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Journal of Prosthodontic Research Jan 2024This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. (Review)
Review
PURPOSE
This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.
STUDY SELECTION
Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.
RESULTS
One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.
CONCLUSIONS
Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Patient Satisfaction; Quality of Life; Tooth
PubMed: 37164658
DOI: 10.2186/jpr.JPR_D_22_00252 -
Clinical Implant Dentistry and Related... Dec 2014The study aims to evaluate the all-on-four treatment concept with regard to survival rates (SRs) of oral implants, applied fixed dental prostheses (FDPs) and temporal... (Review)
Review
PURPOSE
The study aims to evaluate the all-on-four treatment concept with regard to survival rates (SRs) of oral implants, applied fixed dental prostheses (FDPs) and temporal changes in proximal bone levels.
MATERIALS AND METHODS
A systematic review of publications in English and German was performed using the electronic bibliographic database MEDLINE, the Cochrane Library, and Google. Hand searches were conducted of the bibliographies of related journals and systematic reviews. The authors performed evaluations of articles independently, as well as data extraction and quality assessment. Data were submitted the weighted least-squared analysis.
RESULTS
Thirteen (487 initially identified) papers met inclusion criteria. A number of 4,804 implants were initially placed, of which 74 failed, with a majority of failures (74%) within the first 12 months. A total of 1,201 prostheses were incorporated within 48 hours after the surgery. The major prosthetic complication was the fracture of the all-acrylic FDP. The mean cumulative SR/SR ± (standard deviation) (36 months) of implants and prostheses were 99.0 ± 1.0% and 99.9 ± 0.3%, respectively. The averaged bone loss was 1.3 ± 0.4 mm (36 months). No statistically significant differences were found in outcome measures, when comparing maxillary versus mandibular arches and axially versus tilted placed implants.
CONCLUSION
The available data provide promising short-term results for the all-on-four treatment approach; however, current evidence is limited by the quality of available studies and the paucity of data on long-term clinical outcomes of 5 years or greater. In terms of an evidence-based dentistry, the authors recommend further studies designed as randomized controlled clinical trials and reported according to the CONSORT statement.
Topics: Alveolar Bone Loss; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Design; Humans; Mandible; Maxilla; Survival Analysis
PubMed: 23560986
DOI: 10.1111/cid.12068 -
Evidence-based Dentistry Mar 2017Data sourcesA broad computerised search with similar key terms was performed in different databases that included: Ovid Medline, Thomson's ISI Web of Science, PubMed,... (Comparative Study)
Comparative Study Review
Data sourcesA broad computerised search with similar key terms was performed in different databases that included: Ovid Medline, Thomson's ISI Web of Science, PubMed, Science Direct, EMBASE and the Cochrane Library. Grey literature, dissertations, abstracts and theses were searched too. Reference lists of the selected articles were hand-searched.Study selectionThe inclusion criteria included in vivo randomised clinical trials and quasi-randomised clinical trials using gingival retraction techniques with and without cord. Studies were included if they examined the primary outcome from the review: efficiency of haemostasis control, the amount of gingival displacement and the influence of the techniques on gingival/periodontal health. Secondary outcomes accepted for the review included subjective factors reported by the patient such as pain, sensitivity, unpleasant taste and discomfort and operator's experience with both techniques. Non-English papers, clinical reports, animals studies or in vitro studies were excluded.Data extraction and synthesisTwo authors independently searched and screened the articles. Disagreements were resolved by discussion. A third reviewer participated in the eligibility of the studies. The risk of bias was assessed using the Cochrane Collaboration tool. Due to the heterogeneity of measurement variables across the studies and the differences among the studies, a meta-analysis was not performed. A narrative assessment was performed for the outcomes: moisture/bleeding control, gingival displacement, gingival/periodontal health and the subjective outcomes.ResultsFrom the initial search that retrieved 1,342 articles, 19 potential relevant full-text articles were considered for the review. Seven studies were selected for the systematic review. Four randomised clinical trials were included. Sample size ranged from eight to 252 participants per study. Five studies were conducted on patients requiring any indirect fixed restorations on prepared teeth. Two studies were done on unprepared teeth. In all studies, participants were in good health, had a healthy gingival condition and a sound periodontal status.ConclusionsBoth techniques are reliable in achieving gingival retraction. The review supports the observation that gingival retraction paste can more effectively help to achieve a dry field and at the same time be less injurious to soft tissues, however its ability to displace gingival tissues, compared to retraction cord, was compromising. Rather than considering the cost of material or the individual preference of the operator, choosing the right technique to maximise clinical efficiency should be based on scientific evidence. It seems that impregnated gingival cords are more effective on thick gingival tissue whereas paste is more effective when minimal retraction is required for haemostasis control, preservation of the gingiva and less tissue displacement.
Topics: Adult; Aged; Aged, 80 and over; Dental Impression Technique; Evidence-Based Dentistry; Female; Gingival Retraction Techniques; Humans; Male; Middle Aged; Tooth Preparation, Prosthodontic
PubMed: 28338036
DOI: 10.1038/sj.ebd.6401222 -
Periodontology 2000 Oct 2023Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed... (Meta-Analysis)
Meta-Analysis Review
Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed the impact of different biomaterials employed for guided bone regeneration (GBR) simultaneous to implant placement on the stability of radiographic peri-implant bone levels at ≥12 months of follow-up (focused question 1), as well as on bone defect dimension (width/height) changes at re-assessment after ≥4 months (focused question 2). Only randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared different biomaterials for GBR were considered. A Bayesian network meta-analysis (NMA) was performed using a random-effects model. A ranking probability between treatments was obtained, as well as an estimation of the surface under the cumulative ranking value (SUCRA). Overall, whenever the biological principle of GBR was followed, regeneration occurred in a predictable way, irrespective of the type of biomaterial used. A lower efficacy of GBR treatments was suggested for initially large defects, despite the trend did not reach statistical significance. Regardless of the biomaterial employed, a certain resorption of the augmented bone was observed overtime. While GBR was shown to be a safe and predictable treatment, several complications (including exposure, infection, and soft tissue dehiscence) were reported, which tend to be higher when using cross-linked collagen membranes.
Topics: Humans; Alveolar Ridge Augmentation; Biocompatible Materials; Bone Regeneration; Dental Implantation, Endosseous; Dental Implants; Guided Tissue Regeneration, Periodontal; Network Meta-Analysis
PubMed: 37752820
DOI: 10.1111/prd.12531 -
Journal of Dental Research Jun 2016For restoring cavitated dental lesions, whether carious or not, a large number of material combinations are available. We aimed to systematically review and synthesize... (Meta-Analysis)
Meta-Analysis Review
For restoring cavitated dental lesions, whether carious or not, a large number of material combinations are available. We aimed to systematically review and synthesize data of comparative dental restorative trials. A systematic review was performed. Randomized controlled trials published between 2005 and 2015 were included that compared the survival of ≥2 restorative and/or adhesive materials (i.e., no need for restorative reintervention). Pairwise and Bayesian network meta-analyses were performed, with separate evaluations for cervical cavitated lesions and load-bearing posterior cavitated lesions in permanent and primary teeth. A total of 11,070 restorations (5,330 cervical, 5,740 load bearing) had been placed in 3,633 patients in the included trials. Thirty-six trials investigated restoration of cervical lesions (all in permanent teeth) and 36 of load-bearing lesions (8 in primary and 28 in permanent teeth). Resin-modified glass ionomer cements had the highest chance of survival in cervical cavitated lesions; composites or compomers placed via 2-step self-etch and 3-step etch-and-rinse adhesives were ranked next. Restorations placed with 2-step etch-and-rinse or 1-step self-etch adhesives performed worst. For load-bearing restorations, conventional composites had the highest probability of survival, while siloranes were found least suitable. Ambiguity remains regarding which adhesive strategy to use in load-bearing cavitated lesions. Most studies showed high risk of bias, and several comparisons were prone for publication bias. If prioritized for survival, resin-modified glass ionomer cements might be recommended to restore cervical lesions. For load-bearing ones, conventional or bulk fill composites seem most suitable. The available evidence is quantitatively and qualitatively insufficient for further recommendations, especially with regard to adhesive strategies in posterior load-bearing situations. Moreover, different material classifications might yield different findings on the same materials. Future trials should aim for sufficient power, longer follow-up times, and high internal validity to prove or refute differences between certain material combinations. An agreed material classification for future syntheses is desirable.
Topics: Acid Etching, Dental; Bayes Theorem; Composite Resins; Dental Cavity Preparation; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Dentin-Bonding Agents; Evidence-Based Dentistry; Glass Ionomer Cements; Humans
PubMed: 26912220
DOI: 10.1177/0022034516631285 -
Journal of Prosthodontics : Official... Feb 2022This is a systematic review to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This is a systematic review to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed partial dentures (FPDs).
MATERIALS AND METHODS
Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots.
RESULTS
Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I = 95.01%.
CONCLUSIONS
The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
Topics: Crowns; Dental Implants; Denture, Partial, Fixed; Humans
PubMed: 34516686
DOI: 10.1111/jopr.13433 -
The Journal of Prosthetic Dentistry Jun 2019The association between tooth type, location in the dental arch, and selection of a post-and-core system for endodontically treated teeth is unclear. Information on the... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
The association between tooth type, location in the dental arch, and selection of a post-and-core system for endodontically treated teeth is unclear. Information on the influence of these parameters on the failure rate of teeth treated with post-and-core restorations is needed.
PURPOSE
The purpose of this systematic review and meta-analysis was to assess the available evidence on the failure rates of anterior and posterior teeth treated with post-and-core restorations.
MATERIAL AND METHODS
A search was performed in PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and Gray literature for randomized clinical trials comparing the failure rates of anterior and posterior teeth treated with post-and-core restorations. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies.
RESULTS
The search strategy identified 2526 articles, and 6 studies were included in the meta-analysis. No difference in the failure rate of post-and-core restorations placed in anterior and posterior teeth was found in most studies. The risk ratio for anterior versus posterior teeth was 1.06 (95% confidence interval [CI], 0.69-1.64; P=.79). The risk ratio for incisors versus canines was 3.08 (95% CI, 0.56-17.04; P=.20) and that for premolars versus molars was 0.45 (95% CI, 0.12-1.74; P=.25). The risk ratio for prefabricated glass fiber posts on anterior versus posterior teeth was 1.13 (95% CI, 0.61-2.09; P=.70) and that for metal posts was 1.10 (95% CI, 0.64-1.91; P=.72).
CONCLUSIONS
The failure rates in anterior and posterior teeth treated with post-and-core restorations were similar at short- to medium-term follow-up. More well-designed clinical trials comparing the survival and failure rates of anterior and posterior teeth treated with post-and-core restorations with longer follow-up times are needed.
Topics: Brazil; Composite Resins; Dental Restoration Failure; Humans; Incisor; Molar; Post and Core Technique; Tooth, Nonvital
PubMed: 30617032
DOI: 10.1016/j.prosdent.2018.08.004 -
International Journal of Oral and... Jan 2017This systematic review aimed to determine: (1) the expected bone volume gain with the split crest technique, and (2) how the use of surgical instruments affects the... (Meta-Analysis)
Meta-Analysis Review
This systematic review aimed to determine: (1) the expected bone volume gain with the split crest technique, and (2) how the use of surgical instruments affects the performance of this technique. An electronic search was performed in the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Embase, PubMed/MEDLINE, Scopus, and Web of Science databases. Twenty-seven articles met the selection criteria and were subjected to meta-analysis of bone gain and survival rate; 17 reported the use of conventional surgical instruments and nine the use of surgical ultrasound. A total of 4115 implants were installed in 1732 patients (average patient age 52 years). The overall implant survival rate was 97%. The average bone gain in studies that used conventional surgical instruments was 3.61mm, while this was 3.69mm in those that used ultrasound. Only two studies presented a low risk of bias. The greatest problems identified during the qualitative analysis were related to random selection of the population and the absence of statistical analysis. The split crest technique appears to be a promising and effective technique to gain bone width, regardless of the surgical instruments used. Considering the diversity of the studies and implant types, no definitive recommendations can be made, especially with regard to the best instruments and implant design to be used.
Topics: Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Retention; Dental Restoration Failure; Humans; Piezosurgery; Surgical Instruments
PubMed: 27639295
DOI: 10.1016/j.ijom.2016.08.017 -
Journal of Clinical Periodontology Sep 2016A systematic review/meta-analysis was performed to evaluate pain during probing, scaling and root planing using intra-pocket anaesthesia versus placebo in adult patients. (Meta-Analysis)
Meta-Analysis Review
AIM
A systematic review/meta-analysis was performed to evaluate pain during probing, scaling and root planing using intra-pocket anaesthesia versus placebo in adult patients.
METHODS
A search was performed in PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library and Grey literature. IADR abstracts, unpublished trials registries, dissertations and theses were also searched for randomized clinical trials comparing the clinical effectiveness of intra-pocket anaesthesia and placebo. Risk/intensity of pain was the primary outcome. The risk of bias tool from the Cochrane Collaboration was used for quality assessment. Meta-analysis was performed on studies considered at low risk of bias.
RESULTS
A total of 1740 articles were identified. Eleven remained in the qualitative synthesis, and nine studies were considered at "low" risk of bias for meta-analysis. Standardized Hedge's g mean difference for pain intensity using visual analogue scale and Heft-Parker pain scales was -0.576 (95% confidence interval [CI] -0.94 to -0.22; p = 0.002) and for verbal rating scale pain scale it was -1.814 (95% CI -3.38 to -0.245; p = 0.023). The odds ratio for the risk of pain was 0.025 (95% CI 0.003 to 0.25; p = 0.002) and the odds ratio for the need for rescue anaesthesia it was 0.358 (95% CI 0.174 to 0.736; p = 0.005).
CONCLUSIONS
The anaesthetic gel decreases the risk and intensity of pain during probing/SRP.
Topics: Anesthesia, Dental; Brazil; Dental Scaling; Humans; Pain; Pain Measurement; Root Planing
PubMed: 27097588
DOI: 10.1111/jcpe.12565 -
Evidence-based Dentistry Jun 2023Systematic review and meta-analysis of clinical trials, and prospective or retrospective cohort. The protocol of the study was registered in advance on PROSPERO. (Meta-Analysis)
Meta-Analysis
DESIGN
Systematic review and meta-analysis of clinical trials, and prospective or retrospective cohort. The protocol of the study was registered in advance on PROSPERO.
DATA SOURCES
An electronic search in MEDLINE (PubMed), Web of Science, Scopus, and The Cochrane Library was conducted by two independent authors up to September 2022. Additionally, OpenGrey and www.greylit.org were searched for gray literature, whereas ClinicalTrials.gov was searched for detecting any relevant unpublished data.
STUDY SELECTION
The review question was defined in PICOS format as follows: population (P), patients undergoing orthodontic therapy; intervention (I), orthodontic therapy with clear aligner (CA); comparison (C), orthodontic therapy with fixed appliances (FA); outcome (O), periodontal health status and development of gingival recession; studies (S), randomized clinical trials (RCTs), controlled clinical trials, and retrospective or prospective cohort studies. Cross-sectional studies, case series, case reports, studies without a control group, and studies with less than 2 months follow-up were excluded.
DATA ANALYSIS
Periodontal health status was assessed as a primary outcome and it was measured in terms of pocket probing depth (PPD), gingival index (GI), plaque index (PI) and bleeding on probing (BoP). Gingival recession (GR) was assessed as secondary outcome, and was measured as the development or progression of GR, shown by the apical migration of the gingival margin occurring between pre- and post-orthodontic treatment. Each periodontal index was assessed in three-time points; short-term (2-3 months from baseline), mid-term (6-9 months from baseline), and long-term (12 months or more from baseline). A descriptive analysis of included articles was performed. Pairwise meta-analyses were conducted to compare outcomes assessed in FA and CA groups and were only performed when studies reported similar periodontal indices at similar follow-ups.
RESULTS
12 studies (3 RCTs, 8 prospective cohort studies, 1 retrospective cohort study) were included in the qualitative synthesis, of which, 8 studies were included in the quantitative synthesis (meta-analysis). A total of 612 patients (321 treated with buccal FA and 291 with CA) were assessed. Results from meta-analyses favored CA in regards to PI, demonstrating a significant difference in the mid-term follow-up (number of studies = 4, standardized mean difference [SMD] = -0.99, 95% confidence interval [CI] = -1.94 to -0.03, I = 99%, P = 0.04). There was a tendency to report better GI values with CA, specifically in long-term (number of studies = 2, SMD = -0.46 [95% CI, -1.03 to 0.11], I = 96%, P = 0.11). However, no statistical significance between the two treatment modalities was shown for any follow-up intervals (P > 0.05). As for PPD, the long-term follow-up showed statistical significance favoring CA (SMD = -0.93 [95% CI, -1.06 to 0.7], P < 0.0001), whereas short- and mid-term follow-ups did not show significant differences between FA and CA. Overall, patients treated with CA showed better values of BoP and less GR when compared to patients treated with FA.
CONCLUSIONS
Available evidence is still not enough to conclude the superiority of clear aligner therapy in terms of periodontal status during orthodontic treatment compared to fixed appliances.
Topics: Humans; Dental Care; Gingival Recession; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable
PubMed: 37188919
DOI: 10.1038/s41432-023-00890-8