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Background. The authors conducted a systematic review and meta-analysis to compare the long-term clinical and radiographic success of using mineral trioxide aggregate (MTA) and formocresol (FC) as a pulp-dressing material in pulpotomy treatment in primary molars. Types Of Studies Reviewed. The authors searched MEDLINE, Thomson Reuters Web of Science and the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) published from Jan. 1,1990, to May 9, 2013. For an RCT to be included, the authors required that the primary molars treated with a pulpotomy procedure must have received stainless steel crowns as a final restoration and that rubber dam isolation was used during treatment; that the pulp must have been vital as determined clinically by means of hemorrhage control with a cotton pellet; and that the RCT must have included a follow-up period of at least two years. For each included RCT, two authors assessed the risk of bias independently. Results. The authors identified 20 trials and included five of them. A total of 377 primary molars were treated. The authors judged that none of the included RCTs had a low risk of bias. They noted no significant differences in clinical success (relative risk [RR] = 1.01; 95 percent confidence interval [Cl], 0.98-1.05) and radiographic success (RR = 1.09; 95 percent Cl, 0.97-1.21) for primary molars treated with MTA versus those treated with FC. Practical Implications. On the basis of the limited evidence, pulpotomy procedures performed in primary molars involving the use of MTA or FC showed comparable clinical success rates. [ABSTRACT FROM AUTHOR]

The article discusses the necessity of using antibiotic prophylaxis in the extraction of impacted third molars. The authors performed a meta-analysis of 18 trials involving the use and non-use (placebo) of antibiotics in tooth extractions. It was discovered that participants in the antibiotic prophylaxis groups have a significantly higher risk of developing mild and transient antibiotic-related adverse events compared to the placebo groups.

Purpose: This systematic review and meta-analysis assessed whether passive lower lingual arch (LLA) resolves mandibular incisor crowding and affects mandibular arch dimension. Methods: We searched PubMed, Web of Science, and Cochrane Database of Systemic Reviews for both randomized controlled trials and nonrandomized studies from 1940 to March 2018. Inclusion criteria were healthy children in mixed dentition with mandibular incisor crowding treated with LLA. Our primary outcome was the amount of mandibular incisor crowding resolved after LLA, and secondary outcomes were effects of LLA mandibular arch dimension changes versus untreated controls (UTCs). Results: From 559 screened articles, seven gualified for systematic review and meta-analyses. The average resolution of mandibular incisor crowding after LLA was 5.10 mm (P<.001) with the evidence assessed as very low quality Arch perimeter and arch length changes were not significantly different between LLA and UTCs (P=0.20 and P=0.87, respectively). There were significant small increases of 0.79 mm in intercanine width (P<.001) and 0.69 mm in intermolar width (P=.003) with a low and a very low quality of evidence, respectively Conclusions: Lower lingual arch was effective in resolving mandibular incisor crowding without any significant arch perimeter or arch length changes of greater than one mm. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This systematic review and meta-analysis assessed outcomes in primary teeth for the vital pulp therapy (VPT) options of indirect pulp therapy (IPT), direct pulp capping (DPC), and pulpotomy after a minimum of 12 months to determine whether one VPT was superior. Methods: The following databases were searched from I960 to September 2016: MEDLINE, EMBASE, CENTRAL, EBSCO, ICTRP, Dissertation abstracts, and grey literature for parallel and split-mouth randomized controlled trials of at least 12 months duration comparing the success of IPT, DPC, and pulpotomy in children with deep caries in primary teeth. Our primary outcome measure was overall success (combined clinical and radiographic). Three authors determined the included RCTs, performed data extraction, and assessed the risk of bias (ROB). Meta-analysis and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Forty-one articles qualified for meta-analysis (six IPT, four DPC, and 31 pulpotomy) from 322 screened articles. The 24-month success rates were: IPT=94.4 percent, and the liner material (calcium hydroxide [CH]/bonding agents) had no effect on success (P=0.88), based on a moderate quality of evidence; DP =88.8 percent, and the capping agent (CH/alternate agent) did not affect success (P=0.56), based on a low quality of evidence. The combined success rate for all pulpotomies was 82.6 percent based on 1,022 teeth. Mineral trioxide aggregate (MTA) (89.6 percent) and formocresol (EC) (85.0 percent) success rates were the highest of all pulpotomy types and were not significantly different (P=0.15), with a high quality of evidence. MTA’s success rate (92.2 percent) was higher than ferric sulfate (FS) (793 percent) and approached significance (P=0.06), while FS’s success rate (84.8 percent) was not significantly different from FC (87.1 percent), both with a moderate quality of evidence. MTA and FC success rates were significantly better than CH (P=0.0001), with a moderate quality of evidence. At 18 months, sodium hypochlorite (NaOCI) success rate was significantly less than FC (P=0.0l) with a low quality of evidence. Conclusions: The highest level of success and quality of evidence supported IPT and the pulpotomy techniques of MTA and FC for the treatment of deep caries in primary teeth after 24-months. DPC showed similar success rates to IPT and MTA or FC pulpotomy, but the quality of the evidence was lower. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this protocol for a systematic review of randomized controlled trials of primary tooth vital pulp therapy is to describe the reasoning and need for the review, the objectives of the review, and the methodology that will be used to analyse data from the included studies. Publication of a systematic review protocol also helps establish and maintain transparency of the process and accountability for the stated methods and outcomes sought.Methods: This protocol adheres to PRISMA-P standards for protocol reporting. A variety of relevant databases and resources will be searched. Trials selection, data extraction, and risk of bias assessment will be performed by two independent investigators. Primary outcome measures include clinical and radiographic success. Evidence tables will be generated for included study characteristics. The Cochrane risk of bias assessment tool will be applied to the selected studies. For meta-analysis, results will be pooled to provide estimates of appropriate effect size and heterogeneity of trials. The quality of evidence for outcomes will be determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: The proposed systematic review will provide findings useful for pediatric and general dentists, researchers, guideline developers, policymakers, and public and private insurers and can be the basis for an evidence-based guideline on pulp treatment of vital primary teeth with deep caries approximating the pulp. [ABSTRACT FROM AUTHOR]