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Background: Incorporating an additive into lidocaine is a method to enhance the efficacy of the inferior alveolar nerve block (IANB) in mandibular posterior teeth. Objectives: To assess the efficacy of incorporating additives into lidocaine in the success rate of IANB for teeth with the diagnosis of normal pulp (NP) or symptomatic irreversible pulpitis (SIP). Methods: Randomized controlled trials (RCTs) assessing the incorporation of additives into lidocaine on the pulpal anaesthesia success rate of mandibular posterior teeth were searched in PubMed, Scopus, Web of Science, Ovid, EBSCO, Embase, and Cochrane databases up to 1 December 2021. The risk of bias (RoB) was assessed by the Cochrane Risk of Bias Tool. A random‐effects model was employed to calculate the pooled risk ratio (RR) with a 95% confidence interval (CI), using STATA 16. The trial sequential analysis (TSA) was applied to calculate the required information size (RIS). The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to assess the certainty of the evidence. Results: Of 6966 records retrieved initially, 14 trials (8 for NP and 6 for SIP groups) were included in qualitative and quantitative syntheses. All trials were categorized as low and unclear RoB for NP and SIP groups, respectively. In the NP group, with 307 participants, no significant effect was observed for additives incorporated into lidocaine (RR: 0.84; 95% CI: 0.53‒1.32; I2 = 98%). Subgroup analysis revealed that adding mannitol led to a higher success rate (RR = 1.24; 95% CI: 1.15–1.34; I2 = 7.16%). In the SIP group, with 434 participants, no significant effect was shown when the additives were incorporated (RR = 1.22; 95% CI: 0.98–1.52; I2 = 0%). Likewise, in subgroup analysis, incorporating mannitol or sodium bicarbonate demonstrated no significant effect (RR = 1.76; 95% CI: 0.93–3.32; I2 = 18.41% and RR = 1.06; 95% CI: 0.65–1.72; I2 = 53.5%, respectively). Discussion: TSA revealed that the outcome was "inconclusive" for each group. The certainty of the evidence was graded as "very low" and "low" for NP and SIP groups, respectively. Conclusions: The very low to low certainty of evidence indicated that incorporating additives into lidocaine did not increase the efficacy of IANB and supplemental injections are still necessary to help practitioners achieve painless dentistry. Registration: PROSPERO database (CRD42020132585). [ABSTRACT FROM AUTHOR]

Introduction. In recent years, several controversial reports of the correlation between altmetric score and citations have been published (range: -0.2 to 0.8). We conducted a meta-analysis to provide an in-depth statistical analysis of the correlation between altmetric score and number of citations in the field of health sciences. Methods. Three online databases (Web of Science, Scopus, and PubMed) were systematically searched, without language restrictions, from the earliest publication date available through February 29, 2020, using the keywords "altmetric," "citation," and "correlation." Grey literature was also searched via WorldCat, Open Grey, and Google Scholar (first 100 hits only). All studies in the field of health sciences that reported on this correlation were included. Effect sizes were calculated using Fisher's z transformation of correlations. Subgroup analyses based on citation source and sampling methods were performed. Results. From 27 included articles, 8 articles comprise several independent studies. The total sample size was 9,943 articles comprised of 35 studies. The overall pooled effect size was 0.19 (95% confidence interval 0.13 to 0.26). Bivariate partial prediction of interaction between effect size, citation source, and sampling method showed a greater effect size with Web of Science compared with Scopus and Dimensions. Egger's regression showed a marginally nonsignificant publication bias (p = 0.055), and trim-and-fill analysis estimated one missing study in this meta-analysis. Conclusion. In health sciences, currently altmetric score has a positive but weak correlation with number of citations (pooled correlation = 0.19 , 95% C.I 0.12 to 0.25). We emphasize on future examinations to assess changes of correlation pattern between altmetric score and citations over time. [ABSTRACT FROM AUTHOR]

Introduction. As there is no definitive treatment for the recurrent aphthous stomatitis (RAS), most of the available therapies aim at decreasing pain and discomfort. The aim of this study was to investigate the effectiveness of the Iralvex gel on the RAS management. Material and Methods. In this double-blind and placebo-controlled clinical trial study, twenty patients were treated with the Iralvex gel and the other twenty patients were treated with placebo. In every participant complete healing of lesions, pain duration, and intensity were evaluated. Data were analyzed by independent t-test and analysis of variance. Results. Pain was relieved after 6.10 ± 0.29 days in the Iralvex group in comparison to 8.00 ± 0.33 days in the placebo group (P value ≤ 0.001). Complete remission in the Iralvex group was after 6.80 ± 0.27 days and 10.20 ± 0.42 days in the placebo group (P value ≤ 0.001). Furthermore, significant differences in the pain intensity between Iralvex and placebo group measured on days 1, 3, and 5 were obtained (P value ≤ 0.01). Conclusion. The results of this study show that Iralvex gel is effective and cheap remedy for treatment of RAS without side effects. This trial is registered with IRCT201207253251N3. [ABSTRACT FROM AUTHOR]