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Frontiers in Bioengineering and... 2022Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically...
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms "titanium dental implants", "surface properties", "bioactive surface modifications", "biomolecules", "BMP", "antibacterial agent", "peptide", "collagen", "grown factor", "osseointegration", "bone apposition", "osteogenic", "osteogenesis", "new bone formation", "bone to implant contact", "bone regeneration" and " studies", until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
PubMed: 36225604
DOI: 10.3389/fbioe.2022.986112 -
Journal of Prosthodontics : Official... Feb 2023To perform a systematic review that provides an overview of the current literature on fatigue behavior of removable partial denture (RPD) clasp materials based on... (Review)
Review
PURPOSE
To perform a systematic review that provides an overview of the current literature on fatigue behavior of removable partial denture (RPD) clasp materials based on different retentive areas.
MATERIALS AND METHODS
The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Electronic searches were done via PubMed, Scopus, and OVID for studies reporting on RPD clasps and the fatigue failure of clasp materials. Inclusion criteria were English language with full text and in vitro studies only. Exclusion criteria were studies that did not assess the fatigue of RPD clasp materials. A quality assessment and selection of full-text articles were performed according to Consolidated Standards of Reporting Trials criteria.
RESULTS
A total of 182 articles were initially identified and screened. After applying inclusion and exclusion criteria, 15 articles were selected for the final analysis. Seven of the included studies utilized a vertical insertion/removal testing approach. Ten studies used the constant deflection test. Three studies used untapered specimens, and 12 studies used tapered specimens. Ten studies performed post-test analysis.
CONCLUSIONS
Cobalt-chromium (CoCr) is the strongest material in terms of fatigue in relation to the undercut depth and the modern, digitally manufactured RPD clasp materials also exhibit comparable fatigue behavior. Recent RPD clasp materials such as polyetheretherketone (PEEK) or laser sintered CoCr, however, require further study in terms of their fatigue behavior. In order to improve the quality of future studies, a standardized and calibrated fatigue testing method is needed with standardized specimen size and shape, which will reduce the risk of bias and enable meta-analysis for bulk comparison between studies.
Topics: Chromium Alloys; Dental Clasps; Denture Retention; Denture, Partial, Removable; Materials Testing
PubMed: 35405767
DOI: 10.1111/jopr.13519 -
The Journal of Prosthetic Dentistry Jun 2023High-power laser irradiation may be a promising treatment for titanium dental implant surfaces. However, systematic reviews of the influence of high-power laser... (Review)
Review
STATEMENT OF PROBLEM
High-power laser irradiation may be a promising treatment for titanium dental implant surfaces. However, systematic reviews of the influence of high-power laser irradiation on the different properties of titanium surfaces are lacking.
PURPOSE
The purpose of this systematic review was to analyze the influence of surface treatment by high-power laser irradiation on the surface properties of titanium and its alloys.
MATERIAL AND METHODS
The PubMed, LILACS, COCHRANE library, and Science Direct databases were searched, and articles published in the last 10 years were included. Of the 725 articles initially identified, 27 were selected after full reading and the application of inclusion and exclusion criteria.
RESULTS
The studies evaluated showed that laser irradiation treatment, depending on the settings and parameters used, promoted changes in the surface properties of titanium. In general, lower speed and a higher number of scans increased roughness. Laser surface treatment promoted the inclusion of more oxygen and improved the wetting capacity of titanium. Additionally, laser treatment improved the adherence of coatings.
CONCLUSIONS
Changes in the surface properties of titanium after laser treatment have been demonstrated. However, determining protocols with specific parameters is necessary to optimize the results.
Topics: Titanium; Dental Implants; Microscopy, Electron, Scanning; Surface Properties; Lasers
PubMed: 34493390
DOI: 10.1016/j.prosdent.2021.07.026 -
The International Journal of... 2021To conduct a systematic review to evaluate the influence of materials and surfaces used for dental implant abutments on the proliferation of human gingival fibroblasts.
PURPOSE
To conduct a systematic review to evaluate the influence of materials and surfaces used for dental implant abutments on the proliferation of human gingival fibroblasts.
MATERIALS AND METHODS
The focus question of this review was: Which material/surface characteristics used for dental implant abutments influence/enhance proliferation of human gingival fibroblasts? The Medline/PubMed, Embase, and Cochrane Library databases were searched using "gingiva," "fibroblasts," "proliferation," and "dental implant abutments" as main keywords with AND/OR as Boolean operators. In vitro studies reporting 3 to 4 or 6 to 7 days of cell proliferation, surface hydrophilicity, and roughness were included. A quality assessment of the selected studies was performed using the web-based Science in Risk Assessment and Policy (SciRAP) tool.
RESULTS
The search identified 1,144 studies, and 44 were eligible for inclusion. The average reporting quality SciRAP score was 82.87 ± 10.68, and the average methodologic quality SciRAP score was 87.35 ± 10.55. Machined, polished, and coated titanium and zirconia surfaces were most commonly investigated. Several studies analyzed aluminum oxide, cobalt-chrome-molybdenum alloy, lithium disilicate, polyether ether ketone, polymer-infiltrated ceramic network, and bioglass. The best cell proliferation was observed on zirconia and on titanium harboring nanotubules or microgrooves. UV treatment, polydopamine, and nitride coatings also improved cell proliferation. Due to the heterogeneity of the data, no correlation could be established between cell profileration and surface hydrophilicity or roughness. However, surface roughness in the range of R = 15 to 145 nm and Sa = 19 to 500 nm on titanium and zirconia proved most suitable.
CONCLUSION
Titanium surfaces with directional guidance patterning and zirconia surfaces best supported cell proliferation during the first week of cell culture. Lack of standardization in surface definitions (machined or polished), methodology, and reporting prevented analytical comparison and should be imposed in future studies.
Topics: Cell Proliferation; Dental Abutments; Dental Implants; Dental Materials; Fibroblasts; Gingiva; Humans; Materials Testing; Surface Properties; Titanium; Zirconium
PubMed: 33616578
DOI: 10.11607/ijp.7388 -
The International Journal of... Feb 2024The purpose of this systematic review and meta-analysis was to compare the influence of fabrication method (conventional, subtractive, and additive procedures) and... (Meta-Analysis)
Meta-Analysis
Influence of the Manufacturing Trinomial (Technology, Printer, and Material) on the Marginal and Internal Discrepancies of Printed Metal Frameworks for the Fabrication of Tooth-Supported Prostheses: A Systematic Review and Meta-analysis.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the influence of fabrication method (conventional, subtractive, and additive procedures) and manufacturing trinomial (technology, printer, and material combination) on the marginal and internal fit of cobaltchromium (Co-Cr) tooth-supported frameworks.
MATERIALS AND METHODS
An electronic systematic review was performed in five data bases: MEDLINE/PubMed, Embase, World of Science, Cochrane, and Scopus. Studies that reported the marginal and internal discrepancies of tooth-supported Co-Cr additive manufacturing (AM) frameworks were included. Two authors independently completed the quality assessment of the studies by applying the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. A third examiner was consulted to resolve lack of consensus.
RESULTS
A total of 31 articles were included and classified based on the evaluation method: manufacturing accuracy, the dual- or triple-scan method, stereomicroscope, optical coordinate measurement machine, microCT, profilometer, and silicone replica. Six subgroups were created: 3D Systems, Bego, Concept Laser, EOS, Kulzer, and Sisma. Due to the heterogeneity and limited data available, only the silicone replica group was considered for meta-analysis. The metaanalysis showed a mean marginal discrepancy of 91.09 μm (I2 = 95%, P < .001) in the conventional group, 77.48 μm (I2 = 99%, P < .001) in the milling group, and 82.92 μm (I2 = 98%, P < .001) in the printing group. Additionally, a mean internal discrepancy of 111.29 μm (I2 = 94%, P < .001) was obtained in the conventional casting group, 121.96 μm (I2 = 100%, P < .001) in the milling group, and 121.25 μm (I2 = 99%, P < .001) in the printing group.
CONCLUSIONS
Manufacturing method and selective laser melting (SLM) metal manufacturing trinomial did not impact the marginal and internal discrepancies of Co-Cr frameworks for the fabrication of tooth-supported restorations.
Topics: Humans; Computer-Aided Design; Chromium Alloys; Dental Marginal Adaptation; Printing, Three-Dimensional; Denture Design; Dental Prosthesis Design; Technology, Dental; Dental Materials
PubMed: 38819942
DOI: 10.11607/ijp.8830 -
The Cochrane Database of Systematic... Oct 2019Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface... (Review)
Review
BACKGROUND
Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007.
OBJECTIVES
Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis.
DATA COLLECTION AND ANALYSIS
At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading.
MAIN RESULTS
We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces.
AUTHORS' CONCLUSIONS
Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
PubMed: 31600407
DOI: 10.1002/14651858.CD003815.pub5 -
Medicina (Kaunas, Lithuania) Sep 2022The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported... (Review)
Review
The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported frameworks with frameworks fabricated with other materials and techniques. An electronic literature search of English literature was performed using Google Scholar, Scopus, Web of Science, MEDLINE (OVID), EMBASE, and PubMed, using predetermined inclusion criteria. Specific terms were utilized in conducting a search from the inception of the respective database up to May 2022. After the search strategy was applied, the data were extracted and the results were analyzed. The focused question was: Is the misfit of the implant-supported zirconia CAD-CAM framework lower than that of non-Y-TZP implant-supported fixed restorations? Eleven articles were included for qualitative assessment and critical appraisal in this review. In the included studies, Y-TZP CAD-CAM implant-supported frameworks were compared to Titanium (Ti), Ni-Cr, Co-Cr, PEEK and high-density polymer, and cast and CAD-CAM frameworks. The studies used scanning electron microscopy, one-screw tests, digital or optical microscopy, 3D virtual assessment, and replica techniques for analyzing the misfit of frameworks. Six studies showed comparable misfits among the Y-TZP CAD-CAM frameworks and the controls. Three studies showed higher misfits for the Y-TZP CAD-CAM frameworks, whereas two studies reported lower misfits for Y-TZP CAD-CAM implant frameworks compared to controls. Y-TZP CAD-CAM implant-supported frameworks have comparable misfits to other implant-supported frameworks. However, due to heterogeneity in the methodologies of the included studies, the overall numerical misfit of the frameworks assessed in the reviewed studies is debatable.
Topics: Humans; Titanium; Zirconium; Computer-Aided Design; Polymers
PubMed: 36295507
DOI: 10.3390/medicina58101347 -
Brazilian Oral Research 2019The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they... (Meta-Analysis)
Meta-Analysis
The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was "Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?" Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.
Topics: Dental Casting Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Soldering; Humans; Prosthesis Fitting; Welding
PubMed: 31778474
DOI: 10.1590/1807-3107bor-2019.vol33.0110 -
Materials (Basel, Switzerland) Jul 2019Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and... (Review)
Review
Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.
PubMed: 31288384
DOI: 10.3390/ma12132190 -
Journal of Oral & Maxillofacial Research 2021There is a concern whether the enhancement on implant surface roughness is responsible for higher biofilm formation, which acts as an aetiological factor for... (Review)
Review
OBJECTIVES
There is a concern whether the enhancement on implant surface roughness is responsible for higher biofilm formation, which acts as an aetiological factor for peri-implant diseases. The aim of the present systematic review was to answer the following question: "Are rough surfaces more susceptible to early biofilm formation when compared to smoother surfaces on titanium specimens?".
MATERIAL AND METHODS
The research was performed on PubMed, Web of Science and Scopus, up to August 2021. Eligibility criteria included studies that analysed human biofilm formation on titanium specimens with distinct surface roughness (smooth vs minimally, moderate, or rough) over the experimental times of 1 or 3 days. Roughness average (Ra) and biofilm analysis parameters were extracted from selected articles. Risk of bias was evaluated using the Checklist for Quasi-Experimental Studies.
RESULTS
Of 5286 papers, 5 were included and analysed. Smooth titanium surfaces included machined and anodized titanium/Ti-6Al-4V; machined and acid etched TiZr. Minimally, moderately, or rough surfaces comprised titanium and titanium alloys (TiZr, Ti-6Al-4V), that received surface treatments (anodization, acid-etching, blasting, hydroxyapatite-coating). No statistically significant difference on biofilm formation on rough and smooth titanium surfaces was reported by 3 studies, while more contamination on rough titanium surfaces was stated by 2 investigations. An isolated smooth surface has also been associated to higher contamination. Moderate to high quality methodological assessment of studies were identified.
CONCLUSIONS
It is not possible to assume that rough surfaces are more susceptible to early biofilm formation than smooth titanium surfaces. Additional studies are required to study this multifarious interaction.
PubMed: 35222868
DOI: 10.5037/jomr.2021.12401