Evidence-based dentistry最新文献

{"title":"Fibre or facade? Do fibre reinforced composites really hold up in Class II restorations?","authors":"Celine Raseekaanthan, Pirashani Umassudan","doi":"10.1038/s41432-025-01184-x","DOIUrl":"10.1038/s41432-025-01184-x","url":null,"abstract":"Mohamed M H, Abouauf E A, Mosallam R S. Clinical performance of class II MOD fiber reinforced resin composite restorations: an 18-month randomized controlled clinical trial. BMC Oral Health 2025;25: 159. https://doi.org/10.1186/s12903-025-05521-5 . A double blinded 18-month randomised controlled trial was carried out to compare the clinical performance of fibre reinforced resin composites compared to conventional nanohybrid resin composites in restoring Class II MOD cavities. Participants were allocated to one of three groups: Group 1 with short glass fibre reinforced resin composite, Group 2 with polyethylene fibre reinforced resin composite and Group 3 with conventional nanohybrid resin composite. A principal investigator carried out the restorative procedures for all participants. Participants in the study were enrolled from the educational clinic in Cairo University, Egypt. A total of 45 participants with a mean age of 32.3 ± 7.3 years were included. All participants had class II MOD carious lesions in vital posterior teeth with ICDAS scores of 3,4 or 5. Additionally only those with good oral hygiene, a healthy periodontal status and normal occlusion were included. The study excluded pregnant patients, as well as those with systemic disease or evidence of parafunctional habits. Patients with hypersensitivity, allergy to materials used, secondary caries or delayed response to sensibility testing were also excluded. Outcomes were assessed by two examiners at the baseline and at the following time intervals: 3, 6, 12, 18 months using Modified USPHS criteria. The primary outcome assessed was marginal adaptation, followed by gross fracture, marginal discolouration, colour match and recurrent caries. The clinical significance was determined based on relative risk. The chi-Square test compared between groups with significance set at P ≤ 0.016, and Cochran’s Q test compared within groups with significance at P ≤ 0.005, both adjusted using Bonferroni correction. The study was conducted with a 95% confidence level and an 80% statistical power. The study had a 97.7% retention rate with all but one patient successfully completing the 18 month follow up period. Colour match was the only outcome that showed a statistically significant difference between the groups, with short glass fibre reinforced restorations displaying some colour discrepancies. Other outcomes such as marginal adaptation, marginal discoloration, recurrent caries and gross fracture showed no significant differences between groups. Age, gender and tooth distribution also showed no significant statistical differences. The clinical performance of fibre-reinforced resin composite restorations are similar and comparable to nanohybrid composite restorations over an 18-month duration. Short glass fibre-reinforced restorations displayed variations in colour match, indicating that aesthetic outcomes should be carefully considered.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"144-145"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We still need to bridge the gap","authors":"Mona Nasser","doi":"10.1038/s41432-025-01183-y","DOIUrl":"10.1038/s41432-025-01183-y","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"121-122"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01183-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matters of the heart; antibiotic prophylaxis for prevention of infective endocarditis—are we getting it right?","authors":"Rosie Fletcher, Adam Jones","doi":"10.1038/s41432-025-01185-w","DOIUrl":"10.1038/s41432-025-01185-w","url":null,"abstract":"Sperotto F, France K, Gobbo M et al. Antibiotic prophylaxis and infective endocarditis incidence following invasive dental procedures: a systematic review and meta-analysis. JAMA Cardiol 2024; 9:599. https://doi.org/10.1001/jamacardio.2024.0873 . This systematic review evaluates the association between antibiotic prophylaxis (AP) and the incidence of infective endocarditis (IE) following invasive dental procedures (IDPs). A systematic search was conducted across PubMed, Cochrane-CENTRAL, Scopus, Web of Science, Proquest, and Embase, from inception to May 2023. Observational studies, including case-control, case-crossover, cohort, self-controlled case-series, and time-trend studies were included. Data were extracted independently, and structured tools were used to evaluate study quality. A random-effects meta-analysis estimated the pooled-relative risk (RR) of developing IE in high-risk subjects who received AP compared to those who did not. Of 11,217 identified records, 30 studies met inclusion criteria, comprising 1,152,345 IE cases. Among 12 relevant studies, five found a significant protective effect of AP in high-risk subjects. Four studies were combined in meta-analysis and showed AP was associated with a significantly lower IE risk in high-risk individuals (pooled-RR = 0.41, 95% CI: 0.29–0.57). No significant association was found for moderate- or low/unknown-risk subjects. Time-trend studies showed mixed results: some indicated increased IE incidence after AP guideline changes, while others found no change or a decrease. Despite limitations, this review provides an important update on AP use in preventing IE after IDPs. Evidence supports AP use for high-risk individuals, while data remain inconclusive for moderate-risk populations, highlighting the need for further research.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"141-143"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01185-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the relationship between empathy and burnout in dental students: a systematic review.","authors":"Sviatlana Anishchuk, Aidan Seery","doi":"10.1038/s41432-025-01182-z","DOIUrl":"https://doi.org/10.1038/s41432-025-01182-z","url":null,"abstract":"<p><strong>Objectives: </strong>Empathy has an important role in the patient-clinician relationship. However, there is a risk of an emotional overabundance, which can lead to a burnout and exhaustion. The nature of its relationship is yet not clear. This study aims to investigate the relationship between empathy and burnout in dental undergraduate students.</p><p><strong>Methods: </strong>A systematic review was carried out in accordance with Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) using electronic searches on electronic databases: PubMed (PMC), Taylor and Francis, Google Scholar and EBSCO. The databases were examined for studies that were published in English language from 2012 to 2022.</p><p><strong>Results: </strong>There were 2375 articles in total. The studies that only assessed empathy or burnout and targeted other than dental cohorts were excluded from the list. Any studies that were not in English language and had been published before 2012 were also excluded. As a result, only 2 studies were selected for further analysis.</p><p><strong>Conclusion: </strong>Based on this review it can be assumed that the level of burnout depends on the level of empathy in dental cohort students; low empathy can predict high burnout. However, further research is necessary to confirm this relationship.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supervised toothbrushing programs: evaluating impact, barriers, and facilitators - a mixed-method umbrella review.","authors":"Chandrashekar Janakiram, Anju James, Sujay Vivek Vattiprolu, Nitika Monga, Monika Arora","doi":"10.1038/s41432-025-01178-9","DOIUrl":"10.1038/s41432-025-01178-9","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of supervised toothbrushing programs in improving oral health outcomes among children and adolescents aged 3 to 18 years and to explore stakeholders' perceptions in implementing and sustaining tooth brushing programs.</p><p><strong>Methods: </strong>This mixed-method umbrella review followed JBI methodology and PRISMA guidelines. A systematic search was conducted across databases including MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, Epistemonikos, ProQuest, and Google Scholar. A total of 159 articles were identified, and after screening, three systematic reviews met the inclusion criteria. The quantitative and qualitative findings were synthesized using a convergent segregated approach. The Theoretical Domains Framework (TDF) was applied to map barriers and facilitators influencing program adoption and sustainability.</p><p><strong>Results: </strong>The quantitative synthesis included one systematic review with four included trials, two of which found statistically significant reductions in dental caries with supervised toothbrushing. The qualitative synthesis (two mixed-method systematic reviews) revealed key facilitators and barriers. The most prominent enablers and barriers identified across these reviews were knowledge about oral health/tooth brushing, social influences, and environmental context and resources. Specifically, the knowledge domain received 32 enabler responses and 25 barrier responses, underscoring the importance of understanding oral health practices to improve toothbrushing behavior. Social support garnered 35 enabler responses and 26 barrier responses, highlighting the role of a supportive environment in enhancing adherence to toothbrushing routines.</p><p><strong>Conclusion: </strong>This review highlights the effectiveness of supervised toothbrushing programs in reducing dental caries. The qualitative synthesis, guided by the Theoretical Domains Framework (TDF), identifies key barriers and facilitators, including knowledge gaps, environmental constraints, social influences, and behavioural regulation factors.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can AI find the cavities in caries prediction and diagnosis?","authors":"Lucy Bennett,&nbsp;Lucy Tiplady,&nbsp;Greig Taylor","doi":"10.1038/s41432-025-01181-0","DOIUrl":"10.1038/s41432-025-01181-0","url":null,"abstract":"Rokhshad R, Banakar M, Shobeiri, P, Zhang P. Artificial intelligence in early childhood caries detection and prediction: a systematic review and meta-analysis. Pediatr Dent. 2024;46:385–394. A literature search was performed in May 2024 via PubMed, Scopus, Embase, Web of Science, Institute of Electrical and Electronics Engineer database sources, and across the grey literature. Further studies were identified after analysis of reference lists. The research question was defined using the population-intervention-comparison-outcome (PICO) framework. Studies published between 2010 and 2024 were included, that used artificial intelligence (AI) algorithms including machine learning (ML), deep learning (DL) and neutral networks (NN) for detecting and predicting early childhood caries (ECC). Exclusion occurred where the full text was inaccessible and non-English papers. Two independent reviewers screened titles and abstracts, with the use of a third reviewer in the case of any disagreement. The process was then repeated with the full texts to assess eligibility, again with a third reviewer where necessary. A total of 21 studies were used in the final analysis following assessment, 7 of which described ECC detection, and 14 for ECC prediction. The extracted data included author, publication year, study objectives, data modalities, datasets, annotation procedures, follow ups, ML test, AI model architecture, outcome measures and evaluation metrics. The findings were summarised descriptively. Quantitative synthesis was performed on six studies that reported sensitivity and specificity. Summary receiver operator characteristic curves were used to assess discriminatory ability. Statistical analysis was completed. A total of 21 studies were included in the final analysis. It revealed that AI based methods, especially DL algorithms showed promising results in detecting ECC, with accuracy range of 78–86%, sensitivity of 67–96%, and specificity from 81–99%. ECC prediction had accuracy range of 60-100%, sensitivity of 20–100%, and specificity of 54–94%. The pooled sensitivity and specificity of these studies was 80% and 81% respectively, with confidence intervals of 95%, indicating statistically significant effects. AI has demonstrated substantial potential in the detection and prediction of ECC. Further research is required to refine the technology and establish its application in paediatric dentistry.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"139-140"},"PeriodicalIF":2.3,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01181-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating YOLO for dental caries diagnosis: a systematic review and meta-analysis.","authors":"Quang Tuan Lam, Minh Huu Nhat Le, I-Ta Lee, Nguyen Quoc Khanh Le","doi":"10.1038/s41432-025-01180-1","DOIUrl":"https://doi.org/10.1038/s41432-025-01180-1","url":null,"abstract":"<p><strong>Objectives: </strong>Recent advancements in the You Only Look Once (YOLO) algorithm show promise for dental caries diagnosis. We aimed to evaluate the diagnostic performance of different YOLO versions using photographic and radiographic images for caries detection.</p><p><strong>Methods: </strong>We searched PubMed (MEDLINE), EMBASE, Web of Science, and Scopus for studies up to December 12, 2024. Studies using any YOLO version for caries detection were included. Binary diagnostic accuracy data were extracted to calculate pooled sensitivity, specificity, and area under the curve (AUC) using a bivariate random-effects model. Quality was assessed with QUADAS-2 and the Radiomics Quality Score (RQS). This review is registered in PROSPERO (CRD42024615440).</p><p><strong>Results: </strong>We included 15 studies in the systematic review and 14 in the meta-analysis. Overall, YOLO-based models achieved a pooled sensitivity of 79.3% and specificity of 84.9%, with an AUC of 0.832. YOLO using radiographic images demonstrated higher specificity (92.5% vs 72.0%) and AUC (0.847 vs 0.735) than using photographic images, while sensitivity was similar (78.6% vs 80.0%). Differences between YOLO versions (v5 and earlier vs v6 and later) and the use of external validation did not significantly affect diagnostic accuracy.</p><p><strong>Discussion: </strong>Radiograph-based YOLO models showed superior specificity to photograph-based models, reflecting the higher diagnostic detail of radiographs. However, photographic approaches are completely radiation-free and more accessible, which could benefit screening in low-resource settings. Newer YOLO versions did not significantly outperform older versions, likely due to the limited complexity of the task and dataset constraints in current studies.</p><p><strong>Conclusions: </strong>YOLO algorithms provide a reliable tool for dental caries detection. Radiograph imaging combined with YOLO offers enhanced diagnostic specificity, while even older YOLO versions remain effective for caries detection in practice.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between selective serotonin reuptake inhibitors and the periodontal status: a systematic review and meta-analysis of observational clinical studies.","authors":"Liana Rita Nicole Umbrio, Hieu Michael Pham, Abdul B Barmak, Nasser Assery, Elli Anna Kotsailidi","doi":"10.1038/s41432-025-01179-8","DOIUrl":"https://doi.org/10.1038/s41432-025-01179-8","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on periodontal status through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>Nine databases were searched for clinical studies up to September 2024 to identify clinical studies comparing periodontal parameters such as probing depth (PD), clinical attachment level (CAL), marginal bone level (MBL), and gingival and plaque indices (GI and PI) between SSRI-users and non-users. Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Random-effects meta-analyses of mean differences (MD) were performed. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of available evidence.</p><p><strong>Results: </strong>Five cross-sectional studies, including a total of 1254 patients (54.15% females) and 13170 teeth, were included. The use of SSRIs was significantly associated with inferior MBL (MD, 0.10; 95% confidence interval, 0.01 to 0.20) compared to non-users. No significant differences were observed in PD, CAL, and GI between SSRI-users and non-users. The overall quality of evidence was low, and all studies presented a moderate risk of bias.</p><p><strong>Conclusions: </strong>Based on a low level of available scientific evidence, the use of SSRIs has a marginal yet significant effect on MBL. However, there is no direct association between SSRIs usage and periodontal parameters such as PD, CAL, and GI. Nonetheless, further research is warranted.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental science for the medical professional: an evidence-based approach.","authors":"StJohn Crean","doi":"10.1038/s41432-025-01174-z","DOIUrl":"https://doi.org/10.1038/s41432-025-01174-z","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth brushing learning methods: time to change practice?","authors":"Patrick Quinn,&nbsp;Mairead Harding","doi":"10.1038/s41432-025-01175-y","DOIUrl":"10.1038/s41432-025-01175-y","url":null,"abstract":"Leghrouz L, Khole M R, Splieth C H, Schmoekel J. Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial. Caries Res 2024; 58: 399–406. A two-arm single-blinded randomised controlled clinical trial to investigate the effects of the differential learning method versus conventional tooth brushing instruction by assessing changes in plaque levels and gingivitis in children aged three to eight years. Children aged three to eight years with poor oral hygiene at baseline, needing parental assistance with tooth brushing, and available to attend follow-up appointments were included in the study. Exclusion criteria included children with acute dental pain, those with serious systemic diseases requiring special attention during dental care, and those who refused to participate in the study. Participants were randomly assigned to the test and control groups by self-drawing an unlabelled envelope from a box. The sealed envelopes contained oral hygiene instructions with exercises to use the differential learning method for the test group and children in the control group received the usual tooth brushing instructions. Participants were asked to follow the instructions at home for 28 days. The sample size was calculated according to previous similar oral hygiene studies, with a final sample size of 29 participants in each group to allow for dropouts of approximately 30%. Data was analysed using Microsoft Excel, with the significance threshold set at p &lt; 0.05. Descriptive analysis included the calculation of means, standard deviation, absolute numbers, and percentages. Comparisons between the two groups were made using the independent samples t-test for quantitative variables and the chi-squared test for categorical variables. Two calibrated and blinded examiners recorded the papillary bleeding index (PBI) and the Quigley-Hein Index for dental plaque (QHI) at baseline and at the first and second recall visits at four and twelve weeks respectively. Of the 58 children recruited for the study, 46 were included in the final analysis with 22 in the control group and 24 in the test group. At baseline, there were no significant differences between the groups with respect to plaque and gingival indices. At the first recall, a statistically significant difference in the PBI index was found in favour of the test group (test: 0.1 ± 0.2 v. control: 0.3 ± 0.2; p &lt; 0.001) but the difference in relation to the QHI index was not statistically significant (test: 2.1 ± 0.9 v. control 2.6 ± 0.9; p = 0.07). At the second recall, statistically significant differences in both indices were found in favour of the test group (PBI test: 0.1 ± 0.2 v. PBI control: 0.5 ± 0.2; p &lt; 0.001; QHI test: 2.1 ± 0.9 v. QHI control: 3.2 ± 1; p &lt; 0.001). The authors of the study concluded that simple instructions with the differential learning method for home tooth brushing can lead to significantly greater improvements in oral hygiene in chi","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"135-136"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41432-025-01175-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}