-
Journal of Prosthodontic Research Jan 2024This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. (Review)
Review
PURPOSE
This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.
STUDY SELECTION
Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.
RESULTS
One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.
CONCLUSIONS
Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Patient Satisfaction; Quality of Life; Tooth
PubMed: 37164658
DOI: 10.2186/jpr.JPR_D_22_00252 -
BMC Oral Health Oct 2023Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be...
BACKGROUND
Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be biological or mechanical complications during the therapy, which lead to the loss of the implant. This systematic review aims to evaluate the current state of the art in the literature on techniques used for the removal of dental implants. Various aspects will be analyzed, such as the success of the technique, any complications, and the advantages and disadvantages of their use.
METHODS
Two reviewers conducted a literature analysis (PubMed, Embase, Web of Science) of the last 20 years (2003-2023). The main criterion analyzed was the success of the technique, while secondary outcomes such as complications and risks of the technique were also analyzed. 258 articles were identified in the various search databases. 42 eligible articles were subsequently identified after an article screening. Only 18 full texts were subsequently included in the review.
RESULTS
A total of 18 articles were selected and 1142 implants and 595 patients were included. The main techniques used were the Counter-Torque Ratchet Technique (CTRT), Piezoelectric bone surgery (PBS), trephine drills, carbide burs, Erbium, Chromium, Yttrium, Scandium, Gallium, Garnett (Er:Cr:YSGG) laser and carbon dioxide (CO) laser. Combined uses of techniques have been identified such as: PBS and trephine burs or carbide burs, trephine burs with the use of a 3d-printed guide, CTRT and trephine burs. The technique with the highest success rate, less morbidity for the patient, and less removal of bone appears to be the CTRT.
CONCLUSIONS
The use of conservative techniques, especially CTRT, in bone removal is useful to allow for immediate implant placement in the removal area. However, further studies with a high sample size are needed to be performed on all techniques, particularly new randomized controlled trials (RCTs) that allow for the analysis of the success of alternative techniques such as Laser and Piezosurgery, which appear to be very promising.
Topics: Humans; Dental Implants; Bone-Anchored Prosthesis; Dental Implantation, Endosseous; Yttrium; Lasers, Solid-State
PubMed: 37833674
DOI: 10.1186/s12903-023-03438-5 -
Clinical and Experimental Dental... Dec 2023The aim of the systematic review was to compare studies on implant-supported two-unit cantilever crowns with two adjacent implant-supported crowns in the anterior...
OBJECTIVES
The aim of the systematic review was to compare studies on implant-supported two-unit cantilever crowns with two adjacent implant-supported crowns in the anterior region. The second aim was to assess in a 10-year prospective comparative pilot study, hard and soft peri-implant tissue changes in patients with a missing central and adjacent lateral upper incisor, treated with either an implant-supported two-unit cantilever crown or two single implant-supported crowns.
MATERIALS AND METHODS
Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched (last search March 1, 2023). Inclusion criteria were studies reporting outcomes of two missing adjacent teeth in the esthetic region and treated with a single implant-supported two-unit cantilever fixed dental prosthesis, or with two solitary implant-supported crowns. Outcome measures assessed included implant survival (primary), changes in marginal bone and gingiva level, restoration survival, subjective and objective esthetic scores, papilla volume, mid-facial marginal mucosa level, probing depth, bleeding on probing, and biological and technical complications with ≥1-year follow-up. In addition, in a 10-year pilot study, the same outcome measures were assessed of five patients with a single implant-supported two-unit cantilever crown and compared with five patients with two adjacent single implant-supported crowns in the esthetic zone.
RESULTS
Nine articles with 11 study groups were found eligible for data extraction. Meta-analyses of implant survival rates were 96.9% (mean follow-up 3.4 ± 1.4 years) for the implant-cantilever treatment and 97.6% (mean follow-up 3.0 ± 1.8 years) for the adjacent implants treatment (p = .79). In the 10-year comparative pilot study, no clinically relevant changes in hard and soft peri-implant tissue levels occurred in both groups. Patient satisfaction was also high in both groups.
CONCLUSION
Single implant-supported two-unit crowns can be a viable alternative to the placement of two adjacent single implant crowns in the esthetic zone.
Topics: Humans; Dental Implants; Treatment Outcome; Pilot Projects; Dental Implants, Single-Tooth; Prospective Studies; Esthetics, Dental
PubMed: 37592440
DOI: 10.1002/cre2.773 -
Biomedizinische Technik. Biomedical... Feb 2024To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ). (Review)
Review
OBJECTIVES
To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ).
CONTENT
Methods to evaluate the stability of dental implants.
SUMMARY
A search was performed in the PubMed, Scopus, and Web of Science databases for articles on the proposed subject up to January 29, 2023, using search terms that combined "resonance frequency analysis" and "Periotest" with "correlation" or "relationship"; and combinations of "implant stability quotient" and "Periotest" with "correlation" or "relationship." The inclusion criteria were clinical studies in English involving human subjects who received dental implants and evaluating the correlation between PTV and ISQ. A total of 46 articles were screened, of which 10 were selected for full-text analysis, and eight articles were included in this review. Based on three articles, 75 % of the results of this systematic review showed a negative correlation between PTV and ISQ, regardless of the type of stability assessed. Based on the remaining five articles, 100 % (regardless of the patient's gender) and 66.66 % of the results showed a negative correlation for primary and secondary stability, respectively. There is a negative correlation between PTV and ISQ for both primary and secondary dental implant stability.
OUTLOOK
This review can serve as a reference for the development of methodologies for future clinical studies on this topic.
Topics: Humans; Osseointegration; Dental Implants; Dental Implantation, Endosseous; Dental Prosthesis Retention
PubMed: 37489593
DOI: 10.1515/bmt-2023-0194 -
International Journal of Implant... Dec 2023This systematic review aimed to investigate the accuracy of intraoral scan (IOS) impressions of implant-supported restorations in in vivo studies. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This systematic review aimed to investigate the accuracy of intraoral scan (IOS) impressions of implant-supported restorations in in vivo studies.
METHODS
A systematic electronic search and review of studies on the accuracy of IOS implant impressions were conducted to analyze the peer-reviewed literature published between 1989 and August 2023. The bias analysis was performed by two reviewers. Data on the study characteristics, accuracy outcomes, and related variables were extracted. A meta-analysis of randomized control trials was performed to investigate the impact of IOS on peri-implant crestal bone loss and the time involved in the impression procedure.
RESULTS
Ten in vivo studies were included in this systematic review for final analysis. Six studies investigated the trueness of IOS impressions, but did not reach the same conclusions. One study assessed the precision of IOS impressions for a single implant. Four clinical studies examined the accuracy of IOS implant impressions with a follow-up of 1-2 years. In full arches, IOS impression procedure needed significantly less time than conventional one (mean difference for procedure time was 8.59 min [6.78, 10.40 min], P < 0.001), prosthetic survival rate was 100%, and marginal bone levels of all participants could be stably maintained (mean difference in marginal bone loss at 12 months was 0.03 mm [-0.08, 0.14 mm], P = 0.55).
CONCLUSIONS
The accuracy of IOS impressions of implant-supported restorations varied greatly depending on the scanning strategy. The trueness and precision of IOS in the partial and complete arches remain unclear and require further assessment. Based on follow-up clinical studies, IOS impressions were accurate in clinical practice. However, these results should be interpreted with caution, as some evidences are obtained from the same research group.
Topics: Humans; Dental Implants; Research Design; Bone Diseases, Metabolic; Clonal Hematopoiesis; Electronics
PubMed: 38055096
DOI: 10.1186/s40729-023-00517-8 -
Clinical and Experimental Dental... Aug 2023The aim of this article is to establish a comprehensive nationwide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this article is to establish a comprehensive nationwide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in the Turkish population.
MATERIAL AND METHODS
A systematic search of PubMed, Scopus, and Web of Science was supplemented by manual searches of Google Scholar and the reference lists of included studies. Original Turkish health studies of any age were included. Strengthening the Reporting of Observational Studies in Epidemiology assessed study quality and bias (STROBE). Sagittal, vertical, and transverse malocclusion features were retrieved and gathered.
RESULTS
Eleven studies were selected from 434 titles. Two studies showed a high risk of bias, eight low and one moderate. Thirteen thousand two hundred seventy-one individuals were investigated from early childhood to late adulthood. Most studies were sampled from universities and dental (nonorthodontic) clinics. The pooled malocclusion prevalence was 56% for Class I (95% confidence interval (CI): 44-68%), 31% for Class II (CI: 6-42%), and 11% for Class III (CI: 21-37%). The other common types of malocclusions were crowding (41%, CI: 18-65%), overjet (34%, CI: 21-50%), negative overjet (13%, CI: 7-20%), and crossbite (11%, CI: 7-15%). Additionally, there was no significant difference in Class I (relative risk [RR] = 1.00, [0.96-1.05]), Class II ([RR] = 0.97, [0.92-1.03]), and Class III ([RR] = 1.08, [0.96-1.225]) malocclusion by gender.
CONCLUSIONS
This study showed Class I malocclusion has a high prevalence among the Turkish population followed by Class II and Class III malocclusions. In addition, crowding and overjet were the most prevalent malocclusions among Turkish individuals. There were no significant differences in the prevalence of malocclusions between males and females.
Topics: Child, Preschool; Male; Female; Humans; Child; Adolescent; Adult; Malocclusion, Angle Class II; Prevalence; Malocclusion; Malocclusion, Angle Class III; Overbite
PubMed: 37574975
DOI: 10.1002/cre2.771 -
Evidence-based Dentistry Sep 2023A systematic appraisal and statistical aggregation of primary studies in humans. (Meta-Analysis)
Meta-Analysis
DESIGN
A systematic appraisal and statistical aggregation of primary studies in humans.
DATA SOURCES
The researchers utilized PubMed (Medline) and Scopus databases as the primary data sources for this study. They performed a comprehensive literature search based on free keywords and Medical Subject Heading (MeSH) terms to enhance the search accuracy. The database search was concluded on November 13, 2022. Furthermore, a meticulous examination of the references cited in the selected studies was conducted to identify additional relevant articles that could be incorporated into the analysis.
STUDY SELECTION
The systematic review focused on partially or fully edentulous patients receiving dental implants and aimed to determine if the lack of keratinized mucosa at the implant site increased the risk of peri-implantitis compared to patients with adequate keratinized mucosa. Human studies with a minimum of 100 implants, cross-sectional, cohort, or case-control designs, and a follow-up period of at least one year were included. Studies lacking a clear case definition or information on peri-implantitis and those that did not investigate keratinized mucosa as a risk indicator were excluded.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently utilized a systematic review screening website (Rayyan, Qatar Computing Research Institute, Qatar Foundation) to select potential articles, and conflicts were resolved through discussion or consultation with a third reviewer. The data extraction process involved recording information from the included articles, such as study design, patient and implant numbers, prosthesis type (fixed or removable), follow-up duration, peri-implantitis case definition, prevalence at patient and implant levels, keratinized mucosa cutoff value, odds ratio (OR) of peri-implantitis considering keratinized mucosa, and conclusions on the potential effect of keratinized mucosa from each study. The Newcastle Ottawa scale (NOS) and a modified version of NOS were used, respectively, to assess the quality of cohort and cross-sectional studies. Studies scoring below 6 out of 9 points were classified as low quality. For the meta-analysis, the relationship between peri-implantitis and keratinized mucosa was evaluated using the odds ratio (OR) and standard error (SE). Heterogeneity was assessed through the Chi test and I index, determining whether a random-effects or fixed-effects model should be applied. Subgroup and cluster analyses were conducted based on specific criteria, and forest plots and funnel plots were generated to visualize results and identify potential study bias. Sensitivity analysis was performed to verify the robustness of the meta-analysis, with statistical significance set at p < 0.05. The Review Manager (RevMan) software facilitated data analysis. The GRADE rating system was used to determine the level of evidence, considering factors such as bias risk, imprecision, inconsistency, indirectness, and publication bias. The certainty of the evidence was evaluated based on the overall outcomes of analyzed subgroups.
RESULTS
Twenty-two primary studies were identified, and a meta-analysis was conducted on 16 cross-sectional studies. The prevalence of peri-implantitis ranged from 6.68% to 62.3% at the patient level and from 4.5% to 58.1% at the implant level. The overall analysis revealed a significant association between the lack of keratinized mucosa and a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Subgroup analyses with a consistent case definition of peri-implantitis (MBL ≥ 2 mm) showed similar results (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001). Studies focusing on fixed prostheses only demonstrated that the lack of keratinized mucosa was associated with an increased prevalence of peri-implantitis (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001). Among patients under regular implant maintenance, the absence of keratinized mucosa significantly raised the occurrence of peri-implantitis (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002). Studies adjusting for other variables also confirmed a higher risk of peri-implantitis with inadequate keratinized mucosa (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Although some publication bias was observed, the certainty of evidence based on the GRADE system was judged to be "moderate."
CONCLUSIONS
The lack of keratinized mucosa increased the risk of peri-implantitis, emphasizing the need to consider it during dental implant placement. Inadequate data on patient-specific factors and the predominance of cross-sectional studies influenced the evidence quality (i.e., moderate). Future studies with consistent methodologies shall confirm these findings and identify additional risk indicators to improve implant dentistry practices.
Topics: Humans; Peri-Implantitis; Dental Implants; Cross-Sectional Studies; Mucous Membrane; Risk Factors
PubMed: 37537217
DOI: 10.1038/s41432-023-00913-4 -
BMC Oral Health Dec 2023The development of deep learning (DL) algorithms for use in dentistry is an emerging trend. Periodontitis is one of the most prevalent oral diseases, which has a notable... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The development of deep learning (DL) algorithms for use in dentistry is an emerging trend. Periodontitis is one of the most prevalent oral diseases, which has a notable impact on the life quality of patients. Therefore, it is crucial to classify periodontitis accurately and efficiently. This systematic review aimed to identify the application of DL for the classification of periodontitis and assess the accuracy of this approach.
METHODS
A literature search up to November 2023 was implemented through EMBASE, PubMed, Web of Science, Scopus, and Google Scholar databases. Inclusion and exclusion criteria were used to screen eligible studies, and the quality of the studies was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology with the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. Random-effects inverse-variance model was used to perform the meta-analysis of a diagnostic test, with which pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) were calculated, and a summary receiver operating characteristic (SROC) plot was constructed.
RESULTS
Thirteen studies were included in the meta-analysis. After excluding an outlier, the pooled sensitivity, specificity, positive LR, negative LR and DOR were 0.88 (95%CI 0.82-0.92), 0.82 (95%CI 0.72-0.89), 4.9 (95%CI 3.2-7.5), 0.15 (95%CI 0.10-0.22) and 33 (95%CI 19-59), respectively. The area under the SROC was 0.92 (95%CI 0.89-0.94).
CONCLUSIONS
The accuracy of DL-based classification of periodontitis is high, and this approach could be employed in the future to reduce the workload of dental professionals and enhance the consistency of classification.
Topics: Humans; Sensitivity and Specificity; Deep Learning; ROC Curve; Algorithms; Odds Ratio
PubMed: 38114946
DOI: 10.1186/s12903-023-03751-z -
Materials (Basel, Switzerland) Mar 2024Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review... (Review)
Review
BACKGROUND
Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review compared the efficacy of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) or connective tissue grafts (CTGs) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants.
METHODS
Two independent examiners performed an electronic search on MEDLINE and the Cochrane Library based on the following PICOS format: (P) adult patients; (I) soft tissue substitutes and FGGs/CTGs; (C) STSs vs. CTGs; STSs vs. FGGs; STSs vs control; (O) KT width gain; (S) systematic reviews, randomized controlled trials. Studies published before November 2023 were included.
RESULTS
Around teeth, all biomaterials showed superior performance compared to a coronally advanced flap (CAF) alone for treating gingival recessions. However, when compared to CTGs, acellular dermal matrices (ADMs) yield the most similar outcomes to the gold standard (CTGs), even though in multiple recessions, CTGs continue to be considered the most favorable approach. The use of STSs (acellular matrix or tissue-engineered) in combination with apically positioned flaps (APF) resulted in significantly less gain in KT width compared to that achieved with FGGs and APFs. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width.
CONCLUSIONS
Based on the available evidence, questions remain about the alternative use of soft tissue substitutes for conventional grafting procedures using free gingival grafts or connective tissue grafts around teeth and implants.
PubMed: 38473691
DOI: 10.3390/ma17051221 -
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