direction for gold nanoparticle research in oral mucositis; however, there is lack of sufficient evidence to derive any conclusion. Research with standardized parameters including nanoparticle size, capping agent, surface charge, and appropriate oral mucositis animal models will establish risk-benefit balance and margin of safety for therapeutic use of gold nanoparticles for oral mucositis.

Efficacy and safety of Botulinum toxin A for improving esthetics in facial complex: A systematic review

Abstract Aim: To evaluate efficacy and safety of Botulinum toxinA for improving esthetics in the facial complex and correlating them to the dosage and side effects through a systematic review. Methods: A literature search was performed using PubMed, Medline, Web of Sciences, and Scopus databases. Quality of studies was appraised through the GRADE system. This review follows the 'Preferred reporting items for systematic review and meta-analysis protocols' (PRISMA-P) 2015 statement. Efficacy was analyzed through improvement rate and effect sizes. Graphical comparison of efficacy and ocular adverse effects (adverse effects around the eye) at various anatomical locations was made by calculating the average improvement rate and adverse events. Results: Twenty-five studies were included in this systematic review after application of the inclusion criteria. Moderate to severe cases in glabellar, lateral canthal, and forehead regions showed higher improvement rates between 20U to 50U, with an effect lasting up to 120 days. Gender and age seemed to have a direct effect on efficacy. Headaches were the most common adverse effect, followed by injection site bruising; all adverse effects resolved within 3-4 days. Conclusions: Treatment with Botulinum toxinA to enhance esthetics of facial complex is efficient and safe at all recommended dosages. Presence of complexing proteins influenced the efficacy of BoNT-A. undesirable muscular adverse effects around the eyes were more predominant when treating the glabellar region. There was no correlation found between the BoNT-A dosage and side effects, however, an increase in dosage did not always lead to an increase in efficacy.

Resumo Objetivo: Avaliar a eficácia e segurança da toxina botulínica-A para melhorar a estética no complexo facial e correlacioná-la com a dosagem e os efeitos secundários através de uma revisão sistemática. Métodos: Foi realizada uma pesquisa bibliográfica utilizando bases de dados PubMed, Medline, Web of Sciences, e Scopus. A qualidade dos estudos foi avaliada através do sistema GRADE. Esta revisão segue a declaração "Preferred reporting items for systematic review and meta-analysis protocols" (PRISMA-P) 2015. A eficácia foi analisada através da taxa de melhoria e da dimensão dos efeitos.A comparação gráfica da eficácia e dos efeitos adversos oftalmológicos (efeitos adversos em torno do olho) em vários locais anatômicos foi feita através do cálculo da taxa média de melhoria e dos eventos adversos. Resultados: Vinte e cinco estudos foram incluídos nesta revisão sistemática após a aplicação dos critérios de inclusão. Casos moderados a graves em regiões glabelares, canais laterais e testa mostraram taxas de melhoria mais elevadas entre 20U a 50U, com um efeito que durou até 120 dias. O sexo e a idade mostraram ter efeito direto na eficácia. As dores de cabeça foram o efeito adverso mais comum, seguido de hematomas no local da injecção; todos os efeitos adversos foram resolvidos em 3-4 dias. Conclusões: O tratamento com toxina botulínica-A para melhorar a estética do complexo facial é eficiente e seguro em todas as dosagens recomendadas. A presença de proteínas complexas influenciou a eficácia do BoNT-A. Os efeitos adversos musculares indesejáveis à volta dos olhos foram mais predominantes no tratamento da região glabelar. Não foi encontrada qualquer correlação entre a dosagem de BoNT-A e os efeitos secundários, contudo, um aumento da dosagem nem sempre levou a um aumento da eficácia.

Over-the-counter tooth whitening agents: a review of literature

Abstract There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth "by removing extrinsic stains" when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.

Resumo Há um aumento da acessibilidade dos agentes clareadores de venda livre com poucos dados na literatura sobre sua eficácia. Esta revisão foi feita para determinar a eficácia dos agentes clareadores de venda livre predominantes de 2006 a 2018, onde foi feita uma comparação de cada agente com um placebo, sem tratamento ou com outros agentes clareadores de venda livre. As principais categorias de agentes clareadores de venda livre, como dentifrícios, tiras branqueadoras e géis. Estudos em que o dentista prescreveu clareamento caseiro e em consultório, e estudos que demonstraram os agentes clareadores para os participantes. Os artigos foram pesquisados ​​nas bases de dados do Medline (Ovid), PubMed, Cochrane Library e Cochrane Central Register of Controlled Trials. Vinte e quatro artigos foram incluídos na revisão sistemática e a qualidade dos estudos foi determinada pelo critério de classificação GRADE (Classificação de Recomendações, Avaliação, Desenvolvimento e Avaliações). Em comparação com outros clareadores de venda livre, as tiras são relatadas como eficazes. Dois estudos determinaram que as tiras de clareamento são eficazes. As tiras de clareamento mostraram-se eficazes quando comparadas com placebos e outros agentes clareadores de venda livre. Os dentifrícios são eficazes na mudança da tonalidade do dente "removendo manchas extrínsecas" quando comparados a dentifrícios com placebo e sem clareamento, mas não são tão eficazes em comparação com as tiras de clareamento. Há uma falta de evidência com relação à eficácia dos géis de tinta. Embora exista alguma evidência de que os clareadores de venda livre possa alterar a tonalidade no curto prazo, há necessidade de estudos melhor projetados.

A randomized controlled clinical trial comparing the use of displacement cords and aluminum chloride paste.

OBJECTIVES: This clinical study measured the change in opening and height of the displaced gingiva using paste and cord retraction materials for definitive impression making of natural teeth and assessed if they were comparable and clinically acceptable. METHODS: Impressions of 4 maxilla premolars from 10 participants were taken using a split-mouth protocol. All participants were free of periodontal disease, had a thick biotype, a minimal of 3 mm height of keratinized gingival tissue and gingival sulci depths of 2 mm. The bleeding index (BI), gingival index (GI) plaque index (PI), sulcular depth, level of attachment and tooth sensitivity were recorded at baseline, just after retraction, at 24 hours and at 2 weeks. Impressions were poured in stone and then after initial analysis were cross-sectioned to allow measurements of the gingival height change and gap size to be recorded. RESULTS: The paste produced a slightly smaller gap compared to the cord (0.041 mm less, P = .014) whilst the mean displacement for the cord was 0.282 mm and paste was 0.241 mm respectively. Gingival height with the paste was 0.047 mm lower than that achieved by the cord (P = .208). CONCLUSIONS: Cord and paste retraction produced comparable clinically acceptable gingival gaps, with the cord producing statistically larger gap size. CLINICAL SIGNIFICANCE: The cord and paste retraction materials produced comparable clinically acceptable gingival retraction.

A clinical study comparing the efficacy of light activated in-surgery whitening versus in-surgery whitening without light activation.

OBJECTIVES: This randomised controlled clinical trial assessed the efficacy of color change and sensitivity after in surgery whitening with and without light activation. METHODS: Twenty two patients were randomly assigned to one of two different groups: Group A--in-surgery bleaching with light activated 25% hydrogen peroxide gel followed by 2 weeks at home, night time bleaching with 10% carbamide peroxide gel in a customised bleaching tray. Group B--in-surgery bleaching with 25% hydrogen peroxide without light activation followed by 2 weeks at home, night time bleaching with 10% carbamide peroxide gel in a customised bleaching tray. The efficacy of tooth whitening was assessed by determining the color change associated with the six maxillary anterior teeth. Sensitivity was self-assessed with the use of a visual analogue scale (VAS). RESULTS: Overall, there was no significant difference in shade change between the two groups immediately after the in surgery whitening phase, and at one or two weeks post in surgery treatment. With regard to sensitivity immediately following the in surgery whitening participants in Group B reported a significantly higher level of sensitivity in comparison to Group A (p=0.03). CONCLUSIONS: There was no significant difference between the shade improvements achieved by the two whitening protocols tested throughout the 2-week period of the study (p>0.05). There was no statistical significant difference in sensitivity at the one and two week review periods, however, immediately after treatment participants in Group B reported a significantly higher level of sensitivity than participants in Group A (p=0.03).

Summary of: tooth loss and osteoporosis: to assess the association between osteoporosis status and tooth number.

BACKGROUND: Osteopenia and osteoporosis are conditions characterised by a reduction in bone mineral density. There is contradictory evidence whether osteoporotic patients have greater tooth loss than non-osteoporotic patients. OBJECTIVE: To investigate the association between tooth number and osteoporotic status, taking into account the effect of other confounding variables such as age, smoking status, alcohol consumption and the use of hormone replacement therapy. SETTING: Three hundred and fifty-nine patients were recruited from the Manchester region between March 2008 and June 2010. SUBJECTS AND METHODS: Data were collected on osteoporotic status, smoking status, alcohol consumption, age and the use of hormone replacement therapy. Dental panoramic tomographs were taken for each patient and the teeth present were charted and counted. Data were analysed using SPSS software (version 19). RESULTS: Complete data was available for 333 patients. Twenty-seven percent of individuals (90) were classified as osteoporotic. There was a significant relationship between molar tooth number and osteoporotic status (p = 0.017, 95% CI -1.339 to -0.137). CONCLUSION: Clinicians should inform osteoporotic patients they may be at greater risk of tooth loss and instigate more intensive preventive regimens for these individuals.

The effect of an apex locator on exposure to radiation during endodontic therapy.

The objective of this study was to investigate whether the use of an electronic apex locator results in a reduction in X-ray exposure during endodontic therapy. Fifty, sound, extracted, single-rooted canine and incisor teeth were selected and randomly divided into two groups (A and B) of 25 teeth. The working length was determined radiographically with (group B) and without (group A) adjunctive use of an apex locator by one operator. After working length determination, the teeth were sectioned and the actual working length measured for comparison. For group A, 14 retake radiographs were required to determine the working length, whereas group B required no retake radiographs; this difference was highly significant (p < 0.001). The electronic apex locator was extremely accurate in locating the apical foramen with all teeth tested within 0.5 mm of the anatomical apex and 11 (44%) teeth at the apical foramen. In contrast, 15 (60%) teeth tested using radiographs alone were within 0.5 mm of the anatomical apex and only 4 (16%) teeth were actually at the anatomical apex. It was concluded that using an electronic apex locator as an aid to endodontic therapy could potentially reduce the number of diagnostic radiographs required for working length determination. Location of the apical foramen using a combination of an electronic apex locator and radiographs to determine working length is more accurate than using radiographs alone.