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Gerodontology Sep 2019To systematically review longitudinal studies on the association between oral health and frailty indicated by any validated scale or index. (Review)
Review
OBJECTIVE
To systematically review longitudinal studies on the association between oral health and frailty indicated by any validated scale or index.
BACKGROUND
Frailty and poor oral health are common among ageing populations; however, evidence from longitudinal studies is scarce.
METHODS
Three databases (MEDLINE, EMBASE and LILACS) were searched for published literature up to July 2018 using prespecified search strategy. Grey literature was searched using OpenGrey and Google Scholar. Quality of included studies was checked using the Newcastle-Ottawa Quality Assessment Scale (NOS) for longitudinal studies.
RESULTS
Five longitudinal studies from three countries (Mexico, Japan, and UK) that examined the association between oral health and frailty were identified. All studies used Fried's frailty phenotype criteria for measuring frailty. Oral health indicators were number of teeth, periodontal disease, oral functions (functional dentition with occluding pairs and maximum bite force), use of removable dentures, accumulation of oral health problems and dry mouth symptoms. The studies showed significant association of number of teeth (two studies), oral functions (two studies), accumulation of oral health problems and number of dry mouth symptoms with frailty incidence, whereas periodontal disease showed inconsistent associations.
CONCLUSION
This systematic review identified significant longitudinal associations between oral health indicators and frailty that highlight the importance of oral health as a predictor of frailty in older age. There is a need for further research exploring the role of nutrition as a mediator of the relationship between oral health and frailty.
Topics: Aged; Frail Elderly; Frailty; Humans; Japan; Longitudinal Studies; Oral Health
PubMed: 31025772
DOI: 10.1111/ger.12406 -
Journal of Prosthodontics : Official... Apr 2023The strength of 3D-printed resins is affected by different factors, but review articles clarifying these factors are limited. This review lists the factors affecting the... (Review)
Review
PURPOSE
The strength of 3D-printed resins is affected by different factors, but review articles clarifying these factors are limited. This review lists the factors affecting the strength of 3D-printed resins and the possible correlations between them to answer the study question: What are the factors affecting the flexural strength of 3D-printed resins?
METHODS
A database search (PubMed, Google Scholar, and Scopus) was performed, limited to English-language publications between 2010 and February 1, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for study selection. The modified Consolidated Standards of Reporting Trials (CONSORT) checklist was used to determine the risk of bias of the included studies in this review. The data analysis was descriptive due to the presence of many variables in the included studies.
RESULTS
Out of 123 studies, 26 were reviewed for full-text analysis, and 19 met the inclusion criteria and were thus included in this systematic review. The included studies were divided according to the investigated resin: 5 studies tested provisional restorations, seven tested denture base resins, 2 tested occlusal devices, 3 tested orthodontic appliances, 1 tested denture teeth, and 1 tested surgical guide resins. These studies investigated the flexural strength of 3D-printed resins, with different factors, such as reinforcement with fillers or nanofillers; printing orientation, angulation, and directions; post-polymerization time and temperature; third-party printing (switching between printers and materials); printing layer thickness; and post-printing rinsing time. Most factors significantly affected the flexural strength of 3D-printed resin.
CONCLUSIONS
The strength of 3D-printed resins could be improved with one or more of the following factors: filler or nanofiller addition; printing orientation, angulation, or directions; printing layer thickness; and post-polymerization time and temperature. However, further studies combining these factors are recommended.
Topics: Flexural Strength; Materials Testing; Printing, Three-Dimensional; Surface Properties; Temperature
PubMed: 36629333
DOI: 10.1111/jopr.13640 -
Clinical Oral Implants Research Oct 2018The aim of the present review was to compare the outcomes, that is, survival and complication rates of zirconia-ceramic and/or monolithic zirconia implant-supported... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of the present review was to compare the outcomes, that is, survival and complication rates of zirconia-ceramic and/or monolithic zirconia implant-supported fixed dental prostheses (FDPs) with metal-ceramic FDPs.
MATERIALS AND METHODS
An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort studies and retrospective case series on implant-supported FDPs with a mean follow-up of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5-year proportions.
RESULTS
The search provided 5,263 titles and 455 abstracts. Full-text analysis was performed for 240 articles resulting in 19 studies on implant FDPs that met the inclusion criteria. The studies reported on 932 metal-ceramic and 175 zirconia-ceramic FDPs. Meta-analysis revealed an estimated 5-year survival rate of 98.7% (95% CI: 96.8%-99.5%) for metal-ceramic implant-supported FDPs, and of 93.0% (95% CI: 90.6%-94.8%) for zirconia-ceramic implant-supported FDPs (p < 0.001). Thirteen studies including 781 metal-ceramic implant-supported FDPs estimated a 5-year rate of ceramic fractures and chippings to be 11.6% compared with a significantly higher (p < 0.001) complication rate for zirconia implant-supported FDPs of 50%, reported in a small study with 13 zirconia implant-supported FDPs. Significantly (p = 0.001) more, that is, 4.1%, of the zirconia-ceramic implant-supported FDPs were lost due to ceramic fractures compared to only 0.2% of the metal-ceramic implant-supported FDPs. Detailed analysis of factors like number of units of the FDPs or location in the jaws was not possible due to heterogeneity of reporting. No studies on monolithic zirconia implant-supported FDPs fulfilled the inclusion criteria of the present review. Furthermore, no conclusive results were found for the aesthetic outcomes of both FDP-types.
CONCLUSION
For implant-supported FDPs, conventionally veneered zirconia should not be considered as material selection of first priority, as pronounced risk for framework fractures and chipping of the zirconia veneering ceramic was observed. Monolithic zirconia may be an interesting alternative, but its clinical medium- to long-term outcomes have not been evaluated yet. Hence, metal ceramics seems to stay the golden standard for implant-supported multiple-unit FDPs.
Topics: Ceramics; Databases, Factual; Dental Implants; Dental Materials; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Esthetics, Dental; Humans; Metal Ceramic Alloys; Survival Analysis; Zirconium
PubMed: 30328185
DOI: 10.1111/clr.13277 -
The Journal of Prosthetic Dentistry Feb 2023Artificial intelligence applications are increasing in prosthodontics. Still, the current development and performance of artificial intelligence in prosthodontic... (Review)
Review
STATEMENT OF PROBLEM
Artificial intelligence applications are increasing in prosthodontics. Still, the current development and performance of artificial intelligence in prosthodontic applications has not yet been systematically documented and analyzed.
PURPOSE
The purpose of this systematic review was to assess the performance of the artificial intelligence models in prosthodontics for tooth shade selection, automation of restoration design, mapping the tooth preparation finishing line, optimizing the manufacturing casting, predicting facial changes in patients with removable prostheses, and designing removable partial dentures.
MATERIAL AND METHODS
An electronic systematic review was performed in MEDLINE/PubMed, EMBASE, Web of Science, Cochrane, and Scopus. A manual search was also conducted. Studies with artificial intelligence models were selected based on 6 criteria: tooth shade selection, automated fabrication of dental restorations, mapping the finishing line of tooth preparations, optimizing the manufacturing casting process, predicting facial changes in patients with removable prostheses, and designing removable partial dentures. Two investigators independently evaluated the quality assessment of the studies by applying the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies (nonrandomized experimental studies). A third investigator was consulted to resolve lack of consensus.
RESULTS
A total of 36 articles were reviewed and classified into 6 groups based on the application of the artificial intelligence model. One article reported on the development of an artificial intelligence model for tooth shade selection, reporting better shade matching than with conventional visual selection; 14 articles reported on the feasibility of automated design of dental restorations using different artificial intelligence models; 1 artificial intelligence model was able to mark the margin line without manual interaction with an average accuracy ranging from 90.6% to 97.4%; 2 investigations developed artificial intelligence algorithms for optimizing the manufacturing casting process, reporting an improvement of the design process, minimizing the porosity on the cast metal, and reducing the overall manufacturing time; 1 study proposed an artificial intelligence model that was able to predict facial changes in patients using removable prostheses; and 17 investigations that developed clinical decision support, expert systems for designing removable partial dentures for clinicians and educational purposes, computer-aided learning with video interactive programs for student learning, and automated removable partial denture design.
CONCLUSIONS
Artificial intelligence models have shown the potential for providing a reliable diagnostic tool for tooth shade selection, automated restoration design, mapping the preparation finishing line, optimizing the manufacturing casting, predicting facial changes in patients with removable prostheses, and designing removable partial dentures, but they are still in development. Additional studies are needed to further develop and assess their clinical performance.
Topics: Humans; Prosthodontics; Artificial Intelligence; Dental Implants; Tooth; Dental Care; Denture, Partial, Removable
PubMed: 34281697
DOI: 10.1016/j.prosdent.2021.06.001 -
Clinical and Experimental Dental... Feb 2022The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial... (Meta-Analysis)
Meta-Analysis Review
Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications.
OBJECTIVES
The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs.
MATERIAL AND METHODS
An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model.
RESULTS
Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I = 65%, p = .85; I = 75%, p = .88).
CONCLUSIONS
ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Quality of Life
PubMed: 35014207
DOI: 10.1002/cre2.521 -
Journal of Periodontal Research Oct 2018The purpose of this systematic review and meta-analysis was to assess the prevalence, incidence and risk factors of peri-implantitis in the current literature. An... (Meta-Analysis)
Meta-Analysis
The purpose of this systematic review and meta-analysis was to assess the prevalence, incidence and risk factors of peri-implantitis in the current literature. An electronic search was performed to identify publications from January 1980 until March 2016 on 9 databases. The prevalence and incidence of peri-implantitis were assessed in different subgroups of patients and the prevalences were adjusted for sample size (SSA) of studies. For 12 of 111 identified putative risk factors and risk indicators, forest plots were created. Heterogeneity analysis and random effect meta-analysis were performed for selected potential risk factors of peri-implantitis. The search retrieved 8357 potentially relevant studies. Fifty-seven studies were included in the systematic review. Overall, the prevalence of peri-implantitis on implant level ranged from 1.1% to 85.0% and the incidence from 0.4% within 3 years, to 43.9% within 5 years, respectively. The median prevalence of peri-implantitis was 9.0% (SSA 10.9%) for regular participants of a prophylaxis program, 18.8% (SSA 8.8%) for patients without regular preventive maintenance, 11.0% (SSA 7.4%) for non-smokers, 7.0% (SSA 7.0%) among patients representing the general population, 9.6% (SSA 9.6%) for patients provided with fixed partial dentures, 14.3% (SSA 9.8%) for subjects with a history of periodontitis, 26.0% (SSA 28.8%) for patients with implant function time ≥5 years and 21.2% (SSA 38.4%) for ≥10 years. On a medium and medium-high level of evidence, smoking (effect summary OR 1.7, 95% CI 1.25-2.3), diabetes mellitus (effect summary OR 2.5; 95% CI 1.4-4.5), lack of prophylaxis and history or presence of periodontitis were identified as risk factors of peri-implantitis. There is medium-high evidence that patient's age (effect summary OR 1.0, 95% CI 0.87-1.16), gender and maxillary implants are not related to peri-implantitis. Currently, there is no convincing or low evidence available that identifies osteoporosis, absence of keratinized mucosa, implant surface characteristics or edentulism as risk factors for peri-implantitis. Based on the data analyzed in this systematic review, insufficient high-quality evidence is available to the research question. Future studies of prospective, randomized and controlled type including sufficient sample sizes are needed. The application of consistent diagnostic criteria (eg, according to the latest definition by the European Workshop on Periodontology) is particularly important. Very few studies evaluated the incidence of peri-implantitis; however, this study design may contribute to examine further the potential risk factors.
Topics: Humans; Incidence; Peri-Implantitis; Prevalence; Risk Factors
PubMed: 29882313
DOI: 10.1111/jre.12562 -
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 -
International Journal of Implant... Nov 2021Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy... (Review)
Review
BACKGROUND
Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types.
OBJECTIVE
The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type.
MATERIALS AND METHODS
English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis.
RESULTS
Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive.
CONCLUSION
IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Treatment Outcome
PubMed: 34773513
DOI: 10.1186/s40729-021-00394-z -
Drug Design, Development and Therapy 2016To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis.
METHODS
Four electronic databases were searched for trials published in English till July 1, 2015. Randomized controlled trials comparing nystatin with other antifungal therapies or a placebo were included. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis or descriptive study on the efficacy, treatment protocols, and safety of nystatin was conducted.
RESULTS
The meta-analysis showed that nystatin pastille was significantly superior to placebo in treating denture stomatitis. Nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. The descriptive investigations showed that administration of nystatin suspension and pastilles in combination for 2 weeks might achieve a higher clinical and mycological cure rate, and using the nystatin pastilles alone might have a higher mycological cure rate, when compared with using nystatin suspensions alone. Nystatin pastilles at a dose of 400,000 IU resulted in a significantly higher mycological cure rate than that administrated at a dose of 200,000 IU. Furthermore, treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks. Descriptive safety assessment showed that poor taste and gastrointestinal adverse reaction are the most common adverse effects of nystatin.
CONCLUSION
Nystatin pastille was significantly superior to placebo in treating denture stomatitis, while nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. Indirect evidence from a descriptive study demonstrated that administration of nystatin pastille alone or pastille and suspension in combination is more effective than that of suspension alone; prolonged treatment duration for up to 4 weeks can increase the efficacy of nystatin. More well designed and high quality randomized control studies are needed to confirm these findings.
Topics: Candidiasis, Oral; Dose-Response Relationship, Drug; Humans; Nystatin
PubMed: 27042008
DOI: 10.2147/DDDT.S100795 -
Journal of Prosthodontic Research Jan 2018Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when... (Comparative Study)
Comparative Study Meta-Analysis
PURPOSE
Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when the full literature is considered. The aim of this systematic review is to compare conventional complete dentures (CCDs) to unsplinted implant-retained overdentures (IODs) with regard to efficacy, satisfaction and quality of life.
STUDY SELECTION
The main question addressed was: How do CCDs compare to unsplinted IODs with regard to efficacy, satisfaction and quality of life? Three databases were electronically searched to identify articles comparing CCD to unsplinted IOD. Twenty-six articles were selected and reviewed in full. Of these selected articles, twenty-five compared CCDs restoring function in both arches to a maxillary CCD opposing a mandibular IOD retained by two unsplinted implants. Only one articles compared a maxillary CCDs to a maxillary IOD.
RESULTS
Outcome measures varied among the studies, including the Oral Health Impact Profile (OHIP), visual analogue scales (VAS), and masticatory performance tests. Overall, IODs were associated with significantly better patient's masticatory performance and quality of life as indicated by Oral Health as Related to Quality of Life (OHRQoL). Mandibular unsplinted IODs were more likely than CCDs to be associated with improved OHRQoL for edentulous patients and were associated with significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew.
CONCLUSIONS
Results of this systematic review indicate the superiority of IODs retained by two unsplinted mandibular implants when compared to CCDs with regards to efficacy, satisfaction and quality of life.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mastication; Patient Satisfaction; Quality of Life
PubMed: 28666845
DOI: 10.1016/j.jpor.2017.06.004