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This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of interventions for: preventing or treating denture stomatitis; treating denture stomatitis.

Data sourcesThe electronic databases searched included The Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (Central), MEDLINE via Ovid, PsycINFO via Ovid, CINAHL via EBSCO, the US National Institutes of Health Trials Register (Clinical Trials.gov) and the WHO International Clinical Trials Registry Platform. No restrictions regarding language and date of publication were used and reference lists from relevant articles were screened. Authors from eligible studies were contacted for further information.Study selectionRandomised or quasi-randomised controlled trials in children with a non-nutritive sucking habit that compared one intervention with another intervention or a non-intervention control group. The primary outcome of interest explored was the cessation of the habit.Data extraction and synthesisStudy selection, data extraction and risk bias assessment were carried out independently. Three reviewers screened the records, two performed data extraction, two assessed risk of bias and two assessed the overall quality of the evidence. Meta-analysis could not be done.ResultsSix trials involving 252 children (aged 2(1/2) to 18 years). Data were available for only 246 children. Only digit sucking was assessed in the studies. The studies compared single or multiple interventions. All studies were considered high risk of bias due to limitations in the methodology and reporting. The studies had a very small number of participants. Follow up ranged from one to 36 months.ConclusionsThe review found low quality evidence that orthodontic appliances and psychological interventions (including positive and negative reinforcement) are effective at improving sucking cessation in children. There is very low quality evidence that palatal crib is more effective than palatal arch. The orthodontic appliance was more likely to stop digit sucking than no treatment, whether it was used over the short term, risk ratio (RR)= 6.53, 95% confidence interval (CI) 1.67 to 25.53; or long term RR =5.81, (95% CI 1.49 to 22.66); or used in combination with a psychological intervention RR= 6.36, (95% CI 0.97 to 41.96).

Data sourcesCochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register. This register is updated regularly from the Cochrane Library weekly searches of Medline and prospective hand-searching of the journal, Haemophilia. ClinicalTrials.gov was searched for possible ongoing trials.Study selectionTwo reviewers independently selected studies - randomised and quasi-randomised studies were considered.Data extraction and synthesisTwo reviewers independently extracted data and assessed risk of bias using the Cochrane risk of bias tool. Meta-analysis was conducted.ResultsThree RCTs and one quasi-RCT involving a total of 112 patients were included. Two of the trials (one RCT, one quasi-RCT) involving a total of 59 people were conducted in patients undergoing dental extractions. They compared the use of a different type (tranexamic acid or epsilon-aminocaproic acid) and regimen of antifibrinolytic agents as haemostatic support to the initial replacement treatment. They found a reduction of blood loss and requirement of post-operative replacement treatment in people receiving antifibrinolytic agents compared with placebo. The need for re-intervention was not reported by either trial.ConclusionsThere is insufficient evidence from randomised controlled trials to assess the most effective and safe haemostatic treatment to prevent bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgical procedures. Ideally large, adequately powered and well-designed randomised controlled trials would be needed, in particular to address the cost-effectiveness of such demanding treatments in the light of the increasing present economic constraints, and to explore the new challenge of ageing patients with haemophilia or other congenital bleeding disorders. However, performing such trials is always a complex task in this setting and presently does not appear to be a clinical and research priority. Indeed, major and minor surgeries are effectively and safely performed in these individuals in clinical practice, with the numerous national and international recommendations and guidelines providing regimens for treatment in this setting mainly based on data from observational, uncontrolled studies.

Data sourcesPubMed, Web of Science and Cochrane Oral Health Group Trials. Register databases supplemented by hand searching a range of dental implants-related journals.Study selectionRandomised and non-randomised studies comparing implant failure rates in any group of patients receiving dental implants being inserted in fresh extraction sockets compared to the insertion in healed sites were considered.Data extraction and synthesisStudy quality was assessed using the Newcastle-Ottawa scale (NOS). Implant failure (complete loss of implant) and postoperative infection were the dichotomous outcomes measures evaluated, with marginal bone loss as a continuous outcome.ResultsSeventy-three publications were included, five were randomised controlled trials, 26 clinical controlled trials and 42 retrospective studies. The 73 studies included a total of 8241 dental implants inserted in fresh extraction sockets, with 330 failures (4.00%), and 19,410 implants inserted in healed sites, with 599 failures. A random effects meta-analysis (73 studies) found the relative risk of implant failures in fresh socket sites compared to healed sites was RR= 1.58 (95% CI; 1.27 1.95) for the maxilla only RR= 1.61 (95% CI; 0.97 2.66); mandible only RR= 2.15 (95% CI; 0.62-7.47). For implants supporting single crown restoration RR= 2.05 (95% CI; 1.36-3.11) and RR= 1.42 (95% CI; 0.71- 2.83) for those with a full arch prosthesis.There were 31 controlled studies (CCTs) and randomised controlled studies (RCTs) that included 2021 implants inserted in fresh sockets with 96 failures (4.75%) and 2759 implants were inserted in healed sites with 49 failures (1.59%). The relative risk of implant failures in fresh socket sites compared to healed sites was RR= 2.27 (95% CI; 1.57-3.29).ConclusionsThe results of the present review should be interpreted with caution due to the presence of uncontrolled confounding factors in the included studies, most of them not randomised trials. Within the limitations of the existing investigations, the present study suggests that the insertion of dental implants in fresh extraction sockets affects the implant failure rates.

Data sourcesElectronic searches without time or language restrictions were performed in PubMed, Web of Science and the Cochrane Oral Health Group trials Register. A vast manual search was done in many dental implant-related journals. Reference lists were scanned for possible additional studies. Ongoing clinical trials were also searched.Study selectionTitles and abstracts of the reports identified were read independently by the three authors. Disagreements were resolved by discussion. Rejected studies were recorded with the reasons for exclusion. The inclusion criteria included clinical human studies, either randomised or not, comparing the implant failure/survival rates in any group of patients receiving antibiotic prophylaxis versus not receiving antibiotics prior to implant placement. Case reports and non-human studies were excluded. Implant failure was considered as complete loss of the implant.Data extraction and synthesisData were extracted by the authors. Study risk of bias was assessed. Implant failure and post-operative infection were the outcomes measured, both dichotomous outcomes. Results were expressed using fixed or a random effect model depending on the heterogeneity calculated using an I(2) statistical test. The estimate of relative effect was expressed in risk ratio (RR) with 95% confidence interval. Number needed to treat (NNT) was calculated and sensitivity analysis was performed to detect differences among the studies considered to have high a risk of bias.ResultsFourteen trials were included in the review and evaluated a total of 14,872 implants. Of the fourteen studies included in the review eight were randomised clinical trials, four were controlled clinical trials and two were retrospective studies. Seven studies had both patients and operators/outcome assessors blinded to the tested intervention. Nine studies had short follow-ups; six of them with a follow-up of four months, one of five months and two of six months.The antibiotic regimen was variable: seven studies did not use post-op antibiotics in all patients. Seven studies used amoxicillin as the antibiotic of choice. Ten studies had patients rinse with antimicrobial solutions as well.Among the fourteen studies, 8603 implants were placed in patients receiving antibiotics, 304 failures (3.53%) were recorded; 6269 implants were placed in patients not receiving antibiotics or receiving placebo, with 396 failures recorded (6.32%).From eight articles that provided the information about post-operative infection there were 25 occurrences of infection in 1000 patients receiving antibiotics (2.5%) and 29 episodes in 770 patients not receiving antibiotics (3.8%).Some studies involved grafting procedures and a portion of the patients (in nine studies) were smokers.The test of overall effect for implant failure rate showed that the difference between the procedures with or without antibiotic is statistically significant: RR 0.55, 95% confidence interval (CI) 0.41 to 0.75, p value 0.0002, a relative risk reduction (RRR) of 45% and the number needed to treat (NNT) of 50 (95% CI 33-100).For the post operative infection outcome, the results of the meta-analysis showed no statistically significant results; RR 0.84, 95 % confidence interval 0.49-1.44, and a p value of 0.52.The results did not differ in the sensitivity analysis when removing the high risk of bias studies. For the implant failure, the results were RR 0.37, 95% CI 0.19-0.72, p value 0.003, and for the 'post operative infection' outcome the results were RR 0.78, 95% CI 0.38-1.39. p value 0.33. The funnel plot to calculate publication bias showed asymmetry for the studies reporting implant failure, while the studies reporting post-operative infection the funnel plot did not show asymmetry.ConclusionsThe evidence from the review suggests that a prophylactic antibiotic regimen reduces failure of dental implants placed under ordinary conditions. However, there are no apparent differences in the occurrence of post-operative infections in patients receiving or not receiving antibiotics.The results have to be interpreted with caution due to the presence of several cofounding factors in the studies.

Data sourcesCochrane Oral Health Groups Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID and EMBASE via OVID. Databases were searched with no language or date restrictions.Study selectionTwo authors independently reviewed the titles and the abstracts for inclusion. Disagreements were resolved by discussion. If needed, a third author was consulted. Included were randomised clinical trials with a follow-up of at least three months which evaluated the use of prophylactic antibiotic compared to no antibiotic or a placebo and examined different antibiotics of different doses and durations in patients undergoing dental implant placement. The outcomes were implant failure (considered as implant mobility, removal of implant due to bone loss or infection) and prosthesis failure (prosthesis could not be placed).Data extraction and synthesisStandard Cochrane methodology procedures were followed. Risk of bias was completed independently and in duplicate by two review authors. Results were expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes with 95% confidence intervals (CI). The statistical unit was the participant and not the prosthesis or implant. Heterogeneity including both clinical and methodological factors was investigated.ResultsSix randomised clinical trials with 1162 participants were identified for the review. Three trials compared 2 g of preoperative amoxicillin versus placebo (927 participants). One trial compared 3 g of preoperative amoxicillin versus placebo (55 participants). Another trial compared 1 g of preoperative amoxicillin plus 500 mg four times a day for two days versus no antibiotic (80 participants). An additional trial compared four groups: (1) 2 g of preoperative amoxicillin; (2) 2 g of preoperative amoxicillin plus 1 g twice a day for seven days; (3) 1 g of postoperative amoxicillin twice a day for seven days and (4) no antibiotics (100 participants). The overall body of the evidence was considered moderate.The meta-analysis of the six trials showed a statistically significant higher number of implant failures in the group not receiving antibiotics, RR= 0.33 (95% CI; 0.16 to 0.67) P = 0.0002.The number needed to treat for one additional benefit outcome (NNTB) to prevent one person having an implant failure is 25 (95% CI; 14 to 100) based on an implant failure of 6% in participants not receiving antibiotics.There was borderline statistical significance for prosthesis failures (RR= 0.44 (95%CI; 0.19 to 1.00) with no statistically significant differences for infections or adverse events. No conclusive information for the different durations of antibiotics could be determinedConclusionsThere is statistically significant evidence suggesting that a single dose of 2 g or 3 g of amoxicillin given orally is beneficial in reducing dental implant failure in ordinary conditions. No significant adverse events were reported. It is still unknown whether post-operative antibiotics are beneficial and which antibiotic is more effective.

Data sourcesThe Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched with no language or date restrictions.Study selectionThree reviewers independently selected studies. Randomised controlled trials (RCTs) involving interventions to treat patients with neurosensory defect of the inferior alveolar or lingual nerve or both as a sequela of iatrogenic injury were considered.Data extraction and synthesisStandard Cochrane methodological procedures were followed.ResultsTwo studies considered at high risk of bias, reporting data from 26 analysed patients were included. Both studies investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury. Two studies assessed as at high risk of bias, reporting data from 26 analysed participants were included in this review. The age range of participants was from 17 to 55 years. Both trials investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury.Patient-reported altered sensation was partially reported in one study and fully reported in another. Following treatment with laser therapy, there was some evidence of an improvement in the subjective assessment of neurosensory deficit in the lip and chin areas compared to placebo, though the estimates were imprecise: a difference in mean change in neurosensory deficit of the chin of 8.40 cm (95% confidence interval (CI) 3.67 to 13.13) and a difference in mean change in neurosensory deficit of the lip of 21.79 cm (95% CI 5.29 to 38.29). The overall quality of the evidence for this outcome was very low. No studies reported on the effects of the intervention on the remaining primary outcomes of pain, difficulty eating, speaking or taste. No studies reported on quality of life or adverse events.ConclusionsThere is clearly a need for randomised controlled clinical trials to investigate the effectiveness of surgical, medical and psychological interventions for iatrogenic inferior alveolar and lingual nerve injuries. Primary outcomes of this research should include: patient-focused morbidity measures including altered sensation and pain, pain, quantitative sensory testing and the effects of delayed treatment.

Data sourcesThe Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched with no language or date restrictions.Study selectionTwo reviewers independently selected studies. Randomised controlled trials (RCTs) of different techniques and materials for augmenting the maxillary sinus for rehabilitation with dental implants that reported the outcome of implant success or failure at least four months after initial loading were considered.Data extraction and synthesisData were extracted independently by two reviewers and study risk of bias assessed. Results were expressed using fixed-effect models as there were either fewer than four studies or we used Peto odds ratios (ORs) for dichotomous data when there were zero cells in either the treatment or control or both arms and the number of trials was small.ResultsEighteen trials involving 650 patients were included. Five studies were considered to be at low risk of bias, 11 at high risk and two of unclear risk. Four trials (102 patients) evaluated short implants (5 to 8.5 mm long) as an alternative to sinus lift in bone with residual height between 4 and 9 mm. One year after loading there was insufficient evidence to claim differences between the two procedures for prosthesis failure (OR (Peto) 0.37, 95% confidence interval (CI) 0.05 to 2.68; three trials) or implant failure (OR (Peto) 0.44, 95% CI 0.10 to 1.99; four trials). There was however an increase in complications at treated sites when undertaking the sinus lift (OR (Peto) 4.77, 95% CI 1.79 to 12.71, P value = 0.002; four trials).Fourteen trials (548 patients) compared different sinus lift techniques. Only three comparisons included more than one trial. These were bone graft versus no bone graft, autogenous bone versus bone substitute, bone graft with or without platelet-rich plasma (PRP). There was insufficient evidence to claim a benefit for any of these techniques for the primary outcomes of prosthesis and implant failure.The other comparisons with single studies were rotary versus piezosurgery to open a lateral sinus window, two different bone substitutes, use or not of a membrane to seal the lateral window, one- versus two-stage lateral sinus lift, two-stage granular bone versus one-stage autogenous bone blocks and crestal versus lateral sinus lift; two trials compared three different crestal sinus lifting techniques: rotatory versus hand malleting (patients preferred rotatory instruments over hand malleting) and hand versus electric malleting. There was no evidence of a benefit for any sinus lift procedure compared to any other for the primary outcomes prosthesis or implant failure.ConclusionsThere is moderate quality evidence which is insufficient to determine whether sinus lift procedures in bone with residual height between 4 and 9 mm are more or less successful than placing short implants (5 to 8.5 mm) in reducing prosthesis or implant failure up to one year after loading. However, there are more complications at sites treated with sinus lift procedures. Many trials compared different sinus lift procedures and none of these indicated that one procedure reduced prosthetic or implant failures when compared to the other. Based on low quality evidence, patients may prefer rotary instruments over hand malleting for crestal sinus lift.

Data sourcesThe Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, OpenGrey, the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure and the VIP database, the US National Institutes of Health Trials Register, the World Health Organisation (WHO) Clinical Trials Registry Platform and Sciencepaper Online databases were searched with no restrictions on language or date.Study selectionTwo reviewers independently selected studies and only randomised controlled trials (RCTs) and quasi-RCTs with follow-up times >/= one year were considered.Data extraction and synthesisData extraction and risk of bias assessment were carried out independently and in duplicate. Standard Cochrane methodological approaches were used.ResultsOnly one trial involving 303 patients that compared scaling and root andomiz (SRP) with community care was included. It was considered to be at high risk of bias. No data on deaths (all-cause or CVD-related) were reported. There was insufficient evidence to determine the effect of SRP and community care in reducing the risk of CVD recurrence in patients with chronic periodontitis (risk ratio (RR) 0.72; 95% confidence interval (CI) 0.23 to 2.22; very low quality evidence). The effects of SRP compared with community care on high-sensitivity C-reactive protein (hs-CRP) (mean difference (MD) 0.62; -1.45 to 2.69), the number of patients with high hs-CRP (RR 0.77; 95% CI 0.32 to 1.85) and adverse events (RR 9.06; 95% CI 0.49 to 166.82) were also not statistically significant. The study did not assess modifiable cardiovascular risk factors, other blood test results, heart function parameters or revascularisation procedures.ConclusionsWe found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.