Dr. MH. Nekoofar

DDS, MSc, DoIBoE, PhD

Category: Publications

  • Preferred Reporting Items for Study Designs in Endodontology (PRIDE): Guiding Authors to Identify and Correct Reporting Deficiencies in Their Manuscripts Prior to Peer Review

     Preferred Reporting Items for study Designs in Endodontology (PRIDE) guiding authors to identify and correct reporting deficiencies in their.pdf

  • Altmetric Analysis of the Contemporary Scientific Literature in Endodontology

    Aim To analyse and visualize the knowledge structure of scientific articles in the field of Endodontology with high altmetric attention scores to discover hot topics, active researchers and the journals involved.

    Methodology On 5 June 2019, the altmetric data-base (Altmetric LLP, London, UK) was searched using the titles of 11 endodontic journals. Bibliometric data from endodontic articles and journals with an altmetric score>5 (top 5%) were retrieved from PubMed and analysed using the VOSviewer. Science mapping of articles with an altmetric score>5 at two levels was created: author keywords co-occurrence and co-authorship network analysis.

    Results Of the 2197 articles in the field of Endodontology identified with altmetrics, 192 had altmetric scores>5 (top 5%). Considering the total mentions amongst  all  altmetric  resources,  the  Journal  of Endodontics had the highest rank followed by the International  Endodontic  Journal  and  Australian Endodontic Journal. Twitter was the most popular alt-metric data resource followed by patents and Face-book. Meta-analysis, systematic review and pulpitis were the hot topics. At the author level, Dummer P.M.H had the greatest influence on the network. There was no significant correlation between altmetric score and citations count (P>0.05). Mendeley mentions correlated with citations (P<0.05). Conclusions Overall, the altmetric scores of topics within Endodontology were low, possibly due to the specific and specialized nature of the specialty, as well as the difficulty members of the public probably have in understanding endodontic research. Journals and researchers with a focus on Endodontology would have more influence if they were to set-up their own social media profiles and thus enhance their visibility and social impact by immediately sharing research findings and communicating with their network and audience.

    Keywords: Altmetrics, Endodontology, Social Media, Twitter, Facebook

  • Is Articaine More Effective Than Lidocaine in Patients with Irreversible Pulpitis? An Umbrella Review

    Background Pain management can be challenging during root canal treatment of teeth with irreversible pulpitis.

    Aim To identify whether articaine or lidocaine is the most appropriate local anaesthetic solution for teeth with irreversible pulpitis undergoing root canal treatment.

    Data source The protocol of this umbrella review is registered in the PROSPERO database (CRD42019137624). PubMed, EBSCHO host and Scopus databases were searched until June 2019.

    Study eligibility criteria, participants and interventions Systematic reviews published in English comparing the effectiveness of local anaesthesia following administration of articaine or lidocaine in patients under-going root canal treatment of teeth diagnosed with irreversible pulpitis were included. Two independent reviewers selected the studies and carried out the data extraction and the appraisal of the included reviews. Disagreements were resolved in consultation with a third reviewer.

    Study appraisal and synthesis methods The quality of the included reviews was appraised by two independent reviewers using the AMSTAR tool (a measurement tool to assess systematic reviews). Each of the 11 AMSTAR items was given a score of 1 if the specific criterion was met, or 0 if the criterion was not met or the information was unclear.

    Results Five systematic reviews with meta-analyses were included. The AMSTAR score for the reviews ranged from 8 to 11, out of a maximum score of 11, and all reviews were categorized as ‘high’ quality. Two reviews scored 0 for item 8 in AMSTAR because the scientific quality of the clinical trials included in these reviews was not used in the formulation of the conclusions.

    Limitations Systematic reviews published only in the English language were included. Only a small number of studies were available to assess pain intensity during the injection phase, the time until the onset of anaesthesia and the occurrence of adverse events.

    Conclusions and implications of key findings Articaine is more effective than lidocaine for local anaesthesia of teeth with irreversible pulpitis undergoing root canal treatment. There is limited evidence that injection of articaine is less painful, has more rapid onset and has fewer adverse events com-pared with lidocaine.

    Keywords: Articaine, Irreversible Pulpitis, Lidocaine, Meta-Analysis, Umbrella Review, Systematic Review

  • Science Map of Cochrane Systematic Reviews Receiving the Most Altmetric Attention: Network Visualization and Machine Learning Perspective

    Abstract

    Introduction: We aim to visualize and analyze the science map of Cochrane systematic reviews with the high altmetric attention scores. Methods: On 10 May 2019, altmetric data of Cochrane Database of Systematic Reviews obtained from Altmetric database (Altmetric LLP, London, UK). Bibliometric data of top 5% Cochrane systematic reviews further extracted from Web of Science. Keyword co-occurrence, co-authorship and co-citation network visualization were then employed using VOSviewer software. Decision tree and random forest model were used to analyze citations pattern.  Results: 12016 Cochrane systematic reviews with Altmetric attention are found (total mentions=259,968). Twitter was the most popular altmetric resource among these articles. Consequently, the top 5% (607 articles, mean altmetric score=171.2, Confidence Level (CL) 95%=14.4, mean citations= 42.1, CL 95%=1.3) with the highest Altmetric score are included in the study. Keyword co-occurrence network visualization showed female, adult and child as the most accurate keywords respectively. At author level, Helen V Worthington had the greatest impact on the network. At organization and country levels, University of Oxford and U.K had the greatest impact on the network in turn. Co-citation network analysis showed that Lancet and Cochrane database of systematic reviews had the most influence on the network. However, altmetric score do not correlate with citations (r=0.15) (Figure 7), it does correlate with policy document mentions (r=0.61). Results of decision tree and random forest model (a machine learning algorithm) confirmed importance of policy document mentions. Discussion: Despite popularity of Cochrane systematic reviews in Twittersphere, disappointingly, they rarely shared and discussed in newly emerging academic tools (e.g. F1000 prime, Publons and PubPeer). Overall, Wikipedia mentions were low among Cochrane systematic reviews, considering the established partnership between Wikipedia and Cochrane collaboration. Newly emerging and groundbreaking concepts, e.g. genomic medicine, nanotechnology, artificial intelligence not that admired among hot topics.

    Keywords: Cochrane Systematic Review, Altmetrics, Science Map, Twitter, Facebook, Social Media, Citation, Policy Document, Network Visualization, Decision Tree, Random Forest, Machine Learning

  • Animal Testing: A Re‐Evaluation of What it Means to Endodontology

    Animal testing has a long history in the biological evaluation of medical devices used in Dentistry (ISO 7405). Indeed, tests on animals have been used to develop new interventions, materials, devices and drugs as they tend to provide information on their biological mechanisms of action, as well as their efficacy and side-effects before human applications (Singh et al. 2016). As an example, animal studies supported the basis for the understanding of orofacial development (Sharpe 1995). However, animal tests are not essential and may be prohibited by international and local laws, for example, the European Union animal testing ban for cosmetics (EU Regulation No 1223/2009) and the California Cruelty-Free Cosmetics Act (SB-1249). The animal testing bans indicate a public policy shift away from animal testing, to placing more reliance on the results from lab-on chip, organ-on-chip, human cell-based studies and …

  • Preferred Reporting Items for Animal Studies in Endodontology: A Development Protocol

    Abstract

    The regulated use of animals in endodontic research is often necessary to investigate the biological mechanisms of endodontic diseases and to measure the pre-clinical efficacy, biocompatibility, toxicology and safety of new treatments, biomaterials, sealers, drugs, disinfectants, irrigants, devices and instruments. Animal testing is most crucial in situations when research on humans is not ethical, practical or has unknown health risks. Currently, there is a wide variability in the quality of manuscripts that report the results of animal studies. Towards the goal of improving the quality of publications, guidelines for preventing disability, pain, and suffering to animals, and enhanced reporting requirements for animal research have been developed. These guidelines are referred toes Animals in Research: Reporting In Vivo Experiments (ARRIVE). Henceforth, causing any form of animal suffering for research purposes is not accept-able and cannot be justified under any circumstances. The present report describes a protocol for the development of welfare and reporting guidelines for animal studies conducted in the specialty of Endodontology: the Preferred Reporting Items for Animal Studies in Endodontology (PRIASE) guidelines. The PRIASE guidelines will be developed by adapting and modifying the ARRIVE guidelines and the Clinical and Laboratory Images in Publication (CLIP) principles. The development of the new PRIASE guidelines will include a five-step consensus process. An initial draft of the PRIASE guidelines will be developed by a steering committee. Each item in the draft guidelines will then be evaluated by members of a PRIASE Delphi Group (PDG) for its clarity using a dichotomous scale (yes or no) and suitability for its inclusion using a 9-point Likert scale. The online surveys will continue until each item achieves this standard, and a set of items are agreed for further analysis by a PRIASE Face-to-face Consensus Meeting Group (PFCMG). Following the consensus meeting, the steering committee will finalize and confirm the PRIASE guidelines taking into account the responses and comments of the PFCMG. The PRIASE guidelines will be published and disseminated internationally and updated periodically based on feedback from stakeholders.

    Keywords: Animal, Consensus, Delphi Technique, Endodontics, Health Research Reporting Guidelines, Protocol

     Preferred Reporting Items for Animal Studies in Endodontology A Development Protocol.pdf

  • Preferred Reporting Items for RAndomized Trials in Endodontics (PRIRATE) Guidelines: A Development Protocol

    Abstract

    Randomized clinical trials are acknowledged as the most appropriate methodology for demonstrating the efficacy or effectiveness of one intervention as opposed to another and thus play a major role in clinical decision-making. However, it is recognized that despite the existence of various guidelines, for example, the Consolidated Standards for Reporting Trials (CONSORT) statement, the quality of manuscripts describing randomized trials is often suboptimal. The current project aims to develop and disseminate new guidelines, Preferred Reporting Items for RAndomized Trials in Endodontics (PRI-RATE), to improve the planning and reporting quality of randomized trials in the field of Endodontics. The project leads (VN, PD) designed a robust process to develop the PRIRATE guidelines. At first, a steering committee of eight members, including the project leads, was formed. Thereafter, a five-stage consensus process will be followed: initial steps, pre-meeting activities, face-to-face consensus meeting, post-meeting activities and post-publication activities. The steering committee will develop the first draft of the PRIRATE guidelines by identifying relevant and important items from various sources including the CONSORT guidelines and the Clinical and Laboratory Images in Publications (CLIP) principles. This will be followed by the establishment of a PRIRATE Delphi Group (PDG) consisting of 30 members. The individual items of the first draft of the PRIRATE guidelines developed by the steering committee will be evaluated and scored on a 9-point Likert scale by the PDG members. Items with a score of seven and above by more than 70% of PDG members will be included in the second draft of the guidelines, and the Delphi process will be repeated until each item fulfils the set conditions. After obtaining consensus from the PDG, the PRIRATE guidelines will be discussed by 20 selected individuals within a PRIRATE Face-to-face Consensus Meeting Group (PFCMG) to arrive at a final consensus. The final PRIRATE guidelines will be accompanied with an explanation and elaboration document developed by the steering committee and approved by six members, three from the PDG and three from the PFCMG. The PRIRATE guidelines will be published in journals and actively disseminated to educational institutions, national and international academic societies and presented at scientific meetings. The steering committee will periodically revise and update the PRIRATE guidelines based on feedback from stakeholders.

    Keywords: Endodontics, Health Research Reporting Guidelines, Protocol, Randomized Clinical Trial

  • Fracture Resistance of Immature Incisors Following Root Filling with Various Bioactive Endodontic Cements Using an Experimental Bovine Tooth Model

    Abstract

    Objective The aim of this study was to compare the fracture resistance of immature bovine roots when using ProRoot MTA, CEM Cement, and Biodentine as root filling materials. Materials and Methods An immature bovine tooth model was developed by removing the coronal and apical portions of 70 bovine incisors 8 mm above and 12 mm below the cementoenamel junction (CEJ). The specimens were then divided into five groups: ProRoot MTA, CEM Cement, Biodentine, gutta-percha/AH26 sealer, and control. All groups received a 5-mm apical plug with a temporary restorative material. Then, the remaining root canal space was filled with one of the afore-mentioned materials. After setting, the specimens were mounted in acrylic resin. Then, 3 mm coronal to the CEJ from the buccal side of the teeth and at a 135°angle to the long axis, the specimens were loaded until fracture.

    Results The specimens in the Biodentine (2196 N) and ProRoot MTA (2103 N) groups had significantly greater fracture resistance in comparison to the control group (p = 0.01). No significant difference was found between CEM Cement, gutta-percha and sealer AH26, and control groups. No significant differences occurred between the four experimental groups (p = 0.45).

    Conclusion Filling the root canal space with ProRoot MTA and Biodentine contributed to higher fracture resistance values.

    Keywords: Fracture Resistance, Mineral Trioxide Aggregate, CEM Cement, Biodentine

     Fracture Resistance of Immature Incisors Following Root Filling with Various Bioactive Endodontic Cements Using an Experimental Bovine Tooth Model.pdf

  • Crystalline Phases Involved in the Hydration of Calcium Silicate‐Based Cements: Semi‐Quantitative Rietveld X‐Ray Diffraction Analysis

    Abstract

    Chemical comparisons of powder and hydrated forms of calcium silicate cements (CSCs) and calculation of alterations in tricalcium silicate (Ca3SiO5) calcium hydroxide (Ca(OH)2) are essential for understanding their hydration processes. This study aimed to evaluate and compare these changes in ProRoot MTA, Biodentine and CEM cement. Powder and hydrated forms of tooth coloured ProRoot MTA, Biodentine and CEM cement were subjected to X-ray diffraction (XRD) analysis with Rietveld refinement to semi-quantitatively identify and quantify the main phases involved in their hydration process. Data were reported descriptively. Reduction in Ca3SiO5 and formation of Ca(OH)2 were seen after the hydration of ProRoot MTA and Biodentine; however, in the case of CEM cement, no reduction of Ca3SiO5 and no formation of Ca(OH)2 were detected. The highest percentages of amorphous phases were seen in Biodentine samples. Ettringite was detected in the hydrated forms of ProRoot MTA and CEM cement but not in Biodentine.

    Keywords: X-Ray Diffraction Analysis, Chemical Properties, Mineral Trioxide Aggregate

     Crystalline Phases Involved in the Hydration of Calcium Silicate‐Based Cements Semi‐Quantitative Rietveld X‐Ray Diffraction Analysis.pdf

  • Anesthetic Efficacy of Mental/Incisive Nerve Block Compared to Inferior Alveolar Nerve Block Using 4% Articaine in Mandibular Premolars with Symptomatic Irreversible Pulpitis: a Randomized Clinical Trial

    Abstract

    Objectives The aim of this study was to compare the onset, success rate, injection pain, and post-injection pain of mental/incisive nerve block (MINB) with that of inferior alveolar nerve block (IANB) using 4% articaine in mandibular premolars with symptomatic irreversible pulpitis. The accuracy of electrical pulp test (EPT) in determining pulpal anesthesia was also examined.

    Materials and Methods The study was designed as a randomized clinical trial with two study arms-MINB and IANB. Injections were performed using a standardized technique. Root canal treatment was initiated 10 min after the injection. Success was defined as no pain or mild pain during access cavity preparation and instrumentation. Injection pain and post-injection pain (up to 7 days) were recorded. All pain ratings were done using Heft-Parker Visual Analog Scale (HP VAS).

    Results Sixty-four patients were enrolled. The success rate of MINB (93.8%) was higher than IANB (81.2%) but the difference was not significant (p > 0.05). The onset of anesthesia with MINB was significantly quicker, and injection pain was significantly less (p < 0.05), but post-injection pain was significantly higher during the first 4 days (p < 0.001). The accuracy of EPT in determining pulpal anesthesia was 96.88%.

    Conclusions MINB and IANB with 4% articaine had similar efficacy in anesthetizing mandibular premolars with irreversible pulpitis. Post-injection pain with MINB was higher than with IANB.

    Clinical relevance MINB and IANB with 4% articaine can be used interchangeably to anesthetize mandibular premolars with irreversible pulpitis.

    Keywords: 4% Articaine, Inferior Alveolar Nerve Block, Local Anesthesia, Mental/Incisive Nerve Block, Pain

     Clinical Oral Investigations, 2019, 23(2), pp. 839-845.pdf