This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.

Molar Incisor Hypomineralization (MIH) is a developmental enamel defect affecting one in six children worldwide. Although antibiotics have been suggested to influence dental development, their association with MIH remains unclear. This systematic review and meta-analysis evaluated the association between early childhood antibiotic exposure and the risk of developing MIH. MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to December 17, 2024. Observational studies (cross-sectional, case-control) including children aged 6-14 years diagnosed with MIH using validated criteria were eligible. Exposure was defined as antibiotic use before age 4. Studies involving special populations or other enamel defects were excluded. Risk of bias was assessed using the QUIPS tool. A random-effects model calculated odds ratios (ORs) and 95% confidence intervals (CIs). From 3308 records, 41 studies met the criteria and 31 were included in the meta-analysis, with 22,141 participants aged 6-14. Antibiotic use before age 4 was significantly associated with MIH (OR:1.50, 95% CI 1.13 - 1.99, p = 0.0070). Amoxicillin (OR: 1.87; 95% CI: 0.83-4.21, p = 0.104) and penicillin (OR: 2.15; 95% CI: 0.73-6.34, p = 0.130) resulted in higher odds for the development of MIH. Early antibiotic use before age 4 is associated with higher odds of developing MIH. However, given the low certainty of evidence, this finding should be interpreted with caution, as it remains unclear whether the link is direct or indirect, highlighting the need for further research to guide prevention strategies. MIH poses diagnostic and treatment challenges. Contributing factors must be identified judiciously. Prudent antibiotic use should be integrated into clinical practice to reduce potential risk and promote better long-term oral health in children.

Introduction: Optimal systemic treatment for recurrent or advanced endometrial cancer (EC) remains uncertain, particularly in the second-line setting. While first-line chemotherapy with paclitaxel and carboplatin is widely used, its efficacy is limited. Recent evidence suggests that adding immune checkpoint inhibitors (ICIs) to chemotherapy (ChT) can improve progression-free survival (PFS). In addition, hormonal therapies (such as progestins and aromatase inhibitors), targeted therapies and ICIs used alone or in combination are emerging as potential treatment options. Objectives: Our objective was to systematically evaluate the efficacy and safety of systemic therapies beyond standard ChT for patients with recurrent or advanced EC, focusing on progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs). Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), prospective studies, and retrospective studies up to June 2024 on PubMed, Embase, and CENTRAL. Studies evaluating systemic therapies—chemotherapy, hormonal therapy, targeted agents, and ICIs—in recurrent or advanced EC were included. Primary outcomes were PFS and OS; secondary outcomes included grade ≥ 3 treatment-related adverse events. Risk of bias was assessed using the Cochrane RoB 2 and MINORS tools, and GRADE was applied to evaluate the certainty of evidence. Results: Five RCTs evaluated the addition of ICI to conventional ChT. In mismatch repair-deficient (MMRd) patients, the addition of ICI significantly improved PFS and OS compared to the ChT-only group. In mismatch repair-deficient (MMRd) patients, the median PFS (mPFS) was 8.39 months in the ChT group and 22.73 months in the ICI group (HR: 0.34, p < 0.001). OS results were 26.48 and 41.36 months, respectively. In mismatch repair-proficient (MMRp) patients, mPFS was 9.4 months in the ChT group and 10.18 months at the ICI group (HR: 0.72, p = 0.002). OS was 27.37 and 27.79 months, respectively. We conducted several exploratory single-arm subgroup analyses and multiple individual patient data (IPD) meta-analyses across several clinically relevant subgroups, including patients treated with progestins, lenvatinib plus pembrolizumab, PI3K/AKT/mTOR inhibitor monotherapy, and PI3K/AKT/mTOR inhibitors in combination with aromatase inhibitors. Detailed descriptive analyses were performed for each subgroup. Conclusions: Combining chemotherapy with ICIs appears to show the most favorable survival outcomes, especially in MMRd tumors. Taking into account the methodological limitations inherent in the elaboration of lower-level evidence and IPD, hormonal and targeted therapies might be considered viable options, with efficacy and safety profiles dependent on tumor biology. Better stratification of the EC patient cohort is warranted.