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Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Koutris M, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map. J Oral Rehabil 2024; 51:15-28. [PMID: 36261916 DOI: 10.1111/joor.13380] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/26/2022]
Abstract
This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.
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Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Justin Durham
- Newcastle University's School of Dental Sciences, Newcastle, UK
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominik Ettlin
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Birgitta Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingrid Peroz
- Department for Prosthodontics, Charité-University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany
| | - Peter Svensson
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Kreibig SD, Ten Brink M, Mehta A, Talmon A, Zhang JX, Brown AS, Lucas-Griffin SS, Axelrod AK, Manber R, Lavigne GJ, Gross JJ. The Role of Emotion Regulation, Affect, and Sleep in Individuals With Sleep Bruxism and Those Without: Protocol for a Remote Longitudinal Observational Study. JMIR Res Protoc 2023; 12:e41719. [PMID: 37616042 PMCID: PMC10485716 DOI: 10.2196/41719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Sleep bruxism (SB) is an oral behavior characterized by high levels of repetitive jaw muscle activity during sleep, leading to teeth grinding and clenching, and may develop into a disorder. Despite its prevalence and negative outcomes on oral health and quality of life, there is currently no cure for SB. The etiology of SB remains poorly understood, but recent research suggests a potential role of negative emotions and maladaptive emotion regulation (ER). OBJECTIVE This study's primary aim investigates whether ER is impaired in individuals with SB, while controlling for affective and sleep disturbances. The secondary aim tests for the presence of cross-sectional and longitudinal mediation pathways in the bidirectional relationships among SB, ER, affect, and sleep. METHODS The study used a nonrandomized repeated-measures observational design and was conducted remotely. Participants aged 18-49 years underwent a 14-day ambulatory assessment. Data collection was carried out using electronic platforms. We assessed trait and state SB and ER alongside affect and sleep variables. We measured SB using self-reported trait questionnaires, ecological momentary assessment (EMA) for real-time reports of SB behavior, and portable electromyography for multinight assessment of rhythmic masticatory muscle activity. We assessed ER through self-reported trait questionnaires, EMA for real-time reports of ER strategies, and heart rate variability derived from an electrocardiography wireless physiological sensor as an objective physiological measure. Participants' trait affect and real-time emotional experiences were obtained using self-reported trait questionnaires and EMA. Sleep patterns and quality were evaluated using self-reported trait questionnaires and sleep diaries, as well as actigraphy as a physiological measure. For the primary objective, analyses will test for maladaptive ER in terms of strategy use frequency and effectiveness as a function of SB using targeted contrasts in the general linear model. Control analyses will be conducted to examine the persistence of the SB-ER relationship after adjusting for affective and sleep measures, as well as demographic variables. For the secondary objective, cross-sectional and longitudinal mediation analyses will test various competing models of directional effects among self-reported and physiological measures of SB, ER, affect, and sleep. RESULTS This research received funding in April 2017. Data collection took place from August 2020 to March 2022. In all, 237 participants were eligible and completed the study. Data analysis has not yet started. CONCLUSIONS We hope that the effort to thoroughly measure SB and ER using gold standard methods and cutting-edge technology will advance the knowledge of SB. The findings of this study may contribute to a better understanding of the relationship among SB, ER, affect, and sleep disturbances. By identifying the role of ER in SB, the results may pave the way for the development of targeted interventions for SB management to alleviate the pain and distress of those affected. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41719.
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Affiliation(s)
- Sylvia D Kreibig
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Maia Ten Brink
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Ashish Mehta
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Anat Talmon
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Jin-Xiao Zhang
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Alan S Brown
- Department of Psychology, Stanford University, Stanford, CA, United States
| | | | - Ariel K Axelrod
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Gilles J Lavigne
- Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, United States
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LIN GALVINSIMSIANG, CHAN DARYLZHUNKIT, LEE HERNYUE, LOW TT, LAER THITTIKKONSUVANPRATUM, PILLAI MANUSHANTINIPILLAIMURALITHARAN, YEW YUNQING, WAFA SHARIFAHWADEWAFASYEDSAADUNTAREK. EFFECTIVENESS OF RESIN INFILTRATION IN CARIES INHIBITION AND AESTHETIC APPEARANCE IMPROVEMENT OF WHITE-SPOT LESIONS: AN UMBRELLA REVIEW. J Evid Based Dent Pract 2022; 22:101723. [DOI: 10.1016/j.jebdp.2022.101723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/20/2021] [Accepted: 01/19/2022] [Indexed: 01/01/2023]
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Asquini G, Rushton A, Pitance L, Heneghan N, Falla D. The effectiveness of manual therapy applied to craniomandibular structures in the treatment of temporomandibular disorders: protocol for a systematic review. Syst Rev 2021; 10:70. [PMID: 33685496 PMCID: PMC7941703 DOI: 10.1186/s13643-021-01623-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The term temporomandibular disorder (TMD) includes disorders of the temporomandibular joints (TMJ), masticatory muscles and adjacent tissues. Several studies have examined the effectiveness of manual therapy (MT) for TMDs by evaluating changes in pain and maximum mouth opening (MMO). Nevertheless, the effectiveness of MT exclusively applied to the craniomandibular structures (craniomandibular manual therapy (CMMT)) on pain and TMJ range of motion remains unclear. This review aims to evaluate the effectiveness of CMMT on pain and TMJ range of motion in people with TMDs. METHODS This protocol is reported in line with the preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P). Databases including MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews-Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar will be searched from inception as well as key journals and grey literature. Randomised controlled trials involving adults with TMD that compare the effect of any type of CMMT (e.g. mobilisation) on pain and range of motion with a placebo intervention, controlled care intervention or other types of treatment will be included. Two reviewers will independently screen articles for inclusion, extract data, assess risk of bias (revised Cochrane risk of bias tool) for included studies and evaluate overall quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). A meta-analysis will be conducted if possible. If not, a narrative synthesis will be conducted reporting the effectiveness of CMMT according to disorder type (TMJ disorders, masticatory muscle disorders and mixed disorders). DISCUSSION In this review, the effectiveness of MT applied to craniomandibular structures for the treatment of TMD will be evaluated. Results will be submitted for publication in a peer-reviewed journal and presented at conferences. We expect our findings will facilitate treatment planning for manual therapists managing patients with TMD and provide future clinical research implications. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019160213.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Neuro-Musculo-Skeletal-Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Nicola Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
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AL‐Rabab'ah MA, AlTarawneh S, Jarad FD, Devlin H. Methodological Quality of Systematic Reviews Relating to Performance of All‐Ceramic Implant Abutments, Frameworks, and Restorations. J Prosthodont 2020; 30:36-46. [DOI: 10.1111/jopr.13206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mohammad A. AL‐Rabab'ah
- Department of Conservative Dentistry, School of Dentistry The University of Jordan Amman Jordan
- School of Dentistry University of Liverpool UK
- Division of Dentistry The University of Manchester UK
| | - Sandra AlTarawneh
- Department of Removable Prosthodontics, School of Dentistry The University of Jordan Amman Jordan
- Department of Restorative Dentistry UIC College of Dentistry Chicago IL
| | | | - Hugh Devlin
- Division of Dentistry The University of Manchester UK
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Riley P, Glenny AM, Worthington HV, Jacobsen E, Robertson C, Durham J, Davies S, Petersen H, Boyers D. Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation. Health Technol Assess 2020; 24:1-224. [PMID: 32065109 PMCID: PMC7049908 DOI: 10.3310/hta24070] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Splints are a non-invasive, reversible management option for temporomandibular disorders or bruxism. The clinical effectiveness and cost-effectiveness of splints remain uncertain. OBJECTIVES The objectives were to evaluate the clinical effectiveness and cost-effectiveness of splints for patients with temporomandibular disorders or bruxism. This evidence synthesis compared (1) all types of splint versus no/minimal treatment/control splints and (2) prefabricated versus custom-made splints, for the primary outcomes, which were pain (temporomandibular disorders) and tooth wear (bruxism). REVIEW METHODS Four databases, including MEDLINE and EMBASE, were searched from inception until 1 October 2018 for randomised clinical trials. The searches were conducted on 1 October 2018. Cochrane review methods (including risk of bias) were used for the systematic review. Standardised mean differences were pooled for the primary outcome of pain, using random-effects models in temporomandibular disorder patients. A Markov cohort, state-transition model, populated using current pain and Characteristic Pain Intensity data, was used to estimate the incremental cost-effectiveness ratio for splints compared with no splint, from an NHS perspective over a lifetime horizon. A value-of-information analysis identified future research priorities. RESULTS Fifty-two trials were included in the systematic review. The evidence identified was of very low quality with unclear reporting by temporomandibular disorder subtype. When all subtypes were pooled into one global temporomandibular disorder group, there was no evidence that splints reduced pain [standardised mean difference (at up to 3 months) -0.18, 95% confidence interval -0.42 to 0.06; substantial heterogeneity] when compared with no splints or a minimal intervention. There was no evidence that other outcomes, including temporomandibular joint noises, decreased mouth-opening, and quality of life, improved when using splints. Adverse events were generally not reported, but seemed infrequent when reported. The most plausible base-case incremental cost-effectiveness ratio was uncertain and driven by the lack of clinical effectiveness evidence. The cost-effectiveness acceptability curve showed splints becoming more cost-effective at a willingness-to-pay threshold of ≈£6000, but the probability never exceeded 60% at higher levels of willingness to pay. Results were sensitive to longer-term extrapolation assumptions. A value-of-information analysis indicated that further research is required. There were no studies measuring tooth wear in patients with bruxism. One small study looked at pain and found a reduction in the splint group [mean difference (0-10 scale) -2.01, 95% CI -1.40 to -2.62; very low-quality evidence]. As there was no evidence of a difference between splints and no splints, the second objective became irrelevant. LIMITATIONS There was a large variation in the diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these limitations did not indicate a reduction in pain. CONCLUSIONS The very low-quality evidence identified did not demonstrate that splints reduced pain in temporomandibular disorders as a group of conditions. There is insufficient evidence to determine whether or not splints reduce tooth wear in patients with bruxism. There remains substantial uncertainty surrounding the most plausible incremental cost-effectiveness ratio. FUTURE WORK There is a need for well-conducted trials to determine the clinical effectiveness and cost-effectiveness of splints in patients with carefully diagnosed and subtyped temporomandibular disorders, and patients with bruxism, using agreed measures of pain and tooth wear. STUDY REGISTRATION This study is registered as PROSPERO CRD42017068512. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 7. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Elisabet Jacobsen
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Clare Robertson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Justin Durham
- Centre for Oral Health Research and School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Stephen Davies
- TMD Unit, University Dental Hospital of Manchester, Manchester, UK
| | - Helen Petersen
- University Dental Hospital of Manchester, Manchester, UK
| | - Dwayne Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
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Manfredini D. Tinnitus in Temporomandibular Disorders patients: any clinical implications from research findings? Evid Based Dent 2019; 20:30-31. [PMID: 30903128 DOI: 10.1038/s41432-019-0012-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Data sources PubMed, the Cochrane Library and the Web of Science databases supplemented by a search of selected textbooks and the reference lists of included papers.Study selection Two reviewers independently selected studies. Studies involving more than ten TMD patients published in English or Swedish were considered.Data extraction and synthesis Two reviewers independently abstracted data and assessed risk of bias using the Joanna Briggs Institute prevalence critical appraisal pool and Newcastle-Ottawa Scale.Results Twenty-five studies were included. Seventeen described the prevalence or incidence in a TMD population, five reported prevalence and treatment outcomes and three treatment outcomes only. Prevalence of tinnitus ranged from 3.7% to 70% (median 42.3%) in TMD patients compared with 1.7% to 26% (median 12%) in control groups. Only one study provided evidence that treatment could improve symptoms compared with no treatment.Conclusions This systematic review found a higher prevalence of tinnitus in patients with TMD compared with the general population. This supports the comorbidity between TMD and tinnitus; however, all but one of the included primary studies on treatment of TMD lacked control groups, which means that future research should target the pathophysiological association.
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Manfredini D, Ahlberg J, Wetselaar P, Svensson P, Lobbezoo F. The bruxism construct: From cut‐off points to a continuum spectrum. J Oral Rehabil 2019; 46:991-997. [DOI: 10.1111/joor.12833] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 04/29/2019] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry University of Siena Siena Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki Finland
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
- Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON) Aarhus Denmark
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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Melo G, Duarte J, Pauletto P, Porporatti AL, Stuginski‐Barbosa J, Winocur E, Flores‐Mir C, De Luca Canto G. Bruxism: An umbrella review of systematic reviews. J Oral Rehabil 2019; 46:666-690. [DOI: 10.1111/joor.12801] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/04/2019] [Accepted: 04/10/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Gilberto Melo
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Joyce Duarte
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - Patrícia Pauletto
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | - André Luís Porporatti
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
| | | | - Ephraim Winocur
- Department of Oral Rehabilitation Tel Aviv University Tel Aviv Israel
| | - Carlos Flores‐Mir
- Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Santa Catarina Brazil
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