Healthcare

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12 pages, 267 KiB

Open AccessArticle

National Survey on Silver Diamine Fluoride (SDF) Awareness, Knowledge, Attitude, and Use among General Dental Practitioners in the Kingdom of Saudi Arabia—An Exploratory Survey

by Ali Robaian, Mubashir Baig Mirza, Abdullah Alayad, Malak Almutairi, Ashjan Alotaibi and Alanoud Alroqi

Healthcare 2022, 10(11), 2161; https://doi.org/10.3390/healthcare10112161 - 29 Oct 2022

Cited by 2 | Viewed by 1398

Abstract

Silver diamine fluoride (SDF) has been accepted as an appropriate alternative for caries management. However, knowledge and utilization of SDF among dentists vary considerably. The authors in the present study aimed to assess the awareness, knowledge, attitudes, and use of SDF among general [...] Read more.

Silver diamine fluoride (SDF) has been accepted as an appropriate alternative for caries management. However, knowledge and utilization of SDF among dentists vary considerably. The authors in the present study aimed to assess the awareness, knowledge, attitudes, and use of SDF among general dentists (GD) in Saudi Arabia and to correlate the differences based on the different regions and experience levels of the dentists. In this regard, a cross-sectional web-based questionnaire was conducted, and a response was received from 311 GDs from different parts of the country. Information regarding demographic data, knowledge, attitudes, use, and barriers to SDF in dentists’ professional lives were elicited. The mean age of the participants (55.3%) was between 25–35 years. Most (92.45%) of the dentists were aware of the material and (61%) agreed that SDF could arrest carious lesions. More than half of the dentists agreed/strongly agreed that SDF was a good treatment alternative for restorations in children with behavioral issues (63.1%), medically fragile patients (53.7%), patients with severe anxiety (64.5%), patients who underwent radiation or chemotherapy (47.3%), and patients needing general anesthesia for dental treatment (74%). Comparative evaluation using ANOVA revealed regional differences based on knowledge, attitudes, and use. Tukey HSD further highlighted that the practitioners in the western region are more knowledgeable regarding its benefits and utilize it more frequently in their practice compared to other regions. On the other hand, the experience level of the GDs did not have any impact on their knowledge, attitudes, and use of SDF. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

10 pages, 231 KiB

Open AccessArticle

Oral Care Practice, Perception, and Attitude of Nurses in Intensive Care Units in Korea: A Questionnaire Survey

by Mi-Kyoung Jun

Healthcare 2022, 10(10), 2033; https://doi.org/10.3390/healthcare10102033 - 14 Oct 2022

Cited by 2 | Viewed by 2218

Abstract

Background: This cross-sectional study investigated the factors influencing oral care in patients in intensive care units (ICUs) by identifying the current oral care practice status, perceptions, and attitudes of ICU nurses in Korea. Methods: This study surveyed 240 nurses with work experience in [...] Read more.

Background: This cross-sectional study investigated the factors influencing oral care in patients in intensive care units (ICUs) by identifying the current oral care practice status, perceptions, and attitudes of ICU nurses in Korea. Methods: This study surveyed 240 nurses with work experience in the ICU using a self-report questionnaire consisting of 22 items on the status, perception, and attitude towards oral care in the ICU. Results: A total of 227 questionnaires were analyzed. The average age of the participants was 29.79 ± 5.92 years, and the medical ICU was the most type of ICU. The factors affecting the attitude towards oral care and its importance in ICU patients were the experience of working as a nurse (r = 0.336, p < 0.01), ICU work experience (r = 0.218, p < 0.01), and oral care practice frequency (r = 0.167 p < 0.05); these were found to be statistically significant. Conclusions: In this study, the interest of the nurses in oral care practice and education was high, but professional education and the regular implementation of oral care practices were insufficient. To address these problems, it will be necessary to improve oral care practices through dental intervention and education about oral care methods focused on ICU patients. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

25 pages, 6700 KiB

Open AccessArticle

Assessing the Effect of Curcumin on the Oral Mucosal Cytomorphometry and Candidal Species Specificity in Tobacco Users: A Pilot Study

by Prishita Mehta, Rashmi Bhavasar, Namratha A. Ajith, Rahul P. Bhavsar, Maha A. Bahammam, Mohammed Mousa H. Bakri, Khalid J. Alzahrani, Ahmad A. Alghamdi, Ibrahim F. Halawani, Shilpa Bhandi, A. Thirumal Raj and Shankargouda Patil

Healthcare 2022, 10(8), 1507; https://doi.org/10.3390/healthcare10081507 - 10 Aug 2022

Cited by 4 | Viewed by 1971

Abstract

Objectives: Tobacco consumption is of major concern for public health. Compromised oral hygiene accentuated by tobacco leads to alteration in the oral mucosa and microbiome, including Candida, and its species can be identified rapidly using CHROMagar. Curcumin, a naturally available compound possesses [...] Read more.

Objectives: Tobacco consumption is of major concern for public health. Compromised oral hygiene accentuated by tobacco leads to alteration in the oral mucosa and microbiome, including Candida, and its species can be identified rapidly using CHROMagar. Curcumin, a naturally available compound possesses antioxidant, anti-inflammatory, anti-microbial, anti-carcinogenic, anti-fungal, and immunomodulatory properties. Hence, a comprehensive study was planned. Aim: To evaluate and compare cytomorphometric analysis and Candida colonization and speciation in tobacco users before and after the use of curcumin gel. Materials and Methods: The study comprised a total of 120 participants (the study (tobacco habit) group, n = 60 and control (healthy) group, n = 60). The intervention was the application of curcumin gel over the lesion area three times daily for 2 months. All participants’ oral health status was assessed, followed by cytomorphometric analysis and Candida colonization and speciation using CHROMagar. Results: Cytomorphometric analysis showed statistically significant differences in the control and study group for cell diameter (CD), nuclear diameter (ND), CD:ND ratio, and micronuclei (p = 0.0001). Candida colonization had a significantly higher number of colonies in the habit group when compared to the control group. Candida tropicalis was predominant in the study group, whereas Candida albicans was predominant in the control group. In the study group, after intervention with curcumin, a statistically significant difference was seen in nuclear diameter, CD:ND ratio, and micronuclei. There was a reduction in the number of Candida colonies, and Candida albicans was the predominant species observed in the study group after the intervention of curcumin and discontinuation of habit. Conclusion: Curcumin was found to reduce the number of micronuclei and also decreased Candida colonization, along with the discontinuation of habit in tobacco users. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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9 pages, 1315 KiB

Open AccessArticle

Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up

by Tomoyo Takahashi, Masafumi Kihara, Kyosuke Oki, Tatsuya Matsuzaki, Yasunori Ayukawa, Yasuyuki Matsushita and Kiyoshi Koyano

Healthcare 2022, 10(7), 1250; https://doi.org/10.3390/healthcare10071250 - 04 Jul 2022

Cited by 2 | Viewed by 1547

Abstract

This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been [...] Read more.

This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been treated with ISFDPs and followed up with for at least 5 years between October 2009 and March 2020 were enrolled. Patient profiles and implant-related data were extracted. The survival rate of implants up to 5 years as well as the 10-year cumulative survival rate were evaluated. The management of implant loss and prosthetic interventions were also investigated. In total, 195 patients (mean age: 70.1 ± 4.5 years old) and 687 implants (287 ISFDPs) were assessed. The 5-year survival rate was 99.0% and the 10-year cumulative survival rate was 98.1%. Seven of the eleven implants lost were lost due to peri-implantitis. Only three implants in two patients were placed after the loss of the implants; most were restored using non-invasive procedures. Two patients underwent a conversion from ISFDPs to removable prostheses. This study showed that high survival rates were observed in an elderly population with ISFDPs and that non-invasive procedures were often applied after the loss of an implant. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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10 pages, 236 KiB

Open AccessArticle

Oral Care Awareness and Factors Related to the Burden of Nurses at a Community Hospital in Japan

by Takashi Koike, Ryuichi Ohta, Yuhei Matsuda, Chiaki Sano and Takahiro Kanno

Healthcare 2022, 10(6), 1073; https://doi.org/10.3390/healthcare10061073 - 09 Jun 2022

Cited by 3 | Viewed by 1699

Abstract

Objective: This cross-sectional study investigated the oral care knowledge, awareness, and challenges of 159 nurses and identified the factors related to the burden of oral care in Unnan City Hospital, Japan. Materials and Methods: This study included outpatient, ward, and operating room nurses [...] Read more.

Objective: This cross-sectional study investigated the oral care knowledge, awareness, and challenges of 159 nurses and identified the factors related to the burden of oral care in Unnan City Hospital, Japan. Materials and Methods: This study included outpatient, ward, and operating room nurses who answered a questionnaire comprising 19 questions regarding awareness, actual implementation status of oral care provided, burden and learning experiences of oral care, and participants’ characteristics. A univariate regression model was used to assess whether catheterization was associated with the independent variables. Results: The number and rate of valid questionnaires were 134 and 87.6%, respectively. The mean years of clinical experience were 18.71 ± 12.02 years; 95.5% of the nurses were women. There were significant differences in the Oral Health-related Caregiver Burden Index among “interest in oral care” (p = 0.006), “priority of oral care” (p = 0.005), and “burden of oral care”. Conclusions: This study shows that nurses who are highly interested in oral care, prioritize oral care, and do not perceive oral care as a burden. Educational interventions, such as training sessions and direct guidance to solve challenges, are needed and can lead to improvements in the quality of life and advancement of health. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

10 pages, 665 KiB

Open AccessArticle

Dental Students’ Oral Health-Related Quality of Life and Temporomandibular Dysfunction-Self-Rating versus Clinical Assessment

by Dagmar Schnabl, Philipp Sandbichler, Maximilian Neumaier, Johannes Girstmair, Fabian Barbieri, Ines Kapferer-Seebacher, René Steiner, Johannes Laimer and Ingrid Grunert

Healthcare 2021, 9(10), 1348; https://doi.org/10.3390/healthcare9101348 - 11 Oct 2021

Cited by 2 | Viewed by 1363

Abstract

The aim of this study was to compare dental students’ self-perception of oral health with the results of a clinical examination of the masticatory system. Seventy-four dental students (38 (51.4%) females and 36 (48.6%) males) completed the Oral Health Impact Profile questionnaire (OHIP-G-14) [...] Read more.

The aim of this study was to compare dental students’ self-perception of oral health with the results of a clinical examination of the masticatory system. Seventy-four dental students (38 (51.4%) females and 36 (48.6%) males) completed the Oral Health Impact Profile questionnaire (OHIP-G-14) and underwent a clinical examination according to the Graz Dysfunction Index (GDI). Data were analyzed with descriptive and comparative statistics. Median OHIP-G-14 scores were 3 (IQR 0–6) in the total collective, 4 (1–11) in females, and 2 (0–4) in males (p = 0.072). A score of 0 was found in 29.7% of the sample. The results of the GDI were 50% “normal function”, 43.2% “adaptation”, 5.4% “compensation”, and 1.4% “dysfunction”. The comparison of OHIP-G-14 scores and DGI groups showed a significant difference (p = 0.031). Based on the questionnaire, less than one third of the sample indicated maximum oral health-related quality of life. In contrast, the GDI revealed “normal function” or “adaptation” in 93.2%. Dental students underappreciated their oral health condition. Health assessments should not be solely questionnaire-based, especially in health professionals (-to-be). To establish a valid diagnosis of the state of health, self-assessment must be complemented by an objective clinical examination, e.g., GDI. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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11 pages, 464 KiB

Open AccessArticle

Serum Inflammatory and Prooxidant Marker Levels in Different Periodontal Disease Stages

by Ricardo Andreu, Sergio Santos-del-Riego and Francisco Payri

Healthcare 2021, 9(8), 1070; https://doi.org/10.3390/healthcare9081070 - 20 Aug 2021

Cited by 3 | Viewed by 1806

Abstract

Background: Periodontitis has been associated to systemic diseases and this association could be due to an increase in circulating inflammatory and oxidative stress biomarkers in the periodontal disease. This study aimed to evaluate the relationship between inflammatory and pro-oxidant markers according to different [...] Read more.

Background: Periodontitis has been associated to systemic diseases and this association could be due to an increase in circulating inflammatory and oxidative stress biomarkers in the periodontal disease. This study aimed to evaluate the relationship between inflammatory and pro-oxidant markers according to different stages of periodontitis. Methods: This cross-sectional study included 70 subjects who were divided into three groups according to periodontitis stage: stage II (n = 22), stage III (n = 30), and stage IV (n = 18). We evaluated periodontal parameters and levels of high-sensitivity C-reactive protein (hsCRP), fibrinogen, and malondialdehyde (MDA) in serum, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in urine. Results: Serum hsCRP and fibrinogen levels were associated with periodontitis severity, which were higher in stage IV than in stages III and II of periodontitis (p = 0.003 and p = 0.025, respectively). We observed a slight yet insignificant increase in MDA levels related to periodontitis severity. Probing depth and clinical attachment loss were associated with serum fibrinogen and hsCRP levels. However, there were no significant associations between periodontal variables and MDA and 8-OHdG levels. Conclusion: Our data support an association between periodontitis and systemic inflammation, which increases with periodontal disease severity. This indicates the importance of the early diagnosis and treatment of periodontal disease to avoid the development or worsening of systemic inflammatory diseases. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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8 pages, 904 KiB

Open AccessArticle

Oral Mucosa Could Be an Infectious Target of SARS-CoV-2

by Tatsuo Okui, Yuhei Matsuda, Masaaki Karino, Katsumi Hideshima and Takahiro Kanno

Healthcare 2021, 9(8), 1068; https://doi.org/10.3390/healthcare9081068 - 19 Aug 2021

Cited by 14 | Viewed by 2349

Abstract

The World Health Organization reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is caused by respiratory droplets and aerosols from the oral cavity of infected patients. The angiotensin-converting enzyme 2 (ACE2) is considered the host functional protein for SARS-CoV-2 infection. In [...] Read more.

The World Health Organization reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is caused by respiratory droplets and aerosols from the oral cavity of infected patients. The angiotensin-converting enzyme 2 (ACE2) is considered the host functional protein for SARS-CoV-2 infection. In this article, we first revealed that the positive proportion of ACE2 expression in gingival cells collected from the gingival sulcus was increased to the same level as the tongue. Our data demonstrate that cells in the gingival sulcus may be a new entry point for the SARS-CoV-2 virus via a high expression of ACE2. In addition, we first evaluated the expression of ACE2 in various sites of the oral cavity with noninvasive, convenient liquid-based cytology. The liquid-based cytology evaluation of oral tissue may provide a novel preventive medical avenue against COVID-19. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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12 pages, 1046 KiB

Open AccessArticle

Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study

by Rie Osako, Yuhei Matsuda, Chieko Itohara, Yuka Sukegawa-Takahashi, Shintaro Sukegawa, Satoe Okuma, Yoshihiko Furuki and Takahiro Kanno

Healthcare 2021, 9(7), 850; https://doi.org/10.3390/healthcare9070850 - 05 Jul 2021

Cited by 3 | Viewed by 2074

Abstract

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a [...] Read more.

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00–1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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Review

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10 pages, 1584 KiB

Open AccessReview

Efficacy of Methylprednisolone Compared to Other Drugs for Pain, Swelling, and Trismus Control after Third Molar Surgery: A Meta-Analysis

by Mariana González-Morelos, Lorenzo Franco-de la Torre, Diana Laura Franco-González, Eduardo Gómez-Sánchez, Ángel Josabad Alonso-Castro, Nelly Molina-Frechero, Luis Miguel Anaya-Esparza and Mario Alberto Isiordia-Espinoza

Healthcare 2022, 10(6), 1028; https://doi.org/10.3390/healthcare10061028 - 01 Jun 2022

Cited by 1 | Viewed by 1587

Abstract

The purpose of this systematic review and meta-analysis was to assess the efficacy of methylprednisolone compared to other drugs to control postoperative complications following third molar surgery. PubMed and Google Scholar were used for article searching. Thereafter, the trials meeting the selection criteria [...] Read more.

The purpose of this systematic review and meta-analysis was to assess the efficacy of methylprednisolone compared to other drugs to control postoperative complications following third molar surgery. PubMed and Google Scholar were used for article searching. Thereafter, the trials meeting the selection criteria and with high methodological quality, according to the Cochrane Collaboration’s risk of bias tool, were included in this study. The inverse variance test and mean difference using the Review Manager Software 5.3 for Windows were used to carry out data analysis. Qualitative analysis shows that methylprednisolone is more effective than NSAIDs, but inferior to dexamethasone, for controlling postoperative complications after third molar removal. The quantitative analysis showed no statistical difference for pain control, while trismus evaluation showed a statistical difference after 7 postoperative days in favor of methylprednisolone, when compared to other drugs. In conclusion, methylprednisolone was more effective for trismus control compared to other drugs after lower third molar surgery. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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19 pages, 2702 KiB

Open AccessReview

Oral Health Management and Rehabilitation for Patients with Oral Cancer: A Narrative Review

by Yuhei Matsuda, Ruwan D. Jayasinghe, Hui Zhong, Shinichi Arakawa and Takahiro Kanno

Healthcare 2022, 10(5), 960; https://doi.org/10.3390/healthcare10050960 - 23 May 2022

Cited by 4 | Viewed by 4239

Abstract

Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. [...] Read more.

Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. Multidisciplinary team approaches and supportive care in oral cancer treatment reportedly shorten the time to treatment and improve outcomes. Although there is enough evidence confirming the role of oral and maxillofacial surgeons, dentists, and dental hygienists in supportive care in oral cancer treatment, there are very few systematic studies. In particular, oral health management is a concept that encompasses oral function management, oral hygiene management, and oral care during oral cancer treatment. We provide a narrative review focusing on oral health management from a multidisciplinary and supportive care perspective, applicable in oral cancer treatment. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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Other

Jump to: Research, Review

6 pages, 6607 KiB

Open AccessCase Report

A Case of Oral Health Management for a Patient with Extensive Ulceration of the Oral Mucosa Due to Herpes Zoster

by Yuhei Matsuda, Ruriko Mizuno, Saki Miyajima, Shinichi Arakawa and Yuji Kabasawa

Healthcare 2022, 10(11), 2249; https://doi.org/10.3390/healthcare10112249 - 10 Nov 2022

Cited by 2 | Viewed by 2199

Abstract

Oral ulcers caused by herpes zoster virus infection are commonly encountered in daily clinical practice. However, in rare cases, sepsis or viremia can occur with serious outcomes; hence, these must be managed effectively. Here, we report a case of a patient with extensive [...] Read more.

Oral ulcers caused by herpes zoster virus infection are commonly encountered in daily clinical practice. However, in rare cases, sepsis or viremia can occur with serious outcomes; hence, these must be managed effectively. Here, we report a case of a patient with extensive ulceration caused by varicella zoster virus infection. Antiviral treatment was started early, and oral health management was started simultaneously, with oral hygiene instructions for pain control. As a result, the patient was able to resume oral food intake and was discharged from the hospital within a week. This case suggested that oral health management comprising supportive care, with the assistance of dentists and dental hygienists, as well as antiviral therapy, are important in the treatment of oral ulcers associated with herpes zoster virus infection. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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15 pages, 728 KiB

Open AccessSystematic Review

What Are the Complications, Success and Survival Rates for Autotransplanted Teeth? An Overview of Systematic Reviews and Metanalyses

by Ashutosh Kumar Singh, Nikita Khanal, Nisha Acharya, Md Riasat Hasan and Takashi Saito

Healthcare 2022, 10(5), 835; https://doi.org/10.3390/healthcare10050835 - 01 May 2022

Cited by 8 | Viewed by 2740

Abstract

Background: Autotransplantation is the surgical repositioning of a tooth within the same patient. It can be thought of as the controlled avulsion and re-implantation of a tooth and can be a viable alternative to other dental rehabilitation options. This review aimed to evaluate [...] Read more.

Background: Autotransplantation is the surgical repositioning of a tooth within the same patient. It can be thought of as the controlled avulsion and re-implantation of a tooth and can be a viable alternative to other dental rehabilitation options. This review aimed to evaluate the survival rate (SR), major complications such as ankylosis rate (AR) and infection-related root resorption (RR), and overall success and failure rate (FR) in autotransplanted teeth. Methods: Six databases were accessed up to January 2021 to obtain all systematic reviews and meta-analyses (SRs and MAs). Study selection: After title and abstract reading, data extraction was performed from eligible SRs. The methodological quality was calculated for the included SRs using the risk of bias in systematic reviews (ROBIS) tool. Results: Six SRs were included in this review. The overall failure rate ranged from as low as 2.0% to 10.32%. The 1-year survival was very high (97.4–98.0%). The 5-year survival rate ranged from 81 to 98.2%. Major complications of AR ranged from 1.2 to 6.2%, and RR ranged from 2.1 to 10.4%. Conclusion: The overall findings from these SR and MA are promising; however, all the SRs include only single-arm prospective or retrospective studies, the SRs are of overall low methodological quality, and for the heterogeneity of the included SRs, well-designed comparative studies with a long-term follow-up are recommended. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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