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Clinical and Experimental Dental... Dec 2021Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in... (Review)
Review
OBJECTIVES
Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts.
MATERIALS AND METHODS
A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references.
RESULTS
After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies.
CONCLUSION
Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.
Topics: Alloys; Dental Implants; Fibroblasts; Materials Testing; Titanium
PubMed: 34018703
DOI: 10.1002/cre2.444 -
The British Journal of Oral &... Jul 2023Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The... (Meta-Analysis)
Meta-Analysis Review
Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The purpose of this systematic review and meta-analysis was to evaluate clinical evidence, including survival rates, success rates, and marginal bone loss (MBL) on Ti-Zr NDIs that support single crowns. An extensive search was performed in the databases of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for studies published in English up to April 2022. Only peer-reviewed clinical studies with at least 10 patients and a follow-up time of at least 12 months were included. Risk of bias in each study was assessed and data extraction was carried out independently by two reviewers. The outcome variables were survival rates, success rates, and MBL. The search returned 779 results. Eight studies were identified for qualitative analysis and seven for quantitative synthesis. Overall, a total of 256 Ti-Zr NDIs were included. Cumulative implant survival rates and success rates were 97.5% (95% confidence interval (CI): 94.5% to 98.9%) and 97.2% (95% CI: 94.2% to 98.7%), respectively, over a maximum follow-up period of 36 months, with no difference between Ti-Zr NDIs and commercial pure titanium (cpTi) implants. Cumulative mean (SD) MBL was 0.44 (0.04) mm (95% CI: 0.36 to 0.52) after one year. Meta-analysis of MBL indicated a mean difference of 0.02 mm (95% CI: -0.23 to 0.10), with no differences between Ti-Zr NDIs and cpTi implants. Short-term results of Ti-Zr NDIs for single-crown restorations are quite promising, although the number of published studies and follow-up periods are insufficient to determine the real benefit for single crowns. Long-term, follow-up clinical studies are needed to verify the excellent clinical performance of Ti-Zr NDIs.
Topics: Humans; Titanium; Zirconium; Dental Prosthesis Design; Alloys; Crowns; Dental Implants; Dental Restoration Failure
PubMed: 37331853
DOI: 10.1016/j.bjoms.2023.05.005 -
Frontiers in Bioscience (Landmark... Dec 2021The fracture of endodontic instruments inside the canal represents a problem that is not always easy to solve. The reutilization of endodontic instruments after... (Meta-Analysis)
Meta-Analysis Review
The fracture of endodontic instruments inside the canal represents a problem that is not always easy to solve. The reutilization of endodontic instruments after sterilization procedures raises the question of how these processes affect their physical and mechanical properties. Alterations can involve the surface of the instruments, as well as their cutting effectiveness, shape and resistance to torsional and cyclic fatigue. The methodology adopted for this systematic review followed the PRISMA guidelines for systematic reviews. The following search terms were used in PubMed and Scopus: "endodontic sterilization", "endodontic autoclave", "cyclic fatigue", "torsional", "cutting efficiency", "sterilization", "surface characteristics" and "corrosion". After the screening phase, the application of exclusion criteria and the removal of duplicates, 51 studies were identified and divided into four outcomes: cyclic fatigue; deformation and torsional fatigue; corrosion or surface alterations; and cutting efficiency. Our study of the scientific literature highlights disagreements between studies on these effects. After autoclaving, instruments exhibit a reduction in the cutting efficiency, but NiTi alloy instruments have an improved resistance to cyclic and torsional fatigue.
Topics: Equipment Failure; Materials Testing; Network Meta-Analysis; Root Canal Preparation; Sterilization; Stress, Mechanical
PubMed: 34994183
DOI: 10.52586/5062 -
PeerJ 2022Titanium dioxide dental implants have a controversial effect on reactive oxygen species (ROS) production. ROS is necessary for cellular signal transmission and proper... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Titanium dioxide dental implants have a controversial effect on reactive oxygen species (ROS) production. ROS is necessary for cellular signal transmission and proper metabolism, but also has the ability to cause cell death as well as DNA, RNA, and proteins damage by excessive oxidative stress. This study aimed to systematically review the effect of titanium dioxide dental implant-induced oxidative stress and its role on the osteogenesis-angiogenesis coupling in bone remodeling.
METHODS
This systematic review was performed conforming to preferred reporting items for systematic review and meta-analysis (PRISMA) model. Four different databases (PubMed, Science Direct, Scopus and Medline databases) as well as manual searching were adopted. Relevant studies from January 2000 till September 2021 were retrieved. Critical Appraisal Skills Programme (CASP) was used to assess the quality of the selected studies.
RESULTS
Out of 755 articles, only 14 which met the eligibility criteria were included. Six studies found that titanium dioxide nanotube (TNT) reduced oxidative stress and promoted osteoblastic activity through its effect on Wnt, mitogen-activated protein kinase (MAPK) and forkhead box protein O1 (FoxO1) signaling pathways. On the other hand, three studies confirmed that titanium dioxide nanoparticles (TiONPs) induce oxidative stress, reduce ostegenesis and impair antioxidant defense system as a significant negative correlation was found between decreased SIR3 protein level and increased superoxide (O ). Moreover, five studies proved that titanium implant alloy enhances the generation of ROS and induces cytotoxicity of osteoblast cells via its effect on NOX pathway.
CONCLUSION
TiONPs stimulate a wide array of oxidative stress related pathways. Scientific evidence are in favor to support the use of TiO nanotube-coated titanium implants to reduce oxidative stress and promote osteogenesis in bone remodeling. To validate the cellular and molecular cross talk in bone remodeling of the present review, well-controlled clinical trials with a large sample size are required.
Topics: Reactive Oxygen Species; Titanium; Dental Implants; Oxidative Stress; Bone Remodeling
PubMed: 35261818
DOI: 10.7717/peerj.12951 -
Frontiers in Bioengineering and... 2021Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of...
Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of Science were searched using keyword combinations such as microbes and oral and corrosion; microbes and dental and corrosion; microorganisms and oral and corrosion; microorganisms and dental and corrosion. Out of 141 articles, only 25 satisfied the selection criteria. s, sulfate-reducing bacteria, sulfate oxidizing bacteria, Veilonella, Actinomyces, were found to have a potential association with corrosion of intraoral metallic alloys such as stainless steel, titanium, nickel, cobalt-chromium, neodymium-iron-boron magnets, zirconia, amalgam, copper aluminum, and precious metal alloys. The included studies inferred an association between oral microorganisms and intra-oral metallic alloys-based dental appliances, although, it is vital to acknowledge that most studies in the review employed an simulation of the intra-oral condition.
PubMed: 33791285
DOI: 10.3389/fbioe.2021.631103 -
The Cochrane Database of Systematic... Oct 2016Childhood caries (tooth decay) consists of a form of tooth decay that affects the milk teeth (also known as baby or primary teeth) of children. This may range from tooth... (Review)
Review
BACKGROUND
Childhood caries (tooth decay) consists of a form of tooth decay that affects the milk teeth (also known as baby or primary teeth) of children. This may range from tooth decay in a single tooth to rampant caries affecting all the teeth in the mouth. Primary teeth in young children are vital to their development and every effort should be made to retain these teeth for as long as is possible. Dental fillings or restorations have been used as an intervention to repair these damaged teeth. Oral health professionals need to make astute decisions about the type of restorative (filling) material they choose to best manage their patients with childhood caries. This decision is by no means an easy one as remarkable advances in dental restorative materials over the last 10 years has seen the introduction of a multitude of different filling materials claiming to provide the best performance in terms of durability, aesthetics, symptom relief, etc when placed in the mouth. This review sought to compare the different types of dental materials against each other for the same outcomes.
OBJECTIVES
The objective of this review was to compare the outcomes (including pain relief, survival and aesthetics) for restorative materials used to treat caries in the primary dentition in children. Additionally, the restoration of teeth was compared with extraction and no treatment.
SEARCH METHODS
Electronic searches of the following databases were undertaken: the Cochrane Oral Health Group's Trials Register (up to January 2009); CENTRAL (The Cochrane Library 2009, Issue1); MEDLINE (1966 to January 2009); EMBASE (1996 to January 2009); SIGLE (1976 to 2004); and conference proceedings on early childhood caries, restorative materials for paediatric dentistry, and material sciences conferences for dental materials used for children's dentistry (1990 to 2008). The searches attempted to identify all relevant studies irrespective of language.Additionally, the reference lists from articles of eligible papers were searched, handsearching of key journals was undertaken, and personal communication with authors and manufacturers of dental materials was initiated to increase the pool of suitable trials (both published and unpublished) for inclusion into this review.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-randomised controlled trials with a minimum period of 6 months follow up were included. Both parallel group and split-mouth study designs were considered. The unit of randomisation could be the individual, group (school, school class, etc), tooth or tooth pair. Included studies had a drop-out rate of less than 30%. The eligible trials consisted of young children (children less than 12 years) with tooth decay involving at least one tooth in the primary dentition which was symptomatic or symptom free at the start of the study.
DATA COLLECTION AND ANALYSIS
Data were independently extracted, in duplicate, by two review authors. Disagreements were resolved by consultation with a third review author. Authors were contacted for missing or unclear information regarding randomisation, allocation sequence, presentation of data, etc. A quality assessment of included trials was undertaken. The Cochrane Collaboration statistical guidelines were followed for data analysis.
MAIN RESULTS
Only three studies were included in this review. The Fuks 1999 study assessed the clinical performance of aesthetic crowns versus conventional stainless steel crowns in 11 children who had at least two mandibular primary molars that required a crown restoration. The outcomes assessed at 6 months included gingival health (odds ratio (OR) 0.3; 95% confidence interval (CI) 0.01 to 8.32), restoration failure (OR 3.29; 95% CI 0.12 to 89.81), occlusion, proximal contact and marginal integrity. The odds ratios for occlusion, proximal contact and marginal integrity could not be estimated as no events were recorded at the 6-month evaluation. The Donly 1999 split-mouth study compared a resin-modified glass ionomer (Vitremer) with amalgam over a 36-month period. Forty pairs of Class II restorations were placed in 40 patients (21 males; 19 females; mean age 8 years +/- 1.17; age range 6 to 9 years). Although the study period was 3 years (36 months), only the 6- and 12-month results are reported due to the loss to follow up of patients being greater than 30% for the 24- and 36-month data. Marks 1999a recruited 30 patients (age range 4 to 9 years; mean age 6.7 years, standard deviation 2.3) with one pair of primary molars that required a Class II restoration. The materials tested were Dyract (compomer) and Tytin (amalgam). Loss to follow up at 24 and 36 months was 20% and 43% respectively. This meant that only the 24-month data were useable. For all of the outcomes compared in all three studies, there were no significant differences in clinical performance between the materials tested.No studies were found that compared restorations versus extractions or no treatment as an intervention in children with childhood caries.
AUTHORS' CONCLUSIONS
It was disappointing that only three trials that compared three different types of materials were suitable for inclusion into this review. There were no significant differences found in all three trials for all of the outcomes assessed. Well designed, randomised controlled trials comparing the different types of filling materials for similar outcomes are urgently needed in dentistry. There was insufficient evidence from the three included trials to make any recommendations about which filling material to use.
Topics: Child; Child, Preschool; Compomers; Composite Resins; Crowns; Dental Alloys; Dental Amalgam; Dental Caries; Dental Materials; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 27748505
DOI: 10.1002/14651858.CD004483.pub3 -
Heliyon Dec 2022Critically analyzed the existing literature to answer the question "What is the influence of roughness of surfaces for dental implants obtained by additive manufacturing...
OBJECTIVE
Critically analyzed the existing literature to answer the question "What is the influence of roughness of surfaces for dental implants obtained by additive manufacturing compared to machined on osteoblastic cell adhesion and proliferation?"
DESIGN
This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the Open Science Framework. The personalized search strategy was applied to Embase, Pub Med, Scopus, and Science Direct databases and Google Scholar and ProQuest grey literature. The selection process was carried out in two stages independently by two reviewers according to the eligibility criteria. The risk of bias was analyzed using a checklist of important parameters to be considered.
RESULTS
When applying the search strategy on databases 223 articles were found, after removing the duplicates, 171 were analyzed by title and abstract of which 25 were selected for full reading, of these, 6 met the eligibility criteria. 2 studies were included from the reference list totaling 8 articles included in this systematic review and none were included from the Grey Literature. 7 had a low risk of bias and 1 moderate.
CONCLUSIONS
1) Roughness is a property that must be analyzed and correlated with the chemical composition, intrinsic to the alloy and resulting from the surface treatment; morphology of topographic peaks and valleys; printing technique and its parameters; 2) Need for more studies on the biomolecular level to elucidate the mechanism by which the roughness and the morphology of topographical peaks and valleys descriptive of roughness influence osteoblastic adhesion and proliferation.
PubMed: 36643331
DOI: 10.1016/j.heliyon.2022.e12505 -
The Cochrane Database of Systematic... Jul 2019Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially... (Review)
Review
BACKGROUND
Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients.
OBJECTIVES
To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction.
SEARCH METHODS
We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials.
SELECTION CRITERIA
Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review.
DATA COLLECTION AND ANALYSIS
Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data.
MAIN RESULTS
Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs.
AUTHORS' CONCLUSIONS
Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.
PubMed: 31425605
DOI: 10.1002/14651858.CD003814.pub3 -
Materials (Basel, Switzerland) Aug 2022The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the... (Review)
Review
The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the CLP regulation (EC) 1972/2008. : The objective of this review is to conduct a rigorous analysis of the cytocompatibility of cobalt-chromium (Co-Cr) dental alloys. Considering various parameters such as cytotoxicity, type IV hypersensitivity reaction, sensitization, and irritation, we investigated evidence of toxicity of Co-Cr in human dental applications. : Specific search strategies were performed in three electronic databases, namely , , and , using a main restriction in the search regarding the publication date (1995-2022). : Out of a total of 836 articles, only 21 studies were selected and analyzed according to PRISMA methodology. : Among them, 10 in vitro studies using human samples and 11 in vivo studies on human patients were distinguished. Most of the in vitro studies confirmed that Co-Cr alloys have a good cytocompatibility compared to Ni alloys. Regarding the in vivo studies, it appeared that Co-Cr could rarely cause sensitization, irritation, and allergic reactions. Reactions were mainly observed for people allergic to Co or Cr. Nevertheless, titanium-based materials showed better results. : This study proposes a new state of the art on Co-Cr dental alloys and will thus be very useful for carrying out additional studies. : This review will help practitioners in their daily clinical choice.
PubMed: 36079183
DOI: 10.3390/ma15175801 -
Gels (Basel, Switzerland) Jan 2024The aim of the presented systematic review is to update the state of knowledge and relate the properties and composition of fluoride gels to their potential application.... (Review)
Review
The aim of the presented systematic review is to update the state of knowledge and relate the properties and composition of fluoride gels to their potential application. This article aims to explore the effect of fluoride gel application on changes in the properties of dental biomaterials and tooth tissues. The review includes articles assessing studies on the effects of fluoride gel on dental tissues and materials. Employing the PRISMA protocol, a meticulous search was conducted across the PubMed, Scopus, and Web of Science databases, utilizing keywords such as fluoride, gel, and properties. The publications were selected without limitation by the year of publication, and then Cohen's κ test was used to assess the agreement of the respondents. Exclusion criteria included non-English studies, opinion pieces, editorial papers, letters to the editor, review articles and meta-analyses, clinical reports, studies lacking full-text accessibility, and duplicates. The quality of the chosen papers was assessed by two independent reviewers. A total of 2385 were located in databases, of which only 17 met the inclusion criteria. All publications showed increased surface mineralization, and seven studies showed the effect of fluoride gel on the surface of dental tissues. Three articles stated a negative effect of fluoride gels on titanium and stainless steel alloys and glass ionomer fillings. The effects on shear bond strength and plaque deposition require further investigation because the study results are contradictory.
PubMed: 38391429
DOI: 10.3390/gels10020098