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The Journal of Contemporary Dental... Feb 2022The present systematic review and meta-analysis (SR/MA) aimed to test the null hypothesis that there is no difference between socket-shield technique (SST) and... (Meta-Analysis)
Meta-Analysis
AIM
The present systematic review and meta-analysis (SR/MA) aimed to test the null hypothesis that there is no difference between socket-shield technique (SST) and conventional immediate implant placement (CIIP) as an esthetic rehabilitation option for permanent human anterior teeth, against the alternative one of a difference.
BACKGROUND
Socket-shield technique is considered as a highly promising procedure that has the potential to prevent resorption of anterior alveolar ridges, maintains white and pink esthetics, and provides a solution for esthetically critical cases. Controlled randomized clinical trials (RCT) and nonrandomized ones had been identified by searching the following databases: Google Scholar, Scopus, and PubMed. Literature search was determined from January 2010 up to June 2020. Hand searches were also accomplished for relevant abstracts, books, and reference lists. The eligibility criteria included prospective observational controlled RCTs and non-RCTs.
POPULATIONS
patients with endodontically treated/nonrestorable permanent mature anterior teeth indicated for extraction.
INTERVENTIONS
the sockets were subjected to immediate implant placement using SST.
CONTROLS
implants placed with SST compared with those of CIIP.
OUTCOME
the pink esthetic score measured for esthetic rehabilitation. To assess article quality, the Cochrane risk-of-bias tool was used by two independent authors. The data across quantitative studies were analyzed using comprehensive MA software.
REVIEW RESULTS
The initial search found out 172 references through the search strategy and three additional ones were recognized through hand searching. After being filtered, 101 references were screened and recorded. After the inclusion and exclusion criteria were applied, only seven unduplicated prospective controlled RCTs and non-RCTs were involved in the quantitative MA. At the 6-month evaluation period, the total standard difference in mean was 1.07 and test value measuring heterogeneity was 77.182, whereas at the 12-month period, the total standard difference in mean was 1.43 and test value measuring heterogeneity was 64.914.
CONCLUSION
SST had a positive effect on the esthetic rehabilitation for anterior teeth better than CIIP. However, this conclusion was dependent on a very few well-conducted prospective RCT and non-RCT. Further RCTs with longer observational time, proper methodology, and of larger sample size are still required to adequately answer the question of the present SR.
CLINICAL SIGNIFICANCE
There is limited knowledge about the appropriateness of SST in the field of implant dentistry, specifically for esthetic consideration. This SR/MA confirmed the positive effect of the SST over CIIP for esthetic rehabilitation for anterior teeth.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier CRD42020194086.
Topics: Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Observational Studies as Topic; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 35748456
DOI: No ID Found -
Success Rate of Autotransplantation of Teeth With an Open Apex: Systematic Review and Meta-Analysis.Journal of Oral and Maxillofacial... Jan 2017The aim of the present study was to determine the success rate of autotransplanted permanent teeth with an open apex and to identify the most influential prognostic... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of the present study was to determine the success rate of autotransplanted permanent teeth with an open apex and to identify the most influential prognostic factors.
MATERIALS AND METHODS
A systematic search of the MEDLINE, EMBASE, LILACS, and SciELO databases was conducted for January 1990 to August 2015. The study eligibility criteria were primary studies that had evaluated patients with autotransplantation with an open apex, with or without preparation of the socket, and a minimum of 12 months of follow-up. The principal outcome was the success rate of autotransplanted teeth with an open apex. Two of us independently performed the selection process and data extraction. The Effective Public Health Practice Project's Quality Assessment Tool was used for the quality assessment of the studies. The odds ratio (OR) was calculated, with the 95% confidence interval (CI).
RESULTS
A total of 21 studies were included in the present analysis. Of the 21 studies, 10 were retrospective and 11 were prospective. All the studies were of weak methodologic quality. The overall success rate was 89.68%, the survival rate was 98.21%, and the mean follow-up period was 6 years, 3 months (standard deviation 5.81 years). Among the prognostic factors analyzed, the premolars had a lower failure risk than did the molars (OR, 0.46; 95% CI, 0.25 to 0.84). The stage of development of the root and the autotransplantation receptor site showed no statistically significant differences.
CONCLUSIONS
The overall success rate and survival were high, despite the methodologic limitations of the included studies. Further study is needed of the prognostic factors that influence the success of autotransplantation with an open apex.
Topics: Humans; Tooth; Tooth Apex; Transplantation, Autologous; Treatment Outcome
PubMed: 27725103
DOI: 10.1016/j.joms.2016.09.010 -
Oral and Maxillofacial Surgery Jun 2022The replacement of teeth with osseointegrated implants is one of the significant advances in the field of restorative dentistry. The time interval between tooth... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND AND AIMS
The replacement of teeth with osseointegrated implants is one of the significant advances in the field of restorative dentistry. The time interval between tooth extraction and the implant can be very short or long. This systematic review and meta-analysis aimed to collect and evaluate articles related to determining the effect of instant loading of dental implants are placed in the fresh socket initial stability on the clinical success of the implant compared to delay loading dental implants.
MATERIALS AND METHODS
In this study, all the available articles indexed in leading databases, including PubMed, ISI Web of Science, Embase, PsycINFO, PROSPERO, and Scopus, were searched. The full text of the articles meeting the primary criteria to be included in this research was obtained and appraised. Data of studies were extracted if they were scored as a high or moderate level of evidence.
RESULTS
A total of 2258 published articles were found through electronic database searching. After screening the titles and abstracts, and full text of articles, 16 studies met the inclusion criteria and were included in the analysis. The results of this study revealed that regarding the success rate, although there was no significant difference between immediate and delayed of dental implants, immediate procedure showed a lower incidence of bone loss in single implants.
CONCLUSION
Based on the results of this study, immediate loading of dental implant, under certain conditions, is a successful treatment process and is effective in reducing treatment time. Thus, immediate loading represents a valid alternative to the traditional delayed loading rehabilitation.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Immediate Dental Implant Loading; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 34251545
DOI: 10.1007/s10006-021-00983-7 -
Journal of the American Dental... Feb 2013The authors analyzed the literature critically to determine the frequency and nature of incidental findings (IFs) in cone-beam computed tomographic (CBCT) scans of the... (Review)
Review
BACKGROUND
The authors analyzed the literature critically to determine the frequency and nature of incidental findings (IFs) in cone-beam computed tomographic (CBCT) scans of the head and neck region.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic search of several electronic databases (MEDLINE, Embase, PubMed, Scopus, Web of Science, the Cochrane Library) through July 14, 2012, as well as a limited gray-literature search (in Google Scholar). Inclusion criteria encompassed the frequency of reports of IFs in the head and neck region in CBCT imaging, regardless of the sample origin. The authors used no search limitations. They evaluated methodological quality according to 15 criteria related to study design, population characteristics and statistical analysis.
RESULTS
Initially, the authors identified 66 articles from the electronic database searches and another one via the gray-literature search. Once they applied the final selection criteria, they found that only five articles satisfied the inclusion criteria. In articles in which investigators reported the number of IFs as the absolute number of IFs detected, the frequency ranged from 1.3 to 2.9 IFs per CBCT scan. Conversely, in articles in which authors reported the number of IFs as the number of scans containing IFs, the frequency ranged from 24.6 to 93.4 percent of CBCT scans. Methodological quality averaged 77.2 percent (range, 60-93 percent) of the maximum possible score.
CONCLUSIONS AND CLINICAL IMPLICATIONS
IFs are detected relatively frequently in CBCT imaging, and considerable variation is evident in their frequency and nature. The majority are extragnathic findings (that is, those found outside the region of the dentition and alveolus), thus emphasizing the need for complete and proper review of the entire image, regardless of field of view or region of interest.
Topics: Asymptomatic Diseases; Calcinosis; Cone-Beam Computed Tomography; Head; Humans; Incidental Findings; Neck; Nose Diseases; Spinal Diseases; Tooth, Impacted
PubMed: 23372132
DOI: 10.14219/jada.archive.2013.0095 -
Clinical Oral Investigations Jan 2022Alveolar ridge preservation (ARP) is a proactive treatment option aiming at attenuating post-extraction hard and soft tissue dimensional changes. A high number of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Alveolar ridge preservation (ARP) is a proactive treatment option aiming at attenuating post-extraction hard and soft tissue dimensional changes. A high number of different types of biomaterials have been utilized during ARP to seal the socket, but their effectiveness in terms of soft tissue outcomes has rarely been investigated and compared in the literature.
OBJECTIVE
To evaluate the efficacy of different types of membranes and graft materials in terms of soft tissue outcomes (keratinized tissue width changes, vertical buccal height, and horizontal changes) after ARP, and to assign relative rankings based on their performance.
MATERIALS AND METHODS
The manuscript represents the proceedings of a consensus conference of the Italian Society of Osseointegration (IAO). PUBMED (Medline), SCOPUS, Embase, and Cochrane Oral Health's Information Specialist were utilized to conduct the search up to 06 April 2021. English language restrictions were placed and no limitations were set on publication date. Randomized controlled trials that report ARP procedures using different sealing materials, assessing soft tissue as a primary or secondary outcome, with at least 6-week follow-up were included. Network meta-analysis (NMA) was performed using mean, standard deviation, sample size, bias, and follow-up duration for all included studies. Network geometry, contribution plots, inconsistency plots, predictive and confidence interval plots, SUCRA (surface under the cumulative ranking curve) rankings, and multidimensional (MDS) ranking plots were constructed.
RESULTS
A total of 11 studies were included for NMA. Overall, the level of bias for included studies was moderate. Crosslinked collagen membranes (SUCRA rank 81.8%) performed best in vertical buccal height (VBH), autogenous soft tissue grafts (SUCRA rank 89.1%) in horizontal width change (HWch), and control (SUCRA rank 85.8%) in keratinized mucosa thickness (KMT).
CONCLUSIONS
NMA confirmed that the use of crosslinked collagen membranes and autogenous soft tissue grafts represented the best choices for sealing sockets during ARP in terms of minimizing post-extraction soft tissue dimensional shrinkage.
CLINICAL RELEVANCE
Grafting materials demonstrated statistically significantly better performances in terms of soft tissue thickness and vertical buccal height changes, when covered with crosslinked collagen membranes. Instead, soft tissue grafts performed better in horizontal width changes. Non-crosslinked membranes and other materials or combinations presented slightly inferior outcomes.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Biocompatible Materials; Collagen; Humans; Network Meta-Analysis; Tooth Extraction; Tooth Socket
PubMed: 34669038
DOI: 10.1007/s00784-021-04192-0 -
Clinical Oral Implants Research Feb 2012Type I immediate implant placement has gained popularity because it may reduce treatment time, number of surgeries and post-extraction bone loss. However, this is... (Review)
Review
BACKGROUND
Type I immediate implant placement has gained popularity because it may reduce treatment time, number of surgeries and post-extraction bone loss. However, this is potentially challenged by inadequate keratinized mucosa for flap adaptation and difficulties in achieving primary stability. Moreover, it has been proven that post-extraction bone loss is an inevitable biological process, which affects treatment outcomes.
OBJECTIVES
To estimate survival and success rates of implants and the implant-supported prostheses, the prevalence of biological, technical and aesthetic complications, and the magnitude of soft and hard tissue changes following implant placement immediately into fresh extraction sockets.
MATERIAL AND METHODS
An electronic search in MEDLINE (PubMed) and the Cochrane Library from 1991 to July 2010 was performed to include prospective studies on immediate implants with a mean follow-up time of at least 1 year. The survival rates were computed using the STATA statistical software. Weighted means of soft and hard tissue changes were obtained by the inverse variance method.
RESULTS
A total of 46 prospective studies, with a mean follow-up time of 2.08 years, were included. The annual failure rate of immediate implants was 0.82% (95% CI: 0.48-1.39%), translating into the 2-year survival rate of 98.4% (97.3-99%). Among the five factors analysed (reasons for extraction, antibiotic use, position of implant [anterior vs. posterior, maxilla vs. mandible), type of loading], only the regimen of antibiotic use affected the survival rate significantly. Lower failure rates were found in groups that were provided with a course of post-operative antibiotics. The success of implant therapy was difficult to assess due to scarce reporting on biological, technical and aesthetic complications. Soft tissue changes occurred mostly in the first 3 months after the provision of restoration, and then stabilized towards end of the first year. Marginal bone loss predominantly took place in the first year after implant placement, with a magnitude generally less than 1 mm. Controversy on hard tissue preservation with platform-switching technique remained unsolved.
CONCLUSIONS
Despite the high survival rate observed, more long-term studies are necessary to determine the success of implant treatment provided immediately after tooth extraction. Special attention has to be given to aesthetic outcomes.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Humans; Risk Factors; Time Factors; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 22211305
DOI: 10.1111/j.1600-0501.2011.02372.x -
Journal of Medicine and Life Mar 2022The aim of this study was to evaluate the clinical need and impact of socket preservation to protect the bone for future dental implant placement. Moreover, we aimed to... (Review)
Review
The aim of this study was to evaluate the clinical need and impact of socket preservation to protect the bone for future dental implant placement. Moreover, we aimed to list down various methods of socket preservation by going through randomized clinical trials. We searched PubMed, Google Scholar, and Cochrane databases for all relevant publications, where researchers compared various methods and tools for socket preservation. All eight randomized controlled trials mentioned several methods that are helpful in preserving bone levels both horizontally and vertically. The studies included in this systematic review demonstrate that each material has certain efficacy in preserving the socket after tooth extraction for future implant placement. Socket preservation methods and materials are effective in preparing patients for future prostheses.
Topics: Humans; Tooth Extraction; Tooth Socket
PubMed: 35450006
DOI: 10.25122/jml-2021-0308 -
Periodontology 2000 Feb 2023The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant... (Review)
Review
The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient-related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient-related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures.
Topics: Humans; Alveolar Process; Tooth Socket; Tooth Extraction; Alveolar Ridge Augmentation
PubMed: 35913046
DOI: 10.1111/prd.12441 -
Journal of Oral & Maxillofacial Research 2020The aim of this systematic review is to compare immediate implant placement in infected extraction sockets with non-infected extraction sockets in terms of implant... (Review)
Review
OBJECTIVES
The aim of this systematic review is to compare immediate implant placement in infected extraction sockets with non-infected extraction sockets in terms of implant survival and function.
MATERIAL AND METHODS
An electronic search was conducted in PubMed, ScienceDirect, ISI Web of Knowledge and Google Scholar between January 2010 and February 2020. Studies evaluating implant survival rate and main clinical parameters were included for a qualitative and quantitative analysis.
RESULTS
In total, nine studies were included and a pool of 2281 sockets were analysed. Compared with the non-infected group, the infected group showed no significant differences in implant survival rates (risk ratio [RR] = 0.99; 95% confidence interval [CI] = 0.98 to 1; P = 0.08). No significant statistical differences were found in marginal bone level (mean difference [MD] = -0.03; 95% CI = -0.1 to 0.04; P = 0.41), marginal gingival level (MD = -0.07; 95% CI = -0.17 to 0.04; P = 0.23), probing depth (MD = 0.06; 95% CI = -0.24 to 0.36; P = 0.7), modified bleeding index (MD = -0.00162196; 95% CI = -0.09 to 0.09; P = 0.97) and slight but significant changes were seen in width of keratinized gingiva (MD = 0.25; 95% CI = -0.3 to 0.8; P = 0.38) between the groups at the latest follow-up.
CONCLUSIONS
There were no significant difference in implant survival rates, marginal bone level, marginal gingival level, modified bleeding index and probing depth between infected sockets and non-infected sockets. However, slight but significant changes were seen in width of keratinized gingiva favouring the non-infected group.
PubMed: 32760474
DOI: 10.5037/jomr.2020.11201 -
International Journal of Oral and... Mar 2011This systematic review aims to identify and review the best available evidence to answer the clinical question 'What are the incidence and the factors influencing the... (Review)
Review
This systematic review aims to identify and review the best available evidence to answer the clinical question 'What are the incidence and the factors influencing the development of osteoradionecrosis after tooth extraction in irradiated patients?'. A systematic review of published articles on post-irradiation extraction was performed via electronic search of the Medline, Ovid, Embase and Cochrane Library databases. Additional studies were identified by manual reference list search. Evaluation and critical appraisal were done in 3 stages by two independent reviewers and any disagreement was resolved by discussion with a third party. 19 articles were selected for the final analysis. The total incidence of osteoradionecrosis after tooth extraction in irradiated patients was 7%. When extractions were performed in conjunction with prophylactic hyperbaric oxygen, the incidence was 4% while extraction in conjunction with antibiotics gave an incidence of 6%. This systematic review found that while the incidence of osteoradionecrosis after post-irradiation tooth extractions is low, the extraction of mandibular teeth within the radiation field in patients who received a radiation dose higher than 60Gy represents the highest risk of developing osteoradionecrosis. Based on weak evidence, prophylactic hyperbaric oxygen is effective in reducing the risk of developing osteoradionecrosis after post-radiation extractions.
Topics: Anti-Bacterial Agents; Head and Neck Neoplasms; Humans; Hyperbaric Oxygenation; Jaw Diseases; Mandibular Diseases; Osteoradionecrosis; Radiotherapy Dosage; Risk Factors; Time Factors; Tooth Extraction; Tooth Socket
PubMed: 21115324
DOI: 10.1016/j.ijom.2010.10.005