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The scaffolds used in regenerative endodontic therapy (RET) provide structural support for cells so that they can adhere to the scaffolds and also are crucial for cellular proliferation and differentiation. The objective of this network meta-analysis was to compare effects of different intracanal scaffolds on success outcomes of RET.PubMed/Medline, EMBASE, Cochrane, CINAHL, Scopus, and Web of Science databases were searched. Studies evaluating and/or comparing clinical and/or radiographic success of RET using different scaffolds with a minimum of 12 months follow-up were included. The Cochrane Collaboration risk of bias (ROB) tool and appropriate tools from Joanna Brigg's Institute were used for the assessment of ROB. A network meta-analysis was performed to compare the primary outcome (clinical success) and other success outcomes (root maturation, and pulpal sensibility) using different scaffolds.Twenty-seven studies fulfilled the desired inclusion criteria of which 25 had a low ROB whereas two had a moderate ROB. Clinical success of RET using platelet-rich plasma (PRP), blood clot (BC), and platelet-rich fibrin (PRF) scaffolds ranged between 91.66%-100%, 84.61-100%, and 77-100% respectively. The different scaffolds did not show any statistically significant difference in clinical success (PRF versus BC [p=1.000], PRP versus BC [p=1.000], and PRF versus PRP [p=0.999]), apical root closure (PRF versus BC [p=1.000], PRP versus BC [p=0.835], PRF versus PRP[p=0.956]), and pulp sensibility (PRF versus BC[p=0.980], PRP versus BC [p=0.520], and PRF versus PRP, p=0.990]).The intracanal scaffolds used during RET did not result in significant differences in regard to clinical success, root maturation, and pulpal sensibility.

There has been a systematic review of studies that used FEA in dental sciences, but no adequate risk of bias (RoB) analysis technique has been developed. Therefore, the development and validation process of RoB in studies using the finite element analysis in dentistry (ROBFEAD) tool is described. In the first phase of development, the scope of the tool and possible modifications were covered, and validation was done in the second phase. The developed tool comprised 6 domains and a total of 22 guiding questions in these domains. This article proposes the development and validation of ROBFEAD, a tool for measuring RoB in finite element research in dentistry.

External inflammatory root resorption (EIRR) and external replacement root resorption (ERRR) are the most common adverse outcomes after luxation injuries or dental injuries. They are usually detected radiographically after considerable progression. It can be envisaged that evaluation of inflammatory mediators might serve as an objective and reliable method of predicting the risk of resorption. The aim of this systematic review was to assess the evidence regarding the risk of resorption and to provide future research directions.An a priori protocol was prepared by a multidisciplinary expert group, as per the Cochrane handbook and PRISMA guidelines. The systematic search was conducted in six databases and grey-literature sources. Scrutiny of titles and abstracts, and later full-text articles was performed, and data were extracted. Risk of bias analysis was done by using the Joanna Briggs Institute's Critical Appraisal Checklist for analytical cross-sectional and cohort studies.Eight studies were included in the systematic review and could be categorized as per the source of biomarkers, namely epithelial cells from mucosa, gingival crevicular fluid and extracted teeth. The studies utilizing epithelial cells had been conducted between 2015 and 2018 in Brazil and did not find any correlation with EIRR. Two of the studies with extracted teeth found differences in the immunologic profiles of teeth with resorption. Three studies evaluating gingival crevicular fluid found increased levels of dentine sialoprotein and Interleukin-1-α.Among the three sources, the inflammatory gingival crevicular fluid appeared to be the most non-invasive source of biomarkers for predicting trauma-induced root resorption, although the evidence about this came from two studies with moderate and one study with high risk of bias. The primary studies in this systematic review showed variability in terms of the sample sizes, age of the patients, the grading/classification of trauma-induced resorption and the evaluation methods which must be addressed by future researchers.

Research protocol: The protocol was developed as per the recommendations of the Cochrane-handbook and PRISMA and was registered in PROSPERO. Literature search: Search was performed by using MeSH-Terms and keywords in PubMed, Scopus, Embase, Web of Sciences, Lilacs, and Cochrane databases and gray literature sources 15th July 2022. There were no limits regarding the year of publication and language. Hand-searching of included articles was also performed. Titles and abstracts and later full texts were screened as per strict inclusion and exclusion criteria. Data extraction: Self-designed pilot-tested form was used. Quality appraisal: Risk of bias was analyzed through Joanna-Brigg’s-Institute’s-critical appraisal checklist. The evidence analysis was done by using the GRADE approach. Data analysis: Qualitative synthesis was performed for describing the study characteristics, details of sampling, and results of various questionnaires. It was discussed by the expert group and presented using KAP heat map. Meta-analysis was done by using Random Effects Model. Results and interpretation: The risk of bias was found to be low in seven and moderate in one study. It was observed that >50% of parents knew about the urgency to seek professional advice after TDI. Only

Research question: Does dental trauma have impact on the oral health-related quality of life of children and adolescents? Research protocol: Protocol was designed as per the best practices of evidence-based medicine, guidelines for umbrella reviews and registered in PROSPERO. Literature search: PubMed, Scopus, Embase, Web of Sciences and Lilacs were searched for studies meeting the inclusion criteria from start of databases to 15th July 2021. Grey literature and registries of systematic review protocols were also searched. Hand searching of the references of included articles was also performed. The literature search was updated on 15th October 2021. Scrutiny of the titles and abstracts and later full text was done as per the inclusion and exclusion criteria. Data extraction: Self-designed pre-piloted form was used by two reviewers. Quality appraisal: AMSTAR-2 was used to assess the quality of systematic reviews, PRISMA was used to check reporting-characteristics and citation-matrix was used to evaluate study-overlap. Quality of evidence was assessed by using Kohler’s-criteria. Data analysis: Qualitative synthesis was performed for describing the study characteristics, details of sampling and the tool of OHRQoL used. The meta-analytic data was used for evaluating the evidence and its strength for each of the outcomes. Results and interpretation: A significant impact of all types of TDI on OHRQoL in children and adolescents was observed. The effect of uncomplicated TDI on OHRQoL in children and all ages showed no difference from controls. Though the quality of evidence in these interpretations was weak.

The aim of this systematic review and meta-analysis was to evaluate the maxillary sinus characteristics of patients with cleft lip and palate (CLP). The study included manuscripts which met the following criteria: (1) study of individuals with CLP in any age group or gender and (2) study of individuals in whom assessment of maxillary sinus characteristics had been done by cone-beam computed tomography. Studies with (1) individuals having special health-care needs and (2) individuals with any syndrome affecting the development of the head and neck were excluded. In total, 11 articles were included in the review, based on the inclusion and exclusion criteria. Pooled maxillary sinus volume (MSV) on the cleft sides of patients with unilateral cleft lip and palate (UCLP) was found to be 9433.14 mm3 (95% CI, 7453.99-11 412.30), which was significantly smaller than that of controls. The meta-analyses also revealed significantly reduced MSV on the cleft sides of patients with UCLP. The differences between cleft and noncleft sides of the patients with UCLP were not found to be statistically significant. Strength-of-evidence was found to be moderate in 4 characteristics, along with 10 out of 11 articles showing low risk-of-bias. It was concluded that MSV was reduced and mucosal thickening was increased/present in patients with CLP as compared with controls. The differences between MSV of cleft and noncleft sides of the patients with UCLP could not be established. However, heterogeneity was found in terms of sample size, stratification of samples by age, and evaluation of some confounding factors.

Background Crown fractures restored by fragment reattachment are liable to re-fracture, which may cause fragment dislodgement. There is a paucity of literature regarding management of fragment reattachment cases following a further fracture. Hence the aim of the present in-vitro study was to evaluate and compare the efficacy of three different management protocols for such scenarios. Methodology Eighty maxillary bovine incisors without structural deformity and with similar dimensions were fractured as per the standard protocol. They were subjected to drying for 24 hours and the fragments were rehydrated by placing them in a humidification chamber for 15 minutes. They were then reattached by using flowable light-cured composite resin. The teeth (n=20) were fractured again by fixing them in a mechanical frame and using a mallet. They were randomly allocated to three experimental groups. (Group I mechanical abrasion and fragment reattachment, Group II mechanical abrasion, humidification and reattachment, Group III mechanical abrasion and composite restoration, and Group IV positive control with no re-fracture). The samples were thermocycled and the force required to fracture was tested by using a universal testing machine (Instron-3360, USA). This was done by applying a tangential load with a speed of 1 mm/min to the teeth with a 500-kg load cell. Statistical analysis of the results was performed using ANOVA and the independent t-test. Results The highest force required to fracture was reported in Group IV (333.26 ± 66.69N) while the lowest was in Group II (254.86 ± 105.23N). The forces in Group I and Group II were 258.36 ± 65.78N and 298.02 ± 97.94N, respectively (p=0.016, F=3.68). The independent t-test between the groups revealed a significant difference between Group I and Group IV (p= 0.001) and Group II and Group IV (p=0.009). Conclusion The force required to fracture was significantly lower in the groups involving attachment of the re-fractured fragments. Among the experimental groups, the group with composite restoration required the highest force to fracture.

Fragment reattachment is the recommended treatment modality in uncomplicated crown fractures. There is a paucity of literature regarding the mechanisms responsible for increased resistance to fracture after fragment rehydration in such cases. Hence, the aim of this proof-of-concept study was to decipher the microscopic changes in the penetration characteristics of resin in tooth fragments after different rehydration protocols.Sixty bovine incisors free of structural deformities were fractured as per a standard protocol and the fragments were stored in saline at 4°C. They were randomly allocated into three groups (n = 20)-Group 1: negative-control, no-rehydration, Group 2: rehydration by immersion in distilled water for 15 min, Group 3: rehydration by humidification for 15 min. They were subjected to the "experimental bonding protocol" using an eighth-generation bonding agent mixed with rhodamine-B dye. The samples were subjected to decalcification and sectioned into cubical blocks (2 × 2 × 2 mmThe depth of penetration of the resin tags was greatest in Group 2 (927.81 ± 280.38 μm) followed by Group 3 (902.03 ± 371.85 μm) and Group 1 (287.74 ± 124.80 μm). Similarly, the width of the penetrated resin tags was greatest in Group 2 (58.29 ± 21.15), followed by Group 3 (35.53 ± 22.15) and Group 1 (23.89 ± 6.88). The number of resin tags in the majority of the samples in Group 1 had less than 25 tags (65%), whereas there were more than 25 tags in Group 2 (70%) and Group 3 (75%). These differences were statistically significant (p .05).The resin penetration, as observed by the number of tags and their depth and width, was significantly affected by the rehydration of the fragments. The fragments rehydrated in the distilled water had greater penetration of resin tags than those rehydrated in a humidification chamber.

Objectives This Systematic Review was conducted to evaluate the global status of the knowledge of prevention and emergency management of traumatic dental injuries among non-dental healthcare professionals (NDHCP). Methods The protocol was designed as per PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text-words and MeSH terms was performed in established databases as per a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed and risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool and a meta-analysis was performed. Results The qualitative synthesis included 14 studies between 2009-2020 with nine of them from Asia. Majority of the studies had low risk of bias and reported poor overall level of knowledge. Less than 40% of the NDHCP had received a dental trauma first aid training in six of the 10 studies and majority of the participants (>50%) believed that dental trauma training was required in five studies. Less than 36% of the participants were adequately aware of the correct approach towards management of avulsed permanent tooth in five studies. Conclusion The knowledge of non-dental health care professionals regarding the emergency management of traumatic dental injuries was insufficient or low in the majority of studies and the knowledge about prevention was not evaluated. There was a paucity of studies from the countries of Europe and Australia, with wide variability in the study methods, categories of the participants and questionnaire characteristics.

To evaluate the presence of developmental dental anomalies, like microdontia, hypodontia, abnormally shaped teeth (AST), and developmental defects of enamel (DDE) in childhood cancer survivors and compare it with the healthy controls. This cross-sectional analytical study was conducted in 2 groups: childhood cancer survivors (CCS) group including children (> 12 y, m/f) who had undergone anticancer therapy (ACT) before 8 y of age and healthy control group (> 12 y, m/f) without any systemic disease. Pearson chi-square test was used to analyze the difference between the CCS group and the control group for microdontia, hypodontia, AST, DDE and for intragroup analysis in CCS group. Odds ratio was also calculated. A total of 120 and 121 children were included in CCS and control group, respectively. The prevalence of microdontia, hypodontia, abnormally shaped teeth, and DDE was 17.5% (21), 5% (6), 8.33% (10), and 37.5% (45), respectively in CCS group. It was 8.2% (10), 2.5% (3), 1.65% (2), and 22.3% (27), respectively in the control group. A statistically significant difference was seen in microdontia (p = 0.032), abnormally shaped teeth (p = 0.017) and DDE (p = 0.01). Higher prevalence was seen when ACT began at an early age. An association between developmental dental anomalies and anticancer therapy (ACT) exists with significantly higher difference in microdontia, abnormally shaped teeth and DDE among survivors of childhood cancer as compared to healthy population. These known adverse effects of ACT on developing teeth should be considered during treatment planning of the children having cancers.

1. Review title. The various applications and methodological aspects of Finite element analysis in Dental Traumatology Research- A systematic review 2. Original language title. English 3. Anticipated or actual start date. 31-1-2022 4. Anticipated completion date. 30-3-2022 5. Stage of review at time of this submission. Not yet started 6. Named contact. Dr Mohammad Atif 7. Named contact email. Drmohammadatif1991@gmail.com 8. Named contact address. Dr Mohammad Atif Senior Resident, Division of Peodontics and Preventive Dentistry 6th Floor, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi, India-110029 9. Named contact phone number. +91-7620699744 10. Organisational affiliation of the review. Centre for Dental Education and Research All India Institute of Medical Sciences, New Delhi-110029 11. Review team members and their organisational affiliations. Dr Atif Mohammad, Dr Nitesh Tewari, Dr Vijay P Mathur, Dr Rahul Morankar, Dr Manjari Rishikesh, Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, Dr Anoop Chawla, Indian Institute of Technology, Delhi, New Delhi. 12. Funding sources/sponsors. None 13. Conflicts of interest. None 14. Collaborators. None 15. Review question. What are the various applications and methodological aspects of Finite element analysis in Dental traumatology research? 16. Searches. The PubMed, LILACS, Web of Science, EMBASE, Scopus and Cochrane databases will be searched on 2nd February 2022 without any restriction of language and year of publication. A search of the grey literature will be performed in Google Scholar and Open-Grey. The search strategy will include the use of text words and MeSH terms to address the Population (P), Intervention (I), Comparator (C), Outcome (O) of the research question- P- Studies related to any aspect of dental traumatology I- Finite element analysis C- Not required/ Not mandatory O- Distribution of the studies in different domains of dental traumatology and their methodological aspects The search strategy will be Field 1: Traumatic-Dental-Injuries OR Dental-Trauma OR Tooth-avulsion OR Tooth-Fracture OR Tooth-Trauma OR Tooth-Injuries OR Tooth-Luxation or Dental-injuries OR Crown-Fracture OR Crown-Root-fracture OR Root-Fracture OR Dento-alveolar-fracture OR Subluxation OR Concussion OR Contusion OR Lateral-Luxation OR Intrusion OR Intrusive-Luxation OR Extrusion OR Extrusive-Luxation OR Fractured-Tooth Filed 2: Finite-element-analysis OR Finite-element-method OR FEA OR FEM OR Finite-element-model OR Finite-element-algorithms Partial searches with the Boolean tools AND and OR will be done with the above keywords. The translations of the Keywords will be utilized to maximize the scope of the searches. Suitable modification shall be done for different databases and search of grey literature. References of the included articles will be searched. The searches will be saved electronically in EndNote online (Clarivate Analytics), which will also be used for removing the duplicates. The Literature search will be performed independently by two reviewers (MA and NT). In event of any disagreement, the consensus will be established by consulting the senior reviewer (VM). Reference lists of eligible studies will be cross-checked to identify additional studies. 17. URL to search strategy. None 18. Condition or domain being studied. Application of Finite element methods in Dental traumatology research 19. Participants/population. Studies related to any aspect of dental traumatology Exclusion: • Studies not related to dental trauma research. • Letter to editors • Short communications 20. Intervention(s), exposure(s). Finite Element Analysis/Methods 21. Comparator(s)/control. Not required/ Not mandatory 22. Types of study to be included. In vitro studies, in silico 23. Context. All studies involving the use of Finite element method in Dental traumatology will be included. 24. Main outcome(s). Various applications of FEA in different domains dental traumatology 25. Additional outcome(s). Methodological aspects of the FEA studies 26. Data extraction (selection and coding). Two authors NT, MA will assess studies to determine inclusion and undertake data extraction independently. The data extraction will be done using a specially designed pre piloted data extraction form. In event of difference of opinions, the Senior Expert VM will be consulted for agreement. 27. Risk of bias (quality) assessment. Risk of Bias for the studies will be evaluated by using self developed risk of bias tool for use of Finite element analysis in dentistry and will be done by two reviewers MA and MR independently. In event of disagreement, opinion of VP will be taken as final. 28. Strategy for data synthesis. The data will be entered in MS Excel format and synthesized as per the desired outcome variables. The data extraction will be done using a specially designed pre piloted data extraction form. The pilot testing of the sheet will be done in a sample of 10 studies. This will also be done for calibration of the reviewers. The different elements extracted will be- 1. Author (first author) 2. Year 3. Journal 4. Domain of TDI 5. Subdomain of TDI 6. Aim of the study described in the Population (P), Intervention (I), Comparator (C), Outcome (O) 7. Tooth/ Structure modelled 8. DICOM image/ Radiograph/ Photograph used for model development and its source. 9. Designing and Analytical Softwares used 10. 2D/3D model used 11. Static/ dynamic analysis done shape of elements 12. Number of elements and nodes in each model 13. Sub-structures defined in the model, 14. Boundary conditions 15. Restrains 16. Mechanical properties such as isotropic/anisotropic 17. Material behaviour: Linear/non-Linear/plastic/elastoplastic/viscoelastic/ viscoplastic 18. Poissons ratio 19. Youngs modulus(GPA) 20. Density of materials(g/cm3) 21. Material stiffness number 22. Damping effect (if used) 23. Range of force used 24. Point of application of force 25. Duration of force µs 26. Direction of force (Angle) 27. Shape of impact object(if modelled) 28. Degree of freedom 29. Mechanical Modelling(if done) 30. Other findings 31. disadvantage of model 29. Analysis of subgroups or subsets. None planned 30. Type and method of review. Systematic Review 31. Language. English 32. Country. India 33. Other registration details. None 34. Reference and/or URL for published protocol. None 35. Dissemination plans. The systematic review will be submitted to the leading Journal in the field for publication. 36. Keywords. Traumatic Dental Injuries, Dental Trauma, Finite element analysis, Finite element model, Finite element method, Tooth fracture. 37. Details of any existing review of the same topic by the same authors. None 38. Current review status. Not yet started 39. Any additional information. This review is being undertaken to help in providing research directions for use of FEA in Dental traumatology.It will also help to evaluate the shortcomings in extrapolating the results of FEA into clinical practise. This will further aid in developing appropriate interventions for improving the same.

This systematic review will be done to evaluate the various applications of finite element Analysis in Pediatric Dentistry

Objectives Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also lead to the fear of re-injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries. Methods The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad-based search using text-words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk-of-bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool. Results Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross-sectional, used convenience sampling, and were interview-based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk-of-bias in six studies. Conclusion The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics.

The succedaneous permanent teeth develop in close proximity to primary teeth. They can get accidentally luxated or avulsed during the extraction of primary teeth. The purpose of this paper was to describe a case of a 14-year-old boy with an “iatrogenic avulsion” of an immature mandibular second premolar during the extraction of a primary mandibular second molar. The case was managed successfully with replantation technique within 30 minutes of extra oral period and followed up for 5 years. The replanted tooth remained clinically asymptomatic, showed continued root development and eruption and remained vital. This paper had also discussed about the modifications in extraction technique to avoid the iatrogenic avulsion of permanent tooth bud during extraction of primary teeth.

A crown-root fracture is a fracture of both the crown and the root of a tooth. The International Association of Dental Traumatology (2020) guidelines recommended fragment reattachment and stabilization of loose fragments as an immediate management protocol for uncomplicated crown-root fractures. However, the lack of evidence and unpredictability make it a less popular treatment option. The aim of this study was to compare three protocols of fragment reattachment for the management of teeth with crown-root fractures.Eighty mandibular bovine incisors with similar dimensions and no structural deformities were selected and randomized into four groups: Group I (Control/sound teeth); Group II (no rehydration); Group III (rehydration in distilled water for 15 min) and Group IV (rehydration in a humidification chamber for 15 min). A fracture was simulated to extend from the labial side of the middle-third of the crown to the palatal side of the cervical-third of the root. Fragments were exposed to the environment under normal temperature and pressure. Fragments were later reattached as per the standard protocol following the rehydration as specified for each group. Samples were subjected to thermocycling, and the force required to fracture them was evaluated by using a universal testing machine.The highest mean force required to fracture was seen in Group IV (208.27 ± 75.99 N) followed by Group III (182.01 ± 90.13 N) and Group II (158.85 ± 68.04 N). These differences were statistically significant. Comparison of the mean difference of force required to fracture between pairs of groups revealed statistically significant mean differences only between the controls and each experimental group.The force required to fracture the reattached fragments in teeth with crown-root fractures was affected by rehydration of the fragments. The force was higher in fragments reattached after rehydration, and the highest force was required in the teeth that had been rehydrated in a humidification chamber.

BACKGROUND/AIMS Evidence mapping of systematic reviews (SRs) systematically and comprehensively identifies, organizes, and summarizes the distribution of scientific evidence in a field. The aims of this study were to delineate domains in dental traumatology (DT), evaluate the existing SRs within the domains, and identify the paucity of evidence for future research. METHODS Domains and sub-domains of DT were established according to the methods of qualitative research. The protocol for evidence mapping was prepared as per the guidelines of GEM and PRISMA. The search strategy was formulated using words and MeSH terms in eight databases without restriction of languages and year of publication. Gray literature, protocol registries, and references of selected articles were also searched. Duplicates were removed, and the final selection of SRs was completed. Data extraction and quality analysis using the ROBIS tool and the PRISMA checklist were performed. RESULTS The overall search resulted in 64 SRs from 1999 to 2020 with 44 published in last six years. The highest number of SRs had been performed in the Prognostic domain (n = 19) followed by the domains of Epidemiology (n = 15), Therapeutics (n = 10), Oral Biology (n = 7), Diagnostics (n = 6), Preventive (n = 5), and Research Methods (n = 2). Within each domain, there were variabilities in the number of reviewers, a priori protocols, search limitations, risk of bias methods, and meta-analysis. Of the SRs, including 4 Cochrane reviews, 28.4% were inconclusive. A low risk of bias was found in 48.4% of the SRs. Among the registered and ongoing SRs, six were from the domain of epidemiology, two in the domain of therapeutics, five from prognostics, and one each in the domains of prevention and research methods. CONCLUSION The SRs in DT could be mapped in seven domains with variabilities in the methods. The majority had an a priori registered protocol and a low risk of reporting errors. Within the Epidemiology and Preventive domains, SRs were present in all the sub-domains with the majority demonstrating low-risk of bias (ROB). The domain of prognosis had SRs in most sub-domains but with a high ROB. Insufficient numbers of SRs were present in most sub-domains of the Diagnostics, Therapeutics, Research Methods and Oral Biology domains.

Background/aim The majority of traumatic dental injuries (TDI) in childhood and adolescence occur in schools. Since school teachers are often the first responders, their knowledge about the emergency management of TDI needs to be adequate. The aim of this systematic review was to assess and analyse the global status of this knowledge as reported in previous studies and to provide recommendations for future research. Methods The protocol was designed as per PRISMA guidelines and registered in PROSPERO. A broad-based search using text-words and MeSH terms was performed in established databases as per a predefined strategy. Cohort-studies, cross-sectional, case-control studies and randomized/non-randomized trials without any distinction of language and year of publication were included while those without details of sampling strategy, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done by the Joanna-Briggs-Institute's critical appraisal checklist and meta-analysis was performed for four question stems using a random effects model. Results Twenty-three studies were included for qualitative analysis. Most of the studies had been conducted in Asia from 2009 to 2019. Ten studies used case-based questionnaires, mostly adapted from previous studies. Moderate to high risk of bias was observed in 14 studies. Less than 50% of teachers had witnessed a TDI in 8 studies and >75% desired to know more about TDI management in most studies. Less than 50% of teachers in 5 out of 6 studies knew about immediate replantation of avulsed permanent teeth, 95% with 17% of teachers having previous dental-trauma first-aid training and 38% knowing about replantation within 30 minutes. Conclusion The awareness level in several areas of the world is unknown. Studies lacked well-designed questionnaires and teachers exhibited low self-belief and knowledge level in the majority of studies.

Pulpotomy is an effective, vital pulp therapy procedure for caries-affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable.The aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison.This review followed the principles of evidence-based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self-designed pilot-tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta-analyses.The scrutiny of 62 full-text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta-analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full-strength/1:5 diluted and full-strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data.The pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries-affected primary teeth and elucidates the domains that require primary studies in the future.

The journal Dental Traumatology (DT) is one of the best resources in the field of dental traumatology. It has always encouraged publication of case reports of good quality. The CARE statement (2011) was developed for uniform and transparent reporting of cases in medical sciences. Since case reports are inseparable from the DT literature, the aim of this bibliometric-analysis was to evaluate the case reports published in the DT in the last two decades (2001-2021) and assess their compliance regarding CARE guidelines for elucidating the trends in DT and the reporting quality of these papers.Two authors independently observed the tables of contents in all issues of DT from 2002-2021 and identified case reports. Selected articles were scrutinized to determine their eligibility. Data extraction was performed, case reports were segregated into domains, and their CARE compliance was evaluated by using a self-designed-validated method. Differences between the case reports published in two decades (2002-2011 and 2012-2021) were analysed with the Chi-square test.A total of 1612 articles published between February 2002 and October 2021 were scrutinized to identify 357 case reports with 277 from the period of 2002-2011 and 80 between 2012 and 2021. The highest number of case reports originated from Asia (2002-2011:135, 2012-2021:28). The CARE compliances of the majority of reports in the decade of 2002-2011 were between 75 and 85% (good) while the CARE compliances of the majority of reports from 2012-2021 were between 85 and 95% (very good) or95% (excellent). These differences were statistically significant (p .005).The number of case reports published in the decade of 2002-2011 were more than three times the number of case reports published in the decade of 2012-2021. The highest number of reports in both decades were from Asia and belonged to the therapeutic and prognostic domains. The CARE compliances of the reports in the decade of 2012-2021 were better than those from 2002-2011.

Supplemental Material for Global Status of Knowledge, Attitude and Practice on Tobacco Cessation Interventions Among Dental Professionals: A Systematic Review by Harsh Priya, Manali Deb Barma, Bharathi M Purohit, Deepali Agarwal, Upendra Singh Bhadauria, Nitesh Tewari, Shalini Gupta, Deepika Mishra, Rahul Morankar, Vijay Prakash Mathur and Ritu Duggal in Tobacco Use Insights

The aim of this study was to describe the changes in oral health policies and guidelines in response to the Coronavirus disease 2019 (COVID-19) pandemic in different countries and regions around the world. Information on oral health policies and guidelines from 9 countries (Canada, China including Hong Kong, Egypt, India, Japan, New Zealand, Nigeria, Switzerland, and Thailand) were summarized, and sources of the information were mostly the national or regional health authorities and/or dental council/associations. The changes made to the oral health guidelines depended on the severity of the COVID-19 pandemic. This included suspension of non-emergency dental care services at the peak of the COVID-19 outbreak, and easing the restrictions on non-essential and elective dental care when the pandemic became under control. The COVID-19 risk mitigation strategies include strict adherence to infection control practices (use of hand sanitizers, facemask and maintaining social distancing), reducing the amount of aerosol production in the dental setting, and managing the quality of air in the dental treatment rooms by reducing the use of air conditioners and improving air exchange. The COVID-19 pandemic has shown a major impact on dental practice. Dental professionals are trying to adapt to the new norms, while the medium to long-term impact of COVID-19 on dentistry needs further investigation.

As part of the critical appraisal exercise in our center, we reviewed the article published in BMC Oral Health, titled "Impact of uncomplicated traumatic dental injuries on the quality of life of children and adolescents: a systematic review and meta-analysis" authored by Lopez et al. (BMC Oral Health 19(1):224, 2019). We noted a plausible error that can influence the outcomes of this systematic review and meta-analysis which necessitates interpreting the findings of this systematic review with caution.

Diamond-Blackfan anaemia (DBA) is a rare genetic disorder characterised by a decrease in the production of red blood cells due to bone marrow malfunction. The estimation of disease occurrence is approximately 1 in 100 000–2 00 000 live births. This paper presents the case of a 7-year-old male child diagnosed with DBA at the age of 4 months. The diagnosis was established with haematological findings, bone marrow biopsy and molecular testing. The case was managed successfully for dental symptoms without any complication.

Dental professionals are the primary care providers for traumatic dental injuries (TDI). The dental traumatology literature has a number of studies evaluating the knowledge of dental professionals from different parts of the world but its global status is unknown. Hence, the aim of this systematic review was to assess the global status of knowledge for the prevention and emergency management of TDI in dental professionals and to provide recommendations for future research.The protocol was designed as per the PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text words and MeSH terms was performed in established databases as per a pre-defined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done using the Joanna Briggs Institute's critical appraisal tool, and a meta-analysis was performed.Sixteen studies, which had been published between 2008 and 2020, were included for qualitative synthesis. Most of them were cross-sectional, used convenience sampling and evaluated knowledge for avulsion. Previous dental trauma training was undertaken by50% of the participants of five studies,50% knew about the correct approach in management of complicated crown fractures in three studies and ≤60% in four studies knew the critical time for replantation. There was insufficient level of knowledge in50% of the included studies. High risk of bias was found in three studies.The knowledge level in several areas of the world was unknown. The studies lacked uniformity in methods and well-designed questionnaires and they revealed insufficient levels of knowledge among dental professionals.

Lamellar ichthyosis (LI) is a rare genetic condition that affects the skin, with an incidence of less than 1:300 000 in different parts of the world. This report describes a case of a 5-year-old girl with LI and rickets presenting with premature loss of 51, 52, 61, 62 and 71, grade II mobility in 72, 73, 81, 82 and 83 along with loss of supporting bone with 53, 63, 72, 73, 82 and 83. This is the first report describing oral manifestations of this combination of LI and rickets.

Anticoagulant therapy is commonly indicated during pregnancy to prevent thrombosis and prevention of prosthetic heart valve-associated thromboembolic events. Warfarin is a synthetic anticoagulant with low molecular weight and can cross the placenta resulting in congenital abnormalities termed fetal warfarin syndrome. This paper highlights the case of an 8-year-old boy with warfarin embryopathy. It highlights the extraoral and intraoral findings of the case along with the cephalometric analysis and provides insight into the phenotypic variations among the different cases reported in the literature.

Vitamin D–resistant rickets shows the resistance to vitamin D (Vit-D) therapy, which traditionally works well in cases with deficiency rickets. The signs start appearing as early as in the first month of life and are characterised by the defective mineralisation at the ends of cartilage and bones despite having normal Vit-D levels in the serum. This case report highlights the dental and maxillofacial manifestations in a 3-year-old girl diagnosed with pseudo-Vit-D deficiency rickets. The report also highlights the variations in the dental manifestations of the condition reported in the literature.