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The Journal of Prosthetic Dentistry Nov 2023Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported... (Review)
Review
Predictability of single versus double-barrel vascularized fibula flaps and dental implants in mandibular reconstructions: A systematic review and meta-analysis of prospective studies.
STATEMENT OF PROBLEM
Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported prosthesis. Although the double-flap technique seems promising, systematic reviews and meta-analyses of prospective studies are lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the grafted areas of single barrel fibular flaps (SBFF) and double-barrel fibular flaps (DBFF) by considering failure rates, dental implant complications, and bone union at the osteotomy sites.
MATERIAL AND METHODS
A systematic review and meta-analysis was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, population, intervention, control, and outcomes (PICO) question, and the National Health and Medical Research Council scales. The event rate of complications and failures was calculated with a confidence interval (CI) of 95%.
RESULTS
A total of 13 prospective studies with 441 participants and 330 graft sites were identified. A total of 235 participants had SBFF with 445 implants, and 95 had DBFF with 164 implants. The overall combined graft failure rates were 4.2% for SBFF and 3.2% for DBFF. The complication rate was 10% for SBFF and 1.9% for DBFF. Implant failure was at 4.7% in the SBFF group and 3.4% in the DBFF group.
CONCLUSIONS
Complication rates and implant failures were similar for SBFF and DBFF. Therefore, for long-term oral rehabilitation, both SBFF and DBFF are suitable procedures for mandibular reconstruction.
PubMed: 37978003
DOI: 10.1016/j.prosdent.2023.10.007 -
The Journal of Prosthetic Dentistry Mar 2023Proximal contact loss between implant-supported prostheses and adjacent natural teeth is a complication that has been reported in clinical practice. However, the... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Proximal contact loss between implant-supported prostheses and adjacent natural teeth is a complication that has been reported in clinical practice. However, the prevalence of the condition is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to assess the proportion of reported proximal contact loss between implant-supported prostheses and adjacent natural teeth.
MATERIAL AND METHODS
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology criteria and was registered on the international prospective register of systematic reviews (PROSPERO) platform (CRD42021225138). The electronic search was conducted by using the PubMed/MEDLINE, Embase, and Cochrane Library databases to September 2020. The formulated population, intervention, comparison, outcome (PICO) question was "Is there a correlation of the proximal contact loss between implant-supported prostheses and the adjacent natural tooth?" A single-arm meta-analysis of proportion was performed to evaluate the cumulative prevalence of survival and complication rates.
RESULTS
This review included 10 studies, half of which presented proximal contact loss rates higher than 50%. In the general analysis, the open proximal contact showed a cumulative proportion of 41% (confidence interval: 30% to 53%; heterogeneity: I=98%; t=0.578; P<.01). From the subanalysis, the mesial contact (47%; confidence interval: 32% to 62%; heterogeneity: I= 96%; t=0.657; P<.01) and the mandibular arch (41%; confidence interval: 30% to 52%; heterogeneity: I=92%; t=0.302; P<.01) were found to have higher prevalence.
CONCLUSIONS
The prevalence of proximal contact loss was high, occurring more frequently with the mesial contact and in the mandibular arch. Significant differences were not found in relation to sex or between the posterior and anterior regions.
Topics: Humans; Dental Implants; Prevalence; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Databases, Factual
PubMed: 34294422
DOI: 10.1016/j.prosdent.2021.05.025 -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
Supportive Care in Cancer : Official... Oct 2023To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis.
METHODS
An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle-Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool.
RESULTS
A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20-99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56-99.48, p < 0.001).
CONCLUSIONS
Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.
Topics: Humans; Middle Aged; Aged; Bone-Anchored Prosthesis; Head and Neck Neoplasms
PubMed: 37851170
DOI: 10.1007/s00520-023-08088-5 -
The Journal of Prosthetic Dentistry Apr 2022A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited. (Meta-Analysis)
Meta-Analysis Review
Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles.
MATERIAL AND METHODS
Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health-related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P<.001), physical disability (P=.001), and physical pain (P=.003). Fixed prostheses also improved satisfaction, when compared with overdentures for comfort (P=.02), ease of mastication (P<.001), retention (P<.001), and stability (P<.001). The same pattern was observed for overall OHRQoL (P=.01) and satisfaction (P=.01) in which fixed prostheses improved patient satisfaction. Only ease of cleaning presented greater satisfaction for the overdenture group. Clinical parameters did not differ statistically (P>.05) between both types of prosthesis.
CONCLUSIONS
Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients' oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mouth, Edentulous; Patient Reported Outcome Measures; Patient Satisfaction; Quality of Life
PubMed: 33390270
DOI: 10.1016/j.prosdent.2020.11.005 -
The Journal of Prosthetic Dentistry Jun 2022A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking. (Meta-Analysis)
Meta-Analysis Review
Effect of 2-implant mandibular overdenture with different attachments and loading protocols on peri-implant health and prosthetic complications: A systematic review and network meta-analysis.
STATEMENT OF PROBLEM
A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking.
PURPOSE
The purpose of this systematic review and network meta-analysis was to evaluate the effect of different overdenture attachments with delayed or immediately loaded 2-implant-retained mandibular overdentures on peri-implant tissue health.
MATERIAL AND METHODS
A comprehensive search of the PubMed, EMBASE, and Cochrane library was conducted to identify eligible randomized controlled trials (RCTs). The outcomes were marginal bone loss, probing depth, plaque index, bleeding on probing, implant survival rate, and prosthetic complications. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals was calculated.
RESULTS
Sixteen RCT (n=599 participants receiving 1198 dental implants) were included. Five common overdenture attachment systems with delayed or immediate loading were compared. The difference in marginal bone loss and probing depth was not statistically significant when comparing different overdenture attachments with different loading protocols. The rank probability test showed that bar+ immediate loading ranked highest (63.8%) in terms of marginal bone loss, whereas ball+ delayed loading (73.3%) ranked highest in terms of probing depth. The implant survival rate was 100% for the LOCATOR+ delayed loading, resilient telescopic+ delayed loading, and magnet+ immediate loading; however, bar+ delayed loading, ball+ delayed loading, magnet+ delayed loading, LOCATOR+ immediate loading, ball+ immediate loading, and bar+ immediate loading had survival rates of 99.1%, 98.8%, 96.0%, 94.7%, 93.1%, and 91.2%, respectively.
CONCLUSIONS
All types of overdenture attachment with immediate loading or delayed loading had a similar effect on peri-implant health. Bar+ immediate loading was associated with the least marginal bone loss, whereas ball+ delayed loading showed the least probing depth.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible; Network Meta-Analysis; Treatment Outcome
PubMed: 33546861
DOI: 10.1016/j.prosdent.2020.12.016 -
The Journal of Contemporary Dental... Nov 2021The purpose of this review is to compare randomized clinical trials evaluating the peri-implant tissue outcomes using different unsplinted attachment systems in two... (Review)
Review
AIM
The purpose of this review is to compare randomized clinical trials evaluating the peri-implant tissue outcomes using different unsplinted attachment systems in two implant-retained mandibular overdentures.
BACKGROUND
Literature lacks information on various unsplinted attachment systems and their effect on peri-implant tissue health. A focus question (as per PICOS) was set as follows: Does one particular unsplinted attachment system (I) compared with another (C) results in better peri-implant outcomes (O) in two implant-retained mandibular overdentures (P) using randomized controlled trials (RCTs) (S)? The literature search was conducted in the PubMed, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases between January 2011 and December 2021. The keywords used were "denture, overlay," "denture," "overlay" AND "dental prosthesis, implant supported," "dental implants," "dental implant abutment design" AND "jaw, edentulous," "mouth, edentulous" AND "mandible." Only RCTs on two implant-retained mandibular overdentures using unsplinted attachment systems measuring peri-implant tissue outcomes with minimum 1-year follow-up were selected. In total, 224 studies were identified in initial search, and 25 were shortlisted for full-text evaluation. Four studies were included for systematic review upon considering inclusion and exclusion criteria. The risk of bias was evaluated using Cochrane Risk of Bias Tool 2.0 (RoB 2.0).
REVIEW RESULTS
A total of 41 patients received ball attachments (in 3 studies), 36 patients received low-profile attachments (in 3 studies), 16 patients received magnet attachments (in 1 study), and 13 patients received telescopic attachments (in 1 study). All four studies used standard sized implants, however, differed in implant manufacturers. Two studies which compared ball attachments low-profile attachments revealed-similar peri-implant tissue health parameters but differed in crestal bone-level changes. One study compared ball with telescopic attachments and revealed similar results in crestal bone-level changes and all four peri-implant tissue health parameters. Single study compared magnets with low-profile attachments and shown lesser bone loss with magnet attachments. Single study was judged to have low risk of bias, single with some concerns, and remaining two to have high risk of bias.
CONCLUSION
Gingival index and bleeding index of the patients were not influenced by any of the unsplinted overdenture attachment (stud, magnet, telescopic) system. Inconclusive results found among the studies evaluated comparing crestal bone loss and plaque index.
CLINICAL SIGNIFICANCE
This review manuscript has simplified comparative analysis of different unsplinted attachment systems used in two implant mandibular overdentures to help clinicians choose correct system in such situation.
Topics: Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Randomized Controlled Trials as Topic
PubMed: 35343463
DOI: No ID Found -
Journal of Clinical and Experimental... Apr 2021Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those... (Review)
Review
BACKGROUND
Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss in immediate or delayed loaded full mandibular denture retaining dental implants has been recently published. It is interesting to evaluate also the risks of early versus immediate and delayed loading in complete mandibular restorations. The purpose of this systematic review and meta-analysis was to study early (EL) versus immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss.
MATERIAL AND METHODS
The literature review was conducted in PubMed, Web of Science, and the Cochrane Library. Seven randomized clinical trials were included.
RESULTS
The result of a meta-analysis of implant loss before 1 year in EL versus IL was 0.34 (95% CI: 0.08, 1.52), favoring the EL control group, while the outcome for crestal bone loss at the three-year observation was -0.10 (95% CI: -0.28, 0.09), with a tendency toward reduced bone loss for EL. In the EL versus DL group, the result of the meta-analysis of implant loss before one year was inconclusive, while in the comparison regarding crestal bone loss in the first year of observation, the result was -0.03 (95% CI: -0.08,-0.02) with a tendency to less bone loss in EL.
CONCLUSIONS
The risk of early implant loss in the IL group was higher than in the EL group. The results in terms of early implant loss in EL versus DL are inconclusive. Besides, crestal bone loss is greater in immediately and delayed loaded implants, at 1 and 3 years of observation, compared to those loaded early. Dental implants, early dental implant loading, dental prostheses, implant- supported, alveolar bone loss, meta-analysis.
PubMed: 33841740
DOI: 10.4317/jced.57966 -
International Journal of Oral and... May 2023The aim of this systematic review was to determine the most prevalent complications resulting from total temporomandibular joint (TMJ) replacement. An electronic search... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to determine the most prevalent complications resulting from total temporomandibular joint (TMJ) replacement. An electronic search was performed using the Embase, LILACS, MEDLINE (via PubMed), SciELO, Scopus, and Web of Science databases up to June 2022. Prospective and retrospective clinical studies on patients who underwent TMJ replacement were included. Two reviewers performed the study selection, data extraction, and individual risk of bias assessment using the Joanna Briggs Institute Critical Appraisal Tools. The pooled prevalence of each complication was calculated through a proportion meta-analysis using the random-effects model. Twenty-eight studies met the eligibility criteria and were included in the review. All of the eligible studies had a low risk of bias. The results of the meta-analysis revealed that the most prevalent complication was paresis or paralysis of the facial nerve branches (7.8%; 95% confidence interval (CI) 2.6-15.1%, I = 94.5%), followed by sensory alterations (1.8%; 95% CI 0.6-4.9%, I = 88.8%), heterotopic bone formation (1.0%; 95% CI 0.1-2.5%, I = 75.8%), and infection (0.7%; 95% CI 0.1-1.6%, I = 22.7%). In conclusion, TMJ replacement has a low prevalence of complications, and most of them can be managed successfully.
Topics: Humans; Temporomandibular Joint Disorders; Prospective Studies; Retrospective Studies; Temporomandibular Joint; Joint Prosthesis
PubMed: 36494246
DOI: 10.1016/j.ijom.2022.10.009 -
The International Journal of...To evaluate the current literature and provide clinical recommendations related to the number of implants, implant characteristics, loading protocols, survival rates,...
PURPOSE
To evaluate the current literature and provide clinical recommendations related to the number of implants, implant characteristics, loading protocols, survival rates, biologic and mechanical complications, patient satisfaction, and financial considerations for mandibular implant-supported full-arch prostheses.
MATERIALS AND METHODS
A PubMed/MEDLINE search for literature published between January 1, 1980 and February 8, 2019, was performed for systematic reviews on this topic. The PICO question was: In mandibular fully edentulous patients treated with implant full-arch prostheses, is there any difference between fixed and removable implant prostheses in terms of implant and prosthesis survival rates? Only systematic reviews with or without meta-analyses were included. The findings varied based on the type of implant full-arch prosthesis.
RESULTS
High survival rates for implants and prostheses have been reported for fixed and removable implant full-arch prostheses in the mandible. Immediate loading procedures present with high survival rates for both fixed and removable prostheses. There are differences in the number of implants, implant characteristics, complications, and financial implications between these two types of prostheses, which clinicians need to account for as part of the treatment planning process.
CONCLUSION
Implant-supported overdentures and implant-supported fixed complete dentures represent clinically successful treatment approaches. In cases where both treatment options are indicated, patient expectations and cost should be the determining factors for selecting a treatment modality.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Follow-Up Studies; Humans; Mandible; Treatment Outcome
PubMed: 33571328
DOI: 10.11607/ijp.6911