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The Journal of Prosthetic Dentistry Jul 2023Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this... (Review)
Review
STATEMENT OF PROBLEM
Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this type of prosthesis.
PURPOSE
The purpose of this systematic review was to collect scientific evidence on screwmentable prostheses and evaluate their long-term clinical behavior.
MATERIAL AND METHODS
An electronic search was conducted by 2 independent reviewers for articles published in scientific dental journals in English from 2004 to April 2020. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were scientific studies concerning the screwmentable type of prosthesis.
RESULTS
The search provided 494 records. Of these, 24 studies fulfilled the inclusion criteria and were included in the review. The included articles presented significant heterogeneity concerning the manufacturing process and the materials used. One randomized clinical trial, 2 prospective clinical studies, 14 in vitro studies, 3 protocol descriptions, 1 case series, and 3 case reports were included.
CONCLUSIONS
Based on the systematic search of the literature, it is concluded that the screwmentable prosthesis combines advantages of both cement-retained and screw-retained restorations, including passive fit, retrievability, excess cement control, tissue-friendly emergence profile, and improved esthetics. Nevertheless, data from well-designed clinical trials are limited, and further research is required to provide evidence on their long-term clinical behavior.
Topics: Dental Implants; Dental Prosthesis Retention; Prospective Studies; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Dental Cements; Glass Ionomer Cements; Randomized Controlled Trials as Topic
PubMed: 34740460
DOI: 10.1016/j.prosdent.2021.08.027 -
The Journal of Prosthetic Dentistry Feb 2017Currently, which type of suprastructure is preferred when fabricating implant-retained craniofacial prostheses is unknown. (Comparative Study)
Comparative Study Review
STATEMENT OF PROBLEM
Currently, which type of suprastructure is preferred when fabricating implant-retained craniofacial prostheses is unknown.
PURPOSE
The purpose of this systematic review was to identify the best retention system (bar-clips versus magnets) for implant-retained craniofacial prostheses.
MATERIAL AND METHODS
This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of Medline/PubMed and Web of Science databases for clinical trials was conducted on implant-retained craniofacial prostheses published between 2005 and 2015. English-language studies that directly compared different types of retention systems or presented information on implant survival, periimplant soft tissue reactions, and prosthetic complications were included. Nonclinical studies were excluded to eliminate bias.
RESULTS
A total to 173 studies were identified, of which 10 satisfied the inclusion criteria. In total, 492 participants were included in these studies. Four selected studies displayed detailed information with regard to the number of implant failures according to the retention system. As reported, 29 (18.2%) of 159 implants with magnets failed, whereas 25 (31.6%) of 79 implants with bars failed. Overall auricular superstructures showed the highest survival (99.08%). In addition, 55.4% of all participants in the selected studies showed grade 0 of periimplant soft tissue reactions.
CONCLUSIONS
A systematic search for clinical studies resulted in few studies with a short-term follow-up and small number of participants. The limited data collected indicated that magnets show fewer complications than bar superstructures; however, no hard conclusions could be drawn. Further research, preferably in the form of clinical trials, is needed to validate these findings.
Topics: Dental Prosthesis, Implant-Supported; Humans; Magnets; Maxillofacial Prosthesis; Prosthesis Retention
PubMed: 27666496
DOI: 10.1016/j.prosdent.2016.05.020 -
Journal of Plastic, Reconstructive &... Sep 2022Because of the recent attention focused on the aesthetics of the leg, outcomes in the literature are under-reported and require further investigation. We summarized the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Because of the recent attention focused on the aesthetics of the leg, outcomes in the literature are under-reported and require further investigation. We summarized the available evidence on the surgical techniques to augment the volume and dimension of the calf based on clinical outcomes and satisfaction rates.
METHODS
An electronic search was conducted across PubMed MEDLINE, Web of Science, Scopus, and Ovid MEDLINER(R) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Data collection included the patients' characteristics, surgical techniques, and postoperative outcomes. Pooled estimates were calculated with a random-effect meta-analysis using the DerSimonian-Laird model.
RESULTS
This review included 48 articles reporting outcomes of 2455 patients. The average age and follow-up were 33.15 years and 33.58 months, respectively. The most common indications for calf augmentation were esthetic concerns (48.7%). Most patients underwent subfascial implant placement (70.2%) followed by fat transfer (17.6%), submuscular implant placement (10.1%). Overall, the pooled satisfaction rate following calf augmentation was 95.4% (95% CI: 93.7%-97%). The pooled satisfaction rate for implant placement and fat transfer was 96.7% (95% CI: 94.4%-97.9%) and 87.2% (95% CI: 78.5%-96%), respectively. The pooled incidence of implant removal was 1.3% (95% CI: 0.7%-2%). The pooled estimate for additional fat grafting procedures following initial fat transfer was 54.1% (95% CI: 38.3%-70%).
CONCLUSIONS
While fat transfer has an exceptional safety profile, additional procedures to achieve satisfactory outcomes are usually necessary. Subfascial implant placement provides the best volumetric expansion with a lower implant removal rate and optimal safety profile.
Topics: Esthetics; Humans; Leg; Prostheses and Implants
PubMed: 35965213
DOI: 10.1016/j.bjps.2022.06.051 -
JBJS Reviews Oct 2016Despite the expanding body of literature on radial head arthroplasty, the increasing understanding of elbow anatomy, biomechanics, and kinetics, and the evolution of... (Review)
Review
BACKGROUND
Despite the expanding body of literature on radial head arthroplasty, the increasing understanding of elbow anatomy, biomechanics, and kinetics, and the evolution of surgical techniques and prosthesis designs, there is currently no evidence to support one type of radial head prosthesis over another. The purposes of the present report were to review the literature and to explore the association between prosthesis design variables and the timing of surgery and the outcome of modern radial head arthroplasty.
METHODS
The literature search was limited to studies involving skeletally mature patients. Major databases were searched from January 1940 to May 2015 to identify studies relating to functional and subjective outcomes and radiographic results after radial head arthroplasty.
RESULTS
Thirty articles involving 727 patients were included. Seventy percent of the implants were made of cobalt-chromium, 15% were made of pyrocarbon, 9% were made of titanium, and 6% were made of Vitallium. Seventy percent were monopolar, and 30% were bipolar. Twenty-one percent were cemented in place, 32% were press-fit, 32% were intentionally loose-fit, and 15% were fixed with an expandable stem. The weighted average duration of follow-up was 45 months. The rate of revision ranged from 0% to 29% among studies. The incidence of revision was 8% during 2,714 person-years of follow-up across all 727 patients, yielding a crude overall revision rate of 2.06 per 100 person-years of follow-up. The revision rate was not significantly affected by prosthesis polarity, material, or fixation technique, nor was it significantly affected by the delay of treatment. There was also no significant effect of prosthesis polarity, material, or fixation technique on postoperative range of motion. The Mayo Elbow Performance Score was only reported for half of the overall patient population, but, among those patients, the combined rate of excellent and good results was 85%. Seven percent of the overall patient population underwent secondary surgery about the elbow other than revision surgery. Twenty-three percent were reported to have 1 or more complications.
CONCLUSIONS
On the basis of our analysis of the peer-reviewed English-language literature on radial head arthroplasty from January 1940 to May 2015, there seems to be no evidence to support one type of radial head prosthesis over another. The only exception is that silicone prostheses have been shown to be biologically and biomechanically insufficient.
LEVEL OF EVIDENCE
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Topics: Adult; Arthroplasty; Elbow Joint; Elbow Prosthesis; Humans; Prosthesis Design; Radius Fractures; Elbow Injuries
PubMed: 27792673
DOI: 10.2106/JBJS.RVW.15.00095 -
International Journal of Implant... Jul 2023The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.
RESULTS
Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs.
CONCLUSIONS
ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Prosthesis Failure; Titanium; Treatment Outcome; Alloys
PubMed: 37405545
DOI: 10.1186/s40729-023-00479-x -
The Journal of Prosthetic Dentistry Dec 2021Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies.... (Review)
Review
STATEMENT OF PROBLEM
Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies. Consensus is lacking regarding the most appropriate and meaningful outcome measures to use in facial prosthesis research to capture important perspectives.
PURPOSE
The purpose of the systematic review was to identify and synthesize outcome measures used in facial prosthesis research.
MATERIAL AND METHODS
Electronic searches were performed in 11 databases (including nonpeer-reviewed literature). The citations were searched, and expert societies were contacted to identify additional studies. Inclusion criteria comprised studies of participants with facial defects who required or had received prosthetic rehabilitation with an external facial prosthesis. Exclusion criteria comprised participants with ocular prostheses, case reports, case series with fewer than 5 participants, laboratory-based studies, and studies published before 1980. Study selection was performed independently by 2 reviewers. Discrepancies were resolved through discussion or by a third reviewer. Outcome measures were synthesized with a categorization approach based on the perspective, theme, and subtheme of the outcome measures. Quality assessment was performed with an appraisal tool that enabled evaluation of studies with diverse designs.
RESULTS
Database searching identified 13 058 records, and 7406 remained after duplications were removed. After initial screening, 189 potentially relevant records remained, and 186 full texts were located (98% retrieval rate). After full-text screening, 124 records were excluded. Citation searches and contact with expert societies identified 4 further records. In total, 69 articles (grouped into 65 studies) were included. Studies were categorized as per the perspective of their outcome measures, with the following findings: patient-reported (74% of studies), clinical indicators (34%), clinician-reported (8%), multiple viewpoints (6%), and independent observer-reported (3%). Patient-reported outcome measures included tools to assess satisfaction, quality of life, and psychologic health. Variability in the choice of outcome measures was evident among the studies, with many self-designed, unvalidated, condition-specific questionnaires reported. A greater number of outcome measure themes emerged over time; themes such as service delivery and health state utility have recently been evaluated.
CONCLUSIONS
Over the past 40 years, facial prosthesis research has focused on patient-reported outcome measures. Outcome measures relating to other perspectives have been used less frequently, although new themes appear to be emerging in the literature. Future research should use outcome measures with appropriate measurement properties for use with facial prosthetics.
Topics: Dental Implants; Humans; Outcome Assessment, Health Care; Quality of Life
PubMed: 33581868
DOI: 10.1016/j.prosdent.2020.09.010 -
International Orthopaedics Oct 2015The aim of the present narrative review is to report the different aspects related to the fractures around tumour prosthetic implants in terms of technical and medical... (Review)
Review
PURPOSE
The aim of the present narrative review is to report the different aspects related to the fractures around tumour prosthetic implants in terms of technical and medical issues.
METHODS
A non systematic literature review on the topic was performed.
RESULTS
Given the increased rate of limb salvage procedures and megaprostheses implanted for bone tumours, the increased number of osteoporotic periprosthetic fractures, and the burden of revision arthroplasty, the number of surgeries using endoprosthetic implants is likely to increase in the near future. Surgeons will face more frequently the complications related to tumour endoprosthetic implant. Endoprosthetic reconstruction has a higher risk of intra-operative and post-operative complications compared to conventional prosthetic replacement.
CONCLUSIONS
Very rare reports and recommendations are available in literature regarding the treatment of periprosthetic fractures after megaprosthesis, and there is currently no consensus about which should be the standard management for periprosthetic fractures in this population of patients.
Topics: Bone Neoplasms; Causality; Humans; Periprosthetic Fractures; Prostheses and Implants; Prosthesis Implantation; Reoperation; Treatment Outcome
PubMed: 26306584
DOI: 10.1007/s00264-015-2956-7 -
Clinical Oral Implants Research Sep 2015The aim of this systematic review was to identify and summarize the available literature related to CAD/CAM-fabricated implant-supported restorations. (Review)
Review
OBJECTIVES
The aim of this systematic review was to identify and summarize the available literature related to CAD/CAM-fabricated implant-supported restorations.
MATERIALS AND METHODS
A systematic review of the literature was conducted using the Cochrane Library and the US Library of Medicine, National Institute of Health databases (Pubmed). Several search runs with specific search terms were performed and combined. All published papers available on the databases up to January 15, 2015 were considered with primarily no restrictions.
RESULTS
About 12 of 3484 identified papers met the inclusion criteria and were analyzed in the present review. One paper reported results on implant-supported single crowns (SCs), one on partial fixed dental prostheses (FDPs), and 10 papers reported results on full-arch screw-retained FDPs. Publications on SCs and FDPs were very limited but it was possible to identify 10 papers reporting adequate results on full-arch screw-retained FDPs. Survival rates ranged between 92% and 100% with observation times of 1-10 years.
CONCLUSION
The available data provided promising results for CAD/CAM-fabricated implant-supported restorations; nonetheless, current evidence is limited due to the quality of available studies and the paucity of data on long-term clinical outcomes of 5 years or more. In the sense of an evidence-based dentistry, the authors recommend further studies designed as randomized controlled clinical trials and reported according to the CONSORT statement.
Topics: Computer-Aided Design; Crowns; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Evidence-Based Dentistry; Humans
PubMed: 26061615
DOI: 10.1111/clr.12633 -
Updates in Surgery Feb 2022Obstructed Defecation Syndrome (ODS) is a rather complex entity concerning mainly females and causing primarily constipation. Surgical treatment in the form of Ventral... (Meta-Analysis)
Meta-Analysis Review
Obstructed Defecation Syndrome (ODS) is a rather complex entity concerning mainly females and causing primarily constipation. Surgical treatment in the form of Ventral Prosthesis Rectopexy (VPR) has been proposed and seems to have the best outcomes. However, the selection criteria of patients to undergo this kind of operation are not clear and the reported outcomes are mainly short-term and data on long-term outcomes is scarce. This study assesses new evidence on the efficacy of VPR for the treatment of ODS, specifically focusing on inclusion criteria for surgery and the long-term outcomes. A search was performed of MEDLINE, EMBASE, Ovid and Cochrane databases on all studies reporting on VPR for ODS from 2000 to March 2020. No language restrictions were made. All studies on VPR were reviewed systematically. The main outcomes were intra-operative complications, conversion, procedure duration, short-term mortality and morbidity, length of stay, faecal incontinence and constipation, quality of life (QoL) score and patient satisfaction. Quality assessment and data extraction were performed independently by three observers. Fourteen studies including 963 patients were eligible for analysis. The immediate postoperative morbidity rate was 8.9%. A significant improvement in constipation symptoms was observed in the 12-month postoperative period for ODS (p < 0.0001). Current evidence shows that VPR offers symptomatic relief to the majority of patients with ODS, improving both constipation-like symptoms and faecal incontinence for at least 1-2 years postoperatively. Some studies report on functional results after longer follow-up, showing sustainable improvement, although in a lesser extent.
Topics: Defecation; Digestive System Surgical Procedures; Female; Humans; Prostheses and Implants; Quality of Life; Treatment Outcome
PubMed: 34665411
DOI: 10.1007/s13304-021-01177-2 -
Clinical Orthopaedics and Related... Dec 2014Recent studies have attributed adverse local tissue reactions (ALTRs) in patients with total hip arthroplasties (THAs) to tribocorrosion debris generated by modular... (Review)
Review
BACKGROUND
Recent studies have attributed adverse local tissue reactions (ALTRs) in patients with total hip arthroplasties (THAs) to tribocorrosion debris generated by modular femoral stems. The presentations of ALTR are diverse, as are the causes of it, and the biological responses can be important reasons for failure after THA.
QUESTION/PURPOSES
(1) What clinical problems have been reported in patients with modular stems since 1988? (2) What THA design features are associated with tribocorrosion in taper junctions? (3) What are the microscopic and tribological characteristics of the debris produced at the taper junctions? (4) What are the cellular and immunological traits of the biological response to taper tribocorrosion debris?
METHODS
We conducted a systematic review using MEDLINE and EMBASE-cited articles to summarize failure modes associated with modular femoral stems. One hundred sixty-two of 1043 articles reported on the clinical performances or failure modes attributed to modular femoral stems. There were 10 laboratory studies, 26 case reports, 13 Level IV, 94 Level III, 18 Level II, and one Level I of Evidence papers. To address the remaining questions, we did a second review of 524 articles. One hundred twenty-seven articles met the eligibility criteria, including 81 articles on design features related to tribocorrosion, 15 articles on corrosion debris characteristics, and 31 articles on the biological response to tribocorrosion debris.
RESULTS
Sixty-eight of 162 studies reported failure attributed to modular femoral stems for one of these four modularity-related failure modes: tribocorrosion-associated ALTR, dissociation of a taper junction, stem fracture, and mismatch of a femoral head taper attached to a stem with a different trunnion size. The remaining 94 studies found no clinical consequences related to the presence of a taper junction. THA component features associated with tribocorrosion included trunnion geometry and large-diameter femoral heads. Solid tribocorrosion debris is primarily chromium-orthophosphate material of variable size and may be more biologically reactive than wear debris.
CONCLUSIONS
There has been an increase in publications describing ALTR around modular hip prostheses in the last 3 years. Implant design changes, including larger femoral heads and smaller trunnions, have been implicated, but there may also be more recognition of the problem by the orthopaedic community. Analyzing retrieved implants to understand the history of taper-related problems, designing clinically relevant in vitro corrosion tests to test modular junctions, and identifying biomarkers to recognize patients at risk of ALTR should be the focus of ongoing research to help surgeons avoid and detect tribocorrosion-related problems in joint replacements.
Topics: Arthroplasty, Replacement, Hip; Biomechanical Phenomena; Corrosion; Femur; Foreign-Body Migration; Hip Joint; Hip Prosthesis; Humans; Metals; Prosthesis Design; Prosthesis Failure; Risk Factors; Stress, Mechanical; Treatment Outcome
PubMed: 24980639
DOI: 10.1007/s11999-014-3746-z