Tooth autotransplantation is a versatile procedure with several clinical applications among patients across different age groups. The success of this procedure depends on multiple factors. Despite the wealth of studies available, no single primary study or systematic review is able to report on every factor affecting the outcomes of autotransplantation. The aims of this umbrella review were to evaluate treatmentrelated and patient-related outcomes of autotransplantation and to assess the pre-, peri-or post-operative factors that could affect these. An umbrella review was conducted according to the PRISMA statement. A literature search of five databases was performed up to 25 September 2022. Systematic Reviews (SR) with and without meta-analysis evaluating autotransplantation were included. Calibration among reviewers was carried out prior to study selection, data extraction and Risk of Bias (RoB) assessment. Study overlap was calculated using corrected covered area. Meta-metaanalysis (MMA) was performed for suitable SRs. The AMSTAR 2 critical appraisal tool was used to evaluate the quality of evidence. Seventeen SRs met the inclusion criteria. Only two SRs were suitable for conduct of MMA on autotransplantation of open apex teeth. The 5-year and 10-year survival rates were >95%. A narrative summary on factors that could affect autotransplantation outcomes and comparisons of autotransplantation to other treatment options were reported. Five SRs were rated as 'low quality' and 12 SRs were rated as 'critically low quality' in the AMSTAR 2 RoB assessment. In order to facilitate a more homogenous pool of data for subsequent meta-analysis, an Autotransplantation Outcome Index was also proposed to standardise the definition of outcomes. Autotransplantation of teeth with open apices have a high survival rate. Future studies should standardise the reporting of clinical and radiographic findings, as well as the definition of outcomes.
Dental autotransplantation refers to 'transplantation of an unerupted or erupted tooth in the same individual, from one site to another extraction site or a new surgically prepared socket'. 1 It has various advantages, such as conferring a satisfactory gingival outcome among patients, 2 facilitating the growth of alveolar bone 3 and potential for regeneration of normal periodontal ligament (PDL) that allows for proprioception and orthodontic movement. 4 The success and survival rate of autotransplantation is over 85%, with donor teeth with open apices having lower complication rates than those with complete root development. 5 As such, autotransplantation is considered a viable treatment option when applied within a comprehensive plan by an interdisciplinary dental team to replace missing teeth due to traumatic dental injury (TDI) 6 or manage hypodontia 7 among children and adolescents.In recent years, methods to further improve the success and survival of autotransplants have been investigated. This involves presurgical preparation, such as using cone beam computed tomography (CBCT) for surgical simulation and developing three-dimensional (3D)-printed donor teeth replicas or surgical stents prior to the procedure. 8 The former allows clinicians to evaluate the adequacy of the prepared socket before carrying out the actual transplant, which minimises trauma and extra-alveolar time to the donor teeth while
Background Preformed metal crowns (PMCs) have been used to restore carious primary molars and have a high success and survival rate. There are two methods currently employed for PMC placement ‐ the conventional technique (CT) and Hall technique (HT). Aim This systematic review aims to compare the outcomes of PMCs placed using the CT and HT. Design This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta‐analysis statement. A literature search of five databases was performed up to 23 August 2022. Clinical studies comparing carious primary molars restored with PMCs using either technique with a minimum 12‐month follow‐up were included. Risk of bias (RoB) assessment was performed using the National Institutes of Health Quality Assessment tool. Results Five articles met the inclusion criteria, and four were included for meta‐analysis. The 12‐ and 24‐month success and survival rates were above 85% for both groups, with no significant differences shown at 12 and 24 months. The HT requires a shorter treatment duration, is more cost‐effective and has a high level of acceptability among parents when compared to the CT. Four articles were rated fair, and one article was rated good in the RoB assessment. Conclusion Greater consideration may be given towards using the HT as part of standard treatment procedures in managing carious primary molars. Future studies should standardise reporting of outcomes to facilitate a more homogeneous pool of data for future meta‐analysis.
The D-DART (Droplet and Aerosol Reducing Tent) is a foldable design that can be attached to the dental chair to prevent the spread of contaminated dental aerosols. The objective of this study was to evaluate the ability of the D-DART to reduce spread of aerosols generated during dental treatment. Thirty-two patients (sixteen per group) undergoing deep ultrasonic scaling were recruited and randomly allocated to groups D-DART or Control (no D-DART). After 20 min from the start of the treatment, the clinician’s face shield and dental chair light were swabbed and the viable microbial load was quantified (ATP bioluminescence analysis, blinded operator). Statistical analyses were performed with Tukey’s Honest Test with a level of significance pre-set at 5%. There were significant increases in ATP values obtained from the operator’s face shield and dental chair light for the Control compared with baseline (31.3 ± 8.5 and fold increase). There was no significant change in microbial load when the D-DART was used compared with baseline (1.5 ± 0.4 fold increase). The D-DART contained and prevented the spread of aerosols generated during deep scaling procedures.
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