Background: Weight in individuals can affect the saliva structure, which has an essential role in caries prevention. Aim: This meta-analysis aimed to compare individuals with obesity (OB)/overweight (OW) and normal weight (NW) in terms of salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC). Materials and Methods: After electronic databases (Web of Science, PubMed, Scopus, Cochrane Library, and Open Grey databases) were screened, studies were selected depending on inclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias in individual studies. Mean differences (MD) were used to measure the effect estimates in the comparisons of OB vs NW, OW vs NW, and OB+OW vs NW. Additional analyzes such as subgroup, moderator, sensitivity, and grade were also performed. Results: 24 studies and 2072 participants (SFR: 748 OB, 896 NW, SpH: 137 OB, 166 NW, SBC: 62 OB, 63 NW) were included in the quantitative synthesis. Significantly lower SFR was found in the group with OB compared to NW when saliva was stimulated (MD = -0.21, 95% CI [-0.30, -0.12], P < 0.001), but no significance was obtained when saliva was unstimulated (MD = -0.02, 95% CI [-0.11, 0.06], P = 0.55). No significant difference was found in the group with OB compared to NW in SpH (MD = -0.07, 95% CI [-0.26,0.12], P = 0.48) and SBC (MD = -1.10, 95% CI [-2.29,0.09], P = 0.07). Conclusions: SFR significantly decreases in individuals with OB, notably when saliva is stimulated. Besides, the decrease in SFR is much more prominent in adolescence and adulthood than in childhood. Furthermore, the increase in the severity of OB causes a much greater decrease in SFR. However, regarding SpH and SBC, no significant association exists.
Fractal analysis (FA) is a quantitative, objective and non‐invasive method that facilitates the characterisation of the tissue architecture. This study aims to compare the periapical healing at 1‐year follow‐up by evaluating newly generated trabecular bone with FA after Mineral trioxide aggregate (MTA) plug and regenerative endodontic treatment (RET). A total of 55 asymptomatic teeth with a single‐canal, open apex and periapical lesion, treated with MTA plug or RET, were evaluated retrospectively. After considering the inclusion/exclusion criteria, FA was conducted on 30 periapical images using the box‐counting method. In both groups, a significant decrease was observed in the periapical lesion size at 1‐year follow‐up (p < 0.01). However, there was no significant difference between the MTA plug and RET (p > 0.01). Significantly higher fractal dimension values were detected at 1‐year follow‐up in both MTA plug and RET cases (p < 0.01). However, the difference was not significant between the groups (p > 0.01). Both procedures seem to improve periapical healing with a new resistant bone of similar density and complexity.
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