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Clinical Oral Implants Research Sep 2023The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary... (Meta-Analysis)
Meta-Analysis Review
Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis.
OBJECTIVES
The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone.
MATERIALS AND METHODS
An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool.
RESULTS
A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004).
CONCLUSIONS
Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
Topics: Humans; Patient Selection; Dental Implants; Esthetics, Dental; Databases, Factual
PubMed: 37750515
DOI: 10.1111/clr.14109 -
Head & Face Medicine Jul 2021Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.
QUESTIONS ARISE
What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.
METHODS
Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.
RESULTS
The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.
CONCLUSIONS
No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
Topics: Dental Bonding; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontic Wires
PubMed: 34301280
DOI: 10.1186/s13005-021-00281-3 -
Clinical Oral Implants Research Oct 2018To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols...
OBJECTIVES
To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols in partially edentulous patients.
MATERIALS AND METHODS
An electronic search was performed in Medline, Embase, and Central to identify studies investigating the outcome of implants subjected to immediate placement + immediate restoration/loading (Type 1A), immediate placement + early loading (Type 1B), immediate placement + conventional loading (Type 1C), early placement + immediate restoration/loading (Type 2-3A), early placement + early loading (Type 2-3B), early placement + conventional loading (Type 2-3C), late placement + immediate restoration/loading (Type 4A), late placement + early loading (Type 4B), late placement + conventional loading (Type 4C) with implant-supported fixed dental prostheses (IFDPs) in partially edentulous patients. Only human studies with at least 10 cases and a minimum follow-up time of 12 months, reporting on solid-screw-type implants with rough surfaces and an intra-osseous diameter between 3 and 6 mm, were included. A cumulative survival rate for each type of the implant placement and loading protocols was weighted by the duration of follow-up and number of implants.
RESULTS
The search provided 5,248 titles from which 2,362 abstracts and 449 full-text articles were screened. A total of 69 publications that comprised 23 comparative studies (15 randomized controlled trials, 7 controlled clinical trials) and 47 noncomparative studies (34 prospective cohort studies, 13 retrospective cohort studies) were included for analysis. Considerable heterogeneity in study design was found, and therefore, a meta-analysis of controlled studies was not possible. The weighted cumulative survival rate of each type of placement and loading protocol was 98.4% (Type 1A), 98.2% (Type 1B), 96.0% (Type 1C), 100% (Type 2-3B), 96.3% (Type 2-3C), 97.9% (Type 4A), 98.3% (Type 4B), and 97.7% (Type 4C). Type 1C, Type 2-3C, Type 4B, and Type 4C were scientifically and clinically validated (SCV). Type 1A, Type 1B, and Type 4A were clinically documented (CD), and Type 2-3A and Type 2-3B were clinically insufficiently documented (CID).
CONCLUSIONS
Evaluating outcomes in oral implantology by combining the placement and loading protocols are paramount. The selected loading protocol appears to influence the outcome of immediate implant placement.
Topics: Humans; Databases, Factual; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Immediate Dental Implant Loading; Mouth, Edentulous
PubMed: 30328194
DOI: 10.1111/clr.13276 -
Dental Materials : Official Publication... Oct 2015In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations. (Review)
Review
OBJECTIVE
In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations.
DATA
Clinical studies investigating the survival of anterior light-cured composite restorations with at least three years of follow-up were screened and main reasons associated with restoration failure were registered.
SOURCES
PubMed, Scopus, and Cochrane databases were searched without restriction on date or language. Reference lists of eligible studies were hand-searched. The grey literature search was not made systematically.
STUDY SELECTION
Two reviewers screened titles and/or abstracts of 2273 unique studies. In total, 41 studies were selected for full-text reading, from which 17 were included in the qualitative synthesis. The included studies evaluated the clinical performance of Class III and/or IV restorations (10 studies), which were placed due to caries, fracture, or replaced old restorations; veneers and full-coverage restorations placed for aesthetic reasons (five studies); and restorations in worn teeth (two studies). Annual failure rates (AFRs) were calculated for each study.
CONCLUSIONS
In total, 1821 restorations were evaluated and the total failure rate was 24.1%. AFRs varied from 0 to 4.1% and survival rates varied from 53.4% to 100%. Class III restorations generally had lower AFRs than the other restorations. Few studies addressed factors associated with failure, which included adhesive technique, composite resin, retreatment risk, and time required to build-up the restoration. Fracture of tooth/restoration was the most common reason for failure, whereas failures related to aesthetic qualities (color, anatomical form, surface stain) were more frequent when restorations were placed for aesthetic reasons.
Topics: Composite Resins; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Humans
PubMed: 26303655
DOI: 10.1016/j.dental.2015.07.005 -
International Endodontic Journal Apr 2022Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital-pulp-therapy; however, the preferred type is... (Review)
Review
BACKGROUND
Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital-pulp-therapy; however, the preferred type is not specified. Higher success rates for pulpotomy compared to pulp-capping have been documented, which suggests pulpotomy may be a preferable option for complicated crown-fractures.
OBJECTIVES
The purpose of this systematic review was to determine the success rate of pulpotomy (partial and complete) on teeth that suffered complicated crown fractures.
PARTICIPANTS
patients who have suffered a complicated crown fracture to an anterior permanent tooth.
INTERVENTION
pulpotomy (partial or complete). Comparator: pulp-capping or root canal treatment.
OUTCOME
combined clinical and radiographic success at or after 12 months.
METHODS
A systematic literature using key search terms was conducted using PubMed, Web of Science and Cochrane-Central-Register-of-Controlled-Trials (CENTRAL) as well as a grey literature search from inception to May 2021 and without language restricted to English. Strict inclusion criteria were applied. A standardized tool with defined criteria to assess the risk of bias in each study was used. For non-randomized comparative trials, the Robins-I tool was used while the Newcastle-Ottawa scale was used for non-comparative non-randomized studies.
RESULTS
Seven retrospective clinical studies were included. The studies reported high success rates for pulpotomy with overall success ranges for partial or complete pulpotomy ranging from 75% to 96%. One study compared the success rates of pulpotomy to an alternative treatment option pulp capping (90.9% vs. 67%, respectively). Due to the lack of homogeneity in the included studies, a meta-analysis was not possible.
DISCUSSION
This review highlights the limited evidence based for the current guidance on treatment of complicated crown fractures. The findings of the review indicate high success rates for pulpotomy; however, there is a moderate risk of bias and small sample sizes in the included studies with the result that the overall results should be interpreted with caution.
CONCLUSION
Within the limitations of this review, the benefits and high success rates reported for partial pulpotomy suggest this procedure, rather than pulp-capping, should be considered as the treatment of choice for both immature and mature teeth that have suffered complicated crown-fractures.
Topics: Crowns; Dental Pulp Capping; Dentition, Permanent; Humans; Pulpotomy; Retrospective Studies; Treatment Outcome
PubMed: 35076954
DOI: 10.1111/iej.13690 -
Journal of Prosthodontic Research Jul 2022The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology.
STUDY SELECTION
An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search.
RESULTS
From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672).
CONCLUSION
Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
Topics: Computer-Aided Design; Crowns; Dental Prosthesis Design; Dental Restoration Failure; Humans; Zirconium
PubMed: 34615842
DOI: 10.2186/jpr.JPR_D_21_00081 -
Clinical Oral Investigations Jan 2022Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome. (Review)
Review
OBJECTIVE
Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome.
MATERIAL AND METHODS
A search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria (PRISMA). The PICO question was used to address the following specific question: "What is the level of oral health-related quality of life and satisfaction in edentulous patients and with atrophic jaws who received dental implants for full-arch implant-supported restorations following the all-on-four in the mandible or maxilla?"
RESULTS
Eleven studies including 693 patients aged 55 to 71 years were selected. The shortest follow-up period was 3 months and the longest, 7 years. Regarding the OHRQoL assessment method and patient satisfaction, the oral health impact profile (OHIP) and the visual analog scale (VAS) were the most used.
CONCLUSION
OHRQoL and satisfaction in patients whose rehabilitation was based on the all-on-four concept were high. However, the current evidence is still limited by the quality of the available studies, making long-term randomized studies necessary to establish the real effectiveness of this surgical-prosthetic approach.
CLINICAL RELEVANCE
Carefully analyze the aspects related to satisfaction and oral health-related quality of life of rehabilitated patients with implant-supported total prostheses made according to the all-on-four concept, aiming to achieve success through procedures with greater predictability and less complexity, as these are directly associated with recovery oral health of edentulous individuals with less morbidity and minimized costs.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Humans; Jaw, Edentulous; Patient Satisfaction; Personal Satisfaction; Quality of Life; Treatment Outcome
PubMed: 34647147
DOI: 10.1007/s00784-021-04213-y -
Dental Materials : Official Publication... Jun 2015To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and to describe the incidence of biological, technical and... (Review)
Review
OBJECTIVE
To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and to describe the incidence of biological, technical and esthetic complications.
METHODS
Medline (PubMed), Embase and Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported FDPs with a mean follow-up of at least 3 years. This was complemented by an additional hand search and the inclusion of 10 studies from a previous systematic review [1]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions.
RESULTS
Forty studies reporting on 1796 metal-ceramic and 1110 all-ceramic FDPs fulfilled the inclusion criteria. Meta-analysis of the included studies indicated an estimated 5-year survival rate of metal-ceramic FDPs of 94.4% (95% CI: 91.2-96.5%). The estimated survival rate of reinforced glass ceramic FDPs was 89.1% (95% CI: 80.4-94.0%), the survival rate of glass-infiltrated alumina FDPs was 86.2% (95% CI: 69.3-94.2%) and the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function. Even though the survival rate of all-ceramic FDPs was lower than for metal-ceramic FDPs, the differences did not reach statistical significance except for the glass-infiltrated alumina FDPs (p=0.05). A significantly higher incidence of caries in abutment teeth was observed for densely sintered zirconia FDPs compared to metal-ceramic FDPs. Significantly more framework fractures were reported for reinforced glass ceramic FDPs (8.0%) and glass-infiltrated alumina FDPs (12.9%) compared to metal-ceramic FDPs (0.6%) and densely sintered zirconia FDPs (1.9%) in 5 years in function. However, the incidence of ceramic fractures and loss of retention was significantly (p=0.018 and 0.028 respectively) higher for densely sintered zirconia FDPs compared to all other types of FDPs.
CONCLUSIONS
Survival rates of all types of all-ceramic FDPs were lower than those reported for metal-ceramic FDPs. The incidence of framework fractures was significantly higher for reinforced glass ceramic FDPs and infiltrated glass ceramic FDPs, and the incidence for ceramic fractures and loss of retention was significantly higher for densely sintered zirconia FDPs compared to metal-ceramic FDPs.
Topics: Ceramics; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Esthetics, Dental; Humans; Metal Ceramic Alloys; Metals
PubMed: 25935732
DOI: 10.1016/j.dental.2015.02.013 -
Journal of Endodontics Feb 2018Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration... (Review)
Review
INTRODUCTION
Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared.
METHODS
The specific PICO question was as follows: Patient: adults with sufficient endodontic treatment needing a core or post; Intervention: post-endodontic treatment using posts with or without ferrule; Comparison: post-endodontic treatment without posts with or without ferrule; Outcomes: failure rates of post/core complexes with or without ferrule support. A Medline search was performed via PubMed in June 2017 using relevant electronic databases. Additionally, hand search was performed. Only prospective clinical studies in humans comparing the success/survival of teeth restored with or without posts over a minimum time of observation of 5 years were included.
RESULTS
In total, 7 randomized controlled trials and 1 prospective clinical trial met inclusion criteria. Cochrane rating showed high risk of bias in 5 studies. Two of 3 studies support the ferrule-effect concept. Seven of 8 show no post effect. Clinical evidence regarding the influence of tooth location on its survival is scarce.
CONCLUSION
Ferrule effect and maintaining cavity walls are the predominant factors with regard to tooth and restoration survival of endodontically treated teeth. Most studies do not confirm a positive effect of post placement.
Topics: Dental Restoration, Permanent; Humans; Post and Core Technique; Root Canal Therapy; Tooth, Nonvital
PubMed: 29229457
DOI: 10.1016/j.joen.2017.09.020 -
Clinical and Experimental Dental... Dec 2022This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers. (Review)
Review
OBJECTIVES
This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers.
MATERIALS AND METHODS
Based on the PICO question and the search terms, an electronic search was performed in Google Scholar, PubMed (MEDLINE), Scopus, Cochrane Library, Web of Science, Science Direct, Wiley, Ovid, and SAGE for articles published up to July 2022. After including English in vitro studies that evaluated posterior ceramic occlusal overlays at the posterior with ceramic restorations by following the PRISMA statement, the extracted data was tabulated. The methodological quality of the included studies was evaluated. Risk of bias assessment was done independently by two authors using the modified MINORS scale.
RESULTS
About 3138 search results were screened, of which 22 were selected due to their titles. Twenty-one full-text articles were assessed for eligibility. Seventeen in-vitro studies were finalized for the extraction of quantitative data. All 17 articles had a low risk of bias and were retained. The influencing items for evaluating the research were different in most studies; therefore, qualitative synthesis of the results was feasible. They generally included preparation design, material thickness, depth of preparation in the tooth, internal divergence angle, and finish line. Meta-analysis was not done due to heterogeneity of preparation types and evaluation methods. Results revealed that fracture resistance of occlusal veneers is higher than normal mastication force, and it is sufficient to prepare the occlusal surface, use a self-etching primer for bonding, and an acceptable minimum ceramic thickness. The marginal discrepancy of occlusal veneers is clinically acceptable. However, this systematic review faces some limitations due to the lack of in vivo studies, different preparation designs in included studies, different follow-ups, and lack of comprehensive explanations in articles.
CONCLUSIONS
The preparation design of occlusal veneers influences both marginal adaptation and fracture resistance. Various preparation designs are proven to have clinically acceptable fracture strength and marginal adaptation.
Topics: Dental Porcelain; Dental Veneers; Flexural Strength; Dental Stress Analysis; Materials Testing; Ceramics
PubMed: 36062841
DOI: 10.1002/cre2.653