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Several systematic reviews with meta-analyses on the effectiveness of periodontal treatment to improve glycaemic control have been published. So far no overview of these systematic reviews has been performed. The main objective of this report was to assess critically these systematic reviews to provide the reader with a high-level synthesis of research evidence. MEDLINE (via PubMed) and EMBASE databases were searched independently and in duplicate to identify systematic reviews with meta-analyses of clinical studies that assessed the relationship between diabetes mellitus and periodontitis. The last database search was performed on 10 March 2015. The reference lists of included systematic reviews were also scrutinized for further publications. The methodological quality of the included systematic reviews was assessed independently with two validated checklists ( AMSTAR and OQAQ) by two authors. Disagreements in the assessment were resolved by consensus. A total of 226 potential publications were initially retrieved. Eleven systematic reviews with meta-analyses were finally included. Glycosylated haemoglobin A1c (HbA1c) was the most commonly used clinical endpoint. Meta-analytic estimates from systematic reviews generated an average reduction of 0.46% (median 0.40%) of HbA1c in patients with diabetes mellitus who received periodontal treatment. These meta-analyses had, nevertheless, methodological limitations such as inclusion of trials with different types of risk of bias that hinder more robust conclusions. A recent meta-analysis that included recently published large randomized controlled trials did not show significant change in the level of HbA1c at the 6 mo follow-up. The AMSTAR checklist generated results that were more conservative than OQAQ. Findings from this overview do not support the information that periodontal treatment may improve glycaemic control. Methodological issues described in this overview may guide further research on this topic. [ABSTRACT FROM AUTHOR]

Several clinical trials describe the effectiveness of xenogeneic collagen matrix ( XCM) as an alternative option to surgical mucogingival procedures for the treatment of marginal tissue recession and augmentation of insufficient zones of keratinized tissue ( KT). The aim of this systematic review and meta-analysis was to evaluate the clinical and patient-centred outcomes of XCM compared to other mucogingival procedures. Applying guidelines of the Preferred Reporting Items for Systematic Reviews and Meta analyses statement, randomized controlled trials were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analysed using statistical software. A total of 645 studies were identified, of which, six trials were included with 487 mucogingival defects in 170 participants. Overall meta-analysis showed that connective tissue graft ( CTG) in conjunction with the coronally advanced flap ( CAF) had a significantly higher percentage of complete/mean root coverage and mean recession reduction than XCM. Insufficient evidence was found to determine any significant differences in width of KT between XCM and CTG. The XCM had a significantly higher mean root coverage, recession reduction and gain in KT compared to CAF alone. No significant differences in patient's aesthetic satisfaction were found between XCM and CTG, except for postoperative morbidity in favour of XCM. Operating time was significantly reduced with the use of XCM compared with CTG but not with CAF alone. There is no evidence to demonstrate the effectiveness of XCM in achieving greater root coverage, recession reduction and gain in KT compared to CTG plus CAF. Superior short-term results in treating root coverage compared with CAF alone are possible. There is limited evidence that XCM may improve aesthetic satisfaction, reduce postoperative morbidity and shorten the operating time. Further long-term randomized controlled trials are required to endorse the supposed advantages of XCM. [ABSTRACT FROM AUTHOR]

Background Systemic antimicrobials have been used as an adjunctive therapy for the treatment of periodontitis. Nevertheless, it is unclear whether the use of antimicrobials may improve tooth survival in patients with periodontitis. The main objective of this overview of systematic reviews (SRs) with meta-analyses was to assess the evidence supporting systemic antimicrobials for improving tooth survival in patients suffering from periodontitis. Information on adverse events was also extracted from SRs.Methods PubMed and EMBASE databases were searched independently (up to 1st August 2013) to identify SRs with meta-analyses on the use of systemic antimicrobials as an adjunctive treatment to scaling and root planing (SRP) in the treatment of periodontitis. Tooth survival and adverse events were assessed. Clinical effect was also assessed based on endpoints including clinical attachment level and probing depth. The methodological quality of the SRs was assessed by two authors using two checklists (AMSTAR and OQAQ).Results No data on tooth survival after treatment with SRP and antimicrobials were found. Nine SRs were included in this overview. Three SRs showed statistically significant outcome improvement with the use of antimicrobials, although the clinical relevance may be questionable. One SR showed better results based on surrogate endpoints; however, short-term adverse events were more pronounced with the use of antimicrobials. The reporting of long-term data on clinical effects, adverse events and bacterial resistance is scarce. The SRs were of heterogeneous quality.Conclusions Evidence of the efficacy of systemic antimicrobials on improving tooth survival is lacking. Further research focused on tooth survival and adverse events should be performed to provide more robust evidence of the benefits of using systemic antimicrobials for treating periodontitis. [ABSTRACT FROM AUTHOR]

Background Proper scientific reporting is necessary to ensure the correct interpretation of study results by readers. The main objective of this study was to assess the quality of reporting in abstracts of systematic reviews ( SRs) with meta-analyses in periodontology and implant dentistry. Differences in reporting of abstracts in Cochrane and paper-based reviews were also assessed. Methods The Pub Med electronic database and the Cochrane database for SRs were searched on November 11, 2012, independently and in duplicate, for SRs with meta-analyses related to interventions in periodontology and implant dentistry. Assessment of the quality of reporting was performed independently and in duplicate, taking into account items related to the effect direction, numerical estimates of effect size, measures of precision, probability and consistency. Results We initially screened 433 papers and included 146 (127 paper-based and 19 Cochrane reviews, respectively). The direction of evidence was reported in two-thirds of the abstracts while strength of evidence and measure of precision (i.e., confidence interval) were reported in less than half the selected abstracts. Measures of consistency such as I2 statistics were reported in only 5% of the selected sample of abstracts. Cochrane abstracts reported the limitations of evidence and precision better than paper-based ones. Two items ('meta-analysis' in title and abstract, respectively), were nevertheless better reported in paper-based abstracts. Conclusion Abstracts of SRs with meta-analyses in periodontology and implant dentistry currently have no uniform standard of reporting, which may hinder readers' understanding of study outcomes. [ABSTRACT FROM AUTHOR]

Industry-supported clinical trials may present better outcomes than those supported by other sources. The aim of this paper was to assess whether systematic reviews (SRs) published in periodontology and implant dentistry report and discuss the influence of funding sources on study results. Two reviewers conducted a comprehensive search in PubMed and the Cochrane Database of Systematic Reviews independently and in duplicate to identify SRs published up to 11 November 2012. Speciality dental journals and the reference lists of included SRs were also scrutinised. Information on the reporting and discussion of funding sources of primary studies included in the SRs was extracted independently and in duplicate. Any disagreement regarding SR selection or data extraction was discussed until consensus was achieved. Of 146 SRs included in the assessment, only 45 (31%) reported the funding sources of primary studies. Fourteen (10%) SRs discussed the potential influence of funding sources on study results, that is, sponsorship bias. Funding sources are inadequately reported and discussed in SRs in periodontology and implant dentistry. Assessment, reporting, and critical appraisal of potential sponsorship bias of meta-analytic estimates are paramount to provide proper guidance for clinical treatments. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is to evaluate the use of implant-tooth-borne removable partial dentures in prosthetic rehabilitation of Kennedy Class I partially edentulous arches. A comprehensive search was performed in MEDLINE, EMBASE, Cochrane Oral Health Group’s Trials Register, Cochrane Central Register of Controlled Trials, UK National Research Register, Australian New Zealand Clinical Trials Registry (ANZCTR), conference proceedings and abstracts up to 25 August 2009. Searching the reference list of the selected articles and hand searching of several journals were also performed. A total of nine studies were included. Of these, two were randomized, three were retrospective and four were case reports. All but two had a low reporting quality (level IV on a four-level hierarchy of evidence). Nevertheless, the improvement in function, aesthetics and stability has been demonstrated in all studies with minimal prosthetic care. Within the limitations of this study, implant-assisted/supported removable partial denture may provide a simple, economical and less invasive treatment modality. The predictability of such approach in the management of bilateral distal-extension situation is, however, still questionable. A higher quality of published studies namely with a focus on long-term randomized clinical trials are needed. [ABSTRACT FROM AUTHOR]