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Nigerian Journal of Clinical Practice Sep 2023Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients.... (Review)
Review
Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Humans; Middle Aged; Young Adult; Anodontia; Dental Implants; Dental Prosthesis, Implant-Supported; Immediate Dental Implant Loading; Tooth Loss
PubMed: 37794532
DOI: 10.4103/njcp.njcp_884_22 -
Evidence-based Dentistry Dec 2023To evaluate the performance of complete-arch implant-supported fixed dental prostheses (FDPs) fabricated with polyetheretherketone (PEEK) and polyetherketoneketone...
PURPOSE
To evaluate the performance of complete-arch implant-supported fixed dental prostheses (FDPs) fabricated with polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) framework in clinical cases.
MATERIALS AND METHODS
This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews with the number CRD42023399494. The electronic database PubMed, Cochrane Library and EBSCOhost were assessed for clinical research and reports on complete-arch implant-supported FDPs fabricated with PEEK and PEKK framework. Human studies with a minimum follow-up of 1 year and published in an English language were the only ones included.
RESULTS
The initial database and hand search provided 564 articles. Finally, 12 articles published between 2018 and 2022 were included in this systematic review. The mean follow-up ranged from 1 year to 6 years. The included studies reported 119 (114 PEEK, 5 PEKK) complete-arch implant-supported FDPs during 1 year follow-up. The cumulative survival rate of prostheses with PEEK as a framework was 97.3%. Prostheses fractures and complications were found with both PEEK and PEKK frameworks. No implant failure reported with both PEEK and PEKK prostheses.
CONCLUSION
In short-term follow-up, the complete-arch implant-supported FDPs with PEEK as a framework showed a good survival rate and acceptable health of the supporting tissues. The PEEK framework had shown adhesion issues as the most common prosthetic complication. Limited data were available on PEKK as framework material, so further long-term clinical trials are required.
Topics: Humans; Dental Implants; Dental Restoration Failure; Dental Prosthesis, Implant-Supported; Polyethylene Glycols; Ketones
PubMed: 37674039
DOI: 10.1038/s41432-023-00928-x -
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 -
The Journal of Prosthetic Dentistry Nov 2023Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported... (Review)
Review
Predictability of single versus double-barrel vascularized fibula flaps and dental implants in mandibular reconstructions: A systematic review and meta-analysis of prospective studies.
STATEMENT OF PROBLEM
Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported prosthesis. Although the double-flap technique seems promising, systematic reviews and meta-analyses of prospective studies are lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the grafted areas of single barrel fibular flaps (SBFF) and double-barrel fibular flaps (DBFF) by considering failure rates, dental implant complications, and bone union at the osteotomy sites.
MATERIAL AND METHODS
A systematic review and meta-analysis was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, population, intervention, control, and outcomes (PICO) question, and the National Health and Medical Research Council scales. The event rate of complications and failures was calculated with a confidence interval (CI) of 95%.
RESULTS
A total of 13 prospective studies with 441 participants and 330 graft sites were identified. A total of 235 participants had SBFF with 445 implants, and 95 had DBFF with 164 implants. The overall combined graft failure rates were 4.2% for SBFF and 3.2% for DBFF. The complication rate was 10% for SBFF and 1.9% for DBFF. Implant failure was at 4.7% in the SBFF group and 3.4% in the DBFF group.
CONCLUSIONS
Complication rates and implant failures were similar for SBFF and DBFF. Therefore, for long-term oral rehabilitation, both SBFF and DBFF are suitable procedures for mandibular reconstruction.
PubMed: 37978003
DOI: 10.1016/j.prosdent.2023.10.007 -
Journal of Dentistry Aug 2023To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools.
STUDY SELECTION
Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI).
SOURCES
Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023.
DATA
Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (p≤0.003).
CONCLUSIONS
The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques.
CLINICAL SIGNIFICANCE
Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
Topics: Humans; Dental Restoration, Permanent; Dental Amalgam; Dental Cavity Preparation; Composite Resins; Dental Caries; Students; Teaching
PubMed: 37336355
DOI: 10.1016/j.jdent.2023.104589 -
Dental Materials : Official Publication... Dec 2023To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth? (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth?
DATA
Randomized controlled clinical trials (RCTs) investigating direct and indirect resin composite restorations in posterior permanent teeth were considered.
SOURCES
Several electronic databases were searched, with no language or date restrictions. The revised Cochrane Collaboration's tool for assessing risk of bias (RoB-2) was used to analyze the studies; meta-analyses were run and the certainty of evidence was assessed by the GRADE tool. A subgroup meta-analysis was performed for resin composite restorations placed on posterior worn dentition.
STUDY SELECTION
Twenty-three articles were included in qualitative synthesis, while 8 studies were used for meta-analyses. According to the RoB-2 tool, 5 studies were ranked as "low risk", 7 had "some concerns", while 11 papers were rated as "high risk" of bias. There were no statistically significant differences in short-term (p = 0.27; RR=1.54, 95% CI [0.72, 3.33]), medium-term (p = 0.27; RR=1.87, 95% CI [0.61, 5.72]) and long-term longevity (p = 0.86; RR=0.95, 95% CI [0.57, 1.59]). The choice of restorative technique had no influence on short-term survival of resin composite restorations placed on worn dentition (p = 0.13; RR=0.46, 95% CI [0.17, 1.25]). The certainty of evidence was rated as "very low".
CONCLUSIONS
Direct and indirect resin composite restorations may show similar clinical longevity in posterior region, regardless of the observation period or substrate (wear-affected and non-affected dentition). The very low quality of evidence suggests that more long-term RCTs are needed to confirm our results.
Topics: Dental Restoration, Permanent; Composite Resins; Molar
PubMed: 37827872
DOI: 10.1016/j.dental.2023.10.009 -
Oral and Maxillofacial Surgery Mar 2024Postoperative nausea and vomiting (PONV) is a frequently reported adverse event following orthognathic surgery. The aim of this work is to conduct a systematic review of... (Review)
Review
PURPOSE
Postoperative nausea and vomiting (PONV) is a frequently reported adverse event following orthognathic surgery. The aim of this work is to conduct a systematic review of the literature on the subject, and to discuss the role of maxillofacial surgeons and the steps that can be taken to prevent or control PONV in orthognathic surgery.
METHODS
A systematic review was conducted according to the PRISMA guidelines, using the search strategy: (orthognathic AND (nausea OR vomiting)). The authors searched PubMed, Embase, Dimensions, Web of Science and Google Scholar databases, without any language restrictions. RevMan 5.4 was used to create a risk of bias graph and a forest plot.
RESULTS
The included articles were classified as having a low risk of bias, despite the limited literature on the subject. Various measures have been reported to be beneficial in preventing or managing PONV, such as the use of dexamethasone, antiemetic drugs, gastric aspiration, and anesthetic blocks. Effective bleeding control and faster surgeries can also be helpful.
CONCLUSIONS
Throat packs have not been found to be effective in preventing PONV. Although no definitive protocol has been established in the literature, the Enhanced Recovery After Surgery (ERAS) protocol could be a useful approach. Overall, a multimodal approach may be taken to prevent PONV, and further research is needed to establish definitive protocols.
PubMed: 38509315
DOI: 10.1007/s10006-024-01235-0 -
The Journal of Contemporary Dental... Dec 2023The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental...
AIMS
The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry.
BACKGROUND
The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols.
REVIEW RESULTS
Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials.
CONCLUSION
The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice.
CLINICAL SIGNIFICANCE
Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, . Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.
Topics: Child; Humans; Cost-Benefit Analysis; Dental Atraumatic Restorative Treatment; Tooth, Deciduous; Dental Restoration, Permanent; Esthetics, Dental; Dental Caries; Dental Materials; Pain; Parents
PubMed: 38317401
DOI: 10.5005/jp-journals-10024-3607 -
Medicina (Kaunas, Lithuania) Dec 2023: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to... (Meta-Analysis)
Meta-Analysis Review
Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies.
: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. : The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. : The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was -1.22 degrees (95% CI, -1.06--1.39), the mean coronal deviation was -0.15 mm (95% CI, -0.24--0.07), and the mean apical deviation was -0.19 mm (95% CI, -0.27--0.10). : The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery.
Topics: Humans; Dental Implants; Robotics; Surgery, Computer-Assisted; Research Design; Computers; Imaging, Three-Dimensional
PubMed: 38276045
DOI: 10.3390/medicina60010011 -
Clinical Oral Implants Research Sep 2023The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15-25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010.
MATERIAL AND METHODS
An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A).
RESULTS
Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6-99.5) % at 1 year, 97.5 (95.9-98.4) % after 3 years, and 95.8 (93.3-97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8-99.5) % after 1 year, 96.8 (93.6-98.4) % after 2 years, and 94.8 (89.6-97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of -0.71 (-1.25, -0.1) mm, midfacial recession change of -0.15 (-0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES.
CONCLUSIONS
Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.
Topics: Adult; Humans; Prospective Studies; Retrospective Studies; Dental Implants; Esthetics, Dental; Databases, Factual
PubMed: 37750531
DOI: 10.1111/clr.14172