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Efficacy of erythritol powder air‐polishing in active and supportive periodontal therapy: A systematic review and meta‐analysis
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Abstract<sec><title>Objective

This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air‐polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes.

Methods

PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen's kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta‐analysis.

Results

The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16 mm, < 0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non‐significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients.

Conclusion

Erythritol powder air‐polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation.

Clinical relevance

Erythritol powder air‐polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.

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Hypothyroidism has been associated with disorders of glucose and insulin metabolism..The present study was designed to evaluate the possible change in some hormones (free testosterone, estradiol, prolactin, insulin), glucose and homeostasis model assessment of insulin resistance (HOMA-IR) in women with primary hypothyroidism under thyroid hormone replacement therapy .This cross-sectional study was carried on 62 hypothyroid patients׳  women and 22  healthy women as control group at the specialized center for endocrinology and diabetes, AL-Rasafa Directorate of  Health Baghdad, with age range(15-60 years), diagnosed as having primary hypothyroidism on thyroxine replacement therapy with duration not less than four months.

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Self-repairing technology based on micro-capsules is an efficient solution for repairing cracked cementitious composites. Self-repairing based on microcapsules begins with the occurrence of cracks and develops by releasing self-repairing factors in the cracks located in concrete. Based on previous comprehensive studies, this paper provides an overview of various repairing factors and investigative methodologies. There has recently been a lack of consensus on the most efficient criteria for assessing self-repairing based on microcapsules and the smart solutions for improving capsule survival ratios during mixing. The most commonly utilized self-repairing efficiency assessment indicators are mechanical resistance and durab

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