Publication bias in randomized controlled trials in dentistry. What factors affect statistical significance of outcomes?

OBJECTIVES To record the proportion of Randomized Controlled Trials (RCTs) reporting significant (versus non- significant) primary outcomes, published across 12 high impact journals in Dentistry, covering 6 specialty domains. Associations with certain journal, publication and outcome characteristics were examined. METHODS We identified and included all RCTs published from January 1st, 2017 to December 31st, 2021 in the two journals with the highest impact factors (Clarivate Analytics, 2020) from each of the following domains: Periodontology, Endodontics, Restorative Dentistry/ Prosthodontics, Orthodontics, Paediatric Dentistry, Oral and Maxillofacial Surgery. The primary outcome was the proportion of significant/ non- significant findings reported for the primary outcomes under study, while a range of characteristics such as: journal, year of publication, impact factor, funding, registration and others, were tested for associations. RESULTS A total of 474 RCTs were identified and included, with the majority reporting statistically significant outcomes (321/474; 67.7%). The multivariable model revealed significant effects of predictors related to specialty domain (p = 0.01), continent (p = 0.003) and registration (p = 0.004). Compared to Periodontology, RCTs published in Endodontics (OR= 0.40; 95%CIs: 0.22, 0.76) and Orthodontics (OR= 0.41; 95%CIs: 0.23, 0.74) were less likely to present statistically significant effects. There was strong evidence that registered trials presented lower odds of reporting statistically significant findings (OR= 0.52; 95%CIs: 0.34, 0.81). CONCLUSIONS The entirety of dentistry domains demonstrated preferential publication practices of outcomes considered as "successful" and statistically significant, with domains such as Orthodontics and Endodontics being more balanced. Trial non- registration is still prevalent and associated with reporting of statistically significant effects. CLINICAL SIGNIFICANCE The findings of this empirical report bring attention to the interpretation of Systematic Reviews (SRs) conclusions. These largely depend on the availability and nature of outcomes of randomized controlled trials (RCTs) on a topic, which may impact on the synthesized estimate of a pooled effect and its direction

Changes in the Pulp Tissue Complex Induced by Orthodontic Forces: Is There a Need for Concern? A Systematic Review and Meta-Analysis of RCTs and Prospective Clinical Trials

PURPOSE To identify and assess any changes in the pulp tissue complex following orthodontic force application. MATERIALS AND METHODS Published and unpublished literature was searched in seven databases until 9 August 2022 for randomised controlled trials (RCTs) and prospective trials (nR-PCT). Representative key words included 'pulp response', 'pulp tissue', 'orthodontic force', and 'tooth movement'. Study selection, data extraction, risk of bias and certainty of evidence assessment were conducted independently by two reviewers. Random effects meta-analyses with respective confidence intervals (95%CIs) were conducted where applicable. RESULTS A total of 363 records were screened, a final number of 24 articles were eligible for qualitative synthesis, while 8 of those contributed to meta-analyses. There was evidence that pulpal blood flow (PBF) decreased after 3 weeks of tooth movement compared to no force application (4 studies, mean difference: -1.68; 95% CI: -3.21, -0.15; p = 0.03). However, this was not the case after 6 months of treatment (p = 0.68). A rise in the activity of aspartate aminotransferase (AST) was detected after 7 days of treatment, but combining 2 studies, this was not statistically significant (p = 0.25). Other outcomes were assessed through single studies. Risk of bias was within the range of 'some concerns/moderate to high/critical overall', while certainty of evidence was low to very low according to GRADE. CONCLUSIONS As a short-term effect, PBF decreased upon initiation of orthodontic force application, while enzymatic and peptide activity within the pulp was transiently affected. Further long-term evidence of improved quality and certainty is needed

The Effect of Cone-Beam Computed Tomography (CBCT) Evaluation on Treatment Planning after Endodontic Instrument Fracture

Intracanal instrument fracture is a procedural iatrogenic event during endodontic treatment that may affect treatment planning and eventually treatment outcome. Cone Beam Computed Tomography (CBCT) has offered several advantages, especially in endodontic cases in which information from conventional periapical radiograph may not be adequate to allow a precise treatment planning decision and a subsequent appropriate management of the cases. The present study was firstly conducted to assess the effect of CBCT evaluation on the decision-making process after instrument fracture; secondly, to introduce a new clinical approach in cases with fractured instruments located in the mesial roots of mandibular and maxillary molars. The study design was observational. The sample comprised all cases of mandibular and maxillary molars where an instrument fracture had occurred in the mesial roots. Two qualified (National and Kapodistrian University of Athens, Greece) and experienced (more than fifteen years of daily practicing) endodontists evaluated all the cases. The initial treatment plan made by evaluating periapical radiographs of each case was compared to the final plan set after CBCT evaluation. A marginal homogeneity test for paired data was conducted to test the concordance of treatment planning with periapical radiographs versus CBCT. Multivariable logistic regression was structured to identify predictors of modification in treatment planning following CBCT assessment, and to record estimators for decision to remove, bypass or retain the fragment. The level of statistical significance was pre-specified at p < 0.05. Of a total 52 cases evaluated, change in treatment planning with conventional periapical radiograph as a reference, following evaluation of CBCT, was observed in more than half of the teeth. The difference was statistically significant (p < 0.001). Apical location of the fragment was more likely to induce a perceived change in treatment planning after CBCT evaluation (p < 0.01). Canal merging induced 95% lower odds (p = 0.01) for taking a decision to remove or bypass, revealing that retaining the fragment was by far a more likely decision. A significant impact of CBCT preoperative evaluation on treatment planning for the management of such cases was demonstrated. Apical location of the fragment and canal merging seem to influence the decision-making process. Keywords: cone-beam computed tomography; decision making; instrument fracture; treatment plannin

Cardiovascular Disease and Chronic Endodontic Infection. Is There an Association? A Systematic Review and Meta-Analysis

The aim of the present study was to systematically assess existing evidence on the possible association between chronic endodontic infections and cardiovascular disease (CVD). An electronic database search was implemented until 2 October 2020. The main outcome was risk of CVD diagnosis. Risk of bias was assessed through the ROBINS-I tool, while random effects meta-analyses were conducted. The quality of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation. Twenty-one studies were eligible for inclusion, while 10 were included in the quantitative synthesis. Risk for CVD diagnosis in patients with chronic endodontic infection was 1.38 times those without infection (RR = 1.38; 95% CIs: 1.06, 1.80; p = 0.008). Risk of bias ranged from moderate to serious, while the quality of the evidence was graded as very low. Indications for an identified association between chronic endodontic infection and CVDs do exist; however, they are not grounded on high-quality evidence at present. Further research for an establishment of an association based on temporal sequence of the two entities and on unbiased well-conducted cohort studies would be highly valued

Informedia at TRECVID 2003: Analyzing and searching broadcast news video

We submitted a number of semantic classifiers, most of which were merely trained on keyframes. We also experimented with runs of classifiers were trained exclusively on text data and relative time within the video, while a few were trained using all available multiple modalities. 1.2 Interactive search This year, we submitted two runs using different versions of the Informedia systems. In one run, a version identical to last year's interactive system was used by five researchers, who split up the topics between themselves. The system interface emphasizes text queries, allowing search across ASR, closed captions and OCR text. The result set can then be manipulated through: • storyboards of images spanning across video story segments • emphasizing matching shots to a user’s query to reduce the image count to a manageable size • resolution and layout under user control • additional filtering provided through shot classifiers such as outdoors, and shots with people, etc. • display of filter count and distribution to guide their use in manipulating storyboard views. In the best-performing interactive run, for all topics a single researcher used an improved version of the system, which allowed more effective browsing and visualization of the results of text queries using

Natural occurrence of Cucumber mosaic virus infecting water mint (Mentha aquatica) in Antalya and Konya, Turkey

A virus causing a disease in mint (the aromatic and culinary plant) has recently become a problem in the Taurus Mountains, a mountain range in the Mediterranean region of Turkey. To detect the virus and investigate its distribution in the region, mint leaf samples were collected from the vicinity of spring areas in the plateaus of Antalya and Konya in 2009. It was found that Cucumber mosaic virus (CMV) was detected in 27.08% of symptomatic samples tested by DAS-ELISA. To the best of our knowledge, this is the first report of CMV on mint plants in this region of Turkey

Comparison of Bacterial Community Composition of Primary and Persistent Endodontic Infections Using Pyrosequencing

Elucidating the microbial ecology of endodontic infections (EI) is a necessary step in developing effective intra-canal antimicrobials. The aim of the present study was to investigate the bacterial composition of symptomatic and asymptomatic primary and persistent infections in a Greek population, using high throughput sequencing methods

A computational study on outliers in world music

The comparative analysis of world music cultures has been the focus of several ethnomusicological studies in the last century. With the advances of Music Information Retrieval and the increased accessibility of sound archives, large-scale analysis of world music with computational tools is today feasible. We investigate music similarity in a corpus of 8200 recordings of folk and traditional music from 137 countries around the world. In particular, we aim to identify music recordings that are most distinct compared to the rest of our corpus. We refer to these recordings as ‘outliers’. We use signal processing tools to extract music information from audio recordings, data mining to quantify similarity and detect outliers, and spatial statistics to account for geographical correlation. Our findings suggest that Botswana is the country with the most distinct recordings in the corpus and China is the country with the most distinct recordings when considering spatial correlation. Our analysis includes a comparison of musical attributes and styles that contribute to the ‘uniqueness’ of the music of each country