Research interest on dental sealant in dentistry based on the 100 most cited articles: bibliometric analysis.

The aim of this study was to identify and analyze the characteristics of the 100 most cited articles about dental sealants (DS) in dentistry. In September 2023, a search was performed in the Web of Science Core Collection (WoS-CC) database. The following information was extracted from each article: number and density of citations, year of publication, authorship, journal, impact factor, keywords, study design, theme, continent, country, and institution. The citations of the WoS-CC were compared with those of the Scopus and Google Scholar databases. The VOSviewer software was used to generate collaborative networks. The number of citations ranged from 33 to 205. The articles were published between 1961 and 2016. Buonocore MG (7%) was the most prominent author among the most cited. The Journal of the American Dental Association was the most frequent journal (25%) and Journal of Dental Research (7.6) had the highest impact factor. Most studies had interventional (41%) and laboratory (31%) designs, mainly addressing DS effectiveness in the prevention and control of dental caries (86%). There was a predominance of publications from North America (46%) and the USA was the country with the highest number of articles (44%). The most frequent institutions were the Centers for Disease Control and Prevention (USA) and the University of Rochester (USA) (6% each). "Retention" was the most frequent keyword. In conclusion, the 100 most cited articles were mostly interventional and laboratory studies, addressing the retention and efficacy of DS. Most of the articles were concentrated in North America and Europe, demonstrating a little collaboration from other continents.

Postoperative pain after endodontic treatment using 8.25% vs 2.5% sodium hypochlorite in necrotic mandibular molars with apical periodontitis: A randomized double-blind clinical trial.

BACKGROUND: This study aimed to evaluate whether the use of 8.25% sodium hypochlorite (NaOCl), compared with the use of 2.5% NaOCl, leads to higher postoperative pain after endodontic treatment. METHODS: A total of 154 patients were randomly assigned into 2 groups: 8.25% and 2.5% NaOCl. A single-visit endodontic treatment was performed using a standard protocol, varying only the NaOCl concentration. Postoperative pain was assessed using the numeric rating scale at multiple times over 30 days. Overall pain scores over time were explored via multilevel mixed-effects negative binomial regression. The need for pain medication was recorded and compared between groups via the Mann-Whitney U test. RESULTS: The use of 8.25% NaOCl increased postoperative pain scores over time by 3.48 times compared with the use of 2.5% NaOCl (incident rate ratio [IRR], 3.48; 95% CI, 1.57 to 7.67). Furthermore, the 8.25% NaOCl group exhibited higher pain incidence than the 2.5% NaOCl group during the 12-hour through 3-day period, with scores at these times ranging from 2.21 (IRR, 2.21; 95% CI, 1.35 to 3.62) through 10.74 (IRR, 10.74; 95% CI, 3.74 to 30.87) higher. No difference was detected in the number of analgesic capsules administered between groups. CONCLUSIONS: The use of 8.25% NaOCl resulted in higher postoperative pain than the use of 2.5% NaOCl, with pain scores increasing by 3.48 times when this solution was used. Furthermore, the 8.25% NaOCl group exhibited higher pain incidence than the 2.5% NaOCl group during the 12-hour through 3-day period. PRACTICAL IMPLICATIONS: The use of 8.25% NaOCl during endodontic treatment can increase postoperative pain significantly. This clinical trial was registered at the Brazilian Registry of Clinical Trials database (RBR-6vq3hc4).

Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: A systematic review and meta-analysis.

OBJECTIVES: To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH have greater likelihood of presenting DH/toothache than controls. DATA: Studies evaluating DH/toothache in patients with MIH were included. Studies focusing on other enamel defects were excluded. SOURCES: Eight databases, including grey literature, were searched in January 2024. STUDY SELECTION: The methodological quality of studies was assessed using the Joanna Briggs Institute checklist for Cross-sectional studies. Proportion and association meta-analyses, subgrouped by diagnostic methods, were conducted. The certainty of evidence was assessed using GRADE approach. RESULTS: Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses. Two studies fulfilled all items of the methodological quality checklist. The overall prevalence of DH/toothache among patients with MIH was 45 %. Prevalence rates of 30 %, 47 %, and 55 % were estimated based on proxy reports, self-reports, and air stimulation, respectively. The overall prevalence of DH/toothache per tooth was 22 %, ranging from 16 % to 29 % according to the diagnostic method. Patients with MIH demonstrated higher likelihood of presenting proxy reports of DH/toothache compared to those without MIH (OR: 1.51, 95 % CI [1.23-1.85], P < 0.01, I2: 0 %). The certainty of evidence was very low, mainly due to the low methodological quality of included studies and high inconsistency. CONCLUSIONS: The global prevalence of DH/toothache was 22 %, per tooth, and 45 % per patient. Estimates vary according to diagnostic methods. Patients with MIH showed higher likelihood of presenting proxy reports of DH/toothache than controls. CLINICAL SIGNIFICANCE: This systematic review contributes valuable information to the dental literature by assessing the prevalence and associated factors of DH/toothache in patients with MIH. The findings can guide future research, inform clinical practices and public policy makers, and ultimately improve the management of oral health of patients with MIH. REGISTRATION: PROSPERO CRD42023432805.

Willingness and ability to pay for breast cancer treatment among patients from Addis Ababa, Ethiopia: A cross-sectional study.

INTRODUCTION: Breast cancer (BC) is the most common malignant neoplasm among women in Addis Ababa, Ethiopia. The willingness and ability to pay (WATP) for treatment is a contributing factor in the utilization of health care services. The World Health Organization Breast Cancer Initiative calls for 80% of patients to complete multimodality treatment and indicates payment as central factor to improve BC outcome. The objectives of this study are to identify how much female BC patients paid in Addis Ababa for BC treatment, their WATP for BC treatment, and the factors that affect WATP. METHODS: The researchers collected data from 204 randomly selected BC patients who were treated in one of four different health facilities (one public and three private) between September 2018 and May 2019. A structured questionnaire was used to assess their WATP for BC treatment and multivariable regression to investigate factors associated with patients' WATP. RESULTS: Of interviewed patients, 146 (72%) were at reproductive age. Patients' median expenditure for all BC treatment services was 336 US dollars (USD) in a public cancer center and 926 USD in privately owned health facilities. These amounts are in contrast with a reported WATP of 50 USD and 149 USD. WATP increased with increasing expenditure (OR 1.43; 95% CI 1.09 to 1.89 per 100 US), educational level (OR 1.37; 95% CI 1.02 to 1.85) and service quality (OR 1.34; 95% CI 1.04 to 1.72). In contrast, a monthly income increase by 100 USD corresponds to a 17% decrease of WATP (OR 0.83; 95% CI 0.70 to 0.99). CONCLUSIONS: We demonstrated that BC treatment was very expensive for patients, and the cost was much higher than their WATP. Thus, we suggest that BC should be included in both social and community-based health insurance plans and treatment fees should consider patients' WATP.

Adherence to Treatment and Follow-Up of Precancerous Cervical Lesions in Ethiopia.

BACKGROUND: In Ethiopia, both incidence and mortality of cervical cancer are relatively high. Screening services, which were implemented during the past few years, are currently being expanded. The World Health Organization recommends patients with a positive VIA (visual inspection with acetic acid) result should immediately receive treatment followed by rescreening after 1 year as precancerous lesions can reoccur or become residential despite treatment. MATERIALS AND METHODS: Screening logbooks dating between 2017 and 2020 were retrospectively reviewed in 14 health facilities of Addis Ababa and Oromia region. Data for 741 women with a VIA-positive result were extracted and those women were asked to participate in a questionnaire-based phone interview to gain insights about adherence to treatment and follow-up. Data were analyzed using descriptive methods and then fitted into 2 generalized linear models to test variables for an influence on adherence to follow up. RESULTS: Around 13 800 women had received a VIA screening, of which approximately 820 (5.9%) were VIA positive. While over 90% of women with a positive screen received treatment, only about half of the treated patients returned for a follow-up examination. After treatment, 31 women had a VIA-positive re-screen. We found that educational status, age over 40, no/incorrect follow-up appointment, health facility-related barriers, and use of reminders are important drivers of adherence to follow up. CONCLUSION: Our results revealed that adherence to treatment after VIA positive screening is relatively high whereas adherence to follow up recommendations still needs improvement. Reminders like appointment cards and phone calls can effectively reduce the loss of follow-up.

Using a mobile application to reduce potentially inappropriate prescribing for older Brazilian adults in primary care: a triple-blind randomised clinical trial.

BACKGOUND: Potentially inappropriate prescribing (PIP) has been evaluated in several countries, and several strategies have been devised for deprescribing drugs in older adults. The aim of this study was to evaluate the efficacy of a mobile application in reducing PIP for older adults in primary care facilities in Brazil. METHODS: This randomised, triple-blind, parallel-group trial was conducted in 22 public primary care facilities in Brazil. During the intervention phase, the general practitioners (GPs) were randomly allocated to the intervention (MPI Brasil app provides information about PIP, therapeutic alternatives and deprescribing) or control (MedSUS app provides general information about medications) group. All GPs were trained on the Clinical Decision-Making Process and how to access an Evidence-Based Health website. The GPs received an Android tablet with an installed mobile application depending on their allocated group, which they used when caring for older patients over at least 3 months. At the end of this period, a sample of older patients aged ≥ 60 years who had been awaiting medical consultation by the participating GPs were interviewed and their prescriptions analysed. The primary outcome was the frequency of PIP in and between the groups. RESULTS: Among 53 GPs who were administered the baseline survey, 14 were included in the clinical trial. At baseline, 146 prescriptions were analysed: the PIP overall was 37.7% (55/146), in the intervention group was 40.6% (28/69), and in the control group was 35.1% (27/77). After the intervention, 284 prescriptions were analysed: the PIP overall was 31.7% (90/284), in the intervention group was 32.2% (46/143), and in the control group was 31.2% (44/141) (RR: 1.16; 95% CI, 0.76-1.76). In the within-group analysis, the PIP reduced from before to after the intervention in both groups-more significantly in the intervention than in the control group (p < 0.001). In the stratified analysis of PIP frequency by GPs, there was a relative risk reduction in 86% (6/7) of GPs in the intervention group compared to 71% (5/7) in the control group. CONCLUSION: We found that the MPI Brasil app effectively reduced PIP, suggesting that it may be useful to incorporate this tool into clinical practice. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT02918643). First registration on 22/09/2016.

Chitosan in the treatment of mine spoil rainwater - An approach to protect the aquatic biota.

The mining industry suppresses vegetation, exposing large soil areas in its ordinary operation. Water pollution and turbidity are caused by the carrying of solids, mainly colloidal particles, to the watercourses due to the effect of rainfall events. Therefore, the discharge of those effluents will lead to failure with watercourse quality parameters. Thus, there is a need to treat drainages (rainwaters) from the mining industry. However, using common coagulants and flocculants can result in acute or chronic ecotoxicity for aquatic biota. In this scenario, this research aimed to evaluate using a natural coagulant, the biopolymer Chitosan, to remove turbidity from mining industry spoiled water through bio-coagulation. The ecotoxicity of the natural coagulant was compared to the commonly used coagulants. For this purpose, we used synthetic rainwater (SRW) from the dispersion of fine (colloidal) particles in natural waters. Materials (water and soil) were collected in the mining area's sumps (sedimentation basins). The turbidity of the produced SRW ranged from between 500 and 4000 NTU. Jar Tests using Chitosan (CTS), polyaluminum chloride (PAC®12), and Superfloc®N100 variable doses were carried out to compare the effects of the coagulating/flocculating agents on the SRW turbidity reduction. The obtained results demonstrated the efficiency of CHS on turbidity reduction. The results were encouraging for low turbidity samples (<1000 NTU), making it possible to meet the limit parameters recommended by the Brazilian legislation. In addition, it was possible to conclude both CHS and the effluents treated with this coagulant have lower toxicity to aquatic biota than the combination of PAC®12 and Superfloc®N100.

Does the composite attachment of clear aligners compromise the effectiveness of dental bleaching? An in vitro study.

INTRODUCTION: This study aimed to evaluate the effectiveness of dental bleaching with hydrogen peroxide 35% on the surface below the attachments. METHODS: Twenty-four blocks of bovine incisors were equally divided into 2 groups. The control group comprises the enamel surface free of attachments, whereas the attachment group comprises the enamel surface with attachment. Initial staining of samples was performed with black tea for 7 days; then, an attachment was made in the attachment group with Z250 resin and new staining for another 7 days in all samples. After staining, in-office bleaching was performed in both groups, and the attachments from the attachment group were removed. Color reading was performed with a spectrophotometer at all stages: initial (baseline), after 7 days of staining, after 14 days of staining, after immediate bleaching, and after 24 hours of bleaching. The color difference was calculated, and data analysis was performed using the t test for intergroup analysis. RESULTS: The results showed effective bleaching in both groups; however, there was a statistically significant difference in color change between them 24 hours after bleaching. CONCLUSION: It was concluded that the presence of attachment did not impair the action of the bleaching agent on the tooth surface.

Worldwide prevalence of natal and neonatal teeth: Systematic review and meta-analysis.

BACKGROUND: Identifying the presence of teeth in newborns is important as it may require immediate care. This study aimed to determine the worldwide prevalence of natal and neonatal teeth. TYPE OF STUDIES REVIEWED: Six electronic databases and the gray literature were searched on February 23, 2023 to identify observational studies reporting the prevalence of natal or neonatal teeth. Studies assuming natal and neonatal teeth as identical terms or not reporting prevalence indicators were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute checklist for studies reporting prevalence data. The worldwide prevalence of natal and neonatal teeth was estimated via proportion meta-analysis using a ß-binomial model. Heterogeneity across studies was explored via subgroup analyses and meta-regression. RESULTS: None of the 23 included studies fulfilled all items of the methodological quality checklist. The worldwide prevalence of natal teeth was 34.55 (95% CI, 20.12 to 59.26) per 10,000, and the prevalence of neonatal teeth was 4.52 (95% CI, 2.59 to 17.91) per 10,000. Subgroup analysis by continent showed that the prevalence of natal teeth ranged from 11.26 (95% CI, 7.58 to 16.61) per 10,000 in Asia through 75.32 (95% CI, 51.11 to 99.86) per 10,000 in North America, and the prevalence of neonatal teeth ranged from 3.52 (95% CI, 1.73 to 7.06) per 10,000 in Europe through 6.01 (95% CI, 2.25 to 16.60) per 10,000 in South America. Meta-regression did not find a statistically significant association between prevalence rates and year of publication or sample size. PRACTICAL IMPLICATIONS: Approximately 1 in 289 newborns had natal teeth and 1 in 2,212 had neonatal teeth. Although this is not a high prevalence, professionals must be alert to identify these conditions, which often require immediate care.

Optimizing Hypertension Treatment in Older Patients Through Home Blood Pressure Monitoring by Pharmacists in Primary Care: The MINOR Clinical Trial.

PURPOSE: Incorporating technology such as home blood pressure monitoring (HBPM) into the clinical routine generates opportunities to improve BP monitoring and control in primary health care. It is also important to prevent overtreatment. However, the combination of HBPM with collaborative drug therapy management (CDTM) has not yet been studied. This study aimed to assess the efficacy of combining HBPM with CDTM to optimize hypertension treatment for older patients. METHODS: This open-label, parallel-group, randomized clinical trial was conducted between June 2021 and August 2022 in a Brazilian community pharmacy and included older patients (aged ≥60 years) with hypertension. Those who were classified as poorly adherent or nonadherent to the prescribed drug treatment or who were unable to perform HBPM were excluded. In the control group, participants received a BP monitor and instructions on how to perform HBPM. A general practitioner, who was provided a report with the obtained BP values, determined any changes to the treatment protocol. In the intervention group, a pharmacist enrolled participants in a drug therapy management protocol and provided the general practitioner with suggestions to optimize the antihypertensive drug therapy, in addition to the report with the BP values. The following outcomes were considered: the proportion of participants receiving deprescriptions of antihypertensive drugs, other treatment adjustments, and the difference in mean BP between the groups 45 days after performing HBPM. The study used a t test combined with Levene's test to calculate mean intergroup differences in BP, the paired t test to calculate mean intragroup differences in BP, and Pearson's χ2 test to determine intergroup differences in changes in drug therapy. FINDINGS: In each group, 161 participants completed the trial. Antihypertensive agents were deprescribed for 31 (19.3%) participants in the intervention group versus 11 (6.8%) in the control group (P = 0.01). In addition, 14 (8.7%) participants were prescribed antihypertensive drugs in the intervention group versus 11 (6.8%) in the control group (P = 0.52). The mean office systolic BP and HBPM values were lower in the intervention group (P = 0.22 and P = 0.29, respectively). IMPLICATIONS: Combining HBPM with a CDTM protocol effectively optimized antihypertensive treatment for older patients in a primary health care setting. CLINICALTRIALS: gov identifier: NCT04861727.

Tooth Bleaching: A bibliometric analysis of the top 100 most-cited papers.

This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and 'interaction of the bleaching agent with dental tissues', respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

A Bibliometric Analysis of the Top 100 Most-Cited Papers Concerning Dental Fluorosis.

A high number of citations can indicate the potential of any specific paper to influence other research and generate changes in clinical practice. Analyzing the most-cited papers in a certain scientific field may assist researchers to identify the influential papers as well their main characteristics. The present study aimed to analyze the 100 most-cited papers concerning dental fluorosis (DF) through a bibliometric review. A search was performed in the Web of Science Core Collection (WoS-CC) database in November 2021. The papers were displayed in descending order according to the number of citations in WoS-CC. Two independent researchers performed the selection. Scopus and Google Scholar were used to compare the number of citations with WoS-CC. The following data were extracted from the papers: title, authors, number and density of citations, institution, country, continent, year of publication, journal title, keywords, study design, and theme. Collaborative networks were generated using the VOSviewer software. The top 100 most-cited papers were published between 1974 and 2014 and were cited 6,717 times (ranging from 35 to 417). Community Dentistry and Oral Epidemiology (24%), Journal of Dental Research (21%), Journal of Public Health Dentistry (17%), and Caries Research (13%) published the most papers. Observational studies (60%) and literature reviews (19%) were the most common study designs. The main topics were epidemiology (44%) and fluoride intake (32%). The countries with the highest number of papers were the USA (44%), Canada (10%), and Brazil (9%). The University of Iowa (USA) had the most papers (12%). Levy SM was the author with the highest number of papers (12%). The 100 most-cited papers on DF were mainly observational studies focused on epidemiology and originated in North America. There were few interventional studies and systematic reviews among the most-cited papers concerning this topic.

Regional Variation in the Tumor Microenvironment, Immune Escape and Prognostic Factors in Breast Cancer in Sub-Saharan Africa.

The low overall survival rates of patients with breast cancer in sub-Saharan Africa (SSA) are driven by regionally differing tumor biology, advanced tumor stages at diagnosis, and limited access to therapy. However, it is not known whether regional differences in the composition of the tumor microenvironment (TME) exist and affect patients' prognosis. In this international, multicentre cohort study, 1,237 formalin-fixed, paraffin-embedded breast cancer samples, including samples of the "African Breast Cancer-Disparities in Outcomes (ABC-DO) Study," were analyzed. The immune cell phenotypes, their spatial distribution in the TME, and immune escape mechanisms of breast cancer samples from SSA and Germany (n = 117) were investigated using histomorphology, conventional and multiplex IHC, and RNA expression analysis. The data revealed no regional differences in the number of tumor-infiltrating lymphocytes (TIL) in the 1,237 SSA breast cancer samples, while the distribution of TILs in different breast cancer IHC subtypes showed regional diversity, particularly when compared with German samples. Higher TIL densities were associated with better survival in the SSA cohort (n = 400), but regional differences concerning the predictive value of TILs existed. High numbers of CD163+ macrophages and CD3+CD8+ T cells accompanied by reduced cytotoxicity, altered IL10 and IFNγ levels and downregulation of MHC class I components were predominantly detected in breast cancer samples from Western SSA. Features of nonimmunogenic breast cancer phenotypes were associated with reduced patient survival (n = 131). We therefore conclude that regional diversity in the distribution of breast cancer subtypes, TME composition, and immune escape mechanisms should be considered for therapy decisions in SSA and the design of personalized therapies. See related Spotlight by Bergin et al., p. 705.

Knowledge, attitudes, and practice of dentists on Minimal Intervention Dentistry: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID). DATA: Cross-sectional studies that analyzed KAP outcomes on MID principles were included. SOURCES: Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus, and Web of Science) and the gray literature were searched on January 2022. STUDY SELECTION: Two independent reviewers selected the included studies, initially by screening titles and abstracts and, finally, by full-text reading. The methodological quality of studies was assessed by using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies. Proportion meta-analysis was conducted using a random effect model for data analysis. Cochran's Q test was used to assess the heterogeneity and the I² statistic for evaluation of true variation due to heterogeneity. RESULTS: Of 2079 studies initially identified, twelve were included in the systematic review. Twenty-four statements about MID were included in the meta-analysis, based on data from ten studies (n = 1728 participants). The pooled proportion of knowledge on MID was 75.66% (95%CI: 69.33 - 81.48; p < 0.01; I²: 97%; Tau2: 0.0456) and of attitudes and practice was 47.95% (95%CI: 38.55-57.43; p < 0.01; I²: 98%; Tau2: 0.0743). The higher prevalences rates were in the "knowledge" field, and the lowest was in "attitudes and practice". CONCLUSIONS: The findings suggest that the knowledge of dentists on MID topics is acceptable, and the attitudes and practices need improvements. The studies lacked uniformity in methods and there is still a need for more studies to elucidate the KAP of dentists worldwide. CLINICAL SIGNIFICANCE: Understanding the cognizance and the way oral healthcare professionals are treating dental caries is the first step to expanding the minimal intervention evidence into a dental practice. The final goal is to change the practice and make Minimal Intervention Dentistry the standard of care for dental caries worldwide. REGISTRATION: PROSPERO CRD42021257518.

Tooth Bleaching: A bibliometric analysis of the top 100 most-cited papers

Abstract This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and 'interaction of the bleaching agent with dental tissues', respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

Resumo Este estudo analisa as características dos 100 artigos mais citados relacionados ao clareamento dental. Uma pesquisa bibliográfica foi realizada na Web of Science até março de 2022. O número de citações foi cruzado com a contagem de citações na Scopus e na Google Scholar. Foram coletados os seguintes dados: número e densidade de citações; autoria; ano e periódico de publicação; desenho do estudo e temática; palavras-chave; instituição e país de origem. A correlação de Spearman e a regressão de Poisson foram usadas para determinar associações entre o número de citações e as características do estudo. O software VOSviewer foi utilizado para gerar mapas de rede colaborativa para os autores e palavras-chave. O número de citações variou de 66 a 450. Os artigos foram publicados entre 1981 e 2020. O desenho e o tópico de estudo mais frequentes foram estudos laboratoriais e interação do agente clareador com tecidos dentários, respectivamente. Cochran M, Loguercio AD, Matis B, Reis A e Suliman M foram os autores com maior número de artigos. Os países com mais artigos foram os Estados Unidos da América (EUA) (28%) e o Brasil (20%). A Universidade de Indiana e a Universidade Estadual de Ponta Grossa foram as instituições com mais artigos (6% cada). Houve uma correlação muito forte entre o número de citações das três bases de dados. Os 100 artigos mais citados relacionados ao clareamento dentário foram publicados principalmente pelos EUA e Brasil, sendo os estudos laboratoriais que abordaram tópicos relacionados aos efeitos dos agentes clareadores na estrutura dentária os mais prevalentes.

Global Prevalence of Maxillary Sinusitis of Odontogenic Origin and Associated Factors: A Systematic Review and Meta-Analysis.

INTRODUCTION: The overall prevalence of maxillary sinusitis of odontogenic origin (MSOO) is still unknown. Therefore, this study aimed to determine the pooled prevalence of MSOO and verify associations between different odontogenic conditions and MSOO. METHODS: Six electronic databases and the gray literature were searched on August 25, 2022. Two independent reviewers selected observational studies reporting the prevalence of MSOO and associated conditions in adults. Studies that did not use computed tomography for diagnosis were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Data were analyzed by proportion and association meta-analyses. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Thirty-eight studies were included in the qualitative analysis and thirty-one in the meta-analyses. Only 12 studies (31.6%) fulfilled all items of the methodological quality checklist. Overall, the studies reported prevalence measures per maxillary sinus or patient. Thus, the pooled prevalence of MSOO was 51% per sinus (95% confidence interval [CI] [40%-61%]) and 50% per patient (95% CI [41%-59%]). Apical lesion (odds ratio [OR]: 4.03, 95% CI [2.26-7.19]), periodontitis (OR: 5.49, 95% CI [2.27-13.24]), moderate (OR: 2.57, 95% CI [1.85-3.57]) and severe bone loss (OR: 13.80, 95% CI [2.81-67.85] were significantly associated with MSOO. The certainty of the evidence for the associations was very low. CONCLUSIONS: The pooled prevalence of MSOO on computed tomography assessment was 51% per maxillary sinus and 50% per patient. Therefore, half of the maxillary sinusitis may be of odontogenic origin. Apical lesion, periodontitis, and moderate and severe bone loss were significantly associated with MSOO.

Association between dental caries and molar-incisor hypomineralisation in first permanent molars: A hierarchical model.

OBJECTIVE: To assess whether the prevalence of dental caries is associated with the presence of molar-incisor hypomineralisation (MIH) in first permanent molars (FPMs). METHODS: A cross-sectional study was conducted with a sample of 5368 FPMs from 1342 children aged 8-10 years from Florianopolis, Brazil. Dental caries was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index and MIH was assessed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The sociodemographic data were obtained with a questionnaire sent to caregivers. A hierarchical repeated measures Poisson regression, considering dependency among observations, was performed, since the unit of analysis was the tooth. RESULTS: The presence of MIH was associated with a 6.15 times higher prevalence of dental caries in FPMs (PR: 6.15; 95%CI: 4.18-9.04). A monthly family income ≤2 minimum wages and the caries experience in the primary teeth were also significantly associated with greater prevalence rates of dental caries in FPMs. CONCLUSION: The presence of MIH showed a significant association with the prevalence of dental caries in FPMs. Thus, dentists should be alert to cases of MIH. Once the condition is detected, preventive measures should be taken to prevent enamel breakdown and the development of dental caries lesions.

Intrinsic subtypes in Ethiopian breast cancer patient.

PURPOSE: The recent development of multi-gene assays for gene expression profiling has contributed significantly to the understanding of the clinically and biologically heterogeneous breast cancer (BC) disease. PAM50 is one of these assays used to stratify BC patients and individualize treatment. The present study was conducted to characterize PAM50-based intrinsic subtypes among Ethiopian BC patients. PATIENTS AND METHODS: Formalin-fixed paraffin-embedded tissues were collected from 334 BC patients who attended five different Ethiopian health facilities. All samples were assessed using the PAM50 algorithm for intrinsic subtyping. RESULTS: The tumor samples were classified into PAM50 intrinsic subtypes as follows: 104 samples (31.1%) were luminal A, 91 samples (27.2%) were luminal B, 62 samples (18.6%) were HER2-enriched and 77 samples (23.1%) were basal-like. The intrinsic subtypes were found to be associated with clinical and histopathological parameters such as steroid hormone receptor status, HER2 status, Ki-67 proliferation index and tumor differentiation, but not with age, tumor size or histological type. An immunohistochemistry-based classification of tumors (IHC groups) was found to correlate with intrinsic subtypes. CONCLUSION: The distribution of the intrinsic subtypes confirms previous immunohistochemistry-based studies from Ethiopia showing potentially endocrine-sensitive tumors in more than half of the patients. Health workers in primary or secondary level health care facilities can be trained to offer endocrine therapy to improve breast cancer care. Additionally, the findings indicate that PAM50-based classification offers a robust method for the molecular classification of tumors in the Ethiopian context.

Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report.

Craniopharyngiomas (CPs) are benign tumors that are believed to arise from embryonic remnants of the Rathke pouch epithelium. Herein, we report a case of aseptic meningitis due to spontaneous rupture of multicystic CP, which contained an Ommaya catheter. A 19-year-old boy was admitted to the hospital with a 4-day history of acute severe headache after strenuous physical exercise followed by altered sensorium, fever, and neck stiffness. Cerebrospinal fluid (CSF) analysis revealed marked pleocytosis and elevated protein levels. CSF culture was otherwise negative. Cyst reduction on subsequent imaging confirmed the diagnosis. The patient received intravenous steroid therapy and was discharged asymptomatic. This is a rare evolution of a multicystic CP, which was previously treated with intracystic therapy and had an Ommaya catheter. Clinicians should be aware of spontaneous CP rupture and look actively for the occurrence of cholesterol crystals or elevated CSF levels of cholesterol as well as prompt follow-up imaging.

Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta-analysis of clinical studies.

BACKGROUND: The lack of a well-defined apical constriction in primary teeth raises concerns regarding the accuracy of electronic apex locators (EALs) for measuring working length. OBJECTIVES: To evaluate the accuracy of EALs in determining working length in primary teeth pulpectomies. METHODS: Two reviewers searched ten databases up to September 2021. Clinical studies evaluating the accuracy of the electronic measurement of working length in primary teeth pulpectomies were included. Studies without a comparison group, with samples smaller than ten root canals, and that did not use a multiple frequency EAL were excluded. A meta-analysis was conducted to assess the paired differences in mean lengths between measurements obtained by electronic and comparative methods. In addition, a meta-analysis of proportion was applied according to the level of difference between the measures. The risk of bias and applicability of the studies were assessed using the QUADAS-2 tool. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: Twenty-nine studies were included in the qualitative analysis and twenty-three in the quantitative analysis. The methods of comparison for the electronic measurement were the radiographic method, radiovisiographic, scanning electron microscopy, and direct visualization. The meta-analysis showed that the electronic measurement tends to be shorter than radiographic measurement, while the other methods showed no difference. The proportion analysis showed a higher pooled proportion of difference values between electronic and comparative measurements within -0.5 to +0.5 mm (69.31%). The certainty of the evidence suggested very low confidence in estimating the outcome. DISCUSSION: The results of this review denote a good performance of the EALs in determining working length in primary teeth pulpectomies. However, these results are based on clinical studies with low methodological quality and high heterogeneity, which require careful interpretation for clinical practice. CONCLUSIONS: Although the results suggest acceptable accuracy of EALs in determining working length in primary teeth pulpectomies, the low quality of the included studies and the very low certainty of the evidence require clinicians to interpret these results with caution. More robust evidence is required to support that these devices are accurate for primary teeth. REGISTRATION: CRD42021277414 (PROSPERO).