Publications by authors named "Alonso Carrasco Labra"

Objective: In the United States, on average, every 15 s, someone visits a hospital emergency department (ED) for a dental condition. This commentary summarizes the recommendations from a 2024 clinical practice guideline for the pharmacological management of acute dental pain associated with tooth extractions and toothache applicable to ED settings, hospitals, and urgent care clinics where definitive dental treatment is not immediately available.

Methods: A guideline panel convened by the American Dental Association, the ADA Science & Research Institute, the University of Pittsburgh School of Dental Medicine, and Penn Dental Medicine examined the effect of opioid and non-opioid analgesics; local anesthetics, including blocks; corticosteroids; and topical anesthetics on acute dental pain.

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Article Synopsis
  • The text discusses the relationship between population health and public health, highlighting their distinct yet interconnected roles in achieving better health outcomes for communities.
  • Population health emphasizes the analysis of health determinants in specific groups to inform targeted interventions, while public health focuses on broader preventive measures for entire populations.
  • The integration of both fields is crucial for addressing health disparities, improving the efficiency of health systems, and creating effective, equitable health programs.
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Background: Oral diseases are a major global public health problem, impacting the quality of life of those affected. While consensus exists on the importance of high-quality, evidence-informed guidelines to inform practice and public health decisions in medicine, appropriate methodologies and standards are not commonly adhered to among producers of oral health guidelines. This study aimed to systematically identify organizations that develop evidence-informed guidelines in oral health globally and survey the methodological process followed to formulate recommendations.

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Objective: To advance oral health policies (OHPs) in the World Health Organization (WHO) African region, barriers to and facilitators for creating, disseminating, implementing, monitoring and evaluating OHPs in the region were examined.

Methods: Global Health, Embase, PubMed, Public Affairs Information Service Index, ABI/Inform, Web of Science, Academic Search Complete, Scopus, Dissertations Global, Google Scholar, WHO's Institutional Repository for Information Sharing (IRIS), the WHO Noncommunicable Diseases Document Repository and the Regional African Index Medicus and African Journals Online were searched. Technical officers at the WHO Regional Office for Africa were contacted.

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Introduction And Aims: The prioritisation of oral health in all health policies in the WHO African region is gaining momentum. Dental schools in this region are key stakeholders in informing the development and subsequent downstream implementation and monitoring of these policies. The objectives of our study are to determine how dental schools contribute to oral health policies (OHPs) in this region, to identify the barriers to and facilitators for engaging with other local stakeholders, and to understand their capacity to respond to population and public health needs.

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Background: Evidence-informed oral health policies (OHP) can be instrumental in ending the neglect of oral health globally. When appropriately developed and implemented, OHP can improve the efficiency of healthcare systems and the quality of health outcomes. However, more than half of the countries in the World Health Organization (WHO) African region do not have an oral health policy or even the existence of a policy in need of additional and more national-specific OHP as part of non-communicable diseases and universal health coverage agendas.

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Introduction: This study aimed to systematically search and review all available literature regarding systemic (oral or locally injected) corticosteroids in endodontics to assess their effect on postoperative pain.

Methods: A search was conducted using PubMed, Cochrane Library, Embase, Scopus, Dentistry & Oral Science, and ProQuest. Randomized controlled trials enrolling participants undergoing endodontic treatment and assessing the presence of pain and pain scores at 6, 12, and 24 hours postoperatively were included.

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Article Synopsis
  • Chronic inflammation in irreversible pulpitis makes it hard to numb patients, leading to issues with anesthesia during dental treatments.
  • Researchers studied the effects of using corticosteroids before dental procedures to see if it helps improve anesthesia success.
  • The results showed that patients who received corticosteroids had a much higher chance of successful anesthesia, indicating that these medications can be helpful for dental treatments.
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Background: A panel convened by the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania conducted systematic reviews and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after simple and surgical tooth extraction(s) and for the temporary management (ie, definitive dental treatment not immediately available) of toothache associated with pulp and periapical diseases in adolescents, adults, and older adults.

Types Of Studies Reviewed: The panel conducted 4 systematic reviews to determine the effect of opioid and nonopioid analgesics, local anesthetics, corticosteroids, and topical anesthetics on acute dental pain. The panel used the Grading of Recommendations, Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations, Assessment, Development and Evaluation Evidence-to-Decision Framework to formulate recommendations.

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Article Synopsis
  • The text discusses the effectiveness of various therapies for chronic pain related to temporomandibular disorders (TMD), which impact a significant percentage of adults worldwide.
  • Current guidelines for treating TMD are primarily based on consensus, leading to inconsistent recommendations across the board.
  • Strong recommendations favor cognitive behavioral therapy and physical interventions like supervised exercises, while conditional recommendations address a mix of both supportive and discouraged treatments, such as acupuncture and the use of certain medications.
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Oral diseases are a major global public health problem that impacts the quality of life of those affected. While widespread consensus exists on the importance of high-quality, evidence-informed guidelines to inform practice and public health decisions in medicine, appropriate methodologies and standards are not commonly adhered to among producers of oral health guidelines. This systematic survey aims to identify organizations developing evidence-informed guidelines and policy documents in oral health globally, and describe the methods and processes used.

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Approximately, 3.47 billion individuals worldwide are affected by oral disorders, with untreated dental caries being the most prevalent issue, impacting 2.30 billion people.

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Article Synopsis
  • Traumatic dental injuries (TDI) are a significant public health issue, and this study aimed to evaluate the quality of clinical practice guidelines (CPGs) for diagnosing and managing these injuries.
  • A systematic search across multiple databases identified ten CPGs published between 2010 and 2020, primarily from Europe, with reviewers achieving a high agreement level on their assessments.
  • The overall quality of these guidelines was found to be suboptimal, highlighting the need for CPG developers to improve the synthesis of evidence and recommendation formulation through better methodologies.
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Background: A guideline panel convened by the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of Pittsburgh School of Dental Medicine, and Center for Integrative Global Oral Health at the University of Pennsylvania conducted a systematic review and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after 1 or more simple and surgical tooth extractions and the temporary management of toothache (that is, when definitive dental treatment not immediately available) associated with pulp and furcation or periapical diseases in children (< 12 years).

Types Of Studies Reviewed: The authors conducted a systematic review to determine the effect of analgesics and corticosteroids in managing acute dental pain. They used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations.

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Background: Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars.

Types Of Studies Reviewed: The authors conducted a systematic review and meta-analysis.

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Background: In the oral health literature, researchers sometimes report measures of association that are inappropriate for their study design. Clinicians using evidence to inform their practice should be able to interpret clinical study results on the basis of the types of measures of association, independent of what the researchers of a study reported.

Types Of Studies Reviewed: The authors summarized which measures of association can be derived from experimental and observational studies and how to interpret them in the context of different study designs.

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Background: An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs together with the ADA Science and Research Institute's program for Clinical and Translational Research conducted a systematic review and developed recommendations for the treatment of moderate and advanced cavitated caries lesions in patients with vital, nonendodontically treated primary and permanent teeth.

Types Of Studies Reviewed: The authors searched for systematic reviews comparing carious tissue removal (CTR) approaches in Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Trip Medical Database. The authors also conducted a systematic search for randomized controlled trials comparing direct restorative materials in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.

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Article Synopsis
  • Clinical practice guidelines (CPGs) are important rules that help doctors know how to treat patients based on the best information available.
  • Sometimes, doctors don't follow these guidelines because they might not know about them, find them hard to understand, or struggle to put them into practice.
  • In this case, a patient didn't get the right treatment for a dental problem, which caused pain and led to more expensive procedures that could have been avoided if the guidelines were followed.
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Article Synopsis
  • The study evaluated the effectiveness of various analgesics for managing acute pain in children after dental procedures, focusing on dental extractions and irreversible pulpitis.
  • Researchers analyzed data from multiple medical databases and included 6 randomized controlled trials, performing meta-analyses to compare different pain relief medications against each other and placebos.
  • Results indicated ibuprofen and acetaminophen can reduce pain intensity, especially when used together, but there is limited evidence on their effectiveness for irreversible pulpitis and potential side effects were not well-documented.
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Objectives: Minimal important difference (MID), the smallest change or difference that patients perceive as important, aids interpretation of change in patient-reported outcome measure (PROM) scores. A credibility instrument that assesses the methodological rigor of an anchor-based MID includes one core item addressing the correlation between the PROM and the anchor. However, the majority of MID studies in the literature fail to report the correlation.

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Introduction: Evidence-informed oral health policies are crucial to improving patient and population outcomes, but policymakers and organisational leaders infrequently systematically incorporate research evidence. Although there is indirect evidence regarding challenges in other healthcare sectors, the use of evidence-informed oral health policies remains unstudied in oral health. This study aims to assess policymakers' perceived needs, barriers and facilitators in using research evidence to inform policies in oral health.

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Article Synopsis
  • The study looked at how different materials used to fix cavities in teeth can affect treatment success in kids' (primary) and adult (permanent) teeth.
  • Researchers reviewed 38 different studies that tested materials like amalgam and resin composites on various types of cavities.
  • They found that while some materials worked better than others, the differences weren't very big, meaning most of them are pretty similar in effectiveness.
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