Publications by authors named "Graziela De Luca Canto"

88 Publications

Association Between Primary Headache and Bruxism: An Updated Systematic Review.

J Oral Facial Pain Headache 2021 Spring;35(2):129-138

Aims: To answer the question: among observational studies, is there any association between primary headaches and bruxism in adults?

Materials And Methods: A systematic review of observational studies was performed. The search was performed in seven main databases and three gray literature databases. Studies in which samples were composed of adult patients were included. Primary headaches were required to be diagnosed by the International Classification of Headache Disorders. Any diagnostic method for bruxism was accepted. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Tool and the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Associations were analyzed by calculating odds ratios (OR) in Review Manager 5.3 software. The evidence certainty was screened by Grading of Recommendations Assessment, Development, and Evaluation criteria.

Results: Of the 544 articles reviewed, 5 met the inclusion criteria for qualitative analysis. The included studies evaluated both awake and sleep bruxism, as well as tension-type headaches and migraines as primary headaches. Among two migraine studies, one showed an OR of 1.79 (95% CI: 0.96 to 3.33) and another 1.97 (95% CI: 1.5 to 2.55). On the other hand, among three tension-type headache studies, there was a positive association only with awake bruxism, with an OR of 5.23 (95% CI: 2.57 to 10.65). All included articles had a positive answer for more than 60% of the risk of bias questions. The evidence certainty varied between low and very low. Due to high heterogeneity among the studies, it was impossible to perform a meta-analysis.

Conclusion: Patients with awake bruxism have from 5 to 17 times more chance of having tension-type headaches. Sleep bruxism did not have any association with tension-type headache, and the association with migraines is controversial.
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http://dx.doi.org/10.11607/ofph.2745DOI Listing
June 2021

Children's Perceptions of Dentist's Attire and Environment: A Systematic Review and Meta-analysis.

Int J Clin Pediatr Dent 2020 Nov-Dec;13(6):700-716

Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Aim: To assess the children's perceptions of the dentist's attire and environment. The protocol is available in the PROSPERO database.

Search Strategies: Systematic searches in the databases were performed in Cochrane, Latin American and Caribbean Health Sciences, PubMed, PsycINFO, Scopus, and Web of Science from their inception to December 12, 2019, Google Scholar, Open Grey, and ProQuest Dissertations.

Selection Criteria: Criteria consisted of descriptive studies regarding the above matter while two authors assessed the information. The risk of bias was also performed.

Results: Databases showed 1,544 papers and a two-phase assessment selected 21 studies in narrative and 9 in the quantitative synthesis. A meta-analysis demonstrated no difference between white coat and child-friendly attire (OR = 0.63; 95% CI 0.16-2.49; = 3,706) and a decorated plain dental clinic was the preference of the children's majority (OR = 8.75; 95% CI 1.21-63.37; = 150).

Conclusion: It can be concluded that there is no difference in the children's perception, white coat vs child-friendly attire; however, children prefer a decorated dental clinic.

How To Cite This Article: Oliveira LB, Massignan C, De Carvalho RM, Children's Perceptions of Dentist's Attire and Environment: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2020;13(6):700-716.
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http://dx.doi.org/10.5005/jp-journals-10005-1839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060925PMC
May 2021

Lysosomal acid lipase deficiency in pediatric patients: A scoping review.

J Pediatr (Rio J) 2021 May 6. Epub 2021 May 6.

Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Ciências Médicas, Florianópolis, SC, Brazil; Universidade Federal de Santa Catarina, Laboratório de Pesquisa Clínica e Experimental- MENULab, Florianópolis, SC, Brazil; Universidade Federal de Santa Catarina, Departamento de Pediatria, Florianópolis, SC, Brazil Received 29 December 2020; accepted 1 March 2021.

Objective: Lysosomal acid lipase deficiency (LAL-D) is an underdiagnosed autosomal recessive disease with onset between the first years of life and adulthood. Early diagnosis is crucial for effective therapy and long-term survival. The objective of this article is to recognize warning signs among the clinical and laboratory characteristics of LAL-D in pediatric patients through a scope review.

Sources: Electronic searches in the Embase, PubMed, Livivo, LILACS, Web of Science, Scopus, Google Scholar, Open Gray, and ProQuest Dissertations and Theses databases. The dataset included observational studies with clinical and laboratory characteristics of infants, children and adolescents diagnosed with lysosomal acid lipase deficiency by enzyme activity testing or analysis of mutations in the lysosomal acid lipase gene (LIPA). The reference selection process was performed in two stages. The references were selected by two authors, and the data were extracted in June 2020.

Summary Of The Findings: The initial search returned 1593 studies, and the final selection included 108 studies from 30 countries encompassing 206 patients, including individuals with Wolman disease and cholesteryl ester storage disease (CESD). The most prevalent manifestations in both spectra of the disease were hepatomegaly, splenomegaly, anemia, dyslipidemia, and elevated transaminases.

Conclusions: Vomiting, diarrhea, jaundice, and splenomegaly may be correlated, and may serve as a starting point for investigating LAL-D. Familial lymphohistiocytosis should be part of the differential diagnosis with LAL-D, and all patients undergoing upper gastrointestinal endoscopy should be submitted to intestinal biopsy.
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http://dx.doi.org/10.1016/j.jped.2021.03.003DOI Listing
May 2021

Prevalence of orofacial injuries in wheeled non-motor sports athletes: A systematic review and meta-analysis.

Dent Traumatol 2021 Apr 1. Epub 2021 Apr 1.

Department of Dentistry, Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

Background/aims: As the popularity of sports activities grows, so do the number of sport-related injuries. Furthermore, sports that use equipment or vehicles that modify the speed of the player can present more serious injuries. The aim of this systematic review was to identify the overall prevalence of orofacial trauma in wheeled non-motor sports athletes.

Methods: The search strategy was applied in eight electronic databases (Embase, LILACS, Livivo, PEDro, PubMed, Scopus, SportDiscus, and Web of Science). Additionally, a complementary search of the gray literature (Google Scholar, OpenGrey, and ProQuest Dissertations & Theses Global), reference lists of included articles, and studies indicated by experts on the subject was done. The included articles were observational studies with sufficient data of orofacial trauma (type and anatomical site) in wheeled non-motor sport athletes, regardless of the competition level. Risk of bias was assessed by using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The meta-analysis was performed using R Statistics software, and the strength of cumulative evidence was assessed by The Grading of Recommendations Assessment, Development, and Evaluation.

Results: From 4042 identified studies, after the removal of duplicates and phase one of selection (title and abstracts screening), 251 studies remained for phase two (full-text screening). Five articles were finally included. One study was considered to have a low risk of bias and four had a moderate risk of bias. The cumulative prevalence of orofacial injuries in wheeled non-motor sport athletes was 21.7% (CI: 8.7-34.7; I :97.6%) and the prevalence of dental injuries in these sports was 7.5% (CI:4.3-10.7; I :61.9%). The certainty in cumulative evidence was considered to be very low.

Conclusion: About 22% of the wheeled non-motor sport athletes have suffered orofacial injuries. The most prevalent type of injury was classified as dental trauma.
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http://dx.doi.org/10.1111/edt.12661DOI Listing
April 2021

Association between obstructive sleep apnea and health-related quality of life in untreated adults: a systematic review.

Sleep Breath 2021 Mar 11. Epub 2021 Mar 11.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Health Sciences Center, Federal University of Santa Catarina, Campus Universitário Caixa Postal 476 - Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil.

Purpose: The objective of this systematic review was to answer the question: "Is there association between obstructive sleep apnea (OSA) and health-related quality of life (HRQoL) in untreated adults?"

Methods: We included observational studies that evaluated the health-related quality of life of patients with OSA vs control groups, through generic and disease-specific questionnaires. The searches were conducted in six databases: Embase, Lilacs, PsycINFO, PubMed, Scopus, and Web of Science. Additional search in the grey literature and hand search were performed, and also experts were consulted. Risk of bias was performed by using Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional, cohort, and case-control studies. We analyzed the data using a narrative synthesis. The Grading of Recommendations Assessment, Development, and Evaluation evidence profile was used to verify the overall certainty of the assessed evidence.

Results: Nineteen studies were included for qualitative analysis. Generic questionnaires showed worse HRQoL in the OSA group compared to the control group in at least one domain of the HRQoL questionnaires. The affected domains that showed statistical and clinically relevant differences were physical functioning, physical role, pain, general health, vitality, emotional role, and mental health. The certainty of evidence assessment was very low.

Conclusion: The available literature suggests that OSA in untreated adults is associated with worse HRQoL. However, this association seems to disappear when we consider only studies adjusted for related covariates.

Registration: CRD42018114746.
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http://dx.doi.org/10.1007/s11325-021-02323-1DOI Listing
March 2021

Association between sleep bruxism and stress symptoms in adults: A systematic review and meta-analysis.

J Oral Rehabil 2021 May 28;48(5):621-631. Epub 2021 Jan 28.

Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

To synthesise and critically review the association between sleep bruxism (SB) and stress symptoms in adults. A systematic review was performed. The search was completed using seven primary electronic databases in addition to a grey literature search. Two reviewers blindly selected studies based on pre-defined eligibility criteria. Risk of bias of the included articles was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RevMan 5.4 was used to perform the meta-analysis. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Ten studies were included for qualitative analysis, of which three were included for quantitative analysis. Three studies were evaluated to have low risk of bias, and seven were assessed with moderate risk of bias. Quality of evidence was classified as very low for all outcomes. Individuals with SB were found to have higher levels of some self-reported stress symptoms as assessed through questionnaires with a mean difference of 4.59 (95% CI 0.26-8.92). Biomarkers like epinephrine, norepinephrine, cortisol, adrenaline, dopamine, noradrenaline and prolidase enzyme levels also showed a positive association with SB. Although some associations were identified between probable SB and self-reported stress symptoms and biomarkers of stress in adults, given that the quality of evidence was found to be very low, caution should be exercised in interpreting these results. These findings suggest that additional and better designed studies are warranted in order to clarify the link between SB and stress.
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http://dx.doi.org/10.1111/joor.13142DOI Listing
May 2021

Association Between Sleep Bruxism and Quality of Life: A Systematic Review.

J Oral Facial Pain Headache 2020 Fall;34(4):341-352

Aims: To evaluate the association between sleep bruxism (SB) and quality of life (QoL) in the general population.

Methods: A systematic review was conducted, and studies were included with no restrictions regarding age, gender, or language. SB and general health-related QoL and/or oral health-related QoL (OHRQoL) measures in the included studies needed to be based on validated tools. The databases searched were Google Scholar, LILACS, OpenGrey, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. Quality of evidence was evaluated using the Joanna Briggs Institute critical appraisal checklists and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria.

Results: Fourteen studies met the inclusion criteria. Ten studies were published in English, and four in Portuguese. All studies evaluating the association of SB with health-related QoL showed no statistical significance when overall scores were considered. The overall quality of evidence was considered very low due to high heterogeneity among the studies. SB seemed not to be associated with health-related QoL, but did have a negative impact on some characteristics of OHRQoL.

Conclusion: There is insufficient scientific evidence to support or disprove the association between SB and QoL/OHRQoL in the general population.
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http://dx.doi.org/10.11607/ofph.2687DOI Listing
December 2020

Administration of mesenchymal stem cells from adipose tissue at the hip joint of dogs with osteoarthritis: A systematic review.

Res Vet Sci 2021 Mar 24;135:495-503. Epub 2020 Nov 24.

Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

This systematic review aimed to determine the effects of intra-articular administration of mesenchymal stem cells from adipose tissue in dogs with hip joint osteoarthritis (OA). Clinical trials were systematically reviewed, using PubMed, EMBASE, Cochrane Library, LILACS, Web of Science, Scopus, Open Grey, Google Scholar, and ProQuest Dissertation and Thesis without publication year restrictions. References were screened and selected based on predefined eligibility criteria by two independent reviewers, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical outcomes were assessed quantitatively using clinical pain scores, physical examination, imaging examination, questionnaire responses, pain in manipulation, gait analysis, range of joint motion, and adverse effects. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Out of 1483 articles, six met the inclusion criteria for qualitative analysis, with two randomized controlled trials and four before-and-after studies. All studies reported significantly better clinical outcomes in the adipose tissue stem cells (ADSC) group with improvements in pain and function and decreased evidence of hip OA. The risk of bias was categorized as high in the before-and-after studies and moderate to high in the randomized studies. The studies were considered heterogeneous owing to clinical results and methodology. Because of this heterogeneity, it was not possible to perform meta-analysis. Assessments of ADSC reports yielded positive clinical effects that showed improvements in pain and function and decreased evidence of hip osteoarthritis. More high-level, larger-cohort dog studies that utilize standardized protocols are needed.
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http://dx.doi.org/10.1016/j.rvsc.2020.11.014DOI Listing
March 2021

Does the presence of parents in the dental operatory room influence children's behaviour, anxiety and fear during their dental treatment? A systematic review.

Int J Paediatr Dent 2021 May 17;31(3):318-336. Epub 2021 Mar 17.

Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Background: The presence of parents during the dental appointment can affect the child's behaviour and, consequently, the success of the treatment.

Aim: This systematic review aimed to evaluate whether parents' presence in the operatory room influences children's behaviour, anxiety and fear during dental treatment.

Design: EMBASE, Cochrane Library, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, OpenGrey and ProQuest Dissertations and Theses Databases were searched. Randomized and non-randomized clinical trials in which some measure assessing children's behaviour and/or anxiety and fear during dental treatment with the presence and absence of parents were included. Two reviewers assessed studies for selection, extracted data, evaluated bias (Joanna Briggs Institute) and graded the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation). Random-effects meta-analyses using mean difference (MD) and narrative synthesis were performed.

Results: A total of 2846 papers were identified, and after a 2-phase selection, sixteen studies were included (five in meta-analyses). There was no difference in children's behaviour in the presence or absence of parents (P = .23, P = .40, P = .60 and P = .89, respectively). The presence or absence of parents did not influence children's anxiety (P = .94 and P = .97) or fear (DM: -0.08; CI:-0.34-0.19, P = .24). All included studies presented a high risk of bias, and the certainty of evidence was considered to be very low.

Conclusion: It is concluded that parents' presence in the operation room does not influence children's (up to 12 years old) behaviour, anxiety and fear during dental treatment with very low certainty of evidence. Methodological limitations of included studies, however, suggest that better designed trials are needed to adequately understand this issue.
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http://dx.doi.org/10.1111/ipd.12762DOI Listing
May 2021

Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: A systematic review and meta-analysis.

J Craniomaxillofac Surg 2020 Oct 25;48(10):942-955. Epub 2020 Aug 25.

Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.

To assess the available literature on the prevalence of degenerative joint disease (DJD) in patients with anterior disc displacement (ADD) of the temporomandibular joint (TMJ), using a systematic review with meta-analysis. Search strategies were performed in the following databases: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO. A search was also carried out in the gray literature. Two independent reviewers selected the included articles using a two-phase process based on the eligibility criteria. Three reviewers independently collected the required information from the included articles. The methodological quality of the selected studies was assessed individually. In accordance with the inclusion and exclusion criteria, 1349 studies were found and 18 articles were included. The total sample size was 3158 TMJs. The sex distribution was predominant for females (1161 females and 345 males). The average age was 46 (range 10-82) years. Among the 1762 TMJs quantitatively assessed, the prevalence of DJD involving disc displacement with reduction (DDWR) was 35%, while for disc displacement without reduction (DDWoR) the prevalence was 66%. The prevalences of different features of DJD were as follows: sclerosis 24.3%, erosion 23.5%, osteophyte 17.9%, and subcortical cyst 7.6%. The prevalence of DJD in temporomandibular disorder patients with disc displacement is around 50% and is higher in DDWoR (66%) than in DDWR (35%). Sclerosis and erosion would be the most expected radiological signs in a developing DJD. Clinicians should adequately address the frequent DJD features associated with disc displacement in terms of diagnostics and therapeutic management.
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http://dx.doi.org/10.1016/j.jcms.2020.08.004DOI Listing
October 2020

Association between sleep disordered breathing and symptoms of attention deficits in adults: a systematic review.

Sleep Med 2020 09 3;73:223-230. Epub 2020 Jul 3.

Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil; Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, Canada.

Background: In light of previous reported associations between sleep disordered breathing (SDB) and symptoms of attention deficits, the aim of this systematic review (SR) was to evaluate this association in adults.

Methods: Searches were performed on seven main databases including Embase, PubMed, Web of Science, Scopus, PsyncInfo, Livivo and Lilacs; as well as grey literature through Google Scholar, Proquest and OpenGrey. Furthermore, hand-searches were conducted on the reference lists of included articles. Experts were consulted to improve search findings. Risk of Bias was gauged using the Joanna Briggs Institute Critical Appraisal Checklist. The cumulative evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.

Results: 2009 references were identified. After phase-1 and phase-2 of screening against eligibility criteria, eight cross-sectional and one cohort studies were retained for qualitative analysis. Five studies were included for quantitative analysis, with no significant association found (p = 0.99). From the qualitative assessment, three papers showed a positive association with at least one attention symptoms. Risk of bias was judged to be low for six studies and three were classified with moderate risk of bias. Confidence in cumulative evidence was considered very low for continuous data.

Conclusion: Despite the plausibility of an association between SDB and symptoms of attention deficits in adults, current published evidence does not either confirm or refute such association as inferred from its low to very low certainty level.
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http://dx.doi.org/10.1016/j.sleep.2020.06.031DOI Listing
September 2020

Biomarkers in biological fluids in adults with periodontitis and/or obesity: A meta-analysis.

J Indian Soc Periodontol 2020 May-Jun;24(3):191-215. Epub 2020 May 4.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil.

Obesity and periodontal diseases have been investigated to be interconnected, but the molecular mechanism underlying this association is still not clear. The aim of this systematic review is to assess the association of serum, salivary and gingival crevicular fluid (GCF) inflammatory markers (IMs), obesity, and periodontitis. Studies that evaluated IM of adults according to obesity status (O) and periodontitis status (P) (O+P+; O-P+; O+P-) were screened on several electronic databases and grey literature up until February 2019. Risk of bias assessment and level of evidence were evaluated through Fowkes and Fulton scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were grouped according to the biological matrix studied (serum/GCF) and groups (O+P+ vs. O-P+/O+P+ vs. O+P-). Out of the 832 studies screened, 21 were considered in qualitative synthesis and 15 in quantitative synthesis (meta-analysis). Although included studies showed mostly "no" or "minor" problems during the quality assessment, GRADE assessment indicated very low to moderate level of evidence based on the question answered. O+P+ adults exhibited significantly higher serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), leptin, and tumor necrosis factor-α (TNF-alpha) and higher resistin GCF levels than O-P+. O+P+ adults showed significantly higher serum levels of IL-6 and leptin and lower adiponectin serum levels than O+P-. Only qualitative information could be obtained of the IM vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and interferon-γ (IFN-γ). Obesity and periodontitis, together or separately, are associated with altered serum and GCF levels of CRP, IL-6, leptin, TNF-alpha, adiponectin, and resistin. It was not possible to evaluate the association between obesity and periodontitis at salivary levels. The role of recently investigated biomarkers as vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and IFN-γ, which can be key points underlying the association between obesity and periodontitis, remains to be further investigated.
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http://dx.doi.org/10.4103/jisp.jisp_512_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307467PMC
May 2020

Association between painful temporomandibular disorders and sleep quality: A systematic review.

J Oral Rehabil 2020 Aug 26;47(8):1041-1051. Epub 2020 May 26.

Brazilian Center for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

This review aimed to systematically evaluate the association between painful temporomandibular disorders (TMD) and sleep quality in adults. Observational case-control studies using either RDC/TMD or DC/TMD for TMD diagnostic and validated questionnaires for sleep quality were selected by two reviewers in a two-phase process. A systematic review was conducted in accordance with the PRISMA statement. The search was performed in PubMed/MEDLINE, LILACS, SCOPUS, PsycINFO, Web of Science and Grey literature (ProQuest, Google Scholar and OpenGrey). To be eligible, studies had to include adults (>18 years old), with no language, gender or time of publication restrictions. The quality of the papers was assessed using the Newcastle-Ottawa Scale (NOS). Eight case-control studies were included, with high (4) and moderate (4) quality assessment. Seven studies reported a significant association between the presence of painful TMD and sleep quality (P < .05), while the other found impaired sleep in participants with higher sensitivity to heat pain (P < .001). When pain levels were concerned, using different pain scales, six studies found differences when compared to control groups. One study showed that in non-painful TMD, the PSQI values were not different when compared to the control group. An association exists between painful TMD and sleep quality. The presence of pain seems to strongly impact the sleep quality in TMD patients.
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http://dx.doi.org/10.1111/joor.12993DOI Listing
August 2020

Prevalence of dentofacial injuries in contact sports players: A systematic review and meta-analysis.

Dent Traumatol 2020 Oct 16;36(5):477-488. Epub 2020 Apr 16.

Brazilian Centre for Evidence Based Research, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.

Backgrounds/aims: Contact sports present intense physical contact, and usually, players have a high risk for dentofacial injuries. It is unclear how often these injuries occur and which contact sports present the highest rates. The aim of this study was to assess the prevalence of dentofacial injuries among contact sports participants.

Methods: A literature search was performed in seven electronic databases (Embase, LILACS, LIVIVO, PubMed, Scopus, SportDiscus, and Web of Science). The gray literature (Google Scholar, OpenGrey, and ProQuest), as well as the reference lists of included studies, was assessed. Experts were consulted to indicate additional studies. The eligible studies were observational studies that contained details of the contact sports participants who were aged over 18 years old, either professional or not, who sustained at least one dentofacial injury in the past, the number of sustained injuries, and studies which provided quantitative data on the characteristics of the dentofacial injuries, such as type and site. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results: Among 1152 identified studies, 17 articles remained for final analysis. One study was classified as high risk of bias, 14 studies as moderate, and two as low risk. The overall prevalence of dentofacial injuries was 27.57% (95% CI: 17.87-38.47). The prevalence in each sport was rugby 37.36% (95% CI: 17.45-59.82), basketball 27.26% (95% CI: 9.45-50.08), handball 24.59% (95% CI: 14.88-35.83), and field hockey 19.07% (95% CI: 6.82-35.62). The most common injury was dental injury 19.61% (95% CI: 8.13-34.56).

Conclusion: The overall prevalence of dentofacial injuries among collective contact sports participants was approximately 30%. The most common injury presented was dental injury.
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http://dx.doi.org/10.1111/edt.12556DOI Listing
October 2020

Incidence of root resorption after concussion, subluxation, lateral luxation, intrusion, and extrusion: a systematic review.

Clin Oral Investig 2020 Mar 18;24(3):1101-1111. Epub 2020 Jan 18.

Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.

Objective: Traumatic dental injuries often affect the dental hard tissues, periodontal tissues, and dental pulp. Root resorption (RR) is a significantly concerning phenomenon that could lead to loss of the traumatized tooth. The purpose of this systematic review was to analyze the incidences of different types of RR after concussion, subluxation, lateral luxation, intrusive luxation, and extrusive luxation.

Material And Methods: Seven databases were electronically and manually searched for the identification of observational studies that evaluated the incidence of RR after luxation injuries. Following study selection, data extraction, and risk of bias assessment through MAStARI checklist, the GRADE quality of available evidence was assessed.

Results: In total, 14 studies were included in the present systematic review. Ten and four studies presented a moderate and low RoB, respectively, and the overall GRADE quality of evidence was "very low" for all outcomes. The highest incidence rates of RR were observed for teeth with intrusive luxation, followed by those with extrusive luxation, lateral luxation, subluxation, and concussion. In general, the most common type of RR documented for all injuries was inflammatory RR, followed by replacement RR, surface RR, and internal RR.

Conclusions: Our findings suggest that RR most commonly occurs in association with intrusive luxation and by inflammatory RR. Awareness regarding the incidence of RR after injuries is useful for clinicians to minimize the risk and severity of its occurrence, because a late diagnosis of RR may limit treatment alternatives and result in tooth loss.

Clinical Relevance: Knowledge about the incidence of RR in teeth with concussion and different types of luxation injuries can ensure appropriate follow-up protocols and favorable outcomes.
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http://dx.doi.org/10.1007/s00784-020-03199-3DOI Listing
March 2020

Barriers involved in the application of evidence-based dentistry principles: A systematic review.

J Am Dent Assoc 2020 Jan;151(1):16-25.e16

Background: The authors' objective in this systematic review was to investigate the barriers involved in the application of evidence-based dentistry principles, as reported by dentists. The authors registered the protocol in the PROSPERO database.

Types Of Studies Reviewed: Eligible studies included qualitative and quantitative approaches, constituting information about barriers, collected through interviews, questionnaires, or conversation sessions. The authors searched databases and reference lists of preselected studies. After the selection process, the authors evaluated the included studies for potential risk of bias and collected either qualitative or quantitative data.

Results: After the selection process, the authors included 35 studies, of which 16 were reported in this article. The authors synthesized and classified the barriers in 4 categories: self-related, evidence-related, context-related, and patient-related barriers. Shortage of time and financial constraints were the barriers most frequently studied. However, the quantification of these barriers, as well as others, was not possible because of the variability of the results and methodological issues of the included studies.

Conclusions And Practical Implications: The authors suggest the development of valid questionnaires and their use in representative samples to quantify the effects of specific barriers. The authors encourage practitioners to participate in educational programs focused on training in evidence-based dentistry abilities, in addition to seeking accessible and synthesized formats of reliable scientific knowledge.
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http://dx.doi.org/10.1016/j.adaj.2019.08.011DOI Listing
January 2020

Effects of dual blockade in heart failure and renal dysfunction: Systematic review and meta-analysis.

J Renin Angiotensin Aldosterone Syst 2019 Oct-Dec;20(4):1470320319882656

Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Brazil.

Objective: The effect of dual renin-angiotensin system (RAS) inhibition in heart failure (HF) is still controversial. Systematic reviews have shown that dual RAS blockade may reduce mortality and hospitalizations, yet it has been associated with the increased risk of renal dysfunction (RD). Surprisingly, although RD in patients with HF is frequent, the effect of combining RAS inhibitors in HF patients with RD has never been studied in a meta-analysis.

Methods: A systematic review and meta-analysis of randomized clinical trials involving HF patients with RD who received dual blockade analyzing death, cardiovascular (CV) death or HF hospitalization, and adverse events.

Results: Out of 2258 screened articles, 12 studies were included (34,131 patients). Compared with monotherapy, dual RAS inhibition reduced hazard ratio of death to 0.94 (=0.07) and significantly reduced CV death or HF hospitalization to 0.89 (=0.0006) in all individuals, and to 0.86 (=0.005) in patients with RD and to 0.91 (=0.04) without RD. Nevertheless, dual RAS blockade significantly increased the risk of renal impairment (40%), hyperkalemia (44%), and hypotension (42%), although discontinuation of treatment occurs only in 3.68% versus 2.19% (=0.00001).

Conclusions: Dual RAS inhibition therapy reduces the risk of CV death or HF hospitalization. However, cautions monitoring for specific adverse events may be warranted.
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http://dx.doi.org/10.1177/1470320319882656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906583PMC
April 2020

Laser therapy for recurrent aphthous stomatitis: an overview.

Clin Oral Investig 2020 Jan 12;24(1):37-45. Epub 2019 Nov 12.

Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Asa Norte, Brasilia, DF, 70910-900, Brazil.

Objectives: To evaluate therapeutic effects of laser therapy on patients with recurrent aphthous stomatitis assessing evidences from previously published systematic reviews.

Materials And Methods: An overview of systematic reviews was conducted based on PRISMA checklist. Search strategies were developed and adapted for six different electronic databases and a gray literature search was also performed. The methodology quality of the included systematic reviews was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2 (AMSTAR 2).

Results: After a two-step selection, five systematic reviews were included. Methodology quality was considered as a high risk of bias in two systematic reviews, while in the other three were graded as moderate. The systematic reviews' conclusions demonstrated that all included systematics reviews showed positive effects of laser therapy for pain relief, and most of them demonstrated healing improvement. A meta-analysis was not feasible due to heterogeneity in treatments parameters.

Conclusions: Evidence suggested that laser therapy is an effective tool to treat recurrent aphthous stomatitis; nevertheless, more randomized clinical trials should be conducted to compare different lasers parameters.

Clinical Relevance: The present overview evaluated recent evidence about laser therapy for recurrent aphthous stomatitis management in order to contribute for evidence-based dentistry and decision-making. This overview suggests that laser therapy is a safe and promising alternative to treat recurrent aphthous stomatitis, since it promotes wound healing and pain relief.
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http://dx.doi.org/10.1007/s00784-019-03144-zDOI Listing
January 2020

Validity of micro-CT for caries detection: a systematic review and meta-analysis.

Dentomaxillofac Radiol 2020 Oct 20;49(7):20190347. Epub 2019 Nov 20.

Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Objective: To investigate the validity of micro-CT for caries detection in comparison with histology as the reference standard.

Methods: A systematic search was conducted in the databases Latin American and Caribbean Health Sciences (LILACS), LIVIVO, PubMed, Scopus and Web of Science from their inception to 16 January 2019. Grey literature was searched on Open Grey, ProQuest Dissertations and Theses Database and Google Scholar. studies assessing the validity of micro-CT for caries detection were included when compared with histology as the reference standard were included. Two authors independently collected the information and sensitivity, specificity, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated. The risk of bias of the included studies was assessed using the QUADAS-2 tool. Certainty of evidence was assessed with GRADE.

Results: A total of 270 papers were identified, and after a 2-phase selection, 12 studies were included in qualitative and three in quantitative synthesis. For enamel caries diagnostic, sensitivity values ranged from 29.0 to 84.0% indicating high variability while specificity varied from 88.0 to 95.0% indicating good to excellent micro-CT capability do identify the true negative. For dentine caries diagnostic, sensitivity values ranged from 61.0 to 77.0% indicating fair-to-good probability of micro-CT to identify the true positives, while specificity varied from 88.0 to 94.0%. The majority of the included studies presented low risk of bias and moderate certainty of evidence.

Conclusions: This study demonstrated the validity of micro-CT for caries detection in comparison with histology.
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http://dx.doi.org/10.1259/dmfr.20190347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549531PMC
October 2020

Prevalence of dentofacial injuries among combat sports practitioners: A systematic review and meta-analysis.

Dent Traumatol 2020 Apr 10;36(2):124-140. Epub 2019 Sep 10.

Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

Background/aim: Combat sports might result in injuries to the face and teeth. However, it is unclear how often they occur and which sports presents the highest rates. The aim of this study was to investigate the prevalence of dentofacial injuries in combat sports participants.

Material And Methods: A systematic review was performed. Six main electronic databases and three grey literature databases were searched. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of dentofacial injuries (teeth, alveolar bone, jaw, lips, and/or cheekbones) among combat sports participants were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The software r statistics version was used to perform all meta-analyses. Cumulative evidence of the included articles was evaluated using GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation).

Results: From 1104 articles found on all databases, 27 were finally included. Eighteen studies were judged at low, seven at moderate, and two at high risk of bias. The following sports were investigated: boxing, capoeira, fencing, jiu-jitsu, judo, karate, kendo, kickboxing, kung fu, muay thai, sumo, taekwondo, wrestling, and wushu. Results from the meta-analysis suggested a dental pooled prevalence of 25.2% (12.3%-40.8%, i  = 100%) and dentofacial pooled prevalence of 30.3 (18.1%-44.1%, i  = 100%). Considering the sports' categories individually, jiu-jitsu had the highest pooled prevalence of dentofacial injuries (52.9% [37.9%-67.8%, i  = 92%]), while judo was the sport with the lowest pooled prevalence (25.0% [7.6%-48.2%, i  = 98%]). Among Panamerican sports, boxing had the highest prevalence of dental injuries (73.7% [58.7%-86.3%, i  = 0%]). For dentofacial injuries, the GRADE criteria were considered low.

Conclusions: Overall pooled prevalence of dentofacial injuries in combat sports was approximately 30%. Raising awareness regarding the frequency of these injuries might encourage the use of protective devices and reduce complications related to these incidents.
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http://dx.doi.org/10.1111/edt.12508DOI Listing
April 2020

Deglutition disorders as a consequence of head and neck cancer therapies: a systematic review and meta-analysis.

Support Care Cancer 2019 Oct 22;27(10):3681-3700. Epub 2019 Jun 22.

Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília, Brasília, Brazil.

Purpose: In this study, we aimed to estimate the frequency of deglutition disorders in patients pre- and post-treatment for head and neck cancer (HNC).

Methods: Search strategies were developed for the following databases: LILACS, PubMed, SpeechBITE, LIVIVO, Web of Science, and Scopus. Additionally, the gray literature was searched using Google Scholar, OpenGrey, and ProQuest. Only studies that conducted an evaluation of deglutition before and after cancer treatment and had sufficient quantitative data were included. We conducted a proportion of random effects meta-analysis using R statistical software.

Results: Seventeen studies were included. Aspiration showed a high frequency in the period less than 3 months post-treatment, with 28.6% (total sample = 229). Penetration of fluids above the vocal folds and reduced laryngeal elevation were more frequent in the period less than 6 months post-treatment.

Conclusion: The frequency of deglutition disorders and its complications, such as aspiration, appears to be higher in the immediate to 6-month post-treatment period in patients with HNC. The parameter pharyngeal residue continued to increase through the period analyzed.
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http://dx.doi.org/10.1007/s00520-019-04920-zDOI Listing
October 2019

Placebo and nocebo response magnitude on temporomandibular disorder-related pain: A systematic review and meta-analysis.

J Oral Rehabil 2019 Sep 4;46(9):862-882. Epub 2019 Aug 4.

Brazilian Centre for Evidence Based Research, Dentistry Department, Federal University of Santa Catarina, Florianópolis, Brazil.

Objectives: The aim of this systematic review (SR) was to answer the following question: "In adult patients with temporomandibular disorder (TMD)-related pain, what is the placebo or nocebo effect of different therapies?"

Methods: A SR was performed with randomised clinical placebo-controlled trials on diagnosed painful TMD studies from five main databases and from three grey literature. Studies included must have sample older than 18 years, with painful TMD, which diagnosis was done by Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD).

Results: Out of 770 articles obtained, 42 met the inclusion criteria for qualitative and 26 for quantitative analysis. Meta-analysis indicated mean variation on pain intensity for placebo therapy was higher on laser acupuncture with 45.5 mm point reduction, followed by avocado soya bean extract with 36 mm and amitriptyline 25 mg with 25.2 mm. Laser showed a 29% of placebo effect, as well medicine with 19% and other therapies with 26%. Possible nocebo effect of 8% pain increase was found for intra-articular injection of Ultracain.

Conclusions: Based on the available data, the placebo response could play a major effect on TMD pain management and may be responsible from 10% to 75% of pain relief. Laser acupuncture, avocado soya bean and amitriptyline promoted the higher placebo effect. Possible nocebo effect was found only for Ultracain injection with 8%.

Clinical Relevance: Clinicians could apply such evidence to optimise pain management and judgement about treatment efficacy, and researches may find it useful when designing their investigations.
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http://dx.doi.org/10.1111/joor.12827DOI Listing
September 2019

Bruxism: An umbrella review of systematic reviews.

J Oral Rehabil 2019 Jul 7;46(7):666-690. Epub 2019 May 7.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.

Objectives: To synthesise available knowledge about both sleep (SB) and awake bruxism (AB) as depicted by previous published systematic reviews (SR).

Methods: SR investigating any bruxism-related outcome were selected in a two-phase process. Searches were performed on seven main electronic databases and a partial grey literature search on three databases. Risk of bias of included SR was assessed using the "University of Bristol's tool for assessing risk of bias in SR".

Results: From 1038 studies, 41 SR were included. Findings from these SR suggested that (a) among adults, prevalence of AB was 22%-30%, SB (1%-15%), and SB among children and adolescents (3%-49%); (b) factors consistently associated with bruxism were use of alcohol, caffeine, tobacco, some psychotropic medications, oesophageal acidification and second-hand smoke; temporomandibular disorder signs and symptoms presented a plausible association; (c) portable diagnostic devices showed overall higher values of specificity (0.83-1.00) and sensitivity (0.40-1.00); (d) bruxism might result in biomechanical complications regarding dental implants; however, evidence was inconclusive regarding other dental restorations and periodontal impact; (e) occlusal appliances were considered effective for bruxism management, although current evidence was considered weak regarding other therapies.

Conclusions: Current knowledge from SR was mostly related to SB. Higher prevalence rates were found in children and adolescents than in adults. Associated factors and bruxism effects on stomatognathic structures were considerably heterogeneous and inconsistent. Overall good accuracy regarding portable diagnostic devices was found. Interventions' effectiveness was mostly inconclusive regarding the majority of available therapies, with the exception of occlusal appliances.
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http://dx.doi.org/10.1111/joor.12801DOI Listing
July 2019

Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: a meta-analysis.

Clin Oral Investig 2019 May 28;23(5):2021-2040. Epub 2019 Mar 28.

Brazilian Centre for Evidence-based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Objective: To determine the diagnostic accuracy of panoramic radiography (PR) in detecting calcified carotid artery atheroma (CCAA) compared with Doppler ultrasonography or angiography (the reference standard).

Sources: Cochrane, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest were searched. The reference lists of the included studies were also screened.

Data: Observational studies.

Methods: Only studies comparing the diagnostic accuracy of PR in detecting CCAA to Doppler ultrasonography or angiography (the reference standard) were included. The primary outcome measures were sensitivity and specificity. The secondary outcomes were negative predictive values, positive predictive values, diagnostic odds ratios, likelihood ratios (positive and negative), receiver operating characteristic curves, accuracy, and Youden's index. Two reviewers independently participated in the study selection, data extraction, and risk of bias assessment without language restriction. Risk of bias was assessed thought QUADAS-2, and the level of evidence was assessed through GRADE.

Results: A total of 773 citations were identified after duplicates were removed, and 12 studies including 1002 patients were included in the final study. The sensitivity and specificity of the different selected studies varied substantially, with sensitivity ranging from 0.31 to 0.95 and specificity from 0.19 to 0.99.

Conclusions: Most studies reported excellent sensitivity and good specificity. The diagnostic accuracy of PR was good or excellent in 50% of the studies.

Clinical Significance: The identification of CCAA by PR can be a risk predictor for stroke when used as a secondary screening tool.
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http://dx.doi.org/10.1007/s00784-019-02880-6DOI Listing
May 2019

Association between sleep bruxism and anxiety symptoms in adults: A systematic review.

J Oral Rehabil 2019 May 12;46(5):482-491. Epub 2019 Mar 12.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

Background: The purpose of this systematic review was to evaluate the association between sleep bruxism (SB) and anxiety symptoms in adults.

Methods: A systematic review was performed and studies assessing SB by means of questionnaires, clinical examination and/or polysomnography (PSG), and validated questionnaires to assess anxiety, were included. Search strategies were developed for seven main electronic databases. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies, and confidence in cumulative evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation criteria.

Results: Eight cross-sectional studies were included, of which five were judged with low and three with moderate risk of bias. No association with SB was observed in three studies that investigated generic levels of anxiety, while other two papers that evaluated generic anxiety levels through the State-Trait Anxiety Inventory (STAI) found a positive association with probable and definite SB in both STAI-1 and STAI-2 subscales. Only one study evaluated dental anxiety in particular and an association with probable SB was observed regarding very anxious or extremely anxious scores. Two studies assessed specific symptoms of anxiety using the panic-agoraphobic spectra evaluation (PAS-SR) questionnaire. Significantly higher PAS-SR total scores were observed in both studies with regard to SB. No study with definitive assessment of SB was identified.

Conclusion: Current literature is controversial regarding an association between SB and generic symptoms of anxiety in adults. It seems that some specific symptoms of the anxiety disorders spectrum might be associated with probable SB.
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http://dx.doi.org/10.1111/joor.12785DOI Listing
May 2019

Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta-analysis.

J Oral Pathol Med 2019 Apr 12;48(4):270-277. Epub 2019 Feb 12.

Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.

Objective: To assess the prevalence of oral mucosal disorders during pregnancy.

Methods: Observational studies were selected by two reviewers in a two-phase process. Search strategies were applied at CINAHL, LILACS, LIVIVO, PubMed, Scopus, Web of Science, Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated by the software R Statistics version 3.5.1 (The R Foundation, Vienna, Austria). Confidence in cumulative evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.

Results: Fifteen studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, of which 5935 participants were enrolled. The overall prevalence of oral mucosal disorders was 11.8%. Gingival hyperplasia (17.1%), morsicatio buccarum (10%), oral candidiasis (4.4%), pyogenic granuloma (3%), and benign migratory glossitis (2.8%) were the most prevalent lesions. The overall risk of bias was considered moderate, and the quality of evidence was very low.

Conclusion: Disorders of the oral mucosa were present in approximately 1 out of 10 pregnant women. Gingival hyperplasia was the most prevalent lesion. Further studies should apply homogeneous methodology to improve the quality of evidence.
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http://dx.doi.org/10.1111/jop.12831DOI Listing
April 2019

Diagnostic validity of biomarkers in Parkinson's Disease: systematic review and meta-analysis.

Rev Bras Enferm 2018 Nov-Dec;71(6):3074-3083

Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil.

Objective: To identify biomarkers for Parkinson's disease, cerebrospinal fluid, blood, saliva, and urine.

Method: The studies were collected from the Cochrane, LILACS, PubMed, SCOPUS, WEB OF SCIENCE, OpenGrey, ProQuest and Google Scholar databases starting from May 3, 2016 and updated on March 20, 2017. Twenty-two studies were evaluated, by the Quality Assessment Tool for Diagnostic Accuracy Studies and Review Manager 5.3.

Results: Evidence shows that serum antibodies can be used as highly specific and accurate biomarkers for the diagnosis of Parkinson's disease at the outset. Biomarkers in the cerebrospinal fluid are related to increased motor severity, postural instability, gait abnormality, and cognitive impairment.

Conclusion: Serum and cerebrospinal antibodies can be used as diagnostic biomarkers at the onset of the disease.
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http://dx.doi.org/10.1590/0034-7167-2017-0822DOI Listing
March 2019

Accuracy of Casts Fabricated by Digital and Conventional Implant Impressions.

J Oral Implantol 2019 Apr 19;45(2):94-99. Epub 2018 Nov 19.

1   Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.

The purpose of this study was to compare the accuracy of stereolithographic casts (SCs) with those obtained using conventional implant impressions. An epoxy resin model containing dental implants was used as master model. Dental casts (n = 10) were fabricated through both conventional and digital implant impressions. The conventional casts (CCs), SCs, and the master model were digitized, and the accuracy was determined through a deviation analysis and linear measurements. Data were analyzed using paired Student test with < .05. The SCs showed higher deviation at the vestibular area (CC: 41 ± 28.87 μm; SC: 117 ± 36.83 μm) and lingual cusps (CC: 40.70 ± 19.79 μm; SC: 80 ± 42.95 μm) in comparison with CCs. No statistically significant difference was found for linear measurements of conventional and digital casts. The entire-arch accuracy was comparable between casts. However, SCs were less accurate at the cusp level in comparison with CCs.
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http://dx.doi.org/10.1563/aaid-joi-D-17-00142DOI Listing
April 2019

Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis.

Support Care Cancer 2019 Feb 29;27(2):407-421. Epub 2018 Oct 29.

Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology, University of Brasília, Brasília, Brazil.

Purpose: The aim of this systematic review was to identify the interventions used to treat obstructive events, whether thrombotic or non-thrombotic, in long-term central venous catheters (LT-CVC) in cancer patients.

Methods: This review included clinical trials and observational studies reporting the drugs used to treat obstructive catheter events in cancer patients. The authors developed specific search strategies for CINAHL, Cochrane CENTRAL, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest. The authors evaluated methodological quality of included studies using criteria from Cochrane's Collaboration Tool and the Methodological Index for non-randomized studies (MINORS). The quality of evidence was analyzed by using GRADE's software.

Results: More than 9000 articles were found across the databases. After duplicates removed, the studies were selected in 2 phases. After that, only 15 studies were included. The drugs used to restoration of catheter function were urokinase (53.3%), alteplase (20%), tenecteplase (13.3%), reteplase (6.7%), recombinant urokinase (6.7%), and staphylokinase (6.7%). The results of meta-analysis of 14 studies showed an overall restoration rate of ~ 84%. The drug type meta-analysis demonstrates a success rate of ~ 84%, ~ 92%, and ~ 84% for urokinase, alteplase, and tenecteplase groups, respectively. The main methodological problem in included articles concerns the sample. The quality of evidence ranged from very low to high.

Conclusion: The most common interventions used to treat thrombotic catheter occlusion in cancer patients were urokinase and alteplase. No evidence was found about the treatment for non-thrombotic occlusion, thus elucidating an important gap to be investigated.
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http://dx.doi.org/10.1007/s00520-018-4500-yDOI Listing
February 2019

Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review.

Clin Oral Investig 2019 May 11;23(5):2475-2488. Epub 2018 Oct 11.

Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília, Brasília, Brazil.

Objectives: The purpose of this systematic review was to evaluate evidence about the prevalence of degenerative joint disease (DJD) of the temporomandibular joints (TMJ).

Materials And Methods: We performed search on electronic databases and gray literature from their inception to January 2018. Studies reporting prevalence data of DJD on TMJ were included. DJD was assessed through clinical and imaging diagnosis. Studies risk of bias was evaluated using the Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results: From 1082 studies, 32 were identified, and the sample size included 3435 subjects. They were clustered into two groups: the first comprised studies that reported prevalence of DJD in TMJ secondary to rheumatic systemic diseases like juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA) and the second group comprised studies that reported prevalence of DJD on temporomandibular disorder patients. The prevalence of DJD on JIA patients ranged from 40.42% (n = 47) to 93.33% (n = 15) and on RA patients from 45.00% (n = 20) to 92.85% (n = 56). Among TMD patients, the prevalence of DJD reported according to patients ranged from 18.01% (n = 1038) to 84.74% (n = 118) and reported according to joints ranged from 17.97% (n = 178) to 77.23% (n = 224).

Conclusion: This review attempts to high prevalence of DJD in patients with systemic rheumatic disease and a less prevalent, but still high, occurrence in patients with TMD without systemic involvement.

Clinical Relevance: Specialist doctors and dentists should be alert to not underestimate and to correctly diagnose DJD of the TMJ early in patients with rheumatic disease and TMD.
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http://dx.doi.org/10.1007/s00784-018-2664-yDOI Listing
May 2019