Perioperative therapies to reduce edema after orthognathic surgery: a systematic review and meta-analysis.

Objective To systematically review the literature and assess the effectiveness of perioperative systemic and nonsystemic therapies in reducing edema after orthognathic surgery. Study Design Four databases (PubMed, Web of Science, Bireme, and Scopus) were searched. Only randomized clinical trials were included and assessed using the RoB 2.0 software (Cochrane Collaboration, London, UK). Studies were grouped into time of assessment and systemic/nonsystemic therapy. Results Eighteen studies were included in this review (8 in the meta-analysis, n = 349). The qualitative assessment of systemic (enzyme therapy, dexamethasone, betamethasone, and Venoplant) and nonsystemic therapies (thermotherapy and K-Taping) appear to reduce edema. Manual lymphatic drainage (MLD) after 72 hours (CI: -1.03 to 2.31; P = .45), and 30 days (CI: -1.53 to 0.49; P = .49), and laser after 24 hours (CI: -1.36 to 1.48; P = .93), 72 hours (CI: -4.81 to 2.92; P = .63), 30 days (CI: -3.44 to 0.99; P = .28), and 90 days (CI: -1.83 to 0.96; P = .54) showed no significance. Thermotherapy reduced edema after 48 hours (CI: -48.47 to -13.31; P = .0006) and 30 days (CI: -14.73 to -1.98; P = .01). Conclusion The Grading of Recommendations, Assessment, Development and Evaluations tool showed moderate evidence for thermotherapy (significant reduction of edema), whereas the MLD and laser results were rated as high certainty of evidence (no reduction of edema).

Therapies for bruxism: a systematic review and network meta-analysis (protocol).

BACKGROUND: Bruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments (including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy) is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists? METHODS/DESIGN: Comprehensive searches of the Cochrane Library, MEDLINE (via PubMed), Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria (Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism). The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized (i.e., GRADE). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses (PRISMA-NMA) statement. DISCUSSION: This systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is the reality of the patient. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015023308.

The effect of repeated firings on the color of feldspathic ceramics.

The aim of this study was to determine the extent to which repeated firings would change the color of feldspathic ceramics. Specimens were fabricated from five commercially available feldspathic ceramics using a circular stainless steel matrix 11 mm in diameter and 1.0 mm thick (n = 10, shade = A3). Repeated firings were performed and color analysis was completed with a colorimeter using the CIELA B color coordinates. Two-way ANOVA was used to analyze the data, followed by Tukey's post-hoc test (a = 0.05). Three factors were used as determinants: a, a measure of the chroma along the red-green axis; b, a measure of the chroma along the yellow-blue axis; and L, a measure of the lightness-darkness of the specimen on a scale from 0 (black) to 100 (white). The results indicated that a and b values increased and L values decreased after repeated firings, resulting in reddish, yellowish, and darker specimens, respectively (P = 0.001). As the number of firings increased, significant color alterations occurred in the color parameters of the specimens. These alterations resulted in color changes (delta E) that could be considered unacceptable in clinical practice.

Effect of a calcium glycerophosphate fluoride dentifrice formulation on enamel demineralization in situ.

PURPOSE: To evaluate in situ the effect and mechanisms involved in the anticariogenic effect of a calcium glycerophosphate fluoride dentifrice. METHODS: In a double-blind, crossover design, a non-F dentifrice (negative control), a F dentifrice and a F dentifrice containing 0.13% CaGP were compared regarding the inhibition of enamel demineralization. Both F dentifrices contained 1500 microg F/g (w/w) as sodium monofluorophosphate (MFP). Bovine enamel blocks were mounted in contact with a S. mutans test plaque, in palatal appliances worn by 10 volunteers. 30 minutes after treatment with the dentifrices, a sucrose rinse was performed and enamel demineralization was assessed after an additional 45 minutes. RESULTS: No significant difference was observed among groups in the calcium and inorganic phosphate concentrations in the fluid phase of the test plaque 30 minutes after the dentifrice use (P > 0.05), but F concentration was significantly higher for both F dentifrices (P < 0.05). Also, the dentifrices did not differ regarding the pH before or 5 minutes after the sugar challenge (P > 0.05). A higher mineral loss was observed for the non-F dentifrice group (P < 0.05), but no significant difference was observed between the F dentifrices containing CaGP or not (P > 0.05). Using this in situ model, the findings suggested that CaGP at the concentration tested did not enhance the inhibition of enamel demineralization promoted by F dentifrice.

The effect of polishing techniques and time on the surface characteristics and sealing ability of resin composite restorations after one-year storage.

Since there is a lack of information on the surface properties of composite restorations achieved with standard polishing procedures after aging processes, this study evaluated the effects of immediate (IM) and delayed (DE) polishing on the surface roughness (Ra), microhardness (KHN) and microleakage (ML) of microfilled (Filtek A110) and hybrid (Filtek Z250) resin composites after one-year storage. Standardized preparations were made on the buccal surface of 256 bovine teeth, where half were restored with each composite. For each composite, the specimens were randomly allocated to two subgroups. The first group (IM) was polished immediately after gross finishing using three different systems/techniques (n=16): Sof-Lex, Flexicups and Flexicups + Jiffy Polishing Brush + Flexibuffs (sequential), then stored for three weeks in saline. The DE group was stored for two weeks, polished with the same systems and stored for one week. From each subgroup, eight specimens were assessed after three weeks regarding Ra, KHN and ML (baseline), andthe eight remaining specimens were stored for one year before analysis. The data were analyzed (alpha=0.05) with ANOVA, paired Student's t-test (Ra and KHN) or Kruskal-Wallis and Signed Rank tests (microleakage). After one year, microfilled resin composite specimens showed the lowest Ra and KHN (p<0.05). N o differencein microleakage was observed among the different groups (p>0.05). The sequential technique provided the lowest roughness and Sof-Lex the lowest hardness (p<0.05). IM showed similar or better performance than DE for ML and Ra (p<0.05). In conclusion, aging increased the composites Ra and ML in all experimental conditions (p<0.05).