1.Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis
Theodoro WEISSHEIMER ; Karem Paula PINTO ; Emmanuel João Nogueira Leal da SILVA ; Lina Naomi HASHIZUME ; Ricardo Abreu da ROSA ; Marcus Vinicius Reis SÓ
Restorative Dentistry & Endodontics 2023;48(4):e37-
This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies.Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, −271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], p = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, −36.41, 77.59], p = 0.48; I2 = 74%).There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.
2.Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis
Ricardo Purchio GALLETTI ; Gabriel Andrade AGARENO ; Lucas de Abreu SESCONETTO ; Rafael Benjamim Rosa da SILVA ; Rafael Vaz PANDINI ; Lucas Soares GERBASI ; Victor Edmond SEID ; Sérgio Eduardo Alonso ARAUJO ; Francisco TUSTUMI
Annals of Coloproctology 2023;39(5):375-384
Purpose:
This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.
Methods:
A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. The protocol is registered in PROSPERO (No. CRD42021267715).
Results:
Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%–0.01%). The postoperative complication rate was 40% (95% CI, 40%–50%). The length of hospital stay was 13.68 days (95% CI, 11.3–16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%–90%), and 24% of patients (95% CI, 0%–39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P=0.002) was associated with a lower probability of being free of stoma in meta-regression.
Conclusion
Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.
3.Dentinal tubule penetration of sodium hypochlorite in root canals with and without mechanical preparation and different irrigant activation methods
Renata Aqel de OLIVEIRA ; Theodoro WEISSHEIMER ; Gabriel Barcelos SÓ ; Ricardo Abreu da ROSA ; Matheus Albino SOUZA ; Rodrigo Gonçalves RIBEIRO ; Marcus Vinicius Reis SÓ
Restorative Dentistry & Endodontics 2023;48(1):e1-
Objectives:
This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols.
Materials and Methods:
Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student’s t-test were used for data analysis, with a significance level of 5%.
Results:
The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019).
Conclusions
The NaOCl penetration depth was similar in groups with root canal preparation.Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.
4.Does photobiomodulation on the root surface decrease the occurrence of root resorption in reimplanted teeth? A systematic review of animal studies
Theodoro WEISSHEIMER ; Karolina Frick BISCHOFF ; Carolina Horn TROIAN MICHEL ; Bruna BARCELOS SÓ ; Manoela Domingues MARTINS ; Matheus Albino SOUZA ; Ricardo Abreu DA ROSA ; Marcus Vinícius REIS SÓ
Restorative Dentistry & Endodontics 2023;48(3):e24-
This review aimed to answer the following question “Does photobiomodulation treatment of the root surface decrease the occurrence of root resorption in reimplanted teeth?” Electronic searches were performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report databases. Risk of bias was evaluated using SYRCLE Risk of Bias tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool was used to assess the certainty of evidence. In total, 6 studies were included. Five studies reported a reduced occurrence of root resorption in teeth that received photobiomodulation treatment of the root surface prior to replantation. Only 1 study reported contradictory results. The photobiomodulation parameters varied widely among studies. GRADE assessment showed a low certainty of evidence. It can be inferred that photobiomodulation treatment of the root surface prior to replantation of teeth can reduce the occurrence of root resorption. Nonetheless, further clinical studies are needed.Trial Registration: PROSPERO Identifier: CRD42022349891