Background/Aim Combat sports might result in injuries to the face and teeth. However, it is unclear how often they occur and which sports presents the highest rates. The aim of this study was to investigate the prevalence of dentofacial injuries in combat sports participants. Material and Methods A systematic review was performed. Six main electronic databases and three grey literature databases were searched. Studies were blindly selected by two reviewers based on pre‐defined eligibility criteria. Studies that evaluated the prevalence of dentofacial injuries (teeth, alveolar bone, jaw, lips, and/or cheekbones) among combat sports participants were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The software r statistics version was used to perform all meta‐analyses. Cumulative evidence of the included articles was evaluated using GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation). Results From 1104 articles found on all databases, 27 were finally included. Eighteen studies were judged at low, seven at moderate, and two at high risk of bias. The following sports were investigated: boxing, capoeira, fencing, jiu‐jitsu, judo, karate, kendo, kickboxing, kung fu, muay thai, sumo, taekwondo, wrestling, and wushu. Results from the meta‐analysis suggested a dental pooled prevalence of 25.2% (12.3%‐40.8%, i2 = 100%) and dentofacial pooled prevalence of 30.3 (18.1%‐44.1%, i2 = 100%). Considering the sports' categories individually, jiu‐jitsu had the highest pooled prevalence of dentofacial injuries (52.9% [37.9%‐67.8%, i2 = 92%]), while judo was the sport with the lowest pooled prevalence (25.0% [7.6%‐48.2%, i2 = 98%]). Among Panamerican sports, boxing had the highest prevalence of dental injuries (73.7% [58.7%‐86.3%, i2 = 0%]). For dentofacial injuries, the GRADE criteria were considered low. Conclusions Overall pooled prevalence of dentofacial injuries in combat sports was approximately 30%. Raising awareness regarding the frequency of these injuries might encourage the use of protective devices and reduce complications related to these incidents.
Ribeiro DM, R eus JC, Felippe WT, Pacheco-Pereira C, Dutra KL, Santos JN, Porporatti AL, De Luca Canto G. Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a metaanalysis. International Endodontic Journal, 51, 269-283, 2018.The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic review was to answer the following focused questions: (i) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? (ii) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data were collected based on predetermined criteria. The key features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality, and a meta-analysis on all studies was conducted. At the end of the screening, 24 articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior teeth, 49% to premolars and 26% to molars. The main procedural errors reported were ledge formation, furcation perforation, apical transportation and apical perforation. The heterogeneity amongst the studies was high (84-99%). Five studies had a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training.
This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of questionnaires, clinical assessment and portable diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism (SB). Two reviewers searched electronic databases for diagnostic test accuracy studies that compared questionnaires, clinical assessment or portable diagnostic devices for SB, with the reference standard method PSG, comprising previous studies from all languages and with no restrictions regarding age, gender or time of publication. Of the 351 articles, eight met the inclusion criteria for qualitative, and seven for quantitative analysis. The methodology of selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The studies were divided and analysed over three groups: three studies evaluating questionnaires, two regarding the clinical assessment of tooth wear and three covering portable diagnostic devices. The MA indicated that portable diagnostic devices showed the best validity of all evaluated methods, especially as far as a four-channel EMG/ECG recording is concerned. Questionnaires and the clinical assessment can be used as screening methods to identify non-SB individuals, although it is not that good in identifying subjects with SB. The quality of evidence identified through GRADEpro, was from very low-to-moderate, due to statistical heterogeneity between studies.
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