A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at “low,” 2 at “unclear,” and 4 studies at “high” risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.
Objective: To evaluate systemic exposures associated with molar incisor hypomineralization (MIH). Methods: This systematic review was performed using published observational studies that evaluated the systemic exposures associated with MIH. The sources of articles searched were PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and Grey literature. The risk of bias was analysed according to the Newcastle-Ottawa Scale for quality assessment. The meta-analysis was performed considering the exposures during the prenatal, perinatal and postnatal periods using the CMA software.Results: A total of 4207 articles were identified. Twenty-nine studies were eligible for inclusion and 27 were included in the meta-analysis. The studies presented low and moderate risks of bias, except for one that was classified as having a high risk of bias. Maternal illness during pregnancy (OR 1.40; 95% CI 1.18-1.65, P < 0.0001) and psychological stress (OR = 2.65; 95% CI 1.52-4.63; P = 0.001) was observed to be significantly associated with higher odds of MIH. During the perinatal period, caesarean delivery (OR = 1.32, 95% CI 1.11-1.57, P = 0.001) and delivery complications (OR = 2.06; 95% CI 1.47-2.88, P < 0.0001) were also associated with MIH. In the postnatal period, only respiratory diseases (OR = 1.98; 95% CI 1.45-2.70, P < 0.0001) and fever (OR = 1.50; 95% CI 1.22-1.84; P < 0.0001) were associated with higher prevalence of MIH. The evidence was graded as very low quality. Conclusions:Maternal illness, psychological stress, caesarean delivery, delivery complications, respiratory diseases and fever during the first years of a child's life were significantly associated with a higher odds of MIH. However, this should be interpreted with caution, once the primary studies were observational, with serious limitations according to the risk of bias, imprecision, and inconsistency. Further, welldesigned cohort studies are still required. K E Y W O R D Saetiology, dentition, meta-analysis, molar incisor hypomineralization, systematic review | CON CLUS IONAccording to this systematic review, maternal illness, psychological stress, caesarean delivery, delivery complications, respiratory diseases, fever and childhood illnesses were significantly associated with MIH. However, as the evidence was gathered from studies with serious limitations, such as the risk of bias, imprecision and inconsistency, these results should be interpreted with caution.
Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.
Objectives:This in vitro study evaluated the antimicrobial effects of commercial toothpastes containing natural compounds.Materials and Methods:The study groups were divided based on the natural compound present in the toothpaste composition: Sorbitol (I), tocopherol (II), mint (III), cinnamon/mint (IV), propolis/melaleuca (V), mint/açai (VI), mint/guarana (VII), propolis (VIII), negative control (IX), and the positive control (X). The antimicrobial properties of the toothpastes were tested using the disk diffusion method against oral pathogens: Streptococcus mutans, Pseudomonas aeruginosa, and Enterococcus faecalis. The resulting inhibition halos were measured in millimeters.Results:The data indicated that the bacteria responded differently to the toothpastes (P < 0.0001). The diameters of the inhibition halos against S. mutans were in decreasing order of efficacy: Propolis/melaleuca > mint/guarana > mint/açai > sorbitol > tocopherol > cinnamon/mint > propolis > mint (P < 0.001 vs. negative control). E. faecalis showed variable responses to the dentifrices in the following order of decreasing efficacy: Mint/guarana > propolis > sorbitol > mint/açai > tocopherol > cinnamon/mint > mint = propolis/melaleuca = negative control. The product with the highest antimicrobial activity was mint/guarana, which was significantly different than propolis/melaleuca, mint, cinnamon/mint, and tocopherol and negative control (P < 0.001). The statistical analysis indicated that propolis, sorbitol, and mint/açai did not show any differences compared to mint/guarana (P > 0.05) and positive control (P > 0.05). P. aeruginosa was resistant to all dental gels tested including positive control.Conclusion:The toothpastes with natural compounds have therapeutic potential and need more detailed searches for the correct clinic therapeutic application. The results from this study revealed differences in the antimicrobial activities of commercial toothpastes with natural compounds.
The arrangement of the bristles had little influence over the removal of biofilm and gingival conditions. Thus, there is no clinical justification for replacing conventional toothbrushes with more expensive models.
The use of NaOCl may maintain the long-term stability of a resin-eroded dentin interface formed by etch-and-rinse and self-etch adhesives.
OBJECTIVE: To evaluate the effectiveness of tooth brushing supervision in one or more sessions on dental plaque removal and toothbrush wear. MATERIAL AND METHOD: 3- to 5-year-old children received new toothbrushes and attended a puppet theater about oral health. Forty-nine children were randomly selected and divided into 3 groups (GI=20; GII=14; GIII=14). Fones' brushing method was demonstrated to the GI and GII groups to evaluate the following: the professional direct supervision and tooth brushing training in five sessions (GI), the professional direct supervision and a one-training session (GII) and the puppet theater influence only (GIII-control group). The dental plaque index (IPL) was recorded at baseline (T0), after 24 days (T1) and after 46 days (T2) and toothbrush wear (ID) was recorded on T1 and T2. The Kruskal-Wallis test and the Friedman test (IPL), as well as the one-way ANOVA and the paired Student's t-test (ID) (p<0.05) were employed to analyze the data. RESULT: GI showed a significant difference from the others groups in T1 and T2 (p<0.01).The index of toothbrush wear increased (p<0.0001) from 24 days (0.52±0.35mm) to 46 days (0.90±0.48mm), but there was no significant association between toothbrush wear and plaque index for T1 (r=0.230-p= 0.116) as well as for T2 (r=0.226-p=0.121). CONCLUSION: The multiple sessions of professional supervision were effective to reduce the dental plaque index, which was not influenced by toothbrush wear, showing continuous oral hygiene motivation needs.
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