MedNEXT Journal of Medical and Health Sciences

Major considerations and findings of clinical studies on zygomatic implant placement in older patients with severe maxillary atrophy: a systematic review

2025-04-15T01:09:00+00:00

Introduction: Zygomatic implant (ZI) rehabilitation of edentulous patients with maxillary atrophy is an approach that has been used with well-standardized procedures and considerable survival. Objective: The aim was to address and describe the main considerations and findings of clinical studies on the placement of zygomatic implants in elderly patients with severe maxillary atrophy. Methods: The present study followed a concise systematic review model (PRISMA rules). The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 116 articles were found. In total, 41 articles were fully evaluated and 25 were included and evaluated in this study. Of the initial total of articles, 28 articles were excluded because they did not meet the GRADE and AMSTAR-2 classification, and 12 were excluded because they presented a risk of bias that could compromise the credibility of the studies. The symmetric funnel plot does not suggest a risk of bias. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=92.1%>50%. It was concluded that the use of zygomatic implants is an alternative procedure, making implant rehabilitation of extensively atrophic maxillas possible when conventional procedures are not possible. Several anatomical and procedural factors, such as sinus conformation and sinus mucosa thickness, may influence the overall success of zygomatic implant rehabilitation and predispose to a higher occurrence of complications. Furthermore, dynamic navigation technology had better predictability in terms of precision and accuracy.

All-on-four implants using a palatal approach without bone grafts: a systematic review

2025-04-14T15:51:51+00:00

Introduction: The all-on-four technique has proven to be beneficial in reducing stress around dental implants and is a very effective treatment option for edentulous patients. Objective: A systematic review was carried out to present the main characteristics and clinical results of the all-in-four technique in implant dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from June to July 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 82 articles were found, 40 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=58.9%>50%. It was concluded that technical knowledge and anatomical understanding in all-on-four mandibular surgery are essential for predictable and consistent surgical results. The all-on-four configuration proved to be biomechanically superior to parallel implants, considering the radial stresses on the implants and cortical bone. All-on-four treatments are based on the insertion of two anterior implants and two angled ones to cover a larger area. Therefore, implant-supported prostheses may have higher success and survival rates. The cost of treatment can be reduced. Chewing stress can also be minimized to a greater extent. It was observed that the lowest stress was observed in both lateral and vertical loads in the peri-implant region.

Major approaches and clinical optimizations of zygomatic implants through guided surgery: a systematic review

2025-04-14T15:32:23+00:00

Introduction: In the dental implant scenario, the graft to treat severely reabsorbed jaws is currently the gold standard procedure, but there are flaws in this procedure from 10.0 to 30.0 % are reported in the literature. Zygomatic implants have shown, in many cases, improved clinical outcomes compared to bone graft and represent an essential alternative for compromised maxillary bone. Objective: It analyzed the main approaches and clinical optimizations of zygomatic implants through guided surgery. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 195 articles were found, and 48 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=91.7%>50%. It was concluded the zygomatic implant is revolutionizing the procedure of implants in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation, with delayed scarring. Zygomatic implants have in many cases shown better clinical results compared to bone grafts and represent a possible gold standard for dental implants. Robotic placement of zygomatic implants has the potential to produce excellent results.

Clinical outcomes of the importance of minimally traumatic tooth extraction for dental implant and aesthetic: a systematic review

2025-04-14T14:57:58+00:00

Introduction: In the context of tooth extraction, this clinical practice is common for dentists, with the main causes of caries, periodontal disease, and coronal-radicular fractures. The choice for rehabilitation with implants has been growing, and to be carried out, it needs alveolar bone preservation at the implant site and adequate gingival contour, especially in aesthetic regions. However, the new techniques and instruments for minimally traumatic extraction still need to be analyzed, as little research has evaluated the success rate and limitations of these devices. Objective: It was developed a systematic review to highlight the importance of minimally traumatic tooth extraction for dental implants and aesthetics. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 130 articles were found, 32 articles were evaluated in full and 25 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 32 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=81.6%>50%. It was concluded that the use of precise and minimally traumatic techniques enabled satisfactory and functional aesthetic results, as well as improving the patient's aesthetics and self-esteem. The immediate implant placement procedure after tooth extraction preserves bone height and thickness, reduces treatment time and cost, in addition to maintaining the gingival architecture, being important for the aesthetic success of future prosthetic rehabilitation. Also, it presents success rates comparable to implants in fully healed edges, the extraction must be done in a minimally traumatic way, to preserve the maximum bone tissue. The horizontal defects present after the installation of the immediate implant, if they are less than or equal to 3mm, will heal with complete bone filling. However, if they are larger than 3mm, bone graft material and/or membrane should be used so that there is bone healing.

Main clinical findings on the use of the zygomatic implant for compromised maxillary bone: a systematic review

2025-04-14T14:21:51+00:00

Introduction: In the dental implant scenario, the graft to treat severely reabsorbed jaws is currently the gold standard procedure. Still, there are flaws in this procedure until 30.0 % are reported in the literature. Zygomatic implants have shown, in many cases, improved clinical outcomes compared to bone grafts and represent an essential alternative for compromised maxillary bone. Objective: It was analyzed the main literary findings on the use of the zygomatic implant as a necessary alternative for a dental implant. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 122 articles were found, 36 articles were evaluated in full and 34 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 24 studies with a high risk of bias and 38 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=83.7%>50%. It was concluded that the zygomatic implant is revolutionizing the procedure of implants in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation with delayed cicatrization. Zygomatic implants have, in many cases, shown better clinical results compared to bone grafts and represent a possible gold standard for dental implants.

Relationship between indiscriminate use of psychotropic drugs and the development of sigmoid volvulus: a systematic review

2025-04-09T11:10:35+00:00

Introduction: Sigma volvulus is a common cause of intestinal obstruction, especially in vulnerable populations. Psychotropic drugs, widely used for mental disorders, have side effects that can compromise gastrointestinal motility, increasing the risk of sigmoid volvulus. Objective: A brief systematic review was developed to list the central clinical studies and case reports on the relationship between the occurrence of sigmoid volvulus in patients using psychotropic drugs. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 112 articles were found, 25 articles were evaluated in full and 11 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=79.5%>50%. The indiscriminate use of psychotropic drugs represents an underestimated risk factor for the development of sigmoid volvulus. It is crucial to constantly monitor gastrointestinal side effects in patients treated with these drugs and to encourage a comprehensive approach in their clinical management. Reducing anticholinergic load and avoiding serotonergic antagonists will also mitigate hypomotility. Previous abdominal surgery and cecal diameter >10 cm was found to be predictive factors for failure of colonoscopic detorsion. Constipation due to psychotropic drug use was a significant predictor of recurrence of sigmoid volvulus. Effective management of constipation is crucial to prevent recurrence.

Maxillary sinus bone augmentation and injectable plateletrich fibrin (I-PRF) for dental implant: a systematic review

2025-04-03T01:08:17+00:00

Introduction: In the context of bone regeneration for dental implants, maxillary sinus augmentation is a well-documented surgical technique and is one of the therapeutic options for implant placement in the atrophic posterior maxilla, particularly when the residual bone height is less than 5 mm. Several surgical techniques can be used to reconstruct the atrophic alveolar ridge, techniques alone or associated with autogenous, allogeneic, xenogenous grafts, and alloplastic biomaterials. Objective: It was carried out a systematic review to present the main scientific documentation on maxillary sinus augmentation and bone regeneration for dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Experimental and clinical studies (retrospective, prospective and randomized) with qualitative and/or quantitative analysis were included. Results and Conclusion: A total of 123 articles were found, and 35 articles were evaluated in full and 26 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=90.8%>50%. It was concluded that the use of small and large bovine xenograft particles for maxillary sinus augmentation provides comparable bone formation, ensuring stable graft dimensions combined with high implant success and healthy peri-implant conditions. However, the small particle size resulted in better bone-graft contact, providing greater osteoconductivity than with the larger particle size. Based on the literary findings, it was shown that the fibrin-rich plasma is favorable for bone formation processes for dental implants, especially when combined with xenografts.

Nutrological therapy as a fundamental basis for the treatment of chronic patients and with obesity: a systematic review

2025-03-26T12:50:22+00:00

Introduction: In the scenario of chronic diseases, patients admitted to the intensive care unit (ICU) are increasingly obese, with an incidence of up to 40%. Objective: It was to describe the main considerations of the importance of nutritional therapy as a fundamental basis for the treatment of chronic patients and with obesity. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 134 articles were found. A total of 57 articles were evaluated in full and 43 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 11 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=77.4%>50%. Patients admitted to the intensive care unit (ICU) are increasingly obese. Obesity is observed by nutritional imbalance that alters the qualities of individuals' micronutrient status through a concentrated intake of minerals such as iron, calcium, magnesium, zinc, and copper, as well as vitamins. The goals of nutritional therapy are to prevent morbidity and mortality directly attributable to macro- and micronutrient deficiency and to minimize the loss of lean body mass. There are still gaps in information by ASPEN and ESPEN regarding optimal nutritional therapy for patients with obesity during critical illness. International guidelines, therefore, recommend measuring energy expenditure versus energy savings with indirect calorimetry in obese patients.

Major predictors of bruxism in pediatric dentistry: a systematic review

2025-03-24T20:26:26+00:00

Introduction: There is difficulty in determining the prevalence of the habit of bruxism and therefore are important evaluation method, since only 5-20 % of the carrier population of habit are aware that perform the habit. Objective: This study aimed to conduct a quantitative and qualitative overview of the literature findings on the treatment of bruxism in pediatric dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 112 articles were found, 42 articles were evaluated in full and 33 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 32 studies that did not meet GRADE. Most studies did not show homogeneity in their results, with X²=94.8%>50%. Some authors concluded that in children, there are several etiological factors of bruxism, such as psychological, local factors, occupational activities, and systemic conditions, factors such as stress and anxiety little considered the influence of allergic phenomena in this dysfunction. According to the author, in the allergic factor, nocturnal bruxism is from a reflex initiated by the increase in negative pressure in the tympanic cavities when there are successive allergic edemas in the mucosa in the Eustachian tubes. It is concluded that there are a large number of jobs in pediatric dentistry using muscle relaxant boards as a treatment for bruxism and temporomandibular disorder and according to the results obtained with a critical significance level, the vast majority of authors have confirmed the benefits of using the plates. It was concluded that bruxism has a multifactorial etiology because there is ample evidence that emotional stress is a major trigger, while occlusal interference is a predisposing factor. But some theories admit that occlusal disharmony is as etiological factor of bruxism.

Positive clinical effect of ozone therapy in dentistry through randomized clinical studies and meta-analysis: a systematic review

2025-03-22T01:39:59+00:00

Introduction: In dental treatment and oral health, ozone in low concentrations has been used successfully due to its oxidizing and antimicrobial properties. It also has anti-inflammatory and immunological action. Objective: A systematic review was developed to demonstrate the positive clinical effect of ozone therapy in dentistry through randomized clinical studies and meta-analysis. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 111 articles were found, 38 articles were evaluated in full and 13 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with a high risk of bias and 30 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=75.8%>50%. It was concluded that ozone therapy is an alternative to accelerate healing and reduce pain in traumatic and autoimmune ulcers. Ozone offers a painless alternative to conventional treatment for dental caries and has been shown to arrest primary root caries, primary pit, and fissure caries, and clinically reverse the lesion. Its antimicrobial action on endodontic microbiota is quite promising. Ozone gel is suggested as an adjunctive therapy in diabetic patients to improve periodontal health. Oxygen-ozone therapy has been shown to enhance post-extraction healing in patients at risk for MRONJ. As for reducing the microbial load for patients undergoing root canal treatment, ozone therapy has inferior results when compared to conventional chemomechanical techniques using NaOCl.

Major clinical considerations of minimally traumatic tooth extraction and aesthetic management: a systematic review

2025-03-19T02:20:47+00:00

Introduction: After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes can difficult or even impede the placement of dental implants and prosthetic rehabilitation. Minimizing bone remodeling means optimizing the esthetics and functional aspects, and mainly, the sucess of implant treatment. To avoid the residual ridge resorption different techniques and bone graft materials have been proposed. Objective: It was to analyze, through a systematic review, the main clinical considerations of minimally traumatic tooth extraction, in order to highlight the best dental and aesthetic management. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 175 articles were found, and 40 articles were evaluated in full and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 30 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=81.3%>50%. The present study suggests that the alveolar graft technique may increase the risk of disease transmission, cost, and time of treatment. Several studies have stated that the graft material is not fully incorporated into the newly formed bone, indicating less vital bone tissue. Spontaneous cicatrization is still the most used feature since, in intact alveoli and small defects, it is a procedure that does not present significant losses that justify the use of edge preservation techniques. In larger defects, techniques after spontaneous healing, such as a block graft, can be used without the drawbacks of alveolar grafting, such as delayed healing and poor bone quality.

Major approaches and scientific relevance of virtual surgery in implant dentistry: a systematic review

2025-03-19T02:09:06+00:00

Introduction: Dental implant procedures have increased worldwide, reaching approximately one million dental implants per year the optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life stimulated the development of numerous software and hardware for performing computer-guided surgeries, the so-called Guided Surgeries (GS). Objective: The present study carried out a systematic review to highlight the optimization of the safety and effectiveness of digital dental implants. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from November 2024 to January 2025 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found. A total of 42 articles were fully evaluated and 14 were included in the systematic review. A total of 32 studies were excluded because they did not meet the GRADE criteria, and 20 studies were excluded because they had a high risk of bias. Preoperative virtual planning and reconstruction of the mandible guided by dental implants through preoperative designs provide high success rates for the implant and dental rehabilitation, benefiting also prosthetic restorations supported by fixed implants. Still, the concept of using personalized implants with the help of 3D virtual treatment planning, stereolithographic models, and computer-assisted design greatly improves mandibular restoration and helps to obtain a good facial profile, and aesthetic and dental rehabilitation, avoiding complications with autologous grafts.

Major considerations on the gingival graft on dental implant: a concise systematic review

2025-03-16T01:50:09+00:00

Modern implant dentistry uses gingival grafts to promote tissue regeneration around dental implants, ensuring the stability and aesthetics of oral rehabilitation. This study addresses the main types of gingival grafts used, including connective-subepithelial grafts, free gingival tissue grafts, and allogeneic grafts, comparing their clinical indications, advantages, and disadvantages. The connective-subepithelial graft stands out for offering superior aesthetic results, being indicated in visible areas, but requires a donor area, which can increase patient discomfort. Free gingival tissue grafts are effective in increasing keratinized gingiva, essential for peri-implant health, while allogeneic grafts, obtained from tissue banks, eliminate the need for additional surgery, becoming a less invasive option. In addition to the characteristics of the grafts, the study also explores the biomaterials used, such as autogenous, xenogeneic, and allogeneic, analyzing their biocompatibility, osteoconduction, and resorption rate properties, which influence graft integration. Autogenous grafts have high biocompatibility and osteoinductive capacity, while xenogeneic and allogeneic grafts have advantages in terms of accessibility and reduced procedures. The cost and accessibility of graft procedures are important factors in choosing the treatment since the value varies according to the type of graft and the technique applied. Procedures with autogenous grafts tend to be more expensive due to the need for additional surgery, while xenogeneic and allogeneic grafts, which are more accessible, present a balance between cost and effectiveness, especially in health systems with limited coverage. This study provided a comprehensive overview of the indications and limitations of the types of gingival grafts, offering support for the choice of treatments that reconcile health, aesthetics, and cost-effectiveness.

Evaluation of the response to photobiomodulation and magnetotherapy in osteonecrosis of the jaws induced by the use of bisphosphonates: a systematic review

2025-03-15T14:35:00+00:00

Introduction: Bisphosphonates are drugs that act on bone metabolism, inhibiting calcium precipitation and bone resorption. When used for long periods to control osteoporosis, these drugs can cause adverse effects, such as osteonecrosis of the jaws (Bisphosphonate-Related Osteonecrosis of the Jaws - BRONJ), which is more frequent in 8% to 12% of patients when administered intravenously. However, it should be noted that complications, when they occur, are very severe and mutilating, greatly impairing the quality of life of these patients. Energy-based devices (EBD), described in the biophotonic literature, reveal effective anti-inflammatory, analgesic, neoangiogenic, and reparative action. Objective: It was conducted a systematic review to present the main clinical considerations and consequences of the use of bisphosphonates in the occurrence of osteonecrosis of the jaw, as well as to discuss the treatments of photobiomodulation and magnetotherapy. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 118 articles were found, 30 articles were evaluated in full and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=88.5%>50%. It is concluded that with the increasing use of bisphosphonates against osteoporosis especially in cases of postmenopausal women with osteopenia, a proportionally higher incidence of the main adverse effect of these drugs in the maxillomandibular region, osteonecrosis of the jaw, has emerged. The "gold standard" therapy of choice proposed for this disease is surgical treatment. Complications, when present, are very severe and mutilating, greatly impairing the quality of life of these patients. Morbidities include extensive resections, secondary infections, lack of tissue for primary closure, dehiscence, and fistulas, which can evolve into multilateral wounds with serious consequences, such as sepsis. In this regard, photobiomodulation therapy and magnetotherapy demonstrated safety and efficacy in the treatment of bisphosphonate-related osteonecrosis of the jaw, through reduction of inflammatory signs, faster healing, and reduction of postoperative morbidity. Thus, it was demonstrated that only four applications of low-intensity laser and magnetotherapy were sufficient to reduce the inflammatory process in the surgical wound, stimulate the tissue repair process, and provide postoperative analgesia.

Major considerations and clinical outcomes of digital implant dentistry in guided bone regeneration: a systematic review

2025-03-13T19:47:08+00:00

Introduction: It is estimated that up to 43% of osseointegrated implants require guided bone regeneration (GBR) as part of the patient's rehabilitation. Bone loss or insufficiency presents a major challenge for osseointegration. In this sense, the use of CAD-CAM systems (Computer-Aided Design/Computer-Aided Manufacturing) is highlighted in this process. Objective: It elucidated the current clinical considerations of the use of guided bone regeneration for dental implants through the use of CAD-CAM systems. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 118 articles were found, 30 articles were evaluated in full and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=79.5%>50%. Guided bone regeneration is well documented and constitutes a predictable and successful approach to lateral and vertical bone augmentation of atrophic ridges. Thus, guided bone regeneration is considered one of the most commonly applied methods to reconstruct alveolar bone and to treat peri-implant bone deficiencies, as well as to replace lost bone and allow the implant to be fully integrated and maintained during functional loading. The use of digital tools for the automated fabrication of implant parts (CAD-CAM) is an optimizing reality in Dentistry. CAD-CAM enables high-quality, standardized, accurate, and detail-perfect prosthetic restorations. The use of metallic implants in the morse cone system in association with zirconia abutments guarantees a final product with mechanical resistance, biocompatibility, and aesthetics. Also, immunomodulatory guided bone regeneration membranes are developed mainly by improving macrophage recruitment and aggregation as well as regulating macrophage polarization.

Improving buccomaxillofacial surgical techniques and minimally invasive: a systematic review

2025-03-10T17:50:22+00:00

Introduction: In minimally invasive there are several clinical studies with increasing expectations to establish treatment guidelines. Recently, advanced technology in the reconstruction of three-dimensional models based on computed tomography (CT), such as cone beam CT, has opened a new axis in the application of personalized and accurate diagnosis and has been increasingly used in the field of dentistry. Objective: This study aimed to analyze the evolution and consequent importance of improving surgical techniques and minimally invasive treatments in dentistry. It was hypothesized that there were statistically significant results on advances in minimizing trauma, providing patients with quality of life, and better aesthetics. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from June to July 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 139 articles were found. 26 articles were fully evaluated and 15 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 49 studies with a high risk of bias and 34 that did not meet GRADE and AMSTAR-2. Most studies presented homogeneity in their results, with X²=83.8%>50%. The maximum preservation of the integrity of the soft tissues (papillae and free and inserted gingival band) adjacent to the prosthetic spaces should be sought; as preservation of the alveolar bone ridge level. Based on the histological concept living tissues are formed by cells joined by thin elastic tissue and with nerve fibrils, capillaries, lymphatic and blood vessels. The disruption of these cells by surgical trauma provides the release of enzymes that delay healing. For this reason, surgical trauma should be minimized. There are many attempts to minimize the professional effort, reduce surgical time, and alleviate bleeding and inflammatory processes, edema, pain, and ecchymosis that can affect patients. Thus, the maximum preservation of the integrity of the soft tissues adjacent to the prosthetic spaces and the preservation of the level of the ridge of the alveolar bone to achieve a minimization of surgical trauma must be sought.

State of the art in the treatment of knee osteoarthritis using platelet-rich plasma alone or in combination: a systematic review

2025-03-08T11:56:02+00:00

Introduction: Bone diseases comprise a large group of common diseases, including fractures, osteoporosis, and osteoarthritis that affect a large number of individuals. Knee osteoarthritis (KOA) refers to a chronic joint disease characterized by degenerative lesions of the knee cartilage, causing pain, swelling, dyskinesia, and other symptoms of the knee joint. According to the World Health Organization (WHO), KOA has an incidence of approximately 10-15%, with the elderly population accounting for 95%. Objective: This was to conduct a systematic review to present state of the art, through randomized clinical trials and meta-analyses, of the treatment of knee osteoarthritis using platelet-rich plasma alone or in combination with bone marrow aspirate concentrate (stem cells and other cells), mesenchymal stem cells, hyaluronic acid, and corticosteroids. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 126 articles were found, of which 39 articles were fully evaluated and 11 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 31 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=79.9%>50%. The symmetrical funnel plot suggests no risk of bias among studies with small sample sizes. Based on the results, platelet-rich plasma demonstrated a significant advantage over hyaluronic acid, as well as improved symptom relief, lower reintervention rates, and pain improvement. At a minimum follow-up of 6 months, platelet-rich plasma has been shown to significantly improve pain and function in patients with knee osteoarthritis compared with placebo. Furthermore, platelet-rich plasma exhibited the highest values compared to bone marrow aspirate concentrate, hyaluronic acid, and corticosteroids. Furthermore, arthroscopically guided high-dose subchondral injection of primary synovial mesenchymal stem cells cultured in platelet-rich plasma and hyaluronic acid medium can regenerate cartilage defects, improving clinical outcomes. Meta-analyses have shown that the benefits of platelet-rich plasma injections are primarily apparent in the medium- to long-term management of clinical symptoms, including pain relief, improved quality of life, increased activities of daily living, and improved sports capabilities. Clinical outcomes of platelet-rich plasma injections for knee osteoarthritis may be related to the higher dose of platelets.

Major evidence from the crosstalk between nutrology and lifestyle for healthy longevity: a systematic review

2025-03-07T13:39:19+00:00

Introduction: Life expectancy worldwide has increased significantly. Centenarians represent a successful aging phenomenon. Genetic, environmental, and lifestyle factors can determine the life expectancy of humans. Certain healthy foods are associated with longer telomere lengths. Objective: It was to present the main evidence of the crosstalk between nutrition, lifestyle, and healthy longevity to promote health and improve quality of life in aging. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from May to July 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 133 articles were found. A total of 33 articles were evaluated in full and 31 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 27 studies with a high risk of bias and 23 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=72.5%>50%. It was concluded that many metabolic or chronic diseases have been implicated in poor diet and lifestyle. Improving diet quality is associated with reduced all-cause mortality, considering that multivitamin and multimineral supplements can improve life expectancy, such as nutrients such as melatonin and coenzyme Q10 and micronutrients. The synergistic relationship of nutrients to influence physiological and cognitive function. Low concentrations of vitamin D have been linked to accelerated decline in cognition across ethnicities. N-acetylcysteine can help treat schizophrenia, bipolar disorder, and depression by decreasing oxidative stress and reducing glutamatergic dysfunction, and has broader preclinical effects on mitochondria, apoptosis, neurogenesis, and telomere lengthening. A healthy (low-sugar) plant-based diet with a reduced intake of energy-dense meat and processed meat enables healthy longevity. Several mechanisms are involved in the aging process, highlighting AMPK (AMP-activated protein kinase), SIRT1 (sirtuin), mTOR (mammalian target of rapamycin), and insulin/IGF-1 (insulin-like growth factor-1), autophagy impaired, changes in epigenetics, chronic low-grade inflammation, and cellular changes, senescence (inflammation), oxidative stress and telomere shortening.

Major clinical and metabolomic approaches to childhood obesity: a systematic review

2025-03-06T19:19:33+00:00

Introduction: In the context of childhood obesity, of children under 5 years of age in Brazil, 7% are overweight and 3% meet the criteria for obesity. Globally, according to a report from the World Health Organization (WHO), it is estimated that the total number of overweight and obese children in the world could reach 75 million by the year 2025. Objective: It was to carry out a systematic review to present the main approaches to clinical and metabolomics of childhood obesity. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from September to October 2024 in the Scopus, PubMed, Science Direct, Scielo and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 110 articles were recruited for the initial evaluation. A total of 41 articles were evaluated and 19 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X²=89.7%>50%. It was concluded that miRNAs are potential biomarkers for the development of pathologies, such as obesity. A heterogeneous group of these molecules was found to be associated with obesity in children. miR-15b-5p, miR-486-5p and hsa-miR-122-5p were considered good candidates for childhood obesity biomarkers. MiRNA-dependent mechanisms regulate up to 60% of all human genes. MiRNAs influence multiple pathways, including insulin signaling, immunemediated inflammation, adipokine expression, adipogenesis, lipid metabolism, and regulation of food intake.

Major clinical findings of blood and blood component transfusion in polytrauma: a systematic review

2025-03-05T22:24:53+00:00

Introduction: Polytrauma is a well-established cause of death in young people and adults and its burden is a global public concern, with multiple organ failure being the most common cause of mortality. Transfusion medicine is an evolving specialty with transfusion interventions, especially for bleeding patients. The age and sex of the blood component donor can affect post-transfusion results. When analyzing data from 2018, it is estimated that violence and injuries represented 19.5% of all deaths in Brazil. Objective: To present, through a systematic review, the main considerations for the transfusion of blood components in polytrauma in intensive care units, considering different types of trauma and previous procedures to reduce the need for massive blood transfusion. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, with articles dated from 2011 to 2024. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 102 articles were found. A total of 37 articles were evaluated and 16 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 8 studies with a high risk of bias and 30 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I² =16.7%<25%. Transfusion of blood components is necessary in the resuscitation of patients with major trauma. However, packaged red blood cells and platelets break down and undergo chemical changes during storage (known as storage injury) that lead to an inflammatory response when the blood components are transfused into patients. Although some evidence supports a detrimental association between transfusion and a patient's outcome, the mechanisms linking transfusion of stored components to outcomes remain unclear. For the most complete care of massive transfusions, it is imperative to review the concepts of volume/perfusion and tissue oxygenation, as well as the difference between the concepts. Still, there appears to be little or no difference in harm between whole blood transfusion therapy and blood component therapy, based on small studies with very low certainty of evidence. The blood component donor's gender, but not age, may be an important factor associated with post-injury multiple organ failure.

Clinical significance of laser therapy and osseointegration in implant dentistry: a systematic review

2025-03-01T16:16:47+00:00

Introduction: Dental implants are widely used and have a success rate of around 96%. Good bone density is an essential factor for implant stability to resist mechanical forces against dental implants. As a treatment, low-level laser treatment (LLLT) is a type of phototherapy where infrared is absorbed by adjacent tissues, thus reducing the inflammatory response, stimulating osteoblastic activity around the application site, and increasing bone production. Objective: It was to carry out a concise systematic review of the main clinical findings of the use of laser therapy to improve dental implant practices through the optimization of osseointegration. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 155 articles were found, and 23 articles were evaluated in full and 13 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 42 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=82.7%>50%. It was concluded that low-intensity laser irradiation can significantly promote bone consolidation and accelerate the osseointegration process, emphasizing the biostimulating effect of the laser. The application of the 808 nm infrared laser for bone tissue and 630 nm for mucosal tissue in two sessions is considered an effective way to reduce inflammation and improve early healing. Literary findings point to the safety and effectiveness of low-power intravascular lasers in dental implant treatments. The low-power intravascular laser enables local and systemic treatment, optimizing the benefits of its use by dentists, mainly to improve the stabilization of osseointegrated implants and avoid or eliminate contamination.

Endometriosis according to the female population: a prospective observational cross-sectional study

2025-02-21T13:49:45+00:00

Introduction: One of the problems that affects the female population of childbearing age or post-menopause is endometriosis, which is a chronic condition that affects between 2 and 17% of women of reproductive age. Objective: This study was conducted to verify the knowledge that female participants, from private practices or health insurance and the Unified Health System (SUS), have about endometriosis, aiming to obtain data that can support educational actions in public health policies. Methods: This study followed a prospective observational and cross-sectional model, following the STROBE rules. This study was carried out through an electronic questionnaire. It was carried out with a random sample of 204 female participants, 18 years of age or older. The form applied consisted of a questionnaire validated by the reliability of Cronbach's alpha coefficient. Pearson's Chi-Square test was performed, and the statistically associated variables presented p<0.05 (rejecting H0). The project was submitted to the Research Ethics Committee of the Unilago University, located in the city of São José do Rio Preto, São Paulo, Brazil. After approval under numbers 6,901,539. Through the analysis of a standardized research questionnaire, the aim is to obtain quantitative data that elucidate the objective of the research. Results and Conclusion: Knowledge of endometriosis among women showed a statistically significant difference between the variables public health (SUS) versus private health. A better understanding of the pathophysiology of endometriosis is imperative for the development of new therapeutic strategies that are continuous for both the diagnosis and treatment of endometriosis. A brief education program on menstrual health and endometriosis can improve knowledge and attitudes among women. Artificial intelligence can be an important tool for educating and informing patients about endometriosis, providing accurate and comprehensive answers to common questions, and facilitating a better understanding of the condition.

Major relationships among polyphenols, gut microbiota and sports performance: a systematic review

2025-02-16T14:37:50+00:00

Introduction: Among the various phytochemicals, polyphenols represent a heterogeneous class of compounds with marked antioxidant and anti-inflammatory properties. One of the biggest challenges is to understand the mechanisms of the interrelationship between polyphenols and the human body, also considering the fundamental role played by the gut microbiota in their absorption and bioavailability to improve sports performance. Objective: It was to present the main relationships between polyphenols, gut microbiota, and sports performance. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from September to October 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 126 articles were found, and 72 articles were evaluated in full, and 61 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 08 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=75.7%>50%. The Funnel Plot graph showed symmetrical behavior, not suggesting a significant risk of bias in studies with smaller sample sizes. Dietary polyphenols exert several beneficial effects on sports performance, demonstrated in vivo and in human studies. The health-related mechanisms of polyphenols mainly concern the modulation of mitochondrial biogenesis and the stimulation of stress-related enzymes or transcription factors, as well as a nutritional deficiency, which regulates gene expression of essential antioxidant proteins (SOD, Catalase, Glutathione system, etc.). Overall, these mechanisms promote athletic performance by improving cardiometabolic functions, reducing recovery times and post-exercise pain, maintaining a low degree of oxidative stress, and preventing dysregulated inflammatory processes. Therefore, polyphenols are able, through their interaction with the gut microbiota, to favor the proliferation of bacterial genera of great importance for metabolic and cognitive functions, such as Akkermansia, Lactobacilli, and Bifidobacteria. The microbiota, on the other hand, metabolizes polyphenols in the colon to produce small bioactive molecules that exert epigenetic mechanisms on biochemical pathways modulating gene expression.

State of the art of occlusion in dental implants: a systematic review

2025-02-12T01:45:06+00:00

Introduction: Dental implants are a regular feature in daily clinical practice and there is a need to perform routine evaluation and maintenance of implants and their restorations. Occlusal checks form an important part of the maintenance regimen to preserve the integrity of implants, their restorations, and the health of peri-implant tissues. The risks attributable to occlusal forces mainly affect implant restorations and are elevated in the presence of bruxism. Objective: This study presented the main clinical considerations of occlusions in dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from October to November 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 102 articles were found, 45 were evaluated in full and 24 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=82.2%>50%. It was concluded that occlusion is a factor directly responsible for the success or failure of treatments performed with dental implants. It directly interferes with the distribution and absorption of loads resulting from mandibular movement. Understanding how these loads work requires the clinician to seek multiple knowledge, mechanical and biological so that prosthesis planning is well executed.

Major approaches and scientific relevance of virtual surgery in implant dentistry: a systematic review

2025-02-04T01:29:27+00:00

Introduction: Dental implant procedures have increased worldwide, reaching approximately one million dental implants per year the optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life stimulated the development of numerous software and hardware for performing computer-guided surgeries, the so-called Guided Surgeries (GS). Objective: The present study carried out a systematic review to highlight the optimization of the safety and effectiveness of digital dental implants. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from June to July 2024 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found. A total of 42 articles were fully evaluated and 14 were included in the systematic review. A total of 32 studies were excluded because they did not meet the GRADE criteria, and 20 studies were excluded because they had a high risk of bias. Preoperative virtual planning and reconstruction of the mandible guided by dental implants through preoperative designs provide high success rates for the implant and dental rehabilitation, benefiting also prosthetic restorations supported by fixed implants. Still, the concept of using personalized implants with the help of 3D virtual treatment planning, stereolithographic models, and computer-assisted design greatly improves mandibular restoration and helps to obtain a good facial profile, and aesthetic and dental rehabilitation, avoiding complications with autologous grafts.

Importance of computed tomography for identifying the second mesiobuccal canal in endodontic procedures: a systematic review of clinical studies

2025-02-03T15:44:32+00:00

Introduction: Endodontists must have detailed knowledge of the typical anatomy of the dental structure and the atypical forms of external and internal root canals. The first permanent maxillary molar and the second permanent maxillary molar are the teeth with the greatest complexity of root canals, presenting higher rates of endodontic failure. Cone beam computed tomography (CBCT) has made it possible to visualize anatomical structures that are difficult to access in three dimensions, and has become a valuable aid as a complementary examination for endodontic diagnosis and treatment. Objective: This study aimed to address the main considerations and outcomes of clinical studies on the use of cone beam computed tomography in the identification and treatment of second mesiobuccal canals. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to November 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 14 articles were evaluated in full and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 46 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=91.5%<50%. Results and Conclusion: It was concluded that endodontic treatment success can be increased and clinicians’ time can be saved by using the newly developed AI-based models to identify variations in root canal anatomy before treatment. Patient gender, tooth type, and treatment modality play essential roles in identifying the MB2 canal. Furthermore, the availability of preoperative CBCT images was associated with a greater ability to localize the MB2 canal. Understanding the incidence of MB2 canals and the distribution pattern of canal orifices in the pulp floor can help clinicians quickly identify and locate MB2 canals.

Major considerations of nutrology, adult stem cells, and gut microbiota in the process of muscle regeneration in athletes: a systematic review

2025-01-30T12:48:03+00:00

Introduction: Regular physical training associated with nutritional health has broad benefits for the health of the gut microbiota, acting positively on almost all organic systems in the body. In this sense, microRNAs (miRs) have emerged as critical regulators of numerous biological processes, modulating gene expression at the post-transcriptional level. Objective: It was to carry out a systematic review to elucidate the main considerations of nutrology, microRNAs, adult stem cells, and gut microbiota in the process of muscle regeneration in athletes. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2024 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 237 articles were found, and 107 articles were evaluated in full, and 52 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 47 studies with a high risk of bias and 70 studies that did not meet GRADE. miRs play an important role as regulatory molecules during the muscle healing process. Myoblasts are known to secrete exosomes enriched with miRs into the inflammatory environment, whereby miR-224 is transferred to macrophages to inhibit M2 polarization. Additional data demonstrate that WNT-9a may be a direct target of miR-224 for macrophage polarization. The results showed that miR-122 and myogenic markers were down-regulated in C2C12 cells after TGF-β stimulation, and overexpression of miR-122 can restore myogenesis inhibited by TGF-β. Evidence suggests that the exosome derived from mesenchymal stem cells exhibits functions similar to mesenchymal stem cells with low immunogenicity and without tumorization. High rates of intestinal self-renewal are enabled by intestinal stem cells (LGR5+) at the base of intestinal crypts. LGR5+ activity, including proliferation and differentiation rates, is affected by large shifts in nutrient availability, as occurs on a high-fat diet or fasting. The practice of physical activity, endogenous metabolites, and dietary nutrients can directly influence epigenetic enzymes. Dietary manipulations and metabolites can affect tissue stem cell fate decisions. Self-renewal and differentiation of mesenchymal stem cells can be regulated by manipulating vitamin C, A, or D levels and valine restriction.

Gut microbiota-skin axis: a systematic review of healthy aging

2025-01-29T19:14:05+00:00

Introduction: Increasing evidence points to the important relationship between the skin microbiota and its connection with the gut, and vice versa, known as the gut-skin axis, and its anti-aging effects. Integrating the "genome-microbiome-exosome" plays a significant role in aging and skin health. Probiotic-based products are mainly available for the complementary treatment of many dermatological conditions. Objective: It was to analyze, through a systematic review, the main anti-aging nutrological aspects of the gut microbiota-skin axis. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from July to September 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 231 articles were found. A total of 57 articles were evaluated in full and 31 articles were included. According to the GRADE instrument, most studies presented homogeneity in their results, with X²=90.7%>50%. The management of healthy skin is related to the manipulation of intestinal function through functional nutrition, probiotics, and prebiotics. Treatments that enhance or repair a leaky gut barrier may become important as adjunctive therapy in the management of inflammatory skin conditions and may help to increase the effectiveness of standard dermal therapy as well as promote tissue regeneration to mitigate skin aging. All of this would be aimed at modifying the secretory, metabolic and hormonal activity of the intestinal epithelium to positively impact the dermal treatment.

Major clinical outcomes of the endodontic infections and gut microbiota axis: a systematic review

2025-01-23T16:06:01+00:00

Introduction: Endodontic therapy aims to shape, clean, and disinfect the root canal, and is performed by removing all pulp tissue or necrotic remains and microorganisms present in the root canal system. The gut microbiota or specific microbial metabolites not only locally influence the host's inflammatory responses, nutritional intake, or intestinal barrier function, but are also related to the immune and metabolic systems. In addition to antimicrobial activity, calcium hydroxide has properties such as dissolution of organic remnants, anti-inflammatory action, inhibition of inflammatory resorptions, and physical barrier function. Objective: To present the main considerations and clinical outcomes of the relationship between gut microbiota and endodontic infections and highlight endodontic treatment with calcium hydroxide, showing the mechanisms of antibacterial action. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from September to October 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 102 articles were found, 25 were evaluated in full and 09 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=79.2%<50%. It was concluded that, in the setting of endodontic therapy, the presence of microorganisms, particularly gramnegative anaerobes, in the root canal system and cementum resorption gaps after root canal treatment is considered one of the main causes of persistent periapical lesions and, therefore, of endodontic treatment failure. The gut microbiota or specific microbial metabolites not only locally influence the patient's inflammatory responses, nutritional intake, or intestinal barrier function, but are also related to the immune and metabolic systems. The change in the microbiota of the oral-gut axis and its interactions with Helicobacter pylori may be potential targets for the diagnosis and infectious treatment of Helicobacter pylori. Calcium hydroxide in endodontics is the most widely used medication to combat pathology-causing bacteria, but when used alone it may not be able to eliminate these microorganisms. The combination of other medications incorporated into calcium hydroxide contributes to positive results with the elimination of more resistant bacteria.

Behind bars and under the influence: understanding substance use among prison inmates in Sri Lanka

2025-01-04T10:46:57+00:00

Introduction: Substance use among prison inmates is a challenge for many countries around the world and this problem has imposed great waste of human, financial capital which leads to several health costs and social harm to the general community. Objective of this study is to determine the pattern of substance use among prison inmates in Sri Lanka. Methods: The study design was a descriptive cross-sectional study. This study was conducted in 22 selected prison institutions in Sri Lanka covering the entire country. Multi-stage probability proportionate to size stratified cluster sampling method was used. The total sample used for the study was 1730 prison inmates. A validated interviewer administrated questionnaire was used for the data collection. Results: Among the 1730 prison inmates the response rate was 98.7%. The total study sample (1708) was consisted with 938 (55%) convicted prison inmates and 770 (45%) un-convicted prison inmates. The mean age of the study sample was 39.2 years, with a standard deviation of 13.6 years. The highest educational qualification of the majority (36.9%) of the study sample was passing grade 9-11. More than four fifths (1373, 80.4%) of prison inmates had ever used a substance while 335 (19.6%) prison inmates had never used a substance. Among ever users of substances 760 (55.3%) were convicted prison inmates. The most prevalent (81.6%) substance used by prison inmates before imprisonment (82.3%) as well as after imprisonment (19.2%) was cigarettes. Almost four fifth (79.3%) of prison inmates had used alcohol before imprisonment followed by betel (47.6%) and heroine (35.2%). Usage of all the types of substances have declined after imprisonment. More than one tenth (10.8%) of prison inmates had used heroine after imprisonment followed by betel (10.8%) and cannabis (2.7%). Thirteen prison inmates (0.9%) had used injectable non prescribed drugs following imprisonment. Among study participants 14.9% had newly started substance use after imprisonment. Conclusions: The habits of substance use among prison inmates before imprisonment shows a higher value compared to the general population. Significant number of prison inmates had continued their habits substance use even after being imprisoned considering the restricted environment within the prison institutions. Among prison inmates a significant number has started the use of substances for the first time in their life while they were imprisoned.