Thus far, the findings of numerous studies conducted on the accuracy of three-dimensional (3D) printed dental models are conflicting. Therefore, the aim of the network meta-analysis (NMA) is to determine the accuracy of 3D printed dental models compared with digital reference models. Studies comparing the accuracy of 3D printed full-arch dental models manufactured using different printing techniques to initial STL files were included. This study was registered in PROSPERO (CRD42021285863). An electronic search was performed across four databases in November 2021, and search was restricted to the English language. A systematic search was conducted based on a prespecified search query. 16,303 articles were pooled after the removal of the duplicates. Following study selection and data extraction, 11 eligible studies were included in the NMA in 6 subgroups. The outcomes were specified as trueness and precision and expressed as root mean square (RMS) and absolute mean deviation values. Seven printing technologies were analyzed: stereolithography (SLA), digital light processing (DLP), fused deposition modeling/fused filament fabrication (FDM/FFF), MultiJet, PolyJet, continuous liquid interface production (CLIP), and LCD technology. The QUADAS-2 and GRADE were used to evaluate the risk of bias and certainty of evidence. SLA, DLP, and PolyJet technologies were the most accurate in producing full-arch dental models. The findings of the NMA suggest that SLA, DLP, and PolyJet technologies are sufficiently accurate for full-arch dental model production for prosthodontic purposes. In contrast, FDM/FFF, CLIP, and LCD technologies are less suitable for manufacturing dental models.

Periodontitis is the irreversible destructive process of the periodontium and is the major cause of tooth loss in adults worldwide. Diagnosis of early-stage periodontal disease is crucial for improving outcomes, and to this end, the application of indicator biomarkers is gaining interest. One such method involves measuring the level of matrix metalloproteinase-8 (MMP-8). This systematic review and meta-analysis aims to evaluate the salivary MMP-8 level of periodontitis and gingivitis cases compared to healthy controls. We evaluated all studies that compared different laboratory techniques for measuring salivary MMP-8 levels in periodontitis and gingivitis patients, alongside healthy controls. The systematic search was performed on 10 October 2022 in three electronic databases. Pooled mean differences (MD) were calculated with 95 % confidence intervals (CIs) between the researched groups. In addition, the correlation coefficient results between MMP-8 values and other clinical parameters were narratively summarized. Based on 20 eligible studies (n = 1725), patients with periodontitis presented significantly higher MMP-8 levels (MD = 273.26 ng/ml, CI: 194.42; 352.10). Similarly, patients with gingivitis presented significantly higher salivary MMP-8 levels than healthy individuals (MD = 122.82 ng/ml, CI: 64.19; 181.45) based on the results of 10 eligible studies (n = 704). Additionally, we found higher MMP-8 levels in periodontitis compared to gingivitis (MD = 112.04 ng/ml, CI: 56.15; 167.92). The correlation results suggest that salivary MMP-8 is associated with different clinical periodontal parameters. Salivary MMP-8 level measurement may be a reliable method to distinguish between periodontal health and periodontal disease and also to distinguish between gingivitis and periodontitis. The measurement of salivary MMP-8 levels may have the potential to differentiate between periodontal health and disease reliably. Accordingly, it can be considered for integration into routine dental examinations as a quick and convenient method for the early detection and prevention of periodontitis, pending further validation.

Background: Effective and selective oral rinses are required in the daily medical and dental practice. Currently mouthwashes used have substantial side effects. Objectives: Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods: This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The search terms used were “chlorine dioxide” AND “oral”, and only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2-tests. Results: 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487-0.952 vs 0.489-1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489– 1.001, respectively) and also in bacterial counts. Conclusion: Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this outcome is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.

Mineral Trioxide Aggregate (MTA) is the gold standard for vital pulp treatment (VPT), but its superiority over novel calcium silicate-based cements in permanent teeth lacks systematic evidence. This study aimed to compare the efficacy of these materials in VPT through a network meta-analysis. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Library, and Web of Science until January 20, 2024. The inclusion criteria were randomized controlled trials involving VPT with biomaterials and reversible or irreversible pulpitis diagnoses in mature permanent teeth. The primary outcome was the odds ratio (OR) of failure rates with 95% confidence intervals. In the 21 eligible trials, failure rates were significantly higher with calcium-hydroxide than MTA at six (OR 2.26 [1.52-3.36]), 12 (OR 2.53 [1.76-3.62]), and 24 months (OR 2.46 [1.60-3.79]). Failure rates for Totalfill at six (OR 1.19 [0.55-2.58]) and 12 months (OR 1.43 [0.71-2.92]), and Biodentine at six (OR 1.09 [0.66-1.78]), 12 (OR 1.21 [0.74-1.96]), and 24 months (OR 1.47 [0.81-2.68]) were not significantly different from MTA. The results were similar in the direct pulp capping subgroup, whereas, in the partial and full pulpotomy subgroup, there was not enough evidence to achieve significant differences. MTA, Biodentine, and Totalfill are the most efficient materials for VPT. However, calcium-hydroxide-based materials are not recommended in VPT.

Background: Women are typically diagnosed with estrogen receptor-positive breast cancer around the postmenopausal period when declining estrogen levels initiate changes in lipid profiles. Aromatase inhibitors (AI) are used to prevent the progression of cancer; however, a further reduction in estrogen levels may have detrimental effects on lipid levels, which was our working hypothesis. Methods: Our meta-analysis was conducted on the lipid profiles of postmenopausal breast cancer patients at baseline and at different treatment time points. Results: We identified 15 studies, including 1708 patients. Studies using anastrozole (ANA), exemestane (EXE), letrozole (LET), and tamoxifen (TMX) were involved. Subgroup analyses revealed that 3- and 12-month administrations of LET and EXE lead to negative changes in lipid profiles that tend to alter the lipid profile undesirably, unlike ANA and TMX. Conclusions: Our results suggest that, despite statistically significant results, EXE and LET may not be sufficient to cause severe dyslipidemia in patients without cardiovascular comorbidities according to the AHA/ACC Guideline on the Management of Blood Cholesterol. However, the results may raise the question of monitoring the effects of AIs in patients, especially those with pre-existing cardiovascular risk factors such as dyslipidemia.

Introduction: At the initial part of the gastrointestinal tract, multiple tissues serve the normal function of food delivery. Periodontal structures are integral elements of these. When they deteriorate, it is extremely challenging to regenerate and reconstruct them. The conventional intervention for periodontal disease is scaling and root planning with the aim of reducing pathogenic bacteria. However, periodontal pathogens can rapidly recolonize treated areas. Probiotics have been proposed as novel tools for managing oral health by suppressing pathogenic bacteria through their anti-inflammatory effect, but the available data are controversial.Aim: Therefore, we performed a meta-analysis to study the effect of probiotics on periodontal pathogenic bacteria.Methods: The study was registered in PROSPERO under registration number CRD42018094903. A comprehensive literature search from four electronic databases (PubMed, Cochrane CENTRAL, Embase, and Web of Science) yielded nine eligible records for statistical analysis. Studies measuring bacterial counts in saliva and supra- and subgingival plaque were included. Bacterial counts were analyzed using standard mean difference (SMD) and by a random effects model with the DerSimonian–Laird estimation.Results: The results showed a significant decrease in the overall count of Aggregatibacter actinomycetemcomitans in the probiotic-treated group compared to the control at 4 weeks (SMD: −0.28; 95% CI: −0.56–−0.01; p = 0.045) but not later. Analyzing the bacterial counts in subgroups, namely, in saliva and supra- and subgingival plaque, separately, yielded no significant difference. Probiotics had no significant effect on the overall count of Porphyromonas gingivalis at 4 weeks (SMD: −0.02; 95% CI: −0.35−0.31; p = 0.914) or later. Subgroup analysis also revealed no significant difference between treatment and control groups nor did probiotics significantly decrease the overall and subgroup bacterial counts of Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum.Conclusion: Our data support the beneficial effect of probiotics in reducing A. actinomycetemcomitans counts, but not of other key periodontal pathogenic bacteria in periodontal disease patients. However, due to the complex mechanism associated with periodontal disease and the limitations of the available studies, there is a further need for well-designed randomized clinical trials to assess the efficacy of probiotics.