CBCT vs panoramic radiography in assessment of impacted upper canine and root resorption of the adjacent teeth: A systematic review and meta-analysis.

Background: The IC may cause reabsorption of adjacent teeth; therefore detailed assessment of its position would enhance decision-making in the clinical workflow. The objective was to compare cone-beam computed tomography (CBCT) and panoramic radiography (PR) in assessing the position of the impacted upper canine (IC) and root resorption of adjacent teeth. Material and Methods: Pubmed, EMBASE, Science Direct, Web of Science, and SCOPUS databases were searched for studies published before August 2023. Studies that evaluated IC by using both imaging methods were included. For statistical analysis, the Comprehensive Meta-Analysis software (Biostat; Englewood, NJ) was used, p≤0.05. Results: A total of 17 articles were included, with 877 patients (average age of 17.6 years) and 1,115 ICs. The most frequent mesio-distal location of the IC was in sectors 3 and 4. The meta-analysis was performed with eleven studies. CBCT was more accurate in determining the labio-palatal position compared with PR (p<0.001) (CI 95%; 60% in labial position, 0.254-0.542, OR:0.398; 56% in palatal position, 0.350-0.533, OR:0.441; 78% in mid-alveolus position, 0.188-0.234, OR:0.221). For IC angulation to the midline, CBCT showing a smaller and more accurate angle than PR (p<0.001) (CI 95%, 18.008-33.686). IC angulation to the occlusal plane and lateral incisor, there was smaller angle in PR compared to CBCT (p<0.001) (CI 95%, 51.292-65.934; CI 95%, 30.011-55.954). With PR, fewer cases of root resorption of teeth adjacent to the IC were visualized compared with CBCT (86% less) (p<0.001) (CI 95%, 0.089-0.186; OR value: 0.138; n=1049). Conclusions: CBCT showed statistically significant differences compared to PR in the assessment of IC position and root resorption of adjacent teeth. CBCT provided clinically relevant information that may contribute to diagnosing and planning IC treatment when PR was not sufficient. Key words:Canine teeth, tooth, impacted, panoramic radiography, Cone-beam computed tomography, systematic review, meta-analysis.

Histological implications of high-power laser use in the oral soft tissue lesions: a systematic review.

The objective of this study was to describe the histological artifacts caused by high-power laser use compared to cold scalpel surgery in oral soft tissue lesions. Clinical studies that evaluated and compared histological artifacts resulting from the use of high-power lasers and cold scalpels in oral soft tissue lesions biopsies were retrieved from seven databases and four grey literatures, up to July 2022. The risk of bias was investigated using the ROBINS-I tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Seven studies were eligible for qualitative analysis. Based on the results obtained, those four studies had a low risk of bias, and three studies had an unclear risk of bias. The certainty of the evidence was classified as low. Limited evidence showed that epithelial artifacts such as loss of intraepithelial and subepithelial adhesions, accompanied by pyknotic, fusiform, and/or hyperchromic nuclei, were more common when a high-power laser device was used. Four articles reported that the use of high-power lasers did not interfere with the histopathological diagnosis of oral soft tissue lesions. Due to the heterogeneity of the data, a meta-analysis was not performed. Compared to the use of cold scalpels, histological artifacts, particularly those observed in epithelial tissue, are more common when high-powered lasers are used in oral lesions biopsies. The eligibility criteria and adequate indications of high-power lasers in different oral soft tissue lesion treatments must be respected to avoid tissue artifacts that impair precise histopathological diagnosis.

Segmental resection vs. partial resection on treating solid multicystic ameloblastomas of the jaws - recurrence rates: A systematic review and meta-analysis.

Background: The aim of the present study was to compare the recurrence rates of solid multicystic ameloblastomas after segmental resection or marginal resection. Material and Methods: PubMed, ScienceDirect, Web of Science, Scopus, Embase were searched for studies published up to July 2022. The gray literature was also searched. Meta-analysis was performed using OpenMeta Software, p< 0.05 considered significant. Results: Among the search, 8 studies met all eligibility criteria. The group that underwent marginal resection was 1.1 times more likely to present recurrence of the lesion compared to the group that underwent segmental resection. There was no statistically significant difference between the two groups (segmental resection and marginal resection) in all eight studies regarding reducing ND (95% Confidence interval, 0.339 - 3.705; heterogeneity: Q value= 3.105; I2= 0%). Conclusions: The results showed that there was no statistically significant difference between segmental and marginal resection for the treatment of solid multicystic ameloblastomas; however, prospective studies with more rigorous methodological procedures are needed to better compare the surgical techniques. Key words:Ameloblastoma, solid multicystic ameloblastoma, treatment, recurrence.

Prevalence of orofacial alterations in patients with sickle-cell disease: Systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to identify the prevalence of orofacial alterations in sickle-cell disease (SCD) and to compare it with the general population. STUDY DESIGN: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The search was conducted on PubMed, Embase, Scientific Electronic Library Online, Web of Science, Cochrane Library, gray literature, and references of the included articles. RESULTS: A total of 770 records were found, and 28 studies were selected. In SCD, the prevalence of decreased bone density was 57% (95% CI: 35%-80%), with Q: P < .01 and I2 = 95%; for stepladder pattern was 30% (IC: 13%-47%), Q: P < .01 and I²: 93%; for delayed eruption was 20% (95% CI: 6%-34%), with Q: P < .01 and I2 = 86, Q: P < .01 and I2 = 99%; and for malocclusion, 66% (95% CI: 39%-92%), Q: P < .01 and I2 = 98%. A high risk of bias was observed in relation to the sample size of the studies. A limited number of articles compared the prevalence of orofacial alterations in patients with SCD and healthy individuals. CONCLUSIONS: Decreased bone density, malocclusion, orofacial pain, tooth necrosis, eruption delay, periodontal disease, and neuropathies may be present in patients with SCD with variable prevalence.

Clinicopathological Analysis of Actinic Cheilitis: A Systematic Review with Meta-analyses.

BACKGROUND: This systematic review aimed to conduct a complete investigation of the demographic aspects, clinicopathological features, degrees of epithelial dysplasia, and malignant transformation rate of actinic cheilitis. METHODS: The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020201254). A search without year and language restrictions was performed using PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science, and gray literature. Studies that provided information on patients with actinic cheilitis were included, excluding those with general information on other diseases or other types of cheilitis. Risk of bias was explored using the Joanna Briggs Institute tool. Narrative and quantitative data syntheses were performed using meta-analyses and subgroup analyses. Association tests were also performed. RESULTS: Thirteen studies (728 patients) were included. The most prevalent clinical signs were dryness (99%), blurred demarcation between the lip vermilion and skin (82%), scaling (69%), and atrophy (69%). Regarding epithelial dysplasia, a prevalence of mild dysplasia (34.2%), followed by moderate (27.5%), and severe (14.9%). The malignant transformation rate was 14%. Crusts, ulcerations, and erythematous areas were associated with lip carcinoma (p < 0.001), and scaling was associated with actinic cheilitis (p < 0.001). CONCLUSIONS: This study revealed several features of actinic cheilitis, providing an overview of the disease. It is suggested that new studies help develop policy guides for the standardization of clinical criteria, enabling more rigorous and homogeneous analysis of actinic cheilitis.

Occurrence of field cancerization in clinically normal oral mucosa: A systematic review and meta-analysis.

OBJECTIVE: The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC). METHODS: A search of the Cochrane Library, PubMed, Embase, Web of Science, Scopus, and Livivo databases was performed on June 12, 2022, which retrieved 152 records without duplicates. Studies that analyzed FC in biopsies in clinically normal tissue opposite to primary OSCC were included. The search was conducted under the PRISMA guideline and the protocol was registered in PROSPERO (CRD42017077125). RESULTS: Eight articles with 302 patients were included, 192 men and 110 women, mean age 57.1 years. Most patients had deleterious habits. All studies performed histopathological confirmation of OSCC and biopsies were obtained the clinically normal mirror mucosa. The meta-analysis carried out with eight studies. The studies showed 57.3 % of cases with histopathological changes of clinically normal mucosa opposite to primary OSCC (Confidence interval 95 %, 0.443-0.703; heterogeneity: Q value 18.715; I2 73.284 %; n = 205). p53 and Ki-67 immunohistochemical analysis may be predictive for detecting changes. There was p53 immunoexpression in 41.3 % of cases (p = 0.872) (n = 55), ki-67 immunoexpression (< 20 %) in 68 % (p = 0.001) (n = 97) and ki-67 immunoexpression (> 20 %) in 28.4 % of cases (p = 0.000) (n = 110). CONCLUSIONS: The findings suggest that FC can occur, and there are histopathological changes in clinically normal tissue opposite to primary OSCC. Nevertheless, the review showed that more longitudinal studies on FC are needed to draw a conclusive indication of the occurrence of FC in oral tissues opposite to OSCC.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review

ABSTRACT BACKGROUND: Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. OBJECTIVES: To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. DESIGN AND SETTING: Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. METHODS: A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. CONCLUSION: Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review.

BACKGROUND: Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. OBJECTIVES: To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. DESIGN AND SETTING: Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. METHODS: A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. CONCLUSION: Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Diagnostic accuracy of CBCT compared to panoramic radiography in predicting IAN exposure: a systematic review and meta-analysis.

OBJECTIVES: The aim of this study is to verify whether the diagnostic accuracy of cone beam computed tomography (CBCT) is superior to panoramic radiography (PR) in predicting inferior alveolar nerve (IAN) exposure during the lower third molar extraction. MATERIALS AND METHODS: Eight electronic databases were searched up to September 2020. Studies that evaluated the accuracy (sensitivity, specificity, positive-predictive value, and negative predictive value) of both imaging methods were included. The gold standard was the visualization of the IAN exposure during the extraction of lower third molars. The gray literature was also used to include any other paper that might meet the eligibility criteria. The meta-analysis was performed with OpenMeta-Analyst and ReviewManager v.5.3 software. The methodology of the studies was evaluated using QUADAS-2. RESULTS: Among the search, three studies met all the eligibility criteria and were included in the qualitative and quantitative synthesis. The meta-analysis was conducted with all included studies. Accuracy values for CBCT were 95.1% for sensitivity (p=0.666) and 64.4% for specificity (p<0.001). For PR sensitivity and specificity, we observed 73.9% (p=0.101) and 24.8% (p<0.001), respectively. CONCLUSIONS: Both exams were reliable for detecting positive cases of exposure of the IAN. However, CBCT had a better performance compared to PT in predicting IAN exposure during surgery. CLINICAL RELEVANCE: To better understand the CBCT accuracy in predicting the IAN exposure during surgery, since this event can increase the likelihood of IAN injury and, consequently, cause neurosensory disturbances.

Cone-beam computed tomography artifacts in the presence of dental implants and associated factors: an integrative review.

PURPOSE: This study was conducted to review the literature regarding the types of cone-beam computed tomography (CBCT) artifacts around dental implants and the factors that influence their formation. MATERIALS AND METHODS: A search strategy was carried out in the PubMed, Embase, and Scopus databases to identify published between 2010 and 2020, and 9 studies were selected. The implants included 306 titanium, titanium-zirconium, and zirconia implants, as well as 5 titanium cylinders. RESULTS: The artifacts around the implants were the beam-hardening artifact, the streaking artifact, and band-like radiolucent areas. Some factors that influenced the formation of artifacts were the implant material, bone type, evaluated regions, distance, type of CBCT, field of view (FOV) size, milliamperage, peak kilovoltage (kVp), and voxel size. The beam-hardening artifact was the most widely reported, and it was minimized in protocols with a smaller FOV, larger voxels, and higher kVp. CONCLUSION: The risk and benefit of these protocols in individuals with dental implants must be considered, and clinical examinations and complementary radiographs play an essential role in implantology.

Odontodisplasia Regional: relato de caso em criança de 5 anos / Regional Odontodysplasia: a case report in a 5-year-old child

RESUMO A odontodisplasia regional é uma anomalia dentária, pouco comum, não hereditária e com uma etiologia ainda desconhecida. Os tecidos afetados são o esmalte e a dentina, são acometidos nos dentes decíduos e, as vezes na dentição permanente de um mesmo indivíduo. Esta lesão pode ser confundida com outras lesões como por exemplo o odontoma ou dentes com outro tipo de anomalia. O objetivo é relatar um caso de odontodisplasia regional na dentição decídua e permanente de uma criança, assim como apresentar as diferentes ferramentas diagnósticas. Os dentes acometidos mostravam-se ao exame clínico, como dentes hipoplásicos com coloração amarelo amarronzado. Uma radiografia panorâmica e radiografias periapicais, assim como uma biopsia excisional, foram essenciais para obter um diagnóstico correto, e assim poder oferecer uma adequada conduta para a preservação e previsibilidade dos diferentes tipos de tratamentos reabilitadores odontológicos que essa criança poderia ter nos próximos anos até a idade adulta.

SUMMARY Regional odontodysplasia is an uncommon dental anomaly that is not hereditary and has a still unknown etiology. The affected tissues are enamel and dentin, the primary teeth are affected, and sometimes in the permanent dentition of the same individual. This lesion may be confused with other lesions such as odontoma or teeth with another type of anomaly. The objective is to report a case of regional odontodysplasia in the deciduous and permanent dentition of a child, as well as to present the different diagnostic tools. The affected teeth showed clinical examination, such as hypoplastic teeth with a yellow-brown coloration. A panoramic radiograph and periapical radiographs, as well as an excisional biopsy, were essential to obtain a correct diagnosis, so as to be able to offer an adequate conduct for the preservation and predictability of the different types of dental rehabilitation treatments that this child could have in the years to come adulthood.

CBCT does not reduce neurosensory disturbances after third molar removal compared to panoramic radiography: a systematic review and meta-analysis.

OBJECTIVES: The current dentistry scenario is showing an increase in the availability of cone-beam computed tomography (CBCT) in dental offices. Oral surgeons are using three-dimensional information as an additional tool to assess preoperative data for lower third molar (LTM) removal in moderate and high-risk cases of inferior alveolar nerve (IAN) injury diagnosed through the panoramic radiography (PR). The aim of this study is to identify whether CBCT examination reduces neurosensoric disturbances (ND) following the removal of the LTM when compared to PR. MATERIALS AND METHODS: PubMed, Embase, Web of Science, Science Direct, and Scopus electronic databases were searched for studies published up to February 2019. The gray literature was also searched including papers that eventually met the eligibility criteria. Meta-analysis was performed using the comprehensive meta-analysis software, p < 0.05 considered significant. RESULTS: Among the search, 6 studies met all eligibility criteria. There was no statistically significant difference between the two groups (PR and CBCT) in all six studies regarding reducing ND (95%. Confidence interval, 0,788-1734; heterogeneity: Q = 10,361; I2 = 22.788%). CONCLUSIONS: CBCT was not superior to PR in avoiding ND. However, further studies are necessary with standardized parameters for a better comparability between variables in the studies. CLINICAL RELEVANCE: To better understand the CBCT clinical applicability in LTM removal to avoid unnecessary extra radiation when compared to PR to the patient and to improve patient's prognosis.

Impact of temporomandibular disorders on quality of life / O impacto das disfunções temporomandibulares na qualidade de vida / El impacto de las disfunciones temporomandibulares en la calidad de vida

Abstract Introduction: Temporomandibular dysfunction (TMD) may have a major impact on quality of life. Objective: Thus, this integrative review assessed the impact of TMD on quality of life. Method: An electronic and manual search was conducted to identify studies that evaluated the impact of TMD on an individual's quality of life. After the inclusion and exclusion criteria were met, seven articles were included and evaluated according to the quality of evidence using the Newcastle-Ottawa assessment. Results: The selected studies used different instruments to diagnose temporomandibular joint disorders and measure the quality of life. Only three studies used the RDC/TMD. As for quality of life, the most used instrument was the SF-36, followed by Br-MPQ and WHOQOL-Bref. Conclusion: The findings show that there is a negative impact of temporomandibular dysfunction on quality of life, especially regarding its severity. However, further studies are needed to confirm these results.

Resumo Introdução: A disfunção temporomandibular (DTM) pode ter um grande impacto na qualidade de vida das pessoas. Objetivo: Esta revisão integrativa avaliou o impacto da DTM na qualidade de vida da população. Método: Uma busca eletrônica e manual foi realizada para identificar estudos que avaliaram o impacto da DTM na qualidade de vida. Após os critérios de inclusão e exclusão serem estabelecidos, seis artigos foram incluídos e avaliados de acordo com a qualidade de evidências utilizando o Newcastle-Ottawa. Resultados: Os estudos selecionados utilizaram instrumentos distintos para diagnóstico da DTM e da mensuração da qualidade de vida. Os instrumentos de diagnóstico de DTM foram o Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), índice Anamnético de Fonseca, índice de Helkimo e índice Anamnético de Fonseca juntamente com RDC/TMD. Quanto à qualidade de vida, o instrumento mais utilizado foi o SF-36, seguido de Br-MPQ e WHOQOL-Bref. Conclusão: Os achados mostram que existe um impacto negativo da DTM na qualidade de vida, principalmente quanto a sua gravidade. Entretanto, futuras pesquisas são necessárias para confirmar esses resultados.

Resumen Introducción: La disfunción temporomandibular (DTM) puede tener un gran impacto en la calidad de vida de las personas. Objetivo: Esta revisión integrativa evaluó el impacto de la DTM en la calidad de vida de la población. Método: Se realizó una búsqueda electrónica y manual para encontrar estudios que evalúen el impacto de la DTM en la calidad de vida. Después de establecer los criterios de inclusión y exclusión, seis artículos fueron incluidos y evaluados según la calidad de evidencias utilizando la escala Newcastle - Ottawa. Resultados: Los estudios seleccionados utilizaron diversos instrumentos para el diagnóstico de la DTM y para medir la calidad de vida. Los instrumentos de diagnóstico de la DTM fueron Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), índice Anamnésico simplificado de Fonseca, índice de Helkimo e índice Anamnésico simplificado de Fonseca con RDC/TMD. Respecto a la calidad de vida, el instrumento más utilizado fue el SF-36, seguido de Br-MPQ y WHOQOL-Bref. Conclusión: Los resultados mostraron que existe un impacto negativo de la disfunción temporomandibular en la calidad de vida, principalmente respecto a su gravedad. No obstante, futuras investigaciones son necesarias para confirmar esos resultados.

Cervical vertebrae anomalies and cleft lip and palate: a systematic review and meta-analysis.

OBJECTIVES: This study investigated the association of congenital cervical vertebrae anomalies (CVA) with the prevalence of cleft lip and palate (CLP) specifying the most frequent associations. METHODS: A meta-analysis was based on the Preferred Reporting Items of Systematic reviews and Meta-Analyses guideline. A search of the PubMed, Embase, Web of Science, Science Direct, Scopus and Lilacs database was performed until March 2018. Clinical studies that evaluated CVA in individuals with CLP (experimental group) and without CLP (control group) was included. For the statistical analysis, the software Comprehensive Meta-Analysis (Biostat; Englewood, NJ) was used, with a p-value < 0.05 considered significant. RESULTS: A total of 10 articles were included, for a total of 2566 individuals with CLP and 2301 individuals without CLP. The meta-analysis indicated statistically significant differences and the group of individuals with CLP had an increased number of CVA when compared to the group of individuals without CLP (p < 0.05; 95% confidence interval, 2.41-6.11; heterogeneity: Q-value 32.8, I2 72.6%). CONCLUSIONS: This study indicated that CVA are associated with the presence of CLP. Among the patients with CVA the most frequent anomalies were the deficiency of the posterior arch, followed by the fusion of cervical vertebrae. Individuals with cleft palate and those with unilateral cleft lip and palateCLP had an increased prevalence of CVA.

Low-level laser therapy dosimetry most used for oral mucositis due to radiotherapy for head and neck cancer: a systematic review and meta-analysis.

Dosimetry for low-level laser therapy (LLLT) depends on several parameters, such as target tissue type, lesion type and laser equipment used. This study aimed to determine the most used LLLT dosimetry for the treatment and prevention of oral mucositis (OM) resulting from radiation therapy (RT) in head and neck cancer patients (HNCP). This research was conducted according to the PRISMA guidelines using the PICO framework. After extensively searching PubMed, Web of Science, Embase, Scopus, BVS and Cochrane Library databases, we found 130 records and selected 7 studies, involving 363 HNCP with an average age of 60.6 years who received RT. Briefly, sites affected by tumors were the following: oral cavity (170), oropharynx (91), throat (42), larynx (32), nasopharynx (11), hypopharynx (9), and in 8 cases, sites were not reported. These studies used several classifications for OM (RTOG/EORTC, WHO, NCI-CTC) and pain (NRS, VAS and modified VAS). These various researchers performed the LLLT punctual application of different forms using several protocols making analysis difficult. However, LLLT was effective regardless of the parameters used (632.8 nm to 685 nm, 1.8 J/cm2 to 3.0 J/cm2, 10 mW to 60 Mw, 0.8 J to 3.0 J). The meta-analysis showed a better results with preventive LLLT 660 nm, 3.8 J/cm2, 15 mW; 0.15 J compared to preventive LLLT 660 nm, 1.3 J/cm2, 5 mW; 0.05 J (OMS: p = 0.03; NCI-CTC: p = 0.027). We conclude that there is, as of yet, no evidence of better laser dosimetry being more effective. Thus, randomized clinical trials to determine which doses of LLLT are most appropriate for treating and preventing OM due to RT are lacking and should be further investigated.

Manual vs. rotary instrumentation in endodontic treatment of permanent teeth: A systematic review and meta-analysis.

PURPOSE: To systematically review all studies comparing manual instrumentation with at least one rotary instrument in the preparation of the root canal of permanent human teeth. METHODS: The electronic databases PubMed, EMBASE, LILACS, IBECS and BBO were searched. In vitro studies published until 27 of September, 2016 were included. For statistical analysis, we used the Comprehensive Meta-Analysis software (Biostat), considering P< 0.05 significant. RESULTS: A total of 1,104 articles published until September 27, 2016 were obtained, with 57 meeting the eligibility criteria. The studies were grouped according to the main methodology used (computerized tomography, periapical radiography, image amplification and scanning electron microscope). Due to the wide variability of the methodologies and evaluated parameters, a subgroup analysis was performed based on the evaluated parameter. The meta-analysis revealed that rotary instruments caused a significant reduction in instrumentation time and a smaller change of the canal curvature than manual instruments. The rotary instrumentation presented better results regarding root canal transportation, ability of centralization within the canal path and shaping of the canal. Manual instrumentation performed better with regard to the smear layer and debris production, more instrumented canal surfaces and fewer dentin defects. CLINICAL SIGNIFICANCE: An increasing number of studies have compared the efficiency of manual and rotary instrumentation in endodontic treatment of permanent teeth. This study helps elucidate which method is more efficient in the endodontic treatment of permanent teeth.

Levantamento de seio maxilar atraumático sem enxertia óssea: uma revisão integrativa / Atraumatic maxillary sinus augmentation without bone grafting: an integrative review

Objetivo: avaliar a eficácia do levantamento do seio maxilar atraumático sem enxerto ósseo e a taxa de sobrevivência da instalação de implantes imediatos. Material e métodos: realizou-se uma estratégia de busca nas bases de dados Pubmed, Web of Science e Science Direct, obtendo 103 artigos, sendo selecionados 07 estudos publicados entre 2008 até 2019. Resultados: foram registrados 576 pacientes com idades entre 19 e 85 anos de idade, de ambos os sexos e 1,113 implantes instalados. Verificou-se uma taxa de sucesso e sobrevivência dos implantes de 96,6%, após um seguimento de 1 a 3 anos e houve um ganho ósseo de aproximadamente 3mm. Considerações finais: o levantamento de seio maxilar atraumático sem enxerto ósseo é eficaz para reabilitação de áreas edêntulas e mostra um bom resultado ao longo do tempo, com uma taxa média de sobrevivência dos implantes de 96,3%. Ainda faltam estudos para determinar qual tipo de implante é melhor para este tipo de técnica. (AU)

Objective: To assess the efficacy of atraumatic maxillary sinus augmentation without bone grafting and the survival rate of the immediate implant installation. Material and methods: A search strategy was performed the in Pubmed, Web of Science, and Science Direct databases, resulting in 103 articles from which seven studies published between 2008 and 2019 were selected. Results: 576 patients of both sexes, aged between 19 and 85 years, were registered, as well as 1,113 implants installed. There was a success rate and survival of implants of 96.6% after a follow-up of 1 to 3 years and there was a bone gain of approximately 3 mm. Final considerations: The atraumatic maxillary sinus augmentation without bone graft is effective to rehabilitate edentulous areas and shows a good outcome over time, with an average rate of implant survival 96.3%. Further studies are still required to determine which type of implant is best for this type of technique.(AU)