• 제목/요약/키워드: Risk of Bias

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Influence of reciprocating and rotary instrumentation on microbial reduction: a systematic review and meta-analysis of in vitro studies

  • Selen Kucukkaya Eren;Emel Uzunoglu-Ozyurek;Sevilay Karahan
    • Restorative Dentistry and Endodontics
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    • 제46권2호
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    • pp.19.1-19.12
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    • 2021
  • Objectives: The purpose of this study was to conduct a systematic review and meta-analysis of in vitro studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals. Materials and Methods: PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis. Results: Seventeen in vitro studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [-0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk. Conclusions: Although both techniques decrease the microbial content (with reductions of 23.32%-88.47% and 23.33%-89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.

Associations between obstructive sleep apnea and painful temporomandibular disorder: a systematic review

  • Kang, Jeong-Hyun;Lee, Jeong Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.259-266
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    • 2022
  • The relationship between obstructive sleep apnea (OSA) and diverse types of pain conditions have been proposed. However, no consensus on the relationship between OSA and painful temporomandibular disorders (TMDs) has been established. Therefore, this systematic review has been conducted to review the existing literatures and provide comprehensive synthesis of such literatures about OSA and painful TMDs using the evidence-based methodology. A literature search was conducted using two electronic databases, Scopus, and PubMed. Risk of bias was assessed using the risk-of-bias assessment tool for non-randomized study version 2.0. A total of 158 articles were screened from the initial search and eventually, 5 articles were included in this systematic review. One study adopted both the longitudinal prospective cohort and case-control designs and other 4 articles adopted the cross-sectional design. Two studies employed polysomnography (PSG) for the diagnosis of OSA and mentioned the results from the PSG. All cross-sectional studies demonstrated higher OSA prevalence among patients with TMD, and one cohort study suggested OSA as a risk factor for TMD. OSA appears to have potential influences on the development of TMD; however, the role of TMD in the development of OSA remains to be unknown owing to the lack of high-quality evidences.

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

  • Fouda, Atef Abdel Hameed
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권2호
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    • pp.87-98
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    • 2020
  • The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

Low Social Support and Risk for Depression in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

  • Azmiardi, Akhmad;Murti, Bhisma;Febrinasari, Ratih Puspita;Tamtomo, Didik Gunawan
    • Journal of Preventive Medicine and Public Health
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    • 제55권1호
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    • pp.37-48
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    • 2022
  • Objectives: Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. Methods: PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I2 statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. Results: Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I2 = 87%). Conclusions: Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

요추 추간판 탈출증의 매선치료에 대한 문헌적 고찰 (Literature Review of Catgut-embedding Therapy for Lumbar Disk Herniation)

  • 박상훈;전용태;한국인;김민지;이하일;이정한;고연석
    • 한방재활의학과학회지
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    • 제25권4호
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    • pp.29-40
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    • 2015
  • Objectives We have attempted to provide the basis of treatment effects by considering foreign & domestic randomized controlled trials (RCTs), being implemented with catgut-embedding therapy for lumbar disc herniation. Methods We found the literatures prepared in Korean, English, and Chinese by December 2014 in electronic databases (Pubmed, Science Direct, Proquest, OASIS, KMbase, NDSL, RISS, National Assembly Library). We choosed RCTs by selection criteria through abstracts & articles, extracted and analyzed data. Cochrane's Risk of Bias Tool was used & implemented for the risk of bias. Results The total of 17 studies were included in the review. 88.2% of studies were accomplished within the last decade. The experimental group has shown more significant effects in 70.6% of studies, and the long-term & partial significant results were obtained in 29.4% of studies. Affected lumbar area and pelvic limb area with radiating pain were mostly selected for acupoint. Conclusions Overall and partial significant results were obtained from 17 foreign & domestic comparative RCTs which substantiates the treatment effects of catgut-embedding therapy for lumbar disc herniation. Since all studies, however, were exposed to the risk of bias, so future research of higher quality shall be necessary.

림프부종에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석 (Chuna Manual Therapy for Lymphedema: A Systematic Review and Meta-analysis)

  • 정인채;김예은;안정훈;한인식;박인화;차윤엽
    • 한방재활의학과학회지
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    • 제31권2호
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    • pp.15-24
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    • 2021
  • Objectives Purpose of our study is to investigate the preventive and therapeutic effect of Chuna manual therapy (CMT) for lymphedema. Methods A study search of 10 databases was performed. We included the randomized controlled trials (RCTs) which performed CMT for lymphedema in this study. The keywords used were 'chuna' or 'tuina' and 'lymphedema'. Two independent authors rated study quality and risk of bias using the Cochrane risk of bias tool. Results 9 appropriate RCTs were remained after screening. The therapeutic effects of the experimental group was statistically higher than that of the control group with functional exercise or taking western medicine. Subjective symptom score was also lower in the CMT group. Conclusions These results suggests that CMT has sufficient evidence that it is more effective in prevent or alleviating symptoms of lymphedema than conventional treating methods. However, due to the high risk of bias of included studies, further researches are needed with higher quality of evidence.

Systematic Review of the Correlation Between Temporomandibular Disorder and Body Posture

  • Lee, Yoon-Joo;Park, Jong-Hyeon;Lee, Seung-Jeong;Ryu, Hye-Min;Kim, Su-kyeong;Lee, Young-Jun;Yoon, Hyun-Min;Jang, Sun-Hee;Song, Choon-Ho;Kim, Cheol-Hong
    • Journal of Acupuncture Research
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    • 제34권4호
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    • pp.159-168
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    • 2017
  • Background: The aim of this study was to identify well-supported evidence to aid medical treatment of temporomandibular disorder or dysfunction (TMD) in Korea by analyzing the correlation between TMD and body posture in recent international research. Methods: We looked for recent clinical studies on TMD and body posture in Korean and English databases. Bias risk was estimated using the Risk of Bias Assessment Tool for Non-Randomized Studies and the Cochrane Risk of Bias Tool for assessing randomized controlled studies. Results: Nine clinical studies, published between 2005 and 2017, were analyzed. In each, TMD was assessed using the American Academy of Orofacial Pain diagnostic criteria and the Research Diagnostic Criteria for Temporomandibular Disorder. Six studies evaluated body posture using photographs, four studies used stabilometry, and one used both photographs and stabilometry. Conclusion: Six of the nine studies found a correlation between TMD and body posture. Well-designed randomized controlled trials are needed to provide more data to assess the validity of this correlation.

단순성 비만에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석 (Chuna Manual Therapy For Simple Obesity: A Systematic Review and Meta-analysis)

  • 이윤진;이은별;김현지;안희덕;양두화
    • 척추신경추나의학회지
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    • 제16권1호
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    • pp.43-52
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    • 2021
  • Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords "Chuna OR Tuina" AND "Obesity." We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

보조생식술을 시행한 난임환자에서의 뜸 치료에 대한 체계적 문헌고찰 및 메타분석 (The Effectiveness of Moxibustion Treatment in Infertility with IVF-ET: A Systematic Review and Meta-Analysis)

  • 이호성;박용덕;이혜정;황덕상;장준복;이창훈;이진무;김동일
    • 대한한방부인과학회지
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    • 제35권2호
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    • pp.28-41
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    • 2022
  • Objectives: The purpose of this study is to investigate the effectiveness of moxibustion in infertility with In Vitro Fertilization and Embryo Transfer (IVF-ET). Methods: We searched 8 databases (Embase, PubMed, CiNii, CNKI, OASIS, ScienceOn, KMBASE, KISS)to identify eligible studies published before 2021 Oct. We included randomized controlled clinical trials (RCTs) using moxibustion in infertility with IVF-ET. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results: Two RCT studies were eligible in our review. The overall risk of bias was evaluated as unclear. The meta-analysis of 2 trials indicated that favorable results for the use of moxibustion with IVF-ET. Conclusions: This systematic review and meta-analysis of clinical trials suggests that moxibustion with IVF-ET can effect on Infertility patients. However, because of studies included analysis was biased due to unclear risk of bias and unreliable study design, future RCT studies and additional Meta-Analysis are needed to judge the supplementary treatment role of moxibustion in infertility with IVF-ET.

아토피 피부염에서 한약 외용제와 양약 병용 치료의 효과: 체계적 문헌고찰 및 메타분석 (Efficacy of Combination Treatment of Herbal Medicine for External Use and Western Medicine for Atopic Dermatitis: A Systematic Review and Meta Analysis)

  • 이지은;박수진;전서연;김규석
    • 대한융합한의학회지
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    • 제5권1호
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    • pp.5-23
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    • 2023
  • Objectives: This study was conducted to evaluate the effect of combination treatment of herbal medicine for external use and western medicine for atopic dermatitis (AD). Methods: We searched randomized controlled trials (RCTs) which assess the effect of combination treatment of herbal and western medicine for AD through 8 electronic databases from the start to December 2022. The data synthesis was conducted by using Review Manager (RevMan, ver.5.4.1) and Cochrane risk-of-bias tool was used to evaluate the risk of bias. Results: 13 RCTs were included. The combination treatment group had significantly higher total efficacy rate(p<0.0001) and lower SCORAD score (p<0.00001) than the western medicine treatment group. The adverse event rate was also significantly lower in the combination treatment than the western medicine treatment group (p<0.0001). But there was no significant difference in recurrence rate (p=0.09). Conclusion: This study demonstrates that the combination treatment of herbal and western medicine could be safe and effective for AD. However, due to limits of included studies such as high heterogeneity between the literature and unclear risk of bias, further studies are warranted.

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