Background
Removal of teeth results in both horizontal and vertical changes of hard and soft tissue dimensions. The magnitude of these changes is important for decision‐making and comprehensive ...treatment planning, with provisions for possible solutions to expected complications during prosthetic rehabilitation.
Objectives
To review all English dental literature to assess the magnitude of dimensional changes of both the hard and soft tissues of the alveolar ridge up to 12 months following tooth extraction in humans.
Methods
An electronic MEDLINE and CENTRAL search complemented by manual searching was conducted to identify randomized controlled clinical trials and prospective cohort studies on hard and soft tissue dimensional changes after tooth extraction. Only studies reporting on undisturbed post‐extraction dimensional changes relative to a fixed reference point over a clearly stated time period were included. Assessment of the identified studies and data extraction was performed independently by two reviewers. Data collected were reported by descriptive methods. Weighted means and percentages of the dimensional changes over time were calculated where appropriate.
Results
The search provided 3954 titles and 238 s. Full text analysis was performed for 104 articles resulting in 20 studies that met the inclusion criteria. In human hard tissue, horizontal dimensional reduction (3.79 ± 0.23 mm) was more than vertical reduction (1.24 ± 0.11 mm on buccal, 0.84 ± 0.62 mm on mesial and 0.80 ± 0.71 mm on distal sites) at 6 months. Percentage vertical dimensional change was 11–22% at 6 months. Percentage horizontal dimensional change was 32% at 3 months, and 29–63% at 6–7 months. Soft tissue changes demonstrated 0.4–0.5 mm gain of thickness at 6 months on the buccal and lingual aspects. Horizontal dimensional changes of hard and soft tissue (loss of 0.1–6.1 mm) was more substantial than vertical change (loss 0.9 mm to gain 0.4 mm) during observation periods of up to 12 months, when study casts were utilized as a means of documenting the changes.
Conclusions
Human re‐entry studies showed horizontal bone loss of 29–63% and vertical bone loss of 11–22% after 6 months following tooth extraction. These studies demonstrated rapid reductions in the first 3–6 months that was followed by gradual reductions in dimensions thereafter.
Diabetic kidney disease (DKD) is a progressive disorder, which is increasing globally in prevalence due to the increased incidence of obesity and diabetes mellitus. Despite optimal clinical ...management, a significant number of patients with diabetes develop DKD. Hence, hitherto unrecognized factors are likely to be involved in the initiation and progression of DKD. An extensive number of studies have demonstrated the role of microbiota in health and disease. Dysregulation in the microbiota resulting in a deficiency of short chain fatty acids (SCFAs) such as propionate, acetate, and butyrate, by-products of healthy gut microbiota metabolism, have been demonstrated in obesity, type 1 and type 2 diabetes. However, it is not clear to date whether such changes in the microbiota are causative or merely associated with the diseases. It is also not clear which microbiota have protective effects on humans. Few studies have investigated the centrality of reduced SCFA in DKD development and progression or the potential therapeutic effects of supplemental SCFAs on insulin resistance, inflammation, and metabolic changes. SCFA receptors are expressed in the kidneys, and emerging data have demonstrated that intestinal dysbiosis activates the renal renin-angiotensin system, which contributes to the development of DKD. In this review, we will summarize the complex relationship between the gut microbiota and the kidney, examine the evidence for the role of gut dysbiosis in diabetes and obesity-related kidney disease, and explore the mechanisms involved. In addition, we will describe the role of potential therapies that modulate the gut microbiota to prevent or reduce kidney disease progression.
Background
Type I immediate implant placement has gained popularity because it may reduce treatment time, number of surgeries and post‐extraction bone loss. However, this is potentially challenged by ...inadequate keratinized mucosa for flap adaptation and difficulties in achieving primary stability. Moreover, it has been proven that post‐extraction bone loss is an inevitable biological process, which affects treatment outcomes.
Objectives
To estimate survival and success rates of implants and the implant‐supported prostheses, the prevalence of biological, technical and aesthetic complications, and the magnitude of soft and hard tissue changes following implant placement immediately into fresh extraction sockets.
Material and methods
An electronic search in MEDLINE (PubMed) and the Cochrane Library from 1991 to July 2010 was performed to include prospective studies on immediate implants with a mean follow‐up time of at least 1 year. The survival rates were computed using the STATA statistical software. Weighted means of soft and hard tissue changes were obtained by the inverse variance method.
Results
A total of 46 prospective studies, with a mean follow‐up time of 2.08 years, were included. The annual failure rate of immediate implants was 0.82% (95% CI: 0.48–1.39%), translating into the 2‐year survival rate of 98.4% (97.3–99%). Among the five factors analysed (reasons for extraction, antibiotic use, position of implant anterior vs. posterior, maxilla vs. mandible), type of loading, only the regimen of antibiotic use affected the survival rate significantly. Lower failure rates were found in groups that were provided with a course of post‐operative antibiotics. The success of implant therapy was difficult to assess due to scarce reporting on biological, technical and aesthetic complications. Soft tissue changes occurred mostly in the first 3 months after the provision of restoration, and then stabilized towards end of the first year. Marginal bone loss predominantly took place in the first year after implant placement, with a magnitude generally less than 1 mm. Controversy on hard tissue preservation with platform‐switching technique remained unsolved.
Conclusions
Despite the high survival rate observed, more long‐term studies are necessary to determine the success of implant treatment provided immediately after tooth extraction. Special attention has to be given to aesthetic outcomes.
Background
The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in dental restorative ...treatments. The effects of rubber dam usage on the longevity and quality of dental restorations still require evidence‐based discussion. This review compares the effects of rubber dam with other isolation methods in dental restorative treatments. This is an update of the Cochrane Review first published in 2016.
Objectives
To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients.
Search methods
Cochrane Oral Health's Information specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 13 January 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 12) in the Cochrane Library (searched 13 January 2021), MEDLINE Ovid (1946 to 13 January 2021), Embase Ovid (1980 to 13 January 2021), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 13 January 2021), and SciELO BIREME Virtual Health Library (1998 to 13 January 2021). We also searched Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 13 January 2021), VIP database (in Chinese) (1989 to 13 January 2021), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 13 January 2021). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey, and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases.
Selection criteria
We included randomised controlled trials (including split‐mouth trials) over one month in length assessing the effects of rubber dam compared with alternative isolation methods for dental restorative treatments.
Data collection and analysis
Two review authors independently screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. We strictly followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE.
Main results
We included six studies conducted worldwide between 2010 and 2015 involving a total of 1342 participants (of which 233 participants were lost to follow‐up). All the included studies were at high risk of bias.
Five studies compared rubber dam with traditional cotton rolls isolation. One study was excluded from the analysis due to inconsistencies in the presented data. Of the four remaining trials, three reported survival rates of the restorations with a minimum follow‐up of six months. Pooled results from two studies involving 192 participants indicated that the use of rubber dam isolation may increase the survival rates of direct composite restorations of non‐carious cervical lesions (NCCLs) at six months (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.05 to 4.99; low‐certainty evidence). However, the use of rubber dam in NCCLs composite restorations may have little to no effect on the survival rates of the restorations compared to cotton rolls at 12 months (OR 1.38, 95% CI 0.45 to 4.28; 1 study, 30 participants; very low‐certainty evidence) and at 18 months (OR 1.00, 95% CI 0.45 to 2.25; 1 study, 30 participants; very low‐certainty evidence) but the evidence is very uncertain. At 24 months, the use of rubber dam may decrease the risk of failure of the restorations in children undergoing proximal atraumatic restorative treatment in primary molars but the evidence is very uncertain (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97; 1 study, 559 participants; very low‐certainty evidence).
None of the included studies mentioned adverse effects or reported the direct cost of the treatment.
Authors' conclusions
This review found some low‐certainty evidence that the use of rubber dam in dental direct restorative treatments may lead to a lower failure rate of the restorations compared with cotton roll usage after six months. At other time points, the evidence is very uncertain. Further high‐quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.
•PD-L1 detected by IHC was not a robust prognostic factor for survival in HNSCC.•PD-L1 expression might predict progression-free survival in advanced HNSCC.•The combined roles of PD-L1 and CD8+ ...tumor-infiltrating T cells in HNSCC should be further elucidated.
Programmed death-ligand 1 (PD-L1) is an immune checkpoint that is primarily located on the surface of tumor cells. PD-L1 expression detected by immunohistochemistry (IHC) assays has been widely studied to predict survival outcomes in head and neck squamous cell carcinoma (HNSCC) recently. We aimed to review comprehensively the prognostic role of PD-L1 expression for survival in HNSCC.
We systematically searched PubMed, Embase, Web of Science, Cochrane Library and Scopus to identify studies investigating the prognostic role of PD-L1 expression in HNSCC. All studies published before March 31, 2018 were screened. Included studies were assessed using the Quality in Prognosis Studies (QUIPS) tool. Data were extracted and overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), disease-specific survival (DSS) were combined and presented as hazard ratios (HR) with 95% confidence interval (CI) using the generic inverse-variance method.
Twenty-three studies with 3105 patients were analysed. The overall positive rate of PD-L1 in HNSCC was 0.42 (95% CI: 0.36–0.48). There was no significant difference between PD-L1-positive and -negative HNSCC patients in OS (HR: 0.98; 95% CI: 0.71–1.37; p = 0.93), DFS (HR: 1.07; 95% CI: 0.68–1.70; p = 0.76), and DSS (HR: 0.90; 95% CI: 0.63–1.29; p = 0.56). An improved PFS was observed in patients with positive PD-L1 expression (HR: 0.71; 95% CI: 0.55–0.93; p = 0.01). In patients with low CD8+ tumor-infiltrating T cells, a poorer OS was detected in patients with positive PD-L1 expression (HR: 1.90; 95% CI: 1.07–3.36; p = 0.03). Patients with HPV-positive HNSCC were associated with increased PD-L1 expression (OR: 1.99; 95% CI: 1.50–2.64; p < 0.001). However, PD-L1 expression showed no significant benefit on OS in HPV-positive HNSCC (HR: 1.04; 95% CI: 0.65–1.65; p = 0.88).
PD-L1 expression detected by IHC was not recommended to predict survival in HNSCC patients. However, the positive PD-L1 expression might predict better PFS in patients with advanced HNSCC. The combined effects of PD-L1 expression and CD8+ tumor-infiltrating T cells should be further elucidated.
Semicarbazide-sensitive amine oxidase (SSAO) is an enzyme with a unique dual function in controlling inflammation as well as reactive oxygen species (ROS) generation. We have demonstrated benefit of ...SSAO inhibition in acute kidney fibrosis. However the function of SSAO in chronic kidney disease (CKD) and diabetic kidney disease (DKD) is yet to be determined. We aimed to assess the effectiveness of a SSAO inhibitor (SSAOi; PXS-4728A) as an antifibrotic agent using a diabetic model of CKD. Diabetic mice were treated with SSAOi for 24 weeks and outcomes compared with untreated diabetic mice and telmisartan treated animals as a standard of care comparator. Extracellular matrix markers, fibronectin and oxidative stress, were downregulated in diabetic mice treated with SSAOi compared with untreated diabetic mice. Expression of the pan-leukocyte marker CD45 was also supressed by SSAOi. SSAO inhibition in diabetic mice resulted in a significant reduction in glomerulosclerosis and associated albuminuria compared to untreated diabetic mice. However, the effect of SSAO inhibition was less obvious in the tubulointerstitial compartment than in the glomeruli. Therefore, SSAO may be a potential target for diabetic glomerulosclerosis.
This study evaluated the mutational profile of epidermal growth factor receptor (EGFR) and KRAS in non-small cell lung cancers in Hong Kong and determined their relation with smoking history and ...other clinicopathologic features.
Mutational profile of exons 18 to 21 of EGFR and codons 12, 13, and 61 of KRAS were determined in 215 adenocarcinomas, 15 squamous cell (SCC), and 11 EBV-associated lymphoepithelioma-like carcinomas (LELC).
EGFR mutations were prevalent in adenocarcinomas (115 of 215), uncommon in LELC (1 of 11), and not found in SCC (P < 0.001). Among adenocarcinomas, mutations were associated with nonsmokers (83 of 111; P < 0.001), female gender (87 of 131; P < 0.001), and well-differentiated (55 of 86) compared with poorly differentiated (11 of 41) tumors (P < 0.001). Decreasing mutation rates with increasing direct tobacco exposure was observed, with 74.8% (83 of 111) in nonsmokers, 61.1% (11 of 18) in passive, 35.7% (10 of 28) in previous, and 19.0% (11 of 58) in current smokers. There were 53% amino acid substitutions, 43% in-frame deletions, and 4% insertions. Complex patterns with 13% double mutations, including five novel substitutions, were observed. For KRAS, mutations occurred in adenocarcinoma only (21 of 215) and were associated with smokers (11 of 58; P = 0.003), men (14 of 84; P = 0.009) and poorly differentiated (7 of 41) compared with well-differentiated (4 of 86) tumors (P = 0.037). EGFR and KRAS mutations occurred in mutually exclusive tumors. Regression analysis showed smoking history was the significant determinant for both mutations, whereas gender was a confounding factor.
This study shows EGFR mutations are prevalent in lung adenocarcinoma and suggests that it plays an increasing oncogenic role with decreasing direct tobacco damage.
To identify the risk predictors of root caries and to describe their relationship with the incidence and increment of root caries.
Observational longitudinal studies.
Four electronic databases ...(PubMed, MEDLINE, EMBASE, and Scopus) (From 1 January 1990 to 31 January 2019).
Information on the factors associated with the incidence or increment of decayed and filled root surfaces (DF-root) and/or decayed root surfaces (D-root) were extracted by two reviewers independently. The factors were put into six categories, namely social-demographic background, general health, health behaviors, fluoride exposure, oral health habits and oral health condition. From the 440 potential papers identified, 19 papers reporting on 16 cohort studies were finally included. The total sample size was 7340 participants from different countries worldwide, with age ranging from 20 to 100 years. Positive correlations between new root caries and age, baseline root caries experience, gingival recession and use of tobacco were reported while negative correlations were found for socio-economic status, good oral hygiene and use of fluorides. Mixed findings were detected for the association between new root caries and the number of natural teeth.
This systematic review discovered a number of root caries risk predictors in different categories. People who are older, in lower socio-economic status or tobacco users, and those with more root caries experience, gingival recession and poor oral hygiene have higher risk of developing new root caries.
This systematic review provides support that improvement of oral hygiene, prevention of gingival recession, and use of fluoride would be useful strategy for prevention of new root caries.
To compare directly the effect of intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) on salivary flow and quality of life (QoL) in patients with early-stage nasopharyngeal ...carcinoma (NPC).
Fifty-one patients with T2, N0/N1, M0 NPC took part in a randomized controlled clinical study and received IMRT or CRT. Stimulated whole (SWS) and parotid (SPS) saliva flow were measured and Medical Outcomes Short Form 36 (SF-36), European Organization for Research and Treatment of Cancer (EORTC) core quetionnaire, and EORTC head-and-neck module (QLQ-H&N35) were completed at baseline and 2, 6, and 12 months after radiotherapy.
Forty-six patients (88%) were in disease remission 12 months after radiotherapy. At 12 months postradiotherapy, 12 (50.0%) and 20 patients (83.3%) in the IMRT group had recovered at least 25% of preradiotherapy SWS and SPS flow respectively, compared with 1 (4.8%) and 2 patients (9.5%), respectively, in the CRT group. Global health scores showed continuous improvement in QoL after both treatments (p < 0.001). However, after 12 months subscale scores for role-physical, bodily pain, and physical function were significantly higher in the IMRT group, indicating a better condition (p < 0.05). Dry mouth and sticky saliva were problems in both groups 2 months after treatment. In the IMRT group, there was consistent improvement over time with xerostomia-related symptoms significantly less common than in the CRT group at 12 months postradiotherapy.
IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease. The findings support the case for assessment of health-related QoL in relation to head-and-neck cancer using a site-specific approach.
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