Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database of Systematic Reviews.
Objective: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and periapical radiographs (PR) for the detection of external root resorption (ERR). Material and Methods: An electronic search in databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the China National Knowledge Infrastructure, and System for Information on Grey Literature in Europe (SIGLE), was performed until August 2016. A manual search of relevant journals and reference lists of enrolled studies was conducted. The studies investigating the diagnostic accuracy of CBCT or PR for ERR, with simulated ERR as the reference test, were considered eligible. The diagnostic accuracy of CBCT and PR was statistically pooled using a bivariate model. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was used to test the stability of the overall results in the meta-analysis. Results: A total of 15 studies were included in this systematic review. The pooled results showed that CBCT had significantly higher sensitivity (0.89; 95% confidence interval [CI]: 0.77-0.96) and area under curve (0.96; 95% CI: 0.77-0.96) than PR (sensitivity: 0.68; 95% CI: 0.56-0.78; area under curve: 0.88; 95% CI: 0.85-0.90). No difference in sensitivity, specificity, and area under the curve between conventional and digital PR was observed. Conclusions: Currently available evidence suggests that CBCT could be reliable to detect the presence of ERR in clinical practice and has a higher diagnostic efficacy than PR. (Angle Orthod. 2017;87:328-337)
Background Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method. Objectives To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.
The high prevalence and heavy socioeconomic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an upto-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years' follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques. Caries is one of the most prevalent chronic diseases worldwide 1-5. Approximately 2.4 billion people, accounting for 35% of the world population, are affected by untreated caries 1,2. Though enormous public resources have been poured into caries prevention, the global prevalence of untreated caries remained stagnant during the last decades 1. Untreated caries can be much burdensome socioeconomically 3-5. The economic loss thereof amounts to hundreds of billions of dollars every year 3. As a matter of fact, the high prevalence associated with heavy disease burden make caries prevention a major public health goal. First permanent molars (FPMs) are of great significance to caries prevention 6,7. Decay of FPMs constitutes the biggest component of decayed missing filled tooth index (DMFT) among children and adolescents 8,9. As well as being highly prevalent, caries of FPMs also imposes an overwhelming disease burden. FPMs are the keys to establish permanent occlusion 10. Severe FPMs caries often cause pain and infection, diminished dietary intake and malocclusion 1,8-10. At present, two techniques, namely fluoride varnish (FV) and fissure sealant (FS), are introduced to prevent caries of FPMs, both proved effective 11,12. However, it still cannot be concluded clearly which of these two skills is clinically superior. Current practice guidelines recommend a preference for FS over FV 6,7. This recommendation was supported by two very recent systematic reviews. Meta-analysis of them favored FS rather than FV with statistical significance 6,7. But the evidences of these two studies were assessed as weak (Details of their limitations will be identified and discussed below). Besides, a large-scale, high-qualified RCT updated recently showed that ther...
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