-
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 -
BioMed Research International 2021Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional...
OBJECTIVE
Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques.
MATERIALS AND METHODS
The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included.
RESULTS
Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 m) were found in RPDs constructed through digital CAD/CAM systems.
CONCLUSION
A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.
Topics: Computer-Aided Design; Denture Design; Denture, Partial; Denture, Partial, Removable; Humans; Lasers; Workflow
PubMed: 34532499
DOI: 10.1155/2021/3194433 -
The Journal of Prosthetic Dentistry Feb 2021Removable partial dentures (RPDs) are traditionally made by casting, a complex, error-prone, and time-consuming process. Computer-aided design and computer-aided... (Review)
Review
STATEMENT OF PROBLEM
Removable partial dentures (RPDs) are traditionally made by casting, a complex, error-prone, and time-consuming process. Computer-aided design and computer-aided manufacturing (CAD-CAM) RPD systems may simplify the clinical steps and minimize errors; however, the accuracy of CAD-CAM RPD systems is unclear.
PURPOSE
The purpose of this systematic review was to determine whether CAD-CAM systems are accurate for the manufacturing of RPD frameworks.
MATERIAL AND METHODS
A literature search was conducted through Medline-PubMed, Scopus, Lilacs, Web of Science, and Cochrane Library databases using specific keywords for articles published up to November 2019. Three reviewers obtained data and compared the results. All studies evaluated the framework accuracy or fit of prostheses fabricated with conventional and digital techniques.
RESULTS
A total of 7 articles, 2 clinical studies, and 5 in vitro studies that complied with the inclusion criteria were evaluated. One in vitro study compared indirect (extraoral) and direct (intraoral) scanning for partially edentulous ridges and shows that digital scans were better than conventional impressions in terms of trueness. In the other studies included, although the frameworks analyzed had clinically acceptable discrepancies (<311 μm), the material influenced the fit. Polyetheretherketone (PEEK) showed better fit than traditional metal cast RPDs. Co-Cr alloy RPDs produced by rapid prototyping exhibited the highest discrepancies when produced by sintering laser melting.
CONCLUSIONS
The results show that the digital technique for RPD frameworks is accurate. In the studies included, the analyzed frameworks had clinically acceptable gaps, but the results were heterogeneous among studies because the articles used different measurement methods with small sample sizes. Few studies discussed the long-term clinical performance. The digital technique for RPD frameworks was accurate because the misfits and mismatches found in in vitro and clinical studies were within the acceptable clinical limit for RPDs.
Topics: Alloys; Computer-Aided Design; Denture, Partial, Removable; Humans; Lasers; Mouth, Edentulous
PubMed: 32147252
DOI: 10.1016/j.prosdent.2020.01.003 -
International Journal of Environmental... Nov 2019The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge.
BACKGROUND
The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge.
OBJECTIVE
This paper presents a literature review of oral health status and the need for oral care in people with dementia, as compared to people without dementia and also of the relationship between periodontal disease and cognitive impairment.
METHODS
A systematic review was conducted in PubMed, CINAHL, and the Cochrane Library. Fifty-six articles met the inclusion criteria and were consequently included for quality assessment and data extraction.
RESULTS
No significant differences were found between both groups with regard to the number of present teeth, DMFT Index, edentulousness/use of denture, and orofacial pain. Coronal/root caries and retained roots were more common in people with dementia than in those without dementia. Most of the participants with dementia presented gingival bleeding or inflammation and they suffered from the periodontal disease more than people without dementia.
CONCLUSIONS
Poor oral health is a common condition among the elderly with dementia. The education process of caregivers might improve the oral health status of people with dementia. Finally, periodontal disease might contribute to the onset or progression of dementia.
Topics: Aged; Aged, 80 and over; Cognitive Dysfunction; Dementia; Female; Humans; Male; Middle Aged; Oral Health; Oral Hygiene; Periodontal Diseases
PubMed: 31752149
DOI: 10.3390/ijerph16224558 -
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 -
Journal of Clinical Periodontology Jun 2022The aim of this systematic review was to answer the following focused question: "In partially edentulous patients with periodontitis, are removable dental prostheses...
AIM
The aim of this systematic review was to answer the following focused question: "In partially edentulous patients with periodontitis, are removable dental prostheses (RDPs) more efficacious than no prosthetic treatment, treatment to a shortened dental arch (SDA), or tooth-supported fixed dental prostheses (FDPs)?"
MATERIALS AND METHODS
A systematic literature search was performed electronically for the period 1966-2020. Two authors independently assessed the studies for eligibility according to the PRISMA guidelines. Risk assessment was performed using RoB 2.0 and the Newcastle-Ottawa Scale.
RESULTS
Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis. Prospective studies found that RDPs could be maintained without any significant periodontal destruction on a long-term basis. Owing to the heterogeneity of the data, no meta-analysis could be performed. Several studies indicated that RDP increased plaque accumulation. RDPs had only a limited effect on masticatory efficiency and nutritional status. RDPs may improve oral-health-related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA.
CONCLUSIONS
There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss. RDPs do not inevitably improve masticatory efficiency but improve OHRQoL, although less than for patients treated with FDPs including resin-bonded FDPs.
Topics: Dental Implants; Denture, Partial, Removable; Humans; Jaw, Edentulous, Partially; Periodontitis; Prospective Studies; Quality of Life; Retrospective Studies; Tooth Loss
PubMed: 34761421
DOI: 10.1111/jcpe.13519 -
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 Esthetic and Restorative... Jul 2018The aim of this study is to systematically review all the clinical articles about all-ceramic resin-bonded fixed dental prosthesis (RBFDP) in the anterior region and... (Review)
Review
OBJECTIVES
The aim of this study is to systematically review all the clinical articles about all-ceramic resin-bonded fixed dental prosthesis (RBFDP) in the anterior region and assess their designs, clinical procedures, and survival rates. A systematic review was conducted after searching electronic databases PubMed/Medline and EBSCOhost Research Databases for articles published in English between 1987 and July 2017.
MATERIALS AND METHODS
The inclusion criteria were selected as all clinical studies, original design clinical reports, and clinical reports (follow-up time more than 1 year) as all clinical information in the literature are desired to be included in the present review.
RESULTS
The initial electronic search generated 472 articles from PubMed/Medline and 464 articles from EBSCOhost Research Databases. After selection of the articles as per the inclusion criteria, a final sample of 29 original studies is decided as: 1 randomized controlled clinical trial, 4 clinical controlled trials, 4 prospective cohort studies, 2 retrospective cohort studies, 6 original design clinical reports, and 12 clinical reports. After evaluation of the selected articles, it is likely that cantilever design all-ceramic RBFDPs are more successful than two retainer design in the anterior region; however, there is limited evidence for this result in the literature.
CONCLUSION
Well-designed randomized controlled clinical trials with large sample size are still needed to achieve more accurate results about the clinical success rate of different RBFDPs designs in the anterior region.
CLINICAL SIGNIFICANCE
Indications, designs, abutment teeth preparation, provisionalization, try-in, surface treatment options, and cementation of the all-ceramic resin-bonded fixed dental prostheses are described in this article. Clinical survival rates are also given in detail, so that clinicians can easily compare the current studies and give their own decision about all-ceramic resin-bonded fixed dental prostheses in the anterior region.
Topics: Ceramics; Dental Restoration Failure; Denture, Partial, Fixed, Resin-Bonded; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies; Survival Rate
PubMed: 30113136
DOI: 10.1111/jerd.12389