RESUMO
OBJECTIVE: The objective of this systematic review was to evaluate the efficacy of non-surgical periodontal therapy on rheumatoid arthritis activity. MATERIAL AND METHODS: Articles published until April 2019 were electronically searched and screened using PubMed / MEDLINE, Scopus, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). This study was recorded in the international PROSPERO database (CRD42019132205). The PICO question (population, intervention, comparison, results) was: in adult patients with rheumatoid arthritis and periodontitis (P), does non-surgical periodontal treatment (I), as compared to no treatment (C), provides better outcomes in rheumatoid arthritis activity (O). RESULTS: After searching the databases, seven articles were selected for qualitative and five for quantitative analysis. The total number of participants included was 292, with an average age of 50.5 years. All patients had rheumatoid arthritis and periodontal disease. Non-surgical periodontal treatment significantly reduced Disease Activity Score 28 (P = 0.004; I2 = 92%) and erythrocyte sedimentation rate (P = 0.01; I2 = 78%), but with no significant effect on C-reactive protein (P = 0.34; I2 = 92%). CONCLUSIONS: It can be concluded that non-surgical periodontal treatment can benefit patients with rheumatoid arthritis.
RESUMO
STATEMENT OF PROBLEM: A consensus about the effect of crown-to-implant (C/I) ratio in single crowns regarding the implant survival rate and marginal bone loss (MBL) is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the influence of C/I ratio in implant-supported single crowns on clinical outcomes. MATERIAL AND METHODS: The search was made in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018095711). The focused question was "Does the crown-to-implant ratio influence clinical outcomes for implant-supported single crowns?" RESULTS: Five direct comparative studies were included (C/I ratio ≤1 or >1, or ≤2 or >2), including a total of 262 participants with a mean age of 54.5 years. The meta-analysis comparing C/I ratio between ≤1 or >1 revealed no significant differences (P=.18; risk difference:-0.05; 95% confidence interval: -0.11 to 0.02) in terms of implant survival rate; the same was true for C/I ratio between <2 or ≥2 (P=.05; risk difference:-0.06; 95% confidence interval: -0.12 to -0.00), both analysis were made with a mean follow-up period was 36 months. The mean MBL was calculated based in the qualitative data for each C/I ratio: ≤1 (0.15 mm [-0.34 to 0.34]); >1 (0.07 mm [-0.29 to 0.22]); <2 (1.32 mm [0.38-0.9]); and ≥2 (1.37 mm [-0.02 to 0.91]). The qualitative data reported that the most common mechanical complication was screw loosening, and the most common biological complication was peri-implantitis. CONCLUSIONS: The meta-analysis revealed no relationship between categories of C/I ratio for implant survival rate. The qualitative data also suggested that MBL increased as the C/I ratio increased.