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Medicina (Kaunas, Lithuania) Nov 2023: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. : A review of the... (Review)
Review
: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. : A review of the literature was carried out using the following online databases: Embase, The Cochrane Library, MEDLINE-PubMed and Google Scholar. Our search was limited to articles from 2010 to 2023. The search terms consisted of keywords and MeSH terms, which were 'deep margin elevation', 'coronal margin relocation', 'periodontium' and 'periodontal tissues'. The literature was searched thoroughly by two reviewers. Initially, the titles of the articles were extracted. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles. A total of twelve articles, including one randomized clinical trial, three systematic reviews, two prospective cohort, three case series, one a clinical study, one pilot study and one a retrospective study, were selected and analyzed. The review suggests potential benefits of Deep Margin Elevation (DME) over surgical crown lengthening due to reduced invasiveness, yet conclusive effects on periodontal tissue remain unclear, warranting further studies on clinical parameters and inflammatory biomarkers.
Topics: Humans; Prospective Studies; Pilot Projects; Retrospective Studies; Periodontium; Periodontal Ligament; Randomized Controlled Trials as Topic
PubMed: 38003997
DOI: 10.3390/medicina59111948 -
Journal of Taibah University Medical... Apr 2024This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of... (Review)
Review
OBJECTIVES
This research was aimed at assessing comprehension, attitudes, and perspectives regarding artificial intelligence (AI) in dentistry. The null hypothesis was a lack of foundational understanding of AI in dentistry.
METHODS
This systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in May 2023. The eligibility criteria included cross-sectional studies published in English until July 2023, focusing solely on dentists or dental students. Data on AI knowledge, use, and perceptions were extracted and assessed for bias risk with the Joanna Briggs Institute checklist.
RESULTS
Of 408 publications, 22 relevant articles were identified, and 13 studies were included in the review. The average basic AI knowledge score was 58.62 % among dental students and 71.75 % among dentists. More dental students (72.01 %) than dentists (62.60 %) believed in AI's potential for advancing dentistry.
CONCLUSIONS
Thorough AI instruction in dental schools and continuing education programs for practitioners are urgently needed to maximize AI's potential benefits in dentistry. An integrated PhD program could drive revolutionary discoveries and improve patient care globally. Embracing AI with informed understanding and training will position dental professionals at the forefront of technological advancements in the field.
PubMed: 38293587
DOI: 10.1016/j.jtumed.2023.12.010 -
Diagnostics (Basel, Switzerland) Jul 2023Deep learning and diagnostic applications in oral and dental health have received significant attention recently. In this review, studies applying deep learning to... (Review)
Review
Deep learning and diagnostic applications in oral and dental health have received significant attention recently. In this review, studies applying deep learning to diagnose anomalies and diseases in dental image material were systematically compiled, and their datasets, methodologies, test processes, explainable artificial intelligence methods, and findings were analyzed. Tests and results in studies involving human-artificial intelligence comparisons are discussed in detail to draw attention to the clinical importance of deep learning. In addition, the review critically evaluates the literature to guide and further develop future studies in this field. An extensive literature search was conducted for the 2019-May 2023 range using the Medline (PubMed) and Google Scholar databases to identify eligible articles, and 101 studies were shortlisted, including applications for diagnosing dental anomalies ( = 22) and diseases ( = 79) using deep learning for classification, object detection, and segmentation tasks. According to the results, the most commonly used task type was classification ( = 51), the most commonly used dental image material was panoramic radiographs ( = 55), and the most frequently used performance metric was sensitivity/recall/true positive rate ( = 87) and accuracy ( = 69). Dataset sizes ranged from 60 to 12,179 images. Although deep learning algorithms are used as individual or at least individualized architectures, standardized architectures such as pre-trained CNNs, Faster R-CNN, YOLO, and U-Net have been used in most studies. Few studies have used the explainable AI method ( = 22) and applied tests comparing human and artificial intelligence ( = 21). Deep learning is promising for better diagnosis and treatment planning in dentistry based on the high-performance results reported by the studies. For all that, their safety should be demonstrated using a more reproducible and comparable methodology, including tests with information about their clinical applicability, by defining a standard set of tests and performance metrics.
PubMed: 37568875
DOI: 10.3390/diagnostics13152512 -
Clinical Oral Implants Research Sep 2023The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or... (Meta-Analysis)
Meta-Analysis Review
Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area.
OBJECTIVE
The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iS C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.
METHODS
Electronic and manual searches were performed to identify randomized-, prospective-, and retrospective clinical trials with follow-up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iS Cs. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Thirty-two studies reporting on 42 study arms were included in the present systematic review. The meta-analysis of the included studies indicated estimated 3-year survival rates of 98.3% (95%CI: 95.6-99.3%) for porcelain-fused-to-metal (PFM) iFDPs, 97.5% (95%CI: 95.5-98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8-99.6%) for monolithic or micro-veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8-99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6-99.3%] vs. 99.1% [95%CI: 97.6-99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iS Cs.
CONCLUSIONS
Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS Cs showed similarly high short-term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.
Topics: Prospective Studies; Retrospective Studies; Dental Prosthesis Design; Dental Restoration Failure; Dental Porcelain; Ceramics; Zirconium; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 37750526
DOI: 10.1111/clr.14103 -
The Journal of Oral Implantology Dec 2023Dental implants are a predictable option to replace missing teeth. Patients on antiresorptive medications used to treat disorders associated with bone resorption may... (Meta-Analysis)
Meta-Analysis
Dental implants are a predictable option to replace missing teeth. Patients on antiresorptive medications used to treat disorders associated with bone resorption may need dental implants to replace missing teeth. The data on implant failure in patients on antiresorptive medication requiring dental implants, is conflicting and limited. This systematic review aims to investigate if antiresorptive medications have any clinical impact on dental implant survival. Electronic databases were searched until May 2020. The focus question (PICOS): Participants: humans, Interventions: implant placement surgery in patients on antiresorptive medication, Comparisons: patients on antiresorptive medication vs control (patients not on antiresorptive medication), Outcomes: implant survival, and Study design: clinical studies. The protocol of this systematic review was registered in PROSPERO (CRD42020209083). Fourteen nonrandomized studies were selected for data extraction and risk of bias assessment using the ROBINS-1 tool. Only studies with a control were included for the meta-analysis, 8 articles were included in the meta-analysis using implant-level data, and 5 articles were included in the meta-analysis using patient-level data. There was no statistical significance between the 2 groups at the patient level based on 265 patients. However, there was a statistically significant difference at the implant level based on 2697 implants. Therefore, antiresorptive medications, mainly bisphosphonates (BPs), may significantly contribute to implant failure. Antiresorptive medications, especially BPs may reduce implant survival and impair the osseointegration of dental implants. Failed implants in patients on BPs may not lead to osteonecrosis and may be replaced with success.
Topics: Humans; Dental Implants; Bone Density Conservation Agents; Diphosphonates; Osteonecrosis; Osseointegration
PubMed: 37905745
DOI: 10.1563/aaid-joi-D-21-00160 -
Journal of Clinical Periodontology Feb 2024The epidemiological relationship between periodontitis and caries remains controversial, and evidence synthesis is currently lacking. Therefore, this systematic review... (Meta-Analysis)
Meta-Analysis Review
AIM
The epidemiological relationship between periodontitis and caries remains controversial, and evidence synthesis is currently lacking. Therefore, this systematic review was designed to answer the following PECO question: 'In human adults (P), do subjects suffering from periodontitis (E) have higher presence/number of untreated carious lesions and caries experience (O) than subjects not suffering from periodontitis (C)?'.
MATERIALS AND METHODS
Observational studies that met specific inclusion criteria established to answer to the PECO question were included. Two review authors independently searched for eligible studies, screened the titles and abstracts, carried out the full text analysis, extracted the data and performed the risk of bias assessment. In case of disagreement, a third review author took the final decision during ad hoc consensus meetings. Data synthesis was carried out through random-effects meta-analyses.
RESULTS
A total of 18 studies on 21 cohorts, involving 135,018 participants, were included. Meta-analyses showed a significant association between periodontitis and the presence of at least one tooth with either untreated carious lesions (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.32-2.01; p <.00; I = 83.0%) or caries experience (decayed and filled teeth ≥ 1) (OR = 1.27; 95% CI: 1.01-1.59; p = .038; I = 90.0%). Moreover, subjects with periodontitis exhibited a higher number of surfaces (difference in means [MD] = 0.86; 95% CI: 0.46-1.27; p <.001; I = 0.0%) and teeth (MD = 0.35; 95% CI: 0.28-0.42; p <.001; I = 69.6%) with untreated carious lesions, as well as a higher number of teeth with caries experience (standardized difference in means [SMD] = 1.46; 95% CI: 0.15-2.78; p = .029; I = 98.9%) compared with those without periodontitis. Sensitivity analyses focusing on severe periodontitis as exposure mostly showed consistent results. Estimates for caries experience were only slightly attenuated in adjusted models compared with crude models. Subgroup analyses by caries location also indicated that periodontitis was associated only with root caries, while it was not with caries affecting the anatomical crown.
CONCLUSIONS
Periodontitis was found to be associated with the presence and number of treated/untreated root carious lesions. Therefore, caries-specific preventive measures (e.g., fluorides) should be considered for individuals with periodontitis.
Topics: Adult; Humans; Dental Caries; Periodontitis; Fluorides; Dental Care; Root Caries
PubMed: 38084804
DOI: 10.1111/jcpe.13910 -
Clinical Oral Implants Research Nov 2023To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri-implantitis (E) and peri-implant... (Meta-Analysis)
Meta-Analysis Review
AIM
To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri-implantitis (E) and peri-implant health/mucositis (C) in terms of bacterial presence/count (O)?"
MATERIALS AND METHODS
Cross-sectional studies fulfilling specific inclusion criteria established to answer the PECO question were included. Two review authors independently searched for studies, screened the titles and abstracts, did full-text analysis, extracted the data from the included reports, and performed the risk of bias assessment through an adaptation of the Newcastle/Ottawa tool for cross-sectional studies and of the JBI critical appraisal checklist. In case of disagreement, a third reviewer author took the final decision. Study results were summarized using random effects meta-analyses.
RESULTS
A total of 12 studies were included, involving 1233 participants and 1513 implants. Peri-implantitis was associated with the presence of S. epidermidis (Odds ratio, OR = 10.28 [95% Confidence interval, CI: 1.26-83.98]), F. nucleatum (OR = 7.83 [95% CI: 2.24-27.36]), T. denticola (OR = 6.11 [95% CI: 2.72-13.76]), T. forsythia (OR = 4.25 [95% CI: 1.71-10.57]), P. intermedia (OR = 3.79 [95% CI: 1.07-13.35]), and P. gingivalis (OR = 2.46 [95% CI: 1.21-5.00]). Conversely, the presence of A. actinomycetemcomitans (OR = 3.82 [95% CI: 0.59-24.68]), S. aureus (OR = 1.05 [95% CI: 0.06-17.08]), and C. rectus (OR = 1.48 [95% CI: 0.69-3.17]) was not associated with peri-implantitis.
CONCLUSIONS
Peri-implantitis is associated with the presence of S. epidermidis and specific periodontopathogens (P. gingivalis, T. forsythia, T. denticola, F. nucleatum, and P. intermedia). (CRD42021254589).
Topics: Humans; Peri-Implantitis; Staphylococcus aureus; Cross-Sectional Studies; Porphyromonas gingivalis; Microbiota; Dental Implants
PubMed: 37523470
DOI: 10.1111/clr.14153 -
The International Journal of Oral &... Oct 2023To assess the survival rate (SR) and probability of postoperative complications at both the implant and patient level for each of the four surgical techniques for... (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the survival rate (SR) and probability of postoperative complications at both the implant and patient level for each of the four surgical techniques for zygomatic implant (ZI) placement: Brånemark, sinus slot, extrasinus, and extramaxillary.
MATERIALS AND METHODS
A systematic literature review and meta-analysis of clinical studies that reported the survival rate and postoperative ZI complications for the rehabilitation of atrophic edentulous maxillae was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. Two independent reviewers consulted four databases during the literature search: MEDLINE (PubMed), Google Scholar, Clinicaltrials.gov, and LILACS. Duplicate articles were eliminated.
RESULTS
A total of 35 studies were included in the meta-analysis. Subgroup analysis showed that study design (prospective vs retrospective) had no significant impact (P = .10) on the outcomes. The SR was highest for the Brånemark and extrasinus techniques (100%) and lowest for the sinus slot technique (94%; 95% CI = 86% to 102%). The extramaxillary (38%; 95% CI = 1% to 3%) and the Brånemark (29%; 95% CI = 15% to 44%) techniques resulted in the highest occurrence of patient-level complications. Moreover, the extramaxillary technique showed the highest percentage of prothesis-related complications (44%; 95% CI = 27% to 62%).
CONCLUSIONS
ZI placement was demonstrated to be a reliable technique for the rehabilitation of severely atrophic maxillae, irrespective of the surgical technique evaluated. Accurate case and surgical protocol selection is of paramount importance to reduce technique-related postoperative complications.
Topics: Humans; Dental Implants; Retrospective Studies; Prospective Studies; Survival Rate; Dental Implantation, Endosseous; Postoperative Complications; Zygoma; Maxilla; Dental Prosthesis, Implant-Supported; Jaw, Edentulous; Follow-Up Studies
PubMed: 37847828
DOI: 10.11607/jomi.10330 -
The Journal of Prosthetic Dentistry May 2024The increasing use of computer-aided design and computer-aided manufacturing (CAD-CAM) systems has led to the development of resin-ceramic materials that meet the... (Review)
Review
STATEMENT OF PROBLEM
The increasing use of computer-aided design and computer-aided manufacturing (CAD-CAM) systems has led to the development of resin-ceramic materials that meet the requirements of minimally invasive dentistry, including the resin nanoceramic (RNC) and polymer-infiltrated ceramic network (PICN). The wear characteristics of these materials are unclear.
PURPOSE
The purpose of this systematic review was to compare the wear resistance of resin-ceramic materials when compared with one another or with lithium disilicate glass-ceramics.
MATERIAL AND METHODS
The PubMed, Scopus, and DOSS search engines were used to identify articles published between 2013 and 2021. Two independent researchers conducted the systematic review by following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and by following a combination of keywords.
RESULTS
Of a total of 310 articles, 26 were selected, including only 1 clinical study. Among these, 15 compared resin-ceramic materials with each other, while 11 compared resin-ceramic materials with lithium disilicate ceramics. Two types of wear were used to compare the materials: attrition and abrasion. The most commonly studied materials were 2 RNCs (Lava Ultimate and Cerasmart), 1 PICN (Vita Enamic), and 1 ceramic (IPS e.max CAD). Among the resin-ceramic materials, the PICN (Vita Enamic) showed less wear than the RNCs. Of the RNCs, Cerasmart had less attrition wear and less wear of the opposing teeth.
CONCLUSIONS
Lithium disilicate glass-ceramics have a higher wear resistance than resin-ceramic materials, but they cause more wear of the opposing teeth.
Topics: Computer-Aided Design; Ceramics; Humans; Dental Porcelain; Dental Restoration Wear; Dental Materials; Resins, Synthetic
PubMed: 35459543
DOI: 10.1016/j.prosdent.2022.01.027 -
International Endodontic Journal Aug 2024Limited evidence is available regarding the superior clinical properties of bioceramic sealers comparted with traditional standard sealers. (Meta-Analysis)
Meta-Analysis Comparative Study Review
The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: A systematic review and meta-analysis.
BACKGROUND
Limited evidence is available regarding the superior clinical properties of bioceramic sealers comparted with traditional standard sealers.
OBJECTIVES
This review aimed to answer the following research questions: 'In healthy patients requiring a root canal treatment (P), what is the efficacy of premixed bioceramic sealers (I) compared with traditional root canal epoxy resin-based sealers (C) in terms of survival, success rates (PICO1) sealer extrusion and resorption (PICO2) post-obturation pain (PICO3) (O)?'
METHODS
Authors independently searched three electronic databases: PubMed (including MEDLINE), Web of Science, Embase and Scopus up to 31 October 2023. This was accompanied by both grey literature and manual search. Detailed selection criteria were applied, namely mature permanent teeth requiring root canal treatment, premixed bioceramic sealer with gutta-percha as an intervention group, a standard filling technique as control group and full-text available in English. A random-effect meta-analysis was used to synthesize the body of evidence regarding the use of bioceramic sealers in root canal treatment and their impact on post-obturation pain. Effect sizes were represented as relative risks on a logarithmic scale for binary outcomes and as mean differences for continuous outcomes.
RESULTS
A total of 941 articles were identified. Fifteen Comparative clinical studies were finally included. Eleven were randomized clinical trials, and four were prospective clinical trials with control group. The follow-up of these studies was not greater than 2 years. No publication bias was observed in any study. No significant differences were observed between the two groups in terms of survival and success rates. A small non-significant lower risk of extrusion was observed for bioceramics. A small, non-significantly lower post-operative-pain within 24-h was observed when bioceramics were used.
DISCUSSION
The majority of current evidence shows inconsistencies in reporting and is of short-term duration. Robust prospective long-term trials are needed in this area to better support future recommendations.
CONCLUSION
This systematic review is the first to analyse several clinical outcomes using premixed sealers. Included studies differed in terms of clinical protocol and operator expertise, but reported a similar outcome when comparing bioceramic versus standard sealers. Tooth survival, treatment outcome, post-operative pain and periapical extrusion were similar and presented no significant differences between the two sealer types.
REGISTRATION
PROSPERO database (CRD42023449151).
Topics: Humans; Root Canal Filling Materials; Treatment Outcome; Root Canal Obturation; Ceramics; Root Canal Therapy; Pain, Postoperative; Epoxy Resins; Gutta-Percha
PubMed: 38606520
DOI: 10.1111/iej.14069