Artificial Intelligence through Wireless Sensors Applied in Restorative Dentistry: A Systematic Review.

The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners.

Efficacy of wireless sensors in assessing occlusal and bite forces: A systematic review.

BACKGROUND: The noteworthy correlation between bite force and masticatory performance emphasizes its significance as a meaningful and objective method for assessing oral function. Furthermore, in the study of bruxism, the measurement of intraoral bite force assumes critical importance. Given the importance of assessing occlusal forces and bite force, this systematic review aims to assess the efficacy of wireless sensors in measuring these forces. METHODS: The search methodology employed in this systematic review adhered to the guidelines outlined by PRISMA. The strategy involved the exploration of various databases, including PubMed/MEDLINE, SCOPUS and SCIELO. An assessment tool was employed to evaluate the bias risk and study quality. RESULTS: This systematic review encompassed six prospective clinical studies involving a total of 89 participants. Wireless sensors for measuring occlusal forces and bite forces were predominantly employed in healthy adults or individuals with bruxism, along with children undergoing orthodontic treatment. All wireless sensors employed in the studies underwent validation and reproducibility assessments, affirming their reliability. The findings indicated that all wireless sensors exhibited efficacy in detecting occlusal forces and bite forces. CONCLUSION: Wireless sensors offer real-time monitoring of occlusal and bite forces, aiding in understanding force distribution and identifying bruxism patterns. Despite limited studies on their application, these sensors contribute to evolving insights. Integration into clinical practice requires careful consideration of factors like calibration and patient compliance. Ongoing research is crucial to address limitations and enhance the efficacy of wireless sensors in measuring occlusal and bite forces and managing bruxism.

Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of in vitro studies.

OBJECTIVE: To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS: Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS: After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 µm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS: Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.

A Systematic Review of In Vitro Studies Using Microchip Platforms for Identifying Periodontopathogens from the Red Complex.

Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, collectively recognized as periodontopathogens within the red complex, have been extensively studied in clinical samples collected from individuals with periodontitis. A lab-on-a-chip (LOC) is a miniature mechanism that integrates various laboratory operations onto a single microchip or a small-scale platform. This systematic review evaluates the application of LOC technology in identifying microorganisms from the red complex. This study adhered to PRISMA recommendations, and the review process encompassed several databases. In the electronic search, a total of 58 reports were found, and ultimately, 10 studies were considered relevant for inclusion. All these studies described effective, rapid, and reliable LOC systems for detecting and amplifying P. gingivalis, T. forsythia, and T. denticola. Compared to traditional methods, the LOC approach demonstrated minimal reagent requirements. Additionally, the results indicated that the amplification process took approximately 2 to 8 min, while detection could be completed in as little as 2 min and 40 s, resulting in a total experimental duration of around 11 min. Integrating miniaturization, speed, accuracy, and automation within microchip platforms makes them promising tools for detecting and amplifying microorganisms associated with the red complex in periodontal diseases.

Perioperative analgesic efficacy and adverse events of fentanyl in dentistry: A systematic review.

OBJECTIVES: To assess the efficacy and adverse events linked to the utilization of fentanyl for perioperative pain management in dentistry. METHODS: This systematic review of randomized clinical trials (RCTs) adhered to the PRISMA guidelines and incorporated various databases. RESULTS: Eleven RCTs studying 674 patients were analyzed. Perioperative pain was predominantly evaluated in patients undergoing surgery for impacted molars, although some studies also included patients with other conditions such as oral submucous fibrosis, maxillary cancer, bony temporomandibular joint ankylosis, irreversible pulpitis, among others. Combined with dexmedetomidine, fentanyl produced enhanced analgesic effects. It demonstrated comparable efficacy when compared to nefopam and nalbuphine. Both intranasal and intravenous administration routes proved equally effective. In four RCTs, the transdermal fentanyl patch outperformed the control group, except in the clinical trial where it was compared to ropivacaine. The main adverse events associated with the use of fentanyl included nausea, vomiting, drowsiness, delirium, and respiratory depression; however, they were like those reported in the comparison groups. CONCLUSIONS: While fentanyl demonstrated satisfactory perioperative analgesic efficacy, there were other alternatives that displayed better or comparable outcomes. Due to the risks and potential for misuse of fentanyl, these alternatives must be considered although adverse events were also reported.

Applications of Lab on a Chip in Antimicrobial Susceptibility of Staphylococcus aureus: A Systematic Review.

Background and Objectives: Staphylococcus aureus is a prevalent bacterium capable of inducing various infections, including skin and soft tissue infections, bloodstream infections, pneumonia, and surgical site infections. The emergence of antimicrobial resistance in S. aureus, particularly methicillin-resistant S. aureus, has raised substantial concerns within global healthcare settings. Prior to antibiotic prescription, the ideal approach is antimicrobial susceptibility testing (AST); however, this is frequently perceived as excessively complex and time-intensive. Lab-on-a-chip (LOC) technology holds promise in addressing these challenges and advancing fundamental microbiological research while also aiding in the development of therapeutic strategies. This systematic review aims to evaluate the potential utility of LOC for AST of S. aureus. Materials and Methods: This study adhered to the PRISMA guidelines. Various databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS, in addition to gray literature sources, were employed in the review process. Results: Sixteen studies were included in this systematic review. All these studies detailed the effectiveness, rapidity, and predictability of LOC systems for assessing S. aureus susceptibility to various antibiotics. When comparing the LOC approach to traditional manual methods, it was evident that LOC requires a minimal quantity of reagents. Furthermore, most studies reported that the entire LOC procedure took 10 min to 7 h, with results being equally accurate as those obtained through traditional AST protocols. Conclusions: The potential application of LOC for AST of S. aureus is emphasized by its ability to provide rapid access to minimum inhibitory concentration data, which can substantially aid in selecting the most suitable antibiotics and dosages for treating challenging infections caused by this microorganism. Moreover, the rapid AST facilitated by LOC holds promise for enhancing the appropriateness and efficacy of therapy in clinical settings.

Potential Clinical Application of Organs-on-a-Chip in Periodontal Diseases: A Systematic Review of In Vitro Studies.

The periodontium is a unique organ from the standpoint of building an organ-on-a-chip (OoC) since it is a system that is continually threatened by microorganisms, their noxious compounds, and antigenic components. At the same time, periodontal health depends on a balanced connection between the host and the bacteria in the oral cavity, which is a complex micro-ecological environment. The objective of this systematic review of in vitro studies is to revise the potential clinical application of OoC in periodontal diseases. PRISMA was used to guide this analysis. The review framework made use of several databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS as well as the gray literature. This systematic review comprised seven studies. The clinical efficacy of OoC in periodontal diseases was observed in models of the gingival crevice for the research of periodontitis, periodontal medication analysis, the interaction of multiple microbial species, pH measurements in in situ-grown biofilm, testing antimicrobial reagents, evaluation of mucosal interactions with microorganisms, and a device for quantitative exploration of microorganisms. OoC has the potential to advance our understanding of periodontal diseases by providing a more accurate representation of the oral microenvironment and enabling the development of new treatments.

Clinical Efficacy of Platelet Derivatives in Periodontal Tissue Regeneration: An Umbrella Review.

Objectives: This umbrella review aimed to consolidate the best available evidence regarding the clinical efficacy of platelet derivatives in the treatment of periodontal defects associated with periodontitis and in the management of mucogingival deformities. Materials and Methods: The "umbrella review" strategy was used to identify systematic reviews and meta-analyses. The search was performed without language restrictions and updated at the end of February 2023. The PubMed and Scopus databases, together with gray literature, were included in the search. Results: The search yielded 412 studies. Subsequently, 12 articles were selected for further examination based on relevance. Finally, eight systematic reviews and meta-analyses were assessed. Regarding intrabony defects, in terms of clinical attachment level (CAL) gain, platelet-rich fibrin (PRF) was observed to lead to a statistically significant attachment gain compared to surgical therapy alone. PRF was also found to show greater CAL gain compared to platelet-rich plasma (PRP) and other biomaterials. The parameter probing depth decreased significantly when PRF was used compared to surgical therapy alone (P < 0.05). Similar results were seen when leukocyte- and platelet-rich fibrin (L-PRF) was applied. In terms of radiographic bone fill, both PRF and PRP showed significantly greater bone fill compared to surgical therapy. Regarding the results of periodontal plastic surgery, PRF favored a slight root coverage compared to the coronally displaced flap. This result depended on the number of PRF and L-PRF membranes used, but Emdogain or connective tissue graft produced better results regardless. However, an improvement in the healing of periodontal tissues was reported. Conclusions: Therapies with platelet derivatives applied to intrabony defects provided superior regenerative results compared to monotherapies, except in the case of root coverage.

Efficacy of Periodontal Endoscopy during Subgingival Debridement to Treat Periodontitis: A Systematic Review of Randomized Clinical Trials.

This study aims to evaluate the clinical efficacy of periodontal endoscopy (PEND) during subgingival debridement to treat periodontitis. A systematic review of randomized clinical trials (RCTs) was performed. The search strategy included four databases: PubMed, Web of Sciences, Scopus, and Scielo. The initial online exploration generated 228 reports, and 3 RCTs met the selection criteria. These RCTs described a statistically significant decrease in probing depth (PD) in the PEND group compared to controls after 6 and 12 months of follow-up. The improvement in PD was 2.5 mm for PEND and 1.8 mm for the control groups, respectively (p < 0.05). It was also described that the PEND group presented a significantly inferior proportion of PD 7 to 9 mm at 12 months (0.5%) as compared to the control group (1.84%) (p = 0.03). All RCTs noted improvements in clinical attachment level (CAL). It was described as having significant differences in bleeding on probing (BOP) in favor of PEND, with an average reduction of 43% versus 21% in the control groups. Similarly, it was also presented that they were significant differences in plaque indices in favor of PEND. PEND during subgingival debridement to treat periodontitis demonstrated efficacy in reducing PD. Improvement was also observed in CAL and BOP.

A Systematic Review of Randomized Clinical Trials Evaluating the Efficacy of Minimally Invasive Surgery for Soft Tissue Management: Aesthetics, Postoperative Morbidity, and Clinical Results.

Background and Objectives: The necessity for less invasive and patient-friendly surgical therapies guided the development of the "minimally invasive surgical technique" (MIST). The aim of this systematic review was to evaluate the efficacy of MIST for soft tissue management considering aesthetic results, postoperative morbidity, and clinical outcomes. Materials and Methods: Several databases were used to conduct a thorough analysis of the scientific evidence. To investigate randomized clinical trials (RCTs), MeSH terms and keywords were provided. Results: Eleven RCTs were chosen. These experiments included 273 patients. The trials that explored MIST for papilla preservation presented greater efficacy in increasing papillary height (p < 0.05). MIST showed stable clinical outcomes for the management of excessive gingival display and with a flapless technique for single implant placement. Considering the treatment of gingival recessions, some RCTs presented greater root coverage with MIST (p < 0.05), while other trials did not show differences between groups. Regarding aesthetic perception, five RCTs indicated high patient satisfaction with MIST (p < 0.05). Similarly, six RCTs reported that patients in the MIST group presented significantly less post-surgical pain and lower wound healing scores (p < 0.01). Conclusions: It was concluded that using MIST resulted in more clinical studies reporting better clinical outcomes. Considering aesthetic appearance, slightly more than half of the clinical trials also showed improved results with MIST. Likewise, regarding postoperative morbidity, 60% of the clinical trials also described better scores with MIST. All of this indicates that MIST is a good alternative for the management of soft tissues.

Oral lesions in patients with human monkeypox: A systematic scoping review.

OBJECTIVES: To describe the clinical features and location of oral lesions in patients with human monkeypox. METHODS: A systematic scoping review was accomplished by implementing the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. The analysis incorporated varied databases and the gray literature. Keywords were implemented to search publications in all languages until July 2022. RESULTS: The initial electronic exploration included 889 reports, of which 843 studies were eliminated. Reading the full text occasioned the omission of 27 additional investigations. Finally, 19 publications were included. These reports analyzed 1256 patients with monkeypox, mostly described in Europe. Most of them were men who have sex with men. The study population consisted mainly of adults but children were also infected. The oral lesions of monkeypox patients were observed in different parts of the oral mucosa, including lips and tongue, but mainly in the tonsils (15 cases). The oral lesions manifested as papules, vesicles, pustules, and ulcers. Erythema, edema, enanthema, and severe pain were also observed, accompanied by tonsillar enlargement. Sore throat was also reported. Monkeypox is accompanied by a significant number of systemic manifestations, mainly including multiple skin lesions throughout the body, as well as lymphadenopathy, fever, headache, myalgia, and fatigue, among others. The symptoms associated with monkeypox were managed with different antiretroviral and antimicrobial therapies and medications to control pain and fever principally. Seventeen deaths were informed. CONCLUSION: Most monkeypox-associated oral lesions are seen in different parts of the oral mucosa, mainly in the tonsils manifested as papules, vesicles, pustules, and ulcers.

The Potential Clinical Applications of a Microfluidic Lab-on-a-Chip for the Identification and Antibiotic Susceptibility Testing of Enterococcus faecalis-Associated Endodontic Infections: A Systematic Review.

This systematic review evaluated the potential clinical use of microfluidic lab-on-a-chip (LOC) technology in the identification and antibiotic susceptibility testing of E. faecalis in endodontic infections. The search methodology employed in this review adhered to the PRISMA guidelines. Multiple scientific databases, including PubMed/MEDLINE, SCOPUS, and SCIELO, were utilized, along with exploration of grey literature sources. Up to September 2023, these resources were searched using specific keywords and MeSH terms. An initial comprehensive search yielded 202 articles. Ultimately, this systematic review incorporated 12 studies. Out of these, seven aimed to identify E. faecalis, while the remaining five evaluated its susceptibility to different antibiotics. All studies observed that the newly developed microfluidic chip significantly reduces detection time compared to traditional methods. This enhanced speed is accompanied by a high degree of accuracy, efficiency, and sensitivity. Most research findings indicated that the entire process took anywhere from less than an hour to five hours. It is important to note that this approach bypasses the need for minimum inhibitory concentration measurements, as it does not rely on traditional methodologies. Microfluidic devices enable the rapid identification and accurate antimicrobial susceptibility testing of E. faecalis, which are crucial for timely diagnosis and treatment in endodontic infections.

Antibiotic Resistance in Patients with Peri-Implantitis: A Systematic Scoping Review.

The implementation of adjunctive antibiotics has been recommended for the therapy of peri-implantitis (PI). In this review, antibiotic resistance patterns in PI patients were assessed. A systematic scoping review of observational studies and trials was established in conjunction with the PRISMA extension for scoping reviews. The SCOPUS, PubMed/MEDLINE, EMBASE, SCIELO, Web of Science, and LILACS databases were reviewed along with the gray literature. The primary electronic examination produced 139 investigations. Finally, four observational studies met the selection criteria. These studies evaluated 214 implants in 168 patients. Porphyromonas gingivalis and Fusobacterium nucleatum mainly presented high resistance to tetracycline, metronidazole, and erythromycin in PI patients. Similarly, Aggregatibacter actinomycetemcomitans was also highly resistant to clindamycin and doxycycline. Other microorganisms such as Tannerella forsythia, Parvimonas micra, and Prevotella intermedia/nigrescens also presented significant levels of resistance to other antibiotics including amoxicillin, azithromycin, and moxifloxacin. However, most microorganisms did not show resistance to the combination amoxicillin metronidazole. Although the management of adjunctive antimicrobials in the therapy of PI is controversial, in this review, the resistance of relevant microorganisms to antibiotics used to treat PI, and usually prescribed in dentistry, was observed. Clinicians should consider the antibiotic resistance demonstrated in the treatment of PI patients and its public health consequences.

Clinical Efficacy of Treatment of Endodontic-Periodontal Lesions: A Systematic Scoping Review of Experimental Studies.

BACKGROUND: In this review, we evaluated the clinical efficacy of interventions used for the treatment of endo-perio lesions (EPL). METHODS: A systematic scoping review of clinical trials was developed. RESULTS: Seven clinical trials were studied. In at least one study group of six of the seven evaluated trials, endodontic and periodontal treatments were performed simultaneously. All trials showed improvement in probing depth in the studied groups; nevertheless, the experimental groups of five studies demonstrated a statistically significant reduction in this parameter. An increase in clinical attachment level was also reported (p < 0.05). Most trials reported an increase in the filling of the bone defect following therapy (p < 0.05). Mechanical periodontal therapy implemented simultaneously with endodontic therapy demonstrated efficacy in the treatment of concurrent EPL without communication. Endodontic treatment and immediate periodontal surgery did not affect the result of the management of combined EPL with apical communication. The use of diode laser, the management of platelet-rich fibrin (PRF) and titanium-prepared PRF, and the implementation of bone grafts plus endodontic treatment with mineral-trioxide or gutta-percha seems to be an adequate strategy in patients with EPL. CONCLUSIONS: The treatment of EPL using simultaneous endodontic and periodontal therapies seems to be an acceptable treatment alternative.

Influence of the Socio-Economic Context on Self-Reported Gingival Bleeding in Individuals of Ethnic Minority Groups: A Multilevel Analysis.

INTRODUCTION: To evaluate the influence of the socio-economic context on self-reported gingival bleeding (SRGB) in individuals of ethnic minority groups (IEG). METHODS: Data from the 2007 National Public Health Survey in Colombia were collected. A multiple-stage stratified sampling was used. Data from 34.843 subjects were collected through interviews. The influence of socio-economic factors on SRGB in IEG was investigated with logistic and multilevel regression analyses. RESULTS: Out of 34.843 subjects studied, a total of 6.440 individuals were members of ethnic minority groups. SRGB was observed in approximately 5% of IEG. There was a significant difference between IEG and subjects of the rest of the sample (28.403 subjects) regarding SRGB, elementary and high school education, Gross Domestic Product (GDP), Human Development Index (HDI) and Unmet Basic Needs Index (UBNI) disfavouring IEG (P<0.05). The logistic model showed that SRGB was associated with IEG (P<0.001). This association persisted after controlling for confounders. A total of 33 Colombian states (level 2) and 6.440 members (level 1) of ethnic minority groups were included in the multilevel analisys; this model showed that the variance on SRGB was statistically significant at level 1 and 2. However, the variation at IEG level (35%) was smaller than the variation between states (65%) in the multilevel multivariate model. CONCLUSIONS: SRGB was higher in IEG. Also, GDP, HDI and UBNI were unfavourable factors in the members of ethnic minority groups. Considering these detriment factors and the higher variation between states, this study suggests that socio-economic context affects significantly SRGB in IEG.