Evidence-based dentistry
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Evidence-based dentistry · Jun 2019
CommentWhat are the best materials to use for the first arch wire in orthodontic treatment?
Data sources Six electronic databases/registries including Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Oral Health's Trials Register, Embase, World Health Organization International Clinical Trials Registry Platform and The US National Institutes of Health Trials Registry (ClinicalTrials.gov) were searched up to October 2017. No restrictions of language or publication date were set. Study selection Only randomised controlled trials (RCTs) assessing the efficiency of initial arch wires to align teeth with fixed orthodontic braces in either or both upper and lower arches. ⋯ TNT). The first one did not show meaningful differences while in the second insufficient evidence was identified. Conclusions In general terms there is insufficient evidence that any particular material is clinically superior to any other in regards to alignment rate, pain or root resorption.
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Evidence-based dentistry · Jun 2018
Meta AnalysisNon-pharmacological pain relief during orthodontic treatment.
Data sourcesA comprehensive literature search in all languages was carried out. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (till 6 October 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2016, Issue 9), MEDLINE Ovid (1946 till October 6th, 2016), Embase Ovid (1980 till October 6th, 2016) and EThOS (till October 6th, 2016). ⋯ Authors were contacted to clarify study information. Study selectionThe inclusion criteria of studies were defined as patients undergoing orthodontic treatment, up to 18 years of age.
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Data sourcesMedline via PubMed, the Web of Science and the Cochrane Library were searched until April 2014. Study selectionRandomised controlled trials (RCTs) comparing the efficacy of botulinum toxin type A (BoTN-A) with placebo in patients with painful trigeminal (TN) and postherpetic neuralgia (PHN) reporting changes in pain intensity in patients aged 19 years and older available in English were included. Data extraction and synthesisThree authors independently assessed for inclusion, extracted standard data and assessed for risk of bias. ⋯ Standardised difference in mean post treatment pain (six studies) was -0.918 (95% CI -1.197 to -0.639 p<0.001) in favor of BoTN-A. For the percentage of patients experiencing 50% pain reduction (three studies) absolute risk difference and relative risk were calculated (RR 2.892, 95% CI 1.726 to 4.848 p<0.001) in favour of the use of BoTN-A. ConclusionsThe authors concluded that there is moderate evidence regarding the efficacy of BoTN-A in treating patients with trigeminal neuralgia and postherpetic neuralgia.
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Evidence-based dentistry · Dec 2017
CommentOral care with chlorhexidine seems effective for reducing the incidence of ventilator-associated pneumonia.
Data sourcesElectronic databases searched were Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Ovid, Embassy Ovid, LILACS BIREME Virtual Health Library, CINAHL EBSCO, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Database and VIP Database ClinicalTrials.gov and the World Health Organisation International Clinical Trials Registry Platform for ongoing trials. No restrictions on language or date of publication. Study selectionRandomised controlled trials (RCTs) were included evaluating OHC in the form of mouthwashes, swabs or toothbrushing or in combination in critically ill patients receiving mechanical ventilation. ⋯ There is no evidence that OHC including both antiseptics and toothbrushing is different from OHC with antiseptics alone, and some weak evidence to suggest that povidone iodine mouthrinse is more effective than saline/placebo, and saline rinse is more effective than saline swab in reducing VAP. There is insufficient evidence to determine whether powered toothbrushing or other oral care solutions are effective in reducing VAP. There is also insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.
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Evidence-based dentistry · Mar 2017
Review Comparative StudyTo cord or not to cord? That is still a question.
Data sourcesA broad computerised search with similar key terms was performed in different databases that included: Ovid Medline, Thomson's ISI Web of Science, PubMed, Science Direct, EMBASE and the Cochrane Library. Grey literature, dissertations, abstracts and theses were searched too. Reference lists of the selected articles were hand-searched. ⋯ The review supports the observation that gingival retraction paste can more effectively help to achieve a dry field and at the same time be less injurious to soft tissues, however its ability to displace gingival tissues, compared to retraction cord, was compromising. Rather than considering the cost of material or the individual preference of the operator, choosing the right technique to maximise clinical efficiency should be based on scientific evidence. It seems that impregnated gingival cords are more effective on thick gingival tissue whereas paste is more effective when minimal retraction is required for haemostasis control, preservation of the gingiva and less tissue displacement.