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Dental Materials : Official Publication... Dec 2021The aim of this systematic review and meta-analysis was to compare the bond strength between eroded and sound permanent enamel and dentin and to assess whether bonding... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this systematic review and meta-analysis was to compare the bond strength between eroded and sound permanent enamel and dentin and to assess whether bonding performance (immediate and after aging) differs between etch&rinse and self-etch adhesives and can be improved by surface pretreatment prior to bonding.
METHODS
Electronic databases (PubMed, Scopus, Embase, Web of Science, CENTRAL, LILACS, BBO) were searched by two reviewers. Random-effect meta-analyses were performed to compare bond strength to sound and eroded dental hard tissues without and with surface pretreatment prior to bonding, respectively. The effect of adhesive mode (etch&rinse vs. self-etch) and aging (immediate vs. aged) was compared using subgroup analyses. Statistical heterogeneity was assessed using Cochran's Q and I-statistic. Funnel plots and Egger's regression intercept tests were used to evaluate publication bias. Quality and risk of bias of included studies were also assessed.
RESULTS
Fourty-seven studies (45 in vitro, 2 in situ) were included in the systematic review and meta-analyses. Erosion impairs bond strength to dentin (p < 0.001; mean difference: -10.2 MPa [95%CI: -11.9 to -8.6 MPa]), but not to enamel (p = 0.260). Surface pretreatment measures removing or stabilizing the collagenous matrix can improve dentin bond strength (maximum mean difference: +12.4 MPa). Etch&rinse and self-etch adhesives did not perform significantly different on eroded enamel (p = 0.208) and dentin (p = 0.353). The majority of studies (32 of 47) presented a medium risk of bias.
SIGNIFICANCE
Data from in vitro and in situ studies showed that erosion impairs dentin bonding of etch&rinse and self-etch adhesives and makes surface pretreatment prior to bonding of composite restorations necessary.
Topics: Dental Bonding; Dental Cements; Dental Enamel; Dentin; Dentin-Bonding Agents; Materials Testing; Resin Cements
PubMed: 34593245
DOI: 10.1016/j.dental.2021.09.014 -
BioMed Research International 2022The healing of the periapical tissues is crucial to the success of root canal treatment. The review studies effectively examine various endodontic root canal sealants in... (Review)
Review
The healing of the periapical tissues is crucial to the success of root canal treatment. The review studies effectively examine various endodontic root canal sealants in terms of periapical healing. This systematic review was formulated following the PRISMA 2020 guidelines and registered in the international prospective register of systematic reviews (PROSPERO) number-CRD42021239192. To find relevant articles, PubMed Central and Medline databases (until February 2022) were searched. Studies that evaluated healing following the application of different endodontic sealers were analysed. A primary outcome measure was the resolution of periapical lesions following the endodontic treatment. In vivo studies comparing radiographic treatment outcomes and articles with a minimum of 6-month follow-up were included. A total of 9 clinical trial studies that met all the inclusion criteria were included in the analysis. The overall risk of bias was high in four studies out of nine studies. Periapical lesions showed significant healing after endodontic treatment regardless of sealer type, although bioceramic and bioactive sealers had shown better results.
Topics: Dental Pulp Cavity; Root Canal Filling Materials; Root Canal Therapy; Treatment Outcome; Wound Healing
PubMed: 35845966
DOI: 10.1155/2022/3569281 -
International Journal of Implant... Jul 2023The purpose of this systematic review was to assess the evidence regarding the indications for placement of zygomatic implants to rehabilitate edentulous maxillae. (Review)
Review
PURPOSE
The purpose of this systematic review was to assess the evidence regarding the indications for placement of zygomatic implants to rehabilitate edentulous maxillae.
MATERIAL AND METHODS
A focused question using the PIO format was developed, questioning "in patients in need of an implant-supported rehabilitation of the edentulous maxillae, what are the indications for the use of zygomatic implants''. The primary information analyzed and collected was a clear description of the indication for the use of zygomatic implants.
RESULTS
A total of 1266 records were identified through database searching. The full-text review was conducted for 117 papers, and 10 were selected to be included in this review. Zygomatic implant indications were extreme bone atrophy or deficiency secondary to different factors. The quad zygoma concept (two zygomatic implants bilaterally placed and splinted) was applied to 107 patients, the classic zygoma concept (one zygomatic implant bilaterally placed and splinted to standard anterior implants) was used in 88 patients, and the unilateral concept (one zygomatic implant on one side, splinted with one or more conventional implants) was employed in 14 patients.
CONCLUSIONS
The main indication for the use of zygomatic implants was considered extreme maxillary bone atrophy, resulting from many factors. The clear definition of what was considered "extreme bone atrophy" is not uniquely defined in each paper. Further studies are needed to develop clear indications for zygomatic implants.
Topics: Humans; Dental Implants; Atrophy; Databases, Factual; Medicine; Mouth, Edentulous
PubMed: 37391575
DOI: 10.1186/s40729-023-00480-4 -
Clinical Oral Investigations Dec 2021The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures... (Review)
Review
OBJECTIVES
The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.
MATERIALS AND METHODS
Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.
RESULTS
Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.
CONCLUSIONS
Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.
CLINICAL RELEVANCE
Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Patient Comfort; Prospective Studies; Prosthodontics
PubMed: 34568955
DOI: 10.1007/s00784-021-04157-3 -
Drug Metabolism Reviews May 2020Nano-hydroxyapatite (nano-HA) is a material with multiple uses due to its biocompatibility and its resemblance to the nonorganic bone structure. It is used in various...
Nano-hydroxyapatite (nano-HA) is a material with multiple uses due to its biocompatibility and its resemblance to the nonorganic bone structure. It is used in various dental domains such as implantology, surgery, periodontology, esthetics and prevention. The aim of this study is to provide a wide understanding of nano-HA and to promote treatments based on nanomaterials in dentistry. A search in two data bases, Scopus, and PubMED, was conducted over a 5 years period. We chose a 5 years period because this revealed the most recent published studies with the key words 'nano-HA' and 'dentistry'. A number of 32 studies were included in this systematic review. In implantology the main use of nano-HA was as a coating material for titanium implants and its effect was assessed in the matter of osteointegration and inflammatory response as well as antibacterial activity. In tissue engineering the use of nano-HA was directed to surgery and periodontology and this material was assessed mainly as a grafting material. In esthetics and prevention its use was mainly focused on dentinal hypersensitivity treatment, remineralizing potential and as bleaching co-agent. Nano-HA is a relatively novel material with outstanding physical, chemical, mechanical and biological properties that makes it suitable for multiple interventions. It outperformed most of the classic materials used in implantology and surgery but it should be further investigated for bone engineering and caries therapy.
Topics: Animals; Dental Materials; Dental Prosthesis; Humans; Hydroxyapatites; Nanoparticles
PubMed: 32393070
DOI: 10.1080/03602532.2020.1758713 -
Dental Materials : Official Publication... Oct 2021The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.
METHODS
This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.
RESULTS
From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.
SIGNIFICANCE
Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.
Topics: Bayes Theorem; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Materials Testing; Methacrylates; Resin Cements; Tensile Strength
PubMed: 34456050
DOI: 10.1016/j.dental.2021.08.014 -
Clinical Oral Implants Research Oct 2021To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs). (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns.
OBJECTIVE
To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs).
METHODS
Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow-up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all-ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Forty-nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta-analysis of the included studies indicated an estimated 3-year survival rate of veneered-reinforced glass-ceramic implant-supported SCs of 97.6% (95% CI: 87.0%-99.6%). The estimated 3-year survival rates were 97.0% (95% CI: 94.0%-98.5%) for monolithic-reinforced glass-ceramic implant SCs, 96.9% (95% CI: 93.4%-98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%-97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%-97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%-87.7%) for resin-matrix-ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates.
CONCLUSIONS
With the exception of RMC SCs, veneered and monolithic implant-supported ceramic SCs showed favorable short-term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
Topics: Ceramics; Crowns; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Prospective Studies; Retrospective Studies
PubMed: 34642991
DOI: 10.1111/clr.13863 -
International Journal of Paediatric... Jan 2022Preformed metal crowns (PMCs) have been the restoration of choice for paediatric dentistry; however, PMCs have a non-aesthetic appearance, which has become a point of... (Review)
Review
BACKGROUND
Preformed metal crowns (PMCs) have been the restoration of choice for paediatric dentistry; however, PMCs have a non-aesthetic appearance, which has become a point of concern. Recently, prefabricated zirconia crowns (PZCs) have been increasingly used as an aesthetic restorative material for primary teeth, as they have pleasing properties.
AIM
This systematic review summarises the clinical results for PZCs in the primary dentition, including wear on the opposing dentition, retention, fracture resistance, parental satisfaction, gingival health, and cementation materials.
MATERIALS AND METHODS
Electronic database searches were conducted using PubMed, Google Scholar, Web of Science, and the Cochrane Library. Clinical trials, observational studies, and case reports/series were included. The quality of the studies was analysed using the Cochrane tool and the domain-based evaluation for non-randomised studies of interventions.
RESULTS
The search retrieved 166 references, of which 14 studies were included for qualitative analyses. The risk of bias varied from low to unclear. The included studies indicated that prefabricated zirconia crowns are retentive and are not associated with accelerated wear on the opposing dentition. They also exhibit a high fracture resistance, satisfy the parents and are compatible with gingival health. There is, however, inconclusive evidence with regard to cementation materials.
CONCLUSION
Prefabricated Zirconia Crowns appear to be a good alternative to preformed metal crowns in term of esthetics, retention, resistance to fracture, parent satisfaction, and gingival health.
Topics: Child; Crowns; Dental Materials; Humans; Tooth, Deciduous; Zirconium
PubMed: 33772904
DOI: 10.1111/ipd.12793 -
Journal of Esthetic and Restorative... Jan 2022Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP)... (Review)
Review
OBJECTIVES
Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP) ceramics. It has been widely discussed, however, that the differing composition and physical properties of new high-translucent zirconia generations (4Y-TZP and 5Y-TZP) may require alternative bonding materials and procedures. This paper reviewed in vitro studies on the success and durability of bonding protocols to high-translucent zirconia.
MATERIAL AND METHODS
A systematic search of PubMed and Cochrane Library for in vitro studies on bonding to new zirconia generations published until November 2020 was conducted and complemented by a manual search. Studies selected for review fulfilled the applied inclusion and exclusion criteria. The quality of the included studies was assessed with the Cochrane risk-of-bias tool for randomized trials.
RESULTS
Of 629 screened articles, 18 were included in this review. They investigated different surface pretreatment methods, primers, resin cements, aging procedures, and bond strength test protocols. The limited number of the identified studies and the heterogeneity of the extracted data did not allow to conduct a meta-analysis.
CONCLUSIONS
The available evidence suggests that resin bonding protocols successfully applied to conventional zirconia are also the most successful for high-translucent zirconia. Airborne particle abrasion and special phosphate monomer-containing primers or composite resin cements provide long-term durable resin bonds.
CLINICAL SIGNIFICANCE
Durable bonds can be established between high-translucent zirconia and resin cements. The bonding materials and procedures applied do not compromise their physical properties.
Topics: Ceramics; Dental Bonding; Dental Stress Analysis; Materials Testing; Resin Cements; Surface Properties; Zirconium
PubMed: 35072329
DOI: 10.1111/jerd.12876 -
Journal of Esthetic and Restorative... Feb 2024To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without... (Review)
Review
OBJECTIVE
To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage.
MATERIALS AND METHODS
A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies.
RESULTS
Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool.
CONCLUSION
Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies.
CLINICAL SIGNIFICANCE
This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
Topics: Humans; Crowns; Dental Materials; Dental Restoration Failure; Dental Stress Analysis; Materials Testing; Tooth, Nonvital; Prosthodontics
PubMed: 37571973
DOI: 10.1111/jerd.13119