Research methodology in Dentistry: Part I - The essentials and relevance of research

Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review

OBJECTIVE

The aim of this scoping review was to explore and synthesise the current evidence on the antimicrobial activity of antibacterial suture materials used in oral surgery.

METHODS

The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A bibliographic search was carried out in the PubMed and Scopus databases to retrieve all human clinical studies that investigated the antimicrobial efficacy of antibacterial-coated sutures used in oral surgery. Included studies were screened and extracted independently by 2 examiners. Data were tabulated and qualitatively described.

RESULTS

The search initially returned 150 articles and resulted in 5 included studies after the duplicates' removal and the full-text screening. Selected studies were published from 2014 to 2019. Three studies (60%) were randomised clinical trials, whilst the remaining studies did not report information on randomisation. The antimicrobial agents for coated sutures included triclosan and chlorhexidine. In almost all the studies, antibacterial-coated sutures exhibited lower bacterial retention compared to those without coating.

CONCLUSIONS

Within limitations, the antimicrobial-coated sutures employed in oral surgery exhibited good results in terms of their microbicidal activity when compared with sutures that were not coated. Considering the high variability and confounding factors identified in the included studies, more high-quality research is needed to confirm these results. Antimicrobial-coated sutures could represent a promising and clinically valid strategy to reduce microbial colonisation in oral surgery. The reduced bacterial adherence is likely to improve the clinical success of the surgical procedures. Yet, the cost-benefit ratio of antimicrobial-coated sutures should be assessed in larger clinical trials to confirm their efficacy over conventional noncoated sutures.

Deep margin elevation in restorative dentistry: A scoping review

OBJECTIVES

Deep margin elevation (DME) is a restorative approach offering the possibility of performing stepwise elevation of deep proximal cavities to create more favourable margins for direct or indirect restorations. The objectives of this scoping review were to explore what is known or unknown about DME by describing a wide ranging evidence base including peer reviewed literature and non-traditionally published information on the web.

DATA

Data were extracted from the included evidence in order to describe the following: the extent and nature of the evidence base; the situations which are appropriate for DME; the materials and techniques which are used; the outcomes which have been measured in empirical studies; the risks which have been reported; and the findings which have been reported in studies which compared DME to surgical crown lengthening.

SOURCES

This scoping review included a wide range of published evidence and extensive web searching for grey literature, including CPD, training and multimedia information.

STUDY SELECTION

The findings revealed a range of published literature as well as freely available, online information advising practitioners about DME. Most empirical evidence was based on in vitro studies, and there were few clinical studies comparing DME to crown lengthening. Online information included recent, multimedia sources.

CONCLUSIONS

DME is a technique that can be used with motivated patients with good oral hygiene if rubber dam isolation is achieved, if there is no invasion of the connective tissue space, and if a strict restorative protocol is adhered to.

CLINICAL SIGNIFICANCE

With phasing out of amalgam and adhesive dentistry increasing in popularity, DME addresses multiple clinical problems associated with sub-gingival margins prior to restoration.

A scoping review of new technologies for dental plaque quantitation: Benefits and limitations

OBJECTIVES

To determine the validity and reliability of novel digitalized tools for dental plaque detection and explore the benefits and limitations connected to their use.

DATA

Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies comparing dental plaque detection using digitalized systems against a standard reference were included.

SOURCES

PubMed and Scopus were screened from 01 January 2013 to 28 September 2023. Bibliographies of primary studies and principal peer-reviewed scientific journals were manually searched.

STUDY SELECTION

The initial search identified 576 articles, with a total of 13 included in the review, published between 2015 and 2023. Most of the studies included (77 %) were cross-sectional with three being prospective. Digital devices captured 2D and 3D images via cameras and intra-oral scanners, respectively. The Turesky's modified plaque index was the most frequent clinical index. Correlation with clinical examination was moderate to strong, with good to excellent intra- and inter-system agreement.

CONCLUSIONS

Within the limitations of this scoping review, image analysis-based plaque detection systems demonstrated good correlations with clinical plaque indices, using both 2D and 3D imaging systems. Whilst digital plaque detection devices offer advantages in terms of procedural standardization and reproducibility, they also have limitations, therefore currently, their application should be underpinned by a comprehensive clinical examination.

CLINICAL SIGNIFICANCE

Digital plaque detection tools, that provide standardized measurements and store acquired images, facilitate more informed feedback to patients. This objective analysis may enhance clinician confidence in their utility for clinical trials and other applications.

Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis

This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.

Flexural strength of a composite resin light cured with different exposure modes and immersed in ethanol or distilled water media

Aim:

The aim of this in vitro study was to evaluate the flexural strength of a composite resin polymerized with three different modes of light exposure.

Materials and Methods:

The three different modes of light exposure were conventional, 600 mW/cm2/40s; soft start, 300 mW/cm2/10s + 600 mW/cm2/30s; pulse delay, 600 mW/cm2/1s + 60 s of waiting time + 600 mW/cm2/39s). Twenty samples were prepared for each polymerization method. Flexural strength (FS) tests were carried out with a 2 kN load at a speed of 0.5 mm/ min. All tested groups were submitted to analysis of variance (one-way-ANOVA) and Tukey's test (P < 0.05).

Results:

When stored in water, conventional and pulse delay groups presented higher FS values which were statistically different from the soft start group. When stored in 100% ethanol, conventional and soft start groups presented higher FS values which were statistically different from the pulse delay group.

Conclusion:

Different polymerization modes and immersion media can affect the physical properties (flexural strength) of composite resin.

Research methodology in dentistry: Part II - The relevance of statistics in research

The lifeline of original research depends on adept statistical analysis. However, there have been reports of statistical misconduct in studies that could arise from the inadequate understanding of the fundamental of statistics. There have been several reports on this across medical and dental literature. This article aims at encouraging the reader to approach statistics from its logic rather than its theoretical perspective. The article also provides information on statistical misuse in the Journal of Conservative Dentistry between the years 2008 and 2011