Objective To estimate the association between smoking and Schneiderian membrane perforation in sinus floor augmentation. Materials and methods Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Data were extracted by two authors independently. The inclusion criteria were the (1) age of patients >18, (2) the number of participants >10, and (3) smoking and the patients of Schneiderian membrane perforation were accurately recorded. The risk of bias was assessed by the Newcastle–Ottawa scale (NOS). Statistics analyses were conducted using Reman5.4.1 and Stata (15.0). The association of Schneiderian membrane perforation with smoking habits during maxillary sinus floor elevation was expressed as odds ratios (ORs) with a 95% confidence interval (95% CIs). And the I2 statistic was used to estimate statistical heterogeneity. The funnel plot and Egger's tests were used to evaluate the reliability and stability of the results. Results Of 1463 articles screened, nine studies were included in our systematic review, and eight were synthesized for meta‐analysis. Eight were retrospective observational studies and one was a clinical trial, with a total of 1424 patients included. The nine studies were proved as high quality according to the NOS. There was no significant publication bias in the studies (p = 0.827). A random‐effects model was used because of differences in the adopted methodologies (p = 0.39, I2 = 5%). During maxillary sinus augmentation, smoking and Schneiderian membrane perforation were associated (odds ratios, 1.58 [95% CI, 1.10–2.25]). Conclusion Smoking increased the risk of membrane perforation in maxillary sinus floor augmentation. Our evaluation was limited by the poor reporting of the number of cigarettes smoked per day (PROSPERO number was CRD42022306570).
Background Temporomandibular joint disorders (TMD) is the most common non-dental pain complaint in the maxillofacial region, which presents a variety of symptoms and signs, including temporomandibular joints (TMJ) and masticatory muscle pain, joint noise, tinnitus, headaches, irregular or restricted mandibular function, masticatory difficulty, and restricted mouth opening. When comes to the relationship between obesity and TMD, it has remained controversial and inconsistent, therefore, we first conducted this meta-analysis to estimate the unclear relationship between obesity and TMD.Methods Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Subjects were divided into five groups according to BMI level in this study, including the normal weight group: 18.5 ≤ BMI < 23, obesity Ⅰ group: 25 ≤ BMI < 30, obesity Ⅱ group: BMI ≥ 30, non-obesity group: BMI < 25, and obesity group: BMI ≥ 25. Statistics analyses were conducted using Stata (15.0). The number of PROSPERO was CRD42022368315.Results Eight studies were included in this study, and six articles with a total of 74056 participants were synthesized for meta-analysis. Compared to normal weight individuals, the obesity Ⅰ decreased the risk of TMD (OR = 0.80, 95%CI = 0.69–0.94), and it was significantly decreased by obesity Ⅱ (OR = 0.74, 95%CI = 0.56–0.97). Moreover, it was lower in obesity compared with non-obese subjects (OR = 0.83, 95% CI = 0.73–0.94). Furthermore, in obese individuals, it was much lower in obesity Ⅱ than obesity Ⅰ (OR = 0.82, 95% CI = 0.71–0.94).Conclusions Obesity is not a risk factor for TMD, and maybe a protective factor for TMD, of which patients with larger BMI are less likely to suffer from TMD pain. Therefore, the value of BMI should be taken into consideration in the assessment of TMD.
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