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Journal of Periodontology Jan 2021The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous approaches to augment soft tissue volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial for peri-implant health has been subject of debate in the field of implant dentistry. The aim of this systematic review was to analyze the evidence regarding the efficacy of soft tissue augmentation procedures aimed at modifying the PSP and their impact on peri-implant health.
METHODS
A comprehensive search was performed to identify clinical studies that involved soft tissue augmentation around dental implants and reported findings on KMW, MT, and/or STH changes. The effect of the intervention on peri-implant health was also assessed. Selected articles were classified based on the general type of surgical approach to increase PSP, either bilaminar or an apically positioned flap (APF) technique. A network meta-analysis including only randomized-controlled trials (RCTs) reporting on PSP outcomes was conducted to assess and compare different techniques.
RESULTS
A total of 52 articles were included in the qualitative analysis, and 23 RCTs were included as part of the network meta-analysis. Sixteen RCTs reported the outcomes of PSP modification therapy with bilaminar techniques, whereas 7 involved the use of APF. The analysis showed that bilaminar techniques in combination with soft tissue grafts (connective tissue graft [CTG], collagen matrix [CM], and acellular dermal matrix [ADM]) resulted in a significant increase in MT compared to non-augmented sites. In particular, CTG and ADM were associated with higher MT gain as compared to CM and non-augmented sites. However, no significant differences in KMW were observed across different bilaminar techniques. PSP modification via a bilaminar approach utilizing either CTG or CM showed beneficial effects on marginal bone level stability. APF-based approaches in combination with free gingival graft (FGG), CTG, CM, or ADM showed a significant KMW gain compared to non-augmented sites. However, compared to APF alone, only FGG exhibited a significantly higher KMW gain. APF with any evaluated soft tissue graft was associated with with reduction of probing depth, soft tissue dehiscence and plaque index compared to non-augmented sites compared to non-augmented sites. The evidence regarding the effect of PSP modification via APF-based approaches on peri-implant marginal bone loss or preservation is inconclusive.
CONCLUSIONS
Bilaminar approach involving CTG or ADM obtained the highest amount of MT gain, whereas APF in combination with FGG was the most effective technique for increasing KMW. KMW augmentation via APF was associated with a significant reduction in probing depth, soft tissue dehiscence and plaque index, regardless of the soft tissue grafting material employed, whereas bilaminar techniques with CTG or CM showed beneficial effects on marginal bone level stability.
Topics: Connective Tissue; Dental Implants; Gingiva; Network Meta-Analysis; Phenotype
PubMed: 32710810
DOI: 10.1002/JPER.19-0716 -
The Journal of Prosthetic Dentistry Feb 2023Artificial intelligence (AI) applications are growing in dental implant procedures. The current expansion and performance of AI models in implant dentistry applications...
STATEMENT OF PROBLEM
Artificial intelligence (AI) applications are growing in dental implant procedures. The current expansion and performance of AI models in implant dentistry applications have not yet been systematically documented and analyzed.
PURPOSE
The purpose of this systematic review was to assess the performance of AI models in implant dentistry for implant type recognition, implant success prediction by using patient risk factors and ontology criteria, and implant design optimization combining finite element analysis (FEA) calculations and AI models.
MATERIAL AND METHODS
An electronic systematic review was completed in 5 databases: MEDLINE/PubMed, EMBASE, World of Science, Cochrane, and Scopus. A manual search was also conducted. Peer-reviewed studies that developed AI models for implant type recognition, implant success prediction, and implant design optimization were included. The search strategy included articles published until February 21, 2021. Two investigators independently evaluated the quality of the studies by applying the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies (nonrandomized experimental studies). A third investigator was consulted to resolve lack of consensus.
RESULTS
Seventeen articles were included: 7 investigations analyzed AI models for implant type recognition, 7 studies included AI prediction models for implant success forecast, and 3 studies evaluated AI models for optimization of implant designs. The AI models developed to recognize implant type by using periapical and panoramic images obtained an overall accuracy outcome ranging from 93.8% to 98%. The models to predict osteointegration success or implant success by using different input data varied among the studies, ranging from 62.4% to 80.5%. Finally, the studies that developed AI models to optimize implant designs seem to agree on the applicability of AI models to improve the design of dental implants. This improvement includes minimizing the stress at the implant-bone interface by 36.6% compared with the finite element model; optimizing the implant design porosity, length, and diameter to improve the finite element calculations; or accurately determining the elastic modulus of the implant-bone interface.
CONCLUSIONS
AI models for implant type recognition, implant success prediction, and implant design optimization have demonstrated great potential but are still in development. Additional studies are indispensable to the further development and assessment of the clinical performance of AI models for those implant dentistry applications reviewed.
Topics: Humans; Artificial Intelligence; Dental Implantation, Endosseous; Dental Implants; Porosity
PubMed: 34144789
DOI: 10.1016/j.prosdent.2021.05.008 -
International Journal of Environmental... Feb 2022The aim of this systematic review was to summarize the literature regarding the clinical performance of zirconia crowns for primary teeth. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review was to summarize the literature regarding the clinical performance of zirconia crowns for primary teeth.
MATERIALS AND METHODS
Four electronic databases, Ovid, PubMed, Scopus, and Web of Science were searched. Clinical, observational, and laboratory studies were included. Studies that assessed the performance of zirconia crowns for primary teeth using outcomes such as gingival and periodontal health, parental satisfaction, color stability, crown retention, contour, fracture resistance, marginal integrity, surface roughness, and recurrent caries were included. Risk of bias was assessed using different assessment tools depending on the type of the assessed study.
RESULTS
Out of the 2400 retrieved records, 73 full-text records were assessed for eligibility. Thirty-six studies were included for qualitative analysis. The included studies reported that zirconia crowns for primary teeth were associated with better gingival and periodontal health, good retention, high fracture resistance, color stability, high parental acceptance, good marginal adaptation, smooth cosmetic surface, and no recurrent caries.
CONCLUSION
Zirconia crowns are promising alternative to other restorative materials and crowns in the field of pediatric dentistry. They showed higher properties and performance in different clinical aspects and great parental satisfaction.
Topics: Child; Crowns; Gingiva; Humans; Tooth, Deciduous; Zirconium
PubMed: 35270531
DOI: 10.3390/ijerph19052838 -
International Journal of Environmental... Jun 2020Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental...
Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental implant. The aim of this literature review was to summarize the influences of different potential risk factors on the incidence of late dental implant failure. The protocol of this systematic review was prepared and implemented based on the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) guideline. In December 2018, studies published within the previous 10 years on late dental implant failure were selected by fulfilling the eligibility criteria and the risk factors identified in qualified studies were extracted by using a predefined extraction template. Fourteen eligible studies were assessed. The common risk factors for late failure were divided into three groups according to whether they were related to (1) the patient history (radiation therapy, periodontitis, bruxism and early implant failure), (2) clinical parameters (posterior implant location and bone grade 4) or (3) decisions made by the clinician (low initial stability, more than one implant placed during surgery, inflammation at the surgical site during the first year or using an overdenture with conus-type connection). Clinicians should be cautions throughout the treatment process of dental implant-from the initial examination to the treatment planning, surgical operation and prosthesis selection-in order to minimize the risk of late failure of dental implant.
Topics: Dental Implants; Dental Restoration Failure; Humans; Periodontitis; Research Design; Risk Factors
PubMed: 32498256
DOI: 10.3390/ijerph17113931 -
Journal of the American Heart... Jan 2023Background The Ross operation appears to restore normal survival in young and middle-aged adults with aortic valve disease. However, there are limited data comparing it... (Meta-Analysis)
Meta-Analysis Review
Background The Ross operation appears to restore normal survival in young and middle-aged adults with aortic valve disease. However, there are limited data comparing it with conventional aortic valve replacement. Herein, we compared outcomes of the Ross procedure with mechanical and bioprosthetic aortic valve replacement (M-AVR and B-AVR, respectively). Methods and Results MEDLINE and EMBASE were searched through March 2022 to identify randomized controlled trials and propensity score-matched studies that investigated outcomes of patients aged ≥16 years undergoing the Ross procedure, M-AVR, or B-AVR. The systematic literature search identified 2 randomized controlled trials and 8 propensity score-matched studies involving a total of 4812 patients (Ross: n=1991; M-AVR: n=2019; and B-AVR: n=802). All-cause mortality was significantly lower in the Ross procedure group compared with M-AVR (hazard ratio [HR] [95% CI], 0.58 [0.35-0.97]; =0.035) and B-AVR (HR [95% CI], 0.32 [0.18-0.59]; <0.001) groups. The reintervention rate was lower after the Ross procedure and M-AVR compared with B-AVR, whereas it was higher after the Ross procedure compared with M-AVR. Major bleeding rate was lower after the Ross procedure compared with M-AVR. Long-term stroke rate was lower following the Ross procedure compared with M-AVR and B-AVR. The rate of endocarditis was also lower after the Ross procedure compared with B-AVR. Conclusions Improved long-term outcomes of the Ross procedure are demonstrated compared with conventional M-AVR and B-AVR options. These results highlight a need to enhance the recognition of the Ross procedure and revisit current guidelines on the optimal valve substitute for young and middle-aged patients.
Topics: Adult; Humans; Middle Aged; Aortic Valve; Aortic Valve Insufficiency; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Network Meta-Analysis; Retrospective Studies; Treatment Outcome; Adolescent; Young Adult
PubMed: 36565200
DOI: 10.1161/JAHA.122.027715 -
The Journal of Prosthetic Dentistry Dec 2019Immediate loading of dental implants has gained widespread popularity because of its advantages in shortening treatment duration and improving esthetics and patient... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Immediate loading of dental implants has gained widespread popularity because of its advantages in shortening treatment duration and improving esthetics and patient acceptance. However, whether immediate loading can achieve clinical outcomes comparable with those of early or conventional delayed loading is still unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the efficacy of immediate loading versus early or conventional loading implants in patients rehabilitated with fixed prostheses.
MATERIAL AND METHODS
Electronic searches of CENTRAL, EMBASE, and MEDLINE were supplemented by manual searches up to October 2018. Only human randomized controlled trials (RCTs) comparing immediate with early or conventional loading dental implants were included. Quality assessment was performed by using the Cochrane Collaboration tool. For the meta-analysis, the dichotomous and continuous variables were pooled and analyzed by using risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (95% CIs). The outcomes assessed included survival rate, marginal bone level changes, peri-implant gingival level, probing depth, and implant stability. The subgroup analyses included healing methods, implant time, occlusal contact, number of missing teeth, and tooth position.
RESULTS
Thirty-nine trials (49 articles) were included from the initial 763 references evaluated. When compared with conventional loading, with implants regarded as a statistical unit, a statistically significant lower survival rate was observed in the immediate loading dental implant (RR=0.974; 95% CI, 0.954, 0.994; P=.012). Regarding other outcomes, including marginal bone level changes, peri-implant gingival level, probing depth, and implant stability, no statistically significant differences were observed when comparing immediate versus early or conventional loading (P>.05).
CONCLUSIONS
Compared with early loading, immediate loading could achieve comparable implant survival rates and marginal bone level changes. Compared with conventional loading, immediate loading was associated with a higher incidence of implant failure.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Randomized Controlled Trials as Topic; Time Factors; Tooth Loss
PubMed: 31421892
DOI: 10.1016/j.prosdent.2019.05.013 -
International Journal of Environmental... Oct 2020A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the... (Meta-Analysis)
Meta-Analysis
A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = -0.001; = 0.001) and the onlay material used (beta = -0.064; = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.
Topics: Ceramics; Composite Resins; Dental Restoration Failure; Humans; Inlays
PubMed: 33086485
DOI: 10.3390/ijerph17207582 -
Journal of Prosthodontic Research Jan 2022Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the...
PURPOSE
Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the anterior maxillary area. Poor esthetic results are caused by inadequate preparation of the hard and soft tissues in this area before treatment. The socket shield technique may be an alternative for a desirable esthetic outcome in dental implant treatments.
STUDY SELECTION
In the present systematic review, PubMed-Medline, Google Scholar, and ScienceDirect were searched for clinical studies published from January 2000 to December 2018.
RESULTS
Twenty studies were included, comprising one randomized controlled trial, two cohort studies, 14 clinical human case reports, and three retrospective case series. In total, 288 patients treated with the socket shield technique with immediate implant placement and follow-up between 3-60 months after placement were included. A quality assessment showed that 12 of the 20 included studies were of good quality. Twenty-six of the 274 (9.5%) cases developed complications or adverse effects related to the socket shield technique. Most studies reported implant survival without the complications (90.5%); most of the cases that were followed up for more than 12 months after implant placement achieved a good esthetic appearance. The failure rate was low without the complications, although there were some failures due to failed implant osseointegration, socket shield mobility and infection, socket shield exposure, socket shield migration, and apical root resorption.
CONCLUSIONS
The socket shield technique can be used in dental implant treatment, but it remains difficult to predict the long-term success of this technique until high-quality evidence becomes available.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Retrospective Studies; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 33692284
DOI: 10.2186/jpr.JPR_D_20_00054 -
BMC Oral Health Oct 2022Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times and use of probing depth on prevalence rate.
METHODS
Following electronic and manual searches of the literature published from January 2005 to December 2021, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study.
RESULTS
Prevalence of peri-implantitis was 19.53% (95% CI 12.87-26.19) at the patient-level, and 12.53% (95% CI 11.67-13.39) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data.
CONCLUSION
The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
Topics: Humans; Peri-Implantitis; Prevalence; Dental Implants; Research Design
PubMed: 36261829
DOI: 10.1186/s12903-022-02493-8 -
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