Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis.

OBJECTIVES: The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin-bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications. MATERIALS AND METHODS: A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates. RESULTS: Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer-containing luting resin (p > 0.05). CONCLUSIONS: Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass-infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long-term success and survival rates for up to 10 and 15 years. CLINICAL SIGNIFICANCE: Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results.

Dental implant planning using artificial intelligence: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Data on the role of artificial intelligence (AI) in dental implant planning is insufficient. PURPOSE: The purpose of this systematic review with meta-analysis was to analyze and evaluate articles that assess the effectiveness of AI algorithms in dental implant planning, specifically in detecting edentulous areas and evaluating bone dimensions. MATERIAL AND METHODS: A systematic review was conducted across the MEDLINE/PubMed, Web of Science, Cochrane, and Scopus databases. In addition, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies that examined the accuracy of AI-based diagnostic tools on dental radiographs for dental implant planning. The most recent search was conducted in January 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included articles. RESULTS: Twelve articles met the inclusion criteria for this review and focused on the application of AI in dental implant planning using cone beam computed tomography (CBCT) images. The pooled data indicated an overall accuracy of 96% (95% CI=94% to 98%) for the mandible and 83% (95% CI=82% to 84%) for the maxilla in identifying edentulous areas for implant planning. Eight studies had a low risk of bias, 2 studies had some concern of bias, and 2 studies had a high risk of bias. CONCLUSIONS: AI models have the potential to identify edentulous areas and provide measurements of bone as part of dental implant planning using CBCT images. However, additional well-conducted research is needed to enhance the accuracy, generalizability, and applicability of AI-based approaches.

Adaptation of cobalt chromium frameworks fabricated by conventional versus selective laser melting techniques: An in vitro and clinical assessment.

STATEMENT OF PROBLEM: Three-dimensional (3D) printing of cobalt chromium (Co-Cr) removable partial dentures (RPDs)by selective laser melting (SLM) has been claimed to be less challenging than by conventional casting and provides significant improvements. However, the adaptation and fit of the SLM framework and the optimum build orientation are still unclear. PURPOSE: The purpose of this in vitro and clinical study was to evaluate the effect of different build orientations on the adaptation of removable partial denture frameworks fabricated by SLM technology in vitro and to compare the adaptation of the SLM and conventional RPD frameworks clinically. MATERIAL AND METHODS: A master model simulating a maxillary arch of Kennedy class III modification 1 was scanned and duplicated to create a virtual 3D cast and reference cast. Four groups (n=40) of Co-Cr RPD frameworks were fabricated. For the SLM groups, the Co-Cr framework was virtually designed and exported for SLM printing. The SLM printing was done in 3 different build orientations: 0-degree (n=10), 45-degree (n=10), and 90-degree (n=10) groups. Other Co-Cr frameworks were conventionally cast (n=10). All Co-Cr frameworks were scanned and virtually superimposed with the master model using a surface-matching software program. The gap under 9 selected points in the palatal major connectors was analyzed and calculated. A smaller gap indicates more surface adaptation and close contact between the palatal major connector and the master model. The data were analyzed using the Kruskal-Wallis and Dunnett T3 tests (α=.05). Three patients with a partially dentate maxillary arch were enrolled in the clinical part based on inclusion criteria. Two RPD frameworks were provided for each patient (conventional casting and SLM printing). The adaptation of each framework was assessed by measuring the gap between the palatal major connector of the framework and the palate with light-body silicone. The differences in adaptation between the conventional and SLM frameworks were compared by using independent t tests (α=.05). RESULTS: The in vitro study identified significant differences in the adaptation of the palatal major connector among the 4 groups (P<.001), except for conventional and 0-degree SLM printing (P=.999). The conventional and 0-degree SLM frameworks exhibited the best adaptation, with the lowest gap underneath the palatal major connector of the RPD framework (0.01 ±0.02 mm and 0.01 ±0.01 mm, respectively). In the clinical part of the study, no significant difference was found between the adaptation of SLM and the conventional framework (P=.430) CONCLUSIONS: The adaptation of SLM printing can be maximized with less gap under the palatal major connector of the RPD framework when using the 0-degree build orientation. Co-Cr frameworks produced with SLM printing technology were comparable with conventionally produced frameworks; hence, SLM printed frameworks can be an alternative for clinical applications when optimum SLM parameters are applied.

Adhesion of Candida Albicans to digital versus conventional acrylic resins: a systematic review and meta-analysis.

BACKGROUND: The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins (both milled and 3D-printed) compared to the conventional heat-polymerized acrylic resins. METHODS: This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). A comprehensive search of online databases/search tools (Web of Science, Scopus, PubMed, Ovid, and Google Scholar) was conducted for all relevant studies published up until May 29, 2023. Only in-vitro studies comparing the adherence of Candida albicans to the digital and conventional acrylic resins were included. The quantitative analyses were performed using RevMan v5.3 software. RESULTS: Fourteen studies were included, 11 of which were meta-analyzed based on Colony Forming Unit (CFU) and Optical Density (OD) outcome measures. The pooled data revealed significantly lower candida colonization on the milled digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (MD = - 0.36; 95%CI = - 0.69, - 0.03; P = 0.03 and MD = - 0.04; 95%CI = - 0.06, - 0.01; P = 0.0008; as measured by CFU and OD respectively). However, no differences were found in the adhesion of Candida albicans between the 3D-printed digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (CFU: P = 0.11, and OD: P = 0.20). CONCLUSION: The available evidence suggests that candida is less likely to adhere to the milled digitally-fabricated acrylic resins compared to the conventional ones.

Quantitative and qualitative 3D analysis of mandibular lingual concavities: Implications for dental implant planning in the posterior mandible.

OBJECTIVE: The purpose of this study is to investigate the type of ridge (degree of angulation of the lingual concavity) and the buccolingual dimensions in the area of the first and second molars in both genders of different ages and how this will affect implant placement in the posterior mandible. MATERIALS AND METHODS: This retrospective cross-sectional study comprised cone beam computed tomography images of 150 dental patients (75 males and 71 aged ≥30). The following were measured/reported: type (morphology) of the ridge (convex [C], parallel [P], or undercut [U]), buccolingual width at the base and the crest of the ridge, and ridge height. The concavity angle, depth, and length of the U-shaped ridge were measured too. RESULTS: The prevalence of type U ridge ranged from 32.7% in the first molar region to 62.7% in the second molar region. Almost all measurements and ridge type distributions were comparable amongst the age groups (p > .05). Very few significant differences were found when comparing #36 versus #37 and #46 versus #47 teeth, with no differences in the distribution of the ridge types (p > .05). Quite the inverse, all measurements were statistically different when comparing #36 versus #37 and #46 versus #47 teeth, and type U ridge was more frequent in second molar compared to the first molar regions, respectively (p < .05). Many measurements were statistically higher in females; the inverse was true for a few measurements (p < .05). Type U ridge in #36 and #37 was found more frequently among males (p < .001). In contrast, the ridge types in #37 and #47 were not statistically different gender-wise. CONCLUSIONS: The U type of ridge was more prevalent in the investigated population, encountered more frequently in the second molars generally and in the first molars of males than females. Most posterior mandibular measurements are similar age- and side-wise but seem different gender- and tooth-wise.

Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: a systematic review and meta-analysis.

BACKGROUND: Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses. RESULTS: Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes. CONCLUSIONS: PDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted.

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis.

BACKGROUND: A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS: A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS: The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

Quality of web-based Arabic health information on dental implants: an infodemiological study.

BACKGROUND: In the era of the internet, patients seek health information ahead of getting the required treatment. Dental implant, which is among the most sought dental treatments, is not an exception. Incorrect health related information may lead to harmful deeds, so this study sought to assess the quality of web-based Arabic health information on dental implants. METHODS: The following engines were searched: Google ( http://www.google.com ), Yahoo! ( http://www.yahoo.com ), and Bing ( http://www.bing.com ) on 13 January 2022 for specific Arabic terms on "dental implants". The first 100 consecutive websites from each engine were analyzed for eligibility. The eligible websites were assessed using JAMA benchmarks tool, DISCERN tool, and HONcode. An online tool (including FKGL, SMOG and FRE) was used to assess readability of the websites. RESULTS: There were 65 eligible websites, of which only one (1.5%) was HONcode certified. Only 3 (4.5%) websites attained a high score (> 65 out of 80) based on DISCERN tool: The mean DISCERN score was 41.14 ± 12.64. The mean JAMA score was 1.69 ± 1.13; however, only five (7.6%) met all JAMA criteria. The main shortcomings were attributed to not meeting the "Attribution" (54 [83.1%]) and "Authorship" (43 [66.2%]) criteria. The mean grade level of FKGL score was 7.0 ± 4.5. The majority of the websites (60%) scored less than 7, indicating easy content to understand. The mean grade level of SMOG score required to understand a website's text was 3.2 ± 0.6. Around 91% of the websites had reading ease scores ≥ 80, suggesting that the website's content was easy to read. CONCLUSION: Unfortunately, although readable, most of the easily accessible web-based Arabic health information on dental implants does not meet the recognized quality standards.

Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies.

PURPOSE: The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)? STUDY SELECTION: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed. RESULTS: Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI95%= 1.54-2.49, P< 0.00001). CONCLUSIONS: Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.

The influence of horizontal glass fiber posts on fracture strength and fracture pattern of endodontically treated teeth: A systematic review and meta-analysis of in vitro studies.

PURPOSE: This systematic review and meta-analysis aimed to summarize available evidence regarding the effect of horizontal glass fiber posts (HGFPs) on fracture strength and fracture pattern of endodontically treated teeth (ETT) compared to controls without HGFP. The review protocol was registered on the OSF registries. METHODS: Literature searches were conducted in MEDLINE/PubMed, Scopus, Web of Science, Embase, Google Scholar, and ProQuest for all relevant studies published up to February 2022. All in vitro studies that assessed the influence of HGFPs on fracture strength and fracture pattern of ETT whether mesio-occluso-distal or mesio-occlusal or DO cavities were considered eligible. Review Manager (RevMan) was used for the meta-analysis. Subgroup and funnel plot analyses were also performed. Quality assessment was conducted by two independent reviewers. RESULTS: A total of 12 articles met the inclusion criteria, and 10 studies underwent quantitative evaluation. The pooled effect showed that fracture resistance of molar teeth restored with HGFP was significantly higher than teeth without HGFP (standardized mean difference [SMD]: 1.61, 95% confidence interval [CI]: 0.14, 3.09, p = 0.03), whereas marginally significant for premolars (SMD: 1.36, 95% CI: -0.00, 2.73, p = 0.05). Regarding fracture patterns, the presence of an HGFP significantly increased the occurrence of restorable fracture patterns for premolars (odds ratios [OR]: 4.15, 95% CI: 1.60, 10.82, p = 0.004) compared to controls, whereas the difference was not significant for molars (OR: 1.09, 95% CI: 0.43, 2.77, p = 0.85). Moderate risk of bias was identified in 9/12 studies; one study showed a high risk of bias and two studies showed a low risk of bias. CONCLUSIONS: Within the limitations of this study, there is evidence from in vitro studies that the use of HGFP increases the fracture resistance of the ETT when compared to teeth without HGFP and also reduces the occurrence of non-restorable fractures for premolars. However, well-conducted in vitro and prospective clinical studies are warranted to validate this finding.

Bibliometric analysis and evaluation of the Journal of Prosthetic Dentistry from 1970 to 2019.

STATEMENT OF PROBLEM: A comprehensive bibliometric analysis to determine different aspects of the Journal of Prosthetic Dentistry is lacking. PURPOSE: The purpose of this bibliometric study was to analyze the characteristics of the Journal of Prosthetic Dentistry between 1970 and 2019. MATERIAL AND METHODS: The Web of Science Core Collection was used to retrieve 9 categories of the Journal of Prosthetic Dentistry, including keywords and terms used, cited documents published, the countries and organizations of the authors, references, and sources cited during this period. Data were exported to a software program and analyzed for each 10-year period and for the entire 50 years. The highest 10 in each category were reported. Co-occurrence, couthorships, and linkage were also reported. RESULTS: A total of 11 989 records were reached by the search on the Web of Science Core Collection database; of which, 10 638 (92.9%) were included in the analysis. Articles made up 91.1%, of all records, with 217 review documents (1.8%). The most productive decade was 1980 to 1989 with 2936 documents. The total number of citations of all documents (available period 1980 to 2019) including self-citations was 155 112. During the period 1970 to 2019, 14 837 terms were used. The total number of keywords was 4933 (available period 1990 to 2019). There were 15 382 authors, 82 countries, and 2113 organizations identified in articles published in the Journal of Prosthetic Dentistry during this period, with most from the United States. There were 43 027 authors, 95 324 references, and 14 594 sources cited in the Journal of Prosthetic Dentistry during the period surveyed. CONCLUSIONS: This bibliometric analysis provided a comprehensive overview of the impactful role of the Journal of Prosthetic Dentistry in contemporary dentistry, particularly in the field of prosthodontics.

Efficacy of lycopene for management of oral potentially malignant disorders: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to investigate the available evidence on the efficacy of lycopene in the management of oral potentially malignant disorders (OPMDs). STUDY DESIGN: PubMed, Scopus, Web of Science, Google Scholar, China National Knowledge Infrastructure, and ProQuest databases were searched up to April 20, 2022. All clinical trials that assessed the efficacy of lycopene (I) on the signs/symptoms (O) of patients with OPMDs (P) in comparison to either active control or placebo (C) were included. Meta-analysis was conducted using the RevMan software (Cochrane Collaboration, London, UK). RESULTS: A total of 27 clinical trials (20 on oral submucosa fibrosis [OSF], 5 on oral lichen planus [OLP], and 2 on leukoplakia) were included. Overall, lycopene was efficacious in reducing signs and symptoms of OSF, OLP, and leukoplakia. The pooled data revealed comparable efficacy of lycopene and prednisolone in reducing pain and promoting clinical resolution of OLP. Additionally, the pooled data reported comparable efficacy of lycopene and conventional controls in improving the mouth opening and tongue protrusion in patients with OSF. CONCLUSIONS: The results reveal promising effects of lycopene in alleviating signs and symptoms of OSF, OLP, and leukoplakia. However, owing to the observed heterogeneity and short follow-up periods, further well-designed studies with long-term therapy and follow-up are highly recommended.

Clinical Outcomes of Three versus Four Mini-Implants Retaining Mandibular Overdenture: A 5-Year Randomized Clinical Trial.

Background and Objectives: Due to a lack of long-term clinical studies that would clarify whether the insertion of three mini-implants (MDIs) can be as successful treatment as the insertion of four MDIs for the retention of mandibular overdentures (ODs), this 5-year prospective cohort study was set up. Materials and Methods: Participants (n = 83) randomly received either four or three MDIs and a mandibular OD. Clinical examinations were performed at the baseline, as well as after one, three, and five years, respectively. A total of 73 participants (38 in the four-MDI and 35 in the three-MDI groups) partook in the study. The marginal bone level change, success and survival rates, and prosthodontic maintenance were assessed. Results: Repeated measures showed that the mean peri-implant bone loss increased progressively at a small amount over five years in both groups (four-MDI group = -0.36 ± 0.74; three-MDI group = -0.33 ± 0.27 mm; p < 0.05). However, an ANCOVA revealed no significant effects of the group (no significant difference between the three- and the four-MDI groups; F = 0.085; p = 0.771), gender (F = 0.023; p = 0.88), or covariate age (F = 1.95; p = 0.167) on the dependent variable: the 5-year MBL change. The success rate (together with successful survival) was 93.8% in the four-MDI group and 91.7% in the three-MDI group. The log-rank (Mantel-Cox) test revealed no significant differences between them (X2 = 0.373; p = 0.541). Conclusions: In patients with narrow ridges, the insertion of three MDIs in the mandible for overdenture retention can be equally as successful as the insertion of four MDIs.

The possible association between the types of soft palate and gag reflex: a preliminary study / A possível associação entre os tipos de palato mole e o reflexo de vômito: um estudo preliminar

Objective: whether gag reflex, a common problem encountered during dental procedures, is associated with the different types of the soft palate has not been addressed so far. This preliminary study sought to assess the potential association between the different types of soft palate and gag reflex. Material and Methods: one hundred dental patients were recruited. The type of soft palate was determined. Subjective (self-reported) gag reflex was recorded based on many questions and past experience and on a 0-6 VAS. Objective assessment of gag reflex was done using different maneuvers where the posterior part of the tongue and the soft palate were touched by dental mirror, and by taking impression for the upper arch. The association between the types of soft palate and the subjective and objective recorded gag reflex were statistically tested. Results: there were 53 (53%), 33 (33%) and 14 (14%) of the participants with class I, class II and class III soft palate, respectively. A significant association was found between the type of the soft palate and gag reflex in response to one of the subjective items (P= 0.039), more prominent among females (P= 0.009). Concerning the objective assessment, no significant associations were found among males. Meanwhile more females with class II and class III suffered gag reflex and/or actual gagging upon taking the impression (P = 0.001). Conclusion: this study illustrated an association between the type of soft palate and gag reflex, and its severity in females (more specifically soft palate types II and III) more than in males (AU)

Objetivo: o reflexo de vômito, um problema comum encontrado durante procedimentos odontológicos, está ou não associado aos diferentes tipos de palato mole, não foi ainda abordado até o momento. Este estudo preliminar procurou avaliar a possível associação entre os diferentes tipos de palato mole e o reflexo de vômito. Material e Métodos:cem pacientes odontológicos foram recrutados. O tipo de palato mole foi determinado. O reflexo de vômito subjetivo (auto-relatado) foi registrado com base em muitas perguntas e experiências anteriores e em um VAS de 0-6. A avaliação objetiva do reflexo de vômito foi feita por meio de diferentes manobras onde a parte posterior da língua e o palato mole foram tocados por espelho dental e por meio de moldagem da arcada superior. A associação entre os tipos de palato mole e o reflexo de vômito subjetivo e objetivo registrado foi testada estatisticamente. Resultados: houve 53 (53%), 33 (33%) e 14 (14%) participantes com palato mole classe I, classe II e classe III, respectivamente. Foi encontrada associação significativa entre o tipo de palato mole e o reflexo de vômito em resposta a um dos itens subjetivos (P= 0,039), mais proeminente no sexo feminino (P= 0,009). Em relação à avaliação objetiva, não foram encontradas associações significativas entre os homens. Enquanto isso, mais mulheres com classe II e classe III sofreram reflexo de vômito e/ou engasgo real ao receber a impressão (P = 0,001). Conclusão: este estudo ilustrou uma associação entre o tipo de palato mole e reflexo de vômito e sua gravidade em mulheres (mais especificamente palato mole tipos II e III) mais do que em homens. (AU)

Effects of calcium hydroxide intracanal medicament on push-out bond strength of endodontic sealers: A systematic review and meta-analysis.

OBJECTIVE: To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. METHODS: A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05. RESULTS: A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = -0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = -0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias. CONCLUSION: The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers. CLINICAL SIGNIFICANCE: The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers.

Knowledge, beliefs, attitude, and practices of E-cigarette use among dental students: A multinational survey.

BACKGROUND: E-cigarette use is a trend worldwide nowadays with mounting evidence on associated morbidities and mortality. Dentists can modify the smoking behaviors of their patients. This study aimed to explore the knowledge, beliefs, attitude, and practice of E-cigarette use among dental students. MATERIALS AND METHODS: This multinational, cross-sectional, questionnaire-based study recruited undergraduate dental students from 20 dental schools in 11 countries. The outcome variable was current smoking status (non-smoker, E-cigarette user only, tobacco cigarette smoker only, dual user). The explanatory variables were country of residence, sex, age, marital status, and educational level. Multiple linear regression analysis was performed to explore the explanatory variables associated with E-cigarette smoking. RESULTS: Of the 5697 study participants, 5156 (90.8%) had heard about E-cigarette, and social media was the most reported source of information for 33.2% of the participants. For the 5676 current users of E-cigarette and/or tobacco smoking, 4.5% use E-cigarette, and 4.6% were dual users. There were significant associations between knowledge and country (P< 0.05), educational level (B = 0.12; 95% CI: 0.02, 0.21; P = 0.016) and smoking status (P< 0.05). The country of residence (P< 0.05) and smoking status (P< 0.05) were the only statistically significant factors associated with current smoking status. Similarly, there were statistically significant associations between attitude and country (P< 0.05 for one country only compared to the reference) and history of previous E-cigarette exposure (B = -0.52; 95% CI: -0.91, -0.13; P = 0.009). Also, the practice of E-cigarettes was significantly associated with country (P< 0.05 for two countries only compared to the reference) and gender (B = -0.33; 95% CI: -0.52, -0.13; P = 0.001). CONCLUSION: The knowledge of dental students about E-cigarette was unsatisfactory, yet their beliefs and attitudes were acceptable. Topics about E-cigarette should be implemented in the dental curriculum.

Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey.

OBJECTIVES: E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students. METHODS: This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05. RESULTS: Most respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users. CONCLUSION: Dental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Curcumin mouthwashes versus chlorhexidine in controlling plaque and gingivitis: A systematic review and meta-analysis.

OBJECTIVES: The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and gingivitis. METHODS: A comprehensive online search of multiple databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed to identify all relevant studies published up to August 2020, using the following keywords: curcumin, turmeric, gingivitis, periodontal health, and plaque control. All clinical trials that compared the efficacy of curcumin mouthwash with chlorhexidine in controlling dental plaque and gingivitis were included. Data were analysed using Review Manager (RevMan) 5.3 software. The risk of bias was evaluated by two independent reviewers using the Cochrane assessment tool. RESULTS: Six randomized clinical trials (comprising 320 subjects) fulfilled the eligibility criteria. Five studies showed a high risk of bias and only one study showed a low risk of bias. The pooled data of the six included studies revealed comparable efficacy of curcumin and chlorhexidine in reducing dental plaque (I2  = 91%; standardized mean difference [SMD]: 0.27, 95% CI: -0.53, 1.07, p = 0. 51) and gingival inflammation (I2  = 40%; SMD: -0.13, 95% CI: -0.35, 0.09, p = 0.24), with no statistically significant differences between the two groups. CONCLUSION: The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.

Fracture Resistance of Titanium and Fiber Dental Posts: A Systematic Review and Meta-Analysis.

PURPOSE: The fracture resistance of dental post systems is influenced by the material of the post. The purpose of this systematic review and meta-analysis was to assess if there is a difference in fracture resistance between prefabricated dental titanium posts and fiber posts. METHODS: An online electronic search was performed using the PubMed, Scopus, and Web of Science databases for in vitro studies published from 2010 to 2020 in English. The retrieved eligible studies that compared the fracture resistance of titanium and fiber posts on human teeth were selected. The pooled standardized mean difference (SMD) with a 95% confidence interval was calculated. In addition, the trial sequential analysis (TSA) was performed to test if the available studies are sufficient to make conclusive evidence. RESULTS: Of the 1165 retrieved studies, 17 studies were included in the qualitative analysis, while 16 studies were included in the quantitative analysis. Because of the high heterogeneity among studies, data from 10 studies were pooled and submitted to TSA. A total of 852 teeth were evaluated for fracture of the posts in 27 independent comparison groups. The pooled effect of the residual studies revealed no significant difference between titanium and fiber posts (SMD = -0.12; 95% CI = -0.30, 0.06; p = 0.20). Results of the TSA revealed no conclusive evidence. CONCLUSIONS: The results of the current evidence revealed no significant difference between fiber and titanium posts. The evidence is insufficient, and more standardized in vitro studies are required.