Daily Cosmetic Research Analysis
Analyzed 19 papers and selected 3 impactful papers.
Summary
Analyzed 19 papers and selected 3 impactful articles.
Selected Articles
1. CAD-CAM Splints Versus Arch Bars for Management of Dentate Mandibular Fractures - A Randomized Control Study.
In a single-blind randomized trial (n=32), CAD-CAM splints achieved higher rates of normal occlusion at 4 weeks than conventional arch bars (100% vs 75%; P=0.02). Trends toward reduced operative time and postoperative MMF needs were observed in selected subgroups.
Impact: This trial provides randomized evidence that patient-specific, CAD-CAM–guided maxillomandibular fixation can improve occlusal outcomes over traditional methods in dentate mandibular fractures.
Clinical Implications: Adopting CAD-CAM splints for MMF in appropriate mandibular fracture patterns may increase early occlusal accuracy and reduce postoperative MMF needs, with potential operative efficiency gains in selected cases.
Key Findings
- At 4 weeks, normal occlusion occurred in 100% (16/16) of CAD-CAM patients vs 75% (12/16) with arch bars (P=0.02).
- Overall operative time was numerically shorter with CAD-CAM (50.4 vs 59.9 minutes; P=0.1), with benefits in selected subgroups.
- Lower need for postoperative MMF was observed in more complex fracture patterns with CAD-CAM compared with arch bars.
Methodological Strengths
- Single-blind randomized controlled design with prespecified outcomes
- Direct head-to-head comparison of two widely used MMF techniques
Limitations
- Single-center, small sample size (n=32) limits generalizability
- Operative time differences were not statistically significant overall
Future Directions: Multicenter RCTs with larger samples should assess long-term occlusal stability, cost-effectiveness, and patient-centered outcomes comparing CAD-CAM splints and arch bars.
BACKGROUND: Mandibular fractures are technically demanding because accurate restoration of occlusion is required and conventional maxillomandibular fixation (MMF) techniques have important limitations. PURPOSE: The purpose of this study was to measure and compare the clinical efficacy of CAD-CAM splints versus conventional arch bars as MMF techniques in subjects undergoing open reduction and internal fixation (ORIF) of mandibular fractures in the dentate region. STUDY DESIGN AND SETTING: This single-blind randomized clinical study was conducted in the Department of Oral and Maxillofacial Surgery at a tertiary academic center between September 2022 and March 2024. Adult patients indicated for ORIF of mandibular fractures in the dentate region were eligible. Exclusion criteria were isolated condylar fractures, comminuted or edentulous mandibular fractures, and associated midface fractures affecting occlusion. PREDICTOR VARIABLE: The primary predictor variable was the MMF technique and subjects were randomly assigned to CAD-CAM splint or conventional arch bar groups. OUTCOME VARIABLES: The primary outcome was clinical efficacy, assessed by postoperative occlusion, need for and duration of postoperative MMF, and operative time. Secondary outcomes included lower border step deformity, lingual cortical reduction, preparation time, and achievement of condylar pushback. COVARIATES: The covariates were demographics, fracture patterns, and presence of associated condylar fractures and their management. STATISTICAL ANALYSIS: Appropriate tests were used for analysis with significance set at P < .05. RESULTS: The sample was composed of 32 subjects (16 in each group) with a mean age of 29.9 years (standard deviation [SD] 10.7); 28 (87.5%) were males. Normal occlusion at 4 weeks was achieved in 16 of 16 (100%) CAD-CAM subjects and 12 of 16 (75%) arch bar subjects (P = .02). The combined mean operative time was 50.4 minutes (SD 15.8) for CAD-CAM and 59.9 minutes (SD 18.1) for arch bars (P = .1). The combined mean preparation time was 90.9 minutes (SD 9.4) for CAD-CAM splints and 83.9 minutes (SD 10.5) for arch bars (P = .1). CONCLUSION AND RELEVANCE: CAD-CAM splints as an MMF technique are associated with improved occlusal outcomes, a lower need for postoperative MMF in complex fracture patterns, and shorter operative times in selected subgroups compared with conventional arch bars.
2. Effect of Pre-emptive Injection-based Corticosteroid Administration and Its Routes on Post-Endodontic Pain: A Systematic Review and Meta-analysis of Randomized Clinical Trials.
Across nine RCTs (n=917), pre-emptive corticosteroid injections significantly reduced post-endodontic pain at all time points, with the greatest benefit within 12 hours and persistence up to 72 hours. Infiltrative routes showed superior efficacy over intraligamentary administration.
Impact: This PROSPERO-registered, PRISMA-guided meta-analysis provides high-level evidence supporting pre-emptive corticosteroids to mitigate early post-endodontic pain and clarifies route-specific differences.
Clinical Implications: Consider pre-emptive dexamethasone via infiltrative or intraligamentary injection to reduce early post-endodontic pain, especially in patients at high risk of severe postoperative discomfort, while accounting for steroid contraindications.
Key Findings
- Meta-analysis of 9 RCTs (917 participants) showed significant pain reduction versus placebo at all postoperative intervals.
- Analgesic effect was largest within the first 12 hours and sustained, though attenuated, up to 72 hours.
- Infiltrative injections outperformed intraligamentary routes in reducing post-endodontic pain.
Methodological Strengths
- PRISMA 2020 guidance with prospective PROSPERO registration
- Cochrane RoB 2.0 bias assessment and multi-database search strategy
Limitations
- Heterogeneity in corticosteroid type, dose, routes, and pain assessment time points
- Limited long-term outcomes beyond 72 hours and variable trial quality
Future Directions: Head-to-head RCTs comparing specific agents, doses, and routes with standardized pain metrics and longer follow-up are warranted.
BACKGROUND: Post-endodontic pain PP is a frequent complication following root canal treatment RCT, primarily resulting from acute inflammation. Pre-emptive corticosteroid administration has been proposed to attenuate this inflammatory response and reduce PP. This systematic review and meta-analysis assessed the effectiveness of injection-based corticosteroids delivered through different routes in minimizing PP at various postoperative intervals. MATERIAL AND METHODS: A comprehensive search of PubMed, Scopus, Web of Science, LILACS, Cochrane Library, and Google Scholar was conducted up to March 2025, following PRISMA 2020 guidelines. Randomized controlled trials evaluating pre-emptive corticosteroid injections via infiltrative, intraligamentary, or intramuscular routes were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and meta-analyses were performed using Review Manager 5.4. The review was prospectively registered in PROSPERO CRD420251005886. RESULTS: Nine RCTs comprising 917 participants were analyzed. Corticosteroid injections, including dexamethasone, methylprednisolone, and betamethasone, significantly reduced PP compared with placebo at all time points, with the most pronounced effect within the first 12 hours and sustained, though reduced, benefits up to 72 hours. Infiltrative injections demonstrated greater efficacy than intraligamentary routes. CONCLUSIONS: Pre-emptive corticosteroid injections, particularly dexamethasone via infiltrative or intraligamentary routes, effectively reduce post-endodontic pain, especially within the first 24 hours.
3. BREAST-Q Under the Microscope: A Scoping Review of Reporting Gaps in Breast Surgery.
Across 307 studies, BREAST-Q reporting concentrates on a few domains, with psychosocial well-being, satisfaction with breasts, and sexual well-being most commonly reported. Descriptive global weighted means favored cosmetic over reconstruction populations (81.99 vs 74.49), highlighting selective reporting bias and the need for comprehensive, standardized domain coverage.
Impact: By mapping domain-level reporting gaps at scale, this review identifies a key source of bias in patient-reported outcomes for breast surgery and offers a clear path to improve comparability and benchmarking.
Clinical Implications: Journals and investigators should require comprehensive BREAST-Q domain reporting or an overall summary score to reduce selective reporting bias and enable meaningful cross-study comparisons in reconstructive and cosmetic breast surgery.
Key Findings
- Systematic scoping across 5 databases identified 307 eligible studies using BREAST-Q.
- Most frequently reported domains: psychosocial well-being, satisfaction with breasts, and sexual well-being (Reconstruction: 79.12%, 91.21%, 77.29%; Cosmetic: 74.55%, 96.36%, 83.64%).
- Global weighted mean BREAST-Q scores were descriptively higher in cosmetic versus reconstruction groups (81.99 vs 74.49), underscoring reporting biases and heterogeneity.
Methodological Strengths
- Comprehensive multi-database search spanning 2009–2022
- Large-scale cross-context synthesis bridging reconstruction and cosmetic populations
Limitations
- Heterogeneity in study designs and follow-up precluded meta-analysis; analyses remained descriptive
- Selective domain reporting limits comparability and may introduce reporting bias
Future Directions: Adopt reporting guidelines mandating complete BREAST-Q domain coverage or a validated summary score; develop harmonized datasets permitting meta-analytic synthesis.
The BREAST-Q was developed to address a gap in breast surgery outcomes research as a validated, procedure-specific patient-reported outcome measure (PROM) that assesses satisfaction and health related quality of life. Despite global adoption, reporting practices remain inconsistent. This review evaluated how BREAST-Q domains are reported and compated outcomes between postmastectomy reconstruction and cosmetic breast surgery populations. Five databases (PubMed, MEDLINE, PsycINFO, Scopus, and Web of Science) were searched from January 1, 2009 to September 16, 2022. Of 6921 records, 307 studies met inclusion criteria. Eligible studies reported mean BREAST-Q scores (0-100 scale) in patients undergoing postmastectomy reconstruction, breast augmentation, or breast reduction. Studies were grouped as reconstruction (Group 1) or cosmetic (Group 2). Extracted data included publication year, country, sample size, BREAST-Q means ± standard deviation and domain coverage. Analyses were descriptive due to heterogeneity in design, populations, and follow-up The most frequently reported domains in both groups were psychosocial well-being, satisfaction with breasts, and sexual well-being (Group 1: 79.12%, 91.21%, and 77.29%; Group 2: 74.55%, 96.36%, and 83.64%). The aggregate global weighted mean BREAST-Q score was higher in Group 2 than in Group 1 (81.99 vs 74.49), Though these values represent descriptive estimates, not direct comparisons. Although widely used, BREAST-Q reporting is inconsistent, with disproportionate emphasis on select domains. This selective reporting introduces bias and limits comparability. Comprehensive reporting across all domains, or inclusion of an overall summary score, would better reflect patient satisfaction and align with the instrument's intended purpose. Level of Evidence: 3 (Therapeutic).