Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: systematic review update.

OBJECTIVES: To update the findings of a systematic review from the year 2016 on the evidence for the accuracy and potential benefits of cone beam computed tomography (CBCT) in periodontal diagnostics. MATERIAL AND METHODS: A systematic literature search was performed and the criteria for PICO, PRISMA and risk of bias assessment were applied. Only clinical trials (> 10 patients) conducted in humans on periodontal bone loss, i.e. vertical and/or horizontal or furcation involvement, in CBCT compared with clinical and/or conventional radiographic measures were included. RESULTS: From 1152 articles identified, 11 case series on furcations and eight on vertical and/or horizontal bone loss were included. The studies showed moderate risk of bias and heterogeneous study designs. The agreement between non-surgical clinical or two-dimensional radiographic assessments of horizontal, vertical or interfurcal bone loss and CBCT measurements was analysed in 11 studies and was low in six studies with comparable study designs. A high accuracy (80-84%) of CBCT measurements compared with intra-surgical findings of furcation involvement was observed in four studies. Comparing CBCT with intra-surgical measurements of vertical or horizontal bone loss, an accuracy between 58 and 93% was found in four out of six studies. Three studies were analysed and indicated benefits of CBCT in decision making and/or a reduction of treatment costs and time in teeth of interest. CONCLUSIONS: The findings provide additional evidence for the accuracy of CBCT in assessing periodontal bone loss. CLINICAL RELEVANCE: CBCT is an accurate diagnostic tool in periodontology, which needs to be carefully considered in certain situations.

Evaluation of magnetic resonance imaging for diagnostic purposes in operative dentistry-a systematic review.

OBJECTIVES: Magnetic resonance imaging (MRI) is a well-established diagnostic tool in various areas of medicine. The technique provides radiographic images in the absence of ionizing radiation. The aim of the present analysis was to evaluate the best available current external evidence for application of MRI in operative dentistry. MATERIAL AND METHODS: A systematic literature search was performed for studies published by August 2019 in three electronic databases (MEDLINE, Embase via Ovid, Cochrane Library) supplemented by a hand search. The PRISMA criteria were applied to a PICO question. Data were extracted and summarized in data extraction files, and a quality assessment of the included studies was performed. RESULTS: From 287 titles identified, 12 case series with two studies on caries detection, six studies on endodontic, and four studies on anatomical aspects were eligible for inclusion. The studies included showed a high level of heterogeneity and summarized data from 343 subjects. The data available indicate potential of certain MRI settings for diagnostic of caries lesions, presentation of pulp tissues and periapical lesions, and the localization of impacted teeth. CONCLUSIONS: The limited currently available evidence shows potential of certain MRI settings for the use in operative dentistry. Further research needs to assess the applicability and accuracy for dental hard tissues as well as cost-benefit aspects of the MRI technique. CLINICAL RELEVANCE: Certain MRI settings may have the potential as diagnostic tool in operative dentistry.

Does systemically administered azithromycin have an effect on gingival overgrowth? A systematic review.

OBJECTIVE: The aim of this systematic review was to evaluate studies that analyzed the effect of systemically administered azithromycin (AZM) on cyclosporine A (CsA)-mediated gingival overgrowth (GO). STUDY DESIGN: A systematic literature search was performed for publications published by January 1, 2019, using electronic databases and hand search. Human clinical trials (>10 patients) with systemic administration of AZM and a follow-up of ≥6 months, published in the English or German language, were included. RESULTS: From 266 titles identified, 6 publications with data from 104 patients were included. A great heterogeneity in terms of sample size, administration/dosage regimen of AZM, consideration of potential confounders and measurement of GO was observed. Treatment duration with AZM ranged from 3 to 5 days with a maximum dosage of 500 mg/day, gingival response was measured by using various scoring systems. A synthesis of results, by using a vote counting method, was applied. In all included studies, a beneficial effect of systemically administered AZM with respect to a reduction of GO was documented. CONCLUSIONS: Limited evidence from 6 case series suggests a positive effect of systemically administered AZM on the reduction of CsA-mediated GO. Azithromycin may be considered a potential alternative to surgical reduction of GO.