Evidence-based dentistry最新文献

{"title":"Are antibiotics overprescribed for apical periodontitis in dental practice?","authors":"Huda Moutaz Asmael Al-Azzawi","doi":"10.1038/s41432-024-01076-6","DOIUrl":"10.1038/s41432-024-01076-6","url":null,"abstract":"There is a discrepancy in the databases and data sources mentioned by the authors. The abstract references four databases, which differ from those listed in the materials and methods section. According to the methods, the literature search was conducted across three databases: PubMed-MEDLINE, EMBASE, and Scielo. However, the abstract mentions four databases, including MEDLINE/PubMed, Wiley Online Database, Web of Science, and Scopus. All relevant articles were searched using specific keywords derived from Medical Subject Headings (MeSH) terms and text words (TW) related to the topic. Following the screening of titles and abstracts, the full texts of the selected studies were reviewed, and inclusion and exclusion criteria were applied. Any disagreements regarding study inclusion were resolved by consensus. Studies that reported data on antibiotic prescription patterns by dentists for the treatment of apical disease were included. Data extraction was carried out by three independent reviewers, with a fourth author resolving any disagreements. Extracted data included publication details (authors, year of publication), number of respondents, response rate, survey location, and prescriber type (general practitioner, endodontist, or dental surgeon). The primary outcome measured was the percentage of dentists prescribing antibiotics for each form of periapical endodontic disease. The search strategy identified a total of 96 studies, of which 39 cross-sectional studies met the inclusion criteria. Dentists prescribed antibiotics in 25.8% of cases of symptomatic apical periodontitis (AP) and in 31.5% of asymptomatic AP cases. In instances of acute symptomatic apical abscess with swelling and moderate to severe symptoms, approximately 89% of dentists prescribed antibiotics, compared to nearly 100% of endodontists. Endodontists demonstrate more appropriate antibiotic-prescribing practices than general practitioners. Globally, dentists tend to over-prescribe antibiotics for managing apical disease. Therefore, there is a pressing need to enhance antibiotic prescribing practices in the treatment of endodontic infections.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"188-189"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01076-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544570","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":"Guided bone regeneration improves defect fill and reconstructive outcomes in 3-wall peri-implantitis defects.","authors":"Kelvin I Afrashtehfar, Hayam A Alfallaj, Eduardo Fernandez, Souheil Hussaini","doi":"10.1038/s41432-024-01073-9","DOIUrl":"https://doi.org/10.1038/s41432-024-01073-9","url":null,"abstract":"<p><strong>Design: </strong>This multi-center, randomized clinical trial compared the long-term outcomes of guided bone regeneration (GBR) with open flap debridement (OFD) in treating peri-implantitis-related bony defects with ≥3 osseous walls over 36 months. The study aimed to evaluate the healing potential of GBR using a deproteinized bovine bone mineral (DBBM) graft and native bilayer collagen membrane (NBCM) compared to OFD without the use of graft materials.</p><p><strong>Case selection: </strong>Sixty-six individuals diagnosed with peri-implantitis were randomly assigned to either GBR (34 patients) or OFD (32 patients). The OFD group served as the control, where inflamed tissue was removed and the implant surface decontaminated using 3% hydrogen peroxide, but no bone graft was placed. The GBR group received DBBM and NBCM for defect reconstruction. Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUP), mucosal recession (MREC), and patient-reported outcomes (PROs) were assessed over the study duration. Post-surgical care included azithromycin, ibuprofen, and chlorhexidine rinses.</p><p><strong>Study timeline: </strong>The study involved baseline assessments, surgical interventions, and follow-ups at 6, 12, and 36 months. Supportive peri-implant therapy was provided every 3 months during the additional 24-month follow-up.</p><p><strong>Data analysis: </strong>Primary outcome was RDF at 36 months. Secondary outcomes included PPD, BOP, SUP, MREC, and PROs. Descriptive statistics and ANCOVA models were used for analysis.</p><p><strong>Results: </strong>At 36 months, GBR resulted in a mean RDF of 2.13  ±  1.26 mm, compared to 1.64  ±  1.54 mm with OFD (p  =  .18). No significant differences were found in PPD, BOP, SUP, REC, or PROs between the groups. Treatment success (defined as no additional bone loss, PPD ≤ 5 mm, no BOP, and no SUP) was achieved in 46.2% of GBR cases and 20% of OFD cases (p = 0.053).</p><p><strong>Conclusions: </strong>GBR provided improved short-term defect fill and higher treatment success compared to OFD, although the differences were not statistically significant. Both procedures maintained clinical parameters over 36 months, with similar patient satisfaction (PROs) observed for GBR and OFD. The adjunct use of DBBM and NBCM may offer clinical benefits for peri-implantitis cases with specific bony defect morphology.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461487","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":"Does achieving apical patency increase postoperative pain during endodontics?","authors":"Rachel Strickland, Luca Licheri, David Edwards","doi":"10.1038/s41432-024-01058-8","DOIUrl":"https://doi.org/10.1038/s41432-024-01058-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature up to May 2023. Twelve studies were included for meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;Two authors screened databases to identify suitable studies, with a third investigator resolving disagreements. Inclusion criteria were randomized controlled trials (RCTs) involving individuals without systemic diseases, who underwent root canal treatment in a permanent tooth with or without apical patency. Outcomes included pain, number of patients with pain and analgesic use. Exclusion criteria included patients who had undergone tooth extraction, incomplete data reports and studies which were not RCTs. There were no limits on publication language. A search of PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from Google Scholar, ProQuest, OpenAire, and BASE identified 92 articles until May 2023. After removing 42 duplicates, 50 article full texts were assessed. Ultimately, 12 studies were included, seven of which were new relative to previous systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;Data were analysed using RevMan 5.4 software. Dichotomous categorical data were analysed through the Cochran-Mantel-Haenszel test, with the inverse variance method used for continuous data. Following assessment of heterogeneity with the χ&lt;sup&gt;2&lt;/sup&gt; test, fixed- or random- effects modeling was used. Pain scores were reported within one week by ten studies, but three were excluded from meta-analysis due to methodological issues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Studies involving participants aged 14-65 years, with pulp necrosis, apical periodontitis, or pulpitis, were included for analysis. Irrigation solutions varied from saline to sodium hypochlorite (2.25-5.25%), EDTA, citric acid, or chlorhexidine. Types of teeth treated included molars and anterior teeth. All studies used a 10# K-file for apical patency and various hand and nickel-titanium instruments for canal preparation. Generally, there was slightly reduced post-operative pain reported through the maintenance of patency. This was evident in the initial post-operative period of 24 h (OR = 1.69, P = 0.002), 1-day (MD = -1.69, P = 0.03) and 2-days (MD = -0.85, P = 0.04), but became non-significant over the remainder of the 7-day monitoring period. There was no significant difference in analgesic use between groups (OR = 0.82, P = 0.42). Studies were classified into three groups based on quality: four high quality with low risk of bias; three moderate quality with some concerns; and five low quality with high risk of bias. Evidence quality varied; pain scores on days 1 and 2 were of low quality, with very low quality for 12 h and days 3-6. High heterogeneity and imprecision were noted, especially in pain measurements and analgesic use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The meta-analysis indicates that during the initial post-operative pe","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399886","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":"Antibiotics for surgical site infections in patients undergoing orthognathic surgery","authors":"Vaibhav Sahni","doi":"10.1038/s41432-024-01072-w","DOIUrl":"10.1038/s41432-024-01072-w","url":null,"abstract":"PubMed, Embase, Web of Science and Scopus. Randomized Controlled Trials (RCTs) for patients undergoing orthognathic surgery of any type, which evaluated surgical site infections (SSI) in either: long-term (at least 2 days) post-surgical antibiotic dosing versus short term (one day) post-surgical dosing for the same drug; or Orthognathic surgery patients administered a post-surgical single-day antibiotic versus a singular pre-operative dosing of any antibiotic in the post-surgical phase. Singe-arm studies, retrospective studies, unpublished data, studies which were not peer-reviewed, editorials and trials not dealing with patients undergoing orthognathic surgery specifically were not included. Data for the publication year, primary author name, location of the study, antibiotic type, antibiotic protocol with its type, dosing and timing, sample size, protocol of the control group, male gender, age, diagnosis and rates of SSIs were extracted from the included studies. Pooled rates of SSIs were utilized to produce risk ratio (RR). A total of eleven RCTs met the inclusion criteria. As per the meta-analysis, post-orthognathic surgery SSI risk was reduced significantly as a result of long-term prophylactic antibiotic usage when compared to short-term utilization. Further, the meta-analysis demonstrated that there was a significant reduction of SSI risk in patients on a single day prophylactic antibiotic regimen in comparison to those on a single preoperative antibiotic dose. The study observed that long-term (2–7 days) prophylactic antibiotics reduce SSI risk when compared to antibiotic administration over a single day. In turn, it was also found that the latter was of greater benefit over a pre-operative single antibiotic dosage.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"184-185"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01072-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399885","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":"Can systemic antibiotics reduce the need for surgical intervention in treating peri-implantitis?","authors":"Nidhi Parmar","doi":"10.1038/s41432-024-01071-x","DOIUrl":"10.1038/s41432-024-01071-x","url":null,"abstract":"A retrospective cohort design was used to assess the long-term clinical effectiveness of systemic amoxicillin and metronidazole, used adjunctively with non-surgical peri-implantitis treatment (NST) and whether it prevents the need for further surgical interventions. Of the 57 peri-implantitis patients examined, 45 patients were included in this study. The participants were divided into two subgroups in accordance to who had received NST with or without systemic antibiotics. Selection was based on prior participation in a three-month randomised control trial, ensuring comparability of data regarding peri-implantitis severity and treatment history. Data were extracted pre-treatment, 3-months post-treatment and at a long-term follow-up interval of 36 months. The primary outcome was the need for additional surgical intervention and was analysed via Kaplan–Meier analysis and Cox regression. A multitude of secondary clinical outcomes were evaluated using parametric and non-parametric tests, including peri- implant probing depth, bleeding scores and treatment success. Overall, 62.2% of the 45 NST patients did not need surgical peri-implantitis treatment: 73.9% of the subgroup with antibiotics and 50% of the subgroup without antibiotics respectively. However, the difference between the two groups was not statistically significant (log-rank test, p = 0.110). The Cox regression analysis also displayed no significance over the first three years post-treatment (p = 0.115). Additionally, the study found that deeper peri- implant pockets at baseline significantly predicted the need for future surgical treatment (p = 0.031), highlighting the importance of initial disease severity in treatment outcomes. The study concludes that the adjunctive use of systemic amoxicillin and metronidazole with NST may delay but not statistically reduce or prevent a future surgical need. Although a short-term reduction in clinical inflammatory parameters was evident, the long-term effectiveness in altering the progression of peri-implantitis remains limited.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"182-183"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01071-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389137","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":"Are prophylactic antibiotics effective in preventing osteoradionecrosis after high-risk dental extractions?","authors":"Omer Waleed Majid","doi":"10.1038/s41432-024-01068-6","DOIUrl":"10.1038/s41432-024-01068-6","url":null,"abstract":"A systematic review and meta-analysis. To assess and compare the effectiveness of different adjunctive treatments during tooth extraction in post-radiotherapy head and neck patients for preventing osteoradionecrosis (ORN). Two independent reviewers conducted an electronic search through PubMed, Embase, Cochrane Libraries, Scopus and Web of Science databases using relevant search terms. Additionally, references of relevant articles were manually searched for eligible studies. Included were full-length articles (randomized controlled trials (RCTs), clinical trials, or observational studies) published in English, reporting on ORN occurrence after dental extraction, with or without adjunctive interventions, in patients who had previous radiotherapy. Data extraction was similarly performed by two independent researchers. For quality assessment, bias in observational studies was evaluated using the ROBINS-I tool, while the RoB 2 tool was used for RCTs. One-arm meta-analyses estimated pooled ORN prevalence rates for different adjunctive treatments based on patient-level outcomes. For studies with direct comparisons between two modalities, pooled odds ratios for ORN were calculated using pairwise meta-analyses. This systematic review followed PRISMA guidelines and was registered in the PROSPERO database. A total of 29 studies with 1520 patients were included, comprising 4 RCTs, 4 prospective studies, and 21 retrospective observational studies. Five adjunctive treatment modalities around the time of dental extractions were identified: hyperbaric oxygen (HBO), pentoxifylline-tocopherol (PENTO), antibiotics (ABX), platelet-rich fibrin and photobiomodulation. Of the 25 observational studies included, 11 had a serious risk of bias, while all RCTs but 1 had low risk of bias. Egger’s test showed no publication bias for the HBO and ABX groups (p &gt; 0.05). Antibiotics were used in 17 studies, with significant variations in preoperative and postoperative protocols. Most studies utilized penicillin or clindamycin. The pooled prevalence of ORN was significantly lower in the HBO (4.6%), PENTO (3.4%), and ABX (3.8%) groups compared to the Control (17.6%), as indicated by the non-overlapping 95% CIs between the Control and any of the intervention groups. In studies with direct comparisons, HBO exhibited lower odds of developing ORN than the Control (odds ratio [OR] = 0.27) and ABX (OR = 0.57), although these differences were not statistically significant. HBO, PENTO, and ABX show similar reduction in ORN rates compared to no intervention. Given its cost-effectiveness and accessibility, ABX may be the most practical prophylactic modality at present.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"190-191"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01068-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307466","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":"How well do antibacterial sutures control microbial colonization after oral surgery?","authors":"Omer Waleed Majid","doi":"10.1038/s41432-024-01069-5","DOIUrl":"https://doi.org/10.1038/s41432-024-01069-5","url":null,"abstract":"<p><strong>Data sources: </strong>A literature search was conducted through PubMed and Scopus databases to identify articles published from January 2013 to May 2023, using appropriate search terms. There were no language restrictions. Additionally, reference lists of the included studies and key peer-reviewed journals in oral surgery were manually searched for further relevant studies.</p><p><strong>Study selection: </strong>Selection criteria targeted human clinical studies, including cohort studies, randomized clinical trials (RCTs), quasi-experimental studies, case reports, and case series that investigated the antimicrobial activity of antibacterial-coated sutures in oral surgery. Studies were excluded if they were in vitro, ex vivo, or animal studies, as well as if they were non-research or pre-print articles. Two authors independently selected studies, resolving disagreements through discussion or a third expert reviewer.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently extracted data, including author, year, country, study design, sample size, population, intervention, control, surgery type, suture removal time, methodology, main results, and additional information. Discrepancies were resolved through discussion or with input from a third reviewer. This study followed the PRISMA-ScR guidelines for scoping reviews.</p><p><strong>Results: </strong>Out of 150 identified articles, 129 abstracts were reviewed after removing duplicates, and 10 full-text articles were screened, resulting in the inclusion of 5 studies published between 2014 and 2019. Three were RCTs, with one using a split-mouth design, involving 10 to 40 patients aged 18 to 60 years, primarily healthy. The sutures were mostly braided and coated with triclosan or chlorhexidine, while control groups used various non-coated sutures. Suture removal times ranged from 3 to 8 days. Postoperative rinses were advised in two studies, with one study not administering antibiotics and unclear antibiotic use in others. Three studies reported significantly reduced bacterial counts with antimicrobial-coated sutures compared to non-coated ones, while two studies found no significant differences. Triclosan-coated sutures generally showed greater antimicrobial activity, though results varied.</p><p><strong>Conclusion: </strong>Antibacterial-coated sutures in oral surgery showed reduced bacterial retention compared to non-coated sutures. However, methodological variability, small sample sizes, and confounding factors limit the generalizability and reliability of these findings. High-quality RCTs with larger sample sizes are needed for more definitive conclusions. While antibacterial-coated sutures show promise in reducing microbial colonization and potentially improving surgical outcomes, their cost-effectiveness relative to non-coated sutures should be evaluated in larger clinical trials.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307467","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":"Nicotine replacement therapy and oral health: a network meta-analysis of adverse effects in randomized trials","authors":"Gowri Sivaramakrishnan, Kannan Sridharan","doi":"10.1038/s41432-024-01064-w","DOIUrl":"https://doi.org/10.1038/s41432-024-01064-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Nicotine replacement therapies (NRTs) are the primary pharmacological option for smokers looking to quit. However, they can lead to oral health issues, including aphthous ulcers, gastric irritation resulting in tooth wear, mouth irritation, soreness, and dryness, which may decrease patient adherence. Dentists should be integrated into the tobacco cessation team to prevent, detect, and manage these oral side effects associated with NRT use. Therefore, the objective of this network meta-analysis is to examine the relationship between different forms of NRTs and their oral side effects.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>Databases were screened for literature and full text articles were obtained for eligible studies. Relevant data was extracted. NMA Studio was used to perform random-effects network meta-analysis to generate mixed treatment comparison pooled estimates from odds ratios (OR) and 95% confidence intervals (CI). The forest plot was generated, and the network diagram was drawn for key comparisons. The OR and 95% CI were estimated from the data on the number of patients that reported the oral side effects in the included studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 21 articles were included. The Risk of Bias assessment revealed a moderate to low risk across all domains for the included studies. The mixed treatment comparison pooled estimates indicated that nicotine gum was significantly associated with the occurrence of aphthous ulcers [2.25 (1.03, 4.90)] and gastric reflux/vomiting [4.40 (1.51, 12.80)]. Additionally, the results showed that nasal spray significantly caused mouth/throat irritation [5.37 (1.03, 27.92)] and taste disturbance [4.87 (2.83, 8.37)] in comparison to tested NRT interventions.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Significant oral side effects are associated with NRT use, as demonstrated in this study. Dentists should implement tobacco cessation methods in their practices, including pharmacotherapy, to effectively monitor these patients. Continuous education and certification programs should be mandatory for dentists who want to practice tobacco cessation. This should also be included in the undergraduate dental curriculum to help dentists gain confidence in prescribing NRT. Standard evidence-based guidelines should be published to outline possible methods for encouraging tobacco cessation in dental settings.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255444","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":"Similar short-term outcomes for bone-level implants with or without intermediate abutments","authors":"Kelvin I. Afrashtehfar, Carlos A. Jurado, Shatha S. R. H. Alnuaimi, Sultan M. S. Alhadhrami","doi":"10.1038/s41432-024-01065-9","DOIUrl":"https://doi.org/10.1038/s41432-024-01065-9","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Design&lt;/h3&gt;&lt;p&gt;A single-center (university-setting), prospective, longitudinal, split-mouth, single-blind, randomized controlled clinical trial investigated peri-implant parameters of bone-level implants restored with either screw-retained prostheses connected directly to the implants or with intermediate abutments over a 3-year period. The study adhered to the ethical principles of the Helsinki Declaration and the CONSORT guidelines. Ethical approval was granted, and the trial was registered at Clinicaltrials.gov.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Case selection&lt;/h3&gt;&lt;p&gt;Participants included were over 18 years of age, had a plaque index below 25%, and were missing at least two adjacent teeth, allowing for rehabilitation with screw-retained fixed partial prostheses over two implants and 2–4 prosthetic units. Exclusion criteria included long-term use of medications affecting bone metabolism, smoking more than 10 cigarettes per day, history of local radiotherapy, untreated periodontitis, and the need for rehabilitation in the anterior sextant of the maxilla. The primary clinical outcome was marginal bone loss (MBL), while secondary outcomes included probing pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), and patient-reported outcomes (PROs).&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Study timeline&lt;/h3&gt;&lt;p&gt;The study schedule included a screening (visit 1), implant surgery (visit 2), stage-two 8 weeks post-surgery (visit 3), impressions taken 4 weeks post stage-two (visit 4), baseline standardized radiograph (visit 5), followed by 6-month (visit 6), 12-month (visit 7), and 36-month (visit 8) follow-up visits.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Data analysis&lt;/h3&gt;&lt;p&gt;Descriptive statistics and quantitative measures included means, standard deviations (SDs), minimum and maximum values, and 95% confidence intervals (CIs). Clinical parameters (six sites per implant) measured were MBL, PPD, PI, and BOP. Paired &lt;i&gt;t&lt;/i&gt; tests were utilized for intragroup comparisons across different time points and intergroup comparisons at each time point. PROs at 36 months were compared using Student’s &lt;i&gt;t&lt;/i&gt; test. The alpha significance level was set at 0.05.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;The study included 36 patients (72 implants), with two not completing the follow-up due to death and relocation. No implants showed signs of inflammation or mobility. Mean interproximal bone level (IBL) at baseline was 0.13 mm ± 0.15 mm for the control group and 0.10 ± 0.13 mm for the test group. At the 36-month follow-up, mean IBL was 0.13 ± 0.18 mm for the control group and 0.20 ± 0.24 mm for the test group, with no significant differences (F(1, 32) = 1.06; p &gt; 0.05). Clinical parameters (PPD, BOP, PI) at 36 months showed no significant differences between groups. Minor complications occurred in 6.7% of the control group and 5.3% of the test group. PROs indicated no significant differences in gen","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255477","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":"From prescription to protection: combating antimicrobial resistance in dental practice","authors":"Kamran Ali","doi":"10.1038/s41432-024-01063-x","DOIUrl":"10.1038/s41432-024-01063-x","url":null,"abstract":"","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"25 4","pages":"171-172"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41432-024-01063-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268885","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}