Systematic Review Outcomes of autotransplanted teeth with complete root formation: a systematic review and meta-analysis

Abstract Aim: In this review, we assessed clinical outcomes of autotransplanted teeth with complete root formation and the effects of various influencing factors. Materials and Methods: Pubmed, Scopus, Google scholar and a hand search were used to identify prospective and retrospective cohort studies and case series till February 2013. Using multilevel Poisson regression, the annual failure rate (FR), 1-year and 5-year survival rates (SRs), infection-related root resorption rate (RR), ankylosis rate (AR), the influences of systemic antibiotics (SAs), endodontic and splinting modalities and donor tooth morphology were analysed. Failure was defined as a transplant being lost during follow-up. Results: Twenty-six studies were included. The estimated FR, RR, AR, 1-and 5-year SRs were 2.0%, 2.1%, 1.2%, 98.0% and 90.5%, respectively. The estimated FR was higher in the absence of SA, suture splinting, wire splinting ≤14 days and posterior donors. The estimated RR was higher in the absence of SA, endodontic treatment within post-operative 14 days and anterior/premolar donors. The estimated AR was higher with wire splinting and premolar donors. Conclusions: Tooth autotransplantation with complete root formation is a favourable treatment with rare FR, RR and AR. However, SAs, endodontic and splinting modalities and tooth morphology seemed to influence the outcomes

Reno-protective effects of renin–angiotensin system blockade in type 2 diabetic patients: a systematic review and network meta-analysis

AIMS/HYPOTHESIS: This meta-analysis aimed to compare the renal outcomes between ACE inhibitor (ACEI)/angiotensin II receptor blocker (ARB) and other antihypertensive drugs or placebo in type 2 diabetes. METHODS: Publications were identified from Medline and Embase up to July 2011. Only randomised controlled trials comparing ACEI/ARB monotherapy with other active drugs or placebo were eligible. The outcome of end-stage renal disease, doubling of serum creatinine, microvascular complications, microalbuminuria, macroalbuminuria and albuminuria regression were extracted. Risk ratios were pooled using a random-effects model if heterogeneity was present; a fixed-effects model was used in the absence of heterogeneity. RESULTS: Of 673 studies identified, 28 were eligible (n = 13-4,912). In direct meta-analysis, ACEI/ARB had significantly lower risk of serum creatinine doubling (pooled RR = 0.66 [95% CI 0.52, 0.83]), macroalbuminuria (pooled RR = 0.70 [95% CI 0.50, 1.00]) and albuminuria regression (pooled RR 1.16 [95% CI 1.00, 1.39]) than other antihypertensive drugs, mainly calcium channel blockers (CCBs). Although the risks of end-stage renal disease and microalbuminuria were lower in the ACEI/ARB group (pooled RR 0.82 [95% CI 0.64, 1.05] and 0.84 [95% CI 0.61, 1.15], respectively), the differences were not statistically significant. The ACEI/ARB benefit over placebo was significant for all outcomes except microalbuminuria. A network meta-analysis detected significant treatment effects across all outcomes for both active drugs and placebo comparisons. CONCLUSIONS/INTERPRETATION: Our review suggests a consistent reno-protective effect of ACEI/ARB over other antihypertensive drugs, mainly CCBs, and placebo in type 2 diabetes. The lack of any differences in BP decrease between ACEI/ARB and active comparators suggest this benefit is not due simply to the antihypertensive effect