Challenging the Concept that OptiBond FL and Clearfil SE Bond in NCCLs Are Gold Standard Adhesives: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
FDS Dreweck ◽  
A Burey ◽  
M de Oliveira Dreweck ◽  
E Fernandez ◽  
AD Loguercio ◽  
...  

SUMMARY Purpose: The following PICO (Patient/Population, Intervention, Comparison, and Outcomes) question was proposed: “Are retention rates of composite resin restorations in noncarious cervical lesions (NCCLs) when using adhesives considered “gold standard” (OptiBond FL and Clearfil SE Bond) higher than those obtained with other adhesives brands”? Methods: A search was performed in February 2019 (updated in November 2019) in the PubMed/MEDLINE, EMBASE, LILACS, BBO, Web of Science, Cochrane Library, Grey Literature, and IADR abstracts (1990–2018); unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (RCTs) conducted in NCCLs that compared either OptiBond FL or Clearfil SE Bond adhesive with other commercially available adhesives were included. The risk of bias (RoB) was applied by using the Cochrane Collaboration tool. A meta-analysis was performed for retention rates at different follow-up times using a random effects model for both the adhesives. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Grading of Recommendations: Assessment, Development and Evaluation (GRADE) assessed the quality of evidence. Results: After removal of duplicates and noneligible articles, 25 studies remained for qualitative synthesis, as one study was common to the two adhesives, of which 9 studies were used for the OptiBond FL meta-analysis and 14 for the Clearfil SE Bond meta-analysis. No significant differences were observed for retention rates in follow-up periods of 12-24 months (p=0.97), 36–48 months (p=0.72), or 108–156 months (p=0.73) for OptiBond FL; and for 12–24 months (p=0.10) and 36-48 months (p=0.17) for Clearfil SE Bond. A significant difference was only found for OptiBond FL at 60–96 months (p=0.02), but only three studies were included in this meta-analysis. Conclusions: The evidence from available RCTs conducted in NCCLs that compared OptiBond FL or Clearfil SE Bond does not support the widespread concept that these adhesives are better than any other competitive brands available in the dental market.

2020 ◽  
Vol 45 (3) ◽  
pp. E124-E140
Author(s):  
AMO Correia ◽  
E Bresciani ◽  
AB Borges ◽  
DM Pereira ◽  
LC Maia ◽  
...  

SUMMARY Purpose: The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations? Methods: Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location). Results: We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency. Conclusion: The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.


Author(s):  
Mohamed Fahmy Doheim ◽  
Ahmed Elsnhory ◽  
Mohammed Elgammal ◽  
Abdulrahman Ibrahim Hagrass ◽  
Ahmed Hanbal ◽  
...  

Introduction : Stroke is one of the predominant causes of permanent disability, mortality, significant cognitive, physical, and psychosocial morbidity in the world. We conducted this systematic review and meta‐analysis to assess the safety and efficacy of fluoxetine for recovery stroke patients through different time points of follow up. Methods : We searched in PubMed, Cochrane Library, Scopus, and Web of Science databases/ search engines until June 2021. Mean difference (MD) with 95% confidence interval (CI) was applied for continuous data, while risk ratio (RR) with 95% CI was used for dichotomous data. Results : Seventeen randomized clinical trials were identified which assessed the safety and efficacy of fluoxetine compared to placebo for stroke patients. Fluoxetine enhances the National Institutes of Health Stroke Scale (NIHSS) score [MD = ‐0.67, 95 % CI (‐1.19 to ‐0.15), P = 0.01] and the Fugl‐Meyer Motor Scale (FMMS) score [MD = 17.36, 95 % CI (12.12 to 22.61), P <0.00001] at three months follow up. However, the NIHSS score showed no significant difference between the two groups at two weeks [MD = ‐0.32, 95% CI (‐0.72 to 0.07), p = 0.11] or at six months [MD = ‐0.17,95% CI (‐0.47 to 0.14), p = 0.29]. Fluoxetine and placebo‐treated patients had the same overall impact on FMMS scores at one month [MD = 7.77, 95 % CI (‐10.57 to 26.11), P = 0.41]. The fluoxetine arm had a higher risk of broken bone (RR = 2.30, 95% CI [1.59, 3.32], p < 0.001) and hyponatremia (RR = 2.12, 95% CI [1.19, 3.76], p = 0.01) with lower risk of new depression (RR = 0.72, 95% CI [0.61, 0.84], p< 0.001) in comparison to the placebo arm. Conclusions : The efficacy of fluoxetine is likely to take time to emerge, and is expected to be transient. The use of fluoxetine increased the incidence of hyponatremia and bone fractures while decreasing the risk of new‐onset depression.


F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1560 ◽  
Author(s):  
Lamia Gadallah ◽  
Mahmoud Hamdy ◽  
Adel El Bardissy ◽  
Mohamed Abou El Yazeed

Background: Early childhood caries is a serious public health problem. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies  in vital primary incisors. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors. Methods: We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and ClinicalTrials.gov for ongoing trials. Randomized controlled trials were included and assessed with Cochrane risk of bias tool . Primary outcomes were clinical failure and radiological failure. The effect sizes were calculated as risk ratios with 95%CI using the Mantel-Haenszel method. Results: Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was e 2.69, 95% CI 0.76 to 9.58 for clinical failure. For radiographic failure, the sensitivity analysis showed RR 0.45, 95% CI 0.25 to 0.83 with a higher risk for radiographic failure in pulpectomy. The evidence was limited by the small number of trials included in the meta-analysis. Conclusions: Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time are needed.


2020 ◽  
Vol 46 (1) ◽  
pp. E34-E59
Author(s):  
JL de Geus ◽  
BM Maran ◽  
KA Cabral ◽  
A Dávila-Sánchez ◽  
C Tardem ◽  
...  

Clinical Relevance The use of filled adhesive systems does not influence the clinical performance of the adhesive restoration in noncarious cervical lesions. SUMMARY Objective: The aim of this meta-analysis was to investigate the clinical performance of filled vs unfilled adhesive systems when applied in noncarious cervical lesions. Methods and Materials: A systematic search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. Gray literature was also screened. Only randomized controlled clinical trials were included. The risk of bias of the studies was evaluated using the Cochrane Collaboration’s tool. A random-effects meta-analysis was conducted to compare the retention rate, marginal discoloration, and secondary caries of noncarious cervical lesions restored with filled adhesives vs unfilled adhesives. The quality of the body of evidence was assessed using the GRADE approach. Results: A total of 3662 studies were identified after removal of duplicates. Twenty-nine studies remained for qualitative analyses and 28 studies for the meta-analysis. Only one study was judged to have a low risk of bias, and the other 28 were considered to have unclear risk of bias. There was no statistically significant difference between filled adhesives compared with unfilled adhesives in relation to loss of retention, marginal discoloration, or secondary caries at any of the follow-up periods (12–18 months, 24–30 months, 3 years, and 5 years or longer). The quality of evidence was graded as moderate for most outcomes at the respective follow-ups, except when there was an explained heterogeneity, which occurred mainly for loss of retention at the 12-month to 3-year follow-up. The results did not depend on whether microfilled or nanofilled adhesives had been investigated. Conclusions: The addition of fillers into the composition of adhesive systems did not increase the clinical performance (retention rates, marginal discoloration, or secondary caries) of composite restorations placed in noncarious cervical lesions when compared with unfilled adhesives.


2020 ◽  
Vol 45 (6) ◽  
pp. 589-597
Author(s):  
BGS Casado ◽  
EP Pellizzer ◽  
JR Souto Maior ◽  
CAA Lemos ◽  
BCE Vasconcelos ◽  
...  

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.


Author(s):  
Mahmoud H Mohammaden ◽  
Mohamed Elfil ◽  
Mohamed Fahmy Doheim ◽  
Agostinho Camara Pinheiro ◽  
Alhamza R Al‐Bayati ◽  
...  

Introduction : Direct transfer to angiography suite (DTAS) for patients with suspected large vessel occlusion strokes potentially requiring mechanical thrombectomy has been shown to shorten treatment times and improve outcomes compared to conventional imaging (CI) selection. This meta‐analysis compares both approaches to build more concrete evidence. Methods : The potentially relevant studies that were published in four electronic databases/search engines (PubMed, Web of Science, Cochrane Library, and Scopus) till August 2021 were reviewed. Eligible studies were included if they enrolled >10 patients in both groups, were published in English and reported baseline and procedural characteristics and 90‐day outcomes. Relevant data were then extracted and analyzed. Results : Among 4514 searched studies, six qualified for the analysis. Time from door to puncture (MD = ‐26.76minutes, 95 % CI [‐39.48, ‐14.03], P< 0.0001) as well as door to reperfusion (MD = ‐27.21 minutes,95% CI [‐47.42, ‐7.01], P = 0.008) were significantly shorter and the rates of functional independence(mRS0‐2: RR = 1.28, 95% CI [1.03, 1.60], P = 0.03) at 90‐days were significantly higher in the DTAS versus the CI approach. There was no statistically significant difference between DTAS and CI groups in terms of successful reperfusion (modified Thrombolysis In Cerebral Infraction [mTICI] score2B‐3: RR = 0.99, 95% CI [0.93, 1.06], P = 0.86), near complete/ full reperfusion (mTICI 2C‐3: RR = 0.84,95% CI [0.68, 1.04], P = 0.11), or fair outcomes at 90‐days (mRS 0–3: RR = 1.05, 95% CI [0.67, 1.64],P = 0.84). Moreover, there was no difference between groups regarding symptomatic intracranial hemorrhage (RR = 0.81, 95% CI [0.55, 1.17], P = 0.26) or 90 day‐mortality (RR = 0.85, 95% CI [0.59, 1.24],P = 0.41). Conclusions : Our meta‐analysis showed that DTAS significantly improves time metrics and functional outcome with comparable safety to the CI approach. Multicenter randomized clinical trials are ongoing to confirm these results.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253968
Author(s):  
Bowen Li ◽  
Yifeng Xu ◽  
Cailian Lu ◽  
Zhenheng Wei ◽  
Yongyue Li ◽  
...  

Background Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection. Methods From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model. Results This meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22). Conclusion Our meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.


2020 ◽  
Author(s):  
Yanbo Yang ◽  
Mingjia Chen ◽  
Zilan Wang ◽  
Yue Sun ◽  
Fan Jiang ◽  
...  

Abstract Background Erenumab is a novel monoclonal calcitonin gene–related peptide receptor antibody that is used for the preventive treatment of migraine.Objectives To evaluate overall safety and efficacy and dose-response relationship of erenumab in patients with episodic migraine and patients with prior migraine treatment failures.Methods We searched randomized clinical trials on PUBMED, EMBASE database, and Cochrane Library database. A pair-wise meta-analysis and Bayesian network analysis were performed.Results For efficacy outcomes, the network meta-analysis suggests that compared with erenumab 70 mg, participants received erenumab 140 mg reported significantly decreased MSMD and increased 50% response rate, and erenumab was most likely to be ranked first for MMD, MSMD and 50% response rate. For safety outcomes, the network meta-analysis has found no significant difference between the 70 mg group and the 140 mg group measured by AE and SAE. For patients with ≥2 treatment failures, 140mg erenumab group, patients with ≥2 treatment failures reported significantly reduced MMD and MSMD, increased 50%, and 75% response rate, compared with placebo. For safety outcomes, no significant difference was found between 140 mg erenumab group and the placebo group.Conclusion Erenumab was effective in patients with episodic migraine. 140 mg erenumab was associated with better efficacy outcomes without increased risk for developing adverse events compared with 70 mg erenumab, and 140 mg erenumab was effective in patients with prior migraine treatment failures.Registration number: CRD42020198985


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Johanes Nugroho ◽  
Ardyan Wardhana ◽  
Cornelia Ghea

Purpose. A previous meta-analysis has conducted nonrandomized trials for mechanochemical ablation (MOCA). Since medium-term follow-up data from randomized clinical trials (RCTs) are becoming available, we chose to perform a meta-analysis of RCTs to assess the efficacy and safety of MOCA for saphenous vein insufficiency. Methods. A systematic search of all RCTs comparing the anatomical success of MOCA for saphenous vein insufficiency to thermal ablation was performed using the PubMed and Cochrane Library databases. We employed the Mantel-Haenszel random-effects meta-analysis of outcomes using RevMan 5.3. Results. Four studies (615 patients) were included in this meta-analysis. The MOCA group had 93.4% and 84.5%, whereas the thermal ablation group had 95.8% and 94.8% of anatomical success rate at 1 month (short-term) and a period of more than 6 months but less than 1-year follow-up (mid-term), respectively. According to intention-to-treat analysis, there were similar anatomical successes in MOCA and thermal ablation groups at the short-term follow-up (low-quality evidence; relative risk RR=0.98 (95% CI, 0.94–1.03); P=0.44; I2=53%). The estimated effect of MOCA on anatomical success showed a statistically significant reduction at the mid-term follow-up (moderate-quality evidence; RR=0.89 (95% CI, 0.84–0.95); P=0.0002; I2=0%). MOCA had fewer incidence of nerve injury, deep vein thrombosis, and skin burns compared to the thermal ablation procedure (low-quality evidence; RR=0.33 (95% CI, 0.09–1.28); P=0.11; I2=0%). Conclusion. MOCA offered fewer major complications but lesser anatomical success at the period of more than 6 months but less than 1-year follow-up than thermal ablation. Trial Registration. This trial is registered with UMIN Clinical Trial Registry (UMIN ID 000036727).


2019 ◽  
Vol 85 (1) ◽  
pp. 86-91
Author(s):  
Ming Xu ◽  
You-Liang Tao

To conduct a randomized controlled trial (RCT), meta-analysis to assess the effectiveness of drains in reducing complications after laparoscopic cholecystectomy (LC) for acute cholecystitis needs to be carried out. An electronic search of PubMed, Embase, Science Citation Index, and the Cochrane Library from January 1990 to January 2018 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as odds ratios (ORs) with 95 per cent confidence intervals (CIs) using RevMan 5.2. Four RCTs, which included 796 patients, were identified for analysis in our study. There was no statistically significant difference in the rate of morbidities (OR = 1.23, 95% CI 0.55–2.76, P = 0.61). Abdominal pain was more severe in the drain group 24 hours after surgery (mean difference = 0.80, 95% CI 0.47–1.14; P < 0.00001). No significant difference was present with respect to wound infection rate and hospital stay. The use of abdominal drainage does not appear to be of any benefit in patients having undergone early LC for acute cholecystitis.


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