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The Journal of Prosthetic Dentistry Sep 2023Cleft lip and palate are the most frequent congenital anomalies of the face and are often linked with lateral incisor agenesis. The therapeutic decision on whether and... (Review)
Review
STATEMENT OF PROBLEM
Cleft lip and palate are the most frequent congenital anomalies of the face and are often linked with lateral incisor agenesis. The therapeutic decision on whether and how to replace the lateral incisors is not straightforward, and a decision-making tree is needed.
PURPOSE
The purpose of this systematic review was to evaluate the available literature reporting on treatments for the replacement of missing lateral incisors in cleft areas. By analyzing the success and survival rates of these treatments, a decision-making tree was developed.
MATERIAL AND METHODS
The literature search was performed on the PubMed (MEDLINE), Web of Science, Cochrane, EMBASE, Dentistry of Oral and Science Source, and Google Scholar databases and was based on the question: Which treatment for patients with lateral incisor agenesis and cleft lip and palate has a good success rate?
RESULTS
Twenty-six articles were included in this systematic review. A meta-analysis was performed on 14 articles (20 case series, 6 case controls). The estimated overall 5-year survival rates were 96.4% for implant-supported prostheses.
CONCLUSIONS
Different treatment options are available, depending on the clinical situation. If the patient meets the conditions for implant placement, this treatment remains a preferred solution. If the prosthetic space is reduced, orthodontic space closure and composite resin restorations are possible. When these options are not possible, a resin-bonded fixed partial denture is the preferred option. If the teeth adjacent to the edentulous area require extensive restorations, a fixed partial denture may be a suitable alternative.
PubMed: 37679238
DOI: 10.1016/j.prosdent.2023.07.023 -
The Journal of Prosthetic Dentistry Jul 2023Removable partial dentures (RPDs) can be fabricated with conventional casting procedures or computer-aided design and computer-aided manufacturing (CAD-CAM)... (Review)
Review
STATEMENT OF PROBLEM
Removable partial dentures (RPDs) can be fabricated with conventional casting procedures or computer-aided design and computer-aided manufacturing (CAD-CAM) technologies; however, the manufacturing accuracy and internal discrepancy differences among these manufacturing methods remain uncertain.
PURPOSE
The purpose of this systematic review and meta-analysis was to assess the influence of the fabricating method (casting, milling, or additive manufacturing) on the accuracy and internal discrepancy of RPDs.
MATERIAL AND METHODS
An electronic search of the literature was performed in 6 databases: PubMed/Medline, Embase, Web of Science, Scopus, Cochrane, and Google Scholar. The studies that assessed the accuracy and internal discrepancy of RPDs fabricated from casting, milling, and additive manufacturing were included. Studies reporting gaps (mean) and standard deviations were included in the meta-analysis. Publication bias was identified using funnel plot asymmetry and the Egger test.
RESULTS
A total of 25 articles were included. The internal discrepancy of the additively manufactured RPDs ranged from 14.4 to 511 μm and from 7 to 419 μm in conventionally fabricated RPDs. For the milling method, 20 to 66 μm horizontal and 17 to 59 μm vertical discrepancies were reported. The Egger tests indicated no publication bias among the studies that were included in the meta-analysis. Four included studies resulted in more than the acceptable clinical gap (311 μm) for the CAD-CAM method. Independently of the manufacturing method, the greatest internal discrepancies reported were observed under the major connectors. RPDs fabricated by using CAD-CAM techniques required fewer clinical appointments, the RPD design was easier to reproduce, and laboratory time was less than with conventional procedures. However, the reviewed studies described several disadvantages, including limited RPD design programs, difficulties in defining the occlusal plane, expensive materials, and increased laboratory cost.
CONCLUSIONS
Additive and subtractive technologies provide accurate methods for RPD fabrication; however, all challenges, including limited design software programs have not yet been overcome, and casting is still needed when the framework pattern is milled or printed.
PubMed: 37474386
DOI: 10.1016/j.prosdent.2023.04.004 -
Cureus Oct 2023The digital implant impression technique (DIT) and conventional implant impression technique (CIT) workflows in implant-supported fixed partial dentures (FPDs) have not... (Review)
Review
The digital implant impression technique (DIT) and conventional implant impression technique (CIT) workflows in implant-supported fixed partial dentures (FPDs) have not been extensively compared in prior studies. Moreover, there is no agreement on the more accurate method that entails less time in the laboratory and during the clinical phases of fabrication and delivery of the prosthesis, respectively. This review aimed to assess the precision of the imaging procedure and overall fabrication time of the DIT and CIT for the implant-supported FPDs. An electronic search was performed using PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases through EBSCO for relevant studies from January 2014 to April 2023. Following the preliminary screening, the studies that met the inclusion criteria underwent full-text review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cochrane Collaboration risk of bias appraisal tool and Newcastle-Ottawa scale were applied to assess the quality of randomized controlled trials (RCTs) and non-randomized prospective clinical studies, respectively. The initial search yielded 332 studies, and after excluding duplicates, 241 papers were available for screening. Titles and abstracts were reviewed, and 97 articles were chosen for full-text review by two authors independently. Furthermore, 89 articles were excluded in compliance with the PICOS question, and eight studies were chosen for qualitative analysis. Hence, the review comprised two RCTs and six prospective clinical studies. The time efficiency of the implant-supported FPDs was examined in four investigations, three of which used the Trios 3 scanner and one used the Intero scanner. The three-dimensional accuracy of DIT and CIT was compared in six clinical comparative studies. One of the RCTs was rated to have a high risk of bias and the other with a moderate quality of evidence. The six prospective studies were rated to have high-quality of evidence. The findings of this review indicate the prospective applicability of future intraoral scanning systems. The DIT was reported to be outstanding in terms of patient preferences and total fabrication time efficiency. Additional in vivo studies are needed to establish the therapeutic usefulness and time efficiency of integrating DIT in more comprehensive settings.
PubMed: 38034200
DOI: 10.7759/cureus.48027 -
The Journal of Prosthetic Dentistry Jan 2024Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is... (Review)
Review
STATEMENT OF PROBLEM
Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is more rapid and less costly than the conventional process.
PURPOSE
The purpose of this systematic review was to analyze and compare the duration and cost of fixed dental prostheses fabricated using digital and conventional methods from scanning or impression making to delivery of the prosthesis.
MATERIAL AND METHODS
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol registered in the Prospective International Register of Systematic Reviews (PROSPERO) (CRD42023458734). The bibliographic search was carried out using PubMed, Cochrane, and PROSPERO databases. The main keywords used were (Prosthodontic OR restorative dentistry OR denture) AND (CAD CAM OR Digital workflow OR Computer Dentistry OR Digital Design) AND (Economic OR cost OR Financial OR time efficiency). Two investigators undertook the different steps of article selection.
RESULTS
A total of 8 articles published between 2010 and 2023 were found for the qualitative synthesis by using the search criteria. Two studies showed that conventional impressions took more time than digital scans for the fabrication of a single crown, and 1 study showed the opposite. One study found that a digital scan was faster than conventional impression making for the fabrication of a 3-unit fixed partial denture, and another study showed the opposite. The dental laboratory technician spent more time on the conventional workflow than the digital workflow for the 3-unit framework and veneering process. No difference was found between conventional and digital workflows for clinical evaluation and chairside adjustment for the fabrication of a single crown. No articles have compared the cost of fixed prostheses.
CONCLUSIONS
The digital pathway can shorten the laboratory process. However, the duration of the impression or scan may vary depending on the technique used. Studies are needed to analyze the cost-effectiveness of the fabrication of tooth-supported restorations.
PubMed: 38302291
DOI: 10.1016/j.prosdent.2024.01.003 -
The Journal of Prosthetic Dentistry Nov 2023The union of the metal removable partial denture framework to the heat polymerized acrylic resin is related to prosthesis longevity. However, methods to enhance this... (Review)
Review
STATEMENT OF PROBLEM
The union of the metal removable partial denture framework to the heat polymerized acrylic resin is related to prosthesis longevity. However, methods to enhance this bond are not clear to clinicians and dental laboratory technicians.
PURPOSE
The purpose of this systematic review was to identify which metal surface treatments best increase the bond strength between heat polymerized acrylic resin and removable partial denture alloys.
MATERIAL AND METHODS
This review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Registry of Systematic Reviews (PROSPERO) database (CRD42022384926). Electronic searches were carried out independently, by 3 examiners in Medline/PubMed, Scopus, and Web of Science databases, and in the nonpeer-reviewed literature via ProQuest.
RESULTS
The electronic searches resulted in 4143 articles, with 4055 after removing duplicates. After reading the titles and abstracts, 37 articles were selected for reading in full-text version, from which 6 articles were included. All studies evaluated materials for conventional acrylic resin denture base (heat polymerized), processed by water bath, bonded to metal. For the metal framework alloys, cobalt chromium (Co-Cr) alloys were used in 2 studies, titanium (Ti) in 2 studies, and Co-Cr and Ti in the other 2 studies. Different metal surface treatments were used as airborne-particle abrasion with aluminum oxide (particle sizes of 50 µm, 110 µm, and 250 µm) followed by the primer application and the isolated use of the primer, compared to the absence of isolated intervention or airborne-particle abrasion of the metal surface. Among the different primers used, those based on 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) showed the highest acrylic resin-to-metal bond strength values.
CONCLUSIONS
Airborne-particle abrading the metal with AlO followed by applying a 10-MDP-based primer, increased the bond strength between metal framework alloys and heat polymerized acrylic resin denture base material.
PubMed: 37978008
DOI: 10.1016/j.prosdent.2023.10.009 -
The Journal of Prosthetic Dentistry Jan 2024Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However,... (Review)
Review
STATEMENT OF PROBLEM
Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However, whether they are more effective than antifungal drugs is unclear.
PURPOSE
The purpose of this systematic review was to identify whether gels formulated with antimicrobial substances are more effective and biocompatible for the treatment of DS than antifungal drugs.
MATERIAL AND METHODS
This systematic review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022379510). Searches were performed in the PubMed, Lilacs, Web of Science, Scopus, Embase, and Google Scholar databases in November 2022. Randomized and nonrandomized clinical trials comparing the efficacy of experimental gels and conventional antifungals in the treatment of DS were included.
RESULTS
Gels formulated with Zataria multiflora essential oil and clove and cinnamon extracts showed higher antimicrobial efficacy compared with miconazole and clotrimazole. Formulations containing Uncaria tomentosa, Punica granatum, and propolis extract showed similar efficacy to nystatin and miconazole. Two formulations containing P. granatum were less effective than nystatin and miconazole. Gels of Z. multiflora and miconazole induced adverse effects including burning, itching, nausea, and vomiting. The included studies did not evaluate the biocompatibility of the gels.
CONCLUSIONS
Gels formulated with natural antimicrobials such as Z. multiflora, U. tomentosa, P. granatum, propolis, and clove and cinnamon showed higher or similar antimicrobial efficacy to conventional antifungals in the treatment of DS. The biocompatibility of experimental gels based on natural agents should be evaluated.
PubMed: 38195253
DOI: 10.1016/j.prosdent.2023.12.014 -
Clinical Oral Investigations Jan 2024The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of various types of denture adhesives in complete denture... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVES
The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of various types of denture adhesives in complete denture patients.
MATERIAL AND METHODS
A search was conducted for trials published in Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until July 2023 (PROSPERO: CRD42023451045). A network meta-analysis was performed to assess the comparative efficacy of different denture adhesive types and ranked using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence.
RESULTS
Seventeen articles were included in the quantitative analysis. Cream denture adhesives significantly increased bite force in both incisal region (RR = 7.63[95%CI: 3.34, 11.91]) (P < .05) as well as premolar and molar regions (RR = 33.66[95%CI: 15.15, 52.16]). Cream adhesives significantly improved retention of dentures as assessed by the reduced number of denture dislodgments (RR = -5.35[95%CI: -9.93, -0.77]) (P = 0.022), Kapur's index of retention (maxillary denture) (RR = 0.80[95%CI: 0.18, 1.42]) (P = 0.012) and Kapur's index of retention (mandibular denture) (RR = 1.27[95%CI: 0.67, 1.87]) (P < .05). Powder adhesives significantly increased premolar and molar bite force (RR = 36.00[95%CI: 16.20, 55.79]) (P < .05) and Kapur's index of retention (mandibular denture) (RR = 1.54[95%CI: 0.58, 2.49]) (P = 0.002). None of the adhesives were statistically significant for remaining outcomes.
CONCLUSIONS
Cream and powder denture adhesives are effective in enhancing the retention of mandibular dentures (Kapur's index) and bite force in the premolar/molar region in complete denture wearers (moderate level of certainty of evidence).
CLINICAL RELEVANCE
Cream and powder denture adhesives are effective in improving the retention and function of complete dentures.
Topics: Humans; Bite Force; Denture, Complete; Mandible; Network Meta-Analysis; Powders
PubMed: 38183500
DOI: 10.1007/s00784-023-05467-4 -
BMC Oral Health Dec 2023The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications... (Meta-Analysis)
Meta-Analysis
PURPOSE OF THE STUDY
The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications using conventional impression methods improve the marginal and internal fit?
BACKGROUND
The incorporation of digital technology in the fabrication of fixed partial dentures (FPDs) has accelerated over the past decade. This study is directed at evaluating the marginal and internal fit of FPDs manufactured using digital approaches compared to conventional techniques. The need for updated data has encouraged this review.
MATERIALS AND METHODS
An electronic search was conducted in PubMed, Scopus, Web of Science, and the Grey Database to identify relevant studies. The Modified Methodological Index for Non-Randomized Studies (MINORS) was used to assess the risk of bias in in vitro experiments. The key results of this meta-analysis were the standard mean differences (SMDs) and 95% confidence intervals (CI) of each main variance, marginal fit, and internal fit between the digital and conventional techniques. Additional analyses were performed to assess the significance of three subgroup parameters: method of digitalization, cement spacer thickness, and span length, and their influence on the fit of the FPDs.
RESULTS
Based on predefined criteria, of the seven articles included in this systematic review, only five were selected for the quantitative data analysis. The marginal fit results were (P = 0.06; SMD: -1.88; 95% CI: - 3.88, 0.11) (P > 0.05) and the internal fit results were (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.10) (P < 0.05). Regarding the subgroup analyses, the method of digitalization subgroup results were (P = 0.35; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.80; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively. The span length results were (P = 0.10; SMD: -1.89; 95% CI: - 3.89, 0.11) for marginal fit and (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.11) for internal fit. The cement spacer thickness (P = 0.01; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.04; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively.
CONCLUSION
Tooth-retained fixed partial dentures FPDs produced by digital scanning and computer-aided design/computer-aided manufacturing (CAD/CAM) systems can significantly enhance the internal fit compared with those manufactured by traditional methods. Intraoral scanners can replace conventional impressions for the fabrication of FPDs because they minimize the operating time and reduce patient pain. Further clinical studies are required to obtain more conclusive results.
SYSTEMATIC REVIEW REGISTRATION
This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021261397.
Topics: Humans; Dental Marginal Adaptation; Denture, Partial, Fixed; Computer-Aided Design; Research Design; Dental Prosthesis Design
PubMed: 38049754
DOI: 10.1186/s12903-023-03628-1 -
The Journal of Prosthetic Dentistry Nov 2023Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome... (Review)
Review
STATEMENT OF PROBLEM
Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome measures (PROMs) is lacking.
PURPOSE
The purpose of this systematic review was to compare the cost-effectiveness and PROMs between digitally and conventionally fabricated complete dentures.
MATERIAL AND METHODS
An electronic search of publications from 2011 to mid-2023 was established using PubMed/Medline, EBSCOhost, and Google Scholar. Retrospective, prospective, randomized controlled, and randomized crossover clinical studies on at least 10 participants were included. A total of 540 articles were identified and assessed at the title, abstract, and full article level, resulting in the inclusion of 14 articles. Data on cost, number of visits, patient satisfaction, and oral health-related quality of life were examined and reported.
RESULTS
The systematic review included 572 digitally fabricated complete dentures and 939 conventionally fabricated complete dentures inserted in 1300 patients. Digitally fabricated complete dentures require less clinical time with a lower total cost, despite higher material costs compared with the conventional fabrication technique. Digitally and conventionally fabricated complete dentures were found to have significant effects on mastication efficiency, comfort, retention, stability, ease of cleaning, phonetics, and overall patient satisfaction, as well as social disability, functional limitation, psychological discomfort, physical pain, and handicap.
CONCLUSIONS
Digitally fabricated complete dentures are more cost-effective than conventionally fabricated dentures. There are various impacts of conventionally and digitally fabricated complete dentures on PROMs, and they are not better than one another.
PubMed: 38000966
DOI: 10.1016/j.prosdent.2023.10.028 -
Journal of Prosthodontics : Official... Apr 2024This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures. (Review)
Review
PURPOSE
This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures.
MATERIALS AND METHODS
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in Prospero. The formulated population, intervention, comparison, outcome (PICO) question was "What is the clinical outcome of digital versus conventional complete dentures (CDs) in edentulous patients?". The search strategy used three main electronic databases and an additional manual search was completed in August 2023 by following an established search strategy. Initial inclusion was based on titles and abstracts, followed by a detailed review of selected studies, and clinical studies that evaluated the clinical outcome of digital (milled or 3D-printed) versus conventional CDs were included. A qualitative analysis for clinical studies was used to assess the risk of bias. The certainty of the evidence was assessed according to the grading of recommendations, assessment, development, and evaluations (GRADE) system. In addition, a single-arm meta-analysis was performed to evaluate the retention between digital versus conventional CDs.
RESULTS
The initial search yielded a total of 947 articles, out of which 19 were selected for a comprehensive review, and six met the eligibility criteria to be included in this systematic review. The computer-aided design and computer-aided manufacturing (CAD-CAM) CDs showed increased retention, no relevant differences in oral health-related quality of life (OHRQoL), and shorter working time compared to conventional dentures. Two studies were eligible for meta-analysis; retention was significantly better among CAD-CAM fabricated dentures (standardized mean difference [SMD] 0.501) than conventional dentures. The heterogeneity between studies was high (95% CI: 0.049-0.952).
CONCLUSIONS
Clinically, both the milled and the 3D-printed CD fared better than conventional dentures in terms of retention, reduction in the number of appointments, improved patient comfort, and improved predictable maintenance of the denture. Patients' perceptions and satisfaction were independent of the digital and conventional fabricated dentures.
PubMed: 38666691
DOI: 10.1111/jopr.13859