Difference between revisions of "Esposito"
| Line 13: | Line 13: | ||
<span style="font-size: 10pt;"><span style="font-size:larger;">'''Lead author's name and fax:'''</span> <span style="font-size:larger;">Marco Esposito, Cochrane Oral Health Group, espositomarco@hotmail.com</span></span> | <span style="font-size: 10pt;"><span style="font-size:larger;">'''Lead author's name and fax:'''</span> <span style="font-size:larger;">Marco Esposito, Cochrane Oral Health Group, espositomarco@hotmail.com</span></span> | ||
| − | <span style="font-size:larger;">'''Three-part Clinical Question: | + | <span style="font-size:larger;">'''Three-part Clinical Question:'''For previously irradiated patients requiring dental implants, does HBOT therapy around the time of implant, compared to no specific intervention, result in an increase in successful implantation rate or a reduction in adverse outcomes?</span> |
<span style="font-size: 10pt;"><span style="font-size:larger;">'''Search Terms:'''</span> <span style="font-size:larger;">Radiotherapy; dental implants</span></span> | <span style="font-size: 10pt;"><span style="font-size:larger;">'''Search Terms:'''</span> <span style="font-size:larger;">Radiotherapy; dental implants</span></span> | ||
| Line 25: | Line 25: | ||
<span style="font-size: 10pt;"><span style="font-size:larger;">'''Data Extraction''': Data independently extracted by two reviewers. Any dispute adjudicated by third reviewer. Extracted patient details, type of intervention and outcomes of interest.</span></span> | <span style="font-size: 10pt;"><span style="font-size:larger;">'''Data Extraction''': Data independently extracted by two reviewers. Any dispute adjudicated by third reviewer. Extracted patient details, type of intervention and outcomes of interest.</span></span> | ||
| − | <span style="font-size:larger;">''' | + | <span style="font-size:larger;">'''The Evidence:'''</span> |
{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
|- | |- | ||
| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Outcome</span></span>'''</span></p> |
| − | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to Outcome</span></span>'''</span></p> |
| − | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Typical Control Event Rate</span></span>'''</span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Typical Odds Ratio</span></span>'''</span></p> |
| − | | style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative Risk Reduction</span></span>'''</span></p> |
| − | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p> |
|- | |- | ||
| style="border:solid windowtext 1.0pt" | | | style="border:solid windowtext 1.0pt" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Prosthetic failure</span></span>'''</span> |
| − | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1 year</span></span></span></p> |
| − | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">3.00</span></span></span></p> |
| style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | | style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | ||
| style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | | style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | ||
|- | |- | ||
| − | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CI:</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.13 to 67.06</span></span></span></p> |
| style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | | style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | ||
| style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | | style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | ||
|- | |- | ||
| style="border:solid windowtext 1.0pt" | | | style="border:solid windowtext 1.0pt" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Implant failures</span></span>'''</span> |
| − | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1 year</span></span></span></p> |
| − | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.167</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.50</span></span></span></p> |
| − | | style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-100%</span></span></span></p> |
| − | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family: | + | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">-6</span></span></span></p> |
|- | |- | ||
| − | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.60 to 10.46</span></span></span></p> |
| style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | | style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | ||
| − | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:51.9pt; border:solid windowtext 1.0pt" width="72" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">17 to -2</span></span></span></p> |
|- | |- | ||
| style="border:solid windowtext 1.0pt" | | | style="border:solid windowtext 1.0pt" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Postimplantation complications</span></span>'''</span> |
| − | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.5pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1 year</span></span></span></p> |
| − | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">5.0</span></span></span></p> |
| style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | | style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | ||
| style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | | style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | ||
|- | |- | ||
| − | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | colspan="3" style="width:245.6pt; border:solid windowtext 1.0pt" width="388" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.27 to 94.34</span></span></span></p> |
| style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | | style="width:76.45pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="104" | | ||
| style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | | style="width:51.9pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="72" | | ||
| Line 93: | Line 93: | ||
<span style="font-size:larger;">5. This is one of a series of systematic reviews of interventions for these patients</span> | <span style="font-size:larger;">5. This is one of a series of systematic reviews of interventions for these patients</span> | ||
| − | <span style="font-size:larger;">'''Appraised by'''</span> | + | <span style="font-size:larger;">'''Appraised by'''</span>:<span style="font-size:larger;">Vincenzo Zanon c/o Servizio OTI - Istituto Clinico Città di Brescia degli Istituti Ospedalieri Bresciani, SpA - GSD 15, Via Gualla -- 25128 Brescia ITALY Fax: +39-030-37.10.357; Sat, July 09th 2016</span> |
<span style="font-size: 10pt;"><span style="font-size:larger;">'''Email:''' vincenzo.zanon@gmail.com</span></span> | <span style="font-size: 10pt;"><span style="font-size:larger;">'''Email:''' vincenzo.zanon@gmail.com</span></span> | ||
| Line 102: | Line 102: | ||
= <span style="text-align: center;">[[Radiation_tissue_injury|BACK]]</span> = | = <span style="text-align: center;">[[Radiation_tissue_injury|BACK]]</span> = | ||
| − | + | <p style="text-align: center;"> </p> | |
| − | | ||
Revision as of 03:19, 9 July 2019
Little evidence available to assess the effect of hyperbaric oxygen therapy for dental implants into irradiated tissue
| Clinical bottom line: 1. Only one small study found, so no meta-analysis possible. 2. HBOT may not offer any appreciable clinical benefits. |
Citation/s: Esposito M, Worthington HV. Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants. Cochrane Database of Systematic Reviews 2013, Issue 9. Art No.: CD003603. DOI: 10.1002/14651858.CD003603.pub3
Lead author's name and fax: Marco Esposito, Cochrane Oral Health Group, espositomarco@hotmail.com
Three-part Clinical Question:For previously irradiated patients requiring dental implants, does HBOT therapy around the time of implant, compared to no specific intervention, result in an increase in successful implantation rate or a reduction in adverse outcomes?
Search Terms: Radiotherapy; dental implants
The Review:
Data Sources: : Cochrane Library, Medline, Embase, Authors of the review also wrote to RCT author, oral implant manufacturers, personal contacts and an internet discussion group (implantology@yahoogroups.com)
Study Selection: All RCTs enrolling patients having osseointegrated dental implants into an irradiated area and which compare HBOT to no HBOT.
Data Extraction: Data independently extracted by two reviewers. Any dispute adjudicated by third reviewer. Extracted patient details, type of intervention and outcomes of interest.
The Evidence:
Outcome |
Time to Outcome |
Typical Control Event Rate |
Typical Odds Ratio |
Relative Risk Reduction |
NNT |
|
Prosthetic failure |
1 year |
0 |
3.00 |
||
95% CI: |
0.13 to 67.06 |
||||
|
Implant failures |
1 year |
0.167 |
2.50 |
-100% |
-6 |
95% CIs: |
0.60 to 10.46 |
17 to -2 | |||
|
Postimplantation complications |
1 year |
0 |
5.0 |
||
95% CIs: |
0.27 to 94.34 |
||||
Comments:
1. Only 24 randomized patients contributed to this review from a single small study.
2. The outcome assessors were not blinded so this domain was assessed as high risk of bias
3. One patient who lost all implants was excluded from the analysis so this domain was assessed as at unclear risk of bias.
4. This SR has added little information but helps to define a more definitive study.
5. This is one of a series of systematic reviews of interventions for these patients
Appraised by:Vincenzo Zanon c/o Servizio OTI - Istituto Clinico Città di Brescia degli Istituti Ospedalieri Bresciani, SpA - GSD 15, Via Gualla -- 25128 Brescia ITALY Fax: +39-030-37.10.357; Sat, July 09th 2016
Email: vincenzo.zanon@gmail.com
Kill or Update By: December 2020
BACK
