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Clinical Oral Investigations Apr 2022The review systematically explored in vivo or in situ studies investigating the efficacy of nano-hydroxyapatite (nHA) to reduce initiation of or to remineralize initial... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION/OBJECTIVES
The review systematically explored in vivo or in situ studies investigating the efficacy of nano-hydroxyapatite (nHA) to reduce initiation of or to remineralize initial caries lesions.
DATA
Prospective controlled (non-)randomized clinical trials investigating the efficacy of a nHA compared to any other (placebo) treatment or untreated/standard control.
SOURCES
Three electronic databases (Central Cochrane, PubMed-MEDLINE, Ovid EMBASE) were screened. Outcomes were, e.g., ICDAS score, laser fluorescence, enamel remineralization rate, mineral loss, and lesion depth. No language or time restrictions were applied. Risk of bias and level of evidence were graded using the Risk of Bias 2.0 tool and GRADE profiler.
STUDY SELECTION/RESULTS
Five in vivo (and 5 in situ) studies with at least 633 teeth (1031 specimens) being assessed in more than 420 (95) patients were included. No meta-analysis could be performed for in vivo studies due to the high heterogeneity of the study designs and the variety of outcomes. In situ studies indicate that under demineralization conditions, NaF was able to hinder demineralization, whereas nHA did not; simultaneously, nHA did not differ from the fluoride-free control. In contrast, under remineralizing conditions, nHA and NaF show the same remineralizing potential. However, the level of evidence was very low. Furthermore, six studies showed a high risk of bias, and six studies were funded/published by the manufacturers of the tested products.
CONCLUSION
The low number of clinical studies, the relatively short follow-up periods, the high risks of bias, and the limiting grade of evidence do not allow for conclusive evidence on the efficacy of nHA.
CLINICAL RELEVANCE
No conclusive evidence on the efficacy of nHA could be obtained based on the low number of clinical studies, the relatively short follow-up periods, the high risks of bias, the limiting grade of evidence, and study conditions that do not reflect the everyday conditions.
Topics: Dental Caries; Dental Caries Susceptibility; Durapatite; Fluorides; Humans; Prospective Studies
PubMed: 35103837
DOI: 10.1007/s00784-022-04390-4 -
ANZ Journal of Surgery Jan 2011Dermal fillers are gaining popularity for rapid aesthetic improvement. Long-term efficacy and safety have not been well documented. The aim of this systematic review was... (Review)
Review
BACKGROUND
Dermal fillers are gaining popularity for rapid aesthetic improvement. Long-term efficacy and safety have not been well documented. The aim of this systematic review was to assess the safety and efficacy of injectable dermal fillers compared with other facial augmentation techniques for the management of age-related lines and wrinkles.
METHODS
Studies including patients receiving injectable semi-permanent or permanent dermal fillers for age-related lines and wrinkles were included in this review. Efficacy outcomes (including changes in skin thickness and patient satisfaction) and safety outcomes (including mortality, lumps and infections) were examined.
RESULTS
Three randomized control trials and six case series were included. Permanent and semi-permanent dermal fillers improved subjective ratings of appearance and resulted in higher patient satisfaction than temporary fillers. Long-term efficacy appeared good in the few studies that reported it. Short-term safety appeared favourable. Lumps were reported in all but one study but received little follow-up. Long-term safety data were limited.
CONCLUSIONS
The treatment of age-related lines and wrinkles with permanent and semi-permanent dermal fillers is more efficacious compared with temporary fillers in those studies that compared them. Case series evidence suggests that these fillers achieve their objective, which is to decrease the visible effects of age-related changes. These fillers appear at least as safe as temporary fillers in the short term in those studies that compared them. Long-term safety could not be determined.
Topics: Biocompatible Materials; Collagen; Durapatite; Ethanolamines; Humans; Hyaluronic Acid; Mesotherapy; Patient Satisfaction; Polymers; Silicones; Skin Aging; Treatment Outcome
PubMed: 21299793
DOI: 10.1111/j.1445-2197.2010.05351.x -
Plastic and Reconstructive Surgery May 2023Chin augmentation has maintained a high level of popularity among patients and facial plastic surgeons. Several procedures exist to enhance the appearance of a small...
BACKGROUND
Chin augmentation has maintained a high level of popularity among patients and facial plastic surgeons. Several procedures exist to enhance the appearance of a small chin. The aim of this study was to perform a systematic literature review to determine outcomes and complications associated with the different techniques described.
METHODS
MEDLINE, PubMed, PubMed Central (PMC), and Cochrane Central Registry of Controlled Trials (CENTRAL) databases were screened using a search algorithm. The techniques were classified, and related outcomes and complications tabulated and analyzed.
RESULTS
A total of 54 studies on primary chin augmentation published from 1977 to 2020 met inclusion criteria, representing 4897 treated patients. Six main surgical techniques were identified: chin augmentation with implants (silicone, Gore-Tex, Mersilene, Prolene, Medpor, Proplast, hard tissue replacement, porous block hydroxyapatite, or acrylic; n = 3344), osteotomy ( n = 885), autologous grafts (fat, bone, derma, or cartilage; n = 398), fillers (hyaluronic acid, hydroxyapatite, or biphasic polymer; n = 233), local tissue rearrangements ( n = 32), and a combination of implant placement and osteotomy ( n = 5). All techniques provided consistently satisfactory cosmetic outcomes. The overall complication rate of the most represented groups was 15.7% for implants and 19.7% for osteotomy, including 2.4% and 16.4% cases of transient mental nerve-related injuries, respectively.
CONCLUSIONS
All described chin augmentation techniques achieved good outcomes with high patient satisfaction. Thorough knowledge of each technique is essential to minimize each procedure's specific complications. Caution is generally needed to avoid nerve injuries and potential overcorrection or undercorrection.
Topics: Humans; Chin; Face; Genioplasty; Patient Satisfaction; Hydroxyapatites
PubMed: 36729154
DOI: 10.1097/PRS.0000000000010079 -
Annals of Anatomy = Anatomischer... Feb 2022Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone.
MATERIALS AND METHODS
The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively.
RESULTS
From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48).
CONCLUSIONS
The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.
Topics: Alveolar Bone Loss; Bone Transplantation; Durapatite; Follow-Up Studies; Guided Tissue Regeneration, Periodontal; Humans; Retrospective Studies; Treatment Outcome
PubMed: 34864225
DOI: 10.1016/j.aanat.2021.151877 -
Dental Materials : Official Publication... Apr 2008(1) To systematically review the existing literature on in vitro assessments of antagonist wear of ceramic materials; (2) To systematically evaluate possible influencing... (Review)
Review
OBJECTIVE
(1) To systematically review the existing literature on in vitro assessments of antagonist wear of ceramic materials; (2) To systematically evaluate possible influencing factors on material and antagonist wear of ceramic specimens.
METHODS
The database MEDLINE was searched with the terms "enamel," "wear" and "antagonist." The selected studies were analyzed with regard to wear parameters, type of antagonist and outcome. In the laboratory study, three ceramic materials were selected with different compositions and physical properties: IPS d.SIGN low-fusing metal ceramic, IPS Empress leucite ceramic, e.max Press lithium disilicate ceramic. These materials were subjected to the Ivoclar wear method (Willytec chewing simulator, 120,000cycles, 5kg weight) by systematically modifying the following variables which resulted in 36 tests with 8 specimens in each group: (1) configuration (flat, crown specimen), (2) surface treatment (polish, glaze), (3) type of antagonist (ceramic, two types of enamel stylus). Furthermore, the enamel styluses were cut to measure the enamel thickness and cusp width. Wear of both the material and the antagonist was quantified by scanning plaster replicas of the specimens with a laser scanner (etkon es1) and matching baseline and follow-up data with the Match 3D software (Willytec). The data were log-transformed to stabilize the variance and achieve near normality. To test the influence of specific test parameters, a four-way ANOVA with post hoc tests and Bonferroni correction was applied.
RESULTS
The systematic review revealed 20 in vitro studies in which a material and the antagonist wear of the same material was examined. However, the results were inconsistent mainly due to the fact that the test parameters differed widely. Most studies used prepared enamel from extracted molars as the antagonist and flat polished ceramic specimens. The test chamber was filled with water and some sort of sliding movement was integrated in the wear generating process. However, there was a huge variation in relation to the applied force, the used force actuator, the number of cycles, and the frequency of cycles per time as well as the number of specimens. The results of the systematic laboratory tests revealed that the following factors strongly influence the wear: configuration (more material wear of flat versus crown specimens), surface treatment (more antagonist wear of glazed versus polished specimens), the antagonist system (more material wear and less antagonist wear for ceramic stylus versus enamel stylus), and enamel thickness (less wear for thicker enamel). Material wear was not very much different between the materials. However, e.max Press generally caused more antagonist wear than the other two materials, which were quite similar. However, the main influencing factors did not yield consistent results for all the subgroups and there was a huge variability of results within the subgroups especially in those groups that used enamel as antagonist.
SIGNIFICANCE
As far as consistency and correlation with clinical studies is concerned, the set-up that consists of unprepared enamel of molar cusps against glazed crowns seems to be the most appropriate method to evaluate a ceramic material with regard to antagonist wear. However, due to the high variability of results large sample sizes are necessary to differentiate between materials, which calls the whole in vitro approach into question.
Topics: Aluminum Silicates; Analysis of Variance; Apatites; Dental Enamel; Dental Polishing; Dental Porcelain; Dental Restoration Wear; Dental Stress Analysis; Humans; Materials Testing; Metal Ceramic Alloys; Surface Properties; Tooth Attrition; Tooth Crown; Vertical Dimension
PubMed: 17720238
DOI: 10.1016/j.dental.2007.06.016 -
European Review For Medical and... Oct 2023This study aimed to conduct a meta-analysis to compare the effectiveness and safety between titanium mesh cage (TMC) and nano-hydroxyapatite/polyamide 66 cage... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to conduct a meta-analysis to compare the effectiveness and safety between titanium mesh cage (TMC) and nano-hydroxyapatite/polyamide 66 cage (n-HA/PA66) in the surgical treatment of cervical spondylotic myelopathy (CSM) through anterior cervical corpectomy and fusion (ACCF).
MATERIALS AND METHODS
We implemented a comprehensive search strategy across multiple databases, including Wanfang, China Knowledge Network, China Biomedical Literature Database, Wipu, PubMed, Cochran, Embase, and Web of Science. To ensure a thorough examination of available literature, the databases were searched from their inception to January 2023. Two independent researchers evaluated the quality of the included studies by using established criteria. We used RevMan 5.4 (Review Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to facilitate data extraction and analysis.
RESULTS
This analysis included seven controlled clinical studies. The meta-analysis results showed no statistically significant differences between the two groups in terms of operating time, intraoperative bleeding, preoperative Japanese Orthopedic Association (JOA) score, preoperative visual analog scale (VAS) score, preoperative and final follow-up C2-7 Cobb angles, and intervertebral fusion rate (p > 0.05). However, a significant difference was observed between the two groups in terms of the final follow-up JOA [MD = 0.77, 95% CI (0.58, 0.97), p < 0.00001], VAS [MD = -0.50, 95% CI (-0.71, -0.30), p < 0.00001], and sedimentation rate [RR = 0.30, 95% CI (0.18, 0.48), p < 0.00001].
CONCLUSIONS
The use of n-HA/PA66 in ACCF for treating CSM is safe and effective treatment with positive clinical efficacy. In addition, n-HA/PA66 has both effective clinical efficacy and significantly lower fusion settling rates compared to TMC.
Topics: Humans; Nylons; Durapatite; Spinal Fusion; Spondylosis; Treatment Outcome; Spinal Cord Diseases; Cervical Vertebrae; Retrospective Studies
PubMed: 37916330
DOI: 10.26355/eurrev_202310_34136 -
The International Journal of Oral &... 2012To evaluate treatment outcomes of hydroxyapatite-coated implants in comparison to nonhydroxyapatite-coated implants. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate treatment outcomes of hydroxyapatite-coated implants in comparison to nonhydroxyapatite-coated implants.
MATERIALS AND METHODS
A comprehensive electronic search was performed through MEDLINE, EMBASE, the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), the UK National Research Register, and Conference proceedings citation index up to June 2011. Additionally, several journals, bibliographies of selected articles, and relevant reviews were manually searched.
RESULTS
A total of seven studies (one randomized, four prospective, and two retrospective) were included. The quality of the studies was assessed "better" for the randomized and prospective and "fair" for the retrospective. Over a mean observation period of at least 5 years, the survival rates ranged from 77.8% to 98.1% for the hydroxyapatite-coated implants and from 77.1% to 95.2% for the nonhydroxyapatitecoated implants, with no significant differences observed. Hydroxyapatite-coated implants were associated with lower but insignificant failure risk compared with nonhydroxyapatite-coated implants (risk ratio of 0.68; 95% CI 0.33 to 1.41; P = .30). Marginal bone loss quantified in a single study was significantly higher around hydroxyapatite implants (1.51 ± 2.71 mm versus 0.55 ± 1.04 mm; P < .001).
CONCLUSIONS
Hydroxyapatitecoated implants demonstrate short-term survival outcome up to 5 years, which is comparable to that of nonhydroxyapatite-coated implants. The long-term success of hydroxyapatite-coated implants using well designed clinical trials remains lacking in the literature.
Topics: Alveolar Bone Loss; Coated Materials, Biocompatible; Dental Implants; Durapatite; Humans; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 23057025
DOI: No ID Found -
Expert Review of Gastroenterology &... Sep 2021: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux...
: Dental erosion occurs by dissolving dental apatite when exposed to non-bacterial acids. One of the factors that predispose to dental erosion is gastroesophageal reflux disease (GERD) due to chronic regurgitation of gastric contents to the oropharynx. Thus, in addition to other extraesophageal symptoms, individuals with GERD may have erosive dental lesions.: The objective of this systematic review was to evaluate the association and prevalence of erosive wear in patients with GERD. The bibliographic search was performed in the Pubmed and Web of Science databases, using the descriptors 'gastroesophageal reflux disease' AND 'dental erosion', considering clinical studies recently published from 2012 to 2020.: GERD can be considered a risk factor for the development of erosive dental lesions, whose prevalence was significantly higher in this group. However, several other factors can be commonly associated with the prevalence and severity of dental erosion among the world population, such as dietary habits, lifestyle, abrasion and bruxism. Thus, the prevalence and distribution of erosive lesions among healthy and GERD subjects varied widely among studies, which denotes the etiological complexity of dental erosion and reinforces the importance of careful and detailed anamnesis in order to establish an accurate diagnosis.
Topics: Bruxism; Diet; Gastroesophageal Reflux; Humans; Life Style; Prevalence; Risk Factors; Tooth Abrasion; Tooth Erosion
PubMed: 33571021
DOI: 10.1080/17474124.2021.1890030 -
Journal of Cranio-maxillo-facial... Apr 2016To delineate the best procedures for increasing osseointegration in cranio-maxillo-facial surgery using nano-sized calcium phosphate coatings on titanium patient... (Review)
Review
OBJECTIVE
To delineate the best procedures for increasing osseointegration in cranio-maxillo-facial surgery using nano-sized calcium phosphate coatings on titanium patient specific implants.
MATERIALS AND METHODS
A multi-database single-reviewer systematic literature review was conducted.
RESULTS
Twenty-eight papers consisting of twenty-five animal studies and three human studies met the selection criteria. The results of existing literature suggest that titanium implants coated with nano calcium phosphate and hydroxyapatite improves osseointegration and implant fixation. However, not all coating techniques enhance biofunctionalization. Factors including implant microroughness, coating thickness, calcium phosphate solubility, and nanotopography contribute significantly to biofunctionalization. Nonetheless, additional data derived from clinical studies are needed to support this statement, as well as the possible influence of routine autoclaving procedures.
Topics: Animals; Calcium Phosphates; Coated Materials, Biocompatible; Dental Implantation, Endosseous; Dental Implants; Durapatite; Humans; Nanoparticles; Osseointegration; Surface Properties; Titanium
PubMed: 26857757
DOI: 10.1016/j.jcms.2015.12.004 -
Materials Science & Engineering. C,... Jul 2017Strategies to achieve dentin remineralization is at present an important target of restorative dentistry. Remineralization of dentin by a bioactive material is complete... (Review)
Review
BACKGROUND AND OBJECTIVES
Strategies to achieve dentin remineralization is at present an important target of restorative dentistry. Remineralization of dentin by a bioactive material is complete only when the tissue regains its functionality. This is achieved when there is adequate apatite formation which most importantly translates into improved mechanical properties of dentin as a result of intrafibrillar mineralization. Bioactive glass (BAG) is a well-known implant material for bone regeneration and is proven to have excellent ability of apatite formation. Hence, recent studies have proposed BAGs as one of the most desired materials for remineralization of dentin. Therefore the aim of this systematic review was to scope the evidence of bioactive glass to remineralize dentin.
METHODS
The following research question was formulated: "Is there strong evidence for bioactive glass to remineralize dentin?" Three databases (Web of science, PubMed and Science direct) were scanned independently following PRISMA guidelines. Inclusion and exclusion criteria were set to identify relevant articles based on title and abstract screening. Finally, potentially relevant articles were downloaded and the full text was scrutinized to select the articles included in this review.
RESULTS
The first phase of search returned 303 articles. A total of 19 papers with full text were scrutinized for inclusion, of which 3 papers were chosen for the final synthesis. All three studies confirm that BAG treatment leads to enhanced apatite formation in dentin. Only 1 of the 3 studies has reported the mechanical properties of dentin after BAG treatment and it revealed that the Young's modulus and flexural bend strength of BAG treated dentin were much lower than natural dentin even though they had similar apatite content.
CONCLUSIONS
This review highlights the importance of assessing the mechanical properties of dentin alongside to the newly formed apatite content in order to prove BAGs efficiency to remineralize this tissue. Though studies have confirmed that BAGs stimulate excellent apatite formation in dentin, it should be concluded that there isn't sufficient evidence for bioactive glass to effectively remineralize this tissue as the mechanical properties of the BAG treated dentin haven't been well explored.
Topics: Apatites; Dental Materials; Dentin; Glass; Humans; Tooth Remineralization
PubMed: 28482504
DOI: 10.1016/j.msec.2017.03.083