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Clinical Oral Investigations Jan 2022Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome. (Review)
Review
OBJECTIVE
Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome.
MATERIAL AND METHODS
A search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria (PRISMA). The PICO question was used to address the following specific question: "What is the level of oral health-related quality of life and satisfaction in edentulous patients and with atrophic jaws who received dental implants for full-arch implant-supported restorations following the all-on-four in the mandible or maxilla?"
RESULTS
Eleven studies including 693 patients aged 55 to 71 years were selected. The shortest follow-up period was 3 months and the longest, 7 years. Regarding the OHRQoL assessment method and patient satisfaction, the oral health impact profile (OHIP) and the visual analog scale (VAS) were the most used.
CONCLUSION
OHRQoL and satisfaction in patients whose rehabilitation was based on the all-on-four concept were high. However, the current evidence is still limited by the quality of the available studies, making long-term randomized studies necessary to establish the real effectiveness of this surgical-prosthetic approach.
CLINICAL RELEVANCE
Carefully analyze the aspects related to satisfaction and oral health-related quality of life of rehabilitated patients with implant-supported total prostheses made according to the all-on-four concept, aiming to achieve success through procedures with greater predictability and less complexity, as these are directly associated with recovery oral health of edentulous individuals with less morbidity and minimized costs.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Humans; Jaw, Edentulous; Patient Satisfaction; Personal Satisfaction; Quality of Life; Treatment Outcome
PubMed: 34647147
DOI: 10.1007/s00784-021-04213-y -
International Journal of Implant... Jul 2021This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor... (Meta-Analysis)
Meta-Analysis Review
Management of Schneiderian membrane perforations during maxillary sinus floor augmentation with lateral approach in relation to subsequent implant survival rates: a systematic review and meta-analysis.
BACKGROUND
This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival.
MATERIAL AND METHODS
This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed.
RESULTS
Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair.
CONCLUSIONS
Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.
Topics: Maxillary Sinus; Nasal Mucosa; Prostheses and Implants; Sinus Floor Augmentation; Survival Rate; United States
PubMed: 34250560
DOI: 10.1186/s40729-021-00346-7 -
International Journal of Implant... Nov 2021Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy... (Review)
Review
BACKGROUND
Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types.
OBJECTIVE
The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type.
MATERIALS AND METHODS
English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis.
RESULTS
Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive.
CONCLUSION
IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Treatment Outcome
PubMed: 34773513
DOI: 10.1186/s40729-021-00394-z -
The Journal of Prosthetic Dentistry Jul 2023Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this... (Review)
Review
STATEMENT OF PROBLEM
Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this type of prosthesis.
PURPOSE
The purpose of this systematic review was to collect scientific evidence on screwmentable prostheses and evaluate their long-term clinical behavior.
MATERIAL AND METHODS
An electronic search was conducted by 2 independent reviewers for articles published in scientific dental journals in English from 2004 to April 2020. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were scientific studies concerning the screwmentable type of prosthesis.
RESULTS
The search provided 494 records. Of these, 24 studies fulfilled the inclusion criteria and were included in the review. The included articles presented significant heterogeneity concerning the manufacturing process and the materials used. One randomized clinical trial, 2 prospective clinical studies, 14 in vitro studies, 3 protocol descriptions, 1 case series, and 3 case reports were included.
CONCLUSIONS
Based on the systematic search of the literature, it is concluded that the screwmentable prosthesis combines advantages of both cement-retained and screw-retained restorations, including passive fit, retrievability, excess cement control, tissue-friendly emergence profile, and improved esthetics. Nevertheless, data from well-designed clinical trials are limited, and further research is required to provide evidence on their long-term clinical behavior.
Topics: Dental Implants; Dental Prosthesis Retention; Prospective Studies; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Dental Cements; Glass Ionomer Cements; Randomized Controlled Trials as Topic
PubMed: 34740460
DOI: 10.1016/j.prosdent.2021.08.027 -
Journal of Plastic, Reconstructive &... Sep 2022Because of the recent attention focused on the aesthetics of the leg, outcomes in the literature are under-reported and require further investigation. We summarized the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Because of the recent attention focused on the aesthetics of the leg, outcomes in the literature are under-reported and require further investigation. We summarized the available evidence on the surgical techniques to augment the volume and dimension of the calf based on clinical outcomes and satisfaction rates.
METHODS
An electronic search was conducted across PubMed MEDLINE, Web of Science, Scopus, and Ovid MEDLINER(R) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Data collection included the patients' characteristics, surgical techniques, and postoperative outcomes. Pooled estimates were calculated with a random-effect meta-analysis using the DerSimonian-Laird model.
RESULTS
This review included 48 articles reporting outcomes of 2455 patients. The average age and follow-up were 33.15 years and 33.58 months, respectively. The most common indications for calf augmentation were esthetic concerns (48.7%). Most patients underwent subfascial implant placement (70.2%) followed by fat transfer (17.6%), submuscular implant placement (10.1%). Overall, the pooled satisfaction rate following calf augmentation was 95.4% (95% CI: 93.7%-97%). The pooled satisfaction rate for implant placement and fat transfer was 96.7% (95% CI: 94.4%-97.9%) and 87.2% (95% CI: 78.5%-96%), respectively. The pooled incidence of implant removal was 1.3% (95% CI: 0.7%-2%). The pooled estimate for additional fat grafting procedures following initial fat transfer was 54.1% (95% CI: 38.3%-70%).
CONCLUSIONS
While fat transfer has an exceptional safety profile, additional procedures to achieve satisfactory outcomes are usually necessary. Subfascial implant placement provides the best volumetric expansion with a lower implant removal rate and optimal safety profile.
Topics: Esthetics; Humans; Leg; Prostheses and Implants
PubMed: 35965213
DOI: 10.1016/j.bjps.2022.06.051 -
International Journal of Implant... Jul 2023The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.
RESULTS
Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs.
CONCLUSIONS
ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Prosthesis Failure; Titanium; Treatment Outcome; Alloys
PubMed: 37405545
DOI: 10.1186/s40729-023-00479-x -
The Journal of Prosthetic Dentistry Dec 2021Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies.... (Review)
Review
STATEMENT OF PROBLEM
Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies. Consensus is lacking regarding the most appropriate and meaningful outcome measures to use in facial prosthesis research to capture important perspectives.
PURPOSE
The purpose of the systematic review was to identify and synthesize outcome measures used in facial prosthesis research.
MATERIAL AND METHODS
Electronic searches were performed in 11 databases (including nonpeer-reviewed literature). The citations were searched, and expert societies were contacted to identify additional studies. Inclusion criteria comprised studies of participants with facial defects who required or had received prosthetic rehabilitation with an external facial prosthesis. Exclusion criteria comprised participants with ocular prostheses, case reports, case series with fewer than 5 participants, laboratory-based studies, and studies published before 1980. Study selection was performed independently by 2 reviewers. Discrepancies were resolved through discussion or by a third reviewer. Outcome measures were synthesized with a categorization approach based on the perspective, theme, and subtheme of the outcome measures. Quality assessment was performed with an appraisal tool that enabled evaluation of studies with diverse designs.
RESULTS
Database searching identified 13 058 records, and 7406 remained after duplications were removed. After initial screening, 189 potentially relevant records remained, and 186 full texts were located (98% retrieval rate). After full-text screening, 124 records were excluded. Citation searches and contact with expert societies identified 4 further records. In total, 69 articles (grouped into 65 studies) were included. Studies were categorized as per the perspective of their outcome measures, with the following findings: patient-reported (74% of studies), clinical indicators (34%), clinician-reported (8%), multiple viewpoints (6%), and independent observer-reported (3%). Patient-reported outcome measures included tools to assess satisfaction, quality of life, and psychologic health. Variability in the choice of outcome measures was evident among the studies, with many self-designed, unvalidated, condition-specific questionnaires reported. A greater number of outcome measure themes emerged over time; themes such as service delivery and health state utility have recently been evaluated.
CONCLUSIONS
Over the past 40 years, facial prosthesis research has focused on patient-reported outcome measures. Outcome measures relating to other perspectives have been used less frequently, although new themes appear to be emerging in the literature. Future research should use outcome measures with appropriate measurement properties for use with facial prosthetics.
Topics: Dental Implants; Humans; Outcome Assessment, Health Care; Quality of Life
PubMed: 33581868
DOI: 10.1016/j.prosdent.2020.09.010 -
Updates in Surgery Feb 2022Obstructed Defecation Syndrome (ODS) is a rather complex entity concerning mainly females and causing primarily constipation. Surgical treatment in the form of Ventral... (Meta-Analysis)
Meta-Analysis Review
Obstructed Defecation Syndrome (ODS) is a rather complex entity concerning mainly females and causing primarily constipation. Surgical treatment in the form of Ventral Prosthesis Rectopexy (VPR) has been proposed and seems to have the best outcomes. However, the selection criteria of patients to undergo this kind of operation are not clear and the reported outcomes are mainly short-term and data on long-term outcomes is scarce. This study assesses new evidence on the efficacy of VPR for the treatment of ODS, specifically focusing on inclusion criteria for surgery and the long-term outcomes. A search was performed of MEDLINE, EMBASE, Ovid and Cochrane databases on all studies reporting on VPR for ODS from 2000 to March 2020. No language restrictions were made. All studies on VPR were reviewed systematically. The main outcomes were intra-operative complications, conversion, procedure duration, short-term mortality and morbidity, length of stay, faecal incontinence and constipation, quality of life (QoL) score and patient satisfaction. Quality assessment and data extraction were performed independently by three observers. Fourteen studies including 963 patients were eligible for analysis. The immediate postoperative morbidity rate was 8.9%. A significant improvement in constipation symptoms was observed in the 12-month postoperative period for ODS (p < 0.0001). Current evidence shows that VPR offers symptomatic relief to the majority of patients with ODS, improving both constipation-like symptoms and faecal incontinence for at least 1-2 years postoperatively. Some studies report on functional results after longer follow-up, showing sustainable improvement, although in a lesser extent.
Topics: Defecation; Digestive System Surgical Procedures; Female; Humans; Prostheses and Implants; Quality of Life; Treatment Outcome
PubMed: 34665411
DOI: 10.1007/s13304-021-01177-2 -
Clinical Oral Implants Research Sep 2023The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or... (Meta-Analysis)
Meta-Analysis Review
Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area.
OBJECTIVE
The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iS C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.
METHODS
Electronic and manual searches were performed to identify randomized-, prospective-, and retrospective clinical trials with follow-up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iS Cs. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Thirty-two studies reporting on 42 study arms were included in the present systematic review. The meta-analysis of the included studies indicated estimated 3-year survival rates of 98.3% (95%CI: 95.6-99.3%) for porcelain-fused-to-metal (PFM) iFDPs, 97.5% (95%CI: 95.5-98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8-99.6%) for monolithic or micro-veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8-99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6-99.3%] vs. 99.1% [95%CI: 97.6-99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iS Cs.
CONCLUSIONS
Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS Cs showed similarly high short-term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.
Topics: Prospective Studies; Retrospective Studies; Dental Prosthesis Design; Dental Restoration Failure; Dental Porcelain; Ceramics; Zirconium; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 37750526
DOI: 10.1111/clr.14103 -
The Journal of Prosthetic Dentistry Dec 2022Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear. (Review)
Review
STATEMENT OF PROBLEM
Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear.
PURPOSE
The purpose of this systematic review was to examine the influence of implant-supported fixed complete dentures (FCDs), implant-supported overdentures, and removable CDs on speech articulation disorders in patients with at least 1 completely edentulous jaw.
MATERIAL AND METHODS
This study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). The PubMed/Medline, Embase, Web of Science, Scopus, Latin American and Caribbean Health Sciences, Brazilian Clinical Trials Registry, and Cochrane Library databases were searched through April 2020 to identify clinical trials comparing maxillary and/or mandibular implant-supported dentures with removable CD use in terms of speech articulation in participants with at least 1 completely edentulous jaw. The risk of bias of selected studies was assessed with the Joanna Briggs Institute critical appraisal tools, and the quality of evidence was tested by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS
Initially, 2586 articles were identified, and their titles and abstracts were read. Sixteen articles were read in full, and 8 studies (4 paired clinical trials and 4 cross-sectional studies) were included in this review. In total, 290 prosthesis users aged 29 to 90 years, approximately 44 of whom had hearing difficulties, were included. Four studies had a low risk of bias, and 4 studies had a high risk of bias. Distortions of the /s/ phoneme were observed more often in the first 6 months of maxillary FCD use than with removable CD use. Speech articulation did not differ between mandibular FCD and removable CD users. The quality of evidence for speech articulation disorders was low.
CONCLUSIONS
Given the low quality of evidence on speech articulation disorders, further research on speech articulation disorders in prosthesis wearers is needed.
Topics: Humans; Dental Prosthesis, Implant-Supported; Speech; Cross-Sectional Studies; Dental Implants; Denture, Complete; Denture, Overlay; Jaw, Edentulous; Articulation Disorders; Patient Satisfaction
PubMed: 33865562
DOI: 10.1016/j.prosdent.2021.03.006