Faculty Bibliography

Data sourcesThe Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched with no restrictions regarding language or date of publication. Bibliographies of identified publications were also checked for relevant studies, and authors were contacted to identify missing and unreported trials. The WHO International Trials Registry Platform was searched for ongoing studies, using the term 'oral lichen planus'.Study selectionRandomised controlled clinical trials (RCTs) of therapy for symptomatic OLP which compared treatment with a placebo or between treatments or no intervention were considered for this review.Data extraction and synthesisThe titles and abstracts of all reports identified were scanned independently by two review authors. All studies meeting the inclusion criteria were assessed for risk of bias and data were extracted. For dichotomous outcomes, the estimates of effects for the intervention were expressed as risk ratios (RR) together with 95% confidence intervals. For continuous outcomes, mean differences (MD) and 95% confidence intervals were used to summarise the data. Meta-analyses were conducted for studies with similar comparisons reporting the same outcome measures.ResultsTwenty-eight trials were included. Although topical steroids are considered first line treatment for symptomatic OLP, we identified no RCTs that compared steroids with placebo. There is no evidence from the three trials of pimecrolimus that this treatment is better than placebo in reducing pain from OLP. There is weak evidence from two trials, at unclear and high risk of bias respectively, that aloe vera may be associated with a reduction in pain compared to placebo, but it was not possible to pool the pain data from these trials. There is weak and unreliable evidence from two small trials, at high risk of bias, that cyclosporin may reduce pain and clinical signs of OLP, but meta-analysis of these trials was not possible.There were five trials that compared steroids with calcineurin inhibitors, each evaluating a different pair of interventions. There is no evidence from these trials that there is a difference between treatment with steroids compared to calcineurin inhibitors with regard to reducing pain associated with OLP. From six trials there is no evidence that any specific steroid therapy is more or less effective at reducing pain compared to another type or dose of steroid.ConclusionsFrom the 28 trials included in this systematic review, the wide range of interventions compared means there is insufficient evidence to support the effectiveness of any specific treatment as being superior

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Frequency of persistent tooth pain after root canal therapy: a systematic review and meta-analysis. Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT. J Endod 2010;36(2):224-30. REVIEWER: Analia Veitz Keenan, DDS. PURPOSE/QUESTION: The aim of the study was to assess the frequency of pain at 6 months or more in association with endodontically treated permanent teeth. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis. LEVEL OF EVIDENCE: Level 1: Good-quality patient-oriented evidence. STRENGTH OF THE RECOMMENDATION GRADE: Grade A: Consistent, good-quality patient-oriented evidence.

DATA SOURCES: Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, ISI Web of Science, ISI Web of Science Conference Proceedings, BIOSIS, OpenSIGLE. Reference lists of all eligible trials and review articles and their reference lists were searched. STUDY SELECTION: Trials were selected if they met the following criteria: randomised or quasi-randomised controlled trial, involving replacement and repair of resin composite restorations. DATA EXTRACTION AND SYNTHESIS: Titles and abstracts were assessed independently by two review authors for relevance . Full papers were obtained for relevant articles and both review authors studied these. Data synthesis was to follow Cochrane Collaboration statistical guidelines. RESULTS: 279 potentially eligible studies were identified. Only four studies were analysed further but none of these met the inclusion criteria and all were excluded from this review. CONCLUSIONS: There are no published randomised controlled clinical trials relevant to this review question. There is therefore a need for methodologically sound randomised controlled clinical trials that are reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/). Further research also needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, distress and anxiety, time and costs.

Data sourcesMedline, The Cochrane Library, bibliographies of identified studies and hand searching of the journals, Schweizer Monatsschrift fur Zahnmedizin (Acta Medicinae Dentium Helvetica) and Deutsche Zahnarztliche Zeitschrift and Implantologie.Study selectionRandomised-controlled clinical trials, prospective and retrospective studies providing information on ceramic and metal abutments with a mean follow-up time of at least 3 years were included. Patients had to have been examined clinically at the follow-up visit.Data extraction and synthesisAssessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analysed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions.ResultsA total of 29 studies providing information on the clinical performance of the implant abutments were included in the analysis. The estimated 5-year survival rate of ceramic abutments was 99.1% [95% confidence interval (CI): 93.8-99.9%] and 97.4% (95% CI: 96-98.3%) for metal abutments. The estimated cumulative incidence of technical complications after 5 years was 6.9% (95% CI: 3.5-13.4%) for ceramic abutments and 15.9% (95% CI: 11.6-21.5%) for metal abutments. Abutment screw loosening was the most frequent technical problem, occurring at an estimated cumulative incidence after 5 years of 5.1% (95% CI: 3.3-7.7%). All-ceramic crowns supported by ceramic abutments exhibited similar annual fracture rates as metal-ceramic crowns supported by metal abutments. The cumulative incidence of biological complications after 5 years was estimated at 5.2% (95% CI: 0.4-52%) for ceramic and 7.7% (95% CI: 4.7-12.5%) for metal abutments. Aesthetic complications tended to be more frequent at metal abutments.ConclusionsThe 5-year survival rates estimated from annual failure rates appeared to be similar for ceramic and metal abutments. The information included in this review did not provide evidence of differences for the technical and biological outcomes of ceramic and metal abutments. However, the information for ceramic abutments was limited in the number of studies and abutments analysed as well as the accrued follow-up time. Standardised methods for the analysis of abutment strength are needed

DesignRandomised controlled trialInterventionPatients with various malocclusions in which any forward movement of the molars would prevent achievement of an ideal Class I canine relationship were randomly allocated to either the headgear or the implant group. Randomisation was carried out by using a block design and computer-generated random numbers. The allocations were concealed in consecutively numbered, sealed envelopes.Outcome measureThe outcomes were; surgical and orthodontic success rates of the implants, the number of visits, the length of treatment time and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients' attitudes to implant placement.ResultsThe surgical success rate of the implants was 75% and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage.ConclusionsThe use of palatal implants to reinforce anchorage was as effective as extraoral anchorage with headgear

Data sourcesCochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, ISI Web of Science, ISI Web of Science Conference Proceedings, BIOSIS, OpenSIGLE. Reference lists of all eligible trials and review articles, and their reference lists were searched.Study selectionTrials were selected if they met the following criteria: randomised or quasi-randomised controlled trial, involving replacement and repair of amalgam restorations.Data extraction and synthesisTitles and abstracts were assessed independently by two authors. Full papers were obtained for relevant articles. Data synthesis was to follow Cochrane Collaboration statistical guidelines.Results145 potentially eligible studies were identified. Only three studies were analysed further but none of these met the inclusion criteria and all were excluded from this review.ConclusionsThere are no published randomised controlled clinical trials (RCTs) relevant to this review question. There is a need for methodologically sound RCTs reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/). Further research needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, distress and anxiety, time and costs

OBJECTIVE: The objective of this study was to evaluate the ability of a disposable rubber chewing wheel (Rolly Brush device) to remove plaque after meals. METHODOLOGY: This was a randomized, four-armed, investigator-blinded study where subjects were assigned into tooth brushing, mouthrinse, chewing gum, and Rolly Brush groups. Plaque index was measured before and after one of the four plaque removal techniques. Questionnaires were administered to ascertain the subject's opinion of the Rolly Brush device compared with the other plaque removal methods. RESULTS: Rolly Brush removed plaque better than mouth rinsing (p < 0.03). Subjects reported that Rolly Brush removed plaque better than mouthrinse (p < 0.001) or chewing gum (p < 0.001), but not better than tooth brushing (p = 0.365). Subjective reports indicated that the Rolly Brush device was less likely to disrupt taste compared to mouthrinse (12% versus 30% of the subjects, respectively). Subjects randomized to the Rolly Brush group also rated the device highest in terms of ease of use, although there were no statistical differences among the methods. CONCLUSION: These results suggest that a disposable rubber chewing wheel, the Rolly Brush device, is an acceptable means of removing plaque after meals, and should be well tolerated by the public