121 results on '"Varga, Gábor"'
Search Results
2. Comparison of bioactive material failure rates in vital pulp treatment of permanent matured teeth - a systematic review and network meta-analysis.
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Komora P, Vámos O, Gede N, Hegyi P, Kelemen K, Galvács A, Varga G, Kerémi B, and Vág J
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- Humans, Aluminum Compounds therapeutic use, Oxides therapeutic use, Drug Combinations, Pulpitis drug therapy, Pulpitis therapy, Biocompatible Materials therapeutic use, Dentition, Permanent, Dental Pulp Capping methods, Dental Pulp drug effects, Calcium Hydroxide therapeutic use, Randomized Controlled Trials as Topic, Calcium Compounds therapeutic use, Network Meta-Analysis, Silicates therapeutic use
- Abstract
Mineral Trioxide Aggregate (MTA) is the gold standard for vital pulp treatment (VPT), but its superiority over novel calcium silicate-based cements in permanent teeth lacks systematic evidence. This study aimed to compare the efficacy of these materials in VPT through a network meta-analysis. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Library, and Web of Science until January 20, 2024. The inclusion criteria were randomized controlled trials involving VPT with biomaterials and reversible or irreversible pulpitis diagnoses in mature permanent teeth. The primary outcome was the odds ratio (OR) of failure rates with 95% confidence intervals. In the 21 eligible trials, failure rates were significantly higher with calcium-hydroxide than MTA at six (OR 2.26 [1.52-3.36]), 12 (OR 2.53 [1.76-3.62]), and 24 months (OR 2.46 [1.60-3.79]). Failure rates for Totalfill at six (OR 1.19 [0.55-2.58]) and 12 months (OR 1.43 [0.71-2.92]), and Biodentine at six (OR 1.09 [0.66-1.78]), 12 (OR 1.21 [0.74-1.96]), and 24 months (OR 1.47 [0.81-2.68]) were not significantly different from MTA. The results were similar in the direct pulp capping subgroup, whereas, in the partial and full pulpotomy subgroup, there was not enough evidence to achieve significant differences. MTA, Biodentine, and Totalfill are the most efficient materials for VPT. However, calcium-hydroxide-based materials are not recommended in VPT., (© 2024. The Author(s).)
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- 2024
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3. Comparison of implant placement and loading protocols for single anterior maxillary implants: A systematic review and network meta-analysis.
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Qian X, Vánkos B, Kelemen K, Gede N, Varga G, Hegyi P, Gerber G, Hermann P, Joób-Fancsaly Á, and Mikulás K
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Statement of Problem: With increasing esthetic needs, patients prefer missing anterior teeth to be restored as soon as possible, but how the timing of implantation and prosthetic loading influences peri-implant tissue and the esthetic results remains unclear., Purpose: The purpose of this systematic review and network meta-analysis of randomized controlled trials was to investigate and rank the hard-tissue and soft-tissue outcomes, esthetics, and patient satisfaction of single maxillary implant placement and loading protocols., Material and Methods: A systematic search was conducted to identify studies with at least a 1-year follow-up that compared different implant placement and loading protocols and reported on survival, marginal bone loss (MBL), soft tissue, and esthetics. A random effects model and a Bayesian approach were applied to compare protocols by using mean differences (MD) with 95% credible intervals (CrI) and surface under the cumulative ranking curve (SUCRA) values., Results: A total of 43 articles were included, with a follow-up of 1 to 5 years. All protocols had high survival rates and no significant differences for 1-year or 2-year MBL. Immediate placement with immediate loading ranked first in pink and white esthetic scores and satisfaction and was statistically significantly better than immediate placement with delayed loading or late placement protocols in pink esthetic scores, where its advantage over late placement with late loading was also clinically relevant [MD: -1.74, CrI: -2.34 to -1.15]., Conclusions: Immediate implantation with immediate loading showed a considerable esthetic advantage over later rehabilitation, whereas only a slight difference in MBL resulted from different protocols., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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4. Prediabetes and poorly controlled type-2 diabetes as risk indicators for peri-implant diseases:A systematic review and meta-analysis.
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Bencze B, Cavalcante BGN, Romandini M, Róna V, Váncsa S, Varga G, Kivovics M, Szabó B, Agócs G, Géczi Z, Hermann P, Hegyi P, and Végh D
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- Humans, Risk Factors, Peri-Implantitis etiology, Glycemic Control, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 blood, Prediabetic State blood, Dental Implants adverse effects, Glycated Hemoglobin analysis
- Abstract
Objective: The study answers the PECO question: "In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?". Prediabetes (5.7-6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association., Data: Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c., Sources: An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles., Study Selection: Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm., Conclusions: Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases., Clinical Significance: Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health. PROTOCOL REGISTRATION NUMBER: (CRD42022375263)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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5. Hyperpure chlorine dioxide versus chlorhexidine in intra-oral halitosis (ODOR trial) - protocol of a double-blinded, double-arm, parallel non-inferiority pilot randomized controlled trial.
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Szalai EÁ, Teutsch B, Babay V, Galvács A, Hegyi P, Hársfalvi P, Pál R, Varga G, Lohinai ZM, and Kerémi B
- Abstract
Introduction: Intra-oral halitosis (IOH) is the most common type of bad breath; its consequences impair quality of life. However, evidence-based treatment protocols and guidelines are lacking. Our aim is to investigate the effectiveness of chlorine dioxide as an applicable complementary treatment modality in IOH after tongue cleaning., Methods and Analysis: The ODOR trial will be a single-center, double-blinded, parallel-group, double-armed pilot randomized controlled trial with a non-inferiority design. The efficacy of hyperpure chlorine dioxide will be compared to chlorhexidine mouthwash. We plan to investigate the short-term effects of the intervention over a 3-h period. The primary endpoint will be changes in organoleptic test scores. At the end of the pilot investigation of the first 30 patients each, sample size calculation will be performed. If feasible, the investigators will continue the study by enrolling more patients., Trial Registration: The trial has been registered at ClinicalTrials.gov (NCT06219226)., (© 2024. The Author(s).)
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- 2024
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6. The effect of nicotine-containing products on peri-implant tissues: A systematic review and network meta-analysis.
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Vámos O, Komora P, Gede N, Hegyi P, Kelemen K, Varga G, Mikulás K, Kerémi B, and Kispélyi B
- Abstract
Introduction: Smokers have a higher chance of developing peri-implant diseases and are therefore considered an at-risk population. Our aim was to compare peri-implant characteristics in users of electronic cigarettes (EC), waterpipes (WP), cigarettes (CS), smokeless tobacco (ST), and non-smokers (non-users of any nicotine and tobacco product; NS)., Methods: A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, CENTRAL) was performed until April 2023, restricted to English language. Thirty-nine observational studies were included in the qualitative synthesis, of which 32 studies were included in a Bayesian network meta-analysis. Using a predesigned form, two researchers independently collected data about marginal bone loss (MBL), probing pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), modified plaque index (mPI), probing pocket depth > 4mm (PPD>4), gingival index (GI), peri-implant sulcular fluid (PISF) volume, and TNF-α and IL-1β levels. QUIPS and CINeMA were used to evaluate the risk of bias and certainty of evidence., Results: NS had the smallest MBL. Most nicotine-containing product users had significantly higher MBL (CS, MD:1.34 CrI: 0.85, 1.79; WP, MD:1.58 CrI: 0.84, 2.35; ST, MD:2.53, CrI: 1.20, 3.87) than NS. EC did not show significant difference compared to NS (MD:0.52 CrI: -0.33, 1.36). In secondary outcomes NS were ranked in first place. Subset analysis based on smoking habit, implant duration, and maintenance control revealed no differences in ranking probability., Conclusion: Most nicotine-containing product users presented worse peri-implant parameters compared to non-smokers, while EC users did not show significant differences to NS in many outcomes., Implication: Alternative nicotine-containing products are gaining popularity and are often considered less harmful by the general public compared to traditional cigarettes. This is the first network meta-analysis comparing users of four nicotine-containing products and non-smokers. This study shows that CS, WP and ST have a detrimental effect on the overall health of peri-implant tissues. EC users also presented inferior parameters compared to NS, however, the difference was not significant in many outcomes. It is essential to educate patients who are using nicotine-containing products, and to provide proper maintenance and appropriate cessation support. Well-designed multi-armed studies are needed for direct comparison of different products, including heated tobacco products. Greater transparency of confounding factors is needed regarding smoking habit and oral hygiene., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)
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- 2024
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7. Aromatase Inhibitors and Plasma Lipid Changes in Postmenopausal Women with Breast Cancer: A Systematic Review and Meta-Analysis.
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Bérczi B, Farkas N, Hegyi P, Tóth B, Csupor D, Németh B, Lukács A, Czumbel LM, Kerémi B, Kiss I, Szabó A, Varga G, Gerber G, and Gyöngyi Z
- Abstract
Background: Women are typically diagnosed with estrogen receptor-positive breast cancer around the postmenopausal period when declining estrogen levels initiate changes in lipid profiles. Aromatase inhibitors (AI) are used to prevent the progression of cancer; however, a further reduction in estrogen levels may have detrimental effects on lipid levels, which was our working hypothesis. Methods: Our meta-analysis was conducted on the lipid profiles of postmenopausal breast cancer patients at baseline and at different treatment time points. Results: We identified 15 studies, including 1708 patients. Studies using anastrozole (ANA), exemestane (EXE), letrozole (LET), and tamoxifen (TMX) were involved. Subgroup analyses revealed that 3- and 12-month administrations of LET and EXE lead to negative changes in lipid profiles that tend to alter the lipid profile undesirably, unlike ANA and TMX. Conclusions: Our results suggest that, despite statistically significant results, EXE and LET may not be sufficient to cause severe dyslipidemia in patients without cardiovascular comorbidities according to the AHA/ACC Guideline on the Management of Blood Cholesterol. However, the results may raise the question of monitoring the effects of AIs in patients, especially those with pre-existing cardiovascular risk factors such as dyslipidemia.
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- 2024
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8. Isomorphic Insertion of Ce(III)/Ce(IV) Centers into Layered Double Hydroxide as a Heterogeneous Multifunctional Catalyst for Efficient Meerwein-Ponndorf-Verley Reduction.
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Varga G, Nguyen TT, Wang J, Tian D, Zhang R, Li L, and Xu ZP
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The development of highly active acid-base catalysts for transfer hydrogenations of biomass derived carbonyl compounds is a pressing challenge. Solid frustrated Lewis pairs (FLP) catalysis is possibly a solution, but the development of this concept is still at a very early stage. Herein, stable, phase-pure, crystalline hydrotalcite-like compounds were synthesized by incorporating cerium cations into layered double hydroxide (MgAlCe-LDH). Besides the insertion of well-isolated cerium centers surrounded by hydroxyl groups, the formation of hydroxyl vacancies near the aluminum centers, which were formed by the insertion of cerium centers into the layered double hydroxides (LDH) lattice, was also identified. Depending on the initial cerium concentration, LDHs with different Ce(III)/Ce(IV) ratios were produced, which had Lewis acidic and basic characters, respectively. However, the acid-base character of these LDHs was related to the actual Ce(III)/Ce(IV) molar ratios, resulting in significant differences in their catalytic performance. The as-prepared structures enabled varying degrees of transfer hydrogenation (Meerwein-Ponndorf-Verley MPV reduction) of biomass-derived carbonyl compounds to the corresponding alcohols without the collapse of the original lamellar structure of the LDH. The catalytic markers through the test reactions were changed as a function of the amount of Ce(III) centers, indicating the active role of Ce(III)-OH units. However, the cooperative interplay between the active sites of Ce(III)-containing specimens and the hydroxyl vacancies was necessary to maximize catalytic efficiency, pointing out that Ce-containing LDH is a potentially commercial solid FLP catalysts. Furthermore, the crucial role of the surface hydroxyl groups in the MPV reactions and the negative impact of the interlamellar water molecules on the catalytic activity of MgAlCe-LDH were demonstrated. These solid FLP-like catalysts exhibited excellent catalytic performance (cyclohexanol yield of 45%; furfuryl alcohol yield of 51%), which is competitive to the benchmark Sn- and Zr-containing zeolite catalysts, under mild reaction conditions, especially at low temperature ( T = 65 °C).
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- 2024
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9. Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis.
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Tajti P, Solyom E, Váncsa S, Mátrai P, Hegyi P, Varga G, Hermann P, Borbély J, Sculean A, and Mikulás K
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- Humans, Dental Implantation, Endosseous adverse effects, Alveolar Bone Loss etiology, Dental Abutments adverse effects, Dental Implant-Abutment Design, Dental Implants adverse effects
- Abstract
The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing., (© 2023 The Authors. Periodontology 2000 published by John Wiley & Sons Ltd.)
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- 2024
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10. Reduction of intracellular oxidative stress with a copper-incorporated layered double hydroxide.
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Szerlauth A, Madácsy T, Samu GF, Bíró P, Erdélyi M, Varga G, Xu ZP, Maléth J, and Szilágyi I
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- Antioxidants pharmacology, Antioxidants metabolism, Superoxide Dismutase metabolism, Catalase metabolism, Reactive Oxygen Species, Hydroxides, Copper, Oxidative Stress
- Abstract
Biocompatible Cu(II)-doped layered double hydroxide (CMA) nanoparticles were developed to combat reactive oxygen species. The 2-dimensional nanozymes showed both superoxide dismutase- and catalase-like activities in chemical assays, while proving as efficient antioxidants in the reduction of intracellular oxidative stress. The results indicate the great promise of CMA in antioxidant therapies.
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- 2024
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11. Current status of optical scanning in facial prosthetics: A systematic review and meta-analysis.
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König J, Kelemen K, Czumbel LM, Szabó B, Varga G, Borbély J, Németh O, Hegyi P, and Hermann P
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- Humans, Face, Imaging, Three-Dimensional
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Purpose To assess the accuracy of scanning technologies for constructing facial prostheses on human faces.Study selection Our systematic search was performed on five databases. Studies reporting on human volunteers (P) whose faces were scanned with a scanning technology were eligible. The anthropometrical interlandmark distances (ILDs) were used as indicators of accuracy; the ILDs are measured on the virtual models (I) and directly on the faces (C). The virtual models deviated from their true values (O). Studies reporting the measurements on patients with or without facial deformities were included, but cadavers or inanimate objects were reasons for exclusion. We performed a mean difference (MD) / standardized MD analysis with a random effect model. The difficulties regarding the scanning procedure mentioned in the articles were also assessed.Results We found 3723 records after duplicate removal. Twenty five articles were eligible for the qualitative review, and ten articles were included in the quantitative synthesis. Eight different ILDs were compared in MD analyses. The differences were between -0.54-0.43 mm. We also performed a regional three-dimensional analysis to compare scanning technologies in each major region. No significant differences were found in any of the regions and axes. The most mentioned difficulties were artifacts due to motion or blinking.Conclusions The results suggest no systematic skew in linear dimensions neither between direct caliper measurements nor between measurements on the scanned models, scanning technologies, or facial regions.
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- 2024
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12. Comparative analysis of surgical and prosthetic rehabilitation in maxillectomy: A systematic review and meta-analysis on quality-of-life scores and objective speech and masticatory measurements.
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König J, Kelemen K, Váncsa S, Szabó B, Varga G, Mikulás K, Borbély J, Hegyi P, and Hermann P
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Statement of Problem: Patients with oro-antral communication, whether from trauma, disease, or congenital anomalies, have options for surgical reconstruction or prosthetic obturation, but guiding interdisciplinary protocols are lacking., Purpose: The purpose of this systematic review and meta-analysis was to compare surgical reconstruction and prosthetic obturation, identifying correlations with baseline characteristics to determine the most effective approach for specific patients., Material and Methods: A systematic search was conducted in 4 databases. Searching, screening, data extraction, and risk of bias assessment were performed by 2 reviewers. Eligible studies focused on patients with palatomaxillary defects from cancer-related maxilla surgeries. Traumatic or congenital defects were excluded. The study compared prosthetic restoration (either with surgical or definitive obturators) to surgical reconstruction using flaps or grafts. Patients with surgical restoration after tooth extraction were excluded. Both subjective and objective outcomes were used for comparison., Results: Thirteen articles were included in the qualitative synthesis and 9 in the meta-analysis. Patient scores on quality-of-life questionnaires, objective speech, and masticatory ability evaluations were compared. The number of patients who underwent surgical reconstruction was 206, whereas 260 patients received prosthetic obturators. Results showed no significant differences. In the "activity" domain of the University of Washington QoL questionnaire, however, the 1.92 (0.45, 3.40) score difference was not clinically relevant. However, the heterogeneity of trials, the transient nature of subjective evaluations, the low number of participants, and major confounding biases did not allow a solid conclusion to be drawn., Conclusions: The growing number of maxillectomy patients demands firm evidence on which rehabilitation to choose and when it should be done. The result suggests that obturator devices and surgical reconstruction have similar effects on quality of life and health outcomes. A multicentric registry in which patient strata could be analyzed separately by age, adjuvant therapies, defect sizes, and remaining dentition is advocated., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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13. Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods.
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Takács A, Hardi E, Cavalcante BGN, Szabó B, Kispélyi B, Joób-Fancsaly Á, Mikulás K, Varga G, Hegyi P, and Kivovics M
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- Dental Implantation, Endosseous methods, Computer-Aided Design, Cone-Beam Computed Tomography, Imaging, Three-Dimensional, Dental Implants, Surgery, Computer-Assisted methods
- Abstract
Objectives: This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy., Data: In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots., Sources: A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search., Results: A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors., Conclusions: Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives., Clinical Significance: To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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14. Effect of Chitosan on the Number of Streptococcus mutans in Saliva: A Meta-Analysis and Systematic Review.
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Róna V, Bencze B, Kelemen K, Végh D, Tóth R, Kói T, Hegyi P, Varga G, Rózsa NK, and Géczi Z
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- Humans, Streptococcus mutans, Saliva microbiology, Anti-Bacterial Agents pharmacology, Chewing Gum, Chitosan pharmacology, Anti-Infective Agents pharmacology, Dental Caries
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We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on Streptococcus mutans . The systematic search was performed in three databases (Cochrane Library, EMBASE, and PubMed) and included English-language randomized-controlled trials to compare the efficacy of chitosan in reducing the number of S. mutans . To assess the certainty of evidence, the GRADE tool was used. Mean differences were calculated with a 95% confidence interval for one outcome: bacterial counts in CFU/mL. The protocol of the study was registered on PROSPERO, registration number CRD42022365006. Articles were downloaded ( n = 6758) from EMBASE ( n = 2255), PubMed ( n = 1516), and Cochrane ( n = 2987). After the selection process, a total of four articles were included in the qualitative synthesis and three in the quantitative synthesis. Our results show that chitosan reduced the number of bacteria. The difference in mean quantity was -4.68 × 10
5 . The interval of the random-effects model was [-2.15 × 106 ; 1.21 × 106 ] and the prediction interval was [1.03 × 107 ; 9.40 × 106 ]. The I2 value was 98% ( p = 0.35), which indicates a high degree of heterogeneity. Chitosan has some antibacterial effects when used as a component of chewing gum, but further studies are needed. It can be a promising antimicrobial agent for prevention.- Published
- 2023
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15. ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
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Szalai E, Tajti P, Szabó B, Kói T, Hegyi P, Czumbel LM, Varga G, and Kerémi B
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- Adult, Humans, Sensation, Sulfides, Halitosis diagnosis
- Abstract
Background: The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis?, Methods: This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot., Results: A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I
2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01., Discussion: None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2023
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16. Clear guidance to select the most accurate technologies for 3D printing dental models - A network meta-analysis ✰ .
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Németh A, Vitai V, Czumbel ML, Szabó B, Varga G, Kerémi B, Hegyi P, Hermann P, and Borbély J
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- Network Meta-Analysis, Printing, Three-Dimensional, Stereolithography, Models, Dental, Computer-Aided Design
- Abstract
Objectives: Thus far, the findings of numerous studies conducted on the accuracy of three-dimensional (3D) printed dental models are conflicting. Therefore, the aim of the network meta-analysis (NMA) is to determine the accuracy of 3D printed dental models compared with digital reference models., Data: Studies comparing the accuracy of 3D printed full-arch dental models manufactured using different printing techniques to initial STL files were included., Sources: This study was registered in PROSPERO (CRD42021285863). An electronic search was performed across four databases in November 2021, and search was restricted to the English language., Study Selection: A systematic search was conducted based on a prespecified search query. 16,303 articles were pooled after the removal of the duplicates. Following study selection and data extraction, 11 eligible studies were included in the NMA in 6 subgroups. The outcomes were specified as trueness and precision and expressed as root mean square (RMS) and absolute mean deviation values. Seven printing technologies were analyzed: stereolithography (SLA), digital light processing (DLP), fused deposition modeling/fused filament fabrication (FDM/FFF), MultiJet, PolyJet, continuous liquid interface production (CLIP), and LCD technology. The QUADAS-2 and GRADE were used to evaluate the risk of bias and certainty of evidence., Conclusions: SLA, DLP, and PolyJet technologies were the most accurate in producing full-arch dental models., Clinical Significance: The findings of the NMA suggest that SLA, DLP, and PolyJet technologies are sufficiently accurate for full-arch dental model production for prosthodontic purposes. In contrast, FDM/FFF, CLIP, and LCD technologies are less suitable for manufacturing dental models., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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17. Clinical bracket failure rates between different bonding techniques: a systematic review and meta-analysis.
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Dudás C, Czumbel LM, Kiss S, Gede N, Hegyi P, Mártha K, and Varga G
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- Humans, Time Factors, Resin Cements chemistry, Dental Bonding methods, Orthodontic Brackets
- Abstract
Background: Bracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments., Objective: To compare the bond failures of different orthodontic materials based on the results of available clinical studies., Search Methods: A systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures., Selection Criteria: Clinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included., Data Collection and Analysis: Bracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian-Laird estimation., Results: Thirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67-1.61], 1.37 (95% CI, 0.98-1.92), and 0.93 (95% CI, 0.72-1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I2 < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24-0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37-0.52, I2 = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications., Limitations: A major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods., Conclusions and Implications: The results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance., Registration: Prospero with CRD42020163362., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Orthodontic Society.)
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- 2023
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18. Characterization of Electrospun Polysuccinimide-Dopamine Conjugates and Effect on Cell Viability and Uptake.
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Tóth K, S Nagy K, Güler Z, Juhász ÁG, Pállinger É, Varga G, Sarac AS, Zrínyi M, Jedlovszky-Hajdú A, and Juriga D
- Subjects
- Humans, Cell Survival, Drug Delivery Systems, Polymers pharmacology, Polymers chemistry, Dopamine pharmacology, Neuroblastoma
- Abstract
Biocompatible nanofibrous systems made by electrospinning have been studied widely for pharmaceutical applications since they have a high specific surface and the capability to make the entrapped drug molecule amorphous, which increases bioavailability. By covalently conjugating drugs onto polymers, the degradation of the drug as well as the fast clearance from the circulation can be avoided. Although covalent polymer-drug conjugates have a lot of advantages, there is a lack of research focusing on their nano-formulation by electrospinning. In this study, polysuccinimide (PSI) based electrospun fibrous meshes conjugated with dopamine (DA) are prepared. Fiber diameter, mechanical properties, dissolution kinetics and membrane permeability are thoroughly investigated, as these are crucial for drug delivery and implantation. Dopamine release kinetics prove the prolonged release that influenced the viability and morphology of periodontal ligament stem cells (PDLSCs) and SH-SY5Y cells. The presence of dopamine receptors on both cell types is also demonstrated and the uptake of the conjugates is measured. According to flow cytometry analysis, the conjugates are internalized by both cell types, which is influenced by the chemical structure and physical properties. In conclusion, electrospinning of PSI-DA conjugates alters release kinetics, meanwhile, conjugated dopamine can play a key role in cellular uptake., (© 2023 The Authors. Macromolecular Bioscience published by Wiley-VCH GmbH.)
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- 2023
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19. Molecular orientation rules the efficiency of immobilized antioxidants.
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Szerlauth A, Kónya ZD, Papp G, Kónya Z, Kukovecz Á, Szabados M, Varga G, and Szilágyi I
- Subjects
- Spectroscopy, Fourier Transform Infrared, Tannins, Reactive Oxygen Species, Antioxidants pharmacology, Glutathione
- Abstract
Tannic acid (TA) and glutathione (GSH) are important molecular antioxidants against reactive oxygen species. Their efficiency is limited by low solubility and high sensitivity, which may be solved by confinement in composite materials. Here, effect of immobilization of these antioxidants on their radical scavenging activity was investigated using layered double hydroxide (LDH) nanoparticles as hosts. Different preparation methods were applied to build composite systems leading to variations in the molecular orientation of both TA and GSH on the surface or among the layers of LDHs. Systematic combination of spectroscopy (FT-IR, Raman, UV-VIS-NIR-DRS), diffraction (XRD) and microscopy (SEM) methods revealed perpendicular or parallel orientation of TA on the surface of LDH depending on the preparation approach applied. Immobilization of GSH protected the antioxidant molecules from degradation. Radical scavenging tests evidenced that the activity of the antioxidants strongly depends on the molecular orientation. The LDH supported GSH and TA proved as durable and reusable antioxidant agents to be applied as radical scavengers in medical therapies or in industrial processes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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20. The Wisdom in Teeth: Neuronal Differentiation of Dental Pulp Cells.
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Sramkó B, Földes A, Kádár K, Varga G, Zsembery Á, and Pircs K
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- Humans, Stem Cells, Cell Differentiation physiology, Neurogenesis, Cells, Cultured, Dental Pulp, Mesenchymal Stem Cells
- Abstract
Mesenchymal stem/stromal cells (MSCs) are found in almost all postnatal organs. Under appropriate environmental cues, multipotency enables MSCs to serve as progenitors for several lineage-specific, differentiated cell types. In vitro expansion and differentiation of MSCs give the opportunity to obtain hardly available somatic cells, such as neurons. The neurogenic potential of MSCs makes them a promising, autologous source to restore damaged tissue and as such, they have received much attention in the field of regenerative medicine. Several stem cell pool candidates have been studied thus far, but only a few of them showed neurogenic differentiation potential. Due to their embryonic ontology, stem cells residing in the stroma of the dental pulp chamber are an exciting source for in vitro neural cell differentiation. In this study, we review the key properties of dental pulp stem cells (DPSCs), with a particular focus on their neurogenic potential. Moreover, we summarize the various presently available methods used for neural differentiation of human DPSCs also emphasizing the difficulties in reproducibly high production of such cells. We postulate that because DPSCs are stem cells with very close ontology to neurogenic lineages, they may serve as excellent targets for neuronal differentiation in vitro and even for direct reprogramming.
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- 2023
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21. Daily use of chlorine dioxide effectively treats halitosis: A meta-analysis of randomised controlled trials.
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Szalai E, Tajti P, Szabó B, Hegyi P, Czumbel LM, Shojazadeh S, Varga G, Németh O, and Keremi B
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- Humans, Mouthwashes therapeutic use, Oxides therapeutic use, Randomized Controlled Trials as Topic, Chlorine Compounds therapeutic use, Halitosis drug therapy
- Abstract
Objectives: We aimed to conduct a systematic review on published data in order to investigate the efficacy of mouthwash products containing chlorine dioxide in halitosis., Study Design: Systematic review and meta-analysis., Methods: Our search was conducted on 14th October 2021. We searched the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. We analysed data on adults with halitosis, included only randomised controlled trials and excluded in vitro and animal studies. The interventional groups used chlorine dioxide, and the comparator groups used a placebo or other mouthwash. Our primary outcomes were changes in organoleptic test scores (OLS) and Volatile Sulfur Compound (VSC) levels from baseline to the last available follow-up., Results: We found 325 articles in databases. After the selection process, ten articles were eligible for qualitative synthesis, and 7 RCTs with 234 patients were involved in the meta-analysis. Our findings showed a significant improvement in the parameters of the chlorine dioxide group compared to the placebo group in OLS one-day data (mean difference (MD): -0.82; 95% confidence intervals (95% CIs): [-1.04 --0.6]; heterogeneity: I2 = 0%, p = 0.67); and one-week OLS data (MD: -0.24; 95% CIs: [-0.41 --0.07]; I2 = 0%, p = 0.52); and also changes in H2S one-day data (standardised mean difference (SMD): -1.81; 95% CIs: [-2.52 --1.10]); I2 = 73.4%, p = 0.02)., Conclusion: Our data indicate that chlorine dioxide mouthwash may be a good supportive therapy in oral halitosis without known side effects., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Szalai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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22. Delamination of Layered Double Hydroxide in Ionic Liquids under Ambient Conditions.
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Takács D, Varga G, Csapó E, Jamnik A, Tomšič M, and Szilágyi I
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Liquid phase delamination of layered materials into single- or few-layer nanosheets leads to stable nanoscale dispersions of 2D materials. The delamination of layered double hydroxide (LDH) to double hydroxide nanosheets was studied in two ionic liquids (ILs): ethylammonium nitrate (EAN) and 1-butyl-3-methylimidazolium thiocyanate (BMIMSCN). The as-prepared lamellar structure of LDH disappeared upon dispersing it in ILs due to delamination into 2D nanosheets confirmed by X-ray scattering and diffraction techniques and further evaluated by height profile assessment of the nanoparticles by atomic force microscopy. The results showed that both the thickness and lateral size of the dispersed particles decreased in the IL-based samples, indicating that cleavage of the LDH materials can be observed in addition to delamination. The findings prove the concept of delamination of layered materials by ILs under ambient conditions─an excellent way to prepare 2D double hydroxide nanosheet dispersions in one step using nonvolatile green solvents.
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- 2022
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23. Surface modification of two-dimensional layered double hydroxide nanoparticles with biopolymers for biomedical applications.
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Pavlovic M, Szerlauth A, Muráth S, Varga G, and Szilagyi I
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- Humans, Adsorption, Biopolymers, Hydroxides chemistry, Nanoparticles chemistry
- Abstract
Layered double hydroxides (LDHs) are appealing nanomaterials for (bio)medical applications and their potential is threefold. One can gain advantage of the structure of LDH frame (i.e., layered morphology), anion exchanging property towards drugs with acidic character and tendency for facile surface modification with biopolymers. This review focuses on the third aspect, as it is necessary to evaluate the advantages of polymer adsorption on LDH surfaces. Beside the short discussion on fundamental and structural features of LDHs, LDH-biopolymer interactions will be classified in terms of the effect on the colloidal stability of the dispersions. Thereafter, an overview on the biocompatibility and biomedical applications of LDH-biopolymer composite materials will be given. Finally, the advances made in the field will be summarized and future research directions will be suggested., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2022
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24. Patients with inflammatory bowel disease have a higher chance of developing periodontitis: A systematic review and meta-analysis.
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Domokos Z, Uhrin E, Szabó B, Czumbel ML, Dembrovszky F, Kerémi B, Varga G, Hegyi P, Hermann P, and Németh O
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Background and Objective: Periodontitis affects up to one billion people worldwide, and has been proven to be associated with several systemic inflammatory conditions. This study investigates the specific relationship between two multifactorial diseases: Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue, we investigated separately whether IBD patients have a higher chance of developing periodontitis, and equally, whether patients with periodontitis have a higher chance of developing IBD., Methods: The systematic search was performed in three databases: MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered in PROSPERO. All eligible studies investigating the association between IBD and periodontitis from either direction were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. As a primary outcome, we investigated the prevalence of IBD and periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients., Results: The systematic search resulted in 1,715 records, 14 of which were eligible for qualitative synthesis and 8 for quantitative synthesis. On the basis of the results of the primary outcome, IBD diagnosis was associated with significantly higher odds of periodontitis: OR = 2.65 (CI: 2.09-3.36, I
2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated separately the odds in Crohn's disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I2 = 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56 to 4.83, I2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two studies investigated whether patients with periodontitis were more susceptible to IBD, and both found that periodontitis was significantly associated with the risk of subsequent UC, but not with subsequent CD. However, more studies are needed to prove an association., Conclusion: Our analysis confirmed that IBD patients have a higher chance of developing periodontitis, and are a higher risk population in dentistry. Both dentists and gastroenterologists should be aware of this relationship and should emphasize the importance of prevention even more than in the healthy population., Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021286161]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Domokos, Uhrin, Szabó, Czumbel, Dembrovszky, Kerémi, Varga, Hegyi, Hermann and Németh.)- Published
- 2022
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25. Effect of Pravastatin and Simvastatin on the Reduction of Cytochrome C.
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Csomó K, Belik A, Hrabák A, Kovács B, Fábián O, Valent S, Varga G, and Kukor Z
- Abstract
Statins are used to treat hypercholesterolemia, with several pleiotropic effects. Alongside their positive effects (for example, decreasing blood pressure), they can also bring about negative effects/symptoms (such as myopathy). Their main mechanism of action is inducing apoptosis, the key step being the release of cytochrome c from the mitochondria. This can be facilitated by oxidative stress, through which glutathione is oxidized. In this research, glutathione was used as a respiratory substrate to measure the mitochondrial oxygen consumption of rat liver with an O
2 electrode. The reduction of cytochrome c was monitored photometrically. Hydrophilic (pravastatin) and lipophilic (simvastatin) statins were used for the measurements. Pravastatin reduces the reduction of cytochrome c and the oxygen consumption of the mitochondria, while simvastatin, on the other hand, increases the reduction of cytochrome c and the mitochondrial oxygen consumption. The results make it seem probable that statins influence the mitochondrial oxygen consumption through cytochrome c. Simvastatin could enhance the oxidizing capacity of free cytochrome c, thereby increasing oxidative stress and thus facilitating apoptosis. The observed effects could further the understanding of the mechanism of action of statins and thereby aid in constructing optimal statin therapy for every patient.- Published
- 2022
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26. Nanoclay-based sensor composites for the facile detection of molecular antioxidants.
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Szerlauth A, Szalma L, Muráth S, Sáringer S, Varga G, Li L, and Szilágyi I
- Subjects
- Oxidation-Reduction, Antioxidants analysis, Copper chemistry
- Abstract
The detection and quantification of antioxidant molecules is an important task in food science, the fine chemical industry and healthcare. Antioxidants help in preventing the deterioration of nutrition and healthcare products, while eliminating over-the-limit exogenic reactive species, which may lead to illnesses. In our contribution, an inexpensive and rapid method to determine the concentration of various molecular antioxidants was developed. The principle of the analysis relies on the cupric ion reducing antioxidant capacity (CuPRAC) method, which is based on the color-changing reduction of chelated Cu
2+ ions. This complex was successfully immobilized on an alginate-functionalized layered double hydroxide (dLDH) nanosheet via electrostatic interactions. The synthesis conditions of alginate (NaAlg) and the cupric complex were optimized, and the optimized composite was fabricated on cellulose paper to obtain a sensing platform. The paper-based sensor was superior to the ones prepared without the dLDH support, as the limit of detection (LOD) values decreased, and the linearity ranges broadened. The results offer a single-point measurement to evaluate the antioxidant efficiency in a cuvette-based method. The superior ability of the sensor was assigned to the presence of solid dLDH particles, as they offer adsorption sites for the dissolved antioxidant molecules, which contributes significantly to the decrease of the diffusion limitation during the detection process.- Published
- 2022
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27. A Minimally Invasive, Fast Spinal Cord Lateral Hemisection Technique for Modeling Open Spinal Cord Injuries in Rats.
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Csomó KB, Varga G, Belik AA, Hricisák L, Borbély Z, and Gerber G
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- Animals, Laminectomy methods, Rats, Spinal Cord surgery, Spinal Cord Injuries etiology, Spinal Cord Injuries surgery
- Abstract
Open spinal cord injury techniques modeling laceration-like injuries are time-consuming and invasive because they involve laminectomy. This new technique eliminates laminectomy by removing two spinous processes and lifting, then tilting the caudal vertebral arch. The surgical area opens up without the need for laminectomy. Lateral hemisection is then performed with direct visible control under a microscope. The trauma is minimized, requiring only a small bone wound. This technique has several advantages: it is faster and, therefore, less of a burden for the animal, and the bone wound is smaller. Because the laminectomy is eliminated, there is less chance for unwanted injury to the spinal cord, and there are no bone splinters that can cause problems (bone splinters embedded in the spinal cord can cause swelling and secondary damage). The vertebral canal remains intact. The main limitation is that the hemisection can only be performed in the intervertebral spaces. The results show that this technique can be performed much faster than the traditional surgical approach, using laminectomy (11 min vs. 35 min). This technique can be useful for researchers working with animal models of open spinal cord injury as it is widely adaptable and does not require any additional specialized instrumentation.
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- 2022
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28. Maternal overnutrition elevates offspring's blood pressure-A systematic review and meta-analysis.
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Eitmann S, Mátrai P, Németh D, Hegyi P, Lukács A, Bérczi B, Czumbel LM, Kiss I, Gyöngyi Z, Varga G, Balaskó M, and Pétervári E
- Subjects
- Blood Pressure physiology, Body Mass Index, Child, Female, Humans, Pregnancy, Gestational Weight Gain, Hypertension epidemiology, Hypertension etiology, Pediatric Obesity epidemiology, Pediatric Obesity etiology
- Abstract
Background: Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases., Objectives: This systematic review and meta-analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring's obesity on this association., Data Sources: PubMed, EMBASE, Clinicaltrials.gov, CENTRAL., Study Selection and Data Extraction: Human studies published in English before October 2021 were identified that presented quantitative estimates of association between maternal overnutrition just before or during pregnancy and the offspring's BP., Synthesis: Random-effect model with the DerSimonian and Laird weighting method was used to analyse regression coefficients or mean differences., Results: After selection, 17 observational studies (140,517 mother-offspring pairs) were included. Prepregnancy body mass index (ppBMI) showed positive correlation with BP in offspring (regression coefficient for systolic: 0.38 mmHg per kg/m
2 , 95% confidence interval (CI) 0.17, 0.58; diastolic: 0.10 mmHg per kg/m2 , 95% CI 0.05, 0.14). These indicate 1.9 mmHg increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every 5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI also showed association (systolic: 0.08 mmHg per kg/m2 , 95% CI 0.04, 0.11; diastolic: 0.03 mmHg per kg/m2 , 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic BP was higher in children of mothers with excessive GWG than in those of mothers with optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05)., Conclusions: Independent from offspring's BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring. The positive association between GWG and offspring's systolic BP is indirect via offspring's obesity. Reduction in maternal obesity and treatment of obesity in children of obese mothers are needed to prevent hypertension., (© 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.)- Published
- 2022
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29. Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis.
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Lantos K, Dömötör ZR, Farkas N, Kiss S, Szakács Z, Garami A, Varga G, Lujber L, Kanaan R, Hegyi P, Fehér G, and Gaál V
- Subjects
- Adult, Humans, Levodopa therapeutic use, Memantine therapeutic use, Oxygen, Steroids therapeutic use, Visual Acuity, Optic Neuropathy, Ischemic drug therapy, Optic Neuropathy, Ischemic surgery
- Abstract
Background: Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is the second most common cause of optic nerve-related permanent visual loss in adults., Aim: We aimed to analyze the efficacy of the noninvasive and minimally invasive therapeutic options of NAION., Methods: We performed a systematic literature search in MEDLINE, EMBASE, and CENTRAL from inception to 10 June 2019 to identify the studies that report on the effect of different therapies on visual acuity (VA) and visual field (VF). Weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for these outcomes. The efficacy of steroids was investigated in quantitative, oxygen, steroid plus erythropoietin (EPO), levodopa/carbidopa, memantine, and heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) therapies and other therapeutic modalities in qualitative synthesis., Results: Thirty-two studies were found to be eligible. We found that steroid therapy compared to control did not improve VA ( p = 0.182, WMD = 0.14, 95% CI: -0.07, 0.35) or VF ( p = 0.853, WMD = 0.16, 95% CI: -1.54, 1.86). Qualitative analysis could be performed for oxygen, steroid plus EPO, and HELP as well, however, none of them showed VA and VF benefit. Two individual studies found memantine and levodopa beneficial regarding VA., Conclusion: Our systematic review did not reveal any effective treatment. Further investigations are needed to find therapy for NAION.
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- 2022
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30. Culturing and Scaling up Stem Cells of Dental Pulp Origin Using Microcarriers.
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Földes A, Reider H, Varga A, Nagy KS, Perczel-Kovach K, Kis-Petik K, DenBesten P, Ballagi A, and Varga G
- Abstract
Ectomesenchymal stem cells derived from the dental pulp are of neural crest origin, and as such are promising sources for cell therapy and tissue engineering. For safe upscaling of these cells, microcarrier-based culturing under dynamic conditions is a promising technology. We tested the suitability of two microcarriers, non-porous Cytodex 1 and porous Cytopore 2, for culturing well characterized dental pulp stem cells (DPSCs) using a shake flask system. Human DPSCs were cultured on these microcarriers in 96-well plates, and further expanded in shake flasks for upscaling experiments. Cell viability was measured using the alamarBlue assay, while cell morphology was observed by conventional and two-photon microscopies. Glucose consumption of cells was detected by the glucose oxidase/Clark-electrode method. DPSCs adhered to and grew well on both microcarrier surfaces and were also found in the pores of the Cytopore 2. Cells grown in tissue culture plates (static, non-shaking conditions) yielded 7 × 10
5 cells/well. In shake flasks, static preincubation promoted cell adhesion to the microcarriers. Under dynamic culture conditions (shaking) 3 × 107 cells were obtained in shake flasks. The DPSCs exhausted their glucose supply from the medium by day seven even with partial batch-feeding. In conclusion, both non-porous and porous microcarriers are suitable for upscaling ectomesenchymal DPSCs under dynamic culture conditions.- Published
- 2021
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31. Aggregation of Halloysite Nanotubes in the Presence of Multivalent Ions and Ionic Liquids.
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Katana B, Takács D, Szerlauth A, Sáringer S, Varga G, Jamnik A, Bobbink FD, Dyson PJ, and Szilagyi I
- Abstract
Colloidal stability was investigated in two types of particle systems, namely, with bare (h-HNT) and polyimidazolium-functionalized (h-HNT-IP-2) alkali-treated halloysite nanotubes in solutions of metal salts and ionic liquids (ILs). The valence of the metal ions and the number of carbon atoms in the hydrocarbon chain of the IL cations (1-methylimidazolium (MIM
+ ), 1-ethyl-3-methylimidazolium (EMIM+ ), 1-butyl-3-methylimidazolium (BMIM+ ), and 1-hexyl-3-methylimidazolium (HMIM+ )) were altered in the measurements. For the bare h-HNT with a negative surface charge, multivalent counterions destabilized the dispersions at low values of critical coagulation concentration (CCC) in line with the Schulze-Hardy rule. In the presence of ILs, significant adsorption of HMIM+ took place on the h-HNT surface, leading to charge neutralization and overcharging at appropriate concentrations. A weaker affinity was observed for MIM+ , EMIM+ , and BMIM+ , while they adsorbed on the particles to different extents. The order HMIM+ < BMIM+ < EMIM+ < MIM+ was obtained for the CCCs of h-HNT, indicating that HMIM+ was the most effective in the destabilization of the colloids. For h-HNT-IP-2 with a positive surface charge, no specific interaction was observed between the salt and the IL constituent cations and the particles, i.e., the determined charge and aggregation parameters were the same within experimental error, irrespective of the type of co-ions. These results clearly indicate the relevance of ion adsorption in the colloidal stability of the nanotubes and thus provide useful information for further design of processable h-HNT dispersions.- Published
- 2021
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32. Sol-Gel Synthesis of Ceria-Zirconia-Based High-Entropy Oxides as High-Promotion Catalysts for the Synthesis of 1,2-Diketones from Aldehyde.
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Tatar D, Kojčinović J, Marković B, Széchenyi A, Miletić A, Nagy SB, Ziegenheim S, Szenti I, Sapi A, Kukovecz Á, Dinjar K, Tang Y, Stenzel D, Varga G, and Djerdj I
- Abstract
Efficient Lewis-acid-catalyzed direct conversion of aldehydes to 1,2-diketones in the liquid phase was enabled by using newly designed and developed ceria-zirconia-based high-entropy oxides (HEOs) as the actual catalysts. The synergistic effect of various cations incorporated in the same oxide structure (framework) was partially responsible for the efficiency of multicationic materials compared to the corresponding single-cation oxide forms. Furthermore, a clear, linear relationship between the Lewis acidity and the catalytic activity of the HEOs was observed. Due to the developed strategy, exclusively diketone-selective, recyclable, versatile heterogeneous catalytic transformation of aldehydes can be realized under mild reaction conditions.
- Published
- 2021
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33. Copper-Loaded Layered Bismuth Subcarbonate-Efficient Multifunctional Heterogeneous Catalyst for Concerted C-S/C-N Heterocyclization.
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Kocsis M, Ötvös SB, Samu GF, Fogarassy Z, Pécz B, Kukovecz Á, Kónya Z, Sipos P, Pálinkó I, and Varga G
- Abstract
An efficient self-supported Cu(II)Bi(III) bimetallic catalyst with a layered structure was designed and developed. By careful characterization of the as-prepared material, the host structure was identified to exhibit a Sillen-type bismutite framework, with copper(II) ions being loaded as guests. The heterogeneous catalyst enabled C-N and C-S arylations under mild reaction conditions and with high chemoselectivities, thus furnishing valuable phenothiazines via heterocyclization with wide substrate tolerance. As corroborated by detailed catalytic studies, the cooperative, bifunctional catalyst, bearing Lewis acid sites along with copper(II) catalytic sites, facilitated an intriguing concerted C-N/C-S heterocyclization mechanism. The heterogeneous nature of the catalytic reactions was verified experimentally. Importantly, the catalyst was successfully recycled and reused multiple times, persevering its original structural order as well as its initial activity.
- Published
- 2021
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34. Hyaluronic Acid Is an Effective Dermal Filler for Lip Augmentation: A Meta-Analysis.
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Czumbel LM, Farkasdi S, Gede N, Mikó A, Csupor D, Lukács A, Gaál V, Kiss S, Hegyi P, and Varga G
- Abstract
Introduction: The lips and the mouth play an indispensable role in vocalization, mastication and face aesthetics. Various noxious factors may alter and destruct the original structure, and appearance of the lips and the anatomical area surrounding the mouth. The application of hyaluronic acid (HA) may serve as a safe method for lip regeneration. Although a number of studies exist for HA effectiveness and safety, its beneficial effect is not well-established. Aim: The present meta-analysis and systematic review was performed to investigate the effectiveness of HA on lip augmentation. We also investigated the types and nature of adverse effects (AEs) of HA application. Methods: We reported our meta-analysis in accordance with the PRISMA Statement. PROSPERO protocol registration: CRD42018102899. We performed the systematic literature search in CENTRAL, Embase, and MEDLINE. Randomized controlled trials, cohort studies, case series and case reports were included. The untransformed proportion (random-effects, DerSimonian-Laird method) of responder rate to HA injection was calculated. For treatment related AEs descriptive statistics were used. Results: The systematic literature search yielded 32 eligible records for descriptive statistics and 10 records for quantitative synthesis. The results indicated that the overall estimate of responders (percentage of subjects with increased lip fullness by one point or higher) was 91% (ES = 0.91, 95% CI:0.85-0.96) 2 months after injection. The rate of responders was 74% (ES = 0.74, 95% CI:0.66-0.82) and 46% (ES = 0.46, 95% CI:0.28-0.65) after 6 and 12 months, respectively. We included 1,496 participants for estimating the event rates of AEs. The most frequent treatment-related AEs were tenderness (88.8%), injection site swelling (74.3%) and bruising (39.5%). Rare AEs included foreign body granulomas (0.6%), herpes labialis (0.6%) and angioedema (0.3%). Conclusion: Our meta-analysis revealed that lip augmentation with injectable HA is an efficient method for increasing lip fullness for at least up to 6 months after augmentation. Moreover, we found that most AEs of HA treatment were mild or moderate, but a small number of serious adverse effects were also found. In conclusion, further well-designed RCTs are still needed to make the presently available evidence stronger., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Czumbel, Farkasdi, Gede, Mikó, Csupor, Lukács, Gaál, Kiss, Hegyi and Varga.)
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- 2021
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35. Orally Administered Probiotics Decrease Aggregatibacter actinomycetemcomitans but Not Other Periodontal Pathogenic Bacteria Counts in the Oral Cavity: A Systematic Review and Meta-Analysis.
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Sang-Ngoen T, Czumbel LM, Sadaeng W, Mikó A, Németh DI, Mátrai P, Hegyi P, Tóth B, Csupor D, Kiss I, Szabó A, Gerber G, Varga G, and Kerémi B
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Introduction: At the initial part of the gastrointestinal tract, multiple tissues serve the normal function of food delivery. Periodontal structures are integral elements of these. When they deteriorate, it is extremely challenging to regenerate and reconstruct them. The conventional intervention for periodontal disease is scaling and root planning with the aim of reducing pathogenic bacteria. However, periodontal pathogens can rapidly recolonize treated areas. Probiotics have been proposed as novel tools for managing oral health by suppressing pathogenic bacteria through their anti-inflammatory effect, but the available data are controversial. Aim: Therefore, we performed a meta-analysis to study the effect of probiotics on periodontal pathogenic bacteria. Methods: The study was registered in PROSPERO under registration number CRD42018094903. A comprehensive literature search from four electronic databases (PubMed, Cochrane CENTRAL, Embase, and Web of Science) yielded nine eligible records for statistical analysis. Studies measuring bacterial counts in saliva and supra- and subgingival plaque were included. Bacterial counts were analyzed using standard mean difference (SMD) and by a random effects model with the DerSimonian-Laird estimation. Results: The results showed a significant decrease in the overall count of Aggregatibacter actinomycetemcomitans in the probiotic-treated group compared to the control at 4 weeks (SMD: -0.28; 95% CI: -0.56--0.01; p = 0.045) but not later. Analyzing the bacterial counts in subgroups, namely, in saliva and supra- and subgingival plaque, separately, yielded no significant difference. Probiotics had no significant effect on the overall count of Porphyromonas gingivalis at 4 weeks (SMD: -0.02; 95% CI: -0.35-0.31; p = 0.914) or later. Subgroup analysis also revealed no significant difference between treatment and control groups nor did probiotics significantly decrease the overall and subgroup bacterial counts of Prevotella intermedia , Tannerella forsythia , and Fusobacterium nucleatum . Conclusion: Our data support the beneficial effect of probiotics in reducing A. actinomycetemcomitans counts, but not of other key periodontal pathogenic bacteria in periodontal disease patients. However, due to the complex mechanism associated with periodontal disease and the limitations of the available studies, there is a further need for well-designed randomized clinical trials to assess the efficacy of probiotics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Sang-Ngoen, Czumbel, Sadaeng, Mikó, Németh, Mátrai, Hegyi, Tóth, Csupor, Kiss, Szabó, Gerber, Varga and Kerémi.)
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- 2021
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36. A comprehensive time course and correlation analysis of indomethacin-induced inflammation, bile acid alterations and dysbiosis in the rat small intestine.
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Lázár B, László SB, Hutka B, Tóth AS, Mohammadzadeh A, Berekméri E, Ágg B, Balogh M, Sajtos V, Király K, Al-Khrasani M, Földes A, Varga G, Makra N, Ostorházi E, Szabó D, Ligeti B, Kemény Á, Helyes Z, Ferdinandy P, Gyires K, and Zádori ZS
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- Animals, Dysbiosis chemically induced, Dysbiosis microbiology, Inflammation chemically induced, Inflammation metabolism, Inflammation microbiology, Intestine, Small microbiology, Male, Rats, Rats, Wistar, Time Factors, Anti-Inflammatory Agents, Non-Steroidal toxicity, Bile Acids and Salts metabolism, Dysbiosis metabolism, Indomethacin toxicity, Intestine, Small drug effects, Intestine, Small metabolism
- Abstract
It has been proposed that changes in microbiota due to nonsteroidal anti-inflammatory drugs (NSAIDs) alter the composition of bile, and elevation of hydrophobic secondary bile acids contributes to small intestinal damage. However, little is known about the effect of NSAIDs on small intestinal bile acids, and whether bile alterations correlate with mucosal injury and dysbiosis. Here we determined the ileal bile acid metabolome and microbiota 24, 48 and 72 h after indomethacin treatment, and their correlation with each other and with tissue damage in rats. In parallel with the development of inflammation, indomethacin increased the ileal proportion of glycine and taurine conjugated bile acids, but not bile hydrophobicity. Firmicutes decreased with time, whereas Gammaproteobacteria increased first, but declined later and were partially replaced by Bilophila, Bacteroides and Fusobacterium. Mucosal injury correlated negatively with unconjugated bile acids and Gram-positive bacteria, and positively with taurine conjugates and some Gram-negative taxa. Strong positive correlation was found between Lactobacillaceae, Ruminococcaceae, Clostridiaceae and unconjugated bile acids. Indomethacin-induced dysbiosis was not likely due to direct antibacterial effects or alterations in luminal pH. Here we provide the first detailed characterization of indomethacin-induced time-dependent alterations in small intestinal bile acid composition, and their associations with mucosal injury and dysbiosis. Our results suggest that increased bile hydrophobicity is not likely to contribute to indomethacin-induced small intestinal damage., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2021
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37. Three-Dimensional Culture of Ameloblast-Originated HAT-7 Cells for Functional Modeling of Defective Tooth Enamel Formation.
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Földes A, Sang-Ngoen T, Kádár K, Rácz R, Zsembery Á, DenBesten P, Steward MC, and Varga G
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Background: Amelogenesis, the formation of dental enamel, is well understood at the histomorphological level but the underlying molecular mechanisms are poorly characterized. Ameloblasts secrete enamel matrix proteins and Ca
2+ , and also regulate extracellular pH as the formation of hydroxyapatite crystals generates large quantities of protons. Genetic or environmental impairment of transport and regulatory processes (e.g. dental fluorosis) leads to the development of enamel defects such as hypomineralization. Aims: Our aims were to optimize the culture conditions for the three-dimensional growth of ameloblast-derived HAT-7 cells and to test the effects of fluoride exposure on HAT-7 spheroid formation. Methods: To generate 3D HAT-7 structures, cells were dispersed and plated within a Matrigel extracellular matrix scaffold and incubated in three different culture media. Spheroid formation was then monitored over a two-week period. Ion transporter and tight-junction protein expression was investigated by RT-qPCR. Intracellular Ca2+ and pH changes were measured by microfluorometry using the fluorescent dyes fura-2 and BCECF. Results: A combination of Hepato-STIM epithelial cell differentiation medium and Matrigel induced the expansion and formation of 3D HAT-7 spheroids. The cells retained their epithelial cell morphology and continued to express both ameloblast-specific and ion transport-specific marker genes. Furthermore, like two-dimensional HAT-7 monolayers, the HAT-7 spheroids were able to regulate their intracellular pH and to show intracellular calcium responses to extracellular stimulation. Finally, we demonstrated that HAT-7 spheroids may serve as a disease model for studying the effects of fluoride exposure during amelogenesis. Conclusion: In conclusion, HAT-7 cells cultivated within a Matrigel extracellular matrix form three-dimensional, multi-cellular, spheroidal structures that retain their functional capacity for pH regulation and intracellular Ca2+ signaling. This new 3D model will allow us to gain a better understanding of the molecular mechanisms involved in amelogenesis, not only in health but also in disorders of enamel formation, such as those resulting from fluoride exposure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Földes, Sang-Ngoen, Kádár, Rácz, Zsembery, DenBesten, Steward and Varga.)- Published
- 2021
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38. Comparative study of hyperpure chlorine dioxide with two other irrigants regarding the viability of periodontal ligament stem cells.
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Láng O, Nagy KS, Láng J, Perczel-Kovách K, Herczegh A, Lohinai Z, Varga G, and Kőhidai L
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- Cell Differentiation, Hydrogen Peroxide toxicity, Oxides, Stem Cells, Chlorine Compounds toxicity, Periodontal Ligament
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Objectives: Periodontal ligament stem cells (PDLSCs) have an underlined significance as their high proliferative capacity and multipotent differentiation provide an important therapeutic potential. The integrity of these cells is frequently disturbed by the routinely used irrigative compounds applied as periodontal or endodontic disinfectants (e.g., hydrogen peroxide (H
2 O2 ) and chlorhexidine (CHX)). Our objectives were (i) to monitor the cytotoxic effect of a novel dental irrigative compound, chlorine dioxide (ClO2 ), compared to two traditional agents (H2 O2 , CHX) on PDLSCs and (ii) to test whether the aging factor of PDLSC cultures determines cellular responsiveness to the chemicals tested., Methods: Impedimetry (concentration-response study), WST-1 assays (WST = water soluble tetrazolium salt), and morphology analysis were performed to measure changes in cell viability induced by the 3 disinfectants; immunocytochemistry of stem cell markers (STRO-1, CD90, and CD105) measured the induced mesenchymal characteristics., Results: Cell viability experiments demonstrated that the application of ClO2 does not lead to a significant decrease in viability of PLDSCs in concentrations used to kill microbes. On the contrary, traditional irrigants, H2 O2 , and CHX are highly toxic on PDLSCs. Aging of PLDSC cultures (passages 3 vs. 7) has characteristic effects on their responsiveness to these agents as the increased expression of mesenchymal stem cell markers turns to decreased., Conclusions and Clinical Relevance: While the active ingredients of mouthwash (H2 O2 , CHX) applied in endodontic or periodontitis management have a serious toxic effect on PDLSCs, the novel hyperpure ClO2 is less toxic providing an environment favoring dental structure regenerations during disinfectant interventions.- Published
- 2021
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39. TRPM7-Mediated Calcium Transport in HAT-7 Ameloblasts.
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Kádár K, Juhász V, Földes A, Rácz R, Zhang Y, Löchli H, Kató E, Köles L, Steward MC, DenBesten P, Varga G, and Zsembery Á
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- Ameloblasts cytology, Ameloblasts drug effects, Anilides pharmacology, Animals, Cell Line, Humans, Hydrogen-Ion Concentration, Incisor cytology, Ion Channel Gating drug effects, Ion Transport drug effects, Mibefradil pharmacology, Mice, Models, Biological, Naltrexone analogs & derivatives, Naltrexone pharmacology, Rats, Thiadiazoles pharmacology, Ameloblasts metabolism, Calcium metabolism, TRPM Cation Channels metabolism
- Abstract
TRPM7 plays an important role in cellular Ca
2+ , Zn2+ and Mg2+ homeostasis. TRPM7 channels are abundantly expressed in ameloblasts and, in the absence of TRPM7, dental enamel is hypomineralized. The potential role of TRPM7 channels in Ca2+ transport during amelogenesis was investigated in the HAT-7 rat ameloblast cell line. The cells showed strong TRPM7 mRNA and protein expression. Characteristic TRPM7 transmembrane currents were observed, which increased in the absence of intracellular Mg2+ ([Mg2+ ]i ), were reduced by elevated [Mg2+ ]i , and were inhibited by the TRPM7 inhibitors NS8593 and FTY720. Mibefradil evoked similar currents, which were suppressed by elevated [Mg2+ ]i , reducing extracellular pH stimulated transmembrane currents, which were inhibited by FTY720. Naltriben and mibefradil both evoked Ca2+ influx, which was further enhanced by the acidic intracellular conditions. The SOCE inhibitor BTP2 blocked Ca2+ entry induced by naltriben but not by mibefradil. Thus, in HAT-7 cells, TRPM7 may serves both as a potential modulator of Orai-dependent Ca2+ uptake and as an independent Ca2+ entry pathway sensitive to pH. Therefore, TRPM7 may contribute directly to transepithelial Ca2+ transport in amelogenesis.- Published
- 2021
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40. Oxidation of Cysteinate Anions Immobilized in the Interlamellar Space of CaAl-Layered Double Hydroxide.
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Timár Z, Hung TN, Pravda C, Kónya Z, Kukovecz Á, Sipos P, Varga G, and Pálinkó I
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L-Cysteinate-intercalated CaAl-layered double hydroxide (LDH) was prepared by the co-precipitation method producing highly crystalline hydrocalumite phase with a well-pillared interlayer gallery. The obtained materials were characterized by X-ray diffractometry, IR as well as Raman spectroscopies. By performing interlamellar oxidation reactions with peracetic acid as oxidant, oxidation of cysteinate to cystinate in aqueous and cysteinate sulfenic acid in acetonic suspensions occurred. The oxidations could be performed under mild conditions, at room temperature, under neutral pH and in air. It has been shown that the transformation pathways are due to the presence of the layered structure, that is, the confined space of the LDH behaved as molecular reactor.
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- 2021
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41. STRO-1 positive cell expansion during osteogenic differentiation: A comparative study of three mesenchymal stem cell types of dental origin.
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Perczel-Kovách K, Hegedűs O, Földes A, Sangngoen T, Kálló K, Steward MC, Varga G, and Nagy KS
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- Alkaline Phosphatase metabolism, Cell Proliferation, Cells, Cultured, Dental Pulp cytology, Dental Sac cytology, Humans, Periodontal Ligament cytology, Antigens, Surface metabolism, Cell Differentiation, Mesenchymal Stem Cells cytology, Osteogenesis
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Objective: Although the osteogenic differentiation potential of mesenchymal stem cells of dental origin is well established, the roles of different marker proteins in this process remain to be clarified. Our aim was to compare the cellular and molecular changes, focusing in particular on mesenchymal stem cell markers, during in vitro osteogenesis in three dental stem cell types: dental follicle stem cells (DFSCs), periodontal ligament stem cells (PDLSCs) and dental pulp stem cells (DPSCs)., Design: Human DFSCs, PDLSCs and DPSCs were isolated, cultured and their osteogenic differentiation was induced for 3 weeks. Mineralization was assessed by von Kossa staining and calcium concentration measurements. The expression of mesenchymal and osteogenic markers was studied by immunocytochemistry and qPCR techniques. Alkaline phosphatase (ALP) activity and the frequency of STRO-1 positive cells were also quantified., Results: The three cultures all showed abundant mineralization, with high calcium content by day 21. The expression of vimentin and nestin was sustained after osteogenic induction. The osteogenic medium induced a considerable elevation of STRO-1 positive cells. By day 7, the ALP mRNA level had increased more than 100-fold in DFSCs, PDLSCs, and DPSCs. Quantitative PCR results indicated dissimilarities of osteoblastic marker levels in the three dental stem cell cultures., Conclusions: DFSCs, PDLSCs and DPSCs have similar functional osteogenic differentiation capacities although their expressional profiles of key osteogenic markers show considerable variations. The STRO-1 positive cell fraction expands during osteogenic differentiation while vimentin and nestin expression remain high. For identification of stemness, functional studies rather than marker expressions are needed., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
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- 2021
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42. Electrospun Scaffolds in Periodontal Wound Healing.
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Budai-Szűcs M, Ruggeri M, Faccendini A, Léber A, Rossi S, Varga G, Bonferoni MC, Vályi P, Burián K, Csányi E, Sandri G, and Ferrari F
- Abstract
Periodontitis is a set of inflammatory conditions affecting the tissues surrounding the teeth predominantly sustained by bacterial infections. The aim of the work was the design and the development of scaffolds based on biopolymers to be inserted in the periodontal pocket to restore tissue integrity and to treat bacterial infections. Nanofibrous scaffolds were prepared by means of electrospinning. Gelatin was considered as base component and was associated to low and high molecular weight chitosans and alginate. The scaffolds were characterized by chemico-physical properties (morphology, solid state-FTIR and differential scanning calorimetry (DSC)-surface zeta potential and contact angle), and mechanical properties. Moreover, preclinical properties (cytocompatibility, fibroblast and osteoblast adhesion and proliferation and antimicrobial properties) were assessed. All the scaffolds were based on cylindrical and smooth nanofibers and preserved their nanofibrous structure upon hydration independently of their composition. They possessed a high degree of hydrophilicity and negative zeta potentials in a physiological environment, suitable surface properties to enhance cell adhesion and proliferation and to inhibit bacteria attachment. The scaffold based on gelatin and low molecular weight chitosan proved to be effective in vitro to support both fibroblasts and osteoblasts adhesion and proliferation and to impair the proliferation of Streptococcus mutans and Aggregatibacter actinomycetemcomitans , both pathogens involved in periodontitis.
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- 2021
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43. A colloid chemistry route for the preparation of hierarchically ordered mesoporous layered double hydroxides using surfactants as sacrificial templates.
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Varga G, Somosi Z, Kónya Z, Kukovecz Á, Pálinkó I, and Szilagyi I
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An efficient synthetic route was developed to prepare hierarchically ordered mesoporous layered double hydroxide (LDH) materials. Sodium dodecyl sulfate (SDS) was used as a sacrificial template to tune the interfacial properties of the LDH materials during the synthetic process. The SDS dose was optimized to obtain stable dispersions of the SDS-LDH composites, which were calcined, then rehydrated to prepare the desired LDH structures. Results of various characterization studies revealed a clear relationship between the colloidal stability of the SDS-LDH precursors and the structural features of the final materials, which was entirely SDS-free. A comparison to the reference LDH prepared by the traditional co-precipitation-calcination-rehydration method in the absence of SDS shed light on a remarkable increase in the specific surface area (one of the highest within the previously reported LDH materials) and pore volume as well as on the formation of a beneficial pore size distribution. As a proof of concept, the mesoporous LDH was applied as adsorbent for removal of nitrate and dichromate anions from aqueous samples, and excellent efficiency was observed in both sorption capacity and recyclability. These results make the obtained LDH a promising candidate as adsorbent in various industrial and environmental processes, wherever the use of mesoporous and organic content-free materials is required., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2021
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44. Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis.
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Bálint ER, Fűr G, Kiss L, Németh DI, Soós A, Hegyi P, Szakács Z, Tinusz B, Varjú P, Vincze Á, Erőss B, Czimmer J, Szepes Z, Varga G, and Rakonczay Z Jr
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- Alcohol Drinking adverse effects, Azocines, Biliary Tract Diseases complications, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Female, Humans, Male, Pancreatitis epidemiology, Pancreatitis mortality, Pancreatitis, Acute Necrotizing epidemiology, Pancreatitis, Acute Necrotizing etiology, Recurrence, Severity of Illness Index, Hypertriglyceridemia complications, Pancreatitis etiology
- Abstract
The main causes of acute pancreatitis (AP) are biliary disease, alcohol consumption, hypertriglyceridaemia (HTG) and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this meta-analysis was to evaluate the effects of these aetiological factors on the severity and outcome of AP. Pubmed and Embase were searched between 01/01/2012 and 31/05/2020. Included articles involved adult alcoholic, biliary, HTG- or post-ERCP AP (PAP) patients. Primary outcome was severity, secondary outcomes were organ failures, intensive care unit admission, recurrence rate, pancreatic necrosis, mortality, length of hospital stay, pseudocyst, fluid collection and systematic inflammatory response syndrome. Data were analysed from 127 eligible studies. The risk for non-mild (moderately severe and severe) condition was the highest in HTG-induced AP (HTG-AP) followed by alcoholic AP (AAP), biliary AP (BAP) and PAP. Recurrence rate was significantly lower among BAP vs. HTG-AP or AAP patients (OR = 2.69 and 2.98, 95% CI 1.55-4.65 and 2.22-4.01, respectively). Mortality rate was significantly greater in HTG-AP vs. AAP or BAP (OR = 1.72 and 1.50, 95% CI 1.04-2.84 and 0.96-2.35, respectively), pancreatic necrosis occurred more frequently in AAP than BAP patients (OR = 1.58, 95% CI 1.08-2.30). Overall, there is a potential association between aetiology and the development and course of AP. HTG-AP is associated with the highest number of complications. Furthermore, AAP is likely to be more severe than BAP or PAP. Greater emphasis should be placed on determining aetiology on admission.
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- 2020
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45. Comparative Evaluation of Two Hyaluronic Acid Gel Products for the Treatment of Interdental Papillary Defects.
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Mandel I, Farkasdi S, Varga G, and Nagy ÁK
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Objectives: The aim was to investigate the efficacy of single injections of two different hyaluronic acid products, Flex Barrier and Revident, in reducing the size of black triangles to treat Nordland-Tarnow Class I and II recessions., Materials and Methods: Forty adult patients were recruited with at least two upper and two lower interdental papilla defects in the front region between canine teeth. According to the Nordland-Tarnow classification of papillary defects, both Class I and Class II recessions were included in the investigation. Patients were randomly assigned to experimental groups to receive single injections of two different hyaluronic acid products, either Flex Barrier or Revident. The untreated sites served as controls. Photographs were taken before and immediately after the treatment, and again after one week and one month. To determine the size of the black triangles, Image J software was used. For statistical analysis, a mixed-design ANOVA was applied., Results: Both Flex Barrier and Revident significantly decreased the size of the treated defects immediately after the treatment and also one week later (p<0.001). The beneficial effect of Revident lasted longer than Flex Barrier as it remained significant even after one month in Revident-treated patients, however, not in the Flex Barrier-treated group. Furthermore, Nordland-Tarnow Class I lesions generally showed a greater improvement than Class II lesions., Conclusion: In this proof-of-concept, randomized clinical trial we have demonstrated the clinical applicability of both Flex Barrier and Revident, although Revident gave longer-lasting improvements than Flex Barrier. Further trials are needed to optimize multiple-application protocols for treating gingival black triangles., Competing Interests: Conflict of interest The authors declare no conflict of interest.
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- 2020
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46. Bioenergetic Impairment of Triethylene Glycol Dimethacrylate- (TEGDMA-) Treated Dental Pulp Stem Cells (DPSCs) and Isolated Brain Mitochondria are Amended by Redox Compound Methylene Blue † .
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Mikulás K, Komlódi T, Földes A, Sváb G, Horváth G, Nagy ÁM, Ambrus A, Gyulai-Gaál S, Gera I, Hermann P, Varga G, and Tretter L
- Abstract
Background: Triethylene glycol dimethacrylate (TEGDMA) monomers released from resin matrix are toxic to dental pulp cells, induce apoptosis, oxidative stress and decrease viability. Recently, mitochondrial complex I (CI) was identified as a potential target of TEGDMA. In isolated mitochondria supported by CI, substrates oxidation and ATP synthesis were inhibited, reactive oxygen species production was stimulated. Contrary to that, respiratory Complex II was not impaired by TEGDMA. The beneficial effects of electron carrier compound methylene blue (MB) are proven in many disease models where mitochondrial involvement has been detected. In the present study, the bioenergetic effects of MB on TEGDMA-treated isolated mitochondria and on human dental pulp stem cells (DPSC) were analyzed., Methods: Isolated mitochondria and DPSC were acutely exposed to low millimolar concentrations of TEGDMA and 2 μM concentration of MB. Mitochondrial and cellular respiration and glycolytic flux were measured by high resolution respirometry and by Seahorse XF extracellular analyzer. Mitochondrial membrane potential was measured fluorimetrically., Results: MB partially restored the mitochondrial oxidation, rescued membrane potential in isolated mitochondria and significantly increased the impaired cellular O
2 consumption in the presence of TEGDMA., Conclusion: MB is able to protect against TEGDMA-induced CI damage, and might provide protective effects in resin monomer exposed cells.- Published
- 2020
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47. Saliva as a Candidate for COVID-19 Diagnostic Testing: A Meta-Analysis.
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Czumbel LM, Kiss S, Farkas N, Mandel I, Hegyi A, Nagy Á, Lohinai Z, Szakács Z, Hegyi P, Steward MC, and Varga G
- Abstract
Background: COVID-19 is a serious and potentially deadly disease. Early diagnosis of infected individuals will play an important role in stopping its further escalation. The present gold standard for sampling is the nasopharyngeal swab method. However, several recent papers suggested that saliva-based testing is a promising alternative that could simplify and accelerate COVID-19 diagnosis. Objectives: Our aim was to conduct a meta-analysis on the reliability and consistency of SARS-CoV-2 viral RNA detection in saliva specimens. Methods: We have reported our meta-analysis according to the Cochrane Handbook. We searched the Cochrane Library, Embase, Pubmed, Scopus, Web of Science and clinical trial registries for eligible studies published between 1 January and 25 April 2020. The number of positive tests and the total number of tests conducted were collected as raw data. The proportion of positive tests in the pooled data were calculated by score confidence-interval estimation with the Freeman-Tukey transformation. Heterogeneity was assessed using the I
2 measure and the χ2 -test. Results: The systematic search revealed 96 records after removal of duplicates. Twenty-six records were included for qualitative analysis and 5 records for quantitative synthesis. We found 91% (CI 80-99%) sensitivity for saliva tests and 98% (CI 89-100%) sensitivity for nasopharyngeal swab (NPS) tests in previously confirmed COVID-19 patients, with moderate heterogeneity among the studies. Additionally, we identified 18 registered, ongoing clinical trials of saliva-based tests for detection of the virus. Conclusion: Saliva tests offer a promising alternative to NPS for COVID-19 diagnosis. However, further diagnostic accuracy studies are needed to improve their specificity and sensitivity., (Copyright © 2020 Czumbel, Kiss, Farkas, Mandel, Hegyi, Nagy, Lohinai, Szakács, Hegyi, Steward and Varga.)- Published
- 2020
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48. Antimicrobial Efficacy of Chlorhexidine and Sodium Hypochlorite in Root Canal Disinfection: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
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Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Czumbel LM, Sang-Ngoen T, Garami A, Mikó A, Varga G, and Lohinai Z
- Subjects
- Dental Pulp Cavity, Enterococcus faecalis, Randomized Controlled Trials as Topic, Root Canal Therapy, Anti-Bacterial Agents therapeutic use, Chlorhexidine therapeutic use, Root Canal Irrigants therapeutic use, Sodium Hypochlorite therapeutic use
- Abstract
Introduction: We aimed to compare the antimicrobial efficacy of chlorhexidine (CHX) and sodium hypochlorite (NaOCl), 2 irrigants routinely used in root canal therapy of permanent teeth., Methods: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched for randomized controlled trials published until March 2020. The meta-analysis of relative risk (RR) and standardized mean difference (SMD) was performed using a random effects model with a 95% confidence interval (CI). Subgroup analysis was performed for culture and molecular methods of bacterial detection., Results: The literature search yielded 2110 records without duplicates. Eight studies were eligible for a systematic review. No significant differences in the incidence of samples with positive bacterial growth after irrigation (RR = 1.003; 95% CI, 0.729-1.380; P = .987) and mean bacterial number changes (SMD = 0.311; 95% CI, -0.368 to 0.991; P = .369) were observed between CHX and NaOCl in the culture and molecular subgroups. Heterogeneity in RR (I
2 = 0%, P = .673) was low among studies, whereas considerable heterogeneity was observed in the analysis of SMD (I2 = 76.336%, P = .005)., Conclusions: Our findings suggest that both CHX and NaOCl can reduce bacterial infections after irrigation without any significant difference in antimicrobial efficacy between them. Although CHX and NaOCl showed similar efficacy, their molecular mechanisms were different. Therefore, they can be used as the main antibacterial root canal irrigants. However, our results were limited by inconsistencies among retrieved articles and a lack of clinically relevant outcomes. Further well-designed clinical studies are warranted to supplement our results., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2020
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49. Endoscopic versus microscopic stapes surgery outcomes: A meta-analysis and systematic review.
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Koukkoullis A, Tóth I, Gede N, Szakács Z, Hegyi P, Varga G, Pap I, Harmat K, Németh A, Szanyi I, Lujber L, Gerlinger I, and Révész P
- Subjects
- Humans, Treatment Outcome, Endoscopy, Microsurgery, Stapes Surgery methods
- Abstract
Objective: Compare intraoperative and postoperative outcomes of endoscopic and microscopic stapes surgery to provide objective evidence on whether the former is a better alternative than the latter., Methods: We performed a systematic review and meta-analysis for studies that compared endoscopic stapes surgery with microscopic stapes surgery. Only studies that met predetermined criteria were selected and assessed for bias and quality. Primary outcomes were postoperative air-bone gap (ABG) and chorda tympani nerve injury. Secondary outcomes were average operating time, tympanic membrane (TM) perforation, and postoperative taste disturbance, pain, and dizziness. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean difference (WMD) with 95% CI for continuous outcomes. A confidence interval starting above 1.0 was considered as statistically significant. I
2 and χ2 tests were used to quantify statistical heterogeneity. We used funnel plots to look for publication bias and performed a sensitivity analysis., Results: Six nonrandomized cohort studies were eligible. The primary outcomes were ABG < 10 dB: OR = 1.80 (95% CI: 0.96 to 3.38), ABG = 11 dB to 20 dB: OR = 1.49 (95% CI: 0.76 to 2.93), ABG > 20 dB: OR = 2.51 (95% CI: 0.77 to 8.22), and chorda tympani injury: OR = 3.51 (95% CI: 1.55 to 7.93). Secondary outcomes were taste: OR = 2.36 (95% CI: 1.01 to 5.51), average operation time: WMD = 0.14 (95% CI: -11.69 to 11.98), TM perforation: OR = 1.70 (95% CI: 0.44 to 6.58); pain: OR = 0.84 (95% CI: 0.36 to 1.96), and dizziness: OR = 2.15 (95% CI: 0.94 to 4.89)., Conclusions: Endoscopic stapes surgery is a valid alternative to the microscope., Level of Evidence: 2a Laryngoscope, 130: 2019-2027, 2020., (© 2019 The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)- Published
- 2020
- Full Text
- View/download PDF
50. The quadrivalent HPV vaccine is protective against genital warts: a meta-analysis.
- Author
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Lukács A, Máté Z, Farkas N, Mikó A, Tenk J, Hegyi P, Németh B, Czumbel LM, Wuttapon S, Kiss I, Gyöngyi Z, Varga G, Rumbus Z, and Szabó A
- Subjects
- Adolescent, Adult, Child, Condylomata Acuminata epidemiology, Female, Humans, Male, Papillomavirus Infections epidemiology, Papillomavirus Vaccines therapeutic use, Randomized Controlled Trials as Topic, Uterine Cervical Neoplasms epidemiology, Young Adult, Condylomata Acuminata prevention & control, Immunization Programs statistics & numerical data, Papillomavirus Infections prevention & control, Papillomavirus Vaccines administration & dosage, Uterine Cervical Neoplasms prevention & control, Vaccination statistics & numerical data
- Abstract
Background: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses., Methods: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and I-squared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach., Results: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01-0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26-0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61-0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17-0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference., Conclusions: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.
- Published
- 2020
- Full Text
- View/download PDF
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