Assessment of color changes and adverse effects of over-the-counter bleaching protocols: a systematic review and network meta-analysis.

OBJECTIVES: To assess color change efficacy and the adverse effects of varied over-the-counter (OTC) bleaching protocols. METHODOLOGY: The study included randomized clinical trials evaluating color changes from OTC bleaching agents. Nine databases were searched, including the partial capture of the grey literature. The RoB2 tool analyzed the individual risk of bias in the studies. Frequentist network meta-analyses compared treatments through common comparators (∆Eab* and ∆SGU color changes, and tooth sensitivity), integrating direct and indirect estimates and using the mean and risk differences as effect measures with respective 95% confidence intervals. The GRADE approach assessed the certainty of the evidence. RESULTS: Overall, 37 remaining studies constituted the qualitative analysis, and ten composed the meta-analyses. The total sample included 1,932 individuals. ∆Eab* was significantly higher in groups 6% hydrogen peroxide (HP) strips (≥ 14 h). ∆SGU was significantly higher in groups at-home 10% carbamide peroxide (CP) (≥ 14 h), followed by 6% HP strips (≥ 14 h) and 3% HP strips (≥ 14 h). At-home 10% CP (7-13 h) and placebo showed lower risks of tooth sensitivity without significant differences between these treatments. CONCLUSION: Considering the low level of evidence, OTC products presented satisfactory short-term effects on tooth bleaching compared to the placebo, with little to no impact on dentin hypersensitivity and gingival irritation. CLINICAL RELEVANCE: OTC products are proving to be practical alternatives for tooth whitening. However, patients should be advised about the possible risks of carrying out such procedures without professional supervision.

How reliable is stature estimation by dental means? Systematic review and meta-analysis.

Dental measurements have been proposed as parameters for stature estimation for at least 85 years. The scientific literature on the topic, however, is controversial regarding the performance of the method. This systematic literature review of observational cross-sectional studies aimed to compile evidence to support decisions in the forensic practice regarding the use of dental measurements for stature estimation. Embase, LILACS, MedLine (via PubMed), SciELO, Scopus, Web of Science, DansEasy and Open Access Thesis and Dissertations (OATD) were searched. Data regarding the rate of correct stature classifications were extracted. A meta-analysis with a Random Intercept Logistic Regression model and a Logit Transformation was conducted. The search led to 10.803 entries, out of which 15 were considered eligible (n = 1486 individuals). The studies were published between 1990 and 2020 and were authored by South American (n = 7) and Asian (n = 8) research teams. Dental measurements were predominantly (93.34 %) performed on dental casts or via intraoral inspection. The overall rate of correct classifications based on stature was 68 %. Excluding outliers, the overall accuracy of the method decreased to 64 % (95 %CI: 54-73 %). Significant heterogeneity was detected (I² = 72.4 %, τ2 = 0.24, H = 1.91, p < 0.001). Egger's test (p = 0.94) and the funnel plot did not reveal publication bias. Dental measurements are not reliable for stature estimation in the forensic field.

Perception of malocclusion and school performance in adolescents: a systematic review

Abstract This study aimed to assess the potential association between perception malocclusion and school performance in children and adolescents. An electronic search was performed in ten databases. Based on the PECO acronym (Population, Exposition, Comparator, and Outcome), the eligibility criteria included observational studies that compared the school performance of children and adolescents with and without the perception of malocclusion. There were no restrictions on the language or year of publication. Two reviewers selected the studies, extracted the data, and assessed the risk of bias by using the Joanna Briggs Institute tool for cross-sectional studies. School performance was measured by analyzing student grades; levels of absenteeism; and child or adolescent self-perception and/or the perception of parents, guardians, close friends, and teachers regarding the impact of malocclusion on school performance. The data were described narratively/descriptively. The search resulted in 3,581 registers, of which eight were included in the qualitative synthesis. These studies were published between 2007 and 2021. Two studies concluded that there was no significant association between school performance and perception of malocclusion, five studies found that only some of the children with malocclusion had their school performance affected, and one study concluded that there was a significant association between perception of malocclusion and low school performance. Considering all variables and the very low certainty of evidence, the perception of malocclusion seems to negatively impact school performance when associated with external and subjective factors. Further studies using additional measurement standards are required.