Association between prenatal maternal cigarette smoking and early childhood caries. A systematic review.

BACKGROUND: The aim of the present study was to assess the relationship between prenatal maternal cigarette smoking (PMCS) and early childhood caries (ECC) through a systematic review of currently available scientific evidence. MATERIAL AND METHODS: To address the focused question: "Is there an association between PMCS and ECC?" an electronic literature search without time or language restrictions was conducted till May 2017 in indexed databases using various key words including dental caries, pregnancy, smoking, tobacco products and child. Letters to the editor, commentaries, reviews, case reports and case series and studies in which, ECC was investigated without clinical dental examination, were excluded. RESULTS: Eight observational cross-sectional studies were included. The number of participants ranged between 1102 and 76920 children with age ranging between 24 months and 72 months. Seven studies reported a positive association between PMCS and ECC. One study reported that children whose mother smoked at least five cigarettes/day during pregnancy presented a higher caries severity level compared with to those whose mothers did not smoke. One study showed no association between ECC and PMCS. CONCLUSIONS: The association between PMCS and ECC remains debatable. Further well-designed longitudinal studies are needed in this regard. Key words:Cigarette, early childhood caries, pregnancy, risk factors, smoking.

Effect of laser-assisted scaling and root planing on the expression of pro-inflammatory cytokines in the gingival crevicular fluid of patients with chronic periodontitis: A systematic review.

BACKGROUND: The aim of the present systematic review was to assess the efficacy of laser-assisted (low level laser therapy [LLLT], high intensity laser therapy [HILT], or antimicrobial photodynamic therapy [aPDT]) scaling and root planing (SRP) compared with SRP alone on the expression of inflammatory cytokines in the gingival crevicular (GCF) of patients with chronic periodontitis (CP). METHODS: In order to address the focused question: "What is the efficacy of SRP with and without laser and/or aPDT on the expression of pro-inflammatory cytokines in the GCF of patients with CP?" an electronic search without time or language restrictions was conducted up to and including February 2017 in indexed databases using various key words. RESULTS: Twenty-two randomized control trials were included in the present systematic review. Nine studies and six studies assessed the efficacy of LLLT and HILT, as adjunct to SRP, respectively. Seven studies assessed the efficacy of aPDT as adjunct to SRP on down-regulating the expression of pro-inflammatory cytokines in the GCF among patients with CP. The outcomes of the studies included based upon the reduction in the levels of pro-inflammatory cytokines were inconsistent. CONCLUSION: The role of laser-assisted SRP on the expression of pro-inflammatory cytokines in the GCF of patients with CP remains unclear. Further long term and well-designed randomized clinical trials are needed in this regard.

Efficacy of scaling and root planing with and without adjunct antimicrobial photodynamic therapy on the expression of cytokines in the gingival crevicular fluid of patients with periodontitis: A systematic review.

BACKGROUND: The aim of the present review was to study the efficacy of scaling and root planing (SRP) with and without adjunct antibacterial photodynamic therapy (aPDT) on the expression of cytokines in the gingival crevicular fluid (GCF) of patients with periodontitis. METHODS: In order to address the focused question: "What is the efficacy of SRP with and without aPDT on the expression of cytokines in the GCF of patients with periodontitis" an electronic search without time or language restrictions was conducted up to and including July 2016 in indexed databases using various key words. The exclusion criteria included reviews, laboratory and experimental studies, case reports, commentaries, letters to the editor, interviews, updates, studies where intervention group received aPDT without previous SRP, and studies where local delivery of antibiotics was used as adjunctive therapy to aPDT. RESULTS: Six randomized control trials were included in the present systematic review. All studies included a control group which received only SRP. Results from 34% of studies reported lower cytokine levels among individuals receiving adjunct aPDT to SPT compared to patients receiving SRP alone. Selective cytokines reduction in the GCF following SRP with adjunct aPDT compared with SRP alone was reported in 50% of the studies. In one study SRP with adjunct aPDT failed to reduce GCF cytokine concentration. CONCLUSION: From the literature reviewed the efficacy aPDT as adjunct to SRP in downregulating GCF cytokines remains debatable. Further well-designed studies are needed in this regard.