Elf Break

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The Dental Elf is taking a short break and will be back on the 4th November

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Oral cancer detection: Limited evidence for use of chemiluminescence and autofluorescent imaging devices in primary care

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Early detection of oral cancer improves prognosis so methods to improve diagnosis are welcome. The review we look at today looks at two light-based systems: chemiluminescence or autofluorescence. 25 studies were included and they are well summarised but few were tested in primary care. Neither system provided much improvement on the level of sensitivity and specificity achieved by conventional oral examination. Therefore it is suggested that these tools are better suited to specialist clinics in which there is a higher prevalence of disease and where experienced clinicians may better discriminate between benign and malignant lesions.

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Peri-implantitis: lack of high quality evidence for surgical approaches

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Today we look at a review of surgical treatments for the management of peri-implantitis. 21 studies were identified but only 5 were randomised trials, only one of which was at low risk of bias. While all approaches provided some benefit the available evidence is limited.

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Compete dentures: no difference between simplified and traditional approaches to fabrication

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Today we look at a review that compares simplified approaches with traditional methods for constructing complete dentures. 3 small trials reported in 6 papers suggest some advantages of the simplified approach over the traditional. However studies are small and of short duration.

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Caries Prevention: review suggests that education training and fairer payments would increase prevention delivered by dentists

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Seven qualitative studies and 41 surveys were included in this qualitative metasummary of factors that increase or decrease dentists delivery of caries prevention. While the surveys in particular, are of questionable quality some commonality emerges that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists

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Nerve repositioning for implant placement: neurosensory complications common

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This review of complications following inferior alveolar nerve repositioning techniques included 24 studies the majority at high risk of bias. Initial sensory disturbance was highest with lateralisation technique but lower at end of follow up periods than transposition approach.

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Peri-implantitis: little evidence that particular non-surgical treatments are better than debridement alone

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This Bayesian network meta-analysis only included 11 small studies of overall low quality. While the greatest reduction in PPD was seen with debridement in conjunction with antibiotics the difference are small so it is difficult to conclude that any particular non-surgical treatment for peri-implantitis performs better than debridement alone

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Chronic periodontitis: review suggests that Er:YAG laser may provide short term improvement

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This review compares the clinical outcomes of scaling and root planing with Er:YAG laser either as an alternative or as an adjuvant in patients with chronic periodontitis. 12 small trials were included and similar outcomes were seen with both treatments at 3 months . However hetrogeneity in teh studies and the small sample size mean that these finding should be interpreted with caution.

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Anterior mandibular fractures: review suggests lag screws and 1 plate plus an arch bar were superior to 2 miniplates for fixation

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This is one of a series of reviews that has looked at postoperative complications following different treatments for mandibular fractures. This review focuses on anterior mandibular fractures with the findings suggesting that lag screws and single miniplate plus an arch bar were superior to 2 miniplates

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Endodontic microsurgery or single tooth implants after failed root canal treatment

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This systematic review was looking to compare endodontic microsurgery with single implant placement. No studies directly comparing the two treatments were available. 44 studies of single implants and 6 studies of endodontic microsurgery found 2 -4 years survival rates for endodontic microsurgery were 94% and single implants 96%. The quality of the available evidence was moderate.

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