ATMS Journal Winter 2022 (Public Version) | Page 48

RECENT RESEARCH
Background : Prevention is a preliminary focus of periodontitis treatment . Rather than giving complicated treatment to a periodontitis patient , a variety of toothpastes have been suggested to prevent periodontal disease progression . Herbal toothpastes containing natural plant components for maintaining or increasing healing might be a treatment modality for improving oral hygiene . Aloe vera is a medicinal plant with active ingredients that have antioxidant and anti-inflammatory effects . Additionally , increased sodium in the environment inhibits microorganism growth . A toothpaste containing salt and aloe vera may be an option to provide good oral hygiene .
Aim : To assess the in vitro cell migration of human gingival fibroblasts and antimicrobial effects of an herbal toothpaste containing A . vera and Sodium chloride .
Methods : The cytotoxicity of 0.02 % or 0.2 % toothpaste solution on human gingival fibroblast cell line was evaluated using a 3- ( 4,5-dimethylthiazol-2-yl ) - 2,5-diphenyl-2H-tetrazolium bromide ( MTT ) assay . The cell migration after treatment with 0.2 % ( v / v ) toothpaste was determined using a Boyden Chamber assay . The effect of the toothpaste on inhibiting Porphylomonas gingivalis planktonic and biofilm growth was compared with Chlohexidine ( CHX ) using a Disk Diffusion and Biofilm susceptibility test , respectively . The results of the cytotoxicity assay , inhibition zone and percentage of live cells in the biofilm were statistically analyzed with One-way analysis of variance . Cell migration and biofilm inhibition were evaluated using the independent sample t-test and multiple t-test , respectively ( p = 0.05 ).
Results : Neither test concentration of the toothpaste solution was toxic to the target cells . The 0.2 % concentration was selected for the cell migration experiment . The herbal toothpaste formulation significantly increased cell migration compared with the control group ( culture medium ) ( p = . 02 ) The antimicrobial effect of this formulation on the P . gingivalis planktonic form was lower compared with 0.12 % CHX ( positive control group ), however , it demonstrated greater P . gingivalis biofilm formation inhibition compared with the 0.12 % CHX group .
Conclusions : The alternative use of an herbal toothpaste instead of a nonherbal toothpaste formulation should be considered for promoting oral health care . However , further clinical studies are necessary before it can be considered for patient use .
Homeopathy
Gartlehner G , Emprechtinger R , Hackl M , et al .
BMJ Evidence-Based Medicine Epub ahead of print : 2022 . doi : 10.1136 / bmjebm-2021-111846
Objectives : To assess the magnitude of reporting bias in trials assessing homeopathic treatments and its impact on evidence syntheses .
Design : A cross-sectional study and meta-analysis . Two persons independently searched Clinicaltrials . gov , the EU Clinical Trials Register and the International Clinical Trials Registry Platform up to April 2019 to identify registered homeopathy trials . To determine whether registered trials were published and to detect published but unregistered trials , two persons independently searched PubMed , Allied and Complementary Medicine Database , Embase and Google Scholar up to April 2021 . For metaanalyses , we used random effects models to determine the impact of unregistered studies on meta-analytic results .
Main outcomes and measures : We report the proportion of registered but unpublished trials and the proportion of published but unregistered trials . We also assessed whether primary outcomes were consistent between registration and publication . For meta-analyses , we used standardised mean differences ( SMDs ).
Results : Since 2002 , almost 38 % of registered homeopathy trials have remained unpublished , and 50 % of published randomised controlled trials ( RCTs ) have not been registered . Retrospective registration was more common than prospective registration . Furthermore , 25 % of primary outcomes were altered or changed compared with the registry . Although we could detect a statistically significant trend toward an increase of registrations of homeopathy trials ( p = 0.001 ), almost 30 % of RCTs published during the past 5 years had not been registered .
A meta-analysis stratified by registration status of RCTs revealed substantially larger treatment effects of unregistered RCTs ( SMD : −0.53 , 95 % CI −0.87 to −0.20 ) than registered RCTs ( SMD : −0.14 , 95 % CI −0.35 to 0.07 ).
Conclusions : Registration of published trials was infrequent , many registered trials were not published and primary outcomes were often altered or changed . This likely affects the validity of the body of evidence of homeopathic literature and may overestimate the true treatment effect of homeopathic remedies .
Massage , myotherapy and other bodywork
Wegh CAM , Baaleman DF , Tabbers MT , Smidt H , Benninga MA .
Nonpharmacologic treatment for children with functional constipation : A systematic review and meta-analysis . J Pediatr , 2022 ; 240:136-49 .
Objective : To evaluate the effectiveness and safety of nonpharmacologic interventions for the treatment of childhood functional constipation .
Study design : Randomized controlled trials ( RCTs ) evaluating nonpharmacologic treatments in children with func-tional constipation which reported at least 1 outcome of the core outcome set for children with functional constipation .
Results : We included 52 RCTs with 4668 children , aged between 2 weeks and 18 years , of whom 47 % were females . Studied interventions included gut microbiomedirected interventions , other dietary interventions , oral supplements , pelvic floor-directed interventions , electrical
108 | vol28 | no2 | JATMS