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Materials (Basel, Switzerland) Jun 2021The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch... (Review)
Review
The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch prostheses. A literature search was conducted on MEDLINE, Scopus and Cochrane Library, until the 1st of March 2021, with the following search terms: framework or substructure combined with "dental implants". The outcomes evaluated were: implant and prosthesis survival, bone resorption, biological and technical complications. The Cochrane Handbook for Systematic Reviews of Interventions was employed to assess the risk of bias in randomized clinical trials. The Newcastle-Ottawa quality assessment scale was used for non-randomized studies. In total, 924 records were evaluated for title and abstract, and 11 studies were included in the review: 4 clinical randomized trials and 7 cohort studies. The framework materials investigated were: gold alloy, titanium, silver-palladium alloy, zirconia and polymers including acrylic resin and carbon-fiber-reinforced composites. High implant and prosthetic cumulative survival rates were recorded by all included studies. Various materials and different fabrication techniques are now available as alternatives to traditional cast metal frameworks, for full-arch implant-supported rehabilitations. Further long-term studies are needed to validate the use of these materials and clarify their specific clinical indications and manufacturing protocols to optimize their clinical outcomes.
PubMed: 34204681
DOI: 10.3390/ma14123251 -
Journal of Esthetic and Restorative... Dec 2023The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning. (Review)
Review
OBJECTIVE
The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning.
MATERIALS AND METHODS
An electronic search was conducted through PubMed (MEDLINE), Scopus and Cochrane Library, up to March 2023. The literature search intended to retrieve all relevant clinical and in vitro studies about the effect that the various properties of ISBs may have on the accuracy (trueness and precision) of intraoral scanning. Only publications in English language were selected with animal studies, case reports, case series, technique presentation articles and expert opinions being excluded.
RESULTS
A total of 28 studies met the inclusion criteria and were included in this systematic review. They were published between 2019 and 2023 and were all in vitro studies. Among the parameters described, the scan body material, position, geometry, height, diameter, and fixation torque were evaluated. The most common materials used for ISBs were polyetheretherketone (PEEK) and titanium alloys. The diameter and position of ISBs seemed to affect the trueness of implant impressions. Subgingival implant position and decreased ISB height affected negatively the trueness of scanning. Geometrical characteristics of ISBs also affect the implant impression accuracy, especially the bevel location and the types of designing modifications.
CONCLUSIONS
The characteristics of the currently used ISBs vary widely and the available scientific evidence is not yet conclusive about the optimal design of ISB. The implant impression accuracy achieved by any of the studied parameters is encouraging. Clinical studies are however necessary for more concrete conclusions.
CLINICAL SIGNIFICANCE
ISBs play a vital role in the digital workflow and influence significantly the accuracy and fit of implant restorations. More clinical trials are needed in order to conclude to the optimal characteristics of ISBs which would further enhance the success of the restorations.
Topics: Dental Implants; Dental Impression Technique; Computer-Aided Design; Research Design; Imaging, Three-Dimensional
PubMed: 37381677
DOI: 10.1111/jerd.13074 -
Frontiers in Bioengineering and... 2021Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of...
Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of Science were searched using keyword combinations such as microbes and oral and corrosion; microbes and dental and corrosion; microorganisms and oral and corrosion; microorganisms and dental and corrosion. Out of 141 articles, only 25 satisfied the selection criteria. s, sulfate-reducing bacteria, sulfate oxidizing bacteria, Veilonella, Actinomyces, were found to have a potential association with corrosion of intraoral metallic alloys such as stainless steel, titanium, nickel, cobalt-chromium, neodymium-iron-boron magnets, zirconia, amalgam, copper aluminum, and precious metal alloys. The included studies inferred an association between oral microorganisms and intra-oral metallic alloys-based dental appliances, although, it is vital to acknowledge that most studies in the review employed an simulation of the intra-oral condition.
PubMed: 33791285
DOI: 10.3389/fbioe.2021.631103 -
Journal of Dentistry Aug 2023To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools.
STUDY SELECTION
Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI).
SOURCES
Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023.
DATA
Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (p≤0.003).
CONCLUSIONS
The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques.
CLINICAL SIGNIFICANCE
Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
Topics: Humans; Dental Restoration, Permanent; Dental Amalgam; Dental Cavity Preparation; Composite Resins; Dental Caries; Students; Teaching
PubMed: 37336355
DOI: 10.1016/j.jdent.2023.104589 -
The International Journal of Oral &... 2022This review aimed to summarize the current literature on the oral biofilm formation on alternative abutment materials compared with titanium (Ti) or Ti alloy in clinical...
PURPOSE
This review aimed to summarize the current literature on the oral biofilm formation on alternative abutment materials compared with titanium (Ti) or Ti alloy in clinical and in situ conditions.
MATERIALS AND METHODS
An electronic database search was conducted in PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, LIVIVO, BVS, ProQuest, and OpenGrey up to November 2020. Clinical and in situ studies evaluating the biofilm formed on metallic, ceramic, or polymeric abutment materials compared with Ti or Ti alloy were included. Outcome measures were microbial counts/profile, cell viability, and biofilm coverage/thickness. Clinical parameters were deemed secondary outcomes. Risk of bias was assessed by RoB 2 and ROBINS-I tools.
RESULTS
A total of 10 clinical and 9 in situ studies were included. Meta-analysis was not performed due to heterogeneity across studies. The abutment materials polytetrafluoroethylene, gold alloy, gold-platinum alloy, cobalt-chromium, alumina, and zirconia were reported. Six out of ten clinical studies (60%) and four out of nine in situ studies (44%) found no qualitative or quantitative microbiologic differences between tested materials. When significant differences were detected, conflicting results were reported. Clinical outcomes were consistent with healthy conditions for all investigated materials.
CONCLUSION
There is not enough evidence to support the existence of relevant microbiologic differences in the biofilm formed on alternative abutment materials over Ti and its alloys in oral conditions. No evident relationship between microbiologic results and clinical outcomes were found. In situ studies and polymicrobial analyses showed a higher tendency to find significant differences between materials.
Topics: Alloys; Biofilms; Dental Abutments; Dental Implants; Dental Materials; Titanium; Zirconium
PubMed: 35904820
DOI: 10.11607/jomi.9352 -
The Journal of Prosthetic Dentistry May 2022The marginal and internal adaptation of a fixed dental prosthesis depends on a variety of factors, finish line designs being one of them. A clear consensus as to which... (Meta-Analysis)
Meta-Analysis Review
Effect of different finish line preparations on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
The marginal and internal adaptation of a fixed dental prosthesis depends on a variety of factors, finish line designs being one of them. A clear consensus as to which finish line design can provide a better marginal and internal adaptation with respect to cobalt-chromium metal alloy copings fabricated by using computer-aided design and computer-aided manufacturing (CAD-CAM) technology is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the effect of different finish line preparations on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology.
MATERIAL AND METHODS
Electronic (PubMed, Cochrane, EBSCOhost, and Google Scholar) and manual searches were conducted for articles published from January 2010 to December 2020 to identify relevant studies evaluating the effect of different finish line preparations (chamfer, deep chamfer, shoulder, rounded shoulder) on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology.
RESULTS
A total of 573 articles were obtained via electronic search, and 10 articles were obtained through manual search, of which 24 in vitro studies were selected after title, abstract, and full-text screening and were included for both qualitative and quantitative analyses. The marginal adaptation was evaluated under the parameters of marginal gap, absolute marginal discrepancy, and vertical marginal discrepancy, whereas internal adaptation was evaluated under the parameters of internal gap, cervical discrepancy, axial discrepancy, and occlusal discrepancy. The methods of CAD-CAM fabrication (direct metal laser sintering, hard milling, and soft milling) were considered under the subgroup analysis.
CONCLUSIONS
An overall better marginal and internal adaptation was observed with shoulder and rounded shoulder finish line designs when CAD-CAM methods were used for coping fabrication. Marginal and internal adaptation in chamfer and deep chamfer finish line designs showed better results with soft milling and direct metal laser sintering methods, whereas shoulder finish line showed better results with hard milling.
Topics: Adaptation, Psychological; Chromium; Chromium Alloys; Cobalt; Computer-Aided Design; Crowns; Dental Marginal Adaptation; Dental Prosthesis Design
PubMed: 34716012
DOI: 10.1016/j.prosdent.2021.06.030 -
Clinical and Experimental Dental... Dec 2021Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in... (Review)
Review
OBJECTIVES
Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts.
MATERIALS AND METHODS
A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references.
RESULTS
After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies.
CONCLUSION
Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.
Topics: Alloys; Dental Implants; Fibroblasts; Materials Testing; Titanium
PubMed: 34018703
DOI: 10.1002/cre2.444 -
The Journal of Prosthetic Dentistry Mar 2021A consensus on which dental implant alloy and surface treatment provide the best cell viability is unclear. (Review)
Review
STATEMENT OF PROBLEM
A consensus on which dental implant alloy and surface treatment provide the best cell viability is unclear.
PURPOSE
The purpose of this systematic review was to provide information on the influence of surface and intrinsic titanium alloy chemical components on cell viability.
MATERIAL AND METHODS
The PubMed, LILACS, COCHRANE library, and Science Direct databases were electronically searched for the terms dental implants AND titanium AND cytotoxicity. Inclusion criteria were research articles that studied titanium or its alloys for chemical composition and cell viability and were published in English between 1999 and 2019. Articles that did not study titanium and its alloys, articles with nondental or biomedical implants, and articles that were not found in their entirety were excluded.
RESULTS
A total of 1226 articles selected by title or abstract according to the inclusion and exclusion criteria resulted in 51 articles that were reduced to 27 after reading in full. The treatments analyzed were arc fusion, electron beam physical deposition, plasma electrolytic oxidation, coating addition, micro arc oxidation, anodization, thermochemical process, BMP-2 immobilization, pressure-assisted sintering, and alkali heat treatment.
CONCLUSIONS
The evaluated literature did not allow a determination of the best surface treatment for cell viability because of the heterogeneity of the studies regarding the type of alloy, cell used in the MTT assay, study, and implant purpose (biomedical or dental). The cytotoxic effect of chemical components was dependent on dose, time, size, temperature, and cell type. The niobium, tantalum, zirconium, and molybdenum elements have been most often added in the development of less toxic Ti alloys with lower modulus of elasticity and increased strength.
Topics: Alloys; Cell Survival; Dental Implants; Materials Testing; Surface Properties; Titanium; Zirconium
PubMed: 32178882
DOI: 10.1016/j.prosdent.2020.02.001 -
The British Journal of Oral &... Jul 2023Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The... (Meta-Analysis)
Meta-Analysis Review
Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The purpose of this systematic review and meta-analysis was to evaluate clinical evidence, including survival rates, success rates, and marginal bone loss (MBL) on Ti-Zr NDIs that support single crowns. An extensive search was performed in the databases of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for studies published in English up to April 2022. Only peer-reviewed clinical studies with at least 10 patients and a follow-up time of at least 12 months were included. Risk of bias in each study was assessed and data extraction was carried out independently by two reviewers. The outcome variables were survival rates, success rates, and MBL. The search returned 779 results. Eight studies were identified for qualitative analysis and seven for quantitative synthesis. Overall, a total of 256 Ti-Zr NDIs were included. Cumulative implant survival rates and success rates were 97.5% (95% confidence interval (CI): 94.5% to 98.9%) and 97.2% (95% CI: 94.2% to 98.7%), respectively, over a maximum follow-up period of 36 months, with no difference between Ti-Zr NDIs and commercial pure titanium (cpTi) implants. Cumulative mean (SD) MBL was 0.44 (0.04) mm (95% CI: 0.36 to 0.52) after one year. Meta-analysis of MBL indicated a mean difference of 0.02 mm (95% CI: -0.23 to 0.10), with no differences between Ti-Zr NDIs and cpTi implants. Short-term results of Ti-Zr NDIs for single-crown restorations are quite promising, although the number of published studies and follow-up periods are insufficient to determine the real benefit for single crowns. Long-term, follow-up clinical studies are needed to verify the excellent clinical performance of Ti-Zr NDIs.
Topics: Humans; Titanium; Zirconium; Dental Prosthesis Design; Alloys; Crowns; Dental Implants; Dental Restoration Failure
PubMed: 37331853
DOI: 10.1016/j.bjoms.2023.05.005 -
The Journal of Prosthetic Dentistry Mar 2021Infection of a dental implant is undesirable and decreases the success rate of the dental prosthesis; however, systematic reviews on the issue are lacking. (Review)
Review
STATEMENT OF PROBLEM
Infection of a dental implant is undesirable and decreases the success rate of the dental prosthesis; however, systematic reviews on the issue are lacking.
PURPOSE
The purpose of this systematic review was to evaluate studies that dealt with inherent factors or those applied to the titanium surface or alloys to provide an antimicrobial action.
MATERIAL AND METHODS
SCOPUS, PubMed/Medline, Web of Science, EMBASE, and Science Direct databases were searched and manual searches made between June and July 2019 using the keywords "titanium," "surface," "implants," "photoelectron spectroscopy," and "fourier transform infrared spectroscopy." The criteria included in vitro studies evaluating the titanium surface and describing hydrophobicity, surface crystalline phase, nanotopography, surface charges, and their relationship with bacteria and/or osseointegration.
RESULTS
A comprehensive search identified 767 articles that were selected by the title and/or abstract as per the inclusion criteria. Of the 58 studies selected for full reading, 7 were used for this systematic review. Another 6 studies were added by further research, resulting in 13 articles, all in vitro studies. As the selected studies had a high heterogeneity that precluded any statistical analysis of the data, a descriptive analysis of these topics was performed: hydrophilicity, surface crystalline phase, nanotopography, and surface charges.
CONCLUSIONS
The articles analyzed in this systematic review suggest that hydrophilicity, crystalline phase, surface topography, and surface titanium charge, when altered, may provide an antimicrobial surface. However, the strategy used resulted in heterogeneous articles, making it impossible to demonstrate the unique effect of the electrostatic surface of titanium or titanium alloy used for implants and its effect on bacterial control.
Topics: Bacterial Adhesion; Dental Implants; Osseointegration; Static Electricity; Surface Properties; Titanium
PubMed: 32247513
DOI: 10.1016/j.prosdent.2020.02.003