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Clinical Oral Implants Research Oct 2021To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs). (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns.
OBJECTIVE
To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs).
METHODS
Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow-up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all-ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Forty-nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta-analysis of the included studies indicated an estimated 3-year survival rate of veneered-reinforced glass-ceramic implant-supported SCs of 97.6% (95% CI: 87.0%-99.6%). The estimated 3-year survival rates were 97.0% (95% CI: 94.0%-98.5%) for monolithic-reinforced glass-ceramic implant SCs, 96.9% (95% CI: 93.4%-98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%-97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%-97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%-87.7%) for resin-matrix-ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates.
CONCLUSIONS
With the exception of RMC SCs, veneered and monolithic implant-supported ceramic SCs showed favorable short-term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
Topics: Ceramics; Crowns; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Prospective Studies; Retrospective Studies
PubMed: 34642991
DOI: 10.1111/clr.13863 -
European Journal of Orthodontics Jun 2020The use of orthodontic aligners to treat a variety of malocclusions has seen considerable increase in the last years, yet evidence about their efficacy and adverse... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The use of orthodontic aligners to treat a variety of malocclusions has seen considerable increase in the last years, yet evidence about their efficacy and adverse effects relative to conventional fixed orthodontic appliances remains unclear.
OBJECTIVE
This systematic review assesses the efficacy of aligners and fixed appliances for comprehensive orthodontic treatment.
SEARCH METHODS
Eight databases were searched without limitations in April 2019.
SELECTION CRITERIA
Randomized or matched non-randomized studies.
DATA COLLECTION AND ANALYSIS
Study selection, data extraction, and risk of bias assessment was done independently in triplicate. Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity analyses, and the GRADE analysis of the evidence quality.
RESULTS
A total of 11 studies (4 randomized/7 non-randomized) were included comparing aligners with braces (887 patients; mean age 28.0 years; 33% male). Moderate quality evidence indicated that treatment with orthodontic aligners is associated with worse occlusal outcome with the American Board of Orthodontics Objective Grading System (3 studies; MD = 9.9; 95% CI = 3.6-16.2) and more patients with unacceptable results (3 studies; RR = 1.6; 95% CI = 1.2-2.0). No significant differences were seen for treatment duration. The main limitations of existing evidence pertained to risk of bias, inconsistency, and imprecision of included studies.
CONCLUSIONS
Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces.
REGISTRATION
PROSPERO (CRD42019131589).
Topics: Adult; Dental Care; Duration of Therapy; Humans; Malocclusion; Orthodontic Appliances; Orthodontic Appliances, Fixed; Treatment Outcome
PubMed: 31758191
DOI: 10.1093/ejo/cjz094 -
Journal of Endodontics May 2017The aim of this systematic review was to answer the following clinical question: Which is the best treatment option for a pulpally involved tooth? (Comparative Study)
Comparative Study Review
INTRODUCTION
The aim of this systematic review was to answer the following clinical question: Which is the best treatment option for a pulpally involved tooth?
METHODS
An electronic search was conducted in the Cochrane, PubMed (MEDLINE), and ScienceDirect databases between December 2015 and February 2016. A manual search was also performed. The inclusion criteria were randomized clinical trials, prospective or retrospective cohort studies, and cross-sectional studies performed on humans with at least 1 year of follow-up and published within the last 10 years. Two researchers independently screened the title and abstract of every article identified in the search in order to establish its eligibility. The selected articles were classified into different levels of evidence by means of the Strength of Recommendation Taxonomy criteria.
RESULTS
Sixty articles met the inclusion criteria for this systematic review. The survival rate of single-tooth implants was greater than the success rate of the distinct conservative treatments. However, among comparative studies, no important differences between both treatments were observed until at least 8 years later.
CONCLUSIONS
The endodontic treatment and the implant placement are both valid and complementary options for planning oral rehabilitation. Although a level B recommendation can be stated, these results come from retrospective comparative studies because there is a lack of randomized clinical studies comparing both types of therapeutic options.
Topics: Apicoectomy; Dental Implantation; Dental Pulp Diseases; Humans; Retreatment; Tooth Extraction
PubMed: 28343928
DOI: 10.1016/j.joen.2017.01.004 -
International Journal of Paediatric... Mar 2018Several restorative materials with specific indications are used for filling cavities in primary teeth. (Review)
Review
BACKGROUND
Several restorative materials with specific indications are used for filling cavities in primary teeth.
AIM
To systematically review the literature in order to investigate the longevity of primary teeth restorations and the reasons for failure.
DESIGN
Electronic databases were screened, and eligible studies were hand-searched to find longitudinal clinical studies evaluating the survival of restorations (class I, class II, and crown) placed with different materials in primary teeth with at least one year of follow-up.
RESULTS
Thirty-one studies were included, and a high bias risk was observed. Overall, 12,047 restorations were evaluated with 12.5% of failure rate. A high variation on annual failure rate (AFR) was detected (0-29.9%). Composite resin showed the lowest AFRs (1.7-12.9%). Stainless steel crowns (SSC) had the highest success rate (96.1%). Class I restorations and restorations placed using rubber dam presented better AFR. The main reason for failure observed was secondary caries (36.5%).
CONCLUSIONS
An elevated number of failures were observed due to recurrent caries, highlighting the need for professionals to work with a health-promoting approach. The high variation on failure rate among the materials can be due to children's behavior during the procedure, which demands short dental appointments and a controlled environment.
Topics: Child; Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Tooth, Deciduous
PubMed: 29322626
DOI: 10.1111/ipd.12346 -
Clinical Oral Implants Research Jan 2022To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) supported by ceramic implants. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) supported by ceramic implants.
MATERIALS AND METHODS
Based on a focused question and customized PICO framework, electronic (Medline/EMBASE/Cochrane) and manual searches for studies reporting the clinical outcomes of all-ceramic SCs and FDPs supported by ceramic implants ≥12 months were performed. The primary outcomes were reconstruction survival and the chipping proportion. The secondary outcomes were implant survival, technical complications, and patient-related outcome measurements. Meta-analyses were performed after 1, 2, and 5 years using random-effect meta-analyses.
RESULTS
Eight of the 1,403 initially screened titles and 55 full texts were included. Five reported on monolithic lithium disilicate (LS2) SCs, one on veneered zirconia SCs, and two on veneered zirconia SCs and FDPs, which reported all on cement-retained reconstructions (mean observation: 12.0-61.0 months). Meta-analyses estimated a 5-year survival rate of 94% (95% confidence interval [CI]: 82%-100%) for overall implant survival. Reconstruction survival proportions after 5 years were: monolithic LS2, 100% (95%CI: 95%-100%); veneered zirconia SCs, 89% (95%CI: 62%-100%); and veneered zirconia FDPs 94% (95%CI: 81%-100%). The chipping proportion after 5 years was: monolithic LS2, 2% (95%CI: 0%-11%); veneered zirconia SCs, 38% (95%CI: 24%-54%); and veneered zirconia FDPs, 57% (95%CI: 38%-76%). Further outcomes were summarized descriptively.
CONCLUSIONS
Due to the limited data available, only tendencies could be identified. All-ceramic reconstructions supported by ceramic implants demonstrated promising survival rates after mid-term observation. However, high chipping proportions of veneered zirconia SCs and, particularly, FDPs diminished the overall outcome. Monolithic LS2 demonstrated fewer clinical complications. Monolithic reconstructions could be a valid treatment option for ceramic implants.
Topics: Ceramics; Crowns; Dental Implants; Dental Porcelain; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Metal Ceramic Alloys; Zirconium
PubMed: 34665900
DOI: 10.1111/clr.13871 -
Implant Dentistry Dec 2016Occlusal overload may cause implant biomechanical failures, marginal bone loss, or even complete loss of osseointegration. Thus, it is important for clinicians to... (Review)
Review
PURPOSE
Occlusal overload may cause implant biomechanical failures, marginal bone loss, or even complete loss of osseointegration. Thus, it is important for clinicians to understand the role of occlusion in implant long-term stability. This systematic review updates the understanding of occlusion on dental implants, the impact on the surrounding peri-implant tissues, and the effects of occlusal overload on implants. Additionally, recommendations of occlusal scheme for implant prostheses and designs were formulated.
MATERIALS AND METHODS
Two reviewers completed a literature search using the PubMed database and a manual search of relevant journals. Relevant articles from January 1950 to September 20, 2015 published in the English language were considered.
RESULTS
Recommendations for implant occlusion are lacking in the literature. Despite this, implant occlusion should be carefully addressed.
CONCLUSION
Recommendations for occlusal schemes for single implants or fixed partial denture supported by implants include a mutually protected occlusion with anterior guidance and evenly distributed contacts with wide freedom in centric relation. Suggestions to reduce occlusal overload include reducing cantilevers, increasing the number of implants, increasing contact points, monitoring for parafunctional habits, narrowing the occlusal table, decreasing cuspal inclines, and using progressive loading in patients with poor bone quality. Protecting the implant and surrounding peri-implant bone requires an understanding of how occlusion plays a role in influencing long-term implant stability.
Topics: Bite Force; Dental Implantation; Dental Implants; Dental Occlusion; Dental Prosthesis Retention; Humans
PubMed: 27749518
DOI: 10.1097/ID.0000000000000488 -
Orthodontics & Craniofacial Research Nov 2019The aim of this review was to systematically appraise the evidence on aligner mechanics and forces and moments generated across difference types of aligners. In vitro-... (Meta-Analysis)
Meta-Analysis Review
The aim of this review was to systematically appraise the evidence on aligner mechanics and forces and moments generated across difference types of aligners. In vitro- laboratory studies for model simulated tooth movement with aligners. Database searches within Medline via Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS via BIREME Virtual Health Library. Unpublished literature was also searched in Open Grey, ClinicalTrials.gov (www.clinicaltrials.gov), the National Research Register (www.controlled-trials.com) and Center for Open Science (Open Science Framework), using the terms "aligner" AND "orthodontic". Risk of bias assessment was based on the Cochrane Risk of Bias tool. Random effects meta-analyses were conducted. A total of 447 studies were identified through electronic search and after careful consideration of pre- defined eligibility criteria, 13 deemed eligible for inclusion, while 2 were included in the quantitative synthesis. When palatal tipping of the upper central incisor through PET-G aligners was considered, aligner thickness of 0.5, 0.625 or 0.75 mm was not associated with a significantly different moment to force (M/F) ratio, given a common gingival edge width of 3-4 mm. Aligner thickness does not appear to possess a significant role in forces and moments generated by clear aligners under specific settings, while the most commonly examined tooth movements are tipping and rotation. The findings of this review may be applicable to certain conditions in laboratory settings.
Topics: Incisor; Orthodontic Appliance Design; Palate; Rotation; Tooth Movement Techniques
PubMed: 31237410
DOI: 10.1111/ocr.12333 -
Journal of Prosthodontic Research Jan 2022This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication...
PURPOSE
This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication methods and material properties of the dental framework, artificial teeth, and denture base.
STUDY SELECTION
We performed a systematic review of the literature published in online databases from January 1980 to April 2020 regarding RPD fabrication and materials used in the related digital technology. We selected eligible articles, retrieved information regarding digital RPDs, and conducted qualitative/quantitative analyses. In this paper, the computer-aided design/computer-aided manufacturing (CAD/CAM) framework, artificial teeth, and denture base materials are reported.
RESULTS
A variety of materials, such as cobalt-chromium alloy, titanium, zirconia, and polyether ether ketone, are used for dental CAD/CAM frameworks. The mechanical strength of the metal materials used for the CAD/CAM framework was superior to that of the cast framework. However, the fitness and surface roughness of the framework and clasp fabricated using a selective laser melting (SLM) method were not superior to those obtained via cast fabrication. Most material properties and the surface roughness of poly methyl methacrylate (PMMA) discs used for digital RPDs were superior to those of heat-cured PMMA.
CONCLUSION
The use of a CAD/CAM framework and PMMA disc for digital RPDs offers numerous advantages over conventional RPDs. However, technical challenges regarding the accuracy and durability of adhesion between the framework and denture base remain to be solved. In digital fabrication, human technical factors influence the quality of the framework.
Topics: Computer-Aided Design; Denture Bases; Denture, Partial, Removable; Humans; Tooth, Artificial; Workflow
PubMed: 33504722
DOI: 10.2186/jpr.JPR_D_20_00117 -
Clinical Oral Implants Research Mar 2018This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges. (Review)
Review
AIMS
This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges.
MATERIAL AND METHODS
Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random-effects meta-analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported.
RESULTS
Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was -76.24% (95% CI = -137.52% to -14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri-implant sites was -27.27% (95% CI of -45.87% to -8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure.
CONCLUSION
Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri-implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure.
Topics: Alveolar Ridge Augmentation; Bone Regeneration; Bone Transplantation; Databases, Factual; Dental Implantation, Endosseous; Guided Tissue Regeneration, Periodontal; Humans; Membranes, Artificial; Meta-Analysis as Topic; Mouth, Edentulous; Treatment Outcome; Wound Healing
PubMed: 29368353
DOI: 10.1111/clr.13121 -
The Journal of Prosthetic Dentistry Feb 2021The polycrystalline nature of zirconia hinders its ability to bond to tooth structure. Consequently, durable bonding to zirconia has been challenging. In vitro studies... (Review)
Review
STATEMENT OF PROBLEM
The polycrystalline nature of zirconia hinders its ability to bond to tooth structure. Consequently, durable bonding to zirconia has been challenging. In vitro studies have evaluated various methods of bonding to zirconia, but clinical data are sparse.
PURPOSE
The purpose of this systematic review was to critically appraise clinical studies investigating the survival rate of resin-bonded zirconia fixed partial dentures (FPDs), inlay-retained zirconia FPDs, and zirconia veneers.
MATERIAL AND METHODS
Searches were performed in MEDLINE, EMBASE, PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. Clinical studies of over 12 months duration involving bonded zirconia restorations between 1990 and July 2018 were reviewed. All suitable studies were assessed for quality by using a "Questionnaire for selecting articles on Dental Prostheses".
RESULTS
Eight studies were ultimately included. Three studies examined posterior inlay-retained FPDs with estimated survival rates of 12.1% at 10 years, 95.8% at 5 years, and 100% at 20 months. Five studies reviewed anterior, resin-bonded FPDs, all of which had a 3- to 10-year survival rate of 100%. Debonds occurred in all studies, but the prostheses could usually be rebonded.
CONCLUSIONS
With correctly designed buccal and lingual coverage retainers and minimal if any veneering porcelain, zirconia-based, posterior, inlay-retained FPDs seem to have a high clinical survival rate. The role of bonding efficacy in this survival rate is unknown. Anterior, cantilevered, resin-bonded zirconia FPDs seem to have a high clinical survival rate. While these prostheses can debond, fracture of the entire prosthesis is unlikely, so they may be rebonded. To bond zirconia, the use of airborne-particle abrasion with 50-μm alumina (AlO) at 0.1 to 0.25 MPa in combination with a phosphate monomer-containing adhesive resin is recommended until further studies become available. Dental dam isolation is also recommended during zirconia bonding.
Topics: Dental Bonding; Dental Materials; Dental Porcelain; Denture Design; Denture, Partial, Fixed; Treatment Outcome; Zirconium
PubMed: 32115220
DOI: 10.1016/j.prosdent.2019.12.017